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)

Esophageal strictures due to malignant diseases are treated with self-expanding metalicic stents. However, experience is limited with these metalic stents in the cervical esophagus. Due to technical difficulties and procedure-related complications, the cervical esophagus has been assigned as a risky area for stenting procedures. Another encountered problem is patient discomfort after the procedure. In this case report, we present three patients with cervical esophageal strictures who were successfully treated with self-expandable metalic stents. Two of these patients had inoperable esophageal carcinoma and the third had benign stenosis due to radiotherapy of larynx carcinoma. The two patients with malignant disease survived four and six months, respectively, after the procedure. The last patient with benign disease is still alive and has been without dysphagia symptom for six months.
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PMID:Management of cervical esophageal strictures with self-expanding metalic stents. 1720 9

Radiotherapy, when used in head and neck cancer treatment, can produce side effects in the patients, such as decreased salivary production, xerostomia, opportunistic infections, radiation caries, dysphagia, local discomfort and the limitation of mouth opening. The aim of this study was to evaluate the amplitude of mouth opening in patients before and immediately after the completion of radiotherapy, comparing the effectiveness of two physiotherapy exercises. The irradiated sites included the masticatory muscles. The results demonstrated that there were no statistically significant differences between the two instituted exercises; however there was a trend towards better clinical results in group 2. The amplitude of mouth opening showed a trend towards reduction, but this was not statistically significant. When the pterygoid and sternocleidomatoid muscles were included in the irriated field, patients were observed to have more morbidity. This indicates the great importance of these muscles in mouth opening. Based on the results obtained within this study, it is not possible to conclude that physiotherapy exercies are efficacious in preventing trismus. Future longitudinal studies are required to verify the onset of trismus in radiotherapy patients.
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PMID:A mobilization regimen to prevent mandibular hypomobility in irradiated patients: an analysis and comparison of two techniques. 1732 96

Until now, a limited number of studies have been carried out on the social importance of dysphagia and its consequences on the quality of life. Dysphagia is considered a disabling disorder for the individual from the functional point of view of swallowing, as well as the emotional-relational viewpoint. Aim of the study was to detect both the social consequences and the emotional implications which lead the dysphagic patient to evaluate the worsening of the quality of life after the onset of the disorder and how speech therapy can improve it. A survey was carried out on 73 patients, aged between 40-80 years, who had undergone one of the following operations: ENT, maxillo-facial, neurological and presbiphagic. A questionnaire was prepared comprising 25 questions concerning: medical history, eating habits, personal feelings, information about dysphagia and state of health. Research was carried out on a sample of patients who were still actively working and enjoyed an intense social life; almost 50% were under 60 years of age. After the surgical operation, they were found to be more fragile, lacked self-confidence, with limited social relationships and consequently, a tendency to isolation. Most patients, who had previously considered mealtimes an opportunity to meet others and a social gathering, no longer believed them to be a pleasant aspect of their day on account of the difficulty in swallowing. As a result, food consistency had to be changed and strategies had to be invented in order to make the meal less embarrassing. All patients agree they received, initially, little information on dysphagia. They maintain they benefited from speech therapy re-education and placed their confidence in the doctors who were treating them. Dysphagia is a disorder which has a negative influence on the patient's life, worsening it qualitatively from both a social and an emotional point of view. The patient tends to isolate him/herself, and experiences a sense of discomfort and diversity compared to his/her fellows, leading to a decrease in self-esteem. Research shows that patients are duly informed by doctors and health care professionals concerning the problems related to dysphagia and the rehabilitation therapy to be followed. Patients feel more safeguarded and there is an overall improvement in their lives.
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PMID:Social importance of dysphagia: its impact on diagnosis and therapy. 1760 36

Radioiodinated metaiodobenzylguanidine [(131)I-MIBG] is commonly used to treat resistant neuroblastoma or metastatic pheochromocytoma [MP] with little non-hematopoietic toxicity. We describe here transient sialoadenitis, a previously unreported complication. Ten patients [9 neuroblastoma and 1 MP] received 12-18 mCi/kg of (131)I-MIBG. Five patients had bilateral parotid swelling, two with associated buccal discomfort within 24 hr of injection which subsided within 48 hr. Grade 3 or 4 serum amylase elevation was documented in 8/8 patients tested [median 1,336; range: 576-8,830 U/L] which normalized [25-125 U/L] within 4-14 [median 5.5] days. Serum lipase remained normal. Patients did not develop subsequent dry mouth or dysphagia.
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PMID:Transient sialoadenitis: a complication of 131I-metaiodobenzylguanidine therapy. 1797 18

