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Sample records for chronic cough due

  1. Currently available cough suppressants for chronic cough.

    Science.gov (United States)

    Chung, Kian Fan

    2008-01-01

    Chronic cough is a common symptom but only a fraction of patients seek medical attention. Addressing the causes of chronic cough may lead to control of cough; however, this approach is not always successful since there is a certain degree of failure even when the cause(s) of cough are adequately treated; in idiopathic cough, there is no cause to treat. Persistent cough may be associated with deterioration of quality of life, and treatment with cough suppressants is indicated. Currently available cough suppressants include the centrally acting opioids such as morphine, codeine, and dextromethorphan. Peripherally acting antitussives include moguisteine and levodropropizine. Early studies report success in reducing cough in patients with chronic bronchitis or COPD; however, a carefully conducted study showed no effect of codeine on cough of COPD. Success with these cough suppressants can be achieved at high doses that are associated with side effects. Slow-release morphine has been reported to be useful in controlling intractable cough with good tolerance to constipation and drowsiness. There have been case reports of the success of centrally acting drugs such as amitryptiline, paroxetine, gabapentin, and carbamezepine in chronic cough. New opioids such as nociceptin or antagonists of TRPV1 may turn out to be more effective. Efficacy of cough suppressants must be tested in double-blind randomised trials using validated measures of cough in patients with chronic cough not responding to specific treatments. Patients with chronic cough are in desperate need of effective antitussives that can be used either on demand or on a long-term basis.

  2. Treatment of Chronic Cough.

    Science.gov (United States)

    Soni, Resha S; Ebersole, Barbara; Jamal, Nausheen

    2017-01-01

    Objective Chronic cough remains a challenging condition, especially in cases where it persists despite comprehensive medical management. For these particular patients, there appears to be an emerging role for behavior modification therapy. We report a series of patients with refractory chronic cough to assess if there is any benefit of adding behavioral therapy to their treatment regimen. Study Design A case series with planned chart review of patients treated for chronic cough. Setting The review was performed with an outpatient electronic health record system at a tertiary care center. Subjects and Methods The charts of all patients treated for chronic cough by a single laryngologist over a 30-month period were analyzed. Patients' response to treatment and rate of cough improvement were assessed for those with refractory chronic cough who underwent behavior modification therapy. Results Thirty-eight patients with chronic cough were initially treated empirically for the most common causes of cough, of which 32% experienced improvement. Nineteen patients who did not significantly improve with medical management underwent behavior modification therapy with a speech-language pathologist. Of these patients, 84% experienced resolution or marked improvement of their symptoms. Conclusion Behavioral therapy may be underutilized in practice and could lead to improvement of otherwise recalcitrant cough.

  3. Approaching chronic cough.

    Science.gov (United States)

    Poulose, Vijo; Tiew, Pei Yee; How, Choon How

    2016-02-01

    Chronic cough is one of the most common reasons for referral to a respiratory physician. Although fatal complications are rare, it may cause considerable distress in the patient's daily life. Western and local data shows that in patients with a normal chest radiograph, the most common causes are postnasal drip syndrome, postinfectious cough, gastro-oesophageal reflux disease and cough variant asthma. Less common causes are the use of angiotensin-converting enzyme inhibitors, smoker's cough and nonasthmatic eosinophilic bronchitis. A detailed history-taking and physical examination will provide a diagnosis in most patients, even at the primary care level. Some cases may need further investigations or specialist referral for diagnosis.

  4. Cough . 2: Chronic cough in children

    NARCIS (Netherlands)

    J.C. de Jongste (Johan); M.D. Shields

    2003-01-01

    textabstractChronic cough is a common problem in childhood. Viral infections are the most prevalent cause, but other rarer disorders should be excluded whenever cough appears unusually severe and/or frequent, and when there is evidence of failure to thrive and growth retardation. T

  5. Chronic cough in children.

    Science.gov (United States)

    Acosta, Rigoberto; Bahna, Sami L

    2014-08-01

    Cough is probably the most common cause of seeking medical care in pediatric practice. Most acute cough is caused by infection and usually resolves within less than 4 weeks. If it lasts longer, it is considered chronic and deserves investigation to identify the underlying cause, which can be almost any of a wide variety of illnesses of the respiratory tract and certain extrathoracic conditions. This review provides an optimal approach for diagnosis through a skillful history taking, physical examination, and selection of appropriate tests.

  6. Management of chronic refractory cough.

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    Gibson, Peter G; Vertigan, Anne E

    2015-12-14

    Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia. Chronic refractory cough has factors in common with laryngeal hypersensitivity syndromes and chronic pain syndromes, and these similarities help to shed light on the pathophysiology of the condition. Its pathophysiology is complex and includes cough reflex sensitivity, central sensitization, peripheral sensitization, and paradoxical vocal fold movement. Chronic refractory cough often occurs after a viral infection. The diagnosis is made once the main diseases that cause chronic cough have been excluded (or treated) and cough remains refractory to medical treatment. Several treatments have been developed over the past decade. These include speech pathology interventions using techniques adapted from the treatment of hyperfunctional voice disorders, as well as the use of centrally acting neuromodulators such as gabapentin and pregabalin. Potential new treatments in development also show promise.

  7. Chronic Cough in Otorhinolaryngologic Routine

    Directory of Open Access Journals (Sweden)

    Palheta Neto, Francisco Xavier

    2011-04-01

    Full Text Available Introduction: The chronic cough is sometimes manifested as an imprecise symptom, but of great importance for both the diagnosis and the prognosis. In an otorhinolaryngologic approach, several illnesses that can occur with it can be numbered, including 2 of the 3 main causes of chronic cough. Objective: To identify the main otorhinolaryngologic diseases showing the chronic cough as one of their manifestations. Method: A literature's revision was performed in several scientific articles, specialized books and consultation in Birene and Scielo databases. Literature's revision: cough production in the upper airways is usually associated with an inflammatory reaction by stimulating sensitive receptors of these areas or by mechanic stimulus. The main cause of the chronic cough in the otorhinolaryngology day-to-day is the post-nasal drip, gathering together by itself 02 of the most common diseases: rhinitis and sinusitis. Laryngitis as a result of gastroesophageal reflux (GER stands out in the index of chronic cough etiology, but it is not as severe as GER . Neoplasias are also somewhat frequent causes of cough, and the difficulty in diagnosing the cough cause is common in this disease group. Motility disorder, laryngeal irritation persistence, parasitic disease and injuries by inhalation of toxic products were also found as a cause of cough for longer than 03 months. Conclusion:Chronic cough is a frequent and important finding in otorhinolaryngology and cannot be underestimated, and a careful anamnesis is the best way to determine the etiology and perform a correct treatment for the patient's disease.

  8. Laryngeal hypersensitivity in chronic cough.

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    Hull, J H; Menon, A

    2015-12-01

    Patients with chronic cough often report symptoms arising in the throat, in response to non-specific stimuli. Accordingly, the concept of a 'hypersensitivity' of the larynx in chronic cough has evolved over the past ten years. Patients with cough and laryngeal hypersensitivity frequently report features that overlap other laryngeal dysfunction syndromes, including a tendency for the vocal cords to inappropriately adduct. The mechanisms underlying laryngeal hypersensitivity in chronic cough are currently unclear, however recent studies provide new clinical and physiological techniques to aid detection and monitoring of laryngeal hypersensitivity. This review provides an overview of the current state of knowledge in this field.

  9. Premature ventricular complex-induced chronic cough and cough syncope.

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    Stec, S; Dabrowska, M; Zaborska, B; Bielicki, P; Maskey-Warzechowska, M; Tarnowski, W; Chazan, R; Kulakowski, P

    2007-08-01

    The present case study reports a case of chronic cough and cough syncope associated with frequent premature ventricular complexes (PVCs). Careful analysis of cough-related symptoms and ECG monitoring led to the suspicion of PVC-induced cough. A coincidence between PVCs and episodes of cough was also documented by a portable multichannel recorder. Moreover, Doppler echocardiography revealed a PVC-induced transient increase in the pulmonary artery blood flow. After exclusion of other possible aetiologies, complete relief of chronic cough and cough syncope was achieved by radiofrequency ablation of the arrhythmogenic focus located in the right ventricular outflow tract. Premature ventricular complexes should be considered as a cause of chronic cough and cough syncope and an interdisciplinary cooperation can lead to successful diagnosis and treatment of this condition.

  10. Review series: chronic cough: behaviour modification therapies for chronic cough.

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    Vertigan, A E; Theodoros, D G; Gibson, P G; Winkworth, A L

    2007-01-01

    Chronic cough (CC) can be refractory to medical treatment and newer strategies are required for these patients. Behaviour modification therapies are a potential approach for management of cough that does not respond to medical management. Behaviour modification therapy for CC involves an individually tailored programme teaching individuals to increase control over cough symptoms and includes education, specific strategies to suppress the cough, vocal hygiene training and psychoeducational counselling. Several case series have described speech pathology treatment for CC and a recent randomized control trial has demonstrated a significant improvement in symptoms. Possible mechanisms for this improvement include reduced cough reflex sensitivity, increased voluntary control of the cough and reduced stimulation of cough receptors. Respiratory retraining used by physiotherapists may also have potential for use in CC. The validity of psychological therapeutic approaches to CC rests on concepts of CC as a disorder with a psychogenic component, and the ability of cognitive therapies to modify the cough pathway. This work outlines current literature into behavioural management of CC and suggests new directions for practice and research in adults with this condition.

  11. Cough

    Science.gov (United States)

    ... coughing helps your body heal or protect itself. Coughs can be either acute or chronic. Acute coughs begin suddenly and usually last no more than 2 to 3 weeks. Acute coughs are the kind you most often get with ...

  12. TRPV1 and TRPM8 in Treatment of Chronic Cough

    OpenAIRE

    Eva Millqvist

    2016-01-01

    Chronic cough is common in the population, and among some there is no evident medical explanation for the symptoms. Such a refractory or idiopathic cough is now often regarded as a neuropathic disease due to dysfunctional airway ion channels, though the knowledge in this field is still limited. Persistent coughing and a cough reflex easily triggered by irritating stimuli, often in combination with perceived dyspnea, are characteristics of this disease. The patients have impaired quality of li...

  13. Evidence for neuropathic processes in chronic cough.

    Science.gov (United States)

    Niimi, Akio; Chung, Kian Fan

    2015-12-01

    Chronic cough is a very common symptom for which patients seek medical attention but can often be difficult to manage, because associated causes may remain elusive and treatment of any associated causes does not always provide adequate relief. Current antitussives have limited efficacy and undesirable side-effects. Patients with chronic cough typically describe sensory symptoms suggestive of upper airway and laryngeal neural dysfunction. They often report cough triggered by low-level physical and chemical stimuli supporting the recently emerging concept of 'cough hypersensitivity syndrome'. Chronic cough is a neuropathic condition that could be secondary to sensory nerve damage caused by inflammatory, infective and allergic factors. Mechanisms underlying peripheral and central augmentation of the afferent cough pathways have been identified. Successful treatment of chronic cough with agents used for treating neuropathic pain, such as gabapentin and amitriptyline, would also support this concept. Further research of neuropathic cough may lead to the discovery of more effective antitussives in the future.

  14. What is chronic cough in children?

    Directory of Open Access Journals (Sweden)

    Iulia eIOAN

    2014-08-01

    Full Text Available The cough reflex is modulated throughout growth and development. Cough – but not expiration reflex – appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children. Prolonged acute cough is usually related to the long-lasting effects of a previous viral airway infection or to the particular entity called protracted bacterial bronchitis. Cough pointers and type may orient towards specific aetiologies, such as barking cough in croup or tracheomalacia, paroxystic whooping cough in Pertussis. Cough is productive in protracted bacterial bronchitis, sinusitis or bronchiectasis. Cough is usually associated with wheeze or dyspnea on exertion in asthma; however, it may be the sole symptom in cough variant asthma. Thus, paediatric cough has particularities differentiating it from adult cough, so the approach and management should be developmentally specific.

  15. Application of Irwin diagnostic procedures for chronic cough

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    Guo-fang FENG

    2011-07-01

    Full Text Available Objective To explore the advantages and disadvantages of the diagnostic procedures suggested by the Irwin group,and summarize the experiences in diagnosis and treatment,and to beter understand the etiology,diagnosis,differential diagnosis and treatment of chronic cough.Methods Data of 118 patients,who were finally diagnosed as chronic cough according to the diagnostic procedures suggested by Irwin group in the First Affiliated Hospital of General Hospital of PLA in 2009,were retrospectivety analyzed.Results With the Irwin diagnostic procedures of chronic cough,118 patients were diagnosed definitely.The final diagnostic rate reached 100%.The duration to reach the final diagnosis was 1 day to 30 days.Of the 118 patients with chronic cough,113 were cured(96%.32 cases(27.1% were caused by asthma and related diseases(allergic rhinitis,allergic pharyngitis,cough variant asthma and eosinophilic bronchitis;28 cases(23.7% were due to upper airway cough syndrome and related diseases(chronic rhinitis,sinusitis,pharyngeal bursitis,postnasal drip syndrome,chronic laryngitis,and vocal cord polyps;23 cases(19.5% due to gastroesophageal reflux disease;14 cases(11.9% due to lower respiratory tract infection and related diseases(endobronchial tuberculosis,pulmonary tuberculosis,endotracheal mucosal adenocarcinoma,lung cancer,bronchiectasis,and pulmonary fibrosis;10 cases(8.5% due to cardiac insafficiency;6 cases(5.1% due to administration of angiotensin-converting enzyme inhibitor(ACEI-like antihypertensive agents;3 cases(2.5% were psychogenic cough,and 2 cases(1.7% were induced by other causes.Conclusions The Irwin diagnosis of chronic cough is a comprehensive and thorough procedure,and it should be used with delibcration in clinic.The etiology of chronic cough is complicated,mainly including asthma and related diseases,sinusitis and upper airway cough syndrome,and gastroesophageal reflux disease.

  16. Cough sensitivity and extrathoracic airway responsiveness to inhaled capsaicin in chronic cough patients.

    OpenAIRE

    Cho, You Sook; Lee, Chang-Keun; Yoo, Bin; Moon, Hee-Bom

    2002-01-01

    Enhanced cough response has been frequently observed in chronic cough. Recently, extrathoracic airway constriction to inhaled histamine was demonstrated in some chronic cough patients. However, relation between extrathoracic airway hyperresponsiveness (EAHR) and cough sensitivity determined by capsaicin inhalation is unclear in each etiological entity of chronic cough. Seventy-seven patients, with dry cough persisting for 3 or more weeks, normal spirometry and chest radiography, and 15 contro...

  17. Eight International London Cough Symposium 2014: Cough hypersensitivity syndrome as the basis for chronic cough.

    Science.gov (United States)

    Chung, Kian Fan; Canning, Brendan; McGarvey, Lorcan

    2015-12-01

    At the Eighth International London Cough Conference held in London in July 2014, the focus was on the relatively novel concept of cough hypersensitivity syndrome (CHS) as forming the basis of chronic cough. This concept has been formulated following understanding of the neuronal pathways for cough and a realisation that not all chronic cough is usually associated with a cause. The CHS is defined by troublesome coughing triggered by low level of thermal, mechanical or chemical exposure. It also encompasses other symptoms or sensations such as laryngeal hypersensitivity, nasal hypersensitivity and possibly also symptoms related to gastrooesopahgeal reflux. The pathophysiologic basis of the CHS is now being increasingly linked to an enhancement of the afferent pathways of the cough reflex both at the peripheral and central levels. Mechanisms involved include the interactions of inflammatory mechanisms with cough sensors in the upper airways and with neuronal pathways of cough, associated with a central component. Tools for assessing CHS in the clinic need to be developed. New drugs may be developed to control CHS. A roadmap is suggested from the inception of the CHS concept towards the development of newer antitussives at the Symposium.

  18. TRPV1 and TRPM8 in Treatment of Chronic Cough

    Directory of Open Access Journals (Sweden)

    Eva Millqvist

    2016-07-01

    Full Text Available Chronic cough is common in the population, and among some there is no evident medical explanation for the symptoms. Such a refractory or idiopathic cough is now often regarded as a neuropathic disease due to dysfunctional airway ion channels, though the knowledge in this field is still limited. Persistent coughing and a cough reflex easily triggered by irritating stimuli, often in combination with perceived dyspnea, are characteristics of this disease. The patients have impaired quality of life and often reduced work capacity, followed by social and economic consequences. Despite the large number of individuals suffering from such a persisting cough, there is an unmet clinical need for effective cough medicines. The cough treatment available today often has little or no effect. Adverse effects mostly follow centrally acting cough drugs comprised of morphine and codeine, which demands the physician’s awareness. The possibilities of modulating airway transient receptor potential (TRP ion channels may indicate new ways to treat the persistent cough “without a reason”. The TRP ion channel vanilloid 1 (TRPV1 and the TRP melastin 8 (TRPM8 appear as two candidates in the search for cough therapy, both as single targets and in reciprocal interaction.

  19. TRPV1 and TRPM8 in Treatment of Chronic Cough.

    Science.gov (United States)

    Millqvist, Eva

    2016-07-28

    Chronic cough is common in the population, and among some there is no evident medical explanation for the symptoms. Such a refractory or idiopathic cough is now often regarded as a neuropathic disease due to dysfunctional airway ion channels, though the knowledge in this field is still limited. Persistent coughing and a cough reflex easily triggered by irritating stimuli, often in combination with perceived dyspnea, are characteristics of this disease. The patients have impaired quality of life and often reduced work capacity, followed by social and economic consequences. Despite the large number of individuals suffering from such a persisting cough, there is an unmet clinical need for effective cough medicines. The cough treatment available today often has little or no effect. Adverse effects mostly follow centrally acting cough drugs comprised of morphine and codeine, which demands the physician's awareness. The possibilities of modulating airway transient receptor potential (TRP) ion channels may indicate new ways to treat the persistent cough "without a reason". The TRP ion channel vanilloid 1 (TRPV1) and the TRP melastin 8 (TRPM8) appear as two candidates in the search for cough therapy, both as single targets and in reciprocal interaction.

  20. Towards understanding and managing chronic cough.

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    Satia, Imran; Badri, Huda; Al-Sheklly, Bashar; Smith, Jaclyn Ann; Woodcock, Ashley A

    2016-12-01

    Chronic cough is a common and troublesome condition affecting approximately 12% of the general population. It is associated with poor quality of life with psychological, social and physical consequences. Patients typically complain of a dry irritating cough, driven by a strong urge to cough associated with a sensation or irritation located in the throat. Treatment of potential 'causes', ie asthma, gastro-oesophageal reflux disease and rhino-sinusitis, may produce a complete or partial response, but the response of some patients to opiates and alpha-2-delta ligand antagonists (gabapentin and pregabalin) supports the concept that this is primarily a neurological disorder, characterised by hyper-responsiveness of the nerves. Novel and highly effective neuronal treatments are in development and offer hope of better symptom control with fewer side effects within a few years. This review focuses on understanding the mechanism of chronic cough, current management approaches and research that may lead to novel therapies.

  1. Predictors of objective cough frequency in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sumner, Helen; Woodcock, Ashley; Kolsum, Umme;

    2013-01-01

    Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood.......Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood....

  2. The Validity and Precision of the Leicester Cough Questionnaire in COPD Patients with Chronic Cough

    NARCIS (Netherlands)

    Berkhof, Farida F.; Boom, Lisenka N.; ten Hertog, Nynke E.; Uil, Steven M.; Kerstjens, Huib A. M.; van den Berg, Jan W. K.

    2012-01-01

    Background: A validated instrument to assess the effects of chronic cough on health status in patients with chronic obstructive pulmonary disease (COPD) is currently not available. The Leicester Cough Questionnaire (LCQ) is a cough-specific health status questionnaire which is originally validated f

  3. Evidence-based Evaluation and Management of Chronic Cough.

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    Achilleos, Andreas

    2016-09-01

    Chronic cough is common and has a significant impact on the wellbeing of patients and the use and cost of health care services. Traditionally the approach to chronic cough in patients who are nonsmokers and are not taking an angiotensin-converting enzyme inhibitor has focused on the diagnosis and management of the upper airway cough syndrome, asthma, and reflux disease. The evaluation of patients with chronic cough frequently involves trials of empiric therapy for these 3 conditions. Chronic cough may be perpetuated by abnormalities of the cough reflex and sensitization of its afferent and central components.

  4. Multi-centre retrospective analysis of clinical diagnosis and treatment for chronic cough

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    Xiao-ming CHENG

    2011-02-01

    Full Text Available Objective To explore the clinical characteristics and the present status of diagnosis and treatment of chronic cough.Methods The clinical data of 238 in-patients and out-patients of Departments of Respiratory Diseases from 4 teaching hospitals of Chongqing Municipality were collected from Oct.2008 to Dec.2009,and their clinical characteristics,diagnosis and therapeutic effects were retrospectively analyzed.Results A total of 238 patients were enrolled,most of them complained of dry cough and night cough.Throat symptoms were most common,including itching or foreign body sensation,throat discomfort and gastro-oesophageal reflux.Congestion of pharynx and cobblestone like changes in posterior pharyngeal wall were the most common signs in patients with chronic cough.Among all the supplementary examinations,bronchial provocation test resulted in highest positive rate.Etiological diagnosis was done in a total of 254 case-times for diseases leading to chronic cough,among them upper airway cough syndrome(UACS was suspected in 115 case-times.cough variant asthma(CVA in 42 case-times,and cough due to gastroesophageal reflux(GERC in 53 case-times.After the specific treatment targeting UACS,CVA and GERC,in 152 case-times improvement was found after follow-up,including 56,27 and 21 case-times,respectively,with an effective rate of 68.4%(104/152.The final diagnosis for the other 44 case-times with chronic cough was chronic tonsillitis,chronic bronchitis,eosinophilic bronchitis and angiotensin converting enzyme inhibitor(ACEI induced cough.A definite diagnosis was finally made in 148 out of a total of 254 casses,with a diagnostic rate of 58.3%(148/254.Conclusion The final diagnostic rate in etiology of chronic cough is still poor nowadays in our country,and empirical treatment is still the main practice for chronic cough.

  5. Psychological profile of individuals presenting with chronic cough

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    Katrin Hulme

    2017-03-01

    Full Text Available Chronic refractory cough (CRC is a common problem in respiratory clinics. Adverse effects on quality of life are documented in the literature, but relatively little is known about the underlying psychological factors in this patient population. We aimed to investigate the association of psychological factors with chronic cough, comparing CRC to explained cough and non-cough groups. 67 patients attending a specialist cough clinic (CRC, n=25; explained cough, n=42 and 22 non-cough individuals participated. All participants completed the Hospital Anxiety & Depression Scale, Big Five Inventory (Personality, Chalder Fatigue Scale and Patient Health Questionnaire-15. Cough patients also completed the Illness Perception Questionnaire-Revised. Appropriate statistical analyses were used to compare participant groups. Chronic refractory coughers displayed significantly higher levels of anxiety, depression, fatigue and somatic physical symptoms than non-cough participants. Compared to explained coughers, there were higher depression and fatigue scores and significantly more negative illness representations (specifically, strong beliefs regarding negative consequences, lower illness coherence and higher emotional representations. “Explained” coughers reported significantly increased fatigue and somatic symptoms in comparison to non-coughers. The prevalence of fatigue, low mood, negative illness beliefs and increased physical symptom reporting should be considered in consultations and in developing novel interventions for CRC patients.

  6. Psychological profile of individuals presenting with chronic cough

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    Hulme, Katrin; Deary, Vincent; Dogan, Sian

    2017-01-01

    Chronic refractory cough (CRC) is a common problem in respiratory clinics. Adverse effects on quality of life are documented in the literature, but relatively little is known about the underlying psychological factors in this patient population. We aimed to investigate the association of psychological factors with chronic cough, comparing CRC to explained cough and non-cough groups. 67 patients attending a specialist cough clinic (CRC, n=25; explained cough, n=42) and 22 non-cough individuals participated. All participants completed the Hospital Anxiety & Depression Scale, Big Five Inventory (Personality), Chalder Fatigue Scale and Patient Health Questionnaire-15. Cough patients also completed the Illness Perception Questionnaire-Revised. Appropriate statistical analyses were used to compare participant groups. Chronic refractory coughers displayed significantly higher levels of anxiety, depression, fatigue and somatic physical symptoms than non-cough participants. Compared to explained coughers, there were higher depression and fatigue scores and significantly more negative illness representations (specifically, strong beliefs regarding negative consequences, lower illness coherence and higher emotional representations). “Explained” coughers reported significantly increased fatigue and somatic symptoms in comparison to non-coughers. The prevalence of fatigue, low mood, negative illness beliefs and increased physical symptom reporting should be considered in consultations and in developing novel interventions for CRC patients. PMID:28344979

  7. Questionnaire survey of chronic cough in asthmatic patients

    Institute of Scientific and Technical Information of China (English)

    魏为利; 邱忠民; 吕寒静; 杨忠民; 洪光朝; 王岚; 刘兴元; 郑桂芬

    2004-01-01

    @@ Wheezing is a common symptom of asthma and a main reason for most patients to seek medical care. Although wheezing has long been considered the essential symptom of asthma, clinical observations have shown that chronic cough is also an important symptom of asthma, even the sole presenting manifestation in cough variant asthma.1 As a special form of asthma, cough variant asthma probably represents the milder end of the spectrum of asthma or the forerunner of asthma, and may develop into typical asthma when the state of the illness progresses.2 Therefore, there may be a natural course from chronic cough to wheezing in the pathogenesis of asthma. However, there is currently no data to show how many patients with asthma present chronic cough before the first onset of wheezing. To investigate this question, we performed this questionnaire survey.

  8. Discrepancy between presumptive and definite causes of chronic cough

    Institute of Scientific and Technical Information of China (English)

    YU Li; QIU Zhi-hong; WEI Wei-li; LIU Bo; XU Xiang-huai; L(U) Han-jing; QIU Zhong-min

    2011-01-01

    Background The current diagnostic algorithms for chronic cough require the establishment of the primary presumptive causes followed by the confirmation of diagnosis with the specific therapies.The aim of the study was to investigate the discrepancy between presumptive and definite causes and its clinical implication.Methods A total of 109 patients with chronic cough underwent laboratory investigations to identify the cause of cough; including sinus computerized tomography (if needed),histamine bronchial provocation,induced sputum cytology and 24-hour esophageal pH or multi-channel intraluminal impedance combined with pH monitoring.The presumptive causes were confirmed by treating them sequentially.The difference between presumptive and definite causes of chronic cough was compared.Results Single cause was more frequent in the definite diagnosis than in the presumptive diagnosis (78.9% vs.54.1%,x2=15.01,P=0.0001).In contrast,multiple causes were significantly fewer in definite diagnosis than in the presumptive diagnosis (15.6% vs.37.6%,x2=13.53,P=0.0002).There was a discrepancy between definite and presumptive causes in 30 patients (27.5%).Compared with the presumptive causes,definite upper airway cough syndrome (24.8% vs.11.9%,x2=6.0,P=0.01) and gastroesophageal reflux disease (6.4% vs.0,x2=7.23,P=0.007) was more frequent as a single cause of chronic cough while cough variant asthma plus gastroesophageal reflux disease (3.7% vs.11.9%,x2=5.17,P=0.02) and upper airway cough syndrome plus nonasthmatic eosinophilic bronchitis (0 vs.9.2%,x2=10.48,P=0.001) were fewer as multiple causes of chronic cough.Conclusions A discrepancy was common between presumptive and definite causes of chronic cough.To treat presumptive causes sequentially may be a suitable solution for avoidance of erroneous multiple causes and possible over-treatment.

  9. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

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    Carlos Shuler Nin

    2013-12-01

    Full Text Available OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons.RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6% of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6% of the patients, whereas the treatment was ineffective in 1 (8.4%. We observed no complications related to barium swallow, such as contrast aspiration.CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  10. Exacerbation of daily cough and allergic symptoms in adult patients with chronic cough by Asian dust: A hospital-based study in Kanazawa

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    Higashi, Tomomi; Kambayashi, Yasuhiro; Ohkura, Noriyuki; Fujimura, Masaki; Nakanishi, Sayaka; Yoshizaki, Tomokazu; Saijoh, Kiyofumi; Hayakawa, Kazuichi; Kobayashi, Fumihisa; Michigami, Yoshimasa; Hitomi, Yoshiaki; Nakamura, Hiroyuki

    2014-11-01

    The health effects associated with Asian dust have attracted attention due to the rapid increase in the number of Asian dust events in East Asia in recent years. The aim of this study was to investigate the associations between Asian dust and daily cough, as well as allergic symptoms, in adult patients who suffer from chronic cough. We enrolled 86 adult patients from Kanazawa University Hospital, Japan, who were diagnosed with asthma, cough variant asthma, atopic cough or a combination of these conditions. From January to June 2011, subjects recorded their symptoms in a diary every day. Asian dust and non-Asian dust periods were defined according to the dust extinction coefficient, measured using the light detection and ranging (LIDAR). The daily levels of total suspended particulates, polycyclic aromatic hydrocarbons (PAHs) and coexisting factors related to allergies, such as the Japanese cedar pollen count, were measured. McNemar's test showed that there were significantly more cough-positive patients during Asian dust periods than during the non-Asian dust period (p = 0.022). In addition, during Asian dust periods when the daily levels of Japanese cedar pollen, Japanese cypress pollen and PAHs were elevated, there were significantly more patients who experienced itchy eyes than during the non-Asian dust period (p cough and allergic symptoms in adult patients with chronic cough.

  11. Sixty-eight Cases of Child Chronic Cough Treated by Moxibustion

    Institute of Scientific and Technical Information of China (English)

    CUI Xia; WANG Su-mei; WU Li-qun

    2009-01-01

    To observe the therapeutic effects of moxibustion for chronic cough in children. Methods: 68 child cases of chronic cough were treated by moxibustion. Results: 54 cases were cured, 13 cases improved, and one case failed. The cure rate was 79.2%, with a total effective rate of 98.5%. Conclusion: The moxibustion therapy has definite therapeutic effect for children chronic cough.

  12. Pro-Con Debate: Protracted Bacterial Bronchitis as a Cause of Chronic Cough in Children.

    Science.gov (United States)

    Bidiwala, Aneela; Krilov, Leonard R; Pirzada, Melodi; Patel, Sameer J

    2015-08-01

    Pro: Children with chronic cough present a diagnostic challenge. Protracted bacterial bronchitis (PBB) is a chronic, persistent bacterial infection of conducting airways defined by the presence of cough for longer than 4 weeks that resolves with antimicrobial therapy and without an alternative diagnosis. The diagnosis is made by the findings of increased bronchial secretions and edema of the lower airways on flexible bronchoscopy and positive cultures on bronchoalveolar lavage. It is speculated that an initial respiratory insult such as viral infection disrupts normal surface morphology and ciliary function, which leads to chronic self-perpetuating inflammation with the formation of bacterial biofilms, leading to PBB. PBB is often misdiagnosed as asthma, leading to inappropriate and excessive use of steroids. The importance of timely diagnosis should be emphasized due to the potential that PBB may be a precursor to chronic suppurative lung disease or bronchiectasis if left untreated; however, every patient should be adequately assessed to exclude other causes of chronic cough. Con: Clinical criteria for the diagnosis of PBB are nonspecific and may not distinguish it from other known causes of chronic cough, including viral infections. Benefits from antibiotic therapy (particularly prolonged therapy) have not been demonstrated. Respiratory conditions are the most common reason for antibiotic prescriptions during ambulatory visits in the United States, and many of these prescriptions are inappropriate and/or unnecessary. The proposed diagnostic criteria and recommendations for the treatment of PBB will lead to unnecessary overuse of antibiotics.

  13. Diagnosis and treatment of chronic cough in China: an insight into the status quo.

    Science.gov (United States)

    Lai, Kefang; Luo, Wei; Zeng, Guangqiao; Zhong, Nanshan

    2012-07-28

    Chronic cough is a very common complaint in clinics throughout China. Clinical and basic science research on chronic cough started late, but in recent years the effort has yielded promising findings regarding the etiological diagnosis, treatment and pathogenesis. We found that inflammation in nonasthmatic eosinophilic bronchitis has some similarities to cough variant asthma but also a number of distinct differences. Recent evidence has also suggested a mechanistic link between airway neurogenic inflammation and and gastroesophageal reflux cough (GERC). Cough-related animal models have been developed, including models for esophageal reflux, nonasthmatic eosinophilic bronchitis and allergic rhinitis. Normal reference values for differential cell counts in induced sputum, cough sensitivity and esophageal 24-h pH monitoring in Chinese healthy subjects have been established. By using a modified algorithm for the etiological diagnosis of chronic cough, the causes of chronic cough have been investigated across a number of cities in China. The most common causes of chronic cough are cough variant asthma, eosinophilic bronchitis, upper airway cough symptoms, atopic cough and GERC, however, there are some regional variations. The Chinese National Guidelines on Diagnosis and Management of Chronic Cough were drafted in 2005, updated in 2009, and have been widely publicized and disseminated through many channels since their publication.

  14. Cough

    Directory of Open Access Journals (Sweden)

    Keenleyside Georgina

    2006-01-01

    Full Text Available Cough is a common symptom in palliative medicine and the causes may be multifactorial. When problematic it invariably affects quality of life. Evaluation must begin with a detailed history and examination with consideration given to further tests and imaging. Treatment must begin with the identification and correction of any reversible causes in addition to emperic treatment. A logical approach and regular monitoring is advised.

  15. Exposure to daily ambient particulate polycyclic aromatic hydrocarbons and cough occurrence in adult chronic cough patients: A longitudinal study

    Science.gov (United States)

    Anyenda, Enoch Olando; Higashi, Tomomi; Kambayashi, Yasuhiro; Thao, Nguyen Thi Thu; Michigami, Yoshimasa; Fujimura, Masaki; Hara, Johsuke; Tsujiguchi, Hiromasa; Kitaoka, Masami; Asakura, Hiroki; Hori, Daisuke; Yamada, Yohei; Hayashi, Koichiro; Hayakawa, Kazuichi; Nakamura, Hiroyuki

    2016-09-01

    The specific components of airborne particulates responsible for adverse health effects have not been conclusively identified. We conducted a longitudinal study on 88 adult patients with chronic cough to evaluate whether exposure to daily ambient levels of particulate polycyclic aromatic hydrocarbons (PAH) has relationship with cough occurrence. Study participants were recruited at Kanazawa University Hospital, Japan and were physician-diagnosed to at least have asthma, cough variant asthma and/or atopic cough during 4th January to 30th June 2011. Daily cough symptoms were collected by use of cough diaries and simultaneously, particulate PAH content in daily total suspended particles collected on glass fiber filters were determined by high performance liquid chromatography coupled with fluorescence detector. Population averaged estimates of association between PAH exposure and cough occurrence for entire patients and subgroups according to doctor's diagnosis were performed using generalized estimating equations. Selected adjusted odds ratios for cough occurrence were 1.088 (95% confidence interval (CI): 1.031, 1.147); 1.209 (95% CI: 1.060, 1.379) per 1 ng/m3 increase for 2-day lag and 6-day moving average PAH exposure respectively. Likewise, 5 ring PAH had higher odds in comparison to 4 ring PAH. On the basis of doctor's diagnosis, non-asthma group had slightly higher odds ratio 1.127 (95% CI: 1.033, 1.228) per 1 ng/m3 increase in 2-day lag PAH exposure. Our findings suggest that ambient PAH exposure is associated with cough occurrence in adult chronic cough patients. The association may be stronger in non-asthma patients and even at low levels although there is need for further study with a larger sample size of respective diagnosis and inclusion of co-pollutants.

  16. Azithromycin and cough-specific health status in patients with chronic obstructive pulmonary disease and chronic cough : a randomised controlled trial

    NARCIS (Netherlands)

    Berkhof, Farida F.; Doornewaard-ten Hertog, Nynke E.; Uil, Steven M.; Kerstjens, Huib A. M.; van den Berg, Jan W. K.

    2013-01-01

    Background: Macrolides reduce exacerbations in patients with COPD. Their effects on health status has not been assessed as primary outcome and is less clear. This study assessed the effects of prophylactic azithromycin on cough-specific health status in COPD-patients with chronic productive cough. M

  17. CLINICAL EFFICACY OF CRUX SYRUP IN THE MANAGEMENT OF COUGH DUE TO VARIOUS ETIOLOGICAL CONDITIONS

    Directory of Open Access Journals (Sweden)

    Patel Girish

    2013-10-01

    Full Text Available Cough associated with acute and chronic respiratory conditions is common in patients of all ages. The objective of this study was to determine the clinical efficacy of CRUX syrup, a proprietary mixture of herbal ingredients in the management of cough of various etiological conditions in open label, uncontrolled, prospective cohort study. 55 Patients aged 9 - 64 years with cough of more than 1 day but less than 14 days duration was recruited. They were prescribed dose of CRUX syrup according to severity of cough for three days. Treatment results were assessed on the basis of Investigator’s evaluation. At the end of three days prescribed treatment, evaluator’s assessment shown that 29 % patient gave excellent, 55 % patient gave good, 11 % patient gave fair and 5 % patient gave poor response to treatment. The results demonstrate that CRUX treatment has significant decrease in the frequency and severity of cough without any significant side effect in patients of all ages.

  18. Tic disorders in the differential diagnosis of chronic cough in children in relation to four cases.

    Science.gov (United States)

    Karakaya, Işık; Şişmanlar, Şahika Gülen

    2015-09-01

    Chronic cough is a frequent reason for medical referrals in childhood. In patients who do not have signs or symptoms of an underlying respiratory system disease and who do not respond to experimental treatment, psychogenic cough should be considered. In this paper, four patients who were referred to our department with a prediagnosis of psychogenic cough, found to have tic disorder as a result of the assessments performed and improved with antipsychotic medication are presented. The differantial diagnosis of chronic cough in children should include tic disorders as well as psychogenic cough. Tic disorders can be diagnosed easily with detailed history and their response to medical treatment is rather satisfactory. Recognition of these disorders by pediatricians will minimize erroneous diagnoses and inappropriate therapies in children with a complaint of chronic cough.

  19. Natural products for chronic cough: Text mining the East Asian historical literature for future therapeutics.

    Science.gov (United States)

    Shergis, Johannah Linda; Wu, Lei; May, Brian H; Zhang, Anthony Lin; Guo, Xinfeng; Lu, Chuanjian; Xue, Charlie Changli

    2015-08-01

    Chronic cough is a significant health burden. Patients experience variable benefits from over the counter and prescribed products, but there is an unmet need to provide more effective treatments. Natural products have been used to treat cough and some plant compounds such as pseudoephedrine from ephedra and codeine from opium poppy have been developed into drugs. Text mining historical literature may offer new insight for future therapeutic development. We identified natural products used in the East Asian historical literature to treat chronic cough. Evaluation of the historical literature revealed 331 natural products used to treat chronic cough. Products included plants, minerals and animal substances. These natural products were found in 75 different books published between AD 363 and 1911. Of the 331 products, the 10 most frequently and continually used products were examined, taking into consideration findings from contemporary experimental studies. The natural products identified are promising and offer new directions in therapeutic development for treating chronic cough.

  20. Towards improving the diagnosis and management of chronic cough in China

    Institute of Scientific and Technical Information of China (English)

    ZENG Guang-qiao; SUN Bao-qing; ZHONG Nan-shan

    2011-01-01

    Cough is a common condition in clinical settings.Importantly,chronic cough without obvious abnormal chest X-ray findings accounts for about 20%-30% of respiratory clinic visits,and yields a high rate of misdiagnosis and mistreatment.1 Up to 80% of patients with chronic cough were diagnosed with other disorders,such as “chronic bronchitis” or “chronic pharyngolaryngitis”.2,3 As many as 50% of female patients with cough may develop urinary incontinence,which can interfere seriously with their daily living,including work and school performance.4 Along with the increasing demand for a high-quality life among Chinese people,cough as an important issue should be properly addressed by both clinicians and patients.

  1. Smoking reduction and cessation reduce chronic cough in a general population: the Inter99 study

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Godtfredsen, Nina; Jørgensen, Torben

    2008-01-01

    Background: Chronic cough can be the first sign of chronic obstructive disease. A few, and mostly selected, studies exploring the effect of reduced daily tobacco consumption have shown a small effect on pulmonary symptoms. Aim: The aim of this study was to examine if smoking reduction (SR) (>= 50......% of daily tobacco consumption) or smoking cessation (SC) had an effect on chronic cough and phlegm. Methods: A total of 2408 daily smokers were included in a Danish population-based intervention study, Inter99. In the analyses, we included smokers with self-reported chronic cough or phlegm at baseline who...

  2. Influence factors of cough reflex sensitivity in patients with chronic cough%慢性咳嗽患者咳嗽敏感性的影响因素

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 赖克方; 罗炜; 钟南山

    2008-01-01

    Objective To investigate the influence factors of cough reflex sensitivity in patients with chronic cough. Methods Patients with chronic cough were recruited by using a diagnostic program. Cough reflex sensitivity was examined through eapsaicin cough challenge and the LgC5 (C5, the concentration of capsaicin causing five or more coughs ) was used as the index of cough threshold. Score of the severity of cough, age,gender, course of disease, pulmonary ventilation function (FEV1/pred%, MMEF/pred% )and cell differential of induced sputum (the percent of neutrophils, macrophages, lymphocytes, eosinophils)were also recorded for analysis. Results One hundred and fifty patients with different etiology of chronic cough involved in the study. Cough threshold of the patients was correlated with cough score at daytime (r=0.175, P0.05 ). Regression analysis showed that only gender and disease course were significantly corrclated with LgC5 ( all P0.05.多元线性回归分析显示,咳嗽阈值仅与性别、咳嗽病程有关(P均<0.01).结论咳嗽敏感性与咳嗽症状积分反映咳嗽程度的不同特征,性别与咳嗽病程可能影响慢性咳嗽患者的咳嗽敏感性.

  3. Cough and asthma diagnosis: physicians’ diagnosis and treatment of patients complaining of acute, subacute and chronic cough in rural areas of Japan

    Directory of Open Access Journals (Sweden)

    Akira Yamasaki

    2010-03-01

    Full Text Available Akira Yamasaki1, Keichi Hanaki2, Katsuyuki Tomita3, Masanari Watanabe1, Yasuyuki Hasagawa1, Ryota Okazaki1, Miki Yamamura1, Kouji Fukutani4, Yuji Sugimoto5, Kazuhiro Kato4, Masahiro Kodani6, Toshikazu Ikeda7, Tatsuya Konishi8, Yuji Kawasaki9, Hirokazu Tokuyasu9, Hiroki Yajima3, Hitoshi Sejima10, Takeshi Isobe11, Eiji Shimizu1, SAN-IN Asthma Research Group1Third Department of Internal Medicine, 2Department of Pediatrics, Tottori University, Japan; 3Department of Respiratory Medicine, Hakuai Hospital, Japan; 4Department of Respiratory Medicine, San-in Rosai Hospital,  Japan; 5Department of Respiratory Medicine, Tottori Prefectural Central Hospital, Japan; 6Department of Respiratory Medicine, Tottori Red Cross Hospital, Japan; 7Department of Respiratory Medicine, National Organization, Matsue Hospital, Japan; 8Department of Respiratory Medicine, Matsue City Hospital, Japan; 9Department of Respiratory Medicine, Matsue Red Cross Hospital, Japan; 10Department of Pediatrics,  11Department of Internal Medicine, Shimane University, Shimane, JapanBackground: Cough is one of the most common reasons for visiting a clinic. The causes of cough differ according to the duration of cough. Infectious disease is commonly observed in acute cough while noninfectious disease is commonly observed in chronic cough. On the other hand, cough is frequently observed in patients with asthma/cough variant asthma (CVA.Objective: In this study, we investigated the causes of cough in a rural region in Japan and the clinical examination and treatment for the patients diagnosed as asthma/CVA.Methods: We analyzed 124 patients who complained of cough.Results: The most common reason for acute cough was respiratory tract infection while asthma/CVA is the most common reason for subacute and chronic cough. The diagnostic procedure for asthma/CVA depends on clinical symptoms in asthmatic patients with acute cough. While in asthmatic patients with subacute and chronic cough, diagnosis

  4. What Is Cough?

    Science.gov (United States)

    ... Share this page from the NHLBI on Twitter. Cough A cough is your body’s natural reflex to help clear ... endings in your airways and cause coughing. A cough may be acute, subacute, or chronic depending on ...

  5. Effects of Asian dust on daily cough occurrence in patients with chronic cough: A panel study

    Science.gov (United States)

    Higashi, Tomomi; Kambayashi, Yasuhiro; Ohkura, Noriyuki; Fujimura, Masaki; Nakai, Satoshi; Honda, Yasushi; Saijoh, Kiyofumi; Hayakawa, Kazuichi; Kobayashi, Fumihisa; Michigami, Yoshimasa; Olando, Anyenda Enoch; Hitomi, Yoshiaki; Nakamura, Hiroyuki

    2014-08-01

    Asian dust, known as kosa in Japanese, is a major public health concern. In this panel study, we evaluated the effects of exposure to kosa on daily cough occurrence. The study subjects were 86 patients being treated for asthma, cough variant asthma, or atopic cough in Kanazawa University Hospital from January 2011 to June 2011. Daily mean concentrations of kosa and spherical particles were obtained from light detection and ranging (LIDAR) measurements, and were categorized from Grade 1 (0 μg/m3) to 5 (over 100 μg/m3). The association between kosa and cough was analyzed by logistic regression with a generalized estimating equation. Kosa effects on cough were seen for all Grades with potential time lag effect. Particularly at Lag 0 (the day of exposure), a dose-response relationship was observed: the odds ratios for Grades 2, 3, 4, and 5 above the referent (Grade 1) were 1.111 (95% confidence interval (CI): 0.995-1.239), 1.171 (95% CI: 1.006-1.363), 1.357 (95% CI: 1.029-1.788), and 1.414 (95% CI: 0.983-2.036), respectively. Among the patients without asthma, the association was higher: the odds ratios for Grades 2, 3, 4 and 5 were 1.223 (95% CI: 0.999-1.497), 1.309 (95% CI: 0.987-1.737), 1.738 (95% CI: 1.029-2.935) and 2.403 (95% CI: 1.158-4.985), respectively. These associations remained after adjusting for the concentration of spherical particles or particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5). Our findings demonstrate that kosa is an environmental factor which induces cough in a dose-response relationship.

  6. Levocloperastine in the treatment of chronic nonproductive cough: comparative efficacy versus standard antitussive agents.

    Science.gov (United States)

    Aliprandi, P; Castelli, C; Bernorio, S; Dell'Abate, E; Carrara, M

    2004-01-01

    The medical and social impact of cough is substantial. Current antitussive agents at effective doses have adverse events such as drowsiness, nausea and constipation that limit their use. There is also recent evidence that standard antitussive agents, such as codeine, may not reduce cough during upper respiratory infections. Therefore, there is a need for more effective and better-tolerated agents. The efficacy of levocloperastine, a novel antitussive, which acts both centrally on the cough center and on peripheral receptors in the tracheobronchial tree in treating chronic cough, was compared with that of other standard antitussive agents (codeine, levodropropizine and DL-cloperastine) in six open clinical trials. The studies enrolled patients of all ages with cough associated with various respiratory disorders including bronchitis, asthma, pneumonia and chronic obstructive pulmonary disease. Levocloperastine significantly improved cough symptoms (intensity and frequency of cough) in all trials, and improvements were observed after the first day of treatment. In children, levocloperastine reduced nighttime awakenings and irritability, and in adults it was effective in treating cough induced by angiotensin-converting enzyme inhibitors. When compared with other antitussive agents, levocloperastine had improved or comparable efficacy, with a more rapid onset of action. Importantly, no evidence of central adverse events was recorded with levocloperastine, whereas drowsiness was reported by a significant number of patients receiving codeine. Levocloperastine is an effective antitussive agent for the treatment of cough in patients of all ages. It has a more rapid onset of action than standard agents with an improved tolerability profile.

  7. Phenytoin-induced isolated chronic, nocturnal dry cough

    Directory of Open Access Journals (Sweden)

    Fábio A. Nascimento

    2016-01-01

    Full Text Available We report a 72-year-old man with a four-year history of dyscognitive seizures (with occasional secondary generalization who developed isolated, nocturnal dry cough immediately after being started on PO phenytoin. The cough was not accompanied by any other symptom or sign as his physical exam was completely normal. Further investigation with chest CT and spirometry was unremarkable. This symptom persisted for six months and did not resolve until we weaned him off of phenytoin. According to the Naranjo Adverse Drug Reaction Probability Scale, his cough was classified as being probably (score +6 related to the use of this antiepileptic drug. To our knowledge, there has been only one study that reported phenytoin-triggered cough. It described a postoperative patient who developed cough and bronchospasm after receiving IV phenytoin. By reporting our case and discussing the literature on this specific topic, we have essentially two goals. First, we intend to remind clinicians that isolated persistent cough can be an adverse reaction to phenytoin. Second, we hope to encourage further studies that will be able to elucidate the association presented herein.

  8. Therapeutic options for acute cough due to upper respiratory infections in children.

    Science.gov (United States)

    Paul, Ian M

    2012-02-01

    Cough due to upper respiratory tract infections (URIs) is one of the most frequent complaints encountered by pediatric health-care providers, and one of the most disruptive symptoms for children and families. Despite the frequency of URIs, there is limited evidence to support the few therapeutic agents currently available in the United States (US) to treat acute cough due to URI. Published, well-designed, contemporary research supporting the efficacy of narcotics (codeine, hydrocodone) and US Food and Drug Administration (FDA)-approved over-the-counter (OTC) oral antitussives and expectorants (dextromethorphan, diphenhydramine, chlophedianol, and guaifenesin) is absent for URI-associated pediatric cough. Alternatively, honey and topically applied vapor rubs may be effective antitussives.

  9. Analysing the causes of chronic cough: relation to diesel exhaust, ozone, nitrogen oxides, sulphur oxides and other environmental factors

    Directory of Open Access Journals (Sweden)

    Wagner Ulrich

    2006-05-01

    Full Text Available Abstract Air pollution remains a leading cause of many respiratory diseases including chronic cough. Although episodes of incidental, dramatic air pollution are relatively rare, current levels of exposure of pollutants in industrialized and developing countries such as total articles, diesel exhaust particles and common cigarette smoke may be responsible for the development of chronic cough both in children and adults. The present study analyses the effects of common environmental factors as potential causes of chronic cough. Different PubMed-based researches were performed that related the term cough to various environmental factors. There is some evidence that chronic inhalation of diesel can lead to the development of cough. For long-term exposure to nitrogen dioxide (NO2, children were found to exhibit increased incidences of chronic cough and decreased lung function parameters. Although a number of studies did not show that outdoor pollution directly causes the development of asthma, they have demonstrated that high levels pollutants and their interaction with sunlight produce ozone (O3 and that repeated exposure to it can lead to chronic cough. In summary, next to the well-known air pollutants which also include particulate matter and sulphur dioxide, a number of other indoor and outdoor pollutants have been demonstrated to cause chronic cough and therefore, environmental factors have to be taken into account as potential initiators of both adult and pediatric chronic cough.

  10. 慢性咳嗽的临床分析%The clinical analysis of chronic cough

    Institute of Scientific and Technical Information of China (English)

    蒋勤军

    2014-01-01

    目的:探讨慢性咳嗽患者的病因及临床治疗方法。方法对58例慢性咳嗽患者按照咳嗽流程进行检查诊断分析,再根据诊断结果,针对不同病因采取不同治疗方法。结果本组患者咳嗽原因诊断明确87.93%、不明原因12.07%,其中变异性哮喘咳嗽占25.86%、鼻咽喉疾病引起咳嗽占20.69%。临床针对不同病因及病情采取不同治疗方法,治疗有效率为94.83%。结论重视慢性咳嗽的早诊断、早治疗,是提高治疗效果及患者生活质量的有效方法。%objective to explore the etiology and clinical treatment of patients with chronic cough. Methods 58 cases of patients with chronic cough according to cough process inspection diagnosis analysis, according to diagnosis, according to different causes different treatment methods. Results this group of patients cough reason clear diagnosis, unknown reason, 12.07%, 87.93% of cough variability asthma (25.86%), nose and throat diseases cause cough (20.69%). Clinical treatment according to different causes and different treatment methods, treatment effective rate was 94.83%. Conclusion emphasis on early diagnosis and early treatment of chronic cough, is to improve the treatment effect and quality of life of patients with effective methods.

  11. Chronic or recurring cough in children—a presentation of asthma?

    OpenAIRE

    Spelman, Reginald

    1984-01-01

    Thirty-five children between the ages of one year and 11 years who presented with chronic or recurring cough over a two-year period were treated for asthma. They were given bronchodilator syrup for a trial period of one month. All the children improved symptomatically.

  12. Evaluation of Methacholine Challenge Test Results in Chronic Cough Patients Referring to Clinic of Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Derakhshan Deilami Gholamreza

    2009-10-01

    Full Text Available Chronic cough is a common problem in patients visiting physicians and its prevalence in different populations range from 3 to 40%. Postnasal drip, asthma and gastroesophageal reflux are the known cause of chronic cough. Although diagnosis of asthma is usually made by clinical signs and spirometeric results, methacholine challenge test is a good diagnostic test in patients who show normal physical examination and spirometeric results. In this study, the results of methacholine challenge test in chronic cough patients are investigated. This is a cross sectional study performed on patients suffering from chronic cough (over 8 weeks, who went to Pulmonary Disease Clinic of Imam Khomeini Hospital in 2006. Postnasal drip, gastroesophageal reflux was evaluated and ruled out in all patients. Then they were tested by methacholine inhalation using low to high doses of methacholine. The results of test was defined as 20% fall in FEV1 and its relationship with age, sex, history of allergic disease, family history of asthma and smoking status was investigated. 81 patients (36 female and 45 male entered this study who had mean age of 32.5 ± 13.06 years. 81.5% of patients had never smoked or closed contact with smokers, 6.2% were passive smokers, 8.6% were smokers and 3.7% had quit smoking. 37% had suffered from chronic cough less than 6 months, 11% for 6-11 months and 52% for more than 12 months. In 26% of patients, family history of asthma was present and 34.5% had a history of one type of allergy. In 29.5% the results of methacholine challenge test was positive, among them 45.8% showed an intense response and 54.2% a moderate response. The test results and its intensity had no statistically significant relationship with age, sex, smoking status, the duration of cough and family history of asthma, but the relationship between methacholine challenge test and the history of allergic disease was significant. Methacholine challenge test can be used as a

  13. 不同病因慢性咳嗽的咳嗽程度比较%Cough score in patients with different etiology of chronic cough

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 赖克方; 罗炜; 刘春丽; 钟南山

    2008-01-01

    目的 探讨不同病因慢性咳嗽患者咳嗽程度的异同及可能的影响因素.方法 按慢性咳嗽病因诊断程序进行病因诊断,收集单一病因慢性咳嗽患者150例,通过咳嗽积分评价,比较不同病因患者日间及夜间咳嗽程度的差异及其与年龄、性别、病程的关系.结果 纳入患者包括鼻后滴流综合征24例,咳嗽变异型哮喘26例、胃食管反流性咳嗽20例,嗜酸细胞性支气管炎31例,变应性咳嗽30例及感染后咳嗽19例.各组间的日间咳嗽积分比较差异无统计学意义(P>0.05).咳嗽变异型哮喘组的夜间积分明显高于鼻后滴流综合征、胃食管反流性咳嗽、嗜酸粒细胞性支气管炎、变应性咳嗽及感染后咳嗽组(均P<0.01).分别对日间咳嗽积分和夜间咳嗽积分进行有序分类logistic回归分析,显示年龄与日间咳嗽积分有关(P<0.05),性别与夜间咳嗽积分有关(P<0.01).结论 不同病因慢性咳嗽的日间咳嗽程度类似,但咳嗽变异型哮喘夜间咳嗽程度显著高于其他病因的咳嗽.%Objective To investigate the severity of cough in patients with different etiology of chronic cough and its related factors. Methods One hundred and fifty patients with chronic cough were recruited. The diagnosis of the patients was as follows: 24 cases with post nasal drip syndrome (PNDs), 26 cough variant asthma (CVA), 20 gastroesophageal reflux-induced cough (GERC), 31 eosinophilic bronchitis (EB), 30 atopic cough (AC) and 19 cough post infection (CPI). The severity of cough at daytime and night-time were scored by the doctor and the patient at the first visit. The correlation between cough score and age, gender and course duration of patients was analyzed. Results There was no significantly difference of cough score at daytime among different groups. Cough score at night in CVA group was significantly higher than that of other five groups (all P <0.01). Regression analysis showed that cough score at daytime

  14. Can a management pathway for chronic cough in children improve clinical outcomes: protocol for a multicentre evaluation

    Directory of Open Access Journals (Sweden)

    Masters IB

    2010-11-01

    Full Text Available Abstract Background Chronic cough is common and is associated with significant economic and human costs. While cough can be a problematic symptom without serious consequences, it could also reflect a serious underlying illness. Evidence shows that the management of chronic cough in children needs to be improved. Our study tests the hypothesis that the management of chronic cough in children with an evidence-based management pathway is feasible and reliable, and improves clinical outcomes. Methods/Design We are conducting a multicentre randomised controlled trial based in respiratory clinics in 5 major Australian cities. Children (n = 250 fulfilling inclusion criteria (new patients with chronic cough are randomised (allocation concealed to the standardised clinical management pathway (specialist starts clinical pathway within 2 weeks or usual care (existing care until review by specialist at 6 weeks. Cough diary, cough-specific quality of life (QOL and generic QOL are collected at baseline and at 6, 10, 14, 26, and 52 weeks. Children are followed-up for 6 months after diagnosis and cough resolution (with at least monthly contact from study nurses. A random sample from each site will be independently examined to determine adherence to the pathway. Primary outcomes are group differences in QOL and proportion of children that are cough free at week 6. Discussion The clinical management pathway is based on data from Cochrane Reviews combined with collective clinical experience (250 doctor years. This study will provide additional evidence on the optimal management of chronic cough in children. Trial registration ACTRN12607000526471

  15. [Chronic cough and worsening dyspnea: a case of idiopathic tracheal stenosis].

    Science.gov (United States)

    Conti, Valentina; Calia, Nunzio; Pasquini, Claudio; Zardi, Silvia; Finetti, Cinzia; Stomeo, Francesco; Ravenna, Franco

    2013-04-01

    We report a case of idiopathic tracheal stenosis in a 75-year-old woman, who presented to our observation with a diagnosis of asthmatic bronchitis characterized by cough and exertional dyspnea, later complicated by the appearance of tirage. Biopsy of the lesion showed focal squamous metaplasia of the epithelium lining, multiple sclerosis and chronic inflammatory infiltration of the corium. The patient was treated with endoscopic destruction via rigid bronchoscopy, through the combined action of YAG laser and mechanical debulking.

  16. Right sided arcus aorta as a cause of dyspnea and chronic cough

    Directory of Open Access Journals (Sweden)

    Ozkaya Sevket

    2012-10-01

    Full Text Available Abstract Background Right sided arcus aorta (RSAA is a rare condition that is usually asymptomatic. Patients may present with exertional dyspnea and chronic cough. A recent article suggested that RSAA should be included in the differential diagnosis of asthma, especially in patients with intractable exertional dyspnea. We aimed to present the clinical, radiologic and spirometric features of thirteen patients with RSAA observed in four years at the Rize Education and Research Hospital and Samsun Chest Diseases and Thoracic Surgery Hospital. Methods The characteristics of patients with RSAA, including age, gender, symptoms, radiologic and spirometric findings, were retrospectively evaluated. Results A total of thirteen patients were diagnosed with RSAA. Their ages ranged from 17 to 86 years and the male to female ratio was 11:2. Seven of the patients (54% were symptomatic. The most common symptoms were exertional dyspnea, dysphagia and chronic cough. Five patients had received treatment for asthma with bronchodilators. Spirometry showed intrathoracic tracheal obstruction in five patients. Conclusions The RSAA anomaly occurs more frequently than might be estimated from the number of patients who are detected. Patients with intractable exertional dyspnea and chronic cough should be evaluated for the RSAA anomaly by thoracic CT.

  17. 100 cases Cough Powder Treating Chronic cough clinical analysis%止嗽散加减治疗慢性咳嗽100例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘光华

    2012-01-01

      目的:就止嗽散加减治疗慢性咳嗽100例临床分析进行探讨。方法:选择2008年1月至2011年12月在我院收治的慢性咳嗽患者100例,100例患者均采用止嗽散加减治疗,每天都煎1剂,水煎400 mL,早中晚3次空腹温服,儿童要酌情减少剂量,1个疗程为6剂,连续服用3-5个疗程。结果:经过上述治疗之后,100例慢性咳嗽患者显效(症状较治疗前明显减轻)90例(90%),有效(症状有所减轻)8例(8%),无效(治疗前后临床症状无改善)2例(2%),总有效率98%。结论:止嗽散加减治疗慢性咳嗽疗效较好,值得大力推广。%  Objective: Cough Powder Treating clinical analysis 100 cases of chronic cough explore. Method:: Select admitted to a hospital from January 2008 to December 2011, 100 cases of patients with chronic cough, 100 patients were Cough Powder Treating a daily fried, decoction 400 mL, early in the evening 3 times of fasting, warm clothes, children should, where appropriate, to reduce the dose, a treatment for six consecutive taking 3-5 courses. Results: After the above treatment, 100 patients with chronic cough markedly (significantly aleviate the symptoms before treatment) and 90 patients (90%) and effective (symptoms eased) in 8 cases (8%), invalid (no improvement in clinical symptoms before and after treatment ) 2 (2%), with a total efficiency of 98%. Conclusion: Cough Powder Treating chronic cough better effect, is worth promoting.

  18. Treatment of recalcitrant cough with baclofen

    Directory of Open Access Journals (Sweden)

    Paolo Agostinis

    2013-04-01

    Full Text Available Background: Chronic dry cough is a debilitating symptom often refractory to standard antitussive therapy. It may result from increased sensitivity of the cough reflex. Baclofen, an agonist of gamma-aminobutyric acid (GABA, has been shown, in animals, to have antitussive activity via a central mechanism. In normal subjects baclofen has been revealed ability to inhibit capsaicininduced cough and cough due to angiotensin-converting enzyme (ACE inhibitors. In addition, chronic therapy with baclofen has been shown to reduce cough reflex sensitivity in subjects with cervical spinal cord injury. Clinical cases: We describe two patients with chronic refractory cough who obtained symptomatic improvement after oral baclofen administration. The antitussive effect of baclofen, usually used for treatment of spasticity associated with multiple sclerosis and spinal cord lesions, can be explained by central inhibition, but may also involve peripheral inhibitory mechanisms.

  19. Reprint of: Effects of Asian dust on daily cough occurrence in patients with chronic cough: A panel study

    Science.gov (United States)

    Higashi, Tomomi; Kambayashi, Yasuhiro; Ohkura, Noriyuki; Fujimura, Masaki; Nakai, Satoshi; Honda, Yasushi; Saijoh, Kiyofumi; Hayakawa, Kazuichi; Kobayashi, Fumihisa; Michigami, Yoshimasa; Olando, Anyenda Enoch; Hitomi, Yoshiaki; Nakamura, Hiroyuki

    2014-11-01

    Asian dust, known as kosa in Japanese, is a major public health concern. In this panel study, we evaluated the effects of exposure to kosa on daily cough occurrence. The study subjects were 86 patients being treated for asthma, cough variant asthma, or atopic cough in Kanazawa University Hospital from January 2011 to June 2011. Daily mean concentrations of kosa and spherical particles were obtained from light detection and ranging (LIDAR) measurements, and were categorized from Grade 1 (0 μg/m3) to 5 (over 100 μg/m3). The association between kosa and cough was analyzed by logistic regression with a generalized estimating equation. Kosa effects on cough were seen for all Grades with potential time lag effect. Particularly at Lag 0 (the day of exposure), a dose-response relationship was observed: the odds ratios for Grades 2, 3, 4, and 5 above the referent (Grade 1) were 1.111 (95% confidence interval (CI): 0.995-1.239), 1.171 (95% CI: 1.006-1.363), 1.357 (95% CI: 1.029-1.788), and 1.414 (95% CI: 0.983-2.036), respectively. Among the patients without asthma, the association was higher: the odds ratios for Grades 2, 3, 4 and 5 were 1.223 (95% CI: 0.999-1.497), 1.309 (95% CI: 0.987-1.737), 1.738 (95% CI: 1.029-2.935) and 2.403 (95% CI: 1.158-4.985), respectively. These associations remained after adjusting for the concentration of spherical particles or particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5). Our findings demonstrate that kosa is an environmental factor which induces cough in a dose-response relationship.

  20. 慢性咳嗽病因分布的初步调查%Preliminary investigation on etiological diagnosis of chronic cough in Shanghai region

    Institute of Scientific and Technical Information of China (English)

    柳萍; 包婺平; 周新

    2010-01-01

    目的 了解上海地区慢性咳嗽病因分布的特点.方法 以中华医学会制定的(2009版)中慢性咳嗽诊断流程为指导,对98例咳嗽时间≥8周的患者进行病因分析、咳嗽症状积分、视觉模拟评分及Leicester咳嗽问卷调查.结果 98例患者中明确咳嗽病因诊断94例(95.92%),病因未明者4例(4.08%).94例患者中,单一病因82例(87.23%),双重病因12例(12.77%).咳嗽病因包括咳嗽变异性哮喘(CVA)44例(40.00%),上气道咳嗽综合征(UACS)28例(25.45%),嗜酸粒细胞性支气管炎(EB)21例(19.08%),变应性咳嗽5例(4.55%),胃食管反流性咳嗽4例(3.64%),感染后咳嗽3例(2.73%).治疗前后咳嗽积分、视觉模拟评分及Leicester咳嗽积分比较差异有统计学意义(P<0.05).结论 CVA、UACS和EB是上海地区慢性咳嗽的常见原因.%Objective To investigate the causes of chronic cough in Shanghai region. Methods All the cases were diagnosed using a diagnostic protocol designed by Chinese Medical Association. All patients completed cough scores,visual analogue scales and Leicester Cough Questionnaire (LCQ). Results The causes of chronic cough were confirmed in 94 patients (95.92%). Four patients had not been definitely diagnosed (4.08%). Cough due to single cause was found in 82 patients (87.23 % ), and due to double causes in 12 patients (12.77%). The causes included cough variant asthma (CVA) in 44 patients (40.00 % ), upper airway cough syndrome (UACS) in 28 patients ( 25.45 % ), eosinophilic bronchitis (EB)in 21 patients( 19.08% ) ,atopic cough in 5 patients (4.55%) ,gastro-esophageal reflux cough in 4 patients (3.64%), post infection cough in 3 patients (2.73%), chronic bronchitis in 1 patient (0.91%),respectively. There were significant differences in cough scores,visual analogue scales and LCQ between prior-treatment and post-treatment. Conclusions CVA, UACS and EB are the main causes of chronic cough in shanghai region.

  1. Hypoplastic epiglottis in a nonsyndromic child: a rare cause of chronic cough.

    Science.gov (United States)

    Parakh, Ankit; Singh, Varinder

    2013-01-01

    We describe a 2-year-old girl born out of a nonconsanguineous marriage who presented with dry cough since birth, which was often associated with feeding. She never had any choking or cyanotic/apneic spells. Her voice and cry were normal. She was born at term with no obvious congenital anomalies or perinatal problems. The child never had any other significant illness or respiratory distress to warrant hospital admission. On examination, she was a healthy-looking child without any abnormal syndromic facies or craniofacial or any other congenital anomaly. Flexible bronchoscopy done under sedation and local anesthesia revealed a rounded, short, stump-like hypoplastic epiglottis with a smooth contour. The rest of the laryngeal apparatus and the trachea-bronchial tree had normal appearance. The parents were advised to feed the child in a propped-up position and thickening of feeds to avoid aspirations. She remains well under follow-up. Hypoplastic epiglottis is a rare congenital anomaly of the upper airway, which can present with chronic cough. Endoscopic evaluation of the upper airway should be considered early in children presenting with cough associated with feeding problems.

  2. A case of Ross syndrome presented with Horner and chronic cough

    Directory of Open Access Journals (Sweden)

    Aslihan Baran

    2014-01-01

    Full Text Available Ross syndrome is a rare sweating disorder associated with Adie′s tonic pupil, decreased or diminished tendon reflex and unknown etiology. Although autonomic disturbances affecting sudomotor and vasomotor functions are seen commonly, they are rarely symptomatic. While Ross syndrome is typically characterized with dilated tonic pupil, it may be rarely manifested with miotic pupils (little old Adie′s pupil, which can make diagnosis difficult. In this article, we aim to specify the atypical clinical manifestations of syndrome by means of Ross syndrome manifested by autonomic symptoms, Horner syndrome, chronic cough together with bilateral little old Adie′s pupil.

  3. Neurogenic cough.

    Science.gov (United States)

    Altman, Kenneth W; Noordzij, J Pieter; Rosen, Clark A; Cohen, Seth; Sulica, Lucian

    2015-07-01

    We review contemporary concepts of the pathophysiology of neurogenic cough, and its evaluation and treatment based on scientific publications addressing neurogenic cough. Neurogenic cough is thought to be the result of sensory neuropathy, most commonly idiopathic. Because it is principally a sensory phenomenon, clinical evaluation is challenging, the diagnosis most often being made by exclusion. Identification of motor paresis, either by laryngoscopy or laryngeal electromyography, may suggest the presence of sensory neuropathy. The utility of amitriptyline and gabapentin has been demonstrated in randomized clinical trials, and retrospective series and case reports have suggested efficacy of pregabalin, baclofen, and botulinum toxin. Sensory neuropathy appears to be an important cause of chronic refractory cough, and appears amenable to treatment with a variety of pharmacologic agents.

  4. 慢性咳嗽的相关疾病及其治疗现状%Related diseases and treatment status of chronic cough

    Institute of Scientific and Technical Information of China (English)

    徐俪颖; 骆仙芳; 王会仍

    2010-01-01

    This article classified the chronic cough by its properties of dry cough or wet cough and summarizes the etiology and pathogenesis,the diagnosis and differentiation as well as the treatment status of related diseases of chronic cough for clinical reference,such as cough variant asthma,eosinophilic bronchitis,gastro-esophageal reflux cough,upper airway cough syndrome,postinfectious cough,atopic cough,cough related by ACEI,psychogenic cough,chronic obstructive pulmonary disease and other organic pulmonary disease with low incidence of cough.%本文对慢性咳嗽干性或湿性的性质进行病因分类,并对咳嗽变异性哮喘、嗜酸粒细胞性支气管炎、胃食管反流性咳嗽、上呼吸道咳嗽综合征、感染后咳嗽、特应性咳嗽、血管紧张素转换酶抑制剂所致的咳嗽、心理性咳嗽、慢性阻塞性肺疾病及其他咳嗽发生率较少的器质性肺部疾病的病因病机、临床诊断和鉴别诊断及其治疗现状进行综述,以供临床参考.

