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PL
W artykule przedstawiono wyniki przeprowadzonego przez autorki badania przydatności kandydatów na studia logopedyczne do wykonywania zawodu logopedy. Materiał badawczy pobrano od 60 osób, głównie kobiet w wieku od 18 do 24 lat pochodzących z północno-wschodniej Polski. Omówiono najczęściej stwierdzane u badanych wady anatomiczne w obrębie drogi głosowej, zaburzenia głosu, wady wymowy oraz powiązania pomiędzy zaburzeniami artykulacji i okluzji. Wskazano, że zaledwie 26% pacjentów to osoby bez jakichkolwiek zmian klinicznych i artykulacyjnych. U 74% kandydatów na studia logopedyczne zdiagnozowano wady anatomiczne i/lub wymowy, przy czym tylko jedna osoba miała problemy natury foniatrycznej w postaci lekkiej chrypki oraz zmianę barwy głosu, co jednak nie stanowiło przeciwskazania do uprawiania zawodu logopedy. W związku z tym podkreślono, że sama konsultacja foniatryczna, na którą kieruje się kandydatów na studia logopedyczne celem ustalenia obecności lub braku przeciwskazań do wykonywania zawodu logopedy, jest niewystarczająca, gdyż podczas rutynowych badań foniatrycznych lekarze specjaliści koncentrują się na badaniu krtani, nie badają natomiast ani prawidłowości zgryzu, ani poprawności artykulacji, co, jak wykazano w niniejszej pracy, stanowi rzeczywisty problem kandydatów na studia logopedyczne dyskwalifikujący ich z zawodu. Tylko całościowe badanie foniatryczno-ortodontyczno-logopedyczne, uwzględniające zarówno aspekt wizualny, jak i audytywny wymowy głosek i ich połączeń, pozwala na miarodajną ocenę istnienia lub braku przeciwskazań medycznych do wykonywania zawodu logopedy.
EN
This article presents the results of the authors’ research concerning the suitability of candidates for speech therapy university studies and their prospective work as speech and language therapeutists (SLTs). This profession poses special requirements for candidates for speech therapists who work with children with various speech impediments and, therefore, must offer them a model of articulation to follow. Therefore, it is necessary to perform an evaluation of the physical capacity of the candidates for the profession of SLT before they start university studies in speech development. Such initial evaluation of the candidates is indispensable because it demonstrates their physical ability to acquire relevant skills and practice mandatory to possess by future SLTs. The material studied consisted of 60 subjects, mostly women between the ages of 18 and 24 from North-Eastern Poland. The paper discusses anatomical defects frequently observed in the investigated subjects within the vocal tract and in the craniofacial region, as well as speech defects and their connection with articulation disorders and occlusion. It was found that only 26% of the candidates did not present any clinical and/or articulation deviations, while 74% of applicants for logopedics university training were found to have anatomical or articulatory defects. One person had phoniatric problems in the form of discrete hoarseness of the voice, but they do not constitute a contraindication for admission to study speech therapy and prospective practice of the SLT profession. Therefore, the authors emphasize that restricting the examination only to the phoniatric evaluation (obligatory for applicants for speech therapy university studies in Poland) is insufficient, because it does not include the correctness or accuracy of the bite or articulation. As has been demonstrated in our study, such problems subsequently lead to disqualifying the candidates from the SLP profession. Only a comprehensive phoniatric-orthodontic-speech therapy assessment that takes into account both the visual and auditory perceptive aspects of individual speech sounds and their clusters can allow a meaningful assessment of the presence or absence of medical contraindications to practice as a speech therapist.
