Résumé
Objective@#To compare the findings of videofluoroscopic swallowing study (VFSS) in patients with stroke-associated pneumonia (SAP). @*Methods@#Between January 2015 and June 2019, 1245 patients diagnosed with pneumonia underwent VFSS examination. Data were collected through retrospective chart reviews. Depending on the diagnosis, 378 post-stroke patients identified were classified into two groups: 327 non-aspiration pneumonia (non-AP) and 51 aspiration pneumonia (AP). Aspiration pneumonia was diagnosed both clinically and radiologically. VFSS results included 11 items of functional dysphagia scoring (FDS) and 8 points of penetration-aspiration scale (PAS) that analyze the swallowing function by anatomical site. @*Results@#Based on the FDS score, the AP group showed significantly higher values in residue in pyriform sinuses (P= 0.01), as compared to the non-AP group. There was a significant difference in the PAS score between both groups (P＜0.001). @*Conclusion@#Based on the FDS results, AP in SAP is associated with residue in piriform sinuses. VFSS tests therefore have the potential to be clinically applied to predict the occurrence of aspiration pneumonia in stroke patients.
Résumé
Clay-shoveler’s fractures are rare stress-type avulsion fractures of the spinous processes especially in sports. There have been two case reports that discussed clay-shoveler’s fractures in golf. A 36-year-old beginner golfer presented with a pain in the back after practicing golf swing. No fractures were detected using cervical radiography; however, computed tomography (CT) and magnetic resonance imaging (MRI) revealed T2∼T3 spinous process fractures. The patient was treated conservatively and his pain subsided. The mechanism of injury is speculated to that of clay-shoveler’s fractures. Therefore, if a golfer suffers persistent pain in the cervicothoracic region, clay-shoveler’s fracture is one possibility to consider.
Résumé
Clay-shoveler’s fractures are rare stress-type avulsion fractures of the spinous processes especially in sports. There have been two case reports that discussed clay-shoveler’s fractures in golf. A 36-year-old beginner golfer presented with a pain in the back after practicing golf swing. No fractures were detected using cervical radiography; however, computed tomography (CT) and magnetic resonance imaging (MRI) revealed T2∼T3 spinous process fractures. The patient was treated conservatively and his pain subsided. The mechanism of injury is speculated to that of clay-shoveler’s fractures. Therefore, if a golfer suffers persistent pain in the cervicothoracic region, clay-shoveler’s fracture is one possibility to consider.
Résumé
Post-stroke spasticity is a common complication that causes limitations of function, pain and decrement of the quality of life. Although botulinum toxin injection and anti-spastic medications are effective and widely used for the management of post-stroke spasticity, clinical applications are often limited in stroke patients because of their invasiveness and systemic side effects. Alternatively, we performed upper limb muscle-belly extracorporeal shock wave therapy (ESWT) to resolve problematic spasticity in two subacute stroke patients. Serial quantitative ultrasonographic measurements of spastic muscle were conducted to investigate the rheological changes in chronological order by echogenicity comparison. After 4 sessions of weekly ESWT, gradual decrements of clinical spasticity parameters and muscle echogenicity were observed and lasted for 1 week after the cessation of the therapy. ESWT may be a useful alternative management for treating post-stroke spasticity.