Scielo RSS <![CDATA[Revista médica de Chile]]> https://scielo.conicyt.cl/rss.php?pid=0034-988720130006&lang=es vol. 141 num. 6 lang. es <![CDATA[SciELO Logo]]> https://scielo.conicyt.cl/img/en/fbpelogp.gif https://scielo.conicyt.cl <![CDATA[<b>Resultados visuales en pacientes con macroprolactinoma tratados con agonistas de dopamina</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600001&lng=es&nrm=iso&tlng=es Background: Dopamine agonists (DA) effectively reduce tumor size of macroprolactinomas, with the consequent improvement of eventual visual impairment. Aim: To study the visual outcomes in patients with macroprolactinoma treated with DA. Material and Methods: Retrospective cohort study which included patients with macroprolactinoma controlled at a Neuro-endocrinology and Neuro-ophthalmology Department between 1997'and2011, and treated exclusively with DA (bromocriptine or cabergoline). Patients who were operated or had previous radiotherapy and those with an incomplete follow up, were excluded. We analyzed and compared the visual status before and after the beginning of DA treatment. Results: Thirty one patients aged 8 to 59years, were included. Eighteen patients (58%) had visual impairment at the moment of diagnosis (group 1) and 13 had no alterations (group 2). Mean follow up was 36.5 months. Fifteen patients from group 1 (83%) had visual improvement, two remained stable (11 %) and one had a visual deterioration (6%). In group 2, only one non-compliant patient had a visual deterioration. Conclusions: DAs are effective in the management of neuro-ophthalmic complications associated to macroprolactinomas and should be considered asfirst choice therapy in these tumors. <![CDATA[Grosor íntima media carotídeo y asociación con factores de riesgo cardiovascular tradicionales y metabólicos]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600002&lng=es&nrm=iso&tlng=es Background: Carotid intima-media thickness (IMT) is a surrogate marker of subclinical atherosderosis and is associated with cardiovascular risk factors (CVRF) Aim: To analyze the association of CVRF and metabolic factors (MF) with IMT, and if the clustering of these factors modify IMT. Material and Methods: Cross sectional study in 187 participants aged 46±10years (53% male) without CV disease. Weight, height, waist circumference (WC), blood pressure, fasting plasma glucose and lipid profile were measured. Abdominal obesity (AOb) was defined by ATP III criteria. Mean carotid IMT was measured at the farwall of the common carotid artery. The cutoff point for an abnormally high IMT was set at the 75th IMT percentile of the sample. Results: The 75th IMT percentile of the sample was 0.67 mm. In a multivariate analysis four factors were significantly related with a high IMT: age (odds ratio (OR): 5.3, confidence intervals (CI): 2.2-12.9), dyslipidemia (OR: 6.4 CI: 2.3-17.9), systolic blood pressure (OR: 2.9, CI: 1.2-7.1) and AOb (OR: 2.9 (IC: 1.1-7.2). The presence of Oto 4 of these factors was associated with an IMT increment from 0.54 to 0.71 mm (p < 0,001). Conclusions: In this sample dyslipidemia, systolic blood pressure and abdominal obesity were the main predictors of a high IMT. <![CDATA[<strong>Criterios de juicio moral de estudiantes de Medicina, según el Modelo Intuitivo Social</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600003&lng=es&nrm=iso&tlng=es Background: The evaluation of moral judgment criteria in medical students is important to develop effective educational programs in bioethics. Aim: To compare priority judgment criteria and moral judgment tendency in medical students of first and fifth grade. Material and Methods: The Moral Foundations Questionnaire (MFQ30), to identify moral criteria was applied to 259 students, 63.7% from first year and 50.2% women. Results: The dominant moral tendeney both in first and fifth year students was liberal. Justice and compassion were the most important criteria in men and in women, respectively. Respect towards authority and sanctity were the least important criteria in women and men, respectively. Conclusions: The implications for moral psychology and medical education of these results are discussed. <![CDATA[Impacto de un programa de nivelación de ciencias básicas en estudiantes de primer año de la carrera de Medicina]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600004&lng=es&nrm=iso&tlng=es Background: A significant number of students in health careers do not have the knowledge to approve basic courses. Therefore, educational programs to level off knowledge have