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 number of typical ENT complaints which do not involve organic signs or symptoms are presented, such as sinusitis-like headache, otitis-like earache and tonsillo-pharyngitis-like dysphagia. Since patients with such complaints usually visit an ENT specialist first, an introduction of additional diagnostic and therapeutic measures is imperative. Without having been trained in chirotherapy, it is possible to identify painful locations, myogeloses and functional disorders in the craniocervical area. In many cases treatment of these disorders leads to disappearance of associated irritational complaints. In addition to local treatment of the neck, the ENT specialist may employ a procedure as described. Superficial infiltration of the mucous membrane is performed with a local suprarenin-free anaesthetic in an area around the upper wisdom tooth and on the palatoglossal arch. This procedure often leads to spontaneous and lasting relief of symptoms. It is assumed that this has the effect of inhibiting the pathologically irritated afferents and thus of interrupting an altered reflex arc. Relief from the complaints is improved by physiotherapy and by avoiding the detrimental influence of bad posture, nervous stress, air draughts, cold chills etc. Extensive massage therapy can result in worsening of complaints.
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PMID:[Neck-induced myoneural irritation pain--a recommendation for therapy by the ENT physician]. 328 78

One hundred forty-two children with presumed Group A beta-hemolytic streptococcal (GABHS) pharyngitis were enrolled in a randomized double blind prospective study comparing the consequences of immediate penicillin treatment with treatment delayed for 48 to 56 hours. One hundred fourteen of the enrolled patients were culture-positive. An adverse impact of early antibiotic therapy was noted; the incidence of subsequent infections with GABHS was significantly greater in those treated at the initial office visit with penicillin. In the month following documented evaluation of GABHS, a recurrence occurred 2 times more frequently in those treated with penicillin immediately compared with those for whom treatment was delayed 48 to 56 hours. Late recurrences (beyond 1 month but in the same streptococcal season) occurred 8 times more frequently (P less than 0.035). Delay in penicillin treatment did not increase GABHS intrafamilial spread. Symptoms of both groups were assessed for 2 days following the initiation of treatment. Both placebo-treated and penicillin-treated groups used aspirin or acetaminophen ad libitum. Penicillin was shown to reduce fever and relieve sore throat, dysphagia, headache, abdominal pain, lethargy and anorexia significantly beyond that achieved with aspirin or acetaminophen alone. Penicillin had no effect on culture-negative cases.
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PMID:Adverse and beneficial effects of immediate treatment of Group A beta-hemolytic streptococcal pharyngitis with penicillin. 330 16

The authors report a rare case of a huge jugular foramen neurinoma extending to pharyngeal region in a 64 year-old woman who visited an otolaryngologist with complaints of dysphagia, hoarseness and headache in 1984. At that time a submucosal lump was noted in her left pharyngeal region. Biopsy of the tumor proved it to be neurinoma. A CT scan disclosed a dumbell shaped jugular foramen neurinoma and noncommunicating hydrocephalus. Because her symptoms slowly progressed and cerebellar signs as well as signs of increased intracranial pressure was noted, she was referred to our hospital in 1986. She had shown typical sings of left Vernet syndrome, VIIth, VIIIth cranial nerve impairment as well as cerebellar, long tract and increased ICP signs. A subtotal removal was performed from the extracranial and posterior fossa in one stage. The tumor seemed to originate from the Xth cranial nerve. The histological diagnosis of neurinoma was confirmed. Postoperatively, although her dysphagia increased for several weeks, a tracheostomy was not necessary. She was discharged 2 months later and returned to her usual occupation as a house wife. Slight dysphagia and hoarseness were her only chronic symptoms. So far, 88 cases of jugular foramen neurinoma have been reported, 15 of them including our case from Japan. Our case is probably the largest of these reported tumors. Tumors in jugular foramen often masquerade as an acoustic neurinoma or other tumor. However, recently this can usually be diagnosed preoperatively with a careful neurological examination and by means of neuroradiological investigations such as jugular venography, CT scan and MRI.
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PMID:[Huge jugular foramen neurinoma extending to the pharyngeal region: a case report]. 341 64

Infection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negative Pseudomonas aeruginosa bacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well-developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long-term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organism.
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PMID:Osteomyelitis of the base of the skull. 348 33

An open trial of piroxicam, a new nonsteroidal anti-inflammatory agent with long-lasting analgesic and antipyretic activities, was carried out on 49 children as outpatients with viral rhinopharyngitis. Piroxicam administered once daily as an oral suspension gave significant improvement in all parameters, both respiratory (nasal obstruction and discharge, hoarseness, sore throat) and general (headache, dysphagia). A lowering in body temperature was also observed. Recovery seemed to have a more favourable trend in patients treated with piroxicam than to previous treatments. Tolerability of piroxicam was satisfactory in all but six patients who showed only slight transitory side-effects.
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PMID:Treatment of symptoms of rhinopharyngitis in children with a new anti-inflammatory agent. 354 49

A three-year-old boy with a progressive history of headache, vomiting and ataxia in the course of 2 months, was admitted on August 1983, when he was lethargic. Neurological examination revealed dysphagia, scanning speech and tremor in the bilateral hand. CT scan showed a very large enhanced mass in the center of posterior fossa with central necrosis in it and the dilatation of whole ventricular system. Suboccipital craniectomy was immediately performed and the tumor that occupied the vermis and invaded into both cerebellar hemisphere was subtotally removed. Postoperative irradiation was well performed: 4140 rads to the whole brain and 3162 rads to the spinal cord. However, 5 months later, facial palsy in the left side and progressive ataxia became prominent. CT scan showed multiple enhanced masses in the left trigonum and right anterior horn of the lateral ventricles and in the left cerebellopontine angle. In spite of chemotherapy, the patient had a down-hill course, especially after the ventricular hemorrhage, and died on June 9th, 1984. Histologically, the tumor had a lobulated appearance with an aggregation of tumor cells encircled by vascular septae. The cells within lobules generally had vesicular nuclei, which were arranged in parallel row. Occasionally smaller hyperchromatic cells with scant cytoplasm were present along the vascular septae. Reticulin was present within the septa, but was not observed within the lobules. Scattered astrocytic cells and processes were identified within the lobules by the immunoperoxidase technique for GFAP. The fibrillary cytoplasmic processes within the lobules were stained by immunoperoxidase technique for neurofilament (68K).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of cerebellar neuroblastoma]. 361 40

This study was carried out in 30 patients undergoing elective Caesarean section to assess the predictability and reliability of spinal anaesthesia with 5% hyperbaric lignocaine, with a view to incorporating the technique in our failed intubation drill. The spinal was performed with a 25-gauge needle in either the sitting (15 patients) or left lateral position (15 patients). The speed of onset of anaesthesia to T6 was significantly faster (p less than 0.01) in the lateral group, but the duration of action was similar in both groups. Twelve patients had hypotension and four developed severe postspinal headaches. The block progressed to the C2 dermatome in four patients and was associated with dysphagia. This was totally unpredictable and may be due to altered cerebrospinal fluid dynamics in late pregnancy. Therefore, the use of spinal anaesthesia with heavy lignocaine may be inadvisable in obstetric patients, especially following failed intubation.
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PMID:Spinal anaesthesia with hyperbaric lignocaine for elective caesarean section. 377 94

Tiazofurin (2-beta-D-ribofuranosylthiazole-4-carboxamide), a new nucleoside antimetabolite, was evaluated in a phase I trial involving children with refractory cancers. The drug was administered i.v. as a 10-min infusion daily for 5 consecutive days repeated at 3-week intervals. The dose ranged from 550 to 3300 mg/sq m/day. Seventeen patients received 23 courses and were evaluable for toxicity. The maximally tolerated dose was 2200 mg/sq m/day. The major dose-limiting toxicities were nonhematological. Neurotoxicity, including headache, drowsiness, and irritability, was common and was the principal dose-limiting toxicity at the higher doses. Severe myalgias were also dose limiting in one patient. Other side effects were mild, reversible elevations in serum transaminases; nausea, vomiting, and diarrhea; mild hypertension; dysphagia; and exfoliative dermatitis of the hands and feet. Myelotoxicity was not significant. The pharmacokinetics of tiazofurin was studied in 16 patients. Plasma disappearance was triphasic with half-lives of 9.7 min, 1.6 h, and 5.5 h. Clearance was dose related, ranging from 120 ml/min/sq m at 550 mg/sq m/day to 70 ml/min/sq m at 3300 mg/sq m/day. The primary route of elimination was renal with 85% of the drug recoverable in the urine as the parent compound in the 24 h following administration.
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PMID:Pediatric phase I trial and pharmacokinetic study of tiazofurin (NSC 286193). 402 92

The authors described a case of primary intracranial endodermal sinus tumor (EST), and presented a review of 24 reported cases. From the middle of December 1981, this 15-year-old boy experienced progressive diplopia. At the other hospital, partial removal of the intrasellar tumor was performed by a left frontotemporal craniotomy approximately 2 months after the onset of symptoms. The histological diagnosis was suspected to be a pituitary adenoma, and thereafter, 60Co irradiation was carried out for about a month. On June 5th. 1982, the patient was admitted to the Kochi Medical School Hospital, because of increasing headache with diplopia, hoarseness, dysphagia and limitation of tongue movement. On admission, he had a small stature for his age with moderate diabetes insipidus. Neurological examination showed left abducens, glossopharyngeal and vagal nerve palsies in addition to bitemporal hemianopsia. CT scans revealed a heterogenously enhanced high density mass lesion behind the dorsum sellae with an extension from the upper clivus to the sphenoid sinus. Cerebral angiograms showed posterior displacement of the basilar artery. In the endocrinological examination, panhypopituitarism was recognized with a high level of serum alfa-fetoprotein (AFP). While, serum carcinoembryonic antigen (CEA) and human chorionic gonadotropin (HCG) were in normal range. On July 1st. 1982, a left suboccipital craniectomy was performed. The tumor existed mainly in the extradural space along the clivus, and only a small intradural portion of the tumor was excited.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Primary intracranial endodermal sinus tumor with a skull base extension--a case report]. 620 69

A small series of pain syndrome patients shows that disturbances of the head and neck motor system can lead to various pain syndromes as the vicious circle between pain and muscle tension is initiated by a triggering factor. These pain syndromes include varying combinations of the following symptoms: headache, referred otalgia, arthralgia of the temporomandibular joint, styloid syndrome, tendopathia of the hyoid bone, carotidynia, cervical dysphagia and probably most patients with superior laryngeal nerve neuralgia or glossopharyngeal neuralgia. A detailed differentiation of those syndromes is of little value for diagnostic and therapeutical purposes, because the mixed distribution of the pain irradiation does not indicate the localisation of the primary pathology. The pain syndromes of the head and neck motor system can be caused by temporomandibular joint pathology as well as by anatomical or functional alterations of the cervical spine. Acute exacerbations are triggered off by various influences such as inflammation, trauma, scarring after surgery or radiotherapy. Thus diagnostic and therapeutic measures must take into consideration both the motor system itself and any possible triggering factors. The problem frequently needs interdisciplinary co-operation. An attempt to handle the problem within the boundaries of a single discipline such as ENT, may lead to unnecessary and misleading steps. Guidelines for the management of such pain syndromes are outlined.
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PMID:[Pain syndromes of the head, neck and locomotor system--determining current status]. 674 25


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