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)

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.
 ...
PMID:Adverse and beneficial effects of immediate treatment of Group A beta-hemolytic streptococcal pharyngitis with penicillin. 330 16

Acute epiglottitis is seldom encountered in adults, but the condition is probably more frequent than reported in the literature. Nineteen cases of adult epiglottitis were analysed retrospectively. In 53% of the patients, the symptoms were present for less than 24 h prior to hospitalization. Sore throat and dysphagia were invariably present. Three patients presented with stridor and 2 with complete airway obstruction. Throat cultures from 5 patients grew beta-haemolytic streptococci and from 2 Haemophilus influenzae type B was grown. Two tracheotomies and 1 nasotracheal intubation were performed. One death occurred. It is emphasized that any adult with an acute sore throat and dysphagia should undergo indirect laryngoscopy and that blood cultures should always be part of the routine bacteriological investigation. Cooperation and understanding among otolaryngologists and anaesthesiologists is of paramount importance in the management of acute adult epiglottitis, as nasotracheal intubation and cricothyroidotomy appear to be the methods of choice in securing an airway. Ampicillin and chloramphenicol are recommended in the medical treatment.
 ...
PMID:Acute epiglottitis in adults: bacteriology and therapeutic principles. 332 11

Epiglottitis may occur at any age. The typical presentation in the young child and young adult is well known, but the presentation in patients at the extremes of age has not been characterized. At our locale, from 1974 to 1984, 19 children 24 months of age or less and, from 1979 to 1984, 9 adults 50 years of age or greater with epiglottitis were seen in the emergency department. In the infantile group, rapidly progressive interference with swallowing, vocalization, and respiration was encountered in less than half the patients. Symptoms were often prolonged before parents sought attention for their child. No preference was shown for maintenance of the upright position while at rest, as recumbency did not promote stridor or initiate respiratory distress. Respiratory complaints were common and included cough, tachypnea, and retractions. Drooling or retention of pharyngeal secretions was uncommon. The adult population had a history of symptoms that spanned several days. Extreme sore throat, pooling of oral secretions, muffled voice, and elevated temperature were uncommon. Dysphagia and mild respiratory complaints were frequent. Upper airway obstruction did occur. At both extremes of age, exceptions to the classic clinical pattern of epiglottitis occurred with significant frequency. Despite this, diagnosis and management in the emergency department were appropriate in most cases.
 ...
PMID:Epiglottitis at the extremes of age. 337 97

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.
 ...
PMID:Treatment of symptoms of rhinopharyngitis in children with a new anti-inflammatory agent. 354 49

Bleeding involving the upper airway is a rare, highly emergent complication of hemophilia. This report describes the occurrence of two distinct episodes in a patient with severe factor IX deficiency. Clinical data from other cases described in the literature is summarized with regard to predisposing factors, age of incidence, presenting symptomatology, diagnosis, and management. Pertinent features of this bleeding complication include: high prevalence involving the pediatric population, presentation with non-specific symptoms (e.g., sore throat, dysphagia) early in the course of the bleeding episode, progression to complete upper respiratory obstruction if not recognized and treated, and the need for relatively high levels of the deficient coagulation factor for a period of at least 7 days to ensure resolution of the hematoma. The diagnosis is confirmed by observing retropharyngeal soft-tissue widening on lateral neck x-ray or alternatively, via cervical computed tomography.
 ...
PMID:Hemorrhage involving the upper airway in hemophilia. 374 23

The authors conducted a prospective study in 90 patients undergoing upper endoscopic examination under sedation to determine whether there was any beneficial effect in anesthetizing the pharynx with topical anesthesia. These patients were divided into three groups of 30 patients. Group A received 39 ml of viscous lidocaine gargle (2%) diluted with 15 ml of tap water. Group B received the placebo. Group C received neither viscous lidocaine nor placebo. All patients received intravenous meperidine and diazepam titrated to produce adequate sedation for upper endoscopy. It was demonstrated that the undesirable effects of upper endoscopy, that is, gagging, sore throat, and dysphagia, did not differ significantly in any of the three study groups as evaluated by either the patients or the endoscopist. Only two patients complained that the procedure was mildly unpleasant. The authors conclude that the practice of anesthetizing the pharynx in patients receiving sedation for upper endoscopy should be abandoned since anesthesia of the pharynx is not exempt from morbidity and mortality as well as being time-consuming and expensive.
 ...
PMID:Premedication with meperidine and diazepam for upper gastrointestinal endoscopy precludes the need for topical anesthesia. 377 Mar 86