  5. Cough management: a practical approach.

    Science.gov (United States)

    De Blasio, Francesco; Virchow, Johann C; Polverino, Mario; Zanasi, Alessandro; Behrakis, Panagiotis K; Kilinç, Gunsely; Balsamo, Rossella; De Danieli, Gianluca; Lanata, Luigi

    2011-10-10

    Cough is one of the most common symptoms for which patients seek medical attention from primary care physicians and pulmonologists. Cough is an important defensive reflex that enhances the clearance of secretions and particles from the airways and protects the lower airways from the aspiration of foreign materials. Therapeutic suppression of cough may be either disease-specific or symptom related. The potential benefits of an early treatment of cough could include the prevention of the vicious cycle of cough. There has been a long tradition in acute cough, which is frequently due to upper respiratory tract infections, to use symptom-related anti-tussives. Suppression of cough (during chronic cough) may be achieved by disease-specific therapies, but in many patients it is often necessary to use symptomatic anti-tussives, too. According to the current guidelines of the American College of Chest Physician on "Cough Suppressants and Pharmacologic Protussive Therapy" and additional clinical trials on the most frequent anti-tussive drugs, it should be possible to diagnose and treat cough successfully in a majority of cases. Among drugs used for the symptomatic treatment of cough, peripherally acting anti-tussives such as levodropropizine and moguisteine show the highest level of benefit and should be recommended especially in children. By improving our understanding of the specific effects of these anti-tussive agents, the therapeutic use of these drugs may be refined. The present review provides a summary of the most clinically relevant anti-tussive drugs in addition to their potential mechanism of action.

  6. Cough in Sarcoidosis.

    Science.gov (United States)

    Tully, Timothy; Birring, Surinder S

    2016-02-01

    Sarcoidosis is a granulomatous disorder that frequently affects the lungs. Cough is commonly reported by patients and can significantly reduce health-related quality of life. The mechanism of cough is unknown but airway inflammation, mechanical distortion from pulmonary fibrosis and disruption of the vagus nerve are possible. Recent evidence suggests cough reflex hypersensitivity may also be an important mechanism and predictor of the frequency of cough. The investigation of cough should evaluate common causes such as asthma, gastro-oesophageal reflux and rhinitis. In patients with suspected cough due to sarcoidosis, a trial of corticosteroids should be considered. The severity of cough should be evaluated with validated outcome measures such as visual analogue scales, cough severity diary, health-related quality of life questionnaires such as the Leicester Cough Questionnaire and objective cough monitors. Future studies are needed to identify targets for therapeutic development.

  7. Treatment of Cough and Dyspnea due to Acute Bronchitis by Plaster for Cough and Dyspnea-A Report of 735 Cases

    Institute of Scientific and Technical Information of China (English)

    陈振甫; 周文秀; 高举先; 孙江桥

    2002-01-01

    @@ In the light of the theory of treating the internal disease externally, an externally used plaster for treating cough and dyspnea due to acute bronchitis (Ke Chuan Yi Tie Kang 咳喘一贴康) was successfully applied to 735 cases of acute bronchitis (the treatment group), with the other 423 cases treated with routine western drugs as controls. The results showed that the cure rate in the treatment group was significantly higher than that in the control group (P<0.01); and that in the treatment group, the cure rate for the wind-cold type of acute bronchitis was significantly higher than that for the wind-heat type of acute bronchitis (P<0.01).

  8. Etiological analysis of pediatric chronic cough%小儿慢性咳嗽的病因分析

    Institute of Scientific and Technical Information of China (English)

    李治昌; 吕茵; 王义; 刘小权; 楚建萍

    2013-01-01

    Objective To investigate the causes of the chronic cough in children .Methods The clinical data of 245 cases of chronic cough in children were retrospectively studied .Results The causes of 245 cases of infantile cough included cough after respiratory tract infection(26.67%), foreign body in bronchus(20.83%), upper airway cough syndrome (15.00%), and cough variant asthma (CVA) (12.92%).Cough after respiratory tract infection and breast milk aspiration gave priority to chronic cough in baby under 1 year old(62. 71%) .The foreign body in trachea and bronchi and cough after respiratory tract infection were main causes in children aged 1-3 years old (70.09%).CVA and upper airway cough syndrome .(68.92%) were major causes of children over 3 years.Conclusion The etiology of pediatric chronic cough is different for children of different age .The major causes include cough after respiratory tract infection , upper airway cough syndrome , CVA, foreign body in bronchus , and so on.It should be further diagnosed according to cough characteristics , auxiliary examination and therapy because of complex etiology .%目的了解小儿慢性咳嗽的病因。方法对245例慢性咳嗽患儿的临床资料进行回顾性研究。结果245例小儿咳嗽的原因有呼吸道感染后咳嗽(26.67%),支气管异物(20.83%),上气道咳嗽综合征(15.00%),咳嗽变异性哮喘(12.92%)。小于1岁婴儿慢性咳嗽以呼吸道炎症后咳嗽和误吸母乳为主(62.71%),1~3岁小儿以气管、支气管异物和呼吸道感染后咳嗽为主(占70.09%),大于3岁儿童以咳嗽变异性哮喘和上气道咳嗽综合征为主(68.92%)。结论小儿慢性咳嗽的病因根据年龄段不同而异,主要病因有呼吸道炎症后咳嗽、上气道咳嗽综合征、咳嗽变异性哮喘、支气管异物等,其病因较复杂,须根据咳嗽特征、辅助检查、治疗反应来进一步确定。

  9. Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma?

    OpenAIRE

    Fujimura, M; Ogawa, H.; Nishizawa, Y; Nishi, K.

    2003-01-01

    Background: We have described a group of patients who present with isolated chronic bronchodilator resistant non-productive cough with an atopic constitution, eosinophilic tracheobronchitis, and airway cough receptor hypersensitivity without bronchial hyperresponsiveness, which we have termed "atopic cough". Although cough variant asthma (in which the cough responds to bronchodilators) is recognised as a precursor of typical asthma, it is not known whether atopic cough is also a precursor of ...

  10. Chronic cough with normal sweat chloride: Phenotypic descriptions of two rare cystic fibrosis genotypes

    Directory of Open Access Journals (Sweden)

    Hemang Yadav

    2016-01-01

    Full Text Available While our understanding of cystic fibrosis genetics has expanded in recent decades, the genetics and clinical manifestations of the disease remains highly heterogeneous. Diagnosis of CF in non-classical mutations remains a clinical challenge. We describe the clinical presentation of two patients with chronic cough found to have normal sweat chlorides. We discuss the subsequent evaluation that lead to the diagnosis of two rare CF mutations. We briefly discuss the use of the expanded 106-panel of CF mutations (homozygous 3849 + 10  kb C > T, and the role of whole CFTR gene sequencing (heterozygous c.2752-26 A > G/5T.

  11. Living near a Major Road in Beijing: Association with Lower Lung Function, Airway Acidification, and Chronic Cough

    Directory of Open Access Journals (Sweden)

    Zhan-Wei Hu

    2016-01-01

    Conclusions: Long-term exposure to traffic-related air pollution in people who live near major roads in Beijing is associated with lower lung function, airway acidification, and a higher prevalence of chronic cough. EBC pH is a potential useful biomarker for evaluating air pollution exposure.

  12. Levodropropizine in the management of cough associated with cancer or nonmalignant chronic disease--a systematic review.

    Science.gov (United States)

    Schildmann, Eva Katharina; Rémi, Constanze; Bausewein, Claudia

    2011-01-01

    Cough associated with cancer or nonmalignant chronic disease is common and distressing. Levodropropizine, a peripherally acting drug, has been used as an alternative antitussive to opioids. The authors aimed to determine the efficacy and safety of levodropropizine in relieving cough associated with cancer or nonmalignant chronic disease. The authors searched five databases and hand searched relevant journals to identify randomized and nonrandomized controlled trials assessing the antitussive effect of levodropropizine for cough associated with cancer, chronic obstructive pulmonary disease (COPD), interstitial lung disease, or chronic heart failure. Study quality was assessed using a modified version of the Centre for Reviews and Dissemination criteria. The search yielded 58 references. Six were checked in more detail, and four studies were included. Two were randomized controlled trials (RCTs) testing levodropropizine against dihydrocodeine and moguisteine, and two were nonrandomized placebo-controlled studies, all with important limitations and high risk of bias. Levodropropizine was significantly more effective than placebo in reducing cough frequency and severity, and equally effective as dihydrocodeine or moguisteine. It was generally well tolerated. The authors conclude that the evidence for the antitussive efficacy of levodropropizine in these patients is scarce, and is further limited by the methodological weaknesses of the primary studies. Further well-designed research is needed to support its use.

  13. Cough in idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Mirjam J.G. van Manen

    2016-09-01

    Full Text Available Many patients with idiopathic pulmonary fibrosis (IPF complain of chronic refractory cough. Chronic cough is a distressing and disabling symptom with a major impact on quality of life. During recent years, progress has been made in gaining insight into the pathogenesis of cough in IPF, which is most probably “multifactorial” and influenced by mechanical, biochemical and neurosensory changes, with an important role for comorbidities as well. Clinical trials of cough treatment in IPF are emerging, and cough is increasingly included as a secondary end-point in trials assessing new compounds for IPF. It is important that such studies include adequate end-points to assess cough both objectively and subjectively. This article summarises the latest insights into chronic cough in IPF. It describes the different theories regarding the pathophysiology of cough, reviews the different methods to assess cough and deals with recent and future developments in the treatment of cough in IPF.

  14. Prevalence of chronic cough and possible causes in the general population based on the Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Koo, Hyeon-Kyoung; Jeong, Ina; Lee, Sei Won; Park, Jinkyeong; Kim, Joo-Hee; Park, So Young; Park, Hye Yun; Rhee, Chin Kook; Kim, Yee Hyung; Jung, Ji Ye; Kim, Sung-Kyoung; Kim, Yong Hyun; Choi, Eun Young; Moon, Ji-Yong; Shin, Jong-Wook; Kim, Jin Woo; Min, Kyung Hoon; Kim, Sei Won; Yoo, Kwang Ha; Kim, Je Hyeong; Jang, Seung Hun; Yoon, Hyoung Kyu; Kim, Hui Jung; Jung, Ki-Suck; Kim, Deog Kyeom

    2016-09-01

    Although chronic cough is very common, its prevalence and causes have been rarely reported in the large general population including smokers. This study aimed to identify the prevalence of possible causes of chronic cough and their clinical impact.From Korean National Health and Nutrition Examination Survey (KNHANES) data including 119,280 adults aged over 40 years, 302 individuals with chronic cough were recruited irrespective of smoking status. Data from questionnaire, laboratory tests including spirometry, chest radiographs, and otorhinolaryngologic examination were analyzed.The prevalence of chronic cough in adults was 2.5% ± 0.2%. Current smokers occupied 47.7% ± 3.8% of study population and 46.8% ± 3.9% of the subjects showed upper airway cough syndrome (UACS). Based on spirometry, chronic obstructive pulmonary disease (COPD) was identified in 26.4% ± 3.5%. Asthma explained for 14.5% ± 2.8% of chronic cough. Only 4.1% ± 1.6% showed chronic laryngitis suggesting gastro-esophageal reflux-related cough. Abnormalities on chest radiography were found in 4.0% ± 1.2%. Interestingly, 50.3% ± 4.5% of study subjects had coexisting causes. In multivariate analysis, only current smoking (odds ratio [OR] 3.16, P cough. This pattern was not different according to smoking status excepting the prevalence of COPD.Smoking, COPD, and chest radiographic abnormalities should be considered as causes of chronic cough, along with UACS and asthma. Gastro-esophageal reflux-related cough is not prevalent in study population.

  15. Whooping Cough

    Science.gov (United States)

    Whooping cough is an infectious bacterial disease that causes uncontrollable coughing. The name comes from the noise you make when you take a breath after you cough. You may have choking spells or may cough ...

  16. Cough Headaches

    Science.gov (United States)

    ... whether you have primary or secondary cough headaches. Primary cough headache If you have a history of primary cough ... inside the skull Other medications used to treat primary cough headache include methysergide, naproxen (Naprosyn), ergonovine, intravenous dihydroergotamine (D. ...

  17. Diagnostic yield of oesophageal pH monitoring in patients with chronic unexplained cough

    NARCIS (Netherlands)

    Bogte, Auke; Bredenoord, Arjan J.; Smout, Andre J. P. M.

    2008-01-01

    Objective. One of the main causes of persistent cough is gastro-oesophageal reflux. In these patients, excessive oesophageal acid exposure and/or a temporal association between gastro-oesophageal reflux and cough can be demonstrated during 24-h pH monitoring. Impedance pH monitoring may have a highe

  18. Impact of chronic cough on quality of life%慢性咳嗽对生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    余刚; 李昌崇; 张海邻

    2008-01-01

    Chronic cough would have serious impact on the patients' physical and psychological health,as well as the quality of their social life.The physical complications of cough can be easily diagnosed by chronic cough.However,the psychological and social symptoms are often overlooked.In recent years,there are some questionnaires,such as cough-specific quality of life questionnaire,Leicester cough questionnaire,chronic cough impact questionnaire,which have been worked out for evaluating the severity of cough and the effect of cough treatment.%慢性咳嗽可以对患者的生理、心理和社会生活产生严重影响,医师能轻易发现慢性咳嗽对患者生理方面的并发症,而患者在心理和社会生活方面的影响却往往被忽视.近年来.国外一些学者陆续研究制定了咳嗽特异性生活质量问卷、Leicester咳嗽问卷和慢性咳嗽影响问卷等与咳嗽相关的生活质量问卷,用于评价咳嗽的严重度和咳嗽的治疗效果.

  19. Cough in idiopathic pulmonary fibrosis

    NARCIS (Netherlands)

    M.J.G. Van Manen (Mirjam J.G.); S.S. Birring (Surinder S.); C. Vancheri (Carlo); V. Cottin (Vincent); Renzoni, E.A. (Elisabetta A.); Russell, A.-M. (Anne-Marie); M.S. Wijsenbeek (Marlies)

    2016-01-01

    textabstractMany patients with idiopathic pulmonary fibrosis (IPF) complain of chronic refractory cough. Chronic cough is a distressing and disabling symptom with a major impact on quality of life. During recent years, progress has been made in gaining insight into the pathogenesis of cough in IPF,

  20. 慢性咳嗽常见病因之间咳嗽敏感性的差异%Difference of Capsaicin Cough Sensitivity in Common Causes of Chronic Cough

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 刘春丽; 罗炜; 赖克方; 钟南山

    2013-01-01

    目的 慢性咳嗽常表现为对理化刺激因子呈异常增高的咳嗽反应,但不同病因间慢性咳嗽敏感性的差异及机制尚未完全清晰.方法 收集2005年至2010年于广州呼吸疾病研究所咳嗽专科就诊的慢性咳嗽患者,通过慢性咳嗽病因诊断程序确诊其常见病因,进行辣椒素咳嗽激发试验,以咳嗽阈值评估咳嗽敏感性,观察咳嗽敏感性与咳嗽病程、咳嗽严重度、肺通气功能、诱导痰细胞的关系.结果 通过慢性咳嗽诊断程序进行病因诊断后,纳入病例133例,其中上气道咳嗽综合征(UACS) 24例,咳嗽变异型哮喘(CVA) 26例,嗜酸粒细胞性支气管炎(EB)31例,变应性咳嗽(AC)30例、胃食管反流性咳嗽(GERC) 22例.另有同期正常健康志愿者30例作为正常对照.AC、CVA、EB、GERC以及UACS组患者的咳嗽阈值LgC5分别1.70±0.70、2.12±0.67、2.13±0.69、1.69 ±0.73、2.16±0.66,较正常对照(2.63±0.39)均有不同程度的降低(P均<0.05).其中以GERC、AC患者咳嗽阈值降低尤为显著(分别显著低于CVA、EB、UACS组,P均<0.05),其咳嗽阈值低于正常对照单侧95%参考值(125 μmol/L)的比例较CVA、EB、UACS组为多(P均<0.05).慢性咳嗽患者的咳嗽阈值LgC5与咳嗽病程及日间咳嗽积分相关(r值分别为-0.280、-0.168,P均<0.05),但与肺通气功能以及痰细胞分类无关(P均>0.05).结论 慢性咳嗽常见病因患者辣椒素咳嗽敏感性有不同程度的增高,这种差异可能反映了不同病因的咳嗽发病机制不一,可能与支配咳嗽敏感性的神经纤维类型有关.%Objective Chronic cough is often present as increasing cough reaction to various physical and chemical stimulating factors.This study is aimed to investigate the difference of cough sensitivity and its mechanisms which are not clear among different causes of chronic cough.Methods Patients with chronic cough were recruited from cough clinic of Guangzhou Institute of Respiratory

  1. Chronic cough and a normal chest X-ray - a simple systematic approach to exclude common causes before referral to secondary care: a retrospective cohort study.

    Science.gov (United States)

    Turner, Richard D; Bothamley, Graham H

    2016-03-03

    Chronic cough is common in the community and can cause significant morbidity. It is not clear how closely treatment guidelines are used in general practice, or how often specialist referral is indicated. We aimed to assess the management of chronic cough in primary care before referral to a cough clinic, and to assess the outcome of managing chronic cough with an approach of simple investigation and empirical treatment trials. Data were extracted from the records of all patients attending a district general hospital respiratory clinic over a two-year period with isolated chronic cough lasting ⩾8 weeks. The clinic assessed symptoms with a cough-severity visual analogue scale and the Leicester Cough Questionnaire. Among 266 patients, the most frequent diagnoses were asthma (29%), gastro-oesophageal reflux (22%) and angiotensin-converting enzyme inhibitor use (14%). In all, 12% had unexplained chronic cough. Common diagnoses had often not been excluded in primary care: only 21% had undergone spirometry, 86% had undergone chest radiography and attempts to exclude asthma with corticosteroids had been made only in 39%. In the clinic few investigations were conducted that were not available in primary care. Substantial improvements in symptoms occurred with a median (interquartile range) total of 2 (2-3) clinic visits. We estimated that 87% of patients could have been managed solely in primary care; we did not identify distinguishing characteristics among this group. Most cases of chronic cough referred to secondary care could be managed with a simple and systematic approach, which is potentially transferrable to a community setting.

  2. Effect of inhaled procaterol on cough receptor sensitivity to capsaicin in patients with asthma or chronic bronchitis and in normal subjects.

    OpenAIRE

    Fujimura, M; Sakamoto, S.; Kamio, Y.; Bando, T.; Kurashima, K.; T. Matsuda

    1993-01-01

    BACKGROUND--To evaluate the effect of inhaled beta 2 adrenergic agonists on the sensitivity of airway cough receptors, the effect of inhaled procaterol on cough induced by aerosolised capsaicin, a stimulant of C fibres, was studied in patients with asthma or chronic bronchitis and in normal subjects. METHOD--Eleven patients with asthma and 10 with chronic bronchitis and 14 normal subjects participated. Increasing concentrations of capsaicin solution were inhaled for 15 seconds by tidal breath...

  3. 112例误诊为支气管炎的老年慢性咳嗽病因分析%Etiological investigation of the 112 elderly patients with chronic cough misdiagnosed as bronchitis

    Institute of Scientific and Technical Information of China (English)

    林芳; 王浩彦

    2012-01-01

    目的 探讨老年患者慢性咳嗽的误诊及病因分布.方法 基层医院误诊为支气管炎的112例老年慢性咳嗽患者,采用咳嗽诊治指南制定的诊断程序,判断病因并予针对性治疗.结果 最终病因明确107例(95.54%),其中单一病因为89例(79.46%),复合病因为18例(16.07%).老年患者病因诊断前三位为胃食管返流性咳嗽、咳嗽变异型哮喘 、上气道咳嗽综合征,在女性患者和男性患者中分别占26.39%,20.83%,18.06%和29.31%,22.41%,18.97%.三者占慢性咳嗽病因的67.69%,其次是ACEI诱发的咳嗽.经特异性治疗后咳嗽明显减轻或消失为103例,有效率为91.96%,其余均为部分缓解.结论 老年慢性咳嗽病因复杂常被误诊,规范慢性咳嗽病因诊断程序对提高老年慢性咳嗽诊治水平有重要意义.%Objective The purpose of this study is to explore the etiology and misdiagnosis of the elderly patients with chronic cough. Methods A total of 112 the elderly patients ( 62 females, 50 males ) with chronic cough misdiagnosed as bronchitis by primary hospital were studied. Based on " Guideline on Diagnosis and Treatment of Chronic Cough" established by China Medical, the causes of chronic cough would be confirmed and given specific therapy. Results 107 of 112 patients( 95. 54% )were finally confirmed. Chronic cough due to a single cause was found in 89 patients ( 79. 46% ), and due to two causes in 18 patients ( 16. 07% ). The top three causes were gastroesophageal reflux cough ( GERC ), cough variant asthma ( CVA ), upper airway cough syndrome ( UACS ) and accounted for 67. 69% , followed by the ACEI-induced cough. The three causes accounted for 26. 39% , 20. 83% , 18. 06% in females and 29. 31% , 22. 41% , 18. 97% in male patients, respectively. After specific therapy based on diagnosis, cough cured and alleviated in 103 patients (91. 96% ); the rest are partially alleviated. Conclusions The cause of chronic cough in the elderly is complex and often

  4. 咳嗽从瘀血论治经验%The experiences of the treatment on cough from blood stasis

    Institute of Scientific and Technical Information of China (English)

    马献中; 王世彪; 王保平

    2014-01-01

    Cough lung disease is one of the most common syndromes caused by many reasons, cough, a cough and internal cough points, most doctors more responsibility in the lung, spleen, liver, kidney damage, or due to feel the wind, cold, heat, dryness, fire evil and hair, or phlegm due to spleen deficiency, liver fire attacking lung, deficiency of kidney qi and other causes. In recent years, the study found, blood stasis caused one of the main causes of chronic cough, especially in chronic cough patients. Our clinical treatment of chronic bronchitis, cough asthma, pulmonary heart disease, bronchiectasis patients, each with blood stasis of TCM, often obtain good effect. The blood stasis cough experience summarized as follows.

  5. Update on Pediatric Cough.

    Science.gov (United States)

    Kantar, Ahmad

    2016-02-01

    Despite the high prevalence of cough in children, the topic has been poorly researched. Although pediatricians recognize that chronic cough in children is different from that in adults, this difference seems less recognizable to other health professionals. During childhood, the respiratory tract and nervous system undergo a series of anatomical and physiological maturation processes that influence the cough reflex. Additionally, immunological responses undergo developmental and memorial processes that make infection and congenital abnormalities the overwhelming cause of cough in children. The lack of comprehensive clinical data regarding chronic cough in children has initially required pediatricians to adopt an adult approach to the problem. In the last 10 years, however, research has led to the reconsideration of the etiology of chronic cough in children. Currently, attention has focused on protracted bacterial bronchitis as a major cause of chronic cough in preschool-aged children and as a possible precursor of bronchiectasis. New research horizons are emerging for both the treatment and prevention of particular causes of chronic cough in children.

  6. Children chronic cough caused by upper airway cough syndrome 58 cases clinical analysis%上气道咳嗽综合征引起儿童慢性咳嗽58例临床分析

    Institute of Scientific and Technical Information of China (English)

    李兰; 樊红; 何海兰; 李敏; 陈昌辉

    2012-01-01

    目的 探讨上气道咳嗽综合征(UACS)引起儿童慢性咳嗽的临床特点.方法 对58例确诊为UACS的患儿,根据临床表现、辅助检查及治疗作回顾性分析.结果 58例中有鼻部相关原发疾病以慢性鼻窦炎最多共27例(46.6%),其次为变应性鼻炎16例(27.6%),慢性鼻炎10例(17.2%),单纯腺样体炎5例(8.6%),均以慢性咳嗽为主诉,经过积极的抗炎与抗变态反应治疗,50例患儿在连续治疗2周后咳嗽症状缓解,8例患儿继续治疗1周后咳嗽症状缓解,所有鼻窦炎患儿在治疗3个月时复查鼻窦CT均示炎症完全吸收.结论 上气道咳嗽综合征是引起儿童慢性咳嗽的主要原因之一,结合专科检查,积极治疗原发疾病,可有效地消除慢性咳嗽.%Objective To study the clinical characters of children chronic cough caused by upper airway cough syndrome. Methods A respective review of 58 cases diagnosed as upper airway cough syndrome, according to the clinical symptoms % auxiliary examinations and treatments. Results Total of 58 cases had primary rhinal associated diseases. The first was chronic rhinosinusitis 27 cases (46. 6% ) , the other three common were allergic rhinitis 16cases (27. 6% ) ,chronic rhinitis 10 cases (17.2% ) .simple adenoiditis 5 cases (8. 6% ). All patients' chief complaint were chronic cough ,after positive anti-infections and anti-allergy treatment, 50 patients' cough was relieved after two weeks of curious treatment. 8 patients were relieved after three weeks . All cases with rhinosinusitis reexamination of paranasal sinus were absorbed completely after 3 months. Conclusion Upper airway cough syndrome is one of the primary causes of children chronic cough. Based on special examination and positive treatments with primary diseases, chronic cough could be effectively elminated.

  7. Comparative analysis of clinical profile: chronic cough vs paradoxical vocal fold motion

    Science.gov (United States)

    Hartley, Naomi A.; Petty, Brian E.; Johnson, Bethany; Thibeault, Susan L.

    2015-01-01

    Background Ongoing contention surrounding typical demographic and clinical attributes of chronic cough (CC) and paradoxical vocal fold motion (PVFM) impedes timely diagnosis and optimum patient care. Designed to reduce preventable patient morbidity through improved recognition and differentiation, the current study aimed to determine representative clinical profiles for CC and PVFM, with identification of distinctive attributes from the general population and risk factors associated with each diagnosis. Methods Self-reported medical questionnaires, demographic and lifestyle attributes of CC and PVFM cases from a disease-specific outcomes database were compared to US population data and published normative values. Univariate comparison and multivariate regression modelling of age, sex, alcohol intake, smoking, Reflux Symptom Index (RSI), Voice Handicap Index (VHI), and Generalized Anxiety Disorder 7-item Scale (GAD-7) determined distinguishing features between the clinical groups, including odds ratios for presenting with CC versus PVFM. Results Clinical profiles developed from 283 (128 CC, 155 PVFM) adults (18–91years) were significantly different from the general population across each demographic, lifestyle and clinical variable (all p<.01), with the exception of obesity. Age (55.39 ± 13.54 vs 45.07 ± 16.51years, p<.01) and mean RSI score (21.5 ±9.02 vs 18.1±9.08, p<.01) most reliably distinguished CC from PVFM, with those aged 60–69 years (OR=9.45) most likely to be diagnosed with CC. Conclusions Standard clinical profiles of CC and PVFM are distinct from the general population, aiding determination of relative probabilities and risk factors in the differential diagnostic process. Variations between CC and PVFM were subtle, reliably distinguished by age and relative severity of laryngopharyngeal reflux symptomatology. PMID:26507903

  8. Updated guidelines on cough launched

    Institute of Scientific and Technical Information of China (English)

    WANG Zeng-li

    2006-01-01

    @@ Cough is the commonest symptom leading patients to consult with their doctor. What is clear is that at some stage, we all suffer from cough and at times, it is distressing and inhibits normal social activities. In a few subjects, chronic cough leads to a severe loss of quality of life.

  9. 儿童慢性咳嗽的中医诊治研究概述%Research progress of traditional Chinese medicineon in the treatment of children with ;chronic cough

    Institute of Scientific and Technical Information of China (English)

    鲍丽娟; 李江全

    2016-01-01

    Chronic cough is one of the common symptoms of pediatric respiratory. The diagnosis of chronic cough is complicated, and the curative effect is not clear. At present, studies on chronic cough in children are still in the preliminary stage. This article summarized the etiology, pathogenesis and clinical treatment of chronic cough.%本文从儿童慢性咳嗽的病因病机、辨证论治等方面对近年儿童慢性咳嗽的研究进展进行概述,以期开阔儿童慢性咳嗽的治疗思路。

  10. Analysis on Etiology of 68 Children with Chronic Cough.%68例儿童慢性咳嗽的病因构成分析

    Institute of Scientific and Technical Information of China (English)

    王屹; 崔振泽; 黄燕

    2011-01-01

    目的 了解儿童慢性咳嗽的病因构成特点,为慢性咳嗽的病因诊治提供依据.方法 选取2009年3~11月符合慢性咳嗽诊断标准的患儿共68例,对其进行逐步观察、评估、随访的前瞻性描述性研究,以分析儿童慢性咳嗽的常见病因构成.结果 (1)诊断状况:确诊63例,确诊率92.6%,确诊病例中,单一病因42例,两重病因20例,三重病因1例.(2)病因构成:上气道咳嗽综合征32例次(35.2%);呼吸道感染与感染后咳嗽28例次(30.8%);咳嗽变异性哮喘26例次(28.6%);胃食管反流性咳嗽4例次(4.4%)以及病因未明1例次(1.1%).(3)同一年龄组患儿的病因构成并不相同,同一病因在不同年龄组的构成也不尽相同.结论 (1)上气道咳嗽综合征、呼吸道感染与感染后咳嗽、咳嗽变异性哮喘及胃食管反流性咳嗽是儿童慢性咳嗽的常见病因.(2)上气道咳嗽综合征是儿童慢性咳嗽的首位病因.(3)呼吸道感染与感染后咳嗽,贯穿于儿童慢性咳嗽的各个年龄组.%Objective To observe the distribution of the causes of children with chronic cough and provide scientific foundations for practical diagnosis. Methods 68 children meeting the diagnostic criteria of chronic cough in children were selected in Dalian Children Hospital from March 2009 to November 2009 as subjects for the study. Prospective and descriptive studies by were carried out means of gradual observation, assessment and follow - up in order to analyze the causes of chronic cough. Results 1. The diagnosis conditions of 68 patients; there were 63 final diagnosis, with the rate of 92. 6%. There were 20 cases of double causes,and 1 case of triple causes. 2. The constitution of etiology in 68 patients; 32 with the upper airway cough syndrome (35.2% ). 28 with respiratory tract infection and postinfectious cough (30.8% ). 26 with cough variant asthma (28.6% ) ,4 with gastroesophageal reflux cough (4.4% ) and 1 case of unknown etiology

  11. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate.

    Science.gov (United States)

    Kahrilas, Peter J; Smith, Jaclyn A; Dicpinigaitis, Peter V

    2014-02-01

    Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies of chronic cough. Indeed, cough management guidelines published by numerous respiratory societies worldwide recommend evaluation and treatment of GERD as an integral component of the diagnostic/therapeutic algorithm for the management of chronic cough. However, a significant number of patients with chronic cough presumed due to GERD do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of nonacid or weakly acidic reflux. Further contributing to the controversy are recent studies that demonstrate that patients with chronic cough do not have excessive reflux events relative to healthy volunteers. Although a temporal relationship between cough and reflux events has been suggested by studies utilizing impedance-pH monitoring of reflux events and objective cough recording, consensus is lacking in terms of whether this temporal relationship proves a causal link between reflux and cough. The fourth American Cough Conference (New York, June 2013) provided an ideal forum for the debate of this issue between two internationally recognized experts in the field of reflux and chronic cough.

  12. Mesenteric tumor due to chronic anisakiasis

    Directory of Open Access Journals (Sweden)

    Pablo Menéndez

    2015-09-01

    Full Text Available Intestinal anisakiasis is a rare parasitic disease and difficult to diagnose due to symptoms are not specific, so it is considered an underdiagnosed disease. The clinical suspicion with a correct diagnosis of anisakiasis allows the establishment of a correct treatment; in most cases, the resolution is possible with conservative treatment, avoiding unnecessary surgery to the preoperative differential diagnosis of acute abdomen. We report the case of a patient who required urgent surgery secondary to an exacerbation of chronic anisakiasis.

  13. 妊娠外感久咳的中医治疗%Chinese Medicine Treatment for ExogenousChronic Cough during Pregnancy

    Institute of Scientific and Technical Information of China (English)

    崔翠林; 张雪

    2015-01-01

    Objective: To analyze the etiology and pathogenesis of exogenous chronic cough during pregnancy and evaluate the clinical efficacy of heat-clearing, phlegm-resolving and cough-stopping method. Methods:100 cases of exogenous chronic cough during pregnancy were treated by heat-clearing,phlegm-resolving and cough-stopping decoction.Results:It had significant effect and the effective rate was 96%.Conclusion: The traditional Chinese medicine heat-clearing,phlegm-resolving and cough-stopping decoction has anti-inflammatory and antiviral effects.It can stop cough.%目的:探讨妊娠外感久咳的病因病机及清热化痰止咳法治疗妊娠外感久咳的疗效。方法:选取门诊妊娠外感久咳患者100例,采用清热化痰止咳汤进行治疗,门诊观察治疗妊娠外感久咳100例。结果:临床疗效显著,有效率达96%。结论:中药清热化痰止咳汤具有抗炎抗病毒及祛痰镇咳的作用。

  14. A comparison of assisted cough techniques in stable patients with severe respiratory insufficiency due to amyotrophic lateral sclerosis.

    Science.gov (United States)

    Senent, Cristina; Golmard, Jean-Louis; Salachas, François; Chiner, Eusebi; Morelot-Panzini, Capucine; Meninger, Vincent; Lamouroux, Catherine; Similowski, Thomas; Gonzalez-Bermejo, Jesus

    2011-01-01

    Cough can be impaired in ALS. This can result in peak cough flows (PCFs) too low for an adequate airway clearance (<270 l/mn). There are several cough assistance techniques that aim at a better elimination of airway secretions, but which are effective, especially in bulbar patients, is not known. We designed the present investigation to compare the PCFs produced by a range of manual and mechanical techniques in patients with ALS, in non-bulbar but also in bulbar patients. In the whole study population, PCFs ranged from 84 (35-118) l/mn for the spontaneous cough manoeuvre to 488 (243-605) l/min for the in/exsufflator (p = 0.0005). In the bulbar group, these values were 42 (35-130) l/min versus 436 (244-630) l/min, respectively (p = 0.008), and 89 (40-106) l/min versus 491 (192-580) l/min, respectively, in the non-bulbar group (p = 0.019). There was no statistically significant difference between the bulbar and the non-bulbar groups. The in/exsufflator was not always the best tool. We conclude that capacity of coughing efforts to produce efficient peak cough flows can be dramatically improved with different tools, even in patients with very severe bulbar symptoms and that it appears useful to test an array of techniques to optimally tailor cough improvement techniques to individual patients.

  15. 儿童慢性咳嗽111例病因分析%Causes of chronic cough in children:an analysis of 111 cases

    Institute of Scientific and Technical Information of China (English)

    张晓波; 农光民

    2011-01-01

    Objective To investigate the causes of chronic cough in children.Methods A prospective cohort study was performed on 111 children with chronic cough who were referred to the First Affiliated Hospital of Guangxi Medical University between December 2008 and January 2010.The causes of chronic cough were investigted.Results Cough variant asthma (45 cases, 40.5% ) was the most common cause of chronic cough, followed by upper airway cough syndrome (34 cases, 30.6% ), postinfectious cough (19 cases, 17.1% ), allergic cough (5 cases, 4.5% ), Tourette's syndrome (4 cases, 3.6% ), psychogenic cough ( 1 case, 0.9% ) and endobronchial tuberculosis ( 1 case, 0.9% ).The causes were not identified in 2 cases ( 1.8% ).A single cause for chronic cough was noted in 60 patients (54.1% ), and multiple potential causes were noted in 49 patients (44.1% ), including two coexisting causes in 47 patients (42.3%) and three in 2 patients ( 1.8% ).Conclusions The top three causes of chronic cough in children are cough variant asthma, upper airway cough syndrome and postinfectious cough.%目的 探讨儿童慢性咳嗽的病因,为其诊断和治疗提供依据.方法 选择2008年12月至2010年1月广西医科大学第一附属医院儿科的慢性咳嗽患儿111例,对该组患儿进行前瞻性临床研究以获得其病因.结果 儿童慢性咳嗽的病因为:咳嗽变异性哮喘45例(40.5%),上气道咳嗽综合征34例(30.6%),感染后咳嗽19例(17.1%),过敏性咳嗽5例(4.5%).多发性抽动4例(3.6%),心因性咳嗽1例(0.9%),支气管内膜结核1例(O.9%),因为不明2例(1.8%).60例(54.1%)慢性咳嗽为单个病因所致,47例(42.3%)有2种病因,2例(1.8%)有3种病因.结论 本组儿童慢性咳嗽的前3位病因依次为咳嗽变异性哮喘、上气道咳嗽综合征、感染后咳嗽.

  16. 儿童慢性咳嗽病因诊断程序应用研究%Evaluation of the diagnostic procedure for chronic cough in children

    Institute of Scientific and Technical Information of China (English)

    张晓波; 农光民

    2011-01-01

    Objective To explore and evaluate the diagnostic procedure for chronic cough in children.Methods One hundred and eleven patients from the First Affiliated Hospital of Guangxi Medical University with chronic cough between December 2008 and January 2010 were included in the study. Etiologic diagnostic procedure suggested for children by Pediatric Branch of Chinese Medical Association was implemented to manage the patients,and the etiological data were analyzed. Results The causes of chronic cough were identified in 109 cases (98% of the total cases). A single cause of cough was diagnosed in 60 patients (54%), multiple potential causes of cough were recognized in 49 patients (44%), including two coexisting causes in 47 patients (42%) and three in 2 patients (2%).The causes of chronic cough in children were: 45 (40%) with cough variant asthma, 34 (30%) with upper airway cough syndrome, 19 (17%) with postinfection cough, 5 (5%) with allergic cough, 4 (4%) with Tourette's syndrome, 1 (1%) with psychogenic cough and others 3 (3%). Conclusions Etiologic diagnosis of chronic cough in children could be made by integrating the current diagnostic procedures with individual and dynamic evaluation and individual treatment. Improvement of clinical symptom was a main observation point; diagnosis should be revised timely if new diagnostic clues appear. It is important to pay attention to the possibility of coexistence of multiple causes. The diagnostic procedures coult identify and suggest most causes of chronic cough in children.%目的 探讨儿童慢性咳嗽病因诊断程序的应用和评价.方法 选择2008年12月至2010年1月广西医科大学第一附属医院儿科就诊的慢性咳嗽患儿111例,参考中华医学会儿科学分会,儿童慢性咳嗽指南中的病因诊断程序,对病例进行评估并获得其病因.结果 明确及基本明确诊断109例(98%),原因不明2例(2%).单病因60例(54%),2个病因47例(42%),3个病因2例(2

  17. Proton pump inhibitor treatment of patients with gastroesophageal reflux-related chronic cough: A comparison between two different daily doses of lansoprazole

    Institute of Scientific and Technical Information of China (English)

    Fabio Baldi; Roberta Cappiello; Carlotta Cavoli; Stefania Ghersi; Francesco Torresan; Enrico Roda

    2006-01-01

    AIM: To compare two different daily doses of lansoprazole given for 12 weeks and to assess the role of gastrointestinal (GI) investigations as criteria for selecting patients.METHODS: Out of 45 patients referred for unexplained chronic persistent cough, 36 had at least one of the GI investigations (endoscopy, 24-h esophageal pHmetry and a 4-week trial of proton pump inhibitor (PPI)therapy) positive and were randomly assigned to receive either 30 mg lansoprazole o.d. or 30 mg lansoprazole b.i.d. for 12 weeks. Symptoms were evaluated at baseline (visit 1) after the PPI test (visit 2) and after the 12-week lansoprazole treatment period (visit 3).RESULTS: Thirty-five patients completed the study protocol. Twenty-one patients (60.0%) reported complete relief from their cough with no difference between the two treatment groups (58.8% and 61.1%had no cough in 30 mg lansoprazole and 60 mg lansoprazole groups, respectively). More than 80% of the patients who had complete relief from their cough at the end of the treatment showed a positive response to the PPI test.CONCLUSION: Twelve weeks of lansoprazole treatment even at a standard daily dose, is effective in patients with chronic persistent cough. A positive response to an initial PPI test seems to be the best criterion for selecting patients who respond to therapy.

  18. Living near a Major Road in Beijing: Association with Lower Lung Function, Airway Acidification, and Chronic Cough

    Science.gov (United States)

    Hu, Zhan-Wei; Zhao, Yan-Ni; Cheng, Yuan; Guo, Cui-Yan; Wang, Xi; Li, Nan; Liu, Jun-Qing; Kang, Hui; Xia, Guo-Guang; Hu, Ping; Zhang, Ping-Ji; Ma, Jing; Liu, Ying; Zhang, Cheng; Su, Li; Wang, Guang-Fa

    2016-01-01

    Background: The effects of near-road pollution on lung function in China have not been well studied. We aimed to investigate the effects of long-term exposure to traffic-related air pollution on lung function, airway inflammation, and respiratory symptoms. Methods: We enrolled 1003 residents aged 57.96 ± 8.99 years living in the Shichahai Community in Beijing. Distances between home addresses and the nearest major roads were measured to calculate home-road distance. We used the distance categories 1, 2, and 3, representing 200 m, respectively, as the dose indicator for traffic-related air pollution exposure. Lung function, exhaled breath condensate (EBC) pH, and interleukin 6 levels were measured. As a follow-up, 398 participants had a second lung function assessment about 3 years later, and lung function decline was also examined as an outcome. We used regression analysis to assess the impacts of home-road distance on lung function and respiratory symptoms. As the EBC biomarker data were not normally distributed, we performed correlation analysis between home-road distance categories and EBC biomarkers. Results: Participants living a shorter distance from major roads had lower percentage of predicted value of forced expiratory volume in 1 s (FEV1% −1.54, 95% confidence interval [CI]: −0.20 to −2.89). The odds ratio for chronic cough was 2.54 (95% CI: 1.57–4.10) for category 1 and 1.97 (95% CI: 1.16–3.37) for category 2, compared with category 3. EBC pH was positively correlated with road distance (rank correlation coefficient of Spearman [rs] = 0.176, P air pollution in people who live near major roads in Beijing is associated with lower lung function, airway acidification, and a higher prevalence of chronic cough. EBC pH is a potential useful biomarker for evaluating air pollution exposure. PMID:27625090

  19. Cough in obstructive sleep apnoea.

    Science.gov (United States)

    Chan, Kevin; Ing, Alvin; Birring, Surinder S

    2015-12-01

    Obstructive Sleep Apnoea (OSA) has recently been reported to be a cause of chronic cough. It should be considered when cough remains unexplained following investigations and treatments for common causes. The presence of nocturnal cough, snoring and gastro-oesophageal reflux may be helpful in identifying patients who require further investigation. Daytime somnolence is often absent. Continuous positive airway pressure (CPAP) therapy has been reported to be effective in alleviating cough. Therapy for gastro-oesophageal reflux disease, if present, should be optimised. The mechanism of the association between OSA and cough is not clear, but airway inflammation, gastro-oesophageal reflux disease, increased cough reflex sensitivity and tracheobronchomalacia are possible explanations. Further studies should identify clinical predictors of OSA-cough, establish mechanisms and the optimal therapy.

  20. Overview the Treatment of Chronic Cough by Point Application%穴位敷贴治疗慢性咳喘概述

    Institute of Scientific and Technical Information of China (English)

    曹翼; 郭美珠; 杨志新; 吴清; 杨军

    2014-01-01

    Objective to investigate the treatment of chronic cough by Acupoint Application methods and mechanisms. Method:the literature on chronic cough by Acupoint Application have been reviewed. Results: Acupoint Application has fixed point、fixed drugs、dialectical acupoints and dialectical therapy etc.; Acupoint Application has usual y been in the dog days of summer . Acupoint Application cough can adjust the immune function and improve lung function and improve clinical symptoms and signs and improve quality of life. Acupoint Application is an excellent method of cough treatment. Conclusion:The results suggested that the research on the mechanism of chronic cough by Acupoint Application needs to be further strengthened.%目的:探讨穴位敷贴治疗慢性咳喘的方法和机制。方法通过检索近年来的有关文献资料,进行归纳和分析。结果穴位敷贴治疗咳喘有固定穴位、固定药物;辨证取穴、辩证用药等;多于夏季三九天敷贴。穴位敷贴治疗咳喘能够调整机体免疫功能;改善肺功能;改善临床症状和体征;提高生活质量。穴位敷贴治疗咳喘是一种优质的治疗方法。结论穴位敷贴治疗慢性咳喘的机理研究方面有待进一步加强。

  1. Living near a Major Road in Beijing: Association with Lower Lung Function, Airway Acidification, and Chronic Cough

    Institute of Scientific and Technical Information of China (English)

    Zhan-Wei Hu; Yan-Ni Zhao; Yuan Cheng; Cui-Yan Guo; Xi Wang; Nan Li; Jun-Qing Liu

    2016-01-01

    Background:The effects of near-road pollution on lung function in China have not been well studied.We aimed to investigate the effects of long-term exposure to traffic-related air pollution on lung function,airway inflammation,and respiratory symptoms.Methods:We enrolled 1003 residents aged 57.96 ± 8.99 years living in the Shichahai Community in Beijing.Distances between home addresses and the nearest major roads were measured to calculate home-road distance.We used the distance categories 1,2,and 3,representing <100 m,100-200 m,and >200 m,respectively,as the dose indicator for traffic-related air pollution exposure.Lung function,exhaled breath condensate (EBC) pH,and interleukin 6 levels were measured.As a follow-up,398 participants had a second lung function assessment about 3 years later,and lung function decline was also examined as an outcome.We used regression analysis to assess the impacts of home-road distance on lung function and respiratory symptoms.As the EBC biomarker data were not normally distributed,we performed correlation analysis between home-road distance categories and EBC biomarkers.Results:Participants living a shorter distance from major roads had lower percentage of predicted value of forced expiratory volume in 1 s (FEV1%-1.54,95% confidence interval [CI]:-0.20 to-2.89).The odds ratio for chronic cough was 2.54 (95% CI.:1.57-4.10) for category 1 and 1.97 (95% CI.:1.16-3.37) for category 2,compared with category 3.EBC pH was positively correlated with road distance (rank correlation coefficient of Spearman [rs] =0.176,P < 0.001).Conclusions:Long-term exposure to traffic-related air pollution in people who live near major roads in Beijing is associated with lower lung function,airway acidification,and a higher prevalence of chronic cough.EBC pH is a potential useful biomarker for evaluating air pollution exposure.

  2. 环境因素对儿童慢性咳嗽的影响%Influence of environmental factors on chronic cough in children

    Institute of Scientific and Technical Information of China (English)

    黄圣荣

    2012-01-01

    [Objective]To analyze the environmental factors that might affect chronic cough in children, especially those living environment for the etiology of chronic cough in children and to provide intervention clues. [Methods] October 2006 ~ April 2011,3 ~14 years children diagrosed chronic cough (observer group 102 cases, control group of 143 cases), basic materials included respiratory infections family tobacco exposure,an allergy per capita dwelling space,indoor decoration and indoor pets,planting flowers were collected to analyze. [Results] After the intervention,children cough frequency changes had taken place,observer group decreased significantly,with were differences obvious of two group (x2 = 13. 05,P <0. 01). Logistic regression analysis showed:respiratory infection family of tobacco exposure,indoor decoration too,indoor pets as the major factors influencing chronic cough in children. [Conclusion] For children with chronic cough, we should increase the prevention of respiratory tract infection,avoid indoor tobacco exposure,control room excessive decoration and indoor pets sparingly.%[目的]对可能影响儿童慢性咳嗽的环境因素,特别是生活环境进行分析,为儿童慢性咳嗽的病因学研究和干预提供线索. [方法]对2006年10月-2011年4月符合慢性咳嗽诊断标准的3~14岁的儿童,观察组102例,对照组143例的基础资料包括呼吸道感染,家庭烟草暴露,过敏史,人均居住面积,室内装潢及室内养宠物,养植花草等因素进行分析. [结果]采取干预措施后,两组儿童咳嗽的频率都发生了变化,观察组明显下降,两组具有明显的差异性(x2=13.05,P<0.01).Logistic回归分析显示:家庭烟草暴露,呼吸道感染,居室装潢过度,室内养宠物为影响儿童慢性咳嗽的主要因素. [结论]对慢性咳嗽的儿童,应加大呼吸道感染的预防,避免室内烟草暴露,控制居室装潢过度,室内尽量少养宠物.

  3. 临床特征对儿童慢性咳嗽常见病因诊断的价值%Diagnostic values of clinical features for common causes of chronic cough in children

    Institute of Scientific and Technical Information of China (English)

    邬宇芬; 张海邻; 余刚; 李昌崇

    2012-01-01

    目的 对慢性咳嗽常见病因的临床特征进行研究,分析其对各病因诊断的价值.方法 选取2008年1月 - 2009年12月门诊就诊的慢性咳嗽初诊患儿496例,按慢性咳嗽诊断程序作出慢性咳嗽初步诊断并按时随访,根据随访患儿治疗效果得出最终诊断.结果 496例患儿中感染后咳嗽(PIC)69例,咳嗽变异性哮喘(CVA)和变应性咳嗽(AC)219例,上气道咳嗽综合征(UACS)139例.CVA的临床特征主要为夜间咳嗽、干性咳嗽、特应性体质;UACS的临床特征主要为湿痰咳嗽、晨起咳嗽.结论 儿童慢性咳嗽主要病因为CVA、UACS、AC和PIC.各种病因的慢性咳嗽具有其主要的临床特征,其病因构成及临床特征可为经验性诊治慢性咳嗽提供参考.%Objective To research the clinical features of the common cause of chronic cough in children and investigate the value of them in diagnosis. Methods From January 2008 to December 2009, 496 children were primarily diagnosed as chronic cough according to the diagnostic procedure of chronic cough. The final diagnosis was confirmed based on the follow-up treatment. Results Among the 496 children, cough post infections (PIC) was 69 cases, cough variant asthma (CVA) and atopic cough (AC) were 219 cases, and upper airway cough syndrome (UACS) was 139 cases. The main clinical features of CVA included night time cough, dry cough and atopy. The main clinical features of UACS were wet cough and early morning cough. Conclusions The main causes of chronic cough in children were CVA, UACS, AC and PIC. The causes of chronic cough and the clinical feature can provide references for the empirical diagnosis and treatment of chronic cough.

  4. Incidence and factors predicting whooping cough due to parapertussis diagnosis among patients referred to general practitioners, Poland, 2009-2011.

    Science.gov (United States)

    Tomialoic, R; Stefanoff, P; Paradowska-Stankiewicz, I; Zasada, A; Sadkowska-Todys, M

    2015-01-01

    Parapertussis leads to similar symptoms as pertussis, both being caused by bacteria from the genus Bordetella. Poland does not routinely diagnose nor conduct surveillance for parapertussis. We estimated parapertussis incidence and determined predictors of parapertussis diagnosis in the Polish population. Between July 2009 and April 2011, we conducted a prospective cohort study among patients attending 78 general practices. We included patients aged ≥ 3 years, with cough lasting >2 weeks, interviewed patients and collected a nasopharyngeal swab. We confirmed cases by real-time PCR. We estimated parapertussis incidence rates by dividing the number of cases by the summed person-time of observation in respective practices. We assessed predictors of PCR-confirmed parapertussis by comparing cases with patients testing negative. Using logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (95%CI). We identified 78 cases among 1,231 patients meeting inclusion criteria. The incidence rate was 39/100,000 person-years (95%CI 31-49). The highest rates (140/100,000; 95%CI 74-239), were among children 3-5 years of age and the lowest (24/100,000; 95%CI 13-40) among persons aged 20-39 years of age. Boys aged 3-5 years (7.1; 2.1-25.3) and women aged >40 years (4.1; 1.4-11.7) or living in crowded households (4.3; 1.4-12.9) or contacting persons with prolonged cough (2.3; 1.1-4.5) were more likely to be diagnosed. Our results suggest that laboratory diagnosis could be prioritized for children in the preschool age and women aged over 40 who were referred to their GP with prolonged cough. In the absence of vaccine, post-exposure prophylaxis for close contacts of parapertussis cases could an adequate preventative measure.

  5. Mechanical Stimulation by Postnasal Drip Evokes Cough.

    Science.gov (United States)

    Iwata, Toshiyuki; Ito, Isao; Niimi, Akio; Ikegami, Koji; Marumo, Satoshi; Tanabe, Naoya; Nakaji, Hitoshi; Kanemitsu, Yoshihiro; Matsumoto, Hisako; Kamei, Junzo; Setou, Mitsutoshi; Mishima, Michiaki

    2015-01-01

    Cough affects all individuals at different times, and its economic burden is substantial. Despite these widespread adverse effects, cough research relies on animal models, which hampers our understanding of the fundamental cause of cough. Postnasal drip is speculated to be one of the most frequent causes of chronic cough; however, this is a matter of debate. Here we show that mechanical stimuli by postnasal drip cause chronic cough. We distinguished human cough from sneezes and expiration reflexes by airflow patterns. Cough and sneeze exhibited one-peak and two-peak patterns, respectively, in expiratory airflow, which were also confirmed by animal models of cough and sneeze. Transgenic mice with ciliary dyskinesia coughed substantially and showed postnasal drip in the pharynx; furthermore, their cough was completely inhibited by nasal airway blockade of postnasal drip. We successfully reproduced cough observed in these mice by injecting artificial postnasal drip in wild-type mice. These results demonstrated that mechanical stimulation by postnasal drip evoked cough. The findings of our study can therefore be used to develop new antitussive drugs that prevent the root cause of cough.

  6. Mechanical Stimulation by Postnasal Drip Evokes Cough.

    Directory of Open Access Journals (Sweden)

    Toshiyuki Iwata

    Full Text Available Cough affects all individuals at different times, and its economic burden is substantial. Despite these widespread adverse effects, cough research relies on animal models, which hampers our understanding of the fundamental cause of cough. Postnasal drip is speculated to be one of the most frequent causes of chronic cough; however, this is a matter of debate. Here we show that mechanical stimuli by postnasal drip cause chronic cough. We distinguished human cough from sneezes and expiration reflexes by airflow patterns. Cough and sneeze exhibited one-peak and two-peak patterns, respectively, in expiratory airflow, which were also confirmed by animal models of cough and sneeze. Transgenic mice with ciliary dyskinesia coughed substantially and showed postnasal drip in the pharynx; furthermore, their cough was completely inhibited by nasal airway blockade of postnasal drip. We successfully reproduced cough observed in these mice by injecting artificial postnasal drip in wild-type mice. These results demonstrated that mechanical stimulation by postnasal drip evoked cough. The findings of our study can therefore be used to develop new antitussive drugs that prevent the root cause of cough.

  7. Acupuncture Treatment of Cough

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Case History Ms. Wang, 51 years old, a research fellow of a certain academy, paid her first visit on March 10, 2004, with the chief complaint of coughing for two weeks. She had had the problem for 10 years, usually with onset in autumn and winter times. She was once diagnosed to have 'chronic bronchitis', and had been treated with long-term administration of both Chinese and western medicines at several hospitals. The recent onset was induced by sudden change of the cold weather. At the moment, the patient had coughing with expectoration of profuse white watery sputum, chest distress, with coughing worse in the night, which seriously affected her sleep, dry mouth, aversion to cold, the appetite normal, loose stool 2~3 times a day, and the urine normal.

  8. 慢性咳嗽与阻塞性睡眠呼吸暂停低通气综合征相关性研究进展%Association between chronic cough and obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    姚莎莎; 王蓓

    2015-01-01

    The chronic cough is like that cough is the only or main symptom,the duration of cough is more than 8 weeks,and there is no smoking and normal chest radiographs.The chronic cough has an influence on work,life and social activities of patients.The most common causes of chronic cough consist of cough variant asthma,gastro-oesophageal reflux,upper airway cough syndrome and eosinophilic bronchitis,etc.Recent reports indicate an association between unexplained chronic cough and obstructive sleep apnea hypopnea syndrome (OSAHS) and can be effectively treated by continuous positive airway pressure therapy.This article makes a summary of correlation and treatment progress between OSAHS and chronic cough.%慢性咳嗽是以咳嗽为唯一或主要症状,咳嗽持续时间超过8周、无吸烟史且肺部影像学检查无异常的咳嗽.慢性咳嗽对患者的工作、生活和社会活动均造成严重的影响.常见的病因包括:咳嗽变异性哮喘、上气道咳嗽综合征、嗜酸粒细胞性支气管炎、胃食管反流疾病等.近年来多项研究提示OSAHS与慢性咳嗽之间存在一定的相关性,经过无创呼吸机治疗OSAHS可明显改善慢性咳嗽的症状.本文就OSAHS与慢性咳嗽的相关性及治疗进展作一综述.

  9. Diphtheria, pertussis (whooping cough, and tetanus vaccine induced recurrent seizures and acute encephalopathy in a pediatric patient: Possibly due to pertussis fraction

    Directory of Open Access Journals (Sweden)

    Mahendra K Patel

    2012-01-01

    Full Text Available A 5-month-old male patient developed recurrent seizures and acute encephalopathy possibly due to first dose of diphtheria, pertussis (whooping cough, and tetanus (DPT vaccine used for routine immunization. Postreaction computed tomography (CT scan of brain, magnetic resonance imaging (MRI of brain, and electroencephalogram were normal. Pertussis fraction of DPT vaccine is responsible for this reaction. It is suggested that acellular pertussis vaccine should be used instead of whole cell vaccine because it is associated with lower frequency of neurological complications, such as seizures, encephalopathy, and hypotensive episodes. However, acellular pertussis-containing vaccines are currently not affordable in most developing countries.

  10. Extraperitoneal Fluid Collection due to Chronic Pancreatitis.

    Science.gov (United States)

    Yasuda, Takeo; Kamei, Keiko; Araki, Mariko; Nakata, Yasuyuki; Ishikawa, Hajime; Yamazaki, Mitsuo; Sakamoto, Hiroki; Kitano, Masayuki; Nakai, Takuya; Takeyama, Yoshifumi

    2013-01-01

    A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy) was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl) was found to exist in the extraperitoneal space (over the peritoneum), but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.

  11. Extraperitoneal Fluid Collection due to Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    Takeo Yasuda

    2013-08-01

    Full Text Available A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl was found to exist in the extraperitoneal space (over the peritoneum, but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.

  12. 5岁及以下儿童非特异性慢性咳嗽的病因分析%The etiology analysis of nonspecific chronic cough in children 5 or under 5 years old

    Institute of Scientific and Technical Information of China (English)

    陈信; 彭万胜; 瞿色华; 张阵; 武玉猛; 赵武

    2016-01-01

    目的::分析5岁及以下儿童非特异性慢性咳嗽的病因,以提高儿科医生对年幼儿童非特异性慢性咳嗽的病因诊断及治疗水平。方法:回顾性分析85例5岁及以下儿童非特异性慢性咳嗽的临床资料。结果:85例非特异性慢性咳嗽患儿病因分布如下:咳嗽变异性哮喘27例(31.8%),上气道咳嗽综合征32例(37.6%),感染后咳嗽16例(18.8%),胃食管反流性咳嗽3例(3.5%),过敏性咳嗽2例(2.4%),病因不明5例(5.9%)。结论:5岁及以下儿童非特异性慢性咳嗽的主要病因构成比依次为上气道咳嗽综合征、咳嗽变异性哮喘、感染后咳嗽及其他病因。%Objective:To explore the causes of nonspecific chronic cough in children 5 or under 5 years old for improving its diagnosis and treatment. Methods:The clinical data of 85 children 5 or under 5 years old with nonspecific chronic cough were retrospectively analyzed. Results:The etiologic distribution of the 85 children with nonspecific chronic cough included 27 cases of cough variant asthma (31. 8%),32 cases of upper airway cough syndrome(37. 6%),16 cases of post-infection cough(18. 8%),3 cases of gastroesophageal reflux cough(3. 5%),2 cases of atopic cough(2. 4%) and 5 cases of unknown etiology(5. 9%). Conclusions:The main causes of nonspecific chronic cough in children 5 or under 5 years old are the upper airway cough syndrome,cough variant asthma,post-infection cough and other causes in turn.

  13. Cough reflex sensitization from esophagus and nose.

    Science.gov (United States)

    Hennel, Michal; Brozmanova, Mariana; Kollarik, Marian

    2015-12-01

    The diseases of the esophagus and nose are among the major factors contributing to chronic cough although their role in different patient populations is debated. Studies in animal models and in humans show that afferent C-fiber activators applied on esophageal or nasal mucosa do not initiate cough, but enhance cough induced by inhaled irritants. These results are consistent with the hypothesis that activation of esophageal and nasal C-fibers contribute to cough reflex hypersensitivity observed in chronic cough patients with gastroesophageal reflux disease (GERD) and chronic rhinitis, respectively. The afferent nerves mediating cough sensitization from the esophagus are probably the neural crest-derived vagal jugular C-fibers. In addition to their responsiveness to high concentration of acid typical for gastroesophageal reflux (pH cough sensitization are less understood. Increased cough reflex sensitivity was also reported in many patients with GERD or rhinitis who do not complain of cough indicating that additional endogenous or exogenous factors may be required to develop chronic coughing in these diseases.

  14. An update on measurement and monitoring of cough: what are the important study endpoints?

    OpenAIRE

    Spinou, Arietta; Birring, Surinder S.

    2014-01-01

    Considerable progress has been achieved in the development of tools that assess cough. The visual analogue scale (VAS) for cough severity is widely used in clinical practice because it’s simple and practical. The Leicester cough questionnaire (LCQ) and the cough-specific quality of life questionnaire (CQLQ) are the most widely used health status questionnaires for adults with chronic cough. They are well validated for assessing the impact of cough. Cough can be assessed objectively with chall...

  15. 青岛市亚急性、慢性咳嗽中咳嗽变异性哮喘的发病率及相关因素分析%Incidence of cough variant asthma and the correlative factors in sub-acute/chronic cough

    Institute of Scientific and Technical Information of China (English)

    陈建攸; 唐华平; 李猛; 郝万明; 郝月琴

    2015-01-01

    Objective To investigate the incidence of cough variant asthma (CVA) in sub-acute and chron-ic cough in Qingdao, and to analyze the correlative factors. Methods 504 patients with sub-acute/ chronic cough and normal chest X-ray were enrolled. The medical history, physical and laboratory examination and diagnosis of all the patients were retrospectively analyzed. Results The most common reason was cough variant asthma both in sub-acute and chronic cough. Cough variant asthma was related with allergic rhinitis, family history of asthma, personal allergic history and animals (P < 0. 05). There was no significant difference in sexuality. The male morbidity was higher at the age of 13 to 30, and the female morbidity at the age of 40 to 60. Conclusion Cough variant asthma is the most common reason for sub-acute cough and chronic cough. Clinician should improve their understanding of CVA to make a early diagnosis and specified treatment.%目的:调查青岛市亚急性、慢性咳嗽中咳嗽变异性哮喘(CVA)的发病率及相关因素,对其进行分析。方法选取2013年7月至2014年6月期间诊断亚急性及慢性咳嗽,胸片无异常的患者504例作为研究对象,回顾性分析所有研究对象的病史、检查及诊断结果,分析 CVA 的发病率及发病相关因素。结果青岛市亚急性、慢性咳嗽最常见原因均为 CVA,CVA 与过敏性鼻炎、哮喘家族史、个人过敏史、宠物相关(P <0.05),CVA 患者中男女发病率差异无统计学差异,男性 CVA 患者中13-30岁患病率较高,女性 CVA 患者中46-60岁患病率较高。结论 CVA 是青岛市亚急性、慢性咳嗽最常见原因,临床医师应加强对本病的认识,早期诊断,规范治疗。

  16. 自拟咳嗽方治疗急慢性支气管炎200例疗效观察%The effect of self cough decoction in the treatment of acute,chronic bronchitis in 200 cases

    Institute of Scientific and Technical Information of China (English)

    鲜晓燕; 张鲁燕

    2014-01-01

    Objective:To observe the curative effect of self cough decoction add and subtract in the treatment of acute and chronic bronchitis.Methods:200 cases of patients with acute and chronic bronchitis were used self cough decoction add and subtract treatment.Results:The total effective rate was 100%.Conclusion:The curative effect of self cough decoction in the treatment of acute and chronic bronchitis is satisfactory.%目的:观察自拟止咳方加减治疗急慢性支气管炎的疗效。方法:对200例急慢性支气管炎患者采用自拟止咳方加减治疗。结果:总有效率100%。结论:自拟止咳方治疗急慢性支气管炎疗效满意。

  17. Etiological analysis of the children with non-specific chronic cough in Fuzhou area of Fujian province%福建省福州地区儿童慢性咳嗽病因分析

    Institute of Scientific and Technical Information of China (English)

    唐素萍; 刘艳琳; 董李; 华云汉; 郭依华; 陆权

    2011-01-01

    目的 探讨福建省福州地区儿童慢性咳嗽的病因.方法 根据中华医学会儿科学分会呼吸学组与编辑委员会2008年制定的的标准,对福建省福州儿童医院哮喘专科门诊诊断的364例慢性咳嗽患儿,按照指南的诊断流程询问病史,进行体检、辅助检查,初步确定病因后,并针对病因进行特异性治疗,分别在初诊后半个月、1个月、3个月对患儿进行随访,根据辅助检查及疗效判定病因诊断,进而分析病因构成比.结果 364例慢性咳嗽患儿病因依次为:咳嗽变异性哮喘171例(47.0%),上气道咳嗽综合征104例(28.6%),呼吸道感染和感染后咳嗽58例(15.9%),胃食管反流17例(4.7%),支气管异物3例(0.8%);引起慢性咳嗽只有单一病因的299例(82.1%),同时有2种病因的56例(15.4%),同时有3种病因的9例(2.5%).结论 福建省福州地区儿童慢性咳嗽的病因依次为咳嗽变异性哮喘、上气道咳嗽综合征、呼吸道感染和感染后咳嗽、胃食管反流、支气管异物;不同年龄组儿童慢性咳嗽病因构成比不同;部分患儿合并有2或3种病因,表明儿童慢性咳嗽病因呈多因素.%Objective Chronic cough in children is a common pediatric symptom with complex causes and its diagnosis is difficult; chronic cough affects the life of children in both physical and mental health and also learning. Therefore this study aimed to investigate the causes of chronic cough in children in Fuzhou area of Fujian province. Method Data were collected from 364 children with chronic cough who visited the asthma specialist clinic of Children's Hospital of Fuzhou, Fujian Province from March 2009 to April 2010. The diagnosis was made according to Guideline for Diagnosis and Treatment of Chronic Cough in Pediatrics published in 2008. Among the patients, 241 were boys and 123 girls. The patients were divided into 3 age groups: group 1, 1 to 3 years old ( infants and young children group, n =75); group 2, 4 to 6years

  18. Cough in the elderly population: relationships with multiple comorbidity.

    Directory of Open Access Journals (Sweden)

    Woo-Jung Song

    Full Text Available BACKGROUND: The epidemiology of cough in the elderly population has not been studied comprehensively. The present study aimed to investigate the epidemiology of cough in a community elderly population, particularly in relation with their comorbidity. METHODS: A cross-sectional analysis was performed using a baseline dataset from the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort study. Three types of cough (frequent cough, chronic persistent cough, and nocturnal cough were defined using questionnaires. Comorbidity was examined using a structured questionnaire. Health-related quality of life was assessed using the Short Form 36 questionnaire. RESULTS: The prevalence was 9.3% for frequent cough, 4.6% for chronic persistent cough, and 7.3% for nocturnal cough. In multivariate logistic regression analyses, smoking, asthma and allergic rhinitis were found to be risk factors for cough in the elderly. Interestingly, among comorbidities, constipation and uncontrolled diabetes mellitus (HbA1c ≥ 8% were also found to have positive associations with elderly cough. In the Short Form 36 scores, chronic persistent cough was independently related to impairment of quality of life, predominantly in the mental component. CONCLUSIONS: Cough has a high prevalence and is detrimental to quality of life in the elderly. Associations with smoking, asthma and rhinitis confirmed previous findings in younger populations. Previously unrecognised relationships with constipation and uncontrolled diabetes mellitus suggested the multi-faceted nature of cough in the elderly.

  19. Efficacy of levodropropizine in pediatric cough.

    Science.gov (United States)

    De Blasio, Francesco; Dicpinigaitis, Peter V; De Danieli, Gianluca; Lanata, Luigi; Zanasi, Alessando

    2012-10-01

    Cough in children is among the most common problems managed by pediatricians, and occurs more frequently in preschool than in older children. Most acute episodes of cough are due to viral upper respiratory tract infections. The morbidity associated with acute cough in a child extends also to parents, teachers, and other family members and caregivers. Unfortunately, therapeutic options for acute cough in children are severely limited due to the absence of drugs shown to be effective antitussives with an acceptable safety profile. Agents used in the management of adult cough, such as narcotics (codeine, hydrocodone), the non-narcotic opioid dextromethorphan, first-generation, potentially sedating antihistamines, and decongestants such as pseudoephedrine, have all been deemed inadequate for treatment of acute pediatric cough on a risk/benefit basis. A growing body of evidence suggests that the peripherally acting antitussive, levodropropizine, may be an attractive alternative for the treatment of bothersome acute cough in children.

  20. Woes of Whooping Cough

    Science.gov (United States)

    ... in the Operating Room? The Woes of Whooping Cough KidsHealth > For Kids > The Woes of Whooping Cough ... hospital if they get it. How Is Whooping Cough Spread? Pertussis bacteria can live in saliva in ...

  1. Pertussis (Whooping Cough)

    Science.gov (United States)

    ... articles... Pregnant? Help Protect Your Baby from Whooping Cough frame support disabled and/or not supported in ... disease. Also available on YouTube. Pregnancy and Whooping Cough Learn more about whooping cough vaccination during pregnancy... ...

  2. Cough & Cold Medicine Abuse

    Science.gov (United States)

    ... A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold Medicine Abuse ... DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  3. Chronic pneumonia due to Klebsiella oxytoca mimicking pulmonary tuberculosis.

    Science.gov (United States)

    Gera, Kamal; Roshan, Rahul; Varma-Basil, Mandira; Shah, Ashok

    2015-01-01

    Klebsiella species infrequently cause acute community acquired pneumonia (CAP). The chronic form of the disease caused by K. pneumoniae (Friedlander's bacillus) was occasionally seen in the pre-antibiotic era. K. oxytoca is a singularly uncommon cause of CAP. The chronic form of the disease caused by K. oxytoca has been documented only once before. A 50-year-old immunocompetent male smoker presented with haemoptysis for 12 months. Imaging demonstrated a cavitary lesion in the right upper lobe with emphysematous changes. Sputum stains and cultures for Mycobacterium tuberculosis were negative. However, three sputum samples for aerobic culture as well as bronchial aspirate cultured pure growth of K. oxytoca. A diagnosis of chronic pneumonia due to K. oxytoca was established and with appropriate therapy, the patient was largely asymptomatic. The remarkable clinical and radiological similarity to pulmonary tuberculosis can result in patients with chronic Klebsiella pneumonia erroneously receiving anti-tuberculous therapy.

  4. Cough in interstitial lung disease.

    Science.gov (United States)

    Garner, Justin; George, Peter M; Renzoni, Elisabetta

    2015-12-01

    Cough in the context of interstitial lung disease (ILD) has not been the focus of many studies. However, chronic cough has a major impact on quality of life in a significant proportion of patients with ILD. For the purpose of this review, we have chosen to highlight some of the more frequently encountered diffuse lung diseases including idiopathic pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis and systemic sclerosis associated ILD. Many of the underlying mechanisms remain speculative and further research is now required to elucidate the complex pathways involved in the pathogenesis of chronic cough in ILD. This will hopefully pave the way for the identification of new therapeutic agents to alleviate this distressing and often intractable symptom.

