Number Of Swallows Research Articles

The test of masticating and swallowing solids (ToMaSS): An investigation of applicability and clinical utility in children with orofacial myofunctional disorders.

Orofacial myofunctional disorders (OMD) are often associated with limitations of oral ingestion of solid food. The Test of Masticating and Swallowing Solids (ToMaSS) is a simple diagnostic tool to assess and quantify oropharyngeal efficiency while eating a standardised cracker. The objective of this study was to investigate the applicability and clinical utility of the ToMaSS in children with OMD. In this case-control study, data were collected from 18 children between 4 and 11 years with confirmed OMD. Inter-rater reliability and age effects on the ToMaSS parameters were investigated and the specific performance profile of the OMD children was identified. Inter-rater reliability was excellent for the ToMaSS parameters 'bites' (ICC = .999), 'masticatory cycles' (ICC = .961), 'time'(ICC≧ .999) and good for 'number of swallows' (ICC = .810). 'Masticatory cycles' and 'time' decreased as a function of age with a significant difference in the 'number of masticatory cycles' between the youngest (4-6 years) and oldest (10-14 years) participants (p = .006, Z = -2.739). Deviations from normative data in at least one of the four ToMaSS parameters were found in 90% of the OMD children with 'bites', and 'masticatory cycles' predominantly corresponding to the performances expected in typically-developing children in younger age groups. The ToMaSS is a reliable diagnostic instrument and clinically useful to detect limited efficiency of oral solid bolus intake and specific impairments in chewing function and duration of food intake in children with OMD. Our data suggest that OMD is associated with delayed development of efficient solid bolus preparation.

Normal values for swallow events during endoscopic evaluation of swallowing: a preliminary study.

The current investigation aimed to establish preliminary normative data for endoscopic swallow studies (FEES). The investigators collected data for three timing measures (time to whiteout, duration of whiteout, and total swallow time), three swallowing outcomes (safety, efficiency, and number of swallows per bolus), and one physiologic event (glottal response), for both healthy young and older adults using two liquid volumes, one pureed bolus and a solid bolus. Blinded raters retrospectively analyzed 65 randomly selected, deidentified videos of endoscopic swallowing examinations from a pool of 163 young and older adults with typical swallowing abilities. Timing measures and analysis of airway invasion, amount of residue, number of swallows, and glottal response were obtained. Preliminary means and quartiles were established for healthy adults in two age groups (young and old), for time to whiteout (WO), number of swallows per bolus, glottal response, Yale Residue Rating Scale Scores, Penetration-Aspiration Scale scores, duration of WO, and total swallow duration. Differences were found between the older and younger groups. The current study represents a preliminary attempt to provide quantitative and normative values for FEES. These data represent reference values to which other bolus presentations and populations can be compared. The data represents proof of concept and merits additional investigation. 1756246-2: Approved 2022/06/06. Study does not meet criteria. DATA REPOSITORY: https://doi.org/10.6084/m9.figshare.25800025 .

Evidence for peripheral and central actions of codeine to dysregulate swallowing in the anesthetized cat

Systemic administration of opioids has been associated with aspiration and swallow dysfunction in humans. We speculated that systemic administration of codeine would induce dysfunctional swallowing and that this effect would have a peripheral component. Experiments were conducted in spontaneously breathing, anesthetized cats. The animals were tracheotomized and electromyogram (EMG) electrodes were placed in upper airway and chest wall respiratory muscles for recording swallow related motor activity. The animals were allocated into three groups: vagal intact (VI), cervical vagotomy (CVx), and supra-nodose ganglion vagotomy (SNGx). A dose response to intravenous codeine was performed in each animal. Swallowing was elicited by injection of 3 mL of water into the oropharynx. The number of swallows after vehicle was significantly higher in the VI group than in SNGx. Codeine had no significant effect on the number of swallows induced by water in any of the groups. However, the magnitudes of water swallow-related EMGs of the thyropharyngeus muscle were significantly increased in the VI and CVx groups by 2–4 fold in a dose-related manner. In the CVx group, the geniohyoid muscle EMG during water swallows was significantly increased. There was a significant dose-related increase in spontaneous swallowing in each group from codeine. The spontaneous swallow number at the 10 mg/kg dose of codeine was significantly larger in the CVx group than that in the SNGx group. During water-evoked swallows, intravenous codeine increased upper airway motor drive in a dose-related manner, consistent with dysregulation. The data support the existence of both central and peripheral actions of codeine on spontaneous swallowing. At the highest dose of codeine, the reduced spontaneous swallow number in the SNGx group relative to CVx is consistent with a peripheral excitatory action of codeine either on pharyngeal/laryngeal receptors or in the nodose ganglion itself. The higher number of swallows in the CVx group than the VI group supports disinhibition of this behavior by elimination of inhibitory vagal sensory afferents.

