WorldWideScience

Sample records for cough reflex sensitivity

  1. Effect of guaifenesin on cough reflex sensitivity.

    Science.gov (United States)

    Dicpinigaitis, Peter V; Gayle, Yvonne E

    2003-12-01

    Guaifenesin, a commonly used agent for the treatment of cough, is termed an expectorant since it is believed to alleviate cough discomfort by increasing sputum volume and decreasing its viscosity, thereby promoting effective cough. Despite its common usage, relatively few studies, yielding contrasting results, have been performed to investigate the action and efficacy of guaifenesin. To evaluate the effect of guaifenesin on cough reflex sensitivity. Randomized, double-blind, placebo-controlled trial. Academic medical center. Fourteen subjects with acute viral upper respiratory tract infection (URI) and 14 healthy volunteers. On 2 separate days, subjects underwent capsaicin cough challenge 1 to 2 h after receiving a single, 400-mg dose (capsules) of guaifenesin or matched placebo. The concentration of capsaicin inducing five or more coughs (C(5)) was determined. Among subjects with URI, mean (+/- SEM) log C(5) after guaifenesin and placebo were 0.92 +/- 0.17 and 0.66 +/- 0.14, respectively (p = 0.028). No effect on cough sensitivity was observed in healthy volunteers. Our results demonstrate that guaifenesin inhibits cough reflex sensitivity in subjects with URI, whose cough receptors are transiently hypersensitive, but not in healthy volunteers. Possible mechanisms include a central antitussive effect, or a peripheral effect by increased sputum volume serving as a barrier shielding cough receptors within the respiratory epithelium from the tussive stimulus.

  2. Cough reflex sensitization from esophagus and nose.

    Science.gov (United States)

    Hennel, Michal; Brozmanova, Mariana; Kollarik, Marian

    2015-12-01

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

  3. Effect of Guaifenesin on Cough Reflex Sensitivity

    National Research Council Canada - National Science Library

    Peter V. Dicpinigaitis; Yvonne E. Gayle

    2003-01-01

    Background: Guaifenesin, a commonly used agent for the treatment of cough, is termed an expectorant since it is believed to alleviate cough discomfort by increasing sputum volume and decreasing its viscosity...

  4. Cough reflex sensitivity in adolescents with diabetic autonomic neuropathy

    OpenAIRE

    2009-01-01

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

  5. Cough reflex sensitivity in adolescents with diabetic autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Ciljakova M

    2009-12-01

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

  6. Inhibition of cough-reflex sensitivity by benzonatate and guaifenesin in acute viral cough.

    Science.gov (United States)

    Dicpinigaitis, Peter V; Gayle, Yvonne E; Solomon, Gail; Gilbert, Richard D

    2009-06-01

    Acute cough due to viral upper respiratory tract infection (URI) is the most common form of cough and accounts for tremendous expenditure on prescription and non-prescription cough products worldwide. However, few agents have been shown in properly conducted clinical trials to be effective for cough due to URI. The present study evaluated the effect of benzonatate 200mg (B), guaifenesin 600 mg (G), their combination (B+G), and placebo (P) on capsaicin-induced cough in 30 adult nonsmokers with acute URI. On 3 separate days within a 7-day period, 1h after ingesting randomly assigned study drug in a double-blind fashion, subjects underwent capsaicin cough challenge testing, which involved inhalation of incremental doubling concentrations of capsaicin until the concentration of capsaicin inducing 5 or more coughs (C(5)) was attained. Each subject received 3 of 4 possible study drugs. G (p=0.01) but not B (p=NS) inhibited cough-reflex sensitivity (log C(5)) relative to P. The combination of B+G suppressed capsaicin-induced cough to a greater degree than B alone (p<0.001) or G alone (p=0.008). The mechanism by which the combination of B+G causes a potentiation of antitussive effect remains to be elucidated. Our results suggest that B+G may be an effective therapy for acute cough due to the common cold (URI).

  7. Effects of pirfenidone on increased cough reflex sensitivity in guinea pigs.

    Science.gov (United States)

    Okazaki, Akihito; Ohkura, Noriyuki; Fujimura, Masaki; Katayama, Nobuyuki; Kasahara, Kazuo

    2013-10-01

    Pirfenidone, an antifibrotic drug with anti-inflammatory and antioxidant effects, delays fibrosis in idiopathic pulmonary fibrosis (IPF). Patients with IPF have a greater cough reflex sensitivity to inhaled capsaicin than healthy people, and cough is an independent predictor of IPF disease progression; however, the effects of pirfenidone on cough reflex sensitivity are unknown. After challenge with an aerosolized antigen in actively sensitized guinea pigs, pirfenidone was administered intraperitoneally, and the cough reflex sensitivity was measured at 48 h after the challenge. Bronchoalveolar lavage (BAL) was performed, and the tracheal tissue was collected. Pirfenidone suppressed the capsaicin-induced increase in cough reflex sensitivity in a dose-dependent manner. Additionally, increased levels of prostaglandin E2, substance P, and leukotriene B4, but not histamine, in the BAL fluid were dose dependently suppressed by pirfenidone. The decrease in neutral endopeptidase activity in the tracheal tissue was also alleviated by pirfenidone treatment. The total number of cells and components in the BAL fluid was not influenced. These results suggest that pirfenidone ameliorates isolated cough based on increased cough reflex sensitivity associated with allergic airway diseases, and potentially relieve chronic cough in IPF patients who often have increased cough reflex sensitivity. Prospective studies on cough-relieving effects of pirfenidone in patients with IPF are therefore warranted.

  8. Effect of tobacco and electronic cigarette use on cough reflex sensitivity.

    Science.gov (United States)

    Dicpinigaitis, Peter V

    2017-02-06

    Multiple previous studies have shown that otherwise healthy tobacco cigarette smokers have suppressed cough reflex sensitivity compared with nonsmokers and furthermore, that smoking cessation, even after years of tobacco use, leads to prompt enhancement of cough reflex sensitivity. Thus, cough reflex sensitivity is demonstrated to be a dynamic phenomenon, responding to the presence or absence of influences such as tobacco smoke. These studies, however, were unable to identify whether it was the influence of nicotine, or one or more of the numerous components of tobacco cigarette smoke, that were responsible for this effect. More recently, it has been shown that a single exposure to electronic cigarette (e-cig) vapor causes inhibition of cough reflex sensitivity in healthy lifetime nonsmokers. An identical study employing a non-nicotine containing e-cig confirmed an absence of effect on cough reflex sensitivity, thus implicating nicotine as the causative agent of these findings. Recent animal studies demonstrate cough suppression after injection of nicotine into the brains of cats, thus supporting a centrally-mediated antitussive effect of nicotine to explain the results of the aforementioned studies of tobacco smoke and e-cig vapor exposure in humans. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Cough and expiration reflexes elicited by inhaled irritant gases are intensified in ovalbumin-sensitized mice.

    Science.gov (United States)

    Zhang, Cheng; Lin, Ruei-Lung; Hong, Jeff; Khosravi, Mehdi; Lee, Lu-Yuan

    2017-05-01

    This study was designed to determine the effect of active sensitization with ovalbumin (Ova) on cough responses to inhaled irritant gases in mice. Conscious mice moved freely in a recording chamber, while the pressure change in the chamber and audio and video signals of the mouse movements were recorded simultaneously to measure the frequencies of cough reflex (CR) and expiration reflex (ER). To further verify the accuracy of cough analysis, the intrapleural pressure was also recorded by a telemetry sensor surgically implanted in the intrapleural space in a subgroup of mice. During the irritant gas inhalation challenge, sulfur dioxide (SO2; 200 and 400 ppm) or ammonia (NH3; 0.1% and 0.2%) was drawn into the chamber at a constant flow rate for 8 min. Ova sensitization and sham sensitization with vehicle (Veh) were performed over a 25-day period in separate groups of mice. Our results showed that 1) both SO2 and NH3 inhalation challenges increased CR and ER frequencies in a concentration-dependent manner before Ova sensitization; 2) the baseline CR frequency was significantly elevated after Ova sensitization, accompanied by pronounced airway inflammation; and 3) Ova sensitization also markedly augmented the responses of CR and ER to both SO2 and NH3 inhalation challenges; in sharp contrast, the cough responses did not change after sham sensitization in the Veh group. In conclusion, Ova sensitization caused distinct and lingering increases in baseline cough frequency, and also intensified both CR and ER responses to inhaled irritant gases, which probably resulted from an allergic inflammation-induced hypersensitivity of airway sensory nerves. Copyright © 2017 the American Physiological Society.

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

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 赖克方; 罗炜; 钟南山

    2008-01-01

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

  11. Impact of air pollution on age and gender related increase in cough reflex sensitivity of healthy children in Slovakia.

    Directory of Open Access Journals (Sweden)

    Silvia eDemoulin-Alexikova

    2016-02-01

    Full Text Available Background. Numerous studies show higher cough reflex sensitivity (CRS and cough outcomes in children compared to adults and in females compared to males. Despite close link that exists between cough and environment the potential influence of environmental air pollution on age- and gender -related differences in cough has not been studied yet. Purpose. The purpose of our study was to analyse whether the effects of exposure to environmental tobacco smoke (ETS from parental smoking and PM10 from living in urban area are implied in age- and gender-related differences in cough outcomes of healthy, non asthmatic children. Assessment of CRS using capsaicin and incidence of dry and wet cough was performed in 290 children (mean age 13.3±2.6 yrs (138 females/152 males.Results. CRS was significantly higher in girls exposed to ETS [22.3 μmol/l (9.8 – 50.2 μmol/l] compared to not exposed girls [79.9 μmol/l (56.4 – 112.2 μmol/l, p=0.02] as well as compared to exposed boys [121.4 μmol/l (58.2 – 253.1 μmol/l, p=0.01]. Incidence of dry cough lasting more than 3 weeks was significantly higher in exposed compared to not exposed girls. CRS was significantly higher in school-aged girls living in urban area [22.0 μmol/l (10.6 – 45.6 μmol/l] compared to school-aged girls living in rural area [215.9 μmol/l (87.3 – 533.4 μmol/l; p=0.003], as well as compared to teenage girls living in urban area [108.8 μmol/l (68.7 – 172.9 μmol/l; p=0.007]. No CRS differences were found between urban and rural boys when controlled for age group. No CRS differences were found between school-aged and teenage boys when controlled for living area. Conclusions. Our results have shown that the effect of ETS on CRS was gender specific, linked to female gender and the effect of PM10 on CRS was both gender and age specific, related to female gender and school-age. We suggest that age and gender related differences in incidence of cough and CRS might be, at least

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

    Science.gov (United States)

    Canning, Brendan J; Mori, Nanako

    2011-02-01

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

  13. Study of oral care on improving cough reflex sensitivity of recurrent pneumonia patients%口腔护理提高再发肺炎患者咳嗽反射敏感性的研究

    Institute of Scientific and Technical Information of China (English)

    韩则政; 刘慧; 方燕红; 程爱红; 赵欢欢; 余红梅; 吴长蓉

    2009-01-01

    Objective To explore the effects of oral care on improving cough reflex sensitivity and prolonging time span of recurrent pneumonia. Methods Oral care was conducted among 19 pateints with recurrent pneumonia. Using capsaicin-induced cough reflex method, cough reflex thresholds were measured in 19 patients with recurrent pneumonia before the study began, at the 20th day and the twelfth month after the study began. The recorrent time spans were recorded before and after the oral care at the same time. Results Cough reflex threshold was (1.54±0.06) mmol at the 20th day after the oral care began, which was significantly lower than (2.13±0.05) mmol before the the oral care began (P0.05). Pneumonia recurrent time span (210±54)days was significandy longer after performing the oral care than that (143±71)days of before performing the oral care (P0.05);口腔护理后肺炎再发间隔时间为(210±54)d,显著长于口腔护理前的(143±71)d(P<0.05).结论 口腔护理可以提高再发肺炎患者咳嗽反射的敏感性,延长肺炎再发的间隔时间.

  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

    Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced......'s criteria for multiple chemical sensitivity and 15 eczema patients with airway symptoms elicited by odorous chemicals were compared with 29 age-matched, healthy controls. We measured C5--the capsaicin concentration causing five coughs or more--using the single breath inhalation test. No difference was found...

  15. 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...

  16. 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.

  17. Antioxidant activity of herbal polysaccharides and cough reflex.

    Science.gov (United States)

    Nosalova, G; Jurecek, L; Hromadkova, Z; Kostalova, Z; Sadlonova, V

    2013-01-01

    The extraction of Fallopia sachalinensis leaves resulted in two fractions (FS-1 and FS-2). Chemical and spectral analyses of samples revealed the prevalence of pectic polysaccharides with high galacturonic acid, arabinose, galactose, and rhamnose content. Arabinogalactan with a higher content of phenolic prevailed in the FS-1, whereas rhamnogalacturonan predominated in the FS-2 fraction. Both polysaccharides showed significant antioxidant activity according to DPPH and FRAP assays. Evaluation of antitussive activity in healthy adult conscious guinea pigs after oral application of 50 and 75 mg/kg of the FS-2 polysaccharide extracts showed a significant suppression of cough reflex, without an influence on specific airway resistance. The suppression of cough was comparable with that of codeine.

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

    OpenAIRE

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

    2002-01-01

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

  19. Provocation of aspiration reflexes and their effects on the pattern of cough and reflex apnea in cats.

    Science.gov (United States)

    Poliacek, I; Tomori, Z; Simera, M; Barani, H; Visnovcova, N; Halasova, E; Donic, V; Jakus, J

    2009-11-01

    Aspiration reflexes (AspRs) manifesting as reflex spasmodic inspirations and their effects on motor pattern of tracheobronchial cough and reflex apnea were studied on 22 spontaneously breathing pentobarbitone-anesthetized cats. AspRs induced during cough inspiration enhanced peak inspiratory (P<0.01) and expiratory (P<0.02) esophageal pressures, amplitudes of diaphragm (P<0.01) and abdominal muscles (P<0.05) EMG activity, and prolonged the entire expiratory period (P<0.01) and total cycle duration (P<0.05) of cough. Transient inhibitions and splits of cough expiration frequently occurred with AspR within active cough expiratory period; however, cough spatiotemporal characteristics were not altered significantly. Sub-threshold nasopharyngeal stimulation failing to provoke AspR had no significant effects on coughing. Hering-Breuer inflation apnea was moderately prolonged by AspRs (20%; P<0.05), unlike the apnea produced by continual mechanical laryngeal stimulation. AspRs are inducible during tested behaviors interacting with their motor pattern. Central mechanisms involving pulmonary stretch receptor stimulation is suggested for modulation of cough and inflation apnea by AspR.

  20. 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.

  1. Cough

    Science.gov (United States)

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

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

    OpenAIRE

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

    2011-01-01

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

  3. Effect of carbocysteine on cough reflex to capsaicin in asthmatic patients.

    Science.gov (United States)

    Ishiura, Yoshihisa; Fujimura, Masaki; Yamamori, Chihiro; Nobata, Kouichi; Myou, Shigeharu; Kurashima, Kazuyoshi; Michishita, Yasukatsu; Takegoshi, Tadayoshi

    2003-06-01

    Cough, one of the main symptoms of bronchial asthma, is a chronic airway inflammatory disease with functionally damaged bronchial epithelium. Recently, we established an animal model with cough hypersensitivity after antigen challenge and clearly showed the protective effect of carbocysteine in this model. This study was designed to investigate the clinical effect of carbocysteine for cough sensitivity in patients with bronchial asthma. The effects of the two orally active mucoregulatory drugs, carbocysteine and ambroxol hydrochloride, on cough response to inhaled capsaicin were examined in 14 patients with stable asthma. Capsaicin cough threshold, defined as the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough sensitivity. Geometric mean values of the cough threshold at run-in (baseline) and after 4 weeks' treatment of placebo, 1500 mg day-1 of carbocysteine and 45 mg day-1 of ambroxol hydrochloride were 12.8 micro M (95% confidence interval [CI] 5.5, 29.6), 11.0 micro M (95% CI 4.4, 27.5), 21.0 micro M (95% CI 8.8, 50.2) and 11.6 micro M (95% CI 5.8, 23.3), respectively. The cough threshold for carbocysteine was significantly greater than those of ambroxol hydrochloride (P = 0.047) and placebo (P = 0.047), respectively. These findings indicate that carbocysteine administration may be a novel therapeutic option for asthmatic patients, especially with cough variant asthma.

  4. 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.

  5. 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.

  6. Reversal of functional disorders by aspiration, expiration, and cough reflexes and their voluntary counterparts

    Science.gov (United States)

    Tomori, Zoltan; Donic, Viliam; Benacka, Roman; Gresova, Sona; Peregrim, Igor; Kundrik, Martin; Pallayova, Maria; Jakus, Jan

    2012-01-01

    Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation (VF), but it fails to revive infants with sudden infant death syndrome (SIDS). Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are two distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations (SIs) 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 SI 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 (ExpR), manifesting with prompt expiration without preceding inspiration. Stimulation of the oropharynx and lower airways provokes the cough reflex (CR) 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 SIs 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 (MIP and MEP) are voluntary counterparts of airway reflexes, and are useful for diagnosis and therapy of various cardio-respiratory and neuromuscular disorders. PMID:23248602

  7. 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.

  8. Olodaterol attenuates citric acid-induced cough in naive 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

  9. What Is Cough?

    Science.gov (United States)

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

  10. 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.

  11. 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.

  12. Cough

    Directory of Open Access Journals (Sweden)

    Keenleyside Georgina

    2006-01-01

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

  13. Cough reflex is additively potentiated by inputs from the laryngeal and tracheobronchial [corrected] receptors and enhanced by stimulation of the central respiratory neurons.

    Science.gov (United States)

    Kondo, Tetsuri; Hayama, Naoki

    2009-09-01

    The cough is an essential airway defense reflex. In this study we investigated the coordination of inputs from the laryngeal and tracheobronchial receptors in the cough reflex. In 15 beagle dogs (7-9 kg) lightly anesthetized with intravenous profobol (20-30 mg/kg/h), the cough response was elicited with mechanical stimulation of either the vocal chord or tracheal bifurcation. Simultaneous stimulation of both sites increased all the parameters of cough strength, that is, mean pleural pressure (P (pl)), mean expiratory flow, number of cough bouts, and cough duration, in comparison with stimulation of the sites individually. The increases in mean P (pl) and cough duration reached statistical significance (13.3 vs. 18.4 cmH(2)O and 13.3 vs. 18.2 s, respectively). When the anesthetic level became deeper, the prolongation of cough duration almost disappeared, but the augmentation of mean P (pl) was much less affected. During stimulation of the central respiratory neurons by intravenous dimorphoramine or acute hyperoxic hypercapnia, the cough strength increased significantly. We concluded that inputs from the laryngeal and tracheobonchial cough receptors acted in concert and potentiated the cough reflex. Furthermore, stimulation of the central respiratory neurons may increase the intensity of a cough response.

  14. What is chronic cough in children?

    Directory of Open Access Journals (Sweden)

    Iulia eIOAN

    2014-08-01

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

  15. 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.

  16. Cough in obstructive sleep apnoea.

    Science.gov (United States)

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

    2015-12-01

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

  17. Management of chronic refractory cough.

    Science.gov (United States)

    Gibson, Peter G; Vertigan, Anne E

    2015-12-14

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

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

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 刘春丽; 罗炜; 赖克方; 钟南山

    2013-01-01

    Diseases between 2005 to 2010.Using a modified diagnostic algorithm of chronic cough,common causes were identified.Capsaicin cough provocation test was also performed in these patients to assess the cough threshold.The relations between cough reflex sensitivity and duration of cough,cough severity,pulmonary function,induced sputum cell counts were then investigated.Results Through the diagnostic algorithm of chronic cough,the current study evaluated 133 adult patients,including 24 cases with upper airway cough syndrome (UACS),26 patients with cough variant asthma (CVA),31 cases with eosinophilic bronchitis (EB),30 patients with atopic cough (AC),22 cases with gastroesophageal reflux induced cough (GERC).There were 30 healthy volunteers recruited as normal control.The cough threshold of LgC5 in AC,CVA,EB,GERC and UACS was 1.70 ± 0.70,2.12 ± 0.67,2.13 ± 0.69,1.69 ± 0.73,2.16 ± 0.66,respectively.The LgC5 of the normal group (2.63 ± 0.39) was higher than those in chronic cough groups (All P < 0.05).The LgC5 of AC and GERC were lower than CVA,EB and UACS (all P < 0.05).Duration and daytime score of cough showed positive correlations with LgC5 (r =-0.280,-0.168,all P < 0.05).Pulmonary function and differential cell count of induced sputum were not associated with LgC5 (all P > 0.05).Conclusions Different cause of chronic cough exhbit high cough reflex sensitivity to different extent.The difference of cough sensitivity may reflect the different pathogenesis among different causes,and may be related to the type of nerve fiber dominating the cough reflex.

  19. 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.

  20. 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...

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

    Science.gov (United States)

    Achilleos, Andreas

    2016-09-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  3. Cough suppression therapy: does it work?

    Science.gov (United States)

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

    2013-10-01

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

  4. Cough in Sarcoidosis.

    Science.gov (United States)

    Tully, Timothy; Birring, Surinder S

    2016-02-01

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

  5. Gastric sensitivity and reflexes: basic mechanisms underlying clinical problems.

    Science.gov (United States)

    Azpiroz, Fernando; Feinle-Bisset, Christine; Grundy, David; Tack, Jan

    2014-02-01

    Both reflex and sensory mechanisms control the function of the stomach, and disturbances in these mechanisms may explain the pathophysiology of disorders of gastric function. The objective of this report is to perform a literature-based critical analysis of new, relevant or conflicting information on gastric sensitivity and reflexes, with particular emphasis on the comprehensive integration of basic and clinical research data. The stomach exerts both phasic and tonic muscular (contractile and relaxatory) activity. Gastric tone determines the capacity of the stomach and mediates both gastric accommodation to a meal as well as gastric emptying, by partial relaxation or progressive recontraction, respectively. Perception and reflex afferent pathways from the stomach are activated independently by specific stimuli, suggesting that the terminal nerve endings operate as specialized receptors. Particularly, perception appears to be related to stimulation of tension receptors, while the existence of volume receptors in the stomach is uncertain. Reliable techniques have been developed to measure gastric perception and reflexes both in experimental and clinical conditions, and have facilitated the identification of abnormal responses in patients with gastric disorders. Gastroparesis is characterised by impaired gastric tone and contractility, whereas patients with functional dyspepsia have impaired accommodation, associated with antral distention and increased gastric sensitivity. An integrated view of fragmented knowledge allows the design of pathophysiological models in an attempt to explain disorders of gastric function, and may facilitate the development of mechanistically orientated treatments.

  6. Determination of cough sensitivities of patients with different causes of cough%不同病因咳嗽患者的咳嗽敏感性测定

    Institute of Scientific and Technical Information of China (English)

    张巧; 马千里; 龙舟; 黄赞胜; 唐咸军; 吴颖; 王长征

    2011-01-01

    Objective To study the sensitivities of patients with different causes of cough to capsaicin-stimulated cough and to investigate the clinical significance of capsaicin cough provocation test in diagnosis and treatment of different causes of cough. Methods We selected 169 patients with different causes of cough from the outpatients in Chongqing Xinqiao Hospital of Third Military Medical University, including upper airway cough syndrome (UACS) , cough variability asthma (CVA) , gastro-esophageal regurgitation cough (GERC) , cough after a cold, occupational irritant cough and angiotensin-converting enzyme inhibitor ( ACEI) -related cough. Thirty-eight healthy volunteers of our hospital were enrolled as controls. All the subjects were examined by capsaicin cough provocation test, and the results were analyzed to compare the differences of the qualitative (positive rate) and quantitative (log C2 and log C5) indices in different causes of cough. Results A total of 148 patients who were diagnosed as cough by different causes completed the study. Nearly half of the patients (47.4% , 18/38) in the normal control group were cough provocation positive. GERC group had the highest positive rate among the groups with different causes of cough, and the GERC group and cough after a cold group had a significant difference compared with the control group ( P 0.05 ) were not significantly different. Comparison of C2 values in different groups was similar to that of C5 values. According to the 95% confidence intervals of log C5 values, no overlap was detected between the normal control group and the GERC group and cough after a cold group, but there was some overlap between the normal control group and the CVA group. More overlaps were detected between the normal control group and the UACS group, occupational irritant cough group and ACEI-related cough group. Coclusion Cough sensitivities of patients with different causes ofcough are significantly different. Capsaicin cough

  7. Effects of phosphodiesterase 4 inhibitor on cough response in guinea pigs sensitized and challenged with ovalbumin

    Institute of Scientific and Technical Information of China (English)

    吕寒静; 邱忠民; 魏为利; 余莉; 刘瑞麟; 张敏

    2004-01-01

    Background There is currently considerable interest in the potential value of selective inhibitors of cyclic nucleotide phosphodiesterase 4 in the treatment of asthma. However, whether they influence eosinophilic airway inflammation-associated cough remains unclear. The objective of this study was to investigate the effects of selective phosphodiesterase 4 inhibitor SB207499 on cough response and airway inflammation in guinea pigs sensitized and challenged with ovalbumin. Methods Forty sensitized guinea pigs were randomly divided into four groups: control (n=10), challenge (n=10), SB207499 (n=10) and aminophylline (n=10), then challenged with aerosol of 1% ovalbumin or saline. Two hours later, animals were intraperitoneally injected with either saline, 25 mg/kg of SB207499 or aminophylline. At the 24th hour, the injection was repeated with 2.5 mg/kg and 25 mg/kg SB207499 or aminophylline, then cough response to inhaled capsaicin and airway responsiveness to methacholine inducing a 150% of the peak airway pressure to the baseline (PC150) was measured. Finally, total cell number and differentials in bronchoalveolar lavage fluid were analysed. Results The cough frequency per 3 minutes and PC150 in the challenge group were (22±4) times/3 minutes and (198±54) μg/ml, which were significantly different from (6±2) times/3 minutes and (691±81) μg/ml in the control group (P<0.05, respectively). The injection of 25 mg/kg SB207499 significantly inhibited the increased cough response and airway hyperresponsiveness, the cough frequency and PC150 in guinea pigs were (13±2) times/3 minutes and (680±81) μg/ml (P<0.05), which differed significantly from (18±2) times/3 minutes and (400±86) μg/ml after the administration of the same dose of aminophylline (P<0.05). The inhibition of SB207499 on cough response was dose-dependent. Similarly, SB207499 decreased the total cell number and percentage of eosinophils in bronchoalveolar lavage fluid to (2.1±0.5)×106/ml and (20±5

  8. The sensitivity of acoustic cough recording relative to intraesophageal pressure recording and patient report during reflux testing.

    Science.gov (United States)

    Rosen, R; Amirault, J; Heinz, N; Litman, H; Khatwa, U

    2014-11-01

    One of the primary indications for reflux testing with multichannel intraluminal impedance with pH (pH-MII) is to correlate reflux events with symptoms such as cough. Adult and pediatric studies have shown, using cough as a model, that patient report of symptoms is inaccurate. Unfortunately, intraesophageal pressure recording (IEPR) to record coughs is more invasive which limits its utility in children. The primary aim of this study was to validate the use of acoustic cough recording (ACR) during pH-MII testing. We recruited children undergoing pH-MII testing for the evaluation of cough. We simultaneously placed IEPR and pH-MII catheters and an ACR device in each patient. Each 24 h ACR, pH-MII, and IEPR tracing was scored by blinded investigators. Sensitivities for each method of symptom recording were calculated. A total of 2698 coughs were detected; 1140 were patient reported PR, 2425 were IEPR detected, and 2400 were ACR detected. The sensitivity of PR relative to ACR was 45.9% and the sensitivity of IEPR relative to ACR was 93.6%. There was strong inter-rater reliability (κ = 0.78) for the identification of cough by ACR. Acoustic recording is a non-invasive, sensitive method of recording cough during pH-MII testing that is well suited for the pediatric population. © 2014 John Wiley & Sons Ltd.

  9. The pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection

    OpenAIRE

    Florvaag, E.; Johansson, SGO

    2012-01-01

    The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody leve...