  5. Cough suppression therapy: does it work?

    Science.gov (United States)

    Chamberlain, Sarah; Garrod, Rachel; Birring, Surinder S

    2013-10-01

    Cough suppression therapy (CST), also known as cough suppression physiotherapy and speech pathology management is a promising non-pharmacological therapeutic option for patients with refractory chronic cough. CST may consist of education, improving laryngeal hygiene and hydration, cough suppression techniques, breathing exercises and counselling. It is an out-patient therapy delivered in 2-4 sessions. There is evidence to support the efficacy of CST: a randomised controlled trial reported a significant reduction in cough symptoms and other studies have reported improved cough related quality of life, reduced cough reflex hypersensitivity and cough frequency. The mechanism of action of CST is not clear, but it has been shown to reduce cough reflex sensitivity, paradoxical vocal fold movement (PVFM) and extrathoracic hyperresponsiveness. Further research is needed to determine the optimal components of CST, the characteristics of patients in whom it is most effective and to increase the understanding of its mechanisms of action. The effectiveness of CST in other respiratory conditions such as asthma, pulmonary fibrosis, chronic obstructive pulmonary disease and sarcoidosis should also be investigated.

  6. Analysis of pulmonary function of patients with chronic cough%176例慢性咳嗽肺功能检测结果分析

    Institute of Scientific and Technical Information of China (English)

    周燕; 戴吉; 蒋贵平; 胡蝶; 杨厚宇

    2011-01-01

    Objective To study characteristics of pulmonary function of chronic cough.Methods The pulmonary function and airway responsiveness of 176 patients with chronic cough were measured.Results There were 29 patients (14.48 % ) with abnormal pulmonary function and 17 cases (58.62 %) with positive bronchial provocation (dilation) test.There were 46 cases (31.29%) with positive bronchial provocation (dilation) test of 147 patients with normal pulmonary function.63 cases (35.80%) were positive in bronchial provocation (dilation) test.There were 98 cases (66.67%) with mormal pulmonary function with small airway disease, including 41 cases (41.84%) with positive bronchial provocation (dilation) test.There were 49 cases with mormal pulmonary function without small airway disease, including 5 cases (10.20% ) with positive bronchial provocation (dilation) test.Conclusion The decline in ventilatory function in chronic cough is relatively small and the proportion of airway hyperresponsiveness is high.The pulmonary function and airway reactivity should be measured as first-line examination of chronic cough.%目的 探讨肺功能检测在慢性咳嗽诊断的应用价值.方法 对176慢性咳嗽患者行肺通气功能及气道反应性测定,并对测定结果的临床价值进行评定.结果 176例患者肺功能异常者29例(14.48%),其中支气管激发(舒张)试验阳性17例(58.62%);肺功能正常者有147例,支气管激发(舒张)试验阳性46例(31.29%).支气管激发(舒张)试验阳性总例数为63例,阳性率35.80%;肺功能正常且小气道病变者98例(66.67%),其中支气管激发(舒张)试验阳性者41倒(41.84%);肺功能正常无小气道病变患者49例,其中支气管激发(舒张)试验阳性者5例(10.20%),肺功能正常的小气道病变患者支气管激发(舒张)阳性率高于无小气道病变者(P<0.01).结论 慢性咳嗽通气功能下降比例较少,气道高反应性比例较高;肺通气功能及气道反应性测

  7. Fatal Hemoptysis due to Chronic Cavitary Pulmonary Aspergillosis Complicated by Nontuberculous Mycobacterial Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ioannis Kokkonouzis

    2011-01-01

    Full Text Available A 51-year-old man, with a history of severe COPD and bilateral pneumothorax, who was under treatment for pulmonary tuberculosis due to mycobacterium avium, was admitted due to high-grade fever, weight loss, cough, and production of purulent sputum, for almost one month without any special improvement despite adequate antibiotics treatment in outpatient setting. A CT scan revealed multiple consolidations, fibrosis, scaring, and cavitary lesions in both upper lobes with newly shadows which were fungus balls inside them. Aspergillus flavius was isolated in three sputum samples, a diagnosis of chronic cavitary pulmonary aspergillosis was made, and treatment with intravenous amphotericin B was started. An initially clinical improvement was noted, and a first episode of minor hemoptysis was treated with conservative measures. Unfortunately a second major episode of hemoptysis occurred and he died almost immediately. Aspergilloma is defined as the presence of a fungus ball inside a preexisting pulmonary cavity or dilated airway and is one of the clinical conditions associated with the clinical spectrum of pulmonary colonization. Tuberculosis is the most common underling disease. Hemoptysis is the most common symptom. Antifungal antibiotics, surgical interventions, bronchial arteries embolization, and intracavity infusion of antibiotics have been proposed without always adequate sufficiency.

  8. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

    Directory of Open Access Journals (Sweden)

    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  9. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

    Directory of Open Access Journals (Sweden)

    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available   Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  10. A A common symptom in primary health care: The cough

    Directory of Open Access Journals (Sweden)

    Halil Akbulut

    2015-08-01

    Full Text Available Cough is the common symptom consulted by primary health care providers. Although treatment of cough is usually simple, healing period could be longer if it diagnosed wrong. Basicly cough divide into two groups; acute and chronic. While the most common cause of acute cough is upper respiratory tract infections, causes of chronic cough are allergic rihinitis, chronic sinusitis, asthma and gastroeosefageal reflux diseases. Nonetheless cough could be the clinical evidence of highly mortal diseases like pulmonary embolism, tuberculosis and lung cancer. Consequently patients with cough symptom must be evaluated delicately and essential follow up protocol must be planned by primary health care providers. [TAF Prev Med Bull 2015; 14(4.000: 333-337

  11. [Drug therapy for cough].

    Science.gov (United States)

    Koskela, Heikki; Naaranlahti, Toivo

    2016-01-01

    An efficient therapy for cough usually requires identification and treatment of the underlying disease, like asthma. However an underlying disease in cough is not found in all cases and conventional treatment of the underlying disease is ineffective against cough. Drug therapy options are available also for these situations. Honey or menthol can be tried for cough associated with respitatory infections, antihistamines for cough associated with allergic rhinitis, blockers of the leukotriene receptor or muscarinic receptor for asthma-associated cough and morphine for cough associated with a malignant disease. Menthol, blockers of the muscarinic receptor, or dextrometorphan can be tried for prolonged idiopathic cough. Codeine is not necessary in the treatment of cough. Refraining from drug treatment should always be considered.

  12. Clinical analysis of etiological factors of chronic cough in children from Xinjiang area%新疆地区儿童慢性咳嗽病因构成分析

    Institute of Scientific and Technical Information of China (English)

    赵玉立; 徐佩茹; 马志华

    2014-01-01

    Objective To analyze the etiology of chronic cough in Xinjiang children. Methods The clini-cal data of 653 children with chronic cough were retrospectively analyzed, including age, nationality, allergen, family history, environmental factors, pulmonary function and antimicrobial application. Results There were 192 cases of respiratory tract infection and cough after infection (29. 40%), 158 cases of cough-variant asthma (24. 20%), and 140 cases of up-airway cough syndrome ( 21. 44%) . In addition, 163 cases were caused by other reasons (24. 96%), including 84 cases of double etiology (12. 87%) and 5 cases of unknown etiology (0. 77%). The pri-mary causes of chronic cough in different ages and different ethnic groups were different. The main cause of chronic cough of infants (0~6 years old) was infection or cough after infection, and cough variant asthma and upper airway cough syndrome for school-age children (6~14 years old). The main cause of chronic cough for Han and Kazak na-tionality children was post infectious cough, but the course for Uyghur, Hui and Mongol nationality was cough variant asthma. Conclusion The main causes of chronic cough in Xinjiang children etiology are respiratory tract infection and cough after infection, cough variant asthma, and upper airway cough syndrome. The constituent rate of etiology in different ages and nationalities is different. The children are more likely to be diagnosed with cough variant asthma that they have personal history of allergies, family history of allergy or asthma, the exposure history of bad environ-ments and the abnormal of lung function.%目的:分析新疆地区儿童慢性咳嗽的病因特点。方法对收集的653例慢性咳嗽患儿的临床资料进行前瞻性研究,包括主要病因、年龄、民族、过敏原、家族史、环境因素、肺功能情况。结果新疆地区儿童慢性咳嗽病因多为呼吸道感染和感染后咳嗽192例(29.40%)、咳嗽变异性哮喘158例(24.20%)

  13. Diagnostic Value of Clinical Manifestation for Etiology of Chronic Cough in Children%临床资料对儿童慢性咳嗽病因的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张晓波; 农光民

    2011-01-01

    Objective To explore the value of clinical manifestation for etiological diagnosis in children with chronic cough.Methods A prospective cohort study of 117 patients with chronic cough who referred to the First Affiliated Hospital of Guangxi Medical University from Dec.2008 to Jan.2010.The etiological diagnostic procedure adopted in this study was suggested for children by pediatric branch of chinese medical association.The detailed clinical manifestation and etiology of chronic cough were acquired in recruited children.Results The causes of chronic cough in children were cough variant asthma (CVA), upper airway cough syndrome (UACS), postinfectious cough (PIC), allergic cough ( AC ), Tourette's syndrome ( TS), psychogenic cough ( PC ).Dry cough occurred in the morning or evening and increasing cough after exercise suggested CVA ,while UACS had wet cough and nasal symptoms.PIC often had 2 months' duration.PC could have loud dry cough during daytime and TS often with tics.Genders, passive smoking, personal and family history of allergy had no help for etiological diagnosis of chronic cough.Sinusitis, allergic rhinitis and adenoidal hypertrophy were the common reasons of UACS.CVA always had high eosinophil count or positive skin prick test.Conclusions CVA, UACS, PIC were the common reasons for chronic cough in children.Clinical manifestation was useful to identify the etiology of chronic cough in children.Age, course, nature of cough were helpful for etiological diagnosis.Upper airway abnormality ,especially sinusitis may suggest UACS.High eosinophic count or positive skin prick test can support the diagnosis of CVA.%目的 探讨临床资料对儿童慢性咳嗽病因的诊断价值.方法 选择2008年12月-2010年1月在广西医科大学第一附属医院儿科就诊的慢性咳嗽患儿117例,通过前瞻性的临床研究方法 ,获得慢性咳嗽患儿详细的临床资料和病因,分析临床资料对病因诊断的作用.结果 本组慢性咳嗽的病因

  14. Secondary Hemochromatosis due to Chronic Oral Iron Supplementation

    Science.gov (United States)

    Isang, Emmanuel

    2017-01-01

    Iron may accumulate in excess due to a mutation in the HFE gene that upregulates absorption or when it is ingested or infused at levels that exceed the body's ability to clear it. Excess iron deposition in parenchymal tissue causes injury and ultimately organ dysfunction. Diabetes mellitus and hepatic cirrhosis due to pancreas and liver damage are just two examples of diseases that result from iron overload. Despite the rapid growth of information regarding iron metabolism and iron overload states, the most effective treatment is still serial phlebotomies. We present a patient who developed iron overload due to chronic ingestion of oral ferrous sulfate. This case illustrates the importance of querying geriatric patients regarding their use of nonprescription iron products without a medical indication. PMID:28133557

  15. Risk Factors of Airway Hyperresponsiveness of Children with Chronic Cough%慢性咳嗽患儿呼吸道高反应的危险因素

    Institute of Scientific and Technical Information of China (English)

    黄剑峰; 张皓; 王立波

    2012-01-01

    目的 探讨慢性咳嗽患儿呼吸道高反应的危险因素,为儿童慢性咳嗽的诊治提供依据.方法 选择2008年9月- 2009年10月就诊于本院呼吸科 门诊的慢性咳嗽患儿141例.男68例,女73例;年龄(6.56±1.89)岁.予问卷调查及采用Astograph法测定其呼吸道高反应性,对有关变量进行单因素分析,再将单因素分析有意义的变量进一步行Logistic逐步回归分析,应用STATA7.0统计软件进行统计学分析.结果 慢性咳嗽呼吸道反应性测定结果:呼吸道高反应106例,呼吸道反应正常35例.单因素分析有统计学意义的因素:直系亲属哮喘史、特应性皮炎史和被动吸烟.Logistic逐步回归分析显示,慢性咳嗽呼吸道高反应的独立危险因素有直系亲属哮喘史(OR=4.91;95% CI:1.326 ~18.192)和特应性皮炎史(OR=0.26,95%CI:0.116~0.623).结论 直系亲属有哮喘史和患儿有特应性皮炎史是儿童慢性咳嗽呼吸道高反应的独立危险因素.%Objective To investigate the risk factors for airway hyperresponsiveness of children with chronic cough,in order to provide clues for early diagnosis and treatment. Methods One hundred and forty - one children [68 cases were male,73 cases were female;aged (6.56 ± 1.89) years] with chronic cough .visited the Children's Hospital Affiliated to Fudan University from Sep. 2008 to Oct. 2009, were enrolled. Airway responsiveness of them had been determined by astograph measurement, and questionnaire had been finished. Clinical data were analyzed with mono - factor analysis and stepwise multivariate Logistic regression analysis by STATA 7. 0 software. Results One hundred and six cases were airway hyperresponsiveness and 35 cases were normal airway responsiveness. Mono - factor analysis revealed that 3 indexes were obviously significant( P, < 0.05 ), they were immediate family member history of asthma, atopic dermatitis and environmental tobacco smoke exposure. Immediate family member history

  16. [A new portable monitor for long-term cough recording].

    Science.gov (United States)

    Köhler, D; Klauke, M; Schönhofer, B

    1997-06-01

    Cough is a common symptom of pulmonary diseases. For a number of reasons it would be of interest to have information about the frequency of coughs over a given period of time. So far, the cough recorders which are available are either too expensive or unwieldy. Hence, we developed a cough recorder linked to a portable, commercially available actigraph (about the size of a pack of cigarettes) that records coughing as an acoustic signal and ventral thorax movement. The signals are filtered via a band pass and sampled by a peak detektor with different time constants to separate the impulse character of the cough signal from the background noise level. The cough recorder registers coughing cumulatively over a period of one minute and has a storage time of one week. Since the acoustic signals are essential for the interpretation of the recordings, the analogue circuit was subjected to a separate validation programme. For this purpose, the distinction between active coughs of 10 volunteers (total number of coughs 550) and background noises (male and female voices and other defined noises, total number of noises 336) was tested. The complete assembly was then tested over night on 7 hospitalised patients with chronic cough. An infrared video camera system was used to make a reference recording of the overnight coughing. The results show that nearly every cough of the 10 volunteers was recorded (r = 0.99). 97.1% of the background noise was correctly interpreted. The complete recorder assembly correctly recorded 98.9% of the coughs (total 870) in the 7 patients. 4.8% of the background noise was erroneously registered as coughing. Summing up, it can be said that the portable cough recorder affords accurate recording of coughing over a period of one week, correctly distinguishing coughing from background noise.

  17. Native Valve Endocarditis Due to Citrobacter Chronic Prostatitis

    Science.gov (United States)

    Lum, Corey; Bolger, Dennis; Bello, Erlaine

    2014-01-01

    Introduction: Citrobacter koseri is a gram-negative bacillus that rarely causes infection in immunocompetent hosts and typically is associated with urinary or respiratory tract infections. Rarely will Citrobacter be a cause of infective endocarditis. Case Report: We present a case of a 77-year-old man with no known immunocompromising conditions who was hospitalized for infective aortic endocarditis due to Citrobacter koseri originating from a chronically infected prostate. Unusually, he also developed a C. koseri diskitis and phlegmon, which, along with the aortic vegetations, increased in size despite appropriate antibiotics. The patient thus met indications for aortic valve replacement and had improved appearance of lesions in follow-up imaging.

  18. Chronic mycobacterial meningitis due to Mycobacterium chelonae: a case report.

    Science.gov (United States)

    Salmanzadeh, Shokrallah; Honarvar, Negin; Goodarzi, Hamed; Khosravi, Azar Dokht; Nashibi, Roohangiz; Serajian, Amir Arsalan; Hashemzadeh, Mohammad

    2014-10-01

    We report a case of chronic meningitis due to Mycobacterium chelonae. This organism is a rapidly growing Mycobacterium (RGM) and can be found worldwide in environmental sources such as soil, dust, and water. M. chelonae is an uncommon cause of meningitis; the majority of infections caused by this organism are localized cutaneous or soft tissue infections, and rarely lung infections. The organism is indistinguishable phenotypically, so we applied PCR based on the rpoB gene sequence followed by restriction fragment length polymorphism (RFLP) for molecular identification. The subsequent sequencing of RFLP products revealed 99.7% similarity with M. chelonae.

  19. Chronic mycobacterial meningitis due to Mycobacterium chelonae: a case report

    Directory of Open Access Journals (Sweden)

    Shokrallah Salmanzadeh

    2014-10-01

    Full Text Available We report a case of chronic meningitis due to Mycobacterium chelonae. This organism is a rapidly growing Mycobacterium (RGM and can be found worldwide in environmental sources such as soil, dust, and water. M. chelonae is an uncommon cause of meningitis; the majority of infections caused by this organism are localized cutaneous or soft tissue infections, and rarely lung infections. The organism is indistinguishable phenotypically, so we applied PCR based on the rpoB gene sequence followed by restriction fragment length polymorphism (RFLP for molecular identification. The subsequent sequencing of RFLP products revealed 99.7% similarity with M. chelonae.

  20. Pertussis (Whooping Cough) Outbreaks

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... friendly Fact Sheet Pertussis Vaccination Pregnancy and Whooping Cough Clinicians Disease Specifics Treatment Clinical Features Clinical Complications ...

  1. Pertussis (Whooping Cough) Complications

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... friendly Fact Sheet Pertussis Vaccination Pregnancy and Whooping Cough Clinicians Disease Specifics Treatment Clinical Features Clinical Complications ...

  2. Coughing up blood

    Science.gov (United States)

    ... gastrointestinal tract. Blood that comes up with a cough often looks bubbly because it is mixed with ... conditions, diseases, and medical tests may make you cough up blood. These include: Blood clot in the ...

  3. Cold and Cough Medicines

    Science.gov (United States)

    ... What can you do for your cold or cough symptoms? Besides drinking lots of fluids and getting ... medicines. There are lots of different cold and cough medicines, and they do different things. Nasal decongestants - ...

  4. Whooping Cough (Pertussis)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Whooping Cough (Pertussis) KidsHealth > For Parents > Whooping Cough (Pertussis) A A A What's in this article? ... the Doctor en español La tos ferina Whooping cough (pertussis) is an infection of the respiratory system ...

  5. Pulmonary histoplasmosis presenting as chronic productive cough, fever, and massive unilateral consolidation in a 15-year-old immune-competent boy: a case report

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    Mshana Stephen E

    2011-08-01

    Full Text Available Abstract Introduction Severe histoplasmosis is known to be among the AIDS-defining opportunistic infections affecting patients with very low CD4 cell counts in histoplasmosis-endemic areas. Histoplasma capsulatum var. duboisii is common in West and Central Africa, where it occurs in both HIV/AIDS and non-HIV patients. Few cases of life-threatening histoplasmosis in immune-competent individuals have been reported worldwide. Case report We describe a case of pulmonary histoplasmosis diagnosed on the basis of autopsy and histological investigations. A 15-year old East African immune-competent boy with a history of smear-positive tuberculosis and a two-year history of rock cutting presented to our hospital with chronic productive cough, fever, and massive unilateral consolidation. At the time of presentation to our hospital, this patient was empirically treated for recurrent tuberculosis without success, and he died on the seventh day after admission. The autopsy revealed a huge granulomatous lesion with caseation, but no acid-fast bacilli were detected on several Ziehl-Neelsen stains. However, periodic acid-Schiff staining was positive, and the histological examination revealed features suggestive of Histoplasma yeast cells. Conclusion Severe pulmonary histoplasmosis should be considered in evaluating immune-competent patients with risk factors for the disease who present with pulmonary symptoms mimicking tuberculosis.

  6. [Thr prognostic value of chronic cough, sputum and spirometry assessed by 10-year mortality among 1487 working men (author's transl].

    Science.gov (United States)

    Kauffmann, F; Brille, D; Lellouch, J

    1975-01-01

    The aim of the present study is to find out whether or not the diagnosis of chronic bronchitis at an early stage of the disease makes it possible to forecast an excess of mortality within 10 years, among 1487 men examined in 1960/61 while they were at work and aged at the time between 30 and 59 years. After having shown the prognostic value of chronic phlegm and spirographic measurements (VC, FEV1.0, FEV1.0/VC), we tried to state precisely their prognostic value by controlling the tobacco consumption and the socio-occupational class, which are bound to them and are themselves prognostic. FEV 1.0 is the most discriminant variable; its reduction is prognostic as young as 35. Survival-rates decrease regularly with the reduction of FEV1.0; this prognostic role seems to remain in all sociooccupational classes and for smokers as well as for non-smokers; it is more evident for the men who had chronic phlegm than in those who did not have such a symptom. It has been impossible to draw clear conclusions about the prognostic value of phlegm on these points because of interaction existing between phlegm and age.

  7. Clinical diagnosis and treatment of chronic cough empirical analysis of 79 cases%慢性咳嗽经验性诊治79例临床分析

    Institute of Scientific and Technical Information of China (English)

    牛永亮; 李振明

    2014-01-01

    Objective To investigate the beauty of pseudoephedrine-sensitive solution, the efficacy of empiric treatment of chronic salmeterol and fluticasone propionate inhalation powder, omeprazole, such as cough. Methods detailed history, physical examination, basic laboratory and laboratory examinations, chronic cough patients met the diagnostic criteria of the 79 cases, the use of US-sensitized pseudoephedrine solution, salmeterol and fluticasone propionate inhalation powder, omeprazole three drugs based therapy alone or superimposed. Results of 79 cases of newly diagnosed patients with chronic cough treatment stage efficiency 70.9%, subsequent treatment efficiency of 89.9%. Conclusion reasonable inspection and possible causes of chronic cough method of combining empirical treatment coverage in the primary hospital is a good treatment strategy.%目的:探讨美敏伪麻溶液、沙美特罗替卡松粉吸入剂、奥美拉唑等经验性治疗慢性咳嗽的疗效。方法通过详细询问病史、查体、基本的实验室及辅助检查,对符合诊断标准的慢性咳嗽患者79例,采用美敏伪麻溶液、沙美特罗替卡松粉吸入剂、奥美拉唑三药为主单用或联合治疗。结果79例慢性咳嗽患者初诊阶段治疗有效率为70.9%,后续治疗有效率为89.9%。结论合理检查与覆盖慢性咳嗽可能病因的经验性治疗相结合的方法,在基层医院是理想的处理策略。

  8. The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi.

    Directory of Open Access Journals (Sweden)

    Marriott Nliwasa

    Full Text Available Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence.To investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy.Between October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard, and costs were estimated.Of 273 adults recruited, 44.3% (121/273 were HIV-positive and 19.4% (53/273 had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4% with 100% (95% CI: 98.0% to 100% specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2% was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8% was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98; this was lower than Xpert® MTB/RIF (US$ 13.38 but higher than fluorescence smear microscopy (US$ 0.65.The sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis.

  9. Chronic neck pain disability due to an acute whiplash injury.

    Science.gov (United States)

    Nederhand, Marc J; Hermens, Hermie J; IJzerman, Maarten J; Turk, Dennis C; Zilvold, Gerrit

    2003-03-01

    Several theories about musculoskeletal pain syndromes such as whiplash-associated disorder (WAD) suggest that pain and muscle activity interact and may contribute to the chronicity of symptoms. Studies using surface electromyography (sEMG) have demonstrated abnormal muscle activation patterns of the upper trapezius muscles in the chronic stage of WAD (grade II). There are, however, no studies that confirm that these muscle reactions are initiated in the acute stage of WAD, nor that these muscle reactions persist in the transition from acute neck pain to chronic neck pain disability. We analyzed the muscle activation patterns of the upper trapezius muscles in a cohort of 92 subjects with acute neck pain due to a motor vehicle accident (MVA). This cohort was followed up in order to evaluate differences in muscular activation patterns between subjects who have recovered and those subjects who have not recovered following an acute WAD and developed chronic neck pain. sEMG parameters were obtained at 1, 4, 8, 12, and 24 weeks after an MVA. The level of muscle reactivity (the difference in pre- and post-exercise EMG levels) and the level of muscle activity during an isometric and a dynamic task were used as EMG parameters. The results revealed no elevated muscle reactivity either in the acute stage, or during the follow-up period. The results of both the isometric and dynamic task, showed statistically significant different EMG levels between four neck pain disability subgroups (analysis of variance reaching P-levels of 0.000), with an inverse relationship between the level of neck pain disability and EMG level. Furthermore, follow-up assessments of the EMG level during these two tasks, did not show a time related change. In conclusion, in subjects with future disability, the acute stage is characterized by a reorganization of the muscular activation of neck and shoulder muscles, possibly aimed at minimizing the use of painful muscles. This change of motor control, is in

  10. Treatment on chronic rhinosinusitis in children with main complaint of chronic cough%以慢性咳嗽为主诉的儿童慢性鼻-鼻窦炎的治疗

    Institute of Scientific and Technical Information of China (English)

    黄文坚; 尤雅丽

    2012-01-01

    To explore the causes of chronic cough in children and its outcome after treatment of chronic rhinosinusitis(CRS). Method: Fifty-six cases of children who were previously diagnosed as chronic cough by pediatrician with poor treatment outcomes, were made a definite diagnosis of CRS and then treated by otolaryn-gologist. Result;Fifty-six cases of children were made a definite diagnosis of CRS according to CT and/or nasal en-doscopy examination. The cardinal symptom was cough in all cases, in which 35 cases(62. 5% ) with nasal congestion and rhinorrhea, 15 cases(26. 8%) with snoring and mouth breathing, 6 cases(10. 7%) with postnasal drip and expectoralion. Among all the patients, stick purulent secretion in nasal cavity and posterior pharyngeal wall was found in 45 cases(80. 4 %) , nasal polyps in 5 cases(8. 9%), adenoidal hypertrophy in 21 cases(37. 5%), nasal polyps and adenoidal hypertrophy in 4 cases(7. 1%), allergic rhinitis in 19 cases(33. 9%). After the combined treatment of CRS, 45 cases(80. 4%) were cured, 9 cases( 16. 1%) relieved and 2 cases(3. 6%) ineffective. Conclusion: Chronic cough is the commonly cardinal symptom of CRS in children and it can be cured or relieved by combined treatment of CRS.%目的:探讨儿童慢性咳嗽的病因及按慢性鼻-鼻窦炎(CRS)治疗后慢性咳嗽的转归.方法:对在儿科诊断为慢性咳嗽且治疗效果不佳后转至耳鼻咽喉科的CRS患儿进行治疗.结果:56例患儿经CT扫描和(或)鼻内镜检查后确诊为CRS.第一主诉均为咳嗽,其中伴鼻塞、流涕35例(62.5%),伴打鼾及张口呼吸15例(26.8%),伴鼻涕倒流或咳痰6例(10.7%);体检发现有鼻腔及咽后壁黏脓性分泌物45例(80.4%),伴鼻息肉5例(8.9%),伴腺样体肥大21例(37.5%),同时伴鼻息肉及腺样体肥大4例(7.1%),伴变应性鼻炎19例(33.9%).经CRS综合治疗(15例腺样体切除术及4例腺样体、鼻息肉同时手术)后咳嗽治愈45例(80.4%),缓解9例(16.1%),无效2

  11. Systematic Evaluation for Chronic Cough Assessment Tools%慢性咳嗽评估工具的系统评价

    Institute of Scientific and Technical Information of China (English)

    于航(综述); 霍建民(审校)

    2016-01-01

    In recent years,considerable progress has been achieved in the development of cough assess-ing tools,which can be generally divided into two categories,subjective tools and objective tools.Among sub-jective tools,the visual analogue scale ( VAS) ,the Leicester cough questionnaire( LCQ) and the cough-spe-cific quality of life questionnaire(CQLQ) are widely used,they are well validated for assessing the impact of cough.Among the objective tools,cough challenge tests can measure the sensitivity of the cough reflex.Cough frequency monitoring is widely used in clinical trials, and the most widely used cough monitors are the Leices-ter cough monitor ( LCM) and VitaloJak.But cough frequency monitors do not reflect the intensity or the impact of cough on quality of life.Hence,cough should be assessed with a combination of subjective and objective tools.%近年来咳嗽的评估工具有了显著的进展,总体分为主观与客观两类。主观工具中,视觉模拟量表、莱斯特咳嗽问卷和咳嗽特异性生活质量问卷应用广泛,可以有效评估咳嗽对生活质量的影响。客观工具中,咳嗽激发试验用来评估咳嗽反射敏感性。咳嗽频率监测仪广泛应用于临床试验,其中最常用的是莱斯特咳嗽监测仪和VitaloJak。但是,咳嗽频率监测仪不能反映咳嗽的强度及其对生活质量的影响。因此,临床上应主观、客观工具相结合来综合评估咳嗽。

  12. Survey on Specific Life Quality of Elderly Patients with Chronic Cough in Shenyang%沈阳地区老年慢性咳嗽患者特异性生活质量问卷评分调查

    Institute of Scientific and Technical Information of China (English)

    冯秀琴; 宁丽娟

    2013-01-01

    [Objective] To investigate the specific life quality of elderly patients with chronic cough(CC) in Shenyang.[Methods] A total of 41 elderly patients with CC diagnosed in respiratory department of our hospital were chosen as observation group.The selected subjects lived in Shenyang for over 5 years.All patients received the assessment by using Leicesterhire cough life quality questionnaires(LCQ) before treatment.The results were compared between observation group and control group (n =55,middle and young patients).[Results]The scores of every item and domain of LCQ and total LCQ score in observation group were significantly lower than those in control group (P < 0.05),and there was significant difference (P < 0.05).[Conclusion]The specific life quality of elderly patients with chronic cough is obviously worse than the middle and young patients with chronic cough.%[目的]调查沈阳地区老年慢性咳嗽(CC)患者特异性生活质量.[方法]选择本院呼吸内科就诊老年CC患者41例(观察组),入选对象均在沈阳地区生活5年以上,均在治疗前接受“莱斯特咳嗽特异性生活质量问卷”(LCQ)评估,并与55例同期就诊中、青年同病患者(对照组)测试结果比较.[结果]观察组LCQ问卷条目评分、领域评分及LCQ总分均显著低于对照组,其差异均有统计学意义(P<0.05).[结论]老年CC患者特异性生活质量明显差于中青年同病患者.

  13. Cough and exhaled nitric oxide levels: what happens with exercise?

    Science.gov (United States)

    Petsky, Helen L; Kynaston, Jennifer Anne; McElrea, Margaret; Turner, Catherine; Isles, Alan; Chang, Anne B

    2013-01-01

    Cough associated with exertion is often used as a surrogate marker of asthma. However, to date there are no studies that have objectively measured cough in association with exercise in children. Our primary aim was to examine whether children with a pre-existing cough have an increase in cough frequency during and post-exercise. We hypothesized that children with any coughing illness will have an increase in cough frequency post-exercise regardless of the presence of exercise-induced broncho-constriction (EIB) or atopy. In addition, we hypothesized that Fractional exhaled nitric oxide (FeNO) levels decreases post-exercise regardless of the presence of EIB or atopy. Children with chronic cough and a control group without cough undertook an exercise challenge, FeNO measurements and a skin prick test, and wore a 24-h voice recorder to objectively measure cough frequency. The association between recorded cough frequency, exercise, atopy, and presence of EIB was tested. We also determined if the change in FeNO post exercise related to atopy or EIB. Of the 50 children recruited (35 with cough, 15 control), 7 had EIB. Children with cough had a significant increase in cough counts (median 7.0, inter-quartile ranges, 0.5, 24.5) compared to controls (2.0, IQR 0, 5.0, p = 0.028) post-exercise. Presence of atopy or EIB did not influence cough frequency. FeNO level was significantly lower post-exercise in both groups but the change was not influenced by atopy or EIB. Cough post-exertion is likely a generic response in children with a current cough. FeNO level decreases post-exercise irrespective of the presence of atopy or EIB. A larger study is necessary confirm or refute our findings.

  14. Cough and exhaled nitric oxide levels: What happens with exercise?

    Directory of Open Access Journals (Sweden)

    Helen ePetsky

    2013-10-01

    Full Text Available Cough associated with exertion is often used as a surrogate marker of asthma. However, to date there are no studies that have objectively measured cough in association with exercise in children. Our primary aim was to examine whether children with a pre-existing cough have an increase in cough frequency during and post-exercise. We hypothesised that children with any coughing illness will have an increase in cough frequency post-exercise regardless of the presence of exercise induced broncho-constriction (EIB or atopy. In addition, we hypotheised that FeNO levels decreases post-exercise regardless of the presence of EIB or atopy.Children with chronic cough and a control group without cough undertook an exercise challenge, FeNO measurements and a skin prick test and wore a 24-hour voice recorder to objectively measure cough frequency. The association between recorded cough frequency, exercise, atopy and presence of EIB was tested. We also determined if the change in FeNO post exercise related to atopy or EIB.Of the 50 children recruited (35 with cough, 15 control, 7 had EIB. Children with cough had a significant increase in cough counts (median 7.0, IQR 0.5, 24.5 compared to controls (2.0, IQR 0, 5.0, p=0.028 post-exercise. Presence of atopy or EIB did not influence cough frequency. FeNO level was significantly lower post-exercise in both groups but the change was not influenced by atopy or EIB. Cough post-exertion is likely a generic response in children with a current cough. FeNO level decreases post-exercise irrespective of the presence of atopy or EIB. A larger study is necessary confirm or refute our findings.

  15. Research progress of Bordetella pertussis infection and chronic cough in adults%百日咳杆菌感染与成人不明原因慢性咳嗽相关性研究现状

    Institute of Scientific and Technical Information of China (English)

    文芳静; 肖锦秀; 胡克

    2012-01-01

    Although cough variant asthma,upper airway cough syndrome/postnasal drip syndrome,eosinophilic bronchitis and gastroesophageal reflux disease are generally considered as the most common causes of chronic cough,postinfectious cough is also an important factor.Mycoplasma pneumonia and Chlamydia pneumonia have been well known and we often empirically use macrolides for its treatment.Over the years,pertussis has been commonly considered infectious respiratory disease in children.But recent studies have demonstrated it's a common cause of persistent cough in adults and should be considered in differential diagnosis.%尽管咳嗽变异性哮喘、上气道咳嗽综合征/鼻后滴流综合征、嗜酸粒细胞性支气管炎和胃食管反流性咳嗽被普遍认为是不明原因慢性咳嗽(简称慢性咳嗽)最常见病因,但感染后咳嗽也是引起长期咳嗽的一个重要因素.由肺炎支原体和肺炎衣原体等引起的感染后咳嗽多为人们所熟知,且常经验性使用大环内酯类抗生素对其治疗.长期以来,百日咳被认为在儿童呼吸道感染性疾病中较为常见,但近年来的研究表明,百日咳杆菌感染也是引起成人慢性咳嗽的常见原因,需要加以重视和鉴别.

  16. Frequency of Persistent Cough and Trends in Seeking Medical Care and TreatmentResults of an Internet Survey

    Directory of Open Access Journals (Sweden)

    Masaki Fujimura

    2012-01-01

    Conclusions: In this large-scale cohort study, many respondents were unwilling to visit their doctor, despite having chronic cough. Improvements in educational campaigns are needed to encourage people with chronic cough to visit a doctor.

  17. Barriers to accessing TB diagnosis for rural-to-urban migrants with chronic cough in Chongqing, China: A mixed methods study

    Directory of Open Access Journals (Sweden)

    Tang Shenglan

    2008-10-01

    Full Text Available Abstract Background China is facing a significant tuberculosis epidemic among rural-to-urban migrants, which poses a threat to TB control. This study aimed to understand the health seeking behaviour of and health systems responses to migrants and permanent urban residents suffering from chronic cough, in order to identify the factors influencing delays for both groups in receiving a TB diagnosis in urban China. Methods Combining a prospective cohort study of adult suspect TB patients and a qualitative study, the Piot model was used to analyze the health seeking behaviour of TB suspects among migrants and permanent urban residents, the factors influencing their decision and the responses by general health providers. Methods included a patient survey, focus group discussions with migrants in the general population, qualitative interviews with migrant and permanent resident TB suspects and TB patients as well as key stakeholders related to TB control and the management of migrants. Results Sixty eight percent of migrants delayed for more than two weeks before seeking care for symptoms suggestive of TB, compared to 54% of residents (p Conclusion Rural-to-urban migrants are more likely than permanent residents to delay in seeking care for symptoms suggestive of TB in urban Chongqing. 'Patient-' and 'provider-' related factors interact to pose barriers to TB diagnosis for migrants, including: low awareness, and poor knowledge among both the general public and TB suspects about TB as a disease and about the TB control programme; low financial capacity to pay for care and diagnostic tests; and inadequate use of diagnostic tests and referral to TB dispensaries by general health providers.

  18. Pharmacological and clinical overview of cloperastine in treatment of cough

    Directory of Open Access Journals (Sweden)

    Maria Antonietta Catania

    2011-03-01

    Full Text Available Maria Antonietta Catania1, Salvatore Cuzzocrea1,21Department of Clinical and Experimental Medicine and Pharmacology, School of Medicine, University of Messina; 2IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, ItalyAbstract: Cough constitutes an impressive expression of the normal defense mechanisms of the respiratory system. Productive cough associated with catarrh is an important protective system for the lung because it favors the upward movement of secretions and foreign bodies to the larynx and mouth. Cough may also appear without bronchial secretions, as dry cough, which may be persistent when inflammatory disease is chronic or when, in the early stages of respiratory disease, bronchial secretions are not yet fluid. Sometimes bronchitis-induced cough does not significantly affect quality of life, whilst in other cases cough may become so intense as to impair daily activities severely, resulting in permanent disability. This type of cough is one of the most frequent reasons for seeking medical advice. The use of cough suppressants may be appropriate for reaching a precise diagnosis and when dry cough is persistent. Cloperastine has been investigated in various types of cough and, unlike codeine, has been shown to possess dual activity. It also acts as a mild bronchorelaxant and has antihistaminic activity, without acting on the central nervous system or the respiratory center. Here we review the preclinical and clinical evidence of the efficacy and tolerability of cloperastine.Keywords: cough, cloperastine, inflammation, bronchitis

  19. A Prospective, Open Label, Observational Study to Assess the Safety and Efficacy of Herbal Cough Syrup Mykoff® in Patients Suffering from Cough of Varied Aetiologies

    OpenAIRE

    Mangesh Bhalerao; Pradip Awale; Abhijeet Sawle; Dhananjay Sangle; Devendra B Sonawane; Vilas Chavan

    2013-01-01

    A prospective, open label, observational study was conducted at general outpatient clinic to assess the safety and efficacy of herbal cough syrup Mykoff® in patients suffering from cough of varied aetiologies. The patients of either sex, age > 3yrs, suffering from cough due to common cold, mild to moderate upper respiratory tract infections, allergic cough and smoker’s cough were enrolled. The safety was evaluated by means of an analysis of adverse events. In addition, efficacy and tolerabili...

  20. The spectrum and clinical features of causes for chronic cough%"不明原因"慢性咳嗽的病因构成和临床特征分析

    Institute of Scientific and Technical Information of China (English)

    刘国梁; 林江涛

    2009-01-01

    Objective To explore the spectrum and clinical features of causes for chronic cough. Methods A total of 103 patients with at least 8 weeks of chronic cough and normal chest radiographs were recruited from the outpatient clinic of China-Japan Friendship Hospital Department of Respiratory Diseases between Oct 2005 to Feb 2009. The causes were investigated using a well established protocol according to The Chinese Respiratory Society guidelines for management of cough. The diagnostic protocol included history inquiring and physical examination, pulmonary function tests, induced sputum cell differentials, 24 h esophageal pH monitoring, CT of the paranasal sinuses or chest, fiberoptic rhinoscopy or bronchoscopy. The final diagnosis was made based on clinical manifestations, examination findings and a positive response to therapy. The results were compared with those reported in Guangzhou before. Results The cause of chronic cough was defined in 95.1% of the patients, of which 83 patients (83.5% ) with a single cause, 32 (13.6% ) with 2 causes, and 3 (2.9% ) with 3 causes. The most important causes of cough were: cough variant asthma (CVA) (n =41,33.3% ) , rhinitis and/or sinusitis (n =30, 24.4% ), gastroesophageal reflux (GERC) (n=25, 20.3% ), medicine related (n=7, 5.7%), eosinophilic bronchitis(EB) (n=6,4.9% ), atopic (n=4, 3.3% ), and idiopathic (n=6,4.9%). Other causes included pulmonary interstitial fibrosis (n=2, 1.6% ), left heart insufficiency (n=1, 0.8% ) and hronchiectasis (n = 1, 0.8% ) . There was more nocturnal cough in CVA (80.9%, 36/41) than in other causes (x2=19.81 ,P<0.01). In CVA, 63.4% (26/41) was complicated with atopic rhinitis, 68.3% (28/41) showed seasonal variations, and 67.8% (19/28) aggravated in the autumn. GERC manifested more day coughs, with 56.0% (14/25) cough associated with taking food and 68.0% (17/25) with reflux symptoms. There was more productive cough in rhinitis and/or sinusitis (73.3% (22/30) ,x2=24.99,P < 0.01). The percentages

  1. 北京地区儿童慢性咳嗽病因构成比研究%Ratio of cause constituents in children with chronic cough in Beijing

    Institute of Scientific and Technical Information of China (English)

    耿凌云; 陈慧中; 刘传合; 黄荣妍

    2015-01-01

    目的:了解北京地区引起儿童慢性咳嗽的病因构成比。方法根据中华医学会儿科学分会呼吸学组2008年制定的《儿童慢性咳嗽诊断与治疗指南(试行)》的诊断标准和诊疗流程,对2009年5月至2011年4月在首都儿科研究所附属儿童医院呼吸专业门诊就诊的慢性咳嗽患儿进行病因诊断,完成3个月随访后,分析病因构成。结果共纳入213例患儿,年龄1.1~14.0岁,其中≤3岁40例(18.8%),﹥3~6岁134例(62.9%),﹥6岁39例(18.3%)。变应原检测阳性者以吸入性变应原阳性为主。1例患儿24 h 食管下端 pH值监测阳性但特异性治疗效果不支持胃食管反流性咳嗽。病因构成比前4位依次为咳嗽变异性哮喘(CVA)92例(43.2%),CVA 合并上呼吸道咳嗽综合征(UACS)57例(26.8%),UACS 28例(13.2%),呼吸道感染和感染后咳嗽(PIC)26例(12.2%),其他病因咳嗽8例(3.7%),不明原因咳嗽2例(0.9%)。不同年龄组儿童慢性咳嗽的首位病因均为 CVA;第2位病因在≤3岁组为 PIC,在学龄前和学龄儿童组均为 CVA 合并 UACS。结论北京地区儿童慢性咳嗽的前4位病因依次为 CVA、CVA 合并 UACS、UACS 及 PIC,不同年龄组儿童慢性咳嗽的病因构成比有所不同。%Objective To understand the causes and the ratio of cause constituents in children with chronic cough in Beijing. Methods Patients with chronic cough treated at respiratory clinic of the Children' s Hospital Affiliated to Capital Institute of Pediatrics from May 2009 to April 2011 were included in this study. Etiologic diagnostic procedure suggested for children by the Subspecialty Group of Respiratory Diseases,the Society of Pediatrics,Chinese Medical Association in 2008 was implemented to manage the patients. After three - month follow - up,the etiological data was analyzed. Results Totally 213 patients with chronic cough aged 1. 1 to 14. 0 years old

  2. 口服孟鲁司特钠咀嚼片治疗小儿慢性咳嗽的疗效观察%Efficacy of Montelukast Sodium Chewable Tablets for Oral Treatment of Children With Chronic Cough

    Institute of Scientific and Technical Information of China (English)

    吴岚

    2016-01-01

    Objective To investigate the clinical effect of the treatment of chronic cough in children with oral montelukast sodium.Methods 148 children with chronic cough in our hospital were randomly divided into treatment group and control group, the clinical treatment effect of the two groups was compared.Results The total effective rate of the treatment group was higher than that of the control group, the difference was statistically signiifcant (χ2=5.436,P<0.05).Conclusion The clinical application of oral administration of the oral administration of the oral administration of montelukast chewable tablet for the treatment of children with chronic cough can signiifcantly increase the effciency of the clinical treatment.%目的:探讨小儿慢性咳嗽口服孟鲁司特钠咀嚼片的临床治疗效果。方法选取我院收治的小儿慢性咳嗽患者148例,随机均分为治疗组和对照组,比较两组的临床治疗效果。结果治疗组治疗总有效率高于对照组,具有统计学差异(χ2=5.436,P<0.05)。结论小儿慢性咳嗽在常规综合治疗的基础上口服孟鲁司特钠咀嚼片能增加患儿的临床治疗有效率。

  3. Pharm GKB: Cough [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available drocodone may treat Cough hydromorphone may treat Cough May Prevent benzonatate may prevent Cough dextromethorphan...ethorphan may treat Cough guaifenesin may treat Cough hy...g File - Reference Terminology (NDF-RT) May Treat benzonatate may treat Cough cocaine may treat Cough codeine may treat Cough dextrom

  4. Analysis on cause distribution and influence factors of pediatric chronic cough%小儿慢性咳嗽的病因分布及相关影响因素

    Institute of Scientific and Technical Information of China (English)

    姜红

    2016-01-01

    Objective To analyze the cause distribution and influence factors of pediatric chronic cough. Methods 132 patients with pediatric chronic cough from January 2012 to November 2015 in our hospital were selected as research objects. 60 patients with URI during the same period were selected as control group.Related information, including allergies, exposure history, living environment, passive smoking history, and history of respiratory disease in the hospital were obtained by questionnaire for statistical analysis. Results Infants and young children were mainly infected cough, preschool and school-age children were mainly upper airway cough syndrome and cough variant asthma.Single factor analysis result showed that, there were significant differences in dust or chemical material exposure history, history of respiratory disease, atopic physique, passive smoking, excessive decoration, indoor plants or pets allergy and family history asthma (P<0.05).Logistic regression analysis showed that respiratory disease history, indoor plants, or pets, family history of allergy or asthma were regarded as independent influence factors of chronic cough (P<0.05). Conclusion According to the characteristics of children′s cough, the cause of disease analysis, comprehensive evaluation of the patient′s condition suitable interventions can be used to improve the quality of life of children.%目的:分析小儿慢性咳嗽的病因分布及相关影响因素。方法选择2012年1月至2015年11月张家港市中医医院收治的132例慢性咳嗽患儿为研究对象,同时选取同期收治的60例上呼吸道感染患儿为对照组,设计调查问卷获取慢性咳嗽组与对照组患儿的过敏史、接触史、生活环境、被动吸烟史、既往呼吸道疾病住院史等相关信息,对所得数据进行统计分析。结果婴幼儿主要以感染后咳嗽为主,学龄前及学龄儿童主要以上气道咳嗽综合征及咳嗽变异性哮喘为主。单因素

  5. 加巴喷丁治疗难治性慢性咳嗽的有效性及安全性%The efficiency and safety of gabapentin in the treatment of pertinacious chronic cough

    Institute of Scientific and Technical Information of China (English)

    李婷; 蔡娜

    2016-01-01

    目的 探讨加巴喷丁治疗难治性慢性咳嗽的有效性及安全性.方法 56例难治性慢性咳嗽患者分为对照组26例与研究组30例,对照组患者给予临床常规治疗,研究组患者给予加巴喷丁胶囊(300 ~ 1800 mg/d).共持续治疗12周,评价治疗前后所有患者的莱彻斯特咳嗽问卷(LCQ)评分、咳嗽严重程度(VAS评分)、咳嗽次数,同时观察药物不良反应发生情况.结果 治疗后,研究组患者的LCQ评分、VAS评分、咳嗽次数分别为(16.7±3.4)、(26.7±10.5)mm、(22.5±7.9)次m,相对于治疗前与对照组,LCQ评分、VAS评分显著增高,咳嗽次数显著减少(P<0.05).研究组的药物不良反应发生率达到40%,但与对照组比较差异无统计学意义(P>0.05).结论 加巴喷丁治疗难治性慢性咳嗽具有较好的临床疗效,但不良反应发生率较高,建议应在兼顾疗效和副作用的基础上给予该药物治疗.%Objective To discuss the efficiency and safety of gabapentin in the treatment of pertinacious chronic cough.Methods 56 cases of pertinacious chronic cough were divided into control group (26 cases) and research group (30 cases).Patients in control group were given clinical routine treatment,while patients in research group were given gabapentin capsules (300-1800 mg/d) for 12 weeks.Leicester cough questionnaire (LCQ),visual analogue scale (VAS) and cough frequency were evaluated before and after treatment.Adverse drug reaction was observed during the treatment.Results After treatment,LCQ score,VAS score and cough frequency were 06.7±3.4),(26.7±10.5)mm,(22.5±7.9)times/h respectively in research group.LCQ score and VAS score in research group after treatment were significantly higher than those in research group before treatment,those in control group after treatment;cough frequency was significantly lower than that in research group before treatment,that in control group after treatment (P<0.05).The occurrence rate of adverse drug

  6. Validation of a pediatric cough questionnaire.

    Science.gov (United States)

    Hartnick, Christopher J; Zurakowski, David; Haver, Kenan

    2009-11-01

    We conducted a study to determine if a five-item pediatric cough questionnaire (PCQ) is a valid and reliable means of measuring cough-specific quality of life in children. The five questions, which are answered by the child's parent or caregiver, cover cough frequency (Q1), sleep disturbance of the child (Q2), sleep disturbance of the parent (Q3), cough severity (Q4), and the degree of bothersomeness to the child (Q5). Each of the five items was scored on a 6-point Likert scale. The PCQ was administered three times. The first occurred when the parent telephoned to schedule an appointment for the child at a pediatric pulmonology outpatient clinic for a chief complaint of cough. The second PCQ was administered within 2 weeks of the first but before any treatment had been instituted so that test-retest reliability could be assessed. Each child was then diagnosed and treated in accordance with standard care practices. The third PCQ was administered 3 weeks after the second to determine if it would accurately reflect the parent's perception of how the child's cough had changed following treatment. Also, at the second and third encounters, parents were asked to provide their global assessment of whether their child's cough had improved, worsened, or stayed the same since the previous encounter. The parents of 120 children (70 boys and 50 girls; mean age: 6.8 yr) completed all three PCQs. Test-retest reliability was established (p PCQ questions by Spearman correlation analysis (Q1: r = 0.5; Q2: r = 0.38; Q3: r = 0.42; Q4: r = 0.53; Q5: r = 0.5). Other statistical analyses confirmed the PCQ's internal consistency, discriminant validity, and convergent validity. Based on our findings, we conclude that the PCQ is a valid and reliable instrument with which to follow children with chronic cough longitudinally.

  7. Chronic neck pain disability due to an acute whiplash injury

    NARCIS (Netherlands)

    Nederhand, Marc J.; Hermens, Hermie J.; IJzerman, Maarten J.; Turk, Dennis C.; Zilvold, Gerrit

    2003-01-01

    Several theories about musculoskeletal pain syndromes such as whiplash-associated disorder (WAD) suggest that pain and muscle activity interact and may contribute to the chronicity of symptoms. Studies using surface electromyography (sEMG) have demonstrated abnormal muscle activation patterns of the

  8. 加巴喷丁用于难治性慢性咳嗽治疗的研究进展%Progress of research on gabapentin for refractory chronic cough

    Institute of Scientific and Technical Information of China (English)

    钱春艳; 宋惠珠; 蔡小军; 陆守荣; 温浩

    2015-01-01

    综述加巴喷丁治疗难治性慢性咳嗽的研究进展,为其临床合理利用及进一步研究提供科学依据。检索中国知网、万方医学网、PubMed近15年收载的公开发表的有关加巴喷丁治疗慢性咳嗽等感觉神经病变的研究文献并进行综述,对加巴喷丁的作用、机制及其安全性进行整理、归纳及分析。加巴喷丁用于治疗合并感觉神经障碍的难治性咳嗽有效、安全,具有新的临床应用价值,其有效治疗结果可能通过改善中枢敏感化而实现。但因其临床研究数量及资料较少,深入的作用机制及其长期应用的安全性有待进一步研究。%Objective To review advance of gabapentin in treatment of refractory chronic cough, and to provide evidence for its clinical usage and further study.The original articles referring to gabapentin’ s effect on sensory neuropathy such as refractory chronic cough, which were retrieved from CNKI, Wanfang Medical Network, as well as PubMed over the last 15 years, were reviewed.The safety, efficacy and its mechanism of gabapentin were sorted, generalized and analyzed.Gabapentin appears to be effective and safe in the treatment of sensory neuropathic disorder such as refractory chronic cough, and its effective treatment results may come ture through improving central sensitization, which indicates the drug has new clinical application value.Relevant clinical trials investigating its efficacy and safety profile in the treatment of cough are limited and further research are needed.

  9. Diagnostic significance of differential cell count in induced sputum to chronic cough in children%高渗盐水诱导痰细胞学检查在儿童慢性咳嗽诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    钟帼钰; 陈德晖; 罗炜; 陈桥丽; 卢慧敏; 林育能; 潘小安; 吴上志; 赖克方

    2012-01-01

    目的 探讨高渗盐水诱导痰细胞学检查在儿童慢性咳嗽病因诊断中的意义.方法 选择2007年1月至2007年12月广州医学院第一附属医院儿科门诊及住院的198例慢性非特异性咳嗽患儿,参考2006年ACCP《儿童慢性咳嗽临床循证实践指南》的诊断程序进行病因诊断,所有患儿均进行高渗盐水诱导痰细胞学检查,比较不同病因的慢性咳嗽儿童诱导痰细胞学分类的差异.同时选择159名健康儿童作为对照.结果 198例慢性咳嗽患儿中有175例痰诱导成功,成功率为88.4%,不良反应发生率为10.1%,主要表现为咽痒、恶心、咳嗽、头晕,停止诱导后可缓解.对175例痰诱导成功的慢性咳嗽患儿病因进行分析,获得明确诊断的有164例(93.7%),分别是咳嗽变异性哮喘(CVA) 65例(37.1%)、上气道咳嗽综合征(UACS)52例(29.7%)、感染后咳嗽(PIC)37例(21.1%)、嗜酸粒细胞性支气管炎(EB)4例(2.3%)、胃食管反流性咳嗽(GERC)4例(2.3%)、肺结核(TB)1例(0.6%)、气道异物1例(0.6%),病因未明11例(6.3%).CVA、UACS、PIC是本组慢性咳嗽患儿最常见的病因.按年龄分为三组,Ⅰ组(4~6岁)51例(29.1%),Ⅱ组(7~11岁)66例(37.7%),Ⅲ组(12~14岁)58例(33.1%).不同年龄组病因分布差异无统计学意义(P>0.05).不同病因组与正常对照组,以及不同病因组之间诱导痰细胞学分类差异有统计学意义(P <0.05).结论 在儿童开展高渗盐水诱导痰细胞学检查是安全和成功率较高的检测手段,对儿童慢性咳嗽病因诊断起着重要作用.%Objective To explore the diagnostic significance of differential cell count in induced sputum to chronic cough in children.Methods A totle of 198 children with chronic cough in outpatient and inpatient departments of the First Affiliated Hospital of Guangzhou Medical College from January 2007 to December 2007 were included.The causes were investigated by using the guidelines for

  10. Death due to acute tetrachloroethylene intoxication in a chronic abuser.

    Science.gov (United States)

    Amadasi, Alberto; Mastroluca, Lavinia; Marasciuolo, Laura; Caligara, Marina; Sironi, Luca; Gentile, Guendalina; Zoja, Riccardo

    2015-05-01

    Volatile substances are used widespread, especially among young people, as a cheap and easily accessible drug. Tetrachloroethylene is one of the solvents exerting effects on the central nervous system with experiences of disinhibition and euphoria. The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings. The swabs were still soaked in tetrachloroethylene. Toxicological and histological investigations demonstrated the presence of an overlap between chronic intake of the substance (with high concentrations in sites of accumulation, e.g., the adipose tissue, and contemporary tissue damage, as histologically highlighted) and acute intoxication as final cause of death, with a concentration of 158 mg/L in cardiac blood and 4915 mg/kg in the adipose tissue. No other drugs or medicines were detected in body fluids or tissues, and to our knowledge, this is the highest concentration ever detected in forensic cases. This peculiar case confirms the toxicity of this substance and focuses on the importance of complete histological and toxicological investigations in the distinction between chronic abuse and acute intoxication.

  11. Spontaneous urinary extravasation due to chronic ureteral obstruction

    OpenAIRE

    神波, 照夫; 荒井, 豊; 朴, 勺; 池田, 達夫; 竹内, 秀雄; 高山, 秀則; 友吉, 唯夫

    1985-01-01

    Spontaneous nontraumatic perirenal extravasation of urine is an unusual phenomenon, and the majority of the reported case were caused by acute obstruction with passage of a ureteric calculus. Extravasation due to obstruction of more gradual onset occurs less frequently. We report four cases, three caused by tumor obstruction of the ureter, and one thought to be obstructed by the stricture due to ureteral inflammation. We discuss the diagnosis and treatment of spontaneous urinary extravasation...

  12. Inhaled sodium cromoglycate in angiotensin-converting enzyme inhibitor cough.

    Science.gov (United States)

    Hargreaves, M R; Benson, M K

    1995-01-07

    Cough is a frequent side-effect of angiotensin-converting enzyme (ACE) inhibitors. We examined the effects of inhaled sodium cromoglycate in 10 patients with ACE-inhibitor cough in a double-blind crossover study. After a 2-week run-in, patients were randomised to either 2 weeks' inhaled sodium cromoglycate or placebo followed by a further 2 weeks on the other treatment. Patients kept a cough diary during each study period. Cough severity was recorded on a scale from 0 to 12. At the end of each study period the cough threshold to inhaled capsaicin was measured. 9 patients reported a reduction in cough after sodium cromoglycate. Median (range) daily cough scores during run-in and placebo periods were 3.6 (1.9-6.4) and 4.1 (0.6-8.1), respectively (p > 0.05). Median daily cough score after sodium cromoglycate was 1.8 (0.4-3; p sodium cromoglycate; and cough-reflex sensitivity to inhaled capsaicin was significantly reduced. Inhaled sodium cromoglycate is an effective treatment for ACE-inhibitor cough. Its effect may be due to suppression of afferent vagal activity.

  13. Clinical Observation of Chronic Cough in Children Treated with Chinese Medicine Erxian Decoction%中药二仙饮治疗儿童慢性咳嗽临床观察

    Institute of Scientific and Technical Information of China (English)

    杨辉; 武志娟; 张大鹏

    2011-01-01

    目的 观察中药二仙饮治疗小儿慢性咳嗽的临床疗效.方法 选择符合标准的小儿慢性咳嗽患者随机分为两组,中药治疗组42例,采用中药二仙饮治疗.西药治疗组20例给予西药常规治疗,观察咳嗽及其他症状的变化.结果 中药治疗组临床控制9例,显效15例,有效13例,无效5例,总有效率88%;西药治疗组临床控制4例,显效5例,有效8例,无效3例,总有效率85%,两组比较在总有效率上无明显差异.在观察治疗后患儿的咳嗽、大便、胃纳及自汗等变化上,中药治疗组则明显优于西药治疗组(P<0.05).结论 中药二仙饮能有效地治疗小儿慢性咳嗽,且在固扶小儿正气、调理脾胃功能方面优于西药.%Objective To observe the clinical effect of Chinese medicine Erxian Decoction on chronic cough in children. Methods Sixty - two patients with chronic cough were randomly divided into two groups. Fourty - two cases in Chinese medicine treatment group were treated with Chinese medicine Erxian Decoction. Twenty cases in Western medicine treatment group were treated with conventional treatment of Western medicine. Changes in cough and other symptoms were observed. Results In the Chinese medicine treatment group,9 cases achieved clinical control,15 cases had marked effect, 13 cases were effective,5 cases had no effect. The total effective rate was 88% . In the Western medicine treatment group,4 cases achieved clinical control,5 cases had marked effect, 8 cases were effective,3 cases had no effect. The total effective rate was 85% . The total effective rate was not significantly different betwwen the two groups. In cough, stool, appetite, and spontaneous perspiration and other changes after treatment, the Chinese medicine treatment group was significantly better than the Western medicine treatment group ( P < 0. 05 ) . Conclusion Chinese medicine Erxian Decoction can effectively treat children with chronic cough. In strengthening children

  14. LECTURES ON ACUPUNCTURE Part Ⅱ Typical Cases of Cough

    Institute of Scientific and Technical Information of China (English)

    WANG Wei; DONG Hongying; XU Junfeng

    2002-01-01

    @@ Case Ⅰ Male, age of 57 years. History of cough:The patient suffered from cough with profuse sputum for 3 years more. His disorder attacked easily when the climate changed suddenly in autumn and winter. The symptoms such as cough with sticky sputum were more serious. Antibiotics did not work well due to repeated oral administration while the disease attacked. In the day time, the patient always had the symptoms of fullness in chest, poor appetite, and body heaviness. In recent two weeks, the patient had symptoms of cough with profuse white and sticky sputum, fullness in chest, dyspnea, dryness in the mouth but without desire for drinking water, and tiredness.

  15. Cough and Cold Medicine Abuse (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Cough and Cold Medicine Abuse KidsHealth > For Parents > Cough ... cough and cold medicine. Why Do Kids Abuse Cough and Cold Remedies? Before the U.S. Food and ...

  16. Cough management: a practical approach

    OpenAIRE

    De Blasio, Francesco; Virchow, Johann C; Polverino, Mario; Zanasi, Alessandro; Behrakis, Panagiotis K; Kilinç, Gunsely; Balsamo, Rossella; De Danieli, Gianluca; Lanata, Luigi

    2011-01-01

    Cough is one of the most common symptoms for which patients seek medical attention from primary care physicians and pulmonologists. Cough is an important defensive reflex that enhances the clearance of secretions and particles from the airways and protects the lower airways from the aspiration of foreign materials. Therapeutic suppression of cough may be either disease-specific or symptom related. The potential benefits of an early treatment of cough could include the prevention of the viciou...

  17. Acute cough in adults

    Institute of Scientific and Technical Information of China (English)

    Jochen W L Cals; Nick A Francis

    2010-01-01

    @@ A healthy, non-smoking 54 year old woman consults with a severe acute cough. It started two weeks ago with symptoms of a common cold, but she is worried about its duration and would like something to "clear it up. "

  18. Efficacy of coughing in tetraplegic patients

    NARCIS (Netherlands)

    van der Schans, CP; Piers, DA; Mulder, GA

    2000-01-01

    Study Design. A randomized cross-over design study in six tetraplegic patients. Objectives. To investigate the efficacy of coughing in tetraplegic patients. Summary of Background Data. In tetraplegic patients, pulmonary complications due to insufficient clearance of bronchial mucus frequently are de

  19. Important drugs for cough in advanced cancer.

    Science.gov (United States)

    Homsi, J; Walsh, D; Nelson, K A

    2001-11-01

    Cough is a defense mechanism that prevents the entry of noxious materials into the respiratory system and clears foreign materials and excess secretions from the lungs and respiratory tract. In advanced cancer, it is a common symptom that interferes with the patient's daily activity and quality of life. Empiric treatment with antitussive agents is often needed. Two classes of antitussive drugs are available: (1) centrally acting: (a) opioids and (b) non-opioids; (2) peripherally acting: (a) directly and (b) indirectly. Antitussive availability varies widely around the world. Many antitussives, such as benzonatate, codeine, hydrocodone, and dextromethorphan, were extensively studied in the acute and chronic cough settings and showed relatively high efficacy and safety profiles. Benzonatate, clobutinol, dihydrocodeine, hydrocodone, and levodropropizine were the only antitussives specifically studied in cancer and advanced cancer cough. They all have shown to be effective and safe in recommended daily dose for cough. In advanced cancer the patient's current medications, previous antitussive use, the availability of routes of administration, any history of drug abuse, the presence of other symptoms and other factors, all have a role in the selection of antitussives for prescription. A good knowledge of the pharmacokinetics, dosage, efficacy, and side effects of the available antitussives provides for better management.

  20. Whooping Cough PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2015-01-22

    This 30 second PSA encourages pregnant women to get the whooping cough vaccine, called Tdap, during the third trimester of each pregnancy in order to pass antibodies to their babies so they are born with protection against this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  1. Chronic endocarditis due to Legionella anisa: a first case difficult to diagnose

    Directory of Open Access Journals (Sweden)

    F. Compain

    2015-11-01

    Full Text Available Endocarditis due to Legionella spp. is uncommon but presumably underestimated given the prevalence of Legionellae in the environment. We report a first and unusual case of chronic native valve endocarditis due to L. anisa and advocate that the diagnosis of endocarditis be made collaboratively between the cardiologist, surgeon, microbiologist and pathologist.

  2. Chronic endocarditis due to Legionella anisa: a first case difficult to diagnose

    Science.gov (United States)

    Compain, F.; Bruneval, P.; Jarraud, S.; Perrot, S.; Aubert, S.; Napoly, V.; Ramahefasolo, A.; Mainardi, J.-L.; Podglajen, I.

    2015-01-01

    Endocarditis due to Legionella spp. is uncommon but presumably underestimated given the prevalence of Legionellae in the environment. We report a first and unusual case of chronic native valve endocarditis due to L. anisa and advocate that the diagnosis of endocarditis be made collaboratively between the cardiologist, surgeon, microbiologist and pathologist. PMID:26693025

  3. The clinical significance of R35 in IOS examination and health guidance for the preschoolers with chronic cough%学龄前慢性咳嗽患儿IOS检查中R35的临床意义

    Institute of Scientific and Technical Information of China (English)

    谭娴玲; 邹商群; 陈宏君; 黄春平; 林桂艳

    2014-01-01

    Objective:To explore the clinical significance of R35 in impulse oscillometry system( IOS) and the health guidance. Methods:240 cases of pa-tients with chronic cough used IOS examination to observe the indexes and the graphics changes. Patients with nasal itching,nasal congestion,sneezing and or position changes cough and clear voice of cough as the observation group,others as the control group. Results:The indexes of IOS of two groups has signifi-cant(P0. 05). Conclusion:IOS can re-flect the change of each part of the respiratory system disease,especially in patients with atypical clinical symptoms and early auxiliary examination,it can provide objective basis for early clinical treatment and care for health guidance,to improve the quality of life in this part of the crowd.%目的::探讨学龄前慢性咳嗽患儿强迫脉冲振荡( IOS)检查中R35的临床意义及健康指导。方法:选择我院肺功能室2013年6~12月240例诊断为慢性咳嗽患儿,有鼻塞、鼻痒等变应性鼻炎或哮喘合并鼻炎和或有早期咳嗽或体位改变咳嗽加重等上气道咳嗽综合征表现的120例患儿纳入观察组,其余没有上述综合征表现的咳嗽患儿120例纳入对照组。两组患儿均进行IOS检查,对两组5岁以上的患儿同时进行通气功能检测,观察其指标及图形变化。结果:观察组IOS各项参数与对照组比较有统计学意义(P0.05)。结论:IOS检查能很好地反应呼吸系统各部位疾病的改变,特别是临床症状不典型患儿,对其进行早期辅助检查,能为临床治疗和护理健康指导提供早期客观依据,提高生活质量。

  4. Effect Analysis of Pharmaceutical Care Intervention on Children with Chronic Cough%药学服务干预儿童慢性咳嗽的效果分析

    Institute of Scientific and Technical Information of China (English)

    程志宏; 陈彩云

    2015-01-01

    减少药费支出。%Objective:Through providing pharmaceutical care to the children with chronic cough and their families to improve the therapeutic effects of chronic cough and promote rational use of drugs.Methods:A total of 182 children aged 0 ~14 years old,who were diagnosed as chronic cough in our hospital during the second half of 2013,were divided into cough variant asthma(CVA),upper airway cough syndrome(UACS)and post infection cough(PIC)groups by the causes of cough and number of patients in each group was 69,62 and 51 respectively. Each group was randomly divided into experimental group and control group. The experimental groups received not only conventional treatment but also pharmaceutical care intervention,including questionnaire design and fulfillment,education before treatment,the establishment of drug record,feedback to the doctors,outpatient counseling and telephone follow-up for patients. The control groups only received conventional treatment. Investigation and analysis of the experimental and control groups were made on the medication use,times of outpatient and emergency visits upon outbreak of disease and the total medication expenses.Results:In CVA group,oral antibiotics consumption rate decreased to 0.00% after three month intervention by pharmaceutical care, which was significantly lower than that in control group(21.74%)with the statistical significance ofP< 0.05. The utilization of inhaled corticosteroids in experimental group was 100.00% through the period of pharmaceutical care,which was higher than that in control group(30.43%)(P< 0.05). In UACS group,the utilization rate of oral antibiotics in intervention group decreased to 0.00%,which was much lower than that in control group(26.83%) (P< 0.05). The utilization rates of inhaled corticosteroids in experimental group increased to 38.10% and 47.62% after one and three month interventions of pharmaceutical care,while there were only 12.2% and 9.76% in control group(P< 0.05). In PIC group,the usage rate of oral antibiotics decreased

  5. Therapeutic Efficacy Observation on Acupoint Sticking for Edema Due to Chronic Cardiac Failure

    Institute of Scientific and Technical Information of China (English)

    Xu Jia-li

    2014-01-01

    Objective: To evaluate the therapeutic effect of acupoint sticking with Chinese herbs for edema due to chronic cardiac failure. Methods: One hundred and seventy patients in conformity with the diagnostic criteria of edema due to chronic cardiac failure were randomly divided into two groups, 85 cases in each group. The observation group was treated by oral administration of diuretics plus acupoint sticking with Chinese herbs. The control group was treated just by oral administration of diuretics same as the observation group. The therapeutic effects were evaluated after continuous intervention for 14 d. Results: The total effective rate was 90.6% in the observation group, remarkably higher than 67.1% in the control group. The difference of overall therapeutic effect between the two groups was statistically significant (P Conclusion: The therapeutic effect of acupoint sticking with Chinese herbs plus oral administration of diuretics is better than simple oral administration of diuretics in treatment of edema due to chronic cardiac failure.

  6. A Prospective, Open Label, Observational Study to Assess the Safety and Efficacy of Herbal Cough Syrup Mykoff® in Patients Suffering from Cough of Varied Aetiologies

    Directory of Open Access Journals (Sweden)

    Mangesh Bhalerao

    2013-06-01

    Full Text Available A prospective, open label, observational study was conducted at general outpatient clinic to assess the safety and efficacy of herbal cough syrup Mykoff® in patients suffering from cough of varied aetiologies. The patients of either sex, age > 3yrs, suffering from cough due to common cold, mild to moderate upper respiratory tract infections, allergic cough and smoker’s cough were enrolled. The safety was evaluated by means of an analysis of adverse events. In addition, efficacy and tolerability were analysed from the following grades by patients and confirmed by doctor. Of 50 patients, 63% were diagnosed with cough due to upper respiratory tract infections, 17% common cold, 12% allergic cough and 8% smoker’s cough. Substantial improvement, i.e., excellent to good response, in relief of cough was noted in 42 (84% out of 50 patients and fair response in another 4 (8%. Only 4 out of 50 patients showed no relief in symptoms. Most of the patients (98% accepted the remedy well. Only one adverse event was reported. However, a relation to the medication was classified to be unlikely. The test drug Mykoff® is an effective and safe cough syrup that is highly acceptable for patients with cough of short duration.

