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)

Isobutyl-2 cyanoacrylate (IBC) was used to embolize the bronchial arteries of 14 patients with severe hemoptysis. The site of bleeding was supplied by a bronchial artery from the aorta in 11 cases and from a right bronchointercostal trunk in three. IBC was injected after previous reduction of the blood flow in the artery by embolization with particles of dura mater. In all cases, bleeding stopped immediately after occlusion and no spinal cord complications were observed. The results indicate that IBC may be a valuable occluding agent in severe hemoptysis, since it produced virtually permanent occlusion of both the distal and proximal parts of the artery. In 13 patients, bleeding did not recur throughout follow-up periods of 2-17 months. In one patient, it recurred 12 months after embolization but stopped after occlusion of another bronchial artery with IBC. It should be noted, however, that immediately after embolization, five patients experienced violent transient retrosternal burning, and one patient experienced dysphagia and fever for 2 days. Since mediastinal ischemia cannot always be avoided, this procedure must be reserved for cases of severe hemoptysis for which surgical treatment is contraindicated.
 ...
PMID:Bronchial artery occlusion for severe hemoptysis: use of isobutyl-2 cyanoacrylate. 660 May 35

Gastrostomy feeding has been a well established form of nutritional support for patients presenting with total dysphagia for carcinoma of the oesophagus. More recently, total parenteral nutrition has proved to be efficient and safe, offering an alternative to gastrostomy feeding. Twenty-four patients were randomly selected into two groups to compare the efficacy of total parenteral nutrition and gastrostomy feeding with respect to nitrogen balance and weight gain. Total parenteral nutrition was found to be superior to gastrostomy feeding in achieving an earlier positive nitrogen balance and greater weight gain during a 4-week period. However, gastrostomy feeding is still preferred as it is cheap, simple and safe, and allows patients to be active, mobile and self dependent. Total parenteral nutrition is reserved for those patients in whom an earlier operation is advisable.
 ...
PMID:Total parenteral nutrition versus gastrostomy in the preoperative preparation of patients with carcinoma of the oesophagus. 677 88

The rise in incidence of lung abscess due to opportunistic organisms has reemphasized the need for early recognition and treatment. Opportunistic organisms can cause lung abscess in immunocompromised hosts. Most lung abscesses are primary, occurring as a result of aspiration of oral contents into the dependent portions of the lung in persons with dysphagia or decreased consciousness. Symptoms of lung abscess include productive cough, fever, leukocytosis, weight loss, and putrid sputum. Among the complications are progression to a chronic stage, empyema, massive hemoptysis, metastatic brain abscess, and bronchopleural fistula. Treatment of lung abscess is primarily medical, consisting of an appropriate antibiotic regimen and chest physical therapy. Surgery is reserved for unresponsive patients or those with complications.
 ...
PMID:Lung abscess: back for an encore? 708 45

Laser therapy is a well-established, relatively safe, rapid, and highly effective method of palliation for the dysphagia that usually accompanies esophageal and esophagogastric cancer. It is the treatment of choice in many patients, although there remains some disagreement regarding technique and predictors of outcome. The major limitation of laser therapy is the need for repeated treatments, although the interval between treatments may be lengthened by concomitant external beam or endoluminal radiotherapy. When laser therapy is available, use of an esophageal stent should be reserved for special circumstances, such as esophagopulmonary fistulas or extrinsic compression. In addition, stent placement usually is effective when laser photoablation fails or must be performed too frequently. It remains to be seen whether or not technical improvements in esophageal stents will reduce the frequency of complications associated with these devices. Other promising modalities that may be less expensive and more readily available, such as the BICAP tumor probe or injection therapy, deserve further study. It appears that most of these methods are complementary and different modalities may be suited to different types of lesions. The results of phase III clinical trials with PDT, now underway, should help to define the role of this promising modality in the overall scheme of treatment for esophageal cancer. The concept of PDT is attractive, although refinements in photosensitive compounds and methods of light delivery may be needed. Current information suggests a moderately high complication rate for PDT, although this may decrease with technical improvements and increasing experience. Issues surrounding the palliation of esophageal cancer are complex. Whereas the tendency is to focus on technical aspects of therapy and the relief of dysphagia, broader aspects of a patient's quality of life cannot be ignored. Ultimately, the choice of therapy may depend as much on a patient's psychosocial circumstances as on the appearance of the lesion. For instance, the patient who lives at a great distance from the center where laser therapy is performed may be better served by placement of an esophageal stent despite the higher complication rate for this procedure. PDT would be inappropriate for the patient who wishes to spend the remaining few months of life outdoors in the sun. Guiding the patient to the best choice requires the skills of a physician as much as the technical ability of an endoscopist.
 ...
PMID:Palliation of esophageal carcinoma. Laser and photodynamic therapy. 751 23

Poor survival rates and the limited palliation afforded by radiotherapy alone, together with progress made in reconstructive surgery in restoring mucosal continuity after large resections, make total glossectomy reasonably indicated for treatment of advanced carcinoma of the tongue. The Authors reviewed 19 cases (17 males, 2 females, mean age 58.4 years) of total and near total glossectomy without laryngectomy treated at National Cancer Institute "Regina Elena" of Rome from 1990 to 1993 in order to evaluate oncological and functional results. All patients were reconstructed immediately, 16 with a pectoralis major flap, 2 with a nasolabial flap and 1 with a radial forearm free flap and were available for follow-up from 6 to 45 months (mean 29 months). There was no operative mortality and no patient needed total laryngectomy for aspiration. The rate of local recurrencies was 52.6%, most of them (75%) in patients who had undergone total/near total glossectomy for recurrence. Survival rate was 61.5% after 1 year and 20% after 2 years. 94% of patients resumed swallowing and independent oral alimentation (48% of them without any dysphagia); 84%; of the patients were decannulated and 48% produced easily intellegible speech. Data from our experience let us conclude that, in the light of the acceptable functional results obtained with reconstructive flaps, total glossectomy should be considered as the primary treatment modality in advanced carcinoma of the tongue (including T2 > 3 cm exceeding midline), and should not be reserved only for salvaging hopeless situations.
 ...
PMID:[Total/near-total glossectomy for advanced carcinoma of the tongue]. 781 46