EN
Neurogenic dysphagia, as the most common cause of swallowing disorders in the oral and pharyngeal phase, often leads to potentially fatal clinical consequences such as malnutrition, dehydration, aspiration pneumonia, and also worsens the overall functioning of the patient, including the appearance of depression. Thus early diagnosis of dysphagia and appropriate therapeutic measures are important in preventing the above-mentioned complications. Endoscopic assessment of swallowing disorders using a flexible nasofiberoscope (fiberoptic endoscopic evaluation of swallowing – FEES), together with a videofluoroscopic swallow study (VFSS), are the fundamental instrumental examinations in the evaluation of swallowing disorders in patients with neurogenic dysphagia (1, 2). FESS is currently considered to be the gold standard in the diagnosis of neurogenic dysphagia, because it not only allows direct visualization of the act of swallowing, but is safe for the patient, does not require a contrast agent and does not expose the patient and staff to radiation. However, it has some disadvantages and risks for the patient. The aim of this paper is to present the advantages and disadvantages of the FEES method in the assessment of neurogenic dysphagia, with particular emphasis on patients with acute or subacute vascular brain injury.
EN
This paper presents the results of the authors’ research concerning the suitability of candidates for speech therapy university studies and their prospective work as speech and language therapeutists (SLTs). This profession poses special requirements for candidates for speech therapists who work with children with various speech impediments and, therefore, must offer them a model of articulation to follow. Therefore, it is necessary to perform an evaluation of the physical capacity of the candidates for the profession of SLT before they start university studies in speech development. Such initial evaluation of the candidates is indispensable because it demonstrates their physical ability to acquire relevant skills and practice mandatory to possess by future SLTs. The material studied consisted of 60 subjects, mostly women between the ages of 18 and 24 from north-eastern Poland. The paper discusses anatomical defects frequently observed in the investigated subjects within the vocal tract and in the craniofacial region, as well as speech defects and their connection with articulation disorders and occlusion. It was found that only 26% of the candidates did not present any clinical and/or articulation deviations, while 74% of applicants for logopedics university training were found to have anatomical or articulatory defects. One person had phoniatric problems in the form of discrete hoarseness of the voice, but they do not constitute a contraindication for admission to study speech therapy and prospective practice of the SLT profession. Therefore, the authors emphasize that restricting the examination only to the phoniatric evaluation (obligatory for applicants for speech therapy university studies in Poland) is insufficient, because it does not include the correctness or accuracy of the bite or articulation. As has been demonstrated in our study, such problems subsequently lead to disqualifying the candidates from the SLT profession. Only a comprehensive phoniatric-orthodontic-speech therapy assessment that takes into account both the visual and auditory perceptive aspects of voice as well as individual speech sounds and their clusters can allow a meaningful assessment of the presence or absence of contraindications to practice as a speech and language therapist.
PL
Dysfagia neurogenna, jako najczęstsza przyczyna zaburzeń połykania, często prowadzi do potencjalnie śmiertelnych klinicznych konsekwencji takich, jak niedożywienie, odwodnienie, zachłystowe zapalenie płuc, a także pogarsza ogólne funkcjonowanie pacjenta, z pojawieniem się depresji włącznie. Wczesne rozpoznanie dysfagii i odpowiednio szybkie podjęcie działań terapeutycznych ma istotne znaczenie w zapobieganiu wyżej wymienionym powikłaniom. Badanie endoskopowej oceny zaburzeń połykania przy użyciu giętkiego nasofiberoskopu (fiberoptic endoscopic examination of swallowing – FEES), obok badania wideofluoroskopowego (video fluoroscopic swallow study – VFSS), jest podstawowym badaniem instrumentalnej oceny zaburzeń połykania u chorych z objawami dysfagii neurogennej (1, 2). Badanie FEES, które wydaje się „złotym środkiem” w diagnostyce dysfagii neurogennej, jest badaniem bezpiecznym dla pacjenta, nie wymaga podawania środka kontrastowego ani nie naraża pacjenta i personelu na promieniowanie rtg. Posiada jednak pewne ograniczenia oraz niesie ryzyko dla pacjenta. Celem niniejszej pracy jest przedstawienie zalet oraz wad metody FEES w ocenie dysfagii neurogennej, ze szczególnym uwzględnieniem pacjentów z ostrym lub podostrym naczyniopochodnym uszkodzeniem mózgowia.
