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)

A 19-year-old Negro female, gravida 2, para 1, was presented at the Queen Elizabeth Hospital in Barbados, West Indies with difficulty opening her mouth; bleeding, and spasms of the skeletal muscles. A week before, she had undergone an illegal abortion performed by a friend. Curettage; tracheostomy; and passage of a nasogastric tube under general anesthesia were performed after admission. Antitetanus serus; high doses of diazepam; promazine for sedation; and antibiotics were administered. Curarization; assisted ventilation; and maintenance of nutrition through parental fluids were observed. Bilateral pneumothorax; tachycardia; and hypotension complicated the patient's course. The patient was discharged on the 40th day of hospitalization and was advised to visit the medical and gynecology clinic for follow-up examination and completion of tetanus immunization. Factors critical in the management of postabortal tetanus patients include: 1) recognition of classical signs of trismus; risus sardonicus; dysphagia and increased muscular tone and spasms; 2) use of antitetanus serum after sensitivity testing; 3) antibiotic coverage for clostridia and anaerobic organisms; 4) tracheostomy; curarization and assisted ventilation where necessary; 5) continuous medical and nursing care in a quiet room; 6) adequate hydration and nutrition; 7) treatment of site of injury, and curettage where necessary; 8) hysterectomy where necessary; and 9) post treatment immunization.
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PMID:Post-abortal tetanus. 120 40

Between January 1975 and December 1989, the Cardiothoracic Unit of the University College Hospital, Ibadan (U.C.H.) carried out 47 oesophageal replacement procedures using the stomach. The ages of the patients ranged from 3 to 75 years (mean = 53.2 +/- 19.3 years). There were 24 males and 23 females. The indications for oesophageal replacement were as follows: Carcinoma of the oesophagus--34 patients (73.9%), Corrosive stricture--9 patients (17.4%), peptic stricture--1 patient (2.2%), granulomatous oesophageal lesion--1 patient (2.2%), submucous cysts--1 patient (2.2%), oesophageal perforation--1 (2.2%). Twenty patients (58.8%) with oesophageal carcinoma died between 9 and 33 days after operation. The patients with oesophageal perforation, granulomatous lesion and submucous cysts died from sepsis 8, 13 and 6 days respectively after operation due to anastomotic leak. Three patients with corrosive stricture (24%) died 10, 13 and 15 days respectively after operation. All the other 21 (54.7%) patients survived with good results as judged by the absence of dysphagia. Eight of the fourteen surviving patients with carcinoma are lost to follow-up and are presumed dead. There were two intra-operative deaths (4.3%). The operative approaches used were: Transthoracic (21 patients; 9 deaths), Transhiatal oesophagectomy (14 patients; 9 deaths) and retrosternal route (12 patients; 8 deaths). In terms of morbidity, more complications were observed with the transhiatal oesophagectomy (Orringer's technique). It is concluded that whereas oesophagoplasty with the stomach offers good results in patients with benign strictures, the results with carcinoma of the oesophagus in our environment is poor.
West Afr J Med
PMID:Oesophageal reconstruction using the stomach. 130 85

Ninety four neurologists in the United Kingdom, China, and West Germany responded to two structured questionnaires. The first assessed the diagnostic weighting assigned to a number of symptoms, signs, and clinical investigations ascertained from classical descriptions and case notes of patients with motor neuron disease (MND). The second tested the likelihood and consistency of diagnosis in a series of case summaries representing the clinical data of 10 patients with clinically and pathologically documented motor neuron disease. There was a wide measure of agreement concerning the common clinical features of the disease, especially regarding fasciculation of the tongue, fasciculation associated with weakness seen in more than one limb, and dysphagia. In the case summaries, however, there was clear variation in the ranked likelihood of the diagnosis of MND and in the consistency of diagnostic behaviour in the different groups of neurologists. These findings support the need for internationally agreed criteria in the diagnosis of MND. Any such criteria will need to be tested against a standardised data set to establish their validity.
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PMID:Diagnosis of motor neuron disease by neurologists: a study in three countries. 180 Jun 71

