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Sample records for cough motor pattern

  1. Motor Patterns in Walking.

    Science.gov (United States)

    Lacquaniti, F.; Grasso, R.; Zago, M.

    1999-08-01

    Despite the fact that locomotion may differ widely in mammals, common principles of kinematic control are at work. These reflect common mechanical and neural constraints. The former are related to the need to maintain balance and to limit energy expenditure. The latter are related to the organization of the central pattern-generating networks.

  2. Convergence of pattern generator outputs on a common mechanism of diaphragm motor unit recruitment.

    Science.gov (United States)

    Mantilla, Carlos B; Seven, Yasin B; Sieck, Gary C

    2014-01-01

    Motor units are the final element of neuromotor control. In manner analogous to the organization of neuromotor control in other skeletal muscles, diaphragm motor units comprise phrenic motoneurons located in the cervical spinal cord that innervate the diaphragm muscle, the main inspiratory muscle in mammals. Diaphragm motor units play a primary role in sustaining ventilation but are also active in other nonventilatory behaviors, including coughing, sneezing, vomiting, defecation, and parturition. Diaphragm muscle fibers comprise all fiber types. Thus, diaphragm motor units display substantial differences in contractile and fatigue properties, but importantly, properties of the motoneuron and muscle fibers within a motor unit are matched. As in other skeletal muscles, diaphragm motor units are recruited in order such that motor units that display greater fatigue resistance are recruited earlier and more often than more fatigable motor units. The properties of the motor unit population are critical determinants of the function of a skeletal muscle across the range of possible motor tasks. Accordingly, fatigue-resistant motor units are sufficient to generate the forces necessary for ventilatory behaviors, whereas more fatigable units are only activated during expulsive behaviors important for airway clearance. Neuromotor control of diaphragm motor units may reflect selective inputs from distinct pattern generators distributed according to the motor unit properties necessary to accomplish these different motor tasks. In contrast, widely distributed inputs to phrenic motoneurons from various pattern generators (e.g., for breathing, coughing, or vocalization) would dictate recruitment order based on intrinsic electrophysiological properties. © 2014 Elsevier B.V. All rights reserved.

  3. 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

    2017-03-01

    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. 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 H 2 O. Laryngeal movements were assessed from video files. ALS type and characteristics of upper and lower motor neuron symptoms were determined. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Hereditary motor and sensory neuropathy with proximal dominancy in the lower extremities, urinary disturbance, and paroxysmal dry cough.

    Science.gov (United States)

    Miura, Shiroh; Shibata, Hiroki; Kida, Hiroshi; Noda, Kazuhito; Tomiyasu, Katsuro; Yamamoto, Ken; Iwaki, Akiko; Ayabe, Mitsuyoshi; Aizawa, Hisamichi; Taniwaki, Takayuki; Fukumaki, Yasuyuki

    2008-10-15

    We studied a four-generation pedigree of a Japanese family with hereditary neuropathy to elucidate the genetic basis of this disease. Twelve members of the family were enrolled in this study. The clinical features were neurogenic muscle weakness with proximal dominancy in the lower extremities, sensory involvement, areflexia, fine postural tremors, painful muscle cramps, elevated creatine kinase levels, recurrent paroxysmal dry cough, and neurogenic bladder. We performed a genome-wide search using genetic loci spaced at about 13 Mb intervals. Although nine chromosomes (1, 3, 4, 5, 6, 10, 17, 19, and 22) had at least one region in which the logarithm of odds (LOD) score was over 1.0, no loci fulfilled the criteria for significant evidence of linkage. Moreover, we analyzed an extra 14 markers on 3p12-q13 (the locus of hereditary motor and sensory neuropathy, proximal dominant form) and an extra five markers on 3p22-p24 (the locus of hereditary sensory neuropathy with chronic cough) and observed LOD scores of hereditary motor and sensory neuropathy with autosomal dominant inheritance.

  5. Variation in motor output and motor performance in a centrally generated motor pattern

    Science.gov (United States)

    Norris, Brian J.; Doloc-Mihu, Anca; Calabrese, Ronald L.

    2014-01-01

    Central pattern generators (CPGs) produce motor patterns that ultimately drive motor outputs. We studied how functional motor performance is achieved, specifically, whether the variation seen in motor patterns is reflected in motor performance and whether fictive motor patterns differ from those in vivo. We used the leech heartbeat system in which a bilaterally symmetrical CPG coordinates segmental heart motor neurons and two segmented heart tubes into two mutually exclusive coordination modes: rear-to-front peristaltic on one side and nearly synchronous on the other, with regular side-to-side switches. We assessed individual variability of the motor pattern and the beat pattern in vivo. To quantify the beat pattern we imaged intact adults. To quantify the phase relations between motor neurons and heart constrictions we recorded extracellularly from two heart motor neurons and movement from the corresponding heart segments in minimally dissected leeches. Variation in the motor pattern was reflected in motor performance only in the peristaltic mode, where larger intersegmental phase differences in the motor neurons resulted in larger phase differences between heart constrictions. Fictive motor patterns differed from those in vivo only in the synchronous mode, where intersegmental phase differences in vivo had a larger front-to-rear bias and were more constrained. Additionally, load-influenced constriction timing might explain the amplification of the phase differences between heart segments in the peristaltic mode and the higher variability in motor output due to body shape assumed in this soft-bodied animal. The motor pattern determines the beat pattern, peristaltic or synchronous, but heart mechanics influence the phase relations achieved. PMID:24717348

  6. "The cough game": are there characteristic urethrovesical movement patterns associated with stress incontinence?

    Science.gov (United States)

    Lewicky-Gaupp, Christina; Blaivas, Jerry; Clark, Amanda; McGuire, Edward J; Schaer, Gabriel; Tumbarello, Julie; Tunn, Ralf; DeLancey, John O L

    2009-02-01

    This study was carried out to determine whether five experts in female stress urinary incontinence (SUI) could discover a pattern of urethrovesical movement characteristic of SUI on dynamic perineal ultrasound. A secondary analysis of data from a case-control study was performed. Ultrasounds from 31 cases (daily SUI) and 42 controls (continent volunteers) of similar age and parity were analyzed. Perineal ultrasound was performed during a single cough. The five experts, blinded to continence status and urodynamics, classified each woman as stress continent or incontinent. Correct responses ranged from 45.7% to 65.8% (mean 57.4 +/- 7.6). Sensitivity was 53.0 +/- 8.8% and specificity 61.2 +/- 12.4%. The positive predictive value was 48.8 +/- 8.2% and negative predictive value was 65.0 +/- 7.3%. Inter-rater reliability, evaluated by Cohen's kappa statistic, averaged 0.47 [95% CI 0.40-0.50]. Experts could not identify a pattern of urethrovesical movement characteristic of SUI on ultrasound.

  7. Mechanical cough augmentation techniques in amyotrophic lateral sclerosis/motor neuron disease

    OpenAIRE

    Rafiq, M.K.; Bradburn, M.; Mustfa, N.; Mcdermott, C.J.; Annane, D.

    2016-01-01

    © 2016 The Cochrane Collaboration.This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of mechanical insufflator/exsufflator (MI-E) and the breath-stacking technique for reducing morbidity and mortality and enhancing quality of life in people with amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND).

  8. Compositional symbol grounding for motor patterns.

    Science.gov (United States)

    Greco, Alberto; Caneva, Claudio

    2010-01-01

    We developed a new experimental and simulative paradigm to study the establishing of compositional grounded representations for motor patterns. Participants learned to associate non-sense arm motor patterns, performed in three different hand postures, with non-sense words. There were two group conditions: in the first (compositional), each pattern was associated with a two-word (verb-adverb) sentence; in the second (holistic), each same pattern was associated with a unique word. Two experiments were performed. In the first, motor pattern recognition and naming were tested in the two conditions. Results showed that verbal compositionality had no role in recognition and that the main source of confusability in this task came from discriminating hand postures. As the naming task resulted too difficult, some changes in the learning procedure were implemented in the second experiment. In this experiment, the compositional group achieved better results in naming motor patterns especially for patterns where hand postures discrimination was relevant. In order to ascertain the differential effect, upon this result, of memory load and of systematic grounding, neural network simulations were also made. After a basic simulation that worked as a good model of subjects performance, in following simulations the number of stimuli (motor patterns and words) was increased and the systematic association between words and patterns was disrupted, while keeping the same number of words and syntax. Results showed that in both conditions the advantage for the compositional condition significantly increased. These simulations showed that the advantage for this condition may be more related to the systematicity rather than to the mere informational gain. All results are discussed in connection to the possible support of the hypothesis of a compositional motor representation and toward a more precise explanation of the factors that make compositional representations working.

  9. Compositional symbol grounding for motor patterns

    Directory of Open Access Journals (Sweden)

    Alberto eGreco

    2010-11-01

    Full Text Available We developed a new experimental and simulative paradigm to study the establishing of compositional grounded representations for motor patterns. Participants learned to associate nonsense arm motor patterns, performed in three different hand postures, with nonsense words. There were two group conditions: in the first (compositional, each pattern was associated with a two-word (verb-adverb sentence; in the second (holistic, each same pattern was associated with a unique word. Two experiments were performed. In the first, motor pattern recognition and naming were tested in the two conditions. Results showed that verbal compositionality had no role in recognition and that the main source of confusability in this task came from discriminating hand postures. As the naming task resulted too difficult, some changes in the learning procedure were implemented in the second experiment. In this experiment, the compositional group achieved better results in naming motor patterns especially for patterns where hand postures discrimination was relevant. In order to ascertain the differential effect, upon this result, of memory load and of systematic grounding, neural network simulations were also made. After a basic simulation that worked as a good model of subjects performance, in following simulations the number of stimuli (motor patterns and words was increased and the systematic association between words and patterns was disrupted, while keeping the same number of words and syntax. Results showed that in both conditions the advantage for the compositional condition significantly increased. These simulations showed that the advantage for this condition may be more related to the systematicity rather than to the mere informational gain. All results are discussed in connection to the possible support of the hypothesis of a compositional motor representation and towards a more precise explanation of the factors that make compositional representations working.

  10. Motor control by precisely timed spike patterns

    DEFF Research Database (Denmark)

    Srivastava, Kyle H; Holmes, Caroline M; Vellema, Michiel

    2017-01-01

    whether the information in spike timing actually plays a role in brain function. By examining the activity of individual motor units (the muscle fibers innervated by a single motor neuron) and manipulating patterns of activation of these neurons, we provide both correlative and causal evidence......A fundamental problem in neuroscience is understanding how sequences of action potentials ("spikes") encode information about sensory signals and motor outputs. Although traditional theories assume that this information is conveyed by the total number of spikes fired within a specified time...... interval (spike rate), recent studies have shown that additional information is carried by the millisecond-scale timing patterns of action potentials (spike timing). However, it is unknown whether or how subtle differences in spike timing drive differences in perception or behavior, leaving it unclear...

  11. Laryngeal response patterns influence the efficacy of mechanical assisted cough in amyotrophic lateral sclerosis.

    OpenAIRE

    Andersen, Tiina Maarit; Sandnes, Astrid; Brekka, Anne Kristine; Hilland, Magnus; Clemm, Hege; Fondenes, Ove; Tysnes, Ole Bjørn; Heimdal, John-Helge; Halvorsen, Thomas; Vollsæter, Maria; Røksund, Ola Drange

    2016-01-01

    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 v...

  12. Sex differences in cough reflex.

    Science.gov (United States)

    Plevkova, J; Buday, T; Kavalcikova-Bogdanova, N; Ioan, I; Demoulin-Alexikova, S

    2017-11-01

    Majority of patients visiting cough clinics are postmenopausal women, who are affected by intractable cough for years. Why the cough reflex becomes exaggerated in women is not known. Basic research excludes females from the studies contributing to the sex bias which may be responsible for lack of understanding of "hypersensitive" cough in women. Biological and behavioural differences between women and men are the factors affecting cough physiology. Gender also shapes the patterns of behaviour and determines the character of environmental exposures which differs between sexes. The article offers an insight into the physiology of the cough, differences in the maturation of it and biological, social and behavioural factors contributing to the sex differences in cough. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Localization of Motor Neurons and Central Pattern Generators for Motor Patterns Underlying Feeding Behavior in Drosophila Larvae.

    Directory of Open Access Journals (Sweden)

    Sebastian Hückesfeld

    Full Text Available Motor systems can be functionally organized into effector organs (muscles and glands, the motor neurons, central pattern generators (CPG and higher control centers of the brain. Using genetic and electrophysiological methods, we have begun to deconstruct the motor system driving Drosophila larval feeding behavior into its component parts. In this paper, we identify distinct clusters of motor neurons that execute head tilting, mouth hook movements, and pharyngeal pumping during larval feeding. This basic anatomical scaffold enabled the use of calcium-imaging to monitor the neural activity of motor neurons within the central nervous system (CNS that drive food intake. Simultaneous nerve- and muscle-recordings demonstrate that the motor neurons innervate the cibarial dilator musculature (CDM ipsi- and contra-laterally. By classical lesion experiments we localize a set of CPGs generating the neuronal pattern underlying feeding movements to the subesophageal zone (SEZ. Lesioning of higher brain centers decelerated all feeding-related motor patterns, whereas lesioning of ventral nerve cord (VNC only affected the motor rhythm underlying pharyngeal pumping. These findings provide a basis for progressing upstream of the motor neurons to identify higher regulatory components of the feeding motor system.

  14. Motor patterns during walking on a slippery walkway

    NARCIS (Netherlands)

    Cappellini, Germana; Ivanenko, Yuri P; Dominici, Nadia; Poppele, Richard E; Lacquaniti, Francesco

    Friction and gravity represent two basic physical constraints of terrestrial locomotion that affect both motor patterns and the biomechanics of bipedal gait. To provide insights into the spatiotemporal organization of the motor output in connection with ground contact forces, we studied adaptation

  15. Persistent cough in an adolescent.

    Science.gov (United States)

    Stein, M T; Harper, G; Chen, J

    1999-12-01

    Jessica, a 14-year-old girl with a history of asthma, went to her pediatrician's office because of a persistent cough. She had been coughing for at least 3 months with occasional cough-free periods of less than a few days. The cough was nonproductive and was not accompanied by fever, rhinorrhea, or facial or chest pain. Jessica and her mother observed that the cough increased with exercise and typically was not present during sleep. She has used two metered-dose inhalers--albuterol and cromolyn--without any change in the cough pattern. For the past 5 years, Jessica has had mild asthma responsive to albuterol. She enjoys running on the cross-country team, soccer, and dancing. She is an average student and denies any change in academic performance. She has never been hospitalized or had an emergency department visit for asthma or pneumonia. There has been no recent travel or exposure to a person with a chronic productive cough, tobacco smoke, or a live-in pet. Jessica lives with her mother and younger sister in a 10-year-old, carpeted apartment without any evidence of mold or recent renovation. In the process of taking the history, the pediatrician noticed that Jessica coughed intermittently, with two or three coughs during each episode. At times, the cough was harsh; at other times, it was a quiet cough, as if she were clearing her throat. She was cooperative, without overt anxiety or respiratory distress. After a complete physical examination with normal findings, the pediatrician interviewed Jessica and her mother alone. Jessica's parents had been divorced for the past 6 years. She lived with her mother but visited her father, and his new family with two young children, every weekend. She spoke about this arrangement comfortably and said that she loved her father and mother but didn't like the tension she experienced at her father's home. "I don't like adults arguing when kids are around." When asked why she thought the cough persisted so long, she commented in a

  16. Cough & Cold Medicine Abuse

    Science.gov (United States)

    ... Videos for Educators Search English Español Cough & Cold Medicine Abuse KidsHealth / For Teens / Cough & Cold Medicine Abuse ... resfriado Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  17. Pertussis (Whooping Cough)

    Science.gov (United States)

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

  18. Learning new gait patterns: Exploratory muscle activity during motor learning is not predicted by motor modules

    Science.gov (United States)

    Ranganathan, Rajiv; Krishnan, Chandramouli; Dhaher, Yasin Y.; Rymer, William Z.

    2018-01-01

    The motor module hypothesis in motor control proposes that the nervous system can simplify the problem of controlling a large number of muscles in human movement by grouping muscles into a smaller number of modules. Here, we tested one prediction of the modular organization hypothesis by examining whether there is preferential exploration along these motor modules during the learning of a new gait pattern. Healthy college-aged participants learned a new gait pattern which required increased hip and knee flexion during the swing phase while walking in a lower-extremity robot (Lokomat). The new gait pattern was displayed as a foot trajectory in the sagittal plane and participants attempted to match their foot trajectory to this template. We recorded EMG from 8 lower-extremity muscles and we extracted motor modules during both baseline walking and target-tracking using non-negative matrix factorization (NMF). Results showed increased trajectory variability in the first block of learning, indicating that participants were engaged in exploratory behavior. Critically, when we examined the muscle activity during this exploratory phase, we found that the composition of motor modules changed significantly within the first few strides of attempting the new gait pattern. The lack of persistence of the motor modules under even short time scales suggests that motor modules extracted during locomotion may be more indicative of correlated muscle activity induced by the task constraints of walking, rather than reflecting a modular control strategy. PMID:26916510

  19. Suppression of the cough reflex by α2-adrenergic receptor agonists in the rabbit

    Science.gov (United States)

    Cinelli, Elenia; Bongianni, Fulvia; Pantaleo, Tito; Mutolo, Donatella

    2013-01-01

    The α2-adrenergic receptor agonist clonidine has been shown to inhibit citric acid-induced cough responses in guinea pigs when administered by aerosol, but not orally. In contrast, oral or inhaled clonidine had no effect on capsaicin-induced cough and reflex bronchoconstriction in humans. In addition, intravenous administration of clonidine has been shown to depress fentanyl-induced cough in humans. We investigated the effects of the α2-adrenergic receptor agonists, clonidine and tizanidine, on cough responses induced by mechanical and chemical (citric acid) stimulation of the tracheobronchial tree. Drugs were microinjected (30–50 nL) into the caudal nucleus tractus solitarii (cNTS) and the caudal ventral respiratory group (cVRG) as well as administered intravenously in pentobarbital sodium-anesthetized, spontaneously breathing rabbits. Bilateral microinjections of clonidine into the cNTS or the cVRG reduced cough responses at 0.5 mmol/L and abolished the cough reflex at 5 mmol/L. Bilateral microinjections of 0.5 mmol/L tizanidine into the cNTS completely suppressed cough responses, whereas bilateral microinjections of 5 mmol/L into the cVRG only caused mild reductions in them. Depressant effects on the cough reflex of clonidine and tizanidine were completely reverted by microinjections of 10 mmol/L yohimbine. Intravenous administration of clonidine (80–120 μg/kg) or tizanidine (150–300 μg/kg) strongly reduced or completely suppressed cough responses. These effects were reverted by intravenous administration of yohimbine (300 μg/kg). The results demonstrate that activation of α2-adrenergic receptors in the rabbit exerts potent inhibitory effects on the central mechanism generating the cough motor pattern with a clear action at the level of the cNTS and the cVRG. PMID:24400133

  20. Coughing (For Parents)

    Science.gov (United States)

    ... usually don't prescribe antibiotics because these only work against bacteria. Unless a cough won't let your child sleep, cough medicines are not needed. They might help a child stop coughing, but they don't treat the cause of the cough. If you do use an ...

  1. An annoying persistent cough

    Directory of Open Access Journals (Sweden)

    Francesco Cipollini

    2007-03-01

    Full Text Available Chronic cough is a stressful condition and can lead to extensive investigations. We report a case of a 48-year-old woman who had suffered from persistent chronic cough for more than 3 months. She had been treated with cough suppressant. However, her cough was not alleviated by these treatments, and the patient was referred to our hospital. She did not exhibit typical gastroesophageal reflux disease (GERD symptoms heartburn and regurgitation. Esophagoscopy did not disclose reflux esophagitis. The patient was treated with a proton-pump inhibitor, which markedly alleviated her cough. Chronic cough due to GERD was diagnosed. Although the diagnosis of chronic cough due to GERD is not easy when traditionally symptoms are not present, our case report underscores the importance of this association to the differential diagnosis of chronic cough. In these cases a relatively simple test as high dose proton pump-inhibitors trial may be useful to confirm GERD related cough.

  2. Whooping Cough (Pertussis)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Whooping Cough (Pertussis) KidsHealth / For Parents / Whooping Cough (Pertussis) What's in this article? Signs & Symptoms Contagiousness ...

  3. Cough in children.

    Science.gov (United States)

    Lamas, Adelaida; Ruiz de Valbuena, Marta; Máiz, Luis

    2014-07-01

    Cough during childhood is very common, and is one of the most frequent reasons for consultation in daily pediatric practice. The causes differ from those in adults, and specific pediatric guidelines should be followed for correct diagnosis and treatment. The most common cause of cough in children is viral infection producing "normal cough", but all children with persistent cough, i.e. a cough lasting more than 4-8weeks or "chronic cough", must be carefully evaluated in other to rule out specific causes that may include the entire pediatric pulmonology spectrum. The treatment of cough should be based on the etiology. Around 80% of cases can be diagnosed using an optimal approach, and treatment will be effective in 90% of them. In some cases of "nonspecific chronic cough", in which no underlying condition can be found, empirical treatment based on the cough characteristics may be useful. There is no scientific evidence to justify the use of over-the-counter cough remedies (anti-tussives, mucolytics and/or antihistamines), as they could have potentially serious side effects, and thus should not be prescribed in children. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  4. Correlated conductance parameters in leech heart motor neurons contribute to motor pattern formation.

    Science.gov (United States)

    Lamb, Damon G; Calabrese, Ronald L

    2013-01-01

    Neurons can have widely differing intrinsic membrane properties, in particular the density of specific conductances, but how these contribute to characteristic neuronal activity or pattern formation is not well understood. To explore the relationship between conductances, and in particular how they influence the activity of motor neurons in the well characterized leech heartbeat system, we developed a new multi-compartmental Hodgkin-Huxley style leech heart motor neuron model. To do so, we evolved a population of model instances, which differed in the density of specific conductances, capable of achieving specific output activity targets given an associated input pattern. We then examined the sensitivity of measures of output activity to conductances and how the model instances responded to hyperpolarizing current injections. We found that the strengths of many conductances, including those with differing dynamics, had strong partial correlations and that these relationships appeared to be linked by their influence on heart motor neuron activity. Conductances that had positive correlations opposed one another and had the opposite effects on activity metrics when perturbed whereas conductances that had negative correlations could compensate for one another and had similar effects on activity metrics.

  5. Pregnancy and Whooping Cough

    Science.gov (United States)

    ... cough vaccine recommendation for pregnant women, infants and children, preteens and teens, and adults. You may print ... Vaccinating Pregnant Patients Answering Patient Questions Making a Strong ...

  6. Injury patterns among obese children involved in motor vehicle collisions.

    Science.gov (United States)

    Haricharan, Ramanath N; Griffin, Russell L; Barnhart, Douglas C; Harmon, Carroll M; McGwin, Gerald

    2009-06-01

    The purpose of this study was to compare injury patterns among obese children to their nonobese counterparts involved in motor vehicle collisions. A nationwide data collection program containing occupant, collision, and injury details from police-reported tow-away crashes between 1997 and 2006 were used. Risk ratios (RRs) and associated 95% confidence intervals (CIs) were adjusted for age, sex, restraint, seat track position, vehicle curb weight, and total velocity change. An estimated 9 million children aged 2 to 17 years (20.2% obese) were involved in motor vehicle collisions during the study period. Among 2-to-5-year-olds, obesity increased the risk of severe head (RR, 3.67; 95% CI, 1.03-13.08) and thoracic (2.27; 1.01-5.08) injuries. Among 6-to-9-year-olds, obesity increased risk of thoracic (2.31; 1.08-4.95) and lower extremity (LE) injuries (1.89; 1.03-3.47). Among 10-to-13-year-olds, obesity increased the risk of severe thoracic (1.98; 1.08-3.65) and LE (6.06; 2.23-16.44) injuries. Among 14-to-17-year-olds, obesity increased risk of severe LE injuries (1.44; 1.04-2.00) but decreased risk of abdominal (0.20; 0.07-0.60) and head (0.33; 0.18-0.60) injuries, very similar to the pattern reported in obese adults. The pattern of obesity-associated injuries changes from a higher risk of head and thoracic injuries among young children to a pattern in late teenagers that is similar to obese adults.

  7. The impact of lesion location on dysphagia incidence, pattern and complications in acute stroke. Part 2: Oropharyngeal residue, swallow and cough response, and pneumonia.

    Science.gov (United States)

    Suntrup-Krueger, S; Kemmling, A; Warnecke, T; Hamacher, C; Oelenberg, S; Niederstadt, T; Heindel, W; Wiendl, H; Dziewas, R

    2017-06-01

    Dysphagia is a well-known complication of acute stroke. Given the complexity of cerebral swallowing control it is still difficult to predict which patients are likely to develop swallowing dysfunction based on their neuroimaging. In Part 2 of a comprehensive voxel-based imaging study, whether the location of a stroke lesion can be correlated with further dysfunctional swallowing patterns, pulmonary protective reflexes and pneumonia was evaluated. In all, 200 acute stroke cases were investigated applying flexible endoscopic evaluation of swallowing within 96 h from admission. Lesions were mapped using patients' computed tomography/magnetic resonance images and these were registered to a standard space. The percentage of lesioned volume of 137 anatomically defined brain regions was determined on a voxel basis (FSL5.0). Region-specific odds ratios (ORs) were calculated with respect to the presence of oropharyngeal residue, delayed swallow response, insufficient cough reflex and occurrence of pneumonia during hospital stay. Colour-coded lesion location maps of brain regions with significant ORs were created (P pneumonia, but substantial overlap between the last two conditions. This study gives new insights on the cortical representation of single components of swallowing and airway protection behaviours. The lesion model may help to risk-stratify patients for dysphagia and pneumonia based on their brain scan. © 2017 EAN.

  8. First Aid: Coughing

    Science.gov (United States)

    ... this topic for: Parents Kids Teens Flu Center Asthma Center Your Child's Immunizations: Diphtheria, Tetanus & Pertussis Vaccine (DTaP) Whooping Cough (Pertussis) Is It a Cold or the Flu? Why Is Hand Washing So ... Asthma Center Flu Center Whooping Cough Your Lungs & Respiratory ...

  9. Kinematic characteristics of motor patterns in rope skipping

    Directory of Open Access Journals (Sweden)

    Luiz Henrique da Silva

    2009-09-01

    Full Text Available Rope skipping seems to be an easy task to be performed. However, careful analysis of this motor skill shows how complex the execution of this task is. The objective of this study was to examine kinematic variables of jump patterns as a function of skipping frequency. Eight male university students performed a sequence of 30 rope jumps using two jump patterns (alternating support of the feet and simultaneous support of the feet at three skipping frequencies (1.5, 1.7,1.9 Hz. Frequencies were determined with a digital metronome and the rope was turned by the student himself. Rope jumping performance was recorded with two digital cameras for 3Danalysis. Passive markers were attached to the rope and to the ankle, knee and hip joints forcollection of the following dependent variables: continuous relative phase, time interval betweenthe loss of contact of the feet with the ground and cross of the rope under the feet of the volunteer,jump height, and rope height. ANOVA showed that for the pattern with alternating support ofthe feet the jump is executed at a lower height. In addition, analysis of the time interval revealeda delay in the withdrawal of the feet for crossing the rope in the case of the jump pattern with simultaneous support of the feet.

  10. Precise temperature compensation of phase in a rhythmic motor pattern.

    Directory of Open Access Journals (Sweden)

    Lamont S Tang

    2010-08-01

    Full Text Available Most animal species are cold-blooded, and their neuronal circuits must maintain function despite environmental temperature fluctuations. The central pattern generating circuits that produce rhythmic motor patterns depend on the orderly activation of circuit neurons. We describe the effects of temperature on the pyloric rhythm of the stomatogastric ganglion of the crab, Cancer borealis. The pyloric rhythm is a triphasic motor pattern in which the Pyloric Dilator (PD, Lateral Pyloric (LP, and Pyloric (PY neurons fire in a repeating sequence. While the frequency of the pyloric rhythm increased about 4-fold (Q(10 approximately 2.3 as the temperature was shifted from 7 degrees C to 23 degrees C, the phase relationships of the PD, LP, and PY neurons showed almost perfect temperature compensation. The Q(10's of the input conductance, synaptic currents, transient outward current (I(A, and the hyperpolarization-activated inward current (I(h, all of which help determine the phase of LP neuron activity, ranged from 1.8 to 4. We studied the effects of temperature in >1,000 computational models (with different sets of maximal conductances of a bursting neuron and the LP neuron. Many bursting models failed to monotonically increase in frequency as temperature increased. Temperature compensation of LP neuron phase was facilitated when model neurons' currents had Q(10's close to 2. Together, these data indicate that although diverse sets of maximal conductances may be found in identified neurons across animals, there may be strong evolutionary pressure to restrict the Q(10's of the processes that contribute to temperature compensation of neuronal circuits.

  11. Motor Oil Classification using Color Histograms and Pattern Recognition Techniques.

    Science.gov (United States)

    Ahmadi, Shiva; Mani-Varnosfaderani, Ahmad; Habibi, Biuck

    2018-04-20

    Motor oil classification is important for quality control and the identification of oil adulteration. In thiswork, we propose a simple, rapid, inexpensive and nondestructive approach based on image analysis and pattern recognition techniques for the classification of nine different types of motor oils according to their corresponding color histograms. For this, we applied color histogram in different color spaces such as red green blue (RGB), grayscale, and hue saturation intensity (HSI) in order to extract features that can help with the classification procedure. These color histograms and their combinations were used as input for model development and then were statistically evaluated by using linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), and support vector machine (SVM) techniques. Here, two common solutions for solving a multiclass classification problem were applied: (1) transformation to binary classification problem using a one-against-all (OAA) approach and (2) extension from binary classifiers to a single globally optimized multilabel classification model. In the OAA strategy, LDA, QDA, and SVM reached up to 97% in terms of accuracy, sensitivity, and specificity for both the training and test sets. In extension from binary case, despite good performances by the SVM classification model, QDA and LDA provided better results up to 92% for RGB-grayscale-HSI color histograms and up to 93% for the HSI color map, respectively. In order to reduce the numbers of independent variables for modeling, a principle component analysis algorithm was used. Our results suggest that the proposed method is promising for the identification and classification of different types of motor oils.

  12. A central pattern generator producing alternative outputs: pattern, strength, and dynamics of premotor synaptic input to leech heart motor neurons.

    Science.gov (United States)

    Norris, Brian J; Weaver, Adam L; Wenning, Angela; García, Paul S; Calabrese, Ronald L

    2007-11-01

    The central pattern generator (CPG) for heartbeat in medicinal leeches consists of seven identified pairs of segmental heart interneurons and one unidentified pair. Four of the identified pairs and the unidentified pair of interneurons make inhibitory synaptic connections with segmental heart motor neurons. The CPG produces a side-to-side asymmetric pattern of intersegmental coordination among ipsilateral premotor interneurons corresponding to a similarly asymmetric fictive motor pattern in heart motor neurons, and asymmetric constriction pattern of the two tubular hearts, synchronous and peristaltic. Using extracellular recordings from premotor interneurons and voltage-clamp recordings of ipsilateral segmental motor neurons in 69 isolated nerve cords, we assessed the strength and dynamics of premotor inhibitory synaptic output onto the entire ensemble of heart motor neurons and the associated conduction delays in both coordination modes. We conclude that premotor interneurons establish a stereotypical pattern of intersegmental synaptic connectivity, strengths, and dynamics that is invariant across coordination modes, despite wide variations among preparations. These data coupled with a previous description of the temporal pattern of premotor interneuron activity and relative phasing of motor neuron activity in the two coordination modes enable a direct assessment of how premotor interneurons through their temporal pattern of activity and their spatial pattern of synaptic connectivity, strengths, and dynamics coordinate segmental motor neurons into a functional pattern of activity.

  13. Firing patterns of spontaneously active motor units in spinal cord-injured subjects

    NARCIS (Netherlands)

    Zijdewind, Inge; Thomas, Christine K.

    Involuntary motor unit activity at low rates is common in hand muscles paralysed by spinal cord injury. Our aim was to describe these patterns of motor unit behaviour in relation to motoneurone and motor unit properties. Intramuscular electromyographic activity (EMG), surface EMG and force were

  14. Patterns of Weakness, Classification of Motor Neuron Disease, and Clinical Diagnosis of Sporadic Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Statland, Jeffrey M; Barohn, Richard J; McVey, April L; Katz, Jonathan S; Dimachkie, Mazen M

    2015-11-01

    When approaching a patient with suspected motor neuron disease (MND), the pattern of weakness on examination helps distinguish MND from other diseases of peripheral nerves, the neuromuscular junction, or muscle. MND is a clinical diagnosis supported by findings on electrodiagnostic testing. MNDs exist on a spectrum, from a pure lower motor neuron to mixed upper and lower motor neuron to a pure upper motor neuron variant. Amyotrophic lateral sclerosis (ALS) is a progressive mixed upper and lower motor neuron disorder, most commonly sporadic, which is invariably fatal. This article describes a pattern approach to identifying MND and clinical features of sporadic ALS. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Preventing Pertussis (Whooping Cough)

    Science.gov (United States)

    ... causes a whooping sound. They may gag on mucus and throw up after they cough. Not every ... your baby through the placenta and your breast milk. Your baby can get protection from pertussis for ...

  16. Whooping Cough PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    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.

  17. Pertussis (Whooping Cough) Outbreaks

    Science.gov (United States)

    ... of Search Controls Search Form Controls Cancel Submit Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Pertussis Home About Pertussis Causes & Transmission Signs & Symptoms Complications ...

  18. Pertussis (Whooping Cough) Complications

    Science.gov (United States)

    ... of Search Controls Search Form Controls Cancel Submit Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Pertussis Home About Pertussis Causes & Transmission Signs & Symptoms Complications ...

  19. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Sleep/wake firing patterns of human genioglossus motor units.

    Science.gov (United States)

    Bailey, E Fiona; Fridel, Keith W; Rice, Amber D

    2007-12-01

    Although studies of the principal tongue protrudor muscle genioglossus (GG) suggest that whole muscle GG electromyographic (EMG) activities are preserved in nonrapid eye movement (NREM) sleep, it is unclear what influence sleep exerts on individual GG motor unit (MU) activities. We characterized the firing patterns of human GG MUs in wakefulness and NREM sleep with the aim of determining 1) whether the range of MU discharge patterns evident in wakefulness is preserved in sleep and 2) what effect the removal of the "wakefulness" input has on the magnitude of the respiratory modulation of MU activities. Microelectrodes inserted into the extrinsic tongue protrudor muscle, the genioglossus, were used to follow the discharge of single MUs. We categorized MU activities on the basis of the temporal relationship between the spike train and the respiration cycle and quantified the magnitude of the respiratory modulation of each MU using the eta (eta(2)) index, in wakefulness and sleep. The majority of MUs exhibited subtle increases or decreases in respiratory modulation but were otherwise unaffected by NREM sleep. In contrast, 30% of MUs exhibited marked sleep-associated changes in discharge frequency and respiratory modulation. We suggest that GG MUs should not be considered exclusively tonic or phasic; rather, the discharge pattern appears to be a flexible feature of GG activities in healthy young adults. Whether such flexibility is important in the response to changes in the chemical and/or mechanical environment and whether it is preserved as a function of aging or in individuals with obstructive sleep apnea are critical questions for future research.

  1. 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.

  2. Bringing up the rear: new premotor interneurons add regional complexity to a segmentally distributed motor pattern

    Science.gov (United States)

    Norris, Brian J.; Doloc-Mihu, Anca; Calabrese, Ronald L.

    2011-01-01

    Central pattern generators (CPGs) pace and pattern many rhythmic activities. We have uncovered a new module in the heartbeat CPG of leeches that creates a regional difference in this segmentally distributed motor pattern. The core CPG consists of seven identified pairs and one unidentified pair of heart interneurons of which 5 pairs are premotor and inhibit 16 pairs of heart motor neurons. The heartbeat CPG produces a side-to-side asymmetric pattern of activity of the premotor heart interneurons corresponding to an asymmetric fictive motor pattern and an asymmetric constriction pattern of the hearts with regular switches between the two sides. The premotor pattern progresses from rear to front on one side and nearly synchronously on the other; the motor pattern shows corresponding intersegmental coordination, but only from segment 15 forward. In the rearmost segments the fictive motor pattern and the constriction pattern progress from front to rear on both sides and converge in phase. Modeling studies suggested that the known inhibitory inputs to the rearmost heart motor neurons were insufficient to account for this activity. We therefore reexamined the constriction pattern of intact leeches. We also identified electrophysiologically two additional pairs of heart interneurons in the rear. These new heart interneurons make inhibitory connections with the rear heart motor neurons, are coordinated with the core heartbeat CPG, and are dye-coupled to their contralateral homologs. Their strong inhibitory connections with the rearmost heart motor neurons and the small side-to-side phase difference of their bursting contribute to the different motor and beating pattern observed in the animal's rear. PMID:21775711

  3. Patterns of motor recruitment can be determined using surface EMG.

    Science.gov (United States)

    Wakeling, James M

    2009-04-01

    Previous studies have reported how different populations of motor units (MUs) can be recruited during dynamic and locomotor tasks. It was hypothesised that the higher-threshold units would contribute higher-frequency components to the sEMG spectra due to their faster conduction velocities, and thus recruitment patterns that increase the proportion of high-threshold units active would lead to higher-frequency elements in the sEMG spectra. This idea was tested by using a model of varying recruitment coupled to a three-layer volume conductor model to generate a series of sEMG signals. The recruitment varied from (A) orderly recruitment where the lowest-threshold MUs were initially activated and higher-threshold MUs were sequentially recruited as the contraction progressed, (B) a recurrent inhibition model that started with orderly recruitment, but as the higher-threshold units were activated they inhibited the lower-threshold MUs (C) nine models with intermediate properties that were graded between these two extremes. The sEMG was processed using wavelet analysis and the spectral properties quantified by their mean frequency, and an angle theta that was determined from the principal components of the spectra. Recruitment strategies that resulted in a greater proportion of faster MUs being active had a significantly lower theta and higher mean frequency.

  4. 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.

  5. Modulation of the cough reflex by GABAA receptors in the caudal ventral respiratory group of the rabbit

    Directory of Open Access Journals (Sweden)

    Elenia eCinelli

    2012-10-01

    Full Text Available We have previously shown that the caudal ventral respiratory group (cVRG is a possible site of action of some antitussive drugs and plays a crucial role in determining both the expiratory and inspiratory components of the cough motor pattern. In addition, it has been reported that medullary expiratory neurons of the cVRG are subject to potent GABAergic gain modulation. This study was devoted to investigate the role of cVRG GABAA receptors in the control of baseline respiratory activity and cough responses to mechanical and chemical (citric acid stimulation of the tracheobronchial tree. To this purpose, bilateral microinjections (30-50 nl of bicuculline or muscimol were performed into the cVRG of pentobarbital sodium-anesthetized, spontaneously breathing rabbits. Bicuculline (1 mM increased peak abdominal activity and respiratory frequency due to decreases in TE. Cough responses were potentiated mainly owing to increases in the cough number. The recovery was observed within ~ 2 h. On the contrary, muscimol (0.3 mM abolished abdominal activity and decreased respiratory frequency due to increases in TE. In addition, cough responses were progressively reduced and completely suppressed within ~ 20 min. Partial recovery of cough responses was achieved after ~ 3 h or within ~ 5 min following bicuculline microinjections at the same locations. The sneeze reflex induced by mechanical stimulation of the nasal mucosa persisted following bicuculline and muscimol microinjections. However, the number and intensity of expiratory thrusts were enhanced by bicuculline and suppressed by muscimol. The results provide evidence that a potent GABAA-mediated inhibitory modulation is exerted at the level of the cVRG not only on respiratory activity, but also on cough and sneeze reflex responses.

  6. Attentional modulation of reflex cough.

    Science.gov (United States)

    Janssens, Thomas; Silva, Mitchell; Davenport, Paul W; Van Diest, Ilse; Dupont, Lieven J; Van den Bergh, Omer

    2014-07-01

    Reflex cough is a defensive response generated in the brainstem in response to chemical and mechanical stimulation of the airways. However, converging evidence shows that reflex cough is also influenced by central neural control processes. In this study, we investigate whether reflex cough can be modulated by attentional focus on either external stimuli or internal cough-related stimuli. Healthy volunteers (N = 24; seven men; age range, 18-25 years) completed four blocks of citric acid-induced cough challenges while, simultaneously, auditory stimuli were presented. Within each block, four concentrations were administered (30, 100, 300 and 1,000 mM, randomized). During two subsequent blocks, participants focused their attention externally (counting tones). During the other two blocks, participants focused their attention internally (counting coughs). The order of attentional focus was counterbalanced across participants. Ratings of the urge to cough were collected after each challenge. Cough frequency was determined by audio recording. Cough frequency was higher when participants focused their attention internally vs externally (P Reflex cough can be modulated by attentional focus. Internally focused attention may be a mechanism involved in excessive (idiopathic) cough, while an external focus may be introduced as part of treatments targeting excessive cough.

  7. Rapid reorganization of adult rat motor cortex somatic representation patterns after motor nerve injury.

    OpenAIRE

    Sanes, J N; Suner, S; Lando, J F; Donoghue, J P

    1988-01-01

    The potential for peripheral nerve injury to reorganize motor cortical representations was investigated in adult rats. Maps reflecting functional connections between the motor cortex and somatic musculature were generated with intracortical electrical stimulation techniques. Comparison of cortical somatotopic maps obtained in normal rats with maps generated from rats with a facial nerve lesion indicated that the forelimb and eye/eyelid representations expanded into the normal vibrissa area. R...

  8. Peripheral Nerve Injury in Developing Rats Reorganizes Representation Pattern in Motor Cortex

    Science.gov (United States)

    Donoghue, John P.; Sanes, Jerome N.

    1987-02-01

    We investigated the effect of neonatal nerve lesions on cerebral motor cortex organization by comparing the cortical motor representation of normal adult rats with adult rats that had one forelimb removed on the day of birth. Mapping of cerebral neocortex with electrical stimulation revealed an altered relationship between the motor cortex and the remaining muscles. Whereas distal forelimb movements are normally elicited at the lowest threshold in the motor cortex forelimb area, the same stimuli activated shoulder and trunk muscles in experimental animals. In addition, an expanded cortical representation of intact body parts was present and there was an absence of a distinct portion of motor cortex. These data demonstrate that representation patterns in motor cortex can be altered by peripheral nerve injury during development.

  9. 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.

  10. Modeling Hot Spot Motor Vehicle Theft Crime in Relation to Landuse and Settlement Patterns

    Directory of Open Access Journals (Sweden)

    Djaka Marwasta

    2004-01-01

    Full Text Available The crowd of Yogyakarta urban has impacted its surrounding area, including Depok sub district, which is indicated by the rising of physical development, for example education facilities and settlements. The progress does not only bring positive impact, but also negative impact for instance the rising of crime number i.e. motor vehicle robbery. The aims of this research are 1 mapping motor vehicle robbery data as the distribution map and identifying motor vehicle robbery hot spot base on distrbution map; and 2 studying the correlation of motor vehicle robbery hot spot with physical environment phenomena, i.e. land use type and settlement pattern. The research method consists of two parts; they are motor vehicle robbery cluster analysis and the relation of motor vehicle robbery and physical environment analysis. Motor vehicle robbery cluster analysis is using distribution data, which analyzes the distribution into motor vehicle robbery hot spot with nearest neighbor tehnique. Contingency coefficient and frequency distribution analysis is used to analyze the correlation of motor vehicle robbery hot spot and physical environment. Contingency coefficient is used to study the relation of motor vehicle robbery hot spot polygon with physical environment condition, whereas frequency distribution is used to study the distribution of motor vehicle robbery in the hot spot with physical environment condition. Physical environment which consists of land use type, housing density, house regularity pattern, and the average of building size, are obtained from interpretation of black and white panchromatic aerial photograph year 2000, in the scale 1 : 20.000. the most motor vehicle robbery hot spot is found on the settlement area, 68,3% from 378 motor vehicle robbery cases in the hot spot. The seond level is found on the education area (16.4%. The most motor vehicle hot spot in the settlement is found on the hight density and irregular settlement, which have big

  11. 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.

  12. Striatal Dopamine Depletion Patterns and Early Non-Motor Burden in Parkinsons Disease.

    Directory of Open Access Journals (Sweden)

    Su Jin Chung

    Full Text Available The mechanism underlying non-motor symptoms in Parkinson's disease has not yet been elucidated. In this study, we hypothesized that Parkinson patients with more non-motor symptoms have a different pattern of striatal dopamine depletion, particularly in areas other than the sensorimotor striatum, compared to those with fewer non-motor symptoms.We conducted a prospective survey of the degree of non-motor symptoms (using the Korean version of the Non-Motor Symptoms Scale; K-NMSS in 151 patients with early-stage Parkinson's disease who had undergone a dopamine transporter PET scan as an initial diagnostic procedure. We classified the patients into two groups; high non-motor patients (HNM-PD; K-NMSS score ≥ 41 and low non-motor patients (LNM-PD.Patients in the HNM-PD group (n = 71 were older, had longer symptom duration, exhibited more severe motor deficits, and had been prescribed higher levodopa-equivalent doses at follow-up than those in the LNM-PD group. However, dopamine transporter binding to the striatal sub-regions and inter-sub-regional binding ratios were comparable between the two groups. A general linear model showed that the HNM-PD group had significantly more severe motor deficits than the LNM-PD group after controlling for age, gender, symptom duration, and dopamine transporter binding to the sensorimotor striatum.This study demonstrated that the pattern of striatal dopamine depletion does not contribute to early non-motor burden in Parkinson's disease. Our results suggest that LNM-PD patients may have a more benign course of motor symptom progression than HNM-PD patients.

  13. A central pattern generator producing alternative outputs: phase relations of leech heart motor neurons with respect to premotor synaptic input.

    Science.gov (United States)

    Norris, Brian J; Weaver, Adam L; Wenning, Angela; García, Paul S; Calabrese, Ronald L

    2007-11-01

    The central pattern generator (CPG) for heartbeat in leeches consists of seven identified pairs of segmental heart interneurons and one unidentified pair. Four of the identified pairs and the unidentified pair of interneurons make inhibitory synaptic connections with segmental heart motor neurons. The CPG produces a side-to-side asymmetric pattern of intersegmental coordination among ipsilateral premotor interneurons corresponding to a similarly asymmetric fictive motor pattern in heart motor neurons, and asymmetric constriction pattern of the two tubular hearts: synchronous and peristaltic. Using extracellular techniques, we recorded, in 61 isolated nerve cords, the activity of motor neurons in conjunction with the phase reference premotor heart interneuron, HN(4), and another premotor interneuron that allowed us to assess the coordination mode. These data were then coupled with a previous description of the temporal pattern of premotor interneuron activity in the two coordination modes to synthesize a global phase diagram for the known elements of the CPG and the entire motor neuron ensemble. These average data reveal the stereotypical side-to-side asymmetric patterns of intersegmental coordination among the motor neurons and show how this pattern meshes with the activity pattern of premotor interneurons. Analysis of animal-to-animal variability in this coordination indicates that the intersegmental phase progression of motor neuron activity in the midbody in the peristaltic coordination mode is the most stereotypical feature of the fictive motor pattern. Bilateral recordings from motor neurons corroborate the main features of the asymmetric motor pattern.

  14. Description of nighttime cough epochs in patients with stable COPD GOLD II-IV.

    Science.gov (United States)

    Fischer, Patrick; Gross, Volker; Kroenig, Johannes; Weissflog, Andreas; Hildebrandt, Olaf; Sohrabi, Keywan; Koehler, Ulrich

    Chronic cough is one of the main symptoms of COPD. Ambulatory objective monitoring provides novel insights into the determinants and characteristics of nighttime cough in COPD. Nighttime cough was monitored objectively by LEOSound lung sound monitor in patients with stable COPD II-IV. In 30 patients, with 10 patients in each stage group, nighttime cough was analyzed for epoch frequency, epoch severity (epoch length and coughs per epoch), and pattern (productive or nonproductive). Cough was found in all patients ranging from 1 to 294 events over the recording period. In 29 patients, cough epochs were monitored, ranging from 1 to 75 epochs. The highest amount of cough epochs was found in patients with COPD stage III. Active smokers had significantly more productive cough epochs (61%) than nonsmokers (24%). We found a high rate of nighttime cough epochs in patients with COPD, especially in those in stage III. Productive cough was predominantly found in patients with persistent smoking. LEOSound lung sound monitor offers a practical and valuable opportunity to evaluate cough objectively.

  15. Recognizing and Preventing Whooping Cough

    Centers for Disease Control (CDC) Podcasts

    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.

  16. Patterned-string tasks: relation between fine motor skills and visual-spatial abilities in parrots.

    Directory of Open Access Journals (Sweden)

    Anastasia Krasheninnikova

    Full Text Available String-pulling and patterned-string tasks are often used to analyse perceptual and cognitive abilities in animals. In addition, the paradigm can be used to test the interrelation between visual-spatial and motor performance. Two Australian parrot species, the galah (Eolophus roseicapilla and the cockatiel (Nymphicus hollandicus, forage on the ground, but only the galah uses its feet to manipulate food. I used a set of string pulling and patterned-string tasks to test whether usage of the feet during foraging is a prerequisite for solving the vertical string pulling problem. Indeed, the two species used techniques that clearly differed in the extent of beak-foot coordination but did not differ in terms of their success in solving the string pulling task. However, when the visual-spatial skills of the subjects were tested, the galahs outperformed the cockatiels. This supports the hypothesis that the fine motor skills needed for advanced beak-foot coordination may be interrelated with certain visual-spatial abilities needed for solving patterned-string tasks. This pattern was also found within each of the two species on the individual level: higher motor abilities positively correlated with performance in patterned-string tasks. This is the first evidence of an interrelation between visual-spatial and motor abilities in non-mammalian animals.

  17. Motor unit recruitment patterns 1: responses to changes in locomotor velocity and incline.

    Science.gov (United States)

    Hodson-Tole, Emma F; Wakeling, James M

    2008-06-01

    Mammalian skeletal muscles are composed of a mixture of motor unit types, which contribute a range of mechanical and physiological properties to the muscle. For a muscle to effectively contribute to smooth, co-ordinated movement it must activate an appropriate number and combination of motor units to generate the required force over a suitable time period. Much evidence exists indicating that motor units are activated in an orderly fashion, from the slowest through to the fastest. A growing body of evidence, however, indicates that such a recruitment strategy does not always hold true. Here we investigate how motor unit recruitment patterns were influenced by changes in locomotor velocity and incline. Kinematics data and myoelectric signals were collected from three rat ankle extensor muscles during running on a treadmill at nine velocity and incline combinations. Wavelet and principal component analysis were used to simultaneously decompose the signals into time and frequency space. The relative frequency components of the signals were quantified during 20 time windows of a stride from each locomotor condition. Differences in signal frequency components existed between muscles and locomotor conditions. Faster locomotor velocities led to a relative increase in high frequency components, whereas greater inclines led to a relative increase in the low frequency components. These data were interpreted as representing changes in motor unit recruitment patterns in response to changes in the locomotor demand. Motor units were not always recruited in an orderly manner, indicating that recruitment is a multi-factorial phenomenon that is not yet fully understood.

  18. Discharge patterns of human genioglossus motor units during arousal from sleep.

    Science.gov (United States)

    Wilkinson, Vanessa; Malhotra, Atul; Nicholas, Christian L; Worsnop, Christopher; Jordan, Amy S; Butler, Jane E; Saboisky, Julian P; Gandevia, Simon C; White, David P; Trinder, John

    2010-03-01

    Single motor unit recordings of the human genioglossus muscle reveal motor units with a variety of discharge patterns. Integrated multiunit electromyographic recordings of genioglossus have demonstrated an abrupt increase in the muscle's activity at arousal from sleep. The aim of the present study was to determine the effect of arousal from sleep on the activity of individual motor units as a function of their particular discharge pattern. Genioglossus activity was measured using intramuscular fine-wire electrodes inserted via a percutaneous approach. Arousals from sleep were identified using the ASDA criterion and the genioglossus electromyogram recordings analyzed for single motor unit activity. Sleep research laboratory. Sleep and respiratory data were collected in 8 healthy subjects (6 men). 138 motor units were identified during prearousalarousal sleep: 25% inspiratory phasic, 33% inspiratory tonic, 4% expiratory phasic, 3% expiratory tonic, and 35% tonic. At arousal from sleep inspiratory phasic units significantly increased the proportion of a breath over which they were active, but did not appreciably increase their rate of firing. 80 new units were identified at arousals, 75% were inspiratory, many of which were active for only 1 or 2 breaths. 22% of units active before arousal, particularly expiratory and tonic units, stopped at the arousal. Increased genioglossus muscle activity at arousal from sleep is primarily due to recruitment of inspiratory phasic motor units. Further, activity within the genioglossus motoneuron pool is reorganized at arousal as, in addition to recruitment, approximately 20% of units active before arousals stopped firing.

  19. Suboptimal Muscle Synergy Activation Patterns Generalize their Motor Function across Postures.

    Science.gov (United States)

    Sohn, M Hongchul; Ting, Lena H

    2016-01-01

    We used a musculoskeletal model to investigate the possible biomechanical and neural bases of using consistent muscle synergy patterns to produce functional motor outputs across different biomechanical conditions, which we define as generalizability. Experimental studies in cats demonstrate that the same muscle synergies are used during reactive postural responses at widely varying configurations, producing similarly-oriented endpoint force vectors with respect to the limb axis. However, whether generalizability across postures arises due to similar biomechanical properties or to neural selection of a particular muscle activation pattern has not been explicitly tested. Here, we used a detailed cat hindlimb model to explore the set of feasible muscle activation patterns that produce experimental synergy force vectors at a target posture, and tested their generalizability by applying them to different test postures. We used three methods to select candidate muscle activation patterns: (1) randomly-selected feasible muscle activation patterns, (2) optimal muscle activation patterns minimizing muscle effort at a given posture, and (3) generalizable muscle activation patterns that explicitly minimized deviations from experimentally-identified synergy force vectors across all postures. Generalizability was measured by the deviation between the simulated force direction of the candidate muscle activation pattern and the experimental synergy force vectors at the test postures. Force angle deviations were the greatest for the randomly selected feasible muscle activation patterns (e.g., >100°), intermediate for effort-wise optimal muscle activation patterns (e.g., ~20°), and smallest for generalizable muscle activation patterns (e.g., synergy force vector was reduced by ~45% when generalizability requirements were imposed. Muscles recruited in the generalizable muscle activation patterns had less sensitive torque-producing characteristics to changes in postures. We

  20. PHYTOTHERAPY OF COUGH IN CHILDREN

    Directory of Open Access Journals (Sweden)

    O.A. Danilyuk

    2008-01-01

    Full Text Available Characteristics of treatment of cough in children with herbal medications are presented in this article. Poly therapeutic effect of medicinal plants, its high biological activity, relatively low toxicity and wide therapeutic index explain a need of phyto therapy use in treatment of cough. Advantages of phyto therapy are described, children's doses, ways of application of herbal extracts are given. The use of plants depending on the stage of disease and principles of combination of herbal medications during treatment are described.Key words: phyto therapy, cough, medicinal plants.

  1. Examining Differences in Patterns of Sensory and Motor Recovery After Stroke With Robotics.

    Science.gov (United States)

    Semrau, Jennifer A; Herter, Troy M; Scott, Stephen H; Dukelow, Sean P

    2015-12-01

    Developing a better understanding of the trajectory and timing of stroke recovery is critical for developing patient-centered rehabilitation approaches. Here, we quantified proprioceptive and motor deficits using robotic technology during the first 6 months post stroke to characterize timing and patterns in recovery. We also make comparisons of robotic assessments to traditional clinical measures. One hundred sixteen subjects with unilateral stroke were studied at 4 time points: 1, 6, 12, and 26 weeks post stroke. Subjects performed robotic assessments of proprioceptive (position sense and kinesthesia) and motor function (unilateral reaching task and bimanual object hit task), as well as several clinical measures (Functional Independence Measure, Purdue Pegboard, and Chedoke-McMaster Stroke Assessment). One week post stroke, many subjects displayed proprioceptive (48% position sense and 68% kinesthesia) and motor impairments (80% unilateral reaching and 85% bilateral movement). Interindividual recovery on robotic measures was highly variable. However, we characterized recovery as early (normal by 6 weeks post stroke), late (normal by 26 weeks post stroke), or incomplete (impaired at 26 weeks post stroke). Proprioceptive and motor recovery often followed different timelines. Across all time points, robotic measures were correlated with clinical measures. These results highlight the need for more sensitive, targeted identification of sensory and motor deficits to optimize rehabilitation after stroke. Furthermore, the trajectory of recovery for some individuals with mild to moderate stroke may be much longer than previously considered. © 2015 American Heart Association, Inc.

  2. Patterns of motor activity in the isolated nerve cord of the octopus arm.

    Science.gov (United States)

    Gutfreund, Yoram; Matzner, Henry; Flash, Tamar; Hochner, Binyamin

    2006-12-01

    The extremely flexible octopus arm provides a unique opportunity for studying movement control in a highly redundant motor system. We describe a novel preparation that allows analysis of the peripheral nervous system of the octopus arm and its interaction with the muscular and mechanosensory elements of the arm's intrinsic muscular system. First we examined the synaptic responses in muscle fibers to identify the motor pathways from the axial nerve cord of the arm to the surrounding musculature. We show that the motor axons project to the muscles via nerve roots originating laterally from the arm nerve cord. The motor field of each nerve is limited to the region where the nerve enters the arm musculature. The same roots also carry afferent mechanosensory information from the intrinsic muscle to the axial nerve cord. Next, we characterized the pattern of activity generated in the dorsal roots by electrically stimulating the axial nerve cord. The evoked activity, although far reaching and long lasting, cannot alone account for the arm extension movements generated by similar electrical stimulation. The mismatch between patterns of activity in the isolated cord and in an intact arm may stem from the involvement of mechanosensory feedback in natural arm extension.

  3. Motor unit activation patterns during concentric wrist flexion in humans with different muscle fibre composition.

    Science.gov (United States)

    Søgaard, K; Christensen, H; Fallentin, N; Mizuno, M; Quistorff, B; Sjøgaard, G

    1998-10-01

    Muscle activity was recorded from the flexor carpi radialis muscle during static and dynamic-concentric wrist flexion in six subjects, who had exhibited large differences in histochemically identified muscle fibre composition. Motor unit recruitment patterns were identified by sampling 310 motor units and counting firing rates in pulses per second (pps). During concentric wrist flexion at 30% of maximal exercise intensity the mean firing rate was 27 (SD 13) pps. This was around twice the value of 12 (SD 5) pps recorded during sustained static contraction at 30% of maximal voluntary contraction, despite a larger absolute force level during the static contraction. A similar pattern of higher firing rates during dynamic exercise was seen when concentric wrist flexion at 60% of maximal exercise intensity [30 (SD 14) pps] was compared with sustained static contraction at 60% of maximal voluntary contraction [19 (SD 8) pps]. The increase in dynamic exercise intensity was accomplished by recruitment of additional motor units rather than by increasing the firing rate as during static contractions. No difference in mean firing rates was found among subjects with different muscle fibre composition, who had previously exhibited marked differences in metabolic response during corresponding dynamic contractions. It was concluded that during submaximal dynamic contractions motor unit firing rate cannot be deduced from observations during static contractions and that muscle fibre composition may play a minor role.

  4. Evidence for a general stiffening motor control pattern in neck pain: a cross sectional study.

    Science.gov (United States)

    Meisingset, Ingebrigt; Woodhouse, Astrid; Stensdotter, Ann-Katrin; Stavdahl, Øyvind; Lorås, Håvard; Gismervik, Sigmund; Andresen, Hege; Austreim, Kristian; Vasseljen, Ottar

    2015-03-17

    Neck pain is associated with several alterations in neck motion and motor control. Previous studies have investigated single constructs of neck motor control, while few have applied a comprehensive set of tests to investigate cervical motor control. This comparative cross- sectional study aimed to investigate different motor control constructs in neck pain patients and healthy controls. A total of 166 subjects participated in the study, 91 healthy controls (HC) and 75 neck pain patients (NP) with long-lasting moderate to severe neck pain. Neck flexibility, proprioception, head steadiness, trajectory movement control, and postural sway were assessed using a 3D motion tracking system (Liberty). The different constructs of neck motion and motor control were based on tests used in previous studies. Neck flexibility was lower in NP compared to HC, indicated by reduced cervical ROM and conjunct motion. Movement velocity was slower in NP compared to HC. Tests of head steadiness showed a stiffer movement pattern in NP compared to HC, indicated by lower head angular velocity. NP patients departed less from a predictable trajectory movement pattern (figure of eight) compared to healthy controls, but there was no difference for unpredictable movement patterns (the Fly test). No differences were found for postural sway in standing with eyes open and eyes closed. However, NP patients had significantly larger postural sway when standing on a balance pad. Proprioception did not differ between the groups. Largest effect sizes (ES) were found for neck flexibility (ES range: 0.2-0.8) and head steadiness (ES range: 1.3-2.0). Neck flexibility was the only construct that showed a significant association with current neck pain, while peak velocity was the only variable that showed a significant association with kinesiophobia. NP patients showed an overall stiffer and more rigid neck motor control pattern compared to HC, indicated by lower neck flexibility, slower movement velocity

  5. 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.

  6. Cough-induced rib fractures.

    Science.gov (United States)

    Hanak, Viktor; Hartman, Thomas E; Ryu, Jay H

    2005-07-01

    To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the Mayo Clinic in Rochester, Minn, over a 9-year period between January 1, 1996, and January 31, 2005. Bone densitometry data from patients' medical records were analyzed, and T scores were used to classify patients into bone density categories. The mean +/- SD age of the 54 study patients at presentation was 55+/-17 years, and 42 patients (78%) were female. Patients presented with chest wall pain after onset of cough. Rib fracture was associated with chronic cough (> or =3 weeks' duration) in 85% of patients. Rib fractures were documented by chest radiography, rib radiography, computed tomography, or bone scan. Chest radiography had been performed in 52 patients and revealed rib fracture in 30 (58%). There were 112 fractured ribs in 54 patients. One half of patients had more than one fractured rib. Right-sided rib fractures alone were present in 17 patients (26 fractured ribs), left-sided in 23 patients (35 fractured ribs), and bilateral in 14 patients (51 fractured ribs). The most commonly fractured rib on both sides was rib 6. The fractures were most common at the lateral aspect of the rib cage. Bone densitometry was done in 26 patients and revealed osteopenia or osteoporosis in 17 (65%). Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.

