A 65‐year‐old man presented with progessive dysphagia, which proved to be the first clinical manifestation of a periperal lung carcinoma (secondary to a submucosal metatasis in the esophagus). The lung tumor, hidden by the diaphragm on chest x‐ray, was not suspected until a thoracotomy was done. Although dysphagia is known to be the first manifestation of bron‐chogenic carcinomas, such presentation in a case of a peripheral lung carcinoma has not been well described. This case is reported with a review of the literature for cases with dysphagia secondary to a metastatic tumor in the esophagus.

No description available.

Common presenting symptoms of Lung cancer are cough, hemoptysis, chest pain, dyspnea, pleurisy. Dysphagia is a very uncommon presenting feature of Lung cancer. Incidence of Dysphagia in Lung cancer is unclear from Literature. Causes of Dysphagia in case of Lung cancer are Anatomically classified as Oropharyngeal and Esophageal. Causes of oropharyngeal dysphagia are oral candidiasis, oropharyngeal Metastasis of Lung cancer. Causes of esophageal dysphagia are Cervical or Mediastinal Lymphadenopathy, Motor dysfunction because of Brain stem Metastasis, Lambert eaton syndrome, Esophageal candidiasis, Radiation esophagitis. Here by we present an Unusual presentation of an aggressive disease, poorly differentiated SCLC presenting as Mid esophageal dysphagia secondary to extrinsic esophageal compression. 65 year old female with past medical history of Diabetes, Hypertension presented with complaints of worsening sub sternal chest pain radiating to back since last 2 days and progressive dysphagia. Pt underwent Left heart catheterization revealing non obstructive coronary artery disease. Modified Barium swallow showed stasis of contrast in mid esophagus, Endoscopy showed extrinsic compression of the proximal esophagus, normal mucosa. Computerized tomography of chest was done for further evaluation, revealing extensive left cervical, mediastinal, left hilar lymphadenopathy causing extrinsic compression of the esophagus and encasement of the left hilar structures. Further evaluation through Bronchoscopic biopsy of her left upper lobe mass reveals poorly differentiated small cell carcinoma. Staging was performed revealing limited stage disease. Started on concurrent chemotherapy with cisplatin, etoposide and radiation. As SCLC is highly responsive to chemotherapy and radiotherapy sensitive patient got symptomatic relief by the end of first cycle. SCLC is an aggressive lung cancer. As it is a micro metastatic disease in nature at presentation, it’s management is entirely different from Non SCLC. SCLC being an aggressive disease can cause dysphagia in 1-2% during the disease course. SCLC presenting as dysphagia is almost never reported in the literature. Our patient presented with severe dysphagia, described it as “a tennis ball sitting in her food pipe”. Fortunately she presented to the Emergency room with dysphagia and associated chest pain, we were able to make early diagnosis of SCLC, initiate treatment. Delay in the diagnosis lead to rapid progression of disease and poor prognosis. Through our case we wanted to convey that it is very important to obtain meticulous history, keeping broad differentials, which can help improve prognosis. Because not always the presenting features are from the organ of involvement it could be from the contiguous spread or compression.

No description available.

