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)

Over the past 30 years human magnesium (Mg) deficiency has become an accepted fact in most medical circles. Our index patient had striking neurological manifestations including generalized tremulousness, grimaces and fibrillary twitches of facial muscles, athetoid and choreiform movements of upper extremities, dysphagia, inability to speak, repeated convulsions, and confusion. She had received glucose in water and saline intravenously for several months. A patient with chronic alcoholism was noted to have almost identical symptoms and signs as the index patient. He also responded dramatically to MgSO4 injections. This resulted in a series of studies on patients with chronic alcoholism. The evidence of Mg deficiency in alcoholism includes the following: significant hypomagnesemia, strongly positive Mg balance during recovery, significant decrease in muscle Mg, a deficit of total exchangeable 28Mg quantitatively similar to deficit by balance studies, often a dramatic response of symptoms to therapy with Mg, and diuresis of Mg produced by ingestion of alcohol. Lipolysis with high levels of long-chain free fatty acids (FFA) occurs in withdrawal of alcohol in chronic alcoholism, withdrawal of certain addictive drugs, after trauma, surgery, administration of adrenergic compounds or theophylline, exposure to cold, and an adverse environment as in grass staggers. Concentrations of Mg fall when FFA increase in all of the above circumstances. This phenomenon has wide implications in health and disease. Better awareness of Mg deficiency in a wide variety of clinical conditions will result in life-saving treatment and less morbidity of other patients.
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PMID:Magnesium deficiency in human subjects--a personal historical perspective. 398 38

Eighty patients were studied to determine whether dysphagia (delayed transit through oesophagus) occurs in the presence of an enlarged left atrium. Twenty-six patients (group A), with no enlargement of the left atrium but undergoing open heart surgery, were randomly selected as controls. Group B (N = 54) consisted of patients undergoing mitral valve surgery with varying degrees of left atrial enlargement. All patients were requested to swallow, in the standing position, a barium filled capsule or barium filled Slow K tablets. If there was no hold up in the oesophagus the procedure was repeated with the patient seated. When hold up occurred the patient was screened at 5, 10 and 15 min. No hold up was found in any patient in the control group (N = 26). 50% of patients with left atrial enlargement had some degree of hold up, the incidence and duration of which correlated with the size of the atrium. Hold up was just as likely to occur with a capsule or with a 'slow K' tablet. When hold up lasted for more than 15 min, water did not flush away the 'stuck' medicament, but a bolus of solid food did.
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PMID:Mitral valve disease and dysphagia. 624 64

Using noninvasive real-time ultrasound, tongue movement was visualized during single swallowing in eight normal subjects and one neurologically impaired patient with dysphagia and chronic aspiration. In normals, a clearly defined muscular wave of the tongue, traveling at approximately 15 cm/sec, carried a 5-cc test water bolus posteriorly. In the patient who had 12th cranial nerve weakness, there was complete absence of normal tongue activity and no midtongue bolus formation or transmission.
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PMID:Real-time ultrasound visualization of tongue movement during swallowing. 641 84

Prescription of so inoffensive-seeming and common a treatment as mucilaginous laxative may have major (if rare) side effects, such as sudden esophageal obstruction. This usually occurs in old people who do not take enough water with the laxative and who may have minor esophageal pathology such as motility disorders or epibronchic diverticulum. The usually typical symptoms are sudden onset, with retrosternal pain, dysphagia or total aphagia, alimentary vomiting and pseudohypersialorrhea. Diagnosis is always by radiography and endoscopy. Radiography must be performed with gastrografin, due to the risk of bronchoaspiration or esophageal fissure. Endoscopy may demonstrate the mucilagenous mass responsible for the obstruction and in most cases restore patency of the esophagus. This technique should always be attempted, if necessary several times, before resorting to surgery. The authors stress that in patients with a risk of esophageal obstruction, such as old people with esophageal disorders, it is essential to explain clearly to the patient that the laxative must be taken with a sufficient quantity of liquid.
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PMID:[Acute complications caused by a mucilaginous laxative]. 650 64

Oesophageal emptying was studied with scintigraphy, radiography, and the acid clearing test (ACT) in 18 patients reporting dysphagia and previously operated on with fundoplication. Radiography with contrast medium, isodense with water, revealed abnormalities in either motility or emptying capacity in 39% (7/18). A A barium meal showed abnormalities--that is, a tight repair, disruption of the fundoplication, or recurrence of the hernia--in 56% (10/18). The ACT was prolonged in 40% (6/15) of the patients. Pathological findings at scintigraphy with a solid bolus were found in 67% (12/18). Even if scintigraphy with a solid bolus is the method that identifies the highest number of patients with impaired oesophageal function among the tests used, it cannot differentiate between functional and anatomical disorders. A barium meal examination is the method of choice when an anatomical disorder is suspected.
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PMID:Scintigraphy, radiography, and acid clearing in dysphagia patients after anti-reflux surgery. 653 75

