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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of an effortful swallow on the healthy adult esophagus was investigated using concurrent oral and esophageal manometry (water perfusion system) on ten normal adults (5 males and 5 females, 20-35 years old) while swallowing 5-ml boluses of water. The effects of gender, swallow condition (effortful versus noneffortful swallows), and sensor site within the oral cavity, esophageal body, and lower esophageal sphincter (LES) were examined relative to amplitude, duration, and velocity of esophageal body contractions, LES residual pressure, and LES relaxation duration. The results of this study provide novel evidence that an effortful oropharyngeal swallow has an effect on the esophageal phase of swallowing. Specifically, effortful swallowing resulted in significantly increased peristaltic amplitudes within the distal smooth muscle region of the esophagus, without affecting the more proximal regions containing striated muscle fibers. The findings pertaining to the LES are inconclusive and require further exploration using methods that permit more reliable measurements of LES function. The results of this study hold tremendous clinical potential for esophageal disorders that result in abnormally low peristaltic pressures in the distal esophageal body, such as achalasia, scleroderma, and ineffective esophageal motility. However, additional studies are necessary to both replicate and extend the present findings, preferably using a solid-state manometric system in conjunction with bolus flow testing on both normal and disordered populations, to fully characterize the effects of an effortful swallow on the esophagus.
Dysphagia 2007 Oct
PMID:The effect of an effortful swallow on the normal adult esophagus. 1769 7

Scleroderma encompasses an heterogeneous group of autoimmune disorders characterized by an hidebound thickened skin involvement. When the changes are limited to the skin, localized scleroderma is suspected. Although the latter is most often a benign disease, it may be exceptionally associated with involvement of multiple organs, mainly the neurological system. At the opposite, systemic sclerosis is a serious disorder associated with high morbidity and even mortality and defined by an extended skin sclerosis, multiple organ involvement and general symptoms. Raynaud phenomena is nearly always present at the beginning of the disease. Identifying initial manifestations of the disease (Raynaud phenomena, diffuse non pitting edema, symmetrical polyarthritis with tendon friction rubs, dysphagia associated with mucosal telangiectasia) may allow the clinician to rapidly transfer the patient to a specialized reference center in order to organize a multidisciplinary approach and to prompt optimum therapy.
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PMID:[When thinking to scleroderma?]. 1795 22

A female 38 years old, housewife, presented to the Department of Dermatology and Venereology, Mymensingh Medical College Hospital (MMCH) on 08.04.07 with the complaints of i) pain and reduced movement of hand, knee, shoulder and neck joints for 1 year and 9 months ii) tightness of skin over face, neck, limbs and trunk for 1 year and 6 months iii) patchy depigmentation over same areas for 1 year and 3 months iv) deformity of hands with flexion contractures for 6 months and v) dysphagia to solid food for 3 months. She had no complaints of Raynaud's phenomenon. On general examination, she was ill looking, anemic and nutritionally poor. Examination of integumentary system showed smooth, shiny, thick, hard and hidebound skin with pigmentary alteration of 'salt and pepper' appearance over fingers, hands, limbs, face, neck and trunk. Hands appear claw like but more on the right side than the left and there were no other obvious changes suggestive of digital ischaemia (atrophy, ulceration, scarring, gangrene etc). Face has got suggestive features of scleroderma. Examination of the respiratory system showed restriction of chest movement and reduced expansibility of chest wall. No other abnormality was found on examination of other systems. Laboratory investigations showed histopathology typical of scleroderma. X-ray of hands and feet showed suggestive changes, lung function test-showed restrictive lung disease. Barium swallow x-ray of esophagus in supine position showed mild dilation of lower oesophagus. But serology was non-reactive (negative ANA, Negative RA test, Negative VDRL). So, she was diagnosed as a case of progressive systemic sclerosis (PSS) with some atypicality.
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PMID:Unusual presentation of progressive systemic sclerosis. 1862 57

An overlap syndrome of dermatomyositis and scleroderma is reported. The case corresponded to a 27-year-old female with a clinical picture of 14 months evolution, characterized by proximal muscles weakness, erythematous rash in wrists, knees, ankles, Gottron sign, heliotrope periorbital rash and dysphagia. A muscle biopsy was compatible with dermatomyositis; meanwhile the skin biopsy was compatible with scleroderma. Muscle enzymes were increased. Interestingly, the antinuclear antibody determination in HEp-2 cells was positive with a remarkable titer of 81,920 exhibiting a nucleolar pattern. Anti-Jo1 antibody was negative, but anti-PM/Scl-100 positive. The patient received methylprednisolone and cyclophosphamide pulses, with gradual improvement. Present report constitutes a case of overlap dermatomyositis-scleroderma syndrome, with anti-PM/Scl autoantibodies (anti-exosome). The remarkable of this case was the exceptional high antinucleolar antibody titer.
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PMID:A dermatomyositis and scleroderma overlap syndrome with a remarkable high titer of anti-exosome antibodies. 1913 55

Erasmus' syndrome involves the association of systemic scleroderma and exposure to silica particles with or without silicosis. The authors report the observation of a miner with a history of professional silicosis resulting in pulmonary fibrosis. Twenty-five years later, the patient consulted for dysphagia associated with inflammatory arthralgia, cutaneous sclerosis extended to the face and limbs, sclerodactyly and Raynaud's phenomenon. The diagnosis of scleroderma was confirmed and Erasmus' syndrome was retained.
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PMID:[Erasmus syndrome: case report]. 1930 79

