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Hu X, Ma YN, Karako K, Tang W, Song P, Xia Y. Comprehensive assessment and treatment strategies for dysphagia in the elderly population: Current status and prospects. Biosci Trends 2024; 18:116-126. [PMID: 38658363 DOI: 10.5582/bst.2024.01100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
As the population ages, the prevalence of dysphagia among older adults is a growing concern. Age-related declines in physiological function, coupled with neurological disorders and structural changes in the pharynx associated with aging, can result in weakened tongue propulsion, a prolonged reaction time of the submental muscles, delayed closure of the laryngeal vestibule, and delayed opening of the upper esophageal sphincter (UES), increasing the risk of dysphagia. Dysphagia impacts the physical health of the elderly, leading to serious complications such as dehydration, aspiration pneumonia, malnutrition, and even life-threatening conditions, and it also detrimentally affects their psychological and social well-being. There is a significant correlation between frailty, sarcopenia, and dysphagia in the elderly population. Therefore, older adults should be screened for dysphagia to identify both frailty and sarcopenia. A reasonable diagnostic approach for dysphagia involves screening, clinical assessment, and instrumental diagnosis. In terms of treatment, multidisciplinary collaboration, rehabilitation training, and the utilization of new technologies are essential. Future research will continue to concentrate on these areas to enhance the diagnosis and treatment of dysphagia, with the ultimate aim of enhancing the quality of life of the elderly population.
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Affiliation(s)
- Xiqi Hu
- Department of Neurosurgery, Central South University, Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Ya-Nan Ma
- Department of Gastroenterology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Kenji Karako
- Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Wei Tang
- Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Peipei Song
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Ying Xia
- Department of Neurosurgery, Central South University, Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
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Chen J, Dai L, Guo M, Huang H, He R, Jin H, Jin X, Li X, Li Y, Liu Y, Wang C, Wang Y, Wu L, Xing Z, Fujitani J, Sugiura Y, Hinohara C, Tang W. A multidisciplinary collaborative diagnosis and rehabilitation program for dysphagia in general hospitals. Biosci Trends 2024; 18:108-115. [PMID: 38599879 DOI: 10.5582/bst.2024.01076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Dysphagia is a common complication of various clinical conditions, with an increased incidence as age advances. Complications such as aspiration, malnutrition, and aspiration pneumonia caused by dysphagia significantly affect the overall treatment outcomes of patients. Scholars both domestically and internationally are increasingly focusing on early rehabilitation for dysphagia. This article summarizes common conditions causing dysphagia, clinical manifestations, complications, screening assessment, diagnosis, rehabilitation, and nutritional support related to dysphagia. It emphasizes the arrival at a multidisciplinary collaborative diagnosis and formulation of a rehabilitation management plan for dysphagia in general hospitals in order to provide strategic suggestions for establishing a multidisciplinary collaborative model for swallowing disorder management in general hospitals.
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Affiliation(s)
- Juan Chen
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Lili Dai
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Min Guo
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Hui Huang
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Rongfen He
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Hui Jin
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Xin Jin
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Xiaoxiao Li
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Yumin Li
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Yonggang Liu
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Chao Wang
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Yukai Wang
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Li Wu
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Zhongcheng Xing
- Huaibei People's Hospital Affiliated to Bengbu Medical University, Anhui Province, China
| | - Junko Fujitani
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuo Sugiura
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Wei Tang
- National Center for Global Health and Medicine, Tokyo, Japan
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Georgiou R, Voniati L, Papaleontiou A, Gryparis A, Ziavra N, Tafiadis D. Exploring the diagnostic accuracy and applicability of the Gugging Swallowing Screen in children with feeding and/or swallowing disorders. Neurogastroenterol Motil 2024; 36:e14790. [PMID: 38545701 DOI: 10.1111/nmo.14790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/06/2024] [Accepted: 03/17/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND The Gugging Swallowing Screen (GUSS) is a bedside dysphagia screening tool that has been designed to determine the risk of aspiration in acute stroke patients. There is no evidence in the literature for the GUSS for the pediatric population. The present study aimed to determine the diagnostic accuracy of GUSS as a screening tool in the Greek language for children with dysphagia. METHODS Eighty-Greek-Cypriot children aged 3-12 years who had dysphagia participated in this retrospective study. The translated into Greek GUSS was administered twice (pre- and post-therapy) to each patient throughout 24 sessions of dysphagia therapy. KEY RESULTS The GUSS showed a high internal consistency (Cronbach's α = 0.826), good test-retest reliability (rs = 0.767), convergent validity compared to the Greek Pediatric Eating Assessment tool-10 (PEDI-EAT-10) total score (rs = -0.365), and inter-rater reliability (κ = 0.863). A total cutoff points equal to 13.00 was also calculated. Aspiration was identified by the GUSS with low sensitivity and high specificity (PPV 100%, NPV 57%, LR+ NA, LR- 0.79); dysphagia/penetration was identified with high sensitivity and low specificity (PPV 33%, NPV 100%, LR+ 0.102, LR- NA). CONCLUSIONS & INFERENCES The pediatric version of GUSS has been found to be a valuable tool in identifying the risk of aspiration as that of adults. It proved to be used as a good screening guide for selecting and confirming the existence of dysphagia from instrumental assessments. This is the first study of the pediatric version of GUSS, and future studies on this topic are needed.