Age-associated impairment in swallow function is concomitant with nucleus ambiguus motor neuron death in Fischer 344 rats

The nucleus ambiguus contains motor neurons (MNs) innervating the muscles of the larynx, pharynx and oesophagus. Many of the motor units these muscles are comprised of are fast fatigueable units — highly vulnerable to neurodegeneration. Loss of the MNs or damage to the nerves innervating the muscles of the larynx, pharynx and oesophagus may impair swallow, vocalization and/or respiratory functions. Of particular importance, human patients with deficits in swallow are at risk of sequelae such as aspiration pneumonia and malnutrition. In aged male Fischer 344-Brown Norway crosses, age-associated loss of nucleus ambiguus MNs contributes to vocalisation deficits. Here, we use female and male Fischer 344 (F344) at young (6-months old) and old (24-months old) to evaluate swallow function and nucleus ambiguus MN survival. Swallow function was evaluated under anesthesia by delivering an 0.3 mL bolus of water to the base of the tongue and videoing the number of subsequent swallows. A pressure catheter was inserted into the oesophagus to evaluate the incidence and duration of wallow-associated apneas and the magnitude of the schluckatmung in 30 s following bolus delivery. Following functional evaluations, rats were euthanized, perfused with paraformaldehyde and brainstem tissue cryopreserved, sectioned and stained with Nissl to stereologically evaluate the number of nucleus ambiguus MNs. In old age, we observed an ~30% reduction in the number of swallows per delivery of the water bolus and an increased incidence and duration of swallow apnea. Schluckatmung was not affected by age. The number of nucleus ambiguus MNs was reduced by ~20% in old F344 rats, with MN size unaffected. We propose that swallow evaluations are a robust readout of oropharyngeal behaviour, with deficits concomitant with MN death. These findings are similar to age-associated weakness in other skeletal muscle being related to MN death. It is likely that the mechanisms underpinning fast fatigue motor unit MN death in brainstem and spinal pools are similar. This research was funded by HL166204. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Impact of rotenone induced Parkinson’s disease on respiration and swallowing rate in drinking rats

Parkinson’s disease is a neurodegenerative disorder known to cause dysphagia, the major contributor to mortality via aspiration pneumonia. The neurological basis of swallowing dysfunction in Parkinson patients is poorly understood. To explore the mechanisms of swallowing dysfunction, we studied the impact of rotenone treatment on respiration rate and swallowing rate in liquid-drinking rats. We hypothesized that rotenone treatment will cause a decrease in respiratory and swallowing rate compared to untreated liquid-drinking rats. Six rats were injected with 2.75 mg/kg/day intraperitoneal rotenone for 16 days to create the parkinsonian phenotype and subsequently recorded with 200fps video fluoroscopy during barium-infused liquid drinking. Before the first injection and on day 4, 7, 10 and 16, the number of swallows and number of breaths in a ten second period of continuous drinking were scored. The data was then analyzed using Analysis of Variance to determine whether the rotenone injections impacted the respiration or swallowing rate. Rotenone injections led to a decrease in respiration rate (p=0.03), but no change in swallowing rate over a 16-day period (p>0.05). Immunohistochemistry of the dorsolateral striatum of rats that received rotenone treatment for 8 days and 16 days showed significant reduction in tyrosine hydroxylase (TH) immunofluorescence with increased impact due to prolonged treatment (Kruskal Wallis test, p<0.001). TH is the rate limiting step of catecholamine synthesis from tyrosine, confirming that rotenone is affecting dopamine production in this model of Parkinson’s disease. These results indicated that rotenone induced parkinsonian treatment has differential impacts on different brainstem mediated processes, swallowing and respiration. Thus, swallow-respiration coordination is likely impacted in these animals, potentially increasing risk of airway protection failure. Internal Rowan funding to F. Gould supported this work. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Screening performance of a 100-mL water swallowing test in community-dwelling older adults: A receiver operating characteristic analysis.

