Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cough is probably the most frequent symptom in chest diseases. Hence, a rational and economical diagnostic procedure is essential to prevent unnecessary costs to the health services, i.e. acute bronchitis, a self-limiting disease, which is the most frequent cause for cough should not involve extensive per case costs. History, physical examination, chest X-ray and lung function testing--which constitute both the first and second, i.e. the basic level of a stepwise approach--allows to diagnose causes in most patients with cough. Without evidence of the cause after completing this basic diagnostic procedure patients with acute cough may require blood gases analysis, electrocardiography, echocardiography, lung perfusion study, spiral CT angiography, bronchoscopy or laboratory examinations for diagnosis of pulmonary embolism, aspiration or (seldom) pleuritis sicca. Chronic persistent cough (CPC) is diagnosed if the basic standard approach to chronic cough fails to lead to final diagnosis. Patients will then need further subtle diagnostic management, i.e. bronchial provocation testing, 24 hour pH probe, ENT- or neurological examination, high resolution CT of the thorax and bronchoscopy. We present two algorithms for the rational diagnostic approach to acute (figure 1) and chronic (figure 2) cough. Each algorithm considers spectrum and frequency of causes on the one hand, the positive predictive value, costs and patient discomfort due to the examination on the other. Nonetheless, despite extensive examination up to 20% of patients suffering from CPC the cause remains unclear [11]. Frequently, the capsaicin cough challenge test can reveal an idiopathic upregulation of the cough reflex as the hypothesised underlying condition. Psychogenic cough however, a rare condition in adults should not coincide with hypersensitivity of the cough reflex. Inconsistency and low reproducibility of results of the capsaicin challenge in patients with psychogenic cough preclude his routine clinical use. In conclusion, the very common acute bronchitis and the ACE inhibitor-induced cough do not require any other diagnostic procedure except patient history and physical examination. A simple basic diagnostic approach will usually allow to evaluate acute and chronic cough. In the remaining cases the proposed algorithm should be used for best results and to prevent excessive costs.
 ...
PMID:[Proposals for a rationale and for rational diagnosis of coughs]. 1078 50

Congenital tracheo-oesophageal fistula presenting in adulthood is extremely rare. Such a case is presented in a patient who suffered repeated chest problems as an infant, which persisted through the years, and was ultimately diagnosed as 'bakers lung' due to his occupation. He was referred with persistent cough to the ENT department, and an upper endoscopy located a tracheo-oesophageal fistula, which was subsequently resected with complete resolution of his symptoms. Unresolving chest problems or persisting cough should alert the doctor to such a possible diagnosis.
 ...
PMID:Late presentation of congenital tracheo-oesophageal fistula. 1689 48

A young girl presented to the ENT acute clinic with a persistent cough and a bulge in the left oropharynx. As there were no clinical signs suggestive of a quinsy, an MRI was performed that showed a large mass extending from the base of the skull to the epiglottis medialising the lateral and posterior pharyngeal walls. The patient subsequently underwent an excision biopsy which demonstrated a ganglioneuroma, however developed a left-sided Horner's syndrome and mild vocal cord palsy after.
 ...
PMID:Bulge in the tonsillar fossa. Is it a quinsy? 2359 26

The aim of this study was to evaluate patient's experience when performing transnasal flexible endoscopy using EndoSheath Technology without sedation in an ENT outpatient department. Patients were seen at the laryngological clinic of the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, presenting with complaints of reflux like throat cleaning, persistent cough, globus sensation, heartburn, or voice problems. First, we performed stroboscopy. In cases where physical examination findings revealed the presence of LPR, we performed a transnasal flexible esophagoscopy (TNE) using sterile EndoSheath Technology under local anesthesia. 55 patients were investigated and completed a questionnaire on subjective discomfort that they felt during the procedure. The different steps of the examination were assessed separately. Complications were noted down by the surgeon. All patients underwent a complete examination of the upper aerodigestive tract. The time needed for preparation, examination and cleaning measures was recorded as well. The average preparation time for each examination was 24 min. No complications were observed during the procedure. The procedure was well tolerated by all patients and was classified on average as "low-grade unpleasant". In summary, TNE is a safe, quick and well-tolerated procedure that can be performed in a regular examination room under local anesthesia without sedation.
 ...
PMID:Transnasal flexible esophagoscopy (TNE): an evaluation of the patient's experience and time management. 2388 Sep 19