Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H

Factors Influencing Early Diagnosis and Poor Prognosis of Dysphagia After Senile Ischemic Stroke

Dysphagia is often a long-term problem after ischemic stroke, which are often accompanied by complications and results in poor outcome. This study aimed to investigate the influencing factors associated with the prognosis of dysphagia after senile ischemic stroke and evaluate the diagnostic performance of crucial factors. A total of 192 elderly ischemic stroke patients (96 patients without dysphagia with average age of 69.81 ± 4.61 years and 96 patients with dysphagia with average of 70.00 ± 6.66 years) were enrolled in the retrospective study. The clinical factors of the patients were collected and recorded for chi-square analysis and logistic analysis. The receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic performance of international normalized ratio (INR) and homocysteine (Hcy) in senile ischemic stroke patients. The age, cough reflex, history of stroke, mechanical ventilation, eating posture, insufficient elevation of the larynx, standard swallowing assessment (SSA) score, Hcy value, and INR were closely related to endpoint events of patients with dysphagia. The joint model (combined INR and Hcy value) can increase the area under the curve (AUC) value (0.948) with higher sensitivity and specificity for predicting patients with dysphagia occurred endpoint events. The influencing factors for older ischemic stroke patients with dysphagia include age, cough reflex, history of stroke, mechanical ventilation, eating posture, insufficient elevation of the larynx, SSA score, Hcy value, and INR. INR and Hcy were independent risk factors for prognosis and diagnostic markers for patients with dysphagia after senile ischemic stroke.

Traditional knowledge of animal-derived medicines used by Gelao community in Northern Guizhou, China

INTRODUCTION

This study aims to document and preserve the traditional medicinal knowledge of the Gelao community in Northern Guizhou, China, providing valuable insights for modern pharmacological research and the development of these traditional remedies.

METHODS

Our methodology encompassed a blend of literature review, community interviews, and participatory observation to delve into the traditional knowledge of animal-derived medicines among the Gelao community. We employed quantitative ethnological and ecological assessment techniques to evaluate the significance of these practices. Informed consent was secured before conducting interviews, with a focus on ascertaining the types of medicines familiar to the informants, including their local names, sources, methods of preparation, application techniques, diseases treated, frequency of use, and safety considerations.

RESULTS

Our research cataloged 55 varieties of animal-derived medicines utilized by the Gelao people. Out of these, 34 originate from wild animals, mainly encompassing small insects, reptiles, and aquatic species; the remaining 21 are derived from domesticated animals, largely involving their tissues, organs, and various physiological or pathological by-products. These medicines are primarily applied in treating pediatric ailments (13 types), internal disorders (11 types), gynecological issues (3 types), dermatological problems (7 types), ENT conditions (3 types), trauma-related injuries (5 types), joint and bone ailments (5 types), infections (2 types), dental issues (2 types), and urolithiasis (1 type), with three types being used for other miscellaneous conditions. Commonly utilized medicines, such as honey, Blaps beetle, chicken gallstones, and snake-based products, are preferred for their availability, edibility, and safety within the Gelao communities.

CONCLUSION

The Gelao community's traditional medicines represent a rich diversity of animal sources, showcasing extensive expertise and knowledge in their processing and clinical applications. This wealth of traditional knowledge offers novel perspectives for the contemporary pharmacological study and development of these remedies. Additionally, our research plays a crucial role in aiding the preservation and continuation of this invaluable cultural heritage.

Ethnobotanical study of traditional forage plants in the Gansu-Ningxia-Inner Mongolia junction zone: conservation and sustainable utilization for animal husbandry

INTRODUCTION

This study aims to safeguard the ethnobotanical knowledge pertaining to traditional forage plants within the ethnically diverse Gansu-Ningxia-Inner Mongolia junction zone. It seeks to establish a foundation for the sustainable utilization of these traditional resources for animal husbandry.

METHODS

A combination of literature research, village interviews, participatory observation, and ethnobotanical quantitative evaluation methods was employed to investigate and study the traditional knowledge of wild forage plants used by local residents in the study area.

RESULTS

Local residents provided information on 73 forage plants, which were identified as 116 distinct wild forage plant species. These plants belong to 22 families and play an active role in the lives of the local inhabitants. Notably, the families Poaceae, Fabaceae, and Asteraceae are prominent, comprising the most abundant and widely utilized wild forage plants. Bing Cao (collectively referring to plants of the Agropyron, Leymus, and Psammochloa), Suo Cao (collectively referring to plants of the genus Stipa), and Ku Cai (encompassing Lactuca tatarica (L.) C.A.Mey. and Ixeris polycephala Cass.) emerge as the most representative and vital wild forage plants for animal husbandry. Additionally, plants within the Astragalus (referred to collectively as NiaoZi by local residents) in the Fabaceae family, as well as plants from the Amaranthaceae family, exhibit notable significance.

CONCLUSION

Animal husbandry assumes a pivotal role in the local agricultural economy, and the 116 wild forage plants investigated hold substantial importance in its development. Among these, 59 and 103 plant resources display high developmental potential, making them prospective candidates for high-quality cultivated forage grasses. Additionally, extensive grazing practices have resulted in significant ecological degradation within this already fragile ecosystem. The cultivation of forage grasses and the practice of pen-based animal husbandry may emerge as crucial strategies for sustainable development in this area.

Atypical Presentation of Pill Aspiration in Older Adults with Dysphagia: A Picture Not To Be Forgotten

Nonconventional clinical presentations of diseases are common in older adults. Even dramatic events, such as foreign body (FB) inhalation, can occur in a subtle and non-specific manner. Pill aspiration is a rare yet overlooked cause of airway injury. It accounts for approximately 7% of all FB aspirations. In contrast, oral dysphagia and polypharmacology, mainly administrated in solid oral dosage forms (SDOF), like tablets and pills, are common conditions in older adults. Herein, we present a case of SDOF aspiration in a 78-year-old man. FB inhalation developed with general clinical deterioration and neurological impairment (delirium) rather than overt respiratory symptoms. Bronchoscopy provided remarkable images of this unexpected finding. Caregivers and healthcare workers must be aware of the risk of SDOF aspiration and adopt proper safety measures. Early recognition and bronchoscopy for diagnostic and therapeutic purposes can be lifesaving in such cases.