The development of a dysphagia screening test is an urgent issue in the field of frailty prevention among community-dwelling older people. The purpose of this study was to evaluate the screening performance of a 100-mL water swallowing test (WST). The study employed a cross-sectional design. Participants were 304 (65 men and 239 women, mean age = 80 years) Japanese community-dwelling older adults aged over 65 years. We investigated swallowing disorder using the 10-item Eating Assessment Tool (EAT-10), and compared choking signs, swallowing time and number of swallows, and their combination in the 100-mL WST. We calculated the sensitivity and specificity of these indices. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of swallowing time and number of swallows in the 100-mL WST based on the Youden Index among participants without choking signs. The sensitivity and specificity of choking signs in the 100-mL WST were 20% and 91%, respectively. The discriminating ability of swallowing time and number of swallows among participants without any choking signs was .76 and .72, respectively, in the area under the ROC curve. Diagnostic sensitivity and specificity to discriminate dysphagia from normal swallowing ability were 65% and 74% when the cut-off was >10 s based on maximisation of the Youden Index. The 100-mL WST performed best when the indices of choking signs and swallowing time were combined, with a sensitivity and specificity of 72% and 68%, respectively. The 100-mL WST would be an adequate screening tool when compared to the EAT-10.

The landscape of fear in cattle farms? How the presence of barn swallow influences the activity of pest flies

Abstract Insectivorous birds are key suppliers of crucial ecosystem services, especially important for pest control in agricultural systems, and are globally decreasing at a fast rate. Among them, the declining barn swallow Hirundo rustica is particularly linked to cattle farms, where it is impacted by changes in livestock husbandry practices. The presence of swallows in cattle sheds might contribute to control insect pests, but such an effect had never been explored. With this work, we evaluated the potential control effect exerted by barn swallow on economically relevant pest insects, filth flies. To assess whether swallows inside the cattle sheds influence the activity rate of pest flies (especially Musca domestica and Stomoxys calcitrans), we assessed the relative abundance of swallows and flies over 16 weeks in nine different cattle farms in Non valley (Trentino, North‐east Italy), either occupied or not by nesting swallows. From April 2022 to August 2022, we collected weekly data on the activity rate of flies by placing eight white spot cards inside each of nine cattle sheds and counting the deposition of faecal and regurgitation spots by flies. Simultaneously, we collected weekly data regarding swallow occurrence, brood size, number and age of chicks. We applied generalised linear mixed effect models on the activity rate of flies, with spot card and farm as nested random effects, to account for potential random variability between cards and farms. We then assessed through model selection the effect of number of cows, number of swallows, and temperature or week alternatively. Temperature and week were modelled also in interaction with the number of swallows. Fly activity rate followed a seasonal trend with a peak in July, which was markedly lower where swallows were present. Moreover, the positive relationship between flies and temperature was lessened when swallows were abundant. Synthesis and applications. Barn swallows are effective biological control agents for lowering pest fly activity in livestock farms. Farmers were actively involved in swallow conservation within their sheds, also with a shared memorandum‐of‐intent. Harnessing the ecosystem services supplied by farmland birds could bring positive outcomes for people and biodiversity.

The 100ml-Timed Water Swallow Test: Pilot Data from Children with No Dysphagia.

Dysphagia screening tests are useful in identifying possible dysphagia for further evaluation and in supporting feeding recommendations. This study aimed to investigate swallowing parameters in children, while widening the pool of data available, using the '100ml-Timed Water Swallow Test' (100ml-TWST). Sixty Singaporean children aged 4 to 18years old completed the 100ml-TWST via a cup and a straw. Task completion, presence of cough, choke or throat clear, post-swallow voice quality, total time taken and number of swallows were observed. Subsequently, analysis of time per swallow (T/S), volume per swallow (V/S) and volume per time or swallowing capacity (V/T) were performed. Higher tendencies for coughing and task incompletion were observed in younger participants. A shorter time taken, fewer number of swallows, greater V/S and greater swallowing capacity were observed for adolescent or male participants, or via the mode of cup drinking. These could be due to oropharyngeal structural changes and swallow maturation with age, an increased capacity of oropharyngeal structures for swallowing in adolescent males, and more controlled or paced drinking from a straw. A plateau in time taken, number of swallows and swallowing capacity in adolescence were also observed, possibly indicating an emerging maturation of swallow functions during that period. Interestingly, speed of bolus movement was largely unaffected by age, gender and mode of drinking. Pilot data for children with no dysphagia have been established, while gaining insight into the swallowing parameters and maturation process in the paediatric population.