been developed. Aim: To associate the results of a leveling program with the academic performance in cell biology (CB) and biochemistry (BC) of first year medical students. Material and Methods: We applied a test to first year medical students at the beginning and end of the leveling program (control test). The results obtained at the end of the leveling program were correlated with the results obtained in CB and BC. Results: Fifty seven of 89 (64%) first year medical students met the study entry criteria (54% female). Students who completed the leveling program had a significantly higher approval rate in CB (93% versus 75%, P = 0.024), and in BC (95% versus 69%, P = 0.001). After completing the leveling program, the risk of failing CB and BC, decreased by 72 and 84% respectively Conclusions: This study shows that medical students who participate in the leveling program decrease the chances of failing in CB and BC. <![CDATA[Apreciación de estudiantes de Medicina latinoamericanos sobre la capacitación universitaria en investigación científica]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600005&lng=es&nrm=iso&tlng=es Background: Learning research skills should be a goal during undergraduate training of physicians. Aim: To identify Latin American medical students' appraisal on research skills university training Material and Methods: A self-administered survey about experience in research, self-assessment of research skills, quality of training in the area received at the university and that importance of publishing as undergraduate students, was answered by 208 medical students aged 23 ± 3 years (54% male), attending a medical students congress. Results: Seventy percent of respondents pertained to medical students' scientific societies and 34% had published in a scientific journal. Fifty two percent considered as good or very good the training level received at their universities on information retrieval and 45% considered good the training in research methodology. Thirty two percent considered as poor or none the training received in scientific writing and 37% in the publishing process. Eighty nine percent considered student publishing as important and 61% perceived limitations in this matter. Conclusions: The university training level received by Latin American medical students on research and publication process was evaluated as deficient by these students. <![CDATA[Calidad de vida en cáncer de mama: validación del cuestionario BR23 en Chile]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600006&lng=es&nrm=iso&tlng=es Background: Quality of Life assessment in oncologic patients evaluates the impact and sequels of the disease ana the adverse effects of available treatments. Aim: To validate in Chile the breast cancer specific-questionnaire (BR23) developed by the European Organization for Research and Treatment of Cancer (EORTC). Patients and Methods: After performing a linguistic validation of the BR23 according to EORTC instructions, its psychometric properties were tested in 103 patients with breast cancer whose ages ranged from 34 to 83 years. Internal consistency of the scales was assessed using the Cronbach's alpha coefficient. The test-retest correlations of each scale (n = 83) were evaluated. The correlation of BR23 scales with SF36 version 2 and C30 version 3.0 scales was also assessed. The sensitivity and specificity of the instrument were analyzed using receiver operating characteristic curves (ROC). Results: Alpha values showed acceptable levels of internal consistency, ranging between 0.702 and 0.917 in all scales of BR23. The statistical analysis revealed significant test-retest correlations in most scales of BR23. The correlations between BR23 and similar domains of C30 and SF36 questionnaires were also significant. The BR23 questionnaire demonstrated satisfactory levels of sensitivity and specificity when compared with the SF-36 scale. Conclusions: The BR23 questionnaire adapted for use in Chile is linguistically appropriate and psychometrically valid. <![CDATA[Reeducación psicomotriz en personas con enfermedad de Alzheimer]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600007&lng=es&nrm=iso&tlng=es Background: We developed a psychomotor re-education guide (PSEG) adapted to people with Alzheimer disease (AD), including a cognitive stimulation program integrated with the exercise recommendations of the American College of Sports Medicine. Aim: To evaluate the effect of the PSEG on cognitive and functional parameters among patients with AD. Patients and Methods: We applied