  10. The pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection

    OpenAIRE

    Florvaag, E.; Johansson, S. G. O.

    2012-01-01

    The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody leve...

  11. The Fontana paradoxical reflex?

    Science.gov (United States)

    Lavorini, Federico; Fontana, Giovanni; Chellini, Elisa; Magni, Chiara; Pistolesi, Massimo; Widdicombe, John

    2011-09-01

    This commentary describes the "deflation cough" caused by deep lung deflations. Deflation cough is a paradoxical reflex similar to that described by Henry Head in 1889 for lung inflations that probably is mediated by the same sensors and afferent fibers in the lungs and activated by gastroesophageal reflux. We discuss how this reflex must be self-limiting, the general role of paradoxical reflexes in the body, and the possible clinical significance of deflation cough.

  12. Assessment of antitussive efficacy of dextromethorphan in smoking related cough: objective vs. subjective measures

    Science.gov (United States)

    Ramsay, James; Wright, Caroline; Thompson, Rachel; Hull, David; Morice, Alyn H

    2008-01-01

    AIMS Using an established model of smokers cough we measured the antitussive effects of dextromethorphan compared with placebo. METHODS The study was a randomized, double-blind placebo controlled, crossover comparison of 22 mg 0.8 ml−1 dextromethorphan delivered pregastrically with matched placebo. Objective and subjective measurements of cough were recorded. Subjective measures included a daily diary record of cough symptoms and the Leicester quality of life questionnaire. Cough frequency was recorded using a manual cough counter. The objective measure of cough reflex sensitivity was the citric acid, dose–response cough challenge. RESULTS Dextromethorphan was significantly associated with an increase in the concentration of citric acid eliciting an average of two coughs/inhalation (C2) when compared with placebo, 1 h post dose by 0.49 mM (95% CI 0.05, 0.45, geometric mean 3.09) compared with placebo 0.24 mM (geometric mean 1.74) P < 0.05 and at 2 h 0.57 mM (95% CI 0.01, 0.43, geometric mean 3.75) compared with placebo 0.34 mM (geometric mean 2.19) P < 0.05). There was a highly significant improvement in the subjective data when compared with baseline. However, there was no significant difference between placebo and active treatment. No correlation was seen between cough sensitivity to citric acid and recorded cough counts or symptoms. When both subjective and objective data were compared with screening data there was evidence of a marked ‘placebo’ effect. CONCLUSIONS The objective measure of cough sensitivity demonstrates dextromethorphan effectively diminishes the cough reflex sensitivity. However, subjective measures do not support this. Other studies support these findings, which may represent a profound sensitivity of the cough reflex to higher influences. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Dextromethorphan is widely used as a cough suppressant in over the counter medications. Its efficacy in altering cough reflex sensitivity has been shown in

  13. Stretch sensitive reflexes as an adaptive mechanism for maintaining limb stability

    Science.gov (United States)

    Shemmell, Jonathan; Krutky, Matthew A.; Perreault, Eric J.

    2010-01-01

    The often studied stretch reflex is fundamental to the involuntary control of posture and movement. Nevertheless, there remains controversy regarding its functional role. Many studies have demonstrated that stretch reflexes can be modulated in a task appropriate manner. This review focuses on modulation of the long latency stretch reflex, thought to be mediated, at least in part, by supraspinal pathways. For example, this component of the stretch reflex increases in magnitude during interactions with compliant environments, relative to the sensitivity during interactions with rigid environments. This suggests that reflex sensitivity increases to augment limb stability when that stability is not provided by the environment. However, not all results support the stabilizing role of stretch reflexes. Some studies have demonstrated that involuntary responses within the time period corresponding to the long latency reflex can destabilize limb posture. We propose that this debate stems from the fact that multiple perturbation-sensitive pathways can contribute to the long latency stretch reflex and that these pathways have separate functional roles. The presented studies suggest that neural activity occurring within the period normally ascribed to the long latency stretch reflex is highly adaptable to current task demands and possibly should be considered more intelligent than “reflexive.” PMID:20434396

  14. Cough management: a practical approach

    OpenAIRE

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

    2011-01-01

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

  15. Cough management: a practical approach

    OpenAIRE

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

    2011-01-01

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

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

    Science.gov (United States)

    Hargreaves, M R; Benson, M K

    1995-01-07

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

  17. Whooping Cough

    Science.gov (United States)

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

  18. Cough Headaches

    Science.gov (United States)

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

  19. The Pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection.

    Science.gov (United States)

    Florvaag, E; Johansson, S G O

    2012-07-01

    : The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody levels and IgE by around 100-fold. PHO is monovalent for 2 non-cross-reacting epitopes the quaternary ammonium ion (QAI), the main allergenic epitope of NMBA, and a non-QAI epitope. Thus, PHO most unlikely would initiate an allergic inflammatory response. Consequently, IgE sensitization is not revealed by obvious clinical signs, neither through tests based on IgE-sensitized effector cells. Therefore, it will escape detection if not assayed serologically. However, when subjected to general anesthesia, and thus the IgE-sensitized individual is administered a bivalent NMBA intravenously, the unrecognized presence of serum IgE antibodies to QAI may increase the risk of anaphylaxis 200- to 300-fold. Severe damages to patient's health can result, and mortality rates of 3 to 10% are reported. The Scandinavian experience indicates that the chain of events can efficiently be avoided by stopping PHO exposure: Within 1 year, the prevalence of IgE sensitization to PHO and QAI decreases significantly, and after 2 to 3 years, the numbers of reported anaphylactic reactions decreases equally so.

  20. 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.

  1. Changes and implications of cough sensitivity in upper airway cough syndrome%上气道咳嗽综合征的咳嗽敏感性改变及其意义

    Institute of Scientific and Technical Information of China (English)

    王岚; 余莉; 邱志宏; 吕寒静; 邱忠民

    2012-01-01

    目的 探讨上气道咳嗽综合征咳嗽敏感性的改变和临床意义.方法 用辣椒素咳嗽敏感性试验检测94例上气道咳嗽综合征的咳嗽阈值C5,分析治疗后咳嗽阈值C5的改变.结果 94例上气道咳嗽综合征的辣椒素咳嗽阚值C5为3.9 (0.98,7.8)μmol/L,位于正常值范围,仅36例(36/94,38.30%)患者存在咳嗽高敏感性.经治疗咳嗽症状消失后30例患者接受了随访复查,治疗前辣椒素咳嗽阈值C5为5.85 (1.95,31.2) μmol/L,与治疗后的7.8 (0.98,7.8) μmol/L相比,差别无统计学意义(Z=-0.72,P=0.47).其中12例治疗前咳嗽敏感性增高者中有6例降至正常.结论 上气道咳嗽综合征的咳嗽敏感性存在不均一性,与正常值存在较大的重叠和交叉,大部分不符合咳嗽高敏感性综合征的概念.%Objective To investigate the changes and clinical implications of cough sensitivity in upper airway cough syndrome ( UACS ). Methods Cough threshold C5 was measured by capsaicin cough sensitivity test in 94 patients with upper airway cough syndrome; it was also measured in 30 patients after cough completely resolved with specific therapy. Results The mean cough threshold C5 was 5. 85 (1. 95, 31. 2) μmol/L and within the normal range; however, 36 patients (38.30% ) presented cough hypersensitivity. Thirty patients received re-examination of cough sensitivity to capsaicin after cough disappeared, there was no significant difference in cough threshold C5 between pre-and post-treatment [ 5.85 (1.95,31.2) μmol/L vs7.8 (0.98, 7.8)μmol/L, Z= -0.72,P = 0.47 ]. The effective treatment resulted in the recover of cough threshold C5 to normal level in 6 of 12 patients with increased cough sensitivity to capsaicin. Conclusion Cough sensitivity in upper airway cough syndrome is heterogeneous and overlapped with normal value. Therefore, upper airway cough syndrome is not always consistent with the concept of cough hypersensitivity syndrome.

  2. Update on Pediatric Cough.

    Science.gov (United States)

    Kantar, Ahmad

    2016-02-01

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

  3. Is the cutaneous silent period an opiate-sensitive nociceptive reflex?

    Science.gov (United States)

    Inghilleri, Maurizio; Conte, Antonella; Frasca, Vittorio; Berardelli, Alfredo; Manfredi, Mario; Cruccu, Giorgio

    2002-05-01

    In humans, high-intensity electrical stimuli delivered to the fingers induce an inhibitory effect on C7-T1 motoneurons. This inhibitory reflex, called the cutaneous silent period (CSP) is considered a defense response specific for the human upper limbs. It is not clear whether the CSP-like other defense responses such as the corneal reflex and the R III reflex-is an opiate-sensitive nociceptive reflex. Because opiates suppress some, but not all, nociceptive reflexes, we studied the effect of the narcotic-analgesic drug fentanyl on the CSP and the R III reflex. The CSP was recorded from the first dorsal interosseous (FDI) muscle in seven normal subjects during voluntary contraction, before and 10 and 20 min after fentanyl injection. To assess possible fentanyl-induced changes, we also tested the effect of finger stimulation on motor evoked potentials (MEPs) elicited in the FDI muscle by transcranial magnetic stimulation before and after fentanyl injection. Fentanyl-induced changes were also studied on the R III reflex recorded from the biceps femoris muscle. Fentanyl, as expected, suppressed the R III reflex but failed to change the inhibitory effect of finger stimulation on FDI motoneurons. Finger stimulation reduced the size of MEPs in the FDI, and fentanyl injection left this inhibitory effect unchanged. The differential fentanyl-induced modulation of the CSP and R III reflex provides evidence that the CSP circuit is devoid of mu-opiate receptors and is therefore an opiate-insensitive nociceptive reflex, which may be useful in the assessment of central-acting, non-opioid drugs.

  4. Affective modulation of the startle reflex and the Reinforcement Sensitivity Theory of personality: The role of sensitivity to reward.

    Science.gov (United States)

    Aluja, Anton; Blanch, Angel; Blanco, Eduardo; Balada, Ferran

    2015-01-01

    This study evaluated differences in the amplitude of startle reflex and Sensitivity to Reward (SR) and Sensitivity to Punishment (SP) personality variables of the Reinforcement Sensitivity Theory (RST). We hypothesized that subjects with higher scores in SR would obtain a higher startle reflex when exposed to pleasant pictures than lower scores, while higher scores in SP would obtain a higher startle reflex when exposed to unpleasant pictures than subjects with lower scores in this dimension. The sample consisted of 112 healthy female undergraduate psychology students. Personality was assessed using the short version of the Sensitivity to Punishment and Sensitivity Reward Questionnaire (SPSRQ). Laboratory anxiety was controlled by the State Anxiety Inventory. The startle blink reflex was recorded electromyographically (EMG) from the right orbicularis oculi muscle as a response to the International Affective Picture System (IAPS) pleasant, neutral and unpleasant pictures. Subjects higher in SR obtained a significant higher startle reflex response in pleasant pictures than lower scorers (48.48 vs 46.28, p<0.012). Subjects with higher scores in SP showed a light tendency of higher startle responses in unpleasant pictures in a non-parametric local regression graphical analysis (LOESS). The findings shed light on the relationships among the impulsive-disinhibited personality, including sensitivity to reward and emotions evoked through pictures of emotional content.

  5. Effects of carbocysteine on antigen-induced increases in cough sensitivity and bronchial responsiveness in guinea pigs.

    Science.gov (United States)

    Katayama, N; Fujimura, M; Ueda, A; Kita, T; Abo, M; Tachibana, H; Myou, S; Kurashima, K

    2001-06-01

    Carbocysteine is a mucoactive drug and is being used for both acute and chronic infectious airway diseases. Although carbocysteine can repair the damage of epithelial cells caused by exposure to various agents, the effects of this agent on allergic airway diseases such as asthma and eosinophilic bronchitis with an isolated chronic cough, in both of which epithelial damage may be characteristic, is not clear. We investigated the effects of carbocysteine on antigen-induced cough hypersensitivity to inhaled capsaicin at 48 h and bronchial hyperresponsiveness to inhaled methacholine at 72 h after challenge with an aerosolized antigen in actively sensitized guinea pigs. After measuring bronchial responsiveness, we examined neutral endopeptidase (NEP) activity in the tracheal tissue. Carbocysteine (10, 30, or 100 mg/kg) was given intraperitoneally every 12 h for 3 days after antigen challenge. The number of coughs elicited by an aerosol of capsaicin (10(-4) M) was significantly (p carbocysteine groups (6.13 +/- 0.59 at 10 mg/kg, 4.88 +/- 0.67 at 30 mg/kg, and 4.50 +/- 0.33 at 100 mg/kg during 3 min measurement) compared with the control group (9.75 +/- 0.53). Furthermore, carbocysteine dose dependently repaired the antigen-induced decrease of NEP activity in the tracheal tissue, but it did not influence the bronchial hyperresponsiveness or bronchoalveolar lavage cell component. These findings suggest that carbocysteine promotes the repair of damaged epithelium by allergic reaction and may be useful in allergic airway diseases accompanied by isolated chronic coughing, especially eosinophilic bronchitis without asthma and tracheobronchitis with cough hypersensitivity.

  6. Effects of postural threat on spinal stretch reflexes: evidence for increased muscle spindle sensitivity?

    Science.gov (United States)

    Horslen, Brian C; Murnaghan, Chantelle D; Inglis, J Timothy; Chua, Romeo; Carpenter, Mark G

    2013-08-01

    Standing balance is often threatened in everyday life. These threats typically involve scenarios in which either the likelihood or the consequence of falling is higher than normal. When cats are placed in these scenarios they respond by increasing the sensitivity of muscle spindles imbedded in the leg muscles, presumably to increase balance-relevant afferent information available to the nervous system. At present, it is unknown whether humans also respond to such postural threats by altering muscle spindle sensitivity. Here we present two studies that probed the effects of postural threat on spinal stretch reflexes. In study 1 we manipulated the threat associated with an increased consequence of a fall by having subjects stand at the edge of an elevated surface (3.2 m). In study 2 we manipulated the threat by increasing the likelihood of a fall by occasionally tilting the support surface on which subjects stood. In both scenarios we used Hoffmann (H) and tendon stretch (T) reflexes to probe the spinal stretch reflex circuit of the soleus muscle. We observed increased T-reflex amplitudes and unchanged H-reflex amplitudes in both threat scenarios. These results suggest that the synaptic state of the spinal stretch reflex is unaffected by postural threat and that therefore the muscle spindles activated in the T-reflexes must be more sensitive in the threatening conditions. We propose that this increase in sensitivity may function to satisfy the conflicting needs to restrict movement with threat, while maintaining a certain amount of sensory information related to postural control.

  7. Transient receptor potential vanilloid 1 (TRPV1) antagonism in patients with refractory chronic cough: a double-blind randomized controlled trial.

    Science.gov (United States)

    Khalid, Saifudin; Murdoch, Robert; Newlands, Amy; Smart, Kevin; Kelsall, Angela; Holt, Kimberley; Dockry, Rachel; Woodcock, Ashley; Smith, Jaclyn A

    2014-07-01

    Inhalation of capsaicin, the extract of hot chili peppers, induces coughing in both animals and human subjects through activation of transient receptor potential vanilloid 1 (TRPV1) on airway sensory nerves. Therefore the TRPV1 receptor is an attractive target for the development of antitussive agents. We sought to assess the antitussive effect of TRPV1 antagonism in patients with refractory chronic cough. Twenty-one subjects with refractory chronic cough (>8 weeks) attending a specialist clinic were recruited to a randomized, double-blind, placebo-controlled crossover trial assessing a TRPV1 antagonist (SB-705498). Cough reflex sensitivity to capsaicin (concentration of capsaicin inducing at least 5 coughs) and 24-hour cough frequency were coprimary end points assessed after a single dose of SB-705498 (600 mg) and matched placebo. Cough severity and urge to cough were reported on visual analog scales, and cough-specific quality of life data were also collected. Treatment with SB-705498 produced a significant improvement in cough reflex sensitivity to capsaicin at 2 hours and a borderline significant improvement at 24 hours compared with placebo (adjusted mean difference of +1.3 doubling doses at 2 hours [95% CI, +0.3 to +2.2; P = .0049] and +0.7 doubling doses at 24 hours [95% CI, +0.0 to +1.5; P = .0259]). However, 24-hour objective cough frequency was not improved compared with placebo. Patient-reported cough severity, urge to cough, and cough-specific quality of life similarly suggested no effect of SB-705498. This study raises important questions about both the role of TRVP1-mediated mechanisms in patients with refractory chronic cough and also the predictive value of capsaicin challenge testing in the assessment of novel antitussive agents. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  8. How Are Task Reflexivity and Intercultural Sensitivity Related to the Academic Performance of MBA Students?

    Science.gov (United States)

    Lyubovnikova, Joanne; Napiersky, Uwe; Vlachopoulos, Panos

    2015-01-01

    Higher education in business school environments is increasingly focused on how to best equip students with the skills necessary for leadership in the global workplace. This paper examines the impact of two particularly important cognitive capabilities--task reflexivity and intercultural sensitivity, on academic performance in an MBA programme. It…

  9. How Are Task Reflexivity and Intercultural Sensitivity Related to the Academic Performance of MBA Students?

    Science.gov (United States)

    Lyubovnikova, Joanne; Napiersky, Uwe; Vlachopoulos, Panos

    2015-01-01

    Higher education in business school environments is increasingly focused on how to best equip students with the skills necessary for leadership in the global workplace. This paper examines the impact of two particularly important cognitive capabilities--task reflexivity and intercultural sensitivity, on academic performance in an MBA programme. It…

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

    OpenAIRE

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

    1993-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  12. Increased Prepulse Inhibition and Sensitization of the Startle Reflex in Autistic Children

    DEFF Research Database (Denmark)

    Madsen, Gitte Falcher; Bilenberg, Niels; Cantio, Cathriona;

    2014-01-01

    The relation between autism spectrum disorders (ASD) and schizophrenia is a subject of intense debate and research due to evidence of common neurobiological pathways in the two disorders. The objective of this study was to explore whether deficits in prepulse inhibition (PPI) of the startle reflex...... and 40 matched NTD controls were tested in a psychophysiological test battery. The PPI of the acoustic startle reflex was analyzed in 18 ASD subjects and 34 NTD controls. Habituation and sensitization were analyzed in 23 ASD subjects and 39 NTD controls. In trials with less intense prestimuli (76 d....... The relation to PPI deficits observed in schizophrenia is not apparent. Future research should study the developmental course of PPI deficits in ASD patients in a longitudinal design. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc....

  13. Mechanical Stimulation by Postnasal Drip Evokes Cough.

    Directory of Open Access Journals (Sweden)

    Toshiyuki Iwata

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

  14. Mechanical Stimulation by Postnasal Drip Evokes Cough.

    Science.gov (United States)

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

    2015-01-01

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

  15. Cough management: a practical approach.

    Science.gov (United States)

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

    2011-10-10

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

  16. [Laryngeal and larynx-associated reflexes].

    Science.gov (United States)

    Ptok, M; Kühn, D; Miller, S; Jungheim, M; Schroeter, S

    2016-06-01

    The laryngeal adductor reflex and the pharyngoglottal closure reflex protect the trachea and lower respiratory tract against the entrance of foreign material. The laryngeal expiration reflex and the cough reflex serve to propel foreign material, which has penetrated in the cranial direction. The inspiration reflex, the sniff reflex, and the swallowing reflex are further larynx-associated reflexes. In patients with dysphagia the laryngeal adductor reflex can be clinically tested with air pulses. The water swallow test serves to show the integrity of the cough reflex. The sniff reflex is useful to test the abduction function of the vocal folds. Future studies should address laryngeal reflexes more specifically, both for a better understanding of these life-supporting mechanisms and to improve diagnostic procedures in patients with impaired laryngeal function.

  17. Effect of Microinfusion of Angiotensin Ⅱ into the RVLM in Rats on the Baroreceptor Reflex Sensitivity

    Institute of Scientific and Technical Information of China (English)

    ZHANGFeng; GAOXing-ya; ZHUGuo-qing; ZHONGWan-hua

    2004-01-01

    The present study was designed to investigate the effect of microinfusion anglotensin Ⅱ (Ang Ⅱ ),Ang Ⅱ type l(AT1)receptor antagonist lesartan into the rostral ventrolateral medulla(RVLM)on the baroreceptor reflex sensitivity(BRS)in urethane-anesthetized rats. Methods: Reflex changes in heart rate(HR)were elicited by bolus intravenous injection of phenylephrine before and during RVLM microinfusion of saline(0.5μl/h), Ang Ⅱ(1.Snmol/h), losartan (250 nmol/h), and Ang Ⅱ (1.5 nmol/h) pretreated with microinjection of losartan (50 nmol/0.51 μl)into the RVLM. The average ratio between changes in HR in beats per minute(beats, min-1 )and changes in mean arteriaI pressutre [ MAP,mmHg(1 mmHg = 0.133 kPa) ] was used as an index of BRS. Results : Ang Ⅱ resulted in a significant decrease in the BRS for reflex bradycardia compared with control( - 2.1 ~ 0.1 vs - 3.9 + 0.4 beats.min-1·mmHg-1 ).Microinfusion of losartan had no significant effect on BRS for reflex bradycardia.The effect of Ang ][ was almost completely abolished by pretreatment with microinjection of losartan. Conc/us/on: These results showed that the exogenous Ang II in the RVLM produces inhibitory modulation of BRS, which is mediated by AT2 receptor.However,AT1 receptor in the RVLM is not involved in the tonic control of BRS.

  18. The pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection

    National Research Council Canada - National Science Library

    Florvaag, E; Johansson, SGO

    2012-01-01

    The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA...

  19. The Pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection

    National Research Council Canada - National Science Library

    Florvaag, E; Johansson, S G O

    2012-01-01

    : The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA...

  20. Neurogenic cough.

    Science.gov (United States)

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

    2015-07-01

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

  1. 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.

  2. TRPV1 and TRPM8 in Treatment of Chronic Cough

    OpenAIRE

    Eva Millqvist

    2016-01-01

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

  3. Cough responsiveness in neurogenic dysphagia.

    Science.gov (United States)

    Smith, P E; Wiles, C M

    1998-03-01

    In neurogenic dysphagia a good cough is important for airway protection. If triggering of cough, or its effectiveness, is impaired this might result in an increased aspiration risk. Capsaicin, an agent which induces cough through sensory nerve stimulation, was used to test cough sensitivity in groups of patients with and without neurogenic dysphagia. On the basis of swallowing speed (ml/s) in a validated water test 28 alert neurological inpatients (16 women, aged 22-71 years) were classified into 13 with abnormal and 15 with normal swallowing (median swallowing speed 23% and 99%, median volume/swallow 43% and 106% of that predicted for age and sex respectively: pneurogenic dysphagia even after allowing for diagnostic category, the possible presence of a bulbar upper motor neuron lesion, or voluntary respiratory capacity. It is concluded that these patients with neurogenic dysphagia do not have a reduced sensitivity of cough triggering.

  4. IgE-sensitization to the cough suppressant pholcodine and the effects of its withdrawal from the Norwegian market.

    Science.gov (United States)

    Florvaag, E; Johansson, S G O; Irgens, Å; de Pater, G H

    2011-07-01

    IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA), frequent in Norway, was proposed to be caused by exposure to pholcodine (PHO) carrying the allergenic quarternary ammonium ion epitope. Consequently, the PHO-containing drug was withdrawn from the market in March 2007. Describe the effects of withdrawal of PHO on IgE, IgE-antibodies and reported frequencies of anaphylaxis to NMBAs. Three hundred sera from supposedly allergic patients sampled yearly through 2006 to 2010 were analysed for IgE antibodies to PHO, suxamethonium (SUX) and morphine (MOR). Furthermore, IgE and preliminary reports from the Norwegian Network for Anaphylaxis under Anaesthesia (NARA) were monitored. PHO exposure was associated with IgE sensitization to PHO, MOR and SUX. However, after withdrawal, within 1 year, antibody prevalences to PHO and SUX fell significantly from 11.0% to 5.0% and from 3.7% to 0.7%, respectively. At 3 years, SUX had fallen to 0.3%, PHO to 2.7% and MOR to 1.3%. By 2 years, the prevalence of elevated IgE was significantly reduced. After 3 years, the incidence of reported suspected anaesthetic anaphylaxis fell significantly, both the total number, the reactions related to NMBAs and those with IgE antibodies to SUX. Withdrawing of PHO lowered significantly within 1-2 years levels of IgE and IgE antibodies to PHO, MOR and SUX, and, within 3 years, the frequency of NMBA suspected anaphylaxis. The results strengthen the PHO hypothesis considerably and equally the need to question the existence of cough depressants containing PHO. © 2011 John Wiley & Sons A/S.

  5. Examining habituation of the startle reflex with the reinforcement sensitivity theory of personality.

    Science.gov (United States)

    Blanch, Angel; Aluja, Anton; Blanco, Eduardo; Balada, Ferran

    2016-10-01

    The habituation of the acoustic startle reflex (ASR) was examined concerning individual differences in sensitivity to punishment (PUN) and sensitivity to reward (REW), within the general framework of the reinforcement sensitivity theory (RST) of personality. Two hypotheses derived from the RST were evaluated: the separable subsystems hypothesis and the joint subsystems hypothesis. In addition, we examined the direction of the relationship of PUN and REW with the habituation of the ASR. A habituation segment of electromyography recordings of the orbicularis oculi was assessed with an unconditional latent curve model. In accordance with the RST hypotheses, the relationship of PUN and REW on the habituation process was assessed with two conditional latent curve models. There was higher support for the separable subsystems hypothesis. In addition, PUN and REW related with the habituation trajectory of the ASR in the expected directions. Higher levels of PUN and lower levels of REW related with a slower habituation of the ASR, whereas lower levels of PUN and higher levels of REW related with a faster habituation of the ASR.

  6. Currently available cough suppressants for chronic cough.

    Science.gov (United States)

    Chung, Kian Fan

    2008-01-01

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

  7. Cough & Cold Medicine Abuse

    Science.gov (United States)

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

  8. Do sex and atopy influence cough outcome measurements in children?

    Science.gov (United States)

    Chang, Anne B; Gibson, Peter G; Willis, Carol; Petsky, Helen L; Widdicombe, John G; Masters, I Brent; Robertson, Colin F

    2011-08-01

    Despite the commonality of cough and its burden, there are no published data on the relationship between atopy or sex on objectively measured cough frequency or subjective cough scores in children. In 202 children with and without cough, we determined the effect of sex and atopy on validated cough outcome measurements (cough receptor sensitivity [CRS], objective cough counts, and cough scores). We hypothesized that in contrast to adult data, sex does not influence cough outcome measures, and atopy is not a determinant of these cough measurements. We combined data from four previous studies. Atopy (skin prick test), the concentration of capsaicin causing two and five or more coughs (C2 and C5, respectively), objectively measured cough frequency, and cough scores were determined and their relationship explored. The children's (93 girls, 109 boys) mean age was 10.6 years (SD 2.9), and 56% had atopy. In multivariate analysis, CRS was influenced by age (C2 coefficient, 5.9; P = .034; C5 coefficient, 29.1; P = .0001). Atopy and sex did not significantly influence any of the cough outcomes (cough counts, C2, C5, cough score) in control subjects and children with cough. Atopy does not influence important cough outcome measures in children with and without chronic cough. However, age, but not sex, influences CRS in children. Unlike adult data, sex does not affect objective counts or cough score in children with and without chronic cough. Studies on cough in children should be age matched, but matching for atopic status and sex is less important.

  9. 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.

  10. Cough Suppressant and Pharmacologic Protussive Therapy

    Science.gov (United States)

    Bolser, Donald C.