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Affiliation(s)
- Rafaella Georgiou
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
| | - Louiza Voniati
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
| | - Andri Papaleontiou
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Alexandros Gryparis
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Nafsika Ziavra
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Dionysios Tafiadis
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
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Ortiz Pérez P, Valero-Arredondo I, Torcuato-Rubio E, Herrador-López M, Martín-Masot R, Navas-López VM. Nutritional Issues in Children with Dysphagia. Nutrients 2024; 16:1590. [PMID: 38892523 PMCID: PMC11174107 DOI: 10.3390/nu16111590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: Pediatric dysphagia presents significant nutritional challenges, often impacting growth and development due to reduced oral intake, increased nutritional needs, and gastrointestinal complications; (2) Methods: This prospective quasi-experimental study assessed 117 children under 14 years old (20 patients were under 1 year old, 80 were aged 1-7 years, and 17 were older than 7 years), diagnosed with swallowing disorders, to analyze their caloric, macro-, and micronutrient intake and identify potential deficiencies. The severity of dysphagia was established using functional oral intake scales, and dietary records were reviewed over a 3-day period; (3) Results: The study revealed that 39.8% of participants did not meet their total energy expenditure (TEE), highlighting a high prevalence of malnutrition among these children. Furthermore, patients using feeding devices exhibited a significantly lower caloric intake, and over half required significantly modified food textures. After individualized speech therapy and nutritional rehabilitation, participants showed significant improvements in caloric intake, with their energy coverage increasing from 958% to 1198% of the daily requirement. Rehabilitation also improved tolerance to a broader range of food textures; (4) Conclusions: This research underscores the importance of multidisciplinary, individualized nutritional strategies to address the specific challenges of pediatric dysphagia, emphasizing the role of enteral nutrition and therapeutic interventions in improving the quality of life and nutritional outcomes of these children. Further studies are recommended to assess the long-term impact of such strategies.
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Affiliation(s)
- Pilar Ortiz Pérez
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain; (P.O.P.); (I.V.-A.); (E.T.-R.); (M.H.-L.); (V.M.N.-L.)
- PhD Program in Biomedicine, Translational Research and New Health Technologies, University of Málaga, 29010 Málaga, Spain
| | - Inés Valero-Arredondo
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain; (P.O.P.); (I.V.-A.); (E.T.-R.); (M.H.-L.); (V.M.N.-L.)
| | - Encarnación Torcuato-Rubio
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain; (P.O.P.); (I.V.-A.); (E.T.-R.); (M.H.-L.); (V.M.N.-L.)
| | - Marta Herrador-López
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain; (P.O.P.); (I.V.-A.); (E.T.-R.); (M.H.-L.); (V.M.N.-L.)
- Biomedical Research Institute of Málaga and Nanomedicine Platform (IBIMA Plataforma BIONAND), 29590 Málaga, Spain
| | - Rafael Martín-Masot
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain; (P.O.P.); (I.V.-A.); (E.T.-R.); (M.H.-L.); (V.M.N.-L.)
| | - Víctor Manuel Navas-López
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain; (P.O.P.); (I.V.-A.); (E.T.-R.); (M.H.-L.); (V.M.N.-L.)