  7. Major motor atrophic patterns in the face and neck: CT evaluation

    International Nuclear Information System (INIS)

    Harnsberger, H.R.; Dillon, W.P.

    1985-01-01

    Cranial nerve deficits from various pathologic processes of the head and neck may result in characteristic patterns of denervation muscular atrophy. Such atrophic patterns may be clues to the location and extent of the lesion, particularly when cranial nerves are involved early in the course of the disease process. Thirty-six patients with computed tomographic (CT) evidence of muscular atrophy secondary to pathologic conditions involving the motor division of cranial nerves were examined. Five characteristic denervation muscular atrophy patterns seen on CT scans were identified. Recognition of these atrophic patterns can prevent misinterpretation of their CT appearance and direct the CT examination to the course of the compromised cranial nerve from the brainstem to its peripheral innervation

  8. Cough-induced rib fractures.

    Science.gov (United States)

    Sano, Atsushi; Tashiro, Ken; Fukuda, Tsutomu

    2015-10-01

    Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures. Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing. Rib radiography was performed, focusing on the location of the chest pain. When the patient had other signs and symptoms such as fever or persistent cough, computed tomography of the chest was carried out. We analyzed the data retrospectively. Rib fractures were found in 14 of the 17 patients. The age of the patients ranged from 14 to 86 years (median 39.5 years). Ten patients were female and 4 were male. Three patients had chronic lung disease. There was a single rib fracture in 9 patients, and 5 had two or more fractures. The middle and lower ribs were the most commonly involved; the 10th rib was fractured most frequently. Cough-induced rib fractures occur in every age group regardless of the presence or absence of underlying disease. Since rib fractures often occur in the lower and middle ribs, rib radiography is useful for diagnosis. © The Author(s) 2015.

  9. Discharge patterns of human tensor palatini motor units during sleep onset.

    Science.gov (United States)

    Nicholas, Christian L; Jordan, Amy S; Heckel, Leila; Worsnop, Christopher; Bei, Bei; Saboisky, Julian P; Eckert, Danny J; White, David P; Malhotra, Atul; Trinder, John

    2012-05-01

    Upper airway muscles such as genioglossus (GG) and tensor palatini (TP) reduce activity at sleep onset. In GG reduced muscle activity is primarily due to inspiratory modulated motor units becoming silent, suggesting reduced respiratory pattern generator (RPG) output. However, unlike GG, TP shows minimal respiratory modulation and presumably has few inspiratory modulated motor units and minimal input from the RPG. Thus, we investigated the mechanism by which TP reduces activity at sleep onset. The activity of TP motor units were studied during relaxed wakefulness and over the transition from wakefulness to sleep. Sleep laboratory. Nine young (21.4 ± 3.4 years) males were studied on a total of 11 nights. Sleep onset. Two TP EMGs (thin, hooked wire electrodes), and sleep and respiratory measures were recorded. One hundred twenty-one sleep onsets were identified (13.4 ± 7.2/subject), resulting in 128 motor units (14.3 ± 13.0/subject); 29% of units were tonic, 43% inspiratory modulated (inspiratory phasic 18%, inspiratory tonic 25%), and 28% expiratory modulated (expiratory phasic 21%, expiratory tonic 7%). There was a reduction in both expiratory and inspiratory modulated units, but not tonic units, at sleep onset. Reduced TP activity was almost entirely due to de-recruitment. TP showed a similar distribution of motor units as other airway muscles. However, a greater proportion of expiratory modulated motor units were active in TP and these expiratory units, along with inspiratory units, tended to become silent over sleep onset. The data suggest that both expiratory and inspiratory drive components from the RPG are reduced at sleep onset in TP.

  10. Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.

    Science.gov (United States)

    Canning, Brendan J; Chang, Anne B; Bolser, Donald C; Smith, Jaclyn A; Mazzone, Stuart B; McGarvey, Lorcan

    2014-12-01

    Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves innervating other viscera, as well as somatosensory nerves innervating the chest wall, diaphragm, and abdominal musculature regulate cough patterning and cough sensitivity. The responsiveness and morphology of the airway vagal sensory nerve subtypes and the extrapulmonary sensory nerves that regulate coughing are described. The brainstem and higher brain control systems that process this sensory information are complex, but our current understanding of them is considerable and increasing. The relevance of these neural systems to clinical phenomena, such as urge to cough and psychologic methods for treatment of dystussia, is high, and modern imaging methods have revealed potential neural substrates for some features of cough in the human.

  11. Distinct brain metabolic patterns separately associated with cognition, motor function, and aging in Parkinson's disease dementia.

    Science.gov (United States)

    Ko, Ji Hyun; Katako, Audrey; Aljuaid, Maram; Goertzen, Andrew L; Borys, Andrew; Hobson, Douglas E; Kim, Seok Min; Lee, Chong Sik

    2017-12-01

    We explored whether patients with Parkinson's disease dementia (PDD) show a distinct spatial metabolic pattern that characterizes cognitive deficits in addition to motor dysfunction. Eighteen patients with PDD underwent 3 separate positron emission tomography sessions with [ 18 F]fluorodeoxyglucose (for glucose metabolism), fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane (for dopamine transporter density) and Pittsburgh compound-B (for beta-amyloid load). We confirmed in PDD versus normal controls, overall hypometabolism in the posterior and prefrontal brain regions accompanied with hypermetabolism in subcortical structures and the cerebellar vermis. A multivariate network analysis then revealed 3 metabolic patterns that are separately associated with cognitive performance (p = 0.042), age (p = 0.042), and motor symptom severity (p = 0.039). The age-related pattern's association with aging was replicated in healthy controls (p = 0.047) and patients with Alzheimer's disease (p = 0.002). The cognition-related pattern's association with cognitive performance was observed, with a trend-level of correlation, in patients with dementia with Lewy bodies (p = 0.084) but not in patients with Alzheimer's disease (p = 0.974). We found no association with fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane and Pittsburgh compound-B positron emission tomography with patients' cognitive performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Premotor spinal network with balanced excitation and inhibition during motor patterns has high resilience to structural division

    DEFF Research Database (Denmark)

    Petersen, Peter C; Vestergaard, Mikkel; Reveles Jensen, Kristian

    2014-01-01

    Direct measurements of synaptic inhibition (I) and excitation (E) to spinal motoneurons can provide an important insight into the organization of premotor networks. Such measurements of flexor motoneurons participating in motor patterns in turtles have recently demonstrated strong concurrent E...

  13. Railway train versus motor vehicle collisions: a comparative study of injury severity and patterns.

    Science.gov (United States)

    Kligman, M D; Knotts, F B; Buderer, N M; Kerwin, A J; Rodgers, J F

    1999-11-01

    This study compares the demographics, injury severity, resource use, and injury patterns of patients involved in railway train-motor vehicle (RT-MV) to motor vehicle-motor vehicle (MV-MV) collisions. Retrospective trauma registry review of 74 RT-MV and 1,931 MV-MV consecutive patients, age more than 14 years, presenting to two Level I trauma centers, January of 1991 to May of 1998. Compared with MV-MV, RT-MV had significantly more males (72% vs. 54%), higher mortality (15% vs. 7%), higher Injury Severity Score (median, 20 vs. 9), longer intensive care unit length of stay (1.7 vs. 0.04 days), and longer hospital length of stay (7.5 vs. 4 days). RT-MV patients had a higher percentage of scalp/facial lacerations; intracranial hemorrhage; hemothorax and pneumothorax; fractures of the rib/sternum, upper extremity, skull, and face; and lung, splenic, and renal injuries. After adjusting for the difference in Injury Severity Score between groups, the only remaining significant group difference was the odds of a scalp/facial laceration. RT-MV collisions are a marker for more severe injuries, but not a different pattern of injury, compared with MV-MV collisions.

  14. 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.

  15. Cough aerosol in healthy participants: fundamental knowledge to optimize droplet-spread infectious respiratory disease management.

    Science.gov (United States)

    Zayas, Gustavo; Chiang, Ming C; Wong, Eric; MacDonald, Fred; Lange, Carlos F; Senthilselvan, Ambikaipakan; King, Malcolm

    2012-03-21

    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. 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. 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. 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 (< 1 μm) predominated the total number of droplets expelled when coughing. The cough aerosol is the single source of direct, indirect and/or airborne transmission of respiratory infections like the Influenza A H1N1 virus. Open bench, Observational, Cough, Aerosol study. © 2012 Zayas et al; licensee BioMed Central Ltd.

  16. Temporal components of the motor patterns expressed by the human spinal cord reflect foot kinematics.

    Science.gov (United States)

    Ivanenko, Yuri P; Grasso, Renato; Zago, Myrka; Molinari, Marco; Scivoletto, Giorgio; Castellano, Vincenzo; Macellari, Velio; Lacquaniti, Francesco

    2003-11-01

    What are the building blocks with which the human spinal cord constructs the motor patterns of locomotion? In principle, they could correspond to each individual activity pattern in dozens of different muscles. Alternatively, there could exist a small set of constituent temporal components that are common to all activation patterns and reflect global kinematic goals. To address this issue, we studied patients with spinal injury trained to step on a treadmill with body weight support. Patients learned to produce foot kinematics similar to that of healthy subjects but with activity patterns of individual muscles generally different from the control group. Hidden in the muscle patterns, we found a basic set of five temporal components, whose flexible combination accounted for the wide range of muscle patterns recorded in both controls and patients. Furthermore, two of the components were systematically related to foot kinematics across different stepping speeds and loading conditions. We suggest that the components are related to control signals output by spinal pattern generators, normally under the influence of descending and afferent inputs.

  17. An overview of post infectious coughs

    Directory of Open Access Journals (Sweden)

    Samrad Mehrabi

    2016-03-01

    Full Text Available Coughs lasting more than 3 weeks after airway infections are likely regarded as post-infectious coughs. A normal chest radiography unfavors possibility of pulmonary infection. These coughs are selflimited. This study reviews conducted studies in order to identify and define prevalence, pathogenesis, and cure of post-infectious constant coughs. The necessary data and guidelines are gained from English articles in PubMed website. Post-infectious and cough are searched. Post-infectious cough pathogenesis are not known; nevertheless, inflammation, epithelial damages of upper and lower airways, increased mucus secretion, and an increased reactivity of airways can cause these coughs. Despite self-limitedness of these coughs; dextromethorphan, antihistamines, ipratropium bromide, and decongestant are usually prescribed for cure of these coughs. Conversely, antibiotics play no significant role in this regard. These coughs constitutes smaller percentage of chronic coughs and are primarily classified in subacute coughs. Further studies should cover sub-acute and chronic properties of these coughs as well as their prevalence in different age groups and their determinants.

  18. Flip, flop and fly: modulated motor control and highly variable movement patterns of autotomized gecko tails.

    Science.gov (United States)

    Higham, Timothy E; Russell, Anthony P

    2010-02-23

    Many animals lose and regenerate appendages, and tail autotomy in lizards is an extremely well-studied example of this. Whereas the energetic, ecological and functional ramifications of tail loss for many lizards have been extensively documented, little is known about the behaviour and neuromuscular control of the autotomized tail. We used electromyography and high-speed video to quantify the motor control and movement patterns of autotomized tails of leopard geckos (Eublepharis macularius). In addition to rhythmic swinging, we show that they exhibit extremely complex movement patterns for up to 30 min following autotomy, including acrobatic flips up to 3 cm in height. Unlike the output of most central pattern generators (CPGs), muscular control of the tail is variable and can be arrhythmic. We suggest that the gecko tail is well suited for studies involving CPGs, given that this spinal preparation is naturally occurring, requires no surgery and exhibits complex modulation.

  19. Non-stationary discharge patterns in motor cortex under subthalamic nucleus deep brain stimulation.

    Science.gov (United States)

    Santaniello, Sabato; Montgomery, Erwin B; Gale, John T; Sarma, Sridevi V

    2012-01-01

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) directly modulates the basal ganglia (BG), but how such stimulation impacts the cortex upstream is largely unknown. There is evidence of cortical activation in 6-hydroxydopamine (OHDA)-lesioned rodents and facilitation of motor evoked potentials in Parkinson's disease (PD) patients, but the impact of the DBS settings on the cortical activity in normal vs. Parkinsonian conditions is still debated. We use point process models to analyze non-stationary activation patterns and inter-neuronal dependencies in the motor and sensory cortices of two non-human primates during STN DBS. These features are enhanced after treatment with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which causes a consistent PD-like motor impairment, while high-frequency (HF) DBS (i.e., ≥100 Hz) strongly reduces the short-term patterns (period: 3-7 ms) both before and after MPTP treatment, and elicits a short-latency post-stimulus activation. Low-frequency DBS (i.e., ≤50 Hz), instead, has negligible effects on the non-stationary features. Finally, by using tools from the information theory [i.e., receiver operating characteristic (ROC) curve and information rate (IR)], we show that the predictive power of these models is dependent on the DBS settings, i.e., the probability of spiking of the cortical neurons (which is captured by the point process models) is significantly conditioned on the timely delivery of the DBS input. This dependency increases with the DBS frequency and is significantly larger for high- vs. low-frequency DBS. Overall, the selective suppression of non-stationary features and the increased modulation of the spike probability suggest that HF STN DBS enhances the neuronal activation in motor and sensory cortices, presumably because of reinforcement mechanisms, which perhaps involve the overlap between feedback antidromic and feed-forward orthodromic responses along the BG-thalamo-cortical loop.

  20. Muscle activation patterns and motor anatomy of Anna's hummingbirds Calypte anna and zebra finches Taeniopygia guttata.

    Science.gov (United States)

    Donovan, Edward R; Keeney, Brooke K; Kung, Eric; Makan, Sirish; Wild, J Martin; Altshuler, Douglas L

    2013-01-01

    Flying animals exhibit profound transformations in anatomy, physiology, and neural architecture. Although much is known about adaptations in the avian skeleton and musculature, less is known about neuroanatomy and motor unit integration for bird flight. Hummingbirds are among the most maneuverable and specialized of vertebrate fliers, and two unusual neuromuscular features have been previously reported: (1) the pectoralis major has a unique distribution pattern of motor end plates (MEPs) compared with all other birds and (2) electromyograms (EMGs) from the hummingbird's pectoral muscles, the pectoralis major and the supracoracoideus, show activation bursts composed of one or a few spikes that appear to have a very consistent pattern. Here, we place these findings in a broader context by comparing the MEPs, EMGs, and organization of the spinal motor neuron pools of flight muscles of Anna's hummingbird Calypte anna, zebra finches Taeniopygia guttata, and, for MEPs, several other species. The previously shown MEP pattern of the hummingbird pectoralis major is not shared with its closest taxonomic relative, the swift, and appears to be unique to hummingbirds. MEP arrangements in previously undocumented wing muscles show patterns that differ somewhat from other avian muscles. In the parallel-fibered strap muscles of the shoulder, MEP patterns appear to relate to muscle length, with the smallest muscles having fibers that span the entire muscle. MEP patterns in pennate distal wing muscles were the same regardless of size, with tightly clustered bands in the middle portion of the muscle, not evenly distributed bands over the muscle's entire length. Muscle activations were examined during slow forward flight in both species, during hovering in hummingbirds, and during slow ascents in zebra finches. The EMG bursts of a wing muscle, the pronator superficialis, were highly variable in peak number, size, and distribution across wingbeats for both species. In the pectoralis

  1. Chronic dry cough: Diagnostic and management approaches

    Directory of Open Access Journals (Sweden)

    Ashok Mahashur

    2015-01-01

    Full Text Available Cough is the most common symptom for which medical treatment is sought in the outpatient setting. Chronic dry cough poses a great diagnostic and management challenge due to myriad etiologies. Chronic cough has been commonly considered to be caused by gastroesophageal reflux, post-nasal drip or asthma. However, recent evidences suggest that many patients with these conditions do not have cough, and in those with cough, the response to specific treatments is unpredictable at best. This raises questions about the concept of a triad of treatable causes for chronic cough. This article discusses the mechanism and etiology of cough, along with recent advances in the field of cough, highlighting some of the diagnostic and management challenges.

  2. Turtle Flexion Reflex Motor Patterns Show Windup, Mediated Partly by L-type Calcium Channels

    Directory of Open Access Journals (Sweden)

    Keith P. Johnson

    2017-10-01

    Full Text Available Windup is a form of multisecond temporal summation in which identical stimuli, delivered seconds apart, trigger increasingly strong neuronal responses. L-type Ca2+ channels have been shown to play an important role in the production of windup of spinal cord neuronal responses, initially in studies of turtle spinal cord and later in studies of mammalian spinal cord. L-type Ca2+ channels have also been shown to contribute to windup of limb withdrawal reflex (flexion reflex in rats, but flexion reflex windup has not previously been described in turtles and its cellular mechanisms have not been studied. We studied windup of flexion reflex motor patterns, evoked with weak mechanical and electrical stimulation of the dorsal hindlimb foot skin and assessed via a hip flexor (HF nerve recording, in spinal cord-transected and immobilized turtles in vivo. We found that an L-type Ca2+ channel antagonist, nifedipine, applied at concentrations of 50 μM or 100 μM to the hindlimb enlargement spinal cord, significantly reduced windup of flexion reflex motor patterns, while lower concentrations of nifedipine had no such effect. Nifedipine similarly reduced the amplitude of an individual flexion reflex motor pattern evoked by a stronger mechanical stimulus, in a dose-dependent manner, suggesting that L-type Ca2+ channels contribute to each flexion reflex as well as to multisecond summation of flexion reflex responses in turtles. We also found that we could elicit flexion reflex windup consistently using a 4-g von Frey filament, which is not usually considered a nociceptive stimulus. Thus, it may be that windup can be evoked by a wide range of tactile stimuli and that L-type calcium channels contribute to multisecond temporal summation of diverse tactile stimuli across vertebrates.

  3. Variations in motor unit recruitment patterns occur within and between muscles in the running rat (Rattus norvegicus).

    Science.gov (United States)

    Hodson-Tole, E F; Wakeling, J M

    2007-07-01

    Motor units are generally considered to follow a set, orderly pattern of recruitment within each muscle with activation occurring in the slowest through to the fastest units. A growing body of evidence, however, suggests that recruitment patterns may not always follow such an orderly sequence. Here we investigate whether motor unit recruitment patterns vary within and between the ankle extensor muscles of the rat running at 40 cm s(-1) on a level treadmill. In the past it has been difficult to quantify motor unit recruitment patterns during locomotion; however, recent application of wavelet analysis techniques has made such detailed analysis of motor unit recruitment possible. Here we present methods for quantifying the interplay of fast and slow motor unit recruitment based on their myoelectric signals. Myoelectric data were collected from soleus, plantaris and medial gastrocnemius muscles representing populations of slow, mixed and fast fibres, respectively, and providing a good opportunity to relate myoelectric frequency content to motor unit recruitment patterns. Following wavelet transformation, principal component analysis quantified signal intensity and relative frequency content. Significant differences in signal frequency content occurred between different time points within a stride (Pmotor units. The goodness-of-fit of the optimised wavelets to the signal intensity was high for all three muscles (r2>0.98). The low-frequency band had a significantly better fit to signals from the soleus muscle (P<0.001), while the high-frequency band had a significantly better fit to the medial gastrocnemius (P<0.001).

  4. Firing patterns of spontaneously active motor units in spinal cord-injured subjects.

    Science.gov (United States)

    Zijdewind, Inge; Thomas, Christine K

    2012-04-01

    Involuntary motor unit activity at low rates is common in hand muscles paralysed by spinal cord injury. Our aim was to describe these patterns of motor unit behaviour in relation to motoneurone and motor unit properties. Intramuscular electromyographic activity (EMG), surface EMG and force were recorded for 30 min from thenar muscles of nine men with chronic cervical SCI. Motor units fired for sustained periods (>10 min) at regular (coefficient of variation ≤ 0.15, CV, n =19 units) or irregular intervals (CV>0.15, n =14). Regularly firing units started and stopped firing independently suggesting that intrinsic motoneurone properties were important for recruitment and derecruitment. Recruitment (3.6 Hz, SD 1.2), maximal (10.2 Hz, SD 2.3, range: 7.5-15.4 Hz) and derecruitment frequencies were low (3.3 Hz, SD 1.6), as were firing rate increases after recruitment (~20 intervals in 3 s). Once active, firing often covaried, promoting the idea that units received common inputs.Half of the regularly firing units showed a very slow decline (>40 s) in discharge before derecruitment and had interspike intervals longer than their estimated after hyperpolarisation potential (AHP) duration (estimated by death rate and breakpoint analyses). The other units were derecruited more abruptly and had shorter estimated AHP durations. Overall, regularly firing units had longer estimated AHP durations and were weaker than irregularly firing units, suggesting they were lower threshold units. Sustained firing of units at regular rates may reflect activation of persistent inward currents, visible here in the absence of voluntary drive, whereas irregularly firing units may only respond to synaptic noise.

  5. Encoding sensory and motor patterns as time-invariant trajectories in recurrent neural networks.

    Science.gov (United States)

    Goudar, Vishwa; Buonomano, Dean V

    2018-03-14

    Much of the information the brain processes and stores is temporal in nature-a spoken word or a handwritten signature, for example, is defined by how it unfolds in time. However, it remains unclear how neural circuits encode complex time-varying patterns. We show that by tuning the weights of a recurrent neural network (RNN), it can recognize and then transcribe spoken digits. The model elucidates how neural dynamics in cortical networks may resolve three fundamental challenges: first, encode multiple time-varying sensory and motor patterns as stable neural trajectories; second, generalize across relevant spatial features; third, identify the same stimuli played at different speeds-we show that this temporal invariance emerges because the recurrent dynamics generate neural trajectories with appropriately modulated angular velocities. Together our results generate testable predictions as to how recurrent networks may use different mechanisms to generalize across the relevant spatial and temporal features of complex time-varying stimuli. © 2018, Goudar et al.

  6. Cough during infancy and subsequent childhood asthma.

    Science.gov (United States)

    Oren, E; Rothers, J; Stern, D A; Morgan, W J; Halonen, M; Wright, A L

    2015-09-01

    Wheezing in infancy has been associated with subsequent asthma, but whether cough similarly influences asthma risk has been little studied. We sought to determine whether prolonged cough and cough without cold in the first year of life are associated with childhood asthma. Participants in the Infant Immune Study, a non-selected birth cohort, were surveyed 7 times in the first 9 months of life regarding the presence of wheeze and cough. Cough for more than 28 days was defined as prolonged. Parents were asked at 1 year if the child ever coughed without a cold. Asthma was defined as parental report of physician diagnosis of asthma, with symptoms or medication use between 2 and 9 years. Logistic regression was used to assess adjusted odds for asthma associated with cough characteristics. A total of 24% (97) of children experienced prolonged cough and 23% (95) cough without cold in the first 9 months, respectively. Prolonged cough was associated with increased risk of asthma relative to brief cough (OR 3.57, CI: 1.88, 6.76), with the risk being particularly high among children of asthmatic mothers. Cough without cold (OR 3.13, 95% CI: 1.76, 5.57) was also independently associated with risk of childhood asthma. Both relations persisted after adjustment for wheeze and total IgE at age 1. Prolonged cough in infancy and cough without cold are associated with childhood asthma, independent of infant wheeze. These findings suggest that characteristics of cough in infancy are early markers of asthma susceptibility, particularly among children with maternal asthma. © 2015 John Wiley & Sons Ltd.

  7. Communication Deficits and the Motor System: Exploring Patterns of Associations in Autism Spectrum Disorder (ASD)

    Science.gov (United States)

    Mody, M.; Shui, A. M.; Nowinski, L. A.; Golas, S. B.; Ferrone, C.; O'Rourke, J. A.; McDougle, C. J.

    2017-01-01

    Many children with autism spectrum disorder (ASD) have notable difficulties in motor, speech and language domains. The connection between motor skills (oral-motor, manual-motor) and speech and language deficits reported in other developmental disorders raises important questions about a potential relationship between motor skills and…

  8. Endogenous rhythm and pattern-generating circuit interactions in cockroach motor centres

    Directory of Open Access Journals (Sweden)

    Izhak David

    2016-09-01

    Full Text Available Cockroaches are rapid and stable runners whose gaits emerge from the intricate, and not fully resolved, interplay between endogenous oscillatory pattern-generating networks and sensory feedback that shapes their rhythmic output. Here we studied the endogenous motor output of a brainless, deafferented preparation. We monitored the pilocarpine-induced rhythmic activity of levator and depressor motor neurons in the mesothoracic and metathoracic segments in order to reveal the oscillatory networks’ architecture and interactions. Data analyses included phase relations, latencies between and overlaps of rhythmic bursts, spike frequencies, and the dependence of these parameters on cycle frequency. We found that, overall, ipsilateral connections are stronger than contralateral ones. Our findings revealed asymmetries in connectivity among the different ganglia, in which meta-to-mesothoracic ascending coupling is stronger than meso-to-metathoracic descending coupling. Within-ganglion coupling between the metathoracic hemiganglia is stronger than that in the mesothoracic ganglion. We also report differences in the role and mode of operation of homologue network units (manifested by levator and depressor nerve activity. Many observed characteristics are similar to those exhibited by intact animals, suggesting a dominant role for feedforward control in cockroach locomotion. Based on these data we posit a connectivity scheme among components of the locomotion pattern generating system.

  9. Pressure-flow characteristics of normal and disordered esophageal motor patterns.

    Science.gov (United States)

    Singendonk, Maartje M J; Kritas, Stamatiki; Cock, Charles; Ferris, Lara F; McCall, Lisa; Rommel, Nathalie; van Wijk, Michiel P; Benninga, Marc A; Moore, David; Omari, Taher I

    2015-03-01

    To perform pressure-flow analysis (PFA) in a cohort of pediatric patients who were referred for diagnostic manometric investigation. PFA was performed using purpose designed Matlab-based software. The pressure-flow index (PFI), a composite measure of bolus pressurization relative to flow and the impedance ratio, a measure of the extent of bolus clearance failure were calculated. Tracings of 76 pediatric patients (32 males; 9.1 ± 0.7 years) and 25 healthy adult controls (7 males; 36.1 ± 2.2 years) were analyzed. Patients mostly had normal motility (50%) or a category 4 disorder and usually weak peristalsis (31.5%) according to the Chicago Classification. PFA of healthy controls defined reference ranges for PFI ≤142 and impedance ratio ≤0.49. Pediatric patients with pressure-flow (PF) characteristics within these limits had normal motility (62%), most patients with PF characteristics outside these limits also had an abnormal Chicago Classification (61%). Patients with high PFI and disordered motor patterns all had esophagogastric junction outflow obstruction. Disordered PF characteristics are associated with disordered esophageal motor patterns. By defining the degree of over-pressurization and/or extent of clearance failure, PFA may be a useful adjunct to esophageal pressure topography-based classification. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Ineffective cough and mechanical mucociliary clearance techniques.

    Science.gov (United States)

    Fernández-Carmona, A; Olivencia-Peña, L; Yuste-Ossorio, M E; Peñas-Maldonado, L

    Cough is a fundamental defense mechanism for keeping the airway free of foreign elements. Life-threatening situations may arise when cough proves ineffective as a result of muscle weakness or altered mucociliary function. When a patient is unable to cough effectively, techniques are required to either reinforce or replace cough capacity. The use of mechanical systems that facilitate or substitute cough function is increasingly common in Intensive Care Units, where it is relatively frequent to find situations of ineffective cough due to different clinical causes. This review examines the current clinical practice recommendations referred to the indication and use of mechanical cough assist and intrapulmonary percussive ventilation systems. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  11. Optimizing spatial patterns with sparse filter bands for motor-imagery based brain-computer interface.

    Science.gov (United States)

    Zhang, Yu; Zhou, Guoxu; Jin, Jing; Wang, Xingyu; Cichocki, Andrzej

    2015-11-30

    Common spatial pattern (CSP) has been most popularly applied to motor-imagery (MI) feature extraction for classification in brain-computer interface (BCI) application. Successful application of CSP depends on the filter band selection to a large degree. However, the most proper band is typically subject-specific and can hardly be determined manually. This study proposes a sparse filter band common spatial pattern (SFBCSP) for optimizing the spatial patterns. SFBCSP estimates CSP features on multiple signals that are filtered from raw EEG data at a set of overlapping bands. The filter bands that result in significant CSP features are then selected in a supervised way by exploiting sparse regression. A support vector machine (SVM) is implemented on the selected features for MI classification. Two public EEG datasets (BCI Competition III dataset IVa and BCI Competition IV IIb) are used to validate the proposed SFBCSP method. Experimental results demonstrate that SFBCSP help improve the classification performance of MI. The optimized spatial patterns by SFBCSP give overall better MI classification accuracy in comparison with several competing methods. The proposed SFBCSP is a potential method for improving the performance of MI-based BCI. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Severe aberrant glenohumeral motor patterns in a young female rower: A case report

    Directory of Open Access Journals (Sweden)

    McGurk Neal

    2007-11-01

    Full Text Available Abstract Background This case features an 18-year-old female with glenohumeral dysrhythmia and subluxation-relocation patterns. This unusual case highlights the need for careful examination and consideration to the anatomical structures involved. Conventional approaches to shoulder examination include range of motion, orthopaedic tests and manual resistance tests. We also assessed the patient's cognitive ability to coordinate muscle function. With this type of assessment we found that co-contraction of local muscle groups seemed to initially improve the patients abnormal shoulder motion. With this information a rehabilitation method was instituted with a goal to maintain the improvement. Case presentation An 18-year-old female with no history of trauma, presented with painless kinesiopathology of the left shoulder (in abduction consisting of dysrhythmia of the glenohumeral joint and early lateral rotation of the scapula. Examination also showed associated muscle atrophy of the lower trapezius and surrounding general muscle weakness. We used an untested functional assessment method in addition to more conventional methods. Exercise rehabilitation interventions were subsequently prescribed and graduated in accordance with what is known as the General Physical Rehabilitation Pyramid. Conclusion This paper presents an unusual case of aberrant shoulder movement. It highlights the need for careful examination and thought regarding the anatomical structures and normal motor patterns associated with the manoeuvre being tested. It also emphasised the use of co-contraction during examination in an attempt to immediately improve a regional dysrythmia if there is suspicion of a regional aberrant motor pattern. Further research may be warranted to test this approach.

  13. Cellular basis for singing motor pattern generation in the field cricket (Gryllus bimaculatus DeGeer)

    Science.gov (United States)

    Schöneich, Stefan; Hedwig, Berthold

    2012-01-01

    The singing behavior of male crickets allows analyzing a central pattern generator (CPG) that was shaped by sexual selection for reliable production of species-specific communication signals. After localizing the essential ganglia for singing in Gryllus bimaculatus, we now studied the calling song CPG at the cellular level. Fictive singing was initiated by pharmacological brain stimulation. The motor pattern underlying syllables and chirps was recorded as alternating spike bursts of wing-opener and wing-closer motoneurons in a truncated wing nerve; it precisely reflected the natural calling song. During fictive singing, we intracellularly recorded and stained interneurons in thoracic and abdominal ganglia and tested their impact on the song pattern by intracellular current injections. We identified three interneurons of the metathoracic and first unfused abdominal ganglion that rhythmically de- and hyperpolarized in phase with the syllable pattern and spiked strictly before the wing-opener motoneurons. Depolarizing current injection in two of these opener interneurons caused additional rhythmic singing activity, which reliably reset the ongoing chirp rhythm. The closely intermeshing arborizations of the singing interneurons revealed the dorsal midline neuropiles of the metathoracic and three most anterior abdominal neuromeres as the anatomical location of singing pattern generation. In the same neuropiles, we also recorded several closer interneurons that rhythmically hyper- and depolarized in the syllable rhythm and spiked strictly before the wing-closer motoneurons. Some of them received pronounced inhibition at the beginning of each chirp. Hyperpolarizing current injection in the dendrite revealed postinhibitory rebound depolarization as one functional mechanism of central pattern generation in singing crickets. PMID:23170234

  14. Motor control patterns during an active straight leg raise in pain-free subjects.

    Science.gov (United States)

    Beales, Darren John; O'Sullivan, Peter Bruce; Briffa, N Kathryn

    2009-01-01

    Repeated measures. To investigate motor control (MC) patterns of normal subjects during the low level physical load of the active straight leg raise (ASLR). Aberrant MC patterns, as observed with the ASLR test, are considered to be a mechanism for ongoing pain and disability in subjects with chronic musculoskeletal pelvic girdle pain. These patterns may not only affect the provision of lumbopelvic stability, but also respiration and the control of continence. Greater understanding of MC patterns in pain-free subjects may improve the management of pelvic girdle pain. METHODS.: Fourteen pain-free nulliparous women were examined during the ASLR. Electromyography of the anterior abdominal wall, right chest wall and the anterior scaleni, intraabdominal pressure (IAP), intrathoracic pressure (ITP), respiratory rate, pelvic floor kinematics, and downward leg pressure of the nonlifted leg were compared between a left and right ASLR. There was greater activation of obliquus internus abdominis and obliquus externus abdominis on the side of the ASLR. The predominant pattern of activation for the chest wall was tonic activation during an ipsilateral ASLR, and phasic respiratory activation lifting the contralateral leg. Respiratory fluctuation of both IAP and ITP did not differ lifting either leg. The baseline shifts of these pressure variables in response to the physical demand of lifting the leg was also the same either side. There was no difference in respiratory rate, pelvic floor kinematics, or downward leg pressure. Pain-free subjects demonstrate a predominant pattern of greater ipsilateral tonic activation of the abdominal wall and chest wall on the side of the ASLR. This was achieved with minimal apparent disruption to IAP and ITP. The findings of this study demonstrate the plastic nature of the abdominal cylinder and the flexibility of the neuromuscular system in controlling load transference during an ASLR.

  15. Motor Neurons

    DEFF Research Database (Denmark)

    Hounsgaard, Jorn

    2017-01-01

    Motor neurons translate synaptic input from widely distributed premotor networks into patterns of action potentials that orchestrate motor unit force and motor behavior. Intercalated between the CNS and muscles, motor neurons add to and adjust the final motor command. The identity and functional...... in in vitro preparations is far from complete. Nevertheless, a foundation has been provided for pursuing functional significance of intrinsic response properties in motoneurons in vivo during motor behavior at levels from molecules to systems....

  16. Filter Bank Regularized Common Spatial Pattern Ensemble for Small Sample Motor Imagery Classification.

    Science.gov (United States)

    Park, Sang-Hoon; Lee, David; Lee, Sang-Goog

    2018-02-01

    For the last few years, many feature extraction methods have been proposed based on biological signals. Among these, the brain signals have the advantage that they can be obtained, even by people with peripheral nervous system damage. Motor imagery electroencephalograms (EEG) are inexpensive to measure, offer a high temporal resolution, and are intuitive. Therefore, these have received a significant amount of attention in various fields, including signal processing, cognitive science, and medicine. The common spatial pattern (CSP) algorithm is a useful method for feature extraction from motor imagery EEG. However, performance degradation occurs in a small-sample setting (SSS), because the CSP depends on sample-based covariance. Since the active frequency range is different for each subject, it is also inconvenient to set the frequency range to be different every time. In this paper, we propose the feature extraction method based on a filter bank to solve these problems. The proposed method consists of five steps. First, motor imagery EEG is divided by a using filter bank. Second, the regularized CSP (R-CSP) is applied to the divided EEG. Third, we select the features according to mutual information based on the individual feature algorithm. Fourth, parameter sets are selected for the ensemble. Finally, we classify using ensemble based on features. The brain-computer interface competition III data set IVa is used to evaluate the performance of the proposed method. The proposed method improves the mean classification accuracy by 12.34%, 11.57%, 9%, 4.95%, and 4.47% compared with CSP, SR-CSP, R-CSP, filter bank CSP (FBCSP), and SR-FBCSP. Compared with the filter bank R-CSP ( , ), which is a parameter selection version of the proposed method, the classification accuracy is improved by 3.49%. In particular, the proposed method shows a large improvement in performance in the SSS.

  17. 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 acidic reflux such as receptors highly sensitive to acid and receptors for bile acids. The nature of sensory pathways from the nose and their activators relevant for 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Esophageal motor disease and reflux patterns in patients with advanced pulmonary disease undergoing lung transplant evaluation.

    Science.gov (United States)

    Seccombe, J; Mirza, F; Hachem, R; Gyawali, C P

    2013-08-01

    Advanced pulmonary disorders are linked to esophageal hypomotility and reflux disease. However, characterization of esophageal function using high resolution manometry (HRM) and ambulatory pH monitoring, segregation by pulmonary pathology, and comparison to traditional reflux disease are all limited in the literature. Over a 4 year period, 73 patients (55.2 ± 1.3 years, 44F) were identified who underwent esophageal function testing as part of lung transplant evaluation for advanced pulmonary disease (interstitial lung disease, ILD = 47, obstructive lung disease, OLD = 24, other = 2). Proportions of patients with motor dysfunction (≥ 80% failed sequences = severe hypomotility) and/or abnormal reflux parameters (acid exposure time, AET ≥ 4%) were determined, and compared to a cohort of 1081 patients (48.4 ± 0.4 years, 613F) referred for esophageal function testing prior to antireflux surgery (ARS). The proportion of esophageal body hypomotility was significantly higher within advanced pulmonary disease categories (35.6%), particularly ILD (44.7%), compared to ARS patients (12.1%, P esophageal motor pattern or reflux evidence. Interstitial lung disease has a highly significant association with esophageal body hypomotility. Consequently, prevalence of abnormal esophageal acid exposure is high, but implications for post lung transplant chronic rejection remain unclear. © 2013 John Wiley & Sons Ltd.

  19. Identifying patterns of motor performance, executive functioning, and verbal ability in preschool children: A latent profile analysis.

    Science.gov (United States)

    Houwen, Suzanne; Kamphorst, Erica; van der Veer, Gerda; Cantell, Marja

    2018-04-30

    A relationship between motor performance and cognitive functioning is increasingly being recognized. Yet, little is known about the precise nature of the relationship between both domains, especially in early childhood. To identify distinct constellations of motor performance, executive functioning (EF), and verbal ability in preschool aged children; and to explore how individual and contextual variables are related to profile membership. The sample consisted of 119 3- to 4-year old children (62 boys; 52%). The home based assessments consisted of a standardized motor test (Movement Assessment Battery for Children - 2), five performance-based EF tasks measuring inhibition and working memory, and the Receptive Vocabulary subtest from the Wechsler Preschool and Primary Scale of Intelligence Third Edition. Parents filled out the Behavior Rating Inventory of Executive Function - Preschool version. Latent profile analysis (LPA) was used to delineate profiles of motor performance, EF, and verbal ability. Chi-square statistics and multinomial logistic regression analysis were used to examine whether profile membership was predicted by age, gender, risk of motor coordination difficulties, ADHD symptomatology, language problems, and socioeconomic status (SES). LPA yielded three profiles with qualitatively distinct response patterns of motor performance, EF, and verbal ability. Quantitatively, the profiles showed most pronounced differences with regard to parent ratings and performance-based tests of EF, as well as verbal ability. Risk of motor coordination difficulties and ADHD symptomatology were associated with profile membership, whereas age, gender, language problems, and SES were not. Our results indicate that there are distinct subpopulations of children who show differential relations with regard to motor performance, EF, and verbal ability. The fact that we found both quantitative as well as qualitative differences between the three patterns of profiles underscores

  20. Multisubject Learning for Common Spatial Patterns in Motor-Imagery BCI

    Directory of Open Access Journals (Sweden)

    Dieter Devlaminck

    2011-01-01

    Full Text Available Motor-imagery-based brain-computer interfaces (BCIs commonly use the common spatial pattern filter (CSP as preprocessing step before feature extraction and classification. The CSP method is a supervised algorithm and therefore needs subject-specific training data for calibration, which is very time consuming to collect. In order to reduce the amount of calibration data that is needed for a new subject, one can apply multitask (from now on called multisubject machine learning techniques to the preprocessing phase. Here, the goal of multisubject learning is to learn a spatial filter for a new subject based on its own data and that of other subjects. This paper outlines the details of the multitask CSP algorithm and shows results on two data sets. In certain subjects a clear improvement can be seen, especially when the number of training trials is relatively low.

  1. [Automatic Classification of Dry Cough and Wet Cough Based on Improved Reverse Mel Frequency Cepstrum Coefficients].

    Science.gov (United States)

    Zhu, Chunmei; Liu, Baojun; Li, Ping; Mo, Hongqiang; Zheng, Zeguang

    2016-04-01

    Automatic classification of different types of cough plays an important role in clinical.In the previous research of cough classification or cough recognition,traditional Mel frequency cepstrum coefficients(MFCC)which extracts feature mainly from low frequency band is usually used as feature expression.In this paper,by analyzing the distributions of spectral energy of dry/wet cough,it is found that spectral difference of two types of cough exits mainly in middle frequency band and high frequency band.To better reflect the spectral difference of dry cough and wet cough,an improved method of extracting reverse MFCC is proposed.In this method,reverse Mel filter-bank in which filters are allocated in reverse Mel scale is adopted and is improved by placing filters only in the frequency band with high spectral energy.As a result,features are mainly extracted from the frequency band where two types of cough show both high spectral energy and distinguished difference.Detailed process of accessing improved reverse MFCC was introduced and hidden Markov models trained by 60 dry cough and 60 wet cough were used as cough classification model.Classification experiment results for 120 dry cough and 85 wet cough showed that,compared to traditional MFCC,better classification performance was achieved by the proposed method and the total classification accuracy was raised from 89.76%to 93.66%.

  2. 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.

  3. Interactions between posture and locomotion: motor patterns in humans walking with bent posture versus erect posture.

    Science.gov (United States)

    Grasso, R; Zago, M; Lacquaniti, F

    2000-01-01

    Human erect locomotion is unique among living primates. Evolution selected specific biomechanical features that make human locomotion mechanically efficient. These features are matched by the motor patterns generated in the CNS. What happens when humans walk with bent postures? Are normal motor patterns of erect locomotion maintained or completely reorganized? Five healthy volunteers walked straight and forward at different speeds in three different postures (regular, knee-flexed, and knee- and trunk-flexed) while their motion, ground reaction forces, and electromyographic (EMG) activity were recorded. The three postures imply large differences in the position of the center of body mass relative to the body segments. The elevation angles of the trunk, pelvis, and lower limb segments relative to the vertical in the sagittal plane, the ground reaction forces and the rectified EMGs were analyzed over the gait cycle. The waveforms of the elevation angles along the gait cycle remained essentially unchanged irrespective of the adopted postures. The first two harmonics of these kinematic waveforms explain >95% of their variance. The phase shift but not the amplitude ratio between the first harmonic of the elevation angle waveforms of adjacent pairs was affected systematically by changes in posture. Thigh, shank, and foot angles covaried close to a plane in all conditions, but the plane orientation was systematically different in bent versus erect locomotion. This was explained by the changes in the temporal coupling among the three segments. For walking speeds >1 m s(-1), the plane orientation of bent locomotion indicates a much lower mechanical efficiency relative to erect locomotion. Ground reaction forces differed prominently in bent versus erect posture displaying characteristics intermediate between those typical of walking and those of running. Mean EMG activity was greater in bent postures for all recorded muscles independent of the functional role. The waveforms

  4. Antibiotics for whooping cough (pertussis).

    Science.gov (United States)

    Altunaiji, S; Kukuruzovic, R; Curtis, N; Massie, J

    2007-07-18

    Whooping cough is a highly contagious disease. Infants are at highest risk of severe disease and death. Erythromycin for 14 days is currently recommended for treatment and contact prophylaxis, but is of uncertain benefit. To study the benefits and risks of antibiotic treatment of and contact prophylaxis against whooping cough. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library Issue 1, 2007); MEDLINE (January 1966 to March 2007); EMBASE (January 1974 to March 2007). All randomised and quasi-randomised controlled trials of antibiotics for treatment of, and contact prophylaxis against, whooping cough. Three to four review authors independently extracted data and assessed the quality of each trial. Thirteen trials with 2197 participants met the inclusion criteria: 11 trials investigated treatment regimens; 2 investigated prophylaxis regimens. The quality of the trials was variable.Short-term antibiotics (azithromycin for three to five days, or clarithromycin or erythromycin for seven days) were as effective as long-term (erythromycin for 10 to 14 days) in eradicating Bordetella pertussis (B. pertussis) from the nasopharynx (relative risk (RR) 1.02, 95% confidence interval (CI) 0.98 to 1.05), but had fewer side effects (RR 0.66, 95% CI 0.52 to 0.83). Trimethoprim/sulfamethoxazole for seven days was also effective. Nor were there differences in clinical outcomes or microbiological relapse between short and long-term antibiotics. Contact prophylaxis of contacts older than six months of age with antibiotics did not significantly improve clinical symptoms or the number of cases developing culture-positive B. pertussis. Although antibiotics were effective in eliminating B. pertussis, they did not alter the subsequent clinical course of the illness. There is insufficient evidence to determine the benefit of prophylactic treatment of pertussis contacts.

  5. Gastro-oesophageal reflux and cough.

    Science.gov (United States)

    Abdulqawi, Rayid; Houghton, Lesley A; Smith, Jaclyn A

    2013-05-01

    Gastro-oesophageal reflux, either singly or in association with postnasal drip and/or asthma is considered to be a cause of chronic cough. The amount and nature of gastro-oesophageal reflux however is often normal with acid suppression having very little, if any therapeutic effect in these patients. This review examines the challenges posed when exploring the reflux-cough link, and discusses the merits and limitations of the proposed mechanisms of reflux leading to cough.

  6. Motor unit firing rate patterns during voluntary muscle force generation: a simulation study

    Science.gov (United States)

    Hu, Xiaogang; Rymer, William Z.; Suresh, Nina L.

    2014-04-01

    Objective. Muscle force is generated by a combination of motor unit (MU) recruitment and changes in the discharge rate of active MUs. There have been two basic MU recruitment and firing rate paradigms reported in the literature, which describe the control of the MUs during force generation. The first (termed the reverse ‘onion skin’ profile), exhibits lower firing rates for lower threshold units, with higher firing rates occurring in higher threshold units. The second (termed the ‘onion skin’ profile), exhibits an inverse arrangement, with lower threshold units reaching higher firing rates. Approach. Using a simulation of the MU activity in a hand muscle, this study examined the force generation capacity and the variability of the muscle force magnitude at different excitation levels of the MU pool under these two different MU control paradigms. We sought to determine which rate/recruitment scheme was more efficient for force generation, and which scheme gave rise to the lowest force variability. Main results. We found that the force output of both firing patterns leads to graded force output at low excitation levels, and that the force generation capacity of the two different paradigms diverged around 50% excitation. In the reverse ‘onion skin’ pattern, at 100% excitation, the force output reached up to 88% of maximum force, whereas for the ‘onion skin’ pattern, the force output only reached up to 54% of maximum force at 100% excitation. The force variability was lower at the low to moderate force levels under the ‘onion skin’ paradigm than with the reverse ‘onion skin’ firing patterns, but this effect was reversed at high force levels. Significance. This study captures the influence of MU recruitment and firing rate organization on muscle force properties, and our results suggest that the different firing organizations can be beneficial at different levels of voluntary muscle force generation and perhaps for different tasks.

  7. Afferent nerves regulating the cough reflex: Mechanisms and Mediators of Cough in Disease

    Science.gov (United States)

    Canning, Brendan J.

    2010-01-01

    Bronchopulmonary C-fibers and acid-sensitive, capsaicin-insensitive mechanoreceptors innervating the larynx, trachea and large bronchi regulate the cough reflex. These vagal afferent nerves may interact centrally with sensory input arising from afferent nerves innervating the intrapulmonary airways or even extrapulmonary afferents such as those innervating the nasal mucosa and esophagus to produce chronic cough or enhanced cough responsiveness. The mechanisms of cough initiation in health and in disease are briefly described. PMID:20172253

  8. Peripheral nerve injury in developing rats reorganizes representation pattern in motor cortex.

    OpenAIRE

    Donoghue, J P; Sanes, J N

    1987-01-01

    We investigated the effect of neonatal nerve lesions on cerebral motor cortex organization by comparing the cortical motor representation of normal adult rats with adult rats that had one forelimb removed on the day of birth. Mapping of cerebral neocortex with electrical stimulation revealed an altered relationship between the motor cortex and the remaining muscles. Whereas distal forelimb movements are normally elicited at the lowest threshold in the motor cortex forelimb area, the same stim...

  9. Abnormal motor patterns in the framework of the equilibrium-point hypothesis: a cause for dystonic movements?

    Science.gov (United States)

    Latash, M L; Gutman, S R

    1994-01-01

    Until now, the equilibrium-point hypothesis (lambda model) of motor control has assumed nonintersecting force-length characteristics of the tonic stretch reflex for individual muscles. Limited data from animal experiments suggest, however, that such intersections may occur. We have assumed the possibility of intersection of the characteristics of the tonic stretch reflex and performed a computer simulation of movement trajectories and electromyographic patterns. The simulation has demonstrated, in particular, that a transient change in the slope of the characteristic of an agonist muscle may lead to temporary movement reversals, hesitations, oscillations, and multiple electromyographic bursts that are typical of movements of patients with dystonia. The movement patterns of three patients with idiopathic dystonia during attempts at fast single-joint movements (in the elbow, wrist, and ankle) were recorded and compared with the results of the computer simulation. This approach considers that motor disorders in dystonia result from faulty control patterns that may not correlate with any morphological or neurophysiological changes. It provides a basis for the high variability of dystonic movements. The uniqueness of abnormal motor patterns in dystonia, that precludes statistical analysis across patients, may result from subtle differences in the patterns of intersecting characteristics of the tonic stretch reflex. The applicability of our analysis to disordered multijoint movement patterns is discussed.

  10. Altered motor unit discharge patterns in paretic muscles of stroke survivors assessed using surface electromyography

    Science.gov (United States)

    Hu, Xiaogang; Suresh, Aneesha K.; Rymer, William Z.; Suresh, Nina L.

    2016-08-01

    Objective. Hemispheric stroke survivors often show impairments in voluntary muscle activation. One potential source of these impairments could come from altered control of muscle, via disrupted motor unit (MU) firing patterns. In this study, we sought to determine whether MU firing patterns are modified on the affected side of stroke survivors, as compared with the analogous contralateral muscle. Approach. Using a novel surface electromyogram (EMG) sensor array, coupled with advanced template recognition software (dEMG) we recorded surface EMG signals over the first dorsal interosseous (FDI) muscle on both paretic and contralateral sides. Recordings were made as stroke survivors produced isometric index finger abductions over a large force range (20%-60% of maximum). Utilizing the dEMG algorithm, MU firing rates, recruitment thresholds, and action potential amplitudes were estimated for concurrently active MUs in each trial. Main results. Our results reveal significant changes in the firing rate patterns in paretic FDI muscle, in that the discharge rates, characterized in relation to recruitment force threshold and to MU size, were less clearly correlated with recruitment force than in contralateral FDI muscles. Firing rates in the affected muscle also did not modulate systematically with the level of voluntary muscle contraction, as would be expected in intact muscles. These disturbances in firing properties also correlated closely with the impairment of muscle force generation. Significance. Our results provide strong evidence of disruptions in MU firing behavior in paretic muscles after a hemispheric stroke, suggesting that modified control of the spinal motoneuron pool could be a contributing factor to muscular weakness in stroke survivors.

  11. Effects of excitatory and inhibitory neurotransmission on motor patterns of human sigmoid colon in vitro

    Science.gov (United States)

    Aulí, M; Martínez, E; Gallego, D; Opazo, A; Espín, F; Martí-Gallostra, M; Jiménez, M; Clavé, P

    2008-01-01

    Background and purpose: To characterize the in vitro motor patterns and the neurotransmitters released by enteric motor neurons (EMNs) in the human sigmoid colon. Experimental approach: Sigmoid circular strips were studied in organ baths. EMNs were stimulated by electrical field stimulation (EFS) and through nicotinic ACh receptors. Key results: Strips developed weak spontaneous rhythmic contractions (3.67±0.49 g, 2.54±0.15 min) unaffected by the neurotoxin tetrodotoxin (TTX; 1 μM). EFS induced strong contractions during (on, 56%) or after electrical stimulus (off, 44%), both abolished by TTX. Nicotine (1–100 μM) inhibited spontaneous contractions. Latency of off-contractions and nicotine responses were reduced by NG-nitro-L-arginine (1 mM) and blocked after further addition of apamin (1 μM) or the P2Y1 receptor antagonist MRS 2179 (10 μM) and were unaffected by the P2X antagonist NF279 (10 μM) or α-chymotrypsin (10 U mL−1). Amplitude of on- and off-contractions was reduced by atropine (1 μM) and the selective NK2 receptor antagonist Bz-Ala-Ala-D-Trp-Phe-D-Pro-Pro-Nle-NH2 (1 μM). MRS 2179 reduced the amplitude of EFS on- and off-contractions without altering direct muscular contractions induced by ACh (1 nM–1 mM) or substance P (1 nM–10 μM). Conclusions and implications: Latency of EFS-induced off-contractions and inhibition of spontaneous motility by nicotine are caused by stimulation of inhibitory EMNs coreleasing NO and a purine acting at muscular P2Y1 receptors through apamin-sensitive K+ channels. EFS-induced on- and off-contractions are caused by stimulation of excitatory EMNs coreleasing ACh and tachykinins acting on muscular muscarinic and NK2 receptors. Prejunctional P2Y1 receptors might modulate the activity of excitatory EMNs. P2Y1 and NK2 receptors might be therapeutic targets for colonic motor disorders. PMID:18846038

  12. The emergence of sarcomeric, graded-polarity and spindle-like patterns in bundles of short cytoskeletal polymers and two opposite molecular motors

    International Nuclear Information System (INIS)

    Craig, E M; Dey, S; Mogilner, A

    2011-01-01

    We use linear stability analysis and numerical solutions of partial differential equations to investigate pattern formation in the one-dimensional system of short dynamic polymers and one (plus-end directed) or two (one is plus-end, another minus-end directed) molecular motors. If polymer sliding and motor gliding rates are slow and/or the polymer turnover rate is fast, then the polymer-motor bundle has mixed polarity and homogeneous motor distribution. However, if motor gliding is fast, a sarcomeric pattern with periodic bands of alternating polymer polarity separated by motor aggregates evolves. On the other hand, if polymer sliding is fast, a graded-polarity bundle with motors at the center emerges. In the presence of the second, minus-end directed motor, the sarcomeric pattern is more ubiquitous, while the graded-polarity pattern is destabilized. However, if the minus-end motor is weaker than the plus-end directed one, and/or polymer nucleation is autocatalytic, and/or long polymers are present in the bundle, then a spindle-like architecture with a sorted-out polarity emerges with the plus-end motors at the center and minus-end motors at the edges. We discuss modeling implications for actin-myosin fibers and in vitro and meiotic spindles.

  13. Glial tumors in brodmann area 6: spread pattern and relationships to motor areas.

    Science.gov (United States)

    Shah, Komal B; Hayman, L Anne; Chavali, Lakshmi S; Hamilton, Jackson D; Prabhu, Sujit S; Wangaryattawanich, Pattana; Kumar, Vinodh A; Kumar, Ashok J

    2015-01-01

    The posterior frontal lobe of the brain houses Brodmann area 4, which is the primary motor cortex, and Brodmann area 6, which consists of the supplementary motor area on the medial portion of the hemisphere and the premotor cortex on the lateral portion. In this area, safe resection is dependent on accurate localization of the motor cortex and the central sulcus, which can usually be achieved by using thin-section imaging and confirmed by using other techniques. The most reliable anatomic landmarks are the "hand knob" area and the marginal ramus of the cingulate sulcus. Postoperatively, motor deficits can occur not only because of injury to primary motor cortex but also because of injury to the supplementary motor area. Unlike motor cortex injury, the supplementary motor area syndrome is transient, if it occurs at all. On the lateral hemisphere, motor and language deficits can also occur because of premotor cortex injury, but a dense motor deficit would indicate subcortical injury to the corticospinal tract. The close relationship of the subcortical motor fibers and premotor cortex is illustrated. In contrast to the more constant landmarks of the central sulcus and marginal ramus, which aid in preoperative localization, the variable interruptions in the precentral and cingulate sulci of the posterior frontal lobe seem to provide "cortical bridges" for spread of infiltrating gliomas. (©)RSNA, 2015.

  14. Could patients' coughing have communicative significance?

    Science.gov (United States)

    Bailey, Julia V

    2008-01-01

    Medical discourse positions patients with coughs and colds negatively, so consulting health services with 'minor' respiratory illness is therefore more accountable than for other medical problems. Patients face dilemmas since they must persuade doctors of the doctorability of their illness without being seen as hypochondriacal, and they risk losing face if doctors decide that there is nothing much wrong. It is known that the placement of non-lexical features of talk such as laughing or crying can have interactional meaning. Using a data set of video-recorded doctor-patient cough and cold consultations, this study explores whether patients' coughing could have communicative significance. The study is a qualitative analysis of 33 consultations drawing on a constructionist, sociolinguistic analytic approach. Coughing is co-ordinated with talk rather than occurring randomly. Coughing helps patients to demonstrate the doctorability of their symptoms and to legitimize their claims for medical attention. Coughing is also associated with resistance to 'no problem' diagnoses, resulting in changes in the trajectory of talk (for example, soliciting more explanation from doctors and/or re-negotiation of doctors' investigation or treatment plans). Coughing is undoubtedly a manifestation of respiratory illness, but also has communicative significance in consultations for coughs and colds.

  15. 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

  16. The impact of harmfulness information on citric acid induced cough and urge-to-cough.

    Science.gov (United States)

    Janssens, Thomas; Brepoels, Sarah; Dupont, Lieven; Van den Bergh, Omer

    2015-04-01

    The cough reflex is an automatic protective reflex, which can be modulated by conscious effort or other forms of top-down control. In this experiment, we investigated whether information about harmfulness of a cough-inducing substance would augment cough reflex sensitivity and associated urge-to-cough. Healthy participants (N = 39) were randomized to receive information that they were to inhale a harmless substance (natural citric acid), or a potentially harmful substance (a potent agro-chemical acid). Using dosimeter-controlled inhalations, the dose of citric acid eliciting at least three coughs (C3) was determined. Next, participants received 4 blocks of randomized presentations of citric acid at the C3 dose, a sub-threshold dose of citric acid and saline control. C3 was reached for 27/39 participants, and C3 thresholds were not influenced by harmfulness information. During repeated citric acid presentations, framing the cough-inducing substance as a potentially harmful chemical resulted in a greater urge-to-cough compared to information framing it as natural citric acid (p < .01). The experimental manipulation did not influence cough frequencies. Our findings show that harmfulness information influences urge-to-cough, corroborating the role of cortical mechanisms in modulating the urge-to-cough and suggesting that cognitive manipulations may contribute to cough treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Improved children's motor learning of the basketball free shooting pattern by associating subjective error estimation and extrinsic feedback.

    Science.gov (United States)

    Silva, Leandro de Carvalho da; Pereira-Monfredini, Carla Ferro; Teixeira, Luis Augusto

    2017-09-01

    This study aimed at assessing the interaction between subjective error estimation and frequency of extrinsic feedback in the learning of the basketball free shooting pattern by children. 10- to 12-year olds were assigned to 1 of 4 groups combining subjective error estimation and relative frequency of extrinsic feedback (33% × 100%). Analysis of performance was based on quality of movement pattern. Analysis showed superior learning of the group combining error estimation and 100% feedback frequency, both groups receiving feedback on 33% of trials achieved intermediate results, and the group combining no requirement of error estimation and 100% feedback frequency had the poorest learning. Our results show the benefit of subjective error estimation in association with high frequency of extrinsic feedback in children's motor learning of a sport motor pattern.

  18. Coordination of cough and swallow: a meta-behavioral response to aspiration.

    Science.gov (United States)

    Pitts, Teresa; Rose, Melanie J; Mortensen, Ashley N; Poliacek, Ivan; Sapienza, Christine M; Lindsey, Bruce G; Morris, Kendall F; Davenport, Paul W; Bolser, Donald C

    2013-12-01

    Airway protections is the prevention and/or removal of material by behaviors such as cough and swallow. We hypothesized these behaviors are coordinated to respond to aspiration. Anesthetized animals were challenged with simulated aspiration that induced both coughing and swallowing. Electromyograms of upper airway and respiratory muscles together with esophageal pressure were recorded to identify and evaluate cough and swallow. During simulated aspiration, both cough and swallow intensity increased and swallow duration decreased consistent with rapid pharyngeal clearance. Phase restriction between cough and swallow was observed; swallow was restricted to the E2 phase of cough. These results support three main conclusions: 1) the cough and swallow pattern generators are tightly coordinated so as to generate a protective meta-behavior; 2) the trachea provides feedback on swallow quality, informing the brainstem about aspiration incidences; and 3) the larynx and upper esophageal sphincter act as two separate valves controlling the direction of positive and negative pressures from the upper airway into the thorax. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Neuromolecular Imaging Shows Temporal Synchrony Patterns between Serotonin and Movement within Neuronal Motor Circuits in the Brain

    Directory of Open Access Journals (Sweden)

    Patricia A. Broderick

    2013-06-01

    Full Text Available The present discourse links the electrical and chemical properties of the brain with neurotransmitters and movement behaviors to further elucidate strategies to diagnose and treat brain disease. Neuromolecular imaging (NMI, based on electrochemical principles, is used to detect serotonin in nerve terminals (dorsal and ventral striata and somatodendrites (ventral tegmentum of reward/motor mesocorticolimbic and nigrostriatal brain circuits. Neuronal release of serotonin is detected at the same time and in the same animal, freely moving and unrestrained, while open-field behaviors are monitored via infrared photobeams. The purpose is to emphasize the unique ability of NMI and the BRODERICK PROBE® biosensors to empirically image a pattern of temporal synchrony, previously reported, for example, in Aplysia using central pattern generators (CPGs, serotonin and cerebral peptide-2. Temporal synchrony is reviewed within the context of the literature on central pattern generators, neurotransmitters and movement disorders. Specifically, temporal synchrony data are derived from studies on psychostimulant behavior with and without cocaine while at the same time and continuously, serotonin release in motor neurons within basal ganglia, is detected. The results show that temporal synchrony between the neurotransmitter, serotonin and natural movement occurs when the brain is NOT injured via, e.g., trauma, addictive drugs or psychiatric illness. In striking contrast, in the case of serotonin and cocaine-induced psychostimulant behavior, a different form of synchrony and also asynchrony can occur. Thus, the known dysfunctional movement behavior produced by cocaine may well be related to the loss of temporal synchrony, the loss of the ability to match serotonin in brain with motor activity. The empirical study of temporal synchrony patterns in humans and animals may be more relevant to the dynamics of motor circuits and movement behaviors than are studies of

  20. Neuromolecular Imaging Shows Temporal Synchrony Patterns between Serotonin and Movement within Neuronal Motor Circuits in the Brain.