    2011-01-01

    Background Cough-suppressant therapy, previously termed nonspecific antitussive therapy, incorporates the use of pharmacologic agents with mucolytic effects and/or inhibitory effects on the cough reflex itself. The intent of this type of therapy is to reduce the frequency and/or intensity of coughing on a short-term basis. Methods Data for this review were obtained from several National Library of Medicine (PubMed) searches (from 1960 to 2004), which were performed between May and September 2004, of the literature published in the English language, limited to human studies, using combinations of the search terms “cough,” “double-blind placebo-controlled,” “antitussive,” “mucolytic,” “cough clearance,” “common cold,” “protussive,” “guaifenesin,” “glycerol,” and “zinc.” Results Mucolytic agents are not consistently effective in ameliorating cough in patients with bronchitis, although they may be of benefit to this population in other ways. Peripheral and central antitussive agents can be useful in patients with chronic bronchitis, but can have little efficacy in patients with cough due to upper respiratory infection. Some protussive agents are effective in increasing cough clearance, but their long-term effectiveness has not been established. DNase is not effective as a protussive agent in patients with cystic fibrosis. Inhaled mannitol is acutely effective in this patient population, but its therapeutic potential must be investigated further. Conclusions These findings suggest that suppressant therapy is most effective when used for the short-term reduction of coughing. Relatively few drugs are effective as cough suppressants. PMID:16428717

  11. Role of L-DOPA in spinal nociceptive reflex activity: higher sensitivity of Aδ versus C fibre-evoked nociceptive reflexes to L-DOPA.

    Science.gov (United States)

    Schomburg, E D; Dibaj, P; Steffens, H

    2011-01-01

    The role of L-DOPA in spinal nociceptive reflex activity has been re-evaluated. In high spinal cats, with supraspinal loops being excluded, the onset of reflex facilitation induced by noxious radiant heat is delayed after injection of L-DOPA by 4 to 10 s, i.e. the early component of nociceptive reflex facilitation is blocked, while the late component persisted. Further investigations have shown that the early component of reflex facilitation induced by noxious radiant heat is mediated by Adelta-fibres and the late component by C-fibres. Therefore, it can be assumed that L-DOPA, like opioids, preferentially blocks the transmission in nociceptive reflex pathways from Adelta-fibres.

  12. Respiratory component of the orienting reflex: a novel sensitive index of sensory-induced arousal in rats.

    Directory of Open Access Journals (Sweden)

    Eugene eNalivaiko

    2012-01-01

    Full Text Available In humans, the integrated response to a novel stimulus (orienting reflex includes behavioral (head turning etc and well-characterized physiological components (changes in heart rate, respiration, skin conductance, and EEG patterns. In rodents, the physiological components of the orienting reflex include changes in heart rate and cutaneous vasoconstrictor tone, but respiratory changes have so far not been systematically documented. In the present study conducted in adult male Wistar rats, the orienting reflex was elicited by 60-dB acoustic tones while animals were in a whole-body plethysmograph for respiratory recordings. In addition to respiration, in different groups of animals we concurrently recorded either EEG, or heart rate (both by biotelemetry, or tail blood flow (using ultrasound Doppler. Acoustic stimuli provoked vigorous tachypnoeic responses with respiratory rate rising from 80-100 to 450-650 cpm, and with small and variable changes in tidal volume. This respiratory arousal response was often, but not always, accompanied by EEG desynchronization and by variable tail vasoconstriction, and by small and inconsistent changes in the heart rate. We conclude that tachypnoeic responses are a new highly sensitive index of sensory-induced arousal.

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

    Directory of Open Access Journals (Sweden)

    Marriott Nliwasa

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

  14. [Drug therapy for cough].

    Science.gov (United States)

    Koskela, Heikki; Naaranlahti, Toivo

    2016-01-01

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

  15. Chromatic contrast sensitivity during optokinetic nystagmus, visually enhanced vestibulo-ocular reflex, and smooth pursuit eye movements.

    Science.gov (United States)

    Schütz, Alexander C; Braun, Doris I; Gegenfurtner, Karl R

    2009-05-01

    Recently we showed that sensitivity for chromatic- and high-spatial frequency luminance stimuli is enhanced during smooth-pursuit eye movements (SPEMs). Here we investigated whether this enhancement is a general property of slow eye movements. Besides SPEM there are two other classes of eye movements that operate in a similar range of eye velocities: the optokinetic nystagmus (OKN) is a reflexive pattern of alternating fast and slow eye movements elicited by wide-field visual motion and the vestibulo-ocular reflex (VOR) stabilizes the gaze during head movements. In a natural environment all three classes of eye movements act synergistically to allow clear central vision during self- and object motion. To test whether the same improvement of chromatic sensitivity occurs during all of these eye movements, we measured human detection performance of chromatic and luminance line stimuli during OKN and contrast sensitivity during VOR and SPEM at comparable velocities. For comparison, performance in the same tasks was tested during fixation. During the slow phase of OKN we found a similar enhancement of chromatic detection rate like that during SPEM, whereas no enhancement was observable during VOR. This result indicates similarities between slow-phase OKN and SPEM, which are distinct from VOR.

  16. Losing touch: age-related changes in plantar skin sensitivity, lower limb cutaneous reflex strength, and postural stability in older adults.

    Science.gov (United States)

    Peters, Ryan M; McKeown, Monica D; Carpenter, Mark G; Inglis, J Timothy

    2016-10-01

    Age-related changes in the density, morphology, and physiology of plantar cutaneous receptors negatively impact the quality and quantity of balance-relevant information arising from the foot soles. Plantar perceptual sensitivity declines with age and may predict postural instability; however, alteration in lower limb cutaneous reflex strength may also explain greater instability in older adults and has yet to be investigated. We replicated the age-related decline in sensitivity by assessing monofilament and vibrotactile (30 and 250 Hz) detection thresholds near the first metatarsal head bilaterally in healthy young and older adults. We additionally applied continuous 30- and 250-Hz vibration to drive mechanically evoked reflex responses in the tibialis anterior muscle, measured via surface electromyography. To investigate potential relationships between plantar sensitivity, cutaneous reflex strength, and postural stability, we performed posturography in subjects during quiet standing without vision. Anteroposterior and mediolateral postural stability decreased with age, and increases in postural sway amplitude and frequency were significantly correlated with increases in plantar detection thresholds. With 30-Hz vibration, cutaneous reflexes were observed in 95% of young adults but in only 53% of older adults, and reflex gain, coherence, and cumulant density at 30 Hz were lower in older adults. Reflexes were not observed with 250-Hz vibration, suggesting this high-frequency cutaneous input is filtered out by motoneurons innervating tibialis anterior. Our findings have important implications for assessing the risk of balance impairment in older adults. Copyright © 2016 the American Physiological Society.

  17. Cough . 2: Chronic cough in children

    NARCIS (Netherlands)

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

    2003-01-01

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

  18. Cough . 2: Chronic cough in children

    NARCIS (Netherlands)

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

    2003-01-01

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

  19. Pertussis (Whooping Cough) Outbreaks

    Science.gov (United States)

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

  20. Pertussis (Whooping Cough) Complications

    Science.gov (United States)

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

  1. Coughing up blood

    Science.gov (United States)

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

  2. Cold and Cough Medicines

    Science.gov (United States)

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

  3. TRPV1 and TRPM8 in Treatment of Chronic Cough

    Directory of Open Access Journals (Sweden)

    Eva Millqvist

    2016-07-01

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

  4. TRPV1 and TRPM8 in Treatment of Chronic Cough.

    Science.gov (United States)

    Millqvist, Eva

    2016-07-28

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

  5. CXCL12 sensitizes vago-vagal reflex neurons in the dorsal medulla.

    Science.gov (United States)

    Rogers, Richard C; Viard, Edouard; Hermann, Gerlinda E

    2013-01-25

    Previous studies from our laboratory illustrated the potential for stromal cell-derived factor one [CXCL12; also referred to as SDF-1] to act on its receptor [CXCR4] within the dorsal vagal complex [DVC] of the hindbrain to suppress gastric motility (Hermann et al., 2008). While CXCR4 receptors are essential for normal brain development, they also play a critical role in the proliferation of the HIV virus and initiation of metastatic cell growth in the brain. Anorexia, nausea, and failed autonomic regulation of gastrointestinal function are significant causes of morbidity and are contributory factors in the mortality associated with these disease states. The implication of our previous study was that CXCL12 caused gastric stasis by acting on gastric reflex circuit elements in the DVC. This hindbrain complex includes vagal afferent terminations in the solitary nucleus, neurons in the solitary nucleus (NST) and visceral efferent motorneurons in the dorsal motor nucleus (DMN) that are responsible for the regulation of digestive functions from the oral cavity to the transverse colon. In the current study, in vivo single-unit neurophysiological recordings from physiologically-identified NST and DMN components of the gastric accommodation reflex show that while injection of femtomole doses of CXCL12 onto NST or DMN neurons has no effect on their basal activity, CXCL12 amplifies the effect of gastric vagal mechanosensory input to activate the NST and, in turn, inhibit DMN motor activity.

  6. 膝反射灵敏度与膝关节角度关系的探讨%Relationship between knee joint angle and knee reflex sensitivity

    Institute of Scientific and Technical Information of China (English)

    毛新春; 席庆祥; 保宏翔; 常红升; 田卫卫; 廖琦; 陈贤

    2011-01-01

    Objective To explore the relationship between knee joint angle and knee reflex sensitivity, and to provide the most accurate position and a theoretical basis for knee reflex inspection. Methods 149 patients( 298 knee joints )hospitalized in general medicine department who met the criteria were included in this study. They received knee reflex inspections at different angles ranging from 80° to 180° , and the reflex intensity was evaluated and statistically analyzed using curve fitting. Results When knee joint angle was between 125° and 130° ,the total scores of knee reflex were at the highest level according to curve fitting analysis. Conclusion Knee reflex sensitivity is correlated with knee joint angle. When knee joint angle is between 125° and 130°,the knee reflex sensitivity is the highest.%目的 探讨仰卧位膝反射灵敏度与膝关节角度的关系,为临床检查膝反射提供准确的检查体位及理论依据.方法 对普通内科住院患者符合入选条件的149例298个膝关节在80~180°范围内不同角度的反射强度进行积分和统计分析.结果 膝关节角度在125~130°时,膝反射积分值处在最高水平.结论 膝反射灵敏度与膝关节角度相关,仰卧位膝关节角度在125~130°范围时,反射灵敏度最高.

  7. Antitussive effect of naringin on experimentally induced cough in Guinea pigs.

    Science.gov (United States)

    Gao, Sen; Li, Peibo; Yang, Hongliang; Fang, Siqi; Su, Weiwei

    2011-01-01

    The mechanism of action of naringin has been investigated in different models of experimentally induced cough in guinea pigs. In contrast to codeine phosphate (6 mg/kg, intravenous administration [i. v.]), naringin (15, 30, and 60 mg/kg, i. v.) had no central antitussive effect on cough elicited by electrical stimulation of the superior laryngeal nerve. Naringin (0.5, 1.0, and 2.0 µmol) could not prevent the cough reflex induced by stimulation of the trachea after intracerebroventricular injection (i. c. v.), while codeine phosphate (0.5 µmol) was highly effective. Further characterizing the peripheral mechanism of naringin, we found that its effect (50 mg/kg, i. v.) was not affected by the depletion of sensory neuropeptides, whereas levodropropizine (10 mg/kg, i. v.) lost its capacity to prevent cough in the capsaicin-desensitized guinea pig. Furthermore, pretreatment with glibenclamide (10 mg/kg, intraperitoneal [i. p.]) significantly reduced the antitussive effect of pinacidil (5 mg/kg, subcutaneous [s. c.]), but could not antagonize the antitussive effect of naringin (30 mg/kg, s. c.). Our present results suggest that naringin is not a central antitussive drug. And naringin does not exert its peripheral antitussive effect through either the sensory neuropeptides system or the modulation of ATP-sensitive K (+) channels.

  8. Effects of melatonin on prepulse inhibition, habituation and sensitization of the human startle reflex in healthy volunteers

    DEFF Research Database (Denmark)

    Lehtinen, Emilia K; Ucar, Ebru; Glenthøj, Birte Y

    2014-01-01

    Prepulse inhibition of the startle reflex (PPI) is an operational measure of sensorimotor gating, which is demonstrated to be impaired in patients with schizophrenia. In addition, a disruption of the circadian rhythm together with blunted melatonin secretion is regularly found in patients...... with schizophrenia and it is theorized that these may contribute to their attentional deficits. The aim of this study was to assess the effects of acute melatonin on healthy human sensorimotor gating. Twenty-one healthy male volunteers were administered melatonin or placebo after which their levels of PPI were...... assessed. Melatonin significantly reduced startle magnitude and ratings of alertness, but did not influence PPI, nor sensitization and habituation. However, when taking baseline scores in consideration, melatonin significantly increased PPI in low scoring individuals while significantly decreasing...

  9. 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.

  10. Central sensitization in spinal cord injured humans assessed by reflex receptive fields

    DEFF Research Database (Denmark)

    Biurrun Manresa, José Alberto; Finnerup, Nanna Brix; Johannesen, Inger Lauge

    2014-01-01

    after an intramuscular injection of capsaicin in the foot sole in order to induce central sensitization. RESULTS: Both groups presented RRF expansion and lowered NWR thresholds immediately after capsaicin injection, reflected by the enlargement of RRF sensitivity areas and RRF probability areas....... Moreover, the topography of the RRF sensitivity and probability areas were significantly different in SCI volunteers compared to NI volunteers in terms of size and shape. CONCLUSIONS: SCI volunteers can develop central sensitization, despite adaptive/maladaptive changes in synaptic plasticity and lack...

  11. Treatment of Chronic Cough.

    Science.gov (United States)

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

    2017-01-01

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

  12. Approaching chronic cough.

    Science.gov (United States)

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

    2016-02-01

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

  13. The importance of coughs

    African Journals Online (AJOL)

    2012-03-14

    Mar 14, 2012 ... around the vocal cords, carina and the larger airways, and also the eardrums ... therapy may be worthwhile in any case of chronic persistent cough. ... A simple linctus: honey for children with an acute cough is effective [1]. b.

  14. CHILDREN’S COUGH

    Directory of Open Access Journals (Sweden)

    V.S. Isaeva

    2011-01-01

    Full Text Available Coughing is one of the most common reasons why parents seek for a pediatrician’s advice. The most frequent cause of cough in children are acute respiratory infections, but it can also appear against the background of non-infectious nature as well as drug side effect or due to alien object aspiration. Thorough examination and differentiation diagnosis are the cornerstones of making anticough treatment choice allowing to achieve maximum results in short terms, avoiding unnecessary use of medications. This review contains descriptions of main cough reasons as well cough treatment pediatric guidelines.Key words: coughing, children, herbal medications. (Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (6: 186–190

  15. Postauricular reflexes elicited by soft acoustic clicks and loud noise probes: Reliability, prepulse facilitation, and sensitivity to picture contents.

    Science.gov (United States)

    Aaron, Rachel V; Benning, Stephen D

    2016-12-01

    The startle blink reflex is facilitated during early picture viewing, then inhibited by attention during pleasant and aversive pictures compared to neutral pictures, and finally potentiated during aversive pictures specifically. However, it is unclear whether the postauricular reflex, which is elicited by the same loud acoustic probe as the startle blink reflex but enhanced by appetitive instead of defensive emotion, has the same pattern and time course of emotional modulation. We examined this issue in a sample of 90 undergraduates using serially presented soft acoustic clicks that elicited postauricular (but not startle blink) reflexes in addition to standard startle probes. Postauricular reflexes elicited by both clicks and probes correlated during food and nurturant contents, during which they were potentiated compared to neutral pictures, suggesting clicks effectively elicit emotionally modulated postauricular reflexes. The postauricular reflex was initially facilitated during the first 500 ms of picture processing but was larger during pleasant than neutral pictures throughout picture processing, with larger effect sizes during the latter half of picture processing. Across reflexes and eliciting stimuli, measures of emotional modulation had higher coefficient alphas than magnitudes during specific picture contents within each valence, indicating that only emotional modulation measures assess higher-order appetitive or defensive processing. © 2016 Society for Psychophysiological Research.

  16. Bradykinin does not acutely sensitize the reflex pressor response during hindlimb skeletal muscle stretch in decerebrate rats.

    Science.gov (United States)

    Rollins, Korynne S; Smith, Joshua R; Esau, Peter J; Kempf, Evan A; Hopkins, Tyler D; Copp, Steven W

    2017-10-01

    Hindlimb skeletal muscle stretch (i.e., selective activation of the muscle mechanoreflex) in decerebrate rats evokes reflex increases in blood pressure and sympathetic nerve activity. Bradykinin has been found to sensitize mechanogated channels through a bradykinin B2 receptor-dependent mechanism. Moreover, bradykinin B2 receptor expression on sensory neurons is increased following chronic femoral artery ligation in the rat (a model of simulated peripheral artery disease). We tested the hypothesis that injection of bradykinin into the arterial supply of a hindlimb in decerebrate, unanesthetized rats would acutely augment (i.e., sensitize) the increase in blood pressure and renal sympathetic nerve activity during hindlimb muscle stretch to a greater extent in rats with a ligated femoral artery than in rats with a freely perfused femoral artery. The pressor response during static hindlimb muscle stretch was compared before and after hindlimb arterial injection of 0.5 µg of bradykinin. Injection of bradykinin increased blood pressure to a greater extent in "ligated" (n = 10) than "freely perfused" (n = 10) rats. The increase in blood pressure during hindlimb muscle stretch, however, was not different before vs. after bradykinin injection in freely perfused (14 ± 2 and 15 ± 2 mmHg for pre- and post-bradykinin, respectively, P = 0.62) or ligated (15 ± 3 and 14 ± 2 mmHg for pre- and post-bradykinin, respectively, P = 0.80) rats. Likewise, the increase in renal sympathetic nerve activity during stretch was not different before vs. after bradykinin injection in either group of rats. We conclude that bradykinin did not acutely sensitize the pressor response during hindlimb skeletal muscle stretch in freely perfused or ligated decerebrate rats. Copyright © 2017 the American Physiological Society.

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

    Institute of Scientific and Technical Information of China (English)

    于航(综述); 霍建民(审校)

    2016-01-01

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

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

    OpenAIRE

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

    2003-01-01

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

  19. Pharm GKB: Cough [PharmGKB

    Lifescience Database Archive (English)

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

  20. Clinical Implication of Cough CPR in Cardiac Cath Lab

    Directory of Open Access Journals (Sweden)

    Monish S Rau

    2013-02-01

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

  1. Whooping Cough (Pertussis)

    Science.gov (United States)

    ... to 5 days following the start of antibiotic treatment. Prevention Whooping cough can be prevented with the pertussis vaccine , which is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization . DTaP immunizations are routinely given ...

  2. Coughing (For Parents)

    Science.gov (United States)

    ... bacteria Bordetella pertussis . Kids with pertussis will have spells of back-to-back coughs without breathing in ... tears, or peeing less often (or having fewer wet diapers) Reviewed by: Shayan T. Vyas, MD Date ...

  3. 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.

  4. Propofol-induced violent coughing in a patient with Becker′s muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Amit Jain

    2011-01-01

    Full Text Available Propofol anesthesia is often associated with decreased incidence of gagging, coughing or laryngospasm, and provides intense suppression on airway reflex during tracheal intubation and laryngeal mask airway insertion. Propofol pretreatment is also effective in reducing the occurrence of opioid-induced coughing. These benefits are often attributed to bronchodilator and sedative effects of propofol. However, severe coughing following sedative doses of 1% propofol has not been reported so far. We report a rare case of violent coughing following low-dose propofol infusion in a patient with Becker′s muscular dystrophy.

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

    Science.gov (United States)

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

    2007-08-01

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

  6. Pholcodine-containing cough medicines.(Safety and Efficacy Issues)

    National Research Council Canada - National Science Library

    2012-01-01

    ... taken pholcodine-containing cough medicines. Following a thorough review of all available data on the safety and efficacy of pholcodine-containing cough medicines, the Committee found no firm evidence to substantiate the hypothesis of cross-sensitization between pholcodine and NMBAs and a subsequent increased risk of anaphylactic reactions during s...

  7. Acupuncture Treatment of Cough

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

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

  8. Chronic cough in children.

    Science.gov (United States)

    Acosta, Rigoberto; Bahna, Sami L

    2014-08-01

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

  9. What is the relationship between the Glasgow coma scale and airway protective reflexes in the Chinese population?

    Science.gov (United States)

    Rotheray, K R; Cheung, P S Y; Cheung, C S K; Wai, A K C; Chan, D Y S; Rainer, T H; Graham, C A

    2012-01-01

    To describe the relationship of gag and cough reflexes to Glasgow coma score (GCS) in Chinese adults requiring critical care. Prospective observational study of adult patients requiring treatment in the trauma or resuscitation rooms of the Emergency Department, Prince of Wales Hospital, Hong Kong. A long cotton bud to stimulate the posterior pharyngeal wall (gag reflex) and a soft tracheal suction catheter were introduced through the mouth to stimulate the laryngopharynx and elicit the cough reflex. Reflexes were classified as normal, attenuated or absent. A total of 208 patients were recruited. Reduced gag and cough reflexes were found to be significantly related to reduced GCS (p=0.014 and 0.002, respectively). Of 33 patients with a GCS≤8, 12 (36.4%) had normal gag reflexes and 8 (24.2%) had normal cough reflexes. 23/62 (37.1%) patients with a GCS of 9-14 had absent gag reflexes, and 27 (43.5%) had absent cough reflexes. In patients with a normal GCS, 22.1% (25/113) had absent gag reflexes and 25.7% (29) had absent cough reflexes. Our study has shown that in a Chinese population with a wide range of critical illness (but little trauma or intoxication), reduced GCS is significantly related to gag and cough reflexes. However, a considerable proportion of patients with a GCS≤8 have intact airway reflexes and may be capable of maintaining their own airway, whilst many patients with a GCS>8 have impaired airway reflexes and may be at risk of aspiration. This has important implications for airway management decisions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Assessment of cough

    African Journals Online (AJOL)

    2009-02-23

    Feb 23, 2009 ... airways and/or stretch receptors in the distal airways or the lung .... All chronic cough or if suspect pneumonia/cancer .... frequency of drinking days, the number of drinks and the percentage of days classed as heavy drinking.

  11. Acute cough in adults

    Institute of Scientific and Technical Information of China (English)

    Jochen W L Cals; Nick A Francis

    2010-01-01

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

  12. First Aid: Coughing

    Science.gov (United States)

    ... or after coughing Think Prevention! Follow the doctor's treatment plan if your child has asthma or allergies . Avoid anyone who smokes or has a cold . Make sure your child gets the diphtheria-tetanus-acellular pertussis (DTaP) vaccine or combination booster (Tdap) ...

  13. A Study of Relationship between the Acoustic Sensitivity of Vestibular System and the Ability to Trigger Sound-Evoked Muscle Reflex of the Middle Ear in Adults with Normal Hearing

    Directory of Open Access Journals (Sweden)

    S.F. Emami

    2014-07-01

    Full Text Available Introduction & Objective: The vestibular system is sound sensitive and the sensitivity is related to the saccule. The vestibular afferents are projected to the middle ear muscles (such as the stapedius. The goal of this research was studying the relationship between the vestibular hearing and the sound-evoked muscle reflex of the middle ear to 500 HZ. Materials & Methods: This study was a cross sectional-comparison done in audiology department of Sheikholreis C‍‍linic (Hamadan, Iran. The study groups consisted of thirty healthy people and thirty patients with benign paroxysmal positional vertigo. Inclusion criteria of the present study were to have normal hearing on pure tone audiometry, acoustic reflex, and speech discrimination scores. Based on ipsilateral acoustic reflex test at 500HZ, they were divided to normal and abnormal groups. Then they were evaluated by cervical vestibular evoked myogenic potentials (cVEMPs and finally classified in three groups (N Normal ear , (CVUA Contra lateral vertiginous ear with unaffected saccular sensitivity to sound,(IVA Ipsilateral vertiginous ear with affected saccular sensitivity to sound. Results: Thirty affected ears (IVA with decreased vestibular excitability as detected by ab-normal cVEMPs, revealed abnormal findings of acoustic reflex at 500HZ. Whereas, both un-affected (CVUA and normal ears (N had normal results. Multiple comparisons of mean values of cVEMPs (p13,n23 and acoustic reflex at500HZ among the three groups were sig-nificant. The correlation between acoustic reflex at 500HZ and p13 latencies was significant. The n23 latencies showed significant correlation with acoustic reflex at 500HZ. Conclusion: The vestibular sensitivity to sound retains the ability to trigger sound-evoked re-flex of the middle ear at 500 HZ. (Sci J Hamadan Univ Med Sci 2014; 21 (2:99-104

  14. Cough and Cold Medicine Abuse (For Parents)

    Science.gov (United States)

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

  15. Cough in idiopathic pulmonary fibrosis

    NARCIS (Netherlands)

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

    2016-01-01

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

  16. Updated guidelines on cough launched

    Institute of Scientific and Technical Information of China (English)

    WANG Zeng-li

    2006-01-01

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

  17. Cough in idiopathic pulmonary fibrosis

    NARCIS (Netherlands)

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

    2016-01-01

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

  18. Deglutition and Cough in Different Degrees of Parkinson Disease

    Directory of Open Access Journals (Sweden)

    Gasparim, Aretuza Zaupa

    2011-04-01

    Full Text Available Introduction: Parkinson disease is one of the pathologies mostly affecting deglutition. Objective: To analyze the efficiency of both deglutition and cough reflex in cases of laryngeal penetration or tracheal aspiration with food, in different severity stages of Parkinson disease. Study's way: contemporaneous cohort with transverse incision. Method: The sample had 38 patients in the study group and 38 individuals in the control group submitted to a neurologic evaluation and an otorhinolaryngological evaluation by transnasal fiberoptic laryngoscopy. Results: The cough reflex was manifested in 100% of patients without food offering. Alimentary stasis in piriform recesses and epiglottic vallecula in solid, pasty and liquid consistency was significant (p= 0.0000. The laryngeal penetration in liquid consistency was significant (p= 0.0036. Tracheal aspiration occurred in 06 patients of the study group in liquid consistency and it was absent in control group. Conclusion: The efficiency of deglutition in the study group prevailed in the solid consistency, followed by pasty and liquid consistencies. In the control group, deglutition was effective in all individuals. Cough reflex was efficient in most patients of the study group and prevalently inefficient in the subgroup 2.

  19. 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.

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

    Science.gov (United States)

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

    2012-07-28

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

  1. Persistent cough: is it asthma?

    OpenAIRE

    Faniran, A; Peat, J; Woolcock, A

    1998-01-01

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

  2. Interventions for cough in cancer.

    OpenAIRE

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

    2010-01-01

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

  3. Interventions for cough in cancer.

    OpenAIRE

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

    2010-01-01

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

  4. Laryngeal hypersensitivity in chronic cough.

    Science.gov (United States)

    Hull, J H; Menon, A

    2015-12-01

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

  5. Cough induced syncope: A hint to cardiac tamponade diagnosis.

    Science.gov (United States)

    Ramirez, Roberto; Lasam, Glenmore

    2017-05-26

    We report a case of a 75-year-old male with history of lung adenocarcinoma who presented with shortness of breath and frequent episodes of cough-induced syncope. A large pericardial effusion was found on echocardiogram suggestive of cardiac tamponade. Pericardiocentesis was done which improved the dyspnea and eventually resolved the syncope. There are only two other cases reported in the literature with cough-induced syncope in the setting of pericardial effusion or cardiac tamponade. Our clinical vignette also highlights the importance of pulsus paradoxus identification in patients with cough induced syncope to rule out cardiac tamponade since this is the most sensitive physical finding for its diagnosis.

