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)

The author presents the clinical history of 14 patients, from 21 to 48 years of age, 10 men and 4 women, with a final diagnosis of acute epiglottitis who were hospitalized at Gorgas Army Hospital or at the San Fernando Clinic. All the patients had pharyngitis and dysphagia, a few with nasal voice, stridor and difficulty breathing, as the chief complaint. All the patients were initially intubated orally for diagnostic purposes and immediately after nasotracheal intubation was done until the patient improved in 2 or 3 days (one patient remained intubated for 5 days). All patients were kept in the Intensive Care Unit and were treated with Ampicillin and Chloramphenicol IV and lately with a second generation cephalosporin (Cefamandole). The patients allergic to Penicillin were treated with Clindamycin and Chloramphenicol. Corticosteroids were not used in any of the patients. There were no sequelae and none of the patients expired.
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PMID:[Acute epiglottitis in adults]. 143 5

A double-blind, placebo-controlled study was carried out in 231 adult patients suffering from acute diffuse pharyngitis or acute tonsillitis with fever and dysphagia to assess the effectiveness of niflumic acid combined with standard antibiotic therapy in relieving pain and inflammation. Patients were allocated at random to receive either 4 capsules of 250 mg niflumic acid or placebo daily in addition to 1.5 million units phenoxymethyl penicillin for 4 to 5 days. Clinical assessments before and after 2 and 4 days of treatment showed that there was faster resolution of fever, pain, adenopathy, pharyngeal congestion and dysphagia, and improved patient comfort in the niflumic acid group. Few side-effects were recorded and there were only 4 drop-outs due to side-effects in patients receiving niflumic acid.
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PMID:Double-blind, placebo-controlled, multi-centre trial of the efficacy and tolerance of niflumic acid ('Nifluril') capsules in the treatment of tonsillitis in adults. 210 60

A retrospective study was undertaken to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic studies. Ratios of soft-tissue structures in 31 patients aged 7 months to 61 years with epiglottitis were compared with those of age- and sex-matched controls with croup, pharyngitis, and dysphagia. The ratios of epiglottic width to third cervical vertebral body width (EW/C3W) of more than 0.5, of aryepiglottic width to third cervical vertebral body width (AEW/C3W) of more than 0.35, and of epiglottic width to epiglottic height (EW/EH) of 0.6 or more were all found to be 100% sensitive and specific in differentiating between adult patients with and without epiglottitis. In children, EW/C3W, AEW/C3W, and EW/EH ratios of more than 0.5, of more than 0.35, and of 0.6 or more, respectively, were found to be 100% sensitive in detecting epiglottitis with specificities of 87%, 96%, and 87% respectively. These preliminary results suggest that EW/C3W, EW/EH, and AEW/C3W ratios of more than 0.5, of 0.6 or more, and of more than 0.35, respectively, may be useful in the radiologic diagnosis of epiglottitis in patients of all ages.
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PMID:Radiologic diagnosis of epiglottitis: objective criteria for all ages. 200 78

Tiaprofenic acid (Surgam) is a non steroidal anti-inflammatory drug used in France for the treatment of acute inflammation, during episodes of upper respiratory tract infections of children and adults. The efficacy and tolerance of tiaprofenic acid for the treatment of inflammation during adult tonsillitis and pharyngitis were evaluated by a randomized double-blind study versus placebo. We used evaluation criterion taking into consideration dysphagia and inflammatory physical indications of tonsillitis and opinions of investigators and patients. Sixty patients have been included in this study. They received either tiaprofenic acid or placebo during five days together with penicillin V. After 48 hours and 5 days of treatment, the efficacy of tiaprofenic acid was significantly superior to placebo on all principal test studied. Tolerance was good in both groups.
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PMID:[Efficacy and tolerance of tiaprofenic acid in pharyngitis in adults. Results of a randomized study vs placebo]. 252 49

The clinical course of 71 patients with acquired immune deficiency syndrome (AIDS) was evaluated to determine relationships among nutritional status, gastrointestinal symptoms and survival. At baseline, weight loss was present in 98%, hypoalbuminemia (less than 3.5 g/dl) was present in 83%, and gastrointestinal symptoms included pharyngitis (54%), diarrhea (42%), nausea (23%), dysphagia (21%), and anorexia (18%). Both the magnitude of body weight loss and the serum albumin level were strongly associated with life-table analysis of survival. For weight loss, median survival of 520 vs. 48 days occurred in patients with less than 10% versus greater than 20% baseline weight loss, respectively (p less than 0.01). The substantial influence of serum albumin on survival is outlined below. (table; see text) In almost all cases, serial evaluation demonstrated progressive linear decrease in body weight and albumin. In patients with normal baseline albumin, the rate of 0.7 mg/dl albumin decrease per day was less than half that in patients with baseline hypoalbuminemia. A projected "time to develop an albumin level less than 2.5 g/dl" was calculated for patient groups based on initial albumin level and the rate of albumin decrease. The calculated interval was similar to the actual median survival time observed in these groups. We conclude that 1) nutritional status may represent a major determinant of survival in AIDS and 2) the rate of albumin decrease may define a function limiting survival of individual patients with AIDS.
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PMID:Nutritional status, gastrointestinal dysfunction, and survival in patients with AIDS. 210 28