73 cases of anthrax were recorded by the Health Office in the Sivas region in the last 4 years. This paper presents a rare and severe clinical form of anthrax displaying diagnostic difficulties. Six women aged between 16-46 were diagnosed as having throat anthrax and treated in the Infectious Diseases Department of Cumhuriyet University. The lesions were localized on the tonsils in 5 cases and on the base of the tongue in 1 case. The main clinical features were sore throat, dysphagia, fever, regional lymphadenopathy on the neck and toxemia. Three patients died with toxemia and sepsis. The diagnosis was confirmed by the isolation of Bacillus anthracis.
 ...
PMID:Primary throat anthrax. A report of six cases. 377 69

Sixty 3- to 14-year-old outpatients with positive streptococcal group A bacterial cultures and clinical signs and symptoms of pharyngitis were treated with a single intramuscular (IM) injection of penicillin G benzathine/penicillin G procaine in a multicenter study. At the first follow-up visit, usually within 48 hours of the injection, 60 children had negative cultures, and the mean body temperature had decreased from 100.2 +/- 1.6 degrees F to 98.5 +/- 0.5 degree F (P less than 0.05). At this time, the investigators rated 77% of the children clinically cured and the remaining 23% improved; major signs and symptoms (sore throat, difficulty swallowing, lethargy, and cervical node enlargement and tenderness) had disappeared in nearly all of the children. Initial injection site pain, noted in only 15% of the children 48 hours later, probably was secondary to the injection and not drug related. Most other adverse reactions (in seven children) also were injection related, were mild or moderate, and required no countermeasures. At the second follow-up visit approximately 10 days after injection, all children were considered clinically and bacteriologically cured. Thus, the combination of IM benzathine and procaine penicillin not only is safe and effective but eliminates compliance concerns.
 ...
PMID:Rapid symptomatic relief of streptococcal pharyngitis in children. 379 63

The clinical and pathologic findings were studied in 68 patients with primary lymphoma of Waldeyer's ring (WR). The initial sites included: tonsil (51%; 9% bilateral), nasopharynx (35%), base of tongue (9%), and multiple areas (4%). The mean age was 58 years, with a male to female ratio of 1.1:1.0. Tonsillar and base of tongue lesions presented with sore throat and dysphagia, whereas nasopharyngeal lymphomas most commonly presented with nasal, auditory, and cranial nerve sympatomatology. A neck mass was the sole presenting symptom in 12% of patients. Work-up showed 42% Stage I, 47% Stage II, 4% Stage III, and 7% Stage IV. All were non-Hodgkin's lymphomas. Diffuse architecture predominated (71%) and 70% had a histiocytic or large cell morphology (diffuse histiocytic 51%, nodular histiocytic 19%). The National Cancer Institute (NCI) Working Formulation grades were 13% low, 81% intermediate, and 6% high. In difficult cases, detection of monoclonal immunoglobulin, absence of keratin staining, and lack of epithelial features by electron microscopy were useful adjuncts aiding in diagnosis. Following complete remission, 28 patients relapsed, 75% of these within 2 years (median, 10 months). Thirty-seven (54%) patients died with disease (median survival, 27 months). Of these, 89% had disseminated lymphoma. Local-regional disease was the direct cause of death in 13%. Recurrence or persistence of disease in WR occurred in 9% of cases, most with initial clinical evidence of soft tissue extension. Stage I patients had a significantly better median survival (67 months) than Stage II patients (20 months) (P = 0.03). Prognostically favorable histologic parameters included lower NCI Working Formulation grade and follicular architecture. Ten patients (15%) developed extranodal disease, eight involving the gastrointestinal (GI) tract, and all died within 1 year of its occurrence. The findings indicate that stage and certain histologic parameters are important prognostic factors in WR lymphoma. The study confirms the association of primary WR lymphoma with other extranodal disease, particularly involving the GI tract, and emphasizes the poor prognosis of patients in whom this occurs.
 ...
PMID:Primary lymphoma of Waldeyer's ring. Clinicopathologic study of 68 cases. 389 Oct 63

Forty-four patients with sore throat participated in a placebo-controlled, double-blind clinical trial of benzydamine hydrochloride administered as a gargle. After medical evaluation and throat culture, 21 patients were treated with a solution containing benzydamine and 23 patients with a placebo solution. Statistical analysis of scores from patients' diaries showed that benzydamine solution afforded significantly greater (P less than 0.001) relief of pain and dysphagia at 24 hours than did the placebo solution. Physician evaluations at 24 hours showed that the benzydamine solution had significantly greater effect than did placebo on hyperemia (P less than 0.004) and edema (P less than 0.005). Side effects were minimal and of no clinical significance. The findings indicate that benzydamine hydrochloride is safe and effective therapy for the signs and symptoms of sore throat.
 ...
PMID:Double-blind study of benzydamine hydrochloride, a new treatment for sore throat. 390 41


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>