Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKLatar Belakang: Disfagia fase faring ditemukan pada sebagian besar pasien karsinoma nasofaring (KNF) pasca-kemoradiasi. Manuver Mendelsohn bertujuan untuk meningkatkan durasi elevasi kompleks hyolaringeal, telah digunakan dalam penatalaksanaan disfagia dengan berbagai penyebab. Penelitian ini menilai pengaruh latihan manuver Mendelsohn pada penderita KNF pasca-kemoradiasi dengan disfagia fase faring.Metode: Desain kuasi eksperimen dengan penilaian sebelum dan sesudah latihan menelan dengan manuver Mendelsoh selama 6 minggu. Penelitian dilakukan pada 20 pasien KNF yang memenuhi kriteria penelitian. Sampel didapat secara konsekutif. Penilaian dilakukan dengan flexible endoscopic swallowing study (FEES) terhadap standing secretion, residu, penetrasi, dan aspirasi menggunakan konsistensi pure, thick liquid dan thin liquid.Hasil: Terdapat perbedaan bermakan pada penilaian standing secretion (p=0,034). Penilaian terhadap residu mendapatkan perbedaan bermakna pada pemberian pure dan thick liquid (p=0,021 dan p=0,008), sedangkan pada pemberian thin liquid tidak didapatkan perbedaan bermakna (p=0,129). Penilaian terhadap penetrasi mendapatkan perbedaan bermakna pada pemberian pure dan thick liquid (p=0,034 dan p=0,008), pada pemberian thin liquid tidak didapatkan perbedaan bermakna (p=0,059). Penilaian terhadap aspirasi tidak mendapatkan perbedaan bermakna pada pemberian ketiga konsistensi (p=>0,05).Kesimpulan: Latihan menelan dengan manuver Mendelsohn selama 6 minggu memeperbaiki standing secretion, residu pada pemberian pure dan thick liquid, penetrasi pada pemberian pure dan thick liquid. Latihan ini tidak memperbaiki aspirasi secara bermakna pada pemberian ketiga konsistensi.

---

ABSTRACTBackground: Dysphagia is commonly seen in patients with nasopharingeal carcinoma (NPC) post chemoradiation. The Mendelsohn maneuver which promotes a prolonged voluntary of hyolaryngeal elevation at the peak of swallowing process has been used to treat various causes of pharyngeal dysphagia. The aim of the study was to see of the influence of swallowing exercise with Mendelsohn manuever in post-chemoradiation NPC patients with pharyngeal phase dysphagia.Methods: A quasi experimental with pre and post-test assessment at before and after six weeks exercise of Mendelsohn manuever. The study was conducted on 20 NPC patients who met the study criteria. Flexible endoscopic of swallowing study (FEES) was used to asess standing secretion, residue, penetration, and aspiration by giving 3 consistency of food/fluid (pure, thick liquid and thin liquid).Results: There was a significant difference in standing secretion assesment (p=0,034). Significant differences were found in residue assesment of pure and thick liquid, although no significant difference was found in thin liquid (p=0,129). There were also significant differences in penetration assesment of pure and thick liquid (p=0.034 and p = 0.008), but no significant difference in thin liquid ( p = 0.059 ). The study did not find significant differences in assesment of aspiration in all kind of consistencies (p > 0.05). Conclusion: Six weeks swallowing exercise with Mendelsohn manuever can reduce severity of standing secretion, residue and penetration of pure and thick liquid. However the exercise improve aspiration status but did not reach significant difference at all consistencies. ;Background: Dysphagia is commonly seen in patients with nasopharingeal carcinoma (NPC) post chemoradiation. The Mendelsohn maneuver which promotes a prolonged voluntary of hyolaryngeal elevation at the peak of swallowing process has been used to treat various causes of pharyngeal dysphagia. The aim of the study was to see of the influence of swallowing exercise with Mendelsohn manuever in post-chemoradiation NPC patients with pharyngeal phase dysphagia.Methods: A quasi experimental with pre and post-test assessment at before and after six weeks exercise of Mendelsohn manuever. The study was conducted on 20 NPC patients who met the study criteria. Flexible endoscopic of swallowing study (FEES) was used to asess standing secretion, residue, penetration, and aspiration by giving 3 consistency of food/fluid (pure, thick liquid and thin liquid).Results: There was a significant difference in standing secretion assesment (p=0,034). Significant differences were found in residue assesment of pure and thick liquid, although no significant difference was found in thin liquid (p=0,129). There were also significant differences in penetration assesment of pure and thick liquid (p=0.034 and p = 0.008), but no significant difference in thin liquid ( p = 0.059 ). The study did not find significant differences in assesment of aspiration in all kind of consistencies (p > 0.05). Conclusion: Six weeks swallowing exercise with Mendelsohn manuever can reduce severity of standing secretion, residue and penetration of pure and thick liquid. However the exercise improve aspiration status but did not reach significant difference at all consistencies. "

