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At least 1,153 records · Page 64Linked to original sources
PubMed2006

Evaluation of patients with globus pharyngeus with barium swallow pharyngoesophagography.

OBJECTIVE: The objective of this study was to determine the value of barium swallow pharyngoesophagography in the investigation of patients with globus pharyngeus who had no known disease, no operation history in the head and neck region, and no thyroid pathology. We compare the clinical presentation with the radiologic findings to assess the diagnostic accuracy of barium swallow in such patients. METHODS: This was a retrospective study of the clinical records and radiologic reports of 194 patients with globus pharyngeus, between October 1998 and October 2004, that were reviewed and analyzed for correlations between clinical signs and symptoms and barium swallow findings using the chi2 test. All the patients had normal ear, nose, and throat examination, including indirect laryngoscopy and/or nasoendoscopy. Patients with known pharyngeal and esophageal disease, neurologic disease known to cause pharyngeal or esophageal dysfunction, evidence of autoimmune disease or diabetes mellitus, with a thyroid operation in the past and thyroid nodules detected with radiologic investigation were excluded. RESULTS: There were 116 (59.8%) female and 78 (40.2%) male patients. In 114 patients (59%), globus was the only symptom. Sore throat was the most common associated complaint. Benign barium swallow findings were detected in 63.9% of the patients. Cervical osteophyte indentation was the most common finding. In 36.1% of the patients, the radiologic finding was normal. The statistical analysis using the chi2 test showed a significant relationship (P < .001) between the symptoms of globus pharyngeus and the barium swallow results. CONCLUSION: Barium swallow pharyngoesophagography is useful to detect underlying benign characteristic pathologies in patients with globus who have no known head and neck illness.

Adult↗
PubMed2005

A case of pseudoseizures.

Pseudoseizures, historically described as hysterical seizures, closely resemble epileptic attacks. However, they lack the abnormal paroxysmal electrical discharges from the brain seen in epilepsy. Pseudoseizures may represent a dissociative coping mechanism in which anxiety is reduced by the appearance of the pseudoseizure. Psychotherapy is the mainstay of treatment for pseudoseizures.

Adaptation, Psychological↗
PubMedDate not supplied

Conversion reactions in pediatric athletes.

We report five children and adolescents who displayed a conversion reaction in response to stresses induced by athletic competition. Failure to make proper diagnosis led to additional physician referral, needless testing, rehabilitation, or orthotic management. Patients are characterized as high achievers who are frequently younger than peers in the sport. Conversation between child and physician identified the source of conflict in four patients. Physical therapy helps resolve symptoms associated with an acute episode and facilitates transition into psychotherapy. Psychotherapy is recommended only for patients with persistent maladaptive behavior.

Adolescent↗
PubMed1983

Hysterical seizures or pseudoseizures.

With proper diagnosis and management, the frequency of pseudoseizures can be reduced or eliminated. Emotional factors, whether internal or external, can precipitate pseudoseizures. The goals of therapy are to identify pseudoseizures and resolve the conflicts that manifest them; both psychiatric intervention and hypnosis have produced good results in the treatment of pseudoseizures. Nurses are involved in all aspects of care from observation of seizure activity to assessment and implementation of an appropriate plan of care. The care plan should include helping the patient and his family understand the meaning of the patient's pseudoseizures, recognizing the effect of stigma on the patient and his family, assessing the coping skills of the patient and his family, and setting realistic expectations for the patient regarding prognosis and treatment.

Adolescent↗
PubMed1993

Neurologic abnormalities in two dogs suspected Lyme disease.

A 2-year-old mongrel dog developed neurological signs following tick bite. These included astasia, persistent tonic convulsions and hyper-reflexia. Both serum IgG and IgM antibody titers against Borrelia burgdorferi were positive in enzyme-linked immunosorbent assay (ELISA). The neurological signs subsided after high-dose penicillin and streptomycin treatment. A strain of spirochetes (P427a) was isolated from the midgut of Ixodes persulcatus feeding on the dog. Morphological characteristic, immunological property and protein profile revealed that the isolate was B. burgdorferi. Similarly, a 2-year-old Labrador retriever dog developed neurological signs after tick bite and showed a positive IgG antibody titer against B. burgdorferi. Antibiotic treatment was effective also in this case. These findings suggest that neurological symptoms shown in both dogs were caused by infection with B. burgdorferi.