  6. Cough induced syncope: A hint to cardiac tamponade diagnosis

    Science.gov (United States)

    Ramirez, Roberto; Lasam, Glenmore

    2017-01-01

    We report a case of a 75-year-old male with history of lung adenocarcinoma who presented with shortness of breath and frequent episodes of cough-induced syncope. A large pericardial effusion was found on echocardiogram suggestive of cardiac tamponade. Pericardiocentesis was done which improved the dyspnea and eventually resolved the syncope. There are only two other cases reported in the literature with cough-induced syncope in the setting of pericardial effusion or cardiac tamponade. Our clinical vignette also highlights the importance of pulsus paradoxus identification in patients with cough induced syncope to rule out cardiac tamponade since this is the most sensitive physical finding for its diagnosis. PMID:28603595

  7. Distinction between voluntary cough sound and speech in volunteers by spectral and complexity analysis.

    Science.gov (United States)

    Martinek, J; Tatar, M; Javorka, M

    2008-12-01

    Objective monitoring of cough sound for extended period is an important step toward a better understanding of this symptom. Because ambulatory cough monitoring systems are not commercially available, we prepared own monitoring system, which is able to distinguish between voluntary cough sound and speech in healthy volunteers. 20-min sound records were obtained using portable digital voice recorder. Characteristics of the sound events have been calculated in time and frequency domains and by a nonlinear analysis. Based on selected parameters, classification tree was constructed for the classification of cough and non-cough sound events. We validated the usefulness of our algorithm developed against manual counts of cough obtained by a trained observer. The median sensitivity value was 100% (the interquartile range was 98-100) and the median specificity was 95% (the interquartile range was 90-97). In conclusion, we developed an algorithm to distinguish between voluntary cough sound and speech with a high degree of accuracy.

  8. Shoulder reflexes

    DEFF Research Database (Denmark)

    Diederichsen, Louise; Krogsgaard, Michael; Voigt, Michael

    2002-01-01

    Dynamic shoulder stability is dependent on muscular coordination and sensory inputs. In the shoulder, mechanoreceptors are found in the coracoacromial ligament, the rotator cuff tendons, the musculotendinous junctions of the rotator cuff and in the capsule. The number of receptors in the capsule...... is small compared to the number in the other shoulder structures. Proprioceptive information from numerous receptors in muscles and tendons is mediated via fast conducting nervefibers and probably contribute more to kinaestethic sensation than information from capsule and ligaments. Therefore it seems...... likely that the joint receptors have a more distinct role for the kinaestethic sense than muscle receptors. In cats a direct reflex from the afferents innervating the shoulder to the muscles around the shoulder has been presented. The reflex had an extremely short latency (2.7-3.1 ms). In man, a very...

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

    Institute of Scientific and Technical Information of China (English)

    LAI Ke-fang

    2011-01-01

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

  10. Reflexive Positioning in a Politically Sensitive Situation: Dealing with the Threats of Researching the West Bank Settler Experience

    Science.gov (United States)

    Possick, Chaya

    2009-01-01

    For the past 7 years, the author has conducted qualitative research projects revolving around the experiences of West Bank settlers. The political situation in Israel in general, and the West Bank in particular, has undergone rapid and dramatic political, military, and social changes during this period. In highly politically sensitive situations…

  11. Cough and Cold Medicine Abuse

    Science.gov (United States)

    ... nausea produced by high doses of the expectorant guaifenesin commonly found in DXM-containing syrups, young people ... or triple-C), which contain DXM but lack guaifenesin. Drinking promethazine-codeine cough syrup mixed with soda ( ...

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

    Institute of Scientific and Technical Information of China (English)

    赵婷; 邱志宏; 王岚; 余莉; 吕寒静; 邱忠民

    2012-01-01

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

  13. Night cough and general practice research.

    Science.gov (United States)

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

    1986-02-01

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

  14. EVALUATION OF ANTI- TUSSIVE ACTIVITY OF LEAVES OF CAESALPINIA BONDUCELLA F. IN EXPERIMENTALLY INDUCED COUGH IN MICE

    Directory of Open Access Journals (Sweden)

    Sanjay Jain*, Rakesh Barik, Nidhi Yadav and Shivpal Singh

    2013-01-01

    Full Text Available Cough is a natural reflex expulsive defense mechanism of the body, for clearing excess secretions, mucous, inhaled irritants, toxins or foreign substance in the respiratory tract. It is the most common symptom of respiratory disease. When cough becomes serious, opioids are effective, but they have side effects like sedation, constipation, some addiction liability and also compromise the respiratory function. Therefore, there is a need to have effective anti-tussive agent which do not have respiratory suppressant activity. The present study was carried out to evaluate anti-tussive activity of leaves of Caesalpinia bonducella in ammonium hydroxide induced cough model in mice.

  15. Reduced lipolysis response to adipose afferent reflex involved in impaired activation of adrenoceptor-cAMP-PKA-hormone sensitive lipase pathway in obesity

    Science.gov (United States)

    Ding, Lei; Zhang, Feng; Zhao, Ming-Xia; Ren, Xing-Sheng; Chen, Qi; Li, Yue-Hua; Kang, Yu-Ming; Zhu, Guo-Qing

    2016-01-01

    Chemical stimulation of white adipose tissue (WAT) causes adipose afferent reflex (AAR) and sympathetic activation. This study is to investigate the effects of AAR on lipolysis and the mechanisms of attenuated lipolysis response to enhanced AAR in obesity. Obesity was caused by high-fat diet for 12 weeks in rats. AAR was induced by injection of capsaicin into inguinal WAT or electrical stimulation of epididymal WAT afferent nerve. AAR caused sympathetic activation, which was enhanced in obesity rats. AAR increased cAMP levels and PKA activity, promoted hormone sensitive lipase (HSL) and perilipin phosphorylation, and increased lipolysis in WAT, which were attenuated in obesity rats. PKA activity, cAMP, perilipin and β-adrenoceptor levels were reduced, while HSL was upregulated in adipocytes from obesity rats. In primary adipocytes, isoproterenol increased cAMP levels and PKA activity, promoted HSL and perilipin phosphorylation, and increased lipolysis, which were attenuated in obesity rats. The attenuated effects of isoproterenol in adipocytes from obesity rats were prevented by a cAMP analogue dbcAMP. The results indicate that reduced lipolysis response to enhanced AAR in obesity is attributed to the impaired activation of β-adrenoceptor-cAMP-PKA-HSL pathway. Increased cAMP level in adipocytes rectifies the attenuated lipolysis in obesity. PMID:27694818

  16. Reduced lipolysis response to adipose afferent reflex involved in impaired activation of adrenoceptor-cAMP-PKA-hormone sensitive lipase pathway in obesity.

    Science.gov (United States)

    Ding, Lei; Zhang, Feng; Zhao, Ming-Xia; Ren, Xing-Sheng; Chen, Qi; Li, Yue-Hua; Kang, Yu-Ming; Zhu, Guo-Qing

    2016-10-03

    Chemical stimulation of white adipose tissue (WAT) causes adipose afferent reflex (AAR) and sympathetic activation. This study is to investigate the effects of AAR on lipolysis and the mechanisms of attenuated lipolysis response to enhanced AAR in obesity. Obesity was caused by high-fat diet for 12 weeks in rats. AAR was induced by injection of capsaicin into inguinal WAT or electrical stimulation of epididymal WAT afferent nerve. AAR caused sympathetic activation, which was enhanced in obesity rats. AAR increased cAMP levels and PKA activity, promoted hormone sensitive lipase (HSL) and perilipin phosphorylation, and increased lipolysis in WAT, which were attenuated in obesity rats. PKA activity, cAMP, perilipin and β-adrenoceptor levels were reduced, while HSL was upregulated in adipocytes from obesity rats. In primary adipocytes, isoproterenol increased cAMP levels and PKA activity, promoted HSL and perilipin phosphorylation, and increased lipolysis, which were attenuated in obesity rats. The attenuated effects of isoproterenol in adipocytes from obesity rats were prevented by a cAMP analogue dbcAMP. The results indicate that reduced lipolysis response to enhanced AAR in obesity is attributed to the impaired activation of β-adrenoceptor-cAMP-PKA-HSL pathway. Increased cAMP level in adipocytes rectifies the attenuated lipolysis in obesity.

  17. WEAKLY ALGEBRAIC REFLEXIVITY AND STRONGLY ALGEBRAIC REFLEXIVITY

    Institute of Scientific and Technical Information of China (English)

    TaoChangli; LuShijie; ChenPeixin

    2002-01-01

    Algebraic reflexivity introduced by Hadwin is related to linear interpolation. In this paper, the concepts of weakly algebraic reflexivity and strongly algebraic reflexivity which are also related to linear interpolation are introduced. Some properties of them are obtained and some relations between them revealed.

  18. Interventions for cough in cancer.

    Science.gov (United States)

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

    2010-09-08

    Cough is a common symptom in patients with malignancies, especially in patients with lung cancer. Cough is not well controlled in clinical practice and clinicians have few management options to treat it. The primary objective of this review was to determine the effectiveness of interventions, both pharmacological and non-pharmacological, (other than chemotherapy and external beam radiotherapy) in the management of cough in malignant disease (especially in lung cancer). Databases searched included: The Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effectiveness (DARE) (The Cochrane Library issue 4, 2009); MEDLINE (1966 to May 2010); EMBASE (1980 to May 2010); CINAHL (1980 to May 2010); PSYCHINFO (1980 to May 2010); AMED (1985 to May 2010); SIGLE (1980 to May 2010); British Nursing Index (1985 to May 2010); CancerLit (1975 to May 2010). We searched for cough suppressants, antitussives and other drugs with antitussive activity as well as non-pharmacological interventions (see Appendices 1-4 for search terms). We selected randomised controlled trials (RCTs) and clinical trials (quasi-experimental trials, and trials where there is a comparison group but no mention of randomisation) in participants with primary or metastatic lung cancer or other cancers. Two review authors independently assessed titles and abstracts of all studies, and extracted data from all selected studies before reaching consensus. A third review author arbitrated with any disagreement. Meta-analysis was not attempted due to the heterogeneity of studies. Seventeen studies met inclusion criteria and examined either brachytherapy, laser or photodynamic therapy (eight studies) or a variety of pharmacological therapies (nine studies). Overall, there was absence of credible evidence and the majority of studies were of low methodological quality and high risk of bias. Brachytherapy seemed to improve cough in a variety of doses in selected participants

  19. 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.

  20. Dynamics of Voluntary Cough Maneuvers

    Science.gov (United States)

    Naire, Shailesh

    2008-11-01

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

  1. Cough in interstitial lung disease.

    Science.gov (United States)

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

    2015-12-01

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

  2. Reflexes in Psychiatry

    OpenAIRE

    Sanders, Richard D.; Gillig, Paulette Marie

    2011-01-01

    Psychiatric patients often do not cooperate fully with the neurologic examination. Reflexes virtually bypass patient effort and are difficult to consciously determine. This article reviews muscle stretch (deep tendon) reflexes, and pathological reflexes including the extensor plantar (Babinski) and primitive release reflexes. Topics include findings in common psychiatric and neurologic conditions and methods for eliciting these signs.

  3. Reflexive cacti: a survey

    OpenAIRE

    Bojana Mihailović; Marija Rašajski; Zoran Stanić

    2016-01-01

    A graph is called reflexive if its second largest eigenvalue does not exceed 2. We survey the results on reflexive cacti obtained in the last two decades. We also discuss various patterns of appearing of Smith graphs as subgraphs of reflexive cacti. In the Appendix, we survey the recent results concerning reflexive bipartite regular graphs.

  4. The nasocardiac reflex.

    Science.gov (United States)

    Baxandall, M L; Thorn, J L

    1988-06-01

    The oculocardiac reflex is well described and recognised in anaesthesia. The nasocardiac reflex is less well-known. We describe a clinical manifestation of this reflex and describe the relevant anatomy. This reflex may be obtunded during general anaesthesia. during general anaesthesia.

  5. Reflexives in Veracruz Huastec.

    Science.gov (United States)

    Constable, Peter G.

    A study examines various Huastec clause types that are reflexive in some sense, including ordinary reflexives, which involve co-reference. Two mutually exclusive morphosyntactic devices are used in Huastec: reflexive pronouns and verbal morphology. In this way, Huastec is like various European languages. Clauses involving reflexive pronouns and…

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Cox Nancy C

    2005-01-01

    Full Text Available Abstract Background Cough is the most common symptom presenting to doctors. The quality of cough (productive or wet vs dry is used clinically as well as in epidemiology and clinical research. There is however no data on the validity of cough quality descriptors. The study aims were to compare (1 cough quality (wet/dry and brassy/non-brassy to bronchoscopic findings of secretions and tracheomalacia respectively and, (2 parent's vs clinician's evaluation of the cough quality (wet/dry. Methods Cough quality of children (without a known underlying respiratory disease undergoing elective bronchoscopy was independently evaluated by clinicians and parents. A 'blinded' clinician scored the secretions seen at bronchoscopy on pre-determined criteria and graded (1 to 6. Kappa (K statistics was used for agreement, and inter-rater and intra-rater agreement examined on digitally recorded cough. A receiver operating characteristic (ROC curve was used to determine if cough quality related to amount of airway secretions present at bronchoscopy. Results Median age of the 106 children (62 boys, 44 girls enrolled was 2.6 years (IQR 5.7. Parent's assessment of cough quality (wet/dry agreed with clinicians' (K = 0.75, 95%CI 0.58–0.93. When compared to bronchoscopy (bronchoscopic secretion grade 4, clinicians' cough assessment had the highest sensitivity (0.75 and specificity (0.79 and were marginally better than parent(s. The area under the ROC curve was 0.85 (95%CI 0.77–0.92. Intra-observer (K = 1.0 and inter-clinician agreement for wet/dry cough (K = 0.88, 95%CI 0.82–0.94 was very good. Weighted K for inter-rater agreement for bronchoscopic secretion grades was 0.95 (95%CI 0.87–1. Sensitivity and specificity for brassy cough (for tracheomalacia were 0.57 and 0.81 respectively. K for both intra and inter-observer clinician agreement for brassy cough was 0.79 (95%CI 0.73–0.86. Conclusions Dry and wet cough in children, as determined by clinicians and

  8. TCM Differential Treatment of Cough Variant Asthma

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  9. Help Protect Babies from Whooping Cough

    Science.gov (United States)

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

  10. Evidence for neuropathic processes in chronic cough.

    Science.gov (United States)

    Niimi, Akio; Chung, Kian Fan

    2015-12-01

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

  11. Whooping Cough and the Pertussis Vaccine

    Science.gov (United States)

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

  12. Overview of the Management of Cough

    Science.gov (United States)

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

    2014-01-01

    This overview will demonstrate that cough is a common and potentially expensive health-care problem. Improvement in the quality of care of those with cough has been the focus of study for a variety of disciplines in medicine. The purpose of the Cough Guideline and Expert Panel is to synthesize current knowledge in a form that will aid clinical decision-making for the diagnosis and management of cough across disciplines and also identify gaps in knowledge and treatment options. PMID:25080295

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

    Science.gov (United States)

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

  14. An age-dependent sensitivity of the roll-induced vestibuloocular reflex to hypergravity exposure of several days in an amphibian ( Xenopus laevis)

    Science.gov (United States)

    Sebastian, C. E.; Pfau, K.; Horn, E. R.

    In tadpoles of the Southern Clawed Toad ( Xenopus laevis), the effects of an exposure to hypergravity of several days duration on the development of the roll-induced static vestibuloocular reflex (rVOR) were investigated. Special attention was given to the onset of the 9 or 12 days lasting 3G-period during early life. First recordings of the rVOR characteristics for complete 360 ° rolls of the tadpoles were performed 24 hrs after the end of the 3G-period. The rVOR peak-to-peak amplitudes as well as the VOR-gain for a roll angle of 15 ° from 3G-and 1G-samples recorded at the 2nd and 3rd day after 3G-termination agreed for the youngest group, but were reduced by approx. 30% in the older tadpoles. Long-term observations lasting up to 8 weeks after termination of the 3G-period, demonstrated (i) an early retardation of the development, and (ii) a developmental acceleration in all groups so that after 2 weeks in the stage 6/9- and 33/36-samples and after 8 weeks in the stage 45-tadpoles, the rVOR-amplitude as well as the rVOR-gain for a 15 ° roll were at the same level in both the 3G- and the 1G-samples. The results support the existence of a sensitive period for the rVOR development, and additionally demonstrate the importance of the period of the first appearance of the rVOR for the development of adaptive properties of the underlying neuronal network. They also demonstrate the dominant efficiency of genetic programs in the functional development of the vestibular system. Methodological approaches are discussed which will be useful in the further description of the critical period. They include studies on the neuronogenesis and synaptic maturation within the vestibular pathways as well as on the fundamentals of buoyancy control during swimming. A modular but closed mini-system for experimental use is described which allows survival periods lasting many weeks and multiple types of treatments of developing aquatic animals in orbit, controlled automatically.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Efficacy of levodropropizine in pediatric cough.

    Science.gov (United States)

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

    2012-10-01

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

  17. Ineffective cough and mechanical mucociliary clearance techniques.

    Science.gov (United States)

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

    2017-06-12

    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.

  18. The stretch reflex and the contributions of C David Marsden

    Directory of Open Access Journals (Sweden)

    Kalyan B Bhattacharyya

    2017-01-01

    Full Text Available The stretch reflex or myotatic reflex refers to the contraction of a muscle in response to its passive stretching by increasing its contractility as long as the stretch is within physiological limits. For ages, it was thought that the stretch reflex was of short latency and it was synonymous with the tendon reflex, subserving the same spinal reflex arc. However, disparities in the status of the two reflexes in certain clinical situations led Marsden and his collaborators to carry out a series of experiments that helped to establish that the two reflexes had different pathways. That the two reflexes are dissociated has been proved by the fact that the stretch reflex and the tendon reflex, elicited by stimulation of the same muscle, have different latencies, that of the stretch reflex being considerably longer. They hypothesized that the stretch reflex had a transcortical course before it reached the spinal motor neurons for final firing. Additionally, the phenomenon of stimulus-sensitive cortical myoclonus lent further evidence to the presence of the transcortical loop where the EEG correlate preceded the EMG discharge. This concept has been worked out by later neurologists in great detail , and the general consensus is that indeed, the stretch reflex is endowed with a conspicuous transcortical component.

  19. Patterning of somatosympathetic reflexes

    Science.gov (United States)

    Kerman, I. A.; Yates, B. J.

    1999-01-01

    In a previous study, we reported that vestibular nerve stimulation in the cat elicits a specific pattern of sympathetic nerve activation, such that responses are particularly large in the renal nerve. This patterning of vestibulosympathetic reflexes was the same in anesthetized and decerebrate preparations. In the present study, we report that inputs from skin and muscle also elicit a specific patterning of sympathetic outflow, which is distinct from that produced by vestibular stimulation. Renal, superior mesenteric, and lumbar colonic nerves respond most strongly to forelimb and hindlimb nerve stimulation (approximately 60% of maximal nerve activation), whereas external carotid and hypogastric nerves were least sensitive to these inputs (approximately 20% of maximal nerve activation). In contrast to vestibulosympathetic reflexes, the expression of responses to skin and muscle afferent activation differs in decerebrate and anesthetized animals. In baroreceptor-intact animals, somatosympathetic responses were strongly attenuated (to 150 mmHg. These findings demonstrate that different types of somatic inputs elicit specific patterns of sympathetic nerve activation, presumably generated through distinct neural circuits.

  20. Embodied Self-Reflexivity

    Science.gov (United States)

    Pagis, Michal

    2009-01-01

    Drawing on G. H. Mead and Merleau-Ponty, this paper aims to extend our understanding of self-reflexivity beyond the notion of a discursive, abstract, and symbolic process. It offers a framework for embodied self-reflexivity, which anchors the self in the reflexive capacity of bodily sensations. The data consist of two years of ethnographic…

  1. Reflexes from the lungs and airways: historical perspective.

    Science.gov (United States)

    Widdicombe, John

    2006-08-01

    Historical aspects of respiratory reflexes from the lungs and airways are reviewed, up until about 10 yr ago. For most of the 19th century, the possible reflex inputs into the "respiratory center," the position of which had been identified, were very speculative. There was little concept of reflex control of the pattern of breathing. Then, in 1868, Breuer published his paper on "The self-steering of respiration via the Nervus Vagus." For the first time this established the role of vagal inflation and deflation reflexes in determining the pattern of breathing. Head later extended Breuer's work, and Kratschmer laid a similar basis for reflexes from the nose and larynx. Then, 50-60 yr later, the development of the thermionic valve and the oscilloscope allowed recording action potentials from single nerve fibers in the vagus. In 1933, Adrian showed that slowly adapting pulmonary stretch receptors were responsible for the inflation reflex. Later, Knowlton and Larrabee described rapidly adapting receptors and showed that they mediated deep augmented breaths and the deflation reflex. Still later, it was established that rapidly adapting receptors were, at least in part, responsible for cough. In 1954, Paintal began his study of C-fiber receptors (J receptors), work greatly extended by the Coleridges. Since approximately 10 yr ago, when the field of this review stops, there has been an explosion of research on lung and airway receptors, many aspects of which are dealt with in other papers in this series.

  2. Cough

    Science.gov (United States)

    ... in your throat. Warm liquids, such as broth tea or lemon juice, can soothe your throat. Avoid ... Clinic does not endorse any of the third party products and services advertised. Advertising and sponsorship policy ...

  3. Cough

    Science.gov (United States)

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

  4. Coughing

    Science.gov (United States)

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

  5. Whooping cough in a renal transplant recipient.

    Science.gov (United States)

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

    2016-04-01

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

  6. Reflexives and reflexive constructions in Afrikaans

    African Journals Online (AJOL)

    Kate H

    coreferential relationship between the pronoun and some other expression in the sentence. Keywords: reflexives ...... object argument, functions as the complement of a noun. Consider the ...... A minimalist approach to the syntax of. Dutch.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  10. Emotionally Colorful Reflexive Games

    CERN Document Server

    Tarasenko, Sergey

    2011-01-01

    This study addresses the matter of reflexive control of the emotional states by means of Reflexive Game Theory (RGT). It is shown how to build a bridge between RGT and emotions. For this purpose the Pleasure-Arousal-Dominance (PAD) model is adopted. The major advantages of RGT are its ability to predict human behavior and unfold the entire spectra of reflexion in the human mind. On the other hand, PAD provides ultimate approach to model emotions. It is illustrated that emotions are reflexive processes and, consequently, RGT fused with PAD model is natural solution to model emotional interactions between people. The fusion of RGT and PAD, called Emotional Reflexive Games (ERG), inherits the key features of both components. Using ERG, we show how reflexive control can be successfully applied to model human emotional states. Up to date, EGR is a unique methodology capable of modeling human reflexive processes and emotional aspects simultaneously.

  11. Reflex excitability regulates prepulse inhibition.

    Science.gov (United States)

    Schicatano, E J; Peshori, K R; Gopalaswamy, R; Sahay, E; Evinger, C

    2000-06-01

    Presentation of a weak stimulus, a prepulse, before a reflex-evoking stimulus decreases the amplitude of the reflex response relative to reflex amplitude evoked without a preceding prepulse. For example, presenting a brief tone before a trigeminal blink-eliciting stimulus significantly reduces reflex blink amplitude. A common explanation of such data are that sensory processing of the prepulse modifies reflex circuit behavior. The current study investigates the converse hypothesis that the intrinsic characteristics of the reflex circuit rather than prepulse processing determine prepulse modification of trigeminal and acoustic reflex blinks. Unilateral lesions of substantia nigra pars compacta neurons created rats with hyperexcitable trigeminal reflex blinks but normally excitable acoustic reflex blinks. In control rats, presentation of a prepulse reduced the amplitude of both trigeminal and acoustic reflex blinks. In 6-OHDA-lesioned rats, however, the same acoustic prepulse facilitated trigeminal reflex blinks but inhibited acoustic reflex blinks. The magnitude of prepulse modification correlated with reflex excitability. Humans exhibited the same pattern of prepulse modification. An acoustic prepulse facilitated the trigeminal reflex blinks of subjects with hyperexcitable trigeminal reflex blinks caused by Parkinson's disease. The same prepulse inhibited trigeminal reflex blinks of age-matched control subjects. Prepulse modification also correlated with trigeminal reflex blink excitability. These data show that reflex modification by a prepulse reflects the intrinsic characteristics of the reflex circuit rather than an external adjustment of the reflex circuit by the prepulse.

  12. Cough in asthma triggered by reflux episodes.

    Science.gov (United States)

    Mehta, Devendra; He, Zhaoping; Padman, Raj

    2014-05-01

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

  13. 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

  14. 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

  15. Specificity of reflex adaptation for task-relevant variability.

    Science.gov (United States)

    Franklin, David W; Wolpert, Daniel M

    2008-12-24

    The motor system responds to perturbations with reflexes, such as the vestibulo-ocular reflex or stretch reflex, whose gains adapt in response to novel and fixed changes in the environment, such as magnifying spectacles or standing on a tilting platform. Here we demonstrate a reflex response to shifts in the hand's visual location during reaching, which occurs before the onset of voluntary reaction time, and investigate how its magnitude depends on statistical properties of the environment. We examine the change in reflex response to two different distributions of visuomotor discrepancies, both of which have zero mean and equal variance across trials. Critically one distribution is task relevant and the other task irrelevant. The task-relevant discrepancies are maintained to the end of the movement, whereas the task-irrelevant discrepancies are transient such that no discrepancy exists at the end of the movement. The reflex magnitude was assessed using identical probe trials under both distributions. We find opposite directions of adaptation of the reflex response under these two distributions, with increased reflex magnitudes for task-relevant variability and decreased reflex magnitudes for task-irrelevant variability. This demonstrates modulation of reflex magnitudes in the absence of a fixed change in the environment, and shows that reflexes are sensitive to the statistics of tasks with modulation depending on whether the variability is task relevant or task irrelevant.

  16. Abnormal intraepithelial airway nerves in persistent unexplained cough?

    Science.gov (United States)

    O'Connell, F; Springall, D R; Moradoghli-Haftvani, A; Krausz, T; Price, D; Fuller, R W; Polak, J M; Pride, N B

    1995-12-01

    Idiopathic persistent nonproductive cough (PNPC) is characterized by enhanced cough sensitivity to inhaled capsaicin, suggesting that capsaicin-sensitive afferent airway nerves are either present in increased numbers or functionally upregulated. In 16 patients with idiopathic PNPC and eight healthy control subjects, we measured cough sensitivity to inhaled capsaicin and the anatomic density in bronchial epithelium of nerves immunoreactive for the general nerve-marker protein gene product (PGP)-9.5 and the sensory neuropeptides calcitonin-gene-related-peptide (CGRP) and substance-P (SP). The log concentrations of capsaicin required to elicit at least two (C2) and five (C5) coughs were significantly lower in patients (P) than in control subjects (C) (median [range] log C2, P = 0.3 [-0.3 to 1.2] microM; C = 1.5 [0.9 to 2.1], p upper lobe (RUL) and a subsegmental carina of the right lower lobe (RLL), total nerve density (PGP-9.5 immunoreactivity) was greater in P than C, although this was not significant. CGRP-immunoreactive nerve density was significantly higher in P than in C in the RUL (median [range] P = 1.05% [0.13 to 5.08]; C = 0.02% [0 to 0.24], p = 0.001) and RLL (P = 0.59% [0.04 to 3.14]; C = 0% [0 to 0.50], p < 0.02). SP-immunoreactive nerves were not significantly different in the two groups. Abnormal intraepithelial airway nerves containing increased quantities of CGRP are present in patients with idiopathic PNPC.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Whooping cough: identification, assessment and management.

    Science.gov (United States)

    Bentley, Jackie; Pinfield, Jenny; Rouse, Jo

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

  18. Clinical correlation of cervical myelopathy and the hyperactive pectoralis reflex.

    Science.gov (United States)

    Paholpak, Permsak; Jirarattanaphochai, Kitti; Sae-Jung, Surachai; Wittayapairoj, Kriangkrai

    2013-12-01

    A diagnostic study. To validate the correlation between hyperactive pectoralis reflex and the level of cervical myelopathy. The hyperactive pectoralis reflex was proposed to be present in patients with spinal cord compression at the C2-3 and/or C3-4 level. Nevertheless, in a validation study on the correlation of various hyperactive reflexes and the cervical myelopathic level, this particular reflex was not evaluated. All patients presenting with cervical myelopathy between August 2009 and June 2012 were included in this study. Each patient underwent neurological examination for cervical myelopathy focusing on the examination of pathologic reflexes, including the hyperactive pectoralis reflex. We recorded the presence or absence of these reflexes and the level of cervical myelopathy as detected on magnetic resonance imaging. We used the level of spinal cord compression-cranial to C4 of the vertebral body-as the reference level to validate a hyperactive pectoralis reflex. The study included 95 cervical myelopathy patients: 33 patients had most of their compressed cervical cord somewhere above the C4 vertebral body. The hyperactive pectoralis reflex for cervical myelopathy at this level had a respective sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 84.8%, 96.7%, 26.67, and 0.16. The high sensitivity and specificity of the hyperactive pectoralis reflex is very useful for screening and diagnosis of the cervical myelopathic level when it is above the C4 vertebral body.

