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)

Thirty-eight patients of NIDDM, 12 of IDDM and 10 healthy age matched controls were subjected to seven standardised autonomic reflex function tests. A scoring criteria was utilised for diagnosing and grading the severity of dysautonomia. Eight patients of IDDM and 24 of NIDDM had dysautonomia. One-third of the patients in each group had grade IV autonomic dysfunction. Severity of autonomic dysfunction was directly related to the duration of disease in NIDDM whereas in IDDM this relation was not seen. Peripheral neuropathy was almost always associated with dysautonomia in NIDDM. On the contrary, in IDDM dysautonomia was independent of peripheral neuropathy. Charcot's arthopathy, dysphagia, constipation and nocturnal diarrhea were always associated with evidence of dysautonomia. Other symptoms viz. gustatory sweating, postural dizziness and impotence did not necessarily indicate dysautonomia.
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PMID:Clinical dysautonomia in diabetes mellitus--a study with seven autonomic reflex function tests. 1252 Oct 82

During the planning stages of deinstitutionalization, the importance of nursing services must be recognized and given priority consideration in the community placement of persons with serious developmental disabilities. The objective of this study was to survey the medical and nursing profile of a group of nonambulatory, institutionalized individuals with profound mental retardation in anticipation of their nursing and medical needs in the community. Data were collected from the Individual Habilitation Plans of 55 individuals who had resided in a residential facility for individuals with mental retardation and were scheduled for community placement Serious medical problems in decreasing frequency were constipation (96%), seizure disorder (70%), poor dental hygiene (67%), cerebral palsy (62%), scoliosis (61%), contractions (41%), aspiration (44%), skin lesions (40%), and dysphagia (22%). Considering the complexity of health issues encountered in this population, adequate nursing and medical planning are critical to the wellness and successful community placement of a population with special needs.
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PMID:Survey of nursing and medical profile prior to deinstitutionalization of a population with profound mental retardation. 1258 97

Alport syndrome (AS) is a hereditary nephropathy with hematuria progressing to end-stage renal failure (ESRF), sensorineural deafness, and specific eye signs (lenticonus, macular flecks, and congenital cataracts). Inheritance is X-linked in about 85% of the cases, caused by different mutations in the COL4A5 gene. Rarely AS is seen in combination with diffuse leiomyomatosis (DL). DL is a tumorous process involving smooth muscle cells, mostly of the esophagus, but also of the tracheobronchial tree and the female genital tract. Characteristically, the patients have deletions of the 5'-end of both the COL4A5 and the COL4A6 genes, respectively. We here present a 9-year-old boy who was admitted because of a newly diagnosed sensorineural deafness. He was born with cataracts and presented symptoms of dysphagia and bronchial irritation in the first year of life. Macroscopic hematuria was first noticed at 2 years during a febrile infection. Since early childhood the boy suffered from severe constipation. Taking together these symptoms, the diagnosis of Alport syndrome with diffuse leiomyomatosis (AS-DL) has to be considered. Genetic analysis demonstrated the predicted deletion of the COL4A5/COL4A6 genes.
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PMID:Alport syndrome with diffuse leiomyomatosis. 1278 10

(1) For the treatment of cancer pain resistant to WHO step I and II analgesics, several oral morphine preparations are available, in immediate-release and sustained-release formulations. (2) A sustained-release form of oxycodone, an old opiate, was marketed in France in 2002 for oral treatment of cancer pain, in two daily doses. (3) The results of three comparative double-blind trials suggest that 1 mg oxycodone is similarly effective to 1.5 mg of morphine. According to another comparative double-blind trial, 1 mg oxycodone has about the same analgesic efficacy as 0.25 mg of hydromorphone. (4) Oxycodone has the usual opiate side effects including constipation, sedation, nausea and vomiting, and pruritus. (5) Oxycodone has not been tested in comparative trials in patients in whom morphine is ineffective or poorly tolerated. (6) The available product range of sustained-release oxycodone does not allow the dose to be adjusted rapidly at the outset of treatment, and is poorly suited to patients who have difficulty swallowing. (7) In practice, oral morphine remains the reference treatment for cancer pain resistant to WHO step I and II analgesics.
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PMID:Oral oxycodone: new preparation. No better than oral morphine. 1282 66

