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)

A 21-year-old man presented to our emergency department with a two-day complaint of painful swelling and protrusion of the tongue, odynophagia, dysphagia, and difficulty with speech. A nonfluctuant area of tongue swelling was identified; needle aspiration of this site produced 5 mL of pus, with considerable amelioration of symptoms. Culture of the aspirate subsequently grew Hemophilus parainfluenzae, the first such reported case of this pathogen in a glossal abscess. Glossal abscess is a rare clinical entity that may result in airway compromise and disseminated infection to other systems. The presence of a glossal abscess should be considered in all cases of tongue swelling.
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PMID:Glossal abscess. 273 88

A 21-year-old man was admitted for odynophagia and hoarseness of four months duration. He smoked one and a half packs of cigarettes a day and occasionally inhaled marijuana. Indirect laryngoscopy revealed a massive swelling of the entire epiglottis, aryepiglottic folds, and arytenoids. The histopathologic diagnosis of chronic but active nonspecific inflammation was made. Combined antibiotics and steroid therapy gave temporary relief. He was readmitted several months later with progressive shortness of breath, dysphagia, and hoarseness. Biopsy of the epiglottic tissues showed multiple noncaseating epithelioid granulomatous lesions consistent with sarcoidosis. All pertinent laboratory tests failed to establish a definitive diagnosis. The patient eventually underwent supraglottic laryngectomy. He has been symptom-free for 20 months following surgery.
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PMID:Granulomatous laryngitis of unknown etiology. 739 56

Transdermal nicotine delivery systems are widely used in smoking cessation. The purpose of this study was to determine whether common symptoms of pyrosis and dyspepsia associated with these patches are related to gastroesophageal reflux or esophageal dysmotility. Twenty-seven paid volunteer cigarette smokers (> 15 cigarettes/day) without symptomatic gastroesophageal reflux disease participated in this single-blinded, placebo-controlled study. Twenty subjects completed the study. Subjects underwent three sequential 24-h intraesophageal pH/motor studies (Synectics model T32342084, Shore View, MN). The pH/motility probe was positioned 5 cm above the manometrically determined LES. A placebo patch was applied for the first 24-h study and a 15-mg nicotine patch (Nicotrol) was applied for the initial 16 h (removed for remaining 8 h) of the second 24-h period. A 21-mg nicotine patch (Nicoderm) was applied for another 24-h study period. All subjects consumed an identical, defined diet documented by meal receipts, and refrained from smoking and tobacco use throughout the study periods (CO breath test confirmation). The Wilcoxon, paired t-test, exact McNemar statistical methods were used. The results showed that there were no significant differences in reflux symptoms (pyrosis, chest pain, nausea, dysphagia), supine gastroesophageal reflux (number of episodes, duration, or cumulative acid exposure), or the total number of reflux episodes between placebo and nicotine patch treatment periods. The number of post-prandial upright acid reflux episodes (p = 004) and number of upright acid reflux episodes lasting more than 5 min (p = 0.007) were statistically higher with the placebo patch compared to the active nicotine patches. No differences in intraesophageal pH or motility indices were noted between the two transdermal nicotine patches (Nicotrol, Nicoderm). It was concluded that dyspeptic symptoms in subjects utilizing transdermal nicotine patches are not related to gastroesophageal reflux or to esophageal motor abnormalities.
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PMID:Transdermal nicotine patches do not cause clinically significant gastroesophageal reflux or esophageal motor disorders. 1107 35

