There are data suggesting that women swallow liquids at a lower flow rate and ingest smaller volumes in each swallow than men. Our objective in this work was to compare swallowing in asymptomatic men and women by videofluoroscopy. We studied 18 men [age = 33-77 years, mean = 61 (10) years] and 12 women [age = 29-72 years, mean = 53 (15) years] who swallowed in duplicate 5 and 10 ml of liquid and paste barium boluses. None of the volunteers had dysphagia, neurologic diseases, or oral, pharyngeal, or esophageal diseases. The videofluoroscopic examination showed that for the 5-ml bolus, women had a longer oropharyngeal transit [liquid: men, 0.63 (0.21) s, women, 0.88 (0.39) s; paste: men, 0.64 (0.35) s, women, 0.94 (0.58) s], longer oral transit [liquid: men, 0.41 (0.21) s, women, 0.59 (0.35) s; paste: men, 0.39 (0.28) s, women, 0.59 (0.42) s], and longer pharyngeal clearance [liquid: men, 0.36 (0.11) s, women, 0.45 (0.16) s; paste: men, 0.42 (0.25) s, women, 0.56 (0.27) s] compared with men (p < 0.05). We conclude that there are differences in swallowing between men and women, with women having a longer oropharyngeal transit than men for a 5-ml bolus.

-Background -Swallowing coordination is affected by cortical and subcortical inputs from the central nervous system. Our hypothesis is that the swallowing dynamics may be influenced by gender. Aim -To evaluate the influence of gender on water swallowing dynamics. Methods -We studied 111 health subjects, 36 men, aged 24-77 years (mean: 46.3 ± 16.1 years) and 75 women, aged 22-75 years (mean: 39.6 ± 13.3 years). All volunteers swallowed in triplicate 50 mL of water at 4ºC while precisely timed, when we measured the time to swallow all the volume and counted the number of swallows. We calculated the inter-swallow interval: the time to complete the task, in seconds, divided by the number of swallows; swallowing velocity: volume drunk (mL) by the time taken (s); swallowing volume capacity: volume drunk (mL) divided by the number of swallows. Results -Women had a shorter inter-swallow interval, slower swallowing velocity and lower volume capacity than men. Conclusion -Gender has an effect on water swallowing dynamics, with women having a lower swallowing velocity and a lower volume capacity in each swallow than men.

Background/AimsSwallowing is a complex function with the control of the swallowing center being located in the brain stem. Our aim in this investigation was to evaluate, in healthy volunteers, the oral and pharyngeal transit of 2 bolus volumes and 2 consistencies, and the influence of these boluses on the proportion of pharyngeal clearance duration/hyoid movement duration. MethodsVideofluoroscopic evaluation of swallows was performed in 30 healthy volunteers, aged 29-77 years (mean 58 years). The subjects swallowed in duplicate of 5 mL and 10 mL of thick liquid barium and honey thick barium. We measured the duration of oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement, oropharyngeal transit, and the relation pharyngeal clearance duration/hyoid movement duration. ResultsA 10 mL bolus volume caused a longer UES opening duration than a 5 mL bolus volume, for both consistencies. The pharyngeal transit was longer for honey thick bolus consistency than for thick liquid, with both the volumes of 5 mL and 10 mL. For pharyngeal clearance, the difference was significant only with the 10 mL bolus volume. There was no difference associated with bolus volume or consistency in the relation between pharyngeal clearance duration and hyoid movement duration. ConclusionsIncrease in the swallowed bolus volume causes a longer UES opening duration and an increase in bolus consistency from thick liquid to honey thick causes a longer pharyngeal transit duration. The proportion between pharyngeal clearance and hyoid movement does not change with bolus volume or bolus consistency.

