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 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

Preoperative treatment with controlled-release ketoprofen or diclofenac was compared in 56 out-patients, for control of postoperative dental pain, following unilateral or bilateral surgical removal of lower third molars. Six patients were excluded due to non-compliance, leaving 50 evaluable patients. Patients were assessed by the dental surgeon, on the day of the operation and one week later, prior to removal of sutures. Additionally, patients completed a daily diary during the postoperative week. Following surgery, scores for graded dental pain, consumption of paracetamol, incidence of dental bleeding, dysphagia, sleep disturbance and trismus were similar for the two treatment groups. However, median pain scores were consistently elevated in the diclofenac group over those seen with the ketoprofen group. The four adverse events reported were all minor and posed no problem to patient management.
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PMID:Comparison of controlled-release ketoprofen and diclofenac in the control of post-surgical dental pain. 154 48

A 72-year-old man who contracted tetanus after a puncture wound presented with severe dysphagia in association with trismus, risus sardonicus, and nuchal rigidity. We describe his medical course and outcome, including repeated videofluoroscopic barium swallow examinations. We emphasize the value of videofluoroscopy for examining and managing dysphagia in patients with tetanus, in both the acute and chronic stages of this rare illness.
Dysphagia 1989
PMID:Dysphagia in tetanus: evaluation and outcome. 264 Jan 92

Clinical signs in dogs with pseudorabies (Aujeszky's disease) were tabulated from 25 confirmed cases. The duration of disease was short, ranging from 6 to 96 hours. Eight dogs were euthanatized. Of those not euthanatized, 12 (71%) died within 24 hours of onset, 16 (94%) died within 48 hours, and only 1 (6%) lived longer than 48 hours (96 hours) after the onset of clinical signs. All of the dogs had ptyalism, 84% were restless, 84% were anorectic, 76% were atactic, and 64% wandered aimlessly. Sixty-four percent of the dogs had tachypnea, 60% had dyspnea, 56% vocalized, 52% were pruritic, 48% held their necks rigidly, 36% vomited, 36% had muscle spasms, 36% were aggressive, 28% had trismus, and 24% had dysphagia. Five of 25 dogs (20%) had abnormal pupillary light responses. Two of the 25 dogs circled and 2 walked backwards. Each of the following were detected once: blindness, ptosis, facial paresis, excessive lacrimation, head-tilt, head-pressing, signs of abdominal pain, and photophobia. All dogs had been exposed to swine, although in some instances the farmer was unaware pseudorabies existed in the herd or believed it was not in the herd on the basis of negative results on serologic testing.
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PMID:Clinical signs associated with pseudorabies in dogs. 277 5

A case of tetanus is described in a 71-year-old female. Her initial presentation was trismus and dysphagia following a tongue laceration by grossly carious teeth. Subsequently, she developed muscular spasm which led to the diagnosis of tetanus. This paper discusses tetanus generally, and the management of the condition.
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PMID:Tetanus associated with dental sepsis. 315 23

Distinguishing peritonsillar abscess from cellulitis is an important clinical problem, particularly in children, who may require a general anesthetic for drainage of these abscesses. In order to identify those clinical factors most significant for peritonsillar abscess, we did a prospective study of 21 patients who presented with sore throat, fever, trismus, and tonsillar bulge; all symptoms that are consistent with the diagnosis of peritonsillar abscess. On admission, the following parameters were recorded: patient age, duration of sore throat, fever, white blood cell count, drooling, the degree of trismus (measured exactly as incisor-incisor distance), the degree of pharyngotonsillar bulge, and change in voice. After 24 to 48 hours of parenteral antibiotics, 12 patients (57%) had improved sufficiently and were continued on antibiotics until resolution (cellulitis group). Nine patients (43%) had no improvement and underwent surgery for drainage of the peritonsillar abscess (abscess group). At the end of the 18-month study period, the cellulitis and abscess groups were compared. On admission, no significant difference was found in age, duration of sore throat, fever, or white blood cell count. The pharyngotonsillar bulge was mild in 58% and moderate in 42% of the cellulitis group, while in the abscess group, the pharyngotonsillar bulge was mild in only 33% and moderate in 67%. After 24 to 48 hours of parenteral antibiotics, all patients in the cellulitis group had improvement of at least one symptom; whereas, all patients in the abscess group had no change or worsening of at least one symptom, including trismus, dysphagia, voice change, drooling, or pharyngotonsillar bulge. On admission, the precise measurement of trismus was not significantly different in the two groups (24.7 mm in cellulitis group vs. 22.5 mm in abscess group). However, after 24 hours of antibiotics, trismus averaged 7 mm more in the abscess group versus the cellulitis group (p less than 0.05).
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PMID:A clinical prospective study of peritonsillar abscess in children. 316 36

