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)

Based on data indicating that decreases in body weight (BW), arm muscle circumference (AMC), and rapid-turnover proteins (RTPs) correlate with fatal septic complications after surgery for esophageal cancer, we examined possible factors contributing to protein-calorie malnutrition (PCM) in patients with this disease. Eight parameters of nutritional status were assessed. Associations between sex, age, stage of cancer, and degree of dysphagia and PCM were analyzed via multiple linear regression for 75 patients with esophageal cancer and 58 with gastric cancer. These four factors independently contributed to PCM in patients with esophageal cancer, whereas malignant tumor and age contributed to PCM in those with gastric cancer. The degree of dysphagia was related to decreases in serum albumin and RTP and weakly related to decreases in BW and AMC. Stage of cancer, age, and sex were associated with reductions in albumin and/or RTP. Thus, we conclude that simple starvation, malignant tumor, age, and sex contribute to PCM and probably to the occurrence of fatal septic complications postoperatively.
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PMID:Factors related to malnutrition in patients with esophageal cancer. 180 92

A family from eastern Switzerland with oculopharyngeal muscle dystrophy is described. The history shows seven affected persons in three generations. The inheritance pattern is autosomal dominant with complete penetrance. Bilateral ptosis and dysphagia, the hallmarks of the disorder, appear in the fourth decade and progess slowly. The late stage is characterized by ptosis, causing reclination of the head and marked upright posture. Dysphagia may be disabling, causing starvation, or, as in the index case, death by aspiration pneumonia. Surgical procedures are available to correct the ptosis and alleviate dysphagia.
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PMID:[Oculopharyngeal muscular dystrophy]. 647 19

Early weight gain by starving patients managed with total parenteral nutrition has been regarded as spurious - that is, merely an increase in body water. We designed an experiment to mimic the starved state in which glycogen stores are depleted and sodium intake is very low. The subjects were then repleted with a sodium-free, high carbohydrate intake. All subjects who received potassium gained weight and switched to a respiratory exchange ratio which suggested mainly carbohydrate oxidation. From changes in weight and total body water the weight gain was calculated to be the consequence of glycogen storage with 1 g of glycogen obligating 3.21 +/- 0.57 g water. Two patients with total dysphagia showed a similar pattern. Two subjects who did not receive potassium showed a rise in respiratory exchange ratio but failed to store glycogen. Early weight gain in patients who received high-carbohydrate feeding after starvation is a normal phenomenon and represents a return to a more hydrated state consequent upon glycogen repletion.
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PMID:Early weight gain and glycogen-obligated water during nutritional rehabilitation. 681 11

Magnesium deficiency may complicate many diseases. The causes include the following: inadequate intake during starvation or increased requirement during early childhood, pregnancy, or lactation; excessive losses of magnesium as a result of malabsorption from the gastrointestinal tract or from the kidneys during use of diuretics; and to a combination of the two, as in alcoholism. Most often the etiological factors have been operative for a month or more. Acute hypomagnesemia can occur without previous Mg deficiency after epinephrine, cold stress and stress of serious injury or extensive surgery. The clinical manifestations depend on the age of the patient and may begin insidiously or with dramatic suddenness, or there may be no overt symptoms or signs. The manifestations can be divided into the following categories: totally non-specific symptoms and signs ascribable to the primary disease; neuromuscular hyperactivity including tremor, myoclonic jerks, convulsions, Chvostek sign, Trousseau sign (rarely), spontaneous carpopedal spasm (rarely), ataxia, nystagmus and dysphagia; psychiatric disturbances from apathy and coma to some of all facets of delirium; cardiac arrhythmias including ventricular fibrillation and sudden death; hypocalcemia which is responsive only to Mg therapy; and hypokalemia which is not easily nor completely corrected without Mg therapy. The diversity of etiologies and the multiplicity of manifestations result in confusion and controversy. The documentation of normal renal function is absolutely necessary for maximum doses. The order of magnitude of dose is 1.0 meq Mg/kg on day 1, and 0.3 to 0.5 mEq/kg per day for 3 to 5 days. In emergencies such as convulsions or ventricular arrhythmias, a bolus injection of 1.0 gm (8.1 meq) of MgSO4 is indicated. Therapy of Mg deficiency in the presence of renal insufficiency requires smaller doses and frequent monitoring. Complete repletion occurs slowly.
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PMID:Magnesium deficiency. Etiology and clinical spectrum. 702 Mar 47