"Adenoid cystic carcinoma is an extremely rare case of the esophagus. We present a female patient, aged 76 years who present with dysphagia and weight loss for tire last three month. On endoscopy there was a luminal narrowing in the middle third of the esophagus. Diagnosis was challenging due to the stenosis and the tumor size. Histopathological confirmation was obtained by subcarinal fine-needle aspiration biopsy. This type of cancer is very aggressive with short survival time. Further studies are needed to define optimal treatment."

"Disfagia sangat berhubungan dengan peningkatan risiko pneumonia aspirasi yang sering mengakibatkan kematian pada stroke. Oleh karena itu, manajemen yang efektif dan efisien menjadi penting. Terapi perilaku rehabilitasi menelan yang berdasarkan prinsip neuroplastisitas seperti latihan penguatan dan latihan pergerakan orofaring menjadi alternatif yang cukup sering digunakan. Penelitian ini bertujuan untuk menilai perubahan fungsi menelan pada penderita stroke iskemik dengan disfagia neurogenik setelah dilakukan latihan penguatan faring, latihan pergerakan hiolaring dan praktik menelan. Fungsi menelan dinilai dengan menggunakan Penetration Aspiration Scale (PAS) dan Functional Oral Intake Scale (FOIS) berdasarkan pemeriksaan Flexible Endoscopic Evaluation of Swallowing (FEES) sebelum dan setelah intervensi. Intervensi diberikan setiap hari dengan durasi 30-45 menit selama 4 minggu. Terdapat 6 subjek yang menyelesaikan penelitian. Nilai PAS sebelum intervensi adalah 6±1.79 dan setelah intervensi adalah 1.67±0.82 (p=0.003). Sementara itu, nilai FOIS sebelum intervensi adalah 3 (1-5) dan setelah intervensi adalah 5±2.10 (p=0.041). Terdapat perbaikan nilai PAS dan FOIS setelah intervensi. Oleh karena itu, intervensi ini bisa disarankan sebagai salah satu tatalaksana dalam meningkatkan fungsi menelan pada penderita stroke iskemik dengan disfagia neurogenik.

---

Dysphagia is associated with an increased risk of aspiration pneumonia which often results in death in stroke patients. Therefore, effective and efficient management is important. Behavioral therapy for swallowing rehabilitation based on the principles of neuroplasticity such as oropharyngeal strengthening and range of motion exercises are the alternative ones that often be used. This study aimed to assess the changes in swallowing function in ischemic stroke patients with neurogenic dysphagia after pharyngeal strengthening exercise, hyolaryngeal complex range of motion exercise and swallowing practice. Swallowing function was assessed using Penetration Aspiration Scale (PAS) and Functional oral Intake Scale (FOIS) based on Flexible Endoscopic Evaluation of Swallowing (FEES) before and after interventions. The interventions were given every day with a duration of 30-45 minutes for 4 weeks. There were 6 subjects who completed the study. The PAS before the interventions was 6±1.79 and after the interventions was 1.67±0.82 (p=0.003). Meanwhile, the FOIS score before the interventions was 3 (1-5) and after the interventions was 5±2.10 (p=0.041). There was an improvement of PAS and FOIS after the interventions. Therefore, the interventions can be suggested to be used as one of the treatments to improve swallowing function in ischemic stroke patients with neurogenic dysphagia."