  19. STUDY OF ANTITUSSIVE POTENTIAL OF GLYCYRRHIZA GLABRA AND ADHATODA VASICA USING A COUGH MODEL INDUCED BY SULPHUR DIOXIDE GAS IN MICE

    Directory of Open Access Journals (Sweden)

    Yasmeen Jahan* and H.H. Siddiqui

    2012-06-01

    Full Text Available Cough is the most common symptom of respiratory diseases. When cough becomes serious, opioids are effective, but they have side effects like sedation, constipation. Therefore, there is a need to have effective antitussive agent which do not have respiratory depressant activity. The present study was carried out to evaluate antitussive activity of Glycyrrhiza glabra and Adhatoda vasica using a cough model induced by sulphur dioxide gas in mice. The effect of the ethanol extracts of Glycyrrhiza glabra and Adhatoda vasica on SO2 gas induced cough in experimental animals have very significant effects at the level of p<0.01 in inhibiting the cough reflex at a dose of 800 mg/kg and 200 mg/kg body wt. p.o., in comparison with the control group. Mice showed an inhibition of 35.62%, in cough on treatment with Glycyrrhiza glabra and 43.02% inhibition on treatment with Adhatoda vasica within 60 min of the experiment. The antitussive activity of the extract was comparable to that of codeine sulphate (10, 15, 20 mg/kg body wt., a standard anti-tussive agent. Codeine sulphate, as a standard drug for suppression of cough, produced 24.80%, 32.98%, and 45.73% inhibition in cough at a dose of 10 mg/kg, 15 mg/kg and 20 mg/kg respectively, whereas, codeine sulphate (20 mg/kg showed maximum 45.73% (p<0.001 inhibition at 60 min of the experiment.

  20. Objective measurement of cough in otherwise healthy volunteers with acute cough.

    Science.gov (United States)

    Sunger, Kanchan; Powley, William; Kelsall, Angela; Sumner, Helen; Murdoch, Robert; Smith, Jaclyn A

    2013-02-01

    Cough is one of the commonest reasons for medical consultation and acute cough associated with upper respiratory tract infections (URTIs) is a global problem. In otherwise healthy volunteers complaining of cough associated with symptoms of URTI, we aimed to assess objective and subjective measures of cough and their repeatability and perform power calculations for the design of future studies to test therapies. We studied 54 otherwise healthy volunteers with acute cough (<3 weeks) (median age 22 yrs (interquartile range 21-26 yrs), 64% female, mean forced expiratory volume in 1 s 97.6±10.5% predicted). All subjects performed 24-h ambulatory cough monitoring and reported cough frequency and severity using visual analogue scales (VAS) on 2 consecutive days. Sample size calculations were performed for crossover and parallel group study designs. Objective cough frequency was high (session 1: geometric mean 12.1 coughs·h(-1) (95%CI 9.7-15.2)) and fell significantly (session 2: 9.0 coughs·h(-1) (95%CI 6.9-11.6); p<0.001). Repeatability was higher for objective cough frequency (intra-class correlation coefficient (ICC)=0.94, p<0.001) than reported cough frequency (daytime VAS ICC=0.784, p<0.001). Crossover/parallel studies require <15 and <41 subjects per arm to detect a 50% reduction in cough frequency with 90% power, respectively. Acute cough frequency is highly repeatable over any 48-h period, allowing small sample sizes to be used when investigating the effectiveness of novel anti-tussives.

  1. Cruciate ligament reflexes

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Dyhre-Poulsen, Poul; Fischer-Rasmussen, Torsten

    2002-01-01

    The idea of muscular reflexes elicited from sensory nerves of the cruciate ligaments is more than 100 years old, but the existence of such reflexes has not been proven until the recent two decades. First in animal experiments, a muscular excitation could be elicited in the hamstrings when the ant...

  2. Reflexivity in qualitative research

    DEFF Research Database (Denmark)

    Evans, Adam Brian; Nistrup, Anne; Henderson, Hannah

    2017-01-01

    There has been something of a “reflexive shift” in sociological research. Sociological researchers are increasingly encouraged to be “present” within their work, and to recognize their own role in structuring the entire research process. One way to achieve this is through engagement in reflexive...... practice, that is, to reflect on our own values, beliefs, and biographies. It can be difficult to know exactly how a researcher should engage in these practices, however. Here, we discuss our reflexive practice in two case studies, both which utilized the same figurational theoretical framework...... Kingdom. Reflexive practice in both studies was affected by researcher biographies and by study design. In Study 1, both researchers were reasonably detached from the study context, the theoretical framework was in place from the very beginning, and reflexive practice was embedded in the study design...

  3. 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.

  4. Regulation of cough and action potentials by voltage-gated Na channels.

    Science.gov (United States)

    Carr, Michael J

    2013-10-01

    The classical role ascribed to voltage-gated Na channels is the conduction of action potentials. Some excitable tissues such as cardiac muscle and skeletal muscle predominantly express a single voltage-gated Na channels isoform. Of the nine voltage-gated Na channels, seven are expressed in neurons, of these Nav 1.7, 1.8 and 1.9 are expressed in sensory neurons including vagal sensory neurons that innervate the airways and initiate cough. Nav 1.7 and Nav 1.9 are of particular interest as they represent two extremes in the functional diversity of voltage-gated Na channels. Voltage-gated Na channel isoforms expressed in airway sensory neurons produce multiple distinct Na currents that underlie distinct aspects of sensory neuron function. The interaction between voltage-gated Na currents underlies the characteristic ability of airway sensory nerves to encode encounters with irritant stimuli into action potential discharge and evoke the cough reflex.

  5. Etnography and Reflexivity

    Directory of Open Access Journals (Sweden)

    Mario Cardano

    2014-01-01

    Full Text Available This essay deals with a relevant and controversial topic – objectivity in ethnographic research. More specifically, I would like to examine how reflexive procedures, more precisely “reflexive account”, can increase the robustness of results gained through an ethnographic research. The essay is organized in five parts. I will start by giving a preliminary definition of the two key concepts which are at the center of the analysis – objectivity and reflexivity. I will then give a brief description of the epistemological framework in which the proposed conceptions of objectivity and reflexivity are located. Thirdly, I move on to consider the epistemic status of ethnographic research, and will emphasize that ethnographies are not just “theory-laden”, as many writers have stated, but also “praxis” or “procedure laden”. In other words, I will stress that it is not only theories which are inevitably embedded in research, influencing how observations can be made; much the same can also be said of the concrete research practices which contribute to determine the experience of the ethnographer and its representation in a text. Fourthly, I will discuss why it is useful to employ reflexive practices, and then immediately afterwards will illustrate the ways in which reflexive descriptions can contribute to greater objectivity of ethnographic accounts. In conclusion, I will discuss a number of objections which have been raised against this use of reflexivity.

  6. On Reflexive Data Models

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, S.

    2000-08-20

    An information system is reflexive if it stores a description of its current structure in the body of stored information and is acting on the base of this information. A data model is reflexive, if its language is meta-closed and can be used to build such a system. The need for reflexive data models in new areas of information technology applications is argued. An attempt to express basic notions related to information systems is made in the case when the system supports and uses meta-closed representation of the data.

  7. Motor learning in common marmosets: vestibulo-ocular reflex adaptation and its sensitivity to inhibitors of Purkinje cell long-term depression.

    Science.gov (United States)

    Anzai, Mari; Nagao, Soich

    2014-06-01

    Adaptation of the horizontal vestibulo-ocular reflex (HVOR) provides an experimental model for cerebellum-dependent motor learning. We developed an eye movement measuring system and a paradigm for induction of HVOR adaptation for the common marmoset. The HVOR gain in dark measured by 10° (peak-to-peak amplitude) and 0.11-0.5Hz turntable oscillation was around unity. The gain-up and gain-down HVOR adaptation was induced by 1h of sustained out-of-phase and in-phase 10°-0.33Hz combined turntable-screen oscillation in the light, respectively. To examine the role of long-term depression (LTD) of parallel fiber-Purkinje cell synapses, we intraperitonially applied T-588 or nimesulide, which block the induction of LTD in vitro or in vivo preparations, 1h before the test of HVOR adaptation. T-588 (3 and 5mg/kg body weight) did not affect nonadapted HVOR gains, and impaired both gain-up and gain-down HVOR adaptation. Nimesulide (3 and 6mg/kg) did not affect nonadapted HVOR gains, and impaired gain-up HVOR adaptation dose-dependently; however, it very little affected gain-down HVOR adaptation. These findings are consistent with the results of our study of nimesulide on the adaptation of horizontal optokinetic response in mice (Le et al., 2010), and support the view that LTD underlies HVOR adaptation.

  8. 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 ...

  9. Management of Cough: a practical approach

    African Journals Online (AJOL)

    subacute cough symptoms, including lung cancers, pulmonary tuberculosis (TB) ... and patients may complain of symptoms of gastric reflux (e.g. heartburn).7-9 .... Weight loss is recommended for overweight or obese patients. 2. Elevation of ...

  10. Towards understanding and managing chronic cough.

    Science.gov (United States)

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

    2016-12-01

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

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

    Medline Plus

    Full Text Available ... the herd dr. offit's testimony not vaccinating the abcs of mmr & dtp thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus ...

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

    Science.gov (United States)

    ... the herd dr. offit's testimony not vaccinating the abcs of mmr & dtp thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus ...

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

    Medline Plus

    Full Text Available ... not vaccinating the abcs of mmr & dtp thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room ...

  14. Associated factors in children with chronic cough.

    Science.gov (United States)

    Khoshoo, Vikram; Edell, Dean; Mohnot, Sopan; Haydel, Robert; Saturno, Emilio; Kobernick, Aaron

    2009-09-01

    Children presenting with chronic cough are common to the primary care physicians, but data on the etiology are scant. We evaluated 40 children (age range, 5 to 12 years) with chronic cough (> 8 weeks duration) with no obvious cause who were referred by their primary care physicians. All patients underwent an extensive multispecialty workup that included pulmonary, GI, allergy, immunology, and otorhinolaryngology testing. Response to treatment was quantified pretreatment and 8 weeks after treatment by using a visual analog scale. Positive diagnostic test results were noted for gastroesophageal reflux disease (27.5%), allergy (22.5%), asthma (12.5%), infection (5%), aspiration (2.5%), and multiple etiologies (20%). Appropriate treatment for these factors resulted in a significant improvement in cough. Reflux, allergy, and asthma accounted for > 80% of the likely etiologic factors of chronic cough in children and responded to appropriate treatment.

  15. 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....

  16. Validation of a pediatric cough questionnaire.

    Science.gov (United States)

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

    2009-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Aslihan Baran

    2014-01-01

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

  18. Reflex receptive fields for human withdrawal reflexes elicited by non-painful and painful electrical stimulation of the foot sole.

    Science.gov (United States)

    Andersen, O K; Sonnenborg, F A; Arendt-Nielsen, L

    2001-04-01

    Human withdrawal reflex receptive fields (RRFs) were assessed for 4 different electrical stimulus intensities, ranging from below the pain threshold (PTh) to up to two times the PTh intensity (0.8x, 1.2x, 1.6x, and 2.0xPTh). Thirteen subjects participated, and the reflexes were recorded in a sitting position. The stimuli were delivered in random order to 12 positions distributed over the foot sole. Tibialis anterior (TA), gastrocnemius medialis (GM), vastus lateralis (VL), and biceps femoris (BF) reflexes were recorded. Further, knee and ankle joint angle changes were recorded. The strongest reflexes were seen in the TA compared with the other 3 muscles. Dorsi-flexion dominated distal to the talocrural joint corresponding to the TA receptive field area. An expansion of the RRF for the TA and GM was seen when increasing the stimulus intensity from 0.8xPTh to 1.2xPTh and from 1.2xPTh to 1.6xPTh, indicating a gradually increasing reflex threshold towards the border, where TA contraction is inappropriate in a withdrawal reaction. For the BF and VL, the borders of the RRF areas were not detected. By integrating the reflex size within the RRF (i.e. the reflex volume), gradually increasing reflexes for increasing stimulus intensity were seen in all 4 muscles tested, most clearly in the TA and GM. The subjective pain intensity correlated to the reflex volume for the TA, GM, and BF. In conclusion, the highest reflex sensitivity was seen in the centre of the RRF, while the stimulus intensity needed for eliciting a reflex increased towards the receptive field border. Within the RRF, stronger reflexes were evoked for increasing stimulus intensity. The limit in the size of the receptive field size for the TA and GM supports a modular withdrawal reflex organisation.

  19. Optimal effect-site concentration of remifentanil for preventing cough during removal of the double-lumen endotracheal tube from sevoflurane-remifentanil anesthesia: A prospective clinical trial.

    Science.gov (United States)

    Lee, Sook Young; Yoo, Ji Young; Kim, Jong Yeop; Kim, Dae Hee; Lee, Jung Dong; Rho, Go Un; Park, Hyungbae; Park, Sung Yong

    2016-06-01

    Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled. The effective effect-site concentration (Ce) of remifentanil for 50% and 95% of patients (EC50 and EC95) for preventing cough was determined using the isotonic regression method with a bootstrapping approach, following the Dixon up-and-down method. Recovery profiles and hemodynamic values after anesthesia were compared between patients with cough and patients without cough.EC50 and EC95 of remifentanil was 1.670 ng/mL [95% confidence interval (95% CI) 1.393-1.806] and 2.275 ng/mL (95% CI 1.950-2.263), respectively. There were no differences in recovery profiles and hemodynamic values after anesthesia between patients with/without cough. No patients suffered respiratory complications during the emergence period.Remifentanil can be a safe and reliable method of cough prevention during emergence from sevoflurane anesthesia after thoracic surgery requiring DLT. EC50 and EC95 of remifentanil that suppresses coughing is 1.670 and 2.275 ng/mL, respectively.

  20. Biological Motion Cues Trigger Reflexive Attentional Orienting

    Science.gov (United States)

    Shi, Jinfu; Weng, Xuchu; He, Sheng; Jiang, Yi

    2010-01-01

    The human visual system is extremely sensitive to biological signals around us. In the current study, we demonstrate that biological motion walking direction can induce robust reflexive attentional orienting. Following a brief presentation of a central point-light walker walking towards either the left or right direction, observers' performance…

  1. Hip proprioceptors preferentially modulate reflexes of the leg in human spinal cord injury

    OpenAIRE

    Onushko, Tanya; Hyngstrom, Allison; Brian D Schmit

    2013-01-01

    Stretch-sensitive afferent feedback from hip muscles has been shown to trigger long-lasting, multijoint reflex responses in people with chronic spinal cord injury (SCI). These reflexes could have important implications for control of leg movements during functional activities, such as walking. Because the control of leg movement relies on reflex regulation at all joints of the limb, we sought to determine whether stretch of hip muscles modulates reflex activity at the knee and ankle and, conv...

  2. Role of the retrotrapezoid nucleus/parafacial respiratory group in coughing and swallowing in guinea pigs

    Science.gov (United States)

    Shiba, Keisuke; Mukudai, Shigeyuki; Umezaki, Toshiro; Sakaguchi, Hirofumi; Hisa, Yasuo

    2015-01-01

    The retrotrapezoid/parafacial respiratory group (RTN/pFRG) located ventral to the facial nucleus plays a key role in regulating breathing, especially enhanced expiratory activity during hypercapnic conditions. To clarify the roles of the RTN/pFRG region in evoking coughing, during which reflexive enhanced expiration is produced, and in swallowing, during which the expiratory activity is consistently halted, we recorded extracellular activity from RTN/pFRG neurons during these fictive behaviors in decerebrate, paralyzed, and artificially ventilated guinea pigs. The activity of the majority of recorded respiratory neurons was changed in synchrony with coughing and swallowing. To further evaluate the contribution of RTN/pFRG neurons to these nonrespiratory behaviors, the motor output patterns during breathing, coughing, and swallowing were compared before and after brain stem transection at the caudal margin of RTN/pFRG region. In addition, the effects of transection at its rostral margin were also investigated to evaluate pontine contribution to these behaviors. During respiration, transection at the rostral margin attenuated the postinspiratory activity of the recurrent laryngeal nerve. Meanwhile, the late expiratory activity of the abdominal nerve was abolished after caudal transection. The caudal transection also decreased the amplitude of the coughing-related abdominal nerve discharge but did not abolish the activity. Swallowing could be elicited even after the caudal end transection. These findings raise the prospect that the RTN/pFRG contributes to expiratory regulation during normal respiration, although this region is not an essential element of the neuronal networks involved in coughing and swallowing. PMID:26203106

  3. Postnatal temporal, spatial and modality tuning of nociceptive cutaneous flexion reflexes in human infants.

    Science.gov (United States)

    Cornelissen, Laura; Fabrizi, Lorenzo; Patten, Deborah; Worley, Alan; Meek, Judith; Boyd, Stewart; Slater, Rebeccah; Fitzgerald, Maria

    2013-01-01

    Cutaneous flexion reflexes are amongst the first behavioural responses to develop and are essential for the protection and survival of the newborn organism. Despite this, there has been no detailed, quantitative study of their maturation in human neonates. Here we use surface electromyographic (EMG) recording of biceps femoris activity in preterm (reflex (>4 seconds) to a single noxious skin lance which decreases significantly with gestational age. This reflex is not restricted to the stimulated limb: heel lance evokes equal ipsilateral and contralateral reflexes in preterm and term infants. We further show that infant flexion withdrawal reflexes are not always nociceptive specific: in 29% of preterm infants, tactile stimulation evokes EMG activity that is indistinguishable from noxious stimulation. In 40% of term infants, tactile responses are also present but significantly smaller than nociceptive reflexes. Infant flexion reflexes are also evoked by application of calibrated punctate von Frey hairs (vFh), 0.8-17.2 g, to the heel. Von Frey hair thresholds increase significantly with gestational age and the magnitude of vFh evoked reflexes are significantly greater in preterm than term infants. Furthermore flexion reflexes in both groups are sensitized by repeated vFh stimulation. Thus human infant flexion reflexes differ in temporal, modality and spatial characteristics from those in adults. Reflex magnitude and tactile sensitivity decreases and nociceptive specificity and spatial organisation increases with gestational age. Strong, relatively non-specific, reflex sensitivity in early life may be important for driving postnatal activity dependent maturation of targeted spinal cord sensory circuits.

  4. Effect of downsampling and compressive sensing on audio-based continuous cough monitoring.

    Science.gov (United States)

    Casaseca-de-la-Higuera, Pablo; Lesso, Paul; McKinstry, Brian; Pinnock, Hilary; Rabinovich, Roberto; McCloughan, Lucy; Monge-Álvarez, Jesús

    2015-01-01

    This paper presents an efficient cough detection system based on simple decision-tree classification of spectral features from a smartphone audio signal. Preliminary evaluation on voluntary coughs shows that the system can achieve 98% sensitivity and 97.13% specificity when the audio signal is sampled at full rate. With this baseline system, we study possible efficiency optimisations by evaluating the effect of downsampling below the Nyquist rate and how the system performance at low sampling frequencies can be improved by incorporating compressive sensing reconstruction schemes. Our results show that undersampling down to 400 Hz can still keep sensitivity and specificity values above 90% despite of aliasing. Furthermore, the sparsity of cough signals in the time domain allows keeping performance figures close to 90% when sampling at 100 Hz using compressive sensing schemes.

  5. Treatment of Neurogenic Cough with Tramadol: A Pilot Study.

    Science.gov (United States)

    Dion, Gregory R; Teng, Stephanie E; Achlatis, Efstratios; Fang, Yixin; Amin, Milan R

    2017-07-01

    This study employs validated cough assessment tools to prospectively determine the impact of tramadol on cough severity and quality of life in subjects with neurogenic cough. The study was a prospective case series with planned data collection at a tertiary care academic medical center laryngology practice. Sixteen consecutive collected subjects with neurogenic cough prospectively completed pre- and posttreatment validated cough assessment tools, the cough severity index (CSI) and Leicester Cough Questionnaire (LCQ). All subjects in the study reported at least some improvement in their cough symptoms. In a Wilcoxon signed rank test that compared paired results, CSI scores improved from 23 to 14 and LCQ scores improved from 74 to 103 ( P = .003 and P = .005, respectively). This small preliminary assessment suggests that tramadol warrants additional evaluation as a treatment for neurogenic cough.

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

    Directory of Open Access Journals (Sweden)

    Woo-Jung Song

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

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

    Directory of Open Access Journals (Sweden)

    Jennifer C. Nitz, PhD, MPhty, BPhty

    2012-12-01

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

  8. The cough response to ultrasonically nebulized distilled water in heart-lung transplantation patients

    Energy Technology Data Exchange (ETDEWEB)

    Higenbottam, T.; Jackson, M.; Woolman, P.; Lowry, R.; Wallwork, J.

    1989-07-01

    As a result of clinical heart-lung transplantation, the lungs are denervated below the level of the tracheal anastomosis. It has been questioned whether afferent vagal reinnervation occurs after surgery. Here we report the cough frequency, during inhalation of ultrasonically nebulized distilled water, of 15 heart-lung transplant patients studied 6 wk to 36 months after surgery. They were compared with 15 normal subjects of a similar age and sex. The distribution of the aerosol was studied in five normal subjects using /sup 99m/technetium diethylene triamine pentaacetate (/sup 99m/Tc-DTPA) in saline. In seven patients, the sensitivity of the laryngeal mucosa to instilled distilled water (0.2 ml) was tested at the time of fiberoptic bronchoscopy by recording the cough response. Ten percent of the aerosol was deposited onto the larynx and trachea, 56% on the central airways, and 34% in the periphery of the lung. The cough response to the aerosol was strikingly diminished in the patients compared with normal subjects (p less than 0.001), but all seven patients coughed when distilled water was instilled onto the larynx. As expected, the laryngeal mucosa of heart-lung transplant patients remains sensitive to distilled water. However, the diminished coughing when the distilled water is distributed by aerosol to the central airways supports the view that vagal afferent nerves do not reinnervate the lungs after heart-lung transplantation, up to 36 months after surgery.

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

    Science.gov (United States)

    Köhler, D; Klauke, M; Schönhofer, B

    1997-06-01

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

  10. 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.

  11. [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.

  12. Corneomandibular reflex: Anatomical basis

    Directory of Open Access Journals (Sweden)

    Michele Pistacchi

    2015-01-01

    Full Text Available Corneomandibular reflex is a pathological phenomenon evident in cases of severe brainstem damage. It is considered to be a pathological exteroceptive reflex, associated with precentro bulbar tract lesions. The sign is useful in distinguishing central neurological injuries to metabolic disorders in acutely comatose patients, localizing lesions to the upper brainstem area, determining the depth of coma and its evolution, providing evidence of uncal or transtentorial herniation in acute cerebral hemisphere lesions, and it is a marker of supraspinal level impairment in amyotrophic lateral sclerosis and multiple sclerosis. This sign was evident in a patient with severe brain damage. We discuss the literature findings and its relevance in prognosis establishment.

  13. Correlational study on atmospheric concentrations of fine particulate matter and children cough variant asthma.

    Science.gov (United States)

    Zhang, Y-X; Liu, Y; Xue, Y; Yang, L-Y; Song, G-D; Zhao, L

    2016-06-01

    We explored the relationship between atmospheric concentrations of fine particulate matter and children cough variant asthma. 48 children all diagnosed with cough variant asthma were placed in the cough asthma group while 50 children suffering from typical asthma were place in typical asthma group. We also had 50 cases of chronic pneumonia (the pneumonia group) and 50 cases of healthy children (the control group). We calculated the average PM 2.5 and temperature values during spring, summer, autumn and winter and monitored serum lymphocyte ratio, CD4+/CD8+T, immunoglobulin IgE, ventilatory index and high-sensitivity C-reactive protein (hs-CRP) levels. Our results showed that PM 2.5 values in spring and winter were remarkably higher compared to other seasons. Correlated analysis demonstrated that the onset of cough asthma group was happening in spring. The onset of typical asthma group happened mostly in winter, followed by spring. We established a positive correlation between the onset of asthma of cough asthma group and PM 2.5 value (r = 0.623, p = 0.017), and there was also a positive correlation between the onset of asthma of typical asthma group and PM 2.5 value (r = 0.714, p = 0.015). Our results showed that lymphocyte ratio and IgE level in the cough asthma group and the typical asthma group were significantly higher. CD4+/CD8+T was significantly lower in the cough asthma group and the typical asthma group. The hs-CRP level in cough asthma, typical asthma and pneumonia groups were significantly higher than that of the control group. The FEV1/predicted value, FEV1/FVC and MMEF/predicted value in the cough asthma group and the typical asthma group were significantly lower than those in other groups, however when comparing between two groups respectively, the difference was not statistically significant. Our findings showed that PM2.5 was related to the onset of children cough variant asthma. PM2.5 reduced immune regulation and ventilatory function.

  14. 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.

  15. The Babinski reflex.

    Science.gov (United States)

    van Gijn, J

    1995-11-01

    The plantar response is a reflex that involves not only the toes, but all muscles that shorten the leg. In the newborn the synergy is brisk, involving all flexor muscles of the leg; these include the toe 'extensors', which also shorten the leg on contraction and therefore are flexors in a physiological sense. As the nervous system matures and the pyramidal tract gains more control over spinal motoneurones the flexion synergy becomes less brisk, and the toe 'extensors' are no longer part of it. The toes then often go down instead of up, as a result of a segmental reflex involving the small foot muscles and the overlying skin, comparable to the abdominal reflexes. With lesions of the pyramidal system, structural or functional, this segmental, downward response of the toes disappears, the flexion synergy may become disinhibited and the extensor hallucis longus muscle is again recruited into the flexion reflex of the leg: the sign of Babinski. A true Babinski sign denotes dysfunction of the pyramidal tract, and should be clearly distinguished from upgoing toes that do not belong to the flexion synergy of the leg. Correct interpretation of the plantar response depends only to a minor degree on the method or site of stimulation of the foot. It is therefore most important to assess the response in the entire leg.

  16. Reflexivity and social justice

    DEFF Research Database (Denmark)

    Maksimovic, Tijana; Jakobsen, Helle Nordentoft

    2017-01-01

    Career practitioners’ reflexive understanding of their professional role as change agents in career guidance and counselling practices has a major impact on how social justice can be achieved. This entitles an awareness of the way in which guidance and counselling practices are embedded in the co...

  17. Identification of Spinal Reflexes

    NARCIS (Netherlands)

    De Vlugt, E.

    2004-01-01

    Visco-elasticity of joints is important for the maintenance of the human body posture and can in two manners be regulated. By means of cocontraction of antagonistic muscle groups and by neural reflexive feedback of muscle length and muscle strength, measured both by means of sensors in the muscles.