- Biomedical Research Institute of Málaga and Nanomedicine Platform (IBIMA Plataforma BIONAND), 29590 Málaga, Spain
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Mattioli G, Cipriani MS, Barone G, Palo F, Arrigo S, Gandullia P, Avanzini S, Wong MCY. Pediatric nutritional surgery and its implications: results from a unicentric retrospective analysis. Pediatr Surg Int 2024; 40:116. [PMID: 38695977 PMCID: PMC11065931 DOI: 10.1007/s00383-024-05700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE Existing guidelines provide weak recommendations on the surgical management of nutritional problems in children. The objective was to design a management pathway to address the best nutritional surgery (NS) procedure in a given patient. METHODS Retrospective analysis of children treated at our department from January 2015 to December 2019. The sample was divided into two groups according to presence or absence of neurological impairment (NI). Patients with NI (Group 1) were classified in three subgroups based on presenting symptoms: A-Dysphagia without gastroesophageal reflux (GER); B-GER with or without dysphagia; C-Symptoms associated with a delayed gastric emptying. RESULTS A total of 154 patients were included, 111 with NI. One-hundred-twenty-eight patients underwent only one procedure. Complications and mortality were superior in Group 1. In subgroup A, isolated gastrostomy was the first NS in all patients. In subgroup B most of patients were subjected to a Nissen fundoplication, while in 5 cases total esophagogastric dissociation (TEGD) was the first intervention. Considering the entire sample, 92.3% patients who underwent a TEGD did not require further procedures. CONCLUSION NS encompasses various procedures depending on presenting symptoms and neurological status. A management flowchart for these patients is proposed.
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Affiliation(s)
- Girolamo Mattioli
- Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy
- DINOGMI, University of Genoa, Genoa, Italy
| | - Maria Stella Cipriani
- Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy.
- DINOGMI, University of Genoa, Genoa, Italy.
| | - Giulia Barone
- Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy
- DINOGMI, University of Genoa, Genoa, Italy
| | - Federico Palo
- Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy
- DINOGMI, University of Genoa, Genoa, Italy
| | - Serena Arrigo
- Pediatric Gastroenterology and Endoscopy Department, IRCCS, Istituto Giannina Gaslini, 16147, Genoa, Italy
| | - Paolo Gandullia
- Pediatric Gastroenterology and Endoscopy Department, IRCCS, Istituto Giannina Gaslini, 16147, Genoa, Italy
| | - Stefano Avanzini
- Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy
- DINOGMI, University of Genoa, Genoa, Italy
| | - Michela Cing Yu Wong
- Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy
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Onesimo R, Sforza E, Triumbari EKA, Proli F, Leoni C, Giorgio V, Rigante D, Trevisan V, De Rose C, Kuczynska EM, Cerchiari A, Pane M, Mercuri E, Belafsky P, Zampino G. Validation and cross-cultural adaptation of the Italian version of the paediatric eating assessment tool (I-PEDI-EAT-10) in genetic syndromes. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1152-1162. [PMID: 37982346 DOI: 10.1111/1460-6984.12986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/19/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND The Pediatric Eating Assessment Tool (PEDI-EAT-10) is a reliable and valid tool for rapid identification of dysphagia in patients aged 18 months to 18 years. AIMS To translate and adapt the PEDI-EAT-10 into the Italian language and evaluate its validity and reliability. METHODS & PROCEDURES The translation and cross-cultural adaptation of the tool consisted of five stages: initial translation, synthesis of the translations, back translation, expert committee evaluation and test of the prefinal version. The internal consistency of the translated tool was analysed in a clinical group composed of 200 patients with special healthcare needs aged between 18 months and 18 years. They were consecutively enrolled at the Rare Disease Unit, Paediatrics Department, Fondazione Policlinico Agostino Gemelli-IRCCS, Rome. For test-retest reliability, 50 caregivers filled in the PEDI-EAT-10 questionnaire for a second time after a 2-week period. Construct validity was established by comparing data obtained from patients with data from healthy participants (n = 200). The study was approved by the local ethics committee. OUTCOMES & RESULTS Psychometric data obtained from patients (104 M; mean age = 8.08 ± 4.85 years; median age = 7 years) showed satisfactory internal consistency (Cronbach's α = 0.89) and test-retest reliability (Pearson r = 0.99; Spearman r = 0.96). A total of 30% of children were classified as having a high risk of penetration/aspiration. The Italian PEDI-EAT-10 mean total score of the clinical group was significantly different from that resulting from healthy participants. CONCLUSIONS & IMPLICATIONS The PEDI-EAT-10 was successfully translated into Italian, validated and found to be a reliable one-page rapid screening tool to identify dysphagia in children and adolescents with special needs. WHAT THIS PAPER ADDS What is already known on the subject The PEDI-EAT-10 is a valid and reliable quick discriminative paediatric tool for identifying penetration/aspiration risks. What this paper adds to the existing knowledge In the present study we successfully translated and adapted the PEDI-EAT-10 into the Italian language. What are the potential or actual clinical implications of this work? This translation and adaptation increase access to valid feeding and swallowing assessment for children of Italian-speaking families. In addition, the I-PEDI-EAT-10 can suggest further assessment of patients' swallowing abilities.