    Science.gov (United States)

    Broderick, Patricia A

    2013-06-21

    The present discourse links the electrical and chemical properties of the brain with neurotransmitters and movement behaviors to further elucidate strategies to diagnose and treat brain disease. Neuromolecular imaging (NMI), based on electrochemical principles, is used to detect serotonin in nerve terminals (dorsal and ventral striata) and somatodendrites (ventral tegmentum) of reward/motor mesocorticolimbic and nigrostriatal brain circuits. Neuronal release of serotonin is detected at the same time and in the same animal, freely moving and unrestrained, while open-field behaviors are monitored via infrared photobeams. The purpose is to emphasize the unique ability of NMI and the BRODERICK PROBE® biosensors to empirically image a pattern of temporal synchrony, previously reported, for example, in Aplysia using central pattern generators (CPGs), serotonin and cerebral peptide-2. Temporal synchrony is reviewed within the context of the literature on central pattern generators, neurotransmitters and movement disorders. Specifically, temporal synchrony data are derived from studies on psychostimulant behavior with and without cocaine while at the same time and continuously, serotonin release in motor neurons within basal ganglia, is detected. The results show that temporal synchrony between the neurotransmitter, serotonin and natural movement occurs when the brain is NOT injured via, e.g., trauma, addictive drugs or psychiatric illness. In striking contrast, in the case of serotonin and cocaine-induced psychostimulant behavior, a different form of synchrony and also asynchrony can occur. Thus, the known dysfunctional movement behavior produced by cocaine may well be related to the loss of temporal synchrony, the loss of the ability to match serotonin in brain with motor activity. The empirical study of temporal synchrony patterns in humans and animals may be more relevant to the dynamics of motor circuits and movement behaviors than are studies of static parameters

  1. Stereotypic Laryngeal and Respiratory Motor Patterns Generate Different Call Types in Rat Ultrasound Vocalization

    Science.gov (United States)

    RIEDE, TOBIAS

    2014-01-01

    Rodents produce highly variable ultrasound whistles as communication signals unlike many other mammals, who employ flow-induced vocal fold oscillations to produce sound. The role of larynx muscles in controlling sound features across different call types in ultrasound vocalization (USV) was investigated using laryngeal muscle electromyographic (EMG) activity, subglottal pressure measurements and vocal sound output in awake and spontaneously behaving Sprague–Dawley rats. Results support the hypothesis that glottal shape determines fundamental frequency. EMG activities of thyroarytenoid and cricothyroid muscles were aligned with call duration. EMG intensity increased with fundamental frequency. Phasic activities of both muscles were aligned with fast changing fundamental frequency contours, for example in trills. Activities of the sternothyroid and sternohyoid muscles, two muscles involved in vocal production in other mammals, are not critical for the production of rat USV. To test how stereotypic laryngeal and respiratory activity are across call types and individuals, sets of ten EMG and subglottal pressure parameters were measured in six different call types from six rats. Using discriminant function analysis, on average 80% of parameter sets were correctly assigned to their respective call type. This was significantly higher than the chance level. Since fundamental frequency features of USV are tightly associated with stereotypic activity of intrinsic laryngeal muscles and muscles contributing to build-up of subglottal pressure, USV provide insight into the neurophysiological control of peripheral vocal motor patterns. PMID:23423862

  2. Transfer Kernel Common Spatial Patterns for Motor Imagery Brain-Computer Interface Classification

    Science.gov (United States)

    Dai, Mengxi; Liu, Shucong; Zhang, Pengju

    2018-01-01

    Motor-imagery-based brain-computer interfaces (BCIs) commonly use the common spatial pattern (CSP) as preprocessing step before classification. The CSP method is a supervised algorithm. Therefore a lot of time-consuming training data is needed to build the model. To address this issue, one promising approach is transfer learning, which generalizes a learning model can extract discriminative information from other subjects for target classification task. To this end, we propose a transfer kernel CSP (TKCSP) approach to learn a domain-invariant kernel by directly matching distributions of source subjects and target subjects. The dataset IVa of BCI Competition III is used to demonstrate the validity by our proposed methods. In the experiment, we compare the classification performance of the TKCSP against CSP, CSP for subject-to-subject transfer (CSP SJ-to-SJ), regularizing CSP (RCSP), stationary subspace CSP (ssCSP), multitask CSP (mtCSP), and the combined mtCSP and ssCSP (ss + mtCSP) method. The results indicate that the superior mean classification performance of TKCSP can achieve 81.14%, especially in case of source subjects with fewer number of training samples. Comprehensive experimental evidence on the dataset verifies the effectiveness and efficiency of the proposed TKCSP approach over several state-of-the-art methods. PMID:29743934

  3. Architecture of vagal motor units controlling striated muscle of esophagus: peripheral elements patterning peristalsis?

    Science.gov (United States)

    Powley, Terry L; Mittal, Ravinder K; Baronowsky, Elizabeth A; Hudson, Cherie N; Martin, Felecia N; McAdams, Jennifer L; Mason, Jacqueline K; Phillips, Robert J

    2013-12-01

    Little is known about the architecture of the vagal motor units that control esophageal striated muscle, in spite of the fact that these units are necessary, and responsible, for peristalsis. The present experiment was designed to characterize the motor neuron projection fields and terminal arbors forming esophageal motor units. Nucleus ambiguus compact formation neurons of the rat were labeled by bilateral intracranial injections of the anterograde tracer dextran biotin. After tracer transport, thoracic and abdominal esophagi were removed and prepared as whole mounts of muscle wall without mucosa or submucosa. Labeled terminal arbors of individual vagal motor neurons (n=78) in the esophageal wall were inventoried, digitized and analyzed morphometrically. The size of individual vagal motor units innervating striated muscle, throughout thoracic and abdominal esophagus, averaged 52 endplates per motor neuron, a value indicative of fine motor control. A majority (77%) of the motor terminal arbors also issued one or more collateral branches that contacted neurons, including nitric oxide synthase-positive neurons, of local myenteric ganglia. Individual motor neuron terminal arbors co-innervated, or supplied endplates in tandem to, both longitudinal and circular muscle fibers in roughly similar proportions (i.e., two endplates to longitudinal for every three endplates to circular fibers). Both the observation that vagal motor unit collaterals project to myenteric ganglia and the fact that individual motor units co-innervate longitudinal and circular muscle layers are consistent with the hypothesis that elements contributing to peristaltic programming inhere, or are "hardwired," in the peripheral architecture of esophageal motor units. © 2013.

  4. 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.

  5. Improved Volitional Recall of Motor-Imagery-Related Brain Activation Patterns Using Real-Time Functional MRI-Based Neurofeedback.

    Science.gov (United States)

    Bagarinao, Epifanio; Yoshida, Akihiro; Ueno, Mika; Terabe, Kazunori; Kato, Shohei; Isoda, Haruo; Nakai, Toshiharu

    2018-01-01

    Motor imagery (MI), a covert cognitive process where an action is mentally simulated but not actually performed, could be used as an effective neurorehabilitation tool for motor function improvement or recovery. Recent approaches employing brain-computer/brain-machine interfaces to provide online feedback of the MI during rehabilitation training have promising rehabilitation outcomes. In this study, we examined whether participants could volitionally recall MI-related brain activation patterns when guided using neurofeedback (NF) during training. The participants' performance was compared to that without NF. We hypothesized that participants would be able to consistently generate the relevant activation pattern associated with the MI task during training with NF compared to that without NF. To assess activation consistency, we used the performance of classifiers trained to discriminate MI-related brain activation patterns. Our results showed significantly higher predictive values of MI-related activation patterns during training with NF. Additionally, this improvement in the classification performance tends to be associated with the activation of middle temporal gyrus/inferior occipital gyrus, a region associated with visual motion processing, suggesting the importance of performance monitoring during MI task training. Taken together, these findings suggest that the efficacy of MI training, in terms of generating consistent brain activation patterns relevant to the task, can be enhanced by using NF as a mechanism to enable participants to volitionally recall task-related brain activation patterns.

  6. Improved Volitional Recall of Motor-Imagery-Related Brain Activation Patterns Using Real-Time Functional MRI-Based Neurofeedback

    Directory of Open Access Journals (Sweden)

    Epifanio Bagarinao

    2018-04-01

    Full Text Available Motor imagery (MI, a covert cognitive process where an action is mentally simulated but not actually performed, could be used as an effective neurorehabilitation tool for motor function improvement or recovery. Recent approaches employing brain–computer/brain–machine interfaces to provide online feedback of the MI during rehabilitation training have promising rehabilitation outcomes. In this study, we examined whether participants could volitionally recall MI-related brain activation patterns when guided using neurofeedback (NF during training. The participants’ performance was compared to that without NF. We hypothesized that participants would be able to consistently generate the relevant activation pattern associated with the MI task during training with NF compared to that without NF. To assess activation consistency, we used the performance of classifiers trained to discriminate MI-related brain activation patterns. Our results showed significantly higher predictive values of MI-related activation patterns during training with NF. Additionally, this improvement in the classification performance tends to be associated with the activation of middle temporal gyrus/inferior occipital gyrus, a region associated with visual motion processing, suggesting the importance of performance monitoring during MI task training. Taken together, these findings suggest that the efficacy of MI training, in terms of generating consistent brain activation patterns relevant to the task, can be enhanced by using NF as a mechanism to enable participants to volitionally recall task-related brain activation patterns.

  7. Motor unit recruitment patterns 2: the influence of myoelectric intensity and muscle fascicle strain rate.

    Science.gov (United States)

    Hodson-Tole, Emma F; Wakeling, James M

    2008-06-01

    To effectively meet the force requirements of a given movement an appropriate number and combination of motor units must be recruited between and within muscles. Orderly recruitment of motor units has been shown to occur in a wide range of skeletal muscles, however, alternative strategies do occur. Faster motor units are better suited to developing force rapidly, and produce higher mechanical power with greater efficiency at faster shortening strain rates than slower motor units. As the frequency content of the myoelectric signal is related to the fibre type of the active motor units, we hypothesised that, in addition to an association between myoelectric frequency and intensity, there would be a significant association between muscle fascicle shortening strain rate and myoelectric frequency content. Myoelectric and sonomicrometric data were collected from the three ankle extensor muscles of the rat hind limb during walking and running. Myoelectric signals were analysed using wavelet transformation and principal component analysis to give a measure of the signal frequency content. Sonomicrometric signals were analysed to give measures of muscle fascicle strain and strain rate. The relationship between myoelectric frequency and both intensity and muscle fascicle strain rate was found to change across the time course of a stride, with differences also occurring in the strength of the associations between and within muscles. In addition to the orderly recruitment of motor units, a mechanical strategy of motor unit recruitment was therefore identified. Motor unit recruitment is therefore a multifactorial phenomenon, which is more complex than typically thought.

  8. The rhythms of steady posture: Motor commands as spatially organized oscillation patterns

    NARCIS (Netherlands)

    Heitmann, S.; Boonstra, T.W.; Gong, P.; Breakspear, M.; Ermentrout, B.

    2015-01-01

    Beta-band (15-30. Hz) oscillations in motor cortex have been implicated in voluntary movement and postural control. Yet the mechanisms linking those oscillations to function remains elusive. Recently, spatial waves of synchronized beta oscillations have been observed in primary and pre-motor cortex

  9. A novel reflex cough testing device.

    Science.gov (United States)

    Fujiwara, Kazunori; Kawamoto, Katsuyuki; Shimizu, Yoko; Fukuhara, Takahiro; Koyama, Satoshi; Kataoka, Hideyuki; Kitano, Hiroya; Takeuchi, Hiromi

    2017-01-18

    The reflex cough test is useful for detecting silent aspiration, a risk factor for aspiration pneumonia. However, assessing the risk of aspiration pneumonia requires measuring not only the cough reflex but also cough strength. Currently, no reflex cough testing device is available that can directly measure reflex cough strength. We therefore developed a new testing device that can easily and simultaneously measure cough strength and the time until the cough reflex, and verified whether screening with this new instrument is feasible for evaluating the risk of aspiration pneumonia. This device consists of a special pipe with a double lumen, a nebulizer, and an electronic spirometer. We used a solution of prescription-grade L-tartaric acid to initiate the cough reflex. The solution was inhaled through a mouthpiece as a microaerosol produced by an ultrasonic nebulizer. The peak cough flow (PCF) of the induced cough was measured with the spirometer. The 70 patients who participated in this study comprised 49 patients without a history of pneumonia (group A), 21 patients with a history of pneumonia (group B), and 10 healthy volunteers (control group). With the novel device, PCF and time until cough reflex could be measured without adverse effects. The PCF values were 118.3 ± 64.0 L/min, 47.7 ± 38.5 L/min, and 254.9 ± 83.8 L/min in group A, group B, and the control group, respectively. The PCF of group B was significantly lower than that of group A and the control group (p reflex was 4.2 ± 5.9 s, 7.0 ± 7.0 s, and 1 s in group A, group B, and the control group, respectively. This duration was significantly longer for groups A and B than for the control group (A: p reflex and the strength of involuntary coughs for assessment of patients at risk of aspiration pneumonia.

  10. Improved Discriminability of Spatiotemporal Neural Patterns in Rat Motor Cortical Areas as Directional Choice Learning Progresses

    Directory of Open Access Journals (Sweden)

    Hongwei eMao

    2015-03-01

    Full Text Available Animals learn to choose a proper action among alternatives to improve their odds of success in food foraging and other activities critical for survival. Through trial-and-error, they learn correct associations between their choices and external stimuli. While a neural network that underlies such learning process has been identified at a high level, it is still unclear how individual neurons and a neural ensemble adapt as learning progresses. In this study, we monitored the activity of single units in the rat medial and lateral agranular (AGm and AGl, respectively areas as rats learned to make a left or right side lever press in response to a left or right side light cue. We noticed that rat movement parameters during the performance of the directional choice task quickly became stereotyped during the first 2-3 days or sessions. But learning the directional choice problem took weeks to occur. Accompanying rats’ behavioral performance adaptation, we observed neural modulation by directional choice in recorded single units. Our analysis shows that ensemble mean firing rates in the cue-on period did not change significantly as learning progressed, and the ensemble mean rate difference between left and right side choices did not show a clear trend of change either. However, the spatiotemporal firing patterns of the neural ensemble exhibited improved discriminability between the two directional choices through learning. These results suggest a spatiotemporal neural coding scheme in a motor cortical neural ensemble that may be responsible for and contributing to learning the directional choice task.

  11. Help Protect Babies from Whooping Cough

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Past Emails Help Protect Babies from Whooping Cough Language: English (US) ... Emails Language: English (US) Español (Spanish) File Formats Help: How do I view different file formats (PDF, ...

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

    Medline Plus

    Full Text Available ... hiv/aids overview current news labs links & resources hpv overview why vaccinate posters buttons and banners videos ... q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room ...

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

    Medline Plus

    Full Text Available ... getvaxed about GETVAXED print ads go to GETVAXED.ORG cme Immunizations Pertussis (Whooping Cough) One family's struggles ... free-of-charge. Branded videos contain the "PKIDs.ORG" end slate; unbranded videos are provided for organizations ...

  14. 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.

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

    Medline Plus

    Full Text Available ... immunizations current news Flu's Gonna Lose hepatitis a & b vaccines im/sq how to do kids infect ... vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles ...

  16. Cough Medicine: Understanding Your OTC Options

    Science.gov (United States)

    ... CorrectlyPain Relievers: Understanding Your OTC OptionsAntacids and Acid Reducers: OTC Relief for Heartburn and Acid RefluxOTC Cough ... Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics ...

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

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    Full Text Available ... freed meet keri russell posters grand article rich media video/audio pneumonia tb overview links & resources families ... hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. ...

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

    Medline Plus

    Full Text Available ... GETVAXED print ads go to GETVAXED.ORG cme Immunizations Pertussis (Whooping Cough) One family's struggles with pertussis ... not possible without a visit to your doctor. Immunizations stop disease from spreading. Check with your family ...

  19. Repetition priming of motor activity mediated by a central pattern generator: the importance of extrinsic vs. intrinsic program initiators

    Science.gov (United States)

    Siniscalchi, Michael J.; Jing, Jian; Weiss, Klaudiusz R.

    2016-01-01

    Repetition priming is characterized by increased performance as a behavior is repeated. Although this phenomenon is ubiquitous, mediating mechanisms are poorly understood. We address this issue in a model system, the feeding network of Aplysia. This network generates both ingestive and egestive motor programs. Previous data suggest a chemical coding model: ingestive and egestive inputs to the feeding central pattern generator (CPG) release different modulators, which act via different second messengers to prime motor activity in different ways. The ingestive input to the CPG (neuron CBI-2) releases the peptides feeding circuit activating peptide and cerebral peptide 2, which produce an ingestive pattern of activity. The egestive input to the CPG (the esophageal nerve) releases the peptide small cardioactive peptide. This model is based on research that focused on a single aspect of motor control (radula opening). Here we ask whether repetition priming is observed if activity is triggered with a neuron within the core CPG itself and demonstrate that it is not. Moreover, previous studies demonstrated that effects of modulatory neurotransmitters that induce repetition priming persist. This suggests that it should be possible to “prime” motor programs triggered from within the CPG by first stimulating extrinsic modulatory inputs. We demonstrate that programs triggered after ingestive input activation are ingestive and programs triggered after egestive input activation are egestive. We ask where this priming occurs and demonstrate modifications within the CPG itself. This arrangement is likely to have important consequences for “task” switching, i.e., the cessation of one type of motor activity and the initiation of another. PMID:27466134

  20. 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....

  1. Roles for multifunctional and specialized spinal interneurons during motor pattern generation in tadpoles, zebrafish larvae, and turtles

    Directory of Open Access Journals (Sweden)

    Ari Berkowitz

    2010-06-01

    Full Text Available The hindbrain and spinal cord can produce multiple forms of locomotion, escape, and withdrawal behaviors and (in limbed vertebrates site-specific scratching. Until recently, the prevailing view was that the same classes of CNS neurons generate multiple kinds of movements, either through reconfiguration of a single, shared network or through an increase in the number of neurons recruited within each class. The mechanisms involved in selecting and generating different motor patterns have recently been explored in detail in some non-mammalian, vertebrate model systems. Work on the hatchling Xenopus tadpole, the larval zebrafish, and the adult turtle has now revealed that distinct kinds of motor patterns are actually selected and generated by combinations of multifunctional and specialized spinal interneurons. Multifunctional interneurons may form a core, multipurpose circuit that generates elements of coordinated motor output utilized in multiple behaviors, such as left-right alternation. But, in addition, specialized spinal interneurons including separate glutamatergic and glycinergic classes are selectively activated during specific patterns: escape-withdrawal, swimming and struggling in tadpoles and zebrafish, and limb withdrawal and scratching in turtles. These specialized neurons can contribute by changing the way central pattern generator (CPG activity is initiated and by altering CPG composition and operation. The combined use of multifunctional and specialized neurons is now established as a principle of organization across a range of vertebrates. Future research may reveal common patterns of multifunctionality and specialization among interneurons controlling diverse movements and whether similar mechanisms exist in higher-order brain circuits that select among a wider array of complex movements.

  2. Impact of cercal air currents on singing motor pattern generation in the cricket (Gryllus bimaculatus DeGeer)

    Science.gov (United States)

    2015-01-01

    The cercal system of crickets detects low-frequency air currents produced by approaching predators and self-generated air currents during singing, which may provide sensory feedback to the singing motor network. We analyzed the effect of cercal stimulation on singing motor pattern generation to reveal the response of a singing interneuron to predator-like signals and to elucidate the possible role of self-generated air currents during singing. In fictive singing males, we recorded an interneuron of the singing network while applying air currents to the cerci; additionally, we analyzed the effect of abolishing the cercal system in freely singing males. In fictively singing crickets, the effect of short air stimuli is either to terminate prematurely or to lengthen the interchirp interval, depending on their phase in the chirp cycle. Within our stimulation paradigm, air stimuli of different velocities and durations always elicited an inhibitory postsynaptic potential in the singing interneuron. Current injection in the singing interneuron elicited singing motor activity, even during the air current-evoked inhibitory input from the cercal pathway. The disruptive effects of air stimuli on the fictive singing pattern and the inhibitory response of the singing interneuron point toward the cercal system being involved in initiating avoidance responses in singing crickets, according to the established role of cerci in a predator escape pathway. After abolishing the activity of the cercal system, the timing of natural singing activity was not significantly altered. Our study provides no evidence that self-generated cercal sensory activity has a feedback function for singing motor pattern generation. PMID:26334014

  3. Changing pattern in the basal ganglia: motor switching under reduced dopaminergic drive

    Science.gov (United States)

    Fiore, Vincenzo G.; Rigoli, Francesco; Stenner, Max-Philipp; Zaehle, Tino; Hirth, Frank; Heinze, Hans-Jochen; Dolan, Raymond J.

    2016-01-01

    Action selection in the basal ganglia is often described within the framework of a standard model, associating low dopaminergic drive with motor suppression. Whilst powerful, this model does not explain several clinical and experimental data, including varying therapeutic efficacy across movement disorders. We tested the predictions of this model in patients with Parkinson’s disease, on and off subthalamic deep brain stimulation (DBS), focussing on adaptive sensory-motor responses to a changing environment and maintenance of an action until it is no longer suitable. Surprisingly, we observed prolonged perseverance under on-stimulation, and high inter-individual variability in terms of the motor selections performed when comparing the two conditions. To account for these data, we revised the standard model exploring its space of parameters and associated motor functions and found that, depending on effective connectivity between external and internal parts of the globus pallidus and saliency of the sensory input, a low dopaminergic drive can result in increased, dysfunctional, motor switching, besides motor suppression. This new framework provides insight into the biophysical mechanisms underlying DBS, allowing a description in terms of alteration of the signal-to-baseline ratio in the indirect pathway, which better account of known electrophysiological data in comparison with the standard model. PMID:27004463

  4. 77 FR 67613 - Patterns of Safety Violations by Motor Carrier Management

    Science.gov (United States)

    2012-11-13

    ... Internet, you may view the docket online by visiting the Docket Management Facility in Room W12-140 on the... occurred in Sherman, Texas, highlighting the danger posed by motor carriers and other persons who avoid... authority registration for failing to disclose, among other things, common management or control with any...

  5. Theory and Application of Audio-Based Assessment of Cough

    Directory of Open Access Journals (Sweden)

    Yan Shi

    2018-01-01

    Full Text Available Cough is a common symptom of many respiratory diseases. Many medical literatures underline that a system for the automatic, objective, and reliable detection of cough events is important and very promising to detect pathology severity in chronic cough disease. In order to track the development status of an audio-based cough monitoring system, we briefly described the history of objective cough detection and then illustrated the cough sound generating principle. The probable endpoints of cough clinical studies, including cough frequency, intensity of coughing, and acoustic properties of cough sound, were analyzed in this paper. Finally, we introduce some successful cough monitoring equipment and their recognition algorithm in detail. It can be obtained that, firstly, acoustic variability of cough sounds within and between individuals makes it difficult to assess the intensity of coughing. Furthermore, now great progress in audio-based cough detection is being made. Moreover, accurate portable objective monitoring systems will be available and widely used in home care and clinical trials in the near future.

  6. Characterization of urge to cough and cough symptoms associated with the common cold: results of a US internet survey.

    Science.gov (United States)

    Eccles, Ron; Dicpinigaitis, Peter; Turner, Ronald B; Druce, Howard M; Adeleke, Maryann; Mann, Ashley L

    2016-06-01

    Our knowledge of cough physiology is limited despite years of study. Even less is known about the sensation of urge to cough. Given that limited clinical data are available about urge to cough and cough attributes during a common cold, we sought to gain insights into experiences and perceptions related to these symptoms. An internet survey consisting of 51 questions was fielded in the United States. Eligible survey participants included men and women aged 18 years and older who had suffered from a cold with cough within the three months preceding the survey. Participants who confirmed suffering from recurrent cough, asthma, chronic bronchitis, chronic obstructive pulmonary disease, cystic fibrosis, or gastrointestinal reflux were excluded. Of 19,530 initial respondents, 8011 had a cold in the past three months. Of these, 6484 (81%) had experienced cough symptoms; 2708 respondents with cough due to cold and no exclusionary condition made up the analysis sample. Most respondents (62%) reported that cough developed one to two days after the onset of cold symptoms, and 45% felt that cough worsened their other cold symptoms. In 69% of respondents, cough outlasted other cold symptoms. Urge to cough was reported by 98% of respondents, and among these respondents, 64% described it as uncontrollable and 65% rated severity as moderate. More than half of respondents (57%) considered the sensation of urge to cough and the act of coughing as equally bothersome. Although urge to cough and inability to control cough were the most bothersome aspects of cough due to cold, few (<20%) respondents asked healthcare providers for treatment recommendations. Symptoms of urge to cough and cough are common and have a significant impact on cold sufferers. Understanding attributes of these symptoms may provide insights for effective management and the development of novel treatment strategies.

  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. The effect of handedness on spatial and motor representation of pitch patterns in pianists.

    Directory of Open Access Journals (Sweden)

    Eline Adrianne Smit

    Full Text Available This study investigated the effect of handedness on pianists' abilities to adjust their keyboard performance skills to new spatial and motor mappings. Left- and right-handed pianists practiced simple melodies on a regular MIDI piano keyboard (practice and were then asked to perform these with modified melodic contours (the same or reversed melodic contour causing a change of fingering and on a reversed MIDI piano keyboard (test. The difference of performance duration between the practice and the test phase as well as the amount of errors played were used as test measures. Overall, a stronger effect for modified melodic contours than for the reversed keyboard was observed. Furthermore, we observed a trend of left-handed pianists to be quicker and more accurate in playing melodies when reversing their fingering with reversed contours in their left-hand performances. This suggests that handedness may influence pianists' skill to adjust to new spatial and motor mappings.

  9. The pattern of the electromagnetic field emitted by mobile phones in motor vehicle driving simulators

    Directory of Open Access Journals (Sweden)

    Piotr Politański

    2013-06-01

    Full Text Available Introduction: The paper reports the results of the determinations of UMTS EMF distributions in the driver's cab of motor vehicle simulators. The results will serve as the basis for future research on the influence of EMF emitted by mobile phones on driver physiology. Materials and Methods: Two motor vehicle driving simulators were monitored, while an EMF source was placed at the driver's head or on the dashboard of the motor vehicle driving simulator. For every applied configuration, the maximal electric field strength was measured, as were the values at 16 points corresponding to chosen locations on a driver's or passenger's body. Results: When the power was set for the maximum (49 mW, a value of 27 V/m was measured in the vicinity of the driver's head when the phone was close to the head. With the same power, when the phone was placed on the dashboard, the measured maximum was 15.2 V/m in the vicinity of the driver's foot. Similar results were obtained for the passenger. Significant perturbations in EMF distribution and an increase in electric field strength values in the motor vehicle driving simulator were also observed in comparison to free space measurements, and the electric field strength was up to 3 times higher inside the simulator. Conclusions: This study can act as the basis of future studies concerning the influence of the EMF emitted by mobile phones on the physiology of the driver. Additionally, the authors postulate that it is advisable to keep mobile phones at a distance from the head, i.e. use, whenever possible, hands-free kits to reduce EMF exposure, both for drivers and passengers.

  10. Prevalence of cough throughout childhood: A cohort study.

    Directory of Open Access Journals (Sweden)

    Maja Jurca

    Full Text Available Cough in children is a common reason for medical consultations and affects quality of life. There are little population-based data on the epidemiology of recurrent cough in children and how this varies by age and sex, or between children with and without wheeze. We determined the prevalence of cough throughout childhood, comparing several standardised cough questions. We did this for the entire population and separately for girls and boys, and for children with and without wheeze.In a population-based prospective cohort from Leicestershire, UK, we assessed prevalence of cough with repeated questionnaires from early childhood to adolescence. We asked whether the child usually coughed more than other children, with or without colds, had night-time cough or cough triggered by various factors (triggers, related to increased breathing effort, allergic or food triggers. We calculated prevalence from age 1 to 18 years using generalised estimating equations for all children, and for children with and without wheeze.Of 7670 children, 10% (95% CI 10-11% coughed more than other children, 69% (69-70% coughed usually with a cold, 34% to 55% age-dependently coughed without colds, and 25% (25-26% had night-time cough. Prevalence of coughing more than peers, with colds, at night, and triggered by laughter varied little throughout childhood, while cough without colds and cough triggered by exercise, house dust or pollen became more frequent with age. Cough was more common in boys than in girls in the first decade of life, differences got smaller in early teens and reversed after the age of 14 years. All symptoms were more frequent in children with wheeze.Prevalence of cough in children varies with age, sex and with the questions used to assess it, suggesting that comparisons between studies are only valid for similar questions and age groups.

  11. Cough: neurophysiology, methods of research, pharmacological therapy and phonoaudiology

    Directory of Open Access Journals (Sweden)

    Balbani, Aracy Pereira Silveira

    2012-01-01

    Full Text Available Introduction: The cough is the more common respiratory symptom in children and adults. Objective: To present a revision on the neurophysiology and the methods for study of the consequence of the cough, as well as the pharmacotherapy and phonoaudiology therapy of the cough, based on the works published between 2005 and 2010 and indexed in the bases Medline, Lilacs and Library Cochrane under them to keywords "cough" or "anti-cough". Synthesis of the data: The consequence of the cough involves activation of receiving multiples becomes vacant in the aerial ways and of neural projections of the nucleus of the solitary treatment for other structures of the central nervous system. Experimental techniques allow studying the consequence of the cough to the cellular and molecular level to develop new anti-cough agents. It does not have evidences of that anti-cough exempt of medical lapsing they have superior effectiveness to the one of placebo for the relief of the cough. The phonoaudiology therapy can benefit patients with refractory chronic cough to the pharmacological treatment, over all when paradoxical movement of the vocal folds coexists. Final Comments: The boarding to multidiscipline has basic paper in the etiological diagnosis and treatment of the cough. The otolaryngologist must inform the patients on the risks of the anti-cough of free sales in order to prevent adverse poisonings and effect, especially in children.

  12. [Development of cough-relieving herbal teas].

    Science.gov (United States)

    Puodziūniene, Gene; Janulis, Valdimaras; Milasius, Arvydas; Budnikas, Vytautas

    2005-01-01

    Cough-relieving medicinal herbs in tea are used from ancient times. Mucilage present in them or secretion produced under the influence of the active substances covers the oral and throat mucosa soothing its irritability and relieving dry, tiresome cough. It is known that the mixtures of medicinal herbs (Specias) have a complex influence on the human organism and the rational combination of medicinal herbs can improve their curative action and decrease the undesirable side effects. Having summarized the properties of those medicinal herbs we decided to create two formulations of cough-relieving herbal tea. The first formulation consists of marshmallow roots, liquorice roots and lime flowers, the second -- of marshmallow roots, Iceland moss and lime flowers. The methods for identification and assay of the active substances in the compounds were applied. The purity of the mixtures was regulated by limitation of the loss on drying, total ash, microbial contamination, contamination with radionuclides, heavy metals, pesticides and foreign matter. The expiry date of both cough-relieving herbal teas was approved to be 2 years.

  13. 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 ...

  14. Born with Protection against Whooping Cough

    Centers for Disease Control (CDC) Podcasts

    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.

  15. 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.

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

    Medline Plus

    Full Text Available ... immunizations about immunizations current news Flu's Gonna Lose hepatitis a & b vaccines im/sq how to do kids ... abcs of mmr & dtp thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus ...

  17. Face Masks and Cough Etiquette Reduce the Cough Aerosol Concentration of Pseudomonas aeruginosa in People with Cystic Fibrosis.

    Science.gov (United States)

    Wood, Michelle E; Stockwell, Rebecca E; Johnson, Graham R; Ramsay, Kay A; Sherrard, Laura J; Jabbour, Nassib; Ballard, Emma; O'Rourke, Peter; Kidd, Timothy J; Wainwright, Claire E; Knibbs, Luke D; Sly, Peter D; Morawska, Lidia; Bell, Scott C

    2018-02-01

    People with cystic fibrosis (CF) generate Pseudomonas aeruginosa in droplet nuclei during coughing. The use of surgical masks has been recommended in healthcare settings to minimize pathogen transmission between patients with CF. To determine if face masks and cough etiquette reduce viable P. aeruginosa aerosolized during coughing. Twenty-five adults with CF and chronic P. aeruginosa infection were recruited. Participants performed six talking and coughing maneuvers, with or without face masks (surgical and N95) and hand covering the mouth when coughing (cough etiquette) in an aerosol-sampling device. An Andersen Cascade Impactor was used to sample the aerosol at 2 meters from each participant. Quantitative sputum and aerosol bacterial cultures were performed, and participants rated the mask comfort levels during the cough maneuvers. During uncovered coughing (reference maneuver), 19 of 25 (76%) participants produced aerosols containing P. aeruginosa, with a positive correlation found between sputum P. aeruginosa concentration (measured as cfu/ml) and aerosol P. aeruginosa colony-forming units. There was a reduction in aerosol P. aeruginosa load during coughing with a surgical mask, coughing with an N95 mask, and cough etiquette compared with uncovered coughing (P masks during coughing; yet, participants rated the surgical masks as more comfortable (P = 0.013). Cough etiquette provided approximately half the reduction of viable aerosols of the mask interventions during voluntary coughing. Talking was a low viable aerosol-producing activity. Face masks reduce cough-generated P. aeruginosa aerosols, with the surgical mask providing enhanced comfort. Cough etiquette was less effective at reducing viable aerosols.

  18. Cough reflex sensitivity and airway inflammation in patients with chronic cough due to non-acid gastro-oesophageal reflux.

    Science.gov (United States)

    Qiu, Zhihong; Yu, Li; Xu, Shuchang; Liu, Bo; Zhao, Ting; Lü, Hanjing; Qiu, Zhongmin

    2011-05-01

    The aim of this study was to explore the pathogenesis of chronic cough caused by non-acid reflux. Seven patients with chronic cough due to non-acid reflux, 12 patients with chronic cough due to acid reflux, 10 patients with gastro-oesophageal reflux disease without cough and 12 healthy volunteers were recruited for the study. All subjects underwent oesophageal multi-channel intraluminal impedance measurements combined with pH monitoring, and assessment of cough reflex sensitivity to capsaicin and induced sputum cytology. The concentrations of substance P, mast cell tryptase, prostaglandin D2 and histamine in induced sputum were measured by ELISA. Cough threshold C2 and C5 did not differ between patients with chronic cough due to non-acid or acid reflux, but the values were significantly lower than those for patients with gastro-oesophageal reflux disease without cough and healthy volunteers. Weakly acidic reflux episodes were obviously more frequent in patients with chronic cough due to non-acid reflux than in the other three groups. Sputum substance P and mast cell tryptase concentrations were remarkably increased in patients with chronic cough, but were similar for those with cough due to non-acid or acid reflux. There were significant inverse correlations between substance P levels and cough threshold C2 or C5 in patients with cough due to non-acid or acid reflux, and between mast cell tryptase levels and cough threshold C2 in patients with cough due to acid reflux. Chronic cough due to non-acid reflux may be related to cough reflex hypersensitivity caused by neurogenic airway inflammation and mast cell activation, in which weakly acidic reflux is possibly a major factor. © 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.

  19. Resting-state brain activity in the motor cortex reflects task-induced activity: A multi-voxel pattern analysis.

    Science.gov (United States)

    Kusano, Toshiki; Kurashige, Hiroki; Nambu, Isao; Moriguchi, Yoshiya; Hanakawa, Takashi; Wada, Yasuhiro; Osu, Rieko

    2015-08-01

    It has been suggested that resting-state brain activity reflects task-induced brain activity patterns. In this study, we examined whether neural representations of specific movements can be observed in the resting-state brain activity patterns of motor areas. First, we defined two regions of interest (ROIs) to examine brain activity associated with two different behavioral tasks. Using multi-voxel pattern analysis with regularized logistic regression, we designed a decoder to detect voxel-level neural representations corresponding to the tasks in each ROI. Next, we applied the decoder to resting-state brain activity. We found that the decoder discriminated resting-state neural activity with accuracy comparable to that associated with task-induced neural activity. The distribution of learned weighted parameters for each ROI was similar for resting-state and task-induced activities. Large weighted parameters were mainly located on conjunctive areas. Moreover, the accuracy of detection was higher than that for a decoder whose weights were randomly shuffled, indicating that the resting-state brain activity includes multi-voxel patterns similar to the neural representation for the tasks. Therefore, these results suggest that the neural representation of resting-state brain activity is more finely organized and more complex than conventionally considered.

  20. Cough response to citric acid aerosol in occasional smokers.

    OpenAIRE

    Pounsford, J C; Saunders, K B

    1986-01-01

    Twenty two normal women volunteers underwent a standard cough provocation test by inhaling solutions of citric acid of progressively increasing concentration. Eight were non-smokers, eight moderate smokers, and six occasional smokers. All the non-smokers and moderate smokers coughed. Moderate smokers tended to cough more than non-smokers, but not significantly so. None of the occasional smokers coughed at all (p less than 0.001). Possibly the ability to smoke occasionally with enjoyment is a ...

  1. Efficacy of face shields against cough aerosol droplets from a cough simulator.

    Science.gov (United States)

    Lindsley, William G; Noti, John D; Blachere, Francoise M; Szalajda, Jonathan V; Beezhold, Donald H

    2014-01-01

    Health care workers are exposed to potentially infectious airborne particles while providing routine care to coughing patients. However, much is not understood about the behavior of these aerosols and the risks they pose. We used a coughing patient simulator and a breathing worker simulator to investigate the exposure of health care workers to cough aerosol droplets, and to examine the efficacy of face shields in reducing this exposure. Our results showed that 0.9% of the initial burst of aerosol from a cough can be inhaled by a worker 46 cm (18 inches) from the patient. During testing of an influenza-laden cough aerosol with a volume median diameter (VMD) of 8.5 μm, wearing a face shield reduced the inhalational exposure of the worker by 96% in the period immediately after a cough. The face shield also reduced the surface contamination of a respirator by 97%. When a smaller cough aerosol was used (VMD = 3.4 μm), the face shield was less effective, blocking only 68% of the cough and 76% of the surface contamination. In the period from 1 to 30 minutes after a cough, during which the aerosol had dispersed throughout the room and larger particles had settled, the face shield reduced aerosol inhalation by only 23%. Increasing the distance between the patient and worker to 183 cm (72 inches) reduced the exposure to influenza that occurred immediately after a cough by 92%. Our results show that health care workers can inhale infectious airborne particles while treating a coughing patient. Face shields can substantially reduce the short-term exposure of health care workers to large infectious aerosol particles, but smaller particles can remain airborne longer and flow around the face shield more easily to be inhaled. Thus, face shields provide a useful adjunct to respiratory protection for workers caring for patients with respiratory infections. However, they cannot be used as a substitute for respiratory protection when it is needed. [Supplementary materials are

  2. Perception of urge-to-cough and dyspnea in healthy smokers with decreased cough reflex sensitivity

    OpenAIRE

    Kanezaki, Masashi; Ebihara, Satoru; Nikkuni, Etsuhiro; Gui, Peijun; Suda, Chihiro; Ebihara, Takae; Yamasaki, Miyako; Kohzuki, Masahiro

    2010-01-01

    Background Although cigarette smoking has been implicated as an important risk factor for the development of respiratory symptoms, the perceptional aspects of two symptoms in smokers have not been fully elucidated. Therefore, we simultaneously evaluated the cough reflex sensitivity, the cognition of urge-to-cough and perception of dyspnea in both healthy smokers and non-smokers. Methods Fourteen male healthy never-smokers and 14 age-matched male healthy current-smokers were recruited via publ...

  3. Comparative analysis of case screening with varying cough duration ...

    African Journals Online (AJOL)

    Conclusion: The sensitivity analysis of the study showed that using .2 weeks cough with two sputum samples gives almost similar values as .3 weeks cough with three sputum samples, but this needs further confirmatory results of culture sensitivity. Hence, using .2 weeks cough with two sputum samples as the diagnostic ...

  4. Management of Cough: a practical approach | Vally | South African ...

    African Journals Online (AJOL)

    On a regular day, healthcare providers will be contacted by one or more health seekers presenting with cough as a symptom. Cough has been considered an important physiological reflex that protects the airways from aspiration of foreign materials. Cough is one of the most common symptoms for which people seek ...

  5. Generation of complex motor patterns in american grasshopper via current-controlled thoracic electrical interfacing.

    Science.gov (United States)

    Giampalmo, Susan L; Absher, Benjamin F; Bourne, W Tucker; Steves, Lida E; Vodenski, Vassil V; O'Donnell, Peter M; Erickson, Jonathan C

    2011-01-01

    Micro-air vehicles (MAVs) have attracted attention for their potential application to military applications, environmental sensing, and search and rescue missions. While progress is being made toward fabrication of a completely human-engineered MAV, another promising approach seeks to interface to, and take control of, an insect's nervous system. Cyborg insects take advantage of their innate exquisite loco-motor, navigation, and sensing abilities. Recently, several groups have demonstrated the feasibility of radio-controlled flight in the hawkmoth and beetle via electrical neural interfaces. Here, we report a method for eliciting the "jump" response in the American grasshopper (S. Americana). We found that stimulating the metathoracic T3 ganglion with constant-current square wave pulses with amplitude 186 ± 40 μA and frequency 190 ± 13 Hz reproducibly evoked (≥95% success rate) the desired motor activity in N=3 test subjects. To the best of our knowledge, this is the first report of an insect cyborg with a synchronous neuromuscular system.

  6. Discrimination of Motor Imagery-Induced EEG Patterns in Patients with Complete Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    G. Pfurtscheller

    2009-01-01

    Full Text Available EEG-based discrimination between different motor imagery states has been subject of a number of studies in healthy subjects. We investigated the EEG of 15 patients with complete spinal cord injury during imagined right hand, left hand, and feet movements. In detail we studied pair-wise discrimination functions between the 3 types of motor imagery. The following classification accuracies (mean ± SD were obtained: left versus right hand 65.03% ± 8.52, left hand versus feet 68.19% ± 11.08, and right hand versus feet 65.05% ± 9.25. In 5 out of 8 paralegic patients, the discrimination accuracy was greater than 70% but in only 1 out of 7 tetraplagic patients. The present findings provide evidence that in the majority of paraplegic patients an EEG-based BCI could achieve satisfied results. In tetraplegic patients, however, it is expected that extensive training-sessions are necessary to achieve a good BCI performance at least in some subjects.

  7. Lead intoxication induces noradrenaline depletion, motor nonmotor disabilities, and changes in the firing pattern of subthalamic nucleus neurons.

    Science.gov (United States)

    Sabbar, M; Delaville, C; De Deurwaerdère, P; Benazzouz, A; Lakhdar-Ghazal, N

    2012-05-17

    Lead intoxication has been suggested as a high risk factor for the development of Parkinson disease. However, its impact on motor and nonmotor functions and the mechanism by which it can be involved in the disease are still unclear. In the present study, we studied the effects of lead intoxication on the following: (1) locomotor activity using an open field actimeter and motor coordination using the rotarod test, (2) anxiety behavior using the elevated plus maze, (3) "depression-like" behavior using sucrose preference test, and (4) subthalamic nucleus (STN) neuronal activity using extracellular single unit recordings. Male Sprague-Dawley rats were treated once a day with lead acetate or sodium acetate (20 mg/kg/d i.p.) during 3 weeks. The tissue content of monoamines was used to determine alteration of these systems at the end of experiments. Results show that lead significantly reduced exploratory activity, locomotor activity and the time spent on the rotarod bar. Furthermore, lead induced anxiety but not "depressive-like" behavior. The electrophysiological results show that lead altered the discharge pattern of STN neurons with an increase in the number of bursting and irregular cells without affecting the firing rate. Moreover, lead intoxication resulted in a decrease of tissue noradrenaline content without any change in the levels of dopamine and serotonin. Together, these results show for the first time that lead intoxication resulted in motor and nonmotor behavioral changes paralleled by noradrenaline depletion and changes in the firing activity of STN neurons, providing evidence consistent with the induction of atypical parkinsonian-like deficits. Copyright © 2012 IBRO. Published by Elsevier Ltd. All rights reserved.

  8. Unstable patterns and robust synchronization in a model of motor pathway in birdsong

    International Nuclear Information System (INIS)

    Moukam Kakmeni, F.M.; Bowong, S.; Nana, L.; Kofane, T.C.

    2006-10-01

    This paper investigates the fundamental dynamical mechanism responsible for transition to chaos in periodically modulated Duffing-Van der Pol oscillator. It is shown that a modulationally unstable pattern appears into an initially stable motionless state. A further spatiotemporal transition occurs with a sharp interface from the selected stable pattern to a stabilized pattern or chaotic state. Also, the synchronization of the chaotic state of the model is investigated. The results are discussed in the context of generalized synchronization. The main idea is to construct an augmented dynamical system from the synchronization error system, which is itself uncertain. The advantage of this method over existing results is that the synchronization time is explicitly computed. Numerical simulations are provided to verify the operation of the proposed algorithm. (author)

  9. Touchscreen typing-pattern analysis for detecting fine motor skills decline in early-stage Parkinson's disease.

    Science.gov (United States)

    Iakovakis, Dimitrios; Hadjidimitriou, Stelios; Charisis, Vasileios; Bostantzopoulou, Sevasti; Katsarou, Zoe; Hadjileontiadis, Leontios J

    2018-05-16

    Parkinson's disease (PD) is a degenerative movement disorder causing progressive disability that severely affects patients' quality of life. While early treatment can produce significant benefits for patients, the mildness of many early signs combined with the lack of accessible high-frequency monitoring tools may delay clinical diagnosis. To meet this need, user interaction data from consumer technologies have recently been exploited towards unsupervised screening for PD symptoms in daily life. Similarly, this work proposes a method for detecting fine motor skills decline in early PD patients via analysis of patterns emerging from finger interaction with touchscreen smartphones during natural typing. Our approach relies on low-/higher-order statistical features of keystrokes timing and pressure variables, computed from short typing sessions. Features are fed into a two-stage multi-model classification pipeline that reaches a decision on the subject's status (PD patient/control) by gradually fusing prediction probabilities obtained for individual typing sessions and keystroke variables. This method achieved an AUC = 0.92 and 0.82/0.81 sensitivity/specificity (matched groups of 18 early PD patients/15 controls) with discriminant features plausibly correlating with clinical scores of relevant PD motor symptoms. These findings suggest an improvement over similar approaches, thereby constituting a further step towards unobtrusive early PD detection from routine activities.

  10. COUGH IN CHILDREN: NEW DECISION OF OLD PROBLEM

    Directory of Open Access Journals (Sweden)

    T.V. Spichak

    2008-01-01

    Full Text Available Cough in children: new decision of old problem the mechanism of development of cough, classification of its types and main reasons of it are described in this article. Special attention was given to the problem of diagnostics of chronic cough, to peculiarities of modern instrumental diagnostic methods and to principles of therapeutic tactics. The results of treatment with anti inflammatory medication fenspiride (eurespal are presented. Russian and foreign literature data and information from american guideline in cough treatment was used in this article.Key words: cough, children, fenspiride.

  11. Using Fractal and Local Binary Pattern Features for Classification of ECOG Motor Imagery Tasks Obtained from the Right Brain Hemisphere.

    Science.gov (United States)

    Xu, Fangzhou; Zhou, Weidong; Zhen, Yilin; Yuan, Qi; Wu, Qi

    2016-09-01

    The feature extraction and classification of brain signal is very significant in brain-computer interface (BCI). In this study, we describe an algorithm for motor imagery (MI) classification of electrocorticogram (ECoG)-based BCI. The proposed approach employs multi-resolution fractal measures and local binary pattern (LBP) operators to form a combined feature for characterizing an ECoG epoch recording from the right hemisphere of the brain. A classifier is trained by using the gradient boosting in conjunction with ordinary least squares (OLS) method. The fractal intercept, lacunarity and LBP features are extracted to classify imagined movements of either the left small finger or the tongue. Experimental results on dataset I of BCI competition III demonstrate the superior performance of our method. The cross-validation accuracy and accuracy is 90.6% and 95%, respectively. Furthermore, the low computational burden of this method makes it a promising candidate for real-time BCI systems.

  12. Synchronous Spike Patterns in Macaque Motor Cortex during an Instructed-Delay Reach-to-Grasp Task.

    Science.gov (United States)

    Torre, Emiliano; Quaglio, Pietro; Denker, Michael; Brochier, Thomas; Riehle, Alexa; Grün, Sonja

    2016-08-10

    The computational role of spike time synchronization at millisecond precision among neurons in the cerebral cortex is hotly debated. Studies performed on data of limited size provided experimental evidence that low-order correlations occur in relation to behavior. Advances in electrophysiological technology to record from hundreds of neurons simultaneously provide the opportunity to observe coordinated spiking activity of larger populations of cells. We recently published a method that combines data mining and statistical evaluation to search for significant patterns of synchronous spikes in massively parallel spike trains (Torre et al., 2013). The method solves the computational and multiple testing problems raised by the high dimensionality of the data. In the current study, we used our method on simultaneous recordings from two macaque monkeys engaged in an instructed-delay reach-to-grasp task to determine the emergence of spike synchronization in relation to behavior. We found a multitude of synchronous spike patterns aligned in both monkeys along a preferential mediolateral orientation in brain space. The occurrence of the patterns is highly specific to behavior, indicating that different behaviors are associated with the synchronization of different groups of neurons ("cell assemblies"). However, pooled patterns that overlap in neuronal composition exhibit no specificity, suggesting that exclusive cell assemblies become active during different behaviors, but can recruit partly identical neurons. These findings are consistent across multiple recording sessions analyzed across the two monkeys. Neurons in the brain communicate via electrical impulses called spikes. How spikes are coordinated to process information is still largely unknown. Synchronous spikes are effective in triggering a spike emission in receiving neurons and have been shown to occur in relation to behavior in a number of studies on simultaneous recordings of few neurons. We recently published

  13. Assessing altered motor unit recruitment patterns in paretic muscles of stroke survivors using surface electromyography

    Science.gov (United States)

    Hu, Xiaogang; Suresh, Aneesha K.; Rymer, William Z.; Suresh, Nina L.

    2015-12-01

    Objective. The advancement of surface electromyogram (sEMG) recording and signal processing techniques has allowed us to characterize the recruitment properties of a substantial population of motor units (MUs) non-invasively. Here we seek to determine whether MU recruitment properties are modified in paretic muscles of hemispheric stroke survivors. Approach. Using an advanced EMG sensor array, we recorded sEMG during isometric contractions of the first dorsal interosseous muscle over a range of contraction levels, from 20% to 60% of maximum, in both paretic and contralateral muscles of stroke survivors. Using MU decomposition techniques, MU action potential amplitudes and recruitment thresholds were derived for simultaneously activated MUs in each isometric contraction. Main results. Our results show a significant disruption of recruitment organization in paretic muscles, in that the size principle describing recruitment rank order was materially distorted. MUs were recruited over a very narrow force range with increasing force output, generating a strong clustering effect, when referenced to recruitment force magnitude. Such disturbances in MU properties also correlated well with the impairment of voluntary force generation. Significance. Our findings provide direct evidence regarding MU recruitment modifications in paretic muscles of stroke survivors, and suggest that these modifications may contribute to weakness for voluntary contractions.

  14. Pattern of visceral injuries following blunt abdominal trauma in motor vehicular accidents

    International Nuclear Information System (INIS)

    Khan, J.S.; Iqbal, N.; Gardezi, J.R.

    2006-01-01

    To determine the frequency of various visceral injuries following, high-speed motor vehicle crashes with special reference to frequency of liver injuries, severity and complications. The study included 100 consecutive patients of blunt abdominal trauma. Patients of either gender and age above 12 and below 70 were included in this study. Purposive non-probability sampling was done. Injuries were identified, graded and managed accordingly. The data was then entered into SPSS and descriptive statistical tests were applied. Liver was the most common organ injured (35%), followed by spleen (32 %) and small gut (30 %). In 23 patients, liver was the only organ injured. Most of the liver injuries fell under grade I (42.8%) followed by grade II (28.35%) and grade III (22.85%) and were treated by suture hepatorrhaphy alone in 71.42% cases. The operated cases were mostly complicated by wound infection (33.76%). Overall mortality remained high (12%) and was related to a combination of delays in arriving at a diagnosis due to nonavailability of CT scan and routine use of peritoneal lavage. (author)

  15. Recognition of neural brain activity patterns correlated with complex motor activity

    Science.gov (United States)

    Kurkin, Semen; Musatov, Vyacheslav Yu.; Runnova, Anastasia E.; Grubov, Vadim V.; Efremova, Tatyana Yu.; Zhuravlev, Maxim O.

    2018-04-01

    In this paper, based on the apparatus of artificial neural networks, a technique for recognizing and classifying patterns corresponding to imaginary movements on electroencephalograms (EEGs) obtained from a group of untrained subjects was developed. The works on the selection of the optimal type, topology, training algorithms and neural network parameters were carried out from the point of view of the most accurate and fast recognition and classification of patterns on multi-channel EEGs associated with the imagination of movements. The influence of the number and choice of the analyzed channels of a multichannel EEG on the quality of recognition of imaginary movements was also studied, and optimal configurations of electrode arrangements were obtained. The effect of pre-processing of EEG signals is analyzed from the point of view of improving the accuracy of recognition of imaginary movements.

  16. Reorganization of finger coordination patterns through motor exploration in individuals after stroke.

    Science.gov (United States)

    Ranganathan, Rajiv

    2017-09-11

    Impairment of hand and finger function after stroke is common and affects the ability to perform activities of daily living. Even though many of these coordination deficits such as finger individuation have been well characterized, it is critical to understand how stroke survivors learn to explore and reorganize their finger coordination patterns for optimizing rehabilitation. In this study, I examine the use of a body-machine interface to assess how participants explore their movement repertoire, and how this changes with continued practice. Ten participants with chronic stroke wore a data glove and the finger joint angles were mapped on to the position of a cursor on a screen. The task of the participants was to move the cursor back and forth between two specified targets on a screen. Critically, the map between the finger movements and cursor motion was altered so that participants sometimes had to generate coordination patterns that required finger individuation. There were two phases to the experiment - an initial assessment phase on day 1, followed by a learning phase (days 2-5) where participants trained to reorganize their coordination patterns. Participants showed difficulty in performing tasks which had maps that required finger individuation, and the degree to which they explored their movement repertoire was directly related to clinical tests of hand function. However, over four sessions of practice, participants were able to learn to reorganize their finger movement coordination pattern and improve their performance. Moreover, training also resulted in improvements in movement repertoire outside of the context of the specific task during free exploration. Stroke survivors show deficits in movement repertoire in their paretic hand, but facilitating movement exploration during training can increase the movement repertoire. This suggests that exploration may be an important element of rehabilitation to regain optimal function.

  17. Different patterns of motor activity induce differential plastic changes in pyramidal neurons in the motor cortex of rats: A Golgi study.

    Science.gov (United States)

    Vázquez-Hernández, Nallely; González-Tapia, Diana C; Martínez-Torres, Nestor I; González-Tapia, David; González-Burgos, Ignacio

    2017-09-14

    Rehabilitation is a process which favors recovery after brain damage involving motor systems, and neural plasticity is the only real resource the brain has for inducing neurobiological events in order to bring about re-adaptation. Rats were placed on a treadmill and made to walk, in different groups, at different velocities and with varying degrees of inclination. Plastic changes in the spines of the apical and basal dendrites of fifth-layer pyramidal neurons in the motor cortices of the rats were detected after study with the Golgi method. Numbers of dendritic spines increased in the three experimental groups, and thin, mushroom, stubby, wide, and branched spines increased or decreased in proportion depending on the motor demands made of each group. Along with the numerical increase of spines, the present findings provide evidence that dendritic spines' geometrical plasticity is involved in the differential performance of motor activity. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Association between patterns of jaw motor activity during sleep and clinical signs and symptoms of sleep bruxism.

    Science.gov (United States)

    Yoshida, Yuya; Suganuma, Takeshi; Takaba, Masayuki; Ono, Yasuhiro; Abe, Yuka; Yoshizawa, Shuichiro; Sakai, Takuro; Yoshizawa, Ayako; Nakamura, Hirotaka; Kawana, Fusae; Baba, Kazuyoshi

    2017-08-01

    The aim of this study was to investigate the association between patterns of jaw motor activity during sleep and clinical signs and symptoms of sleep bruxism. A total of 35 university students and staff members participated in this study after providing informed consent. All participants were divided into either a sleep bruxism group (n = 21) or a control group (n = 14), based on the following clinical diagnostic criteria: (1) reports of tooth-grinding sounds for at least two nights a week during the preceding 6 months by their sleep partner; (2) presence of tooth attrition with exposed dentin; (3) reports of morning masticatory muscle fatigue or tenderness; and (4) presence of masseter muscle hypertrophy. Video-polysomnography was performed in the sleep laboratory for two nights. Sleep bruxism episodes were measured using masseter electromyography, visually inspected and then categorized into phasic or tonic episodes. Phasic episodes were categorized further into episodes with or without grinding sounds as evaluated by audio signals. Sleep bruxism subjects with reported grinding sounds had a significantly higher total number of phasic episodes with grinding sounds than subjects without reported grinding sounds or controls (Kruskal-Wallis/Steel-Dwass tests; P bruxism subjects with tooth attrition exhibited significantly longer phasic burst durations than those without or controls (Kruskal-Wallis/Steel-Dwass tests; P bruxism subjects with morning masticatory muscle fatigue or tenderness exhibited significantly longer tonic burst durations than those without or controls (Kruskal-Wallis/Steel-Dwass tests; P bruxism represents different aspects of jaw motor activity during sleep. © 2016 European Sleep Research Society.

  19. Effects of patterned peripheral nerve stimulation on soleus spinal motor neuron excitability

    DEFF Research Database (Denmark)

    Jimenez, Samuel; Mordillo-Mateos, Laura; Dileone, Michele

    2018-01-01

    obtained was discarded, since non-patterned 15 Hz stimulation at 110% HT led to pain scores similar to those induced by EcTBS at 110% HT, but was not able to induce any modulation of the H reflex amplitude. Together, the results provide first time evidence that peripheral continuous TBS induces a short......Spinal plasticity is thought to contribute to sensorimotor recovery of limb function in several neurological disorders and can be experimentally induced in animals and humans using different stimulation protocols. In healthy individuals, electrical continuous Theta Burst Stimulation (TBS....... In 26 healthy subjects, we examined the effects of electrical TBS given to the tibial nerve in the popliteal fossa on the excitability of lumbar spinal motoneurons as measured by H-reflex amplitude of the soleus muscle evoked by tibial nerve stimulation. Continuous TBS was given at 110% of H...

  20. Dry night cough as a marker of allergy in preschool children: the PARIS birth cohort.

    Science.gov (United States)

    Rancière, Fanny; Nikasinovic, Lydia; Momas, Isabelle

    2013-03-01

    Early detection of children at risk for developing allergy is an important challenge. Our first analyses in infants from the Pollution and Asthma Risk: an Infant Study (PARIS) birth cohort suggested that dry night cough was associated with parental-reported allergic disorders. The aim of the present study was to refine this finding by investigating the time course of dry night cough from birth to age 4 yr in relation to blood markers of atopy and allergic morbidity. Health outcomes were regularly assessed by parental self-administered questionnaires. Blood markers of atopy were measured at age 18 months. Children with similar patterns of dry night cough over the first 4 yr of life were grouped together using k-means clustering. Associations with atopy/allergy were studied using multinomial logistic regression. Three trajectories of dry night cough were identified in 1869 children. Besides the never/infrequent pattern (72.4%), the transient pattern (8.8%) was composed of children who coughed in the first year and recovered by age 4 yr, while the rising pattern (18.8%) included all symptomatic children at age 4 yr, whether they were persistent or late coughers. Compared with the never/infrequent pattern, the rising pattern was significantly associated with elevated total immunoglobulin E (IgE) level (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.21-2.39) and inhalant allergens sensitization (OR = 2.66, 95% CI = 1.26-5.61) at age 18 months, and with doctor-diagnosed allergic diseases over the first 4 yr such as hay fever (OR = 2.52, 95% CI = 1.49-4.26) and eczema (OR = 1.29, 95% CI = 1.00-1.66). This study provides evidence that persistent/late dry night cough may indicate allergy in preschool children. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  1. Visually driven chaining of elementary swim patterns into a goal-directed motor sequence: a virtual reality study of zebrafish prey capture

    Science.gov (United States)

    Trivedi, Chintan A.; Bollmann, Johann H.

    2013-01-01

    Prey capture behavior critically depends on rapid processing of sensory input in order to track, approach, and catch the target. When using vision, the nervous system faces the problem of extracting relevant information from a continuous stream of input in order to detect and categorize visible objects as potential prey and to select appropriate motor patterns for approach. For prey capture, many vertebrates exhibit intermittent locomotion, in which discrete motor patterns are chained into a sequence, interrupted by short periods of rest. Here, using high-speed recordings of full-length prey capture sequences performed by freely swimming zebrafish larvae in the presence of a single paramecium, we provide a detailed kinematic analysis of first and subsequent swim bouts during prey capture. Using Fourier analysis, we show that individual swim bouts represent an elementary motor pattern. Changes in orientation are directed toward the target on a graded scale and are implemented by an asymmetric tail bend component superimposed on this basic motor pattern. To further investigate the role of visual feedback on the efficiency and speed of this complex behavior, we developed a closed-loop virtual reality setup in which minimally restrained larvae recapitulated interconnected swim patterns closely resembling those observed during prey capture in freely moving fish. Systematic variation of stimulus properties showed that prey capture is initiated within a narrow range of stimulus size and velocity. Furthermore, variations in the delay and location of swim triggered visual feedback showed that the reaction time of secondary and later swims is shorter for stimuli that appear within a narrow spatio-temporal window following a swim. This suggests that the larva may generate an expectation of stimulus position, which enables accelerated motor sequencing if the expectation is met by appropriate visual feedback. PMID:23675322

  2. Visually driven chaining of elementary swim patterns into a goal-directed motor sequence: a virtual reality study of zebrafish prey capture

    Directory of Open Access Journals (Sweden)

    Chintan A Trivedi

    2013-05-01

    Full Text Available Prey capture behavior critically depends on rapid processing of sensory input in order to track, approach and catch the target. When using vision, the nervous system faces the problem of extracting relevant information from a continuous stream of input in order to detect and categorize visible objects as potential prey and to select appropriate motor patterns for approach. For prey capture, many vertebrates exhibit intermittent locomotion, in which discrete motor patterns are chained into a sequence, interrupted by short periods of rest. Here, using high-speed recordings of full-length prey capture sequences performed by freely swimming zebrafish larvae in the presence of a single paramecium, we provide a detailed kinematic analysis of first and subsequent swim bouts during prey capture. Using Fourier analysis, we show that individual swim bouts represent an elementary motor pattern. Changes in orientation are directed towards the target on a graded scale and are implemented by an asymmetric tail bend component superimposed on this basic motor pattern. To further investigate the role of visual feedback on the efficiency and speed of this complex behavior, we developed a closed-loop virtual reality setup in which minimally restrained larvae recapitulated interconnected swim patterns closely resembling those observed during prey capture in freely moving fish. Systematic variation of stimulus properties showed that prey capture is initiated within a narrow range of stimulus size and velocity. Furthermore, variations in the delay and location of swim-triggered visual feedback showed that the reaction time of secondary and later swims is shorter for stimuli that appear within a narrow spatio-temporal window following a swim. This suggests that the larva may generate an expectation of stimulus position, which enables accelerated motor sequencing if the expectation is met by appropriate visual feedback.

