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)

We retrospectively evaluated the medical records of 15 patients diagnosed with leishmaniasis and of 28 patients diagnosed with paracoccidioidomycosis presenting with involvement of the oral-nasal-pharyngeal mucosa seen at Escola Paulista de Medicina from 1986 through 1990. These patients were compared in regard to the following variables: sex, age, time since disease onset, location of lesion, and clinical complaints. Sex, time since disease onset, lesion at the nasal septum, palate, tongue, and lips, and history of oral pain, dysphagia/odynophagia, and nasal obstruction were significantly different in the two groups of patients. The authors point out to the relevance of these findings in the differential clinical diagnosis of leishmaniasis and paracoccidioidomycosis.
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PMID:[The clinical parameters relevant for the differential diagnosis between mucocutaneous leishmaniasis and paracoccidioidomycosis]. 130 49

Between 1974 and 1988, 10 Mayo Clinic patients had unresectable, locally recurrent, or partially resected chemodectomas. Of these 10 tumors, 9 were confirmed pathologically, and 1 was diagnosed clinically. The chemodectoma was located in the jugular bulb in five patients, the middle ear in three, and the carotid body in two. The following symptoms were noted: tinnitus (in eight patients), loss of hearing (in six), hoarseness (in six), dysphagia (in four), pain (in three), and alteration of mental status (in one). Many patients had more than one symptom. Treatment was delivered with megavoltage photons and electrons; total doses ranged from 16.2 to 52 Gy (median, 46 Gy), and the daily doses ranged from 1.6 to 2.4 Gy. Follow-up among the nine survivors ranged from 3 1/2 to 16 years (median, 7 1/2 years). In one patient, the response could not be assessed because the patient died of renal failure 4 months after treatment. All nine assessable patients had decreased symptoms and objective control of the tumor (no evidence of progression of disease). Of the nine assessable patients, four had complete responses, one had a partial response, and four had stable disease. No patient experienced progression of disease after radiotherapy. We conclude that radiotherapy for chemodectomas yields successful results--namely, decreased symptoms and objective control of the tumor.
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PMID:Results of radiotherapy for chemodectomas. 133 29

Over an 11-year period, 12 patients with foreign body perforation of a previously normal oesophagus were treated in our institution. The foreign bodies were most commonly bones (10 cases), 5 of which were chicken bones; other species were pigeon, rabbit, veal, pork and fish (one each); 2 perforations were due to swallowed dentures. The mean age was 60 years (range 42-73) and 6 patients were female. A degree of psychosocial dysfunction was present in 3 patients. Seven patients presented late (> 48 h after ingestion). The commonest presenting symptoms were fever and pain (8 patients). Other symptoms included dysphagia (7), respiratory distress (3), and late cervical abscess formation (3). The diagnosis was established by contrast oesophagography or rigid oesophagoscopy. A third of the perforations were cervical, the remainder intrathoracic. All patients were treated by surgical drainage with or without primary closure of the perforation. There were no operative deaths. Five patients developed postoperative oesophageal leaks which required reoperation in 1 patient. All patients were well and swallowing normally on discharge from hospital. Follow-up endoscopy or oesophagography was carried out in all patients and confirmed the absence of oesophageal disorders. Foreign body perforation of the oesophagus is a rare but important subentity of oesophageal perforation which responds well to surgical treatment.
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PMID:Foreign body perforation of the normal oesophagus. 138 41

1. Head and neck tumors occur predominantly in men between 50 and 70 years of age who typically abuse tobacco or alcohol. These individuals often have poor oral hygiene and dentition as well as nutritional deficits, and achlorhydria, anemia, and iron and riboflavin deficits are common. 2. The tumor and treatment of head and neck cancer may cause many devastating effects, such as facial disfigurement, dysphagia, alterations in airway and communication, partial or total loss of taste and smell, xerostomia, pain, or fatigue. Treatment and rehabilitation may take months. 3. Although advances in technology and reconstructive surgery have not improved the overall survival rate, they preserve appearance, function, and, ultimately, the patient's quality of life.
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PMID:Head and neck cancer resection and reconstruction: from past to present. 141 30

The authors treated 17 patients with achalasia by a thoracoscopic (15 patients) or laparoscopic (2 patients) Heller myotomy. All patients had dysphagia and an upper gastrointestinal series demonstrating a dilated esophagus with a bird-beak deformity at the cardia. Manometry showed a mean lower esophageal sphincter (LES) pressure of 32 +/- 4 mmHg, incomplete sphincter relaxation on swallowing, and no primary esophageal peristalsis. After operation, mean LES pressure was 10 +/- 2 mmHg. Fifteen patients were fed on the second postoperative day. The average hospital stay was 3 days, and there were no deaths or major complications. In three early patients, the myotomy was not carried far enough onto the stomach, and dysphagia persisted until a second myotomy was performed (laparoscopically in two patients). The authors found that having an endoscope in the esophagus during the operation facilitated exposure and was vital to determine the appropriate length of the myotomy. With regard to dysphagia, final results were excellent in 12 patients (70%), good in two patients (12%), fair in two patients (12%), and poor in one patient (6%). Heller myotomy can be safely and reliably performed with minimally invasive techniques. Dysphagia is relieved, postoperative pain is minimal, hospital stay is short, and the patient can return quickly to normal activity.
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PMID:Thoracoscopic esophagomyotomy. Initial experience with a new approach for the treatment of achalasia. 141 78