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Affiliation(s)
- Roberta Onesimo
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Elizabeth Katherine Anna Triumbari
- Nuclear Medicine Unit, TracerGLab, Department of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Proli
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Chiara Leoni
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valentina Giorgio
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Donato Rigante
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentina Trevisan
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina De Rose
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eliza Maria Kuczynska
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonella Cerchiari
- Feeding and Swallowing Services Unit, Department Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Marika Pane
- Università Cattolica del Sacro Cuore, Rome, Italy
- Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - Eugenio Mercuri
- Università Cattolica del Sacro Cuore, Rome, Italy
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Peter Belafsky
- Center for Voice and Swallowing, Department of Otolaryngology-Head & Neck Surgery, University of California Davis, Sacramento, California, USA
| | - Giuseppe Zampino
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Guo X, Mu H, Sun Y, Wang J, Wei J. Analysis of the Improvement Effect of Combined Application of Oral Rehabilitation Training and Neuromuscular Electrical Stimulation on Pediatric Swallowing Disorders. Int J Neurosci 2024:1-10. [PMID: 38651277 DOI: 10.1080/00207454.2024.2346802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/18/2024] [Indexed: 04/25/2024]
Abstract
Pediatric swallowing disorders are common yet often overlooked neuro-muscular system diseases that significantly impact the quality of life and development of affected children. This study aims to explore the effect of combined application of oral rehabilitation training and neuromuscular electrical stimulation on improving pediatric swallowing disorders. Children meeting the inclusion criteria for swallowing disorders were divided into control and experimental groups based on different intervention protocols. The experimental group received combined oral rehabilitation training and neuromuscular electrical stimulation, while the control group received only oral rehabilitation training. Results showed that the intervention was more effective in the experimental group, with shorter recovery time for normal swallowing function and improved nutritional status and quality of life. This study provides scientific evidence for clinical treatment of pediatric swallowing disorders. In conclusion, the combined application of oral rehabilitation training and neuromuscular electrical stimulation effectively improves pediatric swallowing disorders, with superior efficacy compared to single treatment methods. Further research is needed to elucidate the mechanism of action and optimize treatment protocols to enhance the therapeutic outcomes and prognosis of pediatric swallowing disorders.
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Affiliation(s)
- Xiangjun Guo
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Hong Mu
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Yang Sun
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Jing Wang
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
| | - Jianming Wei
- Stomatology clinic of Cangzhou central hospital, Hebei Province, China
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Abedin S, Adeleke OA. State of the art in pediatric nanomedicines. Drug Deliv Transl Res 2024:10.1007/s13346-024-01532-x. [PMID: 38324166 DOI: 10.1007/s13346-024-01532-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
In recent years, the continuous development of innovative nanopharmaceuticals is expanding their biomedical and clinical applications. Nanomedicines are being revolutionized to circumvent the limitations of unbound therapeutic agents as well as overcome barriers posed by biological interfaces at the cellular, organ, system, and microenvironment levels. In many ways, the use of nanoconfigured delivery systems has eased challenges associated with patient differences, and in our opinion, this forms the foundation for their potential usefulness in developing innovative medicines and diagnostics for special patient populations. Here, we present a comprehensive review of nanomedicines specifically designed and evaluated for disease management in the pediatric population. Typically, the pediatric population has distinguishing needs relative to those of adults majorly because of their constantly growing bodies and age-related physiological changes, which often need specialized drug formulation interventions to provide desirable therapeutic effects and outcomes. Besides, child-centric drug carriers have unique delivery routes, dosing flexibility, organoleptic properties (e.g., taste, flavor), and caregiver requirements that are often not met by traditional formulations and can impact adherence to therapy. Engineering pediatric medicines as nanoconfigured structures can potentially resolve these limitations stemming from traditional drug carriers because of their unique capabilities. Consequently, researchers from different specialties relentlessly and creatively investigate the usefulness of nanomedicines for pediatric disease management as extensively captured in this compilation. Some examples of nanomedicines covered include nanoparticles, liposomes, and nanomicelles for cancer; solid lipid and lipid-based nanostructured carriers for hypertension; self-nanoemulsifying lipid-based systems and niosomes for infections; and nanocapsules for asthma pharmacotherapy.