  7. Laryngeal structure and function in dogs with cough.

    Science.gov (United States)

    Johnson, Lynelle R

    2016-07-15

    OBJECTIVE To investigate the prevalence and type of laryngeal abnormalities in dogs examined because of cough that did not have signs of upper airway disease and to compare the prevalence of those abnormalities among dogs with various respiratory tract diseases. DESIGN Prospective study. ANIMALS 138 dogs with cough that did not have signs of upper airway disease. PROCEDURES The study was conducted between July 2001 and October 2014 and included dogs examined for cough that had laryngoscopic and bronchoscopic examinations performed by 1 examiner. Laryngeal hyperemia and swelling were recorded, and laryngeal function was assessed before and after doxapram stimulation when indicated. Results were compared among dogs on the basis of cough duration (acute [ 2 months]) and disease diagnosed (inflammatory airway disease, airway collapse, lower respiratory tract infection, and eosinophilic bronchopneumopathy). RESULTS Laryngeal hyperemia was detected in 73 of 134 (54%) dogs with cough of subacute or chronic duration, and its prevalence did not vary significantly among dogs with various diseases. Thirteen dogs had laryngeal paresis, and 13 dogs had laryngeal paralysis; dysphonia (n = 2) and stridor (1) were uncommon findings in those dogs. The prevalence of laryngeal dysfunction (paresis or paralysis) did not differ significantly among diseases. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that 26 of 138 (19%) dogs examined because of cough alone had laryngeal dysfunction, which suggested that a complete laryngoscopic examination should be included in the diagnostic evaluation of dogs with cough.

  8. Interventions for cough in cancer.

    OpenAIRE

    Molassiotis, Alex; Bailey, Chris; Caress, Ann; Brunton, Lisa; Smith, Jacky

    2010-01-01

    BACKGROUND: Cough is a common symptom in patients with malignancies, especially in patients with lung cancer. Cough is not well controlled in clinical practice and clinicians have few management options to treat it. OBJECTIVES: The primary objective of this review was to determine the effectiveness of interventions, both pharmacological and non-pharmacological, (other than chemotherapy and external beam radiotherapy) in the management of cough in malignant disease (especially in lung cancer)....

  9. Persistent cough: is it asthma?

    OpenAIRE

    Faniran, A; Peat, J; Woolcock, A

    1998-01-01

    The aim of this study was to determine if children in the community with persistent cough can be considered to have asthma. A validated questionnaire was given to the parents of 1245 randomly selected children aged 6-12 years. Atopy was measured with skin prick tests. Children with persistent cough had less morbidity and less atopy compared with children with wheeze. Although the syndrome commonly referred to as "cough variant asthma" could not be shown in this study, a sign...

  10. Oral mucosa alterations in chronic hepatitis and cirrhosis due to HBV or HCV infection.

    Science.gov (United States)

    Sulka, Agnieszka; Simon, Krzysztof; Piszko, Paweł; Kalecińska, Ewa; Dominiak, Marzena

    2006-03-01

    The aim of the study was to evaluate the character of lesions within oral mucosa in patients suffering from chronic hepatitis and cirrhosis of the liver due to either HBV or HCV infection. A total of 74 patients treated at the Clinic of Infectious Diseases in Wrocław for chronic hepatitis B (20 patients, group I) and for chronic hepatitis C (23 patients group III) and cirrhosis of the liver due to HBV (15 patients , group II) and HCV (16 patients, group IV) infection. The control group comprised 29 healthy subjects. Lesions within the oral mucosa found on clinical examinations were confirmed with a histopathological evaluation. Patients suffering from chronic hepatitis B revealed leukoplakia (1/20), melanoplakia (1/20), petechiae (1/20), 17 patients from this group did not show any changes. Patients suffering from chronic hepatitis C revealed leukoplakia (6/23), Delbanco's disease (2/23), melanoplakia (1/23), lichen planus (1/23), petechiae (1/23), 12 patients from this group did not show any changes. Patients suffering from cirrhosis of the liver due of HBV infection revealed leukoplakia (3/15) petechiae (2/15), Delbanco's disease (1/15), angular cheilitis (1/15), aphthae (1/15), 7 patients from this group did not reveal any changes. Patients suffering from cirrhosis of the liver due of HCV infection revealed petechiae (2/16), melanoplakia (1/16), candidosis (1/16), labial herpes (1/16), 11 patients from this group did not reveal any changes. In control group we observed leukoplakia (3/29), Delbanco's disease (1/29), labial herpes (1/29), petechiae (1/29), and 23 subjects did not present pathological lesions within the oral mucosa. Results indicate the lack of connection between chronic HBV and HCV infection as well as the stage of the disease with the incidence and character of oral lesions in oral mucosa.

  11. [Chronic bone pain due to raised FGF23 production? The importance of determining phosphate levels

    NARCIS (Netherlands)

    Jongh, R.T. de; Vervloet, M.G.; Bravenboer, N.; Heijboer, A.C.; Heijer, M. den; Lips, P.

    2013-01-01

    Hypophosphatemia is an important finding in the evaluation of patients with chronic bone pain. Fibroblast-growth factor 23 (FGF23) plays a role in the differential diagnosis of hypophosphatemia. A 34-year-old man had progressive pain in both shoulders and hips due to hypophosphatemic osteomalacia. H

  12. [Risk of acute hepatic insufficiency in children due to chronic accidental overdose of paracetamol (acetaminophen)

    NARCIS (Netherlands)

    Hameleers-Snijders, P.; Hogeveen, M.; Smeitink, J.A.M.; Kramers, C.; Draaisma, J.M.T.

    2007-01-01

    Two girls aged 4 and 3 years, respectively, experienced acute liver failure due to accidental ingestion of supratherapeutic doses of paracetamol (90 mg/kg/day or more). Recognition of chronic paracetamol intoxication as a cause of acute hepatic failure is often delayed. It is important to consider t

  13. 慢性咳嗽伴气道高反应性患儿临床特征%Clinical features of chronic cough with airway hyper-responsiveness in children

    Institute of Scientific and Technical Information of China (English)

    邬宇芬; 张皓; 张欣; 郭艳芳; 董沛晶; 朱晓红

    2016-01-01

    目的 研究慢性咳嗽伴支气管激发试验阳性患儿的临床特征及常规肺通气功能.方法 选取2012年12月至2014年12月在上海交通大学医学院附属上海儿童医学中心、上海市浦东新区公利医院、上海市浦东医院3家三级医院门诊就诊的慢性咳嗽患儿450例,在其就诊及随访时完成问卷调查、常规肺通气功能检查及支气管激发试验.最后完成者共373例,比较其中支气管激发试验阳性组和阴性组临床特征和常规通气肺功能差异.结果 支气管激发试验阳性236例患儿中,170例(72.03%)以干咳为主,139例(58.90%)咳嗽时相多在夜间,明显高于阴性组[27.00%(37/137例)、22.63%(31/137例)],2组比较差异均有统计学意义(x2=71.154、45.973,P均<0.01);支气管激发试验阳性组患儿中123例(52.12%)患儿有湿疹、57例(24.15%)有变应性结膜炎、95例有吸入过敏(40.25%),均高于阴性组[32.85%(45/137例)、10.95%(15/137例)、18.98%(26/137例)],差异均有统计学意义(x2 =13.006、9.701、17.904,P均<0.01);支气管激发试验阳性组患儿家族中有43例(18.22%)家庭成员有支气管哮喘(哮喘)病史,明显高于阴性组[9.49%(13/137例)],差异有统计学意义(x2=5.179,P=0.023).常规肺通气功能方面,支气管激发试验阳性组患儿中有120例(50.85%)患儿存在小气道功能病变,明显高于阴性组[36.50%(50/137例)],差异有统计学意义(x2=7.197,P=0.007).干咳的敏感性和特异性均较高,分别 为72.03%和72.99%,哮喘家族史的特异性最高(90.51%),夜间咳嗽及变应性结膜炎等也有较高的特异性.结论 肺功能检查中反映小气道功能的指标异常,结合哮喘家族史及慢性咳嗽患儿相关的湿疹、变应性结膜炎、吸入过敏病史等临床特征,可以更好地预测气道高反应.%Objective To study the clinical features and spirometry of children with chronic cough and positive findings by

  14. Pathogenesis of nephrogenic diabetes insipidus due to chronic administration of lithium in rats.

    OpenAIRE

    S. Christensen; Kusano, E; Yusufi, A N; Murayama, N; Dousa, T P

    1985-01-01

    A polyuric syndrome with nephrogenic diabetes insipidus (NDI) is a frequent consequence of prolonged administration of lithium (Li) salts. Studies in the past, mainly the acute and in vitro experiments, indicated that Li ions can inhibit hydroosmotic effect of [8-arginine]vasopressin (AVP) at the step of cAMP generation in vitro. However, the pathogenesis of the NDI due to chronic oral administration of low therapeutic doses of Li salts is not yet clarified. We conducted a comprehensive study...

  15. Modelling of coughed droplets in a hospital ward

    DEFF Research Database (Denmark)

    Sadrizadeh, Sasan; Nielsen, Peter Vilhelm

    2016-01-01

    Coughing and its importance for spreading respiratory infectious diseases has been confirmed in many previous studies. The dispersion process of respiratory droplets released by the coughing of a patient in a hospital ward was studied using computational fluid dynamics simulation. Two relatively...... realistic three-dimensional thermal mannequins with a parallel bed arrangement simulated the patients. The maximum dispersion distances in time under ward ventilation conditions were studied. A velocity profile simulated a time-dependent cough with total duration of 0.4 s. The results indicated...... that the transport characteristic of droplets due to coughing is highly influenced by their size. Although the effects of gravity or inertia on small droplets ( 40 μm are significantly affected by gravity and soon fall...

  16. Clinical Implication of Cough CPR in Cardiac Cath Lab

    Directory of Open Access Journals (Sweden)

    Monish S Rau

    2013-02-01

    Full Text Available A 60 year-old-male with inferoposterior ST-elevation myocardial infarction (STEMI was shifted to cardiac cath lab for primary percutaneous coronary intervention (PCI. Coronary angiography revealed right coronary artery (RCA dominance with complete occlusion of the RCA in mid vessel. During angioplasty, the patient developed reperfusion induced Bezold Jarisch Reflex (BJR with profound bradycardia along with decrease in systolic pressure. The patient was asked to cough. The use of cough-CPR maintained the consciousness as the patient was getting syncopal. This report focuses on BJR and cough-CPR specific to interventional cardiology practice within the catheterization laboratory. Awareness of the fact that BJR may develop due to successful restoration of flow which can be managed with cough CPR, atropine and fluids can avoid the administration of vasoconstrictors.

  17. Night cough and general practice research.

    Science.gov (United States)

    Toop, L J; Howie, J G; Paxton, F M

    1986-02-01

    Thirty-four children, aged between three and nine years, presenting with nocturnal cough, were studied on successive nights using an automatic voice activated tape recorder system. Children with a family history of atopy coughed significantly more than children without such a family history. A wide variation in cough frequency was found both between and within subjects. No effects of treatment on cough frequency were demonstrated. Some of the physiological and pathological mechanisms underlying night cough are discussed.

  18. 过敏原皮肤点刺试验在成人慢性咳嗽病因诊断中的应用价值%Applying allergen skin prick test to etiological diagnosis of chronic cough in adult patients

    Institute of Scientific and Technical Information of China (English)

    丁慧强; 王莹; 陈亮

    2014-01-01

    目的:了解我院就诊的成人慢性咳嗽患者变应原分布情况及评价SPT的应用价值。方法:回顾性分析132例慢性咳嗽患者皮肤点刺试验结果,并比较不同性别、不同年龄段慢性咳嗽患者SPT阳性率结果。结果:①132例慢性咳嗽患者SPT结果阳性率为75.76%。不同性别慢性咳嗽患者SPT阳性率,经比较差异无统计学意义(χ2=0.530,P=0.466)。②14种过敏原中,SPT阳性率最高的为粉尘螨,户尘螨、蟑螂、花粉(包括蒿属花粉、葎草花粉、梧桐花粉、白桦花粉、玉米花粉)、真菌(包括酵母菌、青霉菌)、棉絮、猫毛、狗毛依次降低,最少为羽毛。尘螨点刺试验阳性率与其他过敏原相比,差异有高度统计学意义(χ2=715.334,P=0.000)。③不同年龄段慢性咳嗽患者SPT阳性率结果差异有统计学意义(χ2=10.305,P<0.05)。除中年人(45~59岁)与老年人(60~75岁) SPT阳性率之间的差异有统计学意义外,其余两两之间的差异均无统计学意义,可认为中年人SPT阳性率高于老年人。结论:粉尘螨和户尘螨是我院就诊的成人慢性咳嗽患者最常见的变应原,慢性咳嗽患者应尽早行过敏原皮肤点刺试验,其对慢性咳嗽患者的病因诊断有重要意义,并为舌下脱敏治疗提供临床依据。%Objective:To investigate the distribution of allergens in adult patients with chronic cough in Yijishan Hospital ,and evaluate the application value of skin prick testing (SPT).Methods:SPT results were retrospectively summarized in 132 adult cases of chronic cough,and positive SPTs were com-pared in genders and ages.Results:①Positive SPT was found in 75.76% of the 132 patients,yet there was no statistical significance in ages(χ2 =0.530, P=0.466);②Fourteen allergens detected via SPT stood from the highest to the lowest by Dermatophagoides farinae,house dust mites

  19. Probable warfarin interaction with menthol cough drops.

    Science.gov (United States)

    Coderre, Karen; Faria, Claudio; Dyer, Earl

    2010-01-01

    Warfarin is a widely used and effective oral anticoagulant; however, the agent has an extensive drug and food interaction profile. We describe a 46-year-old African-American man who was receiving warfarin for a venous thromboembolism and experienced a decrease in his international normalized ratio (INR). No corresponding reduction had been made in his warfarin dosage, and no changes had been made in his concomitant drug therapy or diet. The patient's INR fell from a therapeutic value of 2.6 (target range 2-3) to 1.6 while receiving a weekly warfarin dose of 50 mg. His INR remained stable at 1.6 for 3 weeks despite incremental increases in his warfarin dose. The patient reported that he had been taking 8-10 menthol cough drops/day due to dry conditions at his workplace during the time period that the INR decreased. Five days after discontinuing the cough drops, his INR increased from 1.6 to 2.9. Over the subsequent 5 weeks, his INR was stabilized at a much lower weekly warfarin dose of 40 mg. Use of the Naranjo adverse drug reaction probability scale indicated that the decreased INR was probably related to the concomitant use of menthol cough drops during warfarin therapy. The mechanism for this interaction may be related to the potential for menthol to affect the cytochrome P450 system as an inducer and inhibitor of certain isoenzymes that would potentially interfere with the metabolism of warfarin. To our knowledge, this is the second case report of an interaction between warfarin and menthol. Patients receiving warfarin should be closely monitored, as they may choose to take over-the-counter products without considering the potential implications, and counseled about a possible interaction with menthol cough drops.

  20. Duloxetine in the treatment of chronic pain due to fibromyalgia and diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Alan Wright

    2010-12-01

    Full Text Available Alan Wright, Kyle E Luedtke, Chad VanDenBergCenter for Clinical Research, Mercer University, Atlanta, Georgia, USAAbstract: Duloxetine is a serotonin-norepinephrine reuptake inhibitor approved by the US Food and Drug Administration for the treatment of fibromyalgia and painful diabetic neuropathy at doses of 60 mg daily. Duloxetine has been shown to significantly improve the symptoms of chronic pain associated with these disorders, as measured by the Fibromyalgia Impact Questionnaire, Brief Pain Inventory scores, the Clinical Global Impressions Scale, and other various outcome measures in several placebo-controlled, randomized, double-blind, multicenter studies. Symptom improvement generally began within the first few weeks, and continued for the duration of the study. In addition, the efficacy of duloxetine was found to be due to direct effects on pain symptoms rather than secondary to improvements in depression or anxiety. Adverse events including nausea, constipation, dry mouth, and insomnia, were mild and transient and occurred at relatively low rates. In conclusion, duloxetine, a selective inhibitor for the serotonin and norepinephrine transporters, is efficacious in the treatment of chronic pain associated with fibromyalgia or diabetic neuropathy, and has a predictable tolerability profile, with adverse events generally being mild to moderate.Keywords: duloxetine, chronic pain, neuropathic pain, fibromyalgia, efficacy, safety

  1. Dynamics of Voluntary Cough Maneuvers

    Science.gov (United States)

    Naire, Shailesh

    2008-11-01

    Voluntary cough maneuvers are characterized by transient peak expiratory flows (PEF) exceeding the maximum expiratory flow-volume (MEFV) curve. In some cases, these flows can be well in excess of the MEFV, generally referred to as supramaximal flows. Understanding the flow-structure interaction involved in these maneuvers is the main goal of this work. We present a simple theoretical model for investigating the dynamics of voluntary cough and forced expiratory maneuvers. The core modeling idea is based on a 1-D model of high Reynolds number flow through flexible-walled tubes. The model incorporates key ingredients involved in these maneuvers: the expiratory effort generated by the abdominal and expiratory muscles, the glottis and the flexibility and compliance of the lung airways. Variations in these allow investigation of the expiratory flows generated by a variety of single cough maneuvers. The model successfully reproduces PEF which is shown to depend on the cough generation protocol, the glottis reopening time and the compliance of the airways. The particular highlight is in simulating supramaximal PEF for very compliant tubes. The flow-structure interaction mechanisms behind these are discussed. The wave speed theory of flow limitation is used to characterize the PEF. Existing hypotheses of the origin of PEF, from cough and forced expiration experiments, are also tested using this model.

  2. Acupuncture for Chronic Urinary Retention due to Spinal Cord Injury: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jia Wang

    2016-01-01

    Full Text Available No systematic review has been published on the use of acupuncture for the treatment of chronic urinary retention (CUR due to spinal cord injury (SCI. The aim of this review was to assess the effectiveness and safety of acupuncture for CUR due to SCI. Three randomized controlled trials (RCTs including 334 patients with CUR due to SCI were included. Meta-analysis showed that acupuncture plus rehabilitation training was much better than rehabilitation training alone in decreasing postvoid residual (PVR urine volume (MD −109.44, 95% CI −156.53 to −62.35. Likewise, a combination of acupuncture and aseptic intermittent catheterization was better than aseptic intermittent catheterization alone in improving response rates (RR 1.23, 95% CI 1.10 to 1.38. No severe adverse events were reported. In conclusion, acupuncture as a complementary therapy may have a potential effect in CUR due to SCI in decreasing PVR and improving bladder voiding. Additionally, acupuncture may be safe in treating CUR caused by SCI. However, due to the lack of high quality RCTs, we could not draw any definitive conclusions. More well-designed RCTs are needed to provide strong evidence.

  3. Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Rosaria M. Ruggeri

    2010-01-01

    Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

  4. Efficacy and safety of Linkus, Aminophylline diphenhydramine and acefyllin piperazine for the treatment of cough in children.

    Science.gov (United States)

    Rehman, Hina; Naveed, Safila; Usmanghani, Khan

    2016-05-01

    To evaluate the safety and efficacy of Linkus, Aminophylline with Diphenhydramine group and Acefyllin Piperazine with Diphenhydramine cough syrup on children having cough and sleep difficulty associated with cough. To determine the effects of Linkus polyherbal syrup (group A) and compared with other parallel allopathic groups (Group B and C) for cough on children and associated sleep quality and improvement. 360 children having cough inducted in 3 different groups randomly selected. Three parallel groups were the part of the study. The first study group was the herbal syrup Linkus, second group of children were taking a syrup of multinational pharmaceutical industry having Aminophylline plus Diphenhydramine however the third group received another famous brand having Acefyllin Piperazine with Diphenhydramine. Informed assent and informed consent have taken from the study subjects and their parents. Subjects with acute cough were included in the study however the subjects with chronic cough considered to be excluded. Every group of individual in the study was informed about the investigational drugs provided. Ethnic groups, frequency of cough and diseases illness (Cough impact on child and its sleep of three different syrups (every group) were assessed on day1 and day 14(pcough including side effects as compare to the other parallel groups B and C (Aminophylline with Diphenhydramine and Acefyllin Piperazine with Diphenhydramine). For nocturnal sleep Linkus providing better results in cough and associated problems. Pain were significantly reduce on day 14 with the herbal Linkus syrup group A (coughs and benefit lung functions and better sleep facilitation.

  5. Chronic ulceration of the leg following extensive scarring due to a snake bite complicated by squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mello, L.F.B.; Barcelos, M.G.; Nogueira Neto, N.C. [Dept. of Radiology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Meohas, W. [Dept. of Surgery (Bone and Soft Tissue), National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Pinto, L.W. [Department of Surgical Pathology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Melo, P.A. [Pharmacology Lab. of Snake-related Toxins, Department of Basic and Clinical Pharmacology, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Smith, J. [Dept. of Radiology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Rua Humberto de Campos 974/1301, Leblon 22430 - 190, Rio de Janeiro, RJ (Brazil)

    2000-05-01

    Chronic ulcers of the leg are common in Brazil, perhaps more common than in the developed world. We report a case of a chronic ulcer of the leg following extensive scarring due to a bite by a venomous snake, which eventually led to a squamous cell carcinoma. (orig.)

  6. Considering the influence of artificial environmental noise to study cough time-frequency features

    Science.gov (United States)

    Van Hirtum, A.; Berckmans, D.

    2003-09-01

    In general the study of the cough mechanism and sound in both animal and human is performed by eliciting coughing in a reproducible way by nebulization of an irritating substance. Due to ventilation the controlled evaporation-protocol causes artificial noises from a mechanical origin. The resulting environmental low-frequency noises complicate cough time-frequency features. In order to optimize the study of the cough-sound the research described in this paper attempts on the one hand to characterize and model the environmental noises and on the other hand to evaluate the influence of the noise on the time-frequency representation for the intended cough sounds by comparing different de-noising approaches. Free field acoustic sound is continuously registered during 30 min citric acid cough-challenges on individual Belgian Landrace piglets and during respiratory infection experiments, with a duration of about 10 days, where room-ventilation was present.

  7. Recognizing and Preventing Whooping Cough

    Centers for Disease Control (CDC) Podcasts

    2015-01-22

    This podcast provides information about the symptoms of whooping cough and how vaccines can help prevent this serious disease for people of all ages. It is especially important for those who will have close contact with a baby to be up to date with their whooping cough vaccine.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  8. Greater trochanteric pain syndrome due to tumoral calcinosis in a patient with chronic kidney disease.

    Science.gov (United States)

    Baek, Dongjin; Lee, Sang Eun; Kim, Woo-Jin; Jeon, Sanghoon; Lee, Kihwa; Jung, Jaewook; Joo, Hyunchul; Park, Jaehong; Kim, Yonghan; Choi, Young-gyun

    2014-01-01

    Tumoral calcinosis is a rare syndrome characterized by massive subcutaneous soft tissue deposits of calcium phosphate near the large joints. It is more prevalent in patients with chronic kidney disease undergoing dialysis. A 57-year-old woman was referred to our pain clinic with the complaint of severe pain in the left buttock and lateral hip. The patient had been suffering from chronic kidney disease for 10 years and had been undergoing peritoneal dialysis over the past 5 years. The patient's symptom was initially suspected to be of lumbar origin at the L5 level and a left L5 transforaminal epidural block was performed, but without success. Re-evaluation of the physical examination revealed severe tenderness over the left greater trochanter and piriformis muscle. On ultrasonographic evaluation, multiple mass-like lesions in the left buttock were observed. About 30 mL of fluid was aspirated from the cystic lesions, followed by 30 mL mixture of 0.08% levobupivacaine and triamcinolone 40 mg injected into the bursa under ultrasound guidance, which brought pain relief. Trochanteric bursitis was thought of as the cause of the symptoms. The patient was diagnosed with tumoral calcinosis based on the past medical history, simple plain radiographs, and hip magnetic resonance imaging (MRI). We diagnosed a case of greater trochanteric pain syndrome due to tumoral calcinosis related to chronic kidney disease in a patient whose symptoms had initially been considered to be radiating leg pain caused by lumbar spinal disease. We report our experience of symptomatic improvement following the repeated ultrasound-guided aspiration of calcific fluid and the injection of a mixture of local anesthetic and steroid.

  9. Help Protect Babies from Whooping Cough

    Science.gov (United States)

    ... Emails CDC Features Help Protect Babies from Whooping Cough Language: English Español (Spanish) Recommend on Facebook Tweet ... few even die from the disease. Understanding Whooping Cough Vaccines: DTaP and Tdap Two vaccines in the ...

  10. FastStats: Whooping Cough or Pertussis

    Science.gov (United States)

    ... Submit What's this? Submit Button NCHS Home Whooping Cough or Pertussis Recommend on Facebook Tweet Share Compartir ... the U.S. Morbidity Reported number of new whooping cough cases: 28,639 (2013) Source: Health, United States, ...

  11. Whooping Cough and the Pertussis Vaccine

    Science.gov (United States)

    ... Gynecology Medical Conditions Nutrition & Fitness Emotional Health Whooping Cough and the Pertussis Vaccine Posted under Health Guides . ... Content Key Facts Pertussis is also called Whooping Cough. The best way to protect yourself from Pertussis ...

  12. TCM Differential Treatment of Cough Variant Asthma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong-de; DENG Yi-qi; ZHANG Yu; HAN Yun; LIN Lin; CHAO En-xiang

    2010-01-01

    @@ Cough variant asthma (CVA), also called latent asthma or cough asthma, is a special type of asthma. With gradually deepened understanding of CVA in recent years, good curative effect has been achieved in TCM treatment of CVA.

  13. Whooping Cough (Pertussis) - Fact Sheet for Parents

    Science.gov (United States)

    ... Teen Vaccine Resources Related Links Vaccines & Immunizations Whooping Cough and the Vaccine (Shot) to Prevent It Language: ... and adults is called Tdap. What is whooping cough? Whooping cough—or pertussis—is a very serious ...

  14. Efficacy and tolerability of levodropropizine in adult patients with non-productive cough. Comparison with dextromethorphan.

    Science.gov (United States)

    Catena, E; Daffonchio, L

    1997-01-01

    The results of a double-blind, randomized clinical trial involving 209 adult patients of either sex with moderate non-productive cough are reported. The therapeutic efficacy and the tolerability of levodropropizine syrup (60 mg t.i.d. for 5 days) was evaluated in comparison with dextromethorphan syrup (15 mg t.i.d. for 5 days). Efficacy was assessed by the number of coughing spells in a 6h period, the cough frequency classes, the cough intensity and the night awakenings due to cough. Tolerability was evaluated by laboratory results, vital signs and any adverse event occurred during the clinical trial, including presence or absence of somnolence. Independently from the underlying pathology and from the degree of baseline cough severity, the number of coughing spells was significantly (P levodropropizine and dextromethorphan already after the 2nd day of treatment, the effect and its time of onset being similar for both drugs. Cough intensity was significantly (P levodropropizine than with dextromethorphan. Concurrently with the relief of cough, the number of night awakenings was decreased remarkably and significantly (P levodropropizine displaying an improvement significantly higher (P levodropropizine (3.6%) group. Overall, somnolence was reported for a low percentage of patients with both drugs, with the percentage of patients experiencing this side effect being one half in the group treated with levodropropizine (4.6%) as compared with dextromethorphan (10.4%). These results confirm the antitussive effectiveness of levodropropizine and point out a more favourable benefit/risk profile when compared to dextromethorphan.

  15. The Chinese national guidelines on diagnosis and management of cough (December 2010)

    Institute of Scientific and Technical Information of China (English)

    LAI Ke-fang

    2011-01-01

    Cough is a defensive physiological reflex of the human body that enables vital clearance of secretions and harmful elements from the respiratory tract;however,frequent and intense coughing may adversely impact on a patient's work,daily life and social activities.Cough is one of the most commonly observed symptoms in clinical practice arising from a wide range of aetiologies.A chronic cough may be overlooked by clinicians,particularly if reassured by the normal appearance on a chest radiograph.Furthermore,70%-80% of these patients are readily mislabelled or diagnosed with “chronic bronchitis” or “bronchitis” in China,then typically treated with substantial but ineffective courses of antibiotics,or subjected to repeated investigations as a result of a diagnosis that is unclear,and may thus suffer more discomfort and fimancial burden from their disease.

  16. Efficacy of multiple biliary stenting for refractory benign biliary strictures due to chronic calcifying pancreatitis

    Science.gov (United States)

    Ohyama, Hiroshi; Mikata, Rintaro; Ishihara, Takeshi; Sakai, Yuji; Sugiyama, Harutoshi; Yasui, Shin; Tsuyuguchi, Toshio

    2017-01-01

    AIM To investigate endoscopic therapy efficacy for refractory benign biliary strictures (BBS) with multiple biliary stenting and clarify predictors. METHODS Ten consecutive patients with stones in the pancreatic head and BBS due to chronic pancreatitis who underwent endoscopic therapy were evaluated. Endoscopic insertion of a single stent failed in all patients. We used plastic stents (7F, 8.5F, and 10F) and increased stents at intervals of 2 or 3 mo. Stents were removed approximately 1 year after initial stenting. BBS and common bile duct (CBD) diameter were evaluated using cholangiography. Patients were followed for ≥ 6 mo after therapy, interviewed for cholestasis symptoms, and underwent liver function testing every visit. Patients with complete and incomplete stricture dilations were compared. RESULTS Endoscopic therapy was completed in 8 (80%) patients, whereas 2 (20%) patients could not continue therapy because of severe acute cholangitis and abdominal abscess, respectively. The mean number of stents was 4.1 ± 1.2. In two (20%) patients, BBS did not improve; thus, a biliary stent was inserted. BBS improved in six (60%) patients. CBD diameter improved more significantly in the complete group than in the incomplete group (6.1 ± 1.8 mm vs 13.7 ± 2.2 mm, respectively, P = 0.010). Stricture length was significantly associated with complete stricture dilation (complete group; 20.5 ± 3.0 mm, incomplete group; 29.0 ± 5.1 mm, P = 0.011). Acute cholangitis did not recur during the mean follow-up period of 20.6 ± 7.3 mo. CONCLUSION Sequential endoscopic insertion of multiple stents is effective for refractory BBS caused by chronic calcifying pancreatitis. BBS length calculation can improve patient selection procedure for therapy. PMID:28101303

  17. Cough reflex sensitivity in adolescents with diabetic autonomic neuropathy

    OpenAIRE

    2009-01-01

    Abstract Objective Diabetic autonomic neuropathy (DAN) is one of the chronic complications of diabetes mellitus which can involve one or more organ systems. DAN without apparent symptoms is more often in childhood and adolescence. While heart rate variability (HRV) and Ewing's battery of cardiovascular tests are regarded as a gold standard for the diagnosis of DAN, the examination of cough reflex sensitivity (CRS) is another possibility. The aim of this study was to compare HRV and CRS in chi...

  18. Exophiala Pneumonia Presenting with a Cough Productive of Black Sputum

    Directory of Open Access Journals (Sweden)

    Yehuda Z. Cohen

    2015-01-01

    Full Text Available Exophiala species are black, yeast-like molds that can cause subcutaneous cysts as well as disseminated disease. Isolated pneumonia due to Exophiala species is extremely uncommon. We report a case of isolated Exophiala pneumonia in a patient with bronchiectasis who presented with worsening dyspnea and a cough productive of black sputum. The production of black sputum, known as melanoptysis, is an uncommon physical finding with a limited differential diagnosis. To our knowledge, this is the first reported case of Exophiala pneumonia presenting with a cough productive of black sputum.

  19. Multicenter clinical study on Fuzhenghuayu capsule against liver fibrosis due to chronic hepatitis B

    Institute of Scientific and Technical Information of China (English)

    Ping Liu; Mo-Bin Wan; Xiong Cai; Zhi-Qing Zhang; Jun Ye; Ren-Xing Zhou; Jia He; Bao-Zhang Tang; Yi-Yang Hu; Cheng Liu; Lie-Ming Xu; Cheng-Hai Liu; Ke-Wei Sun; De-Chang Hu; You-Kuan Yin; Xia-Qiu Zhou

    2005-01-01

    AIM: To study the efficacy and safety of Fuzhenghuayu capsule (FZHY capsule, a capsule for strengthening body resistance to remove blood stasis) against liver fibrosis due to chronic hepatitis B. METHODS: Multicenter, randomized, double blinded and parallel control experiment was conducted in patients (aged from 18 to 65 years) with liver fibrosis due to chronic hepatitis B. Hepatic histologic changes and HBV markers were examined at wk 0 and 24 during treatment. Serologic parameters (HA, LM, P-Ⅲ-P, Ⅳ-C) were determined and B ultrasound examination of the spleen and liver was performed at wk 0, 12 and 24. Liver function (liver function and serologic parameters for liver fibrosis) was observedat wk 0, 6, 12, 18 and 24. Blood and urine routine test, renal function and ECG were examined before and after treatment. RESULTS: There was no significant difference between experimental group (110 cases) and control group (106 cases) in demographic features, vital signs, course of illness, history for drug anaphylaxis and previous therapy, liver function, serologic parameters for liver fibrosis, liver histologic examination (99 cases in experimental group, 96 cases in control group), HBV markers, and renal function. According to the criteria for liver fibrosis staging, meanscore of fibrotic stage(s) in experimental group after treatment (1.80) decreased significantly compared to the previous treatment (2.33, P<0.05), but there was no significant difference in mean score of fibrotic stage(s) (2.11 and 2.14 respectively). There was a significant difference in reverse rate between experimental group (52%) and control group (23.3%) in liver biopsy. With marked effect on decreasing the mean value of inflammatory activity and score of inflammation (P<0.05), Fuzhenghuayu capsule had rather good effects on inhibiting inflammatory activity and was superior to that of Heluoshugan capsule. Compared to that of pretreatment, there was a significant decrease in HA, LM, P-Ⅲ-P and

  20. Pathogenesis of nephrogenic diabetes insipidus due to chronic administration of lithium in rats.

    Science.gov (United States)

    Christensen, S; Kusano, E; Yusufi, A N; Murayama, N; Dousa, T P

    1985-06-01

    A polyuric syndrome with nephrogenic diabetes insipidus (NDI) is a frequent consequence of prolonged administration of lithium (Li) salts. Studies in the past, mainly the acute and in vitro experiments, indicated that Li ions can inhibit hydroosmotic effect of [8-arginine]vasopressin (AVP) at the step of cAMP generation in vitro. However, the pathogenesis of the NDI due to chronic oral administration of low therapeutic doses of Li salts is not yet clarified. We conducted a comprehensive study to clarify the mechanism by which Li administered orally for several weeks induces polyuria and NDI in rats. Albino rats consuming a diet which contained Li (60 mmol/kg) for 4 wk developed marked polyuria and polydipsia; at the end of 4 wk the plasma Li was 0.7 +/- 0.09 mM (mean +/- SEM; n = 36). Li-treated rats had a significantly decreased (-33%) tissue osmolality in papilla and greatly reduced cortico-papillary gradient of urea (cortex--43%; medulla--64%; papilla--74%). Plasma urea was significantly (P less than 0.001) lower in Li-treated rats (5.4 +/- 0.2 mM) compared with controls (6.8 +/- 0.3 mM). Medullary collecting tubules (MCT) and papillary collecting ducts (PCD) microdissected from Li-treated animals had higher content of protein than MCT and PCD from the control rats. The cAMP accumulation in response to AVP added in vitro was significantly (delta = -60%) reduced. Also, the cAMP accumulation in MCT and PCD after incubation with forskolin was markedly lower in Li-treated rats. Addition of 0.5 mM 1-methyl,3-isobutyl-xanthine did not restore the cAMP accumulation in response to AVP and forskolin in MCT from Li-treated animals. In collecting tubule segments from polyuric rats with hypothalamic diabetes insipidus (Brattleboro homozygotes) the AVP-dependent cAMP accumulation was not diminished. The activity of adenylate cyclase (AdC) in MCT of Li-treated rats, both the basal and the activity stimulated by AVP, forskolin, or fluoride, was significantly (delta

  1. Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children

    Science.gov (United States)

    Murad, Mohammad H.; Pringsheim, Tamara; Feinstein, Anthony; Chang, Anne B.; Newcombe, Peter A.; Rubin, Bruce K.; McGarvey, Lorcan P.; Weir, Kelly; Altman, Kenneth W.; Weinberger, Miles; Irwin, Richard S.; Adams, Todd M.; Altman, Kenneth W.; Barker, Alan F.; Birring, Surinder S.; Blackhall, Fiona; Bolser, Donald C.; Boulet, Louis-Philippe; Braman, Sidney S.; Brightling, Christopher; Callahan-Lyon, Priscilla; Canning, Brendan J.; Chang, Anne B.; Coeytaux, Remy; Cowley, Terrie; Davenport, Paul; Diekemper, Rebecca L.; Ebihara, Satoru; El Solh, Ali A.; Escalante, Patricio; Feinstein, Anthony; Field, Stephen K.; Fisher, Dina; French, Cynthia T.; Gibson, Peter; Gold, Philip; Gould, Michael K.; Grant, Cameron; Harding, Susan M.; Harnden, Anthony; Hill, Adam T.; Irwin, Richard S.; Kahrilas, Peter J.; Keogh, Karina A.; Lane, Andrew P.; Lim, Kaiser; Malesker, Mark A.; Mazzone, Peter; Mazzone, Stuart; McCrory, Douglas C.; McGarvey, Lorcan; Molasiotis, Alex; Murad, M. Hassan; Newcombe, Peter; Nguyen, Huong Q.; Oppenheimer, John; Prezant, David; Pringsheim, Tamara; Restrepo, Marcos I.; Rosen, Mark; Rubin, Bruce; Ryu, Jay H.; Smith, Jaclyn; Tarlo, Susan M.; Vertigan, Anne E.; Wang, Gang; Weinberger, Miles; Weir, Kelly; Wiener, Renda Soylemez

    2015-01-01

    BACKGROUND: We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic. METHODS: We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients’ values and preferences, and the clinical context. Final grading was reached by consensus according to Delphi methodology. RESULTS: The results of the systematic review revealed only low-quality evidence to support how to define or diagnose psychogenic or habit cough with no validated diagnostic criteria. With respect to treatment, low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough. Such therapy might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications. Based on multiple resources and contemporary psychologic, psychiatric, and neurologic criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition and tic disorder guidelines), the committee suggests that the terms psychogenic and habit cough are out of date and inaccurate. CONCLUSIONS: Compared with the 2006 CHEST Cough Guidelines, the major change in suggestions is that the terms psychogenic and habit cough be abandoned in favor of somatic cough syndrome and tic cough, respectively, even though the evidence to do so at this time is of low quality. PMID:25856777

  2. Cough reflex sensitivity in adolescents with diabetic autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Ciljakova M

    2009-12-01

    Full Text Available Abstract Objective Diabetic autonomic neuropathy (DAN is one of the chronic complications of diabetes mellitus which can involve one or more organ systems. DAN without apparent symptoms is more often in childhood and adolescence. While heart rate variability (HRV and Ewing's battery of cardiovascular tests are regarded as a gold standard for the diagnosis of DAN, the examination of cough reflex sensitivity (CRS is another possibility. The aim of this study was to compare HRV and CRS in children with diabetes mellitus. Materials and methods Sixty one patients (37 girls, 24 boys aged 15-19 suffering from diabetes mellitus type 1 completed the study. Based on HRV, patients were divided into 2 groups - with DAN (n = 25 and without DAN (n = 32, 4 patients were excluded because of ambiguous results. CRS was studied in each patient by inhalation of gradually increasing concentration of capsaicin. Results Subjects with DAN required a significantly higher concentration of capsaicin needed to evoke 2 coughs (median 625 μmol/l, IQR 68.4-625.0 μmol/l vs. median 29.3 μmol/l, IQR 9.8-156.3 μmol/l, P Conclusion Diabetes mellitus lowers the cough response. Cough reflex sensitivity appears to be another sensitive method for the evaluation of DAN in diabetes.

  3. Acidogenic Potential of “Sugar-Free” Cough Drops

    Science.gov (United States)

    Mayo, John A; Ritchie, John R

    2009-01-01

    A patient presented with extensive marginal ditching around restorations recently placed during whole-mouth rehabilitation. The patient was not xerostomic and was otherwise normal except for the self-reported excessive use of “sugar-free” cough drops sweetened with sorbitol and Isomalt® (an equimolar mix of glucosyl-mannitol and glucosylsorbitol). This prompted an in vitro investigation to determine whether Streptococcus sobrinus 6715, a cariogenic streptococcus, could grow and produce acid in growth medium containing an aqueous extract of such “sugar-free” cough drops. The results indicate that S. sobrinus 6715 uses Isomalt® and sorbitol extensively, producing terminal culture pH as low as 4.2 when grown on medium with cough drop extract containing these sugars. This pH is sufficient to demineralize dental enamel. Patients should be cautioned against the chronic overuse of “sugar-free” cough drops and other “sugar-free” confections sweetened with a mixture of Isomalt® and sorbitol. PMID:19444340

  4. Acidogenic potential of "sugar-free" cough drops.

    Science.gov (United States)

    Mayo, John A; Ritchie, John R

    2009-03-06

    A patient presented with extensive marginal ditching around restorations recently placed during whole-mouth rehabilitation. The patient was not xerostomic and was otherwise normal except for the self-reported excessive use of "sugar-free" cough drops sweetened with sorbitol and Isomalt® (an equimolar mix of glucosyl-mannitol and glucosylsorbitol). This prompted an in vitro investigation to determine whether Streptococcus sobrinus 6715, a cariogenic streptococcus, could grow and produce acid in growth medium containing an aqueous extract of such "sugar-free" cough drops. The results indicate that S. sobrinus 6715 uses Isomalt® and sorbitol extensively, producing terminal culture pH as low as 4.2 when grown on medium with cough drop extract containing these sugars. This pH is sufficient to demineralize dental enamel. Patients should be cautioned against the chronic overuse of "sugar-free" cough drops and other "sugar-free" confections sweetened with a mixture of Isomalt® and sorbitol.

  5. 咳嗽高敏感性综合征%Cough hypersensitivity syndrome

    Institute of Scientific and Technical Information of China (English)

    张怡; 邱忠民

    2015-01-01

    Cough hypersensitivity syndrome is a new diagnostic concept for chronic cough and tries to label chronic cough caused by the diverse etiologies under the umbrella of cough hypersensitivity,which may result in a change in the strategy for the management of chronic cough in the future.However,there currently is a controversy on the benefit of cough hypersensitivity syndrome and many issues remain to be solved.Its value of clinical application needs to be clarified by the further study.%咳嗽高敏感性综合征是慢性咳嗽的诊断新概念,试图从咳嗽高敏感性的角度对不同病因导致的慢性咳嗽进行统一的归纳和认识,可能对今后慢性咳嗽的诊治带来观念上的改变.不过,咳嗽高敏感性综合征的益处目前尚有争议,还有许多问题尚待解决,其临床应用价值尚需进一步的研究阐明.

  6. Chronic suppurative joint effusion due to burkholderia pseudomallei: A case report

    Directory of Open Access Journals (Sweden)

    Madhavi Deshmukh

    2013-01-01

    Full Text Available Burkholderia pseudomallei, a Gram-negative bacillus is the causative agent of Melioidosis, a glanders-like disease, primarily a disease of animals. Melioidosis has been only a rare and sporadic disease in humans outside its endemic region. Currently, diagnosis of B. pseudomallei in the clinical laboratory is very difficult, owing to low awareness of physicians to the nonspecific clinical manifestations, lack of responsiveness among microbiologists outside endemic areas, identification systems in the average sentinel laboratory, and the biosafety conditions necessary to process these organisms. We report a case of chronic left hip joint effusion in a known case of diabetes mellitus. Gram stain of computed tomography (CT-guided aspirate from the joint revealed Gram-negative bacilli along with pus cells. Culture was confirmed as Burkholderia pseudomallei on Vitek2C, which was sensitive to ceftazidime and trimethoprim/sulfmethoxazole. Unfortunately, patient could not be started on appropriate antibiotics due to delay in detection and patient succumbed to severe septicemia. This case is reported to highlight importance of automated identification and sensitivity especially in nonendemic areas and unusual antibiogram of this organism for which disc diffusion method is not standardized.

  7. Effect of tolvaptan in patients with chronic kidney disease due to diabetic nephropathy with heart failure.

    Science.gov (United States)

    Sato, Eiichi; Nakamura, Tsukasa; Amaha, Mayuko; Nomura, Mayumi; Matsumura, Daisuke; Yamagishi, Hidetsugu; Ono, Yuko; Ueda, Yoshihiko

    2014-01-01

    The efficacy of tolvaptan for treating heart failure has already been shown. Adequate data relating to the effect of tolvaptan on the correlation of water balance in renal disease are not available. A retrospective study was conducted on the efficacy and adverse reactions of tolvaptan for treating nephrotic syndrome.The subjects were 26 patients with chronic kidney failure due to diabetic nephropathy with heart failure who were administered tolvaptan and seen between December 2011 and October 2013. The endpoints were urinary output, physical findings, and blood analyses. The expression of aquaporin-2 in the collecting duct, which is related to the action of tolvaptan, was investigated by immunohistochemistry using the kidney tissue obtained for the diagnosis.Responses were seen in 19 of the patients. In the histopathological investigation there was severe glomerulosclerosis in patients with diabetic nephropathy, but the responders were noticeable in that they only had mild tubulointerstitial damage. Non-responders exhibited profound tubulointerstitial damage. The expression of aquaporin-2 was determined in 8 patients, of which 7 were responders who tested positive for aquaporin-2. The remaining case was a non-responder who showed no expression of aquaporin-2.Tolvaptan is considered effective for some cases of nephrotic syndrome. There are no clear parameters for predicting an effect, but the present study showed that aquaporin-2 was expressed in the epithelial cells of the collecting ducts of tolvaptan responders.

  8. Transient receptor potential genes, smoking, occupational exposures and cough in adults

    Directory of Open Access Journals (Sweden)

    Smit Lidwien AM

    2012-03-01

    Full Text Available Abstract Background Transient receptor potential (TRP vanilloid and ankyrin cation channels are activated by various noxious chemicals and may play an important role in the pathogenesis of cough. The aim was to study the influence of single nucleotide polymorphisms (SNPs in TRP genes and irritant exposures on cough. Methods Nocturnal, usual, and chronic cough, smoking, and job history were obtained by questionnaire in 844 asthmatic and 2046 non-asthmatic adults from the Epidemiological study on the Genetics and Environment of Asthma (EGEA and the European Community Respiratory Health Survey (ECRHS. Occupational exposures to vapors, gases, dusts, and/or fumes were assessed by a job-exposure matrix. Fifty-eight tagging SNPs in TRPV1, TRPV4, and TRPA1 were tested under an additive model. Results Statistically significant associations of 6 TRPV1 SNPs with cough symptoms were found in non-asthmatics after correction for multiple comparisons. Results were consistent across the eight countries examined. Haplotype-based association analysis confirmed the single SNP analyses for nocturnal cough (7-SNP haplotype: p-global = 4.8 × 10-6 and usual cough (9-SNP haplotype: p-global = 4.5 × 10-6. Cough symptoms were associated with exposure to irritants such as cigarette smoke and occupational exposures (p TRPV1 further increased the risk of cough symptoms from irritant exposures in asthmatics and non-asthmatics (interaction p Conclusions TRPV1 SNPs were associated with cough among subjects without asthma from two independent studies in eight European countries. TRPV1 SNPs may enhance susceptibility to cough in current smokers and in subjects with a history of workplace exposures.

  9. Effect of interferon therapy on radionuclide imaging in chronic liver diseases due to HCV infection

    Energy Technology Data Exchange (ETDEWEB)

    Ghaffar, Y.; Dorgham, L.; Lotfy, N. [Ain Shams Univ., Imbaba, Giza (Egypt)]|[Menofia Unif., Shebin El Kom (Egypt)] [and others

    1995-09-01

    Interferon (alpha-IFN) exerts a modulating effect on the immune system. Kupffer cells of the liver play an important immunological role by their uptake of various agents and particles, including colloids. We sought to discover if alpha-IFN could enhance the colloid uptake function of the Kupffer cells. The effect of alpha-IFN therapy on radioisotope scans of the liver was studied in 20 patients with chronic liver disease due to hepatitic C virus (HCV) infection who received therapy at a dose of 3 million IU for 6 mo, in another patients who received the same therapy for 12 mo and in matched control groups (10 patients with HCV infection for each study group) who did not received alpha-IFN. A {sup 99m}Tc-sulfur colloid scan of the liver was obtained for each group before and after therapy and, for control subjects, at the start and end of the study periods. The liver-to-spleen geometric mean ratio of colloid uptake was assessed. In the first study group, the mean rate of improvement in the liver-to-spleen ratio was 48% in 70% of the patients, compared to 8% in 20% of controls (p<0.05). In the second study group, mean liver-to-spleen ratio was 88% in 85% of patients, compared to 12% in 40% of controls (p<0.001). Alpha-IFN therapy appears to enhance the colloidal uptake function of Kupffer cells, which adds a new dimension to the immunomodulatory effect of interferon. 13 refs., 2 tabs.

  10. Curative effect of mometasone furoate nasal spray on upper airway cough syndrome in children with chronic rhinosinusitis%糠酸莫米松鼻喷剂对表现为上气道咳嗽综合征的儿童慢性鼻-鼻窦炎的治疗作用

    Institute of Scientific and Technical Information of China (English)

    朱学伟; 孙宇新

    2013-01-01

    Objective:To observe the curative effect of mometasone furoate nasal spray on upper airway cough syndrome in children with chronic rhinosinusitis.Methods:Mometasone furoate nasal spray was used to treat upper airway cough syndrome in 48 children with chronic rhinosinusitis ; the symptoms before and after treatment and the change of total score of signs were observed,and the related adverse reactions were analyzed.Results:The scores of cough symptom and endoscopy before treatment were (3.02 ± 1.61) and (5.80 ±2.00),respectively; the scores of cough symptom and endoscopy at three weeks after treatment were (1.20 ±0.83) and (2.01 ± 1.19),respectively; the total scores of symptoms and signs at two months after treatment were (0.61 ±0.45) and (1.38 ±0.89) on average.There were statistically significant differences in the total scores of symptoms and signs between before and after treatment (P < 0.01).Conclusion:Mometasone furoate nasal spray has a certain curative effect on upper airway cough syndrome in children with chronic rhinosinusitis,the safety and long-term curative effect need further studies.%目的:观察糠酸莫米松鼻喷雾剂治疗表现为上气道咳嗽综合征的儿童慢性鼻-鼻窦炎的效果.方法:对48例表现为上气道咳嗽综合征的慢性鼻-鼻窦炎的患儿,用糠酸莫米松鼻喷雾剂进行治疗,观察治疗前后症状和体征总评分的改变,并对相关不良反应进行分析.结果:采用糠酸莫米松鼻喷雾剂治疗表现为上气道咳嗽综合征的慢性鼻-鼻窦炎患儿,治疗前咳嗽症状和鼻内镜检查评分平均为(3.02±1.61)分及(5.80±2.00)分;治疗3周后咳嗽症状和鼻内镜检查评分为(1.20±0.83)分及(2.01±1.19)分;治疗2个月后症状和体征总评分平均为(0.61±0.45)分及(1.38±0.89)分.治疗前与治疗后症状和体征总评分比较,差异有统计学意义(P<0.01).结论:糠酸莫米松鼻喷剂对表现为上气道咳嗽综合征的儿童慢性鼻-鼻

  11. Whooping cough in a renal transplant recipient.

    Science.gov (United States)

    Garbiras, M; Shabaka, A; Calvo, N; Martin, L; Moreno, M A; Lopez de la Manzanara, V; Sanchez-Fructuoso, A I

    2016-04-01

    Whooping cough is a respiratory infection with a severity that varies with age, immune status, and probably with other factors such as the degree of exposure and the virulence of the organism. The most frequent microorganism responsible for whooping cough is Bordetella pertussis. We present the case of a 62-year-old renal transplant recipient presenting with typical and severe manifestations of whooping cough caused by B. pertussis.

  12. Acute hepatitis due to dengue virus in a chronic hepatitis patient

    OpenAIRE

    Souza, L J; Coelho, J.M.C. de O.; Silva,E. J.; Abukater,M.; Almeida,F.C.R.; A. S. Fonte; L.A Souza

    2008-01-01

    We present a case of acute hepatitis caused by dengue virus, with a significant increase in aspartate transferase and alanine transferase levels in a chronic hepatitis patient attended at the Cane Sugar Planters Hospital of Campos dos Goytacazes, RJ.

  13. Implantation of an Andrastent XL in an adult with advanced chronic heart failure due to coarctation of the aorta.

    Science.gov (United States)

    Białkowski, Jacek; Szkutnik, Małgorzata; Fiszer, Roland; Wolny, Tomasz; Knapik, Tomasz; Nowalany-Kozielska, Ewa; Zembala, Marian

    2011-01-01

    We report the case of a 49 year-old-man with congenital coarctation of the aorta (CoA), admitted in a critical clinical condition due to advanced secondary cardiomyopathy and chronic heart failure. An Andrastent XL was implanted successfully in the CoA. The procedure resulted in an almost completely resolved CoA and prompt clinical improvement in the patient.

  14. Coughing

    Science.gov (United States)

    ... expulsion of air from the lungs through the epiglottis at an amazingly fast speed (estimated at 100 ... to pass through into the lungs. Then the epiglottis closes off the windpipe (larynx), and simultaneously, the ...

  15. Cough

    Science.gov (United States)

    ... doctor before taking decongestants if you have high blood pressure. Talk to your child's doctor before you give children ages 6 years ... and the flu - what to ask your doctor - child When your baby or infant has a fever Review Date 6/22/2015 Updated by: Denis Hadjiliadis, ...

  16. Extraesophageal manifestations of gastroesophageal reflux disease: cough, asthma, laryngitis, chest pain.

    Science.gov (United States)

    Saritas Yuksel, Elif; Vaezi, Michael F

    2012-01-01

    GER is a common condition affecting many patients in different parts of the world. It usually presents with the classic manifestations of heartburn and regurgitation; however, in some it can also present with extraesophageal manifestations such as chronic cough, laryngitis, asthma or chest pain. Commonly employed diagnostic tests such as EGD and ambulatory pH or impedance monitoring in GER, are less useful in extraesophageal syndromes due to their poor sensitivity and specificity. In contrast, empiric trials of PPI's are shown to be cost effective; however, patients may require long-term treatment to establish effectiveness. Diagnostic testing with pH and impedance monitoring are commonly reserved for patients with partial or poor response to the initial treatment with PPI's. Poor response to PPI therapy may be an important indicator for non-GER causes for patients' symptoms and should initiate a search for other potential causes.

  17. Investigation on diagnosis and treatment of cough variant asthma during subacute cough%亚急性咳嗽中咳嗽变异性哮喘诊治之探讨

    Institute of Scientific and Technical Information of China (English)

    杨建民

    2014-01-01

    Objective To discuss the cough variant asthma in subacute cough prevalence and importance in the group.Methods Nearly 5 years in our hospital respiratory department of internal medicine clinic patients in subacute cough group and chronic cough group in incidence of cough variant asthma do comparative analysis . 2009 June to 2013 November were collected , subacute cough group 920 cases,246 cases of chronic cough group , two groups were not included X-ray lung disease , such as chronic bronchitis , chronic obstructive pulmonary disease, bronchiectasis, tuberculosis, lung cancer, pneumonia.The two groups were diagnosed as cough variant asthma, and got comparative analysis .Results The two group confirmed the diagnosis of cough variant asthma patients in group 146 cases, subacute cough, cough variant asthma accounted for 15.87%, 46 cases of chronic cough were cough variant asthma , accounted for 18.69%, two sets of cough variant asthma incidence rate ,no significant differences , P>0.05.Conclusions Cough variant asthma in subacute cough group in incidence rate is relatively high, and the chronic cough group incidence .Therefore, early diagnosis and early treatment of cough variant asthma in subacute cough group has important significance .%目的:探讨咳嗽变异哮喘在亚急性咳嗽组中的发病情况及重要性。方法将近5年时间我院呼吸内科门诊就诊患者亚急性咳嗽组与慢性咳嗽组中咳嗽变异性哮喘的发病比例做对比分析。分别采集2009年6月至2013年11月,亚急性咳嗽组920例,慢性咳嗽组246例,两组均不包含X线肺部有病变的疾病,如慢性支气管炎急性发作、慢性阻塞性肺疾病、支气管扩张、肺结核、肺癌、肺炎等。两组均做肺功能组胺激发试验,阳性结果确诊为咳嗽变异性哮喘,并做对比分析。结果两组确诊为咳嗽变异性哮喘病例中,亚急性咳嗽组咳嗽变异性哮喘发病人数146例,占该组15.87%

  18. Impact on behavioral changes due to chronic use of sertraline in Wistar albino rats

    Directory of Open Access Journals (Sweden)

    Shatavisa Mukherjee

    2015-01-01

    Full Text Available Aim: Despite having better tolerability and a wide range of clinical applications over other antidepressants, selective serotonin reuptake inhibitors (SSRIs are also known to be associated with serious adverse effects like suicidal ideation on chronic use. The present study had explored the impact of the chronic use of sertraline, an SSRI, on the behavioral changes in Wistar albino rats. Materials and Methods: The study was conducted on 30 Wistar albino rats of either sex; divided into five groups. Four groups were subjected to chronic mild stress induced by using various stressors randomly scheduled in a week and continued for a period of 3 weeks. The stressed rodents were subjected to sertraline treatment for 9 weeks in different human therapeutic doses extrapolated to animal doses. Behavioral changes were monitored, assessed, and evaluated throughout the treatment phase with the help of tests such as locomotor activity test, forced swim test, tail suspension test, antianxiety test, and sucrose preference test (SPT. Results: All tests except SPT, demonstrated significant (P < 0.05 reduction in depressive-like activity in the stressed rodents by the mid-treatment phase, followed by an abrupt onset of the depressive state by the end of the treatment phase. SPT showed a significant (P < 0.05 increase in sucrose consumption throughout the treatment phase. Conclusion: Behavioral changes following chronic sertraline administration conferred gradual remission of depression state on initial treatment phase, followed by a reversal of effect on chronic use.

  19. A 65-year-old man with persistent cough and large nodular opacity.

    Science.gov (United States)

    Grimes, Brandon S; Albores, Jeffrey; Barjaktarevic, Igor

    2015-01-01

    A 65-year-old Asian man with a history of chronic hepatitis B infection presented to our pulmonary clinic for second opinion of his chronic, persistent, nonproductive cough. He was evaluated 10 months earlier with chest CT scan, which revealed a large lingular nodular opacity that was diagnosed as nodular cryptogenic organizing pneumonia by CT scan-guided percutaneous lung biopsy. Systemic corticosteroids were initiated and continued over the next 10 months. The dry cough persisted, and he developed intermittent left-sided pleuritic chest pain. He denied fevers, night sweats, hemoptysis, weight loss, or dyspnea. He was a lifelong nonsmoker and moved to the United States from China during childhood.

  20. 阻塞性睡眠呼吸暂停综合征与慢性咳嗽危险因素研究的新进展%The new progress risk factors of chronic cough and obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    李晨辉; 陈莉延

    2016-01-01

    Obstructive sleep apnea syndrome and chronic cough share a number of risk factors including obesity,gender,genetic,and so on.And exploring the relationship between them may provide new methods to improve our understanding of these two diseases.%阻塞性睡眠呼吸暂停综合征和慢性咳嗽之间有着共同的危险因素如肥胖、性别、遗传等.探究两者之间的联系能够为我们对这两种疾病的认识与治疗提供新的方法与思路.

  1. Bacillary Angiomatosis and Bacteremia due to Bartonella quintana in a Patient with Chronic Lymphocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Rosamaria Fulchini

    2013-01-01

    Full Text Available We present a 63-year-old man treated with alemtuzumab for chronic lymphocytic leukemia who developed multiple angiomatous papules and fever. Real-time polymerase chain reaction (RT-PCR from a skin lesion and blood sample revealed Bartonella quintana as causative agent confirming the diagnosis of bacillary angiomatosis with bacteremia. Treatment with doxycycline, initially in combination with gentamicin, led to complete resolution of the lesions. This case shows the importance of considering bacillary angiomatosis as a rare differential diagnosis of angiomatous lesions in the immunocompromised patient, particularly in chronic lymphocytic leukemia and following lymphocyte depleting treatments as alemtuzumab.

  2. 应用穴位贴敷冬病夏治法治疗慢性咳喘56例疗效分析%Analysis on Treatment of 56 Cases of Chronic Cough and Asthma attacked in Winter with Acupoint Application in Summer

    Institute of Scientific and Technical Information of China (English)

    颜惠萍

    2012-01-01

    Objective: To observe clinical effects of acupoint application in treating chronic cough and asthma. Method: Patients received acupoint application at the first day of primary Fu (the dog days), middle Fu and last Fu in summer and the first day of the first nine days (the nine periods following the winter solstice), the second nine days, the third nine days in winter. Result: After the treatment, all 56 patients were alleviated in symptoms of different degrees, had decreases of attacks and improvements of body constitution. Among them, 46 cases were remarkably effective and took up 82.14%; six cases effective and occupied 10.71%; four cases ineffective and took up 7.14%. Conclusion: Acupoint application used to treat chronic cough and asthma has obvious effect without toxic or adverse reaction.%目的:观察穴位贴敷冬病夏治法治疗慢性咳喘的临床疗效.方法:于初伏、中伏、末佚第1天,一九、二九、三九第1天应用穴位贴敷法治疗慢性咳喘56倒,结果:56例患者经治疗,症状有不同程度减轻、急性发病次数减少、体质明显改善.其中显效46例,占82.14%;有效6例,占10.71%;无效4例,占7.14%;总有效率92.86%.结论:穴位贴敷冬病夏治法治疗慢性咳喘的临床疗效显著,无毒副作用.

  3. Cough and Cold Medicine (DXM and Codeine Syrup)

    Science.gov (United States)

    ... Cough and Cold Medicine (DXM and Codeine Syrup) Cough and Cold Medicine (DXM and Codeine Syrup) Street names: Candy, Drank, Robo Print What Are Cough and Cold Medicines? Also known as: robotripping, robo, ...

  4. Headache associated with cough : a review

    NARCIS (Netherlands)

    Cordenier, Ann; De Hertogh, Willem; De Keyser, Jacques; Versijpt, Jan

    2013-01-01

    Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected

  5. Cough in asthma triggered by reflux episodes.

    Science.gov (United States)

    Mehta, Devendra; He, Zhaoping; Padman, Raj

    2014-05-01

    With combined pH and impedance monitoring, non-acid, as well as acid reflux episodes, are more commonly detected immediately prior to cough in asthma in children. Gastroesophageal reflux should be evaluated as a trigger for cough in difficult childhood asthma.

  6. Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction

    DEFF Research Database (Denmark)

    Jeppesen, Maja; Tolstrup, Mai-Britt; Gögenur, Ismail

    2016-01-01

    BACKGROUND: Emergency laparotomy is a high-risk procedure regarding short-term outcomes; however, long-term outcomes are not well described. The aim of this study was to determine the frequency of chronic postoperative pain, pain-related functional impairment, and incisional hernias and to evalua...

  7. Whooping cough: identification, assessment and management.

    Science.gov (United States)

    Bentley, Jackie; Pinfield, Jenny; Rouse, Jo

    Although there is a high uptake of vaccinations providing protection against Bordetella pertussis, the main cause of whooping cough, there has been an increase in the incidence of notifications of the disease in the UK and other developed countries in recent years. The increase in cases of whooping cough is mainly evident in older children and adults. While these individuals may experience persistent and unpleasant symptoms, most notably prolonged cough, symptoms may be mild, in part, because most older children and adults have been vaccinated against the disease. The most significant public health concern relating to whooping cough is that infected older children and adults may transmit the disease to unvaccinated infants who are most vulnerable to the symptoms. This article aims to develop the reader's understanding of whooping cough, including its prevention and management.

  8. Chronic intussuception due to ileocaecal tuberculosis in a young adult with severe anemia: Case report with literature review

    Directory of Open Access Journals (Sweden)

    Mahesh Gupta

    2010-01-01

    Full Text Available Context : Intestinal intussuception in an adult is a rare entity that differs in etiology from its pediatric counterpart owing to underlying pathologic lead points in adults, mostly neoplasms. The main clinical presentation in chronic intussuception in adults remains dull abdominal pain, and acute intussuception is uncommon. Computed tomography (CT remains the diagnostic modality of choice and surgical resection is the optimal treatment. Case Report : We report a case of chronic intussuception in a young adult presenting with severe anemia and chronic abdominal pain in right hypochondrium and lumbar region. Pre operative diagnosis of chronic ileocolocolic intussuception was made on the basis of ultrasound, barium and CT scan findings. Exploratory laparotomy was done and right hemicolectomy with end to end anastomosis was performed. Histopathological examination of resected specimen revealed presence of tuberculosis in the mass along with mesenteric lymph nodes involvement. Postoperative recovery was uneventful and he was put on antitubercular drugs. In follow-up the patient is asymptomatic. Conclusion : Chronic ileocolocolic intussuception due to tuberculosis should be considered as a possible cause of intestinal obstruction in young patients presenting with vague abdominal pain and severe anemia even in the absence of any specific medical history.

  9. Atypical femoral fracture due to chronic use of bisphosphonates: case report☆

    Science.gov (United States)

    Temponi, Eduardo Frois; de Carvalho Junior, Lúcio Honório; Costa, Lincoln Paiva

    2015-01-01

    The causal relationship between chronic use of bisphosphonates and occurrences of atypical femoral fractures has not yet been established. Nonetheless, it is known that their chronic use is more related to fractures with a pattern differing from that of classical osteoporotic fractures. Atypical fractures are still rare events and the benefit from using bisphosphonates remains greater for prevention and treatment of osteoporosis. There are few studies guiding the diagnosis and management of these fractures, thus making it difficult to achieve better results. In this report, we present the case of an elderly patient with an atypical femoral fracture that was managed in accordance with guidance from the American Society for Bone and Mineral Research. PMID:26401508

  10. Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.

    Science.gov (United States)

    Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud

    2014-11-01

    Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation.

  11. 布地奈德雾化吸入疗法在妊娠期慢性咳嗽患者中的应用价值%Analysis on application value of budesonide aerosol inhalation in pregnant patients with chronic cough

    Institute of Scientific and Technical Information of China (English)

    于锡岭

    2013-01-01

    Objective To observe the therapeutic effect of budesonide aerosol inhalation on pregnant patients with chronic cough and its influences on plasma cytokine.Methods Ninety-two pregnant patients with chronic coughs were randomly divided into observation group and control group,46 cases in each group.Patients in the control group were given routine treatment,such as anti-infection,anti-inflammation,relieving cough and eliminating phlegm as well as relieving asthma,while those in the observation group were inhaled with budesonide suspension by air pressure pump based on the treatment of control group.The clinical symptoms,improvement of lung function and levels of plasma cytokine before and after treatment,including interleukin-4 (IL-4),IL-6,IL-10,tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ),were compared in both groups.Results The peak expiratory flow rate (PEFR),forced vital capacity (FVC),forced expiratory volume in 1 second (FEV1) and expiratory volume at the time of forced expiratory 50% vital capacity in the observation group were significantly higher than those in the control group.The levels of IL-4,TNF-α,IL-6,eosnophils (EOS) and immunoglobulin E (IgE) in the observation group were obviously lower than those in the control group,while the levels of IL-10 and IFN-γsignificantly higher than the control group.The symptomatic and visual analog scale scores of cough as well as duration of major clinical symptoms like chest oppression,shortness of breath and coughs in the observation group were all markedly lower than those in the control group,and the effectiveness rate was notably superior to the control group,in which the statistical significance was presented.Conclusion Budesonide aerosol inhalation has explicit therapeutic effects and few adverse reactions in the treatment of chronic cough during pregnancy,is capable of enhancing the symptoms like coughs,chest oppression and shortness of breath rapidly,recovering lung function and correcting

  12. Secondary repair of severe chronic fourth-degree perineal tear due to obstetric trauma

    OpenAIRE

    Weledji, Elroy P; Elong, Adolphe; Verla, Vincent

    2014-01-01

    Obstetric injury is the commonest cause of anal incontinence. We report a case of anal incontinence as a result of severe chronic fourth-degree perineal tear secondary to birthing with complete disruption of the perineum. Secondary repair consisting of an anterior sphincter repair and levatorplasty in a poor resourced area rendered excellent immediate clinical result. The outcome of anterior sphincter repair following obstetric trauma is good but long-term follow-up is required because of the...

  13. Physiotherapy and a Homeopathic Complex for Chronic Low Back Pain Due to Osteoarthritis: A Randomized, Controlled Pilot Study

    OpenAIRE

    Pellow, Janice

    2016-01-01

    Abstract:Context: Osteoarthritis (OA) is a common cause of chronic low back pain (CLBP) and can be managed with the use of drug therapy and physiotherapy. Homeopathic remedies may assist in the management of OA; however, research that supports their effectiveness is limited. Objectives: The study aimed to investigate the efficacy of a homeopathic complex in combination with physiotherapy in the treatment of CLBP due to OA. Design: The study was a six-week, randomized, double-blind, placebo-co...

  14. Inhaled sodium cromoglycate to treat cough in advanced lung cancer patients.

    Science.gov (United States)

    Moroni, M.; Porta, C.; Gualtieri, G.; Nastasi, G.; Tinelli, C.

    1996-01-01

    C-fibres probably represent the common final pathway in both ACE inhibitors and neoplastic cough. A recent report demonstrated that inhaled sodium cromoglycate is an effective treatment for ACE inhibitors' cough; this effect might be due to the suppression of afferent unmyelinated C-fibres. We tested the hypothesis that inhaled sodium cromoglycate might also be effective in lung cancer patients who presented with irritative neoplastic cough. Twenty non-small-cell lung cancer (NSCLC) patients complaining of cough resistant to conventional treatment were randomised to receive, in a double-blind trial, either inhaled sodium cromoglycate or placebo. Patients recorded cough severity daily, before and during treatment, on a 0 to 4 scale. The efficacy of treatment was tested with the Mann-Whitney U-test for non-parametric measures, comparing the intergroup differences in the measures of summary of symptom scores calculated in each patient before and after treatment. We report that inhaled sodium cromoglycate can reduce cough, also in NSCLC patients and that such reduction, observed in all patients treated, is statistically significant (P < 0.001). Inhaled sodium cromoglycate appears to be a cost-effective and safe treatment for lung cancer-related cough. PMID:8688342

  15. Inhaled sodium cromoglycate to treat cough in advanced lung cancer patients.

    Science.gov (United States)

    Moroni, M; Porta, C; Gualtieri, G; Nastasi, G; Tinelli, C

    1996-07-01

    C-fibres probably represent the common final pathway in both ACE inhibitors and neoplastic cough. A recent report demonstrated that inhaled sodium cromoglycate is an effective treatment for ACE inhibitors' cough; this effect might be due to the suppression of afferent unmyelinated C-fibres. We tested the hypothesis that inhaled sodium cromoglycate might also be effective in lung cancer patients who presented with irritative neoplastic cough. Twenty non-small-cell lung cancer (NSCLC) patients complaining of cough resistant to conventional treatment were randomised to receive, in a double-blind trial, either inhaled sodium cromoglycate or placebo. Patients recorded cough severity daily, before and during treatment, on a 0 to 4 scale. The efficacy of treatment was tested with the Mann-Whitney U-test for non-parametric measures, comparing the intergroup differences in the measures of summary of symptom scores calculated in each patient before and after treatment. We report that inhaled sodium cromoglycate can reduce cough, also in NSCLC patients and that such reduction, observed in all patients treated, is statistically significant (P sodium cromoglycate appears to be a cost-effective and safe treatment for lung cancer-related cough.