Patients at various stages of human immunodeficiency virus (HIV) infection require rehabilitation services. These patients present problems for each of the disciplines in a rehabilitation team, and all team members must confront the psychosocial and ethical issues involved with the disease. Patients with HIV infection may have polyneuropathy with multisystem involvement, including dysphagia, autonomic dysfunction, respiratory failure, bowel and bladder dysfunction, generalized weakness, a painful sensory neuropathy, and depression. Guidelines are presented for determining if inpatient rehabilitation or other settings are appropriate. Case management is a valuable strategy for the rehabilitation of patients with this complicated disorder.
West J Med 1991 May
PMID:Human immunodeficiency virus infection and diffuse polyneuropathy. Implications for rehabilitation medicine. 186 48

With the advent of effective antituberculous therapy and pasteurisation of cow's milk, there has been considerable reduction in the worldwide prevalence of tuberculosis. Although tuberculosis of the tonsil is now an uncommon finding, tonsillar granulomata are occasionally seen by histopathologists and rarely, some contain tuberculous organisms. One such case has prompted us to examine the tonsils of seventeen cases of open pulmonary tuberculosis complaining of sore throat, dysphagia or other pharyngeal symptoms. No granulomata were demonstrated in fourteen who yielded representative tonsillar tissue, underlining the rarity of association between secondary pulmonary tuberculosis and tonsillar involvement.
West Afr J Med
PMID:Tuberculosis of the tonsil revisited. 191 91

A case of fracture of hyoid bone associated with laceration of the pharynx and producing severe dysphagia is presented. The mechanism of the injury, the diagnosis and treatment policy of this rare condition are highlighted to alert clinicians of the importance of the injury.
West Afr J Med
PMID:Fracture of the hyoid bone with laceration of the pharynx. 191 92

Ingestion of caustic material is a major management problem which occurs most commonly in children. Twenty-five patients with caustic ingestion seen over a ten-year period are reported. Twelve patients had severe burns, resulting in oesophageal strictures. Of these, ten were children below six years of age (median age, 3 years). Dysphagia and vomiting were the main presenting features. Oropharyngeal burn was present in 83% of patients with oesophageal burns. The strictures involved the entire oesophagus in two patients, the upper third in four, the mid oesophagus in two and the lower third in four. Periodic dilatations were successful in restoring an adequate lumen in 7 patients with short strictures. Five patients required surgery. There was one death. Caustic damage to the oesophagus is preventable. Education of the public and simple measures by manufacturers of caustics are urgently needed.
West Indian Med J 1990 Dec
PMID:Caustic strictures of the oesophagus. 208 71

The indications for and findings in 431 consecutive patients who had upper gastrointestinal endoscopy in Zaria from June 1978 to August 1982 are reviewed. The major indications were dyspepsia (78.1%), upper gastro-intestinal bleeding (12.1%) and portal hypertension (4.2%). Other indications were persistent vomiting, dysphagia and abdominal masses. The mean age of the patients was 32 years. The male: female ratio (3:1) was not different from that in the hospital population. There were no abnormal findings in 32.7%. 26.6% had duodenal ulcers. Duodenitis was noted in 24.8%, oesophageal varices in 6.3%, gastritis in 6.3% and hiatus hernia in 4.6%. In those who presented with upper-gastrointestinal haemorrhage, oesophageal varices (34.6%) and peptic ulcer (17.3%) were the commonest findings. Complication seen commonly were soreness in the throat and thrombophlebitis at the site of valium injection. One death was recorded from the procedure over the period.
West Afr J Med
PMID:Upper gastrointestinal endoscopy in Zaria, northern Nigeria. 208 5

Medication-induced oesophagitis is an unusual cause of oesophageal damage. A patient is presented who developed sudden onset of odynophagia and dysphagia while taking tetracycline. Endoscopy revealed proximal oesophagitis which was confirmed histologically. Symptoms resolved rapidly after stopping the offending drug. Drug-induced oesophagitis should be considered in patients with unexplained oesophageal symptoms. This condition is often unrecognized as symptoms usually resolve on cessation of the drug. Prevention is the best approach.
West Indian Med J 1990 Jun
PMID:Tetracycline-induced proximal oesophagitis. 240 97

The majority of patients with esophageal carcinoma present with dysphagia. The selection criteria and the staging of patients for potential curative resection as well as endoscopic therapeutic options for palliation of this symptom are discussed. The West Virginia University experience has included 14 cases treated with surgical resection and 20 cases treated with laser photoablative therapy. Concurrent radiation and/or chemotherapy have been used in many of the patients.
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PMID:Management of carcinoma of the esophagus. 246 45


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