  3. Correlation between permanent tooth eruption pattern and the predominance of the motor function laterality.

    Science.gov (United States)

    Veloso-Durán, Ana; Vazquez-Salceda, Ma Carmen; López-Jiménez, Julian; Veloso-Durán, Margarita; Puigdollers, Andreu

    2014-09-01

    To asses whether dental eruption order can play a role in the early diagnosis of crossed laterality. Dental eruption pattern along with eye, ear, hand and foot lateralism were examined on 131 children between 6 to 8 years old from public schools from a multietnic population area of Barcelona city. Statistic methods (Statgraphics Plus 5.1 program) were used to evaluate data recollected. Only foot and dentition lateralities behave as independent variables regarding hand laterality. So dental eruption laterality (along with the foot one) would be one of the parameters more related to hand laterality given that dentition variable relationship is greater that the foot one. This suggests that tooth eruption could be more clinically relevant. Crossed laterality hand-foot is significantly more predominant in men (13%) than in women (1,6%). Meanwhile, the relationship between hand and dentition didn't show any influence of sex. Dental eruption order, can be used as a good parameter in the determination of the patient's laterality.

  4. 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.

  5. Pharmacology of Bradykinin-Evoked Coughing in Guinea Pigs

    OpenAIRE

    Hewitt, Matthew M.; Adams, Gregory; Mazzone, Stuart B.; Mori, Nanako; Yu, Li; Canning, Brendan J.

    2016-01-01

    Bradykinin has been implicated as a mediator of the acute pathophysiological and inflammatory consequences of respiratory tract infections and in exacerbations of chronic diseases such as asthma. Bradykinin may also be a trigger for the coughing associated with these and other conditions. We have thus set out to evaluate the pharmacology of bradykinin-evoked coughing in guinea pigs. When inhaled, bradykinin induced paroxysmal coughing that was abolished by the bradykinin B2 receptor antagonis...

  6. A Whooping Cough Education Module for WIC Clients in Utah.

    Science.gov (United States)

    Luthy, Karlen E; Anderson, Alicia; Macintosh, Janelle; Beckstrand, Renea L; Eden, Lacey M; Amy, Ryan; Macintosh, Christopher I

    Clients in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are required to complete education modules quarterly to maintain eligibility. The purposes of this project were to: (1) create a whooping cough vaccination education module for WIC clients; (2) evaluate baseline perceptions of WIC clients on the whooping cough vaccine and disease; and (3) evaluate whooping cough knowledge following completion of the module. A decline in vaccination rates among infants and children using WIC services was reported by a local WIC program director who requested whooping cough vaccination education materials. This quality improvement project included development of a whooping cough education module and evaluation of learning. Learning was evaluated using a pre- and posttest design. Client feedback was solicited via open-ended questions. Quantitative analysis was performed on visual analog-type questions with paired t-tests and a Cohen's d. Content analysis was conducted on open-ended items. The module was designed by a team of vaccination experts and included general definitions, signs and symptoms during the three stages of disease, recommendations to prevent whooping cough, and vaccination recommendations. Learning of users of the module was then evaluated. After using the module, clients indicated they were significantly more likely to vaccinate themselves and their child against whooping cough, and to recommend the vaccination to their family members. The greatest concern of participants about whooping cough was how it affected infants. Participants reported they learned new information on disease seriousness, recognition of symptoms, and treatment options but still requested additional information on the whooping cough disease and vaccine. A whooping cough education module is an effective strategy to improve whooping cough knowledge and promote the whooping cough vaccine.

  7. Learning of temporal motor patterns: An analysis of continuous vs. reset timing

    Directory of Open Access Journals (Sweden)

    Rodrigo eLaje

    2011-10-01

    Full Text Available Our ability to generate well-timed sequences of movements is critical to an array of behaviors, including the ability to play a musical instrument or a video game. Here we address two questions relating to timing with the goal of better understanding the neural mechanisms underlying temporal processing. First, how does accuracy and variance change over the course of learning of complex spatiotemporal patterns? Second, is the timing of sequential responses most consistent with starting and stopping an internal timer at each interval or with continuous timing?To address these questions we used a psychophysical task in which subjects learned to reproduce a sequence of finger taps in the correct order and at the correct times—much like playing a melody at the piano. This task allowed us to calculate the variance of the responses at different time points using data from the same trials. Our results show that while standard Weber’s law is clearly violated, variance does increase as a function of time squared, as expected according to the generalized form of Weber’s law—which separates the source of variance into time-dependent and time-independent components. Over the course of learning, both the time-independent variance and the coefficient of the time-dependent term decrease. Our analyses also suggest that timing of sequential events does not rely on the resetting of an internal timer at each event.We describe and interpret our results in the context of computer simulations that capture some of our psychophysical findings. Specifically, we show that continuous timing, as opposed to reset timing, is expected from population clock models in which timing emerges from the internal dynamics of recurrent neural networks.

  8. Correlation between voluntary cough and laryngeal cough reflex flows in patients with traumatic brain injury.

    Science.gov (United States)

    Lee, Sang Chul; Kang, Seong-Woong; Kim, Min Tae; Kim, Yong Kyun; Chang, Won Hyuk; Im, Sang Hee

    2013-08-01

    To correlate voluntary cough and laryngeal cough reflex (LCR) flows in patients with traumatic brain injury (TBI). Cross-sectional study. University rehabilitation hospital. Patients with TBI (n=25) and healthy controls (n=48). Not applicable. Peak cough flows (PCFs) and LCR flows were measured using a peak flow meter at the oral-nasal interface. The largest value of 3 attempts was recorded for PCF and LCR, respectively. LCR was elicited by 20% solution of pharmaceutic-grade citric acid dissolved in sterile .15M NaCl solution that was inhaled from a nebulizer. PCF was 447.4 ± 99.0 L/min in the control group and 211.7 ± 58.2 L/min in the patient group. LCR was 209.2 ± 63.8L/min in the control group and 170.0 ± 59.7 L/min in the patient group. Both PCF (P=.000) and LCR (P=.013) were significantly reduced in patients with TBI compared to that of the control group. LCR was strongly related to the PCF in both control (R=.645; P=.000) and patient (R=.711; P=.000) groups. As LCR can be measured as a numerical value and significantly correlates with PCF, LCR can be used to estimate cough ability of patients with TBI who cannot cooperate with PCF measurement. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. Autosomal dominant hereditary sensory neuropathy with chronic cough and gastro-oesophageal reflux: clinical features in two families linked to chromosome 3p22-p24.

    Science.gov (United States)

    Spring, Penelope J; Kok, Cindy; Nicholson, Garth A; Ing, Alvin J; Spies, Judith M; Bassett, Mark L; Cameron, John; Kerlin, Paul; Bowler, Simon; Tuck, Roger; Pollard, John D

    2005-12-01

    Autosomal dominant hereditary sensory neuropathy (HSN I) is a clinically and genetically heterogeneous group of disorders, and in some families it is due to mutations in the serine palmitoyltransferase (SPTLC1) gene. We have characterized two families with HSN I associated with cough and gastro-oesophageal reflux (GOR). From a large Australian family, 27 individuals and from a smaller family, 11 individuals provided clinical information and blood for genetic analysis. Affected individuals had an adult onset of paroxysmal cough, GOR and distal sensory loss. Cough could be triggered by noxious odours or by pressure in the external auditory canal (Arnold's ear-cough reflex). Other features included throat clearing, hoarse voice, cough syncope and sensorineural hearing loss. Neurophysiological and pathological studies demonstrated a sensory axonal neuropathy. Gastric emptying studies were normal, and autonomic function and sweat tests were either normal or showed distal hypohidrosis. Cough was likely to be due to a combination of denervation hypersensitivity of the upper airways and oesophagus, and prominent GOR. Most affected individuals were shown on 24 h ambulatory oesophageal pH monitoring to have multiple episodes of GOR, closely temporally associated with coughing. Hoarse voice was probably attributable to acid-induced laryngeal damage, and there was no evidence of vocal cord palsy. No other cause for cough was found on most respiratory or otorhinological studies. Linkage to chromosome 3p22-p24 has been found in both families, with no evidence of linkage to loci for known HSN I, autosomal dominant hereditary motor and sensory neuropathy, hereditary GOR or triple A syndrome. These families represent a genetically novel variant of HSN I, with a distinctive cough owing to involvement of the upper aerodigestive tract.

  10. Symptom research on chronic cough: a historical perspective.

    Science.gov (United States)

    Irwin, R S; Madison, J M

    2001-05-01

    This review provides a perspective on how research on the management of cough has evolved, looks at key methodologic lessons that have been learned from this research and how they may relate to the management of other symptoms, identifies important methodologic challenges that remain to be solved, and lists important questions that still need to be answered. Three important methodologic lessons have been learned. First, cough must be evaluated systematically and according to a neuroanatomic framework. Second, the response to specific therapy must be noted to determine the cause or causes of cough and to characterize the strengths and limitations of diagnostic testing. Third, multiple conditions can simultaneously cause cough. Among the three methodologic challenges that still need to be solved are 1) definitively determining the diagnostic accuracy and reliability of 24-hour esophageal pH monitoring and how best to interpret pH test results, 2) definitively determining the role of nonacid reflux in cough due to gastroesophageal reflux disease, and 3) developing reliable and reproducible subjective and objective methods with which to assess the efficacy of cough therapy. Numerous important clinical questions are still unanswered: What role do empirical therapeutic trials play in diagnosing the cause of chronic cough? What is the most cost-effective approach to the diagnosis and treatment of chronic cough: empirical therapeutic trials or laboratory testing-directed therapeutic trials? How often is environmental air pollution, unrelated to allergies or smoking, responsible for chronic cough?

  11. Psychological profile of individuals presenting with chronic cough

    Directory of Open Access Journals (Sweden)

    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.

  12. A novel approach to locomotion learning: Actor-Critic architecture using central pattern generators and dynamic motor primitives.

    Science.gov (United States)

    Li, Cai; Lowe, Robert; Ziemke, Tom

    2014-01-01

    In this article, we propose an architecture of a bio-inspired controller that addresses the problem of learning different locomotion gaits for different robot morphologies. The modeling objective is split into two: baseline motion modeling and dynamics adaptation. Baseline motion modeling aims to achieve fundamental functions of a certain type of locomotion and dynamics adaptation provides a "reshaping" function for adapting the baseline motion to desired motion. Based on this assumption, a three-layer architecture is developed using central pattern generators (CPGs, a bio-inspired locomotor center for the baseline motion) and dynamic motor primitives (DMPs, a model with universal "reshaping" functions). In this article, we use this architecture with the actor-critic algorithms for finding a good "reshaping" function. In order to demonstrate the learning power of the actor-critic based architecture, we tested it on two experiments: (1) learning to crawl on a humanoid and, (2) learning to gallop on a puppy robot. Two types of actor-critic algorithms (policy search and policy gradient) are compared in order to evaluate the advantages and disadvantages of different actor-critic based learning algorithms for different morphologies. Finally, based on the analysis of the experimental results, a generic view/architecture for locomotion learning is discussed in the conclusion.

  13. A Novel Approach to Locomotion Learning: Actor-Critic Architecture using Central Pattern Generators and Dynamic Motor Primitives

    Directory of Open Access Journals (Sweden)

    Cai eLi

    2014-10-01

    Full Text Available In this article, we propose an architecture of a bio-inspired controller that addresses the problem of learning different locomotion gaits for different robot morphologies. The modelling objective is split into two: baseline motion modelling and dynamics adaptation. Baseline motion modelling aims to achieve fundamental functions of a certain type of locomotion and dynamics adaptation provides a ``reshaping function for adapting the baseline motion to desired motion. Based on this assumption, a three-layer architecture is developed using central pattern generators (CPGs, a bio-inspired locomotor center for the the baseline motion and dynamic motor primitives (DMPs, a model with universal ``reshaping functions. In this article, we use this architecture with the actor-critic algorithms for finding a good ``reshaping function. In order to demonstrate the learning power of the actor-critic based architecture, we tested it on two experiments: 1 learning to crawl on a humanoid and, 2 learning to gallop on a puppy robot. Two types of actor-critic algorithms (policy search and policy gradient are compared in order to evaluate the advantages and disadvantages of different actor-critic based learning algorithms for different morphologies. Finally, based on the analysis of the experimental results, a generic view/architecture for locomotion learning is discussed in the conclusion.

  14. The effect of mindfulness meditation on cough reflex sensitivity.

    Science.gov (United States)

    Young, E C; Brammer, C; Owen, E; Brown, N; Lowe, J; Johnson, C; Calam, R; Jones, S; Woodcock, A; Smith, J A

    2009-11-01

    Chronic cough is common, and medical treatment can be ineffective. Mindfulness is a psychological intervention that aims to teach moment-to-moment non-judgemental awareness of thoughts, feelings and sensations. 30 healthy subjects and 30 patients with chronic cough were studied in two sequential trials. For both studies, cough reflex sensitivity to citric acid (C5) was measured on two occasions, with urge to cough rated following each inhalation; between challenges subjects were randomised to (1) no intervention, (2) mindfulness or (3) no intervention but modified cough challenge (subjects suppress coughing). For the healthy volunteers, measures were 1 h apart and mindfulness was practised for 15 min. For the patients with chronic cough measures were 1 week apart and mindfulness was practised daily for 30 min. In healthy volunteers, median change (interquartile range (IQR)) in cough reflex sensitivity (logC5) for no intervention, mindfulness and suppression was +1.0 (0.0 to +1.3), +2.0 (+1.0 to +3.0) and +3.0 (+2.8 to +3.0) doubling concentrations (p = 0.003); there were significant reductions for both mindfulness (p = 0.043) and suppression (p = 0.002) over no intervention. In patients with cough, median change (IQR) in logC5 for no intervention, mindfulness training and voluntary suppression was 0.0 (-1.0 to +1.0), +1.0 (-0.3 to +1.0) and +1.0 (+1.0 to +2.0) doubling concentrations (p = 0.046); there was a significant reduction for suppression (p = 0.02) but not mindfulness (p = 0.35). Urge to cough did not change after mindfulness compared with control in either healthy subjects (p = 0.33) or those with chronic cough (p = 0.47). Compared with control, mindfulness decreased cough reflex sensitivity in healthy volunteers, but did not alter cough threshold in patients with chronic cough. Both groups were able to suppress cough responses to citric acid inhalation.

  15. Cough mixtures: rational or irrational prescribing in Hong Kong?

    Science.gov (United States)

    Wong, William C W; Dickinson, James; Chan, Cynthia

    2005-08-01

    To investigate the extent and how cough mixtures are prescribed, and what conditions or specific groups of people would contribute to its prescription in Hong Kong. Using diagnosis and drug data obtained from logbooks submitted by participants in the diploma in family medicine course between 1999 and 2003, we selected and analysed all patients with a diagnosis of cough or cough-related illnesses as well as cough mixtures that were used to treat them. This study confirmed that cough-related illnesses were common in the Hong Kong primary care setting and cough mixtures were used quite liberally irrespective of the patients' age and sex. Combination preparations accounted for over half of the prescriptions and cough mixture was used less in severe cases when antibiotics were given. Private doctors working in the public sector. Given the current health care system, inappropriate and over-prescribing of cough mixtures can be improved by promoting health education and awareness among patients seeking medical help for this common medical condition.

  16. 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 ...

  17. Evaluation of Fractioned Nitric Oxide in Chronic Cough Patients

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... Nigerian Journal of Clinical Practice ¦ Volume 21 ¦ Issue 1 ¦ January 2018 bronchitis (PBB), upper airway cough syndrome, and natural healing. ... chronic cough and NO in asthmatic patients, none have investigated FeNO in ...

  18. Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough

    Directory of Open Access Journals (Sweden)

    Angela Jinsook Oh

    2018-06-01

    Full Text Available Purpose: Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. Observations: A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1–2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500–3000 mg per day. Conclusions and importance: We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition. Keywords: Keyhole aqueduct syndrome, Midbrain cleft, Mesencephalic cleft, Syrinx, Syringobulbia, Down-beating nystagmus, Cerebrospinal fluid

  19. Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough.

    Science.gov (United States)

    Oh, Angela Jinsook; Lanzman, Bryan Alexander; Liao, Yaping Joyce

    2018-06-01

    Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500-3000 mg per day. We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition.

  20. Human Syngamosis as an Uncommon Cause of Chronic Cough

    Directory of Open Access Journals (Sweden)

    Pulcherio, Janaína Oliveira Bentivi

    2013-09-01

    Full Text Available Introduction: Chronic cough may represent a diagnostic challenge. Chronic parasitism of upper airways is an unusual cause. Objective: To describe a case of human syngamosis as an uncommon cause of dry cough. Case Report: An endoscopic exam performed in a woman suffering of chronic cough revealed a Y-shaped worm in the larynx identified as Syngamus laryngeus. Discussion: This nematode parasitizes the upper respiratory tract of many animals including humans. The diagnosis is performed by the examination of the worm expelled by cough or by endoscopy. Endoscopic exam is easy to perform and is essential in the diagnosis of causes of chronic cough, even uncommon entities. Removal is the only efficient treatment.

  1. Impact of chronic cough on quality of life.

    Science.gov (United States)

    French, C L; Irwin, R S; Curley, F J; Krikorian, C J

    Cough is the most common complaint for which adult patients seek medical care in the United States; however, the reason(s) for this is unknown. To determine whether chronic cough was associated with adverse psychosocial or physical effects on the quality of life and whether the elimination of chronic cough with specific therapy improved these adverse effects. The study design was a prospective before-and-after intervention trial with patients serving as their own controls. Study subjects were a convenience sample of 39 consecutive and unselected adult patients referred for evaluation and management of a chronic, persistently troublesome cough. Baseline data were available for 39 patients and follow-up for 28 patients (22 women and 6 men). At baseline, demographic, Adverse Cough Outcome Survey (ACOS), and Sickness Impact Profile (SIP) data were collected and patients were managed according to a validated, systematic protocol. Following specific therapy for cough, ACOS and SIP instruments were readministered. The ages, sex, duration, and spectra and frequencies of the causes of cough were similar to multiple other studies. At baseline, patients reported a mean +/- SD of 8.6 +/- 4.8 types of adverse occurrences related to cough. There were significant correlations between multiple ACOS items and total, physical, and psychosocial SIP scores. Psychosocial score correlated with total number of symptoms (PSIP scores. Multiple linear regression analysis showed that 54% of variability of the psychosocial SIP score was explained by 4 ACOS items while none of the physical score was explained. Chronic cough was associated with deterioration in patients' quality of life. The health-related dysfunction was most likely psychosocial. The ACOS and SIP appear to be valid tools in assessing the impact of chronic cough.

  2. Inhibitory effect of cervical trachea and chest wall vibrations on cough reflex sensitivity and perception of urge-to-cough in healthy male never-smokers

    OpenAIRE

    Kashiwazaki, Naohiro; Ebihara, Satoru; Gui, Peijun; Katayama, Norihiro; Ito, Kumiko; Sato, Ryuhei; Oyama, Chika; Ebihara, Takae; Kohzuki, Masahiro

    2013-01-01

    Background Non-pharmacological options for symptomatic management of cough are desired. Although chest wall mechanical vibration is known to ameliorate cough reflex sensitivity, the effect of mechanical vibrations on perceptions of urge-to-cough has not been studied. Therefore, we investigated the effect of mechanical vibration of cervical trachea, chest wall and femoral muscle on cough reflex sensitivity, perceptions of urge-to-cough as well as dyspnea. Methods Twenty-four healthy male never...

  3. Similar circuits but different connectivity patterns between the cerebellum, basal ganglia, and supplementary motor area in early Parkinson's disease patients and controls during predictive motor timing.

    Science.gov (United States)

    Husárová, Ivica; Mikl, Michal; Lungu, Ovidiu V; Mareček, Radek; Vaníček, Jiří; Bareš, Martin

    2013-10-01

    The cerebellum, basal ganglia (BG), and other cortical regions, such as supplementary motor area (SMA) have emerged as important structures dealing with various aspects of timing, yet the modulation of functional connectivity between them during motor timing tasks remains unexplored. We used dynamic causal modeling to investigate the differences in effective connectivity (EC) between these regions and its modulation by behavioral outcome during a motor timing prediction task in a group of 16 patients with early Parkinson's disease (PD) and 17 healthy controls. Behavioral events (hits and errors) constituted the driving input connected to the cerebellum, and the modulation in connectivity was assessed relative to the hit condition (successful interception of target). The driving input elicited response in the target area, while modulatory input changed the specific connection strength. The neuroimaging data revealed similar structure of intrinsic connectivity in both groups with unidirectional connections from cerebellum to both sides of the BG, from BG to the SMA, and then from SMA to the cerebellum. However, the type of intrinsic connection was different between two groups. In the PD group, the connection between the SMA and cerebellum was inhibitory in comparison to the HC group, where the connection was activated. Furthermore, the modulation of connectivity by the performance in the task was different between the two groups, with decreased connectivity between the cerebellum and left BG and SMA and a more pronounced symmetry of these connections in controls. In the same time, there was an increased EC between the cerebellum and both sides of BG with more pronounced asymmetry (stronger connection with left BG) in patients. In addition, in the PD group the modulatory input strengthened inhibitory connectivity between the SMA and the cerebellum, while in the HC group the excitatory connection was slightly strengthened. Our findings indicate that although early PD

  4. Consequences of comorbidity of developmental coordination disorders and learning disabilities for severity and pattern of perceptual-motor dysfunction

    NARCIS (Netherlands)

    Jongmans, MJ; Smits-Engelsman, BCM; Schoemaker, MM

    2003-01-01

    Children with developmental coordination disorder (DCD) have difficulty learning and performing age-appropriate perceptual-motor skills in the absence of diagnosable neurological disorders. Descriptive studies have shown that comorbidity of DCD exists with attention-deficit/hyperactivity disorder

  5. Eccentric muscle damage has variable effects on motor unit recruitment thresholds and discharge patterns in elbow flexor muscles.

    Science.gov (United States)

    Dartnall, Tamara J; Rogasch, Nigel C; Nordstrom, Michael A; Semmler, John G

    2009-07-01

    The purpose of this study was to determine the effect of eccentric muscle damage on recruitment threshold force and repetitive discharge properties of low-threshold motor units. Ten subjects performed four tasks involving isometric contraction of elbow flexors while electromyographic (EMG) data were recorded from human biceps brachii and brachialis muscles. Tasks were 1) maximum voluntary contraction (MVC); 2) constant-force contraction at various submaximal targets; 3) motor unit recruitment threshold task; and 4) minimum motor unit discharge rate task. These tasks were performed on three separate days before, immediately after, and 24 h after eccentric exercise of elbow flexor muscles. MVC force declined (42%) immediately after exercise and remained depressed (29%) 24 h later, indicative of muscle damage. Mean motor unit recruitment threshold for biceps brachii was 8.4+/-4.2% MVC, (n=34) before eccentric exercise, and was reduced by 41% (5.0+/-3.0% MVC, n=34) immediately after and by 39% (5.2+/-2.5% MVC, n=34) 24 h after exercise. No significant changes in motor unit recruitment threshold were observed in the brachialis muscle. However, for the minimum tonic discharge rate task, motor units in both muscles discharged 11% faster (10.8+/-2.0 vs. 9.7+/-1.7 Hz) immediately after (n=29) exercise compared with that before (n=32). The minimum discharge rate variability was greater in brachialis muscle immediately after exercise (13.8+/-3.1%) compared with that before (11.9+/-3.1%) and 24 h after exercise (11.7+/-2.4%). No significant changes in minimum discharge rate variability were observed in the biceps brachii motor units after exercise. These results indicate that muscle damage from eccentric exercise alters motor unit recruitment thresholds for >or=24 h, but the effect is not the same in the different elbow flexor muscles.

  6. Importance of placebo effect in cough clinical trials.

    Science.gov (United States)

    Eccles, Ron

    2010-01-01

    Cough is a unique symptom because, unlike sneeze and other symptoms, it can be under voluntary control and this complicates clinical trials on cough medicines. All over-the-counter cough medicines (OTC) are very effective treatments because of their placebo effect. The placebo effect is enhanced by expectancy related to advertising, brand, packaging, and formulation. This placebo effect creates a problem for the conduct of clinical trials on OTC cough medicines that attempt to demonstrate the efficacy of a pharmacological agent above that of any placebo effect. Up to 85% of the efficacy of some cough medicines can be attributed to a placebo effect. The placebo effect apparent in clinical trials consists of several components: natural recovery, regression of cough response toward mean, demulcent effect, effect of sweetness, voluntary control, and effects related to expectancy and meaning of the treatment. The placebo effect has been studied most in the pain model, and placebo analgesia is reported to depend on the activation of endogenous opioid systems in the brain; this model may be applicable to cough. A balanced placebo design may help to control for the placebo effect, but this trial design may not be acceptable due to deception of patients. The placebo effect in clinical trials may be controlled by use of a crossover design, where feasible, and the changes in the magnitude of the placebo effect in this study design are discussed.

  7. Pharmacology of Bradykinin-Evoked Coughing in Guinea Pigs.

    Science.gov (United States)

    Hewitt, Matthew M; Adams, Gregory; Mazzone, Stuart B; Mori, Nanako; Yu, Li; Canning, Brendan J

    2016-06-01

    Bradykinin has been implicated as a mediator of the acute pathophysiological and inflammatory consequences of respiratory tract infections and in exacerbations of chronic diseases such as asthma. Bradykinin may also be a trigger for the coughing associated with these and other conditions. We have thus set out to evaluate the pharmacology of bradykinin-evoked coughing in guinea pigs. When inhaled, bradykinin induced paroxysmal coughing that was abolished by the bradykinin B2 receptor antagonist HOE 140. These cough responses rapidly desensitized, consistent with reports of B2 receptor desensitization. Bradykinin-evoked cough was potentiated by inhibition of both neutral endopeptidase and angiotensin-converting enzyme (with thiorphan and captopril, respectively), but was largely unaffected by muscarinic or thromboxane receptor blockade (atropine and ICI 192605), cyclooxygenase, or nitric oxide synthase inhibition (meclofenamic acid and N(G)-nitro-L-arginine). Calcium influx studies in bronchopulmonary vagal afferent neurons dissociated from vagal sensory ganglia indicated that the tachykinin-containing C-fibers arising from the jugular ganglia mediate bradykinin-evoked coughing. Also implicating the jugular C-fibers was the observation that simultaneous blockade of neurokinin2 (NK2; SR48968) and NK3 (SR142801 or SB223412) receptors nearly abolished the bradykinin-evoked cough responses. The data suggest that bradykinin induces coughing in guinea pigs by activating B2 receptors on bronchopulmonary C-fibers. We speculate that therapeutics targeting the actions of bradykinin may prove useful in the treatment of cough. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  8. Consumer attitudes on cough and cold: US (ACHOO) survey results.

    Science.gov (United States)

    Blaiss, M S; Dicpinigaitis, P V; Eccles, R; Wingertzahn, M A

    2015-08-01

    The Attitudes of Consumers Toward Health, Cough, and Cold (ACHOO) survey was developed to better inform health care providers on the natural history and impact of common cold and cough, and related consumer experience and behaviors. Randomly selected US Internet/mobile device users were invited to participate in an online survey (N = 3333) in October 2012. Response quotas modeled upon 2010 US Census data ensured a demographically representative sample. To reduce potential bias from the quota design, 75% of the completed surveys were randomly selected as the primary analysis pool. Survey questions assessed participant demographics, frequency and duration of cough/cold symptoms, impact of symptoms on daily life, treatment preferences, and knowledge about cough/cold pathophysiology. In the past year, 84.6% of respondents had experienced at least one cold. Colds typically started with sore/scratchy throat (39.2%), nasal congestion (9.8%), and runny nose (9.3%) and lasted 3-7 days. Cough, the most common cold symptom (73.1%), had a delayed onset (typically 1-5 days after cold onset) and a long duration (>6 days in 35.2%). Nasal congestion and cough were the most bothersome symptoms. Many respondents waited until symptoms were 'bad enough' (42.6%) or multiple symptoms were present (20.2%) before using nonprescription medications. Drivers of choice included effectiveness in relieving symptoms, safety, and past experience. Respondents rarely consulted clinicians regarding treatment, and more than three-quarters had never received instructions from a clinician on how to choose a nonprescription cough/cold medication. Misperceptions regarding etiology and treatment of the common cold were prevalent. The main limitation is potential recall bias, since respondents had to recall cough/cold episodes over the prior year. The ACHOO survey confirms that cold is a common, bothersome experience and that there are gaps in consumers' knowledge of pathophysiology and appropriate

  9. Downregulation of cough by exercise and voluntary hyperpnea.

    Science.gov (United States)

    Fontana, Giovanni A

    2010-01-01

    No information exists on the effects of hyperpnea on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing concentrations of ultrasonically nebulized distilled water (fog), and the index of cough reflex sensitivity, was assessed in 12 healthy humans in control conditions, during exercise, and during voluntary isocapnic hyperventilation (VIH) to the same level as the exercise. The intensity of the urge-to-cough (UTC), a cognitive component of coughing, was also recorded throughout the trials. The log-log relationship between inhaled fog concentrations and the correspondingly evoked UTC values, an index of the perceptual magnitude of the UTC sensitivity, was also calculated. Cough appearance was always assessed audiovisually. At an exercise level of 80% of anaerobic threshold, the mean cough threshold was increased from a control value of 1.03 +/- 0.65 to 2.25 +/- 1.14 ml/min (p VIH, the mean (+/-SD) threshold increased from 1.03 +/- 0.65 to 2.42 +/- 1.16 ml/min (p VIH compared with control, mean UTC values at cough threshold were not significantly changed: control, 3.83 +/- 1.11 cm; exercise, 3.12 +/- 0.82 cm; VIH, 4.08 +/- 1.67 cm. Since the slopes of the log fog concentration/log UTC value were approximately halved during exercise and VIH compared with control, the UTC sensitivity to fog was depressed (p < 0.01). The results indicate that the adjustments brought into action by exercise-induced or voluntary hyperventilation exert inhibitory influences on the sensory and cognitive components of fog-induced cough.

  10. Characteristics of Chinese patients with cough in primary care centre

    Directory of Open Access Journals (Sweden)

    Bai Chunxue

    2011-09-01

    Full Text Available Abstract Background Cough is one of the most common respiratory symptoms and is well characterized in specialized cough clinics with high success rates of diagnosis and treatment. However, there is a paucity of data regarding cough in primary care settings. The present study aimed at investigating clinical epidemiology of cough through a national study of two questionnaire surveys sent to primary care physicians in China. Methods Approximately 18,000 subjects recruited were having daytime or night symptoms of cough and diagnoses of respiratory disease from February 2005 to April 2006 as Survey 1 and from June 2007 to December 2007 as Survey 2. Patients suffering from respiratory malignancy, hyperthyroidism, hypertension, heart disease, diabetes, severe hypohepatia or renal dysfunction, pregnancy, possible pregnancy or lactation, neutropenia were not eligible. Information regarding demography, history of allergies, symptomatic profile, treatment and curative effects for cough was elicited. Results 8216 questionnaires were collected in Survey 1 and 9711 in Survey 2. The mean values of ages were 25.7 and 22.3 years old, respectively. Symptoms included expectoration (74% and 76%, wheeze (59% and 74%, breathlessness (22% and 26%, chest pain (9% and 13% and fever (15% and 18%. About 15% and 23% patients had hypersusceptibility, of whom 6% to 17% had a family history. More than 50% of the cases had histories of allergic rhinitis, asthma, conjunctivitis or atopic dermatitis. Asthma, COPD, and bronchitis were dominant etiologies of cough. Procaterol or the combination of antibiotics and steroids were used as the treatment. Conclusion Causes and outcomes of cough differed with ages and time in this particular national study, while successful and precise diagnosis and management of cough in primary care settings need to be further improved in China.

  11. Modified Valsalva test differentiates primary from secondary cough headache.

    Science.gov (United States)

    Lane, Russell J M; Davies, Paul T G

    2013-03-28

    The current definition of cough headache includes provocation of the symptom by Valsalva manoeuvre, and it is generally believed that all cough headache results from a sudden increase in intracranial pressure. We sought to question that presumption and to determine whether the Valsalva test might distinguish primary from secondary cough headache. We examined 16 consecutive cough headache patients using a modified Valsalva test (exhalation into the connecting tube of a standard anaeroid sphygmomanometer to 60 mm Hg for 10 seconds). A positive response was recorded if the manoeuvre provoked headache. All patients subsequently underwent brain MRI. None of the patients had neurological signs. Eleven had positive modified Valsalva tests. Ten were found subsequently to have posterior fossa pathologies (secondary cough headache: 8 Chiari Type 1 malformations, 2 posterior fossa meningiomas). The cough headache was relieved following surgery in all cases. One patient with a positive Valsalva test had an apparently normal brain MRI but measurements of hindbrain and posterior fossa dimensions were consistent with 'posterior fossa crowdedness'. The remaining 5 patients had negative (4 patients) or equivocal (1 patient) Valsalva tests and normal MRI scans (primary cough headache). These findings suggest that secondary cough headache results from a transient increase in intracranial CSF pressure during exertion in the presence of obstruction to normal cerebrospinal fluid dynamics. The modified Valsalva test can also determine whether tonsillar herniation found on brain MRI is symptomatic. Primary cough headache appears to be caused by a different mechanism, possibly through congestion of the orbital venous plexus in the presence of jugular venous incompetence and a reduced threshold for trigeminal sensory activation.

  12. Hip position and sex differences in motor unit firing patterns of the vastus medialis and vastus medialis oblique in healthy individuals.

    Science.gov (United States)

    Peng, Yi-Ling; Tenan, Matthew S; Griffin, Lisa

    2018-06-01

    Weakness of the vastus medialis oblique (VMO) has been proposed to explain the high prevalence of knee pain in female subjects. Clinicians commonly use exercises in an attempt to preferentially activate the VMO. Recently, our group found evidence to support clinical theory that the VMO is neurologically distinct from the vastus medialis (VM). However, the ability to voluntarily activate these muscle subsections is still disputed. The aim of this study was to determine if VM and VMO activation varies between sexes and if control of the two muscles is different between rehabilitation exercises. Thirteen men and 13 women performed isometric straight leg raises in two hip positions, neutral hip rotation and 30 degrees lateral hip rotation. Bipolar intramuscular fine-wire electrodes were inserted into the VM and VMO to obtain motor unit recruitment thresholds and initial firing rates at recruitment. Linear mixed models and Tukey post hoc tests were used to assess significant differences in 654 motor units. Women demonstrated faster motor unit firing rate at recruitment, 1.18 ± 0.56 Hz higher than men. Motor units fired 0.47 ± 0.19 Hz faster during neutral hip rotation compared with lateral hip rotation. The VMO motor units were recruited 2.92 ± 1.28% earlier than the VM. All motor units were recruited 3.74 ± 1.27% earlier during neutral hip rotation than lateral hip rotation. Thus the VM and the VMO can be activated differentially, and their motor unit recruitment properties are affected by sex and hip position. NEW & NOTEWORTHY This is the first study to reveal differential activation of the vastus medialis oblique from the vastus medialis in clinical exercise protocols. Our research group used fine-wire electrodes to examine EMG signals of the vastus medialis oblique and vastus medialis to avoid possible cross talk. We also consider the effect of sex on motor unit firing patterns because of higher prevalence of knee pain in women, and yet few

  13. Application of a common spatial pattern-based algorithm for an fNIRS-based motor imagery brain-computer interface.

    Science.gov (United States)

    Zhang, Shen; Zheng, Yanchun; Wang, Daifa; Wang, Ling; Ma, Jianai; Zhang, Jing; Xu, Weihao; Li, Deyu; Zhang, Dan

    2017-08-10

    Motor imagery is one of the most investigated paradigms in the field of brain-computer interfaces (BCIs). The present study explored the feasibility of applying a common spatial pattern (CSP)-based algorithm for a functional near-infrared spectroscopy (fNIRS)-based motor imagery BCI. Ten participants performed kinesthetic imagery of their left- and right-hand movements while 20-channel fNIRS signals were recorded over the motor cortex. The CSP method was implemented to obtain the spatial filters specific for both imagery tasks. The mean, slope, and variance of the CSP filtered signals were taken as features for BCI classification. Results showed that the CSP-based algorithm outperformed two representative channel-wise methods for classifying the two imagery statuses using either data from all channels or averaged data from imagery responsive channels only (oxygenated hemoglobin: CSP-based: 75.3±13.1%; all-channel: 52.3±5.3%; averaged: 64.8±13.2%; deoxygenated hemoglobin: CSP-based: 72.3±13.0%; all-channel: 48.8±8.2%; averaged: 63.3±13.3%). Furthermore, the effectiveness of the CSP method was also observed for the motor execution data to a lesser extent. A partial correlation analysis revealed significant independent contributions from all three types of features, including the often-ignored variance feature. To our knowledge, this is the first study demonstrating the effectiveness of the CSP method for fNIRS-based motor imagery BCIs. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Motor skills related to body movement and dance. t-patterns detection Habilidades motrices en expresión corporal y danza. Detección de t-patterns

    Directory of Open Access Journals (Sweden)

    M. Dinušová

    2010-09-01

    Full Text Available

    In the learning processes that promotes the generation of motor actions, teachers usually propose instructions based on kinetic models. The aim of this study is to observe what type of motor answers the subjects generate from kinesic models offered by the teachers. The motor answers to observe refer to the patterns of motor skills of stability, locomotion and manipulation, variations of body-space, time and interaction between participants. 12 Phsysical Activity and Sports Science students without experience in dance participated in the study. 8 sessions were observed focused on space, time, energy and body contact. A specific instrument was created, the observational system of motor skills OSMOS (Castañer, Torrents, Anguera y Dinusôva, 2008,. It was codified with ThemeCoder  (Pattern Vision, 2001 and SDIS-GSEQ   (Bakeman &  Quera, 1996 and THEME (Magnusson, 2000 were used for the reliability and detection of T-patterns .
    Key Words:  Motor Skills, Field Format, Body expression and dance, Motor T-Patterns detection, Kinesic's Model.

    En todo proceso de enseñanza-aprendizaje que promueva la generación de acciones motrices, la elección de los modelos que usan los docentes es una decisión pedagógica de mayor importancia de la que se le suele otorgar.  El objetivo de la investigación es el de observar y constatar qué tipo de respuestas motrices generan los discentes a partir de los modelos de tipo cinésico ofrecidos por los docentes. Las respuestas motrices a observar se refieren a los patrones de habilidades motrices, las variaciones de cuerpo-espacio y tiempo así como de interacción entre los participantes. Han participado en el estudio 12 estudiantes de primer ciclo en Ciencias de la Actividad Física y el deporte con alto bagaje deportivo pero sin experiencia en danza y expresión corporal (EC. Se observaron 8 sesiones

  15. Automatic cough episode detection using a vibroacoustic sensor.

    Science.gov (United States)

    Mlynczak, Marcel; Pariaszewska, Katarzyna; Cybulski, Gerard

    2015-08-01

    Cough monitoring is an important element of the diagnostics of respiratory diseases. The European Respiratory Society recommends objective assessment of cough episodes and the search for methods of automatic analysis to make obtaining the quantitative parameters possible. The cough "events" could be classified by a microphone and a sensor that measures the vibrations of the chest. Analysis of the recorded signals consists of calculating the features vectors for selected episodes and of performing automatic classification using them. The aim of the study was to assess the accuracy of classification based on an artificial neural networks using vibroacoustic signals collected from chest. Six healthy, young men and eight healthy, young women carried out an imitated cough, hand clapping, speech and shouting. Three methods of parametrization were used to prepare the vectors of episode features - time domain, time-frequency domain and spectral modeling. We obtained the accuracy of 95% using artificial neural networks.

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

    Science.gov (United States)

    ... causing a range of effects from lack of motivation to serious health problems. Repeatedly seeking to experience ... misuse cough and cold medicines. Swipe left or right to scroll. Monitoring the Future Study: Trends in ...

  17. Whooping Cough Vaccine Recommendation for Babies and Young Children

    Centers for Disease Control (CDC) Podcasts

    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.

  18. Cough event classification by pretrained deep neural network.

    Science.gov (United States)

    Liu, Jia-Ming; You, Mingyu; Wang, Zheng; Li, Guo-Zheng; Xu, Xianghuai; Qiu, Zhongmin

    2015-01-01

    Cough is an essential symptom in respiratory diseases. In the measurement of cough severity, an accurate and objective cough monitor is expected by respiratory disease society. This paper aims to introduce a better performed algorithm, pretrained deep neural network (DNN), to the cough classification problem, which is a key step in the cough monitor. The deep neural network models are built from two steps, pretrain and fine-tuning, followed by a Hidden Markov Model (HMM) decoder to capture tamporal information of the audio signals. By unsupervised pretraining a deep belief network, a good initialization for a deep neural network is learned. Then the fine-tuning step is a back propogation tuning the neural network so that it can predict the observation probability associated with each HMM states, where the HMM states are originally achieved by force-alignment with a Gaussian Mixture Model Hidden Markov Model (GMM-HMM) on the training samples. Three cough HMMs and one noncough HMM are employed to model coughs and noncoughs respectively. The final decision is made based on viterbi decoding algorihtm that generates the most likely HMM sequence for each sample. A sample is labeled as cough if a cough HMM is found in the sequence. The experiments were conducted on a dataset that was collected from 22 patients with respiratory diseases. Patient dependent (PD) and patient independent (PI) experimental settings were used to evaluate the models. Five criteria, sensitivity, specificity, F1, macro average and micro average are shown to depict different aspects of the models. From overall evaluation criteria, the DNN based methods are superior to traditional GMM-HMM based method on F1 and micro average with maximal 14% and 11% error reduction in PD and 7% and 10% in PI, meanwhile keep similar performances on macro average. They also surpass GMM-HMM model on specificity with maximal 14% error reduction on both PD and PI. In this paper, we tried pretrained deep neural network in

  19. Intravenous lidocaine suppresses fentanyl-induced cough in Children

    OpenAIRE

    Gecaj-Gashi, Agreta; Nikolova-Todorova, Zorica; Ismaili-Jaha, Vlora; Gashi, Musli

    2013-01-01

    Objective Fentanyl-induced cough is usually mild and transitory, but it can be undesirable in patients with increased intracranial pressure, open wounds of the eye, dissecting aortic aneurism, pneumothorax, and reactive airway disease. The aim of this study is to evaluate the efficacy of lidocaine in suppressing fentanyl-induced cough in children during induction in general anesthesia. Methods One hundred and eighty-six children of both sexes, aged between 4?10?years, ASA physical status I an...

  20. Habit-tic cough: Presentation and outcome with simple reassurance.

    Science.gov (United States)

    Wright, Marie F A; Balfour-Lynn, Ian M

    2018-04-01

    Our therapeutic approach to a habit/tic cough is simple reassurance in a single consultation. To quality assure our practice, we followed up children to determine outcomes at least 3 months after diagnosis. Consecutive children diagnosed over 6 years were studied. Medical records were analyzed retrospectively and parents answered a scripted verbal survey. Fifty-five patients were diagnosed (median age 9.9 years), with a median cough duration of 3 months (IQR 2-7.5 months, range up to 3 years). In 51/55 (93%) cases, cough was absent during sleep. 51/55 (93%) received prior medications with median 3 therapeutic trials, none of which resolved the cough. Follow-up was possible in 39/55 (71%) children after a median duration of 1.9 years. In 32/39 (82%), the cough had resolved completely (59% within 4 weeks, including 12% on the day), and it improved in 6/39 (15%). In the 26/39 (67%) parents who said they believed the diagnosis, there was 96% resolution of the cough, versus the 13/39 (33%) who were sceptical or disbelieving, when there was only 54% resolution. 7/39 (18%) children were later diagnosed with a tic disorder, functional symptoms, or a behavioural/psychiatric disorder. Habit cough can be diagnosed from the characteristic history; the crucial question is whether the cough disappears during sleep. We have shown successful long term outcomes following a single consultation with simple reassurance, but it is important that the child and parents believe the explanation. It is not uncommon for subsequent tic disorders or behavioral issues to emerge. © 2018 Wiley Periodicals, Inc.

  1. 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.

  2. Managing patients with chronic cough: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Perotin JM

    2018-06-01

    Full Text Available Jeanne-Marie Perotin,1,2 Claire Launois,1 Maxime Dewolf,1 Antoine Dumazet,1 Sandra Dury,1 François Lebargy,1 Valérian Dormoy,2 Gaëtan Deslee1,2 1Department of Respiratory Diseases, University Hospital of Reims, Reims, France; 2INSERM UMRS 1250, University Hospital of Reims, Reims, France Abstract: Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic cough. Different steps are detailed, including the initial research of an obvious etiology and alert signs that should lead to further investigation of underlying condition. The diagnosis of the most frequent causes: asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airway cough syndrome should be considered, assessed and treated accordingly. Recent advances have been made in the comprehension of refractory chronic cough pathophysiology as well as its pharmacologic and non-pharmacologic treatment, especially speech pathology therapy. Keywords: asthma, gastroesophageal reflux, upper airway cough syndrome, chronic hypersensitivity syndrome, refractory chronic cough, speech pathology therapy

  3. Automatically characterizing sensory-motor patterns underlying reach-to-grasp movements on a physical depth inversion illusion

    Directory of Open Access Journals (Sweden)

    Jillian eNguyen

    2016-01-01

    Full Text Available Recently, movement variability has been of great interest to motor control physiologists as it constitutes a physical, quantifiable form of sensory feedback to aid in planning, updating, and executing complex actions. In marked contrast, the psychological and psychiatric arenas mainly rely on verbal descriptions and interpretations of behavior via observation. Consequently, a large gap exists between the body’s manifestations of mental states and their descriptions, creating a disembodied approach in the psychological and neural sciences: contributions of the peripheral nervous system to central control, executive functions, and decision-making processes are poorly understood. How do we shift from a psychological, theorizing approach to characterize complex behaviors more objectively?We introduce a novel, objective, statistical framework and visuomotor control paradigm to help characterize the stochastic signatures of minute fluctuations in overt movements during a visuomotor task. We also quantify a new class of covert movements that spontaneously occur without instruction. These are largely beneath awareness, but inevitably present in all behaviors. The inclusion of these motions in our analyses introduces a new paradigm in sensory-motor integration. As it turns out, these movements, often overlooked as motor noise, contain valuable information that contributes to the emergence of different kinesthetic percepts. We apply these new methods to help better understand perception-action loops. To investigate how perceptual inputs affect reach behavior, we use a depth inversion illusion: the same physical stimulus produces two distinct depth percepts that are nearly orthogonal, enabling a robust comparison of competing percepts. We find that the moment-by-moment empirically estimated motor output variability can inform us of the participants’ perceptual states, detecting physiologically relevant signals from the peripheral nervous system that

  4. Effect of e-Cigarette Use on Cough Reflex Sensitivity.

    Science.gov (United States)

    Dicpinigaitis, Peter V; Lee Chang, Alfredo; Dicpinigaitis, Alis J; Negassa, Abdissa

    2016-01-01

    E-cigarettes (e-cigs) have attained widespread popularity, yet knowledge of their physiologic effects remains minimal. The aim of this study was to evaluate the effect of a single exposure to e-cig vapor on cough reflex sensitivity. Thirty healthy nonsmokers underwent cough reflex sensitivity measurement using capsaicin cough challenge at baseline, 15 min, and 24 h after e-cig exposure (30 puffs 30 s apart). The end point of cough challenge is the concentration of capsaicin inducing five or more coughs (C5). The number of coughs induced by each e-cig inhalation was counted. A subgroup of subjects (n = 8) subsequently underwent an identical protocol with a non-nicotine-containing e-cig. Cough reflex sensitivity was significantly inhibited (C5 increased) 15 min after e-cig use (?0.29; 95% CI, ?0.43 to ?0.15; P < .0001); 24 h later, C5 returned to baseline (0.24; 95% CI, 0.10-0.38; P = .0002 vs post-15-min value). A subgroup of eight subjects demonstrating the largest degree of cough reflex inhibition had no suppression after exposure to a non-nicotine-containing e-cig (P = .0078 for comparison of ?C5 after nicotine vs non-nicotine device). Furthermore, more coughing was induced by the nicotine-containing vs non-nicotine-containing device (P = .0156). A single session of e-cig use, approximating nicotine exposure of one tobacco cigarette, induces significant inhibition of cough reflex sensitivity. Exploratory analysis of a subgroup of subjects suggests that nicotine is responsible for this observation. Our data, consistent with previous studies of nicotine effect, suggest a dual action of nicotine: an immediate, peripheral protussive effect and a delayed central antitussive effect. ClinicalTrials.gov; No.: NCT02203162; URL: www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  5. [Parental representations of children's cough and expectations on its management].

    Science.gov (United States)

    Ventaja, G; Steyer, E; Machu, J-L; Boivin, J-M

    2016-04-01

    Providing medications for the management of acute cough in infants less than 24 months, a frequent reason for medical consultation, has recently been reduced by the contraindication of various antitussive specialties in France. The objective of this study was to assess the expectations and fears of coughing infants' parents, to determine their representations of coughing, and to quantify the use of self-medication and the risk of a deferral requests to prescribe other drug classes. An opinion and cross-survey was carried out with parents of infants under 24 months of age. A multiple-choice questionnaire was proposed to them in day care centers and Mother and Infant Welfare centers. The data collected were analyzed descriptively and using the Chi(2) test. Logistic regression enabled us to interpret some of the results. Sixty-four percent of parents expect an antitussive treatment from the doctor. For most parents, lifestyle modifications are well integrated (nasal irrigation, considered effective cough relief, hydration, smoking cessation). For 33 % of parents, corticosteroids are an alternative therapy to stop cough. Nearly half (43 %) of parents have sought treatment from their doctor, usually nasal suspensions, corticosteroids, and saline irrigation. Regarding self-medication, 30 % of parents have already given cough syrup or an antitussive suppository without a prescription, in order to stop the cough rapidly for 66 % of them. These parents seem more worried by coughing than other parents (P=0.0110, CI: 0.217; 1.751) as did those who had only one child (P=0.0029, CI: 0.120; 0.582). This study suggests that a large majority of parents understand and accept the new recommendations. But one-third of parents are still worried, not knowing what to do without prescribed medications, which led them to give nonprescription cough syrups and ask for inappropriate treatments. It seems essential to inform parents about the natural history of infant coughing and educate them

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

    Science.gov (United States)

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

    2011-06-28

    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. 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 reflex sensitivities were defined as the lowest concentration of citric acid that elicited two or more coughs (C2) and five or more coughs (C5). The urge-to-cough was evaluated using a modified the Borg scale. There was no significant difference in the cough reflex threshold to citric acid between young and elderly subjects. The urge-to-cough scores at the concentration of C2 and C5 were significantly smaller in the elderly than young subjects. The urge-to-cough log-log slope in elderly subjects (0.73 ± 0.71 point · L/g) was significantly gentler than those of young subjects (1.35 ± 0.53 point · L/g, p < 0.01). There were no significant differences in the urge-to-cough threshold estimated between young and elderly subjects. The cough reflex threshold did not differ between young and elderly subjects whereas cognition of urge-to-cough was significantly decreased in elderly subjects in female never-smokers. Objective monitoring of cough might be important in the elderly people.

  7. Comparison of cough reflex test against instrumental assessment of aspiration.

    Science.gov (United States)

    Miles, Anna; Moore, Sara; McFarlane, Mary; Lee, Fiona; Allen, Jacqueline; Huckabee, Maggie-Lee

    2013-06-13

    Silent aspiration is associated with pneumonia and mortality, and is poorly identified by traditional clinical swallowing evaluation (CSE). The aim of this study was to validate cough reflex testing (CRT) for identification of silent aspiration against aspiration confirmed by instrumental assessment. Cough reflex threshold testing was completed on all patients using inhaled, nebulised citric acid. Within an hour, 80 patients underwent videofluoroscopic study of swallowing (VFSS) and 101 patients underwent fibreoptic endoscopic evaluation of swallowing (FEES). All tests were recorded and analysed by two researchers blinded to the result of the alternate test. Significant associations between CRT result and cough response to aspiration on VFSS (X(2) (2)=11.046, p=.003) and FEES (X(2) (2)=34.079, pacid provide a better predictive measure of silent aspiration. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. 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.

  9. Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis

    OpenAIRE

    Martinak, Bridgette; Bolis, Ramy A.; Black, Jeffrey Ryne; Fargason, Rachel E.; Birur, Badari

    2017-01-01

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM” and “the poor man’s PCP,” is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psych...

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

    Science.gov (United States)

    Potts, James F; Rona, Roberto J; Oyarzun, Manuel J; Amigo, Hugo; Bustos, Patricia

    2008-04-01

    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 semirural 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.

  11. 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.

  12. Indoor Risk Factors for Cough and Their Relation to Wheeze and Sensitization in Chilean Young Adults

    Science.gov (United States)

    Potts, James F.; Rona, Roberto J.; Oyarzun, Manuel J.; Amigo, Hugo; Bustos, Patricia

    2008-01-01

    Objectives. We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Methods. Our sample was composed of 1232 men and women residing in a semirural 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. Results. 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. Conclusions. 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. PMID:17666696

  13. Index finger motor imagery EEG pattern recognition in BCI applications using dictionary cleaned sparse representation-based classification for healthy people

    Science.gov (United States)

    Miao, Minmin; Zeng, Hong; Wang, Aimin; Zhao, Fengkui; Liu, Feixiang

    2017-09-01

    Electroencephalogram (EEG)-based motor imagery (MI) brain-computer interface (BCI) has shown its effectiveness for the control of rehabilitation devices designed for large body parts of the patients with neurologic impairments. In order to validate the feasibility of using EEG to decode the MI of a single index finger and constructing a BCI-enhanced finger rehabilitation system, we collected EEG data during right hand index finger MI and rest state for five healthy subjects and proposed a pattern recognition approach for classifying these two mental states. First, Fisher's linear discriminant criteria and power spectral density analysis were used to analyze the event-related desynchronization patterns. Second, both band power and approximate entropy were extracted as features. Third, aiming to eliminate the abnormal samples in the dictionary and improve the classification performance of the conventional sparse representation-based classification (SRC) method, we proposed a novel dictionary cleaned sparse representation-based classification (DCSRC) method for final classification. The experimental results show that the proposed DCSRC method gives better classification accuracies than SRC and an average classification accuracy of 81.32% is obtained for five subjects. Thus, it is demonstrated that single right hand index finger MI can be decoded from the sensorimotor rhythms, and the feature patterns of index finger MI and rest state can be well recognized for robotic exoskeleton initiation.

  14. Caring for cough : guiding diagnosis in primary care

    NARCIS (Netherlands)

    van Vugt, S.F.

    2013-01-01

    Proper diagnosis in the very common presented acute cough or other LRTI-like symptoms allows GPs to adequately treat and inform their patients about the expected course of their disease. Management depends on the assumed cause of the LRTI, which includes potentially life threatening pneumonia, as

  15. Evaluation of Fractioned Nitric Oxide in Chronic Cough Patients

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... due to its high positive predictive value, its practical nature, the fact that it is a ..... Eosinophilia at complete blood count. 37. 41.1. 8 .... REFERENCES. 1. Massie J. Cough in children: When does it matter? Paediatr. Respir Rev 2006;7:9-14. 2. Chang AB, Landau LI, Van Asperen PP, Glasgow NJ, Robertson.

  16. A Cough-Based Algorithm for Automatic Diagnosis of Pertussis

    Science.gov (United States)

    Pramono, Renard Xaviero Adhi; Imtiaz, Syed Anas; Rodriguez-Villegas, Esther

    2016-01-01

    Pertussis is a contagious respiratory disease which mainly affects young children and can be fatal if left untreated. The World Health Organization estimates 16 million pertussis cases annually worldwide resulting in over 200,000 deaths. It is prevalent mainly in developing countries where it is difficult to diagnose due to the lack of healthcare facilities and medical professionals. Hence, a low-cost, quick and easily accessible solution is needed to provide pertussis diagnosis in such areas to contain an outbreak. In this paper we present an algorithm for automated diagnosis of pertussis using audio signals by analyzing cough and whoop sounds. The algorithm consists of three main blocks to perform automatic cough detection, cough classification and whooping sound detection. Each of these extract relevant features from the audio signal and subsequently classify them using a logistic regression model. The output from these blocks is collated to provide a pertussis likelihood diagnosis. The performance of the proposed algorithm is evaluated using audio recordings from 38 patients. The algorithm is able to diagnose all pertussis successfully from all audio recordings without any false diagnosis. It can also automatically detect individual cough sounds with 92% accuracy and PPV of 97%. The low complexity of the proposed algorithm coupled with its high accuracy demonstrates that it can be readily deployed using smartphones and can be extremely useful for quick identification or early screening of pertussis and for infection outbreaks control. PMID:27583523

  17. Proton pump inhibitor-responsive chronic cough without acid reflux: a case report

    Directory of Open Access Journals (Sweden)

    Nobata Kouichi

    2007-08-01

    Full Text Available Abstract Background Because 24-h esophageal pH monitoring is quite invasive, the diagnosis of gastroesophageal reflux disease (GERD-associated cough has usually been made based merely on the clinical efficacy of treatment with proton pump inhibitor (PPI. Case presentation We recently encountered two patients with PPI-responsive chronic non-productive cough for whom switching from bronchodilators and glucocorticosteroids to PPI resulted in improvement of cough. The cough returned nearly to pre-administration level a few weeks after discontinuation of PPI. Though GERD-associated cough was suspected, 24-h esophageal pH monitoring revealed that the cough rarely involved gastric acid reflux. Following re-initiation of PPI, the cough disappeared again. Conclusion PPI may improve cough unrelated to gastric acid reflux.

  18. Cough in Children: Current Approaches to the Treatment

    Directory of Open Access Journals (Sweden)

    O.O. Rechkina

    2016-03-01

    Full Text Available Introduction. Cough is one of the most common symptoms in the practice of doctors of various specialties, including pediatricians. Cough treatment should be started with the identification of its cause and correct diagnosis. Most often, cough in children is due to the increased viscosity of bronchial secretions, i.e. violation of sputum transport in the bronchial tree, and insufficient activity of ciliated epithelium. The main objective of the treatment of productive cough is dilution of sputum, bronchial secretion and excretion, thus necessitating the administration of mucolytics. Currently, one of the most famous mucolytics is acetylcysteine, cysteine amino acid product, such as ACC®. However, today the question of ACC® (acetylcysteine application in infants and young children is still debatable. This article presents a study whose objective was to evaluate the therapeutic efficacy and tolerability of ACC® (20 mg/ml solution in the treatment of bronchopulmonary diseases in children aged 2 to 6 years. Materials and methods. The study involved 60 children with acute tracheitis, simple bronchitis, acute obstructive bronchitis, recurrent bronchitis in the acute phase, community-acquired pneumonia, asthma exacerbation, cystic fibrosis. Patients of the main groups (n = 40 received ACC® (20 mg/ml solution at the age-specific dosage 3 times a day in combined treatment. Therapy of patients in the control group (n = 20 was conducted without ACC®. Results. During follow-up, patients who received ACC® had significant positive changes in the nature of cough, sputum viscosity and its amount as opposed to a comparison group of patients. Complete disappearance of cough was achieved on day 5–8 from the beginning of treatment, while in the control group patients, this time was longer. The evaluation of the effectiveness of the study drug showed that very good efficacy was achieved in 75 % of patients and good — in 20 %, and among patients who

  19. The lateralizing and localizing value of peri-ictal cough in epileptic seizures

    OpenAIRE

    Korkmaz, Bektaş; Erşen, Gülsün; Delil, Şakir; Özkara, Çiğdem; Yeni, S. Naz

    2013-01-01

    Introduction. Coughing may be observed as an epiphenomenon during or after epileptic seizures. Aim. In this paper we discuss the lateralization and localization value of cough as an epileptic peri/post ictal semiological phenomenon. Material and Methods. Seven patients presenting cough as a part of their symptomatology are presented. We will discuss cough in the context of these seven patients. Results. Six out of these seven patients were multidrug resistant temporal lobe epilepsy patient...

  20. pH and Titratable Acidity of different Cough Syrups in Nigeria ...

    African Journals Online (AJOL)

    Background: Cough linctuses are liquid oral medicines widely used in children to treat cough and related conditions. Some of their constituents are acidic and dental erosive. Objectives: This in vitro study aimed to evaluate the endogenous pH and titratable acidity of Nigerian cough syrups and also determine their erosive ...