The diagnosis and treatment of osteophyte-induced dysphagia can be both challenging and frustrating. DISH is a common finding in the adult population and, like the complaint of dysphagia, increases with age. Clearly, it is a small percentage of cervical osteophytes that present upper aerodigestive difficulties. After excluding other causes of dysphagia, conservative treatment is indicated in the initial management of this disorder and should relieve symptoms in the majority of patients. Surgical management should be reserved for severe and recalcitrant symptoms, and the patient must understand that surgery does not guarantee complete resolution of symptoms. Special thanks to Jerry Basto for his assistance in manuscript preparation.
 ...
PMID:DISH syndrome and its role in dysphagia. 817 Jun 89

Panendoscopy is commonly used for diagnosing synchronous primary neoplasms of the head and neck, although the yield and cost effectiveness has been questioned. To compare symptom-directed selective endoscopy to panendoscopy, 100 consecutive patients with newly diagnosed and untreated squamous cell carcinoma were prospectively evaluated. Symptoms were used to select which studies might have been performed to discover synchronous primary lesions. All patients were subsequently evaluated with chest x-ray, barium esophagram, direct pharyngolaryngoscopy, esophagoscopy, and bronchoscopy with bronchial washings. Seven synchronous primary neoplasms were discovered in six patients with one patient having three separate tumors. There were five synchronous pharyngeal and one oral cavity neoplasms with two of the pharyngeal tumors being asymptomatic. Two primary cervical esophageal tumors and one synchronous esophageal tumor were found in three patients all of whom had symptoms of dysphagia and odynophagia. Two pulmonary metastasis were discovered by chest x-ray in patients with normal bronchoscopies with bronchial washings. Selective symptomatic evaluations would have resulted in one-third savings in total cost and would have minimized excessive procedures and potential morbidity. Direct pharyngolaryngoscopy and chest x-rays are recommended for patients with squamous cell carcinoma of the head and neck but esophagoscopy, esophagogram, and bronchoscopy might be reserved for patients with associated symptoms. Bronchial washings are not recommended.
 ...
PMID:Symptom-directed selective endoscopy and cost containment for evaluation of head and neck cancer. 825 61

BE is a disorder that occurs in children likely as a consequence of prolonged GE reflux of gastroduodenal contents. It usually presents with complications of GE reflux, but it also may be relatively silent in childhood and then present with adenocarcinoma in childhood or present in adulthood. Although seldom recognized in children until relatively recently, it is being diagnosed with greater frequency but not always accurately. The diagnosis of BE can be made with certainty only if landmarks are carefully documented, and a detailed histologic map is made from multiple, large biopsies taken under direct vision at endoscopy; the diagnosis should be reserved for those patients where Barrett's specialized epithelium i.e., goblet cell metaplasia, is present. BE is a diagnosis that should be made with thorough documentation because of the implications for regression, cancer, and the need for follow-up and endoscopic biopsy surveillance. For treatment of complications and because there may be a chance for regression of a young (i.e., childhood) lesion, antireflux surgery or indefinite aggressive acid suppressing medical therapy is required. Because bile reflux may have a pathogenic role in BE, and because of the proven benefits of surgery in producing partial regression and prevention of dysphagia and cancer in some patients, the author's preference at present is for surgery. For children who are poor candidates for surgery, long-term omeprazole should be used (159). Adenocarcinoma does occur in childhood as a complication of BE. Because it can be recognized early, regular surveillance of children with bona fide BE is advisable.
 ...
PMID:Barrett's esophagus: new definitions and approaches in children. 831 40

Achalasia is a primary esophageal motor disorder that is characterized by dysphagia, regurgitation, and chest pain. The diagnosis is suggested by narrowing with the classic "bird's beak" appearance of the distal esophagus. Esophageal manometry showing aperistalsis confirms the diagnosis. Pseudo-achalasia must be excluded with endoscopy. Pneumatic dilatation is the treatment of choice. Surgical myotomy is reserved for patients in whom repeated pneumatic dilatation fails.
 ...
PMID:Coping with achalasia. 846 81

Lingual thyroid gland is a rare clinical entity that is due to failure of descent of the gland anlage early in the course of embryogenesis. It may present with symptoms of dysphagia, upper airway obstruction, or even hemorrhage at any time from infancy through adulthood. We present two illustrative cases of lingual thyroid gland along with a protocol for diagnosis and management of the condition. Elements in the diagnostic and therapeutic evaluation are described with attention to the clinical findings, laboratory tests, and radiographic imaging studies employed in confirming the diagnosis and planning appropriate treatment. The natural history of the condition is reviewed and a treatment strategy is outlined that focuses on the use of suppressive doses of thyroid hormone as the initial therapy. Surgical excision of the gland is reserved for more advanced cases of gland enlargement resulting in airway compromise, severe dysphagia that limits oral intake, or ongoing hemorrhage.
 ...
PMID:Evaluation and management of the lingual thyroid gland. 860 96


<< Previous 1 2 3 4 5 6 7 Next >>