"This is a clear, comprehensive introduction to communication sciences and disorders, with an evidence-based, lifespan perspective. This edition continues the evidence-based, lifespan perspective. It reviews and explains the most recent research evidence pertaining to the assessment and treatment of communication disorders from birth through the end of life in a clear, comprehensible fashion. Each chapter is concise, yet provides comprehensive information appropriate for an introductory-level text. Students gain a basic foundation in the areas of anatomy and physiology of the speech and hearing mechanisms, and an overview of the various disorders that affect voice, fluency, articulation, language, cognition, swallowing, and hearing, along with detailed descriptions of the varying etiologies that cause these impairments"

"Pasien dengan disfagia rentan mengalami komplikasi seperti pneumonia aspirasi hingga kematian. Oleh karena itu diperlukan alat skrining untuk mendiagnosis disfagia secara cepat. GUSS merupakan alat skrining dengan validitas dan reliabilitas yang baik dalam menilai disfagia, namun belum dilakukan uji diagnostik di Indonesia. Subjek penelitian terdiri dari pasien disfagia neurogenik yang kemudian menjalani pemeriksaan GUSS-INA dengan modifikasi bahan uji, dilanjutkan dengan pemeriksaan baku emas FEES. Selanjutnya, dilakukan uji diagnostik untuk melihat sensitivitas dan spesifisitas GUSS-INA sebagai metode skrining disfagia. Rerata pasien disfagia neurogenik di RSCM berusia 56 tahun dengan jumlah proporsi laki – laki lebih besar dengan penyebab tersering adalah stroke, dengan komorbid hipertensi (56.5%), dengan komplikasi pneumonia 21.7%. Sebagian besar mengalami disfagia kronik, seluruh pasien mengalami keluhan subjektif disfagia dengan 3 gejala tersering adalah batuk, tersedak, dan sulit menelan terutama konsistensi padat. Lebih dari separuh pasien membutuhkan selang makan. Rerata status gizi pasien menunjukan indeks masa tubuh 24.92, dengan rerata penurunan BB 2 kg. Berdasarkan pemeriksaan pencitraan pasien stroke, lokasi tersering berada supratentorial, dengan derajat stroke sedang. Rerata nilai GUSS 14 (disfagia sedang) pada seluruh subjek, 28.3% mengalami aspirasi. Hasil Uji diagnostik GUSS-INA sebagai alat skrining deteksi disfagia memiliki nilai Sensitivitas 84%, Spesifisitas 78%, NDP 94%, NDN 54% dan AUC 0.86. Modalitas GUSS-INA dapat dijadikan alat skrining disfagia yang cukup baik.

---

Patient with dysphagia has the tendency to undergo serious complications such as aspiration pneumonia that can cause increased mortality. Screening tool to effectively diagnose dysphagia in patient with difficulty swallowing is needed. GUSS is a screening tool with good validity and reliability; however, no diagnostic test has been done in Indonesia. This study samples consisted of neurogenic dysphagia patients which underwent GUSS-INA with test material modification assessment followed by FEES as gold standard examination. Diagnostic test was then done to analyze sensitivity and specificity of GUSS-INA as dysphagia screening tool. The average age of neurologenic dysphagia patients in Cipto Mangunkusumo Hospital was 56 years with higher male proportion, most common etiology was stroke, with most common morbidity being hypertension (56,5%). History of pneumonia was found in 21.7% patients.Majority of patients have chronic dysphagia, all patients had subjective dysphagia complaint with three most common symptoms being cough, choking, and difficulty swallowing especially of solid texture. More than half of the patients needed feeding tube. The average of BMI was 24.93, with average weight loss of 2 kg. Based on radiology results on post-stroke cases, the most common lesion was supratentorial, with moderate stroke score. Average GUSS score is 14 (moderate dysphagia) from all subjects and in 18.3% patients aspiration in found. Diagnostic test result of GUSS-INA as screening tool for neurogenic dysphagia had 84% sensitivity, 78% specificity, 94% PPV, 54% NPV, and AUC of 0.86. GUSS-INA could be used as a screening tool for dysphagia."