A number of typical ENT complaints which do not involve organic signs or symptoms are presented, such as sinusitis-like headache, otitis-like earache and tonsillo-pharyngitis-like dysphagia. Since patients with such complaints usually visit an ENT specialist first, an introduction of additional diagnostic and therapeutic measures is imperative. Without having been trained in chirotherapy, it is possible to identify painful locations, myogeloses and functional disorders in the craniocervical area. In many cases treatment of these disorders leads to disappearance of associated irritational complaints. In addition to local treatment of the neck, the ENT specialist may employ a procedure as described. Superficial infiltration of the mucous membrane is performed with a local suprarenin-free anaesthetic in an area around the upper wisdom tooth and on the palatoglossal arch. This procedure often leads to spontaneous and lasting relief of symptoms. It is assumed that this has the effect of inhibiting the pathologically irritated afferents and thus of interrupting an altered reflex arc. Relief from the complaints is improved by physiotherapy and by avoiding the detrimental influence of bad posture, nervous stress, air draughts, cold chills etc. Extensive massage therapy can result in worsening of complaints.
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PMID:[Neck-induced myoneural irritation pain--a recommendation for therapy by the ENT physician]. 328 78

One hundred forty-two children with presumed Group A beta-hemolytic streptococcal (GABHS) pharyngitis were enrolled in a randomized double blind prospective study comparing the consequences of immediate penicillin treatment with treatment delayed for 48 to 56 hours. One hundred fourteen of the enrolled patients were culture-positive. An adverse impact of early antibiotic therapy was noted; the incidence of subsequent infections with GABHS was significantly greater in those treated at the initial office visit with penicillin. In the month following documented evaluation of GABHS, a recurrence occurred 2 times more frequently in those treated with penicillin immediately compared with those for whom treatment was delayed 48 to 56 hours. Late recurrences (beyond 1 month but in the same streptococcal season) occurred 8 times more frequently (P less than 0.035). Delay in penicillin treatment did not increase GABHS intrafamilial spread. Symptoms of both groups were assessed for 2 days following the initiation of treatment. Both placebo-treated and penicillin-treated groups used aspirin or acetaminophen ad libitum. Penicillin was shown to reduce fever and relieve sore throat, dysphagia, headache, abdominal pain, lethargy and anorexia significantly beyond that achieved with aspirin or acetaminophen alone. Penicillin had no effect on culture-negative cases.
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PMID:Adverse and beneficial effects of immediate treatment of Group A beta-hemolytic streptococcal pharyngitis with penicillin. 330 16

Cellulitis due to Hemophilus influenzae type B is a rare but treatable event in adults. Herein is described a 67-year-old woman with anterior neck cellulitis caused by H. influenzae type B, documented by positive blood culture results. Six additional cases reported in the literature are reviewed. The following clinical syndrome emerges: the patient is usually older than 50 years of age, and pharyngitis develops first, followed by the onset of high fever and rapidly progressive anterior neck swelling, tenderness, and erythema associated with dysphagia. Because the causative organism may be resistant to ampicillin, the early use of chloramphenicol is recommended along with a beta-lactamase-resistant penicillin or cephalosporin (to cover other potential pathogens), or an appropriate third-generation cephalosporin that would also adequately cover all possible pathogens.
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PMID:Hemophilus influenzae type B cellulitis in adults. 376 1

Sixty 3- to 14-year-old outpatients with positive streptococcal group A bacterial cultures and clinical signs and symptoms of pharyngitis were treated with a single intramuscular (IM) injection of penicillin G benzathine/penicillin G procaine in a multicenter study. At the first follow-up visit, usually within 48 hours of the injection, 60 children had negative cultures, and the mean body temperature had decreased from 100.2 +/- 1.6 degrees F to 98.5 +/- 0.5 degree F (P less than 0.05). At this time, the investigators rated 77% of the children clinically cured and the remaining 23% improved; major signs and symptoms (sore throat, difficulty swallowing, lethargy, and cervical node enlargement and tenderness) had disappeared in nearly all of the children. Initial injection site pain, noted in only 15% of the children 48 hours later, probably was secondary to the injection and not drug related. Most other adverse reactions (in seven children) also were injection related, were mild or moderate, and required no countermeasures. At the second follow-up visit approximately 10 days after injection, all children were considered clinically and bacteriologically cured. Thus, the combination of IM benzathine and procaine penicillin not only is safe and effective but eliminates compliance concerns.
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PMID:Rapid symptomatic relief of streptococcal pharyngitis in children. 379 63

We treated four adults whose upper airway was compromised due to acute epiglottitis. We also reviewed the English literature for all reports of this condition in adults (18 years and older). Among the 158 cases, the infectious etiology was identified in 29 (H. influenzae 20, Streptococcus pneumoniae six, H. parainfluenzae two, Streptococcus pyogenes one). In the remaining cases, the etiology was uncertain. Bacteremia was documented in 23/32 patients (71.9%), but extra-epiglottic infections were strikingly rare (X = six). The clinical manifestations were sore throat (100%), fever (88%), dyspnea (78%), dysphagia (76%), anterior neck cellulitis or tenderness (27%), hoarseness (21%), pharyngitis (20%) and anterior cervical lymphadenopathy (9%). Complete airway obstruction ensued in 23 out of the 119 subjects (18.3%) who had respiratory difficulty. Overall mortality rate was 17.6% but it was 6.4% among the patients who were semi-electively tracheostomized or endotracheally intubated. These findings illustrate that antibiotics therapy active against H. influenzae is required in the treatment of acute epiglottitis in adults. Additionally, airway patency should be established when inspiratory stridor appears assuring uncomplicated recovery.
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PMID:Acute epiglottitis in adults. 670 91


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