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)

Ectodermal dysplasia is a rare group of diseases presenting special problems in management for the otolaryngologist, but the full spectrum of otorhinolaryngologic manifestations has been previously unrecognized in the otolaryngologic literature. The anhidrotic form, characterized by deficient sweating, sparse hair growth and deficient teeth, with associated decreased mucous production in the aerodigestive tract leads to chronic upper respiratory tract infections, otitis, dysphagia, hoarseness, bronchitis and sometimes hemoptysis.
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PMID:Ectodermal dysplasia: the otolaryngologic manifestations and management. 221 Sep 53

We report on 8 children with a right aortic arch and a retrooesophageal component of the upper descending aorta. The chest roentgenogram shows a right aortic arch and the oesophagogram a broad posterior indentation of the oesophagus in every case. Aortography was performed in 5 cases: in 2 children, the branches of the right aortic arch originate in a mirror image relationship to normal, in the other 3 children, the left subclavian artery originates as 4th branch from a retrooesophageal diverticulum of the upper descending aorta. Three children have an acyanotic congenital cardiac defect. Four of the children are asymptomatic while 3 have exertional dyspnoe and one suffers from dysphagia and frequent bronchitis. The symptoms are caused by compression of the oesophagus and the trachea by the right aortic arch, the retrooesophageal diverticulum and the patent or atretic ductus arteriosus originating from the latter. Only one child had to be operated for severe symptoms. There is a significant difference between the right aortic arch with or without a retrooesophageal component. The former mostly occurs alone and sometimes causes clinically significant oesophago-tracheal compression, while the latter is almost always combined with a cyanotic cardiac defect (tetralogy of Fallot, truncus arteriosus) but practically never causes a compression.
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PMID:[The right aortic arch with retrooesophageal component]. 717 20

After a patient died of anastomotic necrosis following a tracheal resection for the management of recurrent thyroid cancer invading the trachea, which had been treated 6 years previously by thyroid lobectomy and 4,800 cGy of radiation to control known residual disease, we explored methods to promote the healing of tissues damaged by irradiation. Between 1979 and 1992, 22 patients underwent major airway resection and reconstruction after receiving large doses of radiation. The average dose was 4,979 +/- 1,113 cGy (range, 3,150 to 6,840 cGy); the number of fractions, 20 to 38; and the average dose per fraction, 180 cGy (range, 150 to 200 cGy). The interval between irradiation and surgical treatment was 42 +/- 105 months (range, 1 to 480 months). Seven cervical, eight midtracheal, and five carinal resections were performed, as well as two mainstem sleeve resections. Omentum was used to protect the anastomosis in 15 patients (68%), a pericardial fat pad was used in 2, and pleura was used in 2. In 3 patients, sternohyoid muscle was placed between the anastomosis and a major vascular structure, but without a tissue wrap. Two patients (9.0%) died postoperatively. Anastomotic dehiscence was the cause of death in a patient treated for lymphoma, and adult respiratory distress syndrome was the cause in the other patient; this patient had undergone carinal pneumonectomy. Complications developed in 8 patients (36%). Two cervical dehiscences were treated by T-tube placement, 2 patients suffered wound infection, and 1 patient each suffered a myocardial infarction, dysphagia, hemoptysis, and bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Reconstructive airway operation after irradiation. 781 13

Vascular rings have been well documented to cause respiratory and gastrointestinal symptoms in infants and children. Few reports document symptomatic vascular rings in adults, and most have emphasized dysphagia as the predominant symptom. We present the case of a 36-year-old white male with a double aortic arch and progressive dyspnea on exertion. This led us to review previous reports of vascular rings in adults. Criteria for review consisted of anatomically complete vascular rings of the aortic arch in adults age 18 years or older. We identified 25 prior cases for review and included our recent patient. The most common vascular ring anomalies in our review of adults is double aortic arch (n = 12; 46%) followed by right aortic arch with aberrant left subclavian artery and ligamentum arteriosum (n = 8; 30%). Of 24 patients (66%), 16 were symptomatic. Reported symptoms involving the respiratory tract (n = 10 of 24; 42%) included dyspnea on exertion (n = 5), bronchitis (n = 2), recurrent pneumonia, stridor, and unspecified respiratory ailment (n = 1 each). Dysphagia was less common, occurring in eight patients (33%). Previously proposed mechanisms for respiratory tract symptoms include tracheomalacia, static or dynamic compression of the airways, intravascular volume infusion, and aspiration. We also propose exercise-induced dilatation of the aortic arch and age-dependent changes in thoracic compliance as potential mechanisms of dyspnea.
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PMID:Vascular rings of the thoracic aorta in adults. 1055 60