"Oessofago-gastro-duodenoscopy (OGD) dilakukan pada pasien yang diterima melalui sistem "open access" dan sistem biasa."

"Oesofago-Gastro-Duodenoscopy (OGD) dilakukan pada pasien yang diterima melalui sistem "open acces " dan sistem biasa. Keluhan dapat berbeda pada pasien yang berumur < 45 tahun atau yang berumur > 45 tahun. Diagnosis rujukan, umur, gender dan faklor lingkungan dapat menimbulkan implikasi penting. Studi ini ditujukan untuk mempelajari profil pasien yang datang untuk OGD berdasarkan usia (< 45 tahun atau > 45 tahun) antara Januari 2004 - Desember 2004 yang dirujuk berdasarkan "open acces system" di wilayah sub-Himalaya, India Utara. Studi ini dilakukan di Indira Gandhi Medical College. Pasien dibagi dua kelompok: kelompok I usia < 45 tahun dan kelompok II usia > 45 tahun. Dari 1186 pasien, 451 (38%) adalah perempuan, 735 (62%) adalah laki-laki. Enam ratus enambelas pasien (52%) berusia < 45 tahun dan 570 (48%) berusia > 45 tahun. Dari kelompok /, 431 (70%) menunjukkan gambaran endoskopi yang normal dan 185 (30%) menunjukkan kelainan. Pada kelompok II 302 (53%) menunjukkan gambaran endoskopi yang normal, dan 268 (47%) memperlihatkan kelainan pada endoskopi. Ulkus gaster dan masa lebih sering terlihat pada kelompok > 45 tahun. "Gastro-esophageal reflex disease" (GERD) lebih sering pada usia muda. Gejala subjektif sama pada kedua kelompok. Disimpulkan bahwa untuk gejala yang sama, kelainan OGD lebih sering pada kelompok usia > 45 tahun. Hasil positif meningkat dari 30% menjadi 47% antara usia < 45 dan > 45 tahun. Disimpulkan bahwa semua pasien usia > 45 Tahun perlu dirujuk untuk endoskopi pada kali pertama kelainan gastrointestinal atau adanya alarm simtom. (MedJ Indones 2006; 15:90-3).

---

The Oesophago-Gastro-Duodenoscopy (OGD) is done in patients received by either open access system or the conventional system. The presenting complaints and OGD findings may differ among patients with age < 45 yrs and those who are more than 45 yrs old. The referral diagnosis, age, sex, and environmental factors have important implications on the chances of finding and objective abnormality on endoscopy in a patient. This study was aimed to evaluate to evaluate the profile of ! 186 patients divided into younger (<45 yrs) and older age (45 or > 45 yrs) groups presenting for oesophago gastroduodenoscopy through open access referral system in sub-Himalayan region of North India. This is a retrospective study carried out on patients who underwent the OGD from Jan, 2004-Dec, 2004. The study was conducted in Indira Gandhi Medical College situated at a moderate altitude in North India. All patients presenting in Medical College during the study period for OGD were taken into study. The patients were divided into two groups based on age; less than 45 yrs and 45 yrs or more than 45 yrs. Their presenting complaint, age, sex, and OGD findings were recorded. The profile was compared between the two groups. A total of 7186 patients underwent OGD; the females were 451(38%) and males were 735(62%); 616(52%) were < 45 yrs old and 570(48%) of the patients were 45 yrs or older. In the group I 431(70%) had a normal endoscopy and 185(30%) showed abnormal endoscopic findings. In group II 302(53%) had a normal endoscopy, and 268(47%) had abnormal findings on endoscopy. Gastric ulcers, mass lesion/new growth were more common in elderly group, Gastro-esophageal reflux disease (GERD) was more common in younger group. The presenting complaints were similar in both groups. It is concluded that for the same presenting diagnosis the yield of OGD was more in patients > 45 yrs old. The positivity rate increased from 30% in < 45 yrs to 47% in the elderly cohort. So, all people >45 yrs should go for endoscopy at the first hint of upper Gl pathology, or appearance of alarm symptoms. (MedJ Indones 2006; 15:90-3)."

