c NORMAL SWALLOWING Sherrington originally studied swallowing in decerebrate cats. He described the effect of various agents—whiskey, oil, water—which, when dropped onto the area supplied by the superior laryngeal nerve, would elicit a “swallow”. This “swallow” did not involve any preparation of a bolus or any lingual propulsion, and was justifiably considered to be a reflex. I will use the ter...

OBJECTIVE As part of our ongoing quality improvement effort, we evaluated our conventional approach to post-oesophagectomy management by comparing it to an alternative postoperative management pathway. METHODS Medical records from 386 consecutive patients undergoing oesophagectomy with gastric conduit for oesophageal cancer or Barrett's oesophagus with high-grade dysplasia were analysed retro...

BACKGROUND Pills (tablets and capsules) are widely used to administer prescription drugs or to take supplements such as vitamins. Unfortunately, little is known about how much effort it takes Americans to swallow these various pills. More specifically, it is not known to what extent hard-to-swallow pills might affect treatment outcomes (eg, interfering with adherence to prescribed medications o...

Our patient differs from most others described in that the symptoms and E.C.G. changes were readily reproduced on swallowing, without resort to balloon dilatation of the oesophagus. In addition his syncope was a presenting symptom of oesophageal carcinoma. Since an oesophageal lesion is commonly found in patients with "swallow syncope" we suggest that a barium swallow should be performed in all...

Figure 1. High-resolution manometry findings. (A) It illustrates a swallow with rapid contractile front velocity (CFV) attributable to spasm. The CFV of 30 and 50 mmHg isobaric contours parallel each other, indicating that no compartmentalized esophageal pressurization has occurred. The CFV value is 10 cm/sec with normal esophagogastric junction relaxation. (B) It shows a swallow with normal CF...

BACKGROUND Epiphrenic diverticulum is an uncommon disorder of the distal third of the esophagus. We report the case of a 73-year-old woman with a large symptomatic esophageal epiphrenic diverticulum, diffuse nonspecific esophageal dysmotility, and a hiatal hernia. METHODS Surgery was indicated by the patient's symptoms, the size of the diverticulum (maximum diameter 10 cm), and the associated...

McGraw et al. (2004) have recently presented evidence that barn swallow (Hirundo rustica) feathers from the forehead and throat do not contain carotenoids, and melanins are the determinants of their chestnut coloration. This contradicts evidence I presented in a book entitled The colour of flight: carotenoids in bird plumage (Stradi, 1995, 1998), where a tridimensional high-performance liquid c...

OBJECTIVES To determine symptoms and findings in patients with dysphagia related to epiglottic dysfunction. To analyze outcomes in patients who underwent partial epiglottidectomy due to dysphagia related to epiglottic dysfunction. STUDY DESIGN Review and analysis of clinical data obtained as part of the diagnosis and treatment of patients with dysphagia related to epiglottic dysfunction. ME...

BACKGROUND Dysphagia is one of the most dangerous symptoms of acute stroke. Various screening tools have been suggested for the early detection of this condition. In spite of conflicting results, measurement of oxygen saturation (SpO2) during clinical swallowing assessment is still recommended by different national guidelines as a screening tool with a decline in SpO2 ≥2% usually being regarded...