Scleroderma and other connective tissue diseases have rarely been reported among Africans. The objective of this paper is to have a retrospective study of the clinical and investigative characteristics of scleroderma patients seen in a rheumatology clinic. This was done in a private practice rheumatology clinic in Lagos, Nigeria. Patients were identified using the American College of Rheumatology criteria for diagnosis of scleroderma. A total of 14 cases of scleroderma are reported. Most of the patients were females and diffuse scleroderma was more frequently seen. Arthritis and reflux esophagitis were the most common nondermatological presentation while Raynaud's phenomenon and dysphagia were the least seen. Restrictive pattern of lung function tests were seen in most of those tested and pulmonary fibrosis was seen in some cases. Antinuclear antibodies were the commonest serological findings with the speckled staining pattern in most cases. Treatments were with standard medications. Scleroderma among Nigerians is rare as elsewhere and there are certain common characteristics as seen elsewhere as well as certain differences.
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PMID:Scleroderma (systemic sclerosis) among Nigerians. 1943 86

Esophageal manometry (EM) findings were reviewed in 14 (13 male) adults diagnosed with eosinophilic esophagitis (EE). One had complete nonperistaltic contractions (amplitude range = 30-180 mmHg) and incomplete relaxation of the lower esophageal sphincter (LES), suggesting vigorous achalasia. After 6 months of steroid therapy the repeat EM showed near-normal findings. One had total aperistalsis with contraction amplitudes less than 10 mmHg and a weak LES pressure (8 mmHg), criteria suggesting scleroderma. Two had low-amplitude (<30 mmHg) nonperistaltic contractions limited to the mid-esophagus. Criteria for nutcracker esophagus were met in two patients. Isolated low LES pressure (<15 mmHg) was observed in four patients who were also receiving proton pump inhibitors, and the remainder had normal EM findings. Our results found that EE can mimic all the categories of EM disturbances, with approximately 50% of our patients having a major impairment of smooth muscle function. The EM abnormality can be reversed to normal in some cases with appropriate treatment for EE.
Dysphagia 2010 Sep
PMID:Disturbances of esophageal motility in eosinophilic esophagitis: a case series. 1970 17

Systemic sclerosis (SSc) is a multisystemic disorder characterized by functional and structural abnormalities of small blood vessels and fibrosis of the skin and internal organs. Eighty percent of subjects with SSc have orofacial manifestations. No tests for oral manifestations have been validated for this pathology, and in the literature there are few studies of speech therapy for subjects with SSc. These facts suggested the need for an exhaustive assessment of mouth mobility and muscle strength, and also of swallowing and voice, in order to plan a targeted and effective speech therapy. The Scleroderma Logopedic Scale (SLS) has been developed to assess disorders in five domains: Impairment, Swallow, Voice, Multifield, and Quality of Life. Perception of these disorders was assessed in 84 subjects with SSc and in 40 healthy subjects. After the first draft, a shorter form (39 items) was obtained after statistical analysis. This scale showed good discriminant and concurrent validity. Internal consistency was good: three of five subscales had a Cronbach alpha coefficient higher than 0.8. The test/retest coefficient for the total score was 0.94. Thirty-six percent of examined subjects showed moderate to severe oropharyngolaryngeal disorders. Swallowing disorders and impairment of mouth (e.g., decrease in mobility and strength) were the most commonly reported problems. Conversely, the change of voice due to the pathology was not perceived as a problem. Fifty-five percent of subjects reported a decreased level of quality of life.
Dysphagia 2010 Jun
PMID:Oropharyngolaryngeal disorders in scleroderma: development and validation of the SLS scale. 1970 19

Systemic sclerosis sine scleroderma is a rare form of limited cutaneous scleroderma. These patients manifest without cutaneous involvement, but do not differ in its clinical or laboratory features and prognosis from classical systemic sclerosis. In the absence of cutaneous signs/symptoms, its diagnosis is delayed leading to morbidity. The exact prevalence of dystrophic calcification in systemic sclerosis sine scleroderma, though a feature of systemic sclerosis, is not known. Development of dystrophic calcification further aggravates patient's woes. This paper describes systemic sclerosis sine scleroderma in a 17-year-old girl diagnosed initially as seronegative juvenile rheumatoid arthritis. She developed progressively increasing disk-like masses of calcinosis over the gluteal regions, knee, elbow, and ankle joints fixed to the overlying skin associated with malaise, anorexia, and weight loss. There was no Raynaud's phenomenon, dysphagia, dyspnoea, sclerodermatous skin, sclerodactyly, telangectasias, or muscle tenderness/weakness. Digital pitted scars, elevated anticentromere antibody values, esophageal hypomotility, and fluffy calcification in subdermal soft tissues in gluteal regions and around wrist, hip, knees, heels, and ankle joints (without affecting the underlying structures) were detected. Therapy with diltiazem and magnesium/aluminum antacids was useful in resolving calcinosis.
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PMID:Systemic sclerosis sine scleroderma and calcinosis cutis: report of a rare case. 1983 61

The authors present a clinical case of a 79 years old female patient, with a progressive cutaneous thickening of the face, trunk and limbs, lasting for 6 years. She also presented exertional dyspnea and intermittent solid dysphagia. The laboratory study identified IgG KAPA monoclonal protein and antinuclear antibodies with a speckled pattern. The nailfold capillaroscopy was normal. A detailed physical examination together with cutaneous histopathology led to the diagnosis of Scleromyxedema, a rare cutaneous scleroderma like disease. The differential diagnosis of cutaneous sclerosis is discussed.
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PMID:[A cutaneous thickening case...]. 2051 47


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