Problems experienced when swallowing solid oral dosage forms in older Japanese patients with dysphagia: A cross-sectional study.

AIMS: We aimed to assess the difficulty in taking solid oral dosage forms (SODFs) among older people with dysphagia and clarify the relationship between difficulty in swallowing SODFs and swallowing function. METHODS AND RESULTS: Outpatients from a dysphagia clinic aged ≥65 years were asked yes-or-no questions about the applicability of eight items regarding difficulty in taking SODFs. Additionally, a videofluorographic swallowing study (VFSS) was performed to assess their swallowing function. The Kruskal-Wallis test and Spearman's rank correlation coefficient were used to analyze the relationship between difficulty in taking SODFs and swallowing function. RESULTS: Among the 93 participants, the average number of SODFs consumed was 5.8 ± 3.1. In the questionnaire, the average number of "yes" answers was 2.2 ± 2.2, and 65 patients (71.0%) answered "yes" to at least one question. Additionally, no significant relationship was observed between the perceived difficulty in swallowing SODFs and VFSS findings. CONCLUSION: Approximately 70% of participants reported subjective difficulty in taking SODFs, showing that patients uniformly reported perceived difficulty in taking SODFs regardless of actual swallowing function. The results of this study suggest that patients must be questioned thoroughly about their SODFs use, regardless of the objective severity of their dysphagia.

Experimental study on the pressure and pulse wave propagation in viscoelastic vessel tubes-effects of liquid viscosity and tube stiffness.

A pulse wave is the displacement wave which arises because of ejection of blood from the heart and reflection at vascular bed and distal point. The investigation of pressure waves leads to understanding the propagation characteristics of a pulse wave. To investigate the pulse wave behavior, an experimental study was performed using an artificial polymer tube and viscous liquid. A polyurethane tube and glycerin solution were used to simulate a blood vessel and blood, respectively. In the case of the 40 wt% glycerin solution, which corresponds to the viscosity of ordinary blood, the attenuation coefficient of a pressure wave in the tube decreased from 4.3 to 1.6 dB/m because of the tube stiffness (Young's modulus: 60 to 200 kPa). When the viscosity of liquid increased from approximately 4 to 10 mPa·s (the range of human blood viscosity) in the stiff tube, the attenuation coefficient of the pressure wave changed from 1.6 to 3.2 dB/m. The hardening of the blood vessel caused by aging and the increase of blood viscosity caused by illness possibly have opposite effects on the intravascular pressure wave. The effect of the viscosity of a liquid on the amplitude of a pressure wave was then considered using a phantom simulating human blood vessels. As a result, in the typical range of blood viscosity, the amplitude ratio of the waves obtained by the experiments with water and glycerin solution became 1:0.83. In comparison with clinical data, this value is much smaller than that seen from blood vessel hardening. Thus, it can be concluded that the blood viscosity seldom affects the attenuation of a pulse wave.