the PSEG to 64 participants with AD aged 64 to 87 years (55% women) during 12 months. At baseline and the end of the intervention, cognitive abilities (Mini Mental State), fitness (Chair Stand test), level of independence (Barthel Index) and quality of life (QoL) (SF-12) were assessed. Results: The application of PSEG resulted in a significant improvement in the QoL and physical capacity of patients with AD. Cognitive ability declined along with disease progression. Conclusions: These results demonstrate the effectiveness of the guide in mild and moderate stages of AD improving the physical fitness and the QoL. <![CDATA[<strong>Óxido nítrico exhalado, asma y atopia</strong>: <strong>análisis en un panel de niños en Santiago, Chile</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600008&lng=es&nrm=iso&tlng=es Background: Chronic airway inflammation is a central process in asthma. Measurement of exhaled nitric oxide (eNO) is a non-invasive biomarker of eosinophilic airway inflammation. Aim: To measure eNO levels in a population of asthmatic and non-asthmatic children and to evaluate their relationship with asthma and atopy. Material and Methods: We studied 143 asthmatic and non-asthmatic children aged 6 to 14 years attended a hospital and primary health service. Participants were tested for allergies and followed during the winter months of 2010 and 2011. They were visited regularly at their homes and eNO levels were measured on each visit using a handheld equipment. Mean eNO distribution were compared by the presence of asthma or atopy using t-test and regression models. Results: No significant differences for mean eNO levels were detected, according to presence of asthma or atopy, by any ofthe statistical methods used. Regression models showed significant effects for age but not for sex. Conclusions: There were no differences in eNO levels in the studied children by the presence of asthma or atopy. <![CDATA[<strong>Resultados del Programa de Prevención de Defectos de Tubo Neural en Chile mediante la fortificación de la harina con ácido fólico</strong>: <strong>Período 2001-2010</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600009&lng=es&nrm=iso&tlng=es Background: Congenital malformations (CMF) have an important role in infant mortality. Neural tube defects (NTD) have great relevance from both social and public health points of view. The ECLAMC (Collaborative Latin American Study of Congenital Malformations) maintains in Chile an epidemiological surveillance of CMF prevalence rate at birth since 1969. Aim: To assess the effect of wheat flour folic acid fortification on the prevalence of NTD. Patients and Methods: Only Anencephaly, Spina bifida and Cephalocele were considered as NTD. All children born in the maternities incorporated to ECLAMC between 1969 and 1999 were considered as belonging to the pre folic acid fortification period and those who were born from 2001 to 2010 were considered as belonging to the post fortification period. Results: The NTD prevalence rate at birth in the pre fortification period was 17.03/10,000. In the second period, there were 291,996 births and among them, 280 newborns were affected by a form of NTD (9.59 in 10,000 births). This represents a 44% decrease (p < 0.01). Anencephaly rate fell from 7.16/10,000 to 3.67/10,000, representing a 49% lower rate (p < 0.01). Spina bifida rate decreased from 8.61/10,000 to 4.49/10,000, representing a 48% lower rate (p < 0.01). Cephalocele had a 20% non-significant reduction. Conclusions: Wheat flour fortification with folic acid reduced by 44% the prevalence rate of NTD at birth. This means that NTDs were prevented in 185 Chilean newborns each year. <![CDATA[<strong>Trastorno de la marcha en la enfermedad de Parkinson</strong>: <strong><i>freezing</i></strong><strong> y perspectivas actuales</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600010&lng=es&nrm=iso&tlng=es More than one third of patients with Parkinson disease experience freezing. It is characterized by the feeling that one's feet are "glued to the floor", and it is more common in the later stages of the disease. The causes of this gait disorder are not yet fully established, but it may lead patients to suffer falls and lose their independence. As a consequence, the development of therapeutic measures which can overcome freezing is of fundamental important for the autonomy of such individuals. There is no consensus in the literature on the most recommended therapeutic measures for the prevention or attenuation of freezing in gait. What seems to be defined