Subsequent to removal of impacted lower third molars the interrelationship of four postoperative variables (swelling, pain, trismus, and dysphagia) was assessed. Patient assessment of postoperative swelling using a visual analogue scale (VAS) was easily accepted by a group (n = 40) of patients aged 17 to 46 years. A significantly positive correlation (r = 0.66, p less than 0.01) existed between metric extraoral swelling and VAS-assessed swelling; however, the latter may represent a more sensitive method when swelling is discrete. Both extraorally and VAS-assessed swelling showed no correlation with dysphagia and VAS-assessed pain. Trismus correlated moderately positively with pain and extraoral swelling (r = 0.38, p less than 0.05) and dysphagia (p less than 0.01). In the present study dysphagia showed no correlation with pain. This study shows that registration of postoperative swelling by means of a VAS may be a sensitive and accurate method with obvious practical advantages.
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PMID:Visual analogue scale assessment of postoperative swelling. A study of clinical inflammatory variables subsequent to third-molar surgery. 318 49

In the preantibiotic era, Ludwig's angina frequently caused asphyxiation and death. Recognized less often today, this rapidly progressive submaxillary cellulitis may still be fatal. A case associated with Haemophilus influenzae bacteremia in an adult is presented. Twelve additional cases of cellulitis of the neck in adults with H influenzae bacteremia are summarized. One hundred forty-one cases of Ludwig's angina reported since 1945 are reviewed and compared with 315 earlier cases. In the cases reported in the antibiotic era, the mean age of the patients was 29 years. Most patients were previously healthy but had evidence of dental disease. Submandibular swelling, elevation of the tongue, fever, dysphagia, and trismus were each present in more than one half of patients. Streptococci and anaerobes were most frequently isolated from soft-tissue cultures. Untreated, this illness is fatal in one half of patients. Early recognition is therefore essential. Appropriate therapy includes maintenance of the airway, antibiotics, and surgical drainage when indicated.
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PMID:Ludwig's angina. Report of a case and review of the literature. 327 67

The effects of radiation therapy on the ability of totally laryngectomized patients to produce voice and speech were examined using objective non-invasive methods. Moderate to severe losses were noted in patients producing voice with all types of alaryngeal modalities: tracheoesophageal, esophageal, and electrolaryngeal. Voice and speech losses were related to the impaired motility and vibratory capability of the esophageal wall and mucosa, to fibrosis of the submandibular region and to trismus. Tracheoesophageal and esophageal voice was recovered some weeks after completion of irradiation. No voice losses were observed in alaryngeal speakers who did not undergo voice restoration until after irradiation. All irradiated patients also showed various degrees of dysphagia during the treatment.
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PMID:The effects of irradiation on alaryngeal voice of totally laryngectomized patients. 338 26

Peritonsillitis encompasses both cellulitis and abscess. To determine the distinguishing factors for cellulitis and abscess, we reviewed 29 patients, 15 with cellulitis and 14 with abscess. Common presenting complaints included dysphagia, trismus, drooling, voice change and fever. Unilateral tonsillar enlargement was usually present, and uvular deviation was noted in 10 of 29 patients. The mean ages of patients with abscess was 15.0 years, and that of patients with cellulitis was 10.8 years. The two groups differed significantly by age (P = 0.02), and discriminant analysis showed age, dysphagia and drooling to be discriminators for abscess patients, while bilaterality or fever were not. Trismus was a discriminator for cellulitis patients. Etiology for abscess included Group A and non-Group A beta-hemolytic streptococci, Group D streptococcus, alpha-streptococcus, anaerobic diphtheroids and coagulase-negative staphylococci. The etiology of the cellulitis was Group A and non-Group A beta-hemolytic streptococci and Streptococcus pneumoniae. Peritonsillitis appeared to increase in frequency. On presentation patients with cellulitis are similar to patients with abscess. Abscess is more likely in adolescents. Recommended therapy is intravenous penicillin and prompt drainage for patients failing to respond.
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PMID:Peritonsillitis: abscess or cellulitis? 346 43


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