Abstract-In the chronic phase of coarctation hypertension (CH) we have shown both reduction in baroreceptor sensitivity (Hypertension. 1992;19[suppl II]: and normalization of the depressed baroreceptor reflex control of heart rate, even with the persistence of hypertension in losartan-treated animals (Am J Physiol. 1995;269:H812-H818). In the present study we analyzed the effects of angiotensin II blockade on afferent aortic nerve activity of CH and sham-operated groups treated chronically with vehicle or losartan (10 mg/kg per day PO). CH was induced by subdiaphragmatic aortic coarctation, and the treatments lasted 8 days (4 control and 4 experimental days). Aortic pressure (conscious rats) and aortic nerve activity simultaneous to pressure (anesthetized rats) were recorded on the fourth day of the experimental period. Losartan-treated rats showed reduced tail pressure (104Ϯ3 versus 117Ϯ3 mm Hg in the vehicle group). In both groups, aortic coarctation caused a significant increase in pressure (25% and 28%, respectively) and a depression of the aortic nerve activity/pressure relationship when compared with sham-operated coarcted animals. In the physiological range of pressure changes, the depression was significantly smaller after losartan treatment (3.30Ϯ0.33 versus 2.18Ϯ0.37%/mm Hg in the losartan-and vehicle-treated CH groups, respectively, versus 5.05Ϯ0.33%/mm Hg in the sham-operated vehicle-treated group). Angiotensin type 1 (AT 1 ) receptor blockade was also accompanied by reduced variability of the afferent discharge. The data suggested that apart from its pressure effect, angiotensin II acts at AT 1 receptors to decrease the sensitivity of aortic afferents during physiological (Ϯ10 mm Hg) increases and decreases in pressure. Thus, angiotensin II may contribute to reductions of baroreceptor gain in chronic hypertension. (Hypertension. 1998;31:973-977.)Key Words: baroreceptors Ⅲ angiotensin II Ⅲ receptors, angiotensin Ⅲ blood pressure Ⅲ losartan Ⅲ hypertension, coarctation T he presence of an endogenous renin-angiotensin system in brain areas involved in cardiovascular regulation has been confirmed by several techniques.1-3 Stimulation of high-affinity Ang II receptors 4-6 leads to a set of coordinated autonomic responses, yielding increases in blood pressure. [6][7][8] An important central action of Ang II is to modulate the baroreceptor reflex control of heart rate 9 -14 and sympathetic tone, 9,15-18 determining for a given increase in blood pressure small compensatory reflex responses, thus contributing to the maintenance of hypertension.In normotensive freely moving rats, we showed that subpressor doses of Ang II administered either into the nucleus tractus solitarii or into the fourth cerebral ventricle caused a marked blunting of the reflex bradycardia, with the bradycardic response being significantly improved by the blockade of endogenous Ang II with saralasin into the nucleus tractus solitarii. 19 We also showed that rats made hypertensive by subdiaphragmatic aortic constriction presented a signi...

Dysphagia is the most common digestive symptom reported by patients with Chagas' disease. The condition results from abnormalities of esophageal motility. Our hypothesis is that there are also alterations of oral and pharyngeal transit during swallowing. We studied by videofluoroscopy the oral and pharyngeal transit during swallowing in 17 patients with dysphagia, a positive serologic test for Chagas' disease, and radiologic demonstration of esophageal involvement. The study also included 15 asymptomatic healthy volunteers. Each subject swallowed in duplicate 5 and 10 ml of liquid and paste barium boluses. Chagas' disease patients had a longer oropharyngeal transit with the 5-ml liquid bolus (p = 0.03), and a longer oral transit (p = 0.01) and pharyngeal transit (p = 0.04) with the 10-ml liquid bolus than controls. There was no difference between patients and controls with swallows of the 5-ml paste bolus. With swallows of the 10-ml paste bolus, the oropharyngeal transit (p = 0.05), pharyngeal transit (p = 0.04), pharyngeal clearance (p = 0.02), and UES opening (p = 0.01) took a longer amount of time in Chagas' disease patients than in controls. We conclude that the duration of pharyngeal transit is longer in patients with Chagas' disease than in normal subjects, especially with a bolus of pasty consistency and a volume of 10 ml.

