In this context, it is crucial to evaluate swallowing in patients in order to provide them with an optimal rehabilitation menu or nursing foods. However, the number of patients who need rehabilitation for dysphagia or who need nursing care has recently increased in this aging era. Additionally, food intake is related to one's quality of life (QOL). Intake of foods and acquisition of nourishment are crucial in living animals. ![]() Thus, this artificial food bolus would be a promising tool for evaluation of swallowing. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa ![]() The bolus volume before swallowing was below 400 mm 3. The results indicated that Young’s modulus of bolus before swallowing was below 150 kPa. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy). The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. Use of proteolytic enzymes in the treatment of proteinaceous esophageal food impaction. At the least, it deserves some discussion, and maybe an RCT. ![]() Additionally, given the expense, varying access to and invasive quality of endoscopy, an effective therapy/adjunctive therapy like papain could be worth bringing back from the island of exiled medications. There were no esophageal perforations, episodes of aspiration pneumonitis or cases of hemorrhagic pulmonary edema.Īlthough this is one case series and there is likely some selection bias in choosing patients for initial papain treatment versus primary endoscopy, this paper calls into question the dogma against papain. Of those, 87% had resolution of the obstruction with papain alone, and 13% underwent subsequent successful, uncomplicated endoscopic removal. Thoracic surgeons reviewed records for emergency department patients with esophageal food bolus impactions at a single academic medical center from 1999 to 2008 and identified 69 with proteinaceous boluses who were initially treated with papain. But, a recent paper in The Journal of Emergency Medicine brings it back to the table. Many societies and reviews specifically call it “obsolete” or “contraindicated”. However, it fell out of favor in the 1970s and 1980s after a few oft-cited case reports documented esophageal perforation, aspiration pneumonitis, and hemorrhagic pulmonary edema in the setting of its use. Papain, a proteolytic enzyme and meat tenderizer, had been used to relieve food bolus impactions since it was first suggested in 1945.
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