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

Foregut cysts frequently cause symptoms in the first three decades of life. The symptoms consist of dyspnea, wheezing, cough and sputum, dysphagia, stridor, and those associated with right heart strain. Symptoms and the radiological appearance of the uncomplicated cyst mimic mediastinal tumour and mediastinal obstruction. The symptoms and radiological appearance of the ruptured infected cyst simulate those of lung abscess, diaphragmatic hernia, ruptured hydatid cyst, cavitated peripheral carcinoma and pulmonary tuberculosis. In this series the differentiation from other cysts was made thus: with intralobar sequestration, a systemic arterial blood supply was demonstrated; with hydatid cyst, there was a positive intradermal skin test and (radiologically) following rupture, the appearance of a pericystic pneumatocele followed by the water-lily sign was diagnostic; with emphysematous cysts, the signs of associated bronchitis were present; in the presence of pseudocysts, there was a previous history of lung abscess, staphylococcal infection or tuberculosis. Cysts should be removed when first diagnosed.
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PMID:Foregut cysts. 1397 21

Hypohidrotic Ectodermal Dysplasia (HED) is a rare recesive genetic disease linked to chromosome X whose main characteristic is the reduction of sweat glands, leading to a deficient sweating and an increase in body temperature. In HED mainly the ectodermal structures are involved such, as epidermis and its anexes (hair and nails), although non-ectodermal tissue may also become involved. Otolaryngologicalmanifestations are related to hypoplasia of the mucous glands of the upper aerodigestive tract, as chronic infections, like rhinitis, pharyngitis, bronchitis and otitis, and also epistaxis, dysphagia, anodontia and, ozena, among others. A case of a young adult male affected with HED who is referred to the Otolaryngology Departament with a history of chronic pharyngitis and ozena, is presented and the literature reviewed.
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PMID:[ENT expression of hypohidrotic ectodermal dysplasia]. 1587 Dec 94

Recurrent respiratory papillomatosis (RRP), which is caused by human papillomavirus types 6 and 11, is the most common benign neoplasm of the larynx among children and the second most frequent cause of childhood hoarseness. After changes in voice, stridor is the second most common symptom, first inspiratory and then biphasic. Less common presenting symptoms include chronic cough, recurrent pneumonia, failure to thrive, dyspnea, dysphagia, or acute respiratory distress, especially in infants with an upper respiratory tract infection. Differential diagnoses include asthma, croup, allergies, vocal nodules, or bronchitis. Reports estimate the incidence of RRP in the United States at 4.3 per 100,000 children and 1.8 per 100,000 adults. Infection in children has been associated with vertical transmission during vaginal delivery from an infected mother. Younger age at diagnosis is associated with more aggressive disease and the need for more frequent surgical procedures to decrease the airway burden. When surgical therapy is needed more frequently than four times in 12 months or there is evidence of RRP outside the larynx, adjuvant medical therapy should be considered. Adjuvant therapies that have been investigated include dietary supplements, control of extra-esophageal reflux disease, potent antiviral and chemotherapeutic agents, and photodynamic therapies; although several have shown promise, none to date has "cured" RRP, and some may have serious side effects. Because RRP, although histologically benign, is so difficult to control and can cause severe morbidity and death, better therapies are needed. The potential for a quadrivalent human papilloma vaccine is being explored to reduce the incidence of this disease.
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PMID:Recurrent respiratory papillomatosis: a review. 1849 62

There is underdiagnosis and low awareness of dysphagia despite that the condition is modifiable and poorly managed symptoms diminish psychological well-being and overall quality of life. Frontline clinicians are in a unique position to be alert to the high prevalence of swallowing difficulty among elderly, evaluate and identify those who need intervention, and assure that individuals receive appropriate care. Proper diagnosis and treatment of oral-pharyngeal dysphagia involves a multidisciplinary healthcare team effort and starts with systematic screening of at-risk patients. The presence of a medical condition such as acute stroke, head and neck cancer, head trauma, Alzheimer's disease, Parkinson's disease, pneumonia or bronchitis is adequate basis for predicting high risk. Systematic screening of dysphagia and resulting malnutrition among at-risk older adults is justified in an effort to avoid pneumonia and is recommended by clinical practice guidelines. Systematic screening with a validated method (e.g. the 10-item Eating Assessment Tool, EAT-10) as part of a comprehensive care protocol enables multidisciplinary teams to more effectively manage the condition, reduce the economic and societal burden, and improve patient quality of life. In fact, care settings with a systematic dysphagia screening program attain significantly better patient outcomes including reduced cases of pneumonia (by 55%) and reduced hospital length of stay.
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PMID:Identifying vulnerable patients: role of the EAT-10 and the multidisciplinary team for early intervention and comprehensive dysphagia care. 2305 97