  16. Exophiala Pneumonia Presenting with a Cough Productive of Black Sputum

    OpenAIRE

    2015-01-01

    Exophiala species are black, yeast-like molds that can cause subcutaneous cysts as well as disseminated disease. Isolated pneumonia due to Exophiala species is extremely uncommon. We report a case of isolated Exophiala pneumonia in a patient with bronchiectasis who presented with worsening dyspnea and a cough productive of black sputum. The production of black sputum, known as melanoptysis, is an uncommon physical finding with a limited differential diagnosis. To our knowledge, this is the fi...

  17. [Dentobronchial syndrome. Can persistent productive cough be caused by parodontitis? A questionnaire study].

    Science.gov (United States)

    Brøndum, C O

    1992-05-18

    In order to investigate the statistical relationship between periodontal disease, symptomless sinuitis and chronic cough an epidemiological survey was performed by questionnaire among 186 patients (age 30-60) suffering from serious periodontal disease. 58% responded. Persistent cough with expectoration was reported only by patients suffering from periodontal disease in the upper molars. The relative risk was significant (p less than 0.01). The prevalence in this group was 28% compared to a 12% prevalence of chronic bronchitis in the normal population. Ten of the patients with persistent cough reported amelioration of symptoms shortly after the dental treatment. This includes eight smokers who continued smoking. The dentists confirmed that the patients in question had very serious periodontal disease. Further investigations including clinical control and X-ray of the teeth and sinuses are recommended.

  18. Effects of Schisandra chinensis extracts on cough and pulmonary inflammation in a cough hypersensitivity guinea pig model induced by cigarette smoke exposure.

    Science.gov (United States)

    Zhong, Shan; Nie, Yi-chu; Gan, Zhen-yong; Liu, Xiao-dong; Fang, Zhang-fu; Zhong, Bo-nian; Tian, Jin; Huang, Chu-qin; Lai, Ke-fang; Zhong, Nan-shan

    2015-05-13

    Schisandra chinensis (S. chinensis) is a traditional Chinese medicine commonly used in prescription medications for the treatment of chronic cough. However, the material basis of S. chinensis in relieving cough has not been completely elucidated yet. This study established a guinea pig model of cough hypersensitivity induced by 14 days of cigarette smoke (CS) exposure, to evaluate the antitussive, antioxidant, and anti-inflammatory effects of three S. chinensis extracts. And then the function of four lignans in reducing expression of TRPV1 and TRPA1 was examined using A549 cells induced by cigarette smoke extract (CSE). The results demonstrated that both ethanol extract (EE) and ethanol-water extract (EWE) of S. chinensis, but not water extract (WE), significantly reduced the cough frequency enhanced by 0.4M citric acid solution in these cough hypersensitivity guinea pigs. Meanwhile, pretreatment with EE and EWE both significantly attenuated the CS-induced increase in infiltration of pulmonary neutrophils and total inflammatory cells, as well as pulmonary MDA, TNF-α, and IL-8, while remarkably increased activities of pulmonary SOD and GSH. According to H&E and immunofluorescence staining assays, airway epithelium hyperplasia, smooth muscle thickening, inflammatory cells infiltration, as well as expression of TRPV1 and TRPA1, were significantly attenuated in animals pretreatment with 1g/kg EE. Moreover, four lignans of EE, including schizandrin, schisantherin A, deoxyschizandrin and γ-schisandrin, significantly inhibited CSE-induced expression of TRPV1, TRPA1 and NOS3, as well as NO release in A549 cells. In conclusion, S. chinensis reduces cough frequency and pulmonary inflammation in the CS-induced cough hypersensitivity guinea pigs. Lignans may be the active components.

  19. Design and characterization of a cough simulator.

    Science.gov (United States)

    Zhang, Bo; Zhu, Chao; Ji, Zhiming; Lin, Chao-Hsin

    2017-02-23

    Expiratory droplets from human coughing have always been considered as potential carriers of pathogens, responsible for respiratory infectious disease transmission. To study the transmission of disease by human coughing, a transient repeatable cough simulator has been designed and built. Cough droplets are generated by different mechanisms, such as the breaking of mucus, condensation and high-speed atomization from different depths of the respiratory tract. These mechanisms in coughing produce droplets of different sizes, represented by a bimodal distribution of 'fine' and 'coarse' droplets. A cough simulator is hence designed to generate transient sprays with such bimodal characteristics. It consists of a pressurized gas tank, a nebulizer and an ejector, connected in series, which are controlled by computerized solenoid valves. The bimodal droplet size distribution is characterized for the coarse droplets and fine droplets, by fibrous collection and laser diffraction, respectively. The measured size distributions of coarse and fine droplets are reasonably represented by the Rosin-Rammler and log-normal distributions in probability density function, which leads to a bimodal distribution. To assess the hydrodynamic consequences of coughing including droplet vaporization and polydispersion, a Lagrangian model of droplet trajectories is established, with its ambient flow field predetermined from a computational fluid dynamics simulation.

  20. Individualized treatment with transcranial direct current stimulation in patients with chronic nonfluent aphasia due to stroke

    Directory of Open Access Journals (Sweden)

    Priyanka eShah

    2015-04-01

    Full Text Available While evidence suggests that transcranial direct current stimulation (tDCS may facilitate language recovery in chronic post-stroke aphasia, individual variability in patient response to different patterns of stimulation remains largely unexplored. We sought to characterize this variability among chronic aphasic individuals, and to explore whether repeated stimulation with an individualized optimal montage could lead to persistent reduction of aphasia severity. In a two-phase study, we first stimulated patients with 4 active montages (left hemispheric anode or cathode; right hemispheric anode or cathode and one sham montage (Phase 1. We examined changes in picture naming ability to address 1 variability in response to different montages among our patients, and 2 whether individual patients responded optimally to at least one montage. During Phase 2, subjects who responded in Phase 1 were randomized to receive either real-tDCS or to receive sham stimulation (10 days; patients who were randomized to receive sham stimulation first were then crossed over to receive real-tDCS (10 days. In both phases, 2mA tDCS was administered for 20 minutes per real-tDCS sessions and patients performed a picture naming task during stimulation. Patients’ language ability was re-tested after 2-weeks and 2-months following real and sham tDCS in Phase 2.In Phase 1, despite considerable individual variability, the greatest average improvement was observed after left-cathodal stimulation. Seven out of 12 subjects responded optimally to at least 1 montage as demonstrated by transient improvement in picture-naming. In Phase 2, aphasia severity improved at 2-weeks and 2-months following real-tDCS but not sham.Despite individual variability with respect to optimal tDCS approach, certain montages result in consistent transient improvement in persons with chronic post-stroke aphasia. This preliminary study supports the notion that individualized tDCS treatment may enhance

  1. Integrating murine gene expression studies to understand obstructive lung disease due to chronic inhaled endotoxin.

    Directory of Open Access Journals (Sweden)

    Peggy S Lai

    Full Text Available RATIONALE: Endotoxin is a near ubiquitous environmental exposure that that has been associated with both asthma and chronic obstructive pulmonary disease (COPD. These obstructive lung diseases have a complex pathophysiology, making them difficult to study comprehensively in the context of endotoxin. Genome-wide gene expression studies have been used to identify a molecular snapshot of the response to environmental exposures. Identification of differentially expressed genes shared across all published murine models of chronic inhaled endotoxin will provide insight into the biology underlying endotoxin-associated lung disease. METHODS: We identified three published murine models with gene expression profiling after repeated low-dose inhaled endotoxin. All array data from these experiments were re-analyzed, annotated consistently, and tested for shared genes found to be differentially expressed. Additional functional comparison was conducted by testing for significant enrichment of differentially expressed genes in known pathways. The importance of this gene signature in smoking-related lung disease was assessed using hierarchical clustering in an independent experiment where mice were exposed to endotoxin, smoke, and endotoxin plus smoke. RESULTS: A 101-gene signature was detected in three murine models, more than expected by chance. The three model systems exhibit additional similarity beyond shared genes when compared at the pathway level, with increasing enrichment of inflammatory pathways associated with longer duration of endotoxin exposure. Genes and pathways important in both asthma and COPD were shared across all endotoxin models. Mice exposed to endotoxin, smoke, and smoke plus endotoxin were accurately classified with the endotoxin gene signature. CONCLUSIONS: Despite the differences in laboratory, duration of exposure, and strain of mouse used in three experimental models of chronic inhaled endotoxin, surprising similarities in gene

  2. How to Treat Pain in the Hepatic Region Due to Chronic Hepatitis?

    Institute of Scientific and Technical Information of China (English)

    林宗广

    2004-01-01

    @@ Chronic viral hepatitis type B and C both have the symptoms of pain in the hepatic region, asthenia, poor appetite, abdominal fullness, among which pain in the hepatic region is the most commonly seen. According to the author's clinical experience, treatment based on accurate TCM differentiation can not only eliminate pain in the hepatic region but also restore the hepatic function at the same time. Differentiation includes analysis of the nature of the hepatic pain and the accompanying symptoms, and the treatment is aimed at the differentiated symptoms. The following are methods of treatment.

  3. A Case of Chronic Pancreatic Insufficiency Due to Valproic Acid in a Child

    Directory of Open Access Journals (Sweden)

    Mary Anne Cooper

    2001-01-01

    Full Text Available A 14-year-old child treated with valproic acid over several years for a seizure disorder developed abdominal pain with radiological evidence of acute pancreatitis. The association with valproic acid was not recognized, and the child continued to take the drug. The patient eventually developed steatorrhea and weight loss that improved with pancreatic enzyme replacement. Radiological evaluation showed an atrophic pancreas. Without evidence of other etiological factors, valproic acid by itself appeared to be the cause of chronic pancreatitis with exocrine pancreatic insufficiency in this patient.

  4. Primary hyperparathyroidism due to an intrathyroidal parathyroid adenoma associated with chronic lymphocytic thyroiditis.

    Science.gov (United States)

    Cating-Cabral, Monica Therese; Cabungcal, Arsenio Claro; Villafuerte, Cesar Vincent; Añel-Quimpo, Joselynna

    2012-06-08

    This is a case of a 44-year-old woman with an anterior neck mass and hypothyroidism who presented with an incidental finding of an elevated serum calcium level and was found to have primary hyperparathyroidism and osteoporosis. During surgical exploration no parathyroid adenoma was found, although a nodule was palpated within the right thyroid lobe. Examination of the excised right thyroid lobe revealed an intrathyroidal parathyroid adenoma and chronic lymphocytic thyroiditis. After surgery, she did not develop severe hypocalcaemia and this was attributed to preoperative treatment with pamidronate. In the months following surgery, parathyroid hormone remained undetectable.

  5. [Extrahepatic manifestations in patients with chronic infections due to the hepatitis C virus].

    Science.gov (United States)

    Ramos-Casals, Manuel

    2009-01-01

    Autoimmunity and viral infections are closely related, and viruses have been proposed as possible etiologic or triggering agents of systemic autoimmune diseases (SAD). The hepatitis C virus (HCV), a linear, single-stranded RNA virus, identified in 1989, is recognized as one of the viruses most often associated with autoimmune features. The association between HCV and SAD has generated growing interest in recent years. The extrahepatic manifestations often observed in patients with chronic HCV infection (both clinical and immunological) may lead to the fulfilment of the current classification criteria for some SAD.

  6. Secondary repair of severe chronic fourth-degree perineal tear due to obstetric trauma.

    Science.gov (United States)

    Weledji, Elroy P; Elong, Adolphe; Verla, Vincent

    2014-05-13

    Obstetric injury is the commonest cause of anal incontinence. We report a case of anal incontinence as a result of severe chronic fourth-degree perineal tear secondary to birthing with complete disruption of the perineum. Secondary repair consisting of an anterior sphincter repair and levatorplasty in a poor resourced area rendered excellent immediate clinical result. The outcome of anterior sphincter repair following obstetric trauma is good but long-term follow-up is required because of the underlying complexity of obstetric injury. As prevention is not always possible, immediate recognition and adequate primary treatment is of importance.

  7. Evaluation of chronic arsenic poisoning due to consumption of contaminated ground water in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Asutosh Ghosh

    2013-01-01

    Full Text Available Background: Chronic arsenic poisoning is an important public health problem and most notable in West Bengal and Bangladesh. In this study different systemic manifestations in chronic arsenic poisoning were evaluated. Methods: A nonrandomized, controlled, cross-sectional, observational study was carried out in Arsenic Clinic, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, over a period of 1 year 4 months. Seventy-three cases diagnosed clinically, consuming water containing arsenic ≥50 μg/L and having hair and nail arsenic level >0.6 μg/L, were included. Special investigations included routine parameters and organ-specific tests. Arsenic levels in the drinking water, hair, and nail were measured in all. Twenty-five nonsmoker healthy controls were evaluated. Results: Murshidabad and districts adjacent to Kolkata, West Bengal, were mostly affected. Middle-aged males were the common sufferers. Skin involvement was the commonest manifestation (100%, followed by hepatomegaly [23 (31.5%] with or without transaminitis [7 (9.58%]/portal hypertension [9 (12.33%]. Restrictive abnormality in spirometry [11 (15.06%], bronchiectasis [4 (5.47%], interstitial fibrosis [2 (2.73%], bronchogenic carcinoma [2 (2.73%], oromucosal plaque [7 (9.58%], nail hypertrophy [10 (13.69%], alopecia [8 (10.95%], neuropathy [5 (6.84%], and Electrocardiography abnormalities [5 (6.84%] were also observed. Conclusions: Mucocutaneous and nail lesions, hepatomegaly, and restrictive change in spirometry were the common and significant findings. Other manifestations were characteristic but insignificant.

  8. Correlation between ultrasonographic and pathologic diagnosis of liver fibrosis due to chronic virus hepatitis

    Institute of Scientific and Technical Information of China (English)

    Lei Shen; Ji-Qiang Li; Min-De Zeng; Lun-Gen Lu; Si-Tao Fan; Han Bao

    2006-01-01

    AIM: To evaluate the validity of ultrasonographic and pathologic diagnosis of liver fibrosis in patients with chronic viral hepatitis.METHODS: The liver fibrosis status in 324 patients was evaluated by both needle biopsy and ultrasonography.Liver fibrosis was divided into S0 -S4 stages. S4 stage was designated as definite cirrhosis. The ultrasonographic examination included qualitative variables, description of liver surface and parenchyma, and quantitative parameters, such as diameter of vessels, blood flow velocity and spleen size.RESULTS: Ultrasonographic qualitative description of liver surface and parenchyma was related with the severity of fibrosis. Among the quantitative ultrasonographic parameters, cut-off value of spleen length (12.1 cm) had a sensitivity of 0.600 and a specificity of 0.753 for diagnosis of liver cirrhosis. The diameters of spleen (8 mm) and portal vein (12 mm) had a diagnostic sensitivity of 0.600and 0.767, and a diagnostic specificity of 0.781 and 0.446,respectively. The diagnostic accuracy for liver cirrhosis was moderately satisfactory, and the negative predictive values of these parameters reached near 0.95.CONCLUSION: Ultrasonography can predict the degree of liver fibrosis or cirrhosis. A single ultrasonographic parameter is limited in sensitivity and specificity for the diagnosis of early cirrhosis. The presence or absence of liver cirrhosis in patients with chronic virus hepatitis can be detected using 2 or 3 quantitative and qualitative parameters, especially the length of spleen, the diameter of spleen vein and echo pattern of liver surface.

  9. Cerebral blood flow and liver function in patients with encephalopathy due to acute and chronic liver diseases

    DEFF Research Database (Denmark)

    Almdal, T; Schroeder, T; Ranek, L

    1989-01-01

    The purpose of the present investigation was to study changes in cerebral blood flow (CBF) in hepatic encephalopathy, to ascertain whether this was related to the changes in liver function and whether these changes gave any prognostic information. CBF, determined by the intravenous xenon-133 method......, and liver functions, assessed by the prothrombin index, bilirubin concentration, and the galactose elimination capacity, were studied in patients with acute fulminant liver failure and in patients with encephalopathy due to chronic liver diseases--that is, cirrhosis of various etiologies. The CBF range...... any differences between patients with acute or chronic liver diseases or the different degrees of hepatic encephalopathy. In conclusion, a marked reduction of the CBF was seen in hepatic encephalopathy, irrespective of the etiology of the disease....

  10. Whooping cough in South-East Romania: a 1-year study.

    Science.gov (United States)

    Dinu, Sorin; Guillot, Sophie; Dragomirescu, Cristiana Cerasella; Brun, Delphine; Lazăr, Stefan; Vancea, Geta; Ionescu, Biatrice Mariana; Gherman, Mariana Felicia; Bjerkestrand, Andreea-Florina-Dana; Ungureanu, Vasilica; Guiso, Nicole; Damian, Maria

    2014-03-01

    The incidence of whooping cough in Romania is substantially underestimated, and, as noted by the health authorities, this is mostly due to the lack of both awareness and biological diagnosis. We conducted a 1-year study in Bucharest in order to assess the circulation of Bordetella pertussis, the main etiological agent of whooping cough. Fifty-one subjects suspected of whooping cough were enrolled. Culture, real-time PCR, and enzyme-linked immunosorbent assay were used for laboratory diagnosis. Whooping cough patients (63%) were distributed among all age groups, and most were unvaccinated, incompletely vaccinated, or had been vaccinated more than 5 years previously. Bordetella holmesii DNA was detected in 22% of the bordetellosis cases; these patients included adults; teenagers; and, surprisingly, young children. B. pertussis isolates were similar to the clinical isolates currently circulating elsewhere in Europe. One isolate does not express pertactin, an antigen included in some acellular pertussis vaccines.

  11. Theobromine inhibits sensory nerve activation and cough.

    Science.gov (United States)

    Usmani, Omar S; Belvisi, Maria G; Patel, Hema J; Crispino, Natascia; Birrell, Mark A; Korbonits, Márta; Korbonits, Dezso; Barnes, Peter J

    2005-02-01

    Cough is a common and protective reflex, but persistent coughing is debilitating and impairs quality of life. Antitussive treatment using opioids is limited by unacceptable side effects, and there is a great need for more effective remedies. The present study demonstrates that theobromine, a methylxanthine derivative present in cocoa, effectively inhibits citric acid-induced cough in guinea-pigs in vivo. Furthermore, in a randomized, double-blind, placebo-controlled study in man, theobromine suppresses capsaicin-induced cough with no adverse effects. We also demonstrate that theobromine directly inhibits capsaicin-induced sensory nerve depolarization of guinea-pig and human vagus nerve suggestive of an inhibitory effect on afferent nerve activation. These data indicate the actions of theobromine appear to be peripherally mediated. We conclude theobromine is a novel and promising treatment, which may form the basis for a new class of antitussive drugs.

  12. Impact of current cough on health-related quality of life in patients with COPD

    Science.gov (United States)

    Deslee, Gaëtan; Burgel, Pierre-Régis; Escamilla, Roger; Chanez, Pascal; Court-Fortune, Isabelle; Nesme-Meyer, Pascale; Brinchault-Rabin, Graziella; Perez, Thierry; Jebrak, Gilles; Caillaud, Denis; Paillasseur, Jean-Louis; Roche, Nicolas

    2016-01-01

    Background Cough and sputum production are frequent in chronic obstructive pulmonary disease (COPD). The objective of this study was to examine the relationship between cough and sputum production and health-related quality of life in COPD. Methods A cross-sectional study was conducted in the French Initiatives COPD cohort and assessed cough and sputum production within the past 7 days using the cough and sputum assessment questionnaire (CASA-Q), health-related quality of life, spirometry, smoking status, dyspnea, exacerbations, anxiety and depression, and comorbidities. Results One hundred and seventy-eight stable COPD patients were included (age, 62 [56–69] years, 128 male, forced expiratory volume in 1 second [FEV1]: 57 [37–72] % predicted) (median [Q1–Q3]). In univariate analyses, health-related quality of life (Saint George’s respiratory questionnaire total score) was associated with each CASA-Q domain and with chronic bronchitis, exacerbations, dyspnea, FEV1, depression, and anxiety. All four domains introduced separately were independently associated with health-related quality of life. When introduced together in multivariate analyses, only the cough impact domain remained independently associated with health-related quality of life (R2=0.60). With chronic bronchitis (standard definition) instead of the CASA-Q, the R2 was lower (R2=0.54). Conclusion This study provides evidence that current cough in the previous 7 days is an important determinant of health-related quality of life impairment in stable COPD patients. PMID:27695305

  13. The association between indirect bilirubin levels and liver fibrosis due to chronic hepatitis C virus infection.

    Science.gov (United States)

    Cengiz, Mustafa; Yılmaz, Guldal; Ozenirler, Seren

    2014-08-01

    We proposed to evaluate the association between serum indirect bilirubin levels and liver fibrosis in patients with chronic hepatitis C (CHC) genotype 1b. Biopsy proven CHC genotype 1b patients' demographics, clinical and histopathological characteristics were evaluated. Logistic regression analysis was done to evaluate the clinical, laboratory and demographic features of the histologically proven liver fibrosis in CHC patients. A total of 112 biopsy proven CHC genotype 1b patients were enrolled into the study. Liver fibrosis scores were measured by using Ishak fibrosis scores and were divided into two groups; fibrosis scores ≤ 2 were categorized as mild fibrosis, 82 patients (73.2%), whereas fibrosis scores >2 were categorized as advanced fibrosis group, 30 patients (26.8%). Patients with advanced fibrosis had lower indirect bilirubin levels than the mild fibrosis group (0.28 ± 0.02 mg/dl vs. 0.44 ± 0.032 mg/dl, pbilirubin level was negatively correlated with advanced fibrosis scores (r=-0.416 and pbilirubin level was an independent predicting factor of advanced liver fibrosis (OR: 0.001, 95% CI: 0.0-0.005, pbilirubin levels and advanced liver fibrosis caused by CHC genotype 1b.

  14. Histopathologic alterations associated with global gene expression due to chronic dietary TCDD exposure in juvenile zebrafish.

    Science.gov (United States)

    Liu, Qing; Spitsbergen, Jan M; Cariou, Ronan; Huang, Chun-Yuan; Jiang, Nan; Goetz, Giles; Hutz, Reinhold J; Tonellato, Peter J; Carvan, Michael J

    2014-01-01

    The goal of this project was to investigate the effects and possible developmental disease implication of chronic dietary TCDD exposure on global gene expression anchored to histopathologic analysis in juvenile zebrafish by functional genomic, histopathologic and analytic chemistry methods. Specifically, juvenile zebrafish were fed Biodiet starter with TCDD added at 0, 0.1, 1, 10 and 100 ppb, and fish were sampled following 0, 7, 14, 28 and 42 d after initiation of the exposure. TCDD accumulated in a dose- and time-dependent manner and 100 ppb TCDD caused TCDD accumulation in female (15.49 ppb) and male (18.04 ppb) fish at 28 d post exposure. Dietary TCDD caused multiple lesions in liver, kidney, intestine and ovary of zebrafish and functional dysregulation such as depletion of glycogen in liver, retrobulbar edema, degeneration of nasal neurosensory epithelium, underdevelopment of intestine, and diminution in the fraction of ovarian follicles containing vitellogenic oocytes. Importantly, lesions in nasal epithelium and evidence of endocrine disruption based on alternatively spliced vasa transcripts are two novel and significant results of this study. Microarray gene expression analysis comparing vehicle control to dietary TCDD revealed dysregulated genes involved in pathways associated with cardiac necrosis/cell death, cardiac fibrosis, renal necrosis/cell death and liver necrosis/cell death. These baseline toxicological effects provide evidence for the potential mechanisms of developmental dysfunctions induced by TCDD and vasa as a biomarker for ovarian developmental disruption.

  15. Histopathologic alterations associated with global gene expression due to chronic dietary TCDD exposure in juvenile zebrafish.

    Directory of Open Access Journals (Sweden)

    Qing Liu

    Full Text Available The goal of this project was to investigate the effects and possible developmental disease implication of chronic dietary TCDD exposure on global gene expression anchored to histopathologic analysis in juvenile zebrafish by functional genomic, histopathologic and analytic chemistry methods. Specifically, juvenile zebrafish were fed Biodiet starter with TCDD added at 0, 0.1, 1, 10 and 100 ppb, and fish were sampled following 0, 7, 14, 28 and 42 d after initiation of the exposure. TCDD accumulated in a dose- and time-dependent manner and 100 ppb TCDD caused TCDD accumulation in female (15.49 ppb and male (18.04 ppb fish at 28 d post exposure. Dietary TCDD caused multiple lesions in liver, kidney, intestine and ovary of zebrafish and functional dysregulation such as depletion of glycogen in liver, retrobulbar edema, degeneration of nasal neurosensory epithelium, underdevelopment of intestine, and diminution in the fraction of ovarian follicles containing vitellogenic oocytes. Importantly, lesions in nasal epithelium and evidence of endocrine disruption based on alternatively spliced vasa transcripts are two novel and significant results of this study. Microarray gene expression analysis comparing vehicle control to dietary TCDD revealed dysregulated genes involved in pathways associated with cardiac necrosis/cell death, cardiac fibrosis, renal necrosis/cell death and liver necrosis/cell death. These baseline toxicological effects provide evidence for the potential mechanisms of developmental dysfunctions induced by TCDD and vasa as a biomarker for ovarian developmental disruption.

  16. Chronic somatic comorbidity and excess mortality due to natural causes in persons with schizophrenia or bipolar affective disorder.

    Directory of Open Access Journals (Sweden)

    Thomas Munk Laursen

    Full Text Available BACKGROUND: Suicide and death by accidents in persons with schizophrenia and bipolar disorder are common, but excess mortality from natural death accounts for even more years of life lost. The impact of somatic comorbidity, however, often is not duly considered in analyses and explanations of excess mortality in patients with psychotic disorders. OBJECTIVE/METHODS: This study investigates and evaluates the impact of 19 severe chronic diseases on excess mortality due to diseases and medical conditions (natural death in individuals with psychotic disorders compared with the general population using a population-based cohort study in Denmark. Incidence/mortality rate ratios of admission/mortality were calculated using survival analysis. RESULTS: Cohort members with psychotic disorders had higher incidence rates of hospital contacts for almost all of the 19 disorders than the general population. The mortality rate ratio (MRR of natural death was 7.10 (95% CI 6.45, 7.81 for schizophrenic men, decreasing to 4.64 (95% CI 4.21, 5.10 after adjustment for the somatic disorders. The same pattern existed in women and in both genders with bipolar disorder. Highest MRRs were observed for psychotic patients without hospital admissions with the investigated somatic disorders. CONCLUSION: Chronic somatic diseases accounted for half of the excess mortality in patients with schizophrenia or bipolar disorder. Chronic disorders investigated in this paper seem to be under-treated or under-detected among such patients.

  17. Does the chronic inflammatory demyelinating polyradiculoneuropathy due to secondary cause differ from primary?

    Directory of Open Access Journals (Sweden)

    Vaibhav Wadwekar

    2011-01-01

    Full Text Available Background: The clinical presentation, neurophysiological findings, and outcome may vary between primary and secondary chronic inflammatory demyelinating polyradiculopathy (CIDP. Objective: To compare clinical and electrodiagnostic features of primary and secondary CIDP. Setting: Tertiary care teaching referral hospital. Materials and Methods: The CIDP patients who were diagnosed as per European Federation of Neurological Societies/Peripheral Nerve Society criteria were included and subjected to detailed history and examinations. The clinical disability was graded on a 0-10 scale. Neurophysiology included motor and sensory nerve conductions and F wave studies of all four limbs. Based on investigations for underlying diseases, the patients were categorized into primary or secondary CIDP. Prednisolone was prescribed in all and azathioprine added in resistant cases. The secondary CIDP group received specific treatment in addition. The outcome was assessed at 3 months, 6 months, and last follow-up. Results: A total of 65 patients aged 17 to 72 years were included and 20 were females. Twenty-five patients had secondary CIDP and include diabetes mellitus (16, POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (4, monoclonal gammopathy of undetermined significance (2, myeloma (1, lymphoma (1, and malignancy (1. The secondary CIDP patients were older (48.35 vs 41.0 years, had less relapsing remitting (0 vs 6 and more frequent dysautonomia (7 vs 1. The demyelinating features were more marked in primary CIDP group and had better outcome compared with secondary CIDP. Conclusions: Of the total patients with CIDP, 38.5% of patients had secondary CIDP which was associated with progressive course, less demyelinating features, and worse prognosis.

  18. Recurrent Chronic Ambulatory Peritoneal Dialysis-Associated Infection due to Rothia dentocariosa

    Directory of Open Access Journals (Sweden)

    Shaun K Morris

    2004-01-01

    Full Text Available Rothia dentocariosa is a commensal organism of the human oropharynx. Clinical infection due to this organism is rare. A case of recurrent peritoneal dialysis-related peritonitis caused by R dentocariosa and a review of the literature is reported. Isolation of R dentocariosa from dialysate fluid should not be dismissed as a contaminant. Although there are no interpretive criteria for antimicrobial susceptibility testing, R dentocariosa appears to be susceptible to a variety of antibiotics including beta-lactams, vancomycin and aminoglycosides. Optimal therapy of peritoneal dialysis peritonitis caused by this organism may also require removal of the catheter.

  19. Gene expression and pathologic alterations in juvenile rainbow trout due to chronic dietary TCDD exposure.

    Science.gov (United States)

    Liu, Qing; Rise, Matthew L; Spitsbergen, Jan M; Hori, Tiago S; Mieritz, Mark; Geis, Steven; McGraw, Joseph E; Goetz, Giles; Larson, Jeremy; Hutz, Reinhold J; Carvan, Michael J

    2013-09-15

    The goal of this project was to use functional genomic methods to identify molecular biomarkers as indicators of the impact of TCDD exposure in rainbow trout. Specifically, we investigated the effects of chronic dietary TCDD exposure on whole juvenile rainbow trout global gene expression associated with histopathological analysis. Juvenile rainbow trout were fed Biodiet starter with TCDD added at 0, 0.1, 1, 10 and 100 ppb (ngTCDD/g food), and fish were sampled from each group at 7, 14, 28 and 42 days after initiation of feeding. 100 ppb TCDD caused 100% mortality at 39 days. Fish fed with 100 ppb TCDD food had TCDD accumulation of 47.37 ppb (ngTCDD/g fish) in whole fish at 28 days. Histological analysis from TCDD-treated trout sampled from 28 and 42 days revealed that obvious lesions were found in skin, oropharynx, liver, gas bladder, intestine, pancreas, nose and kidney. In addition, TCDD caused anemia in peripheral blood, decreases in abdominal fat, increases of remodeling of fin rays, edema in pericardium and retrobulbar hemorrhage in the 100 ppb TCDD-treated rainbow trout compared to the control group at 28 days. Dose- and time-dependent global gene expression analyses were performed using the cGRASP 16,000 (16K) cDNA microarray. TCDD-responsive whole body transcripts identified in the microarray experiments have putative functions involved in various biological processes including growth, cell proliferation, metabolic process, and immune system processes. Nine microarray-identified genes were selected for QPCR validation. CYP1A3 and CYP1A1 were common up-regulated genes and HBB1 was a common down-regulated gene among each group based on microarray data, and their QPCR validations are consistent with microarray data for the 10 and 100 ppb TCDD treatment groups after 28 days exposure (pTCDD-responsive rainbow trout transcripts identified in the present study may lead to the development of new molecular biomarkers for assessing the potential impacts of

  20. Baclofen vs. Dextromethorphan in the treatment of coughing: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Shahriar M

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Cough is one of the most common symptoms for which outpatient care is sought. Since, a few research evaluated efficacy and therapeutic effect of baclofen in remedy of cough (especially chronic cough, In this study we compared the efficacy of oral Baclofen 20 mg with Dextromethorphan to improvement of cough in two groups."n"nMethods: In this double blind randomized clinical trial, 120 patients with chronic cough (up to three weeks that were referred to respiratory diseases clinic of Ali Ebn-e Abitaleb (AS hospital in Zahedan, Iran at 2007 were randomly devided to two groups. 60 peoples in each, (baclofen recipient group with mean age 32.32±6.51 and dextromethorphan recipient group with mean age 31.54±5.06 year were evaluated for qualitative decline of severity, period and duration of cough for 14 days. "n"nResults: In baclofen recipient group 73.3% and in dextromethorphan recipient group 65% all patients had decline of severity, period and duration of the cough. Statistically, there were no significant differences between two groups in regard to qualitative decline of severity, period and duration of cough (p>0.05. Also, there were no drug related side effects in the patients."n"nConclusions: Baclofen

  1. Clues in the differential diagnosis of primary vs secondary cough, exercise, and sexual headaches.

    Science.gov (United States)

    Alvarez, Rocío; Ramón, César; Pascual, Julio

    2014-10-01

    Activity-related headaches can be provoked by Valsalva maneuvers ("cough headache"), prolonged exercise ("exertional headache") and sexual excitation ("sexual headache"). These entities are a challenging diagnostic problem as can be primary or secondary and the etiologies for secondary cases differ depending on the headache type. In this paper we review the clinical clues which help us in the differential diagnosis of patients consulting due to activity-related headaches. Cough headache is the most common in terms of consultation. Primary cough headache should be suspected in patients older than 50 years, if pain does not predominate in the occipital area, if pain lasts seconds, when there are no other symptoms/signs and if indomethacin relieves the headache attacks. Almost half of cough headaches are secondary, usually to a Chiari type I malformation. Secondary cough headache should be suspected in young people, when pain is occipital and lasts longer than one minute, and especially if there are other symptoms/signs and if there is no response to indomethacin. Every patient with cough headache needs cranio-cervical MRI. Primary exercise/sexual headaches are more common than secondary, which should be suspected in women especially with one episode, when there are other symptoms/signs, in people older than 40 and if the headache lasts longer than 24 hours. These patients must have quickly a CT and then brain MRI with MRA or an angioCT to exclude space-occupying lesions or subarachnoid hemorrhage.

  2. Superficial siderosis of the central nervous system due to chronic hemorrhage from a giant invasive prolactinoma.

    Science.gov (United States)

    Steinberg, Jacob; Cohen, José E; Gomori, John M; Fraifeld, Shifra; Moscovici, Samuel; Rosenthal, Guy; Shoshan, Yigal; Itshayek, Eyal

    2013-07-01

    Superficial siderosis of the central nervous system (CNS) is a rare disorder caused by deposition of hemosiderin in neuronal tissue in the subpial layer of the CNS due to slow subarachnoid or intraventricular hemorrhage. The most common neurologic manifestations include progressive gait ataxia, sensorineural hearing loss, and corticospinal tract signs. We present a case of superficial siderosis in a 43-year-old man who presented to the Emergency Department with sudden onset bilateral visual deterioration and a loss of consciousness. A hemorrhagic giant prolactinoma was diagnosed based on brain CT scan, T1-weighted MRI, and an endocrine blood examination. Susceptibility-weighted non-contrast MRI showed pathognomonic signs of superficial siderosis in the form of a hypointensity rim surrounding the brainstem, cerebellar fissures, and cranial nerves VII and VIII. This report demonstrates that superficial siderosis can be caused by pituitary apoplexy.

  3. Gene expression and pathologic alterations in juvenile rainbow trout due to chronic dietary TCDD exposure

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Qing [Department of Biological Sciences, University of Wisconsin-Milwaukee, Lapham Hall, 3209 N. Maryland Ave., Milwaukee, WI 53211 (United States); School of Freshwater Sciences, University of Wisconsin-Milwaukee, 600 E Greenfield Ave, Milwaukee, WI 53204 (United States); Rise, Matthew L. [Ocean Sciences Centre, Memorial University of Newfoundland, 1 Marine Lab Road, St. John' s, NL, A1C 5S7 (Canada); Spitsbergen, Jan M. [Department of Microbiology, Oregon State University, 220 Nash Hall, Corvallis, OR 97331 (United States); Hori, Tiago S. [Ocean Sciences Centre, Memorial University of Newfoundland, 1 Marine Lab Road, St. John' s, NL, A1C 5S7 (Canada); Mieritz, Mark; Geis, Steven [Wisconsin State Laboratory of Hygiene, 465 Henry Mall, Madison, WI 53706 (United States); McGraw, Joseph E. [School of Pharmacy, Concordia University Wisconsin, 12800 North Lake Shore Drive, Mequon, WI 53097 (United States); Goetz, Giles [School of Aquatic and Fishery Sciences, University of Washington, 1122 Northeast Boat Street, Seattle, WA 98195 (United States); Larson, Jeremy; Hutz, Reinhold J. [Department of Biological Sciences, University of Wisconsin-Milwaukee, Lapham Hall, 3209 N. Maryland Ave., Milwaukee, WI 53211 (United States); Carvan, Michael J., E-mail: carvanmj@uwm.edu [Department of Biological Sciences, University of Wisconsin-Milwaukee, Lapham Hall, 3209 N. Maryland Ave., Milwaukee, WI 53211 (United States); School of Freshwater Sciences, University of Wisconsin-Milwaukee, 600 E Greenfield Ave, Milwaukee, WI 53204 (United States)

    2013-09-15

    Highlights: •First report of the effects of dietary TCDD in juvenile trout smaller than 20 g. •TCDD uptake was estimated using published models and confirmed by GC. •First report of dietary TCDD-induced lesions in nasal epithelium in any species. •Several useful biomarkers are identified from microarray-based transcriptomics analysis. -- Abstract: The goal of this project was to use functional genomic methods to identify molecular biomarkers as indicators of the impact of TCDD exposure in rainbow trout. Specifically, we investigated the effects of chronic dietary TCDD exposure on whole juvenile rainbow trout global gene expression associated with histopathological analysis. Juvenile rainbow trout were fed Biodiet starter with TCDD added at 0, 0.1, 1, 10 and 100 ppb (ng TCDD/g food), and fish were sampled from each group at 7, 14, 28 and 42 days after initiation of feeding. 100 ppb TCDD caused 100% mortality at 39 days. Fish fed with 100 ppb TCDD food had TCDD accumulation of 47.37 ppb (ng TCDD/g fish) in whole fish at 28 days. Histological analysis from TCDD-treated trout sampled from 28 and 42 days revealed that obvious lesions were found in skin, oropharynx, liver, gas bladder, intestine, pancreas, nose and kidney. In addition, TCDD caused anemia in peripheral blood, decreases in abdominal fat, increases of remodeling of fin rays, edema in pericardium and retrobulbar hemorrhage in the 100 ppb TCDD-treated rainbow trout compared to the control group at 28 days. Dose- and time-dependent global gene expression analyses were performed using the cGRASP 16,000 (16K) cDNA microarray. TCDD-responsive whole body transcripts identified in the microarray experiments have putative functions involved in various biological processes including growth, cell proliferation, metabolic process, and immune system processes. Nine microarray-identified genes were selected for QPCR validation. CYP1A3 and CYP1A1 were common up-regulated genes and HBB1 was a common down

  4. Multi-scale predictions of massive conifer mortality due to chronic temperature rise

    Science.gov (United States)

    McDowell, Nathan G.; Williams, A.P.; Xu, C.; Pockman, W. T.; Dickman, L. T.; Sevanto, S.; Pangle, R.; Limousin, J.; Plaut, J.J.; Mackay, D.S.; Ogee, J.; Domec, Jean-Christophe; Allen, Craig D.; Fisher, Rosie A.; Jiang, X.; Muss, J.D.; Breshears, D.D.; Rauscher, Sara A.; Koven, C.

    2015-01-01

    Global temperature rise and extremes accompanying drought threaten forests and their associated climatic feedbacks. Our ability to accurately simulate drought-induced forest impacts remains highly uncertain in part owing to our failure to integrate physiological measurements, regional-scale models, and dynamic global vegetation models (DGVMs). Here we show consistent predictions of widespread mortality of needleleaf evergreen trees (NET) within Southwest USA by 2100 using state-of-the-art models evaluated against empirical data sets. Experimentally, dominant Southwest USA NET species died when they fell below predawn water potential (Ψpd) thresholds (April–August mean) beyond which photosynthesis, hydraulic and stomatal conductance, and carbohydrate availability approached zero. The evaluated regional models accurately predicted NET Ψpd, and 91% of predictions (10 out of 11) exceeded mortality thresholds within the twenty-first century due to temperature rise. The independent DGVMs predicted ≥50% loss of Northern Hemisphere NET by 2100, consistent with the NET findings for Southwest USA. Notably, the global models underestimated future mortality within Southwest USA, highlighting that predictions of future mortality within global models may be underestimates. Taken together, the validated regional predictions and the global simulations predict widespread conifer loss in coming decades under projected global warming.

  5. In vivo trial results of a novel ultrasonic cough stimulator

    Directory of Open Access Journals (Sweden)

    Jennifer C. Nitz, PhD, MPhty, BPhty

    2012-12-01

    Full Text Available The aims of these double-blind in-vivo trials of a prototype ultrasonic cough stimulator (CoughStim™ were to establish (1 whether ultrasound (US stimulation can be safely used to stimulate a cough, (2 the most efficient US frequency and power parameters to reliably stimulate a cough, (3 whether single- or dual-sided stimulation is more effective, and (4 whether a cough can be stimulated in adults unable to cough on demand. Fifteen nondisabled volunteers (18–59 yr and seven volunteers unable to cough on demand (85–102 yr were recruited. Stimulation was applied to the neck unilaterally at eight frequencies and two power levels and bilaterally at two frequencies and three power levels. Vital signs were monitored during testing with no adverse responses. CoughStim stimulated a cough in all nondisabled subjects, 80% of subjects at 0.58 MHz and 9 W unilaterally and 75% of subjects at 0.58 MHz and 6 W bilaterally. Of the subjects unable to cough, 71 percent responded to bilateral stimuli (0.54 MHz and 6 W with a strong cough. The CoughStim regularly and safely produced a moderately strong cough response in subjects with or without ability to cough and produced this effect without causing undue discomfort.

  6. Cough and environmental air pollution in China.

    Science.gov (United States)

    Zhang, Qingling; Qiu, Minzhi; Lai, Kefang; Zhong, Nanshan

    2015-12-01

    With fast-paced urbanization and increased energy consumption in rapidly industrialized modern China, the level of outdoor and indoor air pollution resulting from industrial and motor vehicle emissions has been increasing at an accelerated rate. Thus, there is a significant increase in the prevalence of respiratory symptoms such as coughing, wheezing, and decreased pulmonary function. Experimental exposure research and epidemiological studies have indicated that exposure to particulate matter, ozone, nitrogen dioxide, and environmental tobacco smoke have a harmful influence on development of respiratory diseases and are significantly associated with cough and wheeze. This review mainly discusses the effect of air pollutants on respiratory health, particularly with respect to cough, the links between air pollutants and microorganisms, and air pollutant sources. Particular attention is paid to studies in urban areas of China where the levels of ambient and indoor air pollution are significantly higher than World Health Organization recommendations.

  7. [Pertussis (Whooping cough)--an update].

    Science.gov (United States)

    Stock, Ingo

    2015-12-01

    Whooping cough is a highly contagious respiratory disease which is caused predominantly by the gram-negative bacterium Bordetella pertussis. Further Bordetella species such as B. parapertussis and the recently discovered species B. holmesii are also involved in whooping cough-like diseases. Depending on age, vaccination status and distance to pre-infection with B. pertussis, whooping cough shows a wide range of symptoms. The disease occurs at any age, leaving only short time immunity. During the last 15 years, in industrialized countries the number of reported pertussis cases has been increased markedly. The reason for this observation is still unclear Macrolides such as azithromycin and clarithromycin are regarded as antibiotics of first choice. In Germany, combination vaccines containing acellular pertussis vaccines is the most important strategy of prevention. To ensure the best possible protection against pertussis, booster doses at determined times should be given after primary vaccination in infancy.

  8. Effects of ocean acidification on the brown alga Padina pavonica: decalcification due to acute and chronic events.

    Science.gov (United States)

    Gil-Díaz, Teba; Haroun, Ricardo; Tuya, Fernando; Betancor, Séfora; Viera-Rodríguez, María A

    2014-01-01

    Since the industrial revolution, anthropogenic CO₂ emissions have caused ocean acidification, which particularly affects calcified organisms. Given the fan-like calcified fronds of the brown alga Padina pavonica, we evaluated the acute (short-term) effects of a sudden pH drop due to a submarine volcanic eruption (October 2011-early March 2012) affecting offshore waters around El Hierro Island (Canary Islands, Spain). We further studied the chronic (long-term) effects of the continuous decrease in pH in the last decades around the Canarian waters. In both the observational and retrospective studies (using herbarium collections of P. pavonica thalli from the overall Canarian Archipelago), the percent of surface calcium carbonate coverage of P. pavonica thalli were contrasted with oceanographic data collected either in situ (volcanic eruption event) or from the ESTOC marine observatory data series (herbarium study). Results showed that this calcified alga is sensitive to acute and chronic environmental pH changes. In both cases, pH changes predicted surface thallus calcification, including a progressive decalcification over the last three decades. This result concurs with previous studies where calcareous organisms decalcify under more acidic conditions. Hence, Padina pavonica can be implemented as a bio-indicator of ocean acidification (at short and long time scales) for monitoring purposes over wide geographic ranges, as this macroalga is affected and thrives (unlike strict calcifiers) under more acidic conditions.

  9. Effects of ocean acidification on the brown alga Padina pavonica: decalcification due to acute and chronic events.

    Directory of Open Access Journals (Sweden)

    Teba Gil-Díaz

    Full Text Available Since the industrial revolution, anthropogenic CO₂ emissions have caused ocean acidification, which particularly affects calcified organisms. Given the fan-like calcified fronds of the brown alga Padina pavonica, we evaluated the acute (short-term effects of a sudden pH drop due to a submarine volcanic eruption (October 2011-early March 2012 affecting offshore waters around El Hierro Island (Canary Islands, Spain. We further studied the chronic (long-term effects of the continuous decrease in pH in the last decades around the Canarian waters. In both the observational and retrospective studies (using herbarium collections of P. pavonica thalli from the overall Canarian Archipelago, the percent of surface calcium carbonate coverage of P. pavonica thalli were contrasted with oceanographic data collected either in situ (volcanic eruption event or from the ESTOC marine observatory data series (herbarium study. Results showed that this calcified alga is sensitive to acute and chronic environmental pH changes. In both cases, pH changes predicted surface thallus calcification, including a progressive decalcification over the last three decades. This result concurs with previous studies where calcareous organisms decalcify under more acidic conditions. Hence, Padina pavonica can be implemented as a bio-indicator of ocean acidification (at short and long time scales for monitoring purposes over wide geographic ranges, as this macroalga is affected and thrives (unlike strict calcifiers under more acidic conditions.

  10. Chronic disfiguring facial lesions in an immunocompetent patient due to Exophiala spinifera: a case report and review of literature.

    Science.gov (United States)

    Singh, Gagandeep; Shivaprakash, M R; De, Dipankar; Gupta, Prerna; Gupta, Sunita; Kanwar, A J; Chakrabarti, Arunaloke

    2012-10-01

    Exophiala spinifera is a rare fungus causing chromoblastomycosis or different types of phaeohyphomycosis (cutaneous, subcutaneous, disseminated and cyst phaeohyphomycosis). We report a case of a young male with phaeohyphomycosis due to E. spinifera, who had multiple itchy painful papular lesions disfiguring his face for 4 years. His diagnosis was delayed and had received antibacterial and antileishmanial therapy elsewhere without any improvement. While he reported to our hospital, the histopathology of the biopsy collected from the lesion demonstrated acute on chronic inflammation with granuloma formation and darkly pigmented fungal elements. The isolate grown on culture was identified as E. spinifera on the basis of morphological characters. The identification of the isolate was further confirmed by sequencing of the ITS region of ribosomal DNA. After treatment with oral itraconazole, he had marked clinical improvement.

  11. Bordetella pertussis, B. parapertussis, vaccines and cycles of whooping cough.

    Science.gov (United States)

    Bouchez, Valérie; Guiso, Nicole

    2015-10-01

    Whooping cough is a vaccine-preventable disease due to Bordetella pertussis and B. parapertussis. This highly contagious respiratory disease occurs through epidemic cycles every 3-5 years and vaccination did not change this frequency. Models suggest that the cyclic increase of susceptibles is linked to demographic differences and different vaccine coverage. However, differences in surveillance of the disease as well as adaptation of the agents of the disease to their human hosts and to vaccine pressure might also play an important role. These parameters are discussed in this review.

  12. Cough-induced electrostimulation in incontinence.

    Science.gov (United States)

    Vereecken, R L; Sansen, W; VanNuland, T; Dhaene, P

    1994-01-01

    A new method for treatment of urinary stress incontinence is described. Through a vaginal plug the pelvic floor muscles receive a series of electric stimulations which are triggered by an increase of abdominal pressure, detected by an inbuilt pressure sensor. In this study the best parameters for the stimuli are determined during three successive coughs, which are the most common course of urine loss.

  13. Recognizing and Preventing Whooping Cough 2 (Pertussis)

    Centers for Disease Control (CDC) Podcasts

    2010-09-16

    This podcast encourages everyone to get vaccinated against whooping cough (pertussis), especially those who will have close contact with an infant.  Created: 9/16/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/16/2010.

  14. [Experimental whooping cough of nonhuman primate].

    Science.gov (United States)

    Kubrava, D T; Medkova, A Iu; Siniashina, L N; Shevtsova, Z V; Matua, A Z; Kondzharia, I G; Barkaia, V S; Elistratova, Zh V; Karataev, G I; Mikvabia, Z Ia; Gintsburg, A L

    2013-01-01

    Despite considerable success in study of Bordetella pertussis virulence factors, pathogenesis of whooping cough, duration of B. pertussis bacteria persistence, types and mechanisms of immune response are still keep underinvestigated. It can be explained by the absence ofadequate experimental animal model for pertussis study. Our study estimates clinical and laboratory parameters of whooping cough in non-human primates of the Old World in the process of intranasan infection by virulent B. pertussis bacteria. Also the duration of B. pertussis bacteria persistence in animals was investigated. 14 animal units of 4 species of non-human primates of the Old World were used for intranasal infection. The examination of infect animals included: visual exploration of nasopharynx, thermometry, clinical and biochemical blood analyses, identification ofB. pertussis, using microbiologic and molecular genetic analyses, estimation of innate and adoptive immune factors. The development of infectious process was accompanied by generation of B. pertussis bacteria, catarrhal inflammation of nasopharyngeal mucosa, leucocytosis, hypoglycemia specific for pertussis, and activation of innate and adaptive immunity for all primates regardless of specie were seen. While repeated experimental infection in primates single bacterial colonies were registered during only first week after challenge. It occurs like the absence of inflammation of nasopharyngeal mucosa and the lack of laboratory marks of whooping cough, recorded after first challenge. The evident booster effect of humoral immunity was observed. As a model for investigation of B. pertussis bacteria persistence and immune response against whooping cough we suggest the usage of rhesus macaque as more available to experiments.

  15. One Family's Struggles with Pertussis (Whooping Cough)

    Medline Plus

    Full Text Available ... thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. newsfeeds PSAs publications infectious disease workshop pediatric hepatitis report someone you know has hbv/hcv standard ...

  16. Efficacy and safety of levodropropizine and dihydrocodeine on nonproductive cough in primary and metastatic lung cancer.

    Science.gov (United States)

    Luporini, G; Barni, S; Marchi, E; Daffonchio, L

    1998-07-01

    Nonproductive cough is a frequent and distressing symptom in patients with lung cancer, and it is not even relieved by palliative chemotherapy. A double-blind, randomized clinical trial regarding the treatment of nonproductive cough was performed in 140 adults with primary lung cancer or metastatic cancer of the lungs. The therapeutic efficacy and the tolerability of a 7-day treatment with levodropropizine drops (75 mg t.i.d.) were evaluated in comparison with dihydrocodeine drops (10 mg t.i.d.; 7 days). Efficacy was assessed on the basis of cough severity scores, number of night awakenings due to cough, and overall estimate of antitussive efficacy. Tolerability was evaluated by laboratory results, vital signs and any adverse event occurring during the clinical trial, including presence or absence of somnolence. Subjective cough severity was significantly reduced during treatment with either levodropropizine and dihydrocodeine, the antitussive effect and its time-profile being similar for both drugs. Also, according to the investigator's evaluation, both levodropropizine and dihydrocodeine produced a significant decrease in cough severity. Concurrently with the relief of cough, the number of night awakenings was decreased significantly by both drugs, with no difference between the two treatments. No change in laboratory test values was considered clinically relevant, and vital signs were not clinically affected. The number of patients reporting adverse events was similar in the levodropropizine (n=6) and dihydrocodeine (n=4) group. However, the percentage of patients experiencing somnolence in the group receiving levodropropizine (8%) was significantly lower as compared with that of the dihydrocodeine group (22%). These results confirm the antitussive effectiveness of levodropropizine and suggest a more favourable benefit/risk profile when compared to dihydrocodeine.

  17. Encoding of the cough reflex in anesthetized guinea pigs.

    Science.gov (United States)

    Canning, Brendan J; Mori, Nanako

    2011-02-01

    We have previously described the physiological and morphological properties of the cough receptors and their sites of termination in the airways and centrally in the nucleus tractus solitarius (nTS). In the present study, we have addressed the hypothesis that the primary central synapses of the cough receptors subserve an essential role in the encoding of cough. We found that cough requires sustained, high-frequency (≥8-Hz) afferent nerve activation. We also found evidence for processes that both facilitate (summation, sensitization) and inhibit the initiation of cough. Sensitization of cough occurs with repetitive subthreshold activation of the cough receptors or by coincident activation of C-fibers and/or nTS neurokinin receptor activation. Desensitization of cough evoked by repetitive and/or continuous afferent nerve activation has a rapid onset (nervous system-dependent process. The cough reflex can also be actively inhibited upon activation of other airway afferent nerve subtypes, including slowly adapting receptors and pulmonary C-fibers. The sensitization and desensitization of cough are likely attributable to the prominent, primary, and unique role of N-methyl-d-aspartate receptor-dependent signaling at the central synapses of the cough receptors. These attributes may have direct relevance to the presentation of cough in disease and for the effectiveness of antitussive therapies.

  18. EVALUATION OF ANTITUSSIVE ACTIVITY OF VASU COUGH SYRUP IN SULPHUR DIOXIDE (SO2) INDUCED COUGH MODEL IN MICE

    OpenAIRE

    Patel Hirenjal; Upadhyay Umesh; Upadhyay Siddhi; Soni Hardik; Patel Prateek

    2013-01-01

    Cough is the most common symptom of respiratory diseases. When cough becomes serious, opioid drugs are effective, but they have side effects like sedation, delirium, constipation etc.. Therefore, there is a need to search out effective anti-tussive agents that are free from previously mentioned side effects. The present study was carried out to evaluate acute oral toxicity study and anti-tussive activity of Vasu Cough Syrup in sulphur dioxide (SO2)-induced cough model in mice. Albino mice of ...

  19. EVALUATION OF ANTITUSSIVE ACTIVITY OF VASU COUGH SYRUP IN SULPHUR DIOXIDE (SO2 INDUCED COUGH MODEL IN MICE

    Directory of Open Access Journals (Sweden)

    Patel Hirenjal

    2013-06-01

    Full Text Available Cough is the most common symptom of respiratory diseases. When cough becomes serious, opioid drugs are effective, but they have side effects like sedation, delirium, constipation etc.. Therefore, there is a need to search out effective anti-tussive agents that are free from previously mentioned side effects. The present study was carried out to evaluate acute oral toxicity study and anti-tussive activity of Vasu Cough Syrup in sulphur dioxide (SO2-induced cough model in mice. Albino mice of either sex, weighing 25-30 g were divided into four groups (n = 6. Group I served as Disease control, Group II received standard drug i.e. Codeine phosphate (10 mg/kg, p.o., group III to IV were given Vasu Cough Syrup 0.25mL/kg and 0.5mL/kg body wt. p.o., dose. After 30 minutes, the mice were exposed to Sulphur dioxide for 30 sec. The mice were then placed in an observation chamber for counting of cough bouts for five minutes. Vasu Cough Syrup showed 63.91% and 70.64% inhibition in frequency of cough at 0.25mL/kg and 0.5mL/kg dose level respectively. It proves significant anti-tussive activity of Vasu Cough Syrup in Sulphur dioxide induced cough model. Thus, Vasu Cough Syrup can be useful as an alternative medicine for cough.

  20. Dry needling in patients with chronic heel pain due to plantar fasciitis: A single-blinded randomized clinical trial

    Science.gov (United States)

    Eftekharsadat, Bina; Babaei-Ghazani, Arash; Zeinolabedinzadeh, Vahideh

    2016-01-01

    Background: This study examined the effects of dry needling on chronic heel pain due to plantar fasciitis. Methods: During this single-blinded clinical trial, 20 eligible patients were randomized into two groups: A case group treated with dry needling and a control group. Patients’ plantar pain severity, (using modified visual analog scale [VAS] scoring system), range of motion of ankle joint in dorsiflexion [ROMDF] and plantar extension[ROMPE] and foot function index (using standard questionnaires of SEM5 and MDC7) were assessed at baseline, four weeks after intervention and four weeks after withdrawing treatment. Independent sample t-test, Mann-Whitney U test, paired t-test, Wilcoxon signed rank tests, and chi square test were used for data analysis. Results: The mean VAS scores in the case group was significantly lower than the control group after four weeks of intervention (pdry needling, by improving the severity of heel pain, can be used as a good alternative option before proceeding to more invasive therapies of plantar fasciitis. PMID:27683642

  1. Efficacy of Manual Therapy versus Conventional Physical Therapy in Chronic Low Back Pain Due to Lumbar Spondylosis. A Pilot Study

    Directory of Open Access Journals (Sweden)

    Arti Sharma

    2015-06-01

    Full Text Available Objectives: The objective of this work was to compare the efficacy of Maitland mobilization and conventional physical therapy on pain response, range of motion (ROM and functional ability in patients with chronic low back pain due to lumbar spondylosis. Methods: A total sample of 30 subjects (40–70 years of age with complaints of slow insidious onset of low back pain (LBP, with or without radiation not less than three months duration and decrease ROM were randomly assigned to: group-I, Maitland mobilization and lumbar stabilization exercises; group-II conventional physical therapy (traction, strengthening, stretching exercises. and outcomes were assessed for dependent variables. Results: There is statically a significant difference between pre and post measurement readings with time (p = 0.00 and between groups (p < 0.05 with respect to pain and function, but, with respect to ROM readings, showed statistical significance with time (p = 0.00 and no significance between groups (p > 0.05, indicating manual therapy group-I is improving faster and better than conventional physical therapy group-II. Conclusion: Our results showed that manual therapy interventions are more effective in managing low back pain, and function and range of motion of the lumbar spine than conventional physical therapy treatment.

  2. CFD transient simulation of the cough clearance process using an Eulerian wall film model.

    Science.gov (United States)

    Paz, Concepción; Suárez, Eduardo; Vence, Jesús

    2017-02-01

    In this study, a cough cycle is reproduced using a computational methodology. The Eulerian wall film approach is proposed to simulate airway mucus flow during a cough. The reproduced airway domain is based on realistic geometry from the literature and captures the deformation of flexible tissue. To quantify the overall performance of this complex phenomenon, cough efficiency (CE) was calculated, which provided an easily reproducible measurement parameter for the cough clearance process. Moreover, the effect of mucus layer thickness was examined. The relationship between the CE and the mucus viscosity was quantified using reductions from 20 to 80%. Finally, predictions of CE values based on healthy person inputs were compared with values obtained from patients with different respiratory diseases, including chronic obstructive pulmonary disease (COPD) and respiratory muscle weakness (RMW). It was observed that CE was reduced by 50% in patients with COPD compared with that of a healthy person. On average, CE was reduced in patients with RMW to 10% of the average value of a healthy person.

  3. Prevalence of cardiovascular disease in subjects hospitalized due to chronic obstructive pulmonary disease in Beijing from 2000 to 2010

    Institute of Scientific and Technical Information of China (English)

    Hua Cui; Dong-Mei Miao; Zhi-Min Wei; Jian-Fang Cai; Yi Li; Ai-Min Liu; Fan Li

    2012-01-01

    Objectives To investigate the overall prevalence of cardiovascular disease (CVD) in subjects hospitalized for chronic obstructive pulmonary disease (COPD),and explore the prevalence of the major CVD complications and trends in patients with COPD over a 10-year period.Methods Medical records in the PLA General Hospital,Beijing Union Medical College Hospital,and Beijing Hospital from 2000/01/01 to 2010/03/03 were retrospectively reviewed.A total of 4960 patients with COPD were reviewed in the study (3570 males,mean age,72.2 ± 10.5 years; 1390 females,mean age,72.0 ± 10.4 years).Results The prevalence of CVD in COPD patients was 51.7%.The three most prevalent CVDs were ischemic heart disease (28.9%),heart failure (19.6%),and arrhythmia (12.6%).During the 10-year study period,the prevalence of various CVDs in COPD patients showed a gradual increasing trend with increasing age.There was higher morbidity due to ischemic heart disease (P < 0.01) in male COPD patients than in the female counterparts.However,heart failure (P < 0.01)and hypertension (P < 0.01) occurred less frequently in male COPD patients than in female COPD patients.Furthermore,the prevalence of ischemic heart disease decreased year by year.In addition to heart failure,various types of CVD complications in COPD patients tended to occur in younger subjects.The prevalence of all major types of CVD in women tended to increase year by year.Conclusions The prevalence of CVD in patients hospitalized for COPD in Beijing was high.Age,sex and CVD trends,as well as life style changes,should be considered when prevention and control strategies are formulated.

  4. Inhalation errors due to device switch in patients with chronic obstructive pulmonary disease and asthma: critical health and economic issues

    Directory of Open Access Journals (Sweden)

    Roggeri A

    2016-03-01

    Full Text Available Alessandro Roggeri,1 Claudio Micheletto,2 Daniela Paola Roggeri1 1ProCure Solutions, Nembro, Bergamo, Italy, 2Respiratory Unit, Mater Salutis Hospital, Legnago, Verona, Italy Background: Different inhalation devices are characterized by different techniques of use. The untrained switching of device in chronic obstructive pulmonary disease (COPD and asthma patients may be associated with inadequate inhalation technique and, consequently, could lead to a reduction in adherence to treatment and limit control of the disease. The aim of this analysis was to estimate the potential economic impact related to errors in inhalation in patients switching device without adequate training. Methods: An Italian real-practice study conducted in patients affected by COPD and asthma has shown an increase in health care resource consumption associated with misuse of inhalers. Particularly, significantly higher rates of hospitalizations, emergency room visits (ER, and pharmacological treatments (steroids and antimicrobials were observed. In this analysis, those differences in resource consumption were monetized considering the Italian National Health Service (INHS perspective. Results: Comparing a hypothetical cohort of 100 COPD patients with at least a critical error in inhalation vs 100 COPD patients without errors in inhalation, a yearly excess of 11.5 hospitalizations, 13 ER visits, 19.5 antimicrobial courses, and 47 corticosteroid courses for the first population were revealed. In the same way, considering 100 asthma patients with at least a critical error in inhalation vs 100 asthma patients without errors in inhalation, the first population is associated with a yearly excess of 19 hospitalizations, 26.5 ER visits, 4.5 antimicrobial courses, and 21.5 corticosteroid courses. These differences in resource consumption could be associated with an increase in health care expenditure for INHS, due to inhalation errors, of €23,444/yr in COPD and €44,104/yr in

  5. Brain glucose metabolic changes associated with chronic spontaneous Pain due to brachial plexus avulsion:a preliminary positron emission tomography study

    Institute of Scientific and Technical Information of China (English)

    CHEN Fu-yong; TAO Wei; CHENG Xin; WANG Hong-yan; HU Yong-sheng; ZHANG Xiao-hua; LI Yong-jie

    2008-01-01

    Background Previous brain imaging studies suggested that the brain activity underlying the perception of chronic pain maV differ from that underlying acute pain.To investigate the brain regions involved in chronic spontaneous pain due to brachial plexus avulsion(BPA),fluorine-18fluorodeoxygIucose (19F-FDG) positron emission tomography (PET) scanning was applied to determine the glucose metabolic changes in patients with pain due to BPA.Methods Six right-handed patients with chronic spontaneous pain due to left-BPA and twelve right-handed age-and sex-matched healthy control subjects participated in the 18F-FDG PET study.The patients were rated by visual analog scale (VAS) during scanning and Hamilton depression scale and Hamilton anxiety scale after scanning.Statistical parametric mapping 2 (SPM2) was applied for data analysis.Results Compared with healthy subjects,the patients had significant glucose metabolism decreases in the right thalamus and S I(P<0.001,uncorrected),and significant glucose metabolism increases in the right orbitofrontaI cortex (OFC) (BA11),left rostral insula cortex and left dorsolateral prefrontal codex (DLPFC) (BA10/46) (P<0.001,uncorrected).Conclusion These findings suggest that the brain areas involved in emotion.aRention and internal modulation of pain may be related to the chronic spontaneous pain due to BPA.

  6. Honey with Coffee: A new finding in the treatment of Persistent Postinfectious Cough

    Directory of Open Access Journals (Sweden)

    Mohammad-Ali Raeessi

    2011-04-01

    Full Text Available Introduction: Persistent postinfectious cough (PPC is a cough that persists longer than 3 weeks or perhaps for many months after a common cold or an upper respiratory tract infection (URTI. PPC has poor response to routine treatment modalities, so it can be a vexing problem for the patient and the physician alike. Our hypothesis was that honey and/or coffee have some beneficial effects in the treatment of PPC. The aim of this study was to evaluate the therapeutic effects of coffee and/or honey in the treatment of patients with PPC. Materials and Methods: This was a double blind randomized clinical trial, conducted on adult patients during a 6-year period from 2003 to 2009. Included in this study were 84 adult participants that had experienced PPC longer than 3 weeks. All of them had the history of several referrals to different physicians and despite treatment, their cough had persisted. Patients with other causes of chronic cough, or systemic disease or with abnormal routine laboratory tests were excluded. All the included 84 participants were distributed into three groups. For all the participants, a jam-like paste was prepared. Each 600 grams of the product consisted of "70 grams original instant coffee" in the first regimen, "500 grams of honey" in the second regimen and "70 grams of instant coffee plus 500 grams of honey" in the third regimen. These participants were told to dissolve 25 grams of the prescribed product in about 200 CC of warm water (under 60o C, and drink this solution every 8 hours for one week. All the participants were evaluated before and at the end of the first week of their treatment, to measure the frequency of their cough. In addition they were under observation for the first month. Results: Comparing the effectiveness of all three treatment regimens, this study found "honey with coffee" as the most effective treatment modality for PPC (P

  7. Global burden of mortalities due to chronic exposure to ambient PM2.5 from open combustion of domestic waste

    Science.gov (United States)

    Kodros, John K.; Wiedinmyer, Christine; Ford, Bonne; Cucinotta, Rachel; Gan, Ryan; Magzamen, Sheryl; Pierce, Jeffrey R.

    2016-12-01

    Uncontrolled combustion of domestic waste has been observed in many countries, creating concerns for air quality; however, the health implications have not yet been quantified. We incorporate the Wiedinmyer et al (2014 Environ. Sci. Technol. 48 9523-30) emissions inventory into the global chemical-transport model, GEOS-Chem, and provide a first estimate of premature adult mortalities from chronic exposure to ambient PM2.5 from uncontrolled combustion of domestic waste. Using the concentration-response functions (CRFs) of Burnett et al (2014 Environ. Health Perspect. 122 397-403), we estimate that waste-combustion emissions result in 270 000 (5th-95th: 213 000-328 000) premature adult mortalities per year. The confidence interval results only from uncertainty in the CRFs and assumes equal toxicity of waste-combustion PM2.5 to all other PM2.5 sources. We acknowledge that this result is likely sensitive to choice of chemical-transport model, CRFs, and emission inventories. Our central estimate equates to 9% of adult mortalities from exposure to ambient PM2.5 reported in the Global Burden of Disease Study 2010. Exposure to PM2.5 from waste combustion increases the risk of premature mortality by more than 0.5% for greater than 50% of the population. We consider sensitivity simulations to uncertainty in waste-combustion emission mass, the removal of waste-combustion emissions, and model resolution. A factor-of-2 uncertainty in waste-combustion PM2.5 leads to central estimates ranging from 138 000 to 518 000 mortalities per year for factors-of-2 reductions and increases, respectively. Complete removal of waste combustion would only avoid 191 000 (5th-95th: 151 000-224 000) mortalities per year (smaller than the total contributed premature mortalities due to nonlinear CRFs). Decreasing model resolution from 2° × 2.5° to 4° × 5° results in 16% fewer mortalities attributed to waste-combustion PM2.5, and over Asia, decreasing resolution from 0.5° × 0.666° to 2° × 2

  8. Yellow Nail Syndrome: Dystrophic Nails, Peripheral Lymphedema and Chronic Cough

    Directory of Open Access Journals (Sweden)

    Christian Dornia

    2011-01-01

    Full Text Available A case involving a 41-year-old man with yellow nail syndrome (YNS is reported. YNS is a rare disorder characterized by yellow, dystrophic nails, peripheral lymphedema and bronchiectasis with recurrent lower respiratory tract infections. YNS is often misdiagnosed because the syndrome is not well known. An interdisciplinary approach is required to recognize and collate the components of the syndrome accurately. Correct diagnosis is of utmost clinical importance because YNS can occur secondary to malignancies and autoimmune disorders. Hence, the diagnosis of YNS must prompt further investigation.

  9. Glove and PICO: a novel technique for treatment of chronic wound due to osteomyelitis of the hand.

    Science.gov (United States)

    Narayan, Nitisha; Edwards, Daren; Ragoowansi, Raj H

    2014-06-02

    Chronic wounds on the dorsum of the hand are often challenging to treat. Vacuum-assisted closure has enjoyed widespread use in recent years for many difficult chronic wounds as an alternative to surgery. Unfortunately, owing to the unique anatomy of the hand, it is usually very difficult to get a seal without significantly immobilising the hand. We report a case of a chronic wound on the dorsum of the hand as a result of osteomyelitis in a 37-year-old man, which was treated with Single Use Negative Pressure Wound Therapy, 'PICO' (Smith and Nephew Co, UK). We combined the PICO dressing with a rubber glove to get a good seal enabling appropriate suction without immobilising the hand. Once the wound bed was ready, the defect was covered with a reverse forearm flap.

  10. Born with Protection against Whooping Cough

    Centers for Disease Control (CDC) Podcasts

    2015-01-22

    This podcast provides information about whooping cough, a disease that can be deadly for babies, and CDC’s recommendation that all women receive the Tdap vaccine during the third trimester of every pregnancy so their babies can be born with protection from this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  11. A case of antineutrophil cytoplasmic antibody associated vasculitis manifested with chronic cough and pulmonary migratory shadows%咳嗽及肺部游走性阴影为主要表现的抗中性粒细胞胞浆抗体相关性血管炎1例

    Institute of Scientific and Technical Information of China (English)

    郭军; 张晓军; 张桂芝; 张东; 钱小顺

    2013-01-01

    笔者成功诊治1例65岁男性抗中性粒细胞胞浆抗体(ANCA)相关性血管炎患者。该患者主要表现为慢性咳嗽和肺部游走性阴影,曾被诊断为淋巴细胞性间质性肺炎,激素治疗有效,病情复发后查MPO-ANCA阳性,结合肺穿刺活检明确诊断为ANCA相关性血管炎,加用糖皮质激素和环磷酰胺后病情再次缓解。根据文献报道和笔者的临床经验,ANCA相关性血管炎临床表现复杂,缺乏特异性,常被误诊。呼吸科医师对ANCA相关性血管炎肺部受累特点应熟悉,要重视血清ANCA的筛查,以便于本病的早期诊断。%We reported a successful diagnosis and treatment of a 65-year-old male patient with pulmonary lesion caused by antineutrophil cytoplasmic antibody (ANCA) associated vasculitis. The main manifestations of the patient were chronic cough and pulmonary migratory shadows. He was once diagnosed as lymphocytic interstitial pneumonia, and received effective corticosteroid mono-treatment. MPO-ANCA was positive after the disease relapsed, and ultimately, the diagnosis of ANCA associated vasculitis was made after lung puncture biopsy. After combination administration of corticosteroid and cyclophosphamide, all signs and symptoms were relieved. According to literature and our clinical experience, ANCA associated vasculitis had complex, non-specific clinical manifestations, and thus, was often misdiagnosed. In order to facilitate the early diagnosis of this disease, respiratory physicians should be familiar with the characteristics of the pulmonary involvement of ANCA associated vasculitis, and pay more attention to serum ANCA screening.

