Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 80 children who presented to the emergency department (ED) with a complaint of coin ingestion to determine whether radiographs are necessary in all situations and to determine which symptoms or signs are predictive of esophageal coins. Radiographs were considered positive if the coin was in the esophagus. Radiographs were positive in 25 (31%) of patients, of whom 11 (14%) had no symptoms or signs in the ED. Fifty-five (69%) of the 80 patients had subdiaphragmatic foreign bodies (44 [55%]), or no foreign bodies (11 [14%]) seen on films. Fourteen (18%) of the children required removal of the coin. Variables correlating with positive radiograph, in order of significance, included localization, choking at ingestion, drooling in the ED, vomiting, and chest pain (P less than .05). Symptom type was predictive of radiographic findings, and it may be predictive of need for removal. All 14 patients with symptoms or signs in the ED had positive films, as compared to 11 of 66 (16.6%) with no symptoms (chi square = 33.555; P less than .001). Although this relationship is significant, the finding of esophageal foreign body in 17% of patients with no symptoms leads us to recommend that all patients have a chest radiograph if coin ingestion is suspected.
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PMID:Coin ingestion: does every child need a radiograph? 398 65

There are several studies suggesting the paradoxical simultaneous presence of hypertensive lower oesophageal sphincter and gastroesophageal reflux disease. We present a case of a 22-year-old male patient who was examined in our outpatient clinic with oesophageal food bolus impaction during a meal, severe chest pain and drooling. Manometry revealed a hypertensive lower esophageal sphincter pressure (resting pressure 35 mmHg) and pHmetry revealed a DeMeester score > 14.72 (43.27). Six months after therapy with lansoprazole, manometry revealed a normal lower oesophageal sphincter (resting pressure 14 mmHg) and the DeMeester score was < 14.72 (5.89). The patient is now asymptomatic. This report is the only published case which exhibits the normalization of lower oesophageal pressure 6 months after gastroesophageal reflux disease management with lansoprazole, thus proving and establishing the above ''paradox''.
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PMID:Evidence for the ''paradox'' association between hypertensive lower esophageal sphincter and gastroesophageal reflux disease. 1829 72