"Latar Belakang: Disfagia pada stroke dapat menimbulkan berbagai komplikasi yang menurunkan kualitas hidup. Tujuan penelitian ini untuk mengetahui apakah posisi duduk 700 membuat performa menelan berbeda dengan pada posisi duduk 900, pada pasien stroke dengan disfagia neurogenik fase oral dan faring. Metode: Desain pre-post experimental study, dilakukan pada 30 pasien stroke dengan disfagia neurogenik fase oral dan faring, berusia 40 ? 80 tahun dan memenuhi kriteria penerimaan. Performa menelan dievaluasi dengan pemeriksaan FEES pada posisi duduk 900 dan posisi duduk 700. Parameter FEES (standing secretion, preswallowing leakage, residu, penetrasi dan aspirasi) dibandingkan antara kedua posisi duduk. Hasil: Angka kejadian dan tingkat keparahan standing secretion lebih rendah bermakna pada posisi duduk 700. Angka kejadian preswallowing leakage tidak berbeda bermakna antara kedua posisi duduk. Angka kejadian residu lebih rendah tidak bermakna pada posisi duduk 700. Tingkat keparahan residu lebih rendah bermakna pada posisi duduk 700. Angka kejadian penetrasi lebih rendah tidak bermakna pada posisi duduk 700. Tingkat keparahan penetrasi lebih rendah tidak bermakna pada posisi duduk 700. Angka kejadian dan tingkat keparahan aspirasi lebih rendah tidak bermakna pada posisi duduk 700. Simpulan: Posisi duduk reclining 700 membuat performa menelan lebih baik dibandingkan pada posisi duduk 900 pada pasien stroke dengan disfagia neurogenik.

---

Background: Dysphagia in stroke can cause various complications those reducing quality of life. The aim of the study to ackowledge if 700 sitting position makes different swallowing performance from 900 sitting position, in stroke patients with oral and pharyngeal neurogenic dysphagia.

Methods: A pre-post experimental study design, conducted on 30 stroke patients with oral and pharyngeal neurogenic dysphagia, aged 40 ? 80 years old and met the inclusion criteria. Swallowing performance was evaluated with FEES examination in 900 sitting position and 700 sitting position. FEES parameters (standing secretion, preswallowing leakage, residue, penetration and aspiraton) were compared between both sitting positions.

Results: Incidence and severity of standing secretion was significantly lower in 700 sitting position. Incidence of preswallowing leakage wasn?t significantly different between both sitting positions. Incidence of residue was insignificantly lower in 700 sitting position. Severity of residue was significantly lower in 700 sitting position. Incidence of penetration was insignificantly lower in 700 sitting position. Severity of penetration was insigificantly lower in 700 sitting position. Incidence and severity of aspiration was insignificantly lower in 700 sitting position.

Conclusions: 700 reclining sitting position makes better swallowing performance than 900 sitting position, in stroke patients with neurogenic dysphagia."

"Tesis ini disusun untuk menilai pengaruh latihan Functional Chewing terhadap fungsi mengunyah pasien anak palsi serebral dengan disfagia fase orofaringeal menggunakan metode penelitian evidence-based case report (EBCR). Pencarian literatur dilakukan pada Cochrane, Pubmed, Science direct, Oxford Academic dan Sage Journals sesuai dengan pertanyaan klinis. Penelitian ini menggunakan meta-analisis pada kedua jurnal yang didapat untuk menilai kualitasnya berdasarkan validitas, kepentingan dan aplikabilitasnya. Dari hasil meta-analisis didapatkan bahwa subjek penelitian adalah disfagia orofaringeal pada anak palsi serebral dengan GMFCS level V dan indikator kemampuan mengunyah Karaduman Chewing Performance Scale (KCPS) 4 yang mendapatkan latihan Functional Chewing memiliki kemampuan mengunyah yang lebih baik dibandingkan yang mendapatkan latihan oromotor tradisional. Kesimpulan penelitian ini adalah latihan Functional Chewing dapat meningkatkan kemampuan mengunyah pada pasien anak palsi serebral dengan disfagia fase orofaringeal.

