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

A 70-year-old man manifested during four years a progressive clinical picture consisting in palsy of gaze, axial rigidity, disorders of standing and gait, dysarthria, dysphagia. Neuroradiological investigations demonstrated proximal thrombosis of the left subclavian artery with subclavian steal. At necropsy, degenerative changes in several areas of the basal ganglia and brain stem, with presence of globose neurofibrillary tangles, were found, consistently with the pathologic pattern of the Progressive Supranuclear Palsy (PSP). The association of PSP and subclavian steal syndrome has not been previously reported, to our knowledge. We hypothesize that chronic ischemia, due to subclavian steal syndrome, in the vertebral basilar system and its watershed versus carotid system may have favoured the appearance, in these same areas, of the changes of the PSP.
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PMID:Progressive supranuclear palsy in the course of subclavian steal syndrome. 693 74

17 parameters of vital activity (VA) were scanned in 35 female and 12 male dependent geriatric patients (mean age 81). These included mental testing, Barthel score, lung function, urinanalysis, creatinine clearance, Hb, albumin, globulin and electrolytes, skin-folds, locomotion, presence of IHD, hemodynamic state, continence, infections, WBC and lymphocyte count, pressure sores and dysphagia, 4 main templates of VA deterioration identified were: IHD, hemisyndrome (due to CVA), vegetative state (post-CVA) and senile dementia (SDAT). The IHD template was characterized by marked variations in VA, ending in death due to cardiac complications (pulmonary edema, ischemia, etc.). In the 3 other templates VA gradually deteriorated. Gradual declining VA allowed assessment of individual mortality prognosis. Assessment was by approximation of the computed exponent of the extrapolated VA curves; the longer the observation, the fewer the mistakes in assessment. Epidemiologic prognosis data of 48 dependent patients is described; mean age was about 81 years. Hospitalization mean was 853.5 +/- 601 days and for patients with dementia, 1158.6 +/- 622.7 days.
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PMID:[Assessment of vital activity in geriatric patients]. 781 43

A case of necrotizing esophagitis discovered during upper endoscopy is described. An 88-year-old woman was admitted to our hospital with complaints of multiple episodes of coffee ground emesis and dysphagia over 3 months. Ischemia is proposed as the etiology of necrotizing esophagitis on the basis of the patient's significant cardiac history, her age, and low-flow state.
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PMID:Necrotizing esophagitis presenting as a black esophagus. 982 73

Gastroesophageal reflux disease (GERD) is a frequent illness, sometimes causing disabling symptoms and/or permanent oesophageal lesions. Etiology is multifactorial and not completely defined. Therapy is medical at first step, surgical indication is reserved to those patients with less compliance for medical therapy, unsuccessful medical therapy or reflux related complications. Different surgical techniques have been suggested for treatment of GERD, like Nissen, Rossetti or Toupet fundoplication. During the last decade laparoscopy has been proposed as a less invasive approach when surgery is indicated. From 1995 to the first months of 1999, 42 pts (28 females, 14 males, mean age 53.7 years), were operated on. Diagnosis and surgical indication were confirmed preoperatively by barium X-rays, endoscopy and 24 hrs-Ph-manometry. Hiatal hernia was demonstrated in 37 cases (88%), I or II grade esophagitis in 16 and III grade in 2; 1 patient had Barrett oesophagus. 37 pts were operated on by laparoscopic Nissen fundoplication, 5 patients had a Toupet operation. Mortality and conversion rate were 0. Complications occurred in 3 patients: 1 intraoperative pneumothorax, 1 acute cardiac ischemia in a patient with known hypertension, 1 permanent dysphagia successfully treated by endoscopic dilatation. Mean postoperative hospital stay was 6.1 days. Mean follow up was 9 months (3-48) in 100% of cases. Despite the fact that few patients were operated on by using this new less invasive approach, results are encouraging with no mortality, less morbidity and great advantages for patients.
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PMID:[Laparoscopic treatment of gastroesophageal reflux]. 1051 27

Chronologically, complications can be classified as intraoperative, early, and late. The authors analyze complications according to this classification on the basis of more than 400 esophageal operations and related literary data. As regards intraoperative complications, they deal only with those occurring at transhiatal esophagectomy (e.g., tracheal tear, bleeding, pneumothorax, laryngeal nerve injury). Among the early complications, they survey the incidence of transplant necrosis and related mortality, further sequelae ensuing from subacute ischemia of the replaced organ and analyze in detail the questions which arise regarding anastomotic leakage. Firstly, they deal with those causative factors that influence the frequency of anastomotic insufficiency, such as the technical "know-how" of anastomosis making (e.g., one layer vs two layers; stapling or manual suture; interrupted or running suture), the way of replacement using whole stomach or tube-stomach and the consequences originating from the route of replacement (e.g., anterior or posterior mediastinal route). Incidence and management of chylothorax are also dealt with. While dealing with late complications, the authors give a detailed comment on anastomotic strictures and also other factors facilitating the development of late dysphagia, such as peptic stricture and tumor of the organ remnant. Finally, some cases successfully treated by surgery are presented (skin-tube formation in cases following transplant necrosis; abolition of a pharyngogastric anastomosis stricture using a free jejunal transplant and surgical solution of an anastomotic stricture from median sternotomy approach).
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PMID:Complications following esophageal surgery. 1069 50