Acoustic Analysis of Swallowing of an Experimental Meal of Three Food Textures: A Comparative Aging Study

Swallowing disorders in the elderly represent a public health problem, their detections are a medico-economic issue. The acoustic analysis of swallowing has the advantages of being non-invasive with no radiation, compared to videofluoroscopy or fiberoptic swallowing assessments. Acoustic analysis of swallowing has been tested in many studies but only on small food boluses. The aim of this study was to compare the acoustic swallowing parameters of two groups of healthy subjects, before and after 70 years old, during the intake of a series of 3 food textures. A laryngophone was used to record the pharyngeal phase of swallowing. The experimental meal was composed of 100 ml of mashed potatoes, 100 ml of water, and 100 ml of yogurt. Group 1 (50–70 years old) comprised 21 subjects and group 2 (over 70 years old) 23 subjects. Acoustic parameters analyzed were the number of swallows, average duration of swallowing, average duration of inter-swallowing, meal duration, and the average frequency of swallowing per minute. These parameters for groups 1 and 2 were compared. The average duration of inter-swallowing and the meal duration were significantly higher in the older group (p < 0.001), with a mean duration of inter-swallowing that was 2.4 s longer than the younger group. The average swallowing frequency per minute was higher in the younger group (11.3 vs 7.9; p < 0.001). This study demonstrated that acoustic analysis of an experimental meal of three food textures generated usable data on swallowing. In the over 70 age group, there was a decrease in swallowing frequency, indicating a slowdown in food intake. A reduced swallowing frequency could become a criteria to assess presbyphagia.

Modulation of the swallowing reflex by stimulation of the gigantocellular reticular nucleus in the rat

ObjectivesThe gigantocellular reticular nucleus (Gi) projects to the nuclues of the solitary tract nucleus (NTS) and the lateral reticular formation (LRF) above the nucleus ambiguus. The swallowing central pattern generator comprises the NTS and the LRF. The present study examined whether stimulation of the Gi affects the swallowing reflex. MethodsExperiments were performed on urethane-anesthetized rats. The swallowing reflex was evoked by repetitive electrical stimulation of the superior laryngeal nerve and responses were recorded from the mylohyoid muscle on an electromyogram. The Gi was stimulated electrically. In addition, glutamate was injected into the Gi. The Friedman's test, followed by the Wilcoxon signed-rank test with Bonferroni correction, were used to assess the effects of electrical stimulation of the Gi. The Wilcoxon signed-rank test was used to assess the effects of glutamate injection into the Gi. Differences were considered significant at the P < 0.05 level. ResultsThe number of swallows was significantly increased or decreased by electrical stimulation of the Gi or after injection of glutamate into the Gi. In both electrical stimulation of the Gi and injection of glutamate into the Gi, the onset latency of the first swallow was prolonged when the number of swallows was decreased but showed no change when the number of swallows was increased. ConclusionsThe present results suggest that the Gi is involved in the control of swallowing.

An effective salivation-facilitating method for COVID-19 testing: An experimental study.

Simple tools, such as antigen test kits, are readily available for determining coronavirus disease 2019 infection at hospitals and homes. However, it is challenging for elderly people who are prone to dry mouth and other diseases. The main objective of this study was to investigate whether the presence or consumption of a plum pickle can facilitate salivation during coronavirus disease 2019 testing. Twenty healthy adult women participated in the study. The participants were allocated to 2 groups: presentation and non-presentation (n = 10; with and without presentation of a plum pickle, respectively), and eating and non-eating (n = 10; with and without consumption of plum pickle, respectively). We recorded the number of saliva swallows in 1 minute under each condition, using a swallowing test device, which attached film sensors to the hyoid bone and thyroid cartilage. There was a significant difference in the number of swallows between the non-presentation and presentation groups ( P < .01, r = 0.89, Z = -2.82) as well as between the non-eating and eating groups ( P < .01, r = 0.85, Z = -2.68). The strength of 3 factors, namely: direct stimulation with citric acid, saliva buffer capacity, and motor learning, may have affected the results. Our study suggests that saliva collection using the plum pickle is an effective complementary method for facilitating salivation. This technique may be useful in avoiding the risk associated with citric acid intake and for efficient specimen collection during coronavirus disease 2019 testing. In the future, we need to verify this method in elderly participants in a clinical setting.

