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)

We examined the oropharyngeal swallowing ability of 43 patients with spasmodic torticollis using a videofluoroscopic procedure. Twenty-two (51.2%) demonstrated objective evidence of swallowing abnormalities; 15 (34.9%) had subjective complaints. Delayed swallowing reflex and vallecular residue were more frequent (p less than 0.0046) than any other abnormality. The constellations of abnormalities were consistent with neurogenic, postural, and mixed neurogenic-postural types of dysphagia.
Neurology 1990 Sep
PMID:Swallowing function in patients with spasmodic torticollis. 239 32

A retrospective study was undertaken to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic studies. Ratios of soft-tissue structures in 31 patients aged 7 months to 61 years with epiglottitis were compared with those of age- and sex-matched controls with croup, pharyngitis, and dysphagia. The ratios of epiglottic width to third cervical vertebral body width (EW/C3W) of more than 0.5, of aryepiglottic width to third cervical vertebral body width (AEW/C3W) of more than 0.35, and of epiglottic width to epiglottic height (EW/EH) of 0.6 or more were all found to be 100% sensitive and specific in differentiating between adult patients with and without epiglottitis. In children, EW/C3W, AEW/C3W, and EW/EH ratios of more than 0.5, of more than 0.35, and of 0.6 or more, respectively, were found to be 100% sensitive in detecting epiglottitis with specificities of 87%, 96%, and 87% respectively. These preliminary results suggest that EW/C3W, EW/EH, and AEW/C3W ratios of more than 0.5, of 0.6 or more, and of more than 0.35, respectively, may be useful in the radiologic diagnosis of epiglottitis in patients of all ages.
Ann Emerg Med 1990 Sep
PMID:Radiologic diagnosis of epiglottitis: objective criteria for all ages. 200 78

Diffuse idiopathic skeletal hyperostosis previously has been reported to cause a number of extraspinal manifestations including dysphagia, respiratory distress, dysphonia and cervical myelopathy. We report a case of cervical DISH so extensive as to interfere with the swallowing mechanism and lead to aspiration. Patients with DISH who have mechanical compression of the posterior pharynx may be at high risk for aspiration.
Chest 1990 Sep
PMID:Aspiration pneumonia due to diffuse cervical hyperostosis. 239 59

An 81-year-old woman with a 13-year history of hypoparathyroidism developed dysarthria and dysphagia. Cranial computed tomography demonstrated extensive calcification involving the basal ganglia, corona radiata, and deep cerebellar structures. The cerebral small-vessel calcification that occurs in chronic hypoparathyroidism may produce the syndrome of progressive dysarthria and dysphagia.
Arch Neurol 1990 Sep
PMID:Extensive brain calcification and progressive dysarthria and dysphagia associated with chronic hypoparathyroidism. 239 32

A case-control study was undertaken to see if symptoms of upper gastrointestinal (UGI) (oropharyngeal, esophageal, and gastric) dysfunction occurred more frequently in males afflicted with Duchenne muscular dystrophy (DMD) than healthy controls. Subjects included 55 children with confirmed DMD and 55 age-matched controls without neuromuscular disease. All subjects and/or their parents responded to a standard set of questions concerning the frequency of symptoms of UGI dysfunction. Responses of the DMD and control groups were compared using the Wilcoxon signed rank test. A significantly higher percentage of DMD patients experienced nasal quality to the voice, dysphagia, choking while eating, the need to clear the throat during or after eating, heartburn, and vomiting during or after meals, than did controls. Only one symptom--heartburn--was found significantly more frequently in the 33 nonambulatory than the 22 ambulatory DMD subjects. These findings document that feeding difficulty and symptoms consistent with oropharyngeal, esophageal, and gastric dysfunction are more frequent in the DMD population than healthy, age-matched controls.
Arch Phys Med Rehabil 1990 Sep
PMID:Symptoms of upper gastrointestinal dysfunction in Duchenne muscular dystrophy: case-control study. 240 80