---

This thesis was designed to assess the effect of Functional Chewing exercise on the chewing function of children with cerebral palsy with oropharyngeal dysphagia using an evidence-based case report (EBCR) research method. A literature search was performed on Cochrane, Pubmed, Science direct, Oxford Academic and Sage Journals according to clinical questions. This study uses a meta-analysis of the two journals obtained to assess their quality based on their validity, importance and applicability. From the results of the meta-analysis, it was found that the research subject was oropharyngeal dysphagia in children with cerebral palsy with GMFCS level V and the Karaduman Chewing Performance Scale (KCPS) 4 chewing ability indicator who received Functional Chewing exercise had better chewing ability than those who received traditional oromotor exercise. The conclusion of this study is that Functional Chewing exercises can improve chewing ability in children with cerebral palsy with oropharyngeal dysphagia."

"Gangguan menelan atau disfagia sering dijumpai pada pasien stroke, kanker kepala dan leher, serta lansia. Disfagia dapat meningkatkan risiko malnutrisi, aspirasi, dan kematian. Pasien disfagia juga rentan mengalami ansietas atau depresi yang berdampak pada penurunan kualitas hidup. Dysphagia Handicap Index (DHI) merupakan instrumen swaisi yang dirancang khusus untuk menilai kualitas hidup pasien disfagia. Instrumen DHI terdiri dari 25 pertanyaan yang meliputi penilaian domain fisik, fungsional, dan emosional, serta telah diterjemahkan dan divalidasi dalam berbagai bahasa. Penelitian ini bertujuan untuk menguji validitas dan reliabilitas DHI versi Bahasa Indonesia. Kuesioner DHI diterjemahkan ke dalam Bahasa Indonesia melalui proses forward translation dan backward translation, serta cognitive debriefing. Hasil terjemahan balik juga didiskusikan dan disetujui oleh penulis utama DHI. Kuesioner DHI versi Bahasa Indonesia (DHI-INA) final kemudian diujikan kepada 46 subjek dengan berbagai etiologi disfagia. Sebanyak 20 subjek kemudian melakukan pengisian ulang satu minggu setelah pengisian pertama. DHI-INA menunjukkan korelasi yang kuat antara masing-masing domain dan skor total [fisik (r = 0,93); fungsional (r = 0,97); emosional (r = 0,93); dan keparahan (r = 0,84)]. Konsistensi internal DHI-INA juga menunjukkan nilai yang baik (Cronbach's = 0,87), begitu pula uji tes-retest untuk skor total (ICC = 0,94). Tingkat keterbacaan DHI-INA setara dengan kelas 7 berdasarkan formula grafik Fry. Kuesioner DHI-INA merupakan kuesioner yang valid dan reliabel untuk menilai kualitas hidup pasien disfagia.

---

Swallowing problem or dysphagia often found in stroke patients, head and neck cancer, and elderly. Dysphagia increases the risk of malnutrition, aspiration, and death. Patient with dysphagia also prone to have anxiety or depression which has an impact on decreasing quality of life. The Dysphagia Handicap Index (DHI) is a self-administered instrument specially designed to assess the quality of life of dysphagic patients. The DHI instrument consists of 25 questions covering physical, functional, and emotional aspects and has been translated and validated into various languages. This study aims to test the validity and reliability of the Indonesian version of DHI. The DHI questionnaire was translated into Indonesian through a forward and backward translation process, and cognitive debriefing. The backward translation results were discussed and approved by the lead author of DHI. The final Indonesian version of the DHI Questionnaire (DHI-INA) was then tested on 46 subjects with various etiologies of dysphagia. A total of 20 subjects were then refilled one week after the first administration. DHI-INA showed strong correlation between each domain and total score [physical (r = 0.93); functional (r = 0.97); emotional (r = 0.93); and severity (r = 0.84)]. The internal consistency of DHI-INA was also good (Cronbach's a = 0.87), as well as test–retest reliability for the total scores (ICC = 0.94). The readability level of DHI-INA is 7th grade using the Fry graph formula. The DHI-INA questionnaire is a valid and reliable questionnaire to assess the quality of life of dysphagia patients."