  12. Altered quality of life in the early stages of chronic hepatitis C is due to the virus itself

    OpenAIRE

    Strauss, Edna; Porto-Ferreira, Francisco Augusto; de Almeida-Neto, Cesar; Dias Teixeira, Maria Cristina

    2013-01-01

    Health-related quality of life (HRQOL) is impaired in chronic viral hepatitis and a direct role of the virus, although suggested, has not been demonstrated. Our aim was to evaluate HRQOL at blood donation before knowledge of the diagnosis of both hepatitis C virus (HCV) and hepatitis B virus (HBV) so as to elucidate this matter.

  13. [Application of the Gompertz mortality law to the prognosis of lifespan shortening due to chronic internal irradiation].

    Science.gov (United States)

    Panteleev, L I; Shvedov, V L

    1984-01-01

    In experiments on albino rats received strontium 90 in daily doses of 1.85 to 185 kBq/day the regularities of death were studied. It was shown that death of animals exposed to chronic internal radiation followed the Gomperz B. mortality law.

  14. Non-reproducible results in genetic association studies in chronic hepatitis B due to the inadequate controls

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi-hua

    2010-01-01

    @@ Infection of hepatitis B virus (HBV) is ubiquitous although the prevalence of hepatitis B surface antigen (HBsAg) varies considerably worldwide. Persistent HBV infection may lead to severe sequelae such as cirrhosis and hepatocellular carcinoma. Thus, clarification of the mechanism of susceptibility to persistent HBV infection would be valuable for the prevention and treatment of chronic hepatitis B.

  15. Preliminary Evidence of Reduced Urge to Cough and Cough Response in Four Individuals following Remote Traumatic Brain Injury with Tracheostomy

    Science.gov (United States)

    Miller, Sarah; Carnaby, Giselle; Tsai, Hsiu-Wen; Davenport, Paul W.

    2016-01-01

    Cough and swallow protect the lungs and are frequently impaired following traumatic brain injury (TBI). This project examined cough response to inhaled capsaicin solution challenge in a cohort of four young adults with a history of TBI within the preceding five years. All participants had a history of tracheostomy with subsequent decannulation and dysphagia after their injuries (resolved for all but one participant). Urge to cough (UTC) and cough response were measured and compared to an existing database of normative cough response data obtained from 32 healthy controls (HCs). Participants displayed decreased UTC and cough responses compared to HCs. It is unknown if these preliminary results manifest as a consequence of disrupted sensory (afferent) projections, an inability to perceive or discriminate cough stimuli, disrupted motor (efferent) response, peripheral weakness, or any combination of these factors. Future work should attempt to clarify if the observed phenomena are borne out in a larger sample of individuals with TBI, determine the relative contributions of central versus peripheral nervous system structures to cough sensory perceptual changes following TBI (should they exist), and formulate recommendations for systematic screening and assessment of cough sensory perception in order to facilitate rehabilitative efforts. This project is identified with the National Clinical Trials NCT02240329.

  16. Preliminary Evidence of Reduced Urge to Cough and Cough Response in Four Individuals following Remote Traumatic Brain Injury with Tracheostomy

    Directory of Open Access Journals (Sweden)

    Erin Silverman

    2016-01-01

    Full Text Available Cough and swallow protect the lungs and are frequently impaired following traumatic brain injury (TBI. This project examined cough response to inhaled capsaicin solution challenge in a cohort of four young adults with a history of TBI within the preceding five years. All participants had a history of tracheostomy with subsequent decannulation and dysphagia after their injuries (resolved for all but one participant. Urge to cough (UTC and cough response were measured and compared to an existing database of normative cough response data obtained from 32 healthy controls (HCs. Participants displayed decreased UTC and cough responses compared to HCs. It is unknown if these preliminary results manifest as a consequence of disrupted sensory (afferent projections, an inability to perceive or discriminate cough stimuli, disrupted motor (efferent response, peripheral weakness, or any combination of these factors. Future work should attempt to clarify if the observed phenomena are borne out in a larger sample of individuals with TBI, determine the relative contributions of central versus peripheral nervous system structures to cough sensory perceptual changes following TBI (should they exist, and formulate recommendations for systematic screening and assessment of cough sensory perception in order to facilitate rehabilitative efforts. This project is identified with the National Clinical Trials NCT02240329.

  17. Disability due to maternal common mental disorders (CMDs as a risk factor for chronic childhood malnutrition: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jorge Lopes Cavalcante-Neto

    Full Text Available ABSTRACT: CONTEXT AND OBJECTIVE: The disability associated with maternal common mental disorders (CMDs is among the possible explanations for the association between chronic childhood malnutrition and CMDs. CMDs may impair the mother's ability to perform her role, particularly in deprived environments. The present study aimed to evaluate whether disability relating to CMDs could be part of the pathway of the association between childhood malnutrition and maternal CMDs. DESIGN AND SETTING: Cross-sectional study conducted in two institutions: one for malnourished children and another for eutrophic children living in a low-income community in the state of Alagoas, Brazil. METHOD: The cases consisted of 55 malnourished children aged from 12 to 60 months who were attending a nutritional rehabilitation center, with height-for-age z-scores < 2. The controls were 70 eutrophic children of the same age who were attending a day care center in the same area as the cases. The Self-Report Questionnaire made it possible to identify likely cases of maternal CMD. The Sheehan Disability Scale enabled evaluation of the associated disability. RESULTS: Chronic childhood malnutrition was significantly associated with maternal disability relating to CMDs (OR = 2.28; 95% CI: 1.02-5.1. The best logistic regression model using chronic childhood malnutrition as the dependent variable included the following independent variables: higher number of people living in the household; absence of the biological father from the household; and maternal disability relating to CMDs. CONCLUSIONS: If confirmed, the association between chronic childhood malnutrition and maternal disability relating to CMDs may be useful in helping to identify the causal chain between childhood malnutrition and maternal CMDs and to indicate environmental risk factors associated with chronic childhood malnutrition.

  18. 沈英森治疗咳嗽经验%Experience of Professor SHEN Ying-sen on Treating Cough

    Institute of Scientific and Technical Information of China (English)

    徐娅; 许青青

    2012-01-01

    Professor SHEN Ying-sen,a famous doctor in Guangdong province,has achieved good results in differentiation and treatment of cough. Professor SHEN commonly used modified Zhisou powder when treating cough due to exogenous cold and those cases without obvious cold or heat natures. Sangxing decoction is used for cough due to wind-heat invading lung. For recurrent endogenous cough,with less or no sputum,professor SHEN used Jinshui Liujun decoction. Tumor postoperative cough is commonly due to Yin and Qi deficiency or obstruction of phlegm and blood stasis, Yangwei decoction combined with Qianjin Weijing decoction can be used.%沈英森教授是广东省名中医,临床辨治咳嗽取得了很好的疗效.沈教授治疗外感久咳之风寒咳嗽及寒热迹象不明显者常用止嗽散加减.外感风热犯肺常用桑杏汤加减.内伤咳嗽反复发作、迁延不愈,少痰或无痰者用金水六君煎加减.肿瘤术后咳嗽多气阴两虚、痰瘀互结,用养胃汤合千金苇茎汤加减.

  19. Chronic Idiopathic Cough and Chronic Cough in Idiopathic Pulmonary Fibrosis | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available nhaled corticosteroids, benzonatate, dextromethorphan, carbetapentane, H1 antihistamines, leukotriene modifi...eeks of the Screening Visit: Prednisone, narcotic antitussives, baclofen, gabapentin, inhaled corticosteroids, benzonatate, dextromet...horphan, carbetapentane, H1 antihistamines, leukotriene

  20. Chronic stress due to high stocking density in open sea cage farming induces variation in biochemical and immunological functions in Asian seabass (Lates calcarifer, Bloch).

    Science.gov (United States)

    Sadhu, Narasimhulu; Sharma, S R Krupesha; Joseph, Shoji; Dube, Praveen; Philipose, K K

    2014-08-01

    Stocking density is an important factor in cage aquaculture of finfish. Effects of high stocking density (35 fish cubic m(-1)) on a range of biochemical and immunological parameters in Asian seabass reared in open sea floating net cages were compared to fish held in relatively low density (15 fish cubic m(-1)). The results revealed that chronic stress due to high stocking density induced variations in most of the parameters studied as evidenced by increased cortisol and glucose levels and decreased activity of lysozyme, myeloperoxidase and complement. Production of reactive oxygen species, total leucocyte count and total serum protein were also decreased, whereas anti-protease, alkaline phosphatase and acid phosphatase activities were increased in high stocking-density group when compared to low stocking-density group. Effects of chronic stress due to high stocking density were discussed in relation to variations in these parameters.

  1. Disability due to maternal common mental disorders (CMDs) as a risk factor for chronic childhood malnutrition: cross-sectional study

    OpenAIRE

    Jorge Lopes Cavalcante-Neto; Cristiane Silvestre de Paula; Telma Maria de Menezes Toledo Florêncio; Claudio Torres de Miranda

    2016-01-01

    ABSTRACT: CONTEXT AND OBJECTIVE: The disability associated with maternal common mental disorders (CMDs) is among the possible explanations for the association between chronic childhood malnutrition and CMDs. CMDs may impair the mother's ability to perform her role, particularly in deprived environments. The present study aimed to evaluate whether disability relating to CMDs could be part of the pathway of the association between childhood malnutrition and maternal CMDs. DESIGN AND SETTING:...

  2. 77 FR 68132 - Compliance Guidance for Small Business Entities on Labeling for Bronchodilators: Cold, Cough...

    Science.gov (United States)

    2012-11-15

    ... for Bronchodilators: Cold, Cough, Allergy, Bronchodilator, and Antiasthmatic Drug Products for Over... small business entities entitled ``Labeling for Bronchodilators: Cold, Cough, Allergy, Bronchodilator... business entities entitled ``Labeling for Bronchodilators: Cold, Cough, Allergy, Bronchodilator,...

  3. Efficacy of fluticasone on cough: a randomised controlled trial.

    NARCIS (Netherlands)

    Ponsioen, B.P.; Hop, W.C.J.; Vermue, N.A.; Dekhuijzen, P.N.R.; Bohnen, A.M.

    2005-01-01

    Cough may be the consequence of bronchial hyperresponsiveness (BHR) and inflammation. This study was designed to investigate the short-term effects of an inhaled steroid (fluticasone propionate (FP)) on cough, and to determine the effects of smoking, BHR, allergy and forced expiratory volume in one

  4. [Cough leading to the death of an infant].

    Science.gov (United States)

    Hannele, Pruikkonen; Outi, Peltoniemi; Marjo, Renko; Terhi, Tapiainen

    2016-01-01

    Death from infections among previously healthy infants is rare in our country. Occasionally, warning of a severe disease may in the initial phase of the disease become manifest only from the parents' description of the condition of their child. We describe two infants under the age of 3 months with paroxysmal cough, whose whooping cough progressed to require intensive care. A suspicion of whooping cough was not roused neither among those making the emergency care assessment nor by the attending physicians before the patients had to be placed on a ventilator as the illness progressed. One of our patients succumbed to the illness despite of intensive care. Whooping cough should be suspected in all unimmunized infants having paroxysmal cough.

  5. Individualized treatment with transcranial direct current stimulation in patients with chronic non-fluent aphasia due to stroke.

    Science.gov (United States)

    Shah-Basak, Priyanka P; Norise, Catherine; Garcia, Gabriella; Torres, Jose; Faseyitan, Olufunsho; Hamilton, Roy H

    2015-01-01

    While evidence suggests that transcranial direct current stimulation (tDCS) may facilitate language recovery in chronic post-stroke aphasia, individual variability in patient response to different patterns of stimulation remains largely unexplored. We sought to characterize this variability among chronic aphasic individuals, and to explore whether repeated stimulation with an individualized optimal montage could lead to persistent reduction of aphasia severity. In a two-phase study, we first stimulated patients with four active montages (left hemispheric anode or cathode; right hemispheric anode or cathode) and one sham montage (Phase 1). We examined changes in picture naming ability to address (1) variability in response to different montages among our patients, and (2) whether individual patients responded optimally to at least one montage. During Phase 2, subjects who responded in Phase 1 were randomized to receive either real-tDCS or to receive sham stimulation (10 days); patients who were randomized to receive sham stimulation first were then crossed over to receive real-tDCS (10 days). In both phases, 2 mA tDCS was administered for 20 min per real-tDCS sessions and patients performed a picture naming task during stimulation. Patients' language ability was re-tested after 2-weeks and 2-months following real and sham tDCS in Phase 2. In Phase 1, despite considerable individual variability, the greatest average improvement was observed after left-cathodal stimulation. Seven out of 12 subjects responded optimally to at least one montage as demonstrated by transient improvement in picture-naming. In Phase 2, aphasia severity improved at 2-weeks and 2-months following real-tDCS but not sham. Despite individual variability with respect to optimal tDCS approach, certain montages result in consistent transient improvement in persons with chronic post-stroke aphasia. This preliminary study supports the notion that individualized tDCS treatment may enhance aphasia

  6. Are generic and disease-specific health related quality of life correlated? The case of chronic lung disease due to sulfur mustard

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2009-09-01

    Full Text Available

    • BACKGROUND: The aim of this study was to investigate the association between the two most commonly used generic and disease specific health-related quality of life (HRQoL measures in patients with chronic lung disease due to SM: Medical Outcomes Study Short Form 36-Item (SF-36 and St George's Respiratory Questionnaire (SGRQ.
    • METHODS: This is a secondary analysis of Iranian Chemical Warfare Victims Health Assessment Study (ICWVHAS during October 2007 in Isfahan, Iran. In that survey, conducted in an outpatient setting, 292 patients with chronic lung disease due to SM were selected from all provinces in Iran. The total score and sub scores of correlations of SGRQ and SF-36 were assessed. Correlation of quality-of-life scores were evaluated using Pearson’s coefficient.
    • RESULTS: Samples were 276 patients who were selected for our analysis. No significant correlation was found between the total score or sub scores of SF-36 and the total score or sub scores of SGRQ (p > 0.05.
    • CONCLUSIONS: In patients with chronic lung disease due to SM, the SF-36 and SGRQ assess different aspects of HRQoL. Therefore applying both of them together, at least in the research setting is suggested.
    • KEYWORDS: Chronic Lung Disease, Health Related Quality of Life, Generic Health Related Quality of Life, Disease Specific Health Related Quality of Life, Sulfur Mustard.

  7. Activation of Natural Killer Cells in Patients with Chronic Bone and Joint Infection due to Staphylococci Expressing or Not the Small Colony Variant Phenotype

    Directory of Open Access Journals (Sweden)

    Sébastien Viel

    2014-01-01

    Full Text Available Chronic bone and joint infections (BJI are devastating diseases. Relapses are frequently observed, as some pathogens, especially staphylococci, can persist intracellularly by expressing a particular phenotype called small colony variant (SCV. As natural killer (NK cells are lymphocytes specialized in the killing of host cells infected by intracellular pathogens, we studied NK cells of patients with chronic BJI due to staphylococci expressing or not SCVs (10 patients in both groups. Controls were patients infected with other bacteria without detectable expression of SCVs, and healthy volunteers. NK cell phenotype was evaluated from PBMCs by flow cytometry. Degranulation capacity was evaluated after stimulation with K562 cells in vitro. We found that NK cells were activated in terms of CD69 expression, loss of CD16 and perforin, in all infected patients in comparison with healthy volunteers, independently of the SCV phenotype. Peripheral NK cells in patients with chronic BJI display signs of recent activation and degranulation in vivo in response to CD16-mediated signals, regardless of the type of bacteria involved. This could involve a universal capacity of isolates responsible for chronic BJI to produce undetectable SCVs in vivo, which might be a target of future intervention.

  8. Mycotoxins and Antifungal Drug Interactions: Implications in the Treatment of Illnesses Due to Indoor Chronic Toxigenic Mold Exposures

    Directory of Open Access Journals (Sweden)

    Ebere C. Anyanwu

    2004-01-01

    Full Text Available Chronic exposure to toxigenic molds in water-damaged buildings is an indoor environmental health problem to which escalating health and property insurance costs are raising a statewide concern in recent times. This paper reviews the structural and functional properties of mycotoxins produced by toxigenic molds and their interactive health implications with antifungal drugs. Fundamental bases of pathophysiological, neurodevelopmental, and cellular mechanisms of mycotoxic effects are evaluated. It is most likely that the interactions of mycotoxins with antifungal drugs may, at least in part, contribute to the observable persistent illnesses, antifungal drug resistance, and allergic reactions in patients exposed to chronic toxigenic molds. Safe dose level of mycotoxin in humans is not clear. Hence, the safety regulations in place at the moment remain inconclusive, precautionary, and arbitrary. Since some of the antifungal drugs are derived from molds, and since they have structural and functional groups similar to those of mycotoxins, the knowledge of their interactions are important in enhancing preventive measures.

  9. 肾咳辨析%Kidney Cough Differentiation

    Institute of Scientific and Technical Information of China (English)

    张喜梦; 张恒

    2015-01-01

    ABSTRACT:Objective Medical history of kidney cough less systematically, and clinical renal cough a few patients. so people pen according to the clinical manifestations of the patient to kidney cough points for kidney empty cough, Yang deifciency cough, kidney deifciency cough, according to the type of syndrome of dialectical treatment, lfexibility in the use of name old doctor of traditional chinese medicine of clinical experience, the prescription of various, make kidney cough patients get better curative effect.%历代医家对肾咳较少有系统论述,而临床中肾咳病人并不在少数。故笔人根据病人的临床表现把肾咳分为肾阴虚咳、肾阳虚咳、肾气虚咳,根据其证型进行辩证论治,灵活运用名老中医之临证经验方,方药一体,使肾咳病人获得较好疗效。

  10. Eosinophilic tracheobronchitis with cough hypersensitivity caused by Streptomyces albus antigen

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    Haruhiko Ogawa

    2000-01-01

    Full Text Available A 52-year-old woman is reported with atopic cough, in whom bronchoprovocation with Streptomyces albus antigen induced cough and bronchoscopic biopsy revealed eosinophilic tracheobronchitis. She was admitted for the diagnosis and treatment of severe non-productive cough. Although her induced sputum contained 8% eosinophils of nucleated cells and bronchoscopic biopsy specimens revealed eosinophil infiltration in both tracheal and bronchial wall, she did not have bronchial hyperresponsiveness to methacholine or heightened bronchomotor tone. Bronchodilator therapy was not effective for her coughing. Her symptoms worsened on returning home, suggesting the existence of some etiologic agents in her house. Streptomyces albus was isolated from her house. A high titer of anti-S. albus antibody was detected in her serum and the bronchoprovocation test with S. albus antigen was positive: development of coughing 15 min later and decrease in cough threshold to inhaled capsaicin 24 h later (3.9 μmol/L from 31.3 μmol/L prechallenge. This is the first report on eosinophilic tracheobronchitis with cough hypersensitivity caused by allergic reaction to S. albus antigen.

  11. Duodenal-bronchial fistula: an unusual cause of shortness of breath and a productive cough

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    Cynthia Wong, BMBS

    2016-09-01

    Full Text Available Duodenal-bronchial fistulas are very uncommon, even among the already rare subgroup of abdominal-bronchial fistulas. We describe a case of a woman with Crohn's disease who presented with shortness of breath and a productive cough who was found to have a duodeanl bronchial fistula on computed tomography scan. We demonstrate with this case how these rare cases can lead to chronic lung aspirations and require multidisciplinary involvement.

  12. Are pruritus and scratching the cough of the skin?

    Science.gov (United States)

    Misery, Laurent

    2008-01-01

    Pruritus is not the equivalent of the cough of the skin, but itch and scratch can certainly be defined as such. In physiological conditions, they share the same function: to exclude a foreign body. Itch/scratching and cough could be selective responses for the same diseases, mainly atopic diseases, and their pathophysiology is similar (role of C fibers and mast cells; role of histamine, substance P and tachykinins). This is an intriguing analogy rather than a pathophysiological identity. It may be inappropriate for many disease settings. Itch and cough can be triggered or enhanced by stress. This similarity is very interesting because it could give rise to many new research ideas.

  13. Chronic murine myocarditis due to Trypanosoma cruzi: an ultrastructural study and immunochemical characterization of cardiac interstitial matrix

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    Sonia G. Andrade

    1986-03-01

    Full Text Available In an attempt to define the mouse-model for chronic Chagas' disease, a serological, histopathological and ultrastructural study as well as immunotyping of myocardium collagenic matrix were performed on Swiss mice, chronically infected with Trypanosoma cruzi strains: 21 SF and mambaí (Type II; PMN and Bolivia (Type III, spontaneously surviving after 154 to 468 days of infection. Haemagglutination and indirect immunofluorescence tests showed high titres of specific antibodies. The ultrastructural study disclosed the cellular constitution of the inflammatory infiltrate showing the predominance of monocytes, macrophages with intense phagocytic activity, fibroblasts, myofibroblasts and abundant collagen matrix suggesting the association of the inflammatory process with fibrogenesis in chronic chagasic cardiomyopathy. Artertolar and blood capillary alterations together with dissociation of cardiac cells from the capillary wall by edema and inflammation were related to ultrastructural lesions of myocardial cells. Rupture of parasitized cardiac myocells contribute to intensify the inflammatory process in focal areas. Collagen immunotyping showed the predominance of Types III and IV collagen. Collagen degradation and phagocytosis were present suggesting a reversibility of the fibrous process. The mouse model seems to be valuable in the study of the pathogenetic mechanisms in Chagas cardiomyopathy, providing that T. cruzi strains of low virulence and high pathogenecity are used.Utilizando o modelo experimental do camundongo, foi realizado um estudo sorológico, histopatológico e ultraestrutural bem como a imunotipagem do colágeno na matriz conjuntiva do miocárdio em camundongos suiços cronicamente infectados com as cepas 21 SF e Mambaí (Tipo II PMN e Bolívia (Tipo III por períodos de 154 a 468 dias. Os testes sorológicos e de imunofluorescência indireta mostraram altos títulos de anticorpos específicos. O estudo estrutural definiu melhor a

  14. Variability of hemodynamic responses to acute digitalization in chronic cardiac failure due to cardiomyopathy and coronary artery disease.

    Science.gov (United States)

    Cohn, K; Selzer, A; Kersh, E S; Karpman, L S; Goldschlager, N

    1975-04-01

    Eight patients with chronic congestive heart failure (four with cardiomyopathy and four with ischemic heart disease) underwent hemodynamic studies during acute administration of digoxin, given intravenously in two 0-5 mg doses 2 hours apart. Observations were made before administration of digitalis (control period) and serially therafter for 4 hours after the first dose. Resting mean cardiac index and pulmonary arterial wedge pressure were as follows: 2.0 liters/min per m2 and 23 mm Hg (control period); 2.1 and 24 (at 1 hour); 2.0 and 23 (at 2 hours); 2.7 and 19 (at 3 hours); and 2.3 and 20 (at 4 hours). Exercise responses of mean cardiac index and pulmonary arterial wedge pressure in five patients were: 3.1 liters/min per m2 and 36 mm Hg (control period); 3.2 and 33 (at 1 hour); 3.2 and 28 (at 2 hours); 3.1 and 27 (at.3 hours); and 3.4 and 31 (at 4 hours). The pulmonary arterial wedge pressure remained elevated during exercise in all cases. Arrhythmias were seen in five patients after administration of 0.5 mg of digoxin. Hemodynamic improvement at 4 hours involving both reduced filling pressure and increased blood flow was observed in only two patients at rest and in one additional patient during exercise. Acute deterioration of cardiac function (elevated pulmonary arterial wedge pressure of decreased cardiac index) occurred 30 minutes after administration of digoxin in four patients, concomitantly with increased systemic resistance. In six patients, a peak hemodynamic effect appeared 1 to 1 1/2 hours after administration of digoxin, with partial or total loss of initial benefit by 2 and 4 hours. In previously performed studies observations have seldom exceeded 1 hour; the results of this 4 hour study suggest that, in patients with cardiomyopathy or coronary artery disease and chronic congestive heart failure, acute digitalization does not necessarily lead to consistent, marked or lasting hemodynamic improvement. Thus, current concepts of the use of digitalis is

  15. Endoscopic sinus surgery in individuals with facial pain due to chronic maxillary sinusitis ? a functional controlled study

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    Giuseppe Sanges

    2014-08-01

    Full Text Available Objective: To measure the intra-sinus pressure and the maxillary sinus functional efficiency (MSFE in individuals with chronic facial pain after conservative or conventional endoscopic maxillary surgery, as well as in controls. Method: Sinus manometry was performed 5 times during inhalation. Results: The resemblance of pressure values comparing those treated with minimally invasive surgery and controls was remarkable, while traditional surgery significantly decreased intrasinusal pressures. The MSFE was 100% in the three tested times for controls, close to that in those submitted to minimally invasive surgery (98.3%, 98.8%, and 98.0% and significantly impaired after conventional surgery (48.8%, 52.1%, 48.5 %, p<0.01. All patients submitted to minimally invasive surgery remained pain-free after three months of surgery, relative to 46.7% of the submitted to conventional surgery (p<0.05. Conclusion: Minimally invasive sinus surgery is associated with functionality of the chambers that resemble what is found in normal individuals.

  16. Chronic pain due to Little Leaguer’s Shoulder in an adolescent baseball pitcher: a case report

    Science.gov (United States)

    Wasylynko, David

    2015-01-01

    Objective: To describe a case of chronic Little Leaguer’s Shoulder in reference to pain presentation, physical capabilities, and recovery time. Clinical Features: A 17-year-old, junior baseball pitcher presented with shoulder pain when performing high velocity pitching. Conservative treatment for an assumed soft tissue injury failed to resolve the pain, which was regularly aggravated by pitching, and which subsequently prompted further evaluation, and eventual confirmation of Little Leaguer’s Shoulder on subsequent computerized tomography (CT) imaging. Intervention and Outcome: Prior to proper diagnosis, conservative treatment had consisted of activity modification, spinal adjusting, laser therapy, shockwave therapy, Active Release Techniques®, Kinesiotape,® and rehabilitation. Later, rehabilitation, consisting of general muscle and core strengthening, continued for a further six months under the supervision of college athletic trainers. The athlete was able to return to normal pitching duties approximately 12 months later. Summary: In this case, a potentially damaging bone injury masquerading as a simple musculo-tendinous injury created a diagnostic challenge. The patient eventually recovered with rest, time, strengthening, and eventual compliance to prescribed activity modification. PMID:26815884

  17. Acute portal vein thrombosis due to chronic relapsing pancreatitis: a fistula between a pancreatic pseudocyst and the splenic vein.

    Science.gov (United States)

    Kikuchi, Masahiro; Nishizaki, Yasuhiro; Tsuruya, Kota; Hamada, Ikuko; Higashi, Toru; Sakuma, Keiko; Shiozawa, Hirokazu; Aoki, Jun; Nagashima, Rena; Koizumi, Jun; Arase, Yoshitaka; Shiraishi, Koichi; Matsushima, Masashi; Mine, Tetsuya

    2014-02-01

    Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but several other causes might play an important role in PVT pathogenesis. We present a case of alcoholic chronic pancreatitis complicated by acute extensive PVT. The patient was managed conservatively with danaparoid sodium at first, but the thrombosis gradually extended. We then tried radiological intervention using the direct transhepatic and transjugular intrahepatic postsystemic shunt approaches. Although we were able to successfully catheterize the percutaneous transhepatic portal vein (PTP), we could not achieve recanalization of the portal vein. Therefore, PTP catheterization and systemic intravenous infusion of urokinase and heparin was performed to prevent further progression of the thrombosis and cavernous transformation was finally achieved. Computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a pancreatic stone which had possibly induced dilatation of the tail duct and formation of a pancreatic pseudocyst and caused intractable pancreatitis. We performed endoscopic retrograde cholangiopancreatography and placed a stent in the pancreatic duct, which completely cured the pancreatitis. Retrospectively, the previous CT with curved multi-planar reconstruction was reviewed and a fistula was detected between the pancreatic pseudocyst and splenic vein. We concluded that the etiology of the PVT was not only inflammatory extension from pancreatitis but also a fistula between the pancreatic duct and the splenic vein.

  18. Chiari I malformation associated with atlanto-occipital assimilation presenting as orthopnea and cough syncope.

    Science.gov (United States)

    Mangubat, Erwin Zeta; Wilson, Tom; Mitchell, Brian A; Byrne, Richard W

    2014-02-01

    Although it is not uncommon for patients with Chiari I malformations to present with respiratory complaints, cough syncope is a rare presenting symptom. We report an adult patient who had both a Chiari I malformation and atlanto-occipital assimilation, and complained of cough syncope, orthopnea, and central sleep apnea. The patient underwent decompressive craniectomy of the posterior fossa and a cervical level 2 laminectomy. However, due to an initial under-appreciation of the profound narrowing of the foramen magnum as a result of these concomitant pathologies, the patient had continued impaired cerebrospinal fluid flow, leading to a symptomatic pseudomeningocele and required a more extensive decompression that included a cervical level 3 laminectomy as well as a temporary lumbar drain. On 2 year follow-up, he remained asymptomatic.

  19. Acute cough | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available ion E.1.1Medical condition(s) being investigated Acute cough Akuter Husten E.1.1.1Medical condition in easily understood language Acu...igation E.1.2Version 17.1 E.1.2Level LLT E.1.2Classification code 10066522 E.1.2Term Acute cough E.1.2System...igible for inclusion in this trial must fulfill all of the following criteria:1. Acute cough with symptoms l...based on medical history and physical examination7. CS score of at least 50 mm on a 100 mm VAS at V1 8. Acute...te cough Akuter Husten E.1.1.2Therapeutic area Diseases [C] - Respiratory Tract Dis

  20. Rat strain differences in levels and effects of chronic inflammation due to intratracheal instillation of quartz on lung tumorigenesis induced by DHPN.

    Science.gov (United States)

    Nakano, Yuko; Yokohira, Masanao; Hashimoto, Nozomi; Yamakawa, Keiko; Kishi, Sosuke; Ninomiya, Fumiko; Kanie, Shohei; Saoo, Kousuke; Imaida, Katsumi

    2014-10-01

    Chronic inflammatory effects of single intratracheal instillation (i.t.) of quartz on rat lung tumorigenesis were examined using 4 different animal models. At first, in order to determine an appropriate dose of quartz i.t. to promote lung tumorigenesis, F344 male rats were administrated single 0, 0.5, 1, 2 or 4 mg quartz/rat after initiation by N-bis(2-hydroxypropyl) nitrosamine (DHPN). Further studies were performed to examine strain differences of the effects of chronic inflammation caused by quartz i.t. in 3 strains of rat, i.e. F344, Wistar-Hannover and SD. Each was instilled with 2mg quartz/rat after DHPN administration and sacrificed in week 24. In addition, strain differences in generation of inflammation were determined at days 1 and 28. Finally, for determination of long-term effects period, F344 and Wistar-Hannover rats were similarly treated, but the experiment was terminated at week 52. In F344 rats, the tumor areas in DHPN treated groups showed a tendency to increase along with the dose of quartz. F344 rats demonstrated the highest and Wistar-Hannover rats the lowest sensitivity to quartz in acute and chronic phases in the 3 strains. In 52 week, in F344 rats, the multiplicity of tumors and the serum concentration of IL-6 in the group treated with DHPN and quartz were significantly increased. The present experiments indicated that chronic inflammation due to quartz instillation exerted promoting effects on lung carcinogenesis in F344, SD and Wistar-Hannover rats. The strain differences in tumor promotion appeared to correlate with inflammatory reactions to quartz and increase of IL-6.

  1. CHRONIC MENINGITIS IN AN IMMUNOCOMPETENT HOST DUE TO CRYPTOCOCCUS NEOFORMANS VAR. GRUBII - FIRST CASE REPORT FROM TRIPURA, NORTH EAST INDIA

    Directory of Open Access Journals (Sweden)

    Tapan

    2015-10-01

    Full Text Available Cryptococcosis, caused by either of two species, C. neoformans, which is characterized by haploid isolates with the A or D capsular serotype, as well as AD hybrids, or C. gattii, traditionally denoted by serotype B or C. However, more than 90% of infections worldwide are due to haploid strains of C. neoformans var. grubii, which possess the serotype A capsular epitope. Cryptococcal meningitis is mainly a disease of immunocompromised and rare in immunocompetent patients. Prognosis in immunocompetent patients is generally considered good. We report first case of cryptococcal meningitis in an immunocompetent female caused by Cryptococcus neoformans var. grubii.

  2. Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis

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    Nodari Franco

    2011-08-01

    Full Text Available Abstract Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine. From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral, with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with

  3. 止嗽膏穴位贴敷治疗小儿风寒咳嗽临床研究%Climical Research of Stop Cough Anointed Meridians Apply Stick Auxiliary in Treating Pediatrc Cold Cough

    Institute of Scientific and Technical Information of China (English)

    刘立新

    2011-01-01

    Objective: To observe the clinical curative effect of anointed of polio since stop cough in treating cough due to wind - cold evil of children. Methods: 130 example chill cough patients were randomly divided into two groups. The control group with conventional treatment, the treatment group in the control group basis were added cough anointed meridians apply stick, 1 time everyday, and 5 days for a course of treatment, observed the clinical curative effect of two groups. Results: The clinical curative effect of the treatment group was better than control, both phase significantly compared. Conclusion: From stop cough anointed meridians apply stick can be assisted in treating pediatric cold cough, curative effect is distinct, worth clinical promotion.%目的:观察自制止嗽膏对小儿风寒咳嗽的临床疗效.方法:将130例风寒咳嗽的患儿按随机数字表法分为2组.对照组给予常规治疗,治疗组在时照组的基础上加用止嗽膏穴位贴敷,每日1次,5 d为1个疗程,观察两组的临床疗效.结果:治疗组的临床疗效明显优于对照组,两者相比较差异有统计学意义(P<0.05).结论:自制止嗽膏穴位贴敷能辅助治疗小儿风寒咳嗽,疗效显著.

  4. Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Haja Mydin H

    2013-03-01

    Full Text Available Helmy Haja Mydin, Stephen Murphy, Howell Clague, Kishore Sridharan, Ian K TaylorDepartment of Respiratory Medicine, Sunderland Royal Infirmary, Sunderland, United KingdomBackground: In patients with acute hypercapnic respiratory failure (AHRF during exacerbations of COPD, mortality can be high despite noninvasive ventilation (NIV. For some, AHRF is terminal and NIV is inappropriate. However there is no definitive method of identifying patients who are unlikely to survive. The aim of this study was to identify factors associated with inpatient mortality from AHRF with respiratory acidosis due to COPD.Methods: COPD patients presenting with AHRF and who were treated with NIV were studied prospectively. The forced expiratory volume in 1 second (FEV1, World Health Organization performance status (WHO-PS, clinical observations, a composite physiological score (Early Warning Score, routine hematology and biochemistry, and arterial blood gases prior to commencing NIV, were recorded.Results: In total, 65 patients were included for study, 29 males and 36 females, with a mean age of 71 ± 10.5 years. Inpatient mortality in the group was 33.8%. Mortality at 30 days and 12 months after admission were 38.5% and 58.5%, respectively. On univariate analysis, the variables associated with inpatient death were: WHO-PS ≥ 3, long-term oxygen therapy, anemia, diastolic blood pressure < 70 mmHg, Early Warning Score ≥ 3, severe acidosis (pH < 7.20, and serum albumin < 35 g/L. On multivariate analysis, only anemia and WHO-PS ≥ 3 were significant. The presence of both predicted 68% of inpatient deaths, with a specificity of 98%.Conclusion: WHO-PS ≥ 3 and anemia are prognostic factors in AHRF with respiratory acidosis due to COPD. A combination of the two provides a simple method of identifying patients unlikely to benefit from NIV.Keywords: acute exacerbations of COPD, noninvasive ventilation, emphysema, prognostic markers

  5. Impact of current cough on health-related quality of life in patients with COPD

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    Deslee G

    2016-09-01

    Full Text Available Gaëtan Deslee,1 Pierre-Régis Burgel,2 Roger Escamilla,3 Pascal Chanez,4 Isabelle Court-Fortune,5 Pascale Nesme-Meyer,6 Graziella Brinchault-Rabin,7 Thierry Perez,8 Gilles Jebrak,9 Denis Caillaud,10 Jean-Louis Paillasseur,11 Nicolas Roche2On behalf of the Initiatives BPCO Scientific Committee 1Department of Respiratory Diseases, INSERM UMR 903, Maison Blanche Hospital, University Hospital of Reims, Reims, 2Department of Respiratory Diseases, Cochin Hospital, AP-HP and University Paris Descartes, Sorbonne Paris Cité, Paris, 3Department of Respiratory Diseases, Larrey Hospital, Toulouse, 4Department of Respiratory Diseases, APHM, INSERM U1077, CNRS UMR 7733 Aix Marseille Université, Marseille, 5Department of Respiratory Diseases, University Hospital of St Etienne, 6Department of Respiratory Diseases, La Croix Rousse Hospital, Lyon, 7Department of Respiratory Diseases, Pontchaillou Hospital, University Hospital of Rennes, Rennes, 8Department of Respiratory Diseases, Calmette Hospital, University Hospital of Lille, Lille, 9Department of Respiratory Diseases, Bichat Hospital, AP-HP, Paris, 10Department of Respiratory Diseases, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, 11EFFI-STAT, Paris, FranceBackground: Cough and sputum production are frequent in chronic obstructive pulmonary disease (COPD. The objective of this study was to examine the relationship between cough and sputum production and health-related quality of life in COPD.Methods: A cross-sectional study was conducted in the French Initiatives COPD cohort and assessed cough and sputum production within the past 7 days using the cough and sputum assessment questionnaire (CASA-Q, health-related quality of life, spirometry, smoking status, dyspnea, exacerbations, anxiety and depression, and comorbidities.Results: One hundred and seventy-eight stable COPD patients were included (age, 62 [56–69] years, 128 male, forced expiratory volume in 1 second

  6. Rococo study: a real-world evaluation of an over-the-counter medicine in acute cough (a multicentre, randomised, controlled study)

    Science.gov (United States)

    Birring, S S; Brew, J; Kilbourn, A; Edwards, V; Wilson, R; Morice, A H

    2017-01-01

    difference (95% CI) 1.2 (0.05 to 2.36), p=0.04 after 5 days' treatment. More participants prematurely stopped treatment due to cough improvement in the CS1002 group (24.4%) compared with SL (10.7%; p=0.02). Adverse events (AEs) were comparable between CS1002 (20.5%) and SL (27.6%) and largely related to the study indication. 6 participants (7%) in the CS1002 group reduced the dose of medication due to drowsiness/tiredness, which subsequently resolved. These events were not reported by participants as AEs. Conclusions Although the primary end point was not achieved, CS1002 was associated with greater reductions in cough frequency, sleep disruption and improved health status compared with SL. Trial registration number EudraCT number 2014-004255-31. PMID:28093442

  7. Exposure of health care workers and occupants to coughed air in a hospital room with displacement air distribution: impact of ventilation rate and distance from coughing patient

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Bolashikov, Zhecho Dimitrov; Kostadinov, Kamen

    and the coughing patient faced each other. The Peak Cough Time (PCT) was around 6 s, when the doctor was 0.55 m downstream the cough and increased when the distance between the sick patient and the doctor increased. The highest Peak Concentration Level (PCL) for the doctor, i.e. excess of CO2 level in inhaled air...

  8. Changes in hospitalizations due to opportunistic infections, chronic conditions and other causes among HIV patients (1989–2011. A study in a HIV unit

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    C Redondo Sanchez

    2012-11-01

    Full Text Available Background: Reduction in mortality and morbidity in HIV patients due to the introduction of HAART have resulted in changes in patterns of hospital admissions. Objective: To examine trends of HIV patients hospital admissions. Design and method: Serial cross-sectional analysis of HIV-hospitalized patients from 1989 to 2011 in an HIV Care Unit. Each hospitalization was classified as major categories: opportunistic infections, other infections, drug-related admissions, chronic hepatopathy, AIDS and non-AIDS-related tumours and chronic medical conditions (COPD, diabetes and as specific diagnosis: tuberculosis, PCP, CMV, bacterial pneumonia and others. We considered 4 periods of time: pre-HAART, 1989–1996; early HAART, 1997–2001; intermediate HAART, 2002–2006; and present HAART, 2007–2011. Results: We evaluated 2588 admissions. 20.7% of patients were unaware of HIV infection before first admission; this proportion did not change along the time (p=0.27. No previous outpatient follow-up was seen in 34.9% of patients. There were differences in diagnosis, mortality, age and mean inpatient stay time (Table 1 between the analyzed periods of time. Conclusions: (i HAART and older age have changed the pattern of hospital admissions with a decrease of OI-related admissions and an increase of chronic diseases and non-AIDS-related tumours and with a decrease in mortality and length of inpatient stay. (ii Proportion of patients with unknown HIV serostatus before admission has not changed along the time. (iii Pneumonia, respiratory tract infection and tuberculosis were the more common causes of admission.

  9. A CLINICORADIOLOGICAL STUDY OF MIDDLE LOBE SYNDROME DUE TO TUBERCULOSIS

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    Saurabh Karmakar

    2016-09-01

    Full Text Available BACKGROUND Although pulmonary tuberculosis is a common disease in India, tuberculosis of right middle lobe is infrequent. Tuberculosis of the right middle lobe leading to chronic collapse is a cause of Right Middle Lobe syndrome. METHODS The patients attended Pulmonary Medicine Outdoor at Era’s Lucknow Medical College, Lucknow from April 2015 to March 2016. The purpose of this study is to describe the clinicoradiological features of patients of middle lobe syndrome due to tuberculosis. All patients presented with cough with or without expectoration, fever, chest pain, haemoptysis and constitutional symptoms like loss of appetite and weight. Chest X-ray PA view revealed ill-defined opacity abutting the right cardiac border. HRCT thorax was done in each case. The diagnosis of tuberculous aetiology was based on (1 History of chronic cough and fever, not responding to antibiotic therapy and constitutional symptoms, (2 A positive tuberculin test using 2 TU of PPD RT 23 and (3 Detection of acid fast bacilli by direct smear or Mycobacterium tuberculosis by polymerase chain reaction in bronchoalveolar lavage. RESULTS Out of 10 patients, 4 (40% were males and 6 (60% were females. The mean ages of the males were 55.8 years and females were 60.8 years and overall mean age was 59 years. Most of the patients were females and belonged to the middle age and old age group. ATT was started in all the patients. CONCLUSIONS Right middle lobe syndrome predominantly affects the older population and the female gender. Although tuberculosis is a common disease in India, Middle Lobe Syndrome is a very rare presentation of the disease. Due to non-specific symptoms and usually normal chest X-ray PA view in Right Middle Lobe Syndrome, we should keep a high index of suspicion to diagnose the condition.

  10. Symptoms in patients with skin changes due to chronic venous insufficiency often lead to emergency care service: an Italian observational study.

    Science.gov (United States)

    Ruggiero, Michele; Grande, Raffaele; Naso, Agostino; Butrico, Lucia; Rubino, Paolo; Placida, Girolamo Domenico; Cannistrà, Marco; Serra, Raffaele

    2016-10-01

    Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition. Data were evaluated by consulting the medical records, during a 16-month period, available with three Continuous Assistance Services of the Italian territory. The overall population of the referring centres consisted of 1186 patients [739 females (62·31%) and 447 males (37·69%)]. Seventy-nine patients (6·66%) consulted the emergency unit for venous symptoms related to CVD. Patients with more severe disease (CVI, categories C4-C6) represented the majority accounting for 60·75%, while patients with moderate disease (C3) accounted for 35·44% and patients with mild disease (C1-C2 stages) accounted for 3·79%. The main finding of this study is that despite CVI not being a disease that commonly requires medical emergency/urgency intervention, patients with CVI, especially in advanced stage with skin changes, may turn to Continuous Assistance Service for treating bothersome symptoms related to their condition.

  11. The Improvement Two Cases Coughing and Sputum sign Sequela of Pneumonia by Homins Placenta Aqua-Acupuncture

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    Kim, Eun-Gon

    2003-12-01

    Full Text Available Coughing and sputum are symptoms of sequela of Pneumonia. Oriental medicine call it Hae su. Hae su is common sign of lung disease. Hominis Placenta is the dried placenta of a healthy women. The nature of Hominis Placenta is warm and its taste sweet-salty. It has correspondence to the meridians of lung and kindey. Hominis Placenta acupuncture therapy has effect on invigoration of vital energy nourishing blood and tonifying the essence. It can be applied to the disease as Asthma, pulmonary tuberculosis, chronic hepatitis, liver cirrhosis, degenerative change and cerebrovascular disease. We treated two cases coughing and sputum sign Sequela of Pneumonia by Hominis Placenta Aqua-Acupuncture. The symptoms was improved and the patients satisfied

  12. Efficacy of omeprazole on cough, pulmonary function and quality of life of patients with sulfur mustard lung injury: A placebo-control, cross-over clinical trial study

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    Mohammad Hossein Emami

    2014-01-01

    Full Text Available Background: Gastro-esophageal reflux disease (GERD is prevalent and related to more severe disease in patients with respiratory problems. We evaluated the effects of antireflux therapy in warfare victims of exposure to Mustard gas with chronic cough. Materials and Methods: This randomized, double-blind, placebo-controlled, cross-over study was conducted on 45 cases of sulfur mustard injury with chronic cough (≥8 weeks and GERD. Patients were randomized into two groups, receiving either 20 mg twice daily omeprazole-placebo (OP or matching placebo (placebo-omeprazole [PO] for 4 months, followed by a 1-month washout period and the alternative treatment for 4 months. Assessments included GERD and cough, quality of life, and pulmonary function using spirometry. Leicester Cough Questionnaire and SF-36 were used for measuring quality of life. Results: Patients in the OP group experienced a more decrease than those in the PO group in severity of Leicester cough scores during the first 4-month of trial. After crossing the groups, the OP group experienced an increase (P = 0.036 and the PO group experienced a nonsignificant decrease (P = 0.104 in the severity of scores. The OP group also experienced improvement in GERD symptoms and quality of life at the end of the trial, but changes in the PO group was not significant. There was no significant change in respiratory function indices in any groups. Conclusion: Long-term treatment with high-dose omeprazole improved GERD as well as cough, and quality of life, but not changed respiratory function indices in sulfur mustard injured cases with respiratory symptoms.

  13. [Serological evaluation of Bordetella pertussis infection in adults with prolonged cough].

    Science.gov (United States)

    Sönmez, Cemile; Çöplü, Nilay; Gözalan, Ayşegül; Yılmaz, Ülkü; Bilekli, Selen; Demirci, Nilgün Yılmaz; Biber, Çiğdem; Erdoğan, Yurdanur; Esen, Berrin; Çöplü, Lütfi

    2016-07-01

    Pertussis is a vaccine-preventable disease that is transmitted from infected to susceptible individuals by respiratory route. Bordetella pertussis infection may occur at any age as neither vaccine nor natural infection induced immunity lasts life-long. This study was planned to demonstrate the serological evidence of infection among adults, to raise awareness among clinicians and to provide data for the development of strategies to protect vulnerable infants. A total of 538 patients (345 female, 193 male) ages between 18-87 years who had a complain of prolonged cough for more than two weeks were included in the study. Anti-pertussis toxin (PT) IgG and anti-filamentous hemagglutinin (FH) IgG levels from single serum samples were measured by an in-house ELISA test which was standardized and shown to be efficient previously. Anti-PT IgG antibody levels of ≥ 100 EU/ml were considered as acute/recent infection with B.pertussis. In our study, 9.7% (52/538) of the patients had high levels of anti-PT IgG (≥ 100 EU/ml) and among those patients 43 (43/52; 82.7%) also had high (≥ 100 EU/ml) anti-FHA IgG levels. There were no statistically significant differences in terms of age, gender, education level, DPT (diphtheria-pertussis-tetanus) vaccination history, smoking history or average daily cigarette consumption (p> 0.05) between the cases with high antibody levels (n= 52). When the symptoms and the presence of cases with high antibody levels were evaluated, it was detected that no one parameter was significantly different from others, except that 24.1% of the cases with inspiratory whooping had high anti-PT levels. There was also no statistically significant difference between high anti-PT levels ≥ 100 EU/ml and the patients with risk factors [smoking (21/200; 10.5%), presence of disease that cause chronic cough and/or drug usage (19/171; %11.1), and whole factors which cause chronic cough (32/306; %10.5)] and without risk factors (p= 0.581; p= 0.357; p= 0

  14. Experiments on the fluid dynamics of the human cough

    Science.gov (United States)

    Settles, Gary

    2011-11-01

    Human coughing is studied non-intrusively by high-speed schlieren videography, revealing a turbulent jet lasting up to 1 sec with a total expelled air volume of about 2 L. Velocimetry of eddy motion reveals a jet centerline airspeed of at least 8 m/sec. With Re roughly 18,000 the cough jet is inertia-driven and buoyancy is negligible. It shows typical round-turbulent-jet behavior, including a conical spreading angle of 24 deg, despite irregular initial conditions. The cough jet is projected several m into the surrounding air before it mixes out. It is well known that a cough can transmit infectious agents, and we are advised to cover our mouths in an apparent attempt to thwart the jet formation. Present experiments have shown that wearing a surgical mask or respirator designed to prevent the inhalation of infectious agents also interferes with the cough-jet formation, redirecting it into the person's rising thermal plume. (Tang et al., J. Royal. Soc. Interface 6, S727, 2009.)

  15. Aging deteriorated perception of urge-to-cough without changing cough reflex threshold to citric acid in female never-smokers

    OpenAIRE

    Ebihara, Satoru; Ebihara, Takae; Kanezaki, Masashi; Gui, Peijun; Yamasaki, Miyako; Arai, Hiroyuki; Kohzuki, Masahiro

    2011-01-01

    Background The effect of aging on the cognitive aspect of cough has not been studied yet. The purpose of this study is to investigate the aging effect on the perception of urge-to-cough in healthy individuals. Methods Fourteen young, female, healthy never-smokers were recruited via public postings. Twelve elderly female healthy never-smokers were recruited from a nursing home residence. The cough reflex threshold and the urge-to-cough were evaluated by inhalation of citric acid. The cough ref...

  16. Cough Recognition Based on Mel Frequency Cepstral Coefficients and Dynamic Time Warping

    Science.gov (United States)

    Zhu, Chunmei; Liu, Baojun; Li, Ping

    Cough recognition provides important clinical information for the treatment of many respiratory diseases, but the assessment of cough frequency over a long period of time remains unsatisfied for either clinical or research purpose. In this paper, according to the advantage of dynamic time warping (DTW) and the characteristic of cough recognition, an attempt is made to adapt DTW as the recognition algorithm for cough recognition. The process of cough recognition based on mel frequency cepstral coefficients (MFCC) and DTW is introduced. Experiment results of testing samples from 3 subjects show that acceptable performances of cough recognition are obtained by DTW with a small training set.

  17. Parainfluenza 3-Induced Cough Hypersensitivity in the Guinea Pig Airways.

    Directory of Open Access Journals (Sweden)

    Eric J Zaccone

    Full Text Available The effect of respiratory tract viral infection on evoked cough in guinea pigs was evaluated. Guinea pigs were inoculated intranasally with either parainfluenza type 3 (PIV3 and cough was quantified in conscious animals. The guinea pigs infected with PIV3 (day 4 coughed nearly three times more than those treated with the viral growth medium in response to capsaicin, citric acid, and bradykinin. Since capsaicin, citric acid, and bradykinin evoked coughing in guinea pigs can be inhibited by drugs that antagonize the transient receptor potential cation channel, subfamily V, member 1 (TRPV1, it was reasoned that the virally-induced hypertussive state may involve alterations in TPRV1 activity. PIV3 infection caused a phenotypic switch in tracheal nodose Aδ "cough receptors" such that nearly 50% of neurons began to express, de novo, TRPV1 mRNA. There was also an increase TRPV1 expression in jugular C-fiber neurons as determined by qPCR. It has previously been reported that tracheal-specific nodose neurons express the BDNF receptor TrkB and jugular neurons express the NGF receptor TrkA. Jugular neurons also express the artemin receptor GFRα3. All these neurotrophic factors have been associated with increases in TRPV1 expression. In an ex vivo perfused guinea pig tracheal preparation, we demonstrated that within 8 h of PIV3 infusion there was no change in NGF mRNA expression, but there was nearly a 10-fold increase in BDNF mRNA in the tissue, and a small but significant elevation in the expression of artemin mRNA. In summary, PIV3 infection leads to elevations in TRPV1 expression in the two key cough evoking nerve subtypes in the guinea pig trachea, and this is associated with a hypertussive state with respect to various TRPV1 activating stimuli.

  18. 简化咳嗽积分临床应用价值的研究%Validation of the reliability and clinical value of the simplified cough score

    Institute of Scientific and Technical Information of China (English)

    赵婷; 邱志宏; 王岚; 余莉; 吕寒静; 邱忠民

    2012-01-01

    目的 验证简化咳嗽积分方法的重复性和治疗反应性.方法 选择2010年6月至2011年2月在我科就诊的119例慢性咳嗽患者,进行简化咳嗽积分、咳嗽症状积分、莱赛斯特咳嗽问卷和辣椒素咳嗽敏感性测定,分析彼此相关性,计算有效治疗后咳嗽积分的变化率、效应大小及标准化反应均数.其中99例未经治疗的咳嗽症状稳定者间隔3天接受简化咳嗽积分重复性检验.结果 间隔3天简化咳嗽积分重复性检验组内相关系数日间为0.90(95%CI=0.84 ~0.92,P=0.00),夜间为0.89(95%CI=0.91 ~0.96,P=0.00).简化咳嗽积分与咳嗽症状积分呈高度直线正相关(r日间=0.82,P =0.00;r夜间=0.92,P =0.00),与莱赛斯特咳嗽问卷总分有一定程度负相关,与辣椒素咳嗽阈值C2或C5也存在低度负相关.患者有效治疗2周后咳嗽积分变化率、效应大小及标准化反应均数日间分别为46.71%、1.16和1.05,夜间分别为71.87%、1.09和1.10.结论 简化咳嗽积分有很高的重复性和治疗反应性,可作为临床上评估咳嗽严重程度的有效工具.%Objective To validate the repeatability of the simplified cough score and its responsiveness to effective treatment and investigate the relationship between the simplified cough score and cough symptom score.Methods A total of 119 patients with chronic cough referred to our respiratory clinic were recruited into the study between June 2010 and February 2011. Cough severity was evaluated by the simplified cough score,cough symptom score,Leicester cough questionnaire,and cough reflex sensitivity detection,and the correlations among them were analyzed.The change ratio,effect size,and standardized response mean of the simplified cough score were calculated after a 2-week course of effective treatment.The repeatability of the simplified cough score was assessed in 99 untreated patients with stable chronic cough.Results The intraclass correlation coefficient in a 3-day

  19. Denver peritoneovenous shunt in the management of refractory ascites due to chronic liver diseases: impact of patients selection on its outcome.

    Science.gov (United States)

    Abbas, Mohamed; El Damarawy, Mervat; Seyam, Moataz; Awad, Alaa; Madkour, Mona Ezzat; Salah, Mohamed

    2007-12-01

    Forty four patients with refractory ascites due to chronic liver diseases that fulfilling the inclusion criteria of selection were divided into 2 groups. The first group (GI, n=24) was subdivided into 2 subgroups according to degree of liver condition; GIa (n=11) with Child-Pugh class B and GIb (n=13) with early class C. The patients were subjected to P-V shunt (Denver group). Similarly, patients in the second group (GII, n=20) were divided into 2 subgroups GIIa (n=10) & GIIb (n=10) respectively and treated by the repeated tapping and albumin infusion (control group). Postoperative results revealed a significant increase in urine out put (P<0.001), decrease in abdominal girth (P<0.01) and body weight (p<0.01) with more patients fitness and satisfaction than in controls. Postoperative complications were more in GIb. Ascites recurrence occurred in 3 (23%) patients in GIb due to severe infection (2 cases) and irreversible shunt obstruction (1 case) and without recurrence in GIa. So, Denver P-V shunt offers a good palliation in such patients, but its use is more justified in selected cases.

  20. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults

    Energy Technology Data Exchange (ETDEWEB)

    Potts, J.F.; Rona, R.J.; Oyarzun, M.J.; Amigo, H.; Bustos, P. [Kings College London, London (United Kingdom). Dept. for Public Health Science

    2008-04-15

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semi-rural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  1. Long-term effect of extracorporeal shock wave therapy on the treatment of chronic pelvic pain syndrome due to non bacterial prostatitis

    Directory of Open Access Journals (Sweden)

    Amir Moayednia

    2014-01-01

    Full Text Available Background: There is limited evidence about the chronic pelvic pain syndrome (CPPS treatment by shockwave therapy, and the aim of this study was to evaluate the effect of extracorporeal shockwave therapy on CPPS due to non bacterial prostatitis in a long-term period. Materials and Methods: In a follow-up survey, 40 patients with CPPS (that were randomly distributed into the treatment or sham groups were evaluated at 16, 20, and 24 weeks. In the treatment group, patients were treated by extracorporeal shock wave therapy (ESWT once a week for 4 weeks by a protocol of 3000 impulses, 0.25 mJ/m 2 and 3 Hz of frequency. 0.05 mJ/m 2 were added in each week. In the sham group, the same protocol was applied, but with the probe being turned off. The follow-up assessments were done by visual analog scale for pain and National Institutes of Health-developed Chronic Prostatitis Symptom Index (NIH-CPSI. Data were compared using independent t-test or analysis of variences. Results: Three patients did not complete the study protocol, 37 patients were evlauated (19 patients in treatment and 18 patients in the sham group. At week 24, the mean of pain score, urinary score, quality-of-life and NIH-CPSI score between two groups were not statistically different. Conclusion: Although, ESWT therapy as a safe and effective therapy in CPPS in short-term follow-up has been established, its long-term efficacy was not supported by this study.

  2. An integrated care program to prevent work disability due to chronic low back pain: a process evaluation within a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Mechelen Willem

    2009-11-01

    Full Text Available Abstract Background In the past decade, a considerable amount of research has been carried out to evaluate the effectiveness of innovative low back pain (LBP interventions. Although some interventions proved to be effective, they are not always applied in daily practice. To successfully implement an innovative program it is important to identify barriers and facilitators in order to change practice routine. Because usual care is not directly aimed at return to work (RTW, we evaluated an integrated care program, combining a patient-directed and a workplace-directed intervention provided by a multidisciplinary team, including a clinical occupational physician to reduce occupational disability in chronic LBP patients. The aims of this study were to describe the feasibility of the implementation of the integrated care program, to assess the satisfaction and expectations of the involved stakeholders and to describe the needs for improvement of the program. Methods Eligible for this study were patients who had been on sick leave due to chronic LBP. Data were collected from the patients, their supervisors and the involved health care professionals, by means of questionnaires and structured charts, during 3-month follow-up. Implementation, satisfaction and expectations were investigated. Results Of the 40 patients who were eligible to participate in the integrated care program, 37 patients, their supervisors and the health care professionals actually participated in the intervention. Adherence to the integrated care program was in accordance with the protocol, and the patients, their supervisors and the health care professionals were (very satisfied with the program. The role of the clinical occupational physician was of additional value in the RTW process. Time-investment was the only barrier for implementation reported by the multidisciplinary team. Conclusion The implementation of this program will not be influenced by any flaws in its application

  3. Variability in proteinase-antiproteinase balance, nutritional status, and quality of life in stable chronic obstructive pulmonary disease due to tobacco and nontobacco etiology

    Directory of Open Access Journals (Sweden)

    Anant Mohan

    2016-01-01

    Full Text Available Context: Although the role of proteinase/antiproteinase imbalance in chronic obstructive pulmonary disease (COPD due to tobacco is well established, information in COPD due to nontobacco etiology is sparse. Aims: To assess the variability in metalloproteinase activity in COPD related to tobacco and nontobacco causes. Settings and Design: This is a hospital-based, prospective, observational study. Subjects and Methods: Serum matrix metalloproteinase-9 (MMP-9 and tissue inhibitor of metalloproteinases-1 (TIMP-1 were estimated in 200 subjects divided equally into four groups, i.e. COPD in tobacco smokers, COPD in nonsmokers but with exposure to biomass-related indoor air pollution, smokers without COPD, and nonsmoking healthy controls. Anthropometric skinfold measurements, quality of life (QOL using St. George Respiratory Questionnaire, and exercise capacity using the 6-min walk test (6-MWT were carried out. Groups were compared using analysis of variance and Kruskal–Wallis plus Mann–Whitney U-test to assess differences between groups. The Chi-square and Fisher's exact tests were used to evaluate associations among categorical variables. Spearman's rank correlation was calculated to assess the correlation between data. Results: Patients with COPD due to either tobacco or nontobacco etiology were older, more malnourished, had worse QOL, and poorer exercise capacity compared to non-COPD subjects. Triceps, subscapular, and suprailiac skinfold thicknesses were less in smokers with COPD than biomass-related COPD. MMP-9 and TIMP-1 levels were similar across all groups. TIMP-1 significantly correlated with 6-MWT among all groups. Conclusions: The protease-antiprotease balance in COPD is similar irrespective of the presence or absence of tobacco exposure but is related to poor exercise capacity.

  4. Do Not Give Infants Cough and Cold Products Designed for Older Children

    Science.gov (United States)

    ... for You Special Features Use Caution When Giving Cough and Cold Products to Kids Share Tweet Linkedin ... age should not be given any kind of cough and cold product that contains a decongestant or ...

  5. OTC Cough and Cold Products: Not for Infants and Children Under 2 Years of Age

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates OTC Cough and Cold Products: Not For Infants and Children ... FDA recommending about use of over-the-counter cough and cold products for infants and children under ...

  6. The Cough Cylinder : A tool to study measures against airborne spread of (myco-) bacteria

    NARCIS (Netherlands)

    Driessche, K. van den; Marais, B.J.; Wattenberg, M.; Magis-Escurra, C.; Reijers, M.; Tuinman, I.L.; Boeree, M.J.; Soolingen, D. van; Groot, R. de; Cotton, M.F.

    2013-01-01

    BACKGROUND: 'Covering your cough' reduces droplet number, but its effect on airborne pathogen transmission is less clear. The World Health Organization specifically recommends cough etiquette to prevent the spread of Mycobacterium tuberculosis, but implementation is generally poor and evidence suppo

  7. FDA Researchers Advance Science for Vaccines to Prevent Mumps and Whooping Cough

    Science.gov (United States)

    ... Advance Science for Vaccines to Prevent Mumps and Whooping Cough Share Tweet Linkedin Pin it More sharing options ... in the FDA’s laboratories in Silver Spring, MD. Whooping Cough: Background and Key Findings The FDA is studying ...

  8. Levodropropizine for treating cough in adult and children: a meta-analysis of published studies

    OpenAIRE

    Zanasi, Alessandro; Lanata, Luigi; Fontana, Giovanni; Saibene, Federico; Dicpinigaitis, Peter; De Blasio, Francesco

    2015-01-01

    Background Cough is one of the most common symptoms for which patients seek medical attention from primary care physicians and lung specialists. About 40% of the population at any one time report cough. Cough is associated with significantly impaired health-related quality of life. Levodropropizine is an effective and very well tolerated peripheral antitussive drug. We want to compare it to central cough suppressants efficacy (opioids and non-opioids) that may be associated with side effects ...

  9. An observational study on cough in children: epidemiology, impact on quality of sleep and treatment outcome

    OpenAIRE

    De Blasio, Francesco; Dicpinigaitis, Peter V; Bruce K Rubin; De Danieli, Gianluca; Lanata, Luigi; Zanasi, Alessando

    2012-01-01

    Background Cough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider. Methods This is an observational study on acute cough associated with upper respiratory tract infection (URTI) in children. The study evaluates the epidemiology and impact of cough on quality of sleep and children's activities, and the outcome of cough with antitussive treatments in pediatric routine clinical practice. Study assessments were perform...

  10. Mucociliary and cough clearance as a biomarker for therapeutic development

    DEFF Research Database (Denmark)

    Bennett, William D; Daviskas, Evangelia; Hasani, Amir;

    2010-01-01

    A workshop/symposium on “Mucociliary and Cough Clearance (MCC/CC) as a Biomarker for Therapeutic Development” was held on October 21–22, 2008, in Research Triangle Park, NC, to discuss the methods for measurement of MCC/CC and how they may be optimized for assessing new therapies designed...

  11. Characteristics of children consulting for cough, sore throat, or earache

    NARCIS (Netherlands)

    J.H.J.M. Uijen (Hans); H.J. van Duijn (Huug); M.M. Kuyvenhoven (Marijke); F.G. Schellevis (François); J.C. van der Wouden (Hans)

    2008-01-01

    textabstractAbstract BACKGROUND: GPs are often consulted for respiratory tract symptoms in children. AIM: To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. DESIGN OF STUDY: Second Dutch National Survey o

  12. Characteristics of children consulting for cough, sore throat, or earache.

    NARCIS (Netherlands)

    Uijen, H.J.M.; Duijn, H.J. van; Kuyvenhoven, M.M.; Schellevis, F.G.; Wouden, J.C. van der

    2008-01-01

    BACKGROUND: GPs are often consulted for respiratory tract symptoms in children. AIM: To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. DESIGN OF STUDY: Second Dutch National Survey of General Practice (DN

  13. Characteristics of children consulting for cough, sore throat, or earache

    NARCIS (Netherlands)

    Uijen, Johannes H. J. M.; van Duijn, Huug J.; Kuyvenhoven, Marijke M.; Schellevis, Francois G.; van der Wouden, Johannes C.

    2008-01-01

    Background GPs are often consulted for respiratory tract symptoms in children. Aim To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. Design of study Second Dutch National Survey of General Practice (DNSGP

  14. 76 FR 44475 - Labeling for Bronchodilators To Treat Asthma; Cold, Cough, Allergy, Bronchodilator, and...

    Science.gov (United States)

    2011-07-26

    ... Bronchodilators To Treat Asthma; Cold, Cough, Allergy, Bronchodilator, and Antiasthmatic Drug Products for Over...)(6) to establish a monograph for OTC cold, cough, allergy, bronchodilator, and antiasthmatic drug products. The ANPR included the recommendations of the Advisory Review Panel on OTC Cold, Cough,...

  15. Misdiagnosis and mistreatment of ace-inhibitor induced cough decreases therapy compliance

    NARCIS (Netherlands)

    Vegter, S.; de Boer, P.; van Dijk, K. W.; Visser, S. T.; de Jong-van den Berg, L. T.

    2012-01-01

    OBJECTIVES: A common adverse effect of angiotensin-converting enzyme inhibitors (ACEi) is a persistent dry cough. Physicians and pharmacists who fail to recognise dry cough to be ACEi related may prescribe cough suppressants (antitussives), instead of recommended ACEi substitution. The aim of this s

  16. Endoscopic ultrasonography guided celiac plexus neurolysis and celiac plexus block in the management of pain due to pancreatic cancer and chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Anthony J Michaels; Peter V Draganov

    2007-01-01

    Pain is a common symptom of pancreatic disease and is frequently difficult to manage. Pain relief provided by narcotics is often suboptimal and is associated with significant side effects. An alternative approach to pain management in pancreatic disease is the use of celiac plexus block (CPB) or neurolysis (CPN). Originally performed by anesthesiologists and radiologists via a posterior approach, recent advances in endoscopic ultrasonography (EUS) have made this technique an attractive alternative. EUS guided celiac plexus block/neurolysis is simple to perform and avoids serious complications such as paraplegia or pneumothorax that are associated with the posterior approach. EUS guided CPN should be considered first line therapy in patients with pain due to pancreatic cancer. It provides superior pain control compared to traditional management with narcotics. A trend for improved survival in pancreatic cancer patients treated with CPN has been reported,but larger studies are needed to confirm this finding.At this time, the use of EUS guided CPB cannot be recommended as routine therapy for pain in chronic pancreatitis since only one-half of the patients experience pain reduction and the beneficial effect tends to be short lived. EUS guided CPB and CPN should be used as part of a multidisciplinary team approach for pain management.

  17. Huge bilateral ovarian cysts in adulthood as the presenting feature of Van Wyk Grumbach syndrome due to chronic uncontrolled juvenile hypothyroidism

    Directory of Open Access Journals (Sweden)

    K S Shivaprasad

    2013-01-01

    Full Text Available Juvenile primary hypothyroidism causing cystic ovaries and pseudoprecocious puberty (Van-Wyk Grumbach syndrome (VWGS is well documented in literature. There are only a few reports of primary hypothyroidism presenting as ovarian cysts in adults. Here we present a case of huge bilateral ovarian cysts in adulthood as the presenting feature of VWGS due to chronic uncontrolled juvenile hypothyroidism. Large uniloculor right ovarian cyst (119 × 81 × 90 mm and a multicystic left ovary (55 × 45 × 49 mm were detected in a 24 year lady with secondary amenorrhea, galactorrhea, and palpable abdominal mass with history of neonatal jaundice, delayed milestones, short stature, and precocious menarche at age of 7.5 years age. She had elevated levels of cancer antigen (CA-125 which normalized post levothyroxine supplementation. Elevated CA-125 may lead to misdiagnosis of ovarian carcinoma and inadvertent treatment. Bilateral ovarian cysts in adults are a rare presentation of juvenile hypothyroidism. It is necessary to screen for primary hypothyroidism in patients presenting with bilateral ovarian cysts to prevent unnecessary evaluation and treatment.

  18. Acupuncture as an adjunctive therapy to pharmacological treatment in patients with chronic pain due to osteoarthritis of the knee: a 3-armed, randomized, placebo-controlled trial.

    Science.gov (United States)

    Mavrommatis, Christos I; Argyra, Eriphili; Vadalouka, Athina; Vasilakos, Dimitrios G

    2012-08-01

    The efficacy of acupuncture as an adjunctive therapy to pharmacological treatment of chronic pain due to knee osteoarthritis was studied with a 3-armed, single-blind, randomized, sham-controlled trial; it compared acupuncture combined with pharmacological treatment, sham acupuncture including pharmacological treatment, and pharmacological treatment alone. A total of 120 patients with knee osteoarthritis were randomly allocated to 3 groups: group I was treated with acupuncture and etoricoxib, group II with sham acupuncture and etoricoxib, and group III with etoricoxib. The primary efficacy variable was the Western Ontario and McMaster Universities (WOMAC) index and its subscales at the end of treatment at week 8. Secondary efficacy variables included the WOMAC index at the end of weeks 4 and 12, a visual analogue scale (VAS) at the end of weeks 4, 8, and 12, and the Short Form 36 version 2 (SF-36v2) health survey at the end of week 8. An algometer was used to determine changes in a predetermined unique fixed trigger point for every patient at the end of weeks 4, 8, and 12. Group I exhibited statistically significant improvements in primary and secondary outcome measures, except for Short Form mental component, compared with the other treatment groups. We conclude that acupuncture with etoricoxib is more effective than sham acupuncture with etoricoxib, or etoricoxib alone for the treatment of knee osteoarthritis.

