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)

The bisphosphonate, alendronate sodium (e.g. Fosamax) is a bone resorption inhibitor used to treat postmenopausal osteoporotic women and osseous Paget's disease. Esophagitis is one of the adverse effects (AE) associated to its use. Five (5) patients with alendronate-associated esophagitis assisted in the Gastroenterologic Center, Rosario, Argentina, between October 1996 and December 1999 are described. The aim is to correlate the clinical, endoscopic and histopathological findings in 5 women (ages 57-71) complaining for upper digestive symptoms (dysphagia, epigastralgia, retrosternal pain.). All had osteoporosis treated with alendronate 10 mg/day and received detailed instructions about how to take the medication. The time from the beginning of alendronate intake and the appearance of the symptoms was elapsed 30, 35, 67, 85 and 90 days. The esophagitis was graded according to the Savary-Miller Classification. The videoscopy disclosed esophagitis of III and IV grades. Three patients had also antral and antroduodenal lesions, one of them associated to Helicobacter Pylori. Anatomopathologic findings confirm esophagitis and esophagic ulceration. Some authors claim that bisphosphonates as a new class of gastrotoxic drugs with AE similar to aspirin. Even when it is administrated according to the instructions of the manufacturers it should be used with caution. Our contribution emphasize the importance of this AE and suggest measures to diminish or suppress them, and take into consideration those patients who are taking aspirin. With alendronate, as well as with other potentially corrosive agents, is very important to take in mind the measures to prevent AE.
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PMID:[Esophagitis associated with use of alendronate in 5 postmenopausic patients]. 1147 18

The authors describe the use of intravenous sodium valproate (Depacon) to treat three geriatric inpatients: two acutely manic patients who refused oral medication and one dementia patient with agitation and dysphagia receiving end-of-life care for Alzheimer's disease.
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PMID:Uses of intravenous valproate in geriatric psychiatry. 1148 Nov 41

A 67-year-old man presented with dysphagia and difficulty breathing. Physical examination revealed palatal myoclonus. In this patient, the respiratory difficulty was caused by the fragmentation of breathing. Electromyographic examination of the cricothyroid muscle demonstrated rhythmic myoclonic jerks. Magnetic Resonance Imaging (MRI) yielded a pontine midline and right sided tegmental infarct. The patient responded to sodium valproate.
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PMID:Symptomatic palatal myoclonus: an unusual cause of respiratory difficulty. 1148 57

The pharmacokinetics and pharmacodynamics of lansoprazole suspension and lansoprazole capsules were studied. Thirty-six healthy males and females were randomized in a single-dose, open-label, two-period crossover study. Lansoprazole 30 mg was administered via a nasogastric tube as simplified lansoprazole suspension (in 8.4% sodium bicarbonate) or orally as the intact capsule after a minimum 12-hour fast and 5 hours before lunch. Ambulatory 24-hour intragastric pH was monitored at baseline and on day 1 of each treatment period to assess lansoprazole's pharmacodynamics. Blood samples were collected before drug administration and at predetermined intervals up to 24 hours after each dose to assess lansoprazole's pharmacokinetics. Both formulations effectively raised the mean 24-hour intragastric pH (mean 24-hour pH of 3.75 with suspension and 3.52 with intact capsule) and maintained it above threshold values of 3 and 4 for more than 40% of the 24-hour postdose period. The suspension was associated with a significantly shorter mean time to the maximum observed concentration (tmax) compared with the intact capsule. The mean maximum observed plasma concentration (Cmax) of the suspension was significantly higher and the mean area under the concentration-time curve from time zero to infinity (AUC infinity) was significantly lower than those of the intact capsule (879 versus 810 ng/mL and 1825 versus 2229 ng.hr/mL). The 90% confidence intervals obtained by two one-sided tests for both Cmax and AUC infinity were contained within the 0.80 to 1.25 range, confirming the bioequivalence of the two regimens. Simplified lansoprazole suspension effectively controls intragastric pH, is bioequivalent to the intact capsule, and represents an effective therapeutic option for patients who have difficulty swallowing or are unable to swallow lansoprazole capsules.
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PMID:Comparative pharmacokinetics and pharmacodynamics of lansoprazole oral capsules and suspension in healthy subjects. 1151 48

A case of spontaneous, isolated supraglottic haemorrhage in a patient recently started with warfarin sodium treatment is described. The symptoms of sore throat, dysphonia, stridor, dysphagia or a neck swelling in a patient taking anticoagulants should alert the clinician to the possibility of this rare but potentially fatal complication.
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PMID:Spontaneous supraglottic haemorrhage in a patient receiving warfarin sodium treatment. 1155 24

We report an autopsy-confirmed case of amyotrophic lateral sclerosis (ALS) accompanied by syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A 67-year-old man was admitted to our hospital with muscle weakness, dysarthria and dysphagia. During hospitalization, respiratory insufficiency was ingravescent, and hyponatremia, hypo-osmolarity, elevated osmotic pressure of urine, and elevated urinary sodium excretion were noted. Based on these findings we diagnosed ALS with SIADH, and treatment with infusion of concentrated NaCl was started. However, the patient died of respiratory failure on day 50. We assumed that severely restrictive ventilatory impairment was the cause of SIADH in this case.
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PMID:An autopsy case of amyotrophic lateral sclerosis accompanied by syndrome of inappropriate secretion of antidiuretic hormone. 1205 91

