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)

Myotonic dystrophy or Steinert's disease may be discovered during acute respiratory failure, sometimes caused by a general anaesthetic. It complicates chronic respiratory failure which is present in almost all cases, both restrictive and obstructive, the clinical signs of which progress with the myopathy. Apart from myotonic degeneration of the respiratory muscles, a hypoventilation syndrome of central origin has been described, but the etiology of this respiratory failure is dominated by repeated aspiration pneumonia favoured by constant dysphagia and passage of food into the trachea and poor cough reflex. One should attempt to correct this.
 ...
PMID:[Myotonic dystrophy and acute respiratory insufficiency]. 19 96

From January 1986 through 1990, 70 children (42 boys, 28 girls) with esophageal stricture resulting from ingestion of caustic potash underwent simultaneous esophagectomy and colonic interposition utilizing the transhiatal esophageal approach. At the time of the procedure, their ages ranged from 14 months to 6 years (mean, 3.2 years). Thoracotomy was needed in one patient due to accidental injury to the tracheal during esophageal mobilization. There were 3 deaths from respiratory failure. Otherwise, morbidity was low, and there were satisfactory long-term functional results. The use of isoperistaltic left colon based on both ascending and descending branches of the left colic vessels resulted in survival of all grafts. End-to-side esophagocolic anastomosis decreased the incidence of both postoperative leak (2 instances) and late stenosis (1 case needed surgical revision). Construction of a length of colonic graft equal to the gap between the esophagus above the stricture and the stomach and fixation of the graft to the edge of the esophageal hiatus reduced the incidence of late colonic redundancy in the chest; this did occur in 4 cases but was not associated with dysphagia. Routine pyloroplasty and anterior cologastric anastomosis to the gastric antrum contributed to the absence of gastrocolic reflux and peptic ulceration in this series.
 ...
PMID:Transhiatal esophagectomy and colonic interposition for caustic esophageal stricture. 140 42

Croup is a common childhood disease that has no specific diagnostic test. It must be differentiated from life-threatening diseases, such as epiglottitis, that demand specific interventions. A high degree of toxicity, the presence of dysphagia and the absence of cough help distinguish epiglottitis from croup. The usefulness and safety of visualization of the epiglottis in patients with croup are controversial. Clinical recognition of respiratory distress and failure is vital. Hypoxia is common. Pulse oximetry is helpful in the assessment of hypoxia, but readings do not correlate with clinical status or respiratory failure. Although studies have not proved that mist therapy is beneficial, the efficacy of racemic epinephrine is well documented. High dose corticosteroids have proved effective in the treatment of croup. Outpatient use of racemic epinephrine and steroids remains controversial.
 ...
PMID:Diagnosis and treatment of croup. 151 65

Tetanus remains a life-threatening disorder and its fulminating course always presents a challenge to the clinician. We retrospectively evaluated 56 patients with tetanus admitted to VGH-Taipei between 1971 and 1990. All of these patients with tetanus on admission showed typical features, with the most common initial complaints being lockjaw and dysphagia (82.6%). They were diagnosed on clinical identification rather than isolation of the causative agent. The laboratory tests were usually nonspecific and of limited value for diagnosis. Overall, 38 patients were seized with tetanus after an identified wound infection. The most common routes were puncture wound (28.3%) and abrasion wound (19.6%). The majority of patients became symptomatic within 10 days (56.5%) and the shorter interval reflected a more overwhelming course (p less than 0.05). Intravenous drug abusers and larger wounds had a poorer prognosis. The average mortality was 39.1% (18 out of 46 patients; male/female 12/6), with lack of statistical difference between sex and mortality (p greater than 0.5). The course of tetanus in the newborn and elderly was also more deadly (mortality rates of 83.3% and 55.6% respectively). Aspiration pneumonia and subsequent respiratory failure accounted for the most common cause (11 cases, 61.1%) of death. The mortality was still high (28.6%) from 1980-90 even with better supportive care and modern therapeutic equipment.
 ...
PMID:Tetanus: 20 years of clinical experience. 165 80

A hybrid gene comprising the bovine thyroglobulin gene promoter and the coding region for the simian virus-40 large T- and small t-antigens was used to generate 30 transgenic mice by microinjection into the pronuclei of single cell embryos. All animals except three developed, as single primitive pathology, a dramatic enlargement of the thyroid gland. Compression of trachea and esophagus, accompanied by dyspnea, inspiratory stridor, and dysphagia, led to a progressive cachexia and premature death attributed to respiratory failure. Despite the large thyroid volume, T4 levels were abnormally low, and the progression of the syndrome could be delayed by a substitutive treatment with thyroid hormones. The rapid evolution of the disease, leading to the death of most founder transgenic animals before the breeding age, prevented transmission of the transgene to their offspring. Only two transgenic lines are presently surviving. Immunohistochemical analysis of the tissues revealed a specific expression of the simian virus-40 antigens in the thyroid cells. Hyperplasia was already obvious at birth. Older animals displayed moderately to poorly differentiated thyroid adenocarcinomas. Electron microscopy revealed, however, the persistence of cell polarity and the presence of microfollicles between the densely packed cells. Cell lines derived from these large T-expressing thyroids were shown to have lost expression of both thyroglobulin and thyroperoxidase, while expressing low levels of TSH receptors. These transgenic mice could constitute an interesting model of aggressive adenocarcinoma, sharing phenotypical similarities with the anaplastic type of human thyroid tumors.
 ...
PMID:Thyroid adenocarcinomas secondary to tissue-specific expression of simian virus-40 large T-antigen in transgenic mice. 171 32

An 80-year-old man was admitted to our hospital with a complaint of insidious hearing loss and facial palsy. Chest X-ray film showed an abnormal shadow in the right lower lobe. Adenocarcinoma of the lung was diagnosed by transbronchial brushing cytology. During admission, headache and dysphagia appeared, although no abnormality was detected in the brain CT and MRI. Lumbar puncture yielded adenocarcinoma cells in the cerebrospinal fluid. A diagnosis of leptomeningeal metastasis from the adenocarcinoma of the lung was considered and intrathecal administration of methotrexate was performed. The patient's condition deteriorated gradually and he died of respiratory failure. Autopsy revealed massive invasion of tumor cells in the leptomeninges of the brain and spinal cord. This case illustrates that facial nerve palsy with insidious hearing impairment may appear as the initial symptoms in meningeal carcinomatosis resulting from lung cancer metastasis.
 ...
PMID:[Insidious hearing loss and facial palsy as the presenting symptoms of meningeal carcinomatosis resulting from adenocarcinoma of the lung]. 175 49

Authors report the postoperative complication rate in 52 patients who had undergone total thyroidectomy for cancer between 1984 to 1989. Total thyroidectomy has been performed in 9.8% of patients surgically treated for nodular thyroid pathology. Patients age average 49 years in a range 16-75; they were 49 women and 3 men. In 50% of cases we found papillary cancer, follicular in 40%, medullary 4% and anaplastic 6%. We shared postoperative complications in two mean groups: 1) aspecific complications as cardiocirculatory failure, respiratory failure, wound infections or collections, granulomas, keloids; 2) surgery related complications such as hypocalcemia, dysphagia, recurrent++ paralyses. The first group, we noticed just one case of respiratory mechanical failure due to severe tracheomalacia that required a temporary tracheostomy performed at the end of surgical procedure; we did not notice any death due to cardio-circulatory or respiratory failure, nor did we notice any postoperative hemorrhage; one patient presented a wound seroma, two patients presented granulomas due to subcutaneous stitches, and three developed papulous drug-induced erythema. The second group, eight patients developed a transient hypocalcemia beginning on the second postoperative day, without relevant tetanic crisis, well treated by calcium administration; only two of these patients developed permanent hypoparathyroidism. In 3 cases we had to perform exeresis of a laryngeal inferior nerve involved by the cancer, while in 5 more cases we noticed a transient monolateral paralysis that disappeared in 2 or 3 months. Three patients presented dysphagia before intervention and healed post-surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Complications after total thyroidectomy in thyroid carcinoma]. 180 89

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.
 ...
PMID:Human immunodeficiency virus infection and diffuse polyneuropathy. Implications for rehabilitation medicine. 186 48

Dysphagia and respiratory muscle weakness are the two most potentially dangerous findings in patients with neuromuscular disease because they predispose to aspiration pneumonia and respiratory failure. Myasthenia gravis is unique among the neuromuscular disorders for the variety of exacerbating factors that may lead to such clinical deterioration. While the major cause of ventilatory failure remains intensification of the underlying autoimmune process, well intentioned therapy may also lead to situations that necessitate ventilatory support. This report describes a patient with myasthenia gravis and respiratory failure and reviews the various etiologies of pulmonary dysfunction that are associated with the natural course of this disease and its treatment.
 ...
PMID:Respiratory failure associated with myasthenia gravis. 204 Aug 30

Although fistulae and hypercalcemia are rare at the time of diagnosis of esophageal carcinoma, they are not uncommon terminal events. Most fistulae communicate with the respiratory tract. Uncommon sites of fistulae due to esophageal carcinoma include extension to the aorta, pleura, pericardium, and mediastinum. We report a patient with a spontaneous pneumomediastinum discovered during radiologic staging of esophageal carcinoma. The symptoms were dysphagia, weight loss, and pneumonia. The patient had hypercalcemia refractory to conventional measures, another adverse prognostic factor. Cisplatin 100 mg/m2 was tolerated without acute toxicity and lowered the serum calcium to normal. However, the patient died due to respiratory failure 2 days after cisplatin therapy. To our knowledge, this is the first report of a spontaneous pneumomediastinum at presentation of an esophageal carcinoma. The course of our patient and a review of the literature suggest that fistulae and/or hypercalcemia are medical emergencies and are often fatal in esophageal carcinoma.
 ...
PMID:Spontaneous pneumomediastinum in esophageal carcinoma. 223 8


1 2 3 4 5 6 7 8 9 10 Next >>