Quality of life and symptom assessment in paraesophageal hernias: a systematic literature review of reporting standards
Nikhil PatelAiysha PuriViknesh SounderajahLorenzo FerriEwen A. GriffithsDonald E. LowNick MaynardCarmen MuellerManuel PeraMark I. van Berge HenegouwenDavid I. WatsonGiovanni ZaninottoGeorge B. HannaSheraz R. Markar
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Summary Background Paraesophageal hernias (PEH) present with a range of symptoms affecting physical and mental health. This systematic review aims to assess the quality of reporting standards for patients with PEH, identify the most frequently used quality of life (QOL) and symptom severity assessment tools in PEH and to ascertain additional symptoms reported by these patients not captured by these tools. Methods A systematic literature review according to PRISMA protocols was carried out following a literature search of MEDLINE, Embase and Cochrane databases for studies published between January 1960 and May 2020. Published abstracts from conference proceedings were included. Data on QOL tools used and reported symptoms were extracted. Results This review included 220 studies reporting on 28 353 patients. A total of 46 different QOL and symptom severity tools were used across all studies, and 89 different symptoms were reported. The most frequently utilized QOL tool was the Gastro-Esophageal Reflux Disease-Health related quality of life questionnaire symptom severity instrument (47.7%), 57.2% of studies utilized more than 2 QOL tools and ‘dysphagia’ was the most frequently reported symptom, in 55.0% of studies. Notably, respiratory and cardiovascular symptoms, although less common than GI symptoms, were reported and included ‘dyspnea’ reported in 35 studies (15.9%). Conclusions There lacks a QOL assessment tool that captures the range of symptoms associated with PEH. Reporting standards for this cohort must be improved to compare patient outcomes before and after surgery. Further investigations must seek to develop a PEH specific tool, that encompasses the relative importance of symptoms when considering surgical intervention and assessing symptomatic improvement following surgery.Background
Dysphagia is a frequent finding in patients with HD. Up to 75% of the patients die of aspiration pneumonia. Symptoms of dysphagia already start in the very beginning of HD and become more severe when the disease progresses. The different symptoms of dysphagia in HD are already known. It is also known that there are treatment possibilities for dysphagia, such as the Masako and the Mendelsohn manoeuvre, but these are validated for other diseases, like a cerebro vascular accident or Parkinson's disease. There is no evidence that patients with HD benefit from this treatment. In our experience with HD, patients do benefit from dysphagia treatment. In this presentation dysphagia symptoms are presented using X-ray imaging, further, some treatment possibilities for dysphagia will be introduced by presenting a case study.Method
X-ray images on dysphagia symptoms during the different stages of HD were collected. More than 30 HD patients with dysphagia were treated using the Masako and Mendelsohn manoeuvre. For one specific patient a video was made to make a report of her swallowing progress.Results
X-ray images of dysphagia in HD were collected and will be shown in the presentation. More than 30 HD patients were treated for dysphagia using the Masako and Mendelsohn manoeuvre. Most patients could perform at least one manoeuvre, and most patients reported that they benefit from the treatment. For one specific patient a video was made to document the swallowing progress. The video was published on www.huntingtonplein.nl.Conclusion
An impressive collection of X-ray imaging on dysphagia in HD exists. For treatment possibilities, patients with HD seem to benefit from especially the Masako and Mendelsohn manoeuvre. For one patient the findings were documented and recorded on a video. This video was published on www.huntingtonplein.nl, and parts of this video will be presented during the presentation.Aspiration Pneumonia
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Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews
Abstract Background Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. Objectives To compare search methods in systematic reviews of adverse effects with other reviews. Methods The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Results Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials ( RCT s). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. Conclusions The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE . However, reviews of adverse effects are more likely to include a range of study designs (not just RCT s) and search beyond MEDLINE .
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[Objective]To discussion the incidences of dysphagia after stroke at different age stages and in different parts of lesions,as well as corresponding measures.[Methods]The proportions of dysphagia of 620 cases of stroke patients in different age stages and parts of lesions were compared.[Results]The 60-90 age group(77%),the basal ganglia(48%)and brainstem lesion(23%)had higher proportion of dysphagia,which were significantly different with other age stages and other parts of lesions(P﹤0.05).[Conclusions]Elderly patients after stroke are more prone to be with dysphagia than young patients,Basal ganglia and brainstem lesions more easily cause dysphagia than other parts of lesions.