  1. Effects of Chronic Sleep Restriction during Early Adolescence on the Adult Pattern of Connectivity of Mouse Secondary Motor Cortex123

    Science.gov (United States)

    Billeh, Yazan N.; Bernard, Amy; de Vivo, Luisa; Honjoh, Sakiko; Mihalas, Stefan; Ng, Lydia; Koch, Christof

    2016-01-01

    Abstract Cortical circuits mature in stages, from early synaptogenesis and synaptic pruning to late synaptic refinement, resulting in the adult anatomical connection matrix. Because the mature matrix is largely fixed, genetic or environmental factors interfering with its establishment can have irreversible effects. Sleep disruption is rarely considered among those factors, and previous studies have focused on very young animals and the acute effects of sleep deprivation on neuronal morphology and cortical plasticity. Adolescence is a sensitive time for brain remodeling, yet whether chronic sleep restriction (CSR) during adolescence has long-term effects on brain connectivity remains unclear. We used viral-mediated axonal labeling and serial two-photon tomography to measure brain-wide projections from secondary motor cortex (MOs), a high-order area with diffuse projections. For each MOs target, we calculated the projection fraction, a combined measure of passing fibers and axonal terminals normalized for the size of each target. We found no homogeneous differences in MOs projection fraction between mice subjected to 5 days of CSR during early adolescence (P25–P30, ≥50% decrease in daily sleep, n=14) and siblings that slept undisturbed (n=14). Machine learning algorithms, however, classified animals at significantly above chance levels, indicating that differences between the two groups exist, but are subtle and heterogeneous. Thus, sleep disruption in early adolescence may affect adult brain connectivity. However, because our method relies on a global measure of projection density and was not previously used to measure connectivity changes due to behavioral manipulations, definitive conclusions on the long-term structural effects of early CSR require additional experiments. PMID:27351022

  2. Identification of Characteristic Motor Patterns Preceding Freezing of Gait in Parkinson’s Disease Using Wearable Sensors

    Directory of Open Access Journals (Sweden)

    Luca Palmerini

    2017-08-01

    Full Text Available Freezing of gait (FOG is a disabling symptom that is common among patients with advanced Parkinson’s disease (PD. External cues such as rhythmic auditory stimulation can help PD patients experiencing freezing to resume walking. Wearable systems for automatic freezing detection have been recently developed. However, these systems detect a FOG episode after it has happened. Instead, in this study, a new approach for the prediction of FOG (before it actually happens is presented. Prediction of FOG might enable preventive cueing, reducing the likelihood that FOG will occur. Moreover, understanding the causes and circumstances of FOG is still an open research problem. Hence, a quantitative characterization of movement patterns just before FOG (the pre-FOG phase is of great importance. In this study, wearable inertial sensors were used to identify and quantify the characteristics of gait during the pre-FOG phase and compare them with the characteristics of gait that do not precede FOG. The hypothesis of this study is based on the threshold-based model of FOG, which suggests that before FOG occurs, there is a degradation of the gait pattern. Eleven PD subjects were analyzed. Six features extracted from movement signals recorded by inertial sensors showed significant differences between gait and pre-FOG. A classification algorithm was developed in order to test if it is feasible to predict FOG (i.e., detect it before it happens. The aim of the classification procedure was to identify the pre-FOG phase. Results confirm that there is a degradation of gait occurring before freezing. Results also provide preliminary evidence on the feasibility of creating an automatic algorithm to predict FOG. Although some limitations are present, this study shows promising findings for characterizing and identifying pre-FOG patterns, another step toward a better understanding, prediction, and prevention of this disabling symptom.

  3. Characterization of a cerebral palsy-like model in rats: Analysis of gait pattern and of brain and spinal cord motor areas.

    Science.gov (United States)

    Dos Santos, Adriana Souza; de Almeida, Wellington; Popik, Bruno; Sbardelotto, Bruno Marques; Torrejais, Márcia Miranda; de Souza, Marcelo Alves; Centenaro, Lígia Aline

    2017-08-01

    In an attempt to propose an animal model that reproduces in rats the phenotype of cerebral palsy, this study evaluated the effects of maternal exposure to bacterial endotoxin associated with perinatal asphyxia and sensorimotor restriction on gait pattern, brain and spinal cord morphology. Two experimental groups were used: Control Group (CTG) - offspring of rats injected with saline during pregnancy and Cerebral Palsy Group (CPG) - offspring of rats injected with lipopolysaccharide during pregnancy, submitted to perinatal asphyxia and sensorimotor restriction for 30days. At 29days of age, the CPG exhibited coordination between limbs, weight-supported dorsal steps or weight-supported plantar steps with paw rotation. At 45days of age, CPG exhibited plantar stepping with the paw rotated in the balance phase. An increase in the number of glial cells in the primary somatosensory cortex and dorsal striatum were observed in the CPG, but the corpus callosum thickness and cross-sectional area of lateral ventricle were similar between studied groups. No changes were found in the number of motoneurons, glial cells and soma area of the motoneurons in the ventral horn of spinal cord. The combination of insults in the pre, peri and postnatal periods produced changes in hindlimbs gait pattern of animals similar to those observed in diplegic patients, but motor impairments were attenuated over time. Besides, the greater number of glial cells observed seems to be related to the formation of a glial scar in important sensorimotor brain areas. Copyright © 2017 ISDN. Published by Elsevier Ltd. All rights reserved.

  4. Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) with chronic cough and preserved muscle stretch reflexes: evidence for selective sparing of afferent Ia fibres.

    Science.gov (United States)

    Infante, Jon; García, Antonio; Serrano-Cárdenas, Karla M; González-Aguado, Rocío; Gazulla, José; de Lucas, Enrique M; Berciano, José

    2018-04-25

    The aim of this study was to describe five patients with cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS) with chronic cough and preserved limb muscle stretch reflexes. All five patients were in the seventh decade of age, their gait imbalance having been initiated in the fifth decade. In four patients cough antedated gait imbalance between 15 and 29 years; cough was spasmodic and triggered by variable factors. Established clinical picture included severe hypopallesthesia predominating in the lower limbs with postural imbalance, and variable degree of cerebellar axial and appendicular ataxia, dysarthria and horizontal gaze-evoked nystagmus. Upper- and lower-limb tendon jerks were preserved, whereas jaw jerk was absent. Vestibular function testing showed bilateral impairment of the vestibulo-ocular reflex. Nerve conduction studies demonstrated normal motor conduction parameters and absence or severe attenuation of sensory nerve action potentials. Somatosensory evoked potentials were absent or severely attenuated. Biceps and femoral T-reflex recordings were normal, while masseter reflex was absent or attenuated. Sympathetic skin responses were normal. Cranial MRI showed vermian and hemispheric cerebellar atrophy predominating in lobules VI, VII and VIIa. We conclude that spasmodic cough may be an integral part of the clinical picture in CANVAS, antedating the appearance of imbalance in several decades and that sparing of muscle spindle afferents (Ia fibres) is probably the pathophysiological basis of normoreflexia.

  5. The pattern and extent of retrograde transsynaptic transport of WGA-Alexa 488 in the phrenic motor system is dependent upon the site of application.

    Science.gov (United States)

    Goshgarian, Harry G; Buttry, Janelle L

    2014-01-30

    The first aim of the study was to determine if WGA-Alexa 488 would undergo retrograde transsynaptic transport in the phrenic motor system as we have shown with WGA-HRP in a previous study. The advantage of using WGA-Alexa 488 is that labeled neurons could be isolated and analyzed for intracellular molecular mechanisms without exposing tissue sections to chemicals for histochemical staining. The second aim of the study was to investigate the pattern and extent of labeling that occurs when WGA-Alexa 488 is applied to the cervical phrenic nerve as compared to intradiaphragmatic injection. After injecting the hemidiaphragm ipsilateral to a C2 spinal cord hemisection, WGA-Alexa 488 presumably diffused to the contralateral hemidiaphragm and labeled the phrenic nuclei bilaterally. In all animals with hemidiaphragmatic injection, the rostral ventral respiratory group (rVRG) was also labeled bilaterally in the medulla. Thus, injection of WGA-Alexa 488 into the diaphragm results in retrograde transsynaptic transport in the phrenic motor system. After applying WGA-Alexa 488 to the ipsilateral intact cervical phrenic nerve in both C2 hemisected rats and rats with a sham hemisection, only ipsilateral phrenic neurons were labeled; there was no labeling of the rVRG or any other center in the medulla. These results suggest that WGA-Alexa 488 must be applied in the vicinity of the phrenic myoneural junction where there is a high concentration of WGA receptors in order for transsynaptic transport to occur. The present study provides investigators with a new tool to study plasticity in the respiratory system after spinal cord injury. Copyright © 2013. Published by Elsevier B.V.

  6. Sequential voluntary cough and aspiration or aspiration risk in Parkinson's disease.

    Science.gov (United States)

    Hegland, Karen Wheeler; Okun, Michael S; Troche, Michelle S

    2014-08-01

    Disordered swallowing, or dysphagia, is almost always present to some degree in people with Parkinson's disease (PD), either causing aspiration or greatly increasing the risk for aspiration during swallowing. This likely contributes to aspiration pneumonia, a leading cause of death in this patient population. Effective airway protection is dependent upon multiple behaviors, including cough and swallowing. Single voluntary cough function is disordered in people with PD and dysphagia. However, the appropriate response to aspirate material is more than one cough, or sequential cough. The goal of this study was to examine voluntary sequential coughing in people with PD, with and without dysphagia. Forty adults diagnosed with idiopathic PD produced two trials of sequential voluntary cough. The cough airflows were obtained using pneumotachograph and facemask and subsequently digitized and recorded. All participants received a modified barium swallow study as part of their clinical care, and the worst penetration-aspiration score observed was used to determine whether the patient had dysphagia. There were significant differences in the compression phase duration, peak expiratory flow rates, and amount of air expired of the sequential cough produced by participants with and without dysphagia. The presence of dysphagia in people with PD is associated with disordered cough function. Sequential cough, which is important in removing aspirate material from large- and smaller-diameter airways, is also impaired in people with PD and dysphagia compared with those without dysphagia. There may be common neuroanatomical substrates for cough and swallowing impairment in PD leading to the co-occurrence of these dysfunctions.

  7. Influence of Polysaccharides from Aloe vera (Aloe barbadensis Miller, Liliaceae on Mechanically Induced Cough in Cats

    Directory of Open Access Journals (Sweden)

    Martina Šutovská

    2010-01-01

    Full Text Available Different plants have been reported to be a source of polysaccharides that possess a great variety of biological activities, including cough suppression. The experiments were aimed on the influence of two polysaccharides isolated from the gel (A, HF1-Z and one from the epidermis (SL-1 of Aloe vera leaves, characterized by chemical composition and structural properties, on the cough reflex. The method of mechanically induced cough was used in conscious cats. A nylon fibre directed individually into the mucous area of the laryngopharyngeal and tracheobronchial airways via endotracheal cannula elicited the cough reflex. Statistical evaluation registered cough reflex indicators (number of cough efforts - NE, cough frequency - NE min–1 intensity of cough attacks during expiration and inspiration - IA+ and IA-, intensity of maximal inspiratory and expiratory cough efforts - IME- and IME+ showed that gel polysaccharide HF1-Z possessed higher cough-suppressing activity than dropropizine, a nonnarcotic peripheral cough suppressant. Their antitussive activity was accompanied mainly with a decrease of NE, IA+ and IA- from both laryngopharyngeal and tracheobronchial mucous areas of the airways. Results of the presented study also showed minimal influence of polysaccharide HF1-Z on expectoration predictor, IME- and IME+. New pharmacodynamic property of polysaccharides isolated from Aloe vera was shown during experiments, which could be a base of their possible therapeutic use in this indication in future.

  8. 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.

  9. Butorphanol suppresses fentanyl-induced cough during general anesthesia induction

    OpenAIRE

    Cheng, Xiao-Yan; Lun, Xiao-Qin; Li, Hong-Bo; Zhang, Zhi-Jie

    2016-01-01

    Abstract Fentanyl-induced cough (FIC) is unwanted in the patients requiring stable induction of general anesthesia. This study was designed to evaluate the suppressive effects of butorphanol pretreatment on the incidence and severity of FIC during the induction of general anesthesia. A total of 315 patients of American Society of Anesthesiologists physical status I and II, scheduled for elective surgery under general anesthesia were randomized into 3 equally sized groups (n = 0105). Two minut...

  10. Use of cough and cold preparations during breastfeeding.

    Science.gov (United States)

    Mitchell, J L

    1999-12-01

    Adverse reactions in infants from maternal drug ingestion depend largely on the amount of milk consumed by the infant, timing of breastfeeding in relation to dosing, dose of the medication, dosing interval, and duration of therapy. When taking medications, breastfeeding mothers should be instructed to take their medication after breastfeeding, at the lowest effective dose and for the shortest duration. Overall, there are few data from human studies on the use of antihistamines, decongestants, and cough products during breastfeeding. Studies of pseudoephedrine, triprolidine, and loratadine in humans conclude that low levels of each drug would reach a breastfed infant. Since triprolidine and pseudoephedrine are also considered compatible with breastfeeding by the AAP, these 2 drugs should be the first-line choices. Codeine is considered compatible with breastfeeding by the AAP, and would be an acceptable choice for short-term use as a cough suppressant. It is important to note that many of the liquid cough and cold products contain alcohol. In addition, many of the combination products are a mixture of an antihistamine and a decongestant and may also contain aspirin, acetaminophen, ibuprofen, or caffeine. It is preferable for nursing mothers to only take medications that are necessary and to avoid such combination products. The AAP considers alcohol, acetaminophen, ibuprofen, and caffeine compatible with breastfeeding. Aspirin has been associated with significant negative effects on some nursing infants, and the AAP recommends giving aspirin to nursing mothers with caution. Mothers taking cough and cold products should watch for adverse events in their breastfed infants. Infants may experience paradoxical central nervous stimulation from antihistamines and irritability and insomnia from decongestants.

  11. 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.

  12. 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.

  13. Evaluation of etiology of chronic cough in children

    Directory of Open Access Journals (Sweden)

    Yasin Yildiz

    2017-03-01

    Conclusion: The patients who was admitted with chronic cough should be questioned in history for exposure to smoke, nutrition, atopy in the family and postnasal drip, the length of expiration, wheezing like symptoms should be examined in physical examination. Thus, by preventing the delay in the diagnosis of patients with stage the rates of unnecessary diagnostic procedures will be reduced. Also we would be able to prevent the excessive use of drugs. [Cukurova Med J 2017; 42(1.000: 66-72

  14. Accuracy of portable devices in measuring peak cough flow

    International Nuclear Information System (INIS)

    Kulnik, Stefan Tino; Kalra, Lalit; MacBean, Victoria; Birring, Surinder Singh; Moxham, John; Rafferty, Gerrard Francis

    2015-01-01

    Peak cough flow (PCF) measurements can be used as indicators of cough effectiveness. Portable peak flow meters and spirometers have been used to measure PCF, but little is known about their accuracy compared to pneumotachograph systems. The aim of this study was to compare the accuracy of four portable devices (Mini–Wright and Assess peak flow meters, SpiroUSB and Microlab spirometers) in measuring PCF with a calibrated laboratory based pneumotachograph system. Twenty healthy volunteers (mean (SD) age 45 (16) years) coughed through a pneumotachograph connected in series with each portable device in turn, and the differences in PCF readings were analysed. In addition, mechanically generated flow waves of constant peak flow were delivered through each device both independently and when connected in series with the pneumotachograph. Agreement between PCF readings obtained with the pneumotachograph and the portable devices was poor. Peak flow readings were on average lower by approximately 50 L min −1 when measured using the portable devices; 95% limits of agreement spanned approximately 150 L min −1 . The findings highlight the potential for inaccuracy when using portable devices for the measurement of PCF. Depending on the measurement instrument used, absolute values of PCF reported in the literature may not be directly comparable. (paper)

  15. Pain, psychological distress and motor pattern in women with provoked vestibulodynia (PVD) - symptom characteristics and therapy suggestions.

    Science.gov (United States)

    Haugstad, Gro Killi; Wojniusz, Slawomir; Kirste, Unni Merete; Kirschner, Rolf Steinar; Lilleheie, Ingvild; Haugstad, Tor Sigbjørn

    2018-04-25

    Provoked vestibulodynia (PVD) represent a longstanding pain syndrome that affects large numbers of women worldwide. However, no standardized guidelines for PVD treatment exist. In a cross-sectional pilot study we examined 30 PVD patients on multidimensional parameters including pain, psychological distress and quality of movement, in order to obtain a broader understanding of the somatic and psychological symptoms in PVD, and for the future to develop better interventions. Additionally, we compare the findings to previously published results regarding the same parameters in women with chronic pelvic pain (CPP). Thirty women with PVD recruited from a tertiary care university clinic of gynecology were assessed for demographic data, pain intensity (VAS), psychological distress (GHQ-30 and Tampa scale of Kinesophobia) and quality of movement (standardized Mensendieck test, SMT). Average age of the PVD women was 24.7±3.60 years, 60% of them were in permanent relationships, all were nulliparous, none had been subjected to surgical procedures, 100% were working full or part time and 90% were educated to at least undergraduate level. Mean VAS score was 7.77±1.97 (mean±SD), kinesiophobia 24.4±3.95 and anxiety domain of GHQ-30 9.73±4.06. SMT scores were particularly low for the domains of respiration and gait (less than 50% of optimal scores). PVD women display reduced quality of movement, especially for gait and respiration patterns, increased level of anxiety and high average pain scores. These findings are similar to what we have previously reported in CPP patients. However, in contrast to CPP group, PVD women are on average younger, have higher work participation, higher education level and have not been subjected to surgical procedures. Since PVD women display similar, although somewhat less severe, symptom profile than CPP, we suggest that a multidimensional approach to treatment, such as "somatocognitive therapy" should be investigated in this group as it has

  16. 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...

  17. Association between Community Ambulation Walking Patterns and Cognitive Function in Patients with Parkinson’s Disease: Further Insights into Motor-Cognitive Links

    Directory of Open Access Journals (Sweden)

    Aner Weiss

    2015-01-01

    Full Text Available Background. Cognitive function is generally evaluated based on testing in the clinic, but this may not always reflect real-life function. We tested whether parameters derived from long-term, continuous monitoring of gait are associated with cognitive function in patients with Parkinson’s disease (PD. Methods. 107 patients with PD (age: 64.9 ± 9.3 yrs; UPDRS motor sum “off”: 40.4 ± 13.2; 25.23% women wore a 3D accelerometer on their lower back for 3 days. Computerized measures of global cognitive function, executive function, attention, and nonverbal memory were assessed. Three-day acceleration derived measures included cadence, variability, bilateral coordination, and dynamic postural control. Associations between the acceleration derived measures and cognitive function were determined. Results. Linear regression showed associations between vertical gait variability and cadence and between global cognitive score, attention, and executive function (p≤0.048. Dynamic postural control was associated with global cognitive score and attention (p≤0.027. Nonverbal memory was not associated with the acceleration-derived measures. Conclusions. These findings suggest that metrics derived from a 3-day worn body-fixed sensor reflect cognitive function, further supporting the idea that the gait pattern may be altered as cognition declines and that gait provides a window into cognitive function in patients with PD.

  18. Cough reflex sensitivity is increased in the guinea pig model of allergic rhinitis.

    Science.gov (United States)

    Brozmanova, M; Plevkova, J; Tatar, M; Kollarik, M

    2008-12-01

    Increased cough reflex sensitivity is found in patients with allergic rhinitis and may contribute to cough caused by rhinitis. We have reported that cough to citric acid is enhanced in the guinea pig model of allergic rhinitis. Here we address the hypothesis that the cough reflex sensitivity is increased in this model. The data from our previous studies were analyzed for the cough reflex sensitivity. The allergic inflammation in the nose was induced by repeated intranasal instillations of ovalbumin in the ovalbumin-sensitized guinea pigs. Cough was induced by inhalation of doubling concentrations of citric acid (0.05-1.6 M). Cough threshold was defined as the lowest concentration of citric acid causing two coughs (C2, expressed as geometric mean [95% confidence interval]). We found that the cough threshold was reduced in animals with allergic rhinitis. C2 was 0.5 M [0.36-0.71 M] and 0.15 M [0.1-0.23 M] prior and after repeated intranasal instillations of ovalbumin, respectively, Preflex sensitivity. C2 was reduced in animals with allergic rhinitis treated orally with vehicle (0.57 M [0.28-1.1] vs. 0.09 M [0.04-0.2 M], Preflex sensitivity is increased in the guinea pig model of allergic rhinitis. Our results suggest that guinea pig is a suitable model for mechanistic studies of increased cough reflex sensitivity in rhinitis.

  19. 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.

  20. High frequency of pertussis in older children and adolescents with prolonged cough in Turkey.

    Science.gov (United States)

    Aslan, Aslı; Kurugöl, Zafer; Aydemir, Şöhret; Gürsel, Derya; Koturoğlu, Güldane

    2016-01-01

    This study aimed to determine the frequency of B. pertussis infection among Turkish children with prolonged cough. Nasopharyngeal specimens were collected from 7-18 year old children, presenting with prolonged cough of two to four weeks' duration. Specimens were examined for B. pertussis by PCR. Of 101 children with prolonged cough, 20 (19.8%) had a positive PCR testing for B. pertussis. Children who were vaccinated ≥5 years previously had a 6.13-fold higher risk of PCR-confirmed pertussis than those who were vaccinated pertussis (paroxysmal cough, whooping and post-tussive vomiting) were seen in 30%, 15% and 25% of the patients with positive PCR, respectively; 55% of them had only a prolonged cough without any classic symptoms. Pertussis is common among Turkish children with prolonged cough, even after implementation of a fifth dose of pertussis vaccination and despite high vaccination coverage.

  1. Safety Profile of Cough and Cold Medication Use in Pediatrics.

    Science.gov (United States)

    Green, Jody L; Wang, George Sam; Reynolds, Kate M; Banner, William; Bond, G Randall; Kauffman, Ralph E; Palmer, Robert B; Paul, Ian M; Dart, Richard C

    2017-06-01

    The safety of cough and cold medication (CCM) use in children has been questioned. We describe the safety profile of CCMs in children pediatric (75.5%), and single-ingredient (77.5%) formulations were most commonly involved. AEs occurring in >20% of all cases included tachycardia, somnolence, hallucinations, ataxia, mydriasis, and agitation. Twenty cases (0.6%) resulted in death; most were in children pediatric liquid formulations were the most commonly reported products. These characteristics present an opportunity for targeted prevention efforts. Copyright © 2017 by the American Academy of Pediatrics.

  2. Whooping Cough: A Brief History to the 19th Century.

    Science.gov (United States)

    Weston, Robert

    2012-01-01

    This paper examines the history of whooping cough (pertussis) from its first recorded mention in 1190 to the time when its microbial cause was identified. The historical records of the disease are complicated by the variation in the nomenclature employed and through using the same name for disorders with different symptoms. During the early-modern period it was considered to be a disease new to Europe-contagious, dangerous, and potentially epidemic. Believed to be confined to children, its significance was limited until the 18th century when its incidence increased markedly. This essay argues pertussis may have occurred in the late medieval period in individual, though not epidemical, cases.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    or therapeutic evaluation presented details of their methodologies. Attendees participating in the workshop discussions included those interested in the physiology of MCC/CC, some of who use in vitro or animal methods for its study, pharmaceutical companies developing muco-active therapies, and many who were......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...

  4. CODEINE CONTAINING COUGH SYRUP ADDICTION IN ASSAM AND NAGALAND

    OpenAIRE

    Wairagkar, Niteen S.; Das, J.; Kumar, S.; Mahanta, J.; Satyanarayana, K.; Phukan, R.K.; Chetia, M.; Goswami, S.K.

    1994-01-01

    The drug abuse monitoring study of Regional Medical Research Center, Dibrugarh, reported 181 and 395 addicts from the states of Assam and Nagaland respectively in one year. Of these, 48 (26.5%) and 49(12.4%) cases were contributed by the primary abuse of codeine containing cough syrups. A11 addicts were males in their early twenties. Most of the addicts were unmarried and educated up to matriculation. The majority of addicts in Assam were Hindus (85.4%) and in Nagaland Christians (81.63%). Un...

  5. Intranasal vaccine trial for canine infectious tracheobronchitis (kennel cough).

    Science.gov (United States)

    Glickman, L T; Appel, M J

    1981-08-01

    Two field trials were conducted during periods of endemic (summer) and epizootic (winter) canine infectious tracheobronchitis activity to evaluate the efficacy of three intranasal vaccines in a closed commercial beagle breeding kennel. A trivalent vaccine containing Bordetella bronchiseptica, canine parainfluenza, and canine adenovirus-2 was administered at 3 weeks of age. The vaccine was 71.2% and 81.8% effective in decreasing the incidence of coughing during the winter and summer trials, respectively. The number of deaths was lower in each of the vaccine groups than in the placebo groups. No adverse reactions were observed with any of the intranasal vaccines.

  6. 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. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Protease-activated receptor-2 activation exaggerates TRPV1-mediated cough in guinea pigs.

    Science.gov (United States)

    Gatti, Raffaele; Andre, Eunice; Amadesi, Silvia; Dinh, Thai Q; Fischer, Axel; Bunnett, Nigel W; Harrison, Selena; Geppetti, Pierangelo; Trevisani, Marcello

    2006-08-01

    A lowered threshold to the cough response frequently accompanies chronic airway inflammatory conditions. However, the mechanism(s) that from chronic inflammation results in a lowered cough threshold is poorly understood. Irritant agents, including capsaicin, resiniferatoxin, and citric acid, elicit cough in humans and in experimental animals through the activation of the transient receptor potential vanilloid 1 (TRPV1). Protease-activated receptor-2 (PAR2) activation plays a role in inflammation and sensitizes TRPV1 in cultured sensory neurons by a PKC-dependent pathway. Here, we have investigated whether PAR2 activation exaggerates TRPV1-dependent cough in guinea pigs and whether protein kinases are involved in the PAR2-induced cough modulation. Aerosolized PAR2 agonists (PAR2-activating peptide and trypsin) did not produce any cough per se. However, they potentiated citric acid- and resiniferatoxin-induced cough, an effect that was completely prevented by the TRPV1 receptor antagonist capsazepine. In contrast, cough induced by hypertonic saline, a stimulus that provokes cough in a TRPV1-independent manner, was not modified by aerosolized PAR2 agonists. The PKC inhibitor GF-109203X, the PKA inhibitor H-89, and the cyclooxygenase inhibitor indomethacin did not affect cough induced by TRPV1 agonists, but abated the exaggeration of this response produced by PAR2 agonists. In conclusion, PAR2 stimulation exaggerates TRPV1-dependent cough by activation of diverse mechanism(s), including PKC, PKA, and prostanoid release. PAR2 activation, by sensitizing TRPV1 in primary sensory neurons, may play a role in the exaggerated cough observed in certain airways inflammatory diseases such as asthma and chronic obstructive pulmonary disease.

  8. 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.

  9. Occupational and Environmental Contributions to Chronic Cough in Adults: Chest Expert Panel Report.

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    Tarlo, Susan M; Altman, Kenneth W; Oppenheimer, John; Lim, Kaiser; Vertigan, Anne; Prezant, David; Irwin, Richard S

    2016-10-01

    In response to occupational and environmental exposures, cough can be an isolated symptom reflecting exposure to an irritant with little physiological consequence, or it can be a manifestation of more significant disease. This document reviews occupational and environmental contributions to chronic cough in adults, focusing on aspects not previously covered in the 2006 ACCP Cough Guideline or our more recent systematic review, and suggests an approach to investigation of these factors when suspected. MEDLINE and TOXLINE literature searches were supplemented by articles identified by the cough panel occupational and environmental subgroup members, to identify occupational and environmental aspects of chronic cough not previously covered in the 2006 ACCP Cough Guideline. Based on the literature reviews and the Delphi methodology, the cough panel occupational and environmental subgroup developed guideline suggestions that were approved after review and voting by the full cough panel. The literature review identified relevant articles regarding: mechanisms; allergic environmental causes; chronic cough and the recreational and involuntary inhalation of tobacco and marijuana smoke; nonallergic environmental triggers; laryngeal syndromes; and occupational diseases and exposures. Consensus-based statements were developed for the approach to diagnosis due to a lack of strong evidence from published literature. Despite increased understanding of cough related to occupational and environmental triggers, there remains a gap between the recommended assessment of occupational and environmental causes of cough and the reported systematic assessment of these factors. There is a need for further documentation of occupational and environmental causes of cough in the future. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  10. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

    OpenAIRE

    Rukhsana Parvin; Shekhar Bhattacharjee; Swapna Bhattacharjee

    2013-01-01

    Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional...

  11. High frequency analysis of cough sounds in pediatric patients with respiratory diseases.

    Science.gov (United States)

    Kosasih, K; Abeyratne, U R; Swarnkar, V

    2012-01-01

    Cough is a common symptom in a range of respiratory diseases and is considered a natural defense mechanism of the body. Despite its critical importance in the diagnosis of illness, there are no golden methods to objectively assess cough. In a typical consultation session, a physician may briefly listen to the cough sounds using a stethoscope placed against the chest. The physician may also listen to spontaneous cough sounds via naked ears, as they naturally propagate through air. Cough sounds carry vital information on the state of the respiratory system but the field of cough analysis in clinical medicine is in its infancy. All existing cough analysis approaches are severely handicapped by the limitations of the human hearing range and simplified analysis techniques. In this paper, we address these problems, and explore the use of frequencies covering a range well beyond the human perception (up to 90 kHz) and use wavelet analysis to extract diagnostically important information from coughs. Our data set comes from a pediatric respiratory ward in Indonesia, from subjects diagnosed with asthma, pneumonia and rhinopharyngitis. We analyzed over 90 cough samples from 4 patients and explored if high frequencies carried useful information in separating these disease groups. Multiple regression analysis resulted in coefficients of determination (R(2)) of 77-82% at high frequencies (15 kHz-90 kHz) indicating that they carry useful information. When the high frequencies were combined with frequencies below 15kHz, the R(2) performance increased to 85-90%.

  12. Effectiveness of a personalized ventilation system in reducing personal exposure against directly released simulated cough droplets.

    Science.gov (United States)

    Pantelic, J; Tham, K W; Licina, D

    2015-12-01

    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 manikin at distances between 1 and 4 m. Cough droplet concentration was measured with an aerosol spectrometer in the breathing zone of a thermal manikin. Particle image velocimetry was used to characterize the velocity field in the breathing zone. Desktop personalized ventilation substantially reduced 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. Exposure to cough droplets was reduced with increasing distance between cough source and exposed occupant. The results from this study show that an advanced air distribution system such as personalized ventilation reduces exposure to cough-released droplets better than commonly applied overhead mixing ventilation. This work can inform HVAC engineers about different aspects of air distribution systems’ performance and can serve as an aid in making critical design decisions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. 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

    manikin at distances between 1 and 4m. Cough droplet concentration was measured with an aerosol spectrometer in the breathing zone of a thermal manikin. Particle image velocimetry was used to characterize the velocity field in the breathing zone. Desktop personalized ventilation substantially reduced......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...

  14. Cough quality in children: a comparison of subjective vs. bronchoscopic findings

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    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

  15. Whooping cough in school age children presenting with persistent cough in UK primary care after introduction of the preschool pertussis booster vaccination: prospective cohort study.

    Science.gov (United States)

    Wang, Kay; Fry, Norman K; Campbell, Helen; Amirthalingam, Gayatri; Harrison, Timothy G; Mant, David; Harnden, Anthony

    2014-06-24

    To estimate the prevalence and clinical severity of whooping cough (pertussis) in school age children presenting with persistent cough in primary care since the introduction and implementation of the preschool pertussis booster vaccination. Prospective cohort study (November 2010 to December 2012). General practices in Thames Valley, UK. 279 children aged 5 to 15 years who presented in primary care with a persistent cough of two to eight weeks' duration. Exclusion criteria were cough likely to be caused by a serious underlying medical condition, known immunodeficiency or immunocompromise, participation in another clinical research study, and preschool pertussis booster vaccination received less than one year previously. Evidence of recent pertussis infection based on an oral fluid anti-pertussis toxin IgG titre of at least 70 arbitrary units. Cough frequency was measured in six children with laboratory confirmed pertussis. 56 (20%, 95% confidence interval 16% to 25%) children had evidence of recent pertussis infection, including 39 (18%, 13% to 24%) of 215 children who had been fully vaccinated. The risk of pertussis was more than three times higher (21/53; 40%, 26% to 54%) in children who had received the preschool pertussis booster vaccination seven years or more previously than in those who had received it less than seven years previously (20/171; 12%, 7% to 17%). The risk of pertussis was similar between children who received five and three component preschool pertussis booster vaccines (risk ratio for five component vaccine 1.14, 0.64 to 2.03). Four of six children in whom cough frequency was measured coughed more than 400 times in 24 hours. Pertussis can still be found in a fifth of school age children who present in primary care with persistent cough and can cause clinically significant cough in fully vaccinated children. These findings will help to inform consideration of the need for an adolescent pertussis booster vaccination in the United Kingdom. UK

  16. A Ternary Hybrid EEG-NIRS Brain-Computer Interface for the Classification of Brain Activation Patterns during Mental Arithmetic, Motor Imagery, and Idle State.

    Science.gov (United States)

    Shin, Jaeyoung; Kwon, Jinuk; Im, Chang-Hwan

    2018-01-01

    The performance of a brain-computer interface (BCI) can be enhanced by simultaneously using two or more modalities to record brain activity, which is generally referred to as a hybrid BCI. To date, many BCI researchers have tried to implement a hybrid BCI system by combining electroencephalography (EEG) and functional near-infrared spectroscopy (NIRS) to improve the overall accuracy of binary classification. However, since hybrid EEG-NIRS BCI, which will be denoted by hBCI in this paper, has not been applied to ternary classification problems, paradigms and classification strategies appropriate for ternary classification using hBCI are not well investigated. Here we propose the use of an hBCI for the classification of three brain activation patterns elicited by mental arithmetic, motor imagery, and idle state, with the aim to elevate the information transfer rate (ITR) of hBCI by increasing the number of classes while minimizing the loss of accuracy. EEG electrodes were placed over the prefrontal cortex and the central cortex, and NIRS optodes were placed only on the forehead. The ternary classification problem was decomposed into three binary classification problems using the "one-versus-one" (OVO) classification strategy to apply the filter-bank common spatial patterns filter to EEG data. A 10 × 10-fold cross validation was performed using shrinkage linear discriminant analysis (sLDA) to evaluate the average classification accuracies for EEG-BCI, NIRS-BCI, and hBCI when the meta-classification method was adopted to enhance classification accuracy. The ternary classification accuracies for EEG-BCI, NIRS-BCI, and hBCI were 76.1 ± 12.8, 64.1 ± 9.7, and 82.2 ± 10.2%, respectively. The classification accuracy of the proposed hBCI was thus significantly higher than those of the other BCIs ( p < 0.005). The average ITR for the proposed hBCI was calculated to be 4.70 ± 1.92 bits/minute, which was 34.3% higher than that reported for a previous binary hBCI study.

  17. Utility of tests used to diagnose asthma, gastroesophageal reflux and upper airway cough syndrome in patients with chronic cough and normal chest radiography

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    Ahmed E. Mansour

    2012-07-01

    Conclusion: Asthma, UACS, GERD, or some combination of these represent 78% of the causes of chronic cough in our sample. Therefore, these conditions should be considered first during diagnostic evaluation of patients with chronic cough and normal CXR. Inspite of some discrepancy between initial and final diagnoses, the study identifies the group of diagnostic methods best able to identify the cause in the vast majority of cases of chronic cough including sinuses CT scan, rhinoscopy, pulmonary function tests, and esophageal pH monitoring.

  18. Dextromethorphan in Cough Syrup: The Poor Man's Psychosis.

    Science.gov (United States)

    Martinak, Bridgette; Bolis, Ramy A; Black, Jeffrey Ryne; Fargason, Rachel E; Birur, Badari

    2017-09-15

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as "DXM" and "the poor man's PCP," is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia. We report a noteworthy case of severe dextromethorphan use disorder with dextromethorphan-induced psychotic disorder in a 40-year-old Caucasian female, whose symptoms remitted only following treatment with a combination of an antipsychotic and mood stabilizer. While some states have begun to limit the quantity of DXM sold or restrict sales to individuals over 18-years of age, there is currently no federal ban or restriction on DXM. Abuse of DXM, a readily available and typically inexpensive agent that is not detected on a standard urine drug screen, may be an under-recognized cause of substance-induced psychosis. It is imperative that clinicians are aware of the potential psychiatric sequelae of recreational DXM use.

  19. Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis

    Science.gov (United States)

    Martinak, Bridgette; Bolis, Ramy A.; Black, Jeffrey Ryne; Fargason, Rachel E.; Birur, Badari

    2017-01-01

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM” and “the poor man’s PCP,” is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia. We report a noteworthy case of severe dextromethorphan use disorder with dextromethorphan-induced psychotic disorder in a 40-year-old Caucasian female, whose symptoms remitted only following treatment with a combination of an antipsychotic and mood stabilizer. While some states have begun to limit the quantity of DXM sold or restrict sales to individuals over 18-years of age, there is currently no federal ban or restriction on DXM. Abuse of DXM, a readily available and typically inexpensive agent that is not detected on a standard urine drug screen, may be an under-recognized cause of substance-induced psychosis. It is imperative that clinicians are aware of the potential psychiatric sequelae of recreational DXM use. PMID:28936010

  20. Pertussis-associated persistent cough in previously vaccinated children.

    Science.gov (United States)

    Principi, Nicola; Litt, David; Terranova, Leonardo; Picca, Marina; Malvaso, Concetta; Vitale, Cettina; Fry, Norman K; Esposito, Susanna

    2017-11-01

    To evaluate the role of Bordetella pertussis infection, 96 otherwise healthy 7- to 17-year-old subjects who were suffering from a cough lasting from 2 to 8 weeks were prospectively recruited. At enrolment, a nasopharyngeal swab and an oral fluid sample were obtained to search for pertussis infection by the detection of B. pertussis DNA and/or an elevated titre of anti-pertussis toxin IgG. Evidence of pertussis infection was found in 18 (18.7 %; 95 % confidence interval, 11.5-28.0) cases. In 15 cases, the disease occurred despite booster administration. In two cases, pertussis was diagnosed less than 2 years after the booster injection, whereas in the other cases it was diagnosed between 2 and 9 years after the booster dose. This study used non-invasive testing to show that pertussis is one of the most important causes of long-lasting cough in school-age subjects. Moreover, the protection offered by acellular pertussis vaccines currently wanes more rapidly than previously thought.

  1. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

    Directory of Open Access Journals (Sweden)

    Rukhsana Parvin

    2013-01-01

    Full Text Available Background: Cough variant asthma (CVA is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease.

  2. Intraesophageal pressure recording improves the detection of cough during multichannel intraluminal impedance testing in children.

    Science.gov (United States)

    Rosen, Rachel; Amirault, Janine; Giligan, Emily; Khatwa, Umakanth; Nurko, Samuel

    2014-01-01

    One of the primary reasons for referral for reflux testing is to correlate reflux events with symptoms such as cough. Adult studies have suggested that symptom recording is flawed and pediatricians feel this is an even more significant problem because there may be errors in both parental and patient reports. We hypothesize that intraesophageal pressure recording (IEPR) provides an objective method to identify coughs during reflux testing in children. We recruited 20 children undergoing multichannel intraluminal impedance with pH (pH-MII) testing for the evaluation of cough. We placed simultaneous intraesophageal pressure and pH-MII catheters. Tracings were blindly scored by 2 observers without knowledge of patient/parent symptom report. After the blinded scoring, patient/parent report of symptoms was recorded. Ninety-four percent of all coughs were detected by IEPR and only 48% of all coughs were reported by patients/parents. The mean time from the IEPR cough to the patient/parent cough was 11±16 seconds. Using IEPR as the criterion standard for the detection of cough, the sensitivity of patient report for the detection of cough is 46%. Using varying symptom windows because of the increased precision of IEPR, the number of patients with a positive symptom index could be reduced from 30% to 0%, preventing children from being falsely categorized as having reflux-related lung disease. Parental and patient symptom recording in children is inadequate for making the diagnosis of reflux-related lung disease. If patients undergo pH-MII testing for reflux-related cough, IEPR should become the new standard by which to correlate reflux with cough.

  3. Immediate Effects of a Single Session of Motor Skill Training on the Lumbar Movement Pattern During a Functional Activity in People With Low Back Pain: A Repeated-Measures Study.

    Science.gov (United States)

    Marich, Andrej V; Lanier, Vanessa M; Salsich, Gretchen B; Lang, Catherine E; Van Dillen, Linda R

    2018-04-06

    People with low back pain (LBP) may display an altered lumbar movement pattern of early lumbar motion compared to people with healthy backs. Modifying this movement pattern during a clinical test decreases pain. It is unknown whether similar effects would be seen during a functional activity. The objective of this study is was to examine the lumbar movement patterns before and after motor skill training, effects on pain, and characteristics that influenced the ability to modify movement patterns. The design consisted of a repeated-measures study examining early-phase lumbar excursion in people with LBP during a functional activity test. Twenty-six people with chronic LBP received motor skill training, and 16 people with healthy backs were recruited as a reference standard. Twenty minutes of motor skill training to decrease early-phase lumbar excursion during the performance of a functional activity were used as a treatment intervention. Early-phase lumbar excursion was measured before and after training. Participants verbally reported increased pain, decreased pain, or no change in pain during performance of the functional activity test movement in relation to their baseline pain. The characteristics of people with LBP that influenced the ability to decrease early-phase lumbar excursion were examined. People with LBP displayed greater early-phase lumbar excursion before training than people with healthy backs (LBP: mean = 11.2°, 95% CI = 9.3°-13.1°; healthy backs: mean = 7.1°, 95% CI = 5.8°-8.4°). Following training, the LBP group showed a decrease in the amount of early-phase lumbar excursion (mean change = 4.1°, 95% CI = 2.4°-5.8°); 91% of people with LBP reported that their pain decreased from baseline following training. The longer the duration of LBP (β = - 0.22) and the more early-phase lumbar excursion before training (β = - 0.82), the greater the change in early-phase lumbar excursion following training. The long

  4. 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.

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    Parviz Ayazi

    Full Text Available 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.

  5. Successful use of guanfacine in a patient with chronic refractory cough: A case report

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    Gregory W. Kirschen

    2017-01-01

    Full Text Available Chronic idiopathic cough is a common and often frustrating complaint for patients as well as providers. When common etiologies of cough are ruled out and/or do not respond to usual treatments, neurogenic cough should be considered as a diagnosis of exclusion. Here, we report on a 58-year-old woman with an 8-year history of chronic, treatment-refractory cough of unknown etiology that we diagnosed as neurogenic cough and successfully treated with guanfacine monotherapy, with rapid and durable improvement in symptoms. This case was particularly challenging for a number of reasons, including a distant past smoking history and previous pneumonia, a significant psychiatric history, and a mildly deviated nasal septum and nasal osteophyte, all or some of which could have contributed to the etiology of the cough. This case illustrates that neurogenic cough should be a diagnostic consideration in patients presenting with chronic cough in whom other treatment modalities have failed, and also suggests that the therapeutic use of guanfacine in this clinical setting warrants future investigation.

  6. Voluntary Cough Production and Swallow Dysfunction in Parkinson’s Disease

    Science.gov (United States)

    Bolser, Donald; Rosenbek, John; Troche, Michelle; Sapienza, Christine

    2014-01-01

    Cough is important for airway clearance, particularly if penetration/aspiration of foreign material occurs during swallow. Measures of voluntary cough production from ten male participants with stage II–III Parkinson’s disease (PD) who showed no videofluorographic evidence of penetration/aspiration (Group 1) were examined and compared with those of ten male participants with stage II–III PD who showed videofluorographic evidence of penetration/aspiration (Group 2). The degree of penetration/ aspiration was expertly judged from the videofluorographic examinations of the participants’ sequential swallow of a thin, 30-cc bolus. Measured cough parameters included inspiratory phase duration, inspiratory peak flow, compression phase duration, expiratory peak flow, expiratory rise time, and cough volume acceleration. Results indicated significant group differences for the majority of cough measures, except for inspiratory phase duration and inspiratory peak flow. A modest relationship existed between voluntary cough parameters and penetration/aspiration scores. Decreased ability to adequately clear material from the airway with voluntary cough may exacerbate symptoms resulting from penetration/aspiration, particularly for those with neurodegenerative disease. Measurement of voluntary cough may be useful for the evaluation of airway clearance ability. PMID:18483823

  7. Improved voluntary cough immediately following office-based vocal fold medialization injections.

    Science.gov (United States)

    Ruddy, Bari H; Pitts, Teresa E; Lehman, Jeff; Spector, Brian; Lewis, Vicki; Sapienza, Christine M

    2014-07-01

    This study examined changes in voluntary cough airflow measures immediately following in-office injection of Radiesse in patients diagnosed with glottic insufficiency. Due to significant comorbidities, these patients were poor candidates for medialization under general anesthesia. Each patient presented with dysphonia and dysphagia and ineffective voluntary cough, resulting in a poor clearing of secretions and a presence of ingested fluids on examination. Prospective cohort and case series study. Three patients with a diagnosis of glottic insufficiency were included for study based on flexible endoscopy and laryngostroboscopic examination. Voluntary cough airflow measures were obtained approximately 30 minutes before and after the Radiesse injections. The airflow measures were: compression phase duration (CPD), expiratory rise time (EPRT), expiratory phase peak airflow (EPPF), and cough volume acceleration (CVA). Injection of Radiesse was found to improve voluntary cough airflow measures. The immediate increase in the objective airflow measures obtained from voluntary cough production after Radiesse injections can be used to document airway protection improvements. Cough airflow is a straightforward measure to obtain and is considered an objective measure of cough function. 4. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  8. 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,…

  9. Chronic cough management: dealing with a sensation of irritation in the throat.

    Science.gov (United States)

    Ogawa, Haruhiko; Fujimura, Masaki; Ohkura, Noriyuki; Makimura, Koichi

    2013-11-01

    Among the various types of laryngeal paraesthesia suffered by chronic cough patients, we often encounter 'a sensation of irritation in the throat (SIT)'. Our study indicated that capsaicin cough threshold was significantly (P sensation. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  10. Velocity Field Measurements of Human Coughing Using Time Resolved Particle Image Velocimetry

    Science.gov (United States)

    Khan, T.; Marr, D. R.; Higuchi, H.; Glauser, M. N.

    2003-11-01

    Quantitative fluid mechanics analysis of human coughing has been carried out using new Time Resolved Particle Image Velocimetry (TRPIV). The study involves measurement of velocity vector time-histories and velocity profiles. It is focused on the average normal human coughing. Some work in the past on cough mechanics has involved measurement of flow rates, tidal volumes and sub-glottis pressure. However, data of unsteady velocity vector field of the exiting highly time-dependent jets is not available. In this study, human cough waveform data are first acquired in vivo using conventional respiratory instrumentation for various volunteers of different gender/age groups. The representative waveform is then reproduced with a coughing/breathing simulator (with or without a manikin) for TRPIV measurements and analysis. The results of this study would be useful not only for designing of indoor air quality and heating, ventilation and air conditioning systems, but also for devising means of protection against infectious diseases.

  11. 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.

  12. Concordance and discriminatory power of cough measurement devices for individuals with Parkinson disease.

    Science.gov (United States)

    Silverman, Erin P; Carnaby-Mann, Giselle; Pitts, Teresa; Davenport, Paul; Okun, Michael S; Sapienza, Christine

    2014-05-01

    Dysphagia and aspiration pneumonia are two causes of morbidity in Parkinson disease (PD). In PD, impaired airway clearance can lead to penetration of foreign material, resulting in a high prevalence of aspiration pneumonia and death. This study examines three different devices for measurement of peak airflow during voluntary cough in healthy control subjects and those with PD. Two simple and low-cost devices for measuring peak cough airflow were compared with the "gold standard" pneumotachograph. Thirty-five healthy control subjects and 35 individuals with PD produced voluntary cough at three perceived strengths (weak, moderate, and strong cough) for each of the three devices. A significant difference in mean peak cough airflow was demonstrated for disease (F[1,56] = 4.0, P < .05) and sex (F[1,56] = 9.59, P < .003) across devices. The digital and analog meters were comparable to the gold standard demonstrating no significant difference (statistical) by device (digital vs analog) in receiver operating characteristic curve analysis. Both devices were discriminative of the presence of PD. The analog and digital peak airflow meters are suitable alternatives to the gold standard pneumotachograph due to their low cost, portability, ease of use, and high sensitivity relative to normative peak cough airflows. Voluntary cough airflow measures may serve as a noninvasive means of screening for aspiration risk in target populations. Additionally, quantification of cough strength through use of predetermined limens for weak, moderate, and strong cough may assist clinicians in better describing and tracking cough strength as a contributing factor to aspiration risk.

  13. Effectiveness of assisted and unassisted cough capacity in amyotrophic lateral sclerosis patients.

    Science.gov (United States)

    Sancho, Jesús; Servera, Emilio; Bañuls, Pilar; Marín, Julio

    2017-11-01

    Decreased cough capacity during a respiratory infection is one of the main causes of acute respiratory failure and hospitalisation in amyotrophic lateral sclerosis (ALS). To determine whether a respiratory measurement could identify the effectiveness of cough capacity in ALS during a respiratory infection. This was a prospective study of all ALS patients who were treated at a respiratory care unit due to a respiratory infection from 2012 to 2016. The effectiveness of unassisted and assisted coughing was evaluated and respiratory function tests were performed during the acute episode. Forty-eight ALS patients were enrolled, with only four having an effective unassisted cough. The variable which predicted unassisted cough effectiveness was peak cough flow (PCF) (OR 4499.27; 95%CI 3.60-3219086.19; p = 0.022) with a cut-off point of 2.77 L/s (166 L/min). For manually assisted coughing, the predictor of cough effectiveness was manually assisted PCF (cut-off point of 2.82-169 L/min) (OR 2198.602; 95% CI 3.750-1351691.42; p = 0.019). Mechanically assisted PCF (cut-off point of 2.95-177 L/min) was found to be the predictor of mechanically assisted coughing effectiveness (OR 23.40; 95% CI 2.11-258.96; p = 0.010). During a respiratory infection in ALS patients, the effectiveness of assisted and unassisted cough capacity depends on the PCF generated.

  14. Nerve growth factor enhances cough via a central mechanism of action.

    Science.gov (United States)

    El-Hashim, Ahmed Z; Jaffal, Sahar M; Al-Rashidi, Fatma T; Luqmani, Yunus A; Akhtar, Saghir

    2013-08-01

    The mechanisms involved in enhanced cough induced by central and inhaled NGF in guinea pigs were investigated. Cough and airway function were assessed by plethysmography following inhaled or intracerebroventricular (i.c.v.) NGF treatment. Expression of TrkA and/or TRPV1 was determined in bronchi and/or brainstem by real-time PCR and immunoblotting. I.c.v. and inhaled NGF enhanced citric acid induced-cough and airway obstruction. Pretreatment (i.c.v.) with antagonists of TrkA (K252a) or TRPV1 (IRTX) significantly reduced both the NGF (i.c.v.) enhanced cough and airway obstruction whereas the NK1 antagonist (FK888) inhibited only cough. The H1 antagonist (cetirizine) did not affect either. Inhaled NGF increased phosphorylation of TrkA receptors in the bronchi but not the brainstem at 0.5h post-treatment. TrkA mRNA was elevated at 0.5h in the bronchi and at 24h in the brainstem while TRPV1 mRNA was elevated from 0.5h to 24h in brainstem and at 24h in the bronchi. Pretreatment (i.c.v.) with IRTX, but not K252a, significantly inhibited the inhaled NGF-enhanced cough. Central NGF administration enhances cough and airway obstruction by mechanisms dependent on central activation of TrkA, TRPV1 and NK1 receptors while inhaled NGF enhances cough via a mechanism dependent on central TRPV1 and not TrkA receptors. These data show that NGF, in addition to its effects on the airways, has an important central mechanism of action in the enhancement of cough. Therefore, therapeutic strategies targeting NGF signaling in both the airways and CNS may be more effective in the management of cough. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Movement Sonification: Audiovisual benefits on motor learning

    Directory of Open Access Journals (Sweden)

    Weber Andreas

    2011-12-01

    Full Text Available Processes of motor control and learning in sports as well as in motor rehabilitation are based on perceptual functions and emergent motor representations. Here a new method of movement sonification is described which is designed to tune in more comprehensively the auditory system into motor perception to enhance motor learning. Usually silent features of the cyclic movement pattern "indoor rowing" are sonified in real time to make them additionally available to the auditory system when executing the movement. Via real time sonification movement perception can be enhanced in terms of temporal precision and multi-channel integration. But beside the contribution of a single perceptual channel to motor perception and motor representation also mechanisms of multisensory integration can be addressed, if movement sonification is configured adequately: Multimodal motor representations consisting of at least visual, auditory and proprioceptive components - can be shaped subtly resulting in more precise motor control and enhanced motor learning.

  16. Pediatrician’s cough and cold medication prescription for hypothetical cases – A cross-sectional multi-centric study

    Directory of Open Access Journals (Sweden)

    Sudha Chandelia

    2016-03-01

    Full Text Available Background: Concerns over inappropriate use of cough and cold medication (CCM in children have been raised. In addition to being ineffective, these are now considered toxic for young children. Despite this fact studies from some regions have shown high use of these medications by physicians. However data on pediatricians and from India are negligible. Aim: To study the burden and patterns of cough and cold medications use by pediatricians for hypothetical cases. Methods: In this cross-sectional study; 172 pediatricians of various hospitals of Delhi and Haryana were enrolled from February 15 to March 15, 2012. They were contacted personally by authors and asked to write their prescriptions for two hypothetical case scenarios [having cough and cold] of two different age groups; (1 less than 2 years and (2 2–5 years. We made two categories as recommendations exist for children less than 2 years while recommendations for the second category are underway. Results were summarized as percentages, counts and; presented in tables and figures. Chi square test was used to establish association between categorical variables of subgroups. Results: Response rate was 93%. The most used CCM was antihistaminics (82% and systemic sympathomimetics (48%. The use of CCM was significantly less in teaching hospitals as compared to non-teaching (77% vs. 95%; p-value – 0.025. However there was no statistical difference in the practice of post graduates and more senior pediatricians (p value-0.895. No difference in CCM use in two age groups {(82% (less than 2 years vs. 85% (2–5 years; p-value – 0.531} was observed. Conclusion: Overall use of CCM is still high irrespective of patient age, pediatrician’s seniority or hospital setting. Efforts should be made to create awareness among the pediatricians regarding cautious use of these medications.

  17. Motor cortex is required for learning but not for executing a motor skill.

    Science.gov (United States)

    Kawai, Risa; Markman, Timothy; Poddar, Rajesh; Ko, Raymond; Fantana, Antoniu L; Dhawale, Ashesh K; Kampff, Adam R; Ölveczky, Bence P

    2015-05-06

    Motor cortex is widely believed to underlie the acquisition and execution of motor skills, but its contributions to these processes are not fully understood. One reason is that studies on motor skills often conflate motor cortex's established role in dexterous control with roles in learning and producing task-specific motor sequences. To dissociate these aspects, we developed a motor task for rats that trains spatiotemporally precise movement patterns without requirements for dexterity. Remarkably, motor cortex lesions had no discernible effect on the acquired skills, which were expressed in their distinct pre-lesion forms on the very first day of post-lesion training. Motor cortex lesions prior to training, however, rendered rats unable to acquire the stereotyped motor sequences required for the task. These results suggest a remarkable capacity of subcortical motor circuits to execute learned skills and a previously unappreciated role for motor cortex in "tutoring" these circuits during learning. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Motor cortex is required for learning but not executing a motor skill

    Science.gov (United States)

    Kawai, Risa; Markman, Timothy; Poddar, Rajesh; Ko, Raymond; Fantana, Antoniu; Dhawale, Ashesh; Kampff, Adam R.; Ölveczky, Bence P.

    2018-01-01

    Motor cortex is widely believed to underlie the acquisition and execution of motor skills, yet its contributions to these processes are not fully understood. One reason is that studies on motor skills often conflate motor cortex’s established role in dexterous control with roles in learning and producing task-specific motor sequences. To dissociate these aspects, we developed a motor task for rats that trains spatiotemporally precise movement patterns without requirements for dexterity. Remarkably, motor cortex lesions had no discernible effect on the acquired skills, which were expressed in their distinct pre-lesion forms on the very first day of post-lesion training. Motor cortex lesions prior to training, however, rendered rats unable to acquire the stereotyped motor sequences required for the task. These results suggest a remarkable capacity of subcortical motor circuits to execute learned skills and a previously unappreciated role for motor cortex in ‘tutoring’ these circuits during learning. PMID:25892304

  19. The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke.

    Science.gov (United States)

    Mao, Yu-Rong; Lo, Wai Leung; Lin, Qiang; Li, Le; Xiao, Xiang; Raghavan, Preeti; Huang, Dong-Feng

    2015-01-01

    Gait performance is an indicator of mobility impairment after stroke. This study evaluated changes in balance, lower extremity motor function, and spatiotemporal gait parameters after receiving body weight supported treadmill training (BWSTT) and conventional overground walking training (CT) in patients with subacute stroke using 3D motion analysis. Inpatient department of rehabilitation medicine at a university-affiliated hospital. 24 subjects with unilateral hemiplegia in the subacute stage were randomized to the BWSTT (n = 12) and CT (n = 12) groups. Parameters were compared between the two groups. Data from twelve age matched healthy subjects were recorded as reference. Patients received gait training with BWSTT or CT for an average of 30 minutes/day, 5 days/week, for 3 weeks. Balance was measured by the Brunel balance assessment. Lower extremity motor function was evaluated by the Fugl-Meyer assessment scale. Kinematic data were collected and analyzed using a gait capture system before and after the interventions. Both groups improved on balance and lower extremity motor function measures (P training. Both methods can improve balance and motor function.

  20. Is Bjerkandera adusta Important to fungus-associated chronic cough as an allergen? Eight cases' reports.

    Science.gov (United States)

    Ogawa, Haruhiko; Fujimura, Masaki; Takeuchi, Yasuo; Makimura, Koichi

    2009-10-01

    Recently, we have reported a new clinical disease concept called fungus-associated chronic cough (FACC), which entailed the following manifestations: (1) chronic cough; (2) the presence of environmental fungi, particularly basidiomycetous (BM) fungi, in the sputum; and (3) good clinical response to antifungal drugs. To clarify the relationship between the exposure to environmental fungi and the development of cough attacks, we reviewed the clinical records of patients with FACC and performed a molecular biological analysis of the BM fungi. We successfully selected 8 patients with chronic cough, wherein a sputum culture yielded B. adusta beforehand; moreover, we conducted allergological tests such as the immediate-type skin test, a serological test, bronchoprovocation test, and lymphocyte stimulation test (LST), using the antigenic solution of B. adusta. The efficacy of individualized therapy and the clinical manifestations in the eight patients were examined. All the eight patients were diagnosed with FACC. Although three patients who did not show a positive reaction to the bronchoprovocation test or LST showed excellent clinical response to anti-fungal drugs; other 5 patients who showed a positive reaction to the bronchoprovocation test and/or LST seemed to be more intractable because of taking a longer time for complete remission and more frequent recurrence of cough. It was suggested that so-called allergic fungal cough (AFC), which is characterized by sensitization to B. adusta, may be included in a part of chronic intractable cough.

  1. 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. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

  2. Does diurnal variation in cough reflex testing exist in healthy young adults?

    Science.gov (United States)

    Perry, Sarah; Huckabee, Maggie-Lee

    2017-05-01

    The aim of this study was to investigate whether diurnal variation in cough reflex sensitivity exists in healthy young adults when a tidal-breathing method is used. Fifty-three participants (19-37 years) underwent cough reflex testing on two occasions: once in the morning (between 9 am - midday) and once in the afternoon (between 2-5 pm). The order of testing was counter-balanced. Within each assessment, participants inhaled successively higher citric acid concentrations via a facemask, with saline solution randomly interspersed to control for a placebo response. The lowest concentration that elicited a reflexive cough response was recorded. Morning cough thresholds (mean=0.6mol/L) were not different from afternoon cough thresholds (mean=0.6mol/L), p=0.16, T=101, r=-0.14. We found no evidence of diurnal variability in cough reflex testing. There was, however, an order effect irrespective of time of day, confirming that healthy participants are able to volitionally modulate their cough response. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Age correction in cognitive, linguistic, and motor domains for infants born preterm: an analysis of the Bayley Scales of Infant and Toddler Development, Third Edition developmental patterns.

    Science.gov (United States)

    Morsan, Valentina; Fantoni, Carlo; Tallandini, Maria Anna

    2018-03-15

    To verify whether it is appropriate to use age correction for infants born preterm in all the developmental domains (cognitive, linguistic, and motor) considered by the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Seventy-three infants born preterm (26-35wks) without major neurological sequelae and 67 infants born at term were assessed at 12 months (corrected age for infants born preterm). The performance of the infants born preterm was assessed with two different evaluations: scores based on uncorrected age and scores based on corrected age. The developmental trends of infants born at term and infants born preterm differ across domains. Statistical analysis shows that age correction produces an overrated estimate of motor performance (12.5 points [95% confidence interval 9.05-16.01]) but not of cognitive performance. Given the broad use of the Bayley-III by psychologists and paediatricians, these results are important in the early diagnosis of developmental difficulties for children born preterm. Correction for gestational age should be applied for the cognitive domain only; whereas for the motor domain, chronological age should be used. No clear data emerged for language. Age correction with Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) for infants born preterm should be applied differently in cognitive, language, and motor domains. Using corrected age with Bayley-III, the motor skills are overrated. Correction for preterm births adequately measures cognitive skills. No clear indication emerged about language skills. © 2018 Mac Keith Press.

  4. The electric motor handbook

    Energy Technology Data Exchange (ETDEWEB)

    Hurst, R.W.; Feltham, P. (eds.)

    2004-05-01

    This handbook outlines the important role that electric motors play in modern society. It covers the field of motor applications from various motor types to their use and repair. It also presents practical applications of electric motors and methods on motor efficiency. More than half of all electricity generated, and 75 per cent of all industrial electricity consumption is consumed by electric motors. Electrical personnel must be aware of all factors involved in electric motors in order to choose and apply the appropriate size of electric motor. These factors include efficiency, sizing and proper application. The efficient use and maximum life expectancy of electric motors depends on proper motor protection, control and maintenance. This handbook includes articles from leading experts on electric motors in modern electrical systems. The content includes: design considerations; proper electric motor sizing techniques; optimal electric motor application; electric motor protection technology; electric motor control principles; electric motor maintenance and troubleshooting; induction electric motors; electric motor bearing currents; electric motor bearing lubrication; electromagnetism; electric motor enclosures; electric motor testing; electric motor repair; DC electric motor; electric motor starters; electric motor brushes; industrial electric motors; electric motor diagrams; AC electric motors; electric motor wiring; electric motor service; electric motor rewinding; electric motor winding; diagram of electric motor wiring; electric motor kit; and, troubleshooting electric motors. A directory of motor manufacturers and suppliers was also included. refs., tabs., figs.

