Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the past four years three patients have been seen with ischemia of the colon segment following colon interposition. Colon interposition was done for esophageal cancer in two patients and for esophageal stricture following ingestion of lye. Colon ischemia was manifested as early as two weeks in one patient and as late as eight weeks in the others. Colon ischemia presented a frank gangrene with cervical fistula or as dysphagia due to stricture formation. Dysphagia in two patients prompted mechanical dilatation of the colon segment which led to perforation in both cases. All three patients had empyemas. The management of these patients includes proper diagnosis, drainage of abscesses and antibiotic treatment, hyperalimentation and visceral arteriography to delineate the residual colon for reinterposition. Two of the three patients in the series are long-term survivors and are well.
 ...
PMID:Management of colon ischemia following colon interposition for esophageal substitution. 9 13

We encountered two patients with complete trachea and esophagus transection due to suicide and traffic accident respectively. Primary repair of both trachea and esophagus with tracheostomy and adequate drainage were performed. Nothing per oral, and intermittent suction in oral and nasogastric tube, followed by hyperalimentation and broad spectrum antibiotics. The patients were discharged in good condition without dysphagia and chocking.
 ...
PMID:Complete transection of trachea and esophagus. Two-case report. 216 42

The coexistence of malignancy and dysphagia makes nutritional deprivation especially serious in patients with carcinoma of the esophagus. Intravenous hyperalimentation (IVH) is often given and should be of particular value in these patients. Sixty-four patients with carcinoma of the esophagus seen between January, 1975, and February, 1982, were studied retrospectively during their first hospitalization for the disease. Thirty-seven patients received IVH, and 27 did not. There were no significant differences at the time of admission to the hospital between the two groups with respect to age, sex, pathological status, and location of the carcinoma. Also, there was no difference in the incidence of hypoalbuminemia (less than 3 gm/dl) or lymphocytopenia (less than 1,500/mm3). More patients in the IVH group underwent surgical resection of the esophagus. Surgical intervention did not significantly influence hospital mortality. The IVH therapy reduced weight loss (p less than 0.05), but was associated with an increased incidence of pulmonary sepsis (p less than 0.05) and longer hospital stay. The incidence of hypoalbuminemia and lymphocytopenia increased between admission and the end of hospitalization, but it did not significantly differ between the groups. Thus, one cannot assume the effectiveness of IVH in this clinical setting, as its value was not demonstrated in this retrospective series. A prospective randomized study is warranted in view of the high cost and the doubtful clinical impact of an IVH regimen in patients with carcinoma of the esophagus.
 ...
PMID:Clinical impact of intravenous hyperalimentation on esophageal carcinoma: is it worthwhile? 643 36

An unusual case of congenital lower oesophageal diaphragm (web) associated with achalasia is described. An 18-year-old nulliparous girl presented with severe cachexia and aphagia following progressive dysphagia. A barium swallow demonstrated the achalasia, and the oesophageal diaphragm with a central pinhole opening was seen at endoscopy. Parenteral hyperalimentation was required for ten weeks prior to surgery. Circumferential excision of the oesophageal diaphragm in conjunction with Y-V advancement oesophagoplasty gave a good result.
 ...
PMID:Lower oesophageal diaphragm and achalasia in an adult. An unusual association. 652 77

Charts of 28 hyperthyroid patients over 60 years old were retrospectively analyzed and compared with charts of 14 patients under 30 years old. The mean duration of symptoms prior to diagnosis was 16 months in the elderly and five months in the younger group. Heart rate was substantially lower in the older (107 beats/min) vs younger (117 beats/min) study group. The symptom of weakness or fatigue was more prevalent in the elderly group (94 percent) than in the younger group (57 percent). Cardiac palpitation was more prevalent in the elderly patients whereas insomnia, irritability, dysphagia, hyperphagia, and heat intolerance were more prevalent in the younger patients. Fifty percent of the elderly patients complained of chest pain. Cachexia (62 percent), thin, fine hair (50 percent), and weakness (58 percent) were prominent physical findings in the elderly group. Twenty-six percent of the elderly patients had atrial fibrillation. These findings confirm previous studies that show some differences in presentation of hyperthyroidism in elderly patients when compared with younger patients. The authors recommend that thyroid function tests be obtained for broad indications in the elderly.
 ...
PMID:Thyrotoxicosis in the elderly. 664 37