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Affiliation(s)
- Saba Abedin
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Oluwatoyin A Adeleke
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
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Farrell A, Raol N. Current opinion in otolaryngology and head and neck surgery: the role of the otolaryngologist in the management of pediatric dysphagia. Curr Opin Otolaryngol Head Neck Surg 2023; 31:412-418. [PMID: 37820272 DOI: 10.1097/moo.0000000000000934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE OF REVIEW Dysphagia affects at least 1% of the pediatric population. This prevalence further increases in patients who are born prematurely or who have underlying neuromuscular or cardiopulmonary disorders. A multidisciplinary team approach, including an Otolaryngologist, can help promote an expedited diagnosis and therapeutic regimen, ensuring that the patient receives adequate nutrition needed for growth and development. RECENT FINDINGS The development and growth of multidisciplinary aerodigestive clinics have improved outcomes in pediatric patients with dysphagia. If a structural concern is noted on examination, there remain a multitude of medical and surgical options to help improve patient outcomes and swallow. These treatment options are usually multimodality and specific interventions may be employed to target a specific and notable abnormality. SUMMARY Pediatric dysphagia is a complex concern. For the otolaryngologist, etiologies with surgical targets may include ankyloglossia, tonsillar hypertrophy, laryngomalacia, laryngo-esophageal cleft, vocal fold movement impairment, and cricopharyngeal achalasia. The development and formalization of a multidisciplinary approach has streamlined and broadened treatment options for these patients. An otolaryngologist is integral as part of the treatment team of these patients.
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Affiliation(s)
- Annie Farrell
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine
| | - Nikhila Raol
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine
- Division of Pediatric Otolaryngology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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Cerchiari A, Tofani M, Giordani C, Franceschetti S, Capuano E, Pizza F, Della Bella G, Raponi M, Biondo G. Development and Pilot Study of a Pediatric Screening for Feeding and Swallowing Disorders in Infants and Children: The Pediatric Screening–Priority Evaluation Dysphagia (PS–PED). CHILDREN 2023; 10:children10040638. [PMID: 37189887 DOI: 10.3390/children10040638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
Feeding and swallowing disorders (FSD) are common during childhood, with a prevalence of 85% in children with neurodevelopmental disorders. A comprehensive screening is essential to identify FSD and improve health outcomes in a clinical setting. This study aims to develop a new Pediatric Screening tool capable of identifying FSD. This screening tool was developed in three steps: selecting variables based on clinical experience, searching the literature and finding agreement between experts with a two-round Delphi study. This process, which reached 97% of agreement between experts, led to the development of the Pediatric Screening–Priority Evaluation Dysphagia (PS–PED). PS–PED comprises 14 items divided into three main domains: clinical history, health status and feeding condition. We also carried out a pilot test for measuring internal consistency, as measured with Cronbach Coefficient alpha. Concurrent validity, as measured with Pearson correlation coefficient, was tested using a videofluoroscopy swallow study (VFSS) classified with the Penetration Aspiration Scale (PAS). The pilot test was conducted on 59 children with different health conditions. Our findings showed good internal consistency (alpha = 0.731), and a strong linear correlation with PAS (Pearson 0.824). Furthermore, comparing PS–PED and PAS scores, we find preliminary strong discriminant validity to identify children with FSD (p < 0.01). Our results provide evidence on using the 14-item PS–PED as a screening tool for FSD in a clinical sample of children with heterogeneous disease.
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Chang MC, Lee BJ, Park D. The Quality, Reliability, and Accuracy of Videos Regarding Exercises and Management for Dysphagia in Pediatric Populations Uploaded on YouTube. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101514. [PMID: 36291450 PMCID: PMC9600706 DOI: 10.3390/children9101514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/28/2022]
Abstract
Objectives: YouTube is well known for providing easy access to various kinds of video content. In this study, we investigated the quality and reliability of videos on YouTube addressing exercise or dysphagia management in the pediatric population. Methods: Video quality and reliability were assessed by using the Global Quality Scale (GQS) and a modified DISCERN tool, respectively. The accuracy of the information in each video was also evaluated. Other information, including the video source, length, date of upload, as well as the number of views, likes, dislikes, and comments were investigated, and statistical significance was determined. Results: In total, 22 videos on exercises and dysphagia management in pediatric populations were evaluated; 36.4% and 72.7% of these videos did not have high quality or reliability, respectively. Moreover, half of the videos did not contain accurate information. Even when videos were created by medical specialists, many of these YouTube videos were of low quality, reliability, and accuracy. Conclusions: The reliability, quality, and accuracy of many videos on exercise or dysphagia management in the pediatric population were low. Video creators, especially medical specialists, should strive to create videos with high quality, reliability, and accuracy.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, Yeungnam University Hospital, Daegu 41404, Korea
| | - Byung Joo Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu 41199, Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, College of Medicine, Ulsan University Hospital, University of Ulsan, Ulsan 44033, Korea
- Correspondence: ; Tel.: +82-52-250-7222; Fax: +82-52-250-7228
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