Five patients with seizures involving the secondary sensory and/or related areas (SSRA) are presented. Four of five experienced ictal numbness and/or tingling bilaterally and/or axially; this involved fingertips (three patients), lips (two), tongue (two), and was diffuse in one. The fifth patient experienced bilateral ictal pain. Associated ictal symptoms implicating adjacent regions appeared in all five patients, including contralateral clonic movements (two patients), hypersalivation (two), taste (one), vocalization (two), dysphagia (one), and contralateral sensory march (one). Two patients had ictal symptoms suggestive of adjacent temporal lobe involvement. By history, the SSRA was involved at seizure onset in four and by spread in one. All five patients had electroencephalogram (EEG) or subdural EEG supportive evidence of SSRA involvement: ictal (three) and interictal (three). Three patients had lesions in this area shown by magnetic resonance imaging or computerized tomography and all three had histologically proven glial tumours. Relevant experimental physiological and anatomical data are reviewed.
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PMID:Seizures involving secondary sensory and related areas. 142 1

Experience of outpatient esophageal dilation using Savary-Gilliard dilators in 130 patients during a 17 month period is reported. The strictures were radiation induced (48), tumoral stenoses (40), anastomotic (16) and due to other causes (26). Both fluoroscopy and endoscopy were used in 58%, endoscopy alone in 23% and fluoroscopy alone in 19% of patients for placement of the guide wire. One hundred and twenty six stricture dilations (97%) were technically successful. Eighty one (62%) patients could be dilated to 14 mm or more. One hundred and nineteen (94%) patients were dilated in one or two sessions. Among the 109 patients who followed up, dilation was successful in providing adequate dysphagia relief in 97 patients and facilitated the performance of other therapies in 9 patients. Major complications included severe continuous chest pain (1 case), hematemesis (2), fever (4) and transient stridor (2). The patient with persistent pain and 9 patients undergoing other therapies required hospitalization. There were no perforations or death. We conclude that esophageal dilation with Savary-Gilliard dilators is safe and effective even in tumors and post-radiation strictures. It can be performed on an outpatient basis in a majority of patients.
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PMID:Out-patient esophageal dilation: an experience in 130 patients using Savary-Gilliard dilators. 142 33

We reviewed the efficacy and adverse effects of repeated botulinum toxin injections into hyperactive neck muscles of 107 successive patients with spasmodic torticollis. They received 510 injection treatments over a median period of 15 months (range 3-42 months). One patient failed to benefit at all, but 101 (95%) patients reported considerable (moderate or excellent) benefit from at least one treatment. On a global subjective response rating, 93% of 429 treatments resulted in some improvement and 76% in moderate or excellent improvement. Pain reduction followed 89% of 190 treatments with moderate or excellent reduction after 66%. Median duration of benefit was 9 weeks. All torticollis types responded equally well and injections into two (or more) involved neck muscles were more effective than injection into a single muscle. The most frequent adverse effect was dysphagia, occurring after 44% of all treatments, but this was severe after only 2%. Antibodies to botulinum toxin were detected in the serum of three out of the five patients in whom loss of treatment efficacy occurred. We conclude that botulinum toxin treatment is the most effective available therapy for spasmodic torticollis and practical advice is provided for anyone wishing to set up the technique.
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PMID:Botulinum toxin treatment of spasmodic torticollis. 774 82

A retrospective study was performed of an 11 year period (1978-88) to analyse the survival of 112 patients (85 men and 27 women, mean age 63 years) with adenocarcinoma in a columnar lined (Barrett's) oesophagus in respect of surgical treatment, tumour staging, and histological grading. Presenting symptoms were dysphagia (60%) and pain (25%). Only six patients were previously known to have a columnar lined oesophagus. Eighty five patients (76%) underwent partial resection of the oesophagus and cardia. Postoperative mortality was 6%. After resection (n = 85), the 5 year survival was 24%. Survival was significantly better for patients without regional lymph node metastases (stage 0, I, IIA (n = 61): 5 year survival 30%) and even better if the tumour was restricted to the submucosa (stage 0, I (n = 12): 5 year survival 63%). Survival was not influenced by the histological grade of the tumour. Staging based on infiltration of the oesophageal wall and lymph node spread is valuable in determining the prognosis for patients with adenocarcinoma in Barrett's oesophagus.
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PMID:Outcome of surgical treatment of adenocarcinoma in Barrett's oesophagus. 145 66

Esophageal hematoma is a disorder characterized by the sudden development of pain, hematemesis, or dysphagia, commonly with minimal precipitant. We present the case of 59-year-old man with esophageal hematoma, precipitated by eating, with massive hematemesis requiring surgical intervention. A review of 31 additional cases in the literature since 1980 is discussed. The Mallory-Weiss syndrome and Boerhaave syndrome are distinct entities with some clinical similarities.
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PMID:Esophageal hematoma and tear requiring emergency surgical intervention. A case report and literature review. 147 41


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