Impacts of body positions on the geniohyoid muscle contraction and swallowing difficulty in healthy adults.

Body positions affect swallowing and gastroesophageal reflux. Swallowing impairment is one of the main causes of aspiration pneumonia. To prevent pneumonia, evaluation of body positions on gastroesophageal reflux recommended 30 degrees or higher semi-recumbent positions. The geniohypoid muscle and tongue play central roles in swallowing. However, the effects of body positions on contracting rates in the geniohyoid muscle and tongue pressure are unclear. Moreover, correlations between geniohyoid muscle contracting rates and subjective swallowing difficulties are unclear. This study aimed to identify the proper body positions on contracting rates in the geniohyoid muscle, tongue pressure, and subjective swallowing difficulties. Twenty healthy adults swallowed 15- or 50 ml of water at 90 degrees sitting, 60- and 30 degrees semi-recumbent, and 0 degrees supine positions. We scored the subjective swallowing difficulties and measured the tongue pressure and the number of swallows. An ultrasound evaluated the geniohyoid muscle size and contracting rates. At sitting and 60 degrees semi-recumbent positions, the geniohyoid muscle showed greter contracting rates than at 30 degrees semi-recumbent and supine postions (P < 0.05), which resulted in easier swalloiwng. Greater tongue pressure was weakly correlated with fewer swallows (r = -0.339, P = 0.002), whereas the body positions did not affect. Considering swallowing and gastroesophageal reflux together, a trunk angle of 60 degrees or more might be beneficial for reducing the risk of aspiration.

Normative Reference Values for FEES and VASES: Preliminary Data From 39 Nondysphagic, Community-Dwelling Adults.

The aim of this study was to establish preliminary reference values for the Visual Analysis of Swallowing Efficiency and Safety (VASES)-a standardized rating methodology used to evaluate swallowing safety and efficiency for flexible endoscopic evaluation of swallowing (FEES). FEES were completed in nondysphagic, community-dwelling adults using a standardized protocol of 15 swallowing trials that varied by bolus size, consistency, contrast agent, and swallowing instructions. FEES were blindly analyzed using VASES. Primary outcome measures included bolus location at swallow onset, Penetration-Aspiration Scale (PAS) scores, and percentage-based residue ratings for six anatomic landmarks. Secondary outcome measures included sip size, bite size, and number of swallows. Thirty-nine healthy adults completed the study, yielding an analysis of 584 swallows. Swallows were initiated with the bolus in the pharynx for 41.8% of trials. PAS 1 was the most common score, accounting for 75.3% of trials, followed by PAS 3, which accounted for 18.8% of trials. When residue was present (> 0%), the amount was relatively small across all anatomic landmarks, with median residue ratings of 2.0% (oropharynx), 1.5% (hypopharynx), 3.0% (epiglottis), 3.0% (laryngeal vestibule), and 3.5% (vocal folds). Five events of aspiration were observed, which were characterized by subglottic residue ratings of 1%, 3%, 10%, 24%, and 90%. The average sip size of self-selected volume cup sips of water was 19.8 ml, and the average bite size of a 3.0-g saltine cracker was 1.33 g. Moreover, 78% of the trials in this study protocol (except 90-ml trials) were completed in a single swallow. The results from this study provide preliminary norms for VASES that could be used as a reference when assessing functional swallowing outcomes during FEES. While this is an important first step in establishing norms for FEES and VASES, clinicians and researchers should be mindful that the normative reference values from this study are from a relatively small study sample (N = 39), with most people below the age of 60 years (n = 30). Future research should expand on these norms by including a greater number of people across the age continuum and with greater racial, ethnic, and gender diversity. Supplemental Material and Open Science Form: https://doi.org/10.23641/asha.23504325.

Beef and plant-based burgers' mastication parameters depend on texture rather than on serving conditions.