  18. Triagem auditiva neonatal com emissões otoacusticas e reflexo cocleo-palpebral: estudo da sensibilidade e especificidade Newborn Hearing Screening with otoacoustic emissions and cochlear-palpebral reflex: sensitivity and specificity study

    Directory of Open Access Journals (Sweden)

    Rosanna Mariangela Giaffredo Angrisani

    2012-10-01

    Full Text Available OBJETIVO: analisar a especificidade e sensibilidade da TAN com emissões otoacústicas evocadas por estimulo transiente (EOAT associadas à pesquisa do reflexo cócleo-palpebral (RCP, comparando-os aos resultados do Potencial Evocado Auditivo de Tronco Encefalico (PEATE. MÉTODO: a casuística do presente estudo foi composta por 369 RN de risco para deficiência auditiva que foram submetidos à triagem com a captação das emissões otoacústicas evocadas por estímulo transiente e pesquisa do reflexo cócleo- palpebral. Os resultados foram comparados aos resultados do Potencial Evocado Auditivo de Tronco Encefalico (PEATE. RESULTADOS: a incidência do tipo da perda auditiva na população geral foi de 4RN (1,1% com perda coclear, 22 (5,9% com perda condutiva, 2 (0,5% com espectro da neuropatia auditiva (ENA, 14 (3,8% com alteração central e 15 (4,1% com atraso de maturação da via auditiva. A TAN mostrou 100% de sensibilidade e 94,6% de especificidade na detecção de alterações cocleares e espectro da neuropatia auditiva; 77,3% de sensibilidade e 94,6% de especificidade na detecção de alterações condutivas e 42,9% de sensibilidade e 94,6% de especificidade na detecção de alterações centrais. Todos os achados evidenciaram diferenças estatisticamente significantes em relação aos neonatos auditivamente normais. CONCLUSÃO: este protocolo de TAN mostrou-se eficaz na detecção de RN com alterações de cocleares e espectro da neuropatia auditiva com sensibilidade e especificidade elevadas.PURPOSE: to study the specificity and sensitivity of NHS with otoacoustic emissions transient stimulus (TEOAE associated with cochlear-palpebral reflex (CPR, and comparing the results of Auditory Evoked Potential (BAEP. METHOD: three hundred and sixty-nine neonates under risk of hearing loss were evaluated. Evaluation procedures consisted of transient otocoustic emissions(TOAEs, cochlear-palpebral reflex (CPR, and ABR diagnostic carried out in the

  19. 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 ...

  20. Efficacy of coughing in tetraplegic patients

    NARCIS (Netherlands)

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

    2000-01-01

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

  1. [Experimental whooping cough of nonhuman primate].

    Science.gov (United States)

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

    2013-01-01

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

  2. 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.

  3. Important drugs for cough in advanced cancer.

    Science.gov (United States)

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

    2001-11-01

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

  4. Cough-induced electrostimulation in incontinence.

    Science.gov (United States)

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

    1994-01-01

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

  5. Efficacy of coughing in tetraplegic patients

    NARCIS (Netherlands)

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

    2000-01-01

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

  6. 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 ...

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Helen ePetsky

    2013-10-01

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

  9. Diagnostic accuracy of fractional exhaled nitric oxide measurement in predicting cough-variant asthma and eosinophilic bronchitis in adults with chronic cough: A systematic review and meta-analysis.

    Science.gov (United States)

    Song, Woo-Jung; Kim, Hyun Jung; Shim, Ji-Su; Won, Ha-Kyeong; Kang, Sung-Yoon; Sohn, Kyoung-Hee; Kim, Byung-Keun; Jo, Eun-Jung; Kim, Min-Hye; Kim, Sang-Heon; Park, Heung-Woo; Kim, Sun-Sin; Chang, Yoon-Seok; Morice, Alyn H; Lee, Byung-Jae; Cho, Sang-Heon

    2017-09-01

    Individual studies have suggested the utility of fractional exhaled nitric oxide (Feno) measurement in detecting cough-variant asthma (CVA) and eosinophilic bronchitis (EB) in patients with chronic cough. We sought to obtain summary estimates of diagnostic test accuracy of Feno measurement in predicting CVA, EB, or both in adults with chronic cough. Electronic databases were searched for studies published until January 2016, without language restriction. Cross-sectional studies that reported the diagnostic accuracy of Feno measurement for detecting CVA or EB were included. Risk of bias was assessed with Quality Assessment of Diagnostic Accuracy Studies 2. Random effects meta-analyses were performed to obtain summary estimates of the diagnostic accuracy of Feno measurement. A total of 15 studies involving 2187 adults with chronic cough were identified. Feno measurement had a moderate diagnostic accuracy in predicting CVA in patients with chronic cough, showing the summary area under the curve to be 0.87 (95% CI, 0.83-0.89). Specificity was higher and more consistent than sensitivity (0.85 [95% CI, 0.81-0.88] and 0.72 [95% CI, 0.61-0.81], respectively). However, in the nonasthmatic population with chronic cough, the diagnostic accuracy to predict EB was found to be relatively lower (summary area under the curve, 0.81 [95% CI, 0.77-0.84]), and specificity was inconsistent. The present meta-analyses indicated the diagnostic potential of Feno measurement as a rule-in test for detecting CVA in adult patients with chronic cough. However, Feno measurement may not be useful to predict EB in nonasthmatic subjects with chronic cough. These findings warrant further studies to validate the roles of Feno measurement in clinical practice of patients with chronic cough. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. The experience of cough in patients diagnosed with lung cancer.

    Science.gov (United States)

    Molassiotis, Alex; Lowe, Matthew; Ellis, Jacqueline; Wagland, Richard; Bailey, Chris; Lloyd-Williams, Mari; Tishelman, Carol; Smith, Jaclyn

    2011-12-01

    The aim of this study was to explore the patient experience of cough in a population of patients with lung cancer. A qualitative exploratory study design was developed and elicited the views of 26 patients with lung cancer who had current or past experience with cough. The data's four themes highlight the complex and distressing nature of cough, including its interaction with other symptoms, such as breathlessness, fatigue and sleep disturbance. A theme around descriptions of cough suggests typically a dry tickly cough and highlights mechanical and environmental triggers for cough. The theme around the effects of cough in daily life shows the impact of cough in socialising, the embarrassment from cough and the psychological effects experienced by patients. The last theme focuses on strategies for coping with and managing cough, showing the perceived ineffectiveness of current antitussives and the patients' use of a variety of approaches on an ad hoc basis to try to manage their cough often unsuccessfully. Cough has not received the same attention as other cancer symptoms, which means that patients' experience of a distressing and difficult symptom is often unnoticed by health care professionals. More clinical and research attention in this debilitating symptom is necessary.

  12. Spinal reflexes in brain death.

    Science.gov (United States)

    Beckmann, Yesim; Çiftçi, Yeliz; Incesu, Tülay Kurt; Seçil, Yaprak; Akhan, Galip

    2014-12-01

    Spontaneous and reflex movements have been described in brain death and these unusual movements might cause uncertainties in diagnosis. In this study we evaluated the presence of spinal reflexes in patients who fulfilled the criteria for brain death. Thirty-two (22 %) of 144 patients presented unexpected motor movements spontaneously or during examinations. These patients exhibited the following signs: undulating toe, increased deep tendon reflexes, plantar responses, Lazarus sign, flexion-withdrawal reflex, facial myokymia, neck-arm flexion, finger jerks and fasciculations. In comparison, there were no significant differences in age, sex, etiology of brain death and hemodynamic laboratory findings in patients with and without reflex motor movement. Spinal reflexes should be well recognized by physicians and it should be born in mind that brain death can be determined in the presence of spinal reflexes.

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

    OpenAIRE

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

    2013-01-01

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

  14. Survey on attitudes of Italian pediatricians toward cough

    Science.gov (United States)

    Zanasi, Alessandro; Morcaldi, Luigi; Cazzato, Salvatore; Mazzolini, Massimiliano; Lecchi, Marzia; Morselli-Labate, Antonio Maria; Mastroroberto, Marianna; Dal Negro, Roberto W

    2017-01-01

    Context Children’s cough is a daily concern for most pediatricians. The management of both acute and chronic cough requires a systematic and comprehensive approach. Despite the approved protocols for management, the pediatric assessment of cough and the corresponding prescribing attitude frequently do not fit these protocols, which can be affected by parental suggestions – sometimes substantially. Objective The objective of this study was to investigate both the perception and the behavior of a representative sample of Italian pediatricians toward cough in real life. Methods A specific questionnaire consisting of 18 questions was prepared. The questionnaire was completed by 300 pediatricians (all members of PAIDOSS: Italian National Observatory on Health of Childhood and Adolescence) who represented ~300,000 children. Results A vast majority of children have cough throughout the year (99.3% of respondents have cough during autumn/winter and 64.7% in spring/summer). Allergic disease is the most frequent suspected cause of chronic cough in children (53%), and this is supported by the high demand for consultations: 73% seek the opinion of allergologists, 62% of otorhinolaryngologists and only 33% of pulmonologists. The majority of pediatricians (92%) reported that they prescribe therapy in acute cough regardless of cough guidelines. Moreover, the survey pointed out the abuse of aerosol therapy (26% in acute cough and 38% in chronic cough) and of antibiotics prescription (22% in acute cough and 42% in chronic cough). Conclusion Our survey suggests that some Italian pediatricians’ therapeutic attitudes should be substantially improved in order to achieve better management of cough in children and to minimize the burden of cough. PMID:28352199

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

    Directory of Open Access Journals (Sweden)

    Patel Hirenjal

    2013-06-01

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

  16. Mentalis muscle related reflexes.

    Science.gov (United States)

    Gündüz, Ayşegül; Uyanık, Özlem; Ertürk, Özdem; Sohtaoğlu, Melis; Kızıltan, Meral Erdemir

    2016-05-01

    The mentalis muscle (MM) arises from the incisive fossa of the mandible, raises and protrudes the lower lip. Here, we aim to characterize responses obtained from MM by supraorbital and median electrical as well as auditory stimuli in a group of 16 healthy volunteers who did not have clinical palmomental reflex. Reflex activities were recorded from the MM and orbicularis oculi (O.oc) after supraorbital and median electrical as well as auditory stimuli. Response rates over MM were consistent after each stimulus, however, mean latencies of MM response were longer than O.oc responses by all stimulation modalities. Shapes and amplitudes of responses from O.oc and MM were similar. Based on our findings, we may say that MM motoneurons have connections with trigeminal, vestibulocochlear and lemniscal pathways similar to other facial muscles and electrophysiological recording of MM responses after electrical and auditory stimulation is possible in healthy subjects.

  17. Reflex epilepsy: a review

    Directory of Open Access Journals (Sweden)

    Karim Nikkhah

    2017-01-01

    Full Text Available Interesting phenomena of reflex epileptic syndromes are characterized by epileptic seizures each one induced by specific stimulus with a variety of types. Simple triggers, which lead to seizures within seconds, are of sensory type (most commonly visual, most rarely tactile or proprioceptive stimuli. Complex triggers, which are mostly of cognitive type such as praxis, reading, talking, and music, usually induce the epileptic event within minutes. It should differ from what most epileptic patients report as provocative precipitants for seizures (such as emotional stress, fatigue, fever, sleep deprivation, alcohol, and menstrual cycle. The identification of a specific trigger is not only important for patients or their parents to avoid seizures, but also it might help neurologists to choose the most effective antiepileptic drug for each case. In addition, research in this area may possibly reveal some underlying pathophysiology of epileptic phenomena in the brain.In this review, we briefly introduce reported reflex epileptic seizures, their clinical features and management.

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

    Directory of Open Access Journals (Sweden)

    Maria Antonietta Catania

    2011-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Halil Akbulut

    2015-08-01

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

  20. Neurophysiological methods for the assessment of spasticity: the Hoffmann reflex, the tendon reflex, and the stretch reflex

    NARCIS (Netherlands)

    Voerman, Gerlienke; Gregoric, M.; Hermens, Hermanus J.

    PURPOSE: To review the literature concerning neurophysiological methods to assess spasticity with respect to mechanisms and methodology, and to describe the three most commonly used methods: the Hoffmann reflex (H-reflex), the Tendon reflex (T-reflex), and the Stretch Reflex (SR). METHOD: A

  1. Probable warfarin interaction with menthol cough drops.

    Science.gov (United States)

    Coderre, Karen; Faria, Claudio; Dyer, Earl

    2010-01-01

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

  2. Spontaneous lung herniation after a single cough

    Energy Technology Data Exchange (ETDEWEB)

    Tack, D.; Delcour, C. [Dept. of Radiology, C. H. U. de Charleroi (Belgium); Wattiez, A. [Dept. of Pneumology, C. H. U. de Charleroi (Belgium); Schtickzelle, J.C. [Dept. of Emergency Medicine, C. H. U. de Charleroi (Belgium)

    2000-03-01

    Herniation of the lung is commonly caused by congenital rib abnormalities, blunt trauma, or thoracic surgery. Spontaneous hernias are rarely described in the literature. We report a case of a spontaneous intercostal pulmonary hernia following a single cough. In addition, a review of the literature is presented which outlines the classification, causes, and incidence of lung hernias. Some reference is made to possible methods of treatment. (orig.)

  3. Adductor T reflex abnormalities in patients with decreased patellar reflexes.

    Science.gov (United States)

    Tataroglu, Cengiz; Deneri, Ersin; Ozkul, Ayca; Sair, Ahmet; Yaycioglu, Soner

    2009-08-01

    The adductor reflex (AR) is a tendon reflex that has various features that differ from other tendon reflexes. This reflex was tested in different disorders presenting with diminished patellar reflexes such as diabetic lumbosacral radiculoplexus neuropathy (DLRPN), L2-L4 radiculopathy, and distal symmetric diabetic neuropathy (diabetic PNP). The AR and crossed-AR (elicited by tapping the contralateral patellar tendon) were recorded using concentric needle electrodes. Additionally, the patellar T reflex (vm-TR) and vastus medialis H reflex (vm-HR) were recorded using surface electrodes. AR was recorded in only one out of eight patients with DLRPN, but it was recorded in 21 out of 22 patients with L2-L4 radiculopathy (95.5%). Of these reflexes, only AR showed prolonged latency in the L2-L4 radiculopathy group. The latencies of AR, vm-TR, and vm-HR were prolonged in patients with diabetic PNP. We conclude that AR can be useful in the differential diagnosis of some lower motor neuron disorders that present with patellar reflex disturbance. Muscle Nerve 40: 264-270, 2009.

  4. Abraham Guz memorial: Still unresolved hypotheses: Lung reflexes and perceptions of breathing.

    Science.gov (United States)

    Noble, Mark I M

    2015-10-01

    This article constitutes a review of the studies performed by the group of the late A. Guz and other authors on the subjects of lung reflexes and perceptions of respiration. The experimental data suggest that the lung inflation and deflation reflexes are present in man, mediated by large myelinated afferent nerve fibres in the vagus nerves, but that the inflation reflex is weaker than in animals, possibly due to central neuronal inhibition. The authors of animal results on the deflation reflex differ as to the afferent fibres involved in the vagi, but it is argued, on the basis of the data, that the preferred hypothesis is that increased activity of the large myelinated mediates the inflation reflex, and decreased activity in these same fibres mediates the deflation reflex. Smaller myelinated fibres are thought to mediate cough and increased breathing in response to airway irritation, while small non-myelinated C fibres mediate hyperpnoea in response to parenchymal congestion and various disease states. The unpleasant sensation at the break point of breath-holding is not chemically mediated but may depend on a complex response involving vagal afferent, phrenic efferent and phrenic afferent pathways. Other experiments in humans on perception of various unpleasant respiratory sensations are discussed with unclear conclusions. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Ability of device to collect bacteria from cough aerosols generated by adults with cystic fibrosis [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    David N. Ku

    2016-08-01

    Full Text Available Background: Identifying lung pathogens and acute spikes in lung counts remain a challenge in the treatment of patients with cystic fibrosis (CF. Bacteria from the deep lung may be sampled from aerosols produced during coughing. Methods: A new device was used to collect and measure bacteria levels from cough aerosols of patients with CF. Sputum and oral specimens were also collected and measured for comparison. Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus mitis were detected in specimens using Real-Time Polymerase Chain Reaction (RT-PCR molecular assays. Results: Twenty adult patients with CF and 10 healthy controls participated. CF related bacteria (CFRB were detected in 13/20 (65% cough specimens versus 15/15 (100% sputum specimens. Commensal S. mitis was present in 0/17 (0%, p=0.0002 cough specimens and 13/14 (93% sputum samples. In normal controls, no bacteria were collected in cough specimens but 4/10 (40% oral specimens were positive for CFRB. Conclusions: Non-invasive cough aerosol collection may detect lower respiratory pathogens in CF patients, with similar specificity and sensitivity to rates detected by BAL, without contamination by oral CFRB or commensal bacteria.

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

    Science.gov (United States)

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

    2014-08-01

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

  7. Exercise-induced neuromuscular dysfunction under reflex conditions.

    Science.gov (United States)

    Kaufman, T; Burke, J R; Davis, J M; Durstine, J L

    2001-06-01

    The purpose of this research was to describe further the effects of exercise-induced muscle damage on reflex sensitivity. The subjects were eight physically active, but untrained males, between the ages of 18 and 29 years. The effects of eccentric and concentric exercise on patellar tendon reflex responses were determined. The 8 week experiment consisted of two, 5 day, test protocols with a 6 week wash-out period between test protocols. Each 5 day test protocol consisted of the following six test sessions: (1) day 1--baseline, (2) day 2 baseline, (3) day 2--immediate post-exercise, and (4-6) days 3-5: 24, 48, and 72 h post-exercise. On day 2, the subjects made either 100 fatiguing concentric or eccentric isotonic contractions using the right leg at 75% of the corresponding repetition maximum values. During each test session, the electromyogram (EMG) and force-time characteristics of basic and conditioned patellar tendon reflex responses were measured. The reflex amplitudes of basic and conditioned patellar tendon reflex responses were decreased following fatiguing concentric exercise. There were no immediate effects of fatiguing eccentric exercise on the basic and conditioned patellar tendon reflex responses, but the EMG amplitudes of these reflex responses were reduced on the days following eccentric exercise. The amount of conditioned patellar tendon reflex facilitation was decreased following the concentric exercise protocol and at 48 h post-eccentric exercise. Our conditioned reflex data suggest that post-exercise changes to the physiological mechanisms that modulate the recruitment gain of the alpha-motoneuron pool may depend upon the type of fatiguing exercise.

  8. Too Busy for Reflexivity?

    DEFF Research Database (Denmark)

    Ratner, Helene

    highlighted non-symmetric relationships between observer and observed and accused the academic text of enacting a realist genre, concealing the relativism entailed in textual production (Clifford and Marcus 1986, Woolgar 1988, Ashmore 1989). On the other hand, the reflexivity program produced fears...... of a “corrosive relativism in which everything is but a more or less clever expression of opinion” (Geertz 1988:2, 3) and it has suffered the little flattering accusations of piling "layer upon layer of self-consciousness to no avail" (Latour 1988:170) with little “interest [for] … theoretically ambitious...

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

    OpenAIRE

    Spinou, Arietta; Birring, Surinder S.

    2014-01-01

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

  10. The cough suppressive activity of sulfated glucuronoxylan from Fagus sylvatica L.

    Science.gov (United States)

    Nosáľova, G; Jureček, L; Turjan, J; Capek, P; Prisenžňáková, L; Fraňová, S

    2014-06-01

    Hemicellulose polysaccharides represent a large group of natural renewable polymers, however, their application potency is still low. In our study a hardwood 4-O-methylglucuronoxylan was isolated by alkali peroxide extraction of Fagus sylvatica sawdust and modified into sulfated water soluble derivative (MGXS). Highly sulfated MGXS was characterized by HPLC, FTIR and NMR spectroscopies, and tested in vivo on chemically induced cough reflex and smooth muscles reactivity. Farmacological tests revealed an interesting antitussive activity of MGXS. Comparative tests with drug commonly used in a clinical practice revealed that antitussive activity of MGXS was lower than that of opioid receptor agonist codeine, the strongest antitussive drug. Furthermore, the specific reactivity of airways smooth muscle was not significantly affected by MGXS, indicating thus that the polymer is not involved in the bronchodilation process.

  11. Proprioceptive reflexes and neurological disorders

    NARCIS (Netherlands)

    Schouten, A.C.

    2004-01-01

    Proprioceptive reflexes play an important role during the control of movement and posture. Disturbed modulation of proprioceptive reflexes is often suggested as the cause for the motoric features present in neurological disorders. In this thesis methods are developed and evaluated to quantify propri

  12. AMPUTATION AND REFLEX SYMPATHETIC DYSTROPHY

    NARCIS (Netherlands)

    GEERTZEN, JHB; EISMA, WH

    Reflex sympathetic dystrophy is a chronic pain syndrome characterized by chronic burning pain, restricted range of motion, oedema and vasolability. Patients are difficult to treat and the prognosis is very often poor. This report emphasizes that an amputation in case of a reflex sympathetic

  13. Reflexive Aero Structures for Enhanced Survivability Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) proposes to develop an advanced reflexive structure system to increase the survivability of aerostructures. This reflexive...

  14. 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.

  15. Acoustic reflex and general anaesthesia.

    Science.gov (United States)

    Farkas, Z

    1983-01-01

    Infant and small children are not always able to cooperate in impedance measurements. For this reason it was decided, -in special cases, -to perform acoustic reflex examination under general anaesthesia. The first report on stapedius reflex and general anaesthesia was published by Mink et al. in 1981. Under the effect of Tiobutabarbital, Propanidid and Diazepam there is no reflex response. Acoustic reflex can be elicited with Ketamin-hydrochlorid and Alphaxalone-alphadolone acetate narcosis. The reflex threshold remains unchanged and the amplitude of muscle contraction is somewhat increased. The method was used: 1. to assess the type and degree of hearing loss in children with cleft palate and/or lip prior to surgery. 2. to exclude neuromuscular disorders with indication of pharyngoplasties. 3. to quantify hearing level in children--mostly multiply handicapped--with retarded speech development. The results of Behavioral Observation and Impedance Audiometry are discussed and evaluated.

  16. [Reflex seizures, cinema and television].

    Science.gov (United States)

    Olivares-Romero, Jesús

    2015-12-16

    In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot.

  17. Psychological profile of individuals presenting with chronic cough

    Science.gov (United States)

    Hulme, Katrin; Deary, Vincent; Dogan, Sian

    2017-01-01

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

  18. LECTURES ON ACUPUNCTURE Part Ⅱ Typical Cases of Cough

    Institute of Scientific and Technical Information of China (English)

    WANG Wei; DONG Hongying; XU Junfeng

    2002-01-01

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

  19. 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.

  20. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Acoustic reflex patterns in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Canale, Andrea; Albera, Roberto; Lacilla, Michelangelo; Canosa, Antonio; Albera, Andrea; Sacco, Francesca; Chiò, Adriano; Calvo, Andrea

    2017-02-01

    The aim of the study is to investigate acoustic reflex testing in amyotrophic lateral sclerosis patients. Amplitude, latency, and rise time of stapedial reflex were recorded for 500 and 1000 Hz contralateral stimulus. Statistical analysis was performed by the Wilcoxon test and the level of significance was set at 5 %. Fifty-one amyotrophic lateral sclerosis patients and ten sex- and age-matched control subjects were studied. Patients were further divided in two groups: amyotrophic lateral sclerosis-bulbar (38 cases, with bulbar signs at evaluation) and amyotrophic lateral sclerosis-spinal (13 cases, without bulbar signs at evaluation). Stapedial reflex was present in all patients. There was a statistically significant difference in the mean amplitude, latency, and rise time between the amyotrophic lateral sclerosis patients as compared with the controls. Amplitude was lower in both the amyotrophic lateral sclerosis-bulbar and the amyotrophic lateral sclerosis-spinal patients than in the controls (p amyotrophic lateral sclerosis cases with bulbar signs and, moreover, suggesting a possible subclinical involvement of the stapedial motor neuron even in amyotrophic lateral sclerosis-spinal patients. Amplitude and rise time seem to be good sensitive parameters for investigating subclinical bulbar involvement.

  3. Sodium cromoglycate and atropine block the fall in FEV1 but not the cough induced by hypotonic mist.

    Science.gov (United States)

    Fuller, R W; Collier, J G

    1984-01-01

    In a group of patients with mild asthma the inhalation of mist derived from ultrasonically nebulised distilled water caused an increase in cough and a fall in FEV1. Double blind administration for five minutes of sodium cromoglycate (from an original solution containing 30 mg/ml) or atropine (2 mg/ml) by inhalation from a Minineb nebuliser, 30 minutes before the mist challenge, caused a significant reduction in the fall in FEV1 (p less than 0.05), but not in cough, by comparison with the protection afforded by placebo (saline). In a second study the fall in FEV1 caused by the inhalation of distilled water was not significantly different from that seen in response to hypotonic sodium chloride (1.7 g/l, 58 mmol/l), but both produced a significantly greater fall than did a similar mist containing sodium cromoglycate at an original concentration of 10 mg/ml (58 mmol/l). The results show that both atropine and sodium cromoglycate can block the fall in FEV1 due to mist and that protection by sodium cromoglycate is immediate. These results suggest that sodium cromoglycate blocks the nervous reflexes concerned in the response to mist, probably in the afferent limb of the reflex. PMID:6437001

  4. Effect of Electronic Cigarette Use on the Urge-to-Cough Sensation.

    Science.gov (United States)

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

    2016-08-01

    Electronic cigarettes (e-cigs) have attained common usage worldwide, yet knowledge of their physiological effects remains minimal. The aim of this study was to evaluate the effect of a single exposure to e-cig vapor on the urge-to-cough (UTC) threshold and C5. Seventeen healthy nonsmokers underwent C5 measurement employing capsaicin cough challenge at baseline, 15 minutes, and 24 hours after e-cig exposure (30 puffs 30 seconds apart). The endpoint of cough challenge is C5, the concentration of capsaicin inducing five or more coughs. The UTC threshold (Cu) is defined as the lowest concentration of capsaicin inducing UTC without an associated motor cough. The Cu and C5 were significantly inhibited (Cu and C5 increased) 15 minutes after e-cig use. Mean log Cu rose from -0.035±0.08 (SEM) to 0.21±0.12 (P = .005). Mean log C5 increased from 0.60±0.11 to 0.92±0.16 (P = .001). By 24 hours after e-cig exposure, Cu and C5 had returned to baseline levels. A single session of e-cig use, approximating nicotine exposure of one tobacco cigarette, induces significant inhibition of the Cu, as well as C5. Previous studies implicate nicotine as the agent responsible for suppression of C5, and we hypothesize a similar role for nicotine in the suppression of the Cu. Given our observation of the effect of a single e-cig exposure, studies of the respiratory physiologic implications of repeated or chronic e-cig use are warranted. This is the first study to demonstrate that a single exposure to an e-cig significantly inhibits the Cu as measured by capsaicin cough challenge testing. These findings add to the growing body of evidence that e-cig vapor is not a physiologically benign substance, and support further investigation of the effects of repeated or chronic use of e-cigs on cough sensitivity and other respiratory parameters. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  6. 77 FR 68132 - Compliance Guidance for Small Business Entities on Labeling for Bronchodilators: Cold, Cough...

    Science.gov (United States)

    2012-11-15

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

  7. The vestibulosympathetic reflex in humans: neural interactions between cardiovascular reflexes

    Science.gov (United States)

    Ray, Chester A.; Monahan, Kevin D.

    2002-01-01

    1. Over the past 5 years, there has been emerging evidence that the vestibular system regulates sympathetic nerve activity in humans. We have studied this issue in humans by using head-down rotation (HDR) in the prone position. 2. These studies have clearly demonstrated increases in muscle sympathetic nerve activity (MSNA) and calf vascular resistance during HDR. These responses are mediated by engagement of the otolith organs and not the semicircular canals. 3. However, differential activation of sympathetic nerve activity has been observed during HDR. Unlike MSNA, skin sympathetic nerve activity does not increase with HDR. 4. Examination of the vestibulosympathetic reflex with other cardiovascular reflexes (i.e. barorereflexes and skeletal muscle reflexes) has shown an additive interaction for MSNA. 5. The additive interaction between the baroreflexes and vestibulosympathetic reflex suggests that the vestibular system may assist in defending against orthostatic challenges in humans by elevating MSNA beyond that of the baroreflexes. 6. In addition, the further increase in MSNA via otolith stimulation during isometric handgrip, when arterial pressure is elevated markedly, indicates that the vestibulosympathetic reflex is a powerful activator of MSNA and may contribute to blood pressure and flow regulation during dynamic exercise. 7. Future studies will help evaluate the importance of the vestibulosympathetic reflex in clinical conditions associated with orthostatic hypotension.