The vagus nerve stimulator has become a standard modality for intractable pediatric epilepsy. We reviewed our experience with major adverse events, after accidental puncture of a stimulator wire by an emergency room physician seeking intravenous access to treat status epilepticus. The Children's National Medical Center database was reviewed for patients undergoing vagus nerve stimulator placement between January 1988 and June 2006. Patient characteristics, duration of therapy, and treatment-limiting adverse events were noted. Of 62 patients implanted over 8 years, 22 (35%) had adverse events which led to a change in therapy. Adverse events included prominent drooling, coughing, throat discomfort, dysphagia, wound infection, difficulty breathing, vomiting, vocal-cord weakness, lead failure, and iatrogenic (piercing of wire; surgical clipping of wire during revision). Eight patients required nonroutine surgical intervention (13%). There were two unusual case presentations. In a 13-year-old boy with status epilepticus at an outlying emergency department, the stimulator line was pierced in search of intravenous access. In a 25-year-old housepainter, neck paresthesias upon right lateral neck turning were attributed to insufficient strain relief. Treatment-limiting adverse events occurred in approximately one-third of patients. Unanticipated adverse events included misidentification of the wire for intravenous access, clipping of the wire during surgical dissection, and cervical dysesthesias associated with head-turning.
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PMID:Misidentification of vagus nerve stimulator for intravenous access and other major adverse events. 1835 2

Altered salivary flow is frequently observed as a result of head and neck cancer (HNC) treatment. Decreased salivation or xerostomia consequent to radiation therapy is the most frequently observed complication resulting in patient discomfort, tooth decay, periodontal disease, and dysphagia. Excessive salivary flow or sialorrhea can be equally troublesome to the patient and their caregivers. It is caused by tumor or treatment-related dysphagia, or due to altered anatomy from oncologic resections of the upper aerodigestive tract, especially the middle third of the mandible. Post-operative sialoceles and fistulas are other manifestations of abnormal salivary flow which interfere with wound healing. The management of excessive salivary flow in HNC patients is a less frequently discussed subject in medical literature. Complications related to salivary flow can cause increased morbidity and occasionally mortality related to HNC treatment. Consequently, the management of excessive salivary flow in the post-operative setting and for palliation has a great impact on overall outcome of surgical intervention and quality of life for the patient. Excessive salivary flow can be treated with aggressive wound care, pharmacologic inhibition, radiation, or surgery. A review of the literature focused on the management of excessive salivary flow in HNC patients is presented.
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PMID:Management of salivary flow in head and neck cancer patients--a systematic review. 1848 28

The primary indication for an esophagectomy is esophageal cancer or Barrett's esophagus with high-grade dysplasia. Patients undergoing esophagectomy often present with dysphagia, side effects from chemotherapy, decreased appetite, and weight loss. Esophagectomy is a major surgery involving the abdomen, neck, and/or chest requiring 5 to 7 days of NPO status to allow healing of the anastomosis between the upper esophagus and new esophageal conduit (usually the stomach). Placement of a feeding jejunostomy preoperatively or at time of surgery provides enteral access for patients who will experience eating challenges and a slow transition back to a normal diet, challenges that often lead to weight loss in the postoperative period. Supplemental tube feeding given nocturnally can provide a consistent intake while appetite, swallowing, and diet advancements improve during the convalescent period. The postesophagectomy diet advances from liquids to soft solids with restrictions to reduce discomfort and aid swallowing and digestion. The esophagectomy patient will experience physical, dietary, and social adaptation for several months postoperatively. Attention to nutrition throughout the process of diagnosis, treatment, and postoperative care is essential for optimal care of the esophagectomy patient.
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PMID:Nutrition considerations in esophagectomy patients. 1884 57

Gastroesophageal reflux disease (GERD) depends on acid reflux into the distal oesophagus. The typical symptoms of GERD are heartburn, dysphagia, chest discomfort and acid regurgitation. Besides typical symptoms GERD could by manifested by extraesophageal signs. There is increasing number of studies showing that GERD and respiratory diseases coexist frequently.
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PMID:[GERD and respiratory tract diseases]. 1900 34

The once-common practice of packing the nose after septoplasty was based on a desire to prevent postoperative complications such as bleeding, septal hematoma, and adhesion formation. However, it was since found that not only is nasal packing ineffective in this regard, it can actually cause these complications. Although the consensus in the world literature is that packing should be avoided, to the best of our knowledge, no truly randomized study has been undertaken in Southwest Asia upon which to justify this recommendation here. Therefore, we conducted a prospective randomized comparison of the incidence of a variety of postoperative signs and symptoms in 88 patients, 15 years of age and older, who did (n = 44) and did not (n = 44) undergo nasal packing following septoplasty. We found that the patients who underwent packing experienced significantly more postoperative pain, headache, epiphora, dysphagia, and sleep disturbance on the night of surgery. Oral and nasal examinations 7 days postoperatively revealed no significant difference between the two groups in the incidence of bleeding, septal hematoma, adhesion formation, and local infection. Finally, the packing group reported a moderate to high level of pain during removal of the packing. Our findings confirm that nasal packing after septoplasty is not only unnecessary, it is actually a source of patient discomfort and other signs and symptoms.
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PMID:Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. 1900 62

Upper and lower gastrointestinal dysautonomia symptoms (GIDS)--sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time-consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated "Recommended" if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. "Suggested" scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS-PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia-Specific Quality of Life (SWAL-QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD-Autonomic (SCOPA-AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal-related dysautonomia in PD. Only two scales met "Recommended" criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically.
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PMID:Dysautonomia rating scales in Parkinson's disease: sialorrhea, dysphagia, and constipation--critique and recommendations by movement disorders task force on rating scales for Parkinson's disease. 1920 66


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