A new product of minced fish meat with high pressurization was produced for individuals with difficulties in mastication and swallowing and for elderly people on a dysphagia diet. Minced fish meat was added to distill...A new product of minced fish meat with high pressurization was produced for individuals with difficulties in mastication and swallowing and for elderly people on a dysphagia diet. Minced fish meat was added to distilled water at ratios of 1:0.5, 1:1 and 1:1.5 by mixing with 1.5% NaCl. Half of the samples were modified by heating (H-gels) and half by high pressure at 400 MPa for 20 min (P-gels). The hardness of the H- and P-gels was 0.97 to 2.83 [×104 N/m2] and 2.25 to 10.03 [×104 N/m2], respectively. For SDS-PAGE analysis, low-molecular-weight proteins in the P-gel were released more easily than those in the H-gel by the difference in gel formation, which is related to the detection of α-actinin in the supernatant of pressurized actomyosin. The ultrastructural observations showed a regular filamentous network structure in the P-gel. For the sensory evaluation, the P-gels were determined to be more lustrous, juicier, more moderately elastic and smoother. These gels conformed to the criteria of Dietary Uses for Dyspahgic Patients and Japanese Dysphagia Diet 2013. High pressure treatment denatured the protein composition of the minced fish meat gel, which led to a clearer three-dimensional network structure. High pressure made it possible to form minced fish meat gels with a low salt concentration. Obtained minced fish meat gels were improved in textural properties by addition of water and under high pressure, which were different from the ones by traditional heating. Improvement in textural properties will raise the sensory evaluation for elderly and dysphagic people. It is expected that the pressurized gels will be practical for a dysphagia diet.展开更多
AIM: To identify the cut-off value for predicting the ability of elderly patients with dysphagia to swallow pureed diets using a new endoscopy scoring method. METHODS: Endoscopic swallowing evaluation of pureed diets ...AIM: To identify the cut-off value for predicting the ability of elderly patients with dysphagia to swallow pureed diets using a new endoscopy scoring method. METHODS: Endoscopic swallowing evaluation of pureed diets were done in patients ≥ 65 years with dysphagia. The Hyodo-Komagane score for endoscopic swallowing evaluation is expressed as the sum(0-12) of four degrees(0-3) with four parameters:(1) salivary pooling in the vallecula and piriform sinuses;(2) the response of glottal closure reflex induced by touching the epiglottis with the endoscope;(3) the location of the bolus at the time of swallow onset assessed by "white-out" following swallowing of test jelly; and(4) pharyngeal clearance after swallowing of test jelly. We used receiver operating characteristic(ROC) curve analysis to retrospectively analyze the association between the total score and successful oral intake of pureed diets. RESULTS: One hundred and seventy-eight patients were enrolled including 113 men(63%), mean age 83 years(range, 66-98). One hundred and twenty-six patients(71%) were able to eat pureed diets during the observation period(mean ± SD, 19 ± 14 d). In ROC analysis, the cut-off value of the score for eating the pureed diets was 7(sensitivity = 0.98; specificity = 0.91).CONCLUSION: The Hyodo-Komagane endoscopic score is useful to predict the ability to eat pureed diets in elderly patients with dysphagia.展开更多
文摘A new product of minced fish meat with high pressurization was produced for individuals with difficulties in mastication and swallowing and for elderly people on a dysphagia diet. Minced fish meat was added to distilled water at ratios of 1:0.5, 1:1 and 1:1.5 by mixing with 1.5% NaCl. Half of the samples were modified by heating (H-gels) and half by high pressure at 400 MPa for 20 min (P-gels). The hardness of the H- and P-gels was 0.97 to 2.83 [×104 N/m2] and 2.25 to 10.03 [×104 N/m2], respectively. For SDS-PAGE analysis, low-molecular-weight proteins in the P-gel were released more easily than those in the H-gel by the difference in gel formation, which is related to the detection of α-actinin in the supernatant of pressurized actomyosin. The ultrastructural observations showed a regular filamentous network structure in the P-gel. For the sensory evaluation, the P-gels were determined to be more lustrous, juicier, more moderately elastic and smoother. These gels conformed to the criteria of Dietary Uses for Dyspahgic Patients and Japanese Dysphagia Diet 2013. High pressure treatment denatured the protein composition of the minced fish meat gel, which led to a clearer three-dimensional network structure. High pressure made it possible to form minced fish meat gels with a low salt concentration. Obtained minced fish meat gels were improved in textural properties by addition of water and under high pressure, which were different from the ones by traditional heating. Improvement in textural properties will raise the sensory evaluation for elderly and dysphagic people. It is expected that the pressurized gels will be practical for a dysphagia diet.
文摘AIM: To identify the cut-off value for predicting the ability of elderly patients with dysphagia to swallow pureed diets using a new endoscopy scoring method. METHODS: Endoscopic swallowing evaluation of pureed diets were done in patients ≥ 65 years with dysphagia. The Hyodo-Komagane score for endoscopic swallowing evaluation is expressed as the sum(0-12) of four degrees(0-3) with four parameters:(1) salivary pooling in the vallecula and piriform sinuses;(2) the response of glottal closure reflex induced by touching the epiglottis with the endoscope;(3) the location of the bolus at the time of swallow onset assessed by "white-out" following swallowing of test jelly; and(4) pharyngeal clearance after swallowing of test jelly. We used receiver operating characteristic(ROC) curve analysis to retrospectively analyze the association between the total score and successful oral intake of pureed diets. RESULTS: One hundred and seventy-eight patients were enrolled including 113 men(63%), mean age 83 years(range, 66-98). One hundred and twenty-six patients(71%) were able to eat pureed diets during the observation period(mean ± SD, 19 ± 14 d). In ROC analysis, the cut-off value of the score for eating the pureed diets was 7(sensitivity = 0.98; specificity = 0.91).CONCLUSION: The Hyodo-Komagane endoscopic score is useful to predict the ability to eat pureed diets in elderly patients with dysphagia.