EN
Neurogenic dysphagia, as the most common cause of swallowing disorders in the oral and pharyngeal phase, often leads to potentially fatal clinical consequences such as malnutrition, dehydration, aspiration pneumonia, and also worsens the overall functioning of the patient, including the appearance of depression. Thus early diagnosis of dysphagia and appropriate therapeutic measures are important in preventing the above-mentioned complications. Endoscopic assessment of swallowing disorders using a flexible nasofiberoscope (fiberoptic endoscopic evaluation of swallowing – FEES), together with a videofluoroscopic swallow study (VFSS), are the fundamental instrumental examinations in the evaluation of swallowing disorders in patients with neurogenic dysphagia (1, 2). FESS is currently considered to be the gold standard in the diagnosis of neurogenic dysphagia, because it not only allows direct visualization of the act of swallowing, but is safe for the patient, does not require a contrast agent and does not expose the patient and staff to radiation. However, it has some disadvantages and risks for the patient. The aim of this paper is to present the advantages and disadvantages of the FEES method in the assessment of neurogenic dysphagia, with particular emphasis on patients with acute or subacute vascular brain injury.
EN
Adenotonsillar hypertrophy is very common in childhood. Obstruction of the nasopharyngeal airway may cause obligatory oral breathing, chronic open-mouth posture, incorrect inferior or anterior-inferior position of the tongue, disordered swallowing and impaired facial growth. Facial growth disorders frequently result in onset of the specific types of malocclusion and specific speech disorders. Obstruction of the pharynx during sleep by adenotonsillar hypertrophy remains the main cause of sleep apnea syndrome in children. Obstruction of the upper airway by the enlarged adenoid and/or hypertrophic tonsils may lead to hyponasality of the voice and/or cul-de-sac resonance. Malocclusions, in turn, in association with the incorrect tongue positioning in the oral cavity give rise to the disordered articulation of anterior consonants.
PL
Przerost układu adenoidalnego gardła jest w wieku dziecięcym bardzo częsty. Wywołana przez niego obturacja górnej drogi oddechowej utrudnia lub wręcz uniemożliwia fizjologiczne oddychanie przez nos, co inicjuje sekwencyjnie cały szereg komplikacji wtórnych, jak nieprawidłowe oddychanie torem ustnym, zaburzenia połykania, wady zgryzu i artykulacji. Mechaniczna obturacja ujść gardłowych trąbek słuchowych przez przerośnięty migdałek gardłowy utrudnia prawidłowe przewietrzanie uszu środkowych i powoduje powstawanie zaburzeń słuchu o typie przewodzeniowym. Blokada górnej drogi oddechowej poprzez przerośnięty układ adenoidalny gardła jest także najczęstszą przyczyną występowania zespołu bezdechów snu u dzieci. Utrudnienie przepływu powietrza oddechowego przez przerośnięty migdałek gardłowy i/lub podniebienie zaburzać może także prawidłowy rezonans nosowy w mowie, powodując nosowanie zamknięte i/lub tzw. mowę kluskowatą. Zastępcze nieprawidłowe oddychanie torem ustnym powoduje także zaburzenia wzrostu twarzoczaszki i zaburzenia okluzji. Zaburzenia zgryzu w skojarzeniu z dysfunkcją języka są przyczyną występowania zaburzeń artykulacji głosek przednich.
EN
Adenotonsillar hypertrophy is very common in childhood. Obstruction of the nasopharyngeal airway may cause obligatory oral breathing, chronic open-mouth posture, incorrect inferior or anterior-inferior position of the tongue, disordered swallowing and impaired facial growth. Facial growth disorders frequently result in onset of the specific types of malocclusion and specific speech disorders. Obstruction of the pharynx during sleep by adenotonsillar hypertrophy remains the main cause of sleep apnea syndrome in children.. Obstruction of the airflow by the enlarged adenoid and/ or hypertrophic tonsils may lead to hyponasality of the voice and/or cul-de-sac resonance. Malocclusions, in turn, in association with the incorrect tongue positioning in the oral cavity gives rise to the disordered articulation of anterior consonants.
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