are the phenomenological aspects of the disorder and good therapy, represented by the association between drug therapy and sensorial stimuli or motor coordination training geared towards the specificities to avoid motor difficulties of freezing, when triggering factors are present. <![CDATA[<strong>Vasculitis asociadas a anticuerpos anti-citoplasma de neutrófilos</strong>: <strong>avances en patogenia y tratamiento</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600011&lng=es&nrm=iso&tlng=es ANCA (anti-neutrophil cytoplasmic antibodies) associated vasculitis or AAVare a group of diseases with predominant inflammation of small vessels and the presence of detectable ANCA in serum. Due to these common features, it is considered that AAV share pathogenic mechanisms. Consequently, a similar therapeutic approach has been developed. A new nomenclature has been recently proposed, with AAV including "granulomatosis with polyangiitis" (GPA, formerly Wegener's granulomatosis), "microscopic polyangiitis" (MPA), "eosinophilic granulomatosis with polyangiitis" (EGPA, formerly Churg-Strauss disease) and renal limited vasculitis. Research on AAV has shown significant advances in the last two decades, including advances in the knowledge of pathogenic mechanisms such as the pro-inflammatory role of ANCA, AAV murine models and genetic links. Evidence on previous immunosuppressive therapies has improved significantly and new, promissory drugs have been introduced, Rituximab being the most important. We review the advances of pathogenic mechanisms and treatment for these diseases. <![CDATA[Edvard Munch: enfermedad y genialidad en el gran artista noruego]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600012&lng=es&nrm=iso&tlng=es Edvard Munch is one the most transcendental artists of all times. His work is innovative in terms of reflecting the grief, sadness, loneliness and the impact of death in human beings as no one did it before. Behind his work it is possible to find many clues given by Munch himself of the reason of his creativity: a childhood surrounded by death and sorrow, and the development of an affective disorder that led him to alcoholism and many hospitalizations due to psychotic episodes. In this review, we analyze Munch's life and his disease that undoubtedly contributed to his great artistic legacy. <![CDATA[Dimensión ética en la organización de la atención de salud]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600013&lng=es&nrm=iso&tlng=es Health Care at population level is a complex problem. Having this in mind, the purpose of this paper is to focus on the goods that are ethically relevant in the process of caring for health at this level. We briefly analyze some of the Chilean health statistics that, although they show important improvements along the years, demonstrate that certain conditions are to be deemed as inadequate by both healthcare providers and patients. Ethics is a central component to determine how to structure and organize health care systems and how they should operate. We emphasize Human Dignity as an ethical corner stone of the Health Care System, along with other important values such as Justice and Humanization, under the scope of the Ends of Medicine, and other components such as technical competence of providers and the financing of the whole process. We conclude that as far as a health care system is organized in a way that medical practice is well ordered, primarily and fundamentally according the Ends of Medicine and the good of persons, such a health care system is ethically adequate. <![CDATA[Percepción de académicos de carreras de la salud de Chile sobre el perfeccionamiento docente]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600014&lng=es&nrm=iso&tlng=es Background: Continuous training of teachers, in discipline and pedagogical topics, is a key step to improve the quality of educational processes. Aim: To report the perception of Chilean teachers of undergraduate health care programs, about continuous training activities. Material and Methods: Twenty teachers working at different undergraduate health care programs in Chile were interviewed. Maximum variation and theoretical sampling methods were used to select the sample. Data was analyzed by open coding, according to the Grounded Theory guidelines. Results: Nine categories emerged from data analysis: Access to continuous training, meaning of training in discipline, activities of continuous training in discipline, meaning of continuous training in pedagogy, kinds of continuous training in