The limited effectiveness of currently available chemotherapy in the treatment of advanced esophageal cancer, and the poor survival achieved in locally advanced disease with combined chemoradiotherapy with or without surgery, have prompted the evaluation of new agents. Irinotecan (CPT-11, Camptosar) has promising single-agent activity in gastrointestinal cancers. In phase II evaluation of weekly irinotecan plus cisplatin, response rates have exceeded 30% in esophageal and gastric cancers. Irinotecan is an active radiosensitizer in preclinical studies and clinical trials in lung cancer. We performed a phase I trial of weekly irinotecan, cisplatin, and concurrent radiotherapy in locally advanced esophageal cancer. Induction chemotherapy with irinotecan and cisplatin was given prior to radiotherapy, over 6 weeks, cycled on a 2-week-on, 1-week-off schedule to relieve dysphagia. Radiotherapy was given subsequently in 180-cGy daily fractions to a total dose of 5,040 cGy. Doses of chemotherapy, when given with concurrent radiotherapy, were cisplatin at 30 mg/m2 followed by irinotecan at escalated doses (40, 50, 65, and 80 mg/m2), on days 1, 8, 22, and 29. Among 18 patients entered in the trial, minimal toxicity has been observed, with no grade 3/4 esophagitis or diarrhea. Hematologic toxicity has been minimal. Dose-limiting toxicity (ie, requiring more than a 2-week delay in radiotherapy) has been seen in one of three patients at the 80-mg/M2 irinotecan dose level, and accrual continues at this dose level. Among 13 evaluable patients, five complete responses have been seen (38%), including three pathologic complete responses in 10 patients undergoing surgery (30%). Asymptomatic pulmonary emboli were noted on the posttreatment computed tomography scan in 3 of 15 patients, prompting the addition of warfarin sodium (Coumadin) prophylaxis on protocol. Full doses of weekly irinotecan (65 mg/ m2) and cisplatin (30 mg/m2) can be combined safely with concurrent radiotherapy in patients with locally advanced esophageal cancer.
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PMID:Irinotecan, cisplatin, and radiation in esophageal cancer. 1210 99

There are few data available describing the experience of patients who have undergone photodynamic therapy with porfimer sodium for Barrett's esophagus. We describe the results of a satisfaction survey reported by 16 of 18 patients (11 men, 5 women; median age 75 years; median response at 27 months after treatment) treated with photodynamic therapy for Barrett's esophagus with high-grade dysplasia. Treatments were performed on an outpatient basis although two patients required clinic visits for intravenous fluids. Subjects reported their most significant post-treatment problem was odynophagia or dysphagia (75%), which was best treated with a hydrocodone bitartrate and acetaminophen elixir (75%). Cutaneous photosensitivity persisted for a median of six weeks; two patients had phototoxic reactions requiring clinic evaluation and treatment. All but two patients reported swallowing problems lasting a median of four weeks, and weight loss (median 6.8 kg). All patients indicated they would again choose photodynamic therapy if they were faced with a similar choice of endoscopic treatment versus surgery for Barrett's esophagus with high-grade dysplasia. These results indicate a generally high level of satisfaction in patients who have been treated with porfimer sodium photodynamic therapy for Barrett's esophagus with high-grade dysplasia.
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PMID:Photodynamic therapy for Barrett's esophagus and high grade dysplasia: results of a patient satisfaction survey. 1219 46

Between 1999 and 2001, seven horses with fever, dysphagia and a history of chronic upper respiratory tract infection lasting between three weeks and three months were examined. They had been treated unsuccessfully with a variety of antibiotics for three to four weeks. A deep abscess in a retropharyngeal lymph node was diagnosed in each case by clinical examination, endoscopy and echographic examination of the retropharyngeal region. The infected retropharyngeal lymph node of each horse was punctured with a spinal needle under ultrasound guidance. Pus was aspirated from four of the horses, and their abscesses were then rinsed with 0.9 per cent saline solution, and antibiotics (sodium ceftiofur or penicillin) were injected. In the other three horses the pus was too viscous to be aspirated, and the enlarged lymph node was opened along the tract of the needle and rinsed with chlorhexidine. All the horses were treated with penicillin for two weeks and in six of them the clinical signs gradually disappeared. The other horse continued to show fever and the penicillin treatment was continued for another 10 days, after which the signs gradually disappeared over a period of two months.
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PMID:Percutaneous puncture technique for treating persistent retropharyngeal lymph node infections in seven horses. 1262 87

After treatment for hypoadrenocorticism, an 18-month-old dog exhibited marked ataxia and intermittent muscle tremors, progressing to head pressing, dysphagia, and quadraparesis. Serum sodium increased by 38.9 mmol in 48 hours, suggesting myelinolysis. The dog made a complete recovery after intensive treatment.
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PMID:Neurologic complications following treatment of canine hypoadrenocorticism. 1283 44


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