  5. Desensitization of the cough reflex by exercise and voluntary isocapnic hyperpnea.

    Science.gov (United States)

    Lavorini, Federico; Fontana, Giovanni A; Chellini, Elisa; Magni, Chiara; Duranti, Roberto; Widdicombe, John

    2010-05-01

    Little is known about the effects of exercise on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing nebulizer outputs of ultrasonically nebulized distilled water (fog), an index of cough reflex sensitivity, was assessed in twelve healthy humans in control conditions, during exercise and during voluntary isocapnic hyperpnea (VIH) at the same ventilatory level as the exercise. The intensity of the urge to cough (UTC), a cognitive component of coughing, was recorded throughout the trials on a linear scale. The relationships between inhaled fog nebulizer outputs and the correspondingly evoked UTC values, an index of the perceptual magnitude of the UTC sensitivity, were also calculated. Cough appearance was always assessed audiovisually. At an exercise level of 80% of anaerobic threshold, the median cough threshold was increased from a control value of 0.73 to 2.22 ml/min (PVIH, the threshold increased from 0.73 to 2.22 ml/min (PVIH compared with control, mean UTC values at cough threshold were unchanged, i.e., control, 3.83 cm; exercise, 3.12 cm; VIH, 4.08 cm. The relationship of the fog nebulizer output/UTC value was linear in control conditions and logarithmic during both exercise and VIH. The perception of the magnitude of the UTC seems to be influenced by signals or sensations arising from exercising limb and thoracic muscles and/or by higher nervous (cortical) mechanisms. The results indicate that the adjustments brought into action by exercise-induced or voluntary hyperpnea exert inhibitory influences on the sensory and cognitive components of fog-induced cough.

  6. Establishment and clinical applications of a portable system for capturing influenza viruses released through coughing.

    Science.gov (United States)

    Hatagishi, Etsuko; Okamoto, Michiko; Ohmiya, Suguru; Yano, Hisakazu; Hori, Toru; Saito, Wakana; Miki, Hiroshi; Suzuki, Yasushi; Saito, Reiko; Yamamoto, Taro; Shoji, Makoto; Morisaki, Yoshihisa; Sakata, Soichiro; Nishimura, Hidekazu

    2014-01-01

    Coughing plays an important role in influenza transmission; however, there is insufficient information regarding the viral load in cough because of the lack of convenient and reliable collection methods. We developed a portable airborne particle-collection system to measure the viral load; it is equipped with an air sampler to draw air and pass it through a gelatin membrane filter connected to a cone-shaped, megaphone-like device to guide the cough airflow to the membrane. The membrane was dissolved in a medium, and the viral load was measured using quantitative real-time reverse transcriptase-polymerase chain reaction and a plaque assay. The approximate viral recovery rate of this system was 10% in simulation experiments to collect and quantify the viral particles aerosolized by a nebulizer. Using this system, cough samples were collected from 56 influenza A patients. The total viral detection rate was 41% (23/56), and the viral loads varied significantly (from <10, less than the detection limit, to 2240 viral gene copies/cough). Viable viruses were detected from 3 samples with ≤18 plaque forming units per cough sample. The virus detection rates were similar among different groups of patients infected with different viral subtypes and during different influenza seasons. Among patients who did not receive antiviral treatment, viruses were detected in one of six cases in the vaccinated group and four of six cases in the unvaccinated group. We found cases with high viral titers in throat swabs or oral secretions but very low or undetectable in coughs and vice versa suggesting other possible anatomical sites where the viruses might be mixed into the cough. Our system is easy to operate, appropriate for bedside use, and is useful for comparing the viral load in cough samples from influenza patients under various conditions and settings. However, further large-scale studies are warranted to validate our results.

  7. The oesophagus and cough: laryngo-pharyngeal reflux, microaspiration and vagal reflexes

    Science.gov (United States)

    2013-01-01

    Gastro-oesophageal reflux disease is generally considered to be one of the commonest causes of chronic cough, however randomised controlled trials of proton pump inhibitors have often failed to support this notion. This article reviews the most recent studies investigating the mechanisms thought to link reflux and cough, namely laryngo-pharyngeal reflux, micro-aspiration and neuronal cross-organ sensitisation. How recent evidence might shed light on the failure of acid suppressing therapies and suggest new approaches to treating reflux related cough are also discussed. PMID:23590893

  8. Comparison of Two Methods for Inducing Reflex Cough in Patients With Parkinson's Disease, With and Without Dysphagia.

    Science.gov (United States)

    Hegland, Karen W; Troche, Michelle S; Brandimore, Alexandra; Okun, Michael S; Davenport, Paul W

    2016-02-01

    Aspiration pneumonia is a common cause of death in people with Parkinson's disease (PD). Dysfunctional swallowing occurs in the majority of people with PD, and research has shown that cough function is also impaired. Previous studies suggest that testing reflex cough by having participants inhale a cough-inducing stimulus through a nebulizer may be a reliable indicator of swallowing dysfunction, or dysphagia. The primary goal of this study was to determine the cough response to two different cough-inducing stimuli in people with and without PD. The second goal of this study was to compare the cough response to the two different stimuli in people with PD, with and without swallowing dysfunction. Seventy adults (49 healthy and 21 with PD) participated in the study. Aerosolized water (fog) and 200 μM capsaicin were used to induce cough. Each substance was placed in a small, hand-held nebulizer, and presented to the participant. Each cough stimulus was presented three times. The total number of coughs produced to each stimulus trial was recorded. All participants coughed more to capsaicin versus fog (p dysphagia. The data show a differential response of the PD participants to the capsaicin versus fog stimuli. Clinically, this finding may allow for earlier identification of people with PD who are in need of a swallowing evaluation. As well, there are implications for the neural control of cough in this patient population.

  9. 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.

  10. 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.

  11. Cough associated with gastro-oesophageal reflux disease (GORD): Japanese experience.

    Science.gov (United States)

    Niimi, Akio

    2017-12-01

    Differences in the aetiology as well as patient background of chronic cough have been recognised among US, UK, and Japan. One of the marked differences has been the prevalence of gastro-oesophageal reflux disease (GORD), which has been one of the top three causes in Western countries. It was indeed uncommon or rare in Japan, but, with the increasing prevalence of GOR itself, chronic cough associated with GORD seems to have become more common. In this article, cough associated with GORD will be reviewed based on literature and our Japanese experience. Further, potentially broader relevance of GORD in chronic cough will also be mentioned, highlighting the potential importance of dysmotiliy/non-acid reflux. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. 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...

  13. Dos and Don'ts of Giving OTC Cough and Cold Medicines to Your Child

    Science.gov (United States)

    ... workers, extended family members, or babysitters) knows what medicines your child is taking and when he or she should ... ts Don’t give OTC cough and cold medicines to a child younger than 4 years of age unless your ...

  14. Diagnostic utility of fractional exhaled nitric oxide in prolonged and chronic cough according to atopic status

    Directory of Open Access Journals (Sweden)

    Takamitsu Asano

    2017-04-01

    Conclusions: Although high FeNO levels suggested the existence of AC, lower FeNO levels had limited diagnostic significance. Atopic status affects the utility of FeNO levels in the differential diagnosis of prolonged and chronic cough.

  15. Developing control algorithms of a voluntary cough for an artificial bioengineered larynx using surface electromyography of chest muscles: A prospective cohort study.

    Science.gov (United States)

    Banus, M S; Birchall, M A; Graveston, J A

    2018-04-01

    This prospective cohort study investigates the prediction of a voluntary cough using surface electromyography (EMG) of intercostal and diaphragm muscles, to develop control algorithms for an EMG-controlled artificial larynx. The Ear Institute, London. Electromyography onset compared to voluntary cough exhalation onset and to 100 ms (to give the artificial larynx the time to close the bioengineered vocal cords) before voluntary cough exhalation onset, in twelve healthy participants. In the 189 EMG of intercostal muscle-detected voluntary coughs, 172 coughs (91% CI 70-112) were detected before onset of cough exhalation and 128 coughs (67.6% CI 33.7-101.7) 100 ms before onset of cough exhalation. In the 158 EMG of diaphragm muscle-detected voluntary coughs, 149 coughs (94.3% CI 76.3-112.3) were detected before onset of cough exhalation and 102 coughs (64.6% CI 26.6-102.6) 100 ms before onset of cough exhalation. More coughs were detected before onset of cough exhalation when combining EMG activity of intercostal and diaphragm muscles and comparing this to intercostal muscle activity alone (183 coughs [96.8% CI 83.8-109.8] vs 172 coughs, P = .0294). When comparing the mentioned combination to diaphragm muscle activity alone, the higher percentage of detected coughs before cough exhalation onset was not found to be significant (183 coughs vs 149 coughs, P = .295). In addition, more coughs were detected 100 ms before onset of cough exhalation with the mentioned combination of EMG activity and comparing this to intercostal muscles alone (149 coughs [78.8% CI 48.8-108.8] vs 128 coughs, P = .0198) and to diaphragm muscles alone (149 coughs vs 102 coughs, P = .0038). Most voluntary coughs can be predicted based on combined EMG signals of intercostal and diaphragm muscles, and therefore, these two muscle groups will be useful in controlling the bioengineered vocal cords within the artificial larynx during a voluntary cough. © 2017 John Wiley & Sons Ltd.

  16. Motor homopolar

    OpenAIRE

    Martín Muñoz, Agustín

    2007-01-01

    Mostramos la construcción de un modelo de motor homopolar, uno de los más antiguos tipos de motores eléctricos. Se caracterizan porque el campo magnético del imán mantiene siempre la misma polaridad (de ahí su nombre, del griego homos, igual), de modo que, cuando una corriente eléctrica atraviesa el campo magnético, aparece una fuerza que hace girar los elementos no fijados mecánicamente. En el sencillísimo motor homopolar colgado (Schlichting y Ucke 2004), el imán puede girar ...

  17. Regulating cough through modulation of sensory nerve function in the airways.

    Science.gov (United States)

    Spina, D; Page, C P

    2013-10-01

    Whilst local anaesthetics when applied directly to laryngeal nerves or topically to the lung can suppress cough, their chronic use is constrained because of dose limiting side effects. However, the effectiveness of local anaesthetics suggests that selectivity targeting nerves in the airway may provide novel approaches for the treatment of cough in the future. There is a considerable wealth of evidence showing that there are different afferent nerve subtypes in the airways. Traditionally C-fibres have been the focus of much research in the cough field since the stimulation of these afferents by capsaicin is able to elicit cough in guinea-pigs and in man, and drugs targeting various proteins expressed in these nerves (e.g. mu-opioid, NOP1, TRPV1, sodium channels) have been shown to be anti-tussive in preclinical models of cough. However, interest in Aδ fibres has increased recently in light of the discovery of a specific cough receptor in the guinea-pig that is provoked by citric acid and punctate stimulation, but not capsaicin and which has been anatomically linked to Aδ fibres. There is also some evidence that as a result of inflammation in the airways, Aδ fibres can begin to express neuropeptides and TRPV1 receptors so that they can become responsive to endogenous activators of this ion channel and to irritants like capsaicin. Consequently, there is considerable interest in targeting either one or both afferent nerve types for the treatment of chronic cough. However, to date the translation of preclinical studies into man has largely been disappointing and certainly there is a need for better preclinical models in this field. There also remain many challenges to overcome at a clinical level, such as what patient group(s) should be used to assess anti-tussive drugs and whether the use of irritants that induce cough in healthy volunteers (such as citric acid or capsaicin) is of any value in the assessment of novel anti-tussive drugs. The development of several

  18. Frequency of cough during therapy with ACE inhibitors in Greek hypertensives.

    Science.gov (United States)

    Efstratopoulos, A D; Meikopoulos, M; Voyaki, S

    1993-12-01

    Persistent dry cough is one of the most common side-effects during therapy with ACE inhibitors. The frequency of cough ranges widely (from 0.2% to 15%) in different series, being higher in small studies and smaller in retrospective studies with large number of patients. The aim of the present study was to evaluate the true frequency of cough induced by treatment with ACE inhibitors in Greek hypertensives and to determine various possibly correlated parameters, including sex, duration of therapy and kind and dose of ACE inhibitors. All hypertensive patients followed in our Hypertension Clinic and treated with ACE inhibitors participated in the study. A total of 228 patients, 103 males and 125 females, 24-80 years of age, were treated with ACE inhibitors for a period of 1-41 months: 121 with enalapril, 40 with captopril, 39 with lisinopril, 25 with perindopril and 3 with ramipril. During treatment with ACE inhibitors persistent dry cough occurred in 15 patients, 12 women and 3 men, giving a frequency of 6.58%. Eleven patients (4.82%) volunteered the information and three after questioning. The mean age of these 15 patients with cough was significantly higher from that of the group (n = 213) without cough (64.27 +/- 2.5 vs. 57.9 +/- 0.74 years, mean +/- SEM, P = 0.024). The 12 women with cough were significantly older than the 113 without cough (67.77 +/- 2.8 vs. 57.8 +/- 1.04 years, P = 0.032).(ABSTRACT TRUNCATED AT 250 WORDS)

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

    OpenAIRE

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    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...

  20. Patient education about cough: effect on the consulting behaviour of general practice patients.

    Science.gov (United States)

    Rutten, G; Van Eijk, J; Beek, M; Van der Velden, H

    1991-07-01

    The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.

  1. Pertussis prevalence and its determinants among children with persistent cough in urban Uganda.

    Directory of Open Access Journals (Sweden)

    Vincent Kayina

    Full Text Available We determined prevalence of pertussis infection and its associated host and environmental factors to generate information that would guide strategies for disease control.In a cross-sectional study, 449 children aged 3 months to 12 years with persistent cough lasting ≥14 days were enrolled and evaluated for pertussis using DNA polymerase chain reaction (PCR and ELISA serology tests.Pertussis prevalence was 67 (15% (95% Confidence Interval (CI: 12-18 and 81 (20% (95% CI: 16-24 by PCR and ELISA, respectively among 449 participating children. The prevalence was highest in children with >59 months of age despite high vaccination coverage of 94% in this age group. Study demographic and clinical characteristics were similar between pertussis and non-pertussis cases. Of the 449 children, 133 (30% had a coughing household member and 316 (70% did not. Among 133 children that had a coughing household member, sex of child, sharing bed with a coughing household member and having a coughing individual in the neighborhood were factors associated with pertussis. Children that had shared a bed with a coughing household individual had seven-fold likelihood of having pertussis compared to children that did not (odds ratio (OR 7.16 (95% CI: 1.24-41.44. Among the 316 children that did not have a coughing household member, age 40 years of age were the factors associated with pertussis. Age 59 months of age, suggesting the possibility of waning immunity. The factors associated with pertussis varied by presence or absence of a coughing household member.

  2. Market Analysis and Consumer Impacts Source Document. Part II. Review of Motor Vehicle Market and Consumer Expenditures on Motor Vehicle Transportation

    Science.gov (United States)

    1980-12-01

    This source document on motor vehicle market analysis and consumer impacts consists of three parts. Part II consists of studies and review on: motor vehicle sales trends; motor vehicle fleet life and fleet composition; car buying patterns of the busi...

  3. Application of stepping motor

    International Nuclear Information System (INIS)

    1980-10-01

    This book is divided into three parts, which is about practical using of stepping motor. The first part has six chapters. The contents of the first part are about stepping motor, classification of stepping motor, basic theory og stepping motor, characteristic and basic words, types and characteristic of stepping motor in hybrid type and basic control of stepping motor. The second part deals with application of stepping motor with hardware of stepping motor control, stepping motor control by microcomputer and software of stepping motor control. The last part mentions choice of stepping motor system, examples of stepping motor, measurement of stepping motor and practical cases of application of stepping motor.

  4. Classification of voluntary coughs applied to the screening of respiratory disease.

    Science.gov (United States)

    Infante, Christian; Chamberlain, Daniel B; Kodgule, Rahul; Fletcher, Richard Ribon

    2017-07-01

    Pulmonary and respiratory diseases (e.g. asthma, COPD, allergies, pneumonia, tuberculosis, etc.) represent a large proportion of the global disease burden, mortality, and disability. In this context of creating automated diagnostic tools, we explore how the analysis of voluntary cough sounds may be used to screen for pulmonary disease. As a clinical study, voluntary coughs were recorded using a custom mobile phone stethoscope from 54 patients, of which 7 had COPD, 15 had asthma, 11 had allergic rhinitis, 17 had both asthma and allergic rhinitis, and four had both COPD and allergic rhinitis. Data were also collected from 33 healthy subjects. These patients also received full auscultation at 11 sites, given a clinical questionnaire, and underwent full pulmonary function testing (spirometer, body plethysmograph, DLCO) which culminated in a diagnosis provided by an experienced pulmonologist. From machine learning analysis of these data, we show that it is possible to achieve good classification of cough sounds in terms of Wet vs Dry, yielding an ROC curve with AUC of 0.94, and show that voluntary coughs can serve as an effective test for determining Healthy vs Unhealthy (sensitivity=35.7% specificity=100%). We also show that the use of cough sounds can enhance the performance of other diagnostic tools such as a patient questionnaire and peak flow meter; however voluntary coughs alone provide relatively little value in determining specific disease diagnosis.

  5. The effect of vocal fold augmentation on cough symptoms in the presence of glottic insufficiency.

    Science.gov (United States)

    Litts, Juliana K; Fink, Daniel S; Clary, Matthew S

    2017-10-08

    To determine the effect of injection augmentation of the vocal folds on chronic cough symptoms in patients with glottic insufficiency. Medical records from 146 consecutive patients who underwent vocal fold injection augmentation by a fellowship-trained laryngologist between 2013 and 2015 were reviewed. Twenty-three patients (12 male) met inclusion criteria of a vocal fold augmentation injection, cough symptoms lasting more than 8 weeks, and glottic insufficiency as determined by shortened closed phase on stroboscopy. Exclusion criteria included lack of cough complaints, diagnosis of vocal fold immobility, previous history of vocal fold augmentation, and incomplete data sets. Data collected included age, gender, pre- and 1-month postinjection Cough Severity Index (CSI) scores, location of injection (unilateral or bilateral), and patient statement of percent change in symptoms that was recorded at 1-month postinjection visit. Paired t test indicated a significant decrease in CSI scores from pre- (m = 18.5) to 1-month postinjection (m = 12.1) (P = 0.004). Eighteen patients (78.2%) reported a 50% or greater improvement in cough symptoms at the 1-month postinjection visit. Injection augmentation of the vocal folds in the presence of glottic insufficiency appears to improve cough symptoms, as was reported by CSI in patients who are refractory to other medical and behavioral treatments. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Cough-variant asthma: a diagnostic dilemma in the occupational setting.

    Science.gov (United States)

    Lipińska-Ojrzanowska, A; Wiszniewska, M; Walusiak-Skorupa, J

    2015-03-01

    Cough-variant asthma (Corrao's syndrome) is defined as the presence of chronic non-productive cough in patients with bronchial hyperresponsiveness (BHR) and response to bronchodilator therapy. This variant of asthma may present a diagnostic problem in occupational medicine. To describe additional evaluation of cough-variant asthma in a cyanoacrylate-exposed worker in whom standard diagnostic testing was negative. A female beautician was evaluated for suspected occupational allergic rhinitis and asthma. A specific inhalation challenge test (SICT) was performed with cyanoacrylate glues used for applying artificial eyelashes and nails. Spirometry and peak expiratory flow (PEF) measurements were recorded hourly for 24h; methacholine challenge testing was performed and nasal lavage (NL) samples were analysed for eosinophilia. After SICT, the patient developed sneezing, nasal airflow obstruction and cough. Declines in forced expiratory volume in 1 s and PEF were not observed. Eosinophil proportions in NL fluid increased markedly at 4 and 24h after SICT. A significant increase in BHR also occurred 24h after SICT. Clinical symptoms, post-challenge BHR and increased NL eosinophil counts confirmed a positive response to SICT and validated the diagnosis of cough-variant occupational asthma. SICT may be useful in cases where history and clinical data suggest cough-variant asthma and spirometric indices are negative. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Comparison of cough reflex testing with videoendoscopy in recently extubated intensive care unit patients.

    Science.gov (United States)

    Kallesen, Molly; Psirides, Alex; Huckabee, Maggie-Lee

    2016-06-01

    Orotracheal intubation is known to impair cough reflex, but the validity of cough reflex testing (CRT) as a screening tool for silent aspiration in this population is unknown. One hundred and six participants in a tertiary-level intensive care unit (ICU) underwent CRT and videoendoscopic evaluation of swallowing (VES) within 24 hours of extubation. Cough reflex threshold was established for each participant using nebulized citric acid. Thirty-nine (37%) participants had an absent cough to CRT. Thirteen (12%) participants aspirated on VES, 9 (69%) without a cough response. Sensitivity of CRT to identify silent aspiration was excellent, but specificity was poor. There was a significant correlation between intubation duration and presence of aspiration on VES (P= .0107). There was no significant correlation between silent aspiration on VES and length of intubation, age, sex, diagnosis at intensive care unit admission, indication for intubation, Acute Physiology and Chronic Health Evaluation III score, morphine equivalent dose, or time of testing postextubation. Intensive care unit patients are at increased risk of aspiration in the 24 hours following extubation, and an impaired cough reflex is common. However, CRT overidentifies risk of silent aspiration in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. [Features of Bordetella pertussis, Bordetella spp. infection and whopping cough in Córdoba province, Argentina].

    Science.gov (United States)

    Giayetto, Víctor O; Blanco, Sebastián; Mangeaud, Arnaldo; Barbás, María G; Cudolá, Analía; Gallego, Sandra V

    2017-04-01

    Whooping cough is a re-emerging infection in the world and Latin America. It was considered relevant to investigate the clinical and epidemiological profile of Bordetella spp. and Bordetella pertussis infection in Córdoba province, Argentina; evaluating, at the same time, the co-infection with virus producing respiratory infections that may be confused with whooping cough. All whooping cough suspected cases were studied by Polimerase Chain Reaction, amplifying the repeated insertion sequence (IS) 481 and the promoter gene encoding pertussis toxin, between 2011 and 2013. The data were obtained from the clinical and epidemiological records. From 2,588 whooping cough suspected cases, 11.59% was infected by Bordetella spp. and 9.16% was confirmed as Bordetella pertussis infection. The rate of infection was 7.22 and 1.84 per 100,000 for 2011 and 2012, respectively. The infection presented a seasonal tendency and it was mainly found on the group of children between 13 and 24 months old. The co-infection with virus producing respiratory infections, were uncommon. Paroxysmal cough, cyanosis and/or vomiting were predictors of the infection for Bordetella pertussis. To deal with the re-emergence of whooping cough is important the knowledge of the regional epidemiological situation. This paper shows the situation of these infections in the regional clinical and epidemiological context, and makes the information available for health decision-making.

  9. Pheniramine Maleate is more effective than Lidocaine on Fentanyl Induced Cough.

    Science.gov (United States)

    Ozmen, Ozgur; Kara, Duygu; Karaman, Emine Uzlas; Karakoc, Fatma; Karakaya, Muhammet Ahmet; Arslan, Zakir

    2016-01-01

    Fentanyl is frequently used during anesthesia induction. The use of fentanyl can cause cough through different mechanisms. Here, we aimed to investigate effects of pheniramine maleate (PM), an antihistaminic agent, and compare it with lidocaine on fentanyl induced cough. This is a randomized double-blind prospective clinical study of ASA I-II, 120 patients scheduled for elective abdominal surgery. Patients were administered drugs intravenously and randomly allocated into three groups: Group C (2 ml 0.9 % normal saline), Group L (1mg/kg lidocaine), and Group F (PM 45.5 mg). 90 seconds after administration, 2µ/kg fentanyl was applied in three seconds to all patients. Severity of cough (mild: 1-2, moderate: 3-5, severe> 5), time of the cough and vital parameters were recorded 90 seconds after fentanyl injection. Eight patients (25%) in Group C had fentanyl induced cough whereas three patients (7.5%) in Group L and one patient (2.5%) in Group F experienced this phenomenon. There was statistically significant difference between Group F and Group C (p0.05). Pheniramine Maleate 45.5 mg is better that placebo and as effective as lidocaine to prevent fentanyl induced cough.

  10. Sexual affordances, perceptual-motor invariance extraction and intentional nonlinear dynamics: sexually deviant and non-deviant patterns in male subjects.

    Science.gov (United States)

    Renaud, Patrice; Goyette, Mathieu; Chartier, Sylvain; Zhornitski, Simon; Trottier, Dominique; Rouleau, Joanne-L; Proulx, Jean; Fedoroff, Paul; Bradford, John-P; Dassylva, Benoit; Bouchard, Stephane

    2010-10-01

    Sexual arousal and gaze behavior dynamics are used to characterize deviant sexual interests in male subjects. Pedophile patients and non-deviant subjects are immersed with virtual characters depicting relevant sexual features. Gaze behavior dynamics as indexed from correlation dimensions (D2) appears to be fractal in nature and significantly different from colored noise (surrogate data tests and recurrence plot analyses were performed). This perceptual-motor fractal dynamics parallels sexual arousal and differs from pedophiles to non-deviant subjects when critical sexual information is processed. Results are interpreted in terms of sexual affordance, perceptual invariance extraction and intentional nonlinear dynamics.

  11. Motor fuel prices in Turkey

    International Nuclear Information System (INIS)

    Erdogdu, Erkan

    2014-01-01

    The world's most expensive motor fuel (gasoline, diesel and LPG) is sold most likely in the Republic of Turkey. This paper investigates the key issues related to the motor fuel prices in Turkey. First of all, the paper analyses the main reason behind high prices, namely motor fuel taxes in Turkey. Then, it estimates the elasticity of motor fuel demand in Turkey using an econometric analysis. The findings indicate that motor fuel demand in Turkey is quite inelastic and, therefore, not responsive to price increases caused by an increase in either pre-tax prices or taxes. Therefore, fuel market in Turkey is open to opportunistic behavior by firms (through excessive profits) and the government (through excessive taxes). Besides, the paper focuses on the impact of high motor fuel prices on road transport associated activities, including the pattern of passenger transportation, motorization rate, fuel use, total kilometers traveled and CO 2 emissions from road transportation. The impact of motor fuel prices on income distribution in Turkey and Turkish public opinion about high motor fuel prices are also among the subjects investigated in the course of the study. - Highlights: • The key issues (e.g. taxes) related to motor fuel prices in Turkey are explored. • Their impact on transport activities and income distribution is also investigated. • An econometric analysis is performed to estimate motor fuel demand in Turkey. • Motor fuel demand in Turkey is found to be quite inelastic. • Turkish fuel market is open to opportunistic behavior by firms and the government

  12. [PCR testing for Bordetella pertussis in household contacts as a diagnostic tool for atypical whooping cough in unvaccinated young infants].

    Science.gov (United States)

    Cosnes-Lambe, Cecile; Raymond, Josette; Vallet, Christelle; Armengaud, Jean-Baptiste; Bosdure, Emmanuelle; Catalano-Pons, Charlotte; Chalumeau, Martin; El Hajje, Marie-Joelle; Moulin, Florence; de Suremain, Nathalie; Reglier-Poupet, Hélène; Poyart, Claire; Gendrel, Dominique

    2008-10-01

    False-negative findings of polymerase chain reaction (PCR) for genuine pertussis as well as the numerous atypical forms of whooping cough make it difficult to diagnose this disease in young babies. For two years, real-time PCR was performed to test for Bordetella pertussis in 86 infants younger than 6 months hospitalized for apnea or paroxysmal and/or vomiting cough and in 205 of their household contacts, whether or not they coughed. Group 1 included 30 infants for whom PCR detected B. pertussis (25 of whom were also RSV+). PCR was also positive for at least one household contact in 25/30 families. This group included 16 babies with apnea and 12 who developed a whooping cough during follow-up. Group 2 comprised 12 infants whose PCR was negative while at least one household contact had positive results. Five of these infants had severe apnea and 6 developed a whooping cough. Group 3 included 44 infants (28 RSV +) for whom PCR was negative in the index case and in the household contacts: none developed a whooping cough during follow-up. Only 3 of the 54 positive household contacts had a paroxysmal cough or a typical whooping cough and 12 had no cough at all. Positive PCR in a household contact, symptomatic or not, is helpful for the diagnosis of atypical whooping cough in young infants.

  13. Evaluation of Occupational and Environmental Factors in the Assessment of Chronic Cough in Adults: A Systematic Review.

    Science.gov (United States)

    Tarlo, Susan M; Altman, Kenneth W; French, Cynthia T; Diekemper, Rebecca L; Irwin, Richard S

    2016-01-01

    Several recent cough guidelines have advised consideration of occupational or environmental causes for chronic cough, but it is unclear how frequently this recommendation has been routinely applied. Therefore, we undertook a systematic review to address this aspect. Cough guidelines and protocols were reviewed to identify recommendations for assessment of occupational and environmental aspects of chronic cough. The systematic search previously used to identify intervention fidelity to the use of protocols for diagnosis and management of chronic cough in adults was used for this review after extension to June 2015. PubMed, Scopus, and the Cochrane Library were searched using the same search terms and inclusion criteria as previously. Papers that met our criteria were then reviewed to identify methods used to assess occupational and environmental aspects of chronic cough and the outcomes of these assessments. Among the 10 general chronic cough guidelines and protocols identified, only the three published since 2006 included details advising detailed occupational and environmental assessments. One additional cough statement focused entirely on occupational cough. Of the 28 cohort studies of patients with chronic cough that specifically noted that they followed guidelines or protocols, none provided details of occupational and environmental assessments. Despite published recommendations, it is not apparent that occupational and environmental causes for chronic cough are addressed in detail during assessments of patients with chronic cough. This leaves open to speculation whether lack of recognition of an occupational cause may delay important preventive measures, put additional workers at risk, and/or be the reason why a chronic cough may remain unexplained. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  14. Change in Psychological, Physiological, and Situational Factors in Adults After Treatment of Chronic Cough.

    Science.gov (United States)

    French, Cynthia L; Crawford, Sybil L; Bova, Carol; Irwin, Richard S

    2017-09-01

    We hypothesized that addressing anxiety and depressive mood disorders will improve chronic cough severity and cough quality of life (CQOL). Major tenets of the theory of unpleasant symptoms were examined in a longitudinal observational study of consecutive adults with cough of > 8 weeks' duration treated in our cough clinic. At baseline and 3 and 6 months, subjects completed 3 Punum Ladders rating cough severity, the CQOL Questionnaire, the Depression, Anxiety, and Stress Scales-21, and the Duke Functional Social Support Questionnaire. Cross-sectional baseline and longitudinal regression analyses were conducted. Eighty subjects (55 women) with a mean age of 58.5 ± 11.1 years and a cough duration of 86.0 ± 123.7 months were enrolled. At baseline, worse cough severity was significantly associated with less education and worse ability to speak bothered by cough and the urge to cough. Worse CQOL was significantly associated with worse depression symptoms, urinary incontinence, and ability to speak; use of self-prescribed remedies; and younger age. Significant improvements in depression and stress symptoms occurred at 3 and 6 months. Anxiety symptoms improved, particularly in the first 3 months. Improvement in cough severity was significantly associated with less education, male sex, and improvement in ability to speak and urge to cough. Improvement in CQOL was significantly associated with improvement in urinary incontinence, urge to cough, anxiety symptoms, and use of self-prescribed remedies. Using the theory of unpleasant symptoms, we have come to appreciate that managing psychological, physiological, and situational factors in addition to focusing on identifying the cause of cough is important to maximize improvement in CQOL. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. 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

    above background concentration (ppm), for the three measured distances was at 6 h-1. PCL decreased with distance. The exposure of the second patient was low when the doctor was at 0.55 or 1.1 m downstream the cough (blocking effect), but was quite high when at 2.8 m. 6 h-1, recommended in present...

  16. A stepwise protocol for the treatment of refractory gastroesophageal reflux-induced chronic cough

    Science.gov (United States)

    Xu, Xianghuai; Lv, Hanjing; Yu, Li; Chen, Qiang; Liang, Siwei

    2016-01-01

    Background Refractory gastroesophageal reflux-induced chronic cough (GERC) is difficult to manage. The purpose of the study is to evaluate the efficacy of a novel stepwise protocol for treating this condition. Methods A total of 103 consecutive patients with suspected refractory reflux-induced chronic cough failing to a standard anti-reflux therapy were treated with a stepwise therapy. Treatment commences with high-dose omeprazole and, if necessary, is escalated to subsequent sequential treatment with ranitidine and finally baclofen. The primary end-point was overall cough resolution, and the secondary end-point was cough resolution after each treatment step. Results High-dose omeprazole eliminated or improved cough in 28.1% of patients (n=29). Further stepwise of treatment with the addition of ranitide yielded a favorable response in an additional 12.6% (n=13) of patients, and subsequent escalation to baclofen provoked response in another 36.9% (n=38) of patients. Overall, this stepwise protocol was successful in 77.6% (n=80) of patients. The diurnal cough symptom score fell from 3 [1] to 1 [0] (Z=6.316, P=0.000), and the nocturnal cough symptom score decreased from 1 [1] to 0 [1] (Z=–4.511, P=0.000), with a corresponding reduction in the Gastroesophageal Reflux Diagnostic Questionnaire score from 8.6±1.7 to 6.8±0.7 (t=3.612, P=0.000). Conversely, the cough threshold C2 to capsaicin was increased from 0.49 (0.49) µmol/L to 1.95 (2.92) µmol/L (Z=–5.892, P=0.000), and the cough threshold C5 was increased from 1.95 (2.92) µmol/L to 7.8 (5.85) µmol/L (Z=–5.171, P=0.000). Conclusions Sequential stepwise anti-reflux therapy is a useful therapeutic strategy for refractory reflux-induced chronic cough. PMID:26904227

  17. A Longitudinal Study of Association between Heavy Metals and Itchy Eyes, Coughing in Chronic Cough Patients: Related with Non-Immunoglobulin E Mediated Mechanism

    Directory of Open Access Journals (Sweden)

    Thao Thi Thu Nguyen

    2016-01-01

    Full Text Available The association between heavy metals exposure and respiratory diseases or allergic sensitization showing high serum immunoglobulin E (IgE has been suggested. However, previous findings have been inconsistent and the mechanisms responsible remain unclear. We evaluated heavy metal exposure and its association with coughing, itchy eyes in chronic cough patients with different IgE levels. Ninety outpatients in Kanazawa University Hospital were recruited between January–June 2011. Subjects whose total IgE measured by radioimmunosorbent test were asked to record their daily symptoms. We collected daily total suspended particles (TSP from which concentrations of calcium (Ca, cadmium (Cd, chromium (Cr, iron (Fe, manganese (Mn, nickel (Ni, and lead (Pb were determined then divided into high and low level groups. Generalized estimating equations were applied to compute the relationship between concentrations of these metals and symptoms. All metals at high levels were significantly associated with itchy eyes compared with low levels, with exception of Ca, the six others were significant in patients with IgE < 250 IU/mL. Cd, Fe, Mn had association with coughing (odds ratio-OR (95% confidence interval-CI: 1.13 (1.03, 1.24, 1.22 (1.05, 1.42, and 1.13 (1.01, 1.27, respectively, this relationship remained significant for Cd (OR (95% CI: 1.14 (1.03, 1.27 and Mn (OR (95% CI: 1.15 (1.00, 1.31 in patients with lower IgE. Our findings demonstrate the relationship between aerial heavy metals and itchy eyes, coughing in chronic cough patients, suggesting these symptoms may be due to a non-IgE mediated mechanism.

  18. Comparison of voice quality in patients with GERD-related dysphonia or chronic cough.

    Science.gov (United States)

    Domeracka-Kołodziej, Anna; Grabczak, Elżbieta M; Dąbrowska, Marta; Arcimowicz, Magdalena; Lachowska, Magdalena; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

    2014-01-01

    The aim was to compare a voice quality in patients with GERD-related dysphonia or chronic cough and to determine whether there is a relationship between the main symptom reported and voice quality. 249 consecutive patients diagnosed with GERD-related chronic cough or dysphonia were involved in this retrospective study and were divided into two main groups of men and women, and furthermore into groups of chronic cough and dysphonia. Laryngeal lesions were evaluated with videolaryngostroboscopy using Reflux Finding Score. Voice quality was assessed using GRBAS scale, sonograms, and multidimensional voice program (MDVP). All subjects were found to have vocal abnormalities both in subjective and objective voice analysis. Perceptual assessment of voice (GRBAS) did not reveal any differences between analyzed groups depending on the reported symptom. In MDVP analysis, the group of women with cough as the main symptom demonstrated significantly less abnormalities in VTI value. In men with cough as their main complaint, significantly less MDVP abnormalities were found in Jita, Jitt, RAP, PPQ, and sPPQ parameters. The comparison of voice perceptual assessment in patients with GERD-related dysphonia or chronic cough revealed no differences between analyzed groups. In objective voice analysis, the latter group presented lower degree of hoarseness in Yanagihara's scale. In objective MDVP analysis, the chronic cough group presented lower degree of abnormalities only in one of the noise related parameters in females and five frequency perturbation parameters in males. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  19. Mast cells in citric acid-induced cough of guinea pigs

    International Nuclear Information System (INIS)

    Lai, Y.-L.; Lin, T.-Y.

    2005-01-01

    It was demonstrated previously that mast cells play an important role in citric acid (CA)-induced airway constriction. To investigate the role of mast cells in CA-induced cough, three experiments were carried out in this study. In the first experiment, 59 guinea pigs were employed and we used compound 48/80 to deplete mast cells, cromolyn sodium to stabilize mast cells, MK-886 to inhibit leukotriene synthesis, pyrilamine to antagonize histamine H 1 receptor, methysergide to antagonize serotonin receptor, and indomethacin to inhibit cyclooxygenase. In the second experiment, 56 compound 48/80-pretreated animals were divided into two parts; the first one was used to test the role of exogenous leukotriene (LT) C 4 , while the second one to test the role of exogenous histamine in CA-induced cough. Each animal with one of the above pretreatments was exposed sequentially to saline (baseline) and CA (0.6 M) aerosol, each for 3 min. Then, cough was recorded for 12 min using a barometric body plethysmograph. In the third experiment, the activation of mast cells upon CA inhalation was investigated by determining arterial plasma histamine concentration in 17 animals. Exposure to CA induced a marked increase in cough number. Compound 48/80, cromolyn sodium, MK-886 and pyrilamine, but not indomethacin or methysergide, significantly attenuated CA-induced cough. Injection of LTC 4 or histamine caused a significant increase in CA-induced cough in compound 48/80-pretreated animals. In addition, CA inhalation caused significant increase in plasma histamine concentration, which was blocked by compound 48/80 pretreatment. These results suggest that mast cells play an important role in CA aerosol inhalation-induced cough via perhaps mediators LTs and histamine

  20. Identification of genetic factors associated with susceptibility to angiotensin-converting enzyme inhibitors-induced cough.

    Science.gov (United States)

    Grilo, Antonio; Sáez-Rosas, María P; Santos-Morano, Juan; Sánchez, Elena; Moreno-Rey, Concha; Real, Luis M; Ramírez-Lorca, Reposo; Sáez, María E

    2011-01-01

    Angiotensin-converting enzyme inhibitors (ACEi) are the first selected drugs for hypertensive patients because of its protective properties against heart and kidney diseases. Persistent cough is a common adverse reaction associated with ACEi, which can bind to the treatment cessation, but its etiology remains an unresolved issue. The most accepted mechanism is that the inhibition of ACEi increases kinins levels, resulting in the activation of proinflammatory mechanisms and nitric oxide generation. However, relatively little is known about the genetic susceptibility to ACEi-induced cough in hypertensive patients. We carried out a monogenic association analysis of 39 polymorphisms and haplotypes in genes encoding key proteins related to ACEi activity with the occurrence of ACEi-induced cough. We also carried out a digenic association analysis and investigated the existence of epistatic interactions between the analyzed polymorphisms using a logistic regression procedure. Finally, we investigated the predictive value of the identified associations for ACEi-induced cough. We found that genetic polymorphisms in MME [rs2016848, P=0.002, odds ratio (OR)=1.795], BDKRB2 (rs8012552, P=0.012, OR=1.609), PTGER3 (rs11209716, P=0.002, OR=0.565), and ACE (rs4344) genes are associated with ACEi-related cough. For the latter, the effect is sex specific, having a protective effect in males (P=0.027, OR=0.560) and increasing the risk in females (P=0.031, OR=1.847). In addition, genetic interactions between peptidases involved in kinins levels (CPN1 and XPNPEP1) and proteins related to prostaglandin metabolism (PTGIS and PTGIR) strongly modify the risk of ACEi-induced cough presentation (0.102≤OR≤0.384 for protective combinations and 2.732≤OR≤7.216 for risk combinations). These results are consistent with the hypothesis that the mechanism of cough is related to the accumulation of bradykinin, substance P, and prostaglandins.

  1. Pilot study for home monitoring of cough capacity in amyotrophic lateral sclerosis: A case series.

    Science.gov (United States)

    Paneroni, M; Trainini, D; Winck, J C; Vitacca, M

    2014-01-01

    Cough capacity derangement is associated with a high risk of pulmonary complications in amyotrophic lateral sclerosis patients when cough assistance is not routinely performed at home. The primary aim of this study was to evaluate the feasibility of a long-term home based daily self-monitoring cough capacity. Eighteen subjects were enrolled in a 9-month study at home. Changes in peak cough expiratory flow, oxygen saturation, respiratory discomfort and incidence of respiratory deterioration events were evaluated. In subjects presenting respiratory deterioration events, decline in the abovementioned respiratory variables was evaluated (#NCT00613899). During an average follow-up of 125±102 days, a total of 1175 measures were performed on 12 subjects. Mean compliance to proposed evaluations was 37±32% which worsened over time. Peak cough expiratory flow decreased by 15.08±32.43L/min monthly. Five subjects reported 6 episodes of respiratory deterioration events, after a mean period of 136±108 days. They had poor respiratory function and more years of disease. There was no difference in peak cough expiratory flow and its decline whether subjects presented respiratory deterioration events or not. In 4 subjects the respiratory discomfort score significantly worsened after respiratory deterioration events from 3.0±1.41 to 4.25±1.71. Daily self-monitoring of peak cough expiratory flow, oxygen saturation and respiratory discomfort seems difficult to obtain because of poor adherence to measures; this protocol does not seem to add anything to current practice of advising on clinical derangements. Confirmatory larger studies are necessary. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  2. Comparison of clinical characteristics of chronic cough due to non-acid and acid gastroesophageal reflux.

    Science.gov (United States)

    Xu, Xianghuai; Yang, Zhongmin; Chen, Qiang; Yu, Li; Liang, Siwei; Lü, Hanjing; Qiu, Zhongmin

    2015-04-01

    Little is known about non-acid gastroesophageal reflux-induced chronic cough (GERC). The purpose of the study is to explore the clinical characteristics of non-acid GERC. Clinical symptoms, cough symptom score, capsaicin cough sensitivity, gastroesophageal reflux diagnostic questionnaire (GerdQ) score, findings of multichannel intraluminal impedance-pH monitoring (MII-pH) and response to pharmacological anti-reflux therapy were retrospectively reviewed in 38 patients with non-acid GERC and compared with those of 49 patients with acid GERC. Non-acid GERC had the similar cough character, cough symptom score, and capsaicin cough sensitivity to acid GERC. However, non-acid GERC had less frequent regurgitation (15.8% vs 57.1%, χ(2)  = 13.346, P = 0.000) and heartburn (7.9% vs 32.7%, χ(2)  = 7.686, P  = 0.006), and lower GerdQ score (7.4 ± 1.4 vs 10.6 ± 2.1, t = -6.700, P = 0.003) than acid GERC. Moreover, MII-pH revealed more weakly acidic reflux episodes, gas reflux episodes and a higher symptom association probability (SAP) for non-acid reflux but lower DeMeester score, acidic reflux episodes and SAP for acid reflux in non-acid GERC than in acid GERC. Non-acid GERC usually responded to the standard anti-reflux therapy but with delayed cough resolution or attenuation when compared with acid GERC. Fewer patients with non-acid GERC needed an augmented acid suppressive therapy or treatment with baclofen. There are some differences in the clinical manifestations between non-acid and acid GERC, but MII-pH is essential to diagnose non-acid GERC. © 2014 John Wiley & Sons Ltd.

  3. Prevalence of chronic cough, chronic phlegm & associated factors in Mysore, Karnataka, India.

    Science.gov (United States)

    Mahesh, P A; Jayaraj, B S; Prabhakar, A K; Chaya, S K; Vijayasimha, R

    2011-07-01

    Chronic cough and chronic phlegm are important indicators of respiratory morbidity, accelerated lung function decline, increased hospitalization and mortality. This study was planned to estimate the prevalence of chronic cough and phlegm in the absence of dyspneoa and wheezing and to study its associated factors in a representative population of Mysore district. A cross-sectional survey was planned in a representative population of Mysore taluk. Eight villages were randomly selected based on the list of villages from census 2001. Trained field workers using the Burden of Obstructive Diseases questionnaire carried out a house-to-house survey. A total of 4333 adult subjects were enrolled in the study with 2333 males and 2000 females. The prevalence of chronic cough in the community was 2.5 per cent and that of chronic phlegm was 1.2 per cent. A significant association was observed between chronic cough and age, gender, occupation and smoking and chronic phlegm with age, gender, occupation, indoor animals and smoking. A multivariate analysis confirmed independent association of age, occupation and smoking for chronic cough and age and smoking for chronic phlegm. On sub-group analysis of males, heavy smokers had higher prevalence of chronic cough and chronic phlegm as compared to light smokers and non smokers. The prevalence of chronic cough was 2.5 per cent and chronic phlegm was 1.2 per cent in the general population in Mysore which is lower than that observed in other studies. Heavy smoking was an important preventable risk factor identified in this study and efforts towards smoking cessation are crucial to achieve good respiratory health in the community.

  4. Phrenic motor unit recruitment during ventilatory and non-ventilatory behaviors.

    Science.gov (United States)

    Mantilla, Carlos B; Sieck, Gary C

    2011-10-15

    Phrenic motoneurons are located in the cervical spinal cord and innervate the diaphragm muscle, the main inspiratory muscle in mammals. Similar to other skeletal muscles, phrenic motoneurons and diaphragm muscle fibers form motor units which are the final element of neuromotor control. In addition to their role in sustaining ventilation, phrenic motor units are active in other non-ventilatory behaviors important for airway clearance such as coughing or sneezing. Diaphragm muscle fibers comprise all fiber types and are commonly classified based on expression of contractile proteins including myosin heavy chain isoforms. Although there are differences in contractile and fatigue properties across motor units, there is a matching of properties for the motor neuron and muscle fibers within a motor unit. Motor units are generally recruited in order such that fatigue-resistant motor units are recruited earlier and more often than more fatigable motor units. Thus, in sustaining ventilation, fatigue-resistant motor units are likely required. Based on a series of studies in cats, hamsters and rats, an orderly model of motor unit recruitment was proposed that takes into consideration the maximum forces generated by single type-identified diaphragm muscle fibers as well as the proportion of the different motor unit types. Using this model, eupnea can be accomplished by activation of only slow-twitch diaphragm motor units and only a subset of fast-twitch, fatigue-resistant units. Activation of fast-twitch fatigable motor units only becomes necessary when accomplishing tasks that require greater force generation by the diaphragm muscle, e.g., sneezing and coughing. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. 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

  6. Common spatial pattern combined with kernel linear discriminate and generalized radial basis function for motor imagery-based brain computer interface applications

    Science.gov (United States)

    Hekmatmanesh, Amin; Jamaloo, Fatemeh; Wu, Huapeng; Handroos, Heikki; Kilpeläinen, Asko

    2018-04-01

    Brain Computer Interface (BCI) can be a challenge for developing of robotic, prosthesis and human-controlled systems. This work focuses on the implementation of a common spatial pattern (CSP) base algorithm to detect event related desynchronization patterns. Utilizing famous previous work in this area, features are extracted by filter bank with common spatial pattern (FBCSP) method, and then weighted by a sensitive learning vector quantization (SLVQ) algorithm. In the current work, application of the radial basis function (RBF) as a mapping kernel of linear discriminant analysis (KLDA) method on the weighted features, allows the transfer of data into a higher dimension for more discriminated data scattering by RBF kernel. Afterwards, support vector machine (SVM) with generalized radial basis function (GRBF) kernel is employed to improve the efficiency and robustness of the classification. Averagely, 89.60% accuracy and 74.19% robustness are achieved. BCI Competition III, Iva data set is used to evaluate the algorithm for detecting right hand and foot imagery movement patterns. Results show that combination of KLDA with SVM-GRBF classifier makes 8.9% and 14.19% improvements in accuracy and robustness, respectively. For all the subjects, it is concluded that mapping the CSP features into a higher dimension by RBF and utilization GRBF as a kernel of SVM, improve the accuracy and reliability of the proposed method.

  7. 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. © The Author(s) 2015.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Voluntary Cough Airflow Differentiates Safe versus Unsafe Swallowing in Amyotrophic Lateral Sclerosis

    Science.gov (United States)

    Plowman, Emily K.; Watts, Stephanie A.; Robison, Raele; Tabor, Lauren; Dion, Charles; Gaziano, Joy; Vu, Tuan; Gooch, Clifton

    2016-01-01

    Dysphagia and aspiration are prevalent in amyotrophic lateral sclerosis (ALS) and contribute to malnutrition, aspiration pneumonia and death. Early detection of at risk individuals is critical to ensure maintenance of safe oral intake and optimal pulmonary function. We therefore aimed to determine the discriminant ability of voluntary cough airflow measures in detecting penetration/aspiration status in ALS patients. Seventy individuals with ALS (El-Escorial criteria) completed voluntary cough spirometry testing and underwent a standardized videofluoroscopic swallowing evaluation (VFSE). A rater blinded to aspiration status derived six objective measures of voluntary cough airflow and evaluated airway safety using the Penetration Aspiration Scale (PAS). A between groups ANOVA (safe vs. unsafe swallowers) was conducted and sensitivity, specificity, area under the curve (AUC) and likelihood ratios were calculated. VFSE analysis revealed 24 penetrator/aspirators (PAS ≥3) and 46 non-penetrator/aspirators (PAS ≤2). Cough volume acceleration (CVA), peak expiratory flow rise time (PEFRT), and peak expiratory flow rate (PEFR) were significantly different between airway safety groups (p 76ms had sensitivities of 91.3%, 82.6% and 73.9% respectively and specificities of 82.2%, 73.9%, and 78.3% for identifying ALS penetrator/aspirators. Voluntary cough airflow measures identified ALS patients at risk for penetration/aspiration and may be a valuable screening tool with high clinical utility. PMID:26803772

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

    Science.gov (United States)

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    To assess the routine use of barium swallow study in patients with chronic cough. 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. 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. 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.

  11. 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.

  12. 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.

  13. Rib fractures induced by coughing: an unusual cause of acute chest pain.

    Science.gov (United States)

    De Maeseneer, M; De Mey, J; Debaere, C; Meysman, M; Osteaux, M

    2000-03-01

    We report three patients with stress fractures of the ribs induced by coughing. Standard radiographs of the chest and ribs did not reveal evidence of rib fractures in any of the patients. Bone scintigraphy, performed 1 to 2 weeks after initial onset of symptoms, showed a focal area of increased uptake along the chest wall in all cases. Thin section angulated helical CT directly visualized the subtle rib fractures. Initial diagnosis of a cough-induced fracture of the rib may be difficult because of the associated underlying disorder, and unnecessary examinations are commonly performed. Identification of a cough-induced fracture of the rib using helical CT may be clinically important to avoid unnecessary concern and additional examinations.

  14. 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

    between groups in age, body mass index or pulmonary function. The median C5 were 129 micromol/L (control group), 48 micromol/L (multiple chemical sensitivity patients), 32 micromol/L (eczema patients). The reporting of lower airway symptoms from odorous chemicals was significantly (p......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...

  15. Cough urethrocystography: The best radiological evaluation of female stress urinary incontinence?

    International Nuclear Information System (INIS)

    Varpula, M.; Maekinen, J.; Kiilholma, P.

    1989-01-01

    Urethrocystography and simultaneous urethrocystometry were performed on 40 women with primary urinary incontinence. The posterior urethrovesical angle, inclination angle, urethropelvic angle, and an orifice descent angle, not earlier described, were measured on radiographs obtained at rest, during coughing and during straining. The orifice descent angle was used to describe the descent of the internal urethral orifice in the cough radiographs, and was the only measurement that provided a significant correlation with urethrocystometry. The other angles measured, and radiographs obtained at rest or during straining were not useful in the evaluation of female stress urinary incontinence. The authors conclude that the best imaging method for the evaluation of female stress urinary incontinence is urethrocystography employing a single lateral view taken during coughing, with measurement of the orifice descent angle. (orig.)

  16. Reflex Cough and Disease Duration as Predictors of Swallowing Dysfunction in Parkinson's Disease.

    Science.gov (United States)

    Troche, Michelle S; Schumann, Beate; Brandimore, Alexandra E; Okun, Michael S; Hegland, Karen W

    2016-12-01

    Patients with Parkinson's disease (PD) have progressive and pervasive disorders of airway protection. Recent work has highlighted the relationship between reflex and voluntary cough and swallowing safety. The goal of this study was to test the sensitivity and specificity of several airway protective and disease-specific factors for predicting swallowing safety outcomes in PD. Sixty-four participants (44 males) completed measures of voluntary and reflex cough, and swallowing safety. Clinical predictors included disease severity and duration, and cough airflow and sensitivity measures. ROC and Chi-square analyses identified predictors of swallowing safety (penetration-aspiration score) in PD. Disease duration significantly discriminated between patients with normal and abnormal swallowing safety (p = 0.027, sensitivity: 71 %, specificity: 55.4 %). Cough reflex sensitivity significantly discriminated between patients who penetrated above the level of the vocal folds and those with more severe penetration/aspiration (p = 0.021, sensitivity: 71.0 %, specificity 57.6 %). Urge-to-cough sensitivity (log-log linear slope) was the only variable which significantly discriminated between patients with penetration versus aspiration (p = 0.017, sensitivity: 85.7 %, specificity 73.2 %). It is important to identify the factors which influence airway protective outcomes in PD especially given that aspiration pneumonia is a leading cause of death. Results from this study highlight the ecological validity of reflex cough in the study of airway protection and this study further identifies important factors to consider in the screening of airway protective deficits in PD.

  17. Long-lasting cough in an adult German population: incidence, symptoms, and related pathogens.

    Science.gov (United States)

    Weinberger, Raphael; Riffelmann, Marion; Kennerknecht, Nicole; Hülße, Christel; Littmann, Martina; O'Brien, Judith; von Kries, Rüdiger; von König, Carl Heinz Wirsing

    2018-04-01

    Studies of the incidence of pertussis in adults have shown that it accounts for only 5-15% cases of prolonged coughing. We assessed the burden of suffering related to prolonged coughing and tried to identify further causative agents. Based on a sentinel study with 35 general practitioners in two German cities (Krefeld, Rostock), with 3,946 patients fulfilling the inclusion criteria, we estimated the incidence of prolonged coughing in adults. In 975 of these outpatients, PCR and/or serology for adenovirus, Bordetella pertussis and B. parapertussis, human metapneumovirus, influenza virus A and rhinovirus, parainfluenza virus, Mycoplasma pneumonia, and respiratory syncytial virus (RSV) were performed. Treatment data were extracted for a subgroup of 138 patients. Descriptive statistics, including Kaplan-Maier curves were generated. Yearly incidence ranged between 1.4 and 2.1% per population in the two cities. Adult patients sought medical attention only after a median of 3 weeks of coughing. Irrespective of smoking and unrelated to the identified pathogens, the median duration of coughing was 6 weeks, with an interquartile range of 4-11 weeks. In 48.3% of patients, possible pathogens were identified, among which adenovirus (15.1%), RSV (7.5%), B. pertussis (5.6%), and influenza viruses (4.0%) were most often found. Symptoms were not indicative of a specific agent and a total of 64% of patients received antibiotics. Prolonged adult coughing requiring medical attention prompts substantial healthcare use. Apart from B. pertussis, a broad range of pathogens was associated with the symptoms. However, patients sought medical attention too late to guide efficacious therapeutic interventions using the diagnostic tests.

  18. Chest radiography in supporting the diagnosis of asthma in children with persistent cough.

    Science.gov (United States)

    Halaby, Claudia; Feuerman, Martin; Barlev, Dan; Pirzada, Melodi

    2014-03-01

    To establish whether chest radiographic findings suggestive of lower airway obstruction (LAO) disease support the diagnosis of asthma in pediatric patients with persistent cough in an outpatient setting. 180 patient charts were reviewed. The patients were children aged 1 to 18 years referred over a 3-year period to a pediatric pulmonary subspecialty clinic for evaluation of cough lasting ≥ 4 weeks. Chest radiographic images obtained after the initial evaluation of 90 patients diagnosed with cough-variant asthma and 90 patients diagnosed with persistent cough from nonasthma origins were compared with radiologic findings of a control group consisting of patients with a positive tuberculin skin test and no respiratory symptoms. Increased peribronchial markings/peribronchial cuffing and hyperinflation were considered radiographically suggestive findings of LAO disease. Children diagnosed with cough-variant asthma at the initial evaluation had higher rates of chest radiographic findings suggestive of LAO disease (30.00%) than children with persistent cough from other causes (17.80%) or those with a positive tuberculin skin test and no respiratory symptoms (8.16%) (overall P value = 0.0063). They also had higher rates of spirometry abnormalities suggestive of an LAO defect. Children with chest radiographic findings suggestive of LAO disease were found to be younger than those with normal chest radiographic findings (5.0 ± 2.7 years vs 8.6 ± 4.7 years; P < 0.0001). This study suggests that chest radiographic findings indicative of an LAO in correlation with the clinical presentation can support the diagnostic suspicion of asthma, especially in younger children unable to perform spirometry.

  19. The effect of pheniramine on fentanyl-induced cough: a randomized, double blinded, placebo controlled clinical study

    Directory of Open Access Journals (Sweden)

    Zakir Arslan

    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.

  20. ANSYS-MATLAB co-simulation of mucus flow distribution and clearance effectiveness of a new simulated cough device.

    Science.gov (United States)

    Ren, Shuai; Shi, Yan; Cai, Maolin; Zhao, Hongmei; Zhang, Zhaozhi; Zhang, Xiaohua Douglas

    2018-03-05

    Coughing is an irritable reaction that protects the respiratory system from infection and improves mucus clearance. However, for the patients who cannot cough autonomously, an assisted cough device is essential for mucus clearance. Considering the low efficiency of current assisted cough devices, a new simulated cough device based on the pneumatic system is proposed in this paper. Given the uncertainty of airflow rates necessary to clear mucus from airways, the computational fluid dynamics Eulerian wall film model and cough efficiency (CE) were used in this study to simulate the cough process and evaluate cough effectiveness. The Ansys-Matlab co-simulation model was set up and verified through experimental studies using Newtonian fluids. Next, model simulations were performed using non-Newtonian fluids, and peak cough flow (PCF) and PCF duration time were analyzed to determine their influence on mucus clearance. CE growth rate (λ) was calculated to reflect the CE variation trend. From the numerical simulation results, we find that CE rises as PCF increases while the growth rate trends to slow as PCF increases; when PCF changes from 60 to 360 L/min, CE changes from 3.2% to 51.5% which is approximately 16 times the initial value. Meanwhile, keeping a long PCF duration time could greatly improve CE under the same cough expired volume and PCF. The results indicated that increasing the PCF and PCF duration time can improve the efficiency of mucus clearance. This paper provides a new approach and a research direction for control strategy in simulated cough devices for airway mucus clearance. Copyright © 2018 John Wiley & Sons, Ltd.

  1. A Comparison of Risk Factors for Wheeze and Recurrent Cough in Preschool Children

    DEFF Research Database (Denmark)

    Hermann, Christian; Westergaard, T.; Pedersen, B. V.

    2005-01-01

    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......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...

  2. 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.

  3. KNOWLEDGE, ATTITUDE AND PERCEPTION OF PARENTS ON THE USE OF COUGH AND COLD MEDICATIONS IN CHILDREN.

    Science.gov (United States)

    Yong, Chew Chin; Islahudin, Farida; Shah, Noraida Mohamed

    2015-05-01

    This study investigated the knowledge, attitude and perception of parents on the use of cough and cold medications in children. Questionnaires were distributed to parents of children aged parents (n=248) was satisfactory with a mean score of 5.87 +/- 1.70 (from a total of 10) and the overall attitude was positive with a mean score of 41.15 +/- 6.72 (from a total of 50). Ten percent of parents admitted administering cough and cold medications in children aged parents, education level and monthly income were found to significantly influence knowledge level (pchildren from the parents' perspectives.

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

    OpenAIRE

    Mohammad-Ali Raeessi; Jafar Aslani; Homa Gharaie; Ali-Akbar Karimi Zarchi; Neda Raeessi; Shervin Assari

    2011-01-01

    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 ho...

  5. Jidosha's Motors

    OpenAIRE

    Shirakawa Okuma, Rosely; Calderón Orejuela, Javier

    2016-01-01

    La tesis narra la situación de una empresa concesionaria de vehículos nuevos, Jidosha's Motors, perteneciente a una corporación japonesa que cuenta con una cultura muy arraigada de ética y de cumplimiento. Se plantean respuestas, se identifican problemas y sus alternativas de solución para una toma adecuada de decisiones por parte de los directivos, siguiendo una estructura de análisis de situaciones de negocios (ASN). Tesis

  6. Pre-motor and motor activities in early handwriting

    OpenAIRE

    van Zwieten, Koos Jaap

    2011-01-01

    Behavioural studies make use of handwritten letters’ characteristics like strokes, roundedness, etcetera. In consequence, Fisher et al. (2010) studying brain activation during rejected love, noticed typical pre-motor activity patterns, as suggested by irregular writing patterns as well, due to basal ganglia dysfunction (Mergl et al., 2004). A short historical text written in a presumably depressed mood was checked on such characteristics in the light of hypothesised finger-, and hand movement...