Previous studies dealing with plant-based meat analogs confirmed the potential of oral processing methods to identify options for improving those products. Knowing that sensory perception can be influenced by adding condiments, this short communication aimed to investigate the texture and oral processing of four plant-based burger analogs and a beef burger when consumed in portions or as part of model meals with buns and sides. Texture profile analysis indicated that beef burgers and analog E were the toughest. Two analogs (B and S) showed textures close to beef, while one (analog D) displayed significantly lower values for hardness, toughness, cohesiveness, and springiness. The instrumental data was only partly reflected in the mastication parameters. Adaptations in mastication behavior were expected, but differences between the plant-based analogs were smaller than anticipated, although clear differences were observed for consumption time, number of chews and number of swallows. On the whole, mastication patterns concurred within different consumption scenarios (portions, model burgers), and significant correlations with instrumental texture were obtained.

Dietary intakes of individuals with temporomandibular disorders: A comparative study.

There are some studies regarding the potential effects of temporomandibular disorders (TMD) on food intake and eating habits, however the comparison of nutritional intakes and status of individuals with and without TMD have not been adequately reported. Thus, the study aimed to assess the dietary intakes of individuals with TMD, and investigate if there is a difference in nutritional intakes between healthy individuals with and without TMD. Individuals were grouped as 'study group (with TMD)' versus 'control group (no TMD)' according to Fonseca Anamnestic Index. The Oral Health Impact Profile-14 (OHIP-14) was used to assess oral health-related quality of life. Chewing function was evaluated with the Test of Masticating and Swallowing Solids (TOMASS). A 24-h dietary recall method was used to measure daily dietary intakes of the participants, and daily energy, macro- and micronutrient intakes were calculated. In addition, all drinks and foods in dietary records were classified under a specific modification level as 'Liquid-blenderized', 'Minced-moist & soft' and 'Easy-to chew & regular solid foods'. The participants in the study group (30 participants) had higher OHIP-14 score (p < .01) than control group (30 participants). According to TOMASS, number of bites (p = .003) and total time (p = .007) were both higher in the study group than control group. There was no difference in the number of chewing cycles (p = .100) and number of swallowing (p = .764) between groups. No difference was detected between groups in terms of energy, protein, carbohydrate and fat intake. There was no significant difference between groups in mean percentage of energy and macronutrient intakes from modified and regular food textures (p > .05). This study showed that there was no difference between individuals with and without TMD in terms of dietary intakes. The study results suggest that nutritional status of individuals with TMD is similar with healthy individuals without TMD.

Comparison of Oropharyngeal Efficiency Between Two Popular Brands of Marie Biscuits.

The main objective of the study was to compare four measures of TOMASS (number of bites, number of masticatory cycles, number of swallowing and total time taken) across brands of Marie biscuits and gender. The study employed a cross-sectional design with nonrandomized convenience sampling. A total of 60 participants (30 females and 30 males) were recruited for the study in the age range of 18 to 26 years. Prior to enrolment in the study, the participants were screened for potential speech and swallowing issues. Two commercially available crackers (biscuits) in India, Sunfeast Marie Light and Britannia Marie Gold were used. Video recordings of the participants eating the biscuits were analyzed to document four measures of TOMASS. The mean values obtained on all the measures for males were lesser than mean values for females for both the biscuits. Mann-Whitney U test revealed a statistically significant difference across number of swallows and total time taken across gender. There were no significant differences across biscuits on the four TOMASS measures. It can be concluded that the TOMASS measures were near similar for both brands of Marie biscuits. Thus, any of these two brands of Marie could be used for clinical swallow evaluation. However, gender needs to be kept in mind, while interpreting the results of TOMASS. Future studies need to be conducted with other brands of Marie biscuit and in other age groups.

Thickened Water Ingestion in Healthy Men and Women

ObjectiveTo assess, in men and women without dysphagia, the ingestion of thickened water as used in the treatment of patients with dysphagia. The hypothesis was that they have different dynamics of thickened water ingestion. MethodA sample of 34 men (mean age 36 years) and 49 women (mean age 33 years) were assessed. In random order, they ingested 100 mL of pure water and 100 mL of water with 1.2 g, 2.4 g, and 3.6 g of food thickener, containing maltodextrin, xanthan gum, and potassium chloride. It was measured the time they took to ingest the whole volume, the number of swallows, the interval between swallows, the ingestion flow, the volume in each swallow, and the self-perceived difficulty ingesting the water.ResultsWomen took longer to ingest the 100 mL in all the water consistencies and had less ingestion flow. Women ingested less volume in each swallow when 1.2 g of thickener was added to the water. There was no difference between men and women in difficulty ingesting the water. The greater consistency increased the time and decreased the flow of ingestion.ConclusionWater ingestion with different consistencies is slower in women than in men.