The endoscopic insertion of an endoprosthesis is now a standard procedure in the ultimate palliation of malignant obstructing upper gastrointestinal and biliary malignancy. The commercially available prostheses and introducing devices are adequate for the majority of upper intestinal cancers. For some stricturing lesions, especially when associated with fistula formation, individual adaptation of a tygon prosthesis with extra widening rings is often necessary. Nd: Yag laser vaporisation of mainly exophytic cancerous tissue is mainly indicated for those circumstances which are less amenable to prosthesis insertion such as total luminal obstruction, noncircumferential tumorous involvement, polypoid cancers, excessively necrotic and chronically bleeding tumors, lesions extending within 2 cm of the upper esophageal sphincter, markedly angulated cancers of the cardia with almost horizontal tube positioning and cancerous overgrowth occluding the funnel opening. Overall successful insertion occurs in over 90% of patients. Main complications are perforation 5-8% and early or late dislocation. The procedure related mortality fluctuates around 2 to 4%. Overall results with laser application are roughly comparable. The dysphagia free intervall after laser is only around 6 weeks for the majority of the patients. Transpapillary insertion of a straight Amsterdam-type prosthesis rapidly became a standard procedure for palliation of malignant jaundice. For many patients with pancreatic cancer this endoscopic approach competes favorably with corresponding surgical palliative alternatives. Disappearance of jaundice is to be expected in the vast majority of the patients. The only major unsolved problem remains late clogging with biliary sludge which necessitates insertion of new prostheses. Most problematic to breach are bifurcation tumors. Cholangitis is a major complication if one does not succeed at the first attempt to drain both liver lobes.
Dig Dis Sci 1986 Sep
PMID:Upper intestinal and biliary tract endoprosthesis. 242 67

Most oesophageal cancers are incurable by the time the diagnosis is made. Treatment is therefore often palliative, and endoscopic modalities cause considerably less general upset to the patient than surgery, radiotherapy or chemotherapy. Nd:YAG laser recanalisation of advanced obstructing cancers is safe and effective for exophytic tumours that are endoscopically accessible in over 80% of cases. The risk of perforation is less than half that associated with insertion of a perforation is less than half that associated with insertion of a prosthesis, although it is higher in patients who have previously been treated by radiotherapy. After laser treatment, half the patients are able to maintain adequate nutrition until the time of their death from disseminated disease. The other half get further dysphagia due to recurrent exophytic tumour or compression from extrinsic tumour. A few develop fibrous stricturing in the laser treated area. However, many of these recurrences can be treated again with the laser or by dilation with or without a prosthesis. The quality of swallowing is better after laser treatment, as any residual oesophageal muscle function in that area can be used (not possible with a prosthesis), although several treatment sessions are usually required. In the future, the precision of laser effects may make it possible to safely ablate early tumours in their entirety.
Endoscopy 1986 Sep
PMID:Endoscopic laser therapy for oesophageal cancer. 242 8

Dysphagia, regurgitation and hypersalivation due to local destruction or incessant coughing in the presence of a tracheo-broncho-esophageal fistula become the most important distressing factors in the end stage of malignancies in the upper gastrointestinal tract. Inevitably such patients have a short life expectancy. It is often desirable to avoid the morbidity associated with surgery, radiotherapy or chemotherapy. The non-operative insertion of a prosthesis is increasingly being carried out to palliate malignant dysphagia.
Endoscopy 1986 Sep
PMID:Endoscopic prosthesis for advanced esophageal cancer. 242 9

A series of patients with dysphagia associated with terminal malignant disease is presented. 33 patients had clinical evidence of organic dysphagia associated with tumours of the upper aerodigestive tract. Over 80% of this group who underwent necropsy had locally obstructive lesions. Conservative treatment alone led to amelioration of dysphagia in approximately 60% of patients.
Lancet 1988 Sep 24
PMID:Clinical and pathological study of dysphagia conservatively managed in patients with advanced malignant disease. 245 15

Between 1970 and 1988, 149 patients with carcinoma of the cardia were operated on at the Lahey Clinic. Of these patients, 127 (85%) underwent resection; 23 (18.1%) were of a palliative nature. More than 75% had Stage III and IV disease. One patient (0.8%) died within 30 days of the operation of a myocardial infarct. Two other patients failed to leave the hospital. Of 25 postoperative complications, 14 (11%) were considered major. Palliation of dysphagia was successful in 80% of patients. The actuarial 5-year survival rate was 22.4%. Of patients with Stage I and II disease, 36.6% survived for 5 years, and of patients with Stage III disease, 22.5% survived. No patient with Stage IV disease lived for longer than 1 year. It is concluded that limited esophagogastrectomy can be performed in most patients with carcinoma of the cardia with low mortality and morbidity and with satisfactory long-term survival.
Ann Surg 1988 Sep
PMID:Limited esophagogastrectomy for carcinoma of the cardia. Indications, technique, and results. 245 3


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