Esophageal intubation with a plastic prosthesis is a well established palliative treatment for esophageal carcinoma. The technique is safer with endoscopy than previous surgical techniques. Advantages of stent include rapid and long lasting relief of dysphagia in most patients with carcinoma esophagus. Repeated procedures are not required. Placement of prosthesis is the treatment of choice in BEF. Cost is less compared to other palliative modalities such as laser. SEMS have distinct advantages over conventional prosthesis as they may be inserted with less trauma and fewer complications. Diet needs occasionally to be limited to soft or blenderized foods to prevent occlusion. A disadvantage of uncovered SEMS is short duration of palliation due to tumor ingrowth which can be overcome with availability of covered SEMS. Starvation is the most common cause of death in patients with esophageal malignancy. Prosthesis combats deterioration and leads to rapid weight gain. Overall, single time procedure without general anaesthesia, short hospital stay and immediate improvement in dysphagia are considerable gains.
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PMID:Esophageal prosthesis in palliation of malignant esophageal obstruction. 754 40

Anorexia nervosa (AN) is the third most common disorder, after obesity and asthma, in the population of adolescents between 13-18 years of age. Food intake reduction is associated with whole body dysfunction, affecting its physical, psychological and social spheres. As a result of starvation, dysfunction develops in virtually all systems and organs. However, most frequently patients with AN complain of digestive symptoms, such as a feeling of fullness after meals, pain in the upper abdomen, dysphagia, nausea, bloating and constipation. They can have mild functional character, but may also reflect serious complications, including diseases requiring urgent surgical intervention. In addition, gastric complaints may hinder nutritional management of AN. Care of AN patients requires cooperation of many specialists in the field of psychiatry, psychology, paediatrics, internal medicine and nutrition. However, it is often difficult to organize such a team. Therefore, we decided to approach the issues of gastrointestinal symptoms and complications in the course of AN, and the rules of nutritional therapy.
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PMID:Gastrointestinal complications and refeeding guidelines in patients with anorexia nervosa. 2858 33

A 49-year-old lady with no past medical history presented with dysphagia and 40-pound weight loss, which occurred over eight months. On physical examination, she had proximal muscle weakness and crackles in basilar regions of the lungs. Labs were significant for low albumin, elevated transaminases, and high aldolase. Imaging suggested aspiration pneumonitis in both lungs and hepatic steatosis. A swallow evaluation revealed oropharyngeal dysphagia and muscle biopsy confirmed a rare form of myositis. A liver biopsy showed steatohepatitis and a diagnosis of starvation-induced steatohepatitis was made. The patient succumbed to hypoxic respiratory failure from aspiration pneumonitis before the treatment for myositis could be initiated. We report the first case of starvation-induced steatohepatitis in a patient with dysphagia from myositis affecting the oropharyngeal musculature.
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PMID:Thin Patient, Fatty Liver. 3105 22

Although patients with anorexia nervosa (AN) present with various gastrointestinal disorders, little has been understood regarding the incidence and pathophysiology of gastrointestinal ulcers related to AN. A 20-year-old woman with a past history of AN was hospitalized for further examination of dysphagia and chest pain. Her nutritional status was very poor as evidenced by very low body mass index. Esophagogastroduodenoscopy detected longitudinal and geographical ulcers in the entire circumference of the cervical and upper esophagus. Enhanced expression of autophagy-related proteins, LC3B and p62, was seen in the esophageal epithelium surrounding the active ulcers. Expression of these autophagy markers disappeared from the esophageal epithelium soon after the nutritional rehabilitation. Given the fact that starvation and malnutrition are potent inducers for autophagy, these findings suggest that autophagy might be involved in the development of gastrointestinal ulcers in patients with AN.
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PMID:Possible involvement of autophagy in esophageal ulcers in anorexia nervosa. 3190 Aug 39