The Safety of Oral Rehydration Solution Jelly for Water and Electrolyte Intake in Patients with Dysphagia.

Oral rehydration solutions (ORSs) are effective in replacing fluids and electrolytes and are widely used. OS-1 Jelly (Otsuka Pharmaceutical Factory, Tokushima, Japan) is a jelly drink corresponding to code 2-1 of the 2021 Japanese Dysphagia Diet. Although jelly drinks are less likely to be aspirated than liquids, their physical properties vary depending on the product. Therefore, the severity of dysphagia may affect intake status. This study aimed to investigate the association between the intake status of ORS jelly and swallowing function. Thirty-six patients with dysphagia who required videoendoscopic swallowing evaluation at our university hospital were enrolled. Videoendoscopic swallowing evaluation was performed, and each participant swallowed 5 mL of OS-1 Jelly or thickened water modified to International Dysphagia Diet Standardization Initiative (IDDSI) level 2 three times. Statistical analysis was performed to determine the difference in the number of swallows, time until the swallowing reflex, position for inducing the swallowing reflex, presence of pharyngeal residue, penetration, or aspiration between ORS jelly and thickened water. The time until the swallowing reflex was induced and the position of the swallowing reflex triggered were significantly earlier for ORS jelly (p=0.012, p=0.001). The incidence of pharyngeal residue was significantly lower with ORS jelly (p=0.002). The Penetration-Aspiration Scale score was similar for both samples (p=0.062), and no aspiration was observed in either sample. Patients with dysphagia who can swallow thickened water modified to IDDSI level 2 can consume ORS jelly. ORS jelly, which requires no thickening and can be easily and safely consumed, is effective for water and electrolyte intake in patients with dysphagia.

Chewing skills in two and three year old children: Gender and age comparisons on an adapted version of the test of mastication and swallowing (TOMASS-C)

Purpose Few assessment tools objectively measure chewing skills in the paediatric population. There is a need for assessment tools that use consistent foods so comparisons can be made between typically developing children and children with paediatric feeding disorders, and to measure the efficacy of treatment. The Test of Masticating and Swallowing Solids for adults (TOMASS) and children (TOMASS-C) are assessments that use a cracker as a consistent measure to assess chewing skills. Normative data exist for children over 4 years, however, no data are available for younger children. This study investigated age and gender-related differences in mastication skills in typically developing children aged 2–3 years when eating a cracker. Method Thirty participants aged 2;0–3;10 were assessed using an adapted version of the TOMASS-C. Participants were required to eat a single Arnott’s Salada cracker, and the number of bites, masticatory cycles, swallows, and duration of time to finish the cracker were measured. Result Two-year-old children used more masticatory cycles and took longer to finish the cracker than 3-year-old children. There were no significant effects of age on the number of swallows and number of bites, and no significant differences between boys and girls. Conclusion This study provides preliminary normative data for chewing skills in children aged 2 and 3 years and confirms that the TOMASS-C is sensitive to developmental changes in mastication within this younger age range. These results expand our understanding of oral motor and chewing development in children.

Stimulation of the center of the lateral reticular nucleus suppresses the swallowing reflex in rats

Morphological studies have demonstrated that the lateral reticular nucleus (LRt) receives fibers projected from sites that are related to control of the swallowing reflex. Although the LRt may therefore be related to control of the swallowing reflex, the functional role of the LRt in the swallowing reflex remains unknown. The present study examined whether the swallowing reflex is modulated by stimulation of the LRt. These experiments were performed on rats anesthetized by urethane. The swallowing reflex was evoked by repetitive electrical stimulation of the superior laryngeal nerve (SLN) and was identified by electromyographic activities from the mylohyoid muscle. Electrical stimulation was applied to the LRt or glutamate was injected into the LRt. The number of swallows was reduced, and the latency of the onset of the first swallow was increased during electrical stimulation near the middle of the rostrocaudal direction of the LRt. The number of swallows was reduced, and the latency of onset of the first swallow increased after microinjection of glutamate near the rostrocaudal center of the LRt. The present study suggests that the LRt is involved in control of the swallowing reflex.