The purpose of this study was to determine the nature of swallowing evaluation practices in western Washington, specifically in terms of (a) components of the clinical examination most commonly used, (b) consistency of clinical examination practices across clinicians, and (c) consistency of clinical decision-making (instrumental vs. noninstrumental) given specific patient scenarios. A 21-question survey was sent to 150 speech-language pathologists who provide services to dysphagia patients. Of the 72 (48%) surveys that were returned, 64 provided the data for the study. The results revealed that clinicians who responded to the survey differ somewhat regarding which components they include in a clinical examination of swallowing. There was a high degree of consistency for 11 of the 19 components. Inconsistency across clinicians was revealed in four areas: assessment of sensory function, assessment of the gag reflex, cervical auscultation, and assessment of trial swallows using compensatory techniques. Clinicians agreed in their recommendations on two of the six clinical case scenarios. In general, participating clinicians varied widely in their clinical decision-making. These findings are compared with other studies where variability in clinical practice has raised concerns.
Dysphagia 2003
PMID:Dysphagia evaluation practices: inconsistencies in clinical assessment and instrumental examination decision-making. 1282 5

A 21 year old male patient presented with dysphagia. Clinical examination as well as CT and MRT showed a tumor in the right parapharyngeal space. The tumor was resected completely using a transcervical approach. The pathological examination showed a neurofibroma. In this case report, preoperative diagnosis, therapy and follow-up of this rare tumor are discussed.
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PMID:[Solitary neurofibroma of the parapharyngeal space]. 1513 50

A 21-year-old white man in otherwise excellent general health was referred for a painful, progressive, facial eruption with associated fever, malaise, and cervicofacial lymphadenopathy. The patient reported that a vesicular eruption progressed from the left side of his face to also involve the right side of his face over the 48 hours preceding his clinic visit. He also reported some lesions in his throat and the back of his mouth causing pain and difficulty swallowing. Four to 7 days before presentation to us, the patient noted exposure to his girlfriend's cold sore. Additionally, he complained of a personal history of cold sores, but had no recent outbreaks. Physical examination revealed a somewhat ill man with numerous vesicles and donut-shaped, 2-4 mm, crusted erosions predominantly on the left side of the bearded facial skin. There were fewer, but similar-appearing lesions, on the right-bearded skin. The lesions appeared folliculocentric (Figure). Cervical and submandibular lymphadenopathy was present. Oral exam showed shallow erosions on the tonsillar pillars and soft palate. Genital examination was normal. The remainder of the physical exam was unremarkable. A Tzanck smear of vesicular lesions was positive for balloon cells and many multinucleated giant cells with nuclear molding. A viral culture was performed which, in several days, came back positive for herpes simplex virus. The complete blood cell count documented a white blood cell count of 8000/mm3 with 82.6% neutrophils and 9.0% lymphocytes. Based on the clinical presentation and the positive Tzanck smear, the patient was diagnosed with herpes simplex barbae, most likely spread by shaving. The patient was started on acyclovir 200 mg p.o. five times daily for 10 days. Oxycodone 5 mg in addition to acetaminophen 325 mg (Percocet; Endo Pharmaceuticals, Chadds Ford, PA) was prescribed for pain relief. A 1:1:1 suspension of viscous lidocaine (Xylocaine; AstraZeneca Pharmaceuticals LP, Wilmington, DE), diphenhydramine (Benadryl; Pfizer Inc., New York, NY), and attapulgite (Kaopectate; Pfizer Inc., New York, NY) was given as a swish and spit to relieve the oral discomfort. Good hygiene, no skin-to-skin contact with others, and no further shaving to prevent autoinoculation were stressed. He was advised to discard his old razor.
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PMID:Case study: inoculation herpes barbae. 1589 Dec 58

The purpose of this study was to investigate clinical assessment practices and instrumental examination decision-making by speech and language therapists (SLTs) in Ireland. A 21-question survey (including patient scenarios) was sent to 480 SLTs in Ireland. A total of 261 completed surveys were returned (54%), providing demographic information on SLTs currently working in Ireland and their services. Of these 261 surveys, 70 provided the data for the study, focusing on SLTs currently working in dysphagia, with adults/seniors at least some of the time. The results also showed clinician variability regarding which components are included in a bedside clinical examination of swallowing, with a high degree of consistency for only 11 of the 20 components. Clinicians agreed in their instrumental vs. noninstrumental evaluation recommendations for two of the six patient scenarios, with wide variability in clinical decision-making. Possible influences on clinical decision-making are discussed in relation to the findings of similar previous studies, as well as the current status and future needs of dysphagia training and services in Ireland.
Dysphagia 2007 Jul
PMID:Dysphagia evaluation practices of speech and language therapists in Ireland: clinical assessment and instrumental examination decision-making. 1745 47