Background: Knowledge translation models to address existing knowledge gaps in different areas of speech-language pathology practice are providing researchers and clinicians the opportunity to improve efficiency and effectiveness of service delivery. As a developing context, public health care in South Africa can scarce afford the luxury of wasting resources and finances on interventions that are inefficient or without proven benefit given the increasing prevalence of chronic burden of disease such as stroke and traumatic related injury, both of which has dysphagia as a symptom. The outcome of the manner, efficiency and consistency of traditional models of dysphagia management currently being implemented in this context were compared to a pre-existing theoretically proven free water protocol for dysphagia management. Method: The primary aim of the current study was to enable knowledge-to-action translation in dysphagia management by determining the feasibility of using a free water protocol for stroke or traumatic brain injured patients presenting with dysphagia in an acute government hospital setting in Gauteng, South Africa. A mouth care training protocol was developed for nurses as a component of the free water protocol. Nurse perceptions on the training and implementation of mouth care were explored. The quantitative aims investigated if there was a difference between traditional and free water management in terms of a) the occurrence of aspiration pneumonia, b) amount of water intake and c) length of hospitalisation. 139 Nurses and 46 patients with dysphagia were participants. A mixed method design was used. The study was conducted in two phases, phase one comprised the ethnography and the nurse training component. Phase two was quantitative and comprised implementation of the free water protocol by the researcher. Thematic content analysis was used for the qualitative data. Quantitative data was analysed using inferential statistics. Results: The mouth care training protocol for nurses was efficient and effective for the current context. Nurses engaged positively with the study by implementing mouth care successfully when necessary for the dysphagic patients. This combined with consistent daily management of dysphagia with patient involvement, facilitated patient compliance, adequate levels of water intake, with no cases of dehydration, and no incidence of aspiration pneumonia at the end of the intervention period. The comparison group in contrast who received the traditional model of dysphagia management showed longer period of hospitalisation and higher consumption of liquids despite recommendations for liquid restricted diets. There were seven cases of aspiration pneumonia at the end of the intervention period in the comparison group. Conclusions & Implications: Despite no statistically significant differences between the study and comparison groups on the specified outcome measures, clinically significant differences were noted. The method employed in the study seemed to facilitate knowledge translation of the free water protocol to a public hospital context in South Africa. The findings of the study suggested that a collaborative partnership between the speech-language pathologist and nurse was attainable and this seemed to have multifaceted mutual benefits to the patient, institution and the respective professions. Improved monitoring of service provision, implementation of protocols based on contextual evidence, importance of knowledge translation in a developing context and an expanded role of the speech-language pathologist responsive to the needs of the context and patient population were some of the implications that arose from the study.

1 Einleitung 2 Überblick über die ungestörte Entwicklung des Essens und Trinkens und deren Einflussfaktoren 3 Diagnostik Kindlicher Dysphagien 4 Überlegungen zum therapeutischen Vorgehen in der ambulanten Praxis 5 Literatur

1. Einleitung 1.1 Schluckstörungen 1.2 Neurophysiologie des Schluckens 2. Diagnostik 2.1 Klinische Schluckuntersuchungen 2.2 Instrumentelle Schluckuntersuchungen 3. Therapie 3.1 Änderung der Nahrungskonsistenz 3.2 Fazilitationstechniken 3.3 Position und Manöver 3.4 Kombinierte Techniken 3.5 Zusammenfassung 4. Ausblick 5 Literatur

1 Einleitung 2 Das Problem der Messbarkeit: Welche Messgrößen kommen in Frage? 3 Wie oft Schlucken ist normal? Schluckfrequenz bei gesunden Erwachsenen 4 Wie viel Schlucken ist normal? Bolusvolumina bei gesunden Erwachsenen 5 Variabilität normaler Funktionen: Mögliche Gründe 6 Fazit 7 Literatur

1 Einleitung und Fragestellung 2 Methode 3 Ergebnis und Diskussion 4 Literatur

Das Herbsttreffen Patholinguistik wird seit 2007 jährlich vom Verband für Patholinguistik e.V. (vpl) durchgeführt. Die Jubiläumsveranstaltung am 19.11.2011 in Potsdam war nicht nur die 5. Auflage der Veranstaltung, sondern auch ein Fest zum 10jährigen Bestehen des Verbandes. Das Thema lautete "Schluck für Schluck: Dysphagietherapie bei Kindern und Erwachsenen". Im vorliegenden Tagungsband finden sich die Artikel der Hauptvorträge sowie die Abstracts der Posterpräsentationen. / The 'Herbsttreffen Patholinguistik' is an annual conference organized by the Association for Patholinguistics (Verband für Patholinguistik e.V./vpl) since 2007. The anniversary event on November 19th, 2011 in Potsdam marked both the 5th edition of this conference series and the 10th birthday of the vpl. The main topic of the meeting was "Sip by sip: Dysphagia therapy in children and adults". These proceedings contain the papers from the invited talks and the abstracts of the poster presentations.