Fifteen cases of gunshot wounds of the esophagus seen between the years 1970 and 1978 were reviewed, eight involving the cervical esophagus and seven involving the thoracic portion. Most common symptoms were pain, neck tenderness, dyspnea, and dysphagia. Signs observed were subcutaneous emphysema, crepitations, fever, and leukocytosis. Plain X-rays showed pneumomediastinum, hydrothorax, and pneumothorax. Perforations were confirmed by barium studies in 12 patients. Injuries in the cervical portion were treated by prompt exploration, closure of the defect, and drainage. There were no deaths in this group. Thoracic injuries were treated by prompt thoracotomy except in one patient, for whom the diagnosis was not made until 22 hours after the injury; his was the only death in this series. Because of the extensive tissue involvement in gunshot wounds, primary repairs of thoracic esophageal perforations have a high incidence of failure. Defunctionalization of the esophagus, through ligation of the distal esophagus, gastrostomy, and cervical esophagostomy, has provided a safer method. Use of a double strand of absorbable Dexon to ligate the distal esophagus made a second thoracotomy for removal of the ligature unnecessary. We have adopted routine use of hyperalimentation, avoiding the need for feeding jejunostomy.
 ...
PMID:Perforations of the esophagus from gunshot wounds. 670 55

Because of the development in parenteral nutrition, the replacement of thyroid hormones in hypothyroid or athyroid patients under intravenous hyperalimentation has become a new problem to be considered. We tried parenteral replacement of the hormones, intravenously or by enema, in three such patients. Two patients, 54 y-o and 64 y-o females, who underwent laryngo-esophago-thyroidectomy for cervical esophageal cancer or thyroid cancer, had replacement with intravenous l-thyroxine with an initial dose of 100 micrograms/day for 9 and 22 days, respectively. Another patient, a 56 y-o female with dysphagia due to local recurrence of cervical esophageal cancer after laryngo-esophago-thyroidectomy, was given 100 mg of desiccated thyroid by enema for 8 days followed by intravenous l-thyroxine for 104 days. Serum levels of thyroxine, triiodothyronine and TSH before l-thyroxine treatment indicated severe hypothyroidism in all cases. During the first 7 days of the intravenous therapy, serum thyroxine and triiodothyronine levels increased by 0.87 +/- 0.14 microgram/dl/day and 6.7 +/- 4.7 ng/dl/day, respectively, while serum TSH levels decreased by 7.8 +/- 6.4 microU/ml/day. Plasma T4 levels reached the normal level within 7 days, and plasma T3 levels within 11 days, while it took 14 days for plasma TSH levels to decrease to the normal level. The maintenance dose checked by the normal TSH levels in a patient undergoing a long term therapy was 75 micrograms/day or 1.83 micrograms/kg of body weight/day.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Parenteral replacement of thyroid hormones]. 674 69