  19. Three-year follow-up study on hepatic fibrosis due to chronic hepatitis Btreated by interferon-α1b and traditional medicine preparation

    Institute of Scientific and Technical Information of China (English)

    Ming Liang Cheng; Yin Ying Lu; Jun Wu; Tian Ying Luo; Ke Fu Huang; Yi Sheng Ding; Ran Cai Liu; Jia Li; Zhong Li

    2000-01-01

    AIM To investigate the short-term and long-term therapeutic effect of traditional medicine preparation andIFN-α1 b on hepatic fibrosis due to chronic hepatitis B.METHODS Fifty-two patients with hepatic fibrosis of hepatitis B were treated by IFN-alb and traditionalmedicine preparation, then observed the change of serum indexes of hepatic fibrosis, liver biopsy,ultrasonography and fibergastroscopy.RESULTS The serum indexes of hepatic fibrosis decreased significantly after 3-month treatment(P<0.05). The improvement of liver fibrosis was confirmed by liver biopsy, ultrasonography andfibergastroscopy. After 3-year continuous follow-up, the conditions of patients were got better. Symptomsand signs were disappeared. The pathohistologic change of liver, serum index of hepatic fibrosis and liverfunction were continuously improved.CONCLUSION The good short-term and long-term effects were obtained by using IFN-α1b to suppressduplication of hepatitis B virus and traditional medicine preparation to reverse hepatic fibrosis.

  20. Respiratory diseases and the impact of cough in Taiwan: Results from the APBORD observational study.

    Science.gov (United States)

    Lin, Horng-Chyuan; Cho, Sang-Heon; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak Bin Abdul; Thanaviratananich, Sanguansak; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Cahill, Camilla L; Hamrosi, Kim K; Wang, De Yun

    2016-07-01

    Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases (APBORD) study was a cross-sectional, observational study which examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across Asia-Pacific using 1 standard protocol. Here we report symptoms, healthcare resource use (HCRU), work impairment, and associated cost in Taiwan.Consecutive participants aged ≥ 18 years presenting to a physician with symptoms meeting the diagnostic criteria for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed surveys detailing respiratory symptoms, HCRU, work productivity, and activity impairment. Costs including direct medical costs and indirect costs associated with lost work productivity were calculated.The study enrolled 1001 patients. AR was the most frequent primary diagnosis (31.2%). A quarter of patients presented with a combination of respiratory diseases, with AR and asthma being the most frequent combination (14.1%). Cough or coughing up phlegm was the primary reason for the medical visit for patients with asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the primary reasons for AR and rhinosinusitis. Specialists were the most frequently used healthcare resource by patients with AR (26.1%), asthma (26.4%), COPD (26.6%), and rhinosinusitis (47.3%). The mean annual cost per patient with a respiratory disease was US$4511 (SD 5395). The cost was almost double for employed patients (US$8047, SD 6175), with the majority attributable to lost productivity.Respiratory diseases have a significant impact on disease burden in Taiwan. Treatment strategies that prevent lost work productivity could greatly reduce the economic burden of these diseases.

  1. Effectiveness of a personalized ventilation system in reducing personal exposure against directly released simulated cough droplets

    DEFF Research Database (Denmark)

    Pantelic, J.; Tham, K. W.; Licina, Dusan

    2015-01-01

    The inhalation intake fraction was used as an indicator to compare effects of desktop personalized ventilation and mixing ventilation on personal exposure to directly released simulated cough droplets. A cough machine was used to simulate cough release from the front, back, and side of a thermal...... the inhalation intake fraction compared to mixing ventilation for all investigated distances and orientations of the cough release. The results point out that the orientation between the cough source and the breathing zone of the exposed occupant is an important factor that substantially influences exposure...

  2. The influence of coughing on cerebrospinal fluid pressure in an in vitro syringomyelia model with spinal subarachnoid space stenosis

    Directory of Open Access Journals (Sweden)

    Martin Bryn A

    2009-12-01

    Full Text Available Abstract Background The influence of coughing, on the biomechanical environment in the spinal subarachnoid space (SAS in the presence of a cerebrospinal fluid flow stenosis, is thought to be an important etiological factor in craniospinal disorders, including syringomyelia (SM, Chiari I malformation, and hydrocephalus. The aim of this study was to investigate SAS and syrinx pressures during simulated coughing using in vitro models and to provide information for the understanding of the craniospinal fluid system dynamics to help develop better computational models. Methods Four in vitro models were constructed to be simplified representations of: 1 non-communicating SM with spinal SAS stenosis; 2 non-communicating SM due to spinal SAS stenosis with a distensible spinal column; 3 non-communicating SM post surgical removal of a spinal SAS stenosis; and 4 a spinal SAS stenosis due to spinal trauma. All of the models had a flexible spinal cord. To simulate coughing conditions, an abrupt CSF pressure pulse (~ 5 ms was imposed at the caudal end of the spinal SAS by a computer-controlled pump. Pressure measurements were obtained at 4 cm intervals along the spinal SAS and syrinx using catheter tip transducers. Results Pressure measurements during a simulated cough, showed that removal of the stenosis was a key factor in reducing pressure gradients in the spinal SAS. The presence of a stenosis resulted in a caudocranial pressure drop in the SAS, whereas pressure within the syrinx cavity varied little caudocranially. A stenosis in the SAS caused the syrinx to balloon outward at the rostral end and be compressed at the caudal end. A >90% SAS stenosis did not result in a significant Venturi effect. Increasing compliance of the spinal column reduced forces acting on the spinal cord. The presence of a syrinx in the cord when there was a stenosis in the SAS, reduced pressure forces in the SAS. Longitudinal pressure dissociation acted to suck fluid and tissue

  3. Personal Construction of Cough Medicine among Young Substance Abusers in Hong Kong

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2012-01-01

    Full Text Available Although cough medicine abuse is a growing problem in many places, there is no study examining the views of young substance abusers toward cough medicine. The objective of this study was to examine personal constructions of cough medicine abusers via the repertory grid tests (=11. Several observations are highlighted from the study. First, personal constructions of cough medicine were mixed, including the benefits and harmful effects of its abuse. Second, although the informants perceived cough medicine to be addictive and harmful, they perceived cough medicine to be less addictive and less harmful than did heroin. Third, while the informants construed cough medicine to be similar to ketamine and marijuana, they also perceived cough medicine to possess some characteristics of heroin. Fourth, relative to the construed similarity between heroin and the gateway drugs (cigarette, beer, and liquor, the informants construed cough medicine to be more similar to the gateway drugs. Finally, a higher level of perceived dissimilarity between cough medicine and gateway drugs was related to a higher level of perceived harm of cough medicine abuse.

  4. Distinction between voluntary cough sound and speech in volunteers by spectral and complexity analysis.

    Science.gov (United States)

    Martinek, J; Tatar, M; Javorka, M

    2008-12-01

    Objective monitoring of cough sound for extended period is an important step toward a better understanding of this symptom. Because ambulatory cough monitoring systems are not commercially available, we prepared own monitoring system, which is able to distinguish between voluntary cough sound and speech in healthy volunteers. 20-min sound records were obtained using portable digital voice recorder. Characteristics of the sound events have been calculated in time and frequency domains and by a nonlinear analysis. Based on selected parameters, classification tree was constructed for the classification of cough and non-cough sound events. We validated the usefulness of our algorithm developed against manual counts of cough obtained by a trained observer. The median sensitivity value was 100% (the interquartile range was 98-100) and the median specificity was 95% (the interquartile range was 90-97). In conclusion, we developed an algorithm to distinguish between voluntary cough sound and speech with a high degree of accuracy.

  5. Chronic abdominal pain after ventral hernia due to mesh migration and erosion into the sigmoid colon from a distant site: a case report and review of literature.

    Science.gov (United States)

    Millas, S G; Mesar, T; Patel, R J

    2015-10-01

    Hernia repair is one of the most commonly performed procedures in general surgery. Use of mesh has been shown to decrease the overall recurrence rate. Mesh implantation, however, carries its own risks and complications. We report a case of a 41-year-old female who presented with nonspecific, chronic lower abdominal pain after ventral hernia repair with mesh implantation. The chronic pain was found to be the consequence of mesh migration and erosion into the sigmoid colon from a previous supraumbilical hernia repair. Hernia repair, use of mesh, and chronic abdominal pain are discussed.

  6. Latent class analysis of diagnostic tests for adenovirus, Bordetella pertussis and influenza virus infections in German adults with longer lasting coughs.

    Science.gov (United States)

    Sobotzki, C; Riffelmann, M; Kennerknecht, N; Hülsse, C; Littmann, M; White, A; Von Kries, R; Wirsing VON König, C H

    2016-03-01

    Laboratory tests in adult outpatients with longer lasting coughs to identify a potential causal pathogen are rarely performed, and there is no gold standard for these diagnostic tests. While the diagnostic validity of serological tests for pertussis is well established their potential contribution for diagnosing adenovirus and influenza virus A and B infections is unclear. A sentinel study into the population-based incidence of longer lasting coughs in adults was done in Rostock (former East Germany) and Krefeld (former West Germany). A total of 971 outpatients who consulted general practitioners or internists were included. Inclusion criteria were coughing for ⩾1 week and no chronic respiratory diseases. We evaluated the performance of polymerase chain reaction (PCR) as well as IgG and IgA serology, applying a latent class model for diagnosing infections with adenovirus, B. pertussis, and influenza virus A and B. The adult outpatients first sought medical attention when they had been coughing for a median of 3 weeks. In this situation, direct detection of infectious agents by PCR had a low sensitivity. Modelling showed that additional serological tests equally improved sensitivity and specificity for diagnosis for adenovirus, B. pertussis and influenza virus A and B infections. The combination of serology and PCR may improve the overall performance of diagnostic tests for B. pertussis and also for adenovirus, and influenza virus A and B infections.

  7. Antioxidant activity of herbal polysaccharides and cough reflex.

    Science.gov (United States)

    Nosalova, G; Jurecek, L; Hromadkova, Z; Kostalova, Z; Sadlonova, V

    2013-01-01

    The extraction of Fallopia sachalinensis leaves resulted in two fractions (FS-1 and FS-2). Chemical and spectral analyses of samples revealed the prevalence of pectic polysaccharides with high galacturonic acid, arabinose, galactose, and rhamnose content. Arabinogalactan with a higher content of phenolic prevailed in the FS-1, whereas rhamnogalacturonan predominated in the FS-2 fraction. Both polysaccharides showed significant antioxidant activity according to DPPH and FRAP assays. Evaluation of antitussive activity in healthy adult conscious guinea pigs after oral application of 50 and 75 mg/kg of the FS-2 polysaccharide extracts showed a significant suppression of cough reflex, without an influence on specific airway resistance. The suppression of cough was comparable with that of codeine.

  8. Whooping Cough Vaccine Recommendation for Babies and Young Children

    Centers for Disease Control (CDC) Podcasts

    2015-01-22

    This podcast provides information about whooping cough and the recommendation that all children receive the DTaP vaccine, according to CDC’s recommended schedule, to help protect them from this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  9. Whooping Cough Vaccine Recommendation for Preteens and Teens

    Centers for Disease Control (CDC) Podcasts

    2015-01-22

    This podcast provides information about whooping cough and the recommendation that all preteens receive the Tdap vaccine when they are 11 or 12 to help protect them from this serious disease.  Created: 1/22/2015 by National Center for Infectious and Respiratory Disease (NCIRD), Division of Bacterial Disease (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPD).   Date Released: 1/22/2015.

  10. Whooping cough in adults: an update on a reemerging infection.

    Science.gov (United States)

    Paisley, Robert D; Blaylock, Jason; Hartzell, Joshua D

    2012-02-01

    Pertussis, or whooping cough, which is commonly thought of as a pediatric illness, is an underappreciated adult pathogen. Recent outbreaks highlight the significance of pertussis in adults and the risk of transmission to at-risk infants who are most susceptible to complications, including death. This article describes the recent epidemiologic shifts and reviews the clinical presentation, diagnosis, and treatment of pertussis. New vaccination recommendations by the Advisory Committee on Immunization Practices in response to recent outbreaks and infant deaths are highlighted.

  11. Acidogenic Potential of “Sugar-Free” Cough Drops

    OpenAIRE

    2009-01-01

    A patient presented with extensive marginal ditching around restorations recently placed during whole-mouth rehabilitation. The patient was not xerostomic and was otherwise normal except for the self-reported excessive use of “sugar-free” cough drops sweetened with sorbitol and Isomalt® (an equimolar mix of glucosyl-mannitol and glucosylsorbitol). This prompted an in vitro investigation to determine whether Streptococcus sobrinus 6715, a cariogenic streptococcus, could grow and produce acid i...

  12. Respiratory Conditions Update: Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Karel, Daphne J

    2016-09-01

    Chronic obstructive pulmonary disease (COPD) is defined as persistent airflow limitation due to irritant-induced chronic inflammation. A postbronchodilator forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) ratio of 0.7 or less is diagnostic in a patient with dyspnea, chronic cough or sputum production, and a history of irritant exposure. Tobacco smoking is the most significant etiology, and smoking cessation is the only intervention shown to slow disease progression. Long-acting beta2-agonists and long-acting muscarinic antagonists are first-line treatments for patients with persistently symptomatic COPD with an FEV1 of 80% or less of predicted. When COPD is uncontrolled with a long-acting bronchodilator, combination therapy with a long-acting muscarinic antagonist-long-acting beta2-agonist or long-acting beta2-agonist-inhaled corticosteroid should be prescribed. Patients with COPD and reduced exercise tolerance should undergo pulmonary rehabilitation and be evaluated for supplemental oxygen therapy. Other treatment options for persistently symptomatic COPD include inhaler triple therapy (ie, long-acting muscarinic antagonist, long-acting beta2-agonist, inhaled corticosteroid), phosphodiesterase type 4 inhibitors, oxygen, and surgical interventions.

  13. Deglutition and Cough in Different Degrees of Parkinson Disease

    Directory of Open Access Journals (Sweden)

    Gasparim, Aretuza Zaupa

    2011-04-01

    Full Text Available Introduction: Parkinson disease is one of the pathologies mostly affecting deglutition. Objective: To analyze the efficiency of both deglutition and cough reflex in cases of laryngeal penetration or tracheal aspiration with food, in different severity stages of Parkinson disease. Study's way: contemporaneous cohort with transverse incision. Method: The sample had 38 patients in the study group and 38 individuals in the control group submitted to a neurologic evaluation and an otorhinolaryngological evaluation by transnasal fiberoptic laryngoscopy. Results: The cough reflex was manifested in 100% of patients without food offering. Alimentary stasis in piriform recesses and epiglottic vallecula in solid, pasty and liquid consistency was significant (p= 0.0000. The laryngeal penetration in liquid consistency was significant (p= 0.0036. Tracheal aspiration occurred in 06 patients of the study group in liquid consistency and it was absent in control group. Conclusion: The efficiency of deglutition in the study group prevailed in the solid consistency, followed by pasty and liquid consistencies. In the control group, deglutition was effective in all individuals. Cough reflex was efficient in most patients of the study group and prevalently inefficient in the subgroup 2.

  14. Exposure to coughed airborne pathogens in a double bed hospital patient room with overhead mixing ventilation: impact of posture of coughing patient and location of doctor

    DEFF Research Database (Denmark)

    Kierat, W.; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor

    2010-01-01

    The exposure of a doctor and a patient to air coughed by a second infected patient was studied in a mock-up of two-bed hospital infectious ward with mixing ventilation at 22oC (71.6 F) room air temperature. The effect of posture of the coughing patient lying sideways or on back), position...

  15. Efficiency and outcome of non-invasive versus invasive positive pressure ventilation therapy in respiratory failure due to chronic obstructive pulmonary disease.

    Science.gov (United States)

    Amri Maleh, Valiollah; Monadi, Mahmood; Heidari, Behzad; Maleh, Parviz Amri; Bijani, Ali

    2016-01-01

    Background: Application noninvasive ventilation in the patients with exacerbation of chronic obstructive pulmonary disease (COPD) reduced mortality. This case-control study was designed to compare efficiency and outcome of non-invasive (NIV) versus invasive positive pressure ventilation (IPPV) in respiratory failure due to COPD. Methods: The patients were assigned to NIV or IPPV intermittantly.The clinical parameters, including RR (respiratory rate), BP (blood pressure), HR (heart rate) and PH, PaCO2, PaO2 before and 1, 4 and 24 h after treatment were measured. Demographic information such as age, sex, severity of disease based on APACHE score, length of stay and outcome were recorded. Results: Fifty patients were enrolled in the NIV group and 50 patients in IPPV. The mean age was 70.5 in NIV and 63.9 in invasive ventilation group (p>0.05). In IPPV group, the average values of PH: PCO2: and PO2, were 7.22±0.11, 69.64 + 24.25: and 68.86±24.41 .In NIV, the respective values were 7.30±0.07, 83.94±18.95, and 60.60±19.88. In NIV group, after 1, 4 and 24 h treatment, the clinical and ventilation parameters were stable. The mean APACHE score in was IPPV, 26.46±5.45 and in NIV was 12.26±5.54 (p<0.05). The average length of hospital stay in IPPV was 15.90±10 and in NIV 8.12±6.49 days (p<0.05). The total mortality in the NIV was 4 (8%) and in IPPV, 27 patients (54%) (p<0.05). Conclusion: This study indicates that using NIPPV is a useful therapeutic mode of treatment for respiratory failure with acceptable success rate and lower mortality. The application of NIPPV reduces hospital stay, intubation and its consequent complications. PMID:27386061

  16. Cough aerosol in healthy participants: fundamental knowledge to optimize droplet-spread infectious respiratory disease management

    Directory of Open Access Journals (Sweden)

    Zayas Gustavo

    2012-03-01

    Full Text Available Abstract Background The Influenza A H1N1 virus can be transmitted via direct, indirect, and airborne route to non-infected subjects when an infected patient coughs, which expels a number of different sized droplets to the surrounding environment as an aerosol. The objective of the current study was to characterize the human cough aerosol pattern with the aim of developing a standard human cough bioaerosol model for Influenza Pandemic control. Method 45 healthy non-smokers participated in the open bench study by giving their best effort cough. A laser diffraction system was used to obtain accurate, time-dependent, quantitative measurements of the size and number of droplets expelled by the cough aerosol. Results Voluntary coughs generated droplets ranging from 0.1 - 900 microns in size. Droplets of less than one-micron size represent 97% of the total number of measured droplets contained in the cough aerosol. Age, sex, weight, height and corporal mass have no statistically significant effect on the aerosol composition in terms of size and number of droplets. Conclusions We have developed a standard human cough aerosol model. We have quantitatively characterized the pattern, size, and number of droplets present in the most important mode of person-to-person transmission of IRD: the cough bioaerosol. Small size droplets ( Study design Open bench, Observational, Cough, Aerosol study

  17. Mycotic aneurysm of the femoral artery resulting from mismanagement of a pathological femur fracture due to chronic osteomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Mwaka Erisa Sabakaki

    2013-01-01

    Full Text Available Abstract Introduction Mycotic aneurysms are rarely listed among the possible complications of osteomyelitis of the long bones. To the best of our knowledge this is the first case of chronic osteomyelitis associated with a pathological fracture of the femur and a mycotic aneurysm of the femoral artery. Case presentation We present the case of a 13-year-old Ugandan boy who was referred to our hospital with chronic osteomyelitis associated with a pathological fracture of the right femur and a mycotic aneurysm of the femoral artery. He underwent a successful above-knee amputation and is currently undergoing rehabilitation. Conclusions Aneurysms associated with chronic osteomyelitis of the long bones are very rare. However, in Africa, where people often still believe in crude traditional remedies, they should be considered among the possible diagnoses especially where acute injuries of the limbs are massaged and manipulated.

  18. Assessment of antitussive efficacy of dextromethorphan in smoking related cough: objective vs. subjective measures

    Science.gov (United States)

    Ramsay, James; Wright, Caroline; Thompson, Rachel; Hull, David; Morice, Alyn H

    2008-01-01

    AIMS Using an established model of smokers cough we measured the antitussive effects of dextromethorphan compared with placebo. METHODS The study was a randomized, double-blind placebo controlled, crossover comparison of 22 mg 0.8 ml−1 dextromethorphan delivered pregastrically with matched placebo. Objective and subjective measurements of cough were recorded. Subjective measures included a daily diary record of cough symptoms and the Leicester quality of life questionnaire. Cough frequency was recorded using a manual cough counter. The objective measure of cough reflex sensitivity was the citric acid, dose–response cough challenge. RESULTS Dextromethorphan was significantly associated with an increase in the concentration of citric acid eliciting an average of two coughs/inhalation (C2) when compared with placebo, 1 h post dose by 0.49 mM (95% CI 0.05, 0.45, geometric mean 3.09) compared with placebo 0.24 mM (geometric mean 1.74) P < 0.05 and at 2 h 0.57 mM (95% CI 0.01, 0.43, geometric mean 3.75) compared with placebo 0.34 mM (geometric mean 2.19) P < 0.05). There was a highly significant improvement in the subjective data when compared with baseline. However, there was no significant difference between placebo and active treatment. No correlation was seen between cough sensitivity to citric acid and recorded cough counts or symptoms. When both subjective and objective data were compared with screening data there was evidence of a marked ‘placebo’ effect. CONCLUSIONS The objective measure of cough sensitivity demonstrates dextromethorphan effectively diminishes the cough reflex sensitivity. However, subjective measures do not support this. Other studies support these findings, which may represent a profound sensitivity of the cough reflex to higher influences. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Dextromethorphan is widely used as a cough suppressant in over the counter medications. Its efficacy in altering cough reflex sensitivity has been shown in

  19. Iodine Treatment in Children with Subclinical Hypothyroidism Due to Chronic Iodine Deficiency Decreases Thyrotropin and C-Peptide Concentrations and Improves the Lipid Profile

    NARCIS (Netherlands)

    Zimmermann, M.B.; Aeberli, I.; Boonstra, A.; Grimci, L.; Bridson, J.; Chaouki, N.; Mbhenyane, X.; Jooste, P.L.

    2009-01-01

    Background: Chronic iodine deficiency (ID) increases thyrotropin (TSH) concentrations and produces a thyroid hormone pattern consistent with subclinical hypothyroidism (ScH). ScH may be associated with cardiovascular disease risk factors. Thus, the study aim was to determine if iodine treatment of c

  20. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Kadaba, Raghu

    2011-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas due to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects between 3 and 9 people in 100,000; 70% of cases are alcohol-induced.

  1. Breaking the sound barrier? Pitfalls and benefits of acoustic cough monitoring.

    Science.gov (United States)

    Houghton, Lesley A; Smith, Jaclyn A

    2012-12-01

    Traditionally push-button and symptom diaries have been used to document cough events, especially when examining temporal associations between cough and reflux events. More recently, acoustic devices have allowed more accurate recording of cough events, and compared with the latter traditional techniques reported 6-18 times more coughing. Whether the differences reported between these techniques represents disparities in subject groups or cough detection and quantification methods is unknown. In this issue of the American Journal of Gastroenterology, Kavitt et al. show that listeners of such recordings have a 4-fold increase in odds of recording cough events compared with patients using push-button techniques, and that even when using a 5-min window to assess temporal concordance/discordance, over 70% of coughs were not reported by the patients. These observations have potential significant implications when assessing temporal associations between cough and reflux, and thus any clinical decision making based on these data. This editorial examines both the findings of Kavitt et al. and discusses the pitfalls and benefits of validated accurate documentation of cough.

  2. Cough quality in children: a comparison of subjective vs. bronchoscopic findings

    Directory of Open Access Journals (Sweden)

    Cox Nancy C

    2005-01-01

    Full Text Available Abstract Background Cough is the most common symptom presenting to doctors. The quality of cough (productive or wet vs dry is used clinically as well as in epidemiology and clinical research. There is however no data on the validity of cough quality descriptors. The study aims were to compare (1 cough quality (wet/dry and brassy/non-brassy to bronchoscopic findings of secretions and tracheomalacia respectively and, (2 parent's vs clinician's evaluation of the cough quality (wet/dry. Methods Cough quality of children (without a known underlying respiratory disease undergoing elective bronchoscopy was independently evaluated by clinicians and parents. A 'blinded' clinician scored the secretions seen at bronchoscopy on pre-determined criteria and graded (1 to 6. Kappa (K statistics was used for agreement, and inter-rater and intra-rater agreement examined on digitally recorded cough. A receiver operating characteristic (ROC curve was used to determine if cough quality related to amount of airway secretions present at bronchoscopy. Results Median age of the 106 children (62 boys, 44 girls enrolled was 2.6 years (IQR 5.7. Parent's assessment of cough quality (wet/dry agreed with clinicians' (K = 0.75, 95%CI 0.58–0.93. When compared to bronchoscopy (bronchoscopic secretion grade 4, clinicians' cough assessment had the highest sensitivity (0.75 and specificity (0.79 and were marginally better than parent(s. The area under the ROC curve was 0.85 (95%CI 0.77–0.92. Intra-observer (K = 1.0 and inter-clinician agreement for wet/dry cough (K = 0.88, 95%CI 0.82–0.94 was very good. Weighted K for inter-rater agreement for bronchoscopic secretion grades was 0.95 (95%CI 0.87–1. Sensitivity and specificity for brassy cough (for tracheomalacia were 0.57 and 0.81 respectively. K for both intra and inter-observer clinician agreement for brassy cough was 0.79 (95%CI 0.73–0.86. Conclusions Dry and wet cough in children, as determined by clinicians and

  3. Propofol-induced violent coughing in a patient with Becker′s muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Amit Jain

    2011-01-01

    Full Text Available Propofol anesthesia is often associated with decreased incidence of gagging, coughing or laryngospasm, and provides intense suppression on airway reflex during tracheal intubation and laryngeal mask airway insertion. Propofol pretreatment is also effective in reducing the occurrence of opioid-induced coughing. These benefits are often attributed to bronchodilator and sedative effects of propofol. However, severe coughing following sedative doses of 1% propofol has not been reported so far. We report a rare case of violent coughing following low-dose propofol infusion in a patient with Becker′s muscular dystrophy.

  4. Human Cough as a Two-Stage Jet and Its Role in Particle Transport

    Science.gov (United States)

    Li, Yuguo

    2017-01-01

    The human cough is a significant vector in the transmission of respiratory diseases in indoor environments. The cough flow is characterized as a two-stage jet; specifically, the starting jet (when the cough starts and flow is released) and interrupted jet (after the source supply is terminated). During the starting-jet stage, the flow rate is a function of time; three temporal profiles of the exit velocity (pulsation, sinusoidal and real-cough) were investigated in this study, and our results showed that the cough flow’s maximum penetration distance was in the range of a 50.6–85.5 opening diameter (D) under our experimental conditions. The real-cough and sinusoidal cases exhibited greater penetration ability than the pulsation cases under the same characteristic Reynolds number (Rec) and normalized cough expired volume (Q/AD, with Q as the cough expired volume and A as the opening area). However, the effects of Rec and Q/AD on the maximum penetration distances proved to be more significant; larger values of Rec and Q/AD reflected cough flows with greater penetration distances. A protocol was developed to scale the particle experiments between the prototype in air, and the model in water. The water tank experiments revealed that although medium and large particles deposit readily, their maximum spread distance is similar to that of small particles. Moreover, the leading vortex plays an important role in enhancing particle transport. PMID:28046084

  5. 《咳嗽的诊断与治疗指南(2009版)》解析%Introduction of 《Guideline on Diagnosis and Management of Cough(2009)》

    Institute of Scientific and Technical Information of China (English)

    赖克方; 钟南山

    2009-01-01

    The new revision of is published in China in 2009 following the first revision of in 2005. The new revision hold prvious stucture basically, more focuses on diagnosis and management of chronic ough, adds new sections including subacute cough, empiric treatment, phlegm-removing drugs, and assessement of cough severity as an appendix. A few news terms have been intrduced to replace older terms, such as upper airway cough syndrome for post nasal drip symdrotne, and postinfection cough for cough post influenza.%继2005年中国公布了第一版后,2009年正式发布了新修订的.新修订的指南基本了保持了原有的结构,慢性咳嗽的诊断与治疗为重点部分,增加了亚急性咳嗽、经验性治疗与祛痰治疗几个部分,附件增加了咳嗽程度的评估.提出了几个新的诊断名词,建议用上气咳嗽综合征代替原来的鼻后滴流综合征,感染后咳嗽代替原来的感冒后咳嗽.

  6. [Fever, coughing and dyspnea in a 38-year-old female kidney transplant recipient].

    Science.gov (United States)

    Porsche, M; Künzli, E; Dickenmann, M; Hirsch, H H; Battegay, M; Khanna, N

    2012-12-01

    This article reports on a 38-year-old kidney transplant patient who presented with fever, coughing and dypnea. The patient was immunosuppressed with mycophenolate and prednisone. Due to the suspicion of community acquired pneumonia antibiotic treatment was initiated and the patient was admitted to the intensive care unit. Despite antibiotic treatment the condition did not improve and in the subsequently performed bronchioalveolar lavage parainfluenza virus was diagnosed.Infections with respiratory viruses can be fatal in immunosuppressed patients. Human parainfluenza virus is the third most common pathogen of viral pneumonia. Molecular genetic detection methods allow fast and sensitive diagnosis of respiratory materials. As the treatment options are limited for these infections prophylactic measurements are important.

  7. 儿童上气道咳嗽综合征48例临床分析%Clinical study of upper airway cough syndrome in 48 cases

    Institute of Scientific and Technical Information of China (English)

    董传莉; 谢怀珍; 张兰

    2011-01-01

    Objective: To summarize the clinical characteristics of chronic cough in children caused by upper airway cough syndrome ( UACS) . Methods: Forty-eight children diagnosed with UACS were given systematic treatment such as anti-inflammation, anti-allergy, anti-infection decongestants and so on, and the clinical data were collected and analyzed. Results: There were 26 misdiagnosed cases among the 48 cases. The misdiagnositic rate was 54. 17%. After two-week reasonable and targeted treatment, the symptoms and signs in 42 cases were obviously relieved or disappeared. The effective rate was 87. 50%. Conclusions: Chronic cough is the chief complaint of UACS associated with other complex symptoms, so it is easy to be misdiagnosed and mistreated. All the children with upper airway cough syndrome can be diagnosed through its detail history of disease, reasonable physical examination and specialist consultation. The targeted therapy can give satisfied effect to upper airway cough syndrome.%目的:总结上气道咳嗽综合征(upper airway cough syndrome,UACS)引起儿童慢性咳嗽的临床特点,提高对该病的认识.方法:确诊后采用抗炎、抗变态反应、局部使用减充血剂、抗感染等系统治疗.结果:48例UACS患儿中误诊26例,误诊率54.17%.42例患儿在2周内症状明显减轻或消失,治疗有效率87.50%.结论:UACS均以慢性咳嗽为主诉,伴随症状复杂,易被误诊误治.详细询问病史、合理检查、专科会诊有助于明确诊断.给予针对性治疗,绝大部分疗效好.

  8. Mucociliary and cough clearance as a biomarker for therapeutic development

    DEFF Research Database (Denmark)

    Bennett, William D; Daviskas, Evangelia; Hasani, Amir;

    2010-01-01

    A workshop/symposium on “Mucociliary and Cough Clearance (MCC/CC) as a Biomarker for Therapeutic Development” was held on October 21–22, 2008, in Research Triangle Park, NC, to discuss the methods for measurement of MCC/CC and how they may be optimized for assessing new therapies designed...... to improve clearance of airway secretions from the lungs. The utility of MCC/CC as a biomarker for disease progression and therapeutic intervention is gaining increased recognition as a valuable tool in the clinical research community. A number of investigators currently active in using MCC/CC for diagnostic...

  9. Segmental Difference of the Hepatic Fibrosis from Chronic Viral Hepatitis due to Hepatitis B versus C Virus Infection: Comparison Using Dual Contrast Material-Enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jae Ho; Yu, Jeong Sik; Chung, Jae Joon; Kim, Joo Hee; Kim, Ki Whang [Gangnam Severance Hospital, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    We wanted to identify the geographic differences in hepatic fibrosis and their associations with the atrophy-hypertrophy complex in patients with chronic viral hepatitis using the dual-contrast material-enhanced MRI (DC-MRI) with gadopentetate dimeglumine and ferucarbotran. Patients with chronic C (n = 22) and B-viral hepatitis (n = 35) were enrolled for determining the subjective grade of fibrosis (the extent and thickness of fibrotic reticulations) in the right lobe (RL), the caudate lobe (CL), the medial segment (MS) and the lateral segment (LS) of the liver, with using a 5-grade scale, on the gradient echo T2-weighted images of DC-MRI. The fibrosis grades of different segments were compared using the Kruskal-Wallis test followed by post-hoc analysis to establish the segment-by-segment differences. The incidences of two pre-established morphologic signs of cirrhosis were also compared with each other between the two groups of patients. There were significant intersegmental differences in fibrosis grades of the C-viral group (p = 0.005), and the CL showed lower fibrosis grades as compared with the grades of the RL and MS, whereas all lobes were similarly affected in the B-viral group (p = 0.221). The presence of a right posterior hepatic notch was significantly higher in the patients with intersegmental differences of fibrosis between the RL and the CL (19 out of 25, 76%) than those without such differences (6 out of 32, 19%) (p < 0.001). An expanded gallbladder fossa showed no significant relationship (p = 0.327) with the segmental difference of the fibrosis grades between the LS and the MS. The relative lack of fibrosis in the CL with more advanced fibrosis in the RL can be a distinguishing feature to differentiate chronic C-viral hepatitis from chronic B-viral hepatitis and this is closely related to the presence of a right posterior hepatic notch.

  10. Cough variant asthma and airway remodeling%咳嗽变异性哮喘与气道重塑

    Institute of Scientific and Technical Information of China (English)

    祝筱姬; 孟晓; 徐睿

    2014-01-01

    Cough variant asthma(CVA)is a special typologic bronchial asthma (asthma)which presents solely with chronic cough.CVA is a form of asthma,CVA shares a number of pathophysiological features with classic asthma. More importantly,30% to 40% of adult patients with CVA,unless adequately treated,may progress to classic asthma. Cellular infiltration and airway remodeling are pathological basis of CVA.CVA may call an insidious asthma,it was neglected freguently by clinician,and the patients were missed correct diagnosis and treatment.To know correctly pathophysiological features of CVA,it is important significance for clinical treatment,and may decrease incidence of asthma.In this review,we analyzed the correlation between CVA and inflammatory reaction,airway remodeling.%咳嗽变异性哮喘(cough variant asthma,CVA)是指以慢性咳嗽为主要或唯一症状的一种特殊类型哮喘,其病理生理改变与典型哮喘相同,若未及时诊治,约30%~40%可发展成为典型哮喘。气道炎细胞浸润和气道重塑是 CVA 的病理基础。CVA 可称之为一种隐匿性哮喘,常被临床医师所忽略,患者失去正确的诊断与治疗。正确认识 CVA 的病理生理特征,对临床诊断和治疗具有重要的指导意义,可降低典型哮喘的发病率。本文就 CVA 与气道炎性反应和气道重塑的关系作一综述。

  11. Acquired chronic hepatocerebral degeneration due to cirrhosis from non-alcoholic steatohepatitis Síndrome hepatocerebral crónico secundario a cirrosis por esteatohepatitis no alcohólica

    OpenAIRE

    2009-01-01

    Introduction and objective: acquired chronic hepatocerebral degeneration, acquired hepatolenticular degeneration or pseudo-Wilson is an infrequent disorder with a hepatic origin. Cases in the literature are scarce and it is frequently confused with hepatic encephalopathy and Wilson's disease. The aim of this essay is to report a patient suffering from this disorder due to cirrhosis from non-alcoholic steatohepatitis. Case report: we present a 54-year-old man diagnosed from cirrhosis grade B9 ...

  12. Determination of cough sensitivities of patients with different causes of cough%不同病因咳嗽患者的咳嗽敏感性测定

    Institute of Scientific and Technical Information of China (English)

    张巧; 马千里; 龙舟; 黄赞胜; 唐咸军; 吴颖; 王长征

    2011-01-01

    Objective To study the sensitivities of patients with different causes of cough to capsaicin-stimulated cough and to investigate the clinical significance of capsaicin cough provocation test in diagnosis and treatment of different causes of cough. Methods We selected 169 patients with different causes of cough from the outpatients in Chongqing Xinqiao Hospital of Third Military Medical University, including upper airway cough syndrome (UACS) , cough variability asthma (CVA) , gastro-esophageal regurgitation cough (GERC) , cough after a cold, occupational irritant cough and angiotensin-converting enzyme inhibitor ( ACEI) -related cough. Thirty-eight healthy volunteers of our hospital were enrolled as controls. All the subjects were examined by capsaicin cough provocation test, and the results were analyzed to compare the differences of the qualitative (positive rate) and quantitative (log C2 and log C5) indices in different causes of cough. Results A total of 148 patients who were diagnosed as cough by different causes completed the study. Nearly half of the patients (47.4% , 18/38) in the normal control group were cough provocation positive. GERC group had the highest positive rate among the groups with different causes of cough, and the GERC group and cough after a cold group had a significant difference compared with the control group ( P 0.05 ) were not significantly different. Comparison of C2 values in different groups was similar to that of C5 values. According to the 95% confidence intervals of log C5 values, no overlap was detected between the normal control group and the GERC group and cough after a cold group, but there was some overlap between the normal control group and the CVA group. More overlaps were detected between the normal control group and the UACS group, occupational irritant cough group and ACEI-related cough group. Coclusion Cough sensitivities of patients with different causes ofcough are significantly different. Capsaicin cough

  13. Cough and Arabinogalactan Polysaccharide from the Bark of Terminalia Arjuna.

    Science.gov (United States)

    Sivová, V; Bera, K; Ray, B; Nosáľ, S; Nosáľová, G

    2016-01-01

    In this work we investigated the antitussive activity of the medicinal tree Terminalia arjuna. We used the stem bark for extraction and preparation of water extracted isolate and its two fractions: acetone-soluble (TA-S) and acetone precipitated (TA-P) fraction. The presence of a pectic arabinogalactan was confirmed in TA-P fraction by chromatographic and spectroscopic analysis. The antitussive activity of samples was assessed after oral administration in a dose of 50 mg.kg(-1) in healthy guinea pigs, in which cough was elicited by inhalation of citric acid (0.3 mol/L) in body plethysmograph. The water extracted isolate showed a significant ability to decrease the number of cough efforts by 64.2 %; the antitussive activity on par with that of codeine phosphate. The TA-P fraction showed the antitussive activity of 54.8 %. In contrast, TA-S fraction had only a mild antitussive activity. No changes in in vivo airway resistance were noted. We conclude that arabinogalactan is an essential component of Terminalia arjuna that underlies its antitussive action.

  14. Comparison of the Effect of Two Kinds of Iranian Honey and Diphenhydramine on Nocturnal Cough and the Sleep Quality in Coughing Children and Their Parents

    Science.gov (United States)

    Ayazi, Parviz; Mahyar, Abolfazl; Yousef-Zanjani, Mahdieh; Allami, Abbas; Esmailzadehha, Neda; Beyhaghi, Taraneh

    2017-01-01

    Coughing in a child induced by upper respiratory tract infections (URTIs) can be a problem, both for the child and its parents. Current studies show a lack of proven efficacy for over-the counter (OTC) medications, but promising data support the use of honey for children. The aim of this study was to compare the effects of two kinds of Iranian honey with diphenhydramine (DPH) on nocturnal pediatric coughs and the sleep quality of children and their parents. This was a clinical trial (registered in IRCT; No.: 28.20.7932, 15 October 2013). The study consisted of 87 patients. All the parents completed a standard previously validated questionnaire. The children were randomly assigned to one of three treatment groups: Group 1, Honey type 1 (Kimia Company, Iran) (n = 42), Group 2, Honey type 2 (Shahde-Golha, Iran) (n = 25), and Group 3, DPH (n = 20). Each group received double doses of the respective treatments on two successive nights. A second survey was then administered via a telephone interview in which the parents were asked the same questions. The mean scores for all aspects of coughs were significantly decreased in each group before and after the treatment. All three treatments improved the cough and sleep scores. Honey type 1 was superior to DPH in improving all aspects of coughs, except the frequency, and Honey type 2 was more effective than DPH in improving all aspects of coughs, except the sleep quality of the child. There was no significant difference between Honey type 1 and 2 in any aspects of cough relief in the present study. The results suggest that honey may provide better cough relief than DPH in children and improve the sleep quality of children and their parents. PMID:28103276

  15. Chronic restraint stress promotes learning and memory impairment due to enhanced neuronal endoplasmic reticulum stress in the frontal cortex and hippocampus in male mice.

    Science.gov (United States)

    Huang, Rong-Rong; Hu, Wen; Yin, Yan-Yan; Wang, Yu-Chan; Li, Wei-Ping; Li, Wei-Zu

    2015-02-01

    Chronic stress has been implicated in many types of neurodegenerative diseases, such as Alzheimer's disease (AD). In our previous study, we demonstrated that chronic restraint stress (CRS) induced reactive oxygen species (ROS) overproduction and oxidative damage in the frontal cortex and hippocampus in mice. In the present study, we investigated the effects of CRS (over a period of 8 weeks) on learning and memory impairment and endoplasmic reticulum (ER) stress in the frontal cortex and hippocampus in male mice. The Morris water maze was used to investigate the effects of CRS on learning and memory impairment. Immunohistochemistry and immunoblot analysis were also used to determine the expression levels of protein kinase C α (PKCα), 78 kDa glucose-regulated protein (GRP78), C/EBP-homologous protein (CHOP) and mesencephalic astrocyte-derived neurotrophic factor (MANF). The results revealed that CRS significantly accelerated learning and memory impairment, and induced neuronal damage in the frontal cortex and hippocampus CA1 region. Moreover, CRS significantly increased the expression of PKCα, CHOP and MANF, and decreased that of GRP78 in the frontal cortex and hippocampus. Our data suggest that exposure to CRS (for 8 weeks) significantly accelerates learning and memory impairment, and the mechanisms involved may be related to ER stress in the frontal cortex and hippocampus.

  16. Pharmacogenetics of ACE inhibitor-induced angioedema and cough : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mahmoudpour, Seyed Hamidreza; Leusink, Maarten; van der Putten, Lisa; Terreehorst, Ingrid; Asselbergs, Folkert W.; de Boer, Anthonius; Maitland-van der Zee, Anke H.

    2013-01-01

    Aim: Angioedema and cough are the two most important adverse effects of ACE inhibitors (ACEIs). Evidence exists that ACEI-related angioedema/cough is partly genetically determined and several genes have been identified to play a role in the development of ACEI-related adverse effects. Materials & me

  17. Self-medication for cough and the common cold : Information needs of consumers

    NARCIS (Netherlands)

    Kloosterboer, Sanne Maartje; McGuire, Treasure; Deckx, Laura; Moses, Geraldine; Verheij, Theo; van Driel, Mieke

    2015-01-01

    Background: Despite the high use of over-the-counter (OTC) cough and cold medicines, little is known about Australia's cough and cold medicines information needs. The aim of this study was to identify gaps in consumers' perceived knowledge and concerns, to better target consumer medicines informatio

  18. Use of honey associated with Ananas comosus (Bromelin) in the treatment of acute irritative cough

    Science.gov (United States)

    Peixoto, Décio Medeiros; Rizzo, José Angelo; Schor, Deborah; Silva, Almerinda Rêgo; de Oliveira, Dinaldo Cavalcanti; Solé, Dirceu; Sarinho, Emanuel

    2016-01-01

    Abstract Objective: To evaluate the immediate improvement rate of irritative cough in patients treated with the combination of Ananas comosus extract and honey (Bromelin®) compared with the use of honey alone (placebo group). Methods: Pragmatic, double-blind, randomized, parallel-group study with children aged between 2 and 15 years, with irritative cough for at least 24hours. The double-blind assessment of cough was through the number of observed coughing episodes and intensity score for a period of 10minutes of observation. The decrease of one point in the mean total score was considered as a therapeutic effect. Results: There was a reduction in coughing episodes in both groups, as well as in the cough score after 30minutes of drug or honey administration. The change in clinical score above two points, which could indicate marked improvement, occurred in five patients in the bromelin group and only in one in the placebo group, but without significant difference. There were no adverse events. Conclusions: The immediate improvement rate of irritative cough was similar in patients treated with combination of Ananas comosus extract and honey (Bromelin®) compared with the use of honey alone (placebo group). It is possible that honey has a therapeutic effect on mucus and cough characteristics (Clinical Trials: NCT01356693). PMID:27181342

  19. Analysis of Dextromethorphan in Cough Drops and Syrups: A Medicinal Chemistry Laboratory

    Science.gov (United States)

    Hamilton, Todd M.; Wiseman, Frank L., Jr.

    2009-01-01

    Fluorescence spectroscopy is used to determine the quantity of dextromethorphan hydrobromide (DM) in over-the-counter (OTC) cough drops and syrups. This experiment is appropriate for an undergraduate medicinal chemistry laboratory course when studying OTC medicines and active ingredients. Students prepare the cough drops and syrups for analysis,…

  20. Laryngeal response patterns influence the efficacy of mechanical assisted cough in amyotrophic lateral sclerosis

    Science.gov (United States)

    Andersen, Tiina; Sandnes, Astrid; Brekka, Anne Kristine; Hilland, Magnus; Clemm, Hege; Fondenes, Ove; Tysnes, Ole-Bjørn; Heimdal, John-Helge; Halvorsen, Thomas; Vollsæter, Maria; Røksund, Ola Drange

    2017-01-01

    Background Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation–exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. Methods We conducted a cross-sectional study of 20 patients with ALS and 20 healthy age-matched and sex-matched volunteers. We used video-recorded flexible transnasal fibre-optic laryngoscopy during MI-E undertaken according to a standardised protocol, applying pressures of ±20 to ±50 cm H2O. Laryngeal movements were assessed from video files. ALS type and characteristics of upper and lower motor neuron symptoms were determined. Results At the supraglottic level, all patients with ALS and bulbar symptoms (n=14) adducted their laryngeal structures during insufflation. At the glottic level, initial abduction followed by subsequent adduction was observed in all patients with ALS during insufflation and exsufflation. Hypopharyngeal constriction during exsufflation was observed in all subjects, most prominently in patients with ALS and bulbar symptoms. Healthy subjects and patients with ALS and no bulbar symptoms (n=6) coordinated their cough well during MI-E. Conclusions Laryngoscopy during ongoing MI-E in patients with ALS and bulbar symptoms revealed laryngeal adduction especially during insufflation but also during exsufflation, thereby severely compromising the size of the laryngeal inlet in some patients. Individually customised settings can prevent this and thereby improve and extend the use of non-invasive MI-E. PMID:27174631

  1. Fuzzy approach for improved recognition of citric acid induced piglet coughing from continuous registration

    Science.gov (United States)

    Van Hirtum, A.; Berckmans, D.

    2003-09-01

    A natural acoustic indicator of animal welfare is the appearance (or absence) of coughing in the animal habitat. A sound-database of 5319 individual sounds including 2034 coughs was collected on six healthy piglets containing both animal vocalizations and background noises. Each of the test animals was repeatedly placed in a laboratory installation where coughing was induced by nebulization of citric acid. A two-class classification into 'cough' or 'other' was performed by the application of a distance function to a fast Fourier spectral sound analysis. This resulted in a positive cough recognition of 92%. For the whole sound-database however there was a misclassification of 21%. As spectral information up to 10000 Hz is available, an improved overall classification on the same database is obtained by applying the distance function to nine frequency ranges and combining the achieved distance-values in fuzzy rules. For each frequency range clustering threshold is determined by fuzzy c-means clustering.

  2. The correlation of respiratory muscle strength and cough capacity in stroke patients.

    Science.gov (United States)

    Jo, Myeong-Rae; Kim, Nan-Soo

    2016-10-01

    [Purpose] The purpose of this study was to investigate the correlation between respiratory muscle strength and cough capacity in stroke patients. [Subjects and Methods] Forty-two stroke patients were assigned to 2 different groups (intervention group=21, control group=21). Both groups participated in a conventional stroke rehabilitation program, with the intervention group also receiving respiratory muscle training for 20 to 30 minutes a day, 3 times a week for 8 weeks. Respiratory muscle strength (maximal inspiratory pressure, maximal expiratory pressure), forced vital capacity, and cough capacity were measured. [Results] The intervention group showed significant increases in maximal inspiratory pressure, maximal expiratory pressure, forced vital capacity, and cough capacity. The change in maximal inspiratory pressure, maximal expiratory pressure, and forced vital capacity showed a significant correlation with cough capacity, with maximal expiratory pressure showing the highest correlation. [Conclusion] The present study showed that the increase in maximal expiratory pressure plays an important role in improving the cough capacity of stroke patients.

  3. A comparison of risk factors for wheeze and recurrent cough in preschool children

    DEFF Research Database (Denmark)

    Hermann, Christian; Westergaard, Tine; Pedersen, Bo V

    2005-01-01

    In a study of 2,978 Danish children aged 5 years from two suburban counties of Copenhagen, carried out in 1998, the authors compared risk factor profiles for wheeze and recurrent cough without wheeze by using polytomous logistic regression to clarify whether the two conditions are likely to have...... the same etiology. Data were obtained 1) by a mailed parental questionnaire (International Study of Asthma and Allergies in Childhood questions and supplementary questions on cough, sociodemography, perinatal factors, and environmental exposure); 2) through general practitioners (familial allergic disease......); and 3) from the National Medical Birth Register (birth weight). Wheeze (WH) was defined as more than one episode of wheeze within the last 12 months (irrespective of cough status) and recurrent cough without WH (RC) as cough occurring outside colds and usually lasting for periods of more than 1 week...

  4. Febre crônica associada a abscesso esplênico causado por Staphylococcus epidermidis Chronic fever associated with splenic abscess due to Staphylococcus epidermidis

    Directory of Open Access Journals (Sweden)

    Juliana Salles de Carvalho

    2007-10-01

    Full Text Available Abscessos ocultos são causa freqüente de febre crônica. Os abscessos esplênicos são entidades raras, usualmente associadas a quadros subjacentes de cirurgia abdominal, endocardite ou imunodepressão. Apresenta-se um caso de paciente com febre prolongada causada por um abscesso esplênico, cujo principal diagnóstico diferencial era leishmaniose visceral, que provavelmente esteve associado a traumatismo abdominal. O tratamento consistiu em antibioticoterapia seguida de esplenectomia.Occult abscesses are frequent causes of chronic fever. Splenic abscesses are rare entities that are usually associated with underlying conditions such as abdominal surgery, endocarditis or immunodepression. We report on the case of a patient with prolonged fever caused by a splenic abscess, whose main differential diagnosis was visceral leishmaniasis. However, this condition was probably related to abdominal trauma. The treatment consisted of antibiotics followed by splenectomy.

  5. Exhaled air dispersion during coughing with and without wearing a surgical or N95 mask.

    Directory of Open Access Journals (Sweden)

    David S Hui

    Full Text Available OBJECTIVES: We compared the expelled air dispersion distances during coughing from a human patient simulator (HPS lying at 45° with and without wearing a surgical mask or N95 mask in a negative pressure isolation room. METHODS: Airflow was marked with intrapulmonary smoke. Coughing bouts were generated by short bursts of oxygen flow at 650, 320, and 220L/min to simulate normal, mild and poor coughing efforts, respectively. The coughing jet was revealed by laser light-sheet and images were captured by high definition video. Smoke concentration in the plume was estimated from the light scattered by smoke particles. Significant exposure was arbitrarily defined where there was ≥ 20% of normalized smoke concentration. RESULTS: During normal cough, expelled air dispersion distances were 68, 30 and 15 cm along the median sagittal plane when the HPS wore no mask, a surgical mask and a N95 mask, respectively. In moderate lung injury, the corresponding air dispersion distances for mild coughing efforts were reduced to 55, 27 and 14 cm, respectively, p < 0.001. The distances were reduced to 30, 24 and 12 cm, respectively during poor coughing effort as in severe lung injury. Lateral dispersion distances during normal cough were 0, 28 and 15 cm when the HPS wore no mask, a surgical mask and a N95 mask, respectively. CONCLUSIONS: Normal cough produced a turbulent jet about 0.7 m towards the end of the bed from the recumbent subject. N95 mask was more effective than surgical mask in preventing expelled air leakage during coughing but there was still significant sideway leakage.

  6. Prevalence of cough among patients treated with angiotensin converting enzyme inhibitors

    Directory of Open Access Journals (Sweden)

    Gebrehiwot Teklay

    2014-12-01

    Full Text Available Purpose: The aim of this study was to assess the prevalence of cough, its causality and impact on patient adherence in patients taking angiotensin converting enzyme inhibitors. Methods - A cross sectional study was conducted in Ayder Referral Hospital, northern Ethiopia from April to June 2014. Patients who started either captopril or enalapril were interviewed for the occurrence of cough and its characteristics. Data were entered to EPI-info and analyzed using SPSS for windows version 16 statistical software. Logistic regression model was used to analyze variations in occurrence of cough among different factors. P value of less than 0.05 was considered statistically significant. Results - One hundred two patients were participated in this study. Of which, 54(52.9% were females. About half of the respondents (53% were between the ages of 40 to 60. Cough was observed in 30 (29.4% patients. According to World Health Organizations causality scale, the reported cough was certain (drug induced in 5 (7.1% patients; possible in 10 (25% patients; probable in 12 (10.7% patients and unlikely in 3 (57.1% patients. Significant statistical difference was observed between occurrence of cough and durations of treatment (P<0.05. There was no statistically significant difference in occurrence of cough with age, sex, ethnicity, residence, dose and type of ACEI. Conclusion – In this study, dry cough was more prevalent among patients on angiotensin converting enzyme inhibitors. Troublesome cough may affect patient’s sleep and overall adherence to treatment. Health professionals should aware of the characteristics cough and manage accordingly.

  7. Some Problems About Documents Quoting in Cough Chapter of "Internal Medicine”%新世纪教材《中医内科学》“咳嗽”篇历代文献引述的相关问题

    Institute of Scientific and Technical Information of China (English)

    陈根成

    2012-01-01

    Objective:To study the some problems about documents quoting in cough chapter of "internal medicine ". Methods: Control the medical literature,the internal medicine of traditional Chinese medicine "cough" article "classic" theory "cough" cause,the entrails of cough "all gather in the stomach, about lung" understanding, the theory of the pathogenic syndrome, cough syndrome "ten cough" classification,the medical door law "theory dryness evil wound lung treatment such as the literature quoted issues to discuss. Results:Neijing discusses the cause of "cough" very much,no matter pathogenic,internal injury,old gas too and no,viscera dysfunction, and acupuncture in lung, all can lead to cough. Neijing discusses cough "all gather in the stomach, about lung" is the "triple warmer cough shape" character, rather than accept " the entrails of cough". The theory of the pathogenic syndrome, cough syndrome "ten cough" for the except the cough outside,the other five kinds of cough should be "the wind cold cough,cough,cough,cough,bravery a faint Yin cough". The medical door law "in the treatment of dry evil wound lung in the" cold "very cautious, did not put forward" mild "cool embellish" method;In your cough medicine use of acerbity, "Chinese internal medicine" due to the use of the original error and the original meaning and far. Conclusion:the new century textbook the internal medicine of traditional Chinese medicine "cough" articles cited exists many problems, these problems easy to cause the student to the content of the cough misunderstanding, should be correct.%目的:探讨新世纪教材《中医内科学》“咳嗽”篇历代文献引述出现的问题.方法:对照历代医学文献,就《中医内科学》“咳嗽”篇《黄帝内经》论“咳嗽”成因、五脏六腑之咳“皆聚于胃,关于肺”的认识,《诸病源候论·咳嗽候》“十咳”分类,《医门法律》论燥邪伤肺的治疗等文献引述问题进行探讨.结果:《黄帝内经》

  8. Epidemiology of whooping cough & typing of Bordetella pertussis.

    Science.gov (United States)

    Hegerle, Nicolas; Guiso, Nicole

    2013-11-01

    Bordetella pertussis is a Gram-negative human-restricted bacterium that evolved from the broad-range mammalian pathogen, Bordetella bronchiseptica. It causes whooping cough or pertussis in humans, which is the most prevalent vaccine-preventable disease worldwide. The introduction of the pertussis whole-cell vaccination for young children, followed by the introduction of the pertussis acellular vaccination (along with booster vaccination) for older age groups, has affected the bacterial population and epidemiology of the disease. B. pertussis is relatively monomorphic worldwide, but nevertheless, different countries are facing different epidemiological evolutions of the disease. Although it is tempting to link vaccine-driven phenotypic and genotypic evolution of the bacterium to epidemiology, many other factors should be considered and surveillance needs to continue, in addition to studies investigating the impact of current clinical isolates on vaccine efficacy.

  9. Characteristics of children consulting for cough, sore throat, or earache

    Science.gov (United States)

    Uijen, Johannes HJM; van Duijn, Huug J; Kuyvenhoven, Marijke M; Schellevis, François G; van der Wouden, Johannes C

    2008-01-01

    Background GPs are often consulted for respiratory tract symptoms in children. Aim To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. Design of study Second Dutch National Survey of General Practice (DNSGP-2) with a health interview and an additional questionnaire. Setting Children aged 0–17 years registered with 122 GPs in Dutch general practice. Method Characteristics of patients and their GPs were derived from the DNSGP-2 health interview and a questionnaire, respectively. Characteristics of the illness symptoms and GP consultation were acquired by means of an additional questionnaire. Data were analysed using multivariate logistic regression. Results Of all children who completed the questionnaire, 550 reported cough, sore throat, or earache in the 2 weeks preceding the interview with 147 of them consulting their GP. Young children more frequently consulted the GP for respiratory symptoms, as did children with fever, longer duration of symptoms, those reporting their health to be ‘poor to good’, and living in an urban area. When parents were worried, and when a child or their parents were cued by someone else, the GP was also consulted more often. GP-related determinants were not associated with GP consultation by children. Conclusion This study emphasises the importance of establishing the reasons behind children with respiratory tract symptoms consulting their GP. When GPs are aware of possible determinants of the decision to consult a GP, more appropriate advice and reassurance can be given regarding these respiratory symptoms, which are generally self-limiting. PMID:18387228

  10. Diagnostic aid to rule out pneumonia in adults with cough and feeling of fever. A validation study in the primary care setting

    Directory of Open Access Journals (Sweden)

    Held Ulrike

    2012-12-01

    Full Text Available Abstract Background We recently reported the derivation of a diagnostic aid to rule out pneumonia in adults presenting with new onset of cough or worsening of chronic cough and increased body temperature. The aim of the present investigation was to validate the diagnostic aid in a new sample of primary care patients. Methods From two group practices in Zurich, we included 110 patients with the main symptoms of cough and subjective feeling of increased body temperature, and C-reactive protein levels below 50 μg/ml, no dyspnea, and not daily feeling of increased body temperature since the onset of cough. We excluded patients who were prescribed antibiotics at their first consultation. Approximately two weeks after inclusion, practice assistants contacted the participants by phone and asked four questions regarding the course of their complaints. In particular, they asked whether a prescription of antibiotics or hospitalization had been necessary within the last two weeks. Results In 107 of 110 patients, pneumonia could be ruled out with a high degree of certainty, and no prescription of antibiotics was necessary. Three patients were prescribed antibiotics between the time of inclusion in the study and the phone interview two weeks later. Acute rhinosinusitis was diagnosed in one patient, and antibiotics were prescribed to the other two patients because their symptoms had worsened and their CRP levels increased. Use of the diagnostic aid could have missed these two possible cases of pneumonia. These observations correspond to a false negative rate of 1.8% (95% confidence interval: 0.50%-6.4%. Conclusions This diagnostic aid is helpful to rule out pneumonia in patients from a primary care setting. After further validation application of this aid in daily practice may help to reduce the prescription rate of unnecessary antibiotics in patients with respiratory tract infections.

  11. Antiviral efficacy of adefovir dipivoxil versus lamivudine in patients with chronic hepatitis B sequentially treated with lamivudine and adefovir due to lamivudine resistance

    Institute of Scientific and Technical Information of China (English)

    Yeon Seok Seo; Ji Hoon Kim; Jong Eun Yeon; Jong-Jae Park; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak; Chang Hong Lee

    2007-01-01

    AIM: To compare the antiviral efficacy of adefovir (ADV) in lamivudine (LMV)-resistant patients with LMV treatment in nucleoside-na(i)ve patients, using serum samples collected sequentially during the course of treatment progressing from LMV to ADV.METHODS: Forty-four patients with chronic hepatitis B (CHB) were included. The patients were initially treated with LMV and then switched to ADV when LMV resistance developed. Antiviral efficacy was assessed by measuring the following: reduction in serum HBV DNA from baseline, HBV DNA negative conversion (defined as HBV DNA being undectable by the hybridization assay),and HBV DNA response (either HBV DNA level ≤ 105 copies/mL or a ≥ 2 log10 reduction from baseline HBV DNA level).RESULTS: After two and six months of treatment, HBV DNA reduction was greater with LMV compared to ADV treatment (P = 0.021). HBV DNA negative conversion rates were 64% and 27% after one month of LMV and ADV treatment respectively (P = 0.001). Similarly, HBV DNA response rates were 74% and 51% after two months of LMV and ADV treatment respectively (P = 0.026).The time taken to HBV DNA negative conversion and to HBV DNA response were both delayed in ADV treatment compared with LMV.CONCLUSION: The antiviral efficacy of ADV in LMV-resistant patients is slower and less potent than that with LMV in nucleoside-na(i)ve patients during the early course of treatment.

  12. The effect of titrated fentanyl on suppressed cough reflex in healthy adult volunteers.

    Science.gov (United States)

    Kelly, H E; Shaw, G M; Brett, C N; Greenwood, F M; Huckabee, M L

    2016-05-01

    Cough suppression is part of the pharmacodynamic profile of opioids. We investigated the impact of clinical doses of fentanyl on suppressing the cough reflex. Thirteen volunteers received 2 μg.kg(-1) of fentanyl in a divided administration protocol. Three minutes after each administration and at 10 min intervals during washout, suppressed cough reflex testing with nebulised citric acid was performed and compared with fentanyl effect-site concentration. Mean (SD) citric acid concentration provoking cough increased from 0.5 (0.28) mol.l(-1) at baseline to 1.2 (0.50) mol.l(-1) after 2 μg.kg(-1) of fentanyl (p = 0.01). Mean (SD) fentanyl effect-site concentration after the final dose of fentanyl was 1.89 (0.05) ng.ml(-1) . A strong positive correlation was found between suppressed cough reflex thresholds and fentanyl effect-site concentrations during both fentanyl administration and washout phases of the study (r(2) = 0.79, p = 0.01). The mean (SD) length of time for return of suppressed cough response was 44.6 (18.8) min. Clinically relevant doses of fentanyl produced cough reflex suppression in healthy volunteers.

  13. Chronic Bilateral Slipped Capital Femoral Epiphysis as an Unusual Presentation of Congenital Panhypopituitarism due to Pituitary Hypoplasia in a 17-Year-Old Female

    Directory of Open Access Journals (Sweden)

    Sasigarn A. Bowden

    2009-01-01

    Full Text Available We report an interesting case of a 17-year-old normal-statured female who was diagnosed with congenital panhypopituitarism due to pituitary hypoplasia at the presentation of bilateral slipped capital femoral epiphysis. We emphasized the importance of endocrinologic evaluation in patients with atypical slipped capital femoral epiphysis to prevent potential complication of adrenal crisis during surgery. This case also demonstrates growth without growth hormone which resulted in a delay in diagnosis of congenital hypopituitarism in this patient.

  14. Chronic Bilateral Slipped Capital Femoral Epiphysis as an Unusual Presentation of Congenital Panhypopituitarism due to Pituitary Hypoplasia in a 17-Year-Old Female

    Directory of Open Access Journals (Sweden)

    Klingele KevinE

    2009-11-01

    Full Text Available We report an interesting case of a 17-year-old normal-statured female who was diagnosed with congenital panhypopituitarism due to pituitary hypoplasia at the presentation of bilateral slipped capital femoral epiphysis. We emphasized the importance of endocrinologic evaluation in patients with atypical slipped capital femoral epiphysis to prevent potential complication of adrenal crisis during surgery. This case also demonstrates growth without growth hormone which resulted in a delay in diagnosis of congenital hypopituitarism in this patient.

  15. Proteomic analysis reveals significant elevation of heat shock protein 70 in patients with chronic heart failure due to arrhythmogenic right ventricular cardiomyopathy.

    Science.gov (United States)

    Wei, Ying-Jie; Huang, Yin-Xia; Shen, Ya; Cui, Chuan-Jue; Zhang, Xiao-Ling; Zhang, Hao; Hu, Sheng-Shou

    2009-12-01

    As proteins are the ultimate biological determinants of phenotype of disease, we screened altered proteins associated with heart failure due to arrhythmogenic right ventricular cardiomyopathy (ARVC) to identify biomarkers potential for rapid diagnosis of heart failure. By 2-dimensional gel electrophoresis and mass spectrometry, we identified five commonly altered proteins with more than 1.5 fold changes in eight ARVC failing hearts using eight non-failing hearts as reference. Noticeably, one of the altered proteins, heat shock protein 70 (HSP70), was increased by 1.64 fold in ARVC failing hearts compared with non-failing hearts. The increase of cardiac HSP70 was further validated by Western blot, immunochemistry, and enzyme-linked immunosorbent assay (ELISA) in failing hearts due to not only ARVC, but also dilated (DCM, n = 18) and ischemic cardiomyopathy (ICM, n = 8). Serum HSP70 was also observed to be significantly increased in heart failure patients derived from the three forms of cardiomyopathies. In addition, we observed hypoxia/serum depletion stimulation induced significantly elevation of intracellular and extracellular HSP70 in cultured neonatal rat cardiomyocytes. For the first time to our knowledge, we revealed and clearly demonstrated significant up-regulation of cardiac and serum HSP70 in ARVC heart failure patients. Our results indicate that elevated HSP70 is the common feature of heart failure due to ARVC, DCM, and ICM, which suggests that HSP70 may be used as a biomarker for the presence of heart failure due to cardiomyopathies of different etiologies and may hold diagnostic/prognostic potential in clinical practice.

  16. Changes of the cerebral metabolite patterns in patients undergoing hemodialysis due to chronic renal failure: evaluation with proton magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Hye Won; Yu, Hyeon; Yu, Soo Jeong; Kim, Gi Hyeon [Chung-Ang University Medical Center, College of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    We wanted to evaluate the cerebral metabolites in patients with chronic renal failure (CRF) and who were undergoing hemodialysis by performing proton MR spectroscopy and were wanted to evaluate the correlation between the changes in the cerebral metabolite ratios and the duration after starting the initial hemodialysis. Proton MR spectroscopy was performed in 15 patients with CRF and who were undergoing hemodialysis and in ten healthy volunteers. The changes in N-acetylaspartate (NAA), choline-containing compounds (Cho), myo-inositol (Myo), glutamine/glutamate complex (Glx), and creatine (Cr) were analyzed. MR spectroscopy was performed before and after hemodialysis. For the patients with CRF before hemodialysis, the Cho/Cr ratio in the gray matter ({rho} < 0.001) and the Myo/Cr ratio in both the gray and white matter ({rho} < 0.01) were significantly elevated compared with those in the control subjects. For the patients with CRF after hemodialysis, their Cho/Cr ratios were significantly reduced in both the gray and white matter compared with that before hemodialysis ({rho} < 0.05). There was a significant positive correlation between the Cho/Cr ratio and serum Cr in the gray matter of CRF patients after hemodialysis (r = 0.54, {rho} < 0.05). The cerebral metabolite ratios were not significantly correlated with the duration after starting the initial hemodialysis. The cerebral metabolite patterns are significantly different between the patients with CRF and who are undergoing hemodialysis and the normal controls. The cerebral metabolite ratios are not significantly correlated with the duration after starting the initial hemodialysis.

  17. An Experimental Study of Human Exhalation during Breathing and Coughing in a Mixing Ventilated Room

    DEFF Research Database (Denmark)

    Liu, Li; Lia, Yuguo; Nielsen, Peter V.;

    2009-01-01

    This study investigates the characteristics of human exhalation during breathing and coughing. Experiments employing one breathing thermal manikin are conducted in a full-scale test room with a mixing ventilation system. Two artificial lungs are used to generate discontinuous airflows with specific...... flow rates and temperatures for breathing and coughing, respectively. Smoke visualizations are conducted to show the formation, movement and vanishing of the exhalation jets from nose and mouth separately. The transient velocity distribution generated by breathing and coughing in different places...

  18. Evaluation of Clinical Efficacy and Tolerance of Khasceeze –SF Cough Syrup

    OpenAIRE

    S Satam; Jain, R; J Dagaonkar; C Chotalia; Suthar, A.; Joshi, R

    2011-01-01

    Fifty patients of either sex aged 15 - 65 years entered the study to test the efficacy and tolerability of a herbal preparation known as Khasceeze-SF Cough Syrup. They were studied for cough and related symptoms such as sore throat, sneezing, breathlessness and fever. Substantial improvement, i.e., excellent to good response, in relief of cough and other symptoms was noted over 84% out of 50 patients and fair response in 11.64%. Only 4.10% patients showed poor relief in symptoms hence suggest...

  19. The capsaicin cough reflex in patients with symptoms elicited by odorous chemicals

    DEFF Research Database (Denmark)

    Holst, H.; Arendt-Nielsen, Lars; Mosbech, H.;

    2010-01-01

    Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced......'s criteria for multiple chemical sensitivity and 15 eczema patients with airway symptoms elicited by odorous chemicals were compared with 29 age-matched, healthy controls. We measured C5--the capsaicin concentration causing five coughs or more--using the single breath inhalation test. No difference was found...

  20. Chronic nonspherocytic hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency: report of two families with novel mutations causing G6PD Bangkok and G6PD Bangkok Noi.

    Science.gov (United States)

    Tanphaichitr, Voravarn S; Hirono, Akira; Pung-amritt, Parichat; Treesucon, Ajjima; Wanachiwanawin, Wanchai

    2011-07-01

    Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common hereditary enzymopathies worldwide. Mostly G6PD deficient cases are asymptomatic though they may have the risk of neonatal jaundice (NNJ) and acute intravascular hemolysis during oxidative stress. Chronic nonspherocytic hemolytic anemia (CNSHA) due to G6PD deficiency is rare. In Thailand, one case was reported 40 years ago and by biochemical study this G6PD was reported to be a new variant G6PD Bangkok. We, herein, report two families with CNSHA due to G6PD deficiency. In the first family, we have been following up the clinical course of the patient with G6PD Bangkok. In addition to chronic hemolysis, he had three acute hemolytic episodes requiring blood transfusions during childhood period. Multiple gallstones were detected at the age of 27. His two daughters who inherited G6PD Bangkok from him and G6PD Vanua Lava from his wife are asymptomatic. Both of them had NNJ and persistent evidences of compensated hemolysis. Molecular analysis revealed a novel missense mutation 825 G→C predicting 275 Lys→Asn causing G6PD Bangkok. In the second family, two male siblings are affected. They had NNJ and several hemolytic episodes which required blood transfusions. On follow-up they have been diagnosed with chronic hemolysis as evidenced by reticulocytosis and indirect hyperbilirubinemia. Molecular analysis revealed combined missense mutations in exons 12 and 13. The first mutation was 1376 G→T predicting 459 Arg→Leu (known as G6PD Canton) and the second one was 1502 T→G predicting 501 Phe→Cys. We designated the resulting novel G6PD variant, G6PD Bangkok Noi.