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ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Dylczyk-Sommer A. Dysphagia. Part 2: Dysphagia in intensive care patients. Anaesthesiology Intensive Therapy. 2020;52(3):233-236. doi:10.5114/ait.2020.98490. APA Dylczyk-Sommer, A. (2020). Dysphagia. Part 2: Dysphagia in intensive care patients. Anaesthesiology Intensive Therapy, 52(3), 233-236. https://doi.org/10.5114/ait.2020.98490 Chicago Dylczyk-Sommer, Anna. 2020. "Dysphagia. Part 2: Dysphagia in intensive care patients". Anaesthesiology Intensive Therapy 52 (3): 233-236. doi:10.5114/ait.2020.98490. Harvard Dylczyk-Sommer, A. (2020). Dysphagia. Part 2: Dysphagia in intensive care patients. Anaesthesiology Intensive Therapy, 52(3), pp.233-236. https://doi.org/10.5114/ait.2020.98490 MLA Dylczyk-Sommer, Anna. "Dysphagia. Part 2: Dysphagia in intensive care patients." Anaesthesiology Intensive Therapy, vol. 52, no. 3, 2020, pp. 233-236. doi:10.5114/ait.2020.98490. Vancouver Dylczyk-Sommer A. Dysphagia. Part 2: Dysphagia in intensive care patients. Anaesthesiology Intensive Therapy. 2020;52(3):233-236. doi:10.5114/ait.2020.98490.
Aspiration Pneumonia
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In this article, we describe the strengths and weaknesses of several methods of locating systematic reviews, including electronic databases such as MEDLINE, Best Evidence (the electronic version of ACP Journal Club and Evidence-Based Medicine), and the Cochrane Library (a regularly updated source of reviews and controlled trials produced by the Cochrane Collaboration). We also present steps that can be used to critically appraise review articles; as an example, we use a systematic review that evaluates the gastrointestinal toxicity of various nonsteroidal anti-inflammatory drugs in the context of a clinical scenario.
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Objective:Todetermineifcomorbiddysphagiainallhospitalizedpatientshasthepotentialtoprolonghospitalstay and increase morbidity. Dysphagia is increasingly prevalent with age and comorbid medical conditions. Our researchgrouphaspreviouslyshownthatdysphagiaisabad prognostic indicator in patients with stroke. Design: Analysis of national database. Main Outcome Measures: The National Hospital Discharge Survey (NHDS), 2005-2006, was evaluated for presence of dysphagia and the most common comorbid medicalconditions.Patientdemographics,associateddisease,lengthofhospitalstay,morbidityandmortalitywere also evaluated. Results: There were over 77 million estimated hospital admissionsintheperiodevaluated,ofwhich271983were associated with dysphagia. Dysphagia was most commonlyassociatedwithfluidorelectrolytedisorder,esophagealdisease,stroke,aspirationpneumonia,urinarytract infection,andcongestiveheartfailure.Themediannumber of hospitalization days for all patients with dysphagia was 4.04 compared with 2.40 days for those patients without dysphagia. Mortality increased substantially in patients with dysphagia associated with rehabilitation, intervertebral disk disorders, and heart diseases. Conclusions:Dysphagiahasasignificantimpactonhospitallengthofstayandisabadprognosticindicator.Early recognition of dysphagia and intervention in the hospitalized patient is advised to reduce morbidity and length of hospital stay.
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High resolution manometry
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Objective With the recent aging trend in the Japanese population, dysphagia appears to be increasing. However, few epidemiologic surveys have been conducted to determine the prevalence of dysphagia in local inhabitants. Ohkuma et al. prepared a highly reliable questionnaire using a simple test and safe examination method. We investigated the presence/absence of symptoms of dysphagia in local inhabitants, evaluated their association with subjective symptoms, and examined whether the inhabitants were following a particular diet, which is the most important factor in management of dysphagia. Methods A cross-sectional study involving 743 inhabitants (age: over 20) of an isolated island was performed. Each subject was asked basic questions (awareness about the presence/absence of dysphagia and dietary habits), and the data was analyzed by chi-square test. Based on their responses, dysphagia incidence was determined and rated on a 3-category scale (severe, mild, and no dysphagia). Results Responses were recollected from 368 subjects (response rate, 49.5%). The percentage of subjects aware of dysphagia in the severe, mild, and no dysphagia groups was 13.8%, 3.2%, and 0%, respectively and the percentage of subjects who changed their dietary habits was 17.2%, 2.6%, and 0%. These percentages were significantly higher in the severe group than in the mild and no dysphagia groups, though the value was less than 20% in the 3 groups. Conclusion Most subjects in the present study were unaware of dysphagia, suggesting that patients with dysphagia tend to be unaware of the key symptoms of dysphagia.
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