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)

Protein malnutrition is now well established as an important contributory factor to the high mortality in peritoneal dialysis (PD) patients. Low dietary protein calorie intake is one of the factors leading to protein malnutrition. If PD patients develop difficulty eating, percutaneous endoscopic gastrostomy (PEG) feeding may prove beneficial in providing adequate nutrition. Studies on the effectiveness of PEG feeding in PD patients are limited to pediatric patients. The objective of the present study was to assess the outcome of PEG feeding in adult patients with end-stage renal disease (ESRD) on PD. We retrospectively reviewed charts from May 1992 to February 2000 of 10 consecutive patients in our center who had had feeding tubes inserted. The patients' ages ranged from 37 to 81 years, with mean age of 65. Of the 10 patients, 7 were male, 5 were diabetic, and 1 was infected with the human immunodeficiency virus. Two patients had cerebrovascular accident (CVA) with dysphagia, 3 had multi-infarct dementia, 2 had anoxic encephalopathy, 2 had dementia, and 1 had calciphylaxis with anorexia. Of the 10 patients, 9 failed to eat because of neurologic disorders. Two patients who had functioning PEG feedings before starting PD had no complications. Only 2 of 8 patients already on PD continued with long-term PD after a PEG was inserted. Both patients whose PD was not interrupted at the time of PEG placement immediately developed peritonitis. Of the 6 patients who were maintained on hemodialysis (HD), 2 developed peritonitis within one week of starting PEG feedings. The other 4 had no complications from PEG feedings while being maintained on HD, but 1 developed peritonitis when PD was resumed. Of the 5 patients who developed peritonitis, 3 experienced fungal peritonitis. In PD patients, PEG feeding is associated with frequent complications. However, PEG placement prior to PD initiation appears to be safe. Maintaining patients on HD for at least 6 weeks appears to decrease the incidence of peritonitis, but does not eliminate it. Use of anti-fungal prophylaxis and maintenance of the patient on HD for longer than 6 weeks may produce better results.
Adv Perit Dial 2001
PMID:Outcome of percutaneous endoscopic gastrostomy feeding in patients on peritoneal dialysis. 1151 Feb 64

Actinomycosis is a granulomatous lesion caused by actinomyces species, which is an anaerobic non-spore forming gram-positive bacillus. It is a relatively uncommon disease which occurs as opportunistic infection. Most of the reported cases have underlying diseases predisposing them to actinomycosis3. This case report is presented to illustrate the necessity to exclude an underlying disease that may predispose individuals to secondary infection caused by actinomycosis. Two weeks after discharge the patient returned to hospital with symptom of dysphagia. Actinomycosis is not an uncommon disease which occurs throughout the world. Carcinoma of the oesophagus needs to be excluded in a patient with dysphagia and weight loss. Actinomycosis and carcinoma of the oesophagus may coexist in patient with dysphagia. The need for repeated upper gastrointestinal endoscopy and biopsy to confirm or exclude a primary diagnosis of oesophageal actinomycosis has been endorsed by many authors.
Pac Health Dialog 2004 Mar
PMID:Carcinoma of the oesophagus masquerading as actinomycosis: a case report and a review of literature. 1818 49