Pulmonary Manifestations of Gastrointestinal Disease

Collagen Vascular Diseases and Disorders of Connective Tissue

The collagen vascular diseases, also referred to as connective tissue diseases, are a diverse group of systemic inflammatory disorders thought to be immunologically mediated. The concept of collagen vascular disease began to take shape in the 1930s, when it was recognized that rheumatic fever and rheumatoid arthritis can affect connective tissues throughout the body.1,2 During the following decade, as conditions such as systemic lupus erythematosus (SLE) and scleroderma came to be viewed as systemic diseases of connective tissue, the terms diffuse connective disease and diffuse collagen disease were proposed.3,4 During the same period, the designation of diffuse vascular disease was proposed for diseases such as scleroderma, polymyositis, SLE, and polyarteritis nodosa, which featured widespread vascular involvement.5 With the realization that many of these entities can exhibit both systemic connective tissue manifestations and vascular abnormalities, the unifying designation of collagen vascular disease was introduced.6

Assessment of risk factors for pneumonia in dysphagic children: significance of videofluoroscopic swallowing evaluation

The purpose of this study was to investigate the relationship between aspiration, as identified by videofluoroscopic swallowing (VFS) study, and pneumonia in children with suspected dysphagia. Data were retrospectively collected and analysed from 142 children referred for VFS over a one-year period. The median age was 33 months. Aspiration was identified in 44 per cent of the children studied. A history of pneumonia within one year of the VFS was found in 35 per cent. Aspiration, gastro-oesophageal reflux, and age one year or less were significant risk factors for pneumonia. Children with traumatic brain-injury were at less risk for pneumonia than all other children with suspected dysphagia. These results lend objective support to the previously suspected relationship between aspiration and pneumonia in this patient population.