Animals↗
PubMed2005

Prevalence, clinical spectrum and atypical symptoms of gastro-oesophageal reflux in Argentina: a nationwide population-based study.

BACKGROUND: Population-based data on gastro-oesophageal reflux in Latin America are lacking. AIM: To assess gastro-oesophageal reflux symptom prevalence, clinical spectrum and association with the atypical symptoms in our country. METHODS: Gastro-oesophageal reflux self-report questionnaires validated at Mayo Clinic, USA, were submitted to a sample of 1000 residents (aged 18-80 years) from 17 representative geographical areas of Argentina. The samples were selected and stratified according to age, gender, geographical areas and size of town of residence provided by the Argentine Bureau of Statistics and Census. RESULTS: The overall prevalence of any typical gastro-oesophageal reflux symptom experienced in the previous year was 61.2% (95% CI, 57.9-64.6), the prevalence of frequent gastro-oesophageal reflux symptoms was 23.0% (95% CI, 20.1-25.9) and the prevalence of gastro-oesophageal reflux disease was 11.9% (95% CI, 9.6-14.1). Frequent gastro-oesophageal reflux symptoms were associated with dysphagia (OR 2.12, 95% CI, 1.27-3.54, P < 0.01), globus (OR 2.22, 95% CI, 1.35-3.66, P < 0.01) and non-cardiac chest pain (OR 1.55, 95% CI, 1.04-2.31, P < 0.05). CONCLUSIONS: In Argentina, typical symptoms of gastro-oesophageal reflux are highly prevalent at the national level, and frequent gastro-oesophageal reflux symptoms are significantly associated with dysphagia, globus and non-cardiac chest pain.

Adolescent↗
PubMed1977

Factitious skin lesions in a mother and two sons.

A family is described in which a woman, probably in a state of 'hysterical conversion', produced factitious lesions in her own skin (dermatitis artefacta) and in the skin of two sons (child abuse). Non-accidental injury to a child's skin may form part of a spectrum of skin artefacts in the parent.

Adult↗
PubMed1987

Globus sensation is not due to gastro-oesophageal reflux.

Oesophageal manometry and prolonged ambulatory pH monitoring were performed in 47 patients with the globus sensation, 48 control subjects and 28 patients with documented oesophagitis. Globus patients also underwent video-recorded barium examination and rigid endoscopy. Manometry was normal in 38 of the globus group (94%). The mean percentage time below pH 4 was 4.16 in controls, 5.11 in globus patients (NS) and 18.54 in oesophagitis patients (P less than 0.0005). Oesophageal acid exposure did not correlate with sex, smoking or heartburn and correlated with age only in oesophagitis patients (P less than 0.001). Biopsy showed mild laryngitis in 2 globus patients and distal oesophagitis in 6 (13%). Abnormal oesophageal acid exposure and distal oesophageal dysmotility are not aetiological factors in the majority of patients with globus pharyngis.

Adult↗
PubMed1991

The persistence of symptoms in patients with globus pharyngis.

A follow-up study of 104 patients with globus sensation was performed by postal questionnaire. All were asked to complete the Eysenck Personality Questionnaire (EPQ) and a 12-item Throat Symptom Questionnaire. Seventy-two of these patients were sent a follow-up General Health Questionnaire (GHQ). Replies were received from 89 patients (86%), 68 females and 21 males, a mean of 31 months after initial presentation. The feeling of something stuck in the throat had disappeared completely in 27% of patients, but only 4% were never aware of the throat. Throat symptoms showed a reduction with increasing age, but not with increasing interval since presentation. The 15 patients initially treated with antacid therapy had significantly greater dyspepsia scores at review than untreated patients, but no other difference was found between the two groups. GHQ scores showed a small but significant reduction over time. Of EPQ parameters, only the lower lie score in female patients showed any significant difference on repeat testing. Those with persistently high throat scores had significantly lower EPQ lie scores and a trend towards higher GHQ scores at follow-up. None of the psychological parameters measured at the first interview was found to be of prognostic significance. We conclude that, although there is a reduction in occult psychiatric morbidity in patients with the globus sensation over time, underlying personality traits remain stable and that there is a remarkable persistence of pharyngeal symptoms.

Antacids↗
PubMed1992

Globus sensation.

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Conversion Disorder↗