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

    Science.gov (United States)

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

    2016-01-01

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

  9. Questionnaire survey of chronic cough in asthmatic patients

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  10. Oculocardiac reflex during strabismus surgery

    Directory of Open Access Journals (Sweden)

    Mehryar Taghavi Gilani

    2016-12-01

    Full Text Available The activation of oculucardiac reflex (OCR is common during the strabismus surgeries. OCR is known as a trigemino-vagal reflex, which leads to the various side effects including bradycardia, tachycardia, arrhythmia, or in some cases cardiac arrest. This reflex could be activated during intraorbital injections, hematomas, and mechanical stimulation of eyeball and extraocular muscles surgeries. The incidence of OCR varies in a wide range, from 14% to 90%, that depends on anesthetic strategy and drug used for the surgery. The efficacy of various anticholinergic and anesthetic agents on declining the OCR reflex has been evaluated in different studies, especially in children. Although the detection of OCR goes back to 1908, its exact effect is not well recognized during strabismus surgery. In this review, we aimed to summarize the studies investigated the efficacy and potential of various anesthetic medications on inhibiting the OCR in children undergoing strabismus surgery.

  11. Management of Reflex Anoxic Seizures

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-10-01

    Full Text Available Investigators at the Roald Dahl EEG Unit, Alder Hey Children’s NHS Foundation, Liverpool, UK, review the definition, pathophysiology, clinical presentation, and management of reflex anoxic seizures (RAS in children.

  12. Application of Irwin diagnostic procedures for chronic cough

    Directory of Open Access Journals (Sweden)

    Guo-fang FENG

    2011-07-01

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

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

    OpenAIRE

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

    2013-01-01

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

  14. Postnatal temporal, spatial and modality tuning of nociceptive cutaneous flexion reflexes in human infants.

    Directory of Open Access Journals (Sweden)

    Laura Cornelissen

    Full Text Available Cutaneous flexion reflexes are amongst the first behavioural responses to develop and are essential for the protection and survival of the newborn organism. Despite this, there has been no detailed, quantitative study of their maturation in human neonates. Here we use surface electromyographic (EMG recording of biceps femoris activity in preterm (4 seconds to a single noxious skin lance which decreases significantly with gestational age. This reflex is not restricted to the stimulated limb: heel lance evokes equal ipsilateral and contralateral reflexes in preterm and term infants. We further show that infant flexion withdrawal reflexes are not always nociceptive specific: in 29% of preterm infants, tactile stimulation evokes EMG activity that is indistinguishable from noxious stimulation. In 40% of term infants, tactile responses are also present but significantly smaller than nociceptive reflexes. Infant flexion reflexes are also evoked by application of calibrated punctate von Frey hairs (vFh, 0.8-17.2 g, to the heel. Von Frey hair thresholds increase significantly with gestational age and the magnitude of vFh evoked reflexes are significantly greater in preterm than term infants. Furthermore flexion reflexes in both groups are sensitized by repeated vFh stimulation. Thus human infant flexion reflexes differ in temporal, modality and spatial characteristics from those in adults. Reflex magnitude and tactile sensitivity decreases and nociceptive specificity and spatial organisation increases with gestational age. Strong, relatively non-specific, reflex sensitivity in early life may be important for driving postnatal activity dependent maturation of targeted spinal cord sensory circuits.

  15. SYSTEM REFLEXIVE STRATEGIC MARKETING MANAGEMENT

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    A. Dligach

    2013-10-01

    Full Text Available This article reviews the System Reflexive paradigm of strategic marketing management, being based on the alignment of strategic economic interests of stakeholders, specifically, enterprise owners and hired managers, and consumers. The essence of marketing concept of management comes under review, along with the strategic management approaches to business, buildup and alignment of economic interests of business stakeholders. A roadmap for resolving the problems of modern marketing is proposed through the adoption of System Reflexive marketing theory.

  16. SYSTEM REFLEXIVE STRATEGIC MARKETING MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Andrii A. DLIGACH

    2012-07-01

    Full Text Available This article reviews the System Reflexive paradigm of strategic marketing management, being based on the alignment of strategic economic interests of stakeholders, specifically, enterprise owners and hired managers, and consumers. The essence of marketing concept of management comes under review, along with the strategic management approaches to business, buildup and alignment of economic interests of business stakeholders. A roadmap for resolving the problems of modern marketing is proposed through the adoption of System Reflexive marketing theory.

  17. Thenar muscles H reflex in patients with fibromyalgia: A case control study

    Directory of Open Access Journals (Sweden)

    Kamran Azma

    2016-04-01

    Full Text Available Objective: To delineate H-reflex parameters and specify the diagnostic accuracy measures of thenar muscle H-reflex in Fibromyalgia (FM. Methods: The study was a cross sectional study performed on 30 subjects with FM and 30 healthy volunteers in two major referral hospitals. We recorded the number of obtainable thenar H-reflexes and their minimum latency, threshold and amplitude in each group. Results: There was a significantly more chance to elicit the H-reflex in patients with FM. H reflex threshold and minimum latency were lower in FM group but no significant difference was shown for H wave amplitude. According to our study, thenar H-reflex has 46.7% sensitivity, 86.7% specificity and 66.7% diagnostic accuracy to detect FM. It also has moderate predictive values and positive likelihood ratio but low negative likelihood ratio. Conclusion: Higher rate of thenar muscle H-reflex in fibromyalgia can be interpreted as a confirmatory finding to central sensitization theory for this disorder. Obtaining H-reflex from thenar muscles could be a helpful diagnostic tool for fibromyalgia that increases the confidence in diagnosis. Although it is a weak tool for screening because of low sensitivity, it has a relatively high specificity.

  18. Systemic cholecystokinin amplifies vago-vagal reflex responses recorded in vagal motor neurones.

    Science.gov (United States)

    Viard, Edouard; Rogers, Richard C; Hermann, Gerlinda E

    2012-02-01

    Cholecystokinin (CCK) is a potent regulator of visceral functions as a consequence of its actions on vago-vagal reflex circuit elements. This paper addresses three current controversies regarding the role of CCK to control gastric function via vago-vagal reflexes. Specifically: (a) whether CNS vs. peripheral (vagal afferent) receptors are dominant, (b) whether the long (58) vs. short (8) isoform is more potent and (c) whether nutritional status impacts the gain or even the direction of vago-vagal reflexes. Our in vivo recordings of physiologically identified gastric vagal motor neurones (gastric-DMN) involved in the gastric accommodation reflex (GAR) show unequivocally that: (a) receptors in the coeliac-portal circulation are more sensitive in amplifying gastric vagal reflexes; (b) in the periphery, CCK8 is more potent than CCK58; and (c) the nutritional status has a marginal effect on gastric reflex control. While the GAR reflex is more sensitive in the fasted rat, CCK amplifies this sensitivity. Thus, our results are in stark contrast to recent reports which have suggested that vago-vagal reflexes are inverted by the metabolic status of the animal and that this inversion could be mediated by CCK within the CNS.

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

    Science.gov (United States)

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

    2016-09-01

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

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

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    Haruhiko Ogawa

    2000-01-01

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

  1. Laryngeal structure and function in dogs with cough.

    Science.gov (United States)

    Johnson, Lynelle R

    2016-07-15

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

  2. 肾咳辨析%Kidney Cough Differentiation

    Institute of Scientific and Technical Information of China (English)

    张喜梦; 张恒

    2015-01-01

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

  3. 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

  4. 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.

  5. The role of the superior laryngeal nerve in esophageal reflexes.

    Science.gov (United States)

    Lang, I M; Medda, B K; Jadcherla, S; Shaker, R

    2012-06-15

    The aim of this study was to determine the role of the superior laryngeal nerve (SLN) in the following esophageal reflexes: esophago-upper esophageal sphincter (UES) contractile reflex (EUCR), esophago-lower esophageal sphincter (LES) relaxation reflex (ELIR), secondary peristalsis, pharyngeal swallowing, and belch. Cats (N = 43) were decerebrated and instrumented to record EMG of the cricopharyngeus, thyrohyoideus, geniohyoideus, and cricothyroideus; esophageal pressure; and motility of LES. Reflexes were activated by stimulation of the esophagus via slow balloon or rapid air distension at 1 to 16 cm distal to the UES. Slow balloon distension consistently activated EUCR and ELIR from all areas of the esophagus, but the distal esophagus was more sensitive than the proximal esophagus. Transection of SLN or proximal recurrent laryngeal nerves (RLN) blocked EUCR and ELIR generated from the cervical esophagus. Distal RLN transection blocked EUCR from the distal cervical esophagus. Slow distension of all areas of the esophagus except the most proximal few centimeters activated secondary peristalsis, and SLN transection had no effect on secondary peristalsis. Slow distension of all areas of the esophagus inconsistently activated pharyngeal swallows, and SLN transection blocked generation of pharyngeal swallows from all levels of the esophagus. Slow distension of the esophagus inconsistently activated belching, but rapid air distension consistently activated belching from all areas of the esophagus. SLN transection did not block initiation of belch but blocked one aspect of belch, i.e., inhibition of cricopharyngeus EMG. Vagotomy blocked all aspects of belch generated from all areas of esophagus and blocked all responses of all reflexes not blocked by SLN or RLN transection. In conclusion, the SLN mediates all aspects of the pharyngeal swallow, no portion of the secondary peristalsis, and the EUCR and ELIR generated from the proximal esophagus. Considering that SLN is not

  6. 人副流感病毒三型感染对豚鼠咳嗽敏感性的影响%A guinea pig model of parainfluenza virus type 3 infection-induced acute and postinfectious cough

    Institute of Scientific and Technical Information of China (English)

    叶新民; 钟南山; 刘春丽; 刘蓉; 赖克方; 陈如冲

    2010-01-01

    Objective To establish a guinea pig model of cough induced by human parainfluenza virus type 3 (PIV3) infection,and to investigate the change of the cough reflex sensitivity (CRS).Methods Sixty male SPF guinea pigs were divided into 6 groups (n=10,each),namely,a normal control group,an asthma group and 4 groups of PIV3 inoculation which included post-infection day (PID) 6,12,28,and 42.Infected animals were inoculated by intranasal instillation of PIV3 suspension.Control animals were inoculated by uninfected cell culture medium.Asthma animals were sensitized and challenged by ovalbumin.The Buxco system was used to assess cough reflex sensitivity (CRS) elicited by capsaicin and airway hyper-reaction(AHR).Airway inflammation was studied by bronchoalveolar lavage(BAL) cytology and lung histopathology.Results The CRS of PID 6,12,28 and 42 groups was 7.50 (5.25),7.30 (7.25),8.40(9.75) and 8.20 (5.50) Cough counts (CCnt).Compared with 2.50 (3.00) CCnt of the vehicle group,the CRS to capsaicin increased significantly in all the animals with PIV3 inoculation (P value were 0.024,0.03,0.011 and 0.008) and peaked in PID 42.There was no significant difference (P=0.18)between 3.90 (1.75)CCnt of the asthma animals and the normal control.Animals of PID 6 showed significantly greater AHR to 2 highest concentrations of methacholine than the normal controls.BAL total cell counts of both the PIV3-inoculated and the asthma animals were significantly higher than those of the normal control,with the number of lymphocytes increased significantly within first 2 weeks after PIV3 inoculation.The lung pathology of PIV3-inoculated animals showed airway inflammation without pneumonia in acute infectious phase.Conclusions An animal model of cough induced by PIV3 was created.The CRS of infected guinea pigs increased significantly in both acute and subacute phases of cough.Elevation of CRS may be characteristic of cough caused by virus.%目的 研究人副流感病毒3型(PIV3)感染对豚鼠咳

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

    Science.gov (United States)

    Misery, Laurent

    2008-01-01

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

  8. Modelling of coughed droplets in a hospital ward

    DEFF Research Database (Denmark)

    Sadrizadeh, Sasan; Nielsen, Peter Vilhelm

    2016-01-01

    Coughing and its importance for spreading respiratory infectious diseases has been confirmed in many previous studies. The dispersion process of respiratory droplets released by the coughing of a patient in a hospital ward was studied using computational fluid dynamics simulation. Two relatively...... realistic three-dimensional thermal mannequins with a parallel bed arrangement simulated the patients. The maximum dispersion distances in time under ward ventilation conditions were studied. A velocity profile simulated a time-dependent cough with total duration of 0.4 s. The results indicated...

  9. H-reflex changes in adolescents with idiopathic scoliosis: a randomized clinical trial.

    Science.gov (United States)

    Alayat, Mohamed Salaheldien Mohamed; Abdel-Kafy, Ehab Mohamed; Abdelaal, Ashraf Mohamed

    2017-09-01

    [Purpose] To detect H-reflex asymmetry and investigate the effect of direction sensitive exercise therapy protocol among patients with thoracolumbar and/or lumbar scoliosis. [Subjects and Methods] Fifty patients (10-17 years), Cobb's angle 10-20 degrees with thoracolumbar and lumbar scoliosis participated in the study. Soleus H-reflex was tested on both sides during prone lying position and standing position. Patients were randomly assigned into two groups. Group I received direction sensitive exercise therapy while the participants in group II received traditional exercise. Exercises were applied three times per week for twelve successive weeks. [Results] There were significant differences indicating asymmetry in the H-reflex amplitude on concave side. Cobb's angle significantly decreased and the H-reflex amplitude on concave side as well as H concave/convex ratios in both lying and standing significantly increased in both groups. Direction sensitive exercise therapy showed a more significant increase in the measured outcomes than traditional exercises therapy protocol. [Conclusion] H-reflex test was effective in discovering the asymmetry between concave and convex sides. Based on H-reflex test, direction-sensitive exercise therapy was more effective than traditional exercises in decreasing Cobb's angle and increasing H-reflex values as well as H/H percent in concave side in patients with adolescent idiopathic scoliosis.

  10. The trigemino-cervical reflex in tension-type headache.

    Science.gov (United States)

    Nardone, R; Tezzon, F

    2003-05-01

    To investigate the pathophysiology of tension-type headache (TTH) with special reference to central mechanisms and to the involvement of the trigeminal system. Short latency responses can be recorded in tonically active sternocleidomastoid muscle after stimulation of the infraorbital branch of the trigeminal nerve (the trigemino-cervical reflex). This brainstem reflex was studied in 15 healthy subjects, in 15 patients with episodic tension-type headache (ETTH) and in 15 patients with chronic tension-type headache (CTTH) outside of the pain attacks. The trigemino-cervical response was abnormal, in the size or latency, in 13 patients with CTTH and in only one patient with ETTH. This finding strongly suggests that only in the CTTH the underlying pathophysiology involves the trigeminal system. The trigemino-cervical reflex is a sensitive method to evaluate the involvement of the trigeminal brainstem neurones in TTH and their assessment may provide useful diagnostic and prognostic information.

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

    Lifescience Database Archive (English)

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

  12. Modelling of coughed droplets in a hospital ward

    DEFF Research Database (Denmark)

    Sadrizadeh, Sasan; Nielsen, Peter Vilhelm

    2016-01-01

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

  13. Objective measurement of frequency and pattern of nocturnal cough in children with asthma exacerbation.

    Science.gov (United States)

    Hirai, Kota; Enseki, Mayumi; Tabata, Hideyuki; Nukaga, Mariko; Matsuda, Shinichi; Kato, Masahiko; Furuya, Hiroyuki; Mochizuki, Hiroyuki

    2016-08-01

    Although a number of patients with asthma report experiencing persistent cough during sleep, it has not yet been objectively investigated. To classify cough severity and evaluate a characteristic pattern of cough frequency in children with asthma using an objective cough monitoring system. An objective cough monitoring system that specialized in children was used to measure cough frequency and nocturnal cough patterns. Coughs were recorded with microphone and accelerometer and analyzed using a customized software program. The number of nocturnal coughs and the pattern of cough frequency in 30-minute intervals were measured along with the severity of each asthma exacerbation, and the results were compared with children without asthma. The total overnight cough count of 34 children with asthma was higher than that of 15 children without asthma (P children with severe asthma exacerbation was higher than that in children with moderate asthma exacerbation (P children without asthma. The total cough counts and cough patterns in children with asthma were not affected by sex, age, cause of asthma exacerbation, or therapy. Our data indicate huge cough counts and characteristic nocturnal cough patterns in children with asthma. Objective and precise cough monitoring is useful for the management of childhood asthma. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Outside home. Notes on reflexivity

    Directory of Open Access Journals (Sweden)

    Mara Clemente

    2017-01-01

    The paper proffers the idea in which a “reflexive process” on subjectivity can involve and/or hopefully involve the entire experience of the researcher, going beyond the borders of a single research. In the process, unexpected elements of subjectivity can come into play; in other cases the meaning attributed to them can change in time or can have a role different from what had been expected. Some elements, objects of epistemological analyses, as imposed by a reflexive approach, can become objects of attention also on the phenomenological level.

  15. 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.

  16. Pre-emptive oral dexmethorphan reduces fentanyl-induced cough as well as immediate postoperative adrenocortico-tropic hormone and growth hormone level

    Directory of Open Access Journals (Sweden)

    Avik Mukherjee

    2011-01-01

    Full Text Available Background : Fentanyl-induced cough is not always benign and brief and can be remarkably troublesome, spasmodic, and explosive. Dextromethorphan, an opioid derivative with an antitussive action, may be effective in reducing the fentanyl-induced cough. Dextromethorphan, a N-methyl D aspartate receptor antagonist, may have some effect on diminishing the stress response to surgery. This study was undertaken to determine whether preoperative dextromethorphan could effectively attenuate its incidence, severity, and effect on postoperative stress hormone levels. Materials and Methods : Three hundred and twenty patients of American society of anesthesiologists I-II, aged 18-60 years, undergoing elective laparoscopic cholecystectomy or appendicectomy were randomly allocated into two groups (Group C, control; Group D, dextromethorphan consisting of 160 patients each. Patients in Group D received dextromethorphan 40 mg orally and in Group C received placebo tablets 60 minutes before induction of anesthesia. The incidence of cough was recorded for 1 minute after fentanyl injection and graded as none (0, mild (1-2, moderate (3-5, and severe (>5 cough. Blood samples were collected for estimation of stress hormone levels before surgery and again at 1 hour and 24 hours postoperatively and compared. The appearance of adverse reactions was recorded. Results : The incidence of reflex fentanyl cough was lower in dextromethorphan group (3.9% in comparison to placebo (59.8%. Five patients developed mild and one moderate cough in the dextromethorphan group. In the control group, 31 patients developed mild, 29 moderate, and 32 severe cough. The stress hormones were significantly higher at 1 hour and 24 hours postoperatively in both groups in comparison to its preoperative values. However, at 1 hour postoperatively, adrenocorticotropic hormone, epinephrine, and growth hormone values were significantly low in the dextromethorphan group (61.5 ± 21.1 pg/ ml, 142.1 ± 11

  17. The history of examination of reflexes.

    Science.gov (United States)

    Boes, Christopher J

    2014-12-01

    In the late 1800s, Wilhelm Erb, Joseph Babinski, William Gowers, and others helped develop the neurologic examination as we know it today. Erb was one of the first to emphasize a detailed and systematic neurologic exam and was co-discoverer of the muscle stretch reflex, Gowers began studying the knee jerk shortly after it was described, and Babinski focused on finding reliable signs that could differentiate organic from hysterical paralysis. These physicians and others emphasized the bedside examination of reflexes, which have been an important part of the neurologic examination ever since. This review will focus on the history of the examination of the following muscle stretch and superficial/cutaneous reflexes: knee jerk, jaw jerk, deep abdominal reflexes, superficial abdominal reflexes, plantar reflex/Babinski sign, and palmomental reflex. The history of reflex grading will also be discussed.

  18. Spatial control of reflexes, posture and movement in normal conditions and after neurological lesions

    Directory of Open Access Journals (Sweden)

    Feldman Anatol G.

    2016-09-01

    Full Text Available Control of reflexes is usually associated with central modulation of their sensitivity (gain or phase-dependent inhibition and facilitation of their influences on motoneurons (reflex gating. Accumulated empirical findings show that the gain modulation and reflex gating are secondary, emergent properties of central control of spatial thresholds at which reflexes become functional. In this way, the system pre-determines, in a feedforward and task-specific way, where, in a spatial domain or a frame of reference, muscles are allowed to work without directly prescribing EMG activity and forces. This control strategy is illustrated by considering reflex adaptation to repeated muscle stretches in healthy subjects, a process associated with implicit learning and generalization. It has also been shown that spasticity, rigidity, weakness and other neurological motor deficits may have a common source – limitations in the range of spatial threshold control elicited by neural lesions.

  19. Educating the Reflexive Practitioner

    Directory of Open Access Journals (Sweden)

    Marc J. Neveu

    2012-09-01

    wearing any clothes.Notwithstanding such issues, I do believe the studio holds the potentialto be an empowering learning experience. The intention of this article is to question the mode of instruction in an architectural studio. I’ve structured the paper in three parts. First, I will briefly describe the findingsof the study made by the Carnegie Foundation for the Advancementof Teaching known as the Boyer Report.2 To develop and support the findings of the Boyer Report, I introduce the work of the educator Donald Schön. Though I see much merit in the Boyer Report, and Schön’sproposals, I argue that a more nuanced approach is required. I will recommend, therefore, in the second section of this paper that a meansof architectural education as based on the Socratic method may be amore productive approach. My reading of the Socratic method is basedprimarily on early Socratic dialogues and I will specifically use Charmidesto illustrate the issues that I believe are relevant to studio pedagogy.3 From my analysis of Charmides I will, in the third section of the essay,describe how the Socratic method is beneficial to studio pedagogy threeways: reflexive, non-propositional, and finally how Socrates’ approachmay indeed be practical. This last section will be illustrated with a studentproject. It is my conjecture that the Socratic method offers insight intocurrent discussions of educational theory, namely student-centered,project-based learning.

  20. Discrepancy between presumptive and definite causes of chronic cough

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  1. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris

    2015-01-01

    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

  2. Soleus stretch reflex during cycling

    DEFF Research Database (Denmark)

    Grey, Michael James; Pierce, C. W.; Milner, T. E.

    2001-01-01

    The modulation and strength of the human soleus short latency stretch reflex was investigated by mechanically perturbing the ankle during an unconstrained pedaling task. Eight subjects pedaled at 60 rpm against a preload of 10 Nm. A torque pulse was applied to the crank at various positions durin...

  3. Experiments on the fluid dynamics of the human cough

    Science.gov (United States)

    Settles, Gary

    2011-11-01

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

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

    Science.gov (United States)

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

    2012-01-23

    Cough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider. This is an observational study on acute cough associated with upper respiratory tract infection (URTI) in children. The study evaluates the epidemiology and impact of cough on quality of sleep and children's activities, and the outcome of cough with antitussive treatments in pediatric routine clinical practice. Study assessments were performed through a pediatric cough questionnaire (PCQ), developed by the Italian Society of Cough Study. A total of 433 children visited by family care pediatricians for acute cough due to a URTI were enrolled in this study, with mean age of 6.1 years (SD 3.6). Cough type, duration, severity and frequency, cough impact on sleep disturbances of children and parents and on school and sport activities were assessed at baseline. In a subset of 241 children who were either treated with antitussive drugs (levodropropizine n = 101, central antitussives n = 60) or received no treatment (n = 80), the outcome of cough after 6 days was analyzed in terms of resolution, improvement, no change, or worsening. Descriptive analysis, χ2 test, and multivariate analysis with stepwise logistic regression were performed. Cough disturbed sleep in 88% of children and 72% of parents. In children treated with cough suppressants, the duration, type, intensity, and frequency cough were similar at baseline in the two groups respectively treated with levodropropizine and central antitussives (cloperastine and codeine). Both levodropropizine and central drugs reduced cough intensity and frequency. However, percentage of cough resolution was higher with levodropropizine than with central antitussives (47% vs. 28% respectively, p = 0.0012). Acute cough disturbs sleep in most children and their parents. Both levodropropizine and central antitussives reduced cough intensity, with levodropropizine producing a higher cough resolution

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

    Directory of Open Access Journals (Sweden)

    Mangesh Bhalerao

    2013-06-01

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

  6. Reflexivity in Narratives on Practice

    DEFF Research Database (Denmark)

    Jakobsen, Helle Nordentoft; Olesen, Lektor Birgitte Ravn

    Previous research has shown how reflexivity is a precondition for knowledge co-production through productive dialogue in organisational contexts because it entails a re-ordering, re-arranging and re-designing of what one knows and therefore creates new angles of vision. In this paper, we draw...... on Bakhtinian dialogic communication theory and discursive psychology to investigate the written practice narratives of 23 students on a Masters Degree Programme in Educational Studies, focusing on how the process of writing narratives accentuates reflexivity. Our findings indicate that the narratives invite...... a dialogic conception of practice as they entail a conceptual reframing of key elements in practice. In addition, the narratives expose a situational and relational, rather than normative, focus which allows for reflections on emotional and bodily experiences. In conclusion, we argue that practice narratives...

  7. Integrating Reflexivity in Livelihoods Research

    DEFF Research Database (Denmark)

    Prowse, Martin

    2010-01-01

    Much poverty and development research is not explicit about its methodology or philosophical foundations. Based on the extended case method of Burawoy and the epistemological standpoint of critical realism, this paper discusses a methodological approach for reflexive inductive livelihoods researc...... that overcomes the unproductive social science dualism of positivism and social constructivism. The approach is linked to a conceptual framework and a menu of research methods that can be sequenced and iterated in light of research questions.......Much poverty and development research is not explicit about its methodology or philosophical foundations. Based on the extended case method of Burawoy and the epistemological standpoint of critical realism, this paper discusses a methodological approach for reflexive inductive livelihoods research...

  8. Detection of Chlamydophila pneumoniae antigens in patients with chronic cough.

    Science.gov (United States)

    Choroszy-Krol, Irena; Frej-Madrzak, Magdalena; Jama-Kmiecik, Agnieszka; Sarowska, Jolanta; Serek, Pawel; Pirogowicz, Iwona; Nittner-Marszalska, Marita

    2013-01-01

    The aim of this study was to analyze the rate of Chlamydophila pneumoniae infection in adults with symptoms of chronic cough. The study was conducted in 83 hospitalized patients aged 18-67 suffering of chronic cough. The control group consisted of 20 healthy age-matched subjects without any respiratory symptoms. Bacteriological tests on the presence of Chlamydophila pneumoniae antigen were performed in throat swabs by indirect immunofluorescence technique using monoclonal antibodies labeled with fluorescein isothiocyanate. The rate of Chlamydophila infected patients was examined in relation to age and gender. The Chlamydophila pneumoniae antigen was detected in 15 (18 %) out of the 83 patients; about equally in both genders. Furthermore, we found that the patients aged 28-37 constituted the age group that most frequently tested positive for Chlamydophila pneumoniae. Unraveling the presence of Chlamydia infection in chronic cough patients enables to introduce a timely implementation of effective therapy and thus can prevent distant complications.

  9. 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...... with a cough generator. Another heated dummy was used to simulate the second patient in the second bed. The cough consisted of 100% CO2. The Peak Cough Time was 4 s, when the doctor was close to coughing patient and increased more than twice for the exposed patient. The level of exposure (Peak Concentration...... Level) depends on the positioning relative to the cough direction: lying or standing still, facing or turned sideways and changed varied 194 to 10228 ppm. Ventilation rates of 12 h-1 (recommended by present hospital standards) resulted in increased background exposure levels and may suggest risk from...

  10. 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.

  11. Reflexive fatherhood in everyday life

    DEFF Research Database (Denmark)

    Westerling, Allan

    2015-01-01

    This article looks at fathering practices in Denmark, using the findings from a research project on everyday family life in Denmark. It takes a social psychological perspective and employs discursive psychology and theories about reflexive modernisation. It shows how fathers orient towards intimacy...... this analysis and discussion, the article offers a way to understand the complexities of fathering in everyday life from the perspective of fathers....

  12. Integrating Reflexivity in Livelihoods Research

    DEFF Research Database (Denmark)

    Prowse, Martin

    2010-01-01

    Much poverty and development research is not explicit about its methodology or philosophical foundations. Based on the extended case method of Burawoy and the epistemological standpoint of critical realism, this paper discusses a methodological approach for reflexive inductive livelihoods researc...... that overcomes the unproductive social science dualism of positivism and social constructivism. The approach is linked to a conceptual framework and a menu of research methods that can be sequenced and iterated in light of research questions....