Patients with esophageal motor disease have been known to develop symptoms (chest pain, or dysphagia, or both) upon ingestion of warm or cold beverages. A patient with an esophageal motor disorder is described from whom a history of marked symptoms related to bolus temperature was elicited. Manometric monitoring during the administration of wet swallows with cold and warm water boluses reproducibly altered primary swallows from normal amplitude (74 +/- 7 mmHg) peristaltic contractions (warm boluses) to low amplitude (9 +/- 1.0 mmHg) aperistaltic contractions (cold boluses). The striking correlation between clinical history and manometric findings supports altered peristalsis as one mechanism for the development of symptoms related to bolus temperature in patients with esophageal motor disease.
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PMID:Temperature-dependent symptoms in a patient with esophageal motor disease. 662 33

In a 67-year-old man who had a feeding jejunostomy because of dysphagia paralytica, the absorption of aspirin was measured in terms of serum salicylate concentration. A 975-mg dose of aspirin was given as a slurry in water directly into the feeding tube. Peak serum levels of salicylate were well correlated with those in previous studies of aspirin absorption by the oral route in a geriatric population. However, unexpectedly, the half-life of the drug in this patient was twice as long (7.5 hours) as that found in six previous studies (3.7 hours) of elderly patients given similar doses.
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PMID:Aspirin absorption from a feeding jejunostomy. 677 76

Oesophageal motility was assessed in 30 patients with the irritable bowel syndrome and controls matched for age and sex. Lower oesophageal sphincter pressure was significantly lower in the patients than their controls (mean pressures 13.8 and 23.8 cm H2O respectively), and the same degree of difference between patients and controls was maintained in all age groups. In addition, spontaneous activity, repetitive contractions, and the presence of variable-amplitude and simultaneous waves were significantly more common in the patients, who were also more likely to have more than one abnormal pattern of motility. There was no difference in upper oesophageal sphincter pressure between the two groups. These findings may help to explain why patients with the irritable bowel syndrome may complain of upper gastrointestinal symptoms, including heartburn and dysphagia. The results suggest that the syndrome may be a more widespread disorder of smooth muscle, or its innervation, than was previously thought.
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PMID:Oesophageal motility in the irritable bowel syndrome. 678 54

The authors studied the effects of food temperature in esophageal motility by the use of manometry in 26 cases of chagasic megaesophagus of hyperkinetic type. An assembly of three water filled polyvinyl catheters was used. Each catheter had a distal side hole and was connected proximally with a transducer. One catheter was localized at the lower esophageal sphincter and the other two respectively 5 cm and 10 cm above the sphincter. Pressure changes were recorded graphically on a direct writing multichannel recorder. 50 ml of water was introduced into the esophagus at 5 degrees C, 20 degrees C, 35 degrees C, and 50 degrees C. This produced incoordinated contractions at the three levels considered. The motility pressures were quantified by planimetry and transformed in areas of mm2. A statistic analysis showed that more activity accured with extreme temperature, specially with the water at 5 degrees C. This fact permits one to understand the reason of increasing dysphagia in patients with chagasic megaesophagus when very hot food is eaten.
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PMID:[Effects of food temperature on the esophageal motility in Chagas' megaesophagus. Manometric study]. 679 50

Early weight gain by starving patients managed with total parenteral nutrition has been regarded as spurious - that is, merely an increase in body water. We designed an experiment to mimic the starved state in which glycogen stores are depleted and sodium intake is very low. The subjects were then repleted with a sodium-free, high carbohydrate intake. All subjects who received potassium gained weight and switched to a respiratory exchange ratio which suggested mainly carbohydrate oxidation. From changes in weight and total body water the weight gain was calculated to be the consequence of glycogen storage with 1 g of glycogen obligating 3.21 +/- 0.57 g water. Two patients with total dysphagia showed a similar pattern. Two subjects who did not receive potassium showed a rise in respiratory exchange ratio but failed to store glycogen. Early weight gain in patients who received high-carbohydrate feeding after starvation is a normal phenomenon and represents a return to a more hydrated state consequent upon glycogen repletion.
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PMID:Early weight gain and glycogen-obligated water during nutritional rehabilitation. 681 11


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