  7. CITRIC-ACID COUGH THRESHOLD AND AIRWAY RESPONSIVENESS IN ASTHMATIC-PATIENTS AND SMOKERS WITH CHRONIC AIR-FLOW OBSTRUCTION

    NARCIS (Netherlands)

    AUFFARTH, B; DEMONCHY, JGR; VANDERMARK, TW; POSTMA, DS; KOETER, GH

    The relation between citric acid cough threshold and airway hyperresponsiveness was investigated in 11 non-smoking patients with allergic asthma (mean FEV1 94% predicted) and 25 non-atopic smokers with chronic airflow obstruction (mean FEV1 65% predicted). Cough threshold was determined on two

  8. The Abuse of Dextromethorphan-Based Cough Syrup: A Pilot Study of the Community of Waynesboro, Pennsylvania.

    Science.gov (United States)

    Momodou, N. Darboe; And Others

    1996-01-01

    Discusses the emergence of a new type of abused drug, dextromethorphan, which is used in cough syrup. Presents the results of the first phase of a comprehensive investigation of this phenomenon in the Waynesboro, Pa. school district. Survey data indicate abuse of cough syrup has increased over the years and is increasingly perceived as a problem…

  9. Evaluation of Chlamydia pneumoniae and Mycoplasma pneumoniae as etiologic agents of persistent cough in adolescents and adults.

    Science.gov (United States)

    Wadowsky, Robert M; Castilla, Elias A; Laus, Stella; Kozy, Anita; Atchison, Robert W; Kingsley, Lawrence A; Ward, Joel I; Greenberg, David P

    2002-02-01

    Chlamydia pneumoniae and Mycoplasma pneumoniae were evaluated as agents of persistent cough in adolescents and adults (n = 491). Tests of 473 respiratory specimens by culture or PCR or both identified four episodes (0.8%) of M. pneumoniae-associated illness and no episodes of C. pneumoniae illness, suggesting that these bacteria do not frequently cause persistent cough.

  10. Influence of viscous Rhodella grisea (Rhodophyceae) proteoglycan on chemically induced cough reflex

    Czech Academy of Sciences Publication Activity Database

    Nosál´ová, G.; Capek, P.; Flešková, D.; Jureček, L´.; Hindák, F.; Lukavský, Jaromír; Cepák, Vladislav; Ray, B.; Breierová, E.; Turjan, J.

    2011-01-01

    Roč. 49, č. 4 (2011), 1046-1050 ISSN 0141-8130 R&D Projects: GA MŠk 1M0571 Institutional research plan: CEZ:AV0Z60050516 Keywords : Rhodella griesea * proteoglykan * cough Subject RIV: EF - Botanics Impact factor: 2.453, year: 2011

  11. Increasing Efficiency in Evaluation of Chronic Cough: A Multidisciplinary, Collaborative Approach.

    Science.gov (United States)

    Patton, Cynthia M; Lim, Kaiser G; Ramlow, Luke W; White, Kathleen M

    2015-01-01

    Chronic cough is the most common reason for medical office visits in the United States. The typical patient has coughed more than 8 years and seen many specialists. This quality improvement project is an ambulatory clinic redesign to deliver efficient, patient-centered care with interspecialty collaboration. Methodology included the Institute for Healthcare Improvement collaborative model focused on Lean/Six Sigma and ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) Change Management. Interventions targeted education to referring providers, implementation of software changes, building a collaborative interdepartmental scheduling decision tree, and an interclinic dashboard enhancing communication and decision support. Outcome measures compare group resource utilization, evidenced by the total number of specialist referrals for same indication of chronic cough (International Classification of Diseases, Ninth Revision: 786.2), and length of time to complete evaluation. A retrospective review of 165 medical records yielded 2 groups, "current care" (n = 67) and "intervention" (n = 68). The number of specialist referrals per patient was reduced in the intervention group (M = 1.22, SD = 0.48) compared with the current care group (M = 3.33, SD = 1.02). Length of itinerary was reduced in the intervention group (M = 11.90, SD = 12.13, GM = 6.82) compared with the current care group (M = 126.93, SD = 158.13, GM = 54.8). Multidisciplinary collaboration, communication, coordinating diagnosis, and management of multifactorial conditions, such as chronic cough, are associated with lower costs and decreased utilization of health care resources.

  12. 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

    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 st......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...

  13. Obesity and stress urinary incontinence in women: compromised continence mechanism or excess bladder pressure during cough?

    Science.gov (United States)

    Swenson, Carolyn W; Kolenic, Giselle E; Trowbridge, Elisa R; Berger, Mitchell B; Lewicky-Gaupp, Christina; Margulies, Rebecca U; Morgan, Daniel M; Fenner, Dee E; DeLancey, John O

    2017-09-01

    We compared two hypotheses as to why obesity is associated with stress urinary incontinence (SUI): (1) obesity increases demand on the continence system (e.g. higher cough pressure) and (2) obesity compromises urethral function and urethrovaginal support. A secondary analysis was performed using data from a case-control study of SUI in women. Measurements of urethrovaginal support (POP-Q point Aa, urethral axis), urethral function (maximal urethral closure pressure, MUCP), and measures of continence system demand (intravesical pressures at rest and during maximal cough) were analyzed. Cases and controls were divided into three body mass index (BMI) groups: normal (18.5-24.9 kg/m 2 ); overweight (25.0-29.9 kg/m 2 ); and obese (≥30 kg/m 2 ). Logistic regression models where created to investigate variables related to SUI for each BMI group. Structural equation modeling was used to test the direct and indirect relationships among BMI, SUI, maximal cough pressure, MUCP, and POP-Q point Aa. The study included 108 continent controls and 103 women with SUI. MUCP was the factor most strongly associated with SUI in all BMI groups. Maximal cough pressure was significantly associated with SUI in obese women (OR 3.191, 95% CI 1.326, 7.683; p continence mechanism.

  14. Pertussis may be the cause of prolonged cough in adolescents and adults in the interepidemic period.

    Science.gov (United States)

    Pimentel, Analíria Moraes; Baptista, Paulo Neves; Ximenes, Ricardo Arraes de Alencar; Rodrigues, Laura Cunha; Magalhães, Vera; Silva, Andrea Rosane Sousa; Souza, Nadjla Ferreira; Matos, Deize Gomes Cavalcanti de; Pessoa, Ana Kelly Lins

    2015-01-01

    This study was aimed to evaluate the prevalence of pertussis in adolescents and adults with cough lasting more than 14 days and less than 30 days. This is a prospective observational study in interepidemic period of pertusis. Ten public health outpatient clinics in the city of Recife, Brazil, were randomly selected for the study. The study population consisted of individuals aged 10 years and over with cough that had lasted between 14 and 30 days. Nasopharyngeal swabs were collected for culture and PCR in order to identify Bordetella pertussis. We adopted the Centers for Disease Control and Prevention in the US (CDC) definition of cases of pertussis. A total of 192 individuals were identified as suspected cases. Their mean age was 40.7 years. Pertussis was confirmed in 10 of the 192 suspected cases, with an estimated prevalence of 5.21% (95% confidence interval 2.03-8.38). All cases met the clinical case definition for pertussis; one suspect had both culture and PCR positive. PCR confirmed 100% of the cases, 7/10 by PCR and 3/10 by epidemiological linkage with a case confirmed by PCR. During an interepidemic period, 1 in 20 cases of prolonged cough had pertussis, suggesting this is an important cause of prolonged cough in adolescents and adults. Copyright © 2014. Published by Elsevier Editora Ltda.

  15. Bordetella Pertussis virulence factors in the continuing evolution of whooping cough vaccines for improved performance.

    NARCIS (Netherlands)

    Dorji, Dorji; Mooi, Frits; Yantorno, Osvaldo; Deora, Rajendar; Graham, Ross M; Mukkur, Trilochan K

    Despite high vaccine coverage, whooping cough caused by Bordetella pertussis remains one of the most common vaccine-preventable diseases worldwide. Introduction of whole-cell pertussis (wP) vaccines in the 1940s and acellular pertussis (aP) vaccines in 1990s reduced the mortality due to pertussis.

  16. 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. PMID:25781609

  17. 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

  18. The effect of pheniramine on fentanyl-induced cough: a randomized, double blinded, placebo controlled clinical study.

    Science.gov (United States)

    Arslan, Zakir; Çalık, Eyup Serhat; Kaplan, Bekir; Ahiskalioglu, Elif Oral

    2016-01-01

    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. 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. 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 (ppheniramine group and lidocaine group (p=0.856). 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. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  19. [The effect of pheniramine on fentanyl-induced cough: a randomized, double blinded, placebo controlled clinical study].

    Science.gov (United States)

    Arslan, Zakir; Çalık, Eyup Serhat; Kaplan, Bekir; Ahiskalioglu, Elif Oral

    2016-01-01

    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. 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. 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 (ppheniramine group and lidocaine group (p=0.856). 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. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. Effects of Air Stacking Maneuver on Cough Peak Flow and Chest Wall Compartmental Volumes of Subjects With Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Sarmento, Antonio; Resqueti, Vanessa; Dourado-Júnior, Mario; Saturnino, Lailane; Aliverti, Andrea; Fregonezi, Guilherme; de Andrade, Armele Dornelas

    2017-11-01

    To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy subjects positioned at 45° body inclination. Cross-sectional study with a matched-pair design. University hospital. Persons (N=24) with ALS (n=12) and age-matched healthy subjects (n=12). CPF, chest wall compartmental inspiratory capacity, chest wall vital capacity, chest wall tidal volume and operational volumes, breathing pattern, and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography. Compared with healthy subjects, significantly lower CPF (P=.007), chest wall compartmental inspiratory capacity (Pprotocol in the healthy subjects, mainly because of end-inspiratory (P<.001) and abdominal volumes (P=.008). No significant differences were observed in percentage of contribution of the compartments to the inspired volume and end-expiratory volume of both groups. No significant differences were found in chest wall tidal volume, operational volume, and breathing pattern in persons with ALS. Air stacking is effective in increasing CPF, chest wall compartmental inspiratory capacity, and chest wall vital capacity of persons with ALS with no hyperinflation. Differences in compartmental volume contributions are probably because of lung and chest wall physiological changes. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. 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

  2. Task Selection is Critical for the Demonstration of Reciprocal Patterns of Sex Differences in Hand/Arm Motor Control and Near/Far Visual Processing

    Directory of Open Access Journals (Sweden)

    Geoff Sanders

    2008-04-01

    Full Text Available Women have been reported to perform better with hand rather than arm movements (Sanders and Walsh, 2007 and with visual stimuli in near rather than far space (Sanders, Sinclair and Walsh, 2007. Men performed better with the arm and in far space. These reciprocal patterns of sex differences appear as Muscle*Sex and Space*Sex interactions. We investigated these claims using target cancellation tasks in which task difficulty was manipulated by varying target size or the number of distracters. In Study 1 we did not find the Muscle*Sex or the Space*Sex interaction. We argue that ballistic movement was too simple to reveal the Muscle*Sex interaction. However, a trend for the Space*Sex interaction suggested task difficulty was set too high. Study 2 introduced easier levels of difficulty and the overall Space*Sex interaction narrowly failed to reach significance (p = 0.051. In Study 3 the Space*Sex interaction was significant (p = 0.001. A review of the present, and four previously published, studies indicates that task selection is critical if the Space*Sex interaction and its associated reciprocal within-sex differences are to be demonstrated without the obscuring effects of Space and Difficulty. These sex differences are compatible with predictions from the hunter-gatherer hypothesis. Implications for two-visual-system-models are considered.

  3. The motor theory of speech perception revisited.

    Science.gov (United States)

    Massaro, Dominic W; Chen, Trevor H

    2008-04-01

    Galantucci, Fowler, and Turvey (2006) have claimed that perceiving speech is perceiving gestures and that the motor system is recruited for perceiving speech. We make the counter argument that perceiving speech is not perceiving gestures, that the motor system is not recruitedfor perceiving speech, and that speech perception can be adequately described by a prototypical pattern recognition model, the fuzzy logical model of perception (FLMP). Empirical evidence taken as support for gesture and motor theory is reconsidered in more detail and in the framework of the FLMR Additional theoretical and logical arguments are made to challenge gesture and motor theory.

  4. Hereditary motor neuropathies and motor neuron diseases: which is which.

    Science.gov (United States)

    Hanemann, Clemens O; Ludolph, Albert C

    2002-12-01

    When Charcot first defined amyotrophic lateral sclerosis (ALS) he used the clinical and neuropathological pattern of vulnerability as a guideline. Similarly other motor neuron diseases such as the spinal muscular atrophies (SMA) and the motor neuropathies (MN) were grouped following clinical criteria. However, ever since the etiology of these diseases has started to be disclosed by genetics, we have learnt that the limits of the syndromes are not as well defined as our forefathers thought. A mutation leading to ALS can also be associated with the clinical picture of spinal muscular atrophy; even more unexpected is the overlap of the so-called motor neuropathies with the clinical syndrome of slowly progressive ALS or that primary lateral sclerosis (PLS) can be caused by the same gene as that responsible for some cases of ALS. In this review we summarise recent work showing that there is a considerable overlap between CMT, MN, SMA, ALS and PLS. Insights into these phenotypes should lead to study of the variants of motor neuron disease and possibly to a reclassification. This comprehensive review should help to improve understanding of the pathogenesis of motor neuron degeneration and finally may aid the research for urgently needed new treatment strategies, perhaps with validity for the entire group of motor neuron diseases.

  5. Simplification and Validation of Leicester Cough Questionnaire in Mandarin-Chinese

    Directory of Open Access Journals (Sweden)

    Rongjia LIN

    2017-06-01

    Full Text Available Background and objective Patients often have cough after lung surgery, and there is a lack of tools to specifically assess postoperative coughs. LCQ-MC (Leicester Cough Questionnaire in Mandarin-Chinese was revised and validated to explore its value on clinical application. Methods A total of 250 patients undergone the lung operation of single medical team, from September 2015 to December 2016 in the Department ofThoracic Surgery, West China Hospital, Sichuan University, were investigated. Among them, 121 patients completed LCQ-MC and 129 patients completed simplified LCQ-MC, we verified the reliability and validity. Results The new questionnaire was not changed in terms of content layout and the scoring method of LCQ-MC, consisting of 12 items and three domains (physical, psychological and social. There was good content validity (S-CVI/UA=0.83. Concurrent validity was high when the simplified LCQ-MC was compared with daytime cough symptom score (r=-0.578, P<0.001. There was a moderate relationship with response to night-time cough symptom score (r=-0.358, P=-0.004 and SF36 total score (r=0.346, P=0.030, and weak relationship with the Hospital Anxiety and Depression Scale total score (r=-0.241, P=0.046. Cronbach’s alpha coefficients of simplified LCQ-CM total and three domains varied between 0.79 and 0.89. One week apart test-retest reliability (n=30 was high (r=0.88-0.96. Conclusion Simplified LCQ-MC has good reliability and validity that can be used for clinical applications.

  6. Changes in Peak Airflow Measurement During Maximal Cough After Vocal Fold Augmentation in Patients With Glottic Insufficiency.

    Science.gov (United States)

    Dion, Gregory R; Achlatis, Efstratios; Teng, Stephanie; Fang, Yixin; Persky, Michael; Branski, Ryan C; Amin, Milan R

    2017-11-01

    Compromised cough effectiveness is correlated with dysphagia and aspiration. Glottic insufficiency likely yields decreased cough strength and effectiveness. Although vocal fold augmentation favorably affects voice and likely improves cough strength, few data exist to support this hypothesis. To assess whether vocal fold augmentation improves peak airflow measurements during maximal-effort cough following augmentation. This case series study was conducted in a tertiary, academic laryngology clinic. Participants included 14 consecutive individuals with glottic insufficiency due to vocal fold paralysis, which was diagnosed via videostrobolaryngoscopy as a component of routine clinical examination. All participants who chose to proceed with augmentation were considered for the study whether office-based or operative augmentation was planned. Postaugmentation data were collected only at the first follow-up visit, which was targeted for 14 days after augmentation but varied on the basis of participant availability. Data were collected from June 5, 2014, to October 1, 2015. Data analysis took place between October 2, 2015, and March 3, 2017. Peak airflow during maximal volitional cough was quantified before and after vocal fold augmentation. Participants performed maximal coughs, and peak expiratory flow during the maximal cough was captured according to American Thoracic Society guidelines. Among the 14 participants (7 men and 7 women), the mean (SD) age was 62 (18) years. Three types of injectable material were used for vocal fold augmentation: carboxymethylcellulose in 5 patients, hyaluronic acid in 5, and calcium hydroxylapatite in 4. Following augmentation, cough strength increased in 11 participants and decreased cough strength was observed in 3. Peak airflow measurements during maximal cough varied from a decrease of 40 L/min to an increase of 150 L/min following augmentation. When preaugmentation and postaugmentation peak airflow measurements were compared, the

  7. Measurement of the Maximum Frequency of Electroglottographic Fluctuations in the Expiration Phase of Volitional Cough as a Functional Test for Cough Efficiency.

    Science.gov (United States)

    Iwahashi, Toshihiko; Ogawa, Makoto; Hosokawa, Kiyohito; Kato, Chieri; Inohara, Hidenori

    2017-10-01

    The hypotheses of the present study were that the maximum frequency of fluctuation of electroglottographic (EGG) signals in the expiration phase of volitional cough (VC) reflects the cough efficiency and that this EGG parameter is affected by impaired laryngeal closure, expiratory effort strength, and gender. For 20 normal healthy adults and 20 patients diagnosed with unilateral vocal fold paralysis (UVFP), each participant was fitted with EGG electrodes on the neck, had a transnasal laryngo-fiberscope inserted, and was asked to perform weak/strong VC tasks while EGG signals and a high-speed digital image of the larynx were recorded. The maximum frequency was calculated in the EGG fluctuation region coinciding with vigorous vocal fold vibration in the laryngeal HSDIs. In addition, each participant underwent spirometry for measurement of three aerodynamic parameters, including peak expiratory air flow (PEAF), during weak/strong VC tasks. Significant differences were found for both maximum EGG frequency and PEAF between the healthy and UVFP groups and between the weak and strong VC tasks. Among the three cough aerodynamic parameters, PEAF showed the highest positive correlation with the maximum EGG frequency. The correlation coefficients between the maximum EGG frequency and PEAF recorded simultaneously were 0.574 for the whole group, and 0.782/0.717/0.823/0.688 for the male/female/male-healthy/male-UVFP subgroups, respectively. Consequently, the maximum EGG frequency measured in the expiration phase of VC was shown to reflect the velocity of expiratory airflow to some extent and was suggested to be affected by vocal fold physical properties, glottal closure condition, and the expiratory function.

  8. Effect of multiple honey doses on non-specific acute cough in children. An open randomised study and literature review.

    Science.gov (United States)

    Miceli Sopo, S; Greco, M; Monaco, S; Varrasi, G; Di Lorenzo, G; Simeone, G

    2015-01-01

    Honey is recommended for non-specific acute paediatric cough by the Australian guidelines. Current available randomised clinical trials evaluated the effects of a single evening dose of honey, but multiple doses outcomes have never been studied. To evaluate the effects of wildflower honey, given for three subsequent evenings, on non-specific acute paediatric cough, compared to dextromethorphan (DM) and levodropropizine (LDP), which are the most prescribed over-the-counter (OTC) antitussives in Italy. 134 children suffering from non-specific acute cough were randomised to receive for three subsequent evenings a mixture of milk (90ml) and wildflower honey (10ml) or a dose of DM or LDP adjusted for the specific age. The effectiveness was evaluated by a cough questionnaire answered by parents. Primary end-point efficacy was therapeutic success. The latter was defined as a decrease in cough questionnaire score greater than 50% after treatment compared with baseline values. Three children were excluded from the study, as their parents did not complete the questionnaire. Therapeutic success was achieved by 80% in the honey and milk group and 87% in OTC medication group (p=0.25). Milk and honey mixture seems to be at least as effective as DM or LDP in non-specific acute cough in children. These results are in line with previous studies, which reported the health effects of honey on paediatric cough, even if placebo effect cannot be totally excluded. Copyright © 2014 SEICAP. Published by Elsevier Espana. All rights reserved.

  9. Electrical stimulation and motor recovery.

    Science.gov (United States)

    Young, Wise

    2015-01-01

    In recent years, several investigators have successfully regenerated axons in animal spinal cords without locomotor recovery. One explanation is that the animals were not trained to use the regenerated connections. Intensive locomotor training improves walking recovery after spinal cord injury (SCI) in people, and >90% of people with incomplete SCI recover walking with training. Although the optimal timing, duration, intensity, and type of locomotor training are still controversial, many investigators have reported beneficial effects of training on locomotor function. The mechanisms by which training improves recovery are not clear, but an attractive theory is available. In 1949, Donald Hebb proposed a famous rule that has been paraphrased as "neurons that fire together, wire together." This rule provided a theoretical basis for a widely accepted theory that homosynaptic and heterosynaptic activity facilitate synaptic formation and consolidation. In addition, the lumbar spinal cord has a locomotor center, called the central pattern generator (CPG), which can be activated nonspecifically with electrical stimulation or neurotransmitters to produce walking. The CPG is an obvious target to reconnect after SCI. Stimulating motor cortex, spinal cord, or peripheral nerves can modulate lumbar spinal cord excitability. Motor cortex stimulation causes long-term changes in spinal reflexes and synapses, increases sprouting of the corticospinal tract, and restores skilled forelimb function in rats. Long used to treat chronic pain, motor cortex stimuli modify lumbar spinal network excitability and improve lower extremity motor scores in humans. Similarly, epidural spinal cord stimulation has long been used to treat pain and spasticity. Subthreshold epidural stimulation reduces the threshold for locomotor activity. In 2011, Harkema et al. reported lumbosacral epidural stimulation restores motor control in chronic motor complete patients. Peripheral nerve or functional electrical

  10. Fine motor control

    Science.gov (United States)

    ... gross (large, general) motor control. An example of gross motor control is waving an arm in greeting. Problems ... out the child's developmental age. Children develop fine motor skills over time, by practicing and being taught. To ...

  11. Olodaterol attenuates citric acid-induced cough in naïve and ovalbumin-sensitized and challenged guinea pigs.

    Directory of Open Access Journals (Sweden)

    Eva Wex

    Full Text Available 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 < 0.01. Formoterol and salmeterol showed a trend towards reducing cough. On the contrary, indacaterol demonstrated pro-tussive properties as it significantly increased the number of coughs, both in naïve and ovalbumin-sensitized animals (p < 0.001. In conclusion, olodaterol, at doses eliciting bronchodilation, showed antitussive properties in a model of 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

  12. Motor control for a brushless DC motor

    Science.gov (United States)

    Peterson, William J. (Inventor); Faulkner, Dennis T. (Inventor)

    1985-01-01

    This invention relates to a motor control system for a brushless DC motor having an inverter responsively coupled to the motor control system and in power transmitting relationship to the motor. The motor control system includes a motor rotor speed detecting unit that provides a pulsed waveform signal proportional to rotor speed. This pulsed waveform signal is delivered to the inverter to thereby cause an inverter fundamental current waveform output to the motor to be switched at a rate proportional to said rotor speed. In addition, the fundamental current waveform is also pulse width modulated at a rate proportional to the rotor speed. A fundamental current waveform phase advance circuit is controllingly coupled to the inverter. The phase advance circuit is coupled to receive the pulsed waveform signal from the motor rotor speed detecting unit and phase advance the pulsed waveform signal as a predetermined function of motor speed to thereby cause the fundamental current waveform to be advanced and thereby compensate for fundamental current waveform lag due to motor winding reactance which allows the motor to operate at higher speeds than the motor is rated while providing optimal torque and therefore increased efficiency.

  13. A 29-Year-Old Man With Nonproductive Cough, Exertional Dyspnea, and Chest Discomfort.

    Science.gov (United States)

    Halpenny, Darragh; Suh, James; Garofano, Suzette; Alpert, Jeffrey

    2015-09-01

    A 29-year-old man presented with a 5-month history of worsening dry cough, exertional dyspnea, chest tightness, and palpitations. He had been treated by his primary care physician with trials of guaifenesin/codeine, azithromycin, albuterol, and omeprazole without improvement. He denied wheezing, fever, sweats, anorexia, joint pain, swelling, or rash. He had no past medical history. He denied a history of tobacco smoking or IV drug use. He kept no pets, worked as a manager in an office environment, and had no history of occupational inhalational exposure. He reported using aerosolized insect spray to eradicate bed bugs in his house shortly before the cough began but did not report any acute symptoms when using the spray.

  14. CERTAIN ASPECTS OF COUGH PATHOGENETIC THERAPY OF ACUTE CHILD RESPIRATORY INFECTIONS

    Directory of Open Access Journals (Sweden)

    S.I. Bardenikova

    2008-01-01

    Full Text Available An open controlled comparative research was conducted on 263 children with acute respiratory infection (ARI in order to evaluate the clinical effectiveness, acceptability and safety of plant based preparation that contains ivy leaf extract. It was established that prescribing the preparation during the first days of disease reduced the duration of dry and inefficient cough, improved sputum rheology and bronchial tree drainage function, reduced bronchial obstruction intensity, reduced the need for prescribing bronchial spasmolitics less necessary and decreased Staybin term. Compared to other antibcough medicines, plant based preparation with ivy leaf extract has quicker effect (effective on the 1st–3rd day.Key words: children, acute respiratory infections, cough, treatment.

  15. Whooping cough in Pakistan: Bordetella pertussis vs Bordetella parapertussis in 2005-2009.

    Science.gov (United States)

    Bokhari, Habib; Said, Fahad; Syed, Muhammad A; Mughal, Amjad; Kazi, Yasmeen F; Heuvelman, Kees; Mooi, Frits R

    2011-10-01

    Pertussis, or whooping cough, is an acute respiratory disease mainly affecting infants and children and is caused by Bordetella pertussis and Bordetella parapertussis. The aim of this study was to investigate the share of Bordetella species from potential whooping cough cases during 2005-2009. Eight hundred and two samples from suspected pertussis cases were collected, mainly from 2 provinces of Pakistan. Bacterial culture, identification, DNA extraction and routinely used polymerase chain reaction (PCR) methods using IS1001, IS1002 and IS481 were used to identify the Bordetella species. The results were unexpected, because all of the isolates collected from the different cities were identified as B. parapertussis (7.4%); B. pertussis was not isolated from any sample. However, PCR results indicated the presence of a small percentage (0.6%) of B. pertussis among the total cases studied. This study suggests that vaccines to protect against both B. pertussis and B. parapertussis should be considered.

  16. Staggering the dose of sugammadex lowers risks for severe emergence cough: a randomized control trial.

    Science.gov (United States)

    P S, Loh; Miskan, M M; Y Z, Chin; Zaki, R A

    2017-10-11

    Cough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study. A hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0.02 mg/kg with glycopyrrolate (neostigmine group). We found 70% of patients (n = 28) reversed with single boluses of sugammadex had Grade 3 emergence cough compared to 12.5% (n = 5) in the staggered sugammadex group and 17.5% (n = 7) in the neostigmine group (p sugammadex group (n = 14, 35%, p = 0.005). On the other hand, staggering sugammadex lowered risks of developing severe cough (RR 0.2, p sugammadex group and control given neostigmine. In terms of timing, there was no delay in time taken from discontinuing anesthetic agents to reversal and extubation if sugammadex was staggered (emergence time 6.0 ± 3.2 s, p = 0.625 and reversal time 6.5 ± 3.5, p = 0.809). Staggering the dose of sugammadex for reversal will effectively decrease common emergence and early postoperative complications. ANZCTR Number ACTRN12616000116426 . Retrospectively registered on 2nd February 2016.

  17. Fat Dogs and Coughing Horses: K-12 Programming for Veterinary Workforce Development

    OpenAIRE

    San Miguel, Sandra F.; Parker, Loran Carleton; Adedokun, Omolola A.; Burgess, Wilella D.; Cipriani Davis, Kauline S.; Blossom, Thaddaeus D.; Schneider, Jessica L.; Mennonno, Ann M.; Ruhl, Joseph D.; Veatch, Jennifer H.; Wackerly, Amy J.; Shin, Soo Yeon; Ratliff, Timothy L.

    2013-01-01

    Workforce development strategies to educate, inform, and diversify the veterinary profession of the future must begin with children in elementary school. This manuscript provides a description of the Fat Dogs and Coughing Horses program, which takes a multifaceted approach toward informing young students, beginning in first grade, about the interesting work and career opportunities available in the field of veterinary medicine. The program, a collaboration among Purdue University and Indiana ...

  18. Geographical differences in whooping cough in Catalonia, Spain, from 1990 to 2010

    Science.gov (United States)

    2014-01-01

    Background Whooping cough is a communicable disease whose incidence has increased in recent years in some countries with vaccination. Since 1981, in Catalonia (Spain), cases must be reported to the Public Health Department. In 1997, surveillance changed from aggregated counts to individual report and the surveillance system was improved after 2002. Catalan public health is universal with equal coverage geographically. The aim of this study was to determine whether there are differences in whooping cough incidence in rural and urban counties. Methods Cases in 1990–2010 were classified as rural or urban. Incidences and risk ratios (RR) between urban and rural counties and 95% CI were calculated. Associations between rural and urban counties and structural changes during the study period were analysed. Results Twelve years of the whole study period showed differences in incidence between rural and urban counties. The incidence was higher in urban counties in seven years and rural counties in five years. There was a positive association of whooping cough incidence in rural and urban counties in four-week periods. Structural changes were detected in the following four-week periods: 4th in 1993, 7th in 1996 and 3rd 2005 in rural counties and 5th 1993, 9th in 1996 and 8th in 2007 in urban counties. Conclusions Differences in whooping cough between rural and urban counties were found. In most years, the incidence was higher in urban than in rural counties. Rural and urban counties show similar cyclic behaviour when four-week periods were considered. PMID:24649975

  19. A 68-Year-Old Man With Dyspnea on Exertion and Cough.

    Science.gov (United States)

    Agrawal, Abhinav; Sikachi, Rutuja R; Koenig, Seth; Khanijo, Sameer

    2018-06-01

    A 68-year-old man with a history of chronic lymphocytic leukemia well controlled on ibrutinib, hypertension, obesity, and a remote history of smoking (10 pack-years) presented with increasing dyspnea on exertion and cough. He had previously finished two courses of oral antibiotics for his symptoms without significant improvement. On presentation, he had no fevers or sputum production. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  20. Grey Turner's and Cullen's signs induced by spontaneous hemorrhage of the abdominal wall after coughing.

    Science.gov (United States)

    Fan, Zhe; Zhang, Yingyi

    2017-08-01

    Grey Turner's and Cullen's signs are rare clinical signs, which most appear in patients with severe acute pancreatitis. The present patient complained of abdominal pain after coughing. However, contrast-enhanced CT revealed a hemorrhage of the abdominal wall. Therefore, spontaneous hemorrhage of the abdominal wall was diagnosed. The patient recovered through immobilization and hemostasis therapy. This case report and literature review aims to remind clinicians of manifestations and treatment of spontaneous hemorrhage.

  1. Task-dependent activation of distinct fast and slow(er) motor pathways during motor imagery.

    Science.gov (United States)

    Keller, Martin; Taube, Wolfgang; Lauber, Benedikt

    2018-02-22

    Motor imagery and actual movements share overlapping activation of brain areas but little is known about task-specific activation of distinct motor pathways during mental simulation of movements. For real contractions, it was demonstrated that the slow(er) motor pathways are activated differently in ballistic compared to tonic contractions but it is unknown if this also holds true for imagined contractions. The aim of the present study was to assess the activity of fast and slow(er) motor pathways during mentally simulated movements of ballistic and tonic contractions. H-reflexes were conditioned with transcranial magnetic stimulation at different interstimulus intervals to assess the excitability of fast and slow(er) motor pathways during a) the execution of tonic and ballistic contractions, b) motor imagery of these contraction types, and c) at rest. In contrast to the fast motor pathways, the slow(er) pathways displayed a task-specific activation: for imagined ballistic as well as real ballistic contractions, the activation was reduced compared to rest whereas enhanced activation was found for imagined tonic and real tonic contractions. This study provides evidence that the excitability of fast and slow(er) motor pathways during motor imagery resembles the activation pattern observed during real contractions. The findings indicate that motor imagery results in task- and pathway-specific subliminal activation of distinct subsets of neurons in the primary motor cortex. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  2. 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

    % CI: 1.7-8.0), respectively, compared with unchanged smoking habits. It was also significantly more likely not to report phlegm at 1-year follow-up for those who had quit (OR: 7.1; 95% CI: 2.8-18.0), whereas SR was not significantly associated with termination of phlegm (OR: 2.5; 95% CI: 0.9-6.4) when......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...

  3. Differentiation of Lung Cancer, Empyema, and Abscess Through the Investigation of a Dry Cough.

    Science.gov (United States)

    Urso, Brittany; Michaels, Scott

    2016-11-24

    An acute dry cough results commonly from bronchitis or pneumonia. When a patient presents with signs of infection, respiratory crackles, and a positive chest radiograph, the diagnosis of pneumonia is more common. Antibiotic failure in a patient being treated for community-acquired pneumonia requires further investigation through chest computed tomography. If a lung mass is found on chest computed tomography, lung empyema, abscess, and cancer need to be included on the differential and managed aggressively. This report describes a 55-year-old Caucasian male, with a history of obesity, recovered alcoholism, hypercholesterolemia, and hypertension, presenting with an acute dry cough in the primary care setting. The patient developed signs of infection and was found to have a lung mass on chest computed tomography. Treatment with piperacillin-tazobactam and chest tube placement did not resolve the mass, so treatment with thoracotomy and lobectomy was required. It was determined through surgical investigation that the patient, despite having no risk factors, developed a lung abscess. Lung abscesses rarely form in healthy middle-aged individuals making it an unlikely cause of the patient's presenting symptom, dry cough. The patient cleared his infection with proper management and only suffered minor complications of mild pneumoperitoneum and pneumothorax during his hospitalization.

  4. Relation of the Timing of Onset of Rhinitis and Cough to Asthma Attack in Children.

    Science.gov (United States)

    Sugimura, Tetsu; Ozaki, Yukiko; Tananari, Yoshifumi; Yamakawa, Rumi; Hirata, Rumiko

    2016-01-01

    If the risk of progression to asthma could be predicted in patients with rhinitis, prevention of asthma might become possible. The purpose of this study was to clarify the relationship between the duration of rhinitis symptoms and acute asthma attacks in children with a history of asthma who were not on treatment for asthma. In 94 children with a history of asthma who were asymptomatic after completing asthma treatment, we investigated the onset and duration of nasal discharge and cough related to allergic rhinitis. Then the children were followed up for 2 weeks and were classified into either an asthma attack group (Group A) or non-asthma group(Group B). A total of 78 subjects were evaluated after 16 were excluded. The duration of nasal discharge was significantly shorter in Group A than in Group B (5.5±1.9 days vs. 10.4±3.1 days, Pasthma attack may be higher when the onset of cough precedes nasal discharge or when nasal discharge has a short duration and cough shows an early onset. These results may provide assistance when selecting patients for early anti-allergy therapy from among those presenting with upper respiratory tract symptoms.

  5. Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma.

    Science.gov (United States)

    Weinberger, Miles; Abu-Hasan, Mutasim

    2007-10-01

    Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome. The respiratory sounds that occur with the upper airway obstruction caused by the various manifestations of the vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia are often mischaracterized as wheezing and attributed to asthma. The perception of dyspnea is a prominent symptom of hyperventilation attacks. This can occur in those with or without asthma, and patients with asthma may not readily distinguish the perceived dyspnea of a hyperventilation attack from the acute airway obstruction of asthma. Dyspnea on exertion, in the absence of other symptoms of asthma or an unequivocal response to albuterol, is most likely a result of other causes. Most common is the dyspnea associated with normal exercise limitation, but causes of dyspnea on exertion can include other physiologic abnormalities including exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, and exercise-induced supraventricular tachycardia. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations.

  6. 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.

  7. Diagnosis and treatment of patients with nonacid gastroesophageal reflux-induced chronic cough

    Directory of Open Access Journals (Sweden)

    Xianghuai Xu

    2015-01-01

    Full Text Available Gastroesophageal reflux (GER is one of the most common causes of chronic cough, and chronic cough due to GER represents a subtype of GER-related diseases. Gastroesophageal reflux-induced chronic cough (GERC can be divided into two subgroups based on the pH of the GER. Nonacid GERC is less common than acid GERC, and its diagnosis and treatment strategy have not been standardized. However, nonacid GERC usually presents with its unique set of characteristics and features upon diagnosis and treatment in the clinic. Although the underlying molecular mechanism of nonacid GERC is not fully understood, it is considered to be associated with reflux theory, reflex theory and airway hypersensitivity. Multi-channel intraluminal impedance combined with pH monitoring is a promising new technique that can detect both acid and nonacid reflux, and our findings as well as those of others have shown its usefulness in diagnosing nonacid GERC. Development of new diagnostic techniques has led to an increased rate of nonacid GERC diagnosis. We summarize our experience in the diagnosis and treatment of nonacid GERC and provide a guide for future therapeutic approaches.

  8. [Whooping cough in an urban high school in Hungary. Conclusions of a local pertussis outbreak].

    Science.gov (United States)

    Schneider, Ferenc; Stánitz, Eva; Kalácska, Judit; Tompity, Tünde; Gábor, Beáta

    2009-08-16

    Although incidence of pertussis has been gradually decreased with the introduction of active immunization, total eradication is not possible. This has been shown by national and international data, as well. In the early 2000's, slow increase in incidence of pertussis was observed. To demonstrate the presence of Bordetella pertussis in the Hungarian population by presenting 17 cases of adolescent pertussis. Etiology of pertussis was confirmed by quantification of pertussis-antibodies in blood samples taken from permanently coughing patients in the firstly identified subject's vicinity which latter was explored by retrospective data collection. In the vicinity of the first identified patient epidemiologic research identified another 16 patients all of which were confirmed by serological tests. If permanent coughing is present, pertussis needs to be ruled out. Immunity against pertussis obtained by vaccination fades by the end of childhood. Bordetella pertussis circulates in the national population. A booster-vaccination against pertussis in the regular vaccination course for the 11-year old children is recommended. Pertussis in adolescents and in adults is mild and atypical, but in case of prolonged coughing it needs to be considered.

  9. A study of ′cough trick′ technique in reducing vaccination prick pain in adolescents

    Directory of Open Access Journals (Sweden)

    Vikram S. Kumar

    2014-01-01

    Full Text Available Background: The ′cough trick′ (CT technique is used in reducing intramuscular prick (IMP pain during vaccinations and also for brief painful procedures like subcutaneous injection, intravenous cannulation, and so forth. We present the utility study of this technique in male adolescents. Materials and Methods: A Randomized Crossover Volunteer Study of 50 early adolescent male children (age 11-13 receiving immunizations was performed. Participants were recruited from four outpatient pediatric clinics. The strategy required a single "warm-up" cough of moderate force, followed by a second cough that coincided with needle puncture. The principle outcome was self-reported pain. Results: Paired ′t′ test revealed that the procedure was effective at a statistically and clinically significant level for participants. Children found the procedure acceptable and effective. Conclusions: The results of this study suggest that the CT can be an effective strategy for the reduction of pain for male adolescent children undergoing routine immunizations. However, additional research is needed with a larger sample size with different age groups and also including girl children.

  10. Effect of acid suppression therapy on gastroesophageal reflux and cough in idiopathic pulmonary fibrosis: an intervention study.

    Science.gov (United States)

    Kilduff, Claire E; Counter, Melanie J; Thomas, Gareth A; Harrison, Nicholas K; Hope-Gill, Benjamin D

    2014-01-01

    Chronic cough affects more than 70 percent of patients with Idiopathic Pulmonary Fibrosis and causes significant morbidity. Gastroesophageal reflux is the cause of some cases of chronic cough; and also has a postulated role in the aetiology of Idiopathic Pulmonary Fibrosis. A high prevalence of acid; and more recently non-acid, reflux has been observed in Idiopathic Pulmonary Fibrosis cohorts. Therefore, gastroesophageal reflux may be implicated in the pathogenesis of cough in Idiopathic Pulmonary Fibrosis. Eighteen subjects with Idiopathic Pulmonary Fibrosis underwent 24-hour oesophageal impedance and cough count monitoring after the careful exclusion of causes of chronic cough other than gastroesophageal reflux. All 18 were then treated with high dose acid suppression therapies. Fourteen subjects underwent repeat 24-hour oesophageal impedance and cough count monitoring after eight weeks. Total reflux and acid reflux frequencies were within the normal range in the majority of this cohort. The frequencies of non-acid and proximal reflux events were above the normal range. Following high dose acid suppression therapy there was a significant decrease in the number of acid reflux events (p = 0.02), but an increase in the number of non-acid reflux events (p = 0.01). There was no change in cough frequency (p = 0.70). This study confirms that non-acid reflux is prevalent; and that proximal oesophageal reflux occurs in the majority, of subjects with Idiopathic Pulmonary Fibrosis. It is the first study to investigate the effect of acid suppression therapy on gastroesophageal reflux and cough in patients with Idiopathic Pulmonary Fibrosis. The observation that cough frequency does not improve despite verifiable reductions in oesophageal acid exposure challenges the role of acid reflux in Idiopathic Pulmonary Fibrosis associated cough. The finding that non-acid reflux is increased following the use of acid suppression therapies cautions against the widespread use

  11. High efficiency motors; Motores de alta eficiencia

    Energy Technology Data Exchange (ETDEWEB)

    Uranga Favela, Ivan Jaime [Energia Controlada de Mexico, S. A. de C. V., Mexico, D. F. (Mexico)

    1993-12-31

    This paper is a technical-financial study of the high efficiency and super-premium motors. As it is widely known, more than 60% of the electrical energy generated in the country is used for the operation of motors, in industry as well as in commerce. Therefore the importance that the motors have in the efficient energy use. [Espanol] El presente trabajo es un estudio tecnico-financiero de los motores de alta eficiencia y los motores super premium. Como es ampliamente conocido, mas del 60% de la energia electrica generada en el pais, es utilizada para accionar motores, dentro de la industria y el comercio. De alli la importancia que los motores tienen en el uso eficiente de la energia.

  12. High efficiency motors; Motores de alta eficiencia

    Energy Technology Data Exchange (ETDEWEB)

    Uranga Favela, Ivan Jaime [Energia Controlada de Mexico, S. A. de C. V., Mexico, D. F. (Mexico)

    1992-12-31

    This paper is a technical-financial study of the high efficiency and super-premium motors. As it is widely known, more than 60% of the electrical energy generated in the country is used for the operation of motors, in industry as well as in commerce. Therefore the importance that the motors have in the efficient energy use. [Espanol] El presente trabajo es un estudio tecnico-financiero de los motores de alta eficiencia y los motores super premium. Como es ampliamente conocido, mas del 60% de la energia electrica generada en el pais, es utilizada para accionar motores, dentro de la industria y el comercio. De alli la importancia que los motores tienen en el uso eficiente de la energia.

  13. Prevalence of chronic cough and phlegm among male cigar and pipe smokers: results of the Scottish Heart Health Study.

    OpenAIRE

    Brown, C. A.; Woodward, M.; Tunstall-Pedoe, H.

    1993-01-01

    BACKGROUND--Previous studies investigating the effect of cigar or pipe smoking on the occurrence of chronic cough and chronic phlegm have reported prevalences among cigar and pipe smokers lying between those of non-smokers and current cigarette smokers. This study uses data on previous cigarette consumption, current cigar or pipe consumption, and biochemical markers of smoking to provide a detailed analysis of chronic cough and chronic phlegm among cigar and pipe smokers. METHODS--A total of ...

  14. Theobromine for the treatment of persistent cough: a randomised, multicentre, double-blind, placebo-controlled clinical trial.

    Science.gov (United States)

    Morice, Alyn H; McGarvey, Lorcan; Pavord, Ian D; Higgins, Bernard; Chung, Kian Fan; Birring, Surinder S

    2017-07-01

    To investigate the effect of BC1036 on health-related quality of life (QOL) in subjects with persistent cough. The secondary objective was to investigate the effect of BC1036 on subjective cough severity. This was a randomised, multicentre, double-blind, placebo-controlled, parallel-group study in 289 subjects with persistent cough. Subjects received BC1036 or placebo twice daily for 14 days. The primary endpoint comprised cough-related QOL assessed using the validated Leicester Cough Questionnaire (LCQ) at Day 14. Secondary endpoints comprised the LCQ scores at Day 7 and Day 28, cough severity VAS scores at each visit and pulmonary function tests. At baseline, mean total LCQ score in the BC1036 group was lower (i.e., worse QOL) than placebo (P<0.001), indicating significant between-group heterogeneity. Mean baseline-adjusted change in LCQ score at Day 14 was greater for BC1036 [mean (SD) 2.4±3.5] compared to placebo [mean (SD) score 2.2±3.0], but did not reach statistical significance (P=0.60). Mean cough severity VAS score decreased to a greater extent in the BC1036 group compared to placebo, but again the results were not statistically significant (-12.2±23.28 in BC1036 group and -11.0±21.34 in placebo group at Day 14, P=0.688). There was no significant change in pulmonary function measurements. The adverse event (AE) profile was similar in both groups. This study showed that BC1036 was well tolerated and, although the primary endpoint did not achieve statistical significance, the magnitude of improvement was greater with BC1036 compared to placebo with respect to improving QOL and reducing cough severity. ClinicalTrials.gov: NCT01656668.

  15. Recommendations for the proper use of nonprescription cough suppressants and expectorants in solid-organ transplant recipients.

    Science.gov (United States)

    Gabardi, Steven; Carter, Danielle; Martin, Spencer; Roberts, Keri

    2011-03-01

    To describe the pharmacology and safety of oral over-the-counter cough suppressants and expectorants and to present recommendations for the use of these agents in solid-organ transplant recipients based on the potential for adverse drug reactions or drug-disease interactions. Data from journal articles and other sources describing the pharmacology and safety of over-the-counter cough suppressants and expectorants, drug-drug interactions with immunosuppressive agents, and drug-disease state interactions are reviewed. Potential and documented drug-drug interactions between immunosuppressive agents and over-the-counter cough medications guaifenesin, dextromethorphan, diphenhydramine, and codeine were evaluated on the basis of pharmacokinetic and pharmacodynamic principles. Interactions between these cough medications and the physiological changes in the body following transplantation also were examined. Diphenhydramine requires additional monitoring when used to treat cough in transplant recipients owing to its anticholinergic properties and the potential for interactions with cyclosporine. Dextromethorphan can be used in most transplant recipients, although greater caution should be exercised if the patient has undergone liver transplant or has liver impairment. Guaifenesin can be used in transplant recipients but should be used with caution in patients receiving kidney or lung transplants and in patients with renal impairment. Codeine combined with guaifenesin is another option for cough and can be used in most transplant patients although those with reduced renal function should be monitored carefully for adverse events.

  16. The cough reflex is upregulated by lisinopril microinjected into the caudal nucleus tractus solitarii of the rabbit.

    Science.gov (United States)

    Cinelli, Elenia; Bongianni, Fulvia; Pantaleo, Tito; Mutolo, Donatella

    2015-12-01

    We have previously shown that cough potentiation induced by intravenous administration of the AT1 receptor antagonist losartan is lower than that induced by the ACE inhibitor lisinopril in anesthetized and awake rabbits. Since losartan and lisinopril cross the blood-brain barrier, their central action on the cough reflex can be hypothesized. Mechanical stimulation of the tracheobronchial tree and citric acid inhalation were used to induce cough reflex responses in pentobarbital sodium-anesthetized, spontaneously breathing rabbits. Bilateral microinjections (30-50 nl) of losartan (5mM), lisinopril (1mM), bradykinin (0.05 mM), HOE-140 (0.2mM, a bradykinin B2 receptor antagonist) and CP-99,994 (1mM, an NK1 receptor antagonist) were performed into the caudal nucleus tractus solitarii, the predominant site of termination of cough-related afferents. Lisinopril, but not losartan increased the cough number. This effect was reverted by HOE-140 or CP-99,994. Cough potentiation was also induced by bradykinin. The results support for the first time a central protussive action of lisinopril mediated by an accumulation of bradykinin and substance P. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Predicting Extubation Outcome by Cough Peak Flow Measured Using a Built-in Ventilator Flow Meter.

    Science.gov (United States)

    Gobert, Florent; Yonis, Hodane; Tapponnier, Romain; Fernandez, Raul; Labaune, Marie-Aude; Burle, Jean-François; Barbier, Jack; Vincent, Bernard; Cleyet, Maria; Richard, Jean-Christophe; Guérin, Claude

    2017-12-01

    Successful weaning from mechanical ventilation depends on the patient's ability to cough efficiently. Cough peak flow (CPF) could predict extubation success using a dedicated flow meter but required patient disconnection. We aimed to predict extubation outcome using an overall model, including cough performance assessed by a ventilator flow meter. This was a prospective observational study conducted from November 2014 to October 2015. Before and after a spontaneous breathing trial, subjects were encouraged to cough as strongly as possible before freezing the ventilator screen to assess CPF and tidal volume (V T ) in the preceding inspiration. Early extubation success rate was defined as the proportion of subjects not re-intubated 48 h after extubation. Diagnostic performance of CPF and V T was assessed by using the area under the curve of the receiver operating characteristic curve. Cut-off values for CPF and V T were defined according to median values and used to describe the performance of a predictive test combining them with risk factors of early extubation failure. Among 673 subjects admitted, 92 had a cough assessment before extubation. For the 81 subjects with early extubation success, the median CPF was -67.7 L/min, and median V T was 0.646 L. For the 11 subjects with early extubation failure, the median CPF was -57.3 L/min, and median V T was 0.448 L. Area under the curve was 0.61 (95% CI 0.37-0.83) for CPF and 0.64 (95% CI 0.42-0.84) for CPF/V T combined. After dichotomization (CPF 0.55 L), there was a synergistic effect to predict early extubation success ( P meter of an ICU ventilator was able to predict extubation success and to build a composite score to predict extubation failure. The results were close to that found in previous studies that used a dedicated flow meter. This could help to identify high-risk subjects to prevent extubation failure. (ClinicalTrials.gov registration NCT02847221.). Copyright © 2017 by Daedalus Enterprises.

  18. Padrão e ritmo de aquisição das habilidades motoras de lactentes pré-termo nos quatro primeiros meses de idade corrigida Pattern and rate of motor skill acquisition among preterm infants during the first four months corrected age

    Directory of Open Access Journals (Sweden)

    Elaine P. Raniero

    2010-10-01

    Full Text Available OBJETIVOS: Este estudo objetivou caracterizar o padrão e o ritmo de aquisição das habilidades motoras de lactentes nascidos pré-termo nos quatro primeiros meses de idade corrigida, comparando-os com um grupo de lactentes a termo. MÉTODOS: Participaram do estudo 12 lactentes pré-termo saudáveis, (MD=33,6 semanas de idade gestacional, ± 1,25 e 10 lactentes a termo saudáveis (MD=39,1 semanas de idade gestacional, ± 0,73. Eles foram avaliados mensalmente (zero a quatro meses de idade com o Test of Infant Motor Performance (TIMP. RESULTADOS: O padrão de desempenho motor aumentou ao longo dos meses em ambos os grupos, constatando variabilidade nos escores totais em todas as idades. O grupo pré-termo apresentou escore médio mais elevado do que o a termo entre um e quatro meses de idade. Nesse grupo, o ritmo de aquisição motora foi maior de zero a um do que de três a quatro meses. Verificou-se também que os cuidadores desses lactentes iniciaram a estimulação com brinquedos anteriormente aos cuidadores do grupo a termo. Ambos os grupos apresentaram escores médios inferiores aos do TIMP. CONCLUSÕES: Os lactentes pré-termo apresentaram padrão de desenvolvimento motor semelhante aos típicos quanto à sequência de habilidades adquiridas e ritmo acelerado no período de recém-nascido (RN a um mês de idade. Sugere-se que lactentes pré-termo com essas características não necessitam de correção do grau de prematuridade e que programas de acompanhamento orientem os pais e cuidadores a estimulá-los, desde o primeiro mês, com brinquedos, propiciando a exploração precoce de diversos padrões motores.OBJECTIVES: This study aimed to characterize the pattern and rate of motor skill acquisition among preterm infants from newborn to four months corrected age, in comparison with a group of full-term infants. METHODS: Twelve healthy preterm infants (mean gestational age=33.6 weeks ± 1.25 and 10 healthy full-term infants (mean

  19. Human convection flow in spaces with and without ventilation: personal exposure to floor-released particles and cough-released droplets

    DEFF Research Database (Denmark)

    Licina, Dusan; Melikov, Arsen Krikor; Pantelic, Jovan

    2015-01-01

    The effects of the human convective boundary layer (CBL), room airflow patterns, and their velocities on personal exposure are examined. Two pollutants are studied which simulate particles released from the feet and generated at distances of 2 and 3 m by a human cough. A thermal manikin whose body...... shape, size, and surface temperatures correspond to those of an average person is used to simulate the CBL. The findings of the study reveal that for accurate predictions of personal exposure, the CBL needs to be considered, as it can transport the pollution around the human body. The best way...... to control and reduce personal exposure when the pollution originates at the feet is to employ transverse flow from in front and from the side, relative to the exposed occupant. The flow from the above opposing the CBL create the most unfavorable velocity field that can increase personal exposure by 85...

  20. Energy-efficient electric motors study

    Science.gov (United States)

    1981-03-01

    A survey conducted of purchasers of integral horsepower polyphase motors measured current knowledge of and awareness of energy efficient motors, decision making criteria, information sources, purchase and usage patterns, and related factors. The data obtained were used for the electric motor market penetration analysis. Additionally, a telephone survey was made. The study also provides analyses of distribution channels, commercialization constraints, and the impacts of government programs and rising energy prices. Study findings, conclusions, and recommendations are presented. Sample questionnaires and copies of letters to respondents are presented in appendices as well as descriptions of the methods used.

  1. Whooping Cough

    Science.gov (United States)

    ... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...

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

    Directory of Open Access Journals (Sweden)

    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

  3. [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

  4. Learning from sensory and reward prediction errors during motor adaptation.

    Science.gov (United States)

    Izawa, Jun; Shadmehr, Reza

    2011-03-01

    Voluntary motor commands produce two kinds of consequences. Initially, a sensory consequence is observed in terms of activity in our primary sensory organs (e.g., vision, proprioception). Subsequently, the brain evaluates the sensory feedback and produces a subjective measure of utility or usefulness of the motor commands (e.g., reward). As a result, comparisons between predicted and observed consequences of motor commands produce two forms of prediction error. How do these errors contribute to changes in motor commands? Here, we considered a reach adaptation protocol and found that when high quality sensory feedback was available, adaptation of motor commands was driven almost exclusively by sensory prediction errors. This form of learning had a distinct signature: as motor commands adapted, the subjects altered their predictions regarding sensory consequences of motor commands, and generalized this learning broadly to neighboring motor commands. In contrast, as the quality of the sensory feedback degraded, adaptation of motor commands became more dependent on reward prediction errors. Reward prediction errors produced comparable changes in the motor commands, but produced no change in the predicted sensory consequences of motor commands, and generalized only locally. Because we found that there was a within subject correlation between generalization patterns and sensory remapping, it is plausible that during adaptation an individual's relative reliance on sensory vs. reward prediction errors could be inferred. We suggest that while motor commands change because of sensory and reward prediction errors, only sensory prediction errors produce a change in the neural system that predicts sensory consequences of motor commands.

  5. Electric motor handbook

    CERN Document Server

    Chalmers, B J

    2013-01-01

    Electric Motor Handbook aims to give practical knowledge in a wide range of capacities such as plant design, equipment specification, commissioning, operation and maintenance. The book covers topics such as the modeling of steady-state motor performance; polyphase induction, synchronous, and a.c. commutator motors; ambient conditions, enclosures, cooling and loss dissipation; and electrical supply systems and motor drives. Also covered are topics such as variable-speed drives and motor control; materials and motor components; insulation types, systems, and techniques; and the installation, sit

  6. Effectiveness of a cough management algorithm at the transitional phase from acute to chronic cough in Australian children aged <15 years: protocol for a randomised controlled trial.

    Science.gov (United States)

    O'Grady, Kerry-Ann F; Grimwood, Keith; Toombs, Maree; Sloots, Theo P; Otim, Michael; Whiley, David; Anderson, Jennie; Rablin, Sheree; Torzillo, Paul J; Buntain, Helen; Connor, Anne; Adsett, Don; Meng Kar, Oon; Chang, Anne B

    2017-03-03

    Acute respiratory infections (ARIs) are leading causes of hospitalisation in Australian children and, if recurrent, are associated with increased risk of chronic pulmonary disorders later in life. Chronic (>4 weeks) cough in children following ARI is associated with decreased quality-of-life scores and increased health and societal economic costs. We will determine whether a validated evidence-based cough algorithm, initiated when chronic cough is first diagnosed after presentation with ARI, improves clinical outcomes in children compared with usual care. A multicentre, parallel group, open-label, randomised controlled trial, nested within a prospective cohort study in Southeast Queensland, Australia, is underway. 750 children aged algorithm or usual care (107 per group). Randomisation is stratified by reason for presentation, site and total cough duration at day 28 (Ethics Committees have approved the study. The study will inform best-practice management of cough in children. ACTRN12615000132549. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. The Clinical Value of Deflation Cough in Chronic Coughers With Reflux Symptoms.

    Science.gov (United States)

    Lavorini, Federico; Chellini, Elisa; Bigazzi, Francesca; Surrenti, Elisabetta; Fontana, Giovanni A

    2016-06-01

    Patients with deflation cough (DC), the cough-like expulsive effort(s) evoked by maximal lung emptying during a slow vital capacity maneuver, also present symptoms of gastroesophageal reflux. DC can be inhibited by prior intake of antacids. We wished to assess DC prevalence and association between DC and chemical characteristics of refluxate in patients with gastroesophageal reflux symptoms. A total of 157 consecutive outpatients underwent DC assessment and 24-h multichannel intraluminal impedance pH (MII-pH) monitoring; 93/157 also had chronic cough. Patients performed two to four slow vital capacity maneuvers and DC was detected aurally. Subsequently, they underwent 24-h MII-pH monitoring, the outcomes of which were defined as abnormal when acid or non-acid reflux events were > 73. DC occurred in 46/157 patients, 18 of whom had abnormal MII-pH outcomes; 28 of the remaining 111 patients without DC also had abnormal MII-pH findings. Thus, in the patients as a group, there was no association between DC and MII-pH outcomes. DC occurred in 40/93 of the chronic coughers; 15 of whom had acid reflux. All but 2 of the 53 patients without DC had normal MII-pH outcomes (P < .001), and the negative predictive value of DC for excluding acid reflux was 96.2%. At follow-up, 65% of coughers showed significant improvement after treatment. The overall prevalence of DC was 29%, increasing to 43% in chronic coughers in whom the absence of DC virtually excludes acid reflux. Therefore, DC assessment may represent a useful screening test for excluding acid reflux in chronic coughers with reflux symptoms. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  8. Reversal of functional disorders by aspiration, expiration and cough reflexes and their voluntary counterparts

    Directory of Open Access Journals (Sweden)

    Zoltan eTomori

    2012-12-01

    Full Text Available Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation, but it fails to revive infants with sudden infant death syndrome. Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are 2 distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations can be elicited by nasopharyngeal stimulation, strongly activating the brainstem generator for inspiration, which is also involved in the control of gasping. This aspiration reflex (AspR is characterized by spasmodic inspiration without subsequent active expiration and can be elicited during agonal gasping, caused by brainstem trans-sections in cats. Stimulation of the larynx can activate the generator for expiration to evoke the expiration reflex, manifesting with prompt expiration without preceding inspiration. Stimulation of the oro-pharynx and lower airways provokes the cough reflex which results from activating of both generators. The powerful potential of the AspR resembling auto-resuscitation by gasping can influence the control mechanisms of vital functions, mediating reversal of various functional disorders.The AspR in cats interrupted hypoxic apnea, laryngo- and bronchospasm, apneusis and even transient asphyxic coma, and can normalize various hypo- and hyper-functional disorders. Introduction of a nasogastric catheter evoked similar spasmodic inspirations in premature infants and interrupted hiccough attacks in adults. Coughing on demand can prevent anaphylactic shock and resuscitate the pertinent subject. Sniff representing nasal inspiratory pressure and maximal inspiratory and expiratory pressures are voluntary counterparts of airway reflexes, and are useful for diagnosis and therapy of various cardio-respiratory and neuromuscular disorders.

  9. Bordetella Pertussis virulence factors in the continuing evolution of whooping cough vaccines for improved performance.

    Science.gov (United States)

    Dorji, Dorji; Mooi, Frits; Yantorno, Osvaldo; Deora, Rajendar; Graham, Ross M; Mukkur, Trilochan K

    2018-02-01

    Despite high vaccine coverage, whooping cough caused by Bordetella pertussis remains one of the most common vaccine-preventable diseases worldwide. Introduction of whole-cell pertussis (wP) vaccines in the 1940s and acellular pertussis (aP) vaccines in 1990s reduced the mortality due to pertussis. Despite induction of both antibody and cell-mediated immune (CMI) responses by aP and wP vaccines, there has been resurgence of pertussis in many countries in recent years. Possible reasons hypothesised for resurgence have ranged from incompliance with the recommended vaccination programmes with the currently used aP vaccine to infection with a resurged clinical isolates characterised by mutations in the virulence factors, resulting in antigenic divergence with vaccine strain, and increased production of pertussis toxin, resulting in dampening of immune responses. While use of these vaccines provide varying degrees of protection against whooping cough, protection against infection and transmission appears to be less effective, warranting continuation of efforts in the development of an improved pertussis vaccine formulations capable of achieving this objective. Major approaches currently under evaluation for the development of an improved pertussis vaccine include identification of novel biofilm-associated antigens for incorporation in current aP vaccine formulations, development of live attenuated vaccines and discovery of novel non-toxic adjuvants capable of inducing both antibody and CMI. In this review, the potential roles of different accredited virulence factors, including novel biofilm-associated antigens, of B. pertussis in the evolution, formulation and delivery of improved pertussis vaccines, with potential to block the transmission of whooping cough in the community, are discussed.