Two cases of acute presentation of cervical syringomyelia associated with Chiari malformation are reported. In the first case, dysphagia was the main symptom; the second patient had symptoms suggesting acute brain stem ischemia. The mechanism of this acute onset of the illness is discussed.
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PMID:[Acute onset syringomyelia: two cases]. 1145 90

Reversible thermal injury to the esophagus from drinking boiling-hot liquids has been reported to produce alternating pink and white linear bands that impart a "candy-cane" appearance to the inner esophageal wall. This injury has been associated with chest pain, dysphagia, odynophagia, and abdominal pain. We describe a case of candy-cane esophagus caused by thermal injury from smoking freebase cocaine, associated with left shoulder and arm pain, diaphoresis, hypotension, and transient cardiac ischemia. This case illustrates the importance of considering candy cane esophagus in the evaluation of chest pain, even when this symptom is suspected to be of cardiac origin.
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PMID:Candy cocaine esophagus. 1200 65

Our objective was to assess the complications of laparoscopic fundoplication in 77 patients older than 70 years of age. The indications for surgery were (1) complications of reflux esophagitis (n = 17), (2) large hiatal hernia (n = 10), (3) asthma and bronchitis (n = 7), (4) the need for other surgery (n = 13), and (5) a patient's desire to discontinue medical treatment that was controlling reflux esophagitis (n = 30). Operative time varied from 34 to 250 minutes (mean [standard deviation], 116 +/- 20). Hospital stay varied from 12 hours to 19 days (mean, 1.2). No patient needed conversion to open operation. Intraoperative complications were observed in 4 patients (5.2%): left pneumothorax in 2, major operative bleeding in 1, and minor spleen lesion in 1. The most common postoperative complications were gas-bloating syndrome and dysphagia. Gastric ulcer was diagnosed in two. Other postoperative complications included acute delirium, acute urinary retention, and acute ischemia of the lower extremity. One patient died of congestive heart failure. It is concluded that laparoscopic fundoplication is an effective procedure for treating geriatric patients with reflux esophagitis and may be performed with low morbidity and mortality rates.
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PMID:Complications of laparoscopic fundoplication in the elderly. 1259 50

Aberrant subclavian arteries, which form a type of vascular ring, elicit symptoms of dysphagia and chronic respiratory problems. Simple division of the encircling vessel has been the accepted treatment but has frequently led to various long-term complications. These include ischemia of the arm, which in turn results in claudication and the subclavian-vertebral "steal syndrome." Improved methods of reconstructive vascular surgery allow reestablishment of direct flow to the subclavian artery by means of graft insertion or reimplantation of the aberrant artery. With the use of these newer techniques, vascular continuity has been restored in two young patients.
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PMID:RETROESOPHAGEAL SUBCLAVIAN ARTERIES: SURGICAL MANAGEMENT OF SYMPTOMATIC CHILDREN. 1521 11

During the past 2 years, 3 anomalous right subclavian artery aneurysms have been encountered at the St. Louis Heart Institute. The 1st patient, a 72-year-old woman, was found to have an asymptomatic 5-cm-diameter anomalous right subclavian artery aneurysm after surgery for suspected rupture of an abdominal aortic aneurysm. Resection was not attempted because of her poor cardiopulmonary and renal condition. One year later, the patient remains alive with marked cardiopulmonary limitations. The 2nd patient, a 77-year-old man, experienced dysphagia and severe weight loss because of a 14-cm-diameter aneurysm. Three days after undergoing surgical repair, he required reoperation for graft occlusion with right upper-extremity ischemia. Six months after hospital discharge, he died of pulmonary insufficiency and metastatic colon cancer. The 3rd patient, a 73-year-old woman, required emergency surgical intervention because of acute rupture and hypovolemic shock. Thirteen days later, she died of aspiration, asphyxia, and cardiac arrest. On the basis of our experience and a review of the literature, we conclude that symptomatic anomalous right subclavian artery aneurysms are rare, and that surgical intervention entails a relatively high morbidity and mortality rate. If long-term survival is anticipated, associated medical illnesses should be considered before surgery is undertaken.
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PMID:Anomalous right subclavian artery aneurysms. Report of 3 cases, with a review of the literature. 1522 83


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