A 21-year-old woman developed midesophageal stricture two weeks after ingestion of aluminium phosphide (AlP) tablets. Aluminium phosphide is a lethal protoplasmic toxin and is also the most common cause of suicidal poisoning in northern India. Upper gastrointestinal endoscopy (UGIE) showed a tight esophageal stricture 29 cm from the incisors with a circumferential ulcer. Dilatation up to 17 mm was done using Savary-Gilliard dilators. She had repeated dilatations three times at nearly two-week intervals. In view of the resistant stricture, a silicone Polyflex stent was placed across the stricture and removed after 3 months; there was no recurrence of stricture even after three months of follow-up. Patients with recurrent esophageal stricture and those with fistula may benefit from silicone expandable stents.
Dysphagia 2008 Dec
PMID:Aluminium phosphide-induced esophageal stricture palliation with polyflex stent. 1868 93

To survey pediatric (PGI) and adult gastroenterologists (AGI) regarding their perceptions about the etiology, diagnosis, and management of eosinophilic esophagitis (EoE), and to assess whether differences in the clinical approach to EoE exist between these subspecialists. A 21-item survey related to EoE was emailed to PGI who subscribe to the PEDSGI Bulletin Board, and to two AGI per Electoral College vote in the US, randomly selected from each state. The survey was voluntary, and consent was assumed based on survey submission. The responses were submitted anonymously and results compiled in a secure Web site. A total of 249 physicians from across the globe responded to the survey, 68% of whom were PGI. The majority of respondents worked primarily in an academic institution or teaching hospital. Respondents revealed diagnosing an average of six cases (median 8, range 0-30) of EoE in the past 6 months. Ninety-two percent of AGI who see a patient with dysphagia and suspected EoE proceed to endoscopy with biopsies, compared to only 54% of PGI (P < 0.05); 38% of PGI would first perform an upper GI study. Both subspecialties agreed that biopsies of the proximal and distal esophagus are needed to make a definitive diagnosis of EoE. Fifty-eight percent PGI and 44% AGI defined EoE as an eosinophilic density of > or =20 per high power field (hpf) in esophageal biopsies. Seventy-seven percent of PGI but only 16% of AGI reported routine referral of patients for food allergy evaluation (P < 0.05). While 77% PGI and 91% of AGI would rely on a symptom-based follow-up, 27% PGI versus 9% AGI follow patients with biopsies according to a pre-determined schedule and another 38% repeat biopsies as needed, versus 15% AGI. This survey exposes a few inconsistencies among gastroenterologists in the diagnosis, management, and follow-up of patients with EoE. The currently available practice guidelines for the diagnosis and management of EoE are largely based on retrospective studies and expert opinion. The results of this survey suggest that a collaborative effort based on robust research is required upon us to develop evidence for how we care for these patients.
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PMID:Eosinophilic esophagitis: perspectives of adult and pediatric gastroenterologists. 1939 Sep 67

Various drugs are known to cause pill esophagitis. Antimicrobial drugs and nonsteroidal anti-inflammatory drugs are the most common causes of pill-induced esophagitis. Most patients suffer only self-limiting pain, but serious complications can occur. A 21-year-old man was admitted to our outpatient clinic with retrosternal chest pain, dysphagia, and odynophagia complaints, which occurred within 2 weeks after starting dexketoprofen trometamol. An upper endoscopy system examination revealed three well-demarcated ulcers in the esophagus at 35 cm from the incisors. Dexketoprofen trometamol may cause esophageal lesions. This rare disorder should be considered in patients presenting with sudden-onset retrosternal pain in addition to dysphagia and odynophagia.
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PMID:Esophagitis due to dexketoprofen trometamol: a rare case report. 2541 95


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