We reviewed the records of 44 consecutive patients with advanced esophageal carcinoma treated at either a Veterans Administration or a city-country hospital. The patients, 38 men and six women, ranged in age from 27 to 72 years and had been referred for operative management. The average duration of dysphagia was 5 months. All patients underwent a one-stage esophagogastrectomy with esophagogastrostomy. The last 34 patients also had a modified fundoplication. Lesions at the gastroesophageal junction were approached via a low left thoracotomy and the others via a simultaneous right thoracotomy and laparotomy. All patients had preoperative enteral or parenteral hyperalimentation. Seven patients died within 30 days after operation (operative mortality 16%). Twenty-six patients lived from 3 to 28 months postoperatively (average 11.5 months). Eleven are alive at present (average 10 months). Postoperative complications were as follows: anastomotic leak, three patients (two died); respiratory failure, four (two died); stricture, three; myocardial infarction, two (two died); cholecystitis, one; and pulmonary embolus, one (patient died). Thirty-four patients had modified fundoplication, and an inconsequential anastomotic leak developed in one. In contrast, two of the 10 patients who did not have modified fundoplication died as a result of anastomotic leak. Preoperative hospital stay ranged from 10 to 28 days (average 18); postoperative stay ranged from 10 to 40 days (average 16). Except for the three patients in whom stricture developed, all patients (92%) had continuous relief of dysphagia. We conclude that one-stage esophagogastrectomy with esophagogastrostomy is applicable in most cases and is associated with both satisfactory long-term palliation and a reasonable period of hospitalization. The addition of a modified fundoplication results in a relatively low rate of anastomotic leak.
 ...
PMID:Carcinoma of the esophagus. An aggressive one-stage palliative approach. 745 20

We studied 10 patients with lateral medullary infarction. Six patients had severe dysphagia from the onset, and needed tube feeding or intravenous hyperalimentation. Three of these 6 patients resolved dysphagia within 3.5 months. Pharyngoesophagography showed aspiration and pooling in the pharynx in other three patients who showed persisting dysphagia for more than 6 months. The cause of dysphagia was not unilateral paralysis of the pharynx and the larynx. Because there were decreased functions of elevation of the larynx, closure of the vocal cord and the pharyngeal movement, the dysphagia of our patients may be due to disturbance of the neurogenic swallowing control. Persistent dysphagia was associated with anterolateral extension of the infarction in the medulla. Two patients with laryngectomy and permanent tracheostomy were able to be discharged to home. We conclude that surgical treatment is a choice in patients with dysphagia which persists for more than 6 months.
 ...
PMID:[Dysphagia following lateral medullary infarction]. 868 83

One of the main targets of medical care provided in our ward, which specializes in the cooperative practice of hospital- and home-doctors, is to maintain the quality of patients' lives after they are discharged from our hospital through home medical care by home-doctors. Intravenous hyperalimentation and tube-feeding at home are suitable solutions for some patients with dysphagia after cerebral infarction. However, the difficulties faced in their management are the burden on the families, which tends to be an obstacle for at-home-practice. We describe herein a case of severe dysphagia treated successfully through our rehabilitation program and discharged without nutritional supports. An 82-year-old man was admitted to our hospital suffering from pyrexia and dysbasia. The man, who lives with his wife and his son's family, was diagnosed with aspiration pneumonia and multiple cerebral infarctions. The test for swallowing reflex revealed an impaired first phase reflex and intravenous hyperalimentation was performed for his nutritional support. He was still suffering from dysphagia but had the desire to eat orally after his dysbasia and aspiration pneumonia were cured. A rehabilitation program was scheduled with the aims of 1) recovery of ingestion and 2) sufficient expectoration, with an ongoing teaching program for the management of intravenous hyperalimentation. After one month of rehabilitation (ice-massaging, muscle rehabilitation of the tongue and neck and expectoration training in a prone position and after gorging), his ability to swallow was gradually recovered. With the frequent confirmation of absence of aspiration, special forms of diets were served and upgraded from jelly, paste-like-food to soft-cooked steamed rice. The patient is now at home without any nutritional support. Nutritional management without intravenous hyperalimentation or tube-feeding is important or even essential for some families providing home-care for patients. The problem of aging requires us to reduce the burden that families (who may be also getting older) should carry. We try to support patients and families for better home-care through cooperation with society and home-doctors.
 ...
PMID:[A patient with dysphagia treated successfully and discharged without nutritional support]. 1119 Mar 40


1 2 Next >>