  1. Cost-effectiveness of using Polyheal compared with surgery in the management of chronic wounds with exposed bones and/or tendons due to trauma in France, Germany and the UK.

    Science.gov (United States)

    Guest, Julian F; Sladkevicius, Erikas; Panca, Monica

    2015-02-01

    The objective of this study was to assess the cost-effectiveness of Polyheal compared with surgery in treating chronic wounds with exposed bones and/or tendons (EB&T) due to trauma in France, Germany and the UK, from the perspective of the payers. Decision models were constructed depicting the management of chronic wounds with EB&T and spanned the period up to healing or up to 1 year. The models considered the decision by a plastic surgeon to treat these wounds with Polyheal or surgery and was used to estimate the relative cost-effectiveness of Polyheal at 2010/2011 prices. Using Polyheal instead of surgery is expected to increase the probability of healing from 0·93 to 0·98 and lead to a total health-care cost of €7984, €7517 and €8860 per patient in France, Germany and the UK, respectively. Management with surgery is expected to lead to a total health-care cost of €12 300, €18 137 and €11 330 per patient in France, Germany and the UK, respectively. Hence, initial treatment with Polyheal instead of surgery is expected to lead to a 5% improvement in the probability of healing and a substantial decrease in health-care costs of 35%, 59% and 22% in France, Germany and the UK, respectively. Within the models' limitations, Polyheal potentially affords the public health-care system in France, Germany and the UK a cost-effective treatment for chronic wounds with EB&T due to trauma, when compared with surgery. However, this will be dependent on Polyheal's healing rate in clinical practice when it becomes routinely available.

  2. 咳嗽变异型哮喘70例误诊分析%Misdiagnosis Analysis of 70 Cases of Children with Cough Variant Asthma

    Institute of Scientific and Technical Information of China (English)

    阳梅; 谢雪梅; 徐洪涛

    2015-01-01

    Objective To investigate the clinical characteristics, misdiagnosis and preventive measures of children with cough variant asthma. Methods 70 children with cough variant asthma admitted to our hospital during January 2013 and January 2014 were chosen. The clinical data were retrospectively analyzed. Results 49 cases of this group were found to have irritating cough or dry cough, 40 cases of early in the morning and ( or) nighttime cough, 19 cases of cough with a small amount of mucus, 14 cases of dyspnea. 29 (41. 4%) cases were misdiagnosed as bronchitis, 14(20. 0%) cases as acute up-per respiratory tract infection, 10 (14. 3%) cases as tonsillitis, 7(10. 0%) cases as chronic pharyngitis, 3(4. 3%) cases as whooping cough, 3 ( 4. 3%) cases as mycoplasma pneumoniae, 2 ( 2. 9%) cases as hilar lymph node tuberculosis, 2 (2. 9%)cases as bronchial foreign bodies. Misdiagnosed time was 29 d-1 year. 70 cases of misdiagnosis showed no significant treatment effect. After admition a comprehensive analysis of history, clinical manifestations and medical tests were performed. CVA was confirmed after diagnostic criteria were met. After treatment for 3-28 d, symptoms disappeared. Conclusion CVA has some occult clinical manifestations, and is prone to misdiagnosis. Awareness of CVA, detailed medical history inquiry, a comprehensive analysis of the disease, timely medical and technological examinations can reduce or avoid misdiagnosis.%目的:探讨咳嗽变异型哮喘( cough variant asthma, CVA)的临床特点、误诊原因及防范措施。方法对我院2013年1月—2014年1月收治的70例CVA误诊病例的临床资料进行回顾性分析。结果本组表现为刺激性咳嗽或干咳49例,凌晨和(或)夜间咳嗽40例,咳嗽伴少量黏痰19例,胸闷14例。误诊为支气管炎29例(41.4%),急性上呼吸道感染14例(20.0%),扁桃体炎10例(14.3%),慢性咽炎7例(10.0%),百日咳3例(4.3%),支原体肺炎3例(4.3%),肺门淋巴结结核2例(2.9%),

  3. Clinical Observation of 200 Cases of Cough Illness in Remission%咳喘病缓解期治疗200例临床观察

    Institute of Scientific and Technical Information of China (English)

    徐宏

    2015-01-01

    Objective To investigate the disease in remission cough control measures.Methods July 2011-Sep-tember 2014 200 cases of clinic patients with chronic cough, the children are divided into groups according to age, youth group, middle-aged group, elderly group;cough disease into chronic bronchitis, asthmatic bronchitis, bronchial asth-ma;with a particular medicine in the summer“dog days” sticking corresponding points on the human back clinical ob-servation.Results The results showed that children′s group, the total efficiency of 98.4%, 90.5% youth group, the older group 77.6%.Chronic bronchitis best effect, the total efficiency of 82.8%.Conclusions Of remission reasonable comprehensive treatment can improve the cure rate, improvement rate of cough disease and reduce its incidence.%目的:探讨咳喘病缓解期的防治措施。方法收集2011年7月~2014年9月门诊慢性咳喘病患者200例,根据年龄分为少儿组、青年组、中年组、老年组;咳喘病分为慢性支气管炎、喘息性支气管炎、支气管哮喘;用特定的中药在夏季“三伏天”贴敷人体背部相应的穴位进行临床观察。结果显示少儿组总有效率98.4%、青年组90.5%、老年组77.6%。慢性支气管炎疗效最好,总有效率82.8%。结论通过缓解期合理的综合治疗,能够提高咳喘病的痊愈率、好转率、并降低其发病率。

  4. The capsaicin cough reflex in patients with symptoms elicited by odorous chemicals

    DEFF Research Database (Denmark)

    Holst, H; Arendt-Nielsen, L; Mosbech, H;

    2010-01-01

    Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced...... when applying the single breath inhalation method in similar groups of patients with symptoms related to odorous chemicals e.g. other persons wearing of perfume; and to investigate to what extent the reporting of lower airway symptoms influenced the cough reflex. Sixteen patients fulfilling Cullen......'s criteria for multiple chemical sensitivity and 15 eczema patients with airway symptoms elicited by odorous chemicals were compared with 29 age-matched, healthy controls. We measured C5--the capsaicin concentration causing five coughs or more--using the single breath inhalation test. No difference was found...

  5. Shattering a myth - Whooping cough susceptible to antibiotics.

    Science.gov (United States)

    Syed, Muhammad Ali; Jamil, Bushra; Bokhari, Habib

    2016-05-01

    Bordetella parapertussis is the causative agent of a milder form of pertussis or whooping cough. Little is reported about the antibiotic resistance patterns and mechanism of drug resistance of Bordetella parapertussis. The objective of this study has been to investigate antimicrobial resistance, distribution of integrons and presence of gene cassettes to quinolones (qnr) and sulfonamides (sul) among B. parapertussis strains' isolated from Pakistan. Thirty-five (35) samples were collected from various hospitals of Pakistan from children (median age 3 years) with pertussis-like symptoms, all were tested and confirmed to be B. Parapertussis. Resistance profile of Ampicillin, Cephalexin, Sulphamethoxazole, Chloramphenicol, Ofloxacin, Nalidixic acid, Gentamycin and Erythromycin were investigated through all samples. Majority of the isolates were found to be resistant to the afore-mentioned antibiotics except erythromycin. All isolates were resistant to quinolones phenotypically, but qnr genes were detected in only 25.7% (9/35) of isolates. On the other hand, 71.4% (25/35) isolates were resistant to sulfonamides phenotypically. From these 71% strains showing phenotypical resistance, 96% (24/25) were found to possess sul genes. Only two isolates were carrying class 1 integrons, which also harbored sul gene and qnr gene cassettes. It can be safely concluded that the phenotypic resistance patterns seemed mostly independent of presence of integrons. However, interestingly both integrons harboring strains were resistant to quinolones and sulfonamides and also possessed qnr and sul genes.

  6. Whooping cough in 2014 and beyond: an update and review.

    Science.gov (United States)

    Hartzell, Joshua D; Blaylock, Jason M

    2014-07-01

    Pertussis, or whooping cough, has had a dramatic resurgence in the past several years and is the most common vaccine-preventable disease in the world. The year 2012 marked the most cases in the United States in > 50 years. Large outbreaks have occurred in multiple states, and infant deaths have drawn the attention of not only health-care providers but also the media. Although the disease is theoretically preventable by vaccination, it remains a challenge to control. New vaccination strategies have been implemented across different age groups and populations of patients, but vaccine coverage remains dismally low. Acellular vaccines, although safe, do not afford the same long-lasting immunity as the previously used whole-cell vaccine. Ultimately, improvements in the development of vaccines and in vaccination coverage will be essential to decrease the burden of pertussis on society. This article provides a review of pertussis infection and discusses advances related to the epidemiology, diagnosis, treatment, and prevention of infection, as well as continued areas of uncertainty.

  7. Pertussis vaccination and whooping cough: and now what?

    Science.gov (United States)

    Guiso, Nicole

    2014-10-01

    Pertussis or whooping cough is a respiratory disease caused by Bordetella pertussis or Bordetella parapertussis that are only known to infect humans. This severe and acute respiratory disease presents epidemic cycles and became a vaccine-preventable disease in the 1940s/1950s when developed countries introduced vaccination. The first type of vaccine developed against this disease was a whole-cell pertussis (wP) vaccine containing inactivated B. pertussis bacteria. Most developed countries produced their own vaccine and given the pediatric nature of the disease at the time of licensure, infants and toddlers were the primary targets and were thus massively vaccinated. The characterization of few virulence factors produced by B. pertussis enabled the development of second-generation pertussis vaccines called the acellular pertussis (aP) vaccines. These only contain 1-5 purified, detoxified B. pertussis proteins and were first introduced in Japan around 30 years ago. Australia, Europe and North America introduced aP vaccines approximately 15 years later, which replaced wP vaccines since then.

  8. Side effects of budesonide in liver cirrhosis due to chronic autoimmune hepatitis: Influence of hepatic metabolism versus portosystemic shunts on a patient complicated with HCC

    Institute of Scientific and Technical Information of China (English)

    Andreas Geier; Carsten Gartung; Christoph G.Dietrich; Hermann E. Wasmuth; Patrick Reinatz; Siegfried Matern

    2003-01-01

    AIM: To investigate the systemic availability of budesonide in a patient with Child A cirrhosis due to autoimmune hepatitis (AIH) and primary hepatocellular carcinoma, who developed serious side effects.METHODS: Serum levels of budesonide, 6β-OH-budesonide and 16α-OH-prednisolon were measured by HPLC/MS/MS;portosystemic shunt-index (SI) was determined by 99mTc nuclear imaging. All values were compared with a matched control patient without side effects.RESULTS: Serum levels of budesonide were 13-fold increased in the index patient. The ratio between serum levels of the metabolites 6β-OH-budesonide and 16α-OHprednisolone, respectively, and serum levels of budesonide was diminished (1.0 vs. 4.0 for 6β-OH-budesonide, 4.2 vs.10.7 for 16α-OH-prednisolone). Both patients had portosystemic SI (5.7 % and 3.1%) within the range of healthy subjects.CONCLUSION: Serum levels of budesonide vary up to 13-fold in AIH patients with Child A cirrhosis in the absence of relevant portosystemic shunting. Reduced hepatic metabolism, as indicated by reduced metabolite-to-drug ratio, rather than portosystemic shunting may explain systemic side effects of this drug in cirrhosis.

  9. Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Akram Ahmad

    2016-01-01

    Full Text Available Background: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients. Methods: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study. Data were collected by reviewing patient files and then assessed for its appropriateness against the criteria developed in view of the Medication Appropriateness Index and Guidelines of the Indian Academy of Pediatrics. The results were expressed in frequencies and percentages. Chi-square test was used to analyze the data. A P < 0.05 was considered statistically significant. Results: A total of 303 patients were studied during the study period. The mean age of the patients was 3.5 ± 0.6 years. The majority of children were admitted mainly due to chief complaint of fever (63% and cough and cold (56.4%. The appropriateness of antibiotic prescriptions was higher in bloody and watery diarrhea (83.3% and 82.6%; P< 0.05. Cephalosporins (46.2% and penicillins (39.9% were the most commonly prescribed antibiotics, though the generic prescriptions of these drugs were the lowest (13.5% and 10%, respectively. The seniority of prescriber was significantly associated with the appropriateness of prescriptions (P < 0.05. Antibiotics prescription was higher in cold/cough and diarrhea (93.5% in comparison to cough/cold (85% or diarrhea (75% alone. Conclusions: The study observed high rates of antibiotic utilization in Chidambaram during the treatment of cough/cold and/or diarrhea in pediatric patients. The findings highlight the need for combined interventions using education and expert counseling

  10. Sodium cromoglycate and atropine block the fall in FEV1 but not the cough induced by hypotonic mist.

    Science.gov (United States)

    Fuller, R W; Collier, J G

    1984-01-01

    In a group of patients with mild asthma the inhalation of mist derived from ultrasonically nebulised distilled water caused an increase in cough and a fall in FEV1. Double blind administration for five minutes of sodium cromoglycate (from an original solution containing 30 mg/ml) or atropine (2 mg/ml) by inhalation from a Minineb nebuliser, 30 minutes before the mist challenge, caused a significant reduction in the fall in FEV1 (p less than 0.05), but not in cough, by comparison with the protection afforded by placebo (saline). In a second study the fall in FEV1 caused by the inhalation of distilled water was not significantly different from that seen in response to hypotonic sodium chloride (1.7 g/l, 58 mmol/l), but both produced a significantly greater fall than did a similar mist containing sodium cromoglycate at an original concentration of 10 mg/ml (58 mmol/l). The results show that both atropine and sodium cromoglycate can block the fall in FEV1 due to mist and that protection by sodium cromoglycate is immediate. These results suggest that sodium cromoglycate blocks the nervous reflexes concerned in the response to mist, probably in the afferent limb of the reflex. PMID:6437001

  11. ObserveClinicalEffectofHeatCoughSyrupwiththeClinicalEffectofAcupunctureinTreatingCoughCooperatewith AcupunctureTreatmentofCough%热咳糖浆配合针灸治疗咳嗽的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    张力文; 廖侃华; 杜洁挺

    2013-01-01

      目的观察临床中给予热咳糖浆配合针灸治疗咳嗽的临床效果。方法将我院2012年1月至2012年12月之间收录的200例咳嗽患者随机分为两组,对照组患者给予常规热咳糖浆进行治疗,而观察组的患者给予热咳糖浆配合针灸治疗,观察两组的患者临床治疗效果。结果通过两组的患者临床治疗效果对比分析,观察组的患者临床治疗总有效率明显的高于对照组的患者临床治疗总有效率(P<0.05),统计学有意义;两组的患者不良反应发生率比较无明显的差异(P>0.05),统计学无意义。结论临床中对于咳嗽患者给予热咳糖浆配合针灸治疗具有较好的临床疗效,值得临床中应用。%Objective To observe the clinical give heat cough syrup with the clinical effect of acupuncture in treating cough. Methods Between January to 2012 2012 in our hospital were collected in December 200 cases of cough patients were randomly divided into two groups, the control group were given routine heat cough syrup for treatment, while patients in observation group given heat cough syrup with acupuncture treatment, observe the effect of clinical treatment of the two groups. Results Through comparative analysis of clinical therapeutic effect in the two groups of patients with clinical observation and treatment group, the total efifciency of treatment were signiifcantly higher than control group in the total efifciency(P0.05), statistics no signiifcance. Conclusion In clinical practice, cough were treated with heat cough syrup has better clinical curative effect of acupuncture treatment, worthy of clinical application.

  12. Use of Antitussive Drugs in The Treatment of Cough With Acute Onset in Children

    OpenAIRE

    Kasapçopur, Özgür; CEYLAN, Abdullah; İngöl, Hüseyin; Sarp, Adil; Sungurtekin, Necdet

    1992-01-01

    The effect of anti tussive therapy on cough with sudden onset in childhood period was investigated 105 children were studied Children were randomly divided into 3 groups An antitussive combination was administered to the first group antitussive and beta sympathomimetic combination was administered to the second group No drug was administered to the third group but general supportive measures were taken Patients were evaluated both before and during treatment in respect to cough and general ap...

  13. Measurements of airborne influenza virus in aerosol particles from human coughs.

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    William G Lindsley

    Full Text Available Influenza is thought to be communicated from person to person by multiple pathways. However, the relative importance of different routes of influenza transmission is unclear. To better understand the potential for the airborne spread of influenza, we measured the amount and size of aerosol particles containing influenza virus that were produced by coughing. Subjects were recruited from patients presenting at a student health clinic with influenza-like symptoms. Nasopharyngeal swabs were collected from the volunteers and they were asked to cough three times into a spirometer. After each cough, the cough-generated aerosol was collected using a NIOSH two-stage bioaerosol cyclone sampler or an SKC BioSampler. The amount of influenza viral RNA contained in the samplers was analyzed using quantitative real-time reverse-transcription PCR (qPCR targeting the matrix gene M1. For half of the subjects, viral plaque assays were performed on the nasopharyngeal swabs and cough aerosol samples to determine if viable virus was present. Fifty-eight subjects were tested, of whom 47 were positive for influenza virus by qPCR. Influenza viral RNA was detected in coughs from 38 of these subjects (81%. Thirty-five percent of the influenza RNA was contained in particles>4 µm in aerodynamic diameter, while 23% was in particles 1 to 4 µm and 42% in particles<1 µm. Viable influenza virus was detected in the cough aerosols from 2 of 21 subjects with influenza. These results show that coughing by influenza patients emits aerosol particles containing influenza virus and that much of the viral RNA is contained within particles in the respirable size range. The results support the idea that the airborne route may be a pathway for influenza transmission, especially in the immediate vicinity of an influenza patient. Further research is needed on the viability of airborne influenza viruses and the risk of transmission.

  14. Peripheral site of action of levodropropizine in experimentally-induced cough: role of sensory neuropeptides.

    Science.gov (United States)

    Lavezzo, A; Melillo, G; Clavenna, G; Omini, C

    1992-06-01

    The mechanism of action of levodropropizine has been investigated in different models of experimentally-induced cough in guinea-pigs. In particular it has been demonstrated that the antitussive drug has a peripheral site of action by injecting the drug intracerebroventricularly (i.c.v.). In these experiments levodropropizine (40 micrograms/50 microliters i.c.v.) did not prevent electrically-induced cough. On the other hand, codeine (5 micrograms/50 microliters i.c.v.) markedly prevented coughing. A difference in the potency ratio of levodropropizine and codeine has been demonstrated in capsaicin-induced cough; after oral administration, codeine was about two to three times more potent than levodropropizine. However, after aerosol administration the two compounds were equipotent. These data might suggest a peripheral site of action for levodropropizine which is related to sensory neuropeptides. Further support for the role of sensory neuropeptides in the mechanism of action of levodropropizine comes from the results obtained in capsaicin-desensitized animals. In this experimental model levodropropizine failed to prevent the vagally elicited cough in neuropeptide-depleted animals, whereas codeine did not differentiate between control and capsaicin-treated animals. In conclusion, our results support the suggestion that levodropropizine has a peripheral site of action. In addition, the interference with the sensory neuropeptide system may explain, at least in part, its activity in experimentally-induced cough.

  15. Cough, exertional, and sexual headaches: an analysis of 72 benign and symptomatic cases.

    Science.gov (United States)

    Pascual, J; Iglesias, F; Oterino, A; Vázquez-Barquero, A; Berciano, J

    1996-06-01

    We analyzed our experience with cough, exertional, and vascular sexual headaches, evaluated the interrelationships among them, and examined the possible symptomatic cases. Seventy-two patients consulted us because of headaches precipitated by coughing (n = 30), physical exercise (n = 28), or sexual excitement (n = 14). Thirty (42%) were symptomatic. The 17 cases of symptomatic cough headache were secondary to Chiari type I malformation, while the majority of cases of symptomatic exertional headaches and the only case of symptomatic sexual headache were secondary to subarachnoid hemorrhage. Although the precipitant was the same, benign and symptomatic headaches differed in several clinical aspects, such as age at onset, associated clinical manifestations, or response to pharmacologic treatment. Although sharing some properties, such as male predominance, benign cough headache and benign exertional headache are clinically separate conditions. Benign cough headache began significantly later, 43 years on average, than benign exertional headache. By contrast, our findings suggest that there is a close relationship between benign exertional headache and benign vascular sexual headache. We conclude that benign and symptomatic cough headaches are different from both benign and symptomatic exertional and sexual headaches.

  16. Emergence of whooping cough: notes from three early epidemics in Persia.

    Science.gov (United States)

    Aslanabadi, Arash; Ghabili, Kamyar; Shad, Kaveh; Khalili, Majid; Sajadi, Mohammad M

    2015-12-01

    Whooping cough is a relatively new infectious disease afflicting human beings, compared with other infectious diseases, and is undergoing a resurgence despite decades of vaccination. The oldest known epidemic is thought to be the Paris outbreak of 1578. In this Historical Review, we describe three epidemics of whooping cough in Persia, which although arising roughly one century before the Paris outbreak, have not been examined in detail. A great amount of epidemiological detail was reported that not only distinguishes the various stages and complications of whooping cough, but also reveals unique immunological aspects of this disease. The first of these epidemics is the oldest recorded whooping cough epidemic. On the basis of epidemiological features, we propose that this whooping cough epidemic was the first to have taken place in Persia and might have been part of the first pandemic. This theory pushes back the date of first documented emergence of whooping cough by almost a century, which matches molecular data about its spread. Here, we discuss features of these early epidemics in relation to their initial emergence, potential origins, and spread to Europe.

  17. New strategy for cough treatment-Comparison effect and safety of Cofetol cough syrup with dextromethorphan hydrobromide,chorpheniramine mateate and pseudoe phedrine hydiochloride solution in the treatment of acute cough%复方磷酸可待因溶液和美敏伪麻溶液治疗急性咳嗽的疗效和安全性比较

    Institute of Scientific and Technical Information of China (English)

    顾宇彤; 赵琼; 涂海燕; 余勇夫; 白春学; 文富强; 周建英; 李静; 赵乃青; 陈淑靖; 计海婴; 田攀文

    2011-01-01

    目的 以美敏伪麻溶液(惠菲宁)为阳性对照,对复方磷酸可待因溶液(奥亭止咳露)治疗急性咳嗽的有效性和安全性进行评价.方法以由急性上呼吸道感染,急性气管/支气管炎、慢性支气管炎急性加重和上气道咳嗽综合征引起的咳嗽患者为研究对象,采用多中心、分层区段随机、拟双盲对照的临床试验方法,观察两组患者首次服药0、15、30、60和120min以及治疗前后咳嗽、痰黏度和排痰难易程度总积分(TSS).结果符合方案集4个中心治疗结束时试验组症状总分较对照组低[(1.082±1.590)分vs(1.699±1.866)分],试验组症状总分下降较对照组明显[(6.412±1.978)分vs(4.313±2.347)分],治疗有效性(痊愈和显效)试验组优于对照组[(68.60%和13.95%)vs(44.58%和22.89%)](P值均0.05).全分析集与符合方案集结果一致.研究期间两组均无严重不良事件发生,两组不良事件发生率以及合并用药的比例差异均无统计学意义(P>0.05).结论复方磷酸可待因溶液对于控制咳嗽症状具有起效快的特点,并且在服药15 min 时其疗效已经显著优于美敏伪麻溶液.通过5~7 d治疗,复方磷酸可待凶溶液对于控制咳嗽症状的效果可能优于美敏伪麻溶液.%Objective To evaluate the efficacy and safety of Cofetol cough syrup in treating acute cough with dextromethorphan hydrobromide, chorpheniramine mateate and pseudoe phedrine hydiochloride solution as positive control. Methods The patients with acute upper airway infection, acute tracheitis/ bronchitis, exacerbation of chronic bronchitis and upper airway cough syndrome were enrolled into the multiccntre, zonation random and quasi-double blind, controlled clinical study. The total scores of symptoms such as cough, sputum viscosity and the difficulty of eliminating sputum were compared between pre-and post-treatment while recorded at 0, 15, 30, 60 and 120 min after fist drug administration. Results The total score

  18. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  19. Chronic myelocytic leukemia in pregnancy: a case report describing successful treatment using multimodal therapy.

    Science.gov (United States)

    Eskander, Ramez N; Tarsa, Maryam; Herbst, Kenneth D; Kelly, Thomas F

    2011-11-01

    Leukemia during pregnancy is rare, posing a complex series of questions, including appropriate therapy and maternal counseling. Management of chronic myelocytic leukemia (CML) during pregnancy is limited. Our patient presented at 30 weeks' gestation with anemia, leukocytosis, and a non-productive cough. Polymerase chain reaction performed on a peripheral blood sample confirmed presence of the breakpoint cluster region-Abl1 chromosomal translocation and the diagnosis of CML. Therapy included acute leukocytapheresis, followed by α-interferon and imatinib mesylate. The patient responded to treatment and delivered a viable female infant at term weighing 2613 g. Continued imatinib mesylate chemotherapy post-delivery resulted in complete clinical remission. Successful antepartum management of newly diagnosed CML is possible utilizing leukocytapheresis, α-interferon and, more recently, imatinib mesylate. Definitive treatment should not be delayed due to pregnancy.

  20. Chronic otomycosis due to Malassezia Spp

    Directory of Open Access Journals (Sweden)

    R Latha

    2010-01-01

    Full Text Available We report the case of a 31-year-old male presenting with complaints of mild pain in the right ear for three months and hypoacusis for 10 days. On otoscopic examination, a thin, papery, white material was extracted from his ear and sent for fungal identification. This material revealed presence of Malassezia spp - with characteristic "spaghetti and meat ball appearance". The patient was treated with 2% acetic acid, hydrocortisone and Clotrimazole powder for one week and he resolved completely.

  1. Autism Spectrum Disorders May Be Due to Cerebral Toxoplasmosis Associated with Chronic Neuroinflammation Causing Persistent Hypercytokinemia that Resulted in an Increased Lipid Peroxidation, Oxidative Stress, and Depressed Metabolism of Endogenous and Exogenous Substances

    Science.gov (United States)

    Prandota, Joseph

    2010-01-01

    Worldwide, approximately 2 billion people are chronically infected with "Toxoplasma gondii" with largely yet unknown consequences. Patients with autism spectrum disorders (ASD) similarly as mice with chronic toxoplasmosis have persistent neuroinflammation, hypercytokinemia with hypermetabolism associated with enhanced lipid peroxidation, and…

  2. High humidity leads to loss of infectious influenza virus from simulated coughs.

    Directory of Open Access Journals (Sweden)

    John D Noti

    Full Text Available BACKGROUND: The role of relative humidity in the aerosol transmission of influenza was examined in a simulated examination room containing coughing and breathing manikins. METHODS: Nebulized influenza was coughed into the examination room and Bioaerosol samplers collected size-fractionated aerosols (4 µM aerodynamic diameters adjacent to the breathing manikin's mouth and also at other locations within the room. At constant temperature, the RH was varied from 7-73% and infectivity was assessed by the viral plaque assay. RESULTS: Total virus collected for 60 minutes retained 70.6-77.3% infectivity at relative humidity ≤23% but only 14.6-22.2% at relative humidity ≥43%. Analysis of the individual aerosol fractions showed a similar loss in infectivity among the fractions. Time interval analysis showed that most of the loss in infectivity within each aerosol fraction occurred 0-15 minutes after coughing. Thereafter, losses in infectivity continued up to 5 hours after coughing, however, the rate of decline at 45% relative humidity was not statistically different than that at 20% regardless of the aerosol fraction analyzed. CONCLUSION: At low relative humidity, influenza retains maximal infectivity and inactivation of the virus at higher relative humidity occurs rapidly after coughing. Although virus carried on aerosol particles 40% will significantly reduce the infectivity of aerosolized virus.

  3. The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume.

    Science.gov (United States)

    Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus; Mosbech, Holger

    2006-03-01

    Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case control study. The participants completed a symptom questionnaire and underwent a bronchial challenge with capsaicin. Lower, but not upper, respiratory symptoms elicited by perfume were associated with increased capsaicin cough responsiveness. Having severe symptoms to perfume (n=11) did not relate to the site of the symptoms in the airways and was not associated with increased capsaicin cough responsiveness. In conclusion, respiratory symptoms elicited by perfume may reflect local hyperreactivity related to defensive reflexes in the airways, and measurements of the capsaicin cough reflex are relevant when patients with lower respiratory symptoms related to environmental perfume exposures are investigated.

  4. Diagnosis of pertussis in vaccinated children of Khairpur, Sindh, Pakistan by Cough Plate Method

    Directory of Open Access Journals (Sweden)

    Syed Habib Bukhari

    2011-09-01

    Full Text Available Objectives: Pertussis or whooping cough is a communicable infection of upper respiratory tract that mainly affects children. Reports regarding resurgence of pertussis in vaccinated children mainly motivated us to document pertussis in the children. The aim of the study was to explore pertussis in vaccinated children using an alternative method for pertussis diagnosis.Materials and methods: A total of 700 clinical samples were collected during study period (2006-2009, from suspected whooping cough cases of Diphtheria-tetanus- whole cell pertussis (DTwP vaccinated children both male and female aged from 6 months to 84 months The classical ‘Cough Plate Method’ instead of Nasopharyngeal Swab was used for sampling to find out its potential in diagnosis of pertussis.Results: Present study reports the presence of pertussis in vaccinated children using Cough Plate Method. The method successfully isolated Bordetella pertussis from suspected patients of pertussis. A total of 28 culture confirmed cases were detected among 700 samples tested. (Total Isolation rate: 4%.The peak incidence age under risk was 48 months. However, pertussis was detected in children aged as young as 6 and 12 months.Conclusion: The ‘Cough plate’ method used for isolation proved successful and simple instead of nasopharyngeal swabs that is difficult to perform and children may be reluctant to this sampling method when tried. J Microbiol Infect Dis 2011;1 (2 : 68-72

  5. Infección por Bordetella pertussis: Una causa emergente de tos prolongada en adolescentes y adultos Bordetella pertussis infection: An emerging cause of prolonged cough illness in adolescents and adults

    Directory of Open Access Journals (Sweden)

    RODRIGO OSSES A

    2010-03-01

    Full Text Available La tos convulsiva o coqueluche está siendo reconocida cada vez con mayor frecuencia como causa de tos prolongada en adolescentes y adultos. La vacunación sistemática de la población pediátrica ha determinado un cambio en el perfl epidemiológico de la enfermedad, aumentando su prevalencia en la población adulta. Se presenta el caso clínico de una paciente de 45 años, fumadora, enfermera de unidad de hemodiálisis, que consulta por malestar general y tos seca de seis semanas de evolución. La radiografía de tórax era normal y la inmunofuorescencia directa de hisopado nasofaríngeo fue positiva para Bordetella pertussis. A propósito de este caso clínico, revisamos las principales causas de tos crónica: asma bronquial, enfermedad rinosinusal y refujo gastroesofágico; el cuadro clínico, evaluación diagnóstica y tratamiento de la infección por B. pertussis en población adulta.Whooping cough is increasingly recognized as a cause of prolonged cough illness in adolescents and adults. Systematic vaccination has changed its epidemiology, with the majority of cases now primarily affecting adolescents and adults. A 45-year-old female, active smoker, nurse, who works in a dialysis service, presented with a 6-week history of bothersome cough and malaise. Thorax x-ray was normal and direct immunofuorescence of nasopharyngeal swab was positive for Bordetella pertussis. This case illustrates pertussis infection in adulthood. We review the main causes of chronic cough in adults: asthma, chronic rhinosinusitis and gastroesophageal refux; the clinical features, prevalence, diagnostic tools, and management of adult patients with B. pertussis infection to increase awareness of this highly contagious disease.

  6. Effect of downsampling and compressive sensing on audio-based continuous cough monitoring.

    Science.gov (United States)

    Casaseca-de-la-Higuera, Pablo; Lesso, Paul; McKinstry, Brian; Pinnock, Hilary; Rabinovich, Roberto; McCloughan, Lucy; Monge-Álvarez, Jesús

    2015-01-01

    This paper presents an efficient cough detection system based on simple decision-tree classification of spectral features from a smartphone audio signal. Preliminary evaluation on voluntary coughs shows that the system can achieve 98% sensitivity and 97.13% specificity when the audio signal is sampled at full rate. With this baseline system, we study possible efficiency optimisations by evaluating the effect of downsampling below the Nyquist rate and how the system performance at low sampling frequencies can be improved by incorporating compressive sensing reconstruction schemes. Our results show that undersampling down to 400 Hz can still keep sensitivity and specificity values above 90% despite of aliasing. Furthermore, the sparsity of cough signals in the time domain allows keeping performance figures close to 90% when sampling at 100 Hz using compressive sensing schemes.

  7. The effect of pheniramine on fentanyl-induced cough: a randomized, double blinded, placebo controlled clinical study

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    Zakir Arslan

    2016-08-01

    Full Text Available Abstract Background and objectives: There are many studies conducted on reducing the frequency and severity of fentayl-induced cough during anesthesia induction. We propose that pheniramine maleate, an antihistaminic, may suppress this cough. We aim to observe the effect of pheniramine on fentanyl-induced cough during anesthesia induction. Methods: This is a double-blinded, prospective, three-arm parallel, randomized clinical trial of 120 patients with ASA (American Society of Anesthesiologists physical status III and IV who aged ≥18 and scheduled for elective open heart surgery during general anesthesia. Patients were randomly assigned to three groups of 40 patients, using computer-generated random numbers: placebo group, pheniramine group, and lidocaine group. Results: Cough incidence differed significantly between groups. In the placebo group, 37.5% of patients had cough, whereas the frequency was significantly decreased in pheniramine group (5% and lidocaine group (15% (Fischer exact test, p = 0.0007 and p = 0.0188, respectively. There was no significant change in cough incidence between pheniramine group (5% and lidocaine group (15% (Fischer exact test, p = 0.4325. Cough severity did also change between groups. Post Hoc tests with Bonferroni showed that mean cough severity in placebo differed significantly than that of pheniramine group and lidocaine group (p < 0.0001 and p = 0.009, respectively. There was no significant change in cough severity between pheniramine group and lidocaine group (p = 0.856. Conclusion: Intravenous pheniramine is as effective as lidocaine in preventing fentayl-induced cough. Our results emphasize that pheniramine is a convenient drug to decrease this cough.

  8. [Chronic otitis mediaChronic Otitis Media].

    Science.gov (United States)

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

    There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss.

  9. Coughing leading to spontaneous pneumomediastinum and subcutaneous emphysema in a young male

    Directory of Open Access Journals (Sweden)

    Ruchi Sachdeva

    2015-01-01

    Full Text Available A 20-year male college student, nonsmoker, nonalcoholic, average built presented with sudden onset cough since last 1 day along with diffuse swelling in the neck, difficulty in swallowing both liquids and solid since 1 day. There was history of rhinorrhea alternating with nasal block intermittently with change of seasons since last 3-4 years. There was no history of weight lifting, drug intake, tuberculosis or trauma, or family history of allergy. A case report of self-limiting spontaneous pneumomediastinum following a sudden bout of coughing with no underlying lung lesion is being reported.

  10. Efficacy and tolerability of levodropropizine and dropropizine in children with non-productive cough.

    Science.gov (United States)

    Banderali, G; Riva, E; Fiocchi, A; Cordaro, C I; Giovannini, M

    1995-01-01

    The antitussive efficacy and tolerability of dropropizine and of its enantiomer levodropropizine were evaluated in children with non-productive cough; 258 were evaluable for tolerability and 254 for efficacy. Patients randomly received either 1 mg/kg dropropizine or 2 mg/kg levodropropizine orally, three times daily for 3 days. There were statistically significant decreases in the frequency of coughing spells and nocturnal awakenings after both levodropropizine and dropropizine treatments (P Levodropropizine is as effective as an antitussive as dropropizine, but appears to carry a lower risk of daytime somnolence.

  11. Effects of phosphodiesterase 4 inhibitor on cough response in guinea pigs sensitized and challenged with ovalbumin

    Institute of Scientific and Technical Information of China (English)

    吕寒静; 邱忠民; 魏为利; 余莉; 刘瑞麟; 张敏

    2004-01-01

    Background There is currently considerable interest in the potential value of selective inhibitors of cyclic nucleotide phosphodiesterase 4 in the treatment of asthma. However, whether they influence eosinophilic airway inflammation-associated cough remains unclear. The objective of this study was to investigate the effects of selective phosphodiesterase 4 inhibitor SB207499 on cough response and airway inflammation in guinea pigs sensitized and challenged with ovalbumin. Methods Forty sensitized guinea pigs were randomly divided into four groups: control (n=10), challenge (n=10), SB207499 (n=10) and aminophylline (n=10), then challenged with aerosol of 1% ovalbumin or saline. Two hours later, animals were intraperitoneally injected with either saline, 25 mg/kg of SB207499 or aminophylline. At the 24th hour, the injection was repeated with 2.5 mg/kg and 25 mg/kg SB207499 or aminophylline, then cough response to inhaled capsaicin and airway responsiveness to methacholine inducing a 150% of the peak airway pressure to the baseline (PC150) was measured. Finally, total cell number and differentials in bronchoalveolar lavage fluid were analysed. Results The cough frequency per 3 minutes and PC150 in the challenge group were (22±4) times/3 minutes and (198±54) μg/ml, which were significantly different from (6±2) times/3 minutes and (691±81) μg/ml in the control group (P<0.05, respectively). The injection of 25 mg/kg SB207499 significantly inhibited the increased cough response and airway hyperresponsiveness, the cough frequency and PC150 in guinea pigs were (13±2) times/3 minutes and (680±81) μg/ml (P<0.05), which differed significantly from (18±2) times/3 minutes and (400±86) μg/ml after the administration of the same dose of aminophylline (P<0.05). The inhibition of SB207499 on cough response was dose-dependent. Similarly, SB207499 decreased the total cell number and percentage of eosinophils in bronchoalveolar lavage fluid to (2.1±0.5)×106/ml and (20±5

  12. Cough induced rib fracture, rupture of the diaphragm and abdominal herniation

    Directory of Open Access Journals (Sweden)

    Wurl Peter

    2006-11-01

    Full Text Available Abstract Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of the diaphragm, and an abdominal wall herniation. The hernia was repaired through surgical treatment without bowel resection, the diaphragm and the internal and oblique abdominal muscle were adapted, and the abdomen was reinforced with a prolene net. Although each individual injury is well documented in the literature, the combination of rib fracture, abdominal herniation and diaphragm rupture has not been reported.

  13. Cover Your Cough! A Short and Simple Activity to Demonstrate the Antimicrobial Effect of Desiccation

    Directory of Open Access Journals (Sweden)

    Jennifer Cook Easterwood

    2013-08-01

    Full Text Available Many undergraduate microbiology laboratory manuals include exercises demonstrating the antimicrobial effects of physical agents, such as UV light and heat, and chemical agents, such as disinfectants and antibiotics (3, 4. There is, however, a lack of exercises examining the effects of desiccation on bacterial growth and survival. This particular form of antimicrobial control is especially relevant today with an increased emphasis on coughing and sneezing into one’s sleeve or a tissue, where microbes will not contaminate hands and will eventually desiccate and die (2. Desiccation can have bacteriostatic or bactericidal effects depending on the species, the material on which the organism has desiccated, and the length of time. The absence of water can damage many cellular components, including enzymes, nucleic acids, and cell membranes (1. However, many prokaryotes have some degree of resistance to desiccation, with Escherichia coli surviving around 24 hours and Bacillus species surviving upwards of 300 years, though these numbers can vary due to a number of confounding factors (5. Some of these factors include the method by which desiccation occurred, whether desiccation occurred in a natural or laboratory situation, and the species itself (5. To address the effects of desiccation on bacterial growth and survival, a short, simple exercise was developed. By inoculating various materials with bacterial cultures and allowing them to air-dry for 24 hours, students can visualize the effects of desiccation by analyzing the growth, or lack thereof, when organisms are transferred to nutrient agar plates. This exercise has been used in a health professions microbiology course as well as a microbiology course for biology and biochemistry majors. It is short enough to be conducted during a standard lecture period or during a longer laboratory period in conjunction with other experiments demonstrating the effectiveness of physical agents on microbial

  14. A genome-wide association study identifies variants in KCNIP4 associated with ACE inhibitor-induced cough

    DEFF Research Database (Denmark)

    Mosley, J D; Shaffer, C M; Van Driest, S L;

    2016-01-01

    The most common side effect of angiotensin-converting enzyme inhibitor (ACEi) drugs is cough. We conducted a genome-wide association study (GWAS) of ACEi-induced cough among 7080 subjects of diverse ancestries in the Electronic Medical Records and Genomics (eMERGE) network. Cases were subjects di...

  15. A genome-wide association study identifies variants in KCNIP4 associated with ACE inhibitor-induced cough

    NARCIS (Netherlands)

    Mosley, J D; Shaffer, C M; Van Driest, S L; Weeke, P E; Wells, Q S; Karnes, J H; Velez Edwards, D R; Wei, W-Q; Teixeira, P L; Bastarache, L; Crawford, D C; Li, R; Manolio, T A; Bottinger, E P; McCarty, C A; Linneman, J G; Brilliant, M H; Pacheco, J A; Thompson, W; Chisholm, R L; Jarvik, G P; Crosslin, D R; Carrell, D S; Baldwin, E; Ralston, J; Larson, E B; Grafton, J; Scrol, A; Jouni, H; Kullo, I J; Tromp, G; Borthwick, K M; Kuivaniemi, H; Carey, D J; Ritchie, M D; Bradford, Y; Verma, S S; Chute, C G; Veluchamy, A; Siddiqui, M K; Palmer, C N A; Doney, A; Mahmoud Pour, Seyed Hamidreza; Maitland-van der Zee, A H; Morris, A D; Denny, J C; Roden, D M

    2015-01-01

    The most common side effect of angiotensin-converting enzyme inhibitor (ACEi) drugs is cough. We conducted a genome-wide association study (GWAS) of ACEi-induced cough among 7080 subjects of diverse ancestries in the Electronic Medical Records and Genomics (eMERGE) network. Cases were subjects diagn

  16. Nocturnal Dry Cough in the First 7 Years of Life is Associated With Asthma at School Age

    NARCIS (Netherlands)

    Boudewijn, Ilse M.; Savenije, Olga E. M.; Koppelman, Gerard H.; Wijga, Alet H.; Smit, Henriette A.; de Jongste, Johan C.; Gehring, Ulrike; Postma, Dirkje S.; Kerkhof, Marjan

    2015-01-01

    Background: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  17. The Effects of Antitussive Treatment of ACE Inhibitor-Induced Cough on Therapy Compliance : A Prescription Sequence Symmetry Analysis

    NARCIS (Netherlands)

    Vegter, S.; de Boer, P.; van Dijk, K.W.; Visser, Sipke; de Jong-van den Berg, L.T.W.

    2013-01-01

    Background A common adverse effect of angiotensin-converting enzyme inhibitors (ACEI) is a persistent dry cough. Physicians and pharmacists who fail to recognise dry cough to be ACEI related may prescribe antitussives, instead of recommended ACEI substitution. Objective The aim of this study was to

  18. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age

    NARCIS (Netherlands)

    Boudewijn, Ilse M; Savenije, Olga E M; Koppelman, Gerard H; Wijga, Alet H; Smit, Henriëtte A; de Jongste, Johan C; Gehring, Ulrike; Postma, Dirkje S; Kerkhof, Marjan

    2015-01-01

    BACKGROUND: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  19. Causality investigations in deer (Capreolus capreolus L. , 1758) to verify chronic fluoride intoxication due to nuisances. Kausalanalytische Untersuchungen zum Nachweis immissionsbedingter chronischer Fluoridintoxikation beim Reh (Capreolus capreolus L. , 1758)

    Energy Technology Data Exchange (ETDEWEB)

    Kierdorf, U.

    1988-02-06

    An anomaly found in the permanent teeth of deer (Capreolus capreolus L.) was investigated as to its generation and distribution. The examined lower jaws stemmed from different regions of the federal Laender North-Rhine Westphalia and Baden-Wuerttemberg. The diagnosis made on the basis of the pathomorphological findings attributed the tooth deformities to dental fluorosis, in other words, the animals suffered chronic fluoride intoxication during tooth development. Analyses of the fluoride content of lower-jaw bones, tooth enamel and dentine from afflicted deer and non-afflicted animals confirmed this assumption. Radiological investigations as to the crown development of permanent molar teeth of deer permitted to formulate a hypothesis regarding the varying degree of deformation sustained by the teeth in the event of dental fluorosis. Both the fetus and fawn are assumed to be largely protected from intoxication even in a severely contaminated environment because of several protective mechanisms being effective during the early post-natal phase. The excessive wear of the teeth presumably leads to older animals mincing their feed inadequately and having, accordingly, a lower life expectancy. The conclusion drawn was that the animals sustained fluorosis due to their being exposed to nuisances from industrial activities. The thesis discusses the suitability of deer and other ruminants living in the wild as biological indicators.

  20. Effectiveness and safety of noninvasive positive-pressure ventilation for severe hypercapnic encephalopathy due to acute exacerbation of chronic obstructive pulmonary disease:a prospective case-control study

    Institute of Scientific and Technical Information of China (English)

    ZHU Guang-fa; ZHANG Wei; ZONG Hua; XU Qiu-fen; LIANG Ying

    2007-01-01

    Background Although severe encephalopathy has been proposed as a possible contraindication to the use of noninvasive positive-pressure ventilation(NPPV),increasing clinical reports showed it was effective in patients with impaired consciousness and even coma secondary to acute respiratory failure,especially hypercapnic acute respiratory failure(HARF).To further evaluate the effectiveness and safety of NPPV for severe hypercapnic encephalopathy,a prospective case-control study was conducted at a university respiratory intensive care unit(RICU)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)during the past 3 years.Methods Forty-three of 68 consecutive AECOPD patients requiring ventilatory support for HARF were divided into 2 groups,which were carefully matched for age,sex,COPD course,tobacco use and previous hospitalization history,according to the severity of encephalopathy,22 patients with Glasgow coma scale(GCS)0.05),but group A needed an average of 7 cmH2O higher of maximal pressure support during NPPV,and 4,4 and 7 days longer of NPPV time,RICU stay and hospital stay respectively than group B(P<0.05 or P<0.01).NPPV therapy failed in 12 patients(6 in each group)because of excessive airway secretions(7 patients),hemodynamic instability(2),worsening of dyspnea and deterioration of gas exchange(2),and gastric content aspiration(1).Conclusions Selected patients with severe hypercapnic encephalopathy secondary to HARF can be treated as effectively and safely with NPPV as awake patients with HARF due to AECOPD;a trial of NPPV should be instituted to reduce the need of endotracheal intubation in patients with severe hypercapnic encephalopathy who are otherwise good candidates for NPPV due to AECOPD.

  1. Establishment of gastro-esophageal regurgitation cough scoring system for clinical diagnosis%胃食道反流性咳嗽临床诊断评分系统的建立

    Institute of Scientific and Technical Information of China (English)

    张巧; 马千里; 黄赞胜; 王彬; 程晓明; 林科雄; 王长征

    2011-01-01

    Objective To establish a gastro-esophageal regurgitation cough ( GERC ) scoring system through analyzing and summarize clinical characteristics of chronic cough patients in order to investigate a quick diagnostic method for GERC. Methods A total of 202 outpatients with chronic cough from our department during June 2010 to February 2011 were rerolled in this study. The inclusion criterions were cough for over 8 weeks and normal chest X-ray film. These patients were firstly diagnosed as 3 common causes of chronic cough, based on their clinical features, that is , GERC, cough variability asthma ( CVA) , and upper airway cough syndrome ( UACS). After empiric treatment, all patients were followed up at last 2 to 4 weeks to evaluate the treatment efficiency. The turning point for GERC diagnosis was confirmed according to our scoring system. Results In this study, the analysis for clinical features from 122 patients diagnosed as GERC, UACS or CVA showed that there was no significant difference in age, severity and duration of cough among 3 groups. CVA group had significantly higher incidence of rhinitis/sinusitis than GERC group (P =0. 019) , and GERC group had significantly higher rate of history of stomach illness than UACS group ( P = 0. 023 ). Percentage of hacking cough was higher in GERC group than other groups, that of night-time cough was higher in CVA group than in the other groups (P =0. 000) , and there was no significant difference between the 2 groups (P =0. 781).GERC group had significantly higher proportion of reflux symptoms than UACS group ( P = 0. 002 ) and CVA group (P = 0. 007 ) , and higher proportion of stomach symptoms than UACS group ( P = 0. 001 ) and CVA group ( P - 0. 027 ). But for the symptoms of rhinitis/sinusitis, UACS group and CVA group had higher proportion than GERC group. There were significant difference in GERC scores among the 3 groups ( P < 0. 001). GERC score ≤4 was determined as the turning point for predicting GERC, with a

  2. Acquired chronic hepatocerebral degeneration due to cirrhosis from non-alcoholic steatohepatitis Síndrome hepatocerebral crónico secundario a cirrosis por esteatohepatitis no alcohólica

    Directory of Open Access Journals (Sweden)

    A. Burgos

    2009-11-01

    Full Text Available Introduction and objective: acquired chronic hepatocerebral degeneration, acquired hepatolenticular degeneration or pseudo-Wilson is an infrequent disorder with a hepatic origin. Cases in the literature are scarce and it is frequently confused with hepatic encephalopathy and Wilson's disease. The aim of this essay is to report a patient suffering from this disorder due to cirrhosis from non-alcoholic steatohepatitis. Case report: we present a 54-year-old man diagnosed from cirrhosis grade B9 of the Child Pugh classification. He progressively developed a picture with bradylalia, mild postural and action tremor and spatial and temporal disorientation. Further studies demonstrated an increase of the values of hepatic transaminases and a hiperintensity in the basal nuclei in the cerebral magnetic resonance imaging. Clinical and radiological data established the diagnosis of hepatocerebral degeneration. Conclusions: acquired chronic hepatocerebral degeneration is a disorder rarely reported in the literature that it is usually confused with other diseases. We alert about the need of having this diagnosis into account with patients developing neurological symptoms after hepatic disease.Fundamento y objetivo: el síndrome hepatocerebral crónico, también denominado degeneración hepatolenticular crónica adquirida (DHCA o pseudo-Wilson, es un trastorno poco frecuente de origen hepático. Los casos recogidos en la literatura son escasos y frecuentemente es confundido con la encefalopatía hepática y con la enfermedad de Wilson. El objetivo de este artículo es presentar un paciente que sufre este trastorno de forma secundaria a una cirrosis por esteatohepatitis no alcohólica. Caso clínico: se trata de un varón de 54 años diagnosticado de cirrosis en grado funcional de Child-Pugh B9 que presentó un cuadro progresivo de bradilalia, temblor postural y de acción leve y, en ocasiones, desorientación temporoespacial. Los estudios complementarios

  3. Sinusitis in children and adolescents with chronic or recurrent headache: a case-control study.

    Science.gov (United States)

    Senbil, Nesrin; Gürer, Y K Yavuz; Uner, Ciğdem; Barut, Yaşar

    2008-02-01

    The aim of this study was to determine the frequency of misdiagnosis of sinus headache in migraine and other primary headache types in the children and adolescents with chronic or recurrent headaches. Children with chronic or recurrent headaches (n = 310) were prospectively evaluated. Data collection for each patient included history of previously diagnosed sinusitis due to headache, and additional sinusitis complaints (such as fever, cough, nasal discharge, postnasal discharge) at the time of sinusitis diagnosis, and improvement of the headache following treatment of sinusitis. If sinus radiographs existed they were recorded. The study included 214 patients with complete data. One hundred and sixteen (54.2%) patients have been diagnosed as sinusitis previously and 25% of them had at least one additional complaint, while 75% of them had none. Sinusitis treatment had no effect on the headaches in 60.3% of the patients. Sinus graphy had been performed in 52.8%, and 50.4% of them were normal. The prevalence of sinus headache concomitant with primary headache, and only sinus headache was detected in 7 and 1%, respectively, in our study. Approximately 40% of the patients with migraine and 60% of the patients with tension-type headache had been misdiagnosed as "sinus headache". Children with chronic or recurrent headaches are frequently misdiagnosed as sinus headache and receive unnecessary sinusitis treatment and sinus graphy.

  4. Olodaterol attenuates citric acid-induced cough in naïve and ovalbumin-sensitized and challenged guinea pigs.

    Science.gov (United States)

    Wex, Eva; Bouyssou, Thierry

    2015-01-01

    Excessive coughing is a common feature of airway diseases. Different G-protein coupled receptors, including β2-adrenergic receptors (β2-AR), have been implicated in the molecular mechanisms underlying the cough reflex. However, the potential antitussive property of β2-AR agonists in patients with respiratory disease is a matter of ongoing debate. The aim of our study was to test the efficacy of the long-acting β2-AR agonist olodaterol with regard to its antitussive property in a pre-clinical model of citric acid-induced cough in guinea pigs and to compare the results to different clinically relevant β2-AR agonists. In our study β2-AR agonists were intratracheally administered, as dry powder, into the lungs of naïve or ovalbumin-sensitized guinea pigs 15 minutes prior to induction of cough by exposure to citric acid. Cough events were counted over 15 minutes during the citric acid exposure. Olodaterol dose-dependently inhibited the number of cough events in naïve and even more potently and with a greater maximal efficacy in ovalbumin-sensitized guinea pigs (p citric acid-induced cough in naïve and ovalbumin-sensitized guinea pigs. This is in agreement with pre-clinical and clinical studies showing antitussive efficacy of β2-AR agonists. Indacaterol increased the number of coughs in this model, which concurs with clinical data where a transient cough has been observed after indacaterol inhalation. While the antitussive properties of β2-AR agonists can be explained by their ability to lead to the cAMP-induced hyperpolarization of the neuron membrane thereby inhibiting sensory nerve activation and the cough reflex, the mechanism underlying the pro-tussive property of indacaterol is not known.

  5. Fourier transform infrared and near-infrared spectroscopic methods for the detection of toxic Diethylene Glycol (DEG) contaminant in glycerin based cough syrup

    OpenAIRE

    Ahmed, M. Khalique; McLeod, Michael P.; Nézivar, Jean; Giuliani, Allison W.

    2010-01-01

    Recently there have been reports of the contamination of cough syrups with Diethylene Glycol (DEG). The consumption of such cough syrups has devastating effects on the health. In this paper we report evidence that Fourier transform infrared (FT-IR) and near-infrared (NIR) spectroscopic techniques are viable, simple, cost effective, rapid and fool proof methods for the identification and quantification of DEG in glycerin based cough syrups. The FT-IR and NIR spectra of the glycerin based cough...

  6. The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume

    DEFF Research Database (Denmark)

    Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus

    2006-01-01

    of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case...

  7. Personal exposure to cough released droplets in quiescent environment and ventilated spaces

    DEFF Research Database (Denmark)

    Licina, Dusan; Melikov, Arsen Krikor; Pantelic, Jovan;

    2014-01-01

    This study shows the results of an experimental investigation of personal exposure to cough released droplets. Human body is resembled by a thermal manikin with a body shape and surface temperature distribution of a real person. The objective of the study is to examine personal exposure of the ma......This study shows the results of an experimental investigation of personal exposure to cough released droplets. Human body is resembled by a thermal manikin with a body shape and surface temperature distribution of a real person. The objective of the study is to examine personal exposure...... of the manikin exposed to cough released droplets in a calm indoor environment and under uniform air patterns relative to a human body. The findings show that human body orientation relative to the direction and magnitude of invading flow from the surroundings considerably modifies personal exposure. Surrounding...... uniform flows is most of the scenarios decrease the exposure to cough droplets, however not in all scenarios. Study results show that understanding of the air patterns should be prioritized in ventilation design practice....

  8. LECTURES ON ACUPUNCTURE Part Ⅰ Clinical Acupuncture Lecture Twenty-Eight COUGH

    Institute of Scientific and Technical Information of China (English)

    XU Li; SHANG Xiukui; PAN Xingfang

    2002-01-01

    @@ Cough, a main symptom of the lung problems, may result either from invasion of the exogenous factors induced dysfunction of the lungqi in dispersion or from disorders of the lung itself or from dysfunction of other zang-fu organs affecting the lung.

  9. Angiotensin converting enzyme inhibitor associated cough: a population-based case-control study.

    NARCIS (Netherlands)

    Visser, L.E.; Stricker, B.H.C.; Velden, J. van der; Paes, A.H.P.; Bakker, A.

    1995-01-01

    The objectives of this study were to determine the risk for coughing as an adverse reaction to angiotensin converting enzyme (ACE) inhibitors under everyday circumstances in a large population and to study whether this adverse effect is more common in women. A population-based case-control study was

  10. Transient receptor potential genes, smoking, occupational exposures and cough in adults

    NARCIS (Netherlands)

    Smit, L.A.; Kogevinas, M.; Antó, J.; Bouzigon, E.; González, J.R.; Le Moual, N.; Kromhout, J.; Carsin, A.; Pin, I.; Jarvis, D.; Vermeulen, R.C.H.; Janson, C.; Heinrich, J.; Gut, I.; Lathrop, M.; Valverde, M.A.; Demenais, F.; Kauffmann, F.

    2012-01-01

    BACKGROUND: Transient receptor potential (TRP) vanilloid and ankyrin cation channels are activated by various noxious chemicals and may play an important role in the pathogenesis of cough. The aim was to study the influence of single nucleotide polymorphisms (SNPs) in TRP genes and irritant exposure

  11. Antitussive effect of naringin on experimentally induced cough in Guinea pigs.

    Science.gov (United States)

    Gao, Sen; Li, Peibo; Yang, Hongliang; Fang, Siqi; Su, Weiwei

    2011-01-01

    The mechanism of action of naringin has been investigated in different models of experimentally induced cough in guinea pigs. In contrast to codeine phosphate (6 mg/kg, intravenous administration [i. v.]), naringin (15, 30, and 60 mg/kg, i. v.) had no central antitussive effect on cough elicited by electrical stimulation of the superior laryngeal nerve. Naringin (0.5, 1.0, and 2.0 µmol) could not prevent the cough reflex induced by stimulation of the trachea after intracerebroventricular injection (i. c. v.), while codeine phosphate (0.5 µmol) was highly effective. Further characterizing the peripheral mechanism of naringin, we found that its effect (50 mg/kg, i. v.) was not affected by the depletion of sensory neuropeptides, whereas levodropropizine (10 mg/kg, i. v.) lost its capacity to prevent cough in the capsaicin-desensitized guinea pig. Furthermore, pretreatment with glibenclamide (10 mg/kg, intraperitoneal [i. p.]) significantly reduced the antitussive effect of pinacidil (5 mg/kg, subcutaneous [s. c.]), but could not antagonize the antitussive effect of naringin (30 mg/kg, s. c.). Our present results suggest that naringin is not a central antitussive drug. And naringin does not exert its peripheral antitussive effect through either the sensory neuropeptides system or the modulation of ATP-sensitive K (+) channels.

  12. Cough reflex is additively potentiated by inputs from the laryngeal and tracheobronchial [corrected] receptors and enhanced by stimulation of the central respiratory neurons.

    Science.gov (United States)

    Kondo, Tetsuri; Hayama, Naoki

    2009-09-01

    The cough is an essential airway defense reflex. In this study we investigated the coordination of inputs from the laryngeal and tracheobronchial receptors in the cough reflex. In 15 beagle dogs (7-9 kg) lightly anesthetized with intravenous profobol (20-30 mg/kg/h), the cough response was elicited with mechanical stimulation of either the vocal chord or tracheal bifurcation. Simultaneous stimulation of both sites increased all the parameters of cough strength, that is, mean pleural pressure (P (pl)), mean expiratory flow, number of cough bouts, and cough duration, in comparison with stimulation of the sites individually. The increases in mean P (pl) and cough duration reached statistical significance (13.3 vs. 18.4 cmH(2)O and 13.3 vs. 18.2 s, respectively). When the anesthetic level became deeper, the prolongation of cough duration almost disappeared, but the augmentation of mean P (pl) was much less affected. During stimulation of the central respiratory neurons by intravenous dimorphoramine or acute hyperoxic hypercapnia, the cough strength increased significantly. We concluded that inputs from the laryngeal and tracheobonchial cough receptors acted in concert and potentiated the cough reflex. Furthermore, stimulation of the central respiratory neurons may increase the intensity of a cough response.

  13. Resolution of Chronic Aspiration Pneumonitis Following Endoscopic Endonasal Repair of Spontaneous Cerebrospinal Fluid Fistula of the Skull Base.

    Science.gov (United States)

    Seltzer, Justin; Babadjouni, Arash; Wrobel, Bozena B; Zada, Gabriel

    2016-06-01

    Spontaneous cerebrospinal fluid (CSF) rhinorrhea due to a skull base defect requires prompt diagnosis and treatment. Multiple surgical options are available for repairing the fistula, including the two-layer "fascial apposition" method and use of a pedicled nasal-septal flap. A 44-year-old obese woman presented with 4 months of progressive cough, exertional dyspnea, hoarseness, and intermittent fluid drainage from the right nostril. Chest computed tomography (CT) imaging and bronchoscopy showed chronic pneumonitis, which was confirmed by pulmonary wedge resection. CT and magnetic resonance imaging of the skull base, as well as laboratory analysis of the nasal fluid for β2-transferrin, confirmed a skull base defect causing CSF rhinorrhea. During surgery, insertion of a lumbar drain with the intrathecal fluorescein administration was performed, followed by endoscopic endonasal repair using an autologous fascial apposition graft and pedicled nasal-septal flap. Both the CSF leak and the pulmonary complications resolved following the operation with no symptoms at 11-month follow-up. This is the first reported case of spontaneous CSF rhinorrhea complicated by chronic aspiration and pneumonitis. Increased diagnostic complexity due to chronic pulmonary complications resulted in unnecessary interventions and treatment delays. Prompt recognition of spontaneous CSF leaks is essential to prevent potentially harmful complications.

  14. Role of the retrotrapezoid nucleus/parafacial respiratory group in coughing and swallowing in guinea pigs

    Science.gov (United States)

    Shiba, Keisuke; Mukudai, Shigeyuki; Umezaki, Toshiro; Sakaguchi, Hirofumi; Hisa, Yasuo

    2015-01-01

    The retrotrapezoid/parafacial respiratory group (RTN/pFRG) located ventral to the facial nucleus plays a key role in regulating breathing, especially enhanced expiratory activity during hypercapnic conditions. To clarify the roles of the RTN/pFRG region in evoking coughing, during which reflexive enhanced expiration is produced, and in swallowing, during which the expiratory activity is consistently halted, we recorded extracellular activity from RTN/pFRG neurons during these fictive behaviors in decerebrate, paralyzed, and artificially ventilated guinea pigs. The activity of the majority of recorded respiratory neurons was changed in synchrony with coughing and swallowing. To further evaluate the contribution of RTN/pFRG neurons to these nonrespiratory behaviors, the motor output patterns during breathing, coughing, and swallowing were compared before and after brain stem transection at the caudal margin of RTN/pFRG region. In addition, the effects of transection at its rostral margin were also investigated to evaluate pontine contribution to these behaviors. During respiration, transection at the rostral margin attenuated the postinspiratory activity of the recurrent laryngeal nerve. Meanwhile, the late expiratory activity of the abdominal nerve was abolished after caudal transection. The caudal transection also decreased the amplitude of the coughing-related abdominal nerve discharge but did not abolish the activity. Swallowing could be elicited even after the caudal end transection. These findings raise the prospect that the RTN/pFRG contributes to expiratory regulation during normal respiration, although this region is not an essential element of the neuronal networks involved in coughing and swallowing. PMID:26203106

  15. [A child with iritis due to Chlamydia pneumoniae infection].

    Science.gov (United States)

    Yamada, S; Tsumura, N; Nagai, K; Yamada, T; Sakata, Y; Tominaga, K; Kato, H; Motohiro, T; Masunaga, N; Mochizuki, M

    1994-12-01

    A case of uncommon iritis due to Chlamydia pneumoniae (C. pneumoniae) is reported. The patient was a 9-year-old boy who had suffered from cough, pharyngeal pain, and low grade fever. The symptoms persisted for more than 1 month in spite of an oral cephem antibiotic. Ophthalmalgia, congestion around the iris and cough had lasted with alleviation and exacerbation. A diagnosis of C. pneumoniae infection was made by specific polymerase chain reaction (PCR) method and microimmunofluorescence test (MIF). The symptoms subsided with administration of clarithromycin (CAM: 300 mg/day) for 2 weeks. Because of the simultaneous alleviation of iritis, C. pneumoniae infection was considered to introduce the iritis. Much remains to be clarified about this pathogenesis of iritis and more detailed evaluations are required.

  16. Changes and implications of cough sensitivity in upper airway cough syndrome%上气道咳嗽综合征的咳嗽敏感性改变及其意义

    Institute of Scientific and Technical Information of China (English)

    王岚; 余莉; 邱志宏; 吕寒静; 邱忠民

    2012-01-01

    目的 探讨上气道咳嗽综合征咳嗽敏感性的改变和临床意义.方法 用辣椒素咳嗽敏感性试验检测94例上气道咳嗽综合征的咳嗽阈值C5,分析治疗后咳嗽阈值C5的改变.结果 94例上气道咳嗽综合征的辣椒素咳嗽阚值C5为3.9 (0.98,7.8)μmol/L,位于正常值范围,仅36例(36/94,38.30%)患者存在咳嗽高敏感性.经治疗咳嗽症状消失后30例患者接受了随访复查,治疗前辣椒素咳嗽阈值C5为5.85 (1.95,31.2) μmol/L,与治疗后的7.8 (0.98,7.8) μmol/L相比,差别无统计学意义(Z=-0.72,P=0.47).其中12例治疗前咳嗽敏感性增高者中有6例降至正常.结论 上气道咳嗽综合征的咳嗽敏感性存在不均一性,与正常值存在较大的重叠和交叉,大部分不符合咳嗽高敏感性综合征的概念.%Objective To investigate the changes and clinical implications of cough sensitivity in upper airway cough syndrome ( UACS ). Methods Cough threshold C5 was measured by capsaicin cough sensitivity test in 94 patients with upper airway cough syndrome; it was also measured in 30 patients after cough completely resolved with specific therapy. Results The mean cough threshold C5 was 5. 85 (1. 95, 31. 2) μmol/L and within the normal range; however, 36 patients (38.30% ) presented cough hypersensitivity. Thirty patients received re-examination of cough sensitivity to capsaicin after cough disappeared, there was no significant difference in cough threshold C5 between pre-and post-treatment [ 5.85 (1.95,31.2) μmol/L vs7.8 (0.98, 7.8)μmol/L, Z= -0.72,P = 0.47 ]. The effective treatment resulted in the recover of cough threshold C5 to normal level in 6 of 12 patients with increased cough sensitivity to capsaicin. Conclusion Cough sensitivity in upper airway cough syndrome is heterogeneous and overlapped with normal value. Therefore, upper airway cough syndrome is not always consistent with the concept of cough hypersensitivity syndrome.

  17. Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease

    OpenAIRE

    2005-01-01

    Background: Quadriceps muscle weakness is common in chronic obstructive pulmonary disease (COPD) but is not observed in a small hand muscle (adductor pollicis). Although this could be explained by reduced activity in the quadriceps, the observation could also be explained by anatomical location of the muscle or fibre type composition. However, the abdominal muscles are of a similar anatomical and fibre type distribution to the quadriceps, although they remain active in COPD. Cough gastric pre...

  18. The efficacy of the homeopathic complex (Arnica montana 6CH, Bryonia alba 6CH, Kalmia latifolia 6CH, Rhus toxicodendron 6CH Calcarea fluorica 6CH) and physiotherapy in the treatment of chronic low back due to osteoarthritis

    OpenAIRE

    2015-01-01

    M.Tech. (Homoeopathy) Chronic pain, such as chronic low back pain caused by osteoarthritis (OA), can disrupt the quality of life by eroding the will to live, disturbing sleep and appetite, creating fatigue, and impairing recovery from illness or injury (Manchikanti et al. 2003:10). Conventional treatment used for OA includes drug therapy and physiotherapy. Homoeopathy has a wide range of remedies that can be useful in the treatment of symptoms, such as pain and stiffness that may be caused...

  19. EVALUATION OF ANTI- TUSSIVE ACTIVITY OF LEAVES OF CAESALPINIA BONDUCELLA F. IN EXPERIMENTALLY INDUCED COUGH IN MICE

    Directory of Open Access Journals (Sweden)

    Sanjay Jain*, Rakesh Barik, Nidhi Yadav and Shivpal Singh

    2013-01-01

    Full Text Available Cough is a natural reflex expulsive defense mechanism of the body, for clearing excess secretions, mucous, inhaled irritants, toxins or foreign substance in the respiratory tract. It is the most common symptom of respiratory disease. When cough becomes serious, opioids are effective, but they have side effects like sedation, constipation, some addiction liability and also compromise the respiratory function. Therefore, there is a need to have effective anti-tussive agent which do not have respiratory suppressant activity. The present study was carried out to evaluate anti-tussive activity of leaves of Caesalpinia bonducella in ammonium hydroxide induced cough model in mice.

  20. 《竹林寺女科秘传》论治妊娠咳嗽浅析%Analysis of Zhulinsi Nvke Mizhuan in Treating Pregnancy cough

    Institute of Scientific and Technical Information of China (English)

    李瑞丽; 王杰; 傅金英; 于胜男

    2014-01-01

    By analyzing the Zhulinsi Nvke Mizhuan component,showing its distinctive square compatibility of drugs,prescription cleverly cut herbs when,rather than stick to the ancient Zungu,quite a lot of merit. In the treatment of pregnancy cough,this is the gold of the lung is damaged,treatment is simply to grasp the nature of the lungs recover,but Zhifei,while not forgetting both the spleen and kidney. In addition,in the treatment of pregnancy cough,should pay attention to nursing care per tire. Cough for a long time due to tire easily hurt each pregnancy disease cough should be early intervention to prevent a cold,eat spicy flare of the goods,avoid smoke stimulation;regardless of appearance or in the treatment of disease-causing internal injuries,must consider the physical characteristics of pregnant women in order to raise yin lungs based. In short,Zhulinsi Nvke Mizhuan is one with a higher value of gynecological clinical mono-graphs,worthy of our TCM doctors seriously learn from.%通过分析《竹林寺妇科秘传》的方药组成,可见其方配伍用药独具匠心,组方巧妙,方药切当,遵古而不拘泥于古,颇多可取之处。在治疗妊娠咳嗽时,本在于肺的金性被破坏,治疗要抓住根本就是恢复肺金的本性,但治肺的同时,不忘兼顾脾肾。另外,在治疗妊娠咳嗽时,应注意顾护胎元。因嗽久每易伤胎,妊娠病咳应早期干预,预防感冒,忌食辛辣动火之品,避免烟尘刺激;在治疗上无论外观或内伤致病,必然要考虑孕妇的体质特点,以养阴润肺为主。总之,《竹林寺女科秘传》是一部具有较高临床使用价值的妇科专著,值得广大中医医生认真借鉴和学习。