-Context -The swallowing behavior is affected by age and possibly by gender. However, the interaction of the effects of age and gender on swallowing is not completely known. Objective -To evaluate the possibility of interaction of gender and age on human swallowing behavior. Method -Swallowing was evaluated in 89 healthy subjects by the water swallowing test, 43 men and 46 women aged 20-40 years (younger, n = 38), 41-60 years (middle-aged, n = 31) and 61-80 years (older, n = 20). Each subject ingested in triplicate 50 mL of water while precisely timed and the number of swallows needed to ingest all the volume was counted. Results -The interval between swallows was shorter and the volume in each swallow was smaller in women compared to men. In older subjects the time to ingest the 50 mL of water was longer, the interval between swallows was longer, and swallowing flow and volume in each swallow were smaller than in younger and middle-aged subjects. The swallowing flow was lower in women compared to men in younger subjects. The volume of each swallow was smaller in women than in men in younger and middle-aged subjects. There was no difference in swallowing flow and volume between older men and older women. Conclusion -Age and gender influence swallowing behavior, with the effect of gender being more evident in younger subjects and the effect of age being more evident in men. HEADINGS -Age effect. Gender identity. Deglutition.

Background. Chagas' disease causes esophageal motility impairment similar to that seen in idiopathic achalasia. Our hypothesis is that the disease could affect the results of swallowing evaluation and the esophageal response to swallows. Methods. We studied, by the water-swallowing test, the swallowing dynamics of 40 patients with esophageal involvement by Chagas' disease and 75 controls. During the clinical test, each subject ingested 50 ml of water while we precisely timed and counted the number of swallows. We calculated the interswallow interval, the swallowing fl ow rate, and the swallowing volume capacity. We also evaluated the proximal esophageal contractions of 32 patients with Chagas' disease and 31 controls. After swallows in duplicate of 3 ml water, the pharyngeal contractions 1 cm above the upper esophageal sphincter and the proximal esophageal body contractions 5 cm from the pharyngeal recording point were recorded. Results. In the water-swallowing test, patients with Chagas' disease took a longer time to drink all the volume, had a higher number of swallows, a longer interswallow interval, a lower swallowing fl ow rate, and took a smaller volume in each swallow than the control subjects. Patients with Chagas' disease had a longer interval between onset of pharyngeal and onset of proximal esophageal contractions and had contractions of lower amplitude. Conclusions. We conclude that patients with esophageal involvement by Chagas' disease ingest water more slowly, with a smaller volume in each swallow, and have a later proximal esophageal response to swallows than normal subjects.

BackgroundPatients with respiratory diseases, such as chronic obstructive pulmonary disease (COPD), may have swallowing dysfunction.ObjectiveThe aim of this investigation was to evaluate the oral and pharyngeal phases of swallowing in patients with COPD.MethodsWe studied 16 patients with clinical manifestations and pulmonary function tests diagnosis of COPD (mean age: 68 years) and 15 nonsmoking healthy volunteers (mean age: 65 years) with normal pulmonary function tests. All subjects were submitted to clinical and videofluoroscopic evaluation of swallowing. Each subject performed in duplicate swallows of 5 mL and 10 mL of liquid bolus, paste bolus, and a solid bolus.ResultsIn general, the duration of the events of the pharyngeal phase of swallowing was longer in COPD patients than controls. The difference was significant in the laryngeal vestibular closure, hyoid movement, and pharyngeal transit with swallows of both volumes of liquid bolus; in oral–pharyngeal transit with 5 mL paste bolus; and in pharyngeal and oral–pharyngeal transit with solid bolus. The difference between the duration of maximal laryngeal elevation and the duration of pharyngeal transit was higher in control subjects than in patients with COPD.ConclusionThe results suggested that patients with COPD have a longer pharyngeal swallowing phase than normal subjects, which is associated with a decrease in the difference between the duration of maximal laryngeal elevation and the duration of pharyngeal transit.