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

    Directory of Open Access Journals (Sweden)

    Eric J Zaccone

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

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

    Directory of Open Access Journals (Sweden)

    Yehuda Z. Cohen

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Akira Yamasaki

    2010-03-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Science.gov (United States)

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

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

    Science.gov (United States)

    Mayo, John A; Ritchie, John R

    2009-01-01

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

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

    Science.gov (United States)

    Mayo, John A; Ritchie, John R

    2009-03-06

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

  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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  7. [Clinical relevance of cardiopulmonary reflexes in anesthesiology].

    Science.gov (United States)

    Guerri-Guttenberg, R A; Siaba-Serrate, F; Cacheiro, F J

    2013-10-01

    The baroreflex, chemoreflex, pulmonary reflexes, Bezold-Jarisch and Bainbridge reflexes and their interaction with local mechanisms, are a demonstration of the richness of cardiovascular responses that occur in human beings. As well as these, the anesthesiologist must contend with other variables that interact by attenuating or accentuating cardiopulmonary reflexes such as, anesthetic drugs, surgical manipulation, and patient positioning. In the present article we review these reflexes and their clinical relevance in anesthesiology. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  8. Neural reflexes in inflammation and immunity

    National Research Council Canada - National Science Library

    Andersson, Ulf; Tracey, Kevin J

    2012-01-01

    .... Development of advanced neurophysiological and immunological techniques recently enabled the study of reflex neural circuits that maintain immunological homeostasis, and are essential for health in mammals...

  9. Reflexive Aero Structures for Enhanced Survivability Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) will develop an advanced reflexive structure technology system to increase the survivability of future systems constructed of...

  10. A method of reflexive balancing in a pragmatic, interdisciplinary and reflexive bioethics.

    Science.gov (United States)

    Ives, Jonathan

    2014-07-01

    In recent years there has been a wealth of literature arguing the need for empirical and interdisciplinary approaches to bioethics, based on the premise that an empirically informed ethical analysis is more grounded, contextually sensitive and therefore more relevant to clinical practice than an 'abstract' philosophical analysis. Bioethics has (arguably) always been an interdisciplinary field, and the rise of 'empirical' (bio)ethics need not be seen as an attempt to give a new name to the longstanding practice of interdisciplinary collaboration, but can perhaps best be understood as a substantive attempt to engage with the nature of that interdisciplinarity and to articulate the relationship between the many different disciplines (some of them empirical) that contribute to the field. It can also be described as an endeavour to explain how different disciplinary approaches can be integrated to effectively answer normative questions in bioethics, and fundamental to that endeavour is the need to think about how a robust methodology can be articulated that successfully marries apparently divergent epistemological and metaethical perspectives with method. This paper proposes 'Reflexive Bioethics' (RB) as a methodology for interdisciplinary and empirical bioethics, which utilizes a method of 'Reflexive Balancing' (RBL). RBL has been developed in response to criticisms of various forms of reflective equilibrium, and is built upon a pragmatic characterization of Bioethics and a 'quasi-moral foundationalism', which allows RBL to avoid some of the difficulties associated with RE and yet retain the flexible egalitarianism that makes it intuitively appealing to many.

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

  15. Enhanced D1 and D2 inhibitions induced by low-frequency trains of conditioning stimuli: differential effects on H- and T-reflexes and possible mechanisms.

    Science.gov (United States)

    Mezzarane, Rinaldo André; Magalhães, Fernando Henrique; Chaud, Vitor Martins; Elias, Leonardo Abdala; Kohn, André Fabio

    2015-01-01

    Mechanically evoked reflexes have been postulated to be less sensitive to presynaptic inhibition (PSI) than the H-reflex. This has implications on investigations of spinal cord neurophysiology that are based on the T-reflex. Preceding studies have shown an enhanced effect of PSI on the H-reflex when a train of ~10 conditioning stimuli at 1 Hz was applied to the nerve of the antagonist muscle. The main questions to be addressed in the present study are if indeed T-reflexes are less sensitive to PSI and whether (and to what extent and by what possible mechanisms) the effect of low frequency conditioning, found previously for the H-reflex, can be reproduced on T-reflexes from the soleus muscle. We explored two different conditioning-to-test (C-T) intervals: 15 and 100 ms (corresponding to D1 and D2 inhibitions, respectively). Test stimuli consisted of either electrical pulses applied to the posterior tibial nerve to elicit H-reflexes or mechanical percussion to the Achilles tendon to elicit T-reflexes. The 1 Hz train of conditioning electrical stimuli delivered to the common peroneal nerve induced a stronger effect of PSI as compared to a single conditioning pulse, for both reflexes (T and H), regardless of C-T-intervals. Moreover, the conditioning train of pulses (with respect to a single conditioning pulse) was proportionally more effective for T-reflexes as compared to H-reflexes (irrespective of the C-T interval), which might be associated with the differential contingent of Ia afferents activated by mechanical and electrical test stimuli. A conceivable explanation for the enhanced PSI effect in response to a train of stimuli is the occurrence of homosynaptic depression at synapses on inhibitory interneurons interposed within the PSI pathway. The present results add to the discussion of the sensitivity of the stretch reflex pathway to PSI and its functional role.

  16. Carotid baroreceptor reflexes in humans during orthostatic stress.

    Science.gov (United States)

    Cooper, V L; Hainsworth, R

    2001-09-01

    Orthostatic stress, including standing, head-up tilting and lower body suction, results in increases in peripheral vascular resistance but little or no change in mean arterial pressure. This study was undertaken to determine whether the sensitivity of the carotid baroreceptor reflex was enhanced during conditions of decreased venous return. We studied eight healthy subjects and determined responses of pulse interval (ECG) and forearm vascular resistance (mean finger blood pressure divided by Doppler estimate of brachial artery blood velocity) to graded increases and decreases in carotid transmural pressure, effected by a neck suction/pressure device. Responses were determined with and without the application of lower body negative pressure (LBNP) at -40 mmHg. Stimulus-response curves were determined as the responses to graded neck pressure changes and the differential of this provided estimates of reflex sensitivity. Changes in carotid transmural pressure caused graded changes in R-R interval and vascular resistance. The cardiac responses were unaffected by LBNP. Vascular resistance responses, however, were significantly enhanced during LBNP and the peak gain of the reflex was increased from 1.2 +/- 0.3 (mean +/- S.E.M.) to 2.2 +/- 0.3 units (P < 0.05). The increased baroreflex gain may contribute to maintenance of blood pressure during orthostatic stress and limit the pressure decreases during prolonged periods of such stress.

  17. Hip proprioceptors preferentially modulate reflexes of the leg in human spinal cord injury.

    Science.gov (United States)

    Onushko, Tanya; Hyngstrom, Allison; Schmit, Brian D

    2013-07-01

    Stretch-sensitive afferent feedback from hip muscles has been shown to trigger long-lasting, multijoint reflex responses in people with chronic spinal cord injury (SCI). These reflexes could have important implications for control of leg movements during functional activities, such as walking. Because the control of leg movement relies on reflex regulation at all joints of the limb, we sought to determine whether stretch of hip muscles modulates reflex activity at the knee and ankle and, conversely, whether knee and ankle stretch afferents affect hip-triggered reflexes. A custom-built servomotor apparatus was used to stretch the hip muscles in nine chronic SCI subjects by oscillating the legs about the hip joint bilaterally from 10° of extension to 40° flexion. To test whether stretch-related feedback from the knee or ankle would be affected by hip movement, patellar tendon percussions and Achilles tendon vibration were delivered when the hip was either extending or flexing. Surface electromyograms (EMGs) and joint torques were recorded from both legs. Patellar tendon percussions and Achilles tendon vibration both elicited reflex responses local to the knee or ankle, respectively, and did not influence reflex responses observed at the hip. Rather, the movement direction of the hip modulated the reflex responses local to the joint. The patellar tendon reflex amplitude was larger when the perturbation was delivered during hip extension compared with hip flexion. The response to Achilles vibration was modulated by hip movement, with an increased tonic component during hip flexion compared with extension. These results demonstrate that hip-mediated sensory signals modulate activity in distal muscles of the leg and appear to play a unique role in modulation of spastic muscle activity throughout the leg in SCI.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  20. 76 FR 44475 - Labeling for Bronchodilators To Treat Asthma; Cold, Cough, Allergy, Bronchodilator, and...

    Science.gov (United States)

    2011-07-26

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

  1. Reflexivity in Narratives on Practice

    DEFF Research Database (Denmark)

    Jakobsen, Helle Nordentoft; Olesen, Lektor Birgitte Ravn

    on Bakhtinian dialogic communication theory and discursive psychology to investigate the written practice narratives of 23 students on a Masters Degree Programme in Educational Studies, focusing on how the process of writing narratives accentuates reflexivity. Our findings indicate that the narratives invite...... a dialogic conception of practice as they entail a conceptual reframing of key elements in practice. In addition, the narratives expose a situational and relational, rather than normative, focus which allows for reflections on emotional and bodily experiences. In conclusion, we argue that practice narratives...

  2. Two ways to support reflexivity

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine; Knudsen, Hanne

    2013-01-01

    Management (MEM). MEM provides the participating managers with a new language that can give them a critical distance to the overload of expectations they meet at work and MEM teaches the participants to translate this new language into practice. The pedagogy used for this is labelled ‘experimental management......’. This requires participants to conduct experiments in their own organization, to reflect on and analyse their experiences with concepts from the curriculum. While the new language and the experimental teaching format are difficult, the participants learn a reflexive practice that can enable them to life up...

  3. Structural cure for reflex syncope?

    Science.gov (United States)

    Sulke, Neil; Eysenck, William; Badiani, Sveeta; Furniss, Stephen

    2016-01-20

    The ROX Coupler is a device that allows creation of a central arteriovenous anastomosis at the iliac level. The device has been shown to improve exercise capacity in patients with chronic obstructive pulmonary disease and is CE marked for the treatment of resistant and uncontrolled hypertension. Reflex syncope is a challenging clinical condition with limited proven therapeutic options. We describe the resolution of symptoms and tilt table response of a patient who underwent insertion of a ROX Coupler to treat hypertension, and also incidentally had pre-existing vasodepressor syncope.

  4. The Dynamics of the Stapedial Acoustic Reflex.

    Science.gov (United States)

    Moss, Sherrin Mary

    Available from UMI in association with The British Library. This thesis aims to separate the neural and muscular components of the stapedial acoustic reflex, both anatomically and physiologically. It aims to present an hypothesis to account for the differences between ipsilateral and contralateral reflex characteristics which have so far been unexplained, and achieve a greater understanding of the mechanisms underlying the reflex dynamics. A technique enabling faithful reproduction of the time course of the reflex is used throughout the experimental work. The technique measures tympanic membrane displacement as a result of reflex stapedius muscle contraction. The recorded response can be directly related to the mechanics of the middle ear and stapedius muscle contraction. Some development of the technique is undertaken by the author. A model of the reflex neural arc and stapedius muscle dynamics is evolved that is based upon a second order system. The model is unique in that it includes a latency in the ipsilateral negative feedback loop. Oscillations commonly observed on reflex responses are seen to be produced because of the inclusion of a latency in the feedback loop. The model demonstrates and explains the complex relationships between neural and muscle dynamic parameters observed in the experimental work. This more comprehensive understanding of the interaction between the stapedius dynamics and the neural arc of the reflex would not usually have been possible using human subjects, coupled with a non-invasive measurement technique. Evidence from the experimental work revealed the ipsilateral reflex to have, on average, a 5 dB lower threshold than the contralateral reflex. The oscillatory charcteristics, and the steady state response, of the contralateral reflex are also seen to be significantly different from those of the ipsilateral reflex. An hypothesis to account for the experimental observations is proposed. It is propounded that chemical neurotransmitters

  5. [Non-reflex activity of the CNS].

    Science.gov (United States)

    Brozek, G

    1995-06-01

    Recent studies of biological rhythms have modified Sherrington's concept of nervous system as exclusively reflexive to include the fact that some neural activity is also endogenously rhythmic. Reflexes are undoubtedly the most important components of animal's and human behavior. But are reflexes the basic units of all complex movements and acts? Rhythmical movements such as respiration, walking and running and other forms of locomotion, as well as rhythmical alimentary processes such as respiration, walking and running and other forms of locomotion, as well as rhythmical alimentary processes such as licking, mastication, and the peristaltic propulsion of nutrients and waste are examples of acts controlled by intrinsic oscillators, so called central pattern generators. Information from the periphery is, however, essential for controlling the extent and rate of movements. Between reflex and non-reflex activity it is possible to place complex species-specific responses called by ethologists fixed-action patterns. Recent investigators have shown that many complex sequences of behavior like speech or piano playing are determined by an internal plan, rather than being generated by a "chain" of reflexes. Non-reflexive activity appears earlier in ontogeny, and is probably phylogenetically older than reflexes.

  6. Reflexive choice in Dutch and German

    NARCIS (Netherlands)

    Hendriks, Petra; Hoeks, John C. J.; Spenader, Jennifer

    2014-01-01

    Standard Dutch and German have two reflexive forms: a weak form ('zich' in Dutch and 'sich' in German) and a strong form ('zichzelf' in Dutch and 'sich selbst' in German). The choice between the two reflexive forms in Dutch has been explained by the selectional restrictions of the verb, distinguishi

  7. Reflexivity in Teams: A Measure and Correlates

    NARCIS (Netherlands)

    M.C. Schippers (Michaéla); D.N. den Hartog (Deanne); P.L. Koopman (Paul)

    2005-01-01

    textabstractReflexivity -the extent to which teams reflect upon and modify their functioning- has been identified as a possible key factor in the effectiveness of work teams. The aim of the present study was to develop a questionnaire to measure (aspects of) reflexivity, with a focus on team reflect

  8. Axon reflexes in human cold exposed fingers

    NARCIS (Netherlands)

    Daanen, H.A.M.; Ducharme, M.B.

    2000-01-01

    Exposure of fingers to severe cold induces cold induced vasodilation (CIVD). The mechanism of CIVD is still debated. The original theory states that an axon reflex causes CIVD. To test this hypothesis, axon reflexes were evoked by electrical stimulation of the middle fingers of hands immersed in

  9. Axon reflexes in human cold exposed fingers

    NARCIS (Netherlands)

    Daanen, H.A.M.; Ducharme, M.B.

    2000-01-01

    Exposure of fingers to severe cold induces cold induced vasodilation (CIVD). The mechanism of CIVD is still debated. The original theory states that an axon reflex causes CIVD. To test this hypothesis, axon reflexes were evoked by electrical stimulation of the middle fingers of hands immersed in wat

  10. [Cutaneo-muscular reflexes of the human hand. II. Neurophysiologic aspects of reflex organization and coordination].

    Science.gov (United States)

    Meinck, H M; Berkefeld, J; Conrad, B

    1987-09-01

    The organization and coordination of cutaneo-muscular reflexes of human finger and arm muscles to electrical stimulation of the digital nerves were investigated in 14 healthy volunteers. Thumb and finger muscles, although antagonists, showed homonymous reflex effects whereas the wrist and elbow muscles exhibited an reciprocally alternating reflex pattern in pairs of antagonists (Fig. 1). The mechanographical correlate of the homonymous reflex activity in distal muscles was a short release (Fig. 6). The receptive field for evoking such reflex effects covered both the palmar and dorsal surfaces of the fingers (Fig. 2). However, with stimulation of the thumb, the muscles of the fingers and of the wrist showed reflex reversal (Figs 3, 5). If the stimulus was moved from the second to the fifth fingers, a successive attenuation of the transcortical reflex component was seen (Fig. 4). It is concluded that the reflexes investigated are complex flexor reflexes comprising both a distal release and a proximal flexion synergy. According to opposition of the thumb in grasping, the receptive field terminates between thumb and index finger. These reflexes are supposed to have no assisting function during corticalized manipulatory movements--in contrast to the long-loop reflexes evoked by epicritic sensibility. The transcortical servo is blocked if the eliciting stimulus is contaminated by nociceptive signals; its receptive field is confined to those fingers used in the precision grip.

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

    DEFF Research Database (Denmark)

    Pantelic, J.; Tham, K. W.; Licina, Dusan

    2015-01-01

    The inhalation intake fraction was used as an indicator to compare effects of desktop personalized ventilation and mixing ventilation on personal exposure to directly released simulated cough droplets. A cough machine was used to simulate cough release from the front, back, and side of a thermal...... the inhalation intake fraction compared to mixing ventilation for all investigated distances and orientations of the cough release. The results point out that the orientation between the cough source and the breathing zone of the exposed occupant is an important factor that substantially influences exposure...

  12. Reliability of the NINDS Myotatic Reflex Scale.

    Science.gov (United States)

    Litvan, I; Mangone, C A; Werden, W; Bueri, J A; Estol, C J; Garcea, D O; Rey, R C; Sica, R E; Hallett, M; Bartko, J J

    1996-10-01

    The assessment of deep tendon reflexes is useful for localization and diagnosis of neurologic disorders, but only a few studies have evaluated their reliability. We assessed the reliability of four neurologists, instructed in two different countries, in using the National Institute of Neurological Disorders and Stroke (NINDS) Myotatic Reflex Scale. To evaluate the role of training in using the scale, the neurologists randomly and blindly evaluated a total of 80 patients, 40 before and 40 after a training session. Inter- and intraobserver reliability were measured with kappa statistics. Our results showed substantial to near-perfect intraobserver reliability, and moderate-to-substantial interobserver reliability of the NINDS Myotatic Reflex Scale. The reproducibility was better for reflexes in the lower than in the upper extremities. Neither educational background nor the training session influenced the reliability of our results. The NINDS Myotatic Reflex Scale has sufficient reliability to be adopted as a universal scale.

  13. Recruitment properties and significance of short latency reflexes in neck and eye muscles evoked by brief lateral head accelerations.

    Science.gov (United States)

    Colebatch, James G; Dennis, Danielle L; Govender, Sendhil; Chen, Peggy; Todd, Neil P McAngus

    2014-09-01

    Short lateral head accelerations were applied to investigate the recruitment properties of the reflexes underlying the earliest ocular and cervical electromyographic reflex responses to these disturbances. Components of both reflexes are vestibular dependent and have been termed "ocular vestibular evoked myogenic potentials" and "cervical vestibular evoked myogenic potentials", respectively. Previous investigations using a unilateral vestibular stimulus have indicated that some but not all these vestibular-dependent reflexes show a simple power law relationship to stimulus intensity. In particular, crossed otolith-ocular reflexes showed evidence of an inflection separating two types of behaviour. The present stimulus acts bilaterally, and only the earliest crossed otolith-ocular reflex, previously shown to have a strictly unilateral origin, showed evidence of an inflection. Reflex changes in ocular torsion could, in principle, correct for the changes associated with translation for an elevated eye, but our findings indicated that the responses were consistent with previous reports of tilt-type reflexes. For the neck, both vestibular and segmental (muscle spindle) reflexes were evoked and followed power law relationships, without any clear separation in sensitivity. Our findings are consistent with previous evidence of "tilt-like" reflexes evoked by lateral acceleration and suggest that the departure from a power law occurs as a consequence of a unilateral crossed pathway. For the neck, responses to transients are likely to always consist of both vestibular and non-vestibular (segmental) components. Most of the translation-evoked ocular and cervical reflexes appear to follow power law relationship to stimulus amplitude over a physiological range.

  14. 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.

  15. The cardiopulmonary reflexes of spontaneously hypertensive rats are normalized after regression of left ventricular hypertrophy and hypertension

    Directory of Open Access Journals (Sweden)

    T.A. Uggere

    2000-05-01

    Full Text Available Cardiopulmonary reflexes are activated via changes in cardiac filling pressure (volume-sensitive reflex and chemical stimulation (chemosensitive reflex. The sensitivity of the cardiopulmonary reflexes to these stimuli is impaired in the spontaneously hypertensive rat (SHR and other models of hypertension and is thought to be associated with cardiac hypertrophy. The present study investigated whether the sensitivity of the cardiopulmonary reflexes in SHR is restored when cardiac hypertrophy and hypertension are reduced by enalapril treatment. Untreated SHR and WKY rats were fed a normal diet. Another groups of rats were treated with enalapril (10 mg kg-1 day-1, mixed in the diet; SHRE or WKYE for one month. After treatment, the volume-sensitive reflex was evaluated in each group by determining the decrease in magnitude of the efferent renal sympathetic nerve activity (RSNA produced by acute isotonic saline volume expansion. Chemoreflex sensitivity was evaluated by examining the bradycardia response elicited by phenyldiguanide administration. Cardiac hypertrophy was determined from the left ventricular/body weight (LV/BW ratio. Volume expansion produced an attenuated renal sympathoinhibitory response in SHR as compared to WKY rats. As compared to the levels observed in normotensive WKY rats, however, enalapril treatment restored the volume expansion-induced decrease in RSNA in SHRE. SHR with established hypertension had a higher LV/BW ratio (45% as compared to normotensive WKY rats. With enalapril treatment, the LV/BW ratio was reduced to 19% in SHRE. Finally, the reflex-induced bradycardia response produced by phenyldiguanide was significantly attenuated in SHR compared to WKY rats. Unlike the effects on the volume reflex, the sensitivity of the cardiac chemosensitive reflex to phenyldiguanide was not restored by enalapril treatment in SHRE. Taken together, these results indicate that the impairment of the volume-sensitive, but not the

  16. Whooping cough in adults: an update on a reemerging infection.

    Science.gov (United States)

    Paisley, Robert D; Blaylock, Jason; Hartzell, Joshua D

    2012-02-01

    Pertussis, or whooping cough, which is commonly thought of as a pediatric illness, is an underappreciated adult pathogen. Recent outbreaks highlight the significance of pertussis in adults and the risk of transmission to at-risk infants who are most susceptible to complications, including death. This article describes the recent epidemiologic shifts and reviews the clinical presentation, diagnosis, and treatment of pertussis. New vaccination recommendations by the Advisory Committee on Immunization Practices in response to recent outbreaks and infant deaths are highlighted.

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

    OpenAIRE

    2009-01-01

    A patient presented with extensive marginal ditching around restorations recently placed during whole-mouth rehabilitation. The patient was not xerostomic and was otherwise normal except for the self-reported excessive use of “sugar-free” cough drops sweetened with sorbitol and Isomalt® (an equimolar mix of glucosyl-mannitol and glucosylsorbitol). This prompted an in vitro investigation to determine whether Streptococcus sobrinus 6715, a cariogenic streptococcus, could grow and produce acid i...

  18. 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.

  19. 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.

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

    OpenAIRE

    2015-01-01

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

  1. Does inhaling menthol affect nasal patency or cough?

    Science.gov (United States)

    Kenia, Priti; Houghton, Tom; Beardsmore, Caroline

    2008-06-01

    There is widespread use of menthol in over-the-counter medications, despite scant information on any beneficial effects. Our aim was to assess the effect of menthol on nasal air flow, perception of nasal patency and cough challenge testing. Subjects comprised 42 healthy children aged 10 and 11 in a school setting. We used a single-blind pseudo-randomized cross-over trial to compare the effect of an inhalation of either menthol or placebo(eucalyptus oil). Baseline and post-intervention measurements were made on each of 2 consecutive days. Main outcome measures were (i) nasal expiratory and inspiratory flows and volumes, measured by spirometer, (ii) perception of nasal patency, assessed with a visual analogue scale (VAS), and (iii) the number of coughs in response to nebulized citric acid. There was no effect of menthol on any of the spirometric measurements. Following menthol, there was a significant increase in the perception of nasal patency (mean difference in log VAS (menthol-placebo) = -0.207, 95%CI -0.329, -0.085). The cough count after menthol inhalation was reduced when compared to baseline but the change was not different from that after placebo (mean difference in cough count (menthol-placebo) = -1.71, 95%CI -4.11, 0.69). Menthol has no effect on objective measures of flow but significantly increases the perception of nasal patency. It may not be possible to extrapolate these findings to younger children and those with rhinitis. Extending the study of menthol to these groups, including investigations of the efficacy and safety profiles, will provide further valuable evidence for its common use.

  2. Forced expiratory technique, directed cough, and autogenic drainage.

    Science.gov (United States)

    Fink, James B

    2007-09-01

    In health, secretions produced in the respiratory tract are cleared by mucociliary transport, cephalad airflow bias, and cough. In disease, increased secretion viscosity and volume, dyskinesia of the cilia, and ineffective cough combine to reduce secretion clearance, leading to increased risk of infection. In obstructive lung disease these conditions are further complicated by early collapse of airways, due to airway compression, which traps both gas and secretions. Techniques have been developed to optimize expiratory flow and promote airway clearance. Directed cough, forced expiratory technique, active cycle of breathing, and autogenic drainage are all more effective than placebo and comparable in therapeutic effects to postural drainage; they require no special equipment or care-provider assistance for routine use. Researchers have suggested that standard chest physical therapy with active cycle of breathing and forced expiratory technique is more effective than chest physical therapy alone. Evidence-based reviews have suggested that, though successful adoption of techniques such as autogenic drainage may require greater control and training, patients with long-term secretion management problems should be taught as many of these techniques as they can master for adoption in their therapeutic routines.

  3. Clinicoradiological diagnosis of cough-induced intercostal hernia.

    Science.gov (United States)

    Dobradin, Andrew; Bello, Jessica

    2013-07-01

    Cough-induced intercostal hernias without any type of external trauma are very uncommon. There have been less than 10 cases documented in literature. This clinical report describes a 66-year-old male who developed an intercostal hernia induced by a severe cough due to bilateral pneumonia and a subsequent rib fracture. It took almost a full year to diagnose this patient's chest wall mass. Only after taking careful history and reviewing all the images, the diagnosis of intercostal hernia was made. He was referred to a cardiothoracic surgeon for treatment. Intercostal hernias can be caused by the sheer exertion of coughing without any prior history of trauma to the chest wall or abdomen. Early diagnosis is difficult and had to be based on clinical signs and symptoms. The imaging studies might help to establish diagnosis, but cannot replace a diligent examination and clinical interview. The treatment of the chest wall defect is case dependent. Surgical repair reinforcement of the intercostal muscles might be required with prosthetic nonabsorbable (polypropylene) mesh.

  4. [Urinary urgency and reflex incontinence].

    Science.gov (United States)

    Madersbacher, H

    1991-07-01

    Urge and reflex incontinence are caused by detrusor dysfunction:urgency may be due to hyperactivity or hypersensitivity of the bladder. Neurogenic hyperactivity of the detrusor is called detrusor hyperreflexia: the neurogenic uninhibited bladder is caused by incomplete, and the so-called reflex bladder by complete, suprasacral lesions. The pathophysiology of symptomatic and idiopathic detrusor hyperactivity and the therapeutic armentarium are described. Bladder drill together with biofeedback and pharmacotherapy with spasmolytic drugs - several potent spasmolytic drugs with different modes of action are available - are the basis of treatment for hyperactivity and hypersensitivity of the detrusor. An alternative is electrostimulation: stimulation of the afferents of the pudendal nerve, via the pelvic floor (anal, vaginal), percutaneously (dorsal nerve of the penis, clitoric nerve) or by the implantation of electrodes results in inhibition of the detrusor. Most (80-90%) patients can be treated successfully by conservative means. Operative measurements comprise bladder denervation and bladder augmentation. The results of bladder denervation by transtrigonal phenolization of the pelvic plexus are highly controversial. In patients with uncontrollable hyperactivity of the detrusor, augmentation of the bladder (e.g. clam ileocystoplasty) is the method of choice, while for those with uncontrollable hypersensitivity of the detrusor, cystectomy followed by bladder substitution should be performed as a last resort. Treatment for urinary incontinence due to detrusor hyperreflexia must be selected bearing in mind that bladder emptying is inadequate, in most cases because of dyssynergia between detrusor and external sphincter. Therapy is basically aimed at transforming hyperreflexia of the detrusor into hyporeflexia, primarily by potent spasmolytic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Pharmacology of reflex blinks in the rat: a novel model for headache research.

    Science.gov (United States)

    Jones, M G; Andreou, A P; McMahon, S B; Spanswick, D

    2016-12-01

    Migraineurs are highly sensitive to the nitric oