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)

Review of the world literature to the end of 1971 has provided data on 838 cases of esophageal leiomyomata, including our own 19 surgically removed lesions. Although esophageal leiomyoma is the most common of the benign tumors of the esophagus, it is still rare compared with carcinoma. It occurs in more men than women, by a ratio of 1.9 to 1. Over 50% of the patients with leiomyoma of the esophagus are asymptomatic. Dysphagia and vague pain are the most frequent symptoms. Pyrosis is mentioned in the literature as present in 40% of the cases, but it is considered mainly as symptom of coexistent hiatal hernia. Diagnostic problems often arise, as the smooth muscle tumors may mimic mediastinal neoplasms, cysts, or even aneurysms, or complicate coexisting hiatal hernia and esophageal diverticulum. Operative management by transthoracic enucleation is the procedure of choice, although resection of the esophagaus may be required in few cases. Postoperative morbidity is minimal and results are excellent.
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PMID:Leiomyomata of the esophagus. An analysis of 838 cases. 99 Nov 29

Long-term use of corticoids had proved beneficial in the treatment of advanced stomatological cancers, the effective dose being 40 mg of prednisone per day. In so far as it is possible to distinguish any specific action on individual symptoms, its action on pain was obvious in 40% of cases, on inflammation and infection in 52% of cases on fever (independent of infection) in 14% of cases, on oedema in 34% of cases. It was almost invariably favourable on the general condition. The method of using it emphasize how easy it is to use corticoids by injection which is of particular value in our speciality in view of: dysphagia, administration of large doses, deficiencies in the general condition, sometimes a matter of urgency. The counter-indications usually recognized for corticoids need to be modified in the case of cancer patients. Incidents occur surprisingly rarely and are minor relative to the advantages of the therapy, provided the patient is kept under strict supervision.
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PMID:[Corticotherapy and stomatologic oncology]. 105 39

Invasion of the esophagus by Candida albicans probably occurs more frequently than the reported cases suggest. The disease usually occurs following immunosuppression but may occur after antibiotic therapy. It is heralded by the sudden onset of severe pain and dysphagia, and recovery or death from dissemination may occur. Roentgenographically, impaired motility is much more prominent than disordered motility or spasm. Narrowing, a cobblestone epithelium, and later, erosions and ulcerations are seen. Antifungal agents are adequate therapy.
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PMID:Esophageal moniliasis. A review of common and less frequent characteristics. 110 22

The results of fibreoptic endoscopy have been assessed retrospectively in 71 patients referred for consideration of the oesophagus as the possible or probable cause of their symptoms. Gross endoscopic abnormality was uncommon but friability of the mucosa was seen in about half of the patients with typical symptoms of "reflux-pain" and a quarter of those without. The combination of radiological reflux and endoscopic abnormality--that is, true reflux oesophagitis--was seen in only a third of the patients with typical symptoms though much less commonly in those with atypical symptoms. Histological abnormality was common but did not relate well to symptom pattern. The results of the acid perfusion test were significantly related to symptom pattern though overlap was observed between the two symptomatic groups. Six of these patients had had or were awaiting surgery to correct reflux and they all had uniformly positive findings. This study confirms the value of the acid perfusion test in clarifying the diagnosis of reflux pain, espcially if the symptoms are difficult to assess. Endoscopy and biopsy added little further information of diagnostic value and could probably be reserved for the small minority of patients who have special problems such as blood loss or dysphagia or where clarification of a radiological lesion is required.
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PMID:Oesophagoscopy, biopsy, and acid perfusion test in diagnosis of "reflux oesophagitis". 110 62

During one six-month period 11 patients were referred with a diagnosis of coronary artery disease, because of recurrent episodes of severe, prolonged retrosternal chest pain necessitating from one to seven hospital admissions per patient for "suspect myocardial infarction". In no instance was this diagnosis proved by electrocardiogram or serum enzyme changes, but 7 of the 11 patients had abnormal resting electrocardiograms. Selective coronary arteriograms were normal in 10 patients and revealed nonobstructive coronary artery disease in the 11th patient. Esophageal studies revealed hiatus hernia in 9 and mild to severe disordered motored activity of the esophagus in all 11. Acid perfusion into the esophagus reproduced the chest pain in nine patients and in the other two, the hiatus hernia was incarcerated. On direct questioning, all patients indicated that the pain was worsened by lying down and bending over, and in eight patients there was a history of pharyngoesophageal or gastroesophageal dysphagia. In this day when the problem of chest pain with normal coronary arteries is very topical, our report emphasizes the need to consider symptomatic esophageal disease in the differential diagnosis of this problem.
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PMID:Esophageal disease as a cause of severe retrosternal chest pain. 112 87