  10. Síndrome coqueluchoide y tos ferina Pertussis-like syndrome and whooping cough

    Directory of Open Access Journals (Sweden)

    Carlos Dotres Martínez

    2012-12-01

    Full Text Available El síndrome coqueluchoide, cuadro parecido a la tos ferina, es uno de los síndromes respiratorios bajos más comunes en la práctica pediátrica sobre todo en los últimos años. La tos ferina sigue siendo la enfermedad inmunoprevenible más antigua de la infancia que aún causa brotes importantes, principalmente en niños, pero también en adolescentes y adultos. El objetivo de esta revisión es proporcionar información a todos los médicos generales y pediatras de atención primaria y secundaria de salud sobre este problema epidemiológico y de su actual reemergencia. El control de esta enfermedad es un problema de salud tanto en países desarrollados como en vías de desarrollo. Uno de los mayores obstáculos que ha contribuido a una tardía intervención epidemiológica y tratamiento de la tos ferina en varios países del mundo, ha sido la baja sospecha clínica de esta enfermedad en los médicos y trabajadores de la salud, y el desconocimiento de la familia, en la mayoría de las veces. En el momento actual existe una reemergencia mundial de la tos ferina, situación que es necesario conocer y aceptar para un oportuno diagnóstico y tratamiento.Pertussis-like syndrome, a clinical picture similar to whooping cough, is one of the most common lower respiratory syndromes in the pediatric practice in recent years. Whooping cough continues to be one of the oldest preventable diseases in infants, which still causes significant outbreaks mainly in children, but also in adolescents and adults. The objective of this review was to provide general physicians and pediatricians at the primary and the secondary health care levels with information about this present re-emerging epidemiological problem. The management of this disease is difficult for both the developed and the developing countries. One of the major obstacles that lead to delayed epidemiological intervention and treatment of whooping cough in several countries has been the poor clinical

  11. Incidence of Mycobacterium tuberculosis in the sputa of coughing inmates in selected Ghanaian prisons

    International Nuclear Information System (INIS)

    Gyamfi, O.K.; Bedzra, K.D.; Biney, E.; Marfo, K.; Khan, B.K.; Bonsu, F.A.; Addo, K. K.

    2007-01-01

    One hundred and ninety-five (195) inmates, from eight (8) selected prisons within Ghana's penal system, each with an active cough of at least one week (as the inclusion criterion) were made to submit two sputum samples each for screening for Mycobacterium tuberculosis (MTB) using culture and subsequent microscopy and biochemical speciation tests. This sampling population was made up of 111 convicts and 84 remand prisoners. Forty eight (48) or 24.6% of these sputum samples returned a positive growth of MTB on Loweinstein-Jensen (LJ) slants. All growths harvested were also acid-fast on Ziehl-Neelsen (ZN) microscopy. Out of the 111 convicted prisoners, 26 (or 23.4%) gave sputum samples which returned a positive growth on culture. On the other hand out of the 84 remanded inmates, 22 (or 26.2%) were positive on culture. Of all the total sputum samples returning a positive growth on culture, 54.2% (26/48) was from convicted inmates who made up 56.9% (111/195) of the sampling population whilst remanded inmates who made up only 39.3% (84/195) of our sampling population were responsible for 43.1% (22/54) of all positive culture growths. The percentage of MTB growths on culture in the sputa from coughing inmates domiciled in individual cells of selected prisons are interesting and instructive. The highest number of coughing inmates sampled in a single individual cell was 9 out of which 55.6% (5/9) had sputa giving a positive growth of MTB on culture. The percentage of positive growths of sputa obtained from coughing inmates in individual cells ranged from 20% (1/5) to 100% (1/1 and 2/2) for the selected prisons. A batch of samples (N=19) obtained from isolated inmates symptomatic for TB and at various stages of the DOTS chemotherapy were also analysed. Six (6) samples were positive on culture. Four (4) of these samples emanated from inmates on DOTS chemotherapy for periods between 69 and 290 days whilst the other 2 emanated from inmates on treatment for a period less than 60

  12. Handbook on linear motor application

    International Nuclear Information System (INIS)

    1988-10-01

    This book guides the application for Linear motor. It lists classification and speciality of Linear Motor, terms of linear-induction motor, principle of the Motor, types on one-side linear-induction motor, bilateral linear-induction motor, linear-DC Motor on basic of the motor, linear-DC Motor for moving-coil type, linear-DC motor for permanent-magnet moving type, linear-DC motor for electricity non-utility type, linear-pulse motor for variable motor, linear-pulse motor for permanent magneto type, linear-vibration actuator, linear-vibration actuator for moving-coil type, linear synchronous motor, linear electromagnetic motor, linear electromagnetic solenoid, technical organization and magnetic levitation and linear motor and sensor.

  13. Spatially dynamic recurrent information flow across long-range dorsal motor network encodes selective motor goals.

    Science.gov (United States)

    Yoo, Peter E; Hagan, Maureen A; John, Sam E; Opie, Nicholas L; Ordidge, Roger J; O'Brien, Terence J; Oxley, Thomas J; Moffat, Bradford A; Wong, Yan T

    2018-03-08

    Performing voluntary movements involves many regions of the brain, but it is unknown how they work together to plan and execute specific movements. We recorded high-resolution ultra-high-field blood-oxygen-level-dependent signal during a cued ankle-dorsiflexion task. The spatiotemporal dynamics and the patterns of task-relevant information flow across the dorsal motor network were investigated. We show that task-relevant information appears and decays earlier in the higher order areas of the dorsal motor network then in the primary motor cortex. Furthermore, the results show that task-relevant information is encoded in general initially, and then selective goals are subsequently encoded in specifics subregions across the network. Importantly, the patterns of recurrent information flow across the network vary across different subregions depending on the goal. Recurrent information flow was observed across all higher order areas of the dorsal motor network in the subregions encoding for the current goal. In contrast, only the top-down information flow from the supplementary motor cortex to the frontoparietal regions, with weakened recurrent information flow between the frontoparietal regions and bottom-up information flow from the frontoparietal regions to the supplementary cortex were observed in the subregions encoding for the opposing goal. We conclude that selective motor goal encoding and execution rely on goal-dependent differences in subregional recurrent information flow patterns across the long-range dorsal motor network areas that exhibit graded functional specialization. © 2018 Wiley Periodicals, Inc.

  14. Investigations of the migrating motor complex in domestic turkeys.

    Science.gov (United States)

    Mueller, L R; Duke, G E; Evanson, O A

    1990-09-01

    The motor correlate of the migrating myoelectric complex (MMC) was characterized in domestic turkeys, and feeding state, age, sex, and time of day were examined as possible factors influencing the motor activity observed. Strain gauge transducers, and in a few birds Ag-AgCl bipolar electrodes, were implanted on the caudoventral thin muscle of the muscular stomach, the duodenum, ileum, cecum, and colon. Contractility was recorded for 8-10 h per bird on alternating days for 2-3 wk, except in birds involved in four 24-h recording sessions during a 2-wk period. Intense motor activity characteristic of phase III of the MMC occurred only in the ileum; other phases could not be identified. The duration, propagation velocity, and percent of cyclic motor patterns propagating from one site to another were similar to those reported in other galliform species. The occurrence of cyclic motor activity appeared to be related to food consumption; the number of motor patterns occurring during an intense feeding session was less than the number observed 1.5-2 h after feeding. In addition, more motor patterns were recorded in fasted poults during the light period than in the dark; however, the reverse was observed in juveniles fed ad libitum. Cyclic motor activity recorded in fasted 18-wk-old birds was of longer duration than that in fasted 8-wk-old birds. No statistically significant differences were noted in the cyclic motor patterns of male vs. female poults.

  15. Impact of cough and common cold on productivity, absenteeism, and daily life in the United States: ACHOO Survey.

    Science.gov (United States)

    Dicpinigaitis, Peter V; Eccles, Ron; Blaiss, Michael S; Wingertzahn, Mark A

    2015-08-01

    Although the common cold is among the most frequent ailments encountered in clinical practice, little is known about its impact on productivity, absenteeism, and daily life. The United States Attitudes of Consumers Toward Health, Cough, and Cold (ACHOO) survey was developed to inform healthcare providers on patients' experience of cough/cold. This analysis focuses on the impact of cough/cold on daily activity, productivity, and absenteeism; other results are reported elsewhere. ACHOO was a 36-question online survey. US adult Internet/mobile device users (N = 3333) were recruited in October 2012. Response quotas modeled on 2010 US Census data ensured a demographically representative sample; 75% of completed surveys were randomized as the primary analysis pool. Demographics and impact of cough/cold were reported using means, frequencies, and percentages. Weighted least squares regression or weighted paired t-test were used to identify factors associated with greater impact. The analysis pool (N = 2505) included 1342 (53.6%) women and 1163 (46.4%) men (mean ages, 46.7 and 45.9 years). A majority (84.7%) had ≥1 cold in the past year. Fifty-two percent said cough/cold impacted daily life a fair amount to a lot. Productivity decreased by a mean 26.4%, and 44.5% of respondents reported work/school absenteeism (usually 1-2 days) during a cold. Overall, 93% of survey participants reported sleep difficulty (slight to extreme) during a cough/cold. Among all respondents, 57% reported cough or nasal congestion as the symptoms making sleep difficult. Higher frequency of colds, more cold symptoms, difficulty sleeping, and worse overall health status correlated with greater impact on productivity, absenteeism, and daily life. Study limitations include the potential for recall bias given the retrospective nature of the self-reports. Furthermore, no attempt was made to distinguish treatment effects, if any, from those of the underlying cough/cold. To our knowledge, this is

  16. In vivo antitussive activity of Coccinia grandis against irritant aerosol and sulfur dioxide-induced cough model in rodents

    Directory of Open Access Journals (Sweden)

    Shakti Prasad Pattanayak and Priyashree Sunita

    2009-12-01

    Full Text Available Coccinia grandis (Cucurbitaceae has extensively used to get relief from asthma and cough by the indigenous people of India. The antitussive effect of aerosols of two different concentrations (2.5%, 5% w/v of methanol extract of C. grandis fruits were tested by counting the numbers of coughs produced due to aerosols of citric acid, 10 min after exposing the male guinea pigs to aerosols of test solutions for 7 min. In another set of experiment methanol extract was investigated for its therapeutic efficacy on a cough model induced by sulfur dioxide gas in mice. The results showed significant reduction of cough number obtained in the presence of both concentrations of methanol extract as that of the prototype antitussive agent codeine phosphate. Also, methanol extract exhibited significant antitussive effect at 100, 200 and 400 mg/kg, per orally by inhibiting the cough by 20.57, 33.73 and 56.71% within 90 min of performing the experiment respectively.

  17. Interacting adiabatic quantum motor

    Science.gov (United States)

    Bruch, Anton; Kusminskiy, Silvia Viola; Refael, Gil; von Oppen, Felix

    2018-05-01

    We present a field-theoretic treatment of an adiabatic quantum motor. We explicitly discuss a motor called the Thouless motor which is based on a Thouless pump operating in reverse. When a sliding periodic potential is considered to be the motor degree of freedom, a bias voltage applied to the electron channel sets the motor in motion. We investigate a Thouless motor whose electron channel is modeled as a Luttinger liquid. Interactions increase the gap opened by the periodic potential. For an infinite Luttinger liquid the coupling-induced friction is enhanced by electron-electron interactions. When the Luttinger liquid is ultimately coupled to Fermi liquid reservoirs, the dissipation reduces to its value for a noninteracting electron system for a constant motor velocity. Our results can also be applied to a motor based on a nanomagnet coupled to a quantum spin Hall edge.

  18. Chronic motor tic disorder

    Science.gov (United States)

    Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...

  19. Piezoelectric Motors, an Overview

    OpenAIRE

    Karl Spanner; Burhanettin Koc

    2016-01-01

    Piezoelectric motors are used in many industrial and commercial applications. Various piezoelectric motors are available in the market. All of the piezoelectric motors use the inverse piezoelectric effect, where microscopically small oscillatory motions are converted into continuous or stepping rotary or linear motions. Methods of obtaining long moving distance have various drive and functional principles that make these motors categorized into three groups: resonance-drive (piezoelectric ult...

  20. Electric Motor Thermal Management

    Energy Technology Data Exchange (ETDEWEB)

    Bennion, Kevin S [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-01

    Thermal management enables more efficient and cost-effective motors. This Annual Merit Review presentation describes the technical accomplishments and progress in electric motor thermal management R&D over the last year. This project supports a broad industry demand for data, analysis methods, and experimental techniques to improve and better understand motor thermal management.

  1. Programmable dc motor controller

    Science.gov (United States)

    Hopwood, J. E.

    1982-11-01

    A portable programmable dc motor controller, with features not available on commercial instruments was developed for controlling fixtures during welding processes. The controller can be used to drive any dc motor having tachometer feedback and motor requirements not exceeding 30 volts, 3 amperes. Among the controller's features are delayed start time, upslope time, speed, and downslope time.

  2. Evaluation of Esophageal Motor Function With High-resolution Manometry

    Science.gov (United States)

    2013-01-01

    For several decades esophageal manometry has been the test of choice to evaluate disorders of esophageal motor function. The recent introduction of high-resolution manometry for the study of esophageal motor function simplified performance of esophageal manometry, and revealed previously unidentified patterns of normal and abnormal esophageal motor function. Presentation of pressure data as color contour plots or esophageal pressure topography led to the development of new tools for analyzing and classifying esophageal motor patterns. The current standard and still developing approach to do this is the Chicago classification. While this methodical approach is improving our diagnosis of esophageal motor disorders, it currently does not address all motor abnormalities. We will explore the Chicago classification and disorders that it does not address. PMID:23875094

  3. Aversive stimuli exacerbate defensive motor behaviour in motor conversion disorder.

    Science.gov (United States)

    Blakemore, Rebekah L; Sinanaj, Indrit; Galli, Silvio; Aybek, Selma; Vuilleumier, Patrik

    2016-12-01

    Conversion disorder or functional neurological symptom disorder (FND) can affect the voluntary motor system, without an organic cause. Functional symptoms are thought to be generated unconsciously, arising from underlying psychological stressors. However, attempts to demonstrate a direct relationship between the limbic system and disrupted motor function in FND are lacking. We tested whether negative affect would exacerbate alterations of motor control and corresponding brain activations in individuals with FND. Ten patients and ten healthy controls produced an isometric precision-grip contraction at 10% of maximum force while either viewing visual feedback of their force output, or unpleasant or pleasant emotional images (without feedback). Force magnitude was continuously recorded together with change in brain activity using fMRI. For controls, force output decayed from the target level while viewing pleasant and unpleasant images. Patients however, maintained force at the target level without decay while viewing unpleasant images, indicating a pronounced effect of negative affect on force output in FND. This emotional modulation of force control was associated with different brain activation patterns between groups. Contrasting the unpleasant with the pleasant condition, controls showed increased activity in the inferior frontal cortex and pre-supplementary motor area, whereas patients had greater activity in the cerebellum (vermis), posterior cingulate cortex, and hippocampus. Engagement of a cerebellar-limbic network in patients is consistent with heightened processing of emotional salience, and supports the role of the cerebellum in freezing responses in the presence of aversive events. These data highlight a possible neural circuit through which psychological stressors elicit defensive behaviour and modulate motor function in FND. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Structural Elements and Cough Suppressing Activity of Polysaccharides from Zingiber officinale Rhizome.

    Science.gov (United States)

    Bera, K; Nosalova, G; Sivova, V; Ray, B

    2016-01-01

    Zingiber officinale is used for the management of fever, bronchial asthma and cough for thousands of years. While the link to a particular indication has been established in human, the active principle of the formulation remains unknown. Herein, we have investigated a water extracted polysaccharides (WEP) containing fraction from its rhizome. Utilizing a traditional aqueous extraction protocol and using chemical, chromatographic and spectroscopic methods a fraction containing a branched glucan and polygalaturonan in a ratio of 59:1 was characterized. This glucan, which has a molecular mass of 36 kDa, is made up of terminal-, (1,4)- and (1,4,6)-linked α-Glcp residues. Oral administration of WEP in doses of 25 and 50 mg/kg body weight significantly inhibited the number of citric acid-induced cough efforts in guinea pigs. It does not alter the specific airway smooth muscle reactivity significantly. Thus, traditional aqueous extraction method provides molecular entities, which induces antitussive activity without addiction. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Reduced exposure to coughed air by a novel ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Brand, Marek

    2012-01-01

    A novel hospital bed integrated ventilation and cleaning unit (HBIVCU) for local airflow control and cleansing, limiting the airborne spread of contagious air coughed from a sick patient in a hospital room, was developed. The performance efficiency of the unit, to successfully reduce occupants......’ exposure to coughed air, was studied in a full-scale, two-bed hospital room mock-up, 4.65 m x 4.65 m x 2.60 m (W x L x H), with two patients and a doctor. Four units were placed along the two sides of both beds close to the head. The room was ventilated by overhead mixing air distribution at 22 °C room air...... of the novel unit, at background ventilation rates of 3 h-1and 6 h-1, was evaluated by measuring the excess CO2 concentration at the mouth of both the doctor and the exposed patient. When the novel method was not used, the CO2 concentration (exposure) measured in the air “inhaled” by the doctor exceeded 20...

  6. Leicester Cough Questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil.

    Science.gov (United States)

    Felisbino, Manuela Brisot; Steidle, Leila John Marques; Gonçalves-Tavares, Michelle; Pizzichini, Marcia Margaret Menezes; Pizzichini, Emilio

    2014-01-01

    To translate the Leicester Cough Questionnaire (LCQ) to Portuguese and adapt it for use in Brazil. Cross-cultural adaptation of a quality of life questionnaire requires a translated version that is conceptually equivalent to the original version and culturally acceptable in the target country. The protocol used consisted of the translation of the LCQ to Portuguese by three Brazilian translators who were fluent in English and its back-translation to English by another translator who was a native speaker of English and fluent in Portuguese. The back-translated version was evaluated by one of the authors of the original questionnaire in order to verify its equivalence. Later in the process, a provisional Portuguese-language version was thoroughly reviewed by an expert committee. In 10 patients with chronic cough, cognitive debriefing was carried out in order to test the understandability, clarity, and acceptability of the translated questionnaire in the target population. On that basis, the final Portuguese-language version of the LCQ was produced and approved by the committee. Few items were questioned by the source author and revised by the committee of experts. During the cognitive debriefing phase, the Portuguese-language version of the LCQ proved to be well accepted and understood by all of the respondents, which demonstrates the robustness of the process of translation and cross-cultural adaptation. The final version of the LCQ adapted for use in Brazil was found to be easy to understand and easily applied.

  7. Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics.

    Directory of Open Access Journals (Sweden)

    Edward C Jones-López

    Full Text Available The diagnosis of latent tuberculosis (TB infection (LTBI is complicated by the absence of a gold standard. Discordance between tuberculin skin tests (TST and interferon gamma release assays (IGRA occurs in 10-20% of individuals, but the underlying mechanisms are poorly understood.We analyzed data from a prospective household contact study that included cough aerosol culture results from index cases, environmental and contact factors. We assessed contacts for LTBI using TST and IGRA at baseline and six weeks. We examined TST/IGRA discordance in qualitative and quantitative analyses, and used multivariable logistic regression analysis with generalized estimating equations to analyze predictors of discordance.We included 96 TB patients and 384 contacts. Discordance decreased from 15% at baseline to 8% by six weeks. In adjusted analyses, discordance was related to less crowding (p = 0.004, non-cavitary disease (OR 1.41, 95% CI: 1.02-1.96; p = 0.03, and marginally with BCG vaccination in contacts (OR 1.40, 95% CI: 0.99-1.98, p = 0.06.We observed significant individual variability and temporal dynamism in TST and IGRA results in household contacts of pulmonary TB cases. Discordance was associated with a less intense infectious exposure, and marginally associated with a BCG-mediated delay in IGRA conversion. Cough aerosols provide an additional dimension to the assessment of infectiousness and risk of infection in contacts.

  8. Pilot study for home monitoring of cough capacity in amyotrophic lateral sclerosis: A case series

    Directory of Open Access Journals (Sweden)

    M. Paneroni

    2014-07-01

    Full Text Available Background: Cough capacity derangement is associated with a high risk of pulmonary complications in amyotrophic lateral sclerosis patients when cough assistance is not routinely performed at home. The primary aim of this study was to evaluate the feasibility of a long-term home based daily self-monitoring cough capacity. Methods: Eighteen subjects were enrolled in a 9-month study at home. Changes in peak cough expiratory flow, oxygen saturation, respiratory discomfort and incidence of respiratory deterioration events were evaluated. In subjects presenting respiratory deterioration events, decline in the abovementioned respiratory variables was evaluated (#NCT00613899. Results: During an average follow-up of 125 ± 102 days, a total of 1175 measures were performed on 12 subjects. Mean compliance to proposed evaluations was 37 ± 32% which worsened over time. Peak cough expiratory flow decreased by 15.08 ± 32.43 L/min monthly. Five subjects reported 6 episodes of respiratory deterioration events, after a mean period of 136 ± 108 days. They had poor respiratory function and more years of disease. There was no difference in peak cough expiratory flow and its decline whether subjects presented respiratory deterioration events or not. In 4 subjects the respiratory discomfort score significantly worsened after respiratory deterioration events from 3.0 ± 1.41 to 4.25 ± 1.71. Conclusion: Daily self-monitoring of peak cough expiratory flow, oxygen saturation and respiratory discomfort seems difficult to obtain because of poor adherence to measures; this protocol does not seem to add anything to current practice of advising on clinical derangements. Confirmatory larger studies are necessary. Resumo: Antecedentes: A disfunção na capacidade de tosse está associada a um elevado risco de complicações pulmonares nos doentes com esclerose lateral amiotrófica, quando a sua monitorização não é realizada rotineiramente no domicílio. O

  9. Clinical and neurophysiologic characterization of an European family with hereditary sensory neuropathy, paroxysmal cough and gastroesophageal reflux

    Directory of Open Access Journals (Sweden)

    Pedro Barros

    2014-04-01

    Full Text Available In 2002, Spring et al reported a family with an autosomal dominant form of hereditary sensory neuropathy; patients also presented adult onset of gastroesophageal reflux and cough. Since then, no further families have been described. Objective: To study a new Portuguese family with these characteristics. Method: To describe the clinical and neurophysiologic characteristics of one family with features of sensory neuropathy associated with cough and gastroesophageal erflux. Results: Three of five siblings presented a similar history of paroxysmal cough (5th decade. About a decade later they experienced numbness and paraesthesia in the feets and in all cases there was evidence of an axonal sensory neuropathy. A history of gastroesophageal reflux of variable severity and age of onset was also present. Discussion: Molecular genetic studies have demonstrated genetic heterogeneity between the hereditary sensory neuropathy type 1 subtypes. The identification of these families is of major importance because further work is required to identify the underlying genetic defect.

  10. Clinical and neurophysiologic characterization of an European family with hereditary sensory neuropathy, paroxysmal cough and gastroesophageal reflux.

    Science.gov (United States)

    Barros, Pedro; Morais, Hugo; Santos, Catarina; Roriz, José; Coutinho, Paula

    2014-04-01

    In 2002, Spring et al reported a family with an autosomal dominant form of hereditary sensory neuropathy; patients also presented adult onset of gastroesophageal reflux and cough. Since then, no further families have been described. To study a new Portuguese family with these characteristics. To describe the clinical and neurophysiologic characteristics of one family with features of sensory neuropathy associated with cough and gastroesophageal erflux. Three of five siblings presented a similar history of paroxysmal cough (5th decade). About a decade later they experienced numbness and paraesthesia in the feet and in all cases there was evidence of an axonal sensory neuropathy. A history of gastroesophageal reflux of variable severity and age of onset was also present. Molecular genetic studies have demonstrated genetic heterogeneity between the hereditary sensory neuropathy type 1 subtypes. The identification of these families is of major importance because further work is required to identify the underlying genetic defect.

  11. “The Barking Girl”: A Case Report of Psychogenic Cough in a Child with a Review of Literature

    Science.gov (United States)

    Jakati, Praveen Kumar; Naskar, Subrata; Khanna, Anisha

    2017-01-01

    A 9-year-old girl presented with 2-month history of continuous coughing; despite detailed evaluation, no organic cause was found. Considering the provisional diagnosis of a psychogenic cough, she was advised for psychiatry consultation. After a psychological assessment, she was found to have comorbid anxiety (Screen for Child Anxiety Related Disorders score- 25) along with punitive parenting and sibling rivalry issues. She was initially treated with parental psychoeducation, play therapy, and behavior therapy. Since she did not show expected progress with the treatment, low-dose escitalopram was started along with the ongoing therapy, considering her anxiety. There was a significant improvement in her symptoms in 1-month follow-up. She maintained improvement during further follow-ups. This case illustrates the need to identify and treat comorbid psychiatric issues in the management of a psychogenic cough. PMID:28852260

  12. "The Barking Girl": A Case Report of Psychogenic Cough in a Child with a Review of Literature.

    Science.gov (United States)

    Jakati, Praveen Kumar; Naskar, Subrata; Khanna, Anisha

    2017-01-01

    A 9-year-old girl presented with 2-month history of continuous coughing; despite detailed evaluation, no organic cause was found. Considering the provisional diagnosis of a psychogenic cough, she was advised for psychiatry consultation. After a psychological assessment, she was found to have comorbid anxiety (Screen for Child Anxiety Related Disorders score- 25) along with punitive parenting and sibling rivalry issues. She was initially treated with parental psychoeducation, play therapy, and behavior therapy. Since she did not show expected progress with the treatment, low-dose escitalopram was started along with the ongoing therapy, considering her anxiety. There was a significant improvement in her symptoms in 1-month follow-up. She maintained improvement during further follow-ups. This case illustrates the need to identify and treat comorbid psychiatric issues in the management of a psychogenic cough.

  13. Prevalence, diagnosis, and disease course of pertussis in adults with acute cough: a prospective, observational study in primary care.

    Science.gov (United States)

    Teepe, Jolien; Broekhuizen, Berna D L; Ieven, Margareta; Loens, Katherine; Huygen, Kris; Kretzschmar, Mirjam; de Melker, Hester; Butler, Chris C; Little, Paul; Stuart, Beth; Coenen, Samuel; Goossens, Herman; Verheij, Theo J M

    2015-10-01

    Most cases of adult pertussis probably remain undiagnosed. To explore the prevalence, diagnosis, and disease course of acute pertussis infection in adult patients presenting with acute cough. Prospective observational study between 2007 and 2010 in primary care in 12 European countries. Adults presenting with acute cough (duration of ≤28 days) were included. Bordetella pertussis infection was determined by polymerase chain reaction (from nasopharyngeal flocked swabs and sputa) and by measurement of immunoglobulin G antibodies to pertussis toxin (PT) in venous blood at day 28. An antibody titre to PT of ≥125 IU/ml or PCR positive result in a respiratory sample defined recent infection. Patients completed a symptom diary for 28 days. Serum and/or respiratory samples were obtained in 3074 patients. Three per cent (93/3074) had recent B. pertussis infection. Prior cough duration >2 weeks discriminated to some extent between those with and without pertussis (adjusted odds ratio 1.89, 95% confidence interval = 1.17 to 3.07; P = 0.010). Median cough duration after presentation was 17 and 12 days in patients with and without pertussis, respectively (P = 0.008). Patients with pertussis had longer duration of phlegm production (P = 0.010), shortness of breath (P = 0.037), disturbed sleep (P = 0.013) and interference with normal activities or work (P = 0.033) after presentation. Pertussis infection plays a limited role among adults presenting with acute cough in primary care, but GPs should acknowledge the possibility of pertussis in uncomplicated lower respiratory tract infection. As in children, pertussis also causes prolonged symptoms in adults. However, pertussis is difficult to discern from other acute cough syndromes in adults at first presentation. © British Journal of General Practice 2015.

  14. Motor/generator

    Science.gov (United States)

    Hickam, Christopher Dale [Glasford, IL

    2008-05-13

    A motor/generator is provided for connecting between a transmission input shaft and an output shaft of a prime mover. The motor/generator may include a motor/generator housing, a stator mounted to the motor/generator housing, a rotor mounted at least partially within the motor/generator housing and rotatable about a rotor rotation axis, and a transmission-shaft coupler drivingly coupled to the rotor. The transmission-shaft coupler may include a clamp, which may include a base attached to the rotor and a plurality of adjustable jaws.

  15. Piezoelectric Motors, an Overview

    Directory of Open Access Journals (Sweden)

    Karl Spanner

    2016-02-01

    Full Text Available Piezoelectric motors are used in many industrial and commercial applications. Various piezoelectric motors are available in the market. All of the piezoelectric motors use the inverse piezoelectric effect, where microscopically small oscillatory motions are converted into continuous or stepping rotary or linear motions. Methods of obtaining long moving distance have various drive and functional principles that make these motors categorized into three groups: resonance-drive (piezoelectric ultrasonic motors, inertia-drive, and piezo-walk-drive. In this review, a comprehensive summary of piezoelectric motors, with their classification from initial idea to recent progress, is presented. This review also includes some of the industrial and commercial applications of piezoelectric motors that are presently available in the market as actuators.

  16. Motor degradation prediction methods

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, J.R.; Kelly, J.F.; Delzingaro, M.J.

    1996-12-01

    Motor Operated Valve (MOV) squirrel cage AC motor rotors are susceptible to degradation under certain conditions. Premature failure can result due to high humidity/temperature environments, high running load conditions, extended periods at locked rotor conditions (i.e. > 15 seconds) or exceeding the motor`s duty cycle by frequent starts or multiple valve stroking. Exposure to high heat and moisture due to packing leaks, pressure seal ring leakage or other causes can significantly accelerate the degradation. ComEd and Liberty Technologies have worked together to provide and validate a non-intrusive method using motor power diagnostics to evaluate MOV rotor condition and predict failure. These techniques have provided a quick, low radiation dose method to evaluate inaccessible motors, identify degradation and allow scheduled replacement of motors prior to catastrophic failures.

  17. Neuroplasticity & Motor Learning

    DEFF Research Database (Denmark)

    Jensen, Jesper Lundbye

    Practice of a new motor task is usually associated with an improvement in performance. Indeed, if we stop practicing and return the next day to the same task, we find that our performance has been maintained and may even be better than it was at the start of the first day. This improvement...... is a measure of our ability to form and store a motor memory of the task. However, the initial memory of the task is labile and may be subject to interference. During and following motor learning plastic changes occur within the central nervous system. On one hand these changes are driven by motor practice......, on the other hand the changes underlie the formation of motor memory and the retention of improved motor performance. During motor learning changes may occur at many different levels within the central nervous system dependent on the type of task and training. Here, we demonstrate different studies from our...

  18. Energy-efficient electric motors study

    Energy Technology Data Exchange (ETDEWEB)

    1981-03-23

    The study identifies the industrial decision makers, investigated the information they needed to know, how they can best be reached, and the motivating factors for purchasing energy-efficient electric motors. A survey was conducted of purchasers of integral horsepower polyphase motors. The survey measured current knowledge of and awareness of energy-efficient motors, decision-making criteria, information sources, purchase and usage patterns, and related factors. The survey data were used for the electric motor market penetration analysis. Additionally, a telephone survey was made. The study also provides analyses of distribution channels, commercialization constraints, and the impacts of government programs and rising energy prices. A description of study findings, conclusions, and recommendations is presented. Sample questionnaires and copies of letters to respondents are presented in 3 appendices. Appendices D and E contain descriptions of the methods used. (MCW)

  19. Motor unit recruitment for dynamic tasks: current understanding and future directions.

    Science.gov (United States)

    Hodson-Tole, Emma F; Wakeling, James M

    2009-01-01

    Skeletal muscle contains many muscle fibres that are functionally grouped into motor units. For any motor task there are many possible combinations of motor units that could be recruited and it has been proposed that a simple rule, the 'size principle', governs the selection of motor units recruited for different contractions. Motor units can be characterised by their different contractile, energetic and fatigue properties and it is important that the selection of motor units recruited for given movements allows units with the appropriate properties to be activated. Here we review what is currently understood about motor unit recruitment patterns, and assess how different recruitment patterns are more or less appropriate for different movement tasks. During natural movements the motor unit recruitment patterns vary (not always holding to the size principle) and it is proposed that motor unit recruitment is likely related to the mechanical function of the muscles. Many factors such as mechanics, sensory feedback, and central control influence recruitment patterns and consequently an integrative approach (rather than reductionist) is required to understand how recruitment is controlled during different movement tasks. Currently, the best way to achieve this is through in vivo studies that relate recruitment to mechanics and behaviour. Various methods for determining motor unit recruitment patterns are discussed, in particular the recent wavelet-analysis approaches that have allowed motor unit recruitment to be assessed during natural movements. Directions for future studies into motor recruitment within and between functional task groups and muscle compartments are suggested.

  20. Probing the genome-scale metabolic landscape of Bordetella pertussis, the causative agent of whooping cough.

    Science.gov (United States)

    Branco Dos Santos, Filipe; Olivier, Brett G; Boele, Joost; Smessaert, Vincent; De Rop, Philippe; Krumpochova, Petra; Klau, Gunnar W; Giera, Martin; Dehottay, Philippe; Teusink, Bas; Goffin, Philippe

    2017-08-25

    Whooping cough is a highly-contagious respiratory disease caused by Bordetella pertussi s. Despite vaccination, its incidence has been rising alarmingly, and yet, the physiology of B. pertussis remains poorly understood. We combined genome-scale metabolic reconstruction, a novel optimization algorithm and experimental data to probe the full metabolic potential of this pathogen, using strain Tohama I as a reference. Experimental validation showed that B. pertussis secretes a significant proportion of nitrogen as arginine and purine nucleosides, which may contribute to modulation of the host response. We also found that B. pertussis can be unexpectedly versatile, being able to metabolize many compounds while displaying minimal nutrient requirements. It can grow without cysteine - using inorganic sulfur sources such as thiosulfate - and it can grow on organic acids such as citrate or lactate as sole carbon sources, providing in vivo demonstration that its TCA cycle is functional. Although the metabolic reconstruction of eight additional strains indicates that the structural genes underlying this metabolic flexibility are widespread, experimental validation suggests a role of strain-specific regulatory mechanisms in shaping metabolic capabilities. Among five alternative strains tested, three were shown to grow on substrate combinations requiring a functional TCA cycle, but only one could use thiosulfate. Finally, the metabolic model was used to rationally design growth media with over two-fold improvements in pertussis toxin production. This study thus provides novel insights into B. pertussis physiology, and highlights the potential, but also limitations of models solely based on metabolic gene content. IMPORTANCE The metabolic capabilities of Bordetella pertussis - the causative agent of whooping cough - were investigated from a systems-level perspective. We constructed a comprehensive genome-scale metabolic model for B. pertussis , and challenged its predictions

  1. Two Distinct Episodes Of Whooping Cough Caused By Consecutive Bordetella Pertussis And Bordetella Parapertussis Infections In A Fully Immunized Healthy Boy.

    Science.gov (United States)

    Heininger, Ulrich; Schlassa, Detlef

    2016-11-01

    We describe a 5-year-old, fully immunized boy with polymerase chain reaction-proven consecutive Bordetella pertussis and Bordetella parapertussis infections causing typical whooping cough at the age of 2 and 5 years, respectively. Neither pertussis immunization nor disease provides reliable immunity against further episodes of whooping cough.

  2. 3D visualization of movements can amplify motor cortex activation during subsequent motor imagery

    Directory of Open Access Journals (Sweden)

    Teresa eSollfrank

    2015-08-01

    Full Text Available A repetitive movement practice by motor imagery (MI can influence motor cortical excitability in the electroencephalogram (EEG. The feedback and the feedback environment should be inherently motivating and relevant for the learner and should have an appeal of novelty, real-world relevance or aesthetic value (Ryan and Deci, 2000; Merrill, 2007. This study investigated if a realistic visualization in 3D of upper and lower limb movements can amplify motor related potentials during motor imagery. We hypothesized that a richer sensory visualization might be more effective during instrumental conditioning, resulting in a more pronounced event related desynchronisation (ERD of the upper alpha band (10-12 Hz over the sensorimotor cortices thereby potentially improving MI based BCI protocols for motor rehabilitation. The results show a strong increase of the characteristic patterns of ERD of the upper alpha band components for left and right limb motor imagery present over the sensorimotor areas in both visualization conditions. Overall, significant differences were observed as a function of visualization modality (2D vs. 3D. The largest upper alpha band power decrease was obtained during motor imagery after a 3-dimensional visualization. In total in 12 out of 20 tasks the end-user of the 3D visualization group showed an enhanced upper alpha ERD relative to 2D visualization modality group, with statistical significance in nine tasks.With a realistic visualization of the limb movements, we tried to increase motor cortex activation during MI. Realistic visual feedback, consistent with the participant’s motor imagery, might be helpful for accomplishing successful motor imagery and the use of such feedback may assist in making BCI a more natural interface for motor imagery based BCI rehabilitation.

  3. Environmental Factors Affecting Preschoolers' Motor Development

    Science.gov (United States)

    Venetsanou, Fotini; Kambas, Antonis

    2010-01-01

    The process of development occurs according to the pattern established by the genetic potential and also by the influence of environmental factors. The aim of the present study was to focus on the main environmental factors affecting motor development. The review of the literature revealed that family features, such as socioeconomic status,…

  4. Early functional impairment of sensory-motor connectivity in a mouse model of spinal muscular atrophy

    Science.gov (United States)

    Mentis, George Z.; Blivis, Dvir; Liu, Wenfang; Drobac, Estelle; Crowder, Melissa E.; Kong, Lingling; Alvarez, Francisco J.; Sumner, Charlotte J.; O'Donovan, Michael J.

    2011-01-01

    SUMMARY To define alterations of neuronal connectivity that occur during motor neuron degeneration, we characterized the function and structure of spinal circuitry in spinal muscular atrophy (SMA) model mice. SMA motor neurons show reduced proprioceptive reflexes that correlate with decreased number and function of synapses on motor neuron somata and proximal dendrites. These abnormalities occur at an early stage of disease in motor neurons innervating proximal hindlimb muscles and medial motor neurons innervating axial muscles, but only at end-stage disease in motor neurons innervating distal hindlimb muscles. Motor neuron loss follows afferent synapse loss with the same temporal and topographical pattern. Trichostatin A, which improves motor behavior and survival of SMA mice, partially restores spinal reflexes illustrating the reversibility of these synaptic defects. De-afferentation of motor neurons is an early event in SMA and may be a primary cause of motor dysfunction that is amenable to therapeutic intervention. PMID:21315257

  5. Video Assisted Thoracoscopic Surgical Enucleation of a Giant Esophageal Leiomyoma Presenting with Persistent Cough

    Directory of Open Access Journals (Sweden)

    Parvez Mujawar

    2016-01-01

    Full Text Available Esophageal leiomyoma is a relatively rare tumor of esophagus but it is the most common benign neoplasm of the esophagus. Small esophageal leiomyoma can be observed but larger ones and those producing symptoms should be excised. As observed for other esophageal tumors, dysphagia is its main symptom. Traditionally, open thoracotomy and enucleation are its main treatment but in the last few years video assisted thoracoscopic surgical (VATS enucleation is gaining recognition with proven advantages of minimally invasive surgery. Herein we present our experience with patient presenting with cough rather than dysphagia as a main symptom, who was diagnosed to be having giant esophageal leiomyoma. VATS guided enucleation was accomplished successfully. Size of lesion was 16×4×3 cm. Postoperative recovery was uneventful and patient is not having any signs of recurrence, after three years during follow-up period.

  6. Adverse events associated with opioid-containing cough and cold medications in children.

    Science.gov (United States)

    Paul, Ian M; Reynolds, Kate M; Green, Jody L

    2018-04-10

    Until recently most of the scrutiny of opioid-containing cough and cold medications (CCMs) by the US Food and Drug Administration (FDA) was focused on codeine, only recently shifting equal focus to those containing hydrocodone. We characterized adverse events (AEs) in children Dictionary for Regulatory Activities with preferred terms reported. One hundred and fourteen of the 7035 (2%) cases reviewed involved an opioid-containing product. Ninety-eight cases involved an AE at least potentially related to the opioid ingredient (38 (39%) codeine; 60 (61%) hydrocodone). All three fatality cases involved hydrocodone with an antihistamine. Among non-fatalities, somnolence, lethargy, and/or respiratory depression were more commonly reported among hydrocodone cases than codeine cases (86% vs. 61%; p = .005). These safety surveillance data support the FDA's expanded label changes limiting opioid CCMs for children.

  7. Detection of Infectious Influenza Virus in Cough Aerosols Generated in a Simulated Patient Examination Room

    Science.gov (United States)

    Noti, John D.; Lindsley, William G.; Blachere, Francoise M.; Cao, Gang; Kashon, Michael L.; Thewlis, Robert E.; McMillen, Cynthia M.; King, William P.; Szalajda, Jonathan V.; Beezhold, Donald H.

    2015-01-01

    Background The potential for aerosol transmission of infectious influenza virus (ie, in healthcare facilities) is controversial. We constructed a simulated patient examination room that contained coughing and breathing manikins to determine whether coughed influenza was infectious and assessed the effectiveness of an N95 respirator and surgical mask in blocking transmission. Methods National Institute for Occupational Safety and Health aerosol samplers collected size-fractionated aerosols for 60 minutes at the mouth of the breathing manikin, beside the mouth, and at 3 other locations in the room. Total recovered virus was quantitated by quantitative polymerase chain reaction and infectivity was determined by the viral plaque assay and an enhanced infectivity assay. Results Infectious influenza was recovered in all aerosol fractions (5.0% in >4 µm aerodynamic diameter, 75.5% in 1–4 µm, and 19.5% in <1 µm; n = 5). Tightly sealing a mask to the face blocked entry of 94.5% of total virus and 94.8% of infectious virus (n = 3). A tightly sealed respirator blocked 99.8% of total virus and 99.6% of infectious virus (n = 3). A poorly fitted respirator blocked 64.5% of total virus and 66.5% of infectious virus (n = 3). A mask documented to be loosely fitting by a PortaCount fit tester, to simulate how masks are worn by healthcare workers, blocked entry of 68.5% of total virus and 56.6% of infectious virus (n = 2). Conclusions These results support a role for aerosol transmission and represent the first reported laboratory study of the efficacy of masks and respirators in blocking inhalation of influenza in aerosols. The results indicate that a poorly fitted respirator performs no better than a loosely fitting mask. PMID:22460981

  8. Pilot study for home monitoring of cough capacity in amyotrophic lateral sclerosis: A case series

    Directory of Open Access Journals (Sweden)

    M. Paneroni

    2014-07-01

    Full Text Available Background: Cough capacity derangement is associated with a high risk of pulmonary complications in amyotrophic lateral sclerosis patients when cough assistance is not routinely performed at home. The primary aim of this study was to evaluate the feasibility of a long‐term home based daily self‐monitoring cough capacity. Methods: Eighteen subjects were enrolled in a 9‐month study at home. Changes in peak cough expiratory flow, oxygen saturation, respiratory discomfort and incidence of respiratory deterioration events were evaluated. In subjects presenting respiratory deterioration events, decline in the abovementioned respiratory variables was evaluated (#NCT00613899. Results: During an average follow‐up of 125 ± 102 days, a total of 1175 measures were performed on 12 subjects. Mean compliance to proposed evaluations was 37 ± 32% which worsened over time. Peak cough expiratory flow decreased by 15.08 ± 32.43 L/min monthly. Five subjects reported 6 episodes of respiratory deterioration events, after a mean period of 136 ± 108 days. They had poor respiratory function and more years of disease. There was no difference in peak cough expiratory flow and its decline whether subjects presented respiratory deterioration events or not. In 4 subjects the respiratory discomfort score significantly worsened after respiratory deterioration events from 3.0 ± 1.41 to 4.25 ± 1.71. Conclusion: Daily self‐monitoring of peak cough expiratory flow, oxygen saturation and respiratory discomfort seems difficult to obtain because of poor adherence to measures; this protocol does not seem to add anything to current practice of advising on clinical derangements. Confirmatory larger studies are necessary. Resumo: Antecedentes: A disfunção na capacidade de tosse está associada a um elevado risco de complicações pulmonares nos doentes com esclerose lateral amiotrófica, quando

  9. An investigation into the stability and sterility of citric acid solutions used for cough reflex testing.

    Science.gov (United States)

    Falconer, James R; Wu, Zimei; Lau, Hugo; Suen, Joanna; Wang, Lucy; Pottinger, Sarah; Lee, Elaine; Alazawi, Nawar; Kallesen, Molly; Gargiulo, Derryn A; Swift, Simon; Svirskis, Darren

    2014-10-01

    Citric acid is used in cough reflex testing in clinical and research settings to assess reflexive cough in patients at risk of swallowing disorders. To address a lack of knowledge in this area, this study investigated the stability and sterility of citric acid solutions. Triplicate solutions of citric acid (0.8 M) in isotonic saline were stored at 4 ± 2 °C for up to 28 days and analysed by high-performance liquid chromatography. Microbiological sterility of freshly prepared samples and bulk samples previously used for 2 weeks within the hospital was determined using a pour plate technique. Microbial survival in citric acid was determined by inoculating Staphylococcus aureus, Escherichia coli, or Candida albicans into citric acid solution and monitoring the number of colony-forming units/mL over 40 min. Citric acid solutions remained stable at 4 °C for 28 days (98.4 ± 1.8 % remained). The freshly prepared and clinical samples tested were sterile. However, viability studies revealed that citric acid solution allows for the survival of C. albicans but not for S. aureus or E. coli. The microbial survival study showed that citric acid kills S. aureus and E. coli but has no marked effect on C. albicans after 40 min. Citric acid samples at 0.8 M remained stable over the 4-week testing period, with viable microbial cells absent from samples tested. However, C. albicans has the ability to survive in citric acid solution if inadvertently introduced in practice. For this reason, in clinical and research practice it is suggested to use single-use aliquots prepared aseptically which can be stored for up to 28 days at 4 °C.

  10. Motor degradation prediction methods

    International Nuclear Information System (INIS)

    Arnold, J.R.; Kelly, J.F.; Delzingaro, M.J.

    1996-01-01

    Motor Operated Valve (MOV) squirrel cage AC motor rotors are susceptible to degradation under certain conditions. Premature failure can result due to high humidity/temperature environments, high running load conditions, extended periods at locked rotor conditions (i.e. > 15 seconds) or exceeding the motor's duty cycle by frequent starts or multiple valve stroking. Exposure to high heat and moisture due to packing leaks, pressure seal ring leakage or other causes can significantly accelerate the degradation. ComEd and Liberty Technologies have worked together to provide and validate a non-intrusive method using motor power diagnostics to evaluate MOV rotor condition and predict failure. These techniques have provided a quick, low radiation dose method to evaluate inaccessible motors, identify degradation and allow scheduled replacement of motors prior to catastrophic failures

  11. Identifying asthma and chronic obstructive pulmonary disease in patients with persistent cough presenting to general practitioners : descriptive study

    NARCIS (Netherlands)

    Thiadens, HA; de Bock, GH; Deker, FW; Huysman, JAN; Springer, MP; Postma, DS

    1998-01-01

    Objective: To determine the prevalence of asthma and chronic obstructive pulmonary disease in patients not known to have these disorders, who present in general practice with persistent cough, and to ascertain criteria to help general practitioners in diagnosis. Design: Descriptive study. Setting:

  12. Evaluation of microbial and physico-chemical qualities of some cough syrups marketed in Sana’a city, Yemen.

    Directory of Open Access Journals (Sweden)

    Ali G. Al−Kaf

    2015-08-01

    Full Text Available Context: Microbial contamination of cough syrups can bring clinical hazards to the users or patients as well as physical and chemical changes in the product. Aims: To evaluate the microbial and physicochemical characteristics of two hundred samples of four different types of cough syrups marketed in Sana’a city, Yemen. Methods: All collected samples were subjected to the following examinations: the total microbial count, type of isolated microorganisms, physical parameters, and concentration of active ingredients were identified and assessed by standard techniques described in US Pharmacopeia. Results: All the cough syrup samples used contained viable microbial load within acceptable limit according Pharmacopeia specifications. Bacillus subtilis, Micrococcus fulvum, and Staphylococcus epidermidis were the most commonly recovered bacteria. However, Aspergillus niger, Aspergillus fumigatus, Penicillium notatum, Mucor sp., and Aspergillus flavus were the most fungi isolated. The physical properties represented in the appearance, density, and pH of the analyzed samples complied with Pharmacopoeia standards. The concentrations of diphenhydramine HCl (92,51 – 108,78%, pseudoephedrine HCl (94,55 – 109,07%, and triprolidine HCl (98,20 – 104,19% were recorded. Conclusions: All cough syrups marketed in Sana’a City had good microbiological and physico-chemical qualities.

  13. Effects of safety warnings on prescription rates of cough and cold medicines in children below 2 years of age

    NARCIS (Netherlands)

    E.F. Sen (Fatma); K.M.C. Verhamme (Katia); M. Felisi (Mariagrazia); G.W. 't Jong (Geert); C. Giaquinto (Carlo); G. Picelli (Gino); A. Ceci (Adriana); M.C.J.M. Sturkenboom (Miriam)

    2011-01-01

    textabstractAIM: The aim of the study was to assess the influence of national and international warnings on the prescription rates of cough and cold medicines (CCMs) in the youngest children (<2 years) in the Netherlands and Italy. METHODS: Analysis of outpatient electronic medical records of

  14. A randomized placebo controlled trial to evaluate the effects of butamirate and dextromethorphan on capsaicin induced cough in healthy volunteers.

    Science.gov (United States)

    Faruqi, Shoaib; Wright, Caroline; Thompson, Rachel; Morice, Alyn H

    2014-12-01

    The examination of cough reflex sensitivity through inhalational challenge can be utilized to demonstrate pharmacological end points. Here we compare the effect of butamirate, dextromethorphan and placebo on capsaicin-induced cough in healthy volunteers. In this randomized, placebo-controlled, six way crossover study the effect of dextromethrophan 30 mg, four doses of butamirate and placebo was evaluated on incremental capsaicin challenges performed at baseline and 2, 4, 6, 8, 12 and 24 h following dosing. The primary end point was the area under the curve (AUC(0,12h)) of log10 C5 from pre-dose to 12 h after dosing. Plasma butamirate metabolites were analyzed to evaluate pharmacokinetic and pharmacodynamic relationships. Thirty-four subjects (13 males, median age 25 years) completed the study. Cough sensitivity decreased from baseline in all arms of the study. Dextromethorphan was superior to placebo (P = 0.01) but butamirate failed to show significant activity with maximum attenuation at the 45 mg dose. There was no apparent relationship between pharmacokinetic and pharmacodynamic parameters for butamirate. We have demonstrated for the first time that dextromethorphan attenuates capsaicin challenge confirming its broad activity on the cough reflex. The lack of efficacy of butamirate could be due to formulation issues at higher doses. © 2014 The British Pharmacological Society.

  15. Exhaled breath condensate pH and cysteinyl leukotriens in patients with chronic cough secondary to acid gastroesophageal reflux.

    Science.gov (United States)

    Heffler, Enrico; Crimi, Claudia; Brussino, Luisa; Nicola, Stefania; Sichili, Stefania; Dughera, Luca; Rolla, Giovanni; Crimi, Nunzio

    2016-12-22

    Chronic cough is one of the most common clinical problems and it may be secondary to different stimuli and diseases, including low-level physical and chemical stimulation of the esophageal-bronchial reflex, suggestive of cough-reflex hyperresponsiveness, in patients with gastroesophageal reflux; however, it is still debated whether gastroesophageal reflux could induce airway inflammation and acidification. The aim of this study was to investigate airway pH and cysteynil-leukotrienes (Cys-LTs) concentration (a marker of airway inflammation) in exhaled breath condensate (EBC). Patients with chronic cough and for which all known causes, excluding gastroesophageal reflux, had been investigated and ruled out, were enrolled in the study. All patients underwent 24 h pH monitoring, and EBC was collected to assess pH and Cys-LTs concentration. Forty-five patients were included in the study and those with gastroesophageal reflux had significantly lower EBC-pH and higher concentration of EBC-Cys-LTs. There was a linear inverse correlation between EBC-pH values and EBC-Cys-LTs logarithmically transformed, and a multivariate analysis confirmed that the only significant determinat variable of EBC-Cys-LTs was the presence of gastroesophageal reflux. This study adds knowledge on possible mechanisms related to chronic cough associated with gastroesophageal reflux, which seems to be strictly dependent on airway acidification and the production of Cys-LTs, therefore suggesting an underlying neurogenic inflammation with tachykinins involvement.

  16. Clinical Effects and Safety of Zhi Sou San for Cough: A Meta-Analysis of Randomized Trials

    Directory of Open Access Journals (Sweden)

    Ningchang Cheng

    2017-01-01

    Full Text Available Introduction. Zhi Sou San (ZSS, a traditional Chinese prescription, has been widely applied in treating cough. The purpose of this meta-analysis was to evaluate the effectiveness and safety of ZSS for cough. Methods. We searched relevant articles up to 5 March 2017 in seven electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL, MEDLINE, PubMed, Chinese National Knowledge Infrastructure (CNKI, Cqvip Database (VIP, China Biology Medicine disc (CBM, and Wanfang Data. Randomized controlled trials (RCTs were eligible, regardless of blinding. The primary outcome was the total effective rate. Results. Forty-six RCTs with a total of 4007 participants were identified. Compared with western medicine, ZSS significantly improved the total effective rate (OR: 4.45; 95% CI: 3.62–5.47 and the pulmonary function in terms of FEV1 (OR: 0.35; 95% CI: 0.24–0.46 and decreased the adverse reactions (OR: 0.05; 95% CI: 0.02–0.01 and the recurrence rate (OR: 0.30; 95% CI: 0.16–0.57. However, there was no significant improvement in the cough symptom score comparing ZSS with western medicine. Conclusions. This meta-analysis shows that ZSS has significant additional benefits and relative safety in treating cough. However, more rigorously designed investigations and studies, with large sample sizes, are needed because of the methodological flaws and low quality of the included trials in this meta-analysis.

  17. Cryogenic Electric Motor Tested

    Science.gov (United States)

    Brown, Gerald V.

    2004-01-01

    Technology for pollution-free "electric flight" is being evaluated in a number of NASA Glenn Research Center programs. One approach is to drive propulsive fans or propellers with electric motors powered by fuel cells running on hydrogen. For large transport aircraft, conventional electric motors are far too heavy to be feasible. However, since hydrogen fuel would almost surely be carried as liquid, a propulsive electric motor could be cooled to near liquid hydrogen temperature (-423 F) by using the fuel for cooling before it goes to the fuel cells. Motor windings could be either superconducting or high purity normal copper or aluminum. The electrical resistance of pure metals can drop to 1/100th or less of their room-temperature resistance at liquid hydrogen temperature. In either case, super or normal, much higher current density is possible in motor windings. This leads to more compact motors that are projected to produce 20 hp/lb or more in large sizes, in comparison to on the order of 2 hp/lb for large conventional motors. High power density is the major goal. To support cryogenic motor development, we have designed and built in-house a small motor (7-in. outside diameter) for operation in liquid nitrogen.

  18. Hybrid vehicle motor alignment

    Science.gov (United States)

    Levin, Michael Benjamin

    2001-07-03

    A rotor of an electric motor for a motor vehicle is aligned to an axis of rotation for a crankshaft of an internal combustion engine having an internal combustion engine and an electric motor. A locator is provided on the crankshaft, a piloting tool is located radially by the first locator to the crankshaft. A stator of the electric motor is aligned to a second locator provided on the piloting tool. The stator is secured to the engine block. The rotor is aligned to the crankshaft and secured thereto.

  19. Help-seeking and antibiotic prescribing for acute cough in a Chinese primary care population: a prospective multicentre observational study.

    Science.gov (United States)

    Wong, Carmen Ka Man; Liu, Zhaomin; Butler, Chris C; Wong, Samuel Yeung Shan; Fung, Alice; Chan, Dicken; Yip, Benjamin Hon Kei; Kung, Kenny

    2016-01-21

    Acute cough is a common reason to prescribe antibiotics in primary care. This study aimed to explore help-seeking and antibiotic prescribing for acute cough in Chinese primary care population. This is a prospective multicentre observational study that included adults presenting with acute cough. Clinicians recorded patients' presenting symptoms, examination findings and medication prescription. Patients completed symptom diaries for up to 28 days by charting their symptom severity and recovery. Adjusted binary logistic regression models identified factors independently associated with antibiotic prescription. Primary care clinicians (n=19) recruited 455 patients. A total of 321 patients (70.5%) returned their completed symptom diaries. Concern about illness severity (41.6%) and obtaining a prescription for symptomatic medications (45.9%), rather than obtaining a prescription for antibiotics, were the main reasons for consulting. Antibiotics were prescribed for 6.8% (n=31) of patients, of which amoxicillin was the most common antimicrobial prescribed (61.3%), as it was associated with clinicians' perception of benefit from antibiotic treatment (odds ratio (OR): 25.9, 95% confidence interval (CI): 6.7-101.1), patients' expectation for antibiotics (OR: 5.1, 95% CI: 1.7-11.6), anticipation (OR: 5.1, 95% CI: 1.6-15.0) and request for antibiotics (OR 15.7, 95% CI: 5.0-49.4), as well as the severity of respiratory symptoms (cough, sputum, short of breath and wheeze OR: 2.7-3.7, all Pantibiotic prescription rates between private primary care clinicians and public primary care clinicians (17.4 vs 1.6%, P=0.00). Symptomatic medication was prescribed in 98.0% of patients. Mean recovery was 9 days for cough and 10 days for all symptoms, which was not significantly associated with antibiotic treatment. Although overall antibiotic-prescribing rates were low, there was a higher rate of antibiotic prescribing among private primary care clinicians, which warrants further

  20. Economic decision-making compared with an equivalent motor task.

    Science.gov (United States)

    Wu, Shih-Wei; Delgado, Mauricio R; Maloney, Laurence T

    2009-04-14

    There is considerable evidence that human economic decision-making deviates from the predictions of expected utility theory (EUT) and that human performance conforms to EUT in many perceptual and motor decision tasks. It is possible that these results reflect a real difference in decision-making in the 2 domains but it is also possible that the observed discrepancy simply reflects typical differences in experimental design. We developed a motor task that is mathematically equivalent to choosing between lotteries and used it to compare how the same subject chose between classical economic lotteries and the same lotteries presented in equivalent motor form. In experiment 1, we found that subjects are more risk seeking in deciding between motor lotteries. In experiment 2, we used cumulative prospect theory to model choice and separately estimated the probability weighting functions and the value functions for each subject carrying out each task. We found no patterned differences in how subjects represented outcome value in the motor and the classical tasks. However, the probability weighting functions for motor and classical tasks were markedly and significantly different. Those for the classical task showed a typical tendency to overweight small probabilities and underweight large probabilities, and those for the motor task showed the opposite pattern of probability distortion. This outcome also accounts for the increased risk-seeking observed in the motor tasks of experiment 1. We conclude that the same subject distorts probability, but not value, differently in making identical decisions in motor and classical form.

  1. Interpretation of positive results of a methacholine inhalation challenge and 1 week of inhaled bronchodilator use in diagnosing and treating cough-variant asthma.

    Science.gov (United States)

    Irwin, R S; French, C T; Smyrnios, N A; Curley, F J

    1997-09-22

    In diagnosing cough due to asthma, methacholine chloride inhalation challenge (MIC) interpreted in a traditional fashion has been shown to have positive predictive values from 60% to 82%. To determine whether any features of positive results of an MIC or the results of a 1-week trial of inhaled beta-agonist therapy were helpful in predicting when the cough was due to asthma. The study design was a prospective, randomized, double-blind, placebo-controlled, crossover format performed in adult, nonsmoking subjects, who were referred for diagnosis and treatment of chronic cough. The subjects had no other respiratory complaints or medical conditions for which they were taking medications, the results of baseline spirometry and chest roentgenograms were normal, and the results of MIC were positive. After obtaining baseline data, including MICs on 2 separate days, objective cough counting, and self-assessment of cough severity using a visual analog scale, subjects were randomized to receive 2 inhalations (1.3 mg) of metaproterenol sulfate or placebo by metered dose inhaler attached to a spacer device every 4 hours while awake. At 1 week, data identical to baseline were collected, and subjects received the other metered dose inhaler for 7 days. At 1 week, data identical to baseline were collected. After completion of the protocol, subjects were followed up in the clinic to observe the final response of the cough to specific therapy. Based on the disappearance of the cough with specific therapy, the cough was due to asthma in 9 of 15 subjects and nonasthma in 6 of 15 subjects. Baseline data were similar between groups. With respect to MICs, there were no significant differences between groups in the cumulative dose of methacholine that provoked a 20% decrease in forced expiratory volume in 1 second from the postsaline baseline value (PD20 values), slopes of dose-response curves, and maximal-response plateaus. Cough severity significantly improved after 1 week of

  2. Motor network structure and function are associated with motor performance in Huntington's disease.

    Science.gov (United States)

    Müller, Hans-Peter; Gorges, Martin; Grön, Georg; Kassubek, Jan; Landwehrmeyer, G Bernhard; Süßmuth, Sigurd D; Wolf, Robert Christian; Orth, Michael

    2016-03-01

    In Huntington's disease, the relationship of brain structure, brain function and clinical measures remains incompletely understood. We asked how sensory-motor network brain structure and neural activity relate to each other and to motor performance. Thirty-four early stage HD and 32 age- and sex-matched healthy control participants underwent structural magnetic resonance imaging (MRI), diffusion tensor, and intrinsic functional connectivity MRI. Diffusivity patterns were assessed in the cortico-spinal tract and the thalamus-somatosensory cortex tract. For the motor network connectivity analyses the dominant M1 motor cortex region and for the basal ganglia-thalamic network the thalamus were used as seeds. Region to region structural and functional connectivity was examined between thalamus and somatosensory cortex. Fractional anisotropy (FA) was higher in HD than controls in the basal ganglia, and lower in the external and internal capsule, in the thalamus, and in subcortical white matter. Between-group axial and radial diffusivity differences were more prominent than differences in FA, and correlated with motor performance. Within the motor network, the insula was less connected in HD than in controls, with the degree of connection correlating with motor scores. The basal ganglia-thalamic network's connectivity differed in the insula and basal ganglia. Tract specific white matter diffusivity and functional connectivity were not correlated. In HD sensory-motor white matter organization and functional connectivity in a motor network were independently associated with motor performance. The lack of tract-specific association of structure and function suggests that functional adaptation to structural loss differs between participants.

  3. Infrared thermography application on predictive maintenance for exhaust fan motor

    International Nuclear Information System (INIS)

    I Wayan Widiana; Jakaria; Artadi Heru; Mulyono

    2013-01-01

    To determine the condition of the exhaust fan motor in terms of heat dissipation, predictive maintenance needs to be done. One way is to use infrared thermography. The method used is an infrared thermography with qualitative technique which the analysis focused on the distribution patterns of heat captured by the infrared camera. From measurement results expected to be obtained data of the heat distribution occurs in the motor exhaust fan so it can be given treatment or further improvements recommendations to avoid failure of the operation. Results of measurements on the motor</