pedagogy, quality of continuous training in pedagogy, ideal of continuous training in pedagogy, outcomes of continuous training in pedagogy and needs for continuous training in pedagogy. Conclusions: Teachers of health care programs prefer to participate in contextualized training activities. Also, they emphasize their need of training in evaluation and teaching strategies. <![CDATA[<strong>Proceso estilohioideo elongado y calcificado asintomático</strong>: <strong>Presentación de un caso</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600015&lng=es&nrm=iso&tlng=es The stylohyoid process is a cylindrical bony structure surrounded by important anatomical structures including vessels and nerves. Calcification and elongation of the stylohyoid ligament complex over 30 mm may be associated with neck and facial pain, known as Eagle's syndrome. However, a bilateral ossified and elongated stylohyoid complex may be devoid of symptoms. We report a 79-year-old symptom-free female who presented on a routine conventional dental radiographic exam an 80.96 mm psendoarticulated stylohyoid complex in the left side and an 75.85 mm on the other. On CAT scan, both processes were calcified.<hr/>El proceso estilohioideo es una estructura ósea rodeada por nervios y vasos sanguíneos. La calcificación elongación del ligamento estilohioideo en más de 30 mm puede asociarse a dolor facial y del cuello, conocido como síndrome de Eagle. Sin embargo, esta alteración anatómica puede ser asintomática. Presentamos una mujer asintomática de 79 años a quien se le descubrieron procesos estilohioideo pseudo articulado de 80,96 mm a un lado y 75,85 mm al otro lado, en una radiografía dental convencional. En la tomografía axial computada, ambos procesos estaban calcificados. <![CDATA[<strong>Síndrome hemolítico-urémico asociado al uso de gemcitabina</strong>: <strong>Caso clínico</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600016&lng=es&nrm=iso&tlng=es Gemcitabine is a widely used drug in the treatment of advanced pancreatic cancer and other malignancies. It is generally well tolerated and exceptionally its use has been associated with hemolytic-uremic syndrome, causing acute kidney injury, hipertension, chronic renal failure requiring dialysis, and death. We report a 60-year-old man with pancreatic carcinoma and regional lymph node invasion, whom after four months of therapy with gemcitabine and after dose number 11, suddenly developed an acute nephritic syndrome with moderate renal impairment, associated with severe anemia (hemoglobin 6.0 g/dL) and thrombocytopenia (20,000 mm³). Renal biopsy showed the classic findings of thrombotic microangiopathy Gemcitabine was discontinued and renal function and hematological parameters gradually improved. <![CDATA[<strong>Disfagia cervical espondilótica por hiperostosis esquelética difusa idiopática en un paciente joven</strong>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600017&lng=es&nrm=iso&tlng=es Diffuse idiopathic skeletal hyperostosis (DISH) is an under-diagnosed condition producing flowing ossification of the antero-lateral ligaments of the spine. Affecting predominantly males over 65 years old, it is an unusual cause of dysphagia and dysphonia. We report a 45-year-old mole with a three years history of dysphonia and three months of dysphagia. The initial diagnosis was gastroesophageal reflux, and an endoscopy ruled out esophageal luminal pathology. Cervical spine radiographs showed ossification of the cervical anterior longitudinal ligament with large, prominent osteophytes from C3 to C6, producing esophageal and upper airway compression; these images were compatible with DISH. Cervical osteophyte resection resulted in complete resolution of symptoms. DISH should be considered in the differential diagnosis of dysphagia and dysphonia. <![CDATA[Publicación de artículos en inglés en revistas médicas en español: ¿Realmente no aumenta el número de citaciones en revistas indexadas?]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600018&lng=es&nrm=iso&tlng=es Diffuse idiopathic skeletal hyperostosis (DISH) is an under-diagnosed condition producing flowing ossification of the antero-lateral ligaments of the spine. Affecting predominantly males over 65 years old, it is an unusual cause of dysphagia and dysphonia. We report a 45-year-old mole with a three years history of dysphonia and three months of dysphagia. The initial diagnosis was gastroesophageal reflux, and an endoscopy ruled out esophageal luminal pathology. Cervical spine radiographs showed ossification of the cervical anterior longitudinal ligament with large, prominent osteophytes from C3 to C6, producing esophageal and upper airway compression; these images were compatible with DISH. Cervical osteophyte resection resulted in complete resolution of symptoms. DISH should be considered in the differential diagnosis of dysphagia and dysphonia. <![CDATA[<b>Publicación de artículos en inglés en revistas médicas en español</b>: <b>¿Realmente no aumenta el número de citaciones en revistas indexadas?</b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600019&lng=es&nrm=iso&tlng=es Diffuse idiopathic skeletal hyperostosis (DISH) is an under-diagnosed condition producing flowing ossification of the antero-lateral ligaments of the spine. Affecting predominantly males over 65 years old, it is an unusual cause of dysphagia and dysphonia. We report a 45-year-old mole with a three years history of dysphonia and three months of dysphagia. The initial diagnosis was gastroesophageal reflux, and an endoscopy ruled out esophageal luminal pathology. Cervical spine radiographs showed ossification of the cervical anterior longitudinal ligament with large, prominent osteophytes from C3 to C6, producing esophageal and upper airway compression; these images were compatible with DISH. Cervical osteophyte resection resulted in complete resolution of symptoms. DISH should be considered in the differential diagnosis of dysphagia and dysphonia. <![CDATA[El uso de probióticos como alternativa en la prevención de las infecciones urinarias recurrentes en mujeres]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600020&lng=es&nrm=iso&tlng=es Diffuse idiopathic skeletal hyperostosis (DISH) is an under-diagnosed condition producing flowing ossification of the antero-lateral ligaments of the spine. Affecting predominantly males over 65 years old, it is an unusual cause of dysphagia and dysphonia. We report a 45-year-old mole with a three years history of dysphonia and three months of dysphagia. The initial diagnosis was gastroesophageal reflux, and an endoscopy ruled out esophageal luminal pathology. Cervical spine radiographs showed ossification of the cervical anterior longitudinal ligament with large, prominent osteophytes from C3 to C6, producing esophageal and upper airway compression; these images were compatible with DISH. Cervical osteophyte resection resulted in complete resolution of symptoms. DISH should be considered in the differential diagnosis of dysphagia and dysphonia. <![CDATA[<b>¿Es la araña "tigre", <i>Scytodes globula, </i>una predadora efectiva de la araña del rincón, <i>Loxosceles laeta?</i></b>]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600021&lng=es&nrm=iso&tlng=es Diffuse idiopathic skeletal hyperostosis (DISH) is an under-diagnosed condition producing flowing ossification of the antero-lateral ligaments of the spine. Affecting predominantly males over 65 years old, it is an unusual cause of dysphagia and dysphonia. We report a 45-year-old mole with a three years history of dysphonia and three months of dysphagia. The initial diagnosis was gastroesophageal reflux, and an endoscopy ruled out esophageal luminal pathology. Cervical spine radiographs showed ossification of the cervical anterior longitudinal ligament with large, prominent osteophytes from C3 to C6, producing esophageal and upper airway compression; these images were compatible with DISH. Cervical osteophyte resection resulted in complete resolution of symptoms. DISH should be considered in the differential diagnosis of dysphagia and dysphonia. <![CDATA[El uso del correo electrónico en la comunicación médico-paciente]]> https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000600022&lng=es&nrm=iso&tlng=es Diffuse idiopathic skeletal hyperostosis (DISH) is an under-diagnosed condition producing flowing ossification of the antero-lateral ligaments of the spine. Affecting predominantly males over 65 years old, it is an unusual cause of dysphagia and dysphonia. We report a 45-year-old mole with a three years history of dysphonia and three months of dysphagia. The initial diagnosis was gastroesophageal reflux, and an endoscopy ruled out esophageal luminal pathology. Cervical spine radiographs showed ossification of the cervical anterior longitudinal ligament with large, prominent osteophytes from C3 to C6, producing esophageal and upper airway compression; these images were compatible with DISH. Cervical osteophyte resection resulted in complete resolution of symptoms. DISH should be considered in the differential diagnosis of dysphagia and dysphonia.