Over a 2-year period, 34 children were referred to the division of pediatric gastroenterology at the University of Virginia with chronic upper gastrointestinal symptoms whose symptoms rapidly and completely resolved when their unrecognized constipation was treated. The average age at presentation was 8.24 (SD 0.78) years and average duration of upper intestinal symptoms was 15.6 (SD 3.5) months. Twenty-six of 34 had experienced recurrent vomiting, 6 complained of chronic nausea, 17 had chronic symptoms of gastroesophageal reflux, and 20 complained of chronic or recurrent abdominal pain, most often in the epigastric region. Smaller numbers had experienced early satiety, choking, gagging, dysphagia, or intermittent diarrhea. Given the prevalence of constipation in childhood, it seems likely that many children who experience chronic upper intestinal symptoms may be suffering from chronic unrecognized constipation as the cause of their upper intestinal symptoms.
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PMID:Recurrent vomiting and persistent gastroesophageal reflux caused by unrecognized constipation. 1520 51

The intrinsic neurones of the enteric nervous system (ENS) play a fundamental role in the regulation of gastrointestinal functions. Although much remains to be learnt about the changes that take place in intestinal nerves during ageing, evidence suggests that selective neurodegeneration may occur in the ageing ENS. Age-associated changes in intestinal innervation may contribute to the gastrointestinal disorders that increase in incidence in the elderly, such as dysphagia, gastrointestinal reflux and constipation. A number of other factors, such as immobility, co-morbidity, and side effects of therapeutic medication for other disorders however, are also likely to contribute to the aetiology of these conditions. An important finding in rodents is that the neuronal losses that take place in the ENS during ageing may be prevented by calorie restriction; an indication that diet may influence gastrointestinal ageing. Thus, it is of importance to understand not only how the ENS changes during 'normal' ageing, but also how external factors contribute to these changes. Here, current knowledge of how intestinal innervation is affected during normal ageing and how these changes may impact upon gastrointestinal physiology are reviewed.
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PMID:Ageing of the enteric nervous system. 1556 36

Food-borne botulism is a disease caused by the ingestion of food contaminated with botulinum toxin, often present in smoked meat, canned food and preserved food; it can occur as sporadic case or as an outbreak. In the last decades there has been an increasing incidence of food-borne botulism in Portugal. The authors do a review of five cases of food-borne botulism, three isolated cases and 2 familiar. Four were associated with the ingestion of smoked ham and one of canned tunafish. The incubation period was 48 hours in one patient and 4 days in another, in the remaining patients it was not possible to determine this period. The clinical picture was dominated in all patients by diplopy, dysphagia, dizziness, blurred vision, dry mouth and constipation, and in two patients there were gastrointestinal complains. In one patient the electromyography findings were compatible with pre-synaptic neuromuscular blockage. A toxin type B was found in the serum of one patient and in the food involved in the two familiar cases. All patients experienced complete recovery with only symptomatic treatment. With this article the authors intend to call attention to this diagnosis, which is not rare, but difficult for someone not familiar with its presentation, being of notice that the diagnosis is essentially clinic with a strong epidemiological history, confirmed by typical electromyography findings and by the identification of the toxin involved. In Portugal there is only descriptions of clinical cases associated with the type B and the type E toxins, not being necessary the resource to the antitoxin therapy.
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PMID:[Food-borne botulism: review of five cases]. 1563 28

The aim of this study was to investigate the presence of gastroesophageal reflux with 24-hour pH monitoring in children with cerebral palsy. In the second part of the study, we started cisapride with the children with documented gastroesophageal reflux and evaluated the efficacy of cisapride with the second 24-hour pH monitoring. This study was performed before discontinuation of cisapride with US Food and Drug Administration reports in Turkish markets. Twenty-eight children who had been followed up in the Department of Pediatric Neurology between 1999 and 2000 were enrolled in the study. Twenty-four-hour pH monitoring was performed on all patients. Two parameters were evaluated as pathologic: a reflux index (percentage of time the pH value was <4) over 4.5% and reflux longer than 15 minutes even when the reflux index was below 4.5%. Cisapride treatment was assigned to the patients with pathologic monitoring results at a dose of 0.2 mg/kg/day for 3 months. Electrocardiograms (ECGs) were analyzed before and after cisapride treatment. Symptoms suggestive of gastroesophageal dysfunction were dysphagia in 18 cases (64.3%), constipation in 8 cases (28.6%), vomiting in 6 (14.2%) cases, and recurrent pneumonia in 2 cases (8.5%). The reflux index was > or =4.5% in 13 (46.4%) of the 28 cases. Reflux was longer than 15 minutes in 2 (7.1%) cases. Cisapride was started in 15 cases with pathologic monitoring results. Appetite improved in 6 cases and dysphagia disappeared in 8 cases after cisapride therapy (P < .05). pH monitoring was repeated in 12 cases after 3 months and was normal in 8 of them. Improvement in the reflux index and total reflux episodes was statistically significant after therapy (P = .008). No adverse effects occurred. Even though the drug is no longer marketed, we concluded that it improved the symptoms and quality of life in spastic children with gastroesophageal reflux.
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PMID:Gastroesophageal reflux in children with cerebral palsy: efficacy of cisapride. 1570 73

Thyroid diseases may be related to gastrointestinal motility symptoms. Such symptoms can vary in degree and, sometimes, are the only clue of a thyroid disease or, at least, the first. The mechanism by which the thyroid hormones can influence gastrointestinal motility, even if not still completely elucidated, can be found in a synergism between a direct effect of the thyronins and an indirect effect mediated by cathecolamines on the muscle cell receptors. Neck discomfort and dysphagia are common findings in patients with thyroid diseases. Hyper- and hypothyroidism can impair esophageal motility, modifying pharyngo-esophageal structure and/or muscular function and interacting with the neuro-humoral regulation of the esophageal peristalsis. Oesophageal motility alterations, observed in patients affected by small non-toxic goiter, are less understandable. At the gastro-duodenal level, basic and postprandial electric rhythm alterations have been observed in hyperthyroid patients, often associated with delayed gastric emptying, too. In such patients, the autonomous nervous system dysfunction may even modify the neuro-hormonal mutual regulation (vagal influence decrease) of the gastro-duodenal myoelectric activity. Hypothyroidism may cause a delay of the gastric emptying too, but such pattern may also be related to an associated autoimmune disease or to an independent chronic modification of the gastric mucosa. Diarrhoea and malabsorption are common findings together with hyperthyroidism, whereas constipation is frequently observed in hypothyroidism. The clinically most demanding situation is certainly the secondary chronic intestinal pseudo-obstruction syndrome, which involves the bowel in most cases, but may also show up by means of a mega-small bowel or a mega-duodenum, or even all of the above. In conclusion it may be stated that: 1) thyroid diseases may be related to symptoms due to digestive motility dysfunction. 2) Any segment of the gastrointestinal trait may be involved. 3) The typical clinical manifestations of the thyroid illnesses may be borderline, missing or concealed by other intercurrent illnesses, especially in the elderly patients. 4) Motility-related digestive symptoms may conceal an underlying, easily misdetected, thyroid disease and must be therefore carefully analyzed.
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PMID:[Thyroid-intestinal motility interactions summary]. 1578 86

Foods that account for 90% of allergic reactions in children are cow's milk protein, eggs, peanut, soy, tree nuts, fish, and wheat. Food allergy can manifest as urticaria/angioedema, anaphylaxis, atopic dermatitis, respiratory symptoms, or a gastrointestinal (GI) disorder. GI allergic manifestations can be classified as immunoglobulin E (IgE) mediated (immediate GI hypersensitivity and oral allergy syndrome); "mixed" GI allergy syndromes (involving some IgE components and some non-IgE or T-cell-mediated components) include eosinophilic esophagitis and eosinophilic gastroenteritis. Non-IgE-mediated or T-cell-mediated allergic GI disorders include dietary protein enteropathy, protein-induced enterocolitis, and proctitis. All these conditions share a common denominator: the response of the immune system to a specific protein leading to pathologic inflammatory changes in the GI tract. This immunological response can elicit symptoms such as diarrhea, vomiting, dysphagia, constipation, or GI blood loss, symptoms consistent with a GI disorder. The detection of food allergies can be accomplished by the use of radioallergosorbent (RAST) testing and skin prick tests in helping to assess the IgE-mediated disorders. Patch tests may help evaluate delayed hypersensitivity reactions. Treatment of GI allergic disorders ranges from strict dietary elimination of offending food(s), use of protein hydrolysates, and use of L-amino acid-based formula when protein hydrolysates fail. Treatment with topical (for eosinophilic esophagitis) or systemic steroids is used if all dietary measures are unsuccessful. Maternal breast feeding or the use from birth of hydrolysate formulas (extensive or partial hydrolysates) may be efficacious in the prevention of atopic disease in "high-risk" families (with at least 1 parent or sibling with a history of atopic disease).
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PMID:Gastrointestinal manifestations of food allergies in pediatric patients. 1620 93


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