Since January, 1972, the authors have operated upon 4 patients with idiopathic diffuse exophageal spasm. Clinical details and barium studies are included. Extramucosal myotomy extending from the gastric fundus to the aortic arch was done in each case. Pre- and postoperative manometric studies were carried out in all. After operation in each patient the dysphagia and substernal pain disappeared and in 3 patients radiological patterns changed. The myotomy was associated with marked fall of contractile wave pressures in the body of esophagus. The basal pressures of the esophageal body elevated, in 2 cases fell after the myotomy; in 2 with normal preoperative pressure it remained unchanged. At the lower esophageal sphincter the resting and yield pressures remained similar to the preoperative readings but the myotomy produced a disappearance of the relaxation and contraction pressure. The authors conclude that with myotomy they cannot correct the nature of the functional disorder but, by reducing the amplitude of the waves and lowering the resting pressure if elevated, they can relieve the patient's symptoms.
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PMID:Pre- and postoperative manometric studies in diffuse esophageal spasm. 115 94

A safe, simple, effective and fast gastrophasty for the dilatable strictured esophagus has proved sound in dogs and feasible and effective in twenty-five patients. Several of the patients who had been operated upon elsewhere had recurrences. Postoperative follow-up studies of the 25 patients operated upon have revealed freedom from substernal pain, dysphagia, aspiration and bleeding in the upper part of the gastrointestinal tract. Encouraged by the success of the surgical techinique in patients with stricture of the esophagus, we have recently applied the same technique in the repair of hiatal hernia without stricture.
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PMID:A simplified, improved techniqe for the Collis gastroplasty for dilatable esophageal strictures. 125 73

The diagnosis, management and outcome in 12 adults with acute epiglottitis was reviewed. Painful dysphagia was a universal symptom and respiratory distress affected eight patients, six of whom required urgent airway intervention. All patients received parenteral antibiotics, ten received steroids and four received adrenaline. Respiratory distress resolved in two patients given adrenaline and airway intervention was avoided. Indirect laryngoscopy is the investigation of choice and this is preferable to neck radiology. Two patients died and it is stressed that this condition must be distinguished from other more common causes of a severe sore throat. The patient should be managed in a unit with the facilities and expertise to effect acute airway intervention.
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PMID:Acute epiglottitis in adults: a potentially lethal cause of sore throat. 769 36

Acute suppurative thyroiditis is an uncommon thyroid disorder usually caused by bacterial infection. The most common route of infection is a fistula that originates from the fundus of the pyriform sinus. Pre-existing thyroid disease, most commonly nodular goiter, has been reported to be present in acute suppurative thyroiditis. A 44 year old man presented a subacute thyroiditis, resolved by nonsteroidal antiinflammatory treatment. One year later, the patient abruptly complained of fever and painful swelling in the thyroid region. A relapse subacute thyroiditis was diagnosed and prednisone treatment was started. A few days later owing to a worsening of the pain and of the clinical features the patient was referred to our department. He presented dysphagia and he was feverish, the overlying skin of the neck swelling was erythematous and warm. There was a neutrophilia (83.7%). Plasma FT4, FT3 and TSH were normal. Anterior neck region ultrasonography showed an enlargement of the left thyroid lobe with poorly defined shapes and inhomogeneous parenchyma while the right lobe of the gland was normal. The 131-I thyroid scan showed a large cold area in the upper part of the left thyroid lobe and preserved radionuclide uptake in the residual parenchyma. The RAIU was normal. We diagnosed acute suppurative thyroiditis and started antibiotics treatment. The day after the patient was still feverish and he gave out from the mouth a great quantity of sero-purulent material with a swelling reduction and improvement of the neck pain. Barium swallow examination did not show any fistula in the cervical esophagus. The fistula opening was demonstrated by indirect laryngoscopy in the postero-lateral side of hypopharynx.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute suppurative thyroiditis in a patient with prior subacute thyroiditis]. 129 72

The present study deals with data from an on-going collaborative programme of early diagnosis for upper aero-digestive tract tumors established since 1990 by three ENT Departments of the Friuli-Venezia Giulia Region, Northeastern Italy. The aim of the study was firstly to evaluate the socio-economic characteristics and clinical features of alcoholics in treatment who were offered a free ENT check-up, and secondly to test the feasibility of this type of referral of high-risk patients from non-medical associations to the ENT specialist. A total of 683 patients, of which 151 (78%) were males and 151 (22%) were females, underwent ENT examination. About 25% of the patients were symptomatic, the most frequent symptom being dysphonia (50%) followed by cough (19%), while dyspnoea, dysphagia and pain were present in about 5% of the patients. Other than nearly 50% negative findings, ENT examination revealed a high percentage of inflammatory lesions (30%) of the upper aero-digestive tract. In 37 patients (6%) a precancerous lesion was found and in four cases an histologically confirmed tumor was diagnosed. Although the present study cannot be considered a complete screening, it did clearly evaluate the amount of response given by this high-risk population of alcoholics in treatment to the offer of an ENT examination and gives encouraging results concerning the feasibility of early diagnosis programmes for upper aero-digestive tract tumors which do not follow the normal routine of a sanitary referral by a general practitioner.
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PMID:[The program for early diagnosis of the upper respiratory tract and digestive system neoplasms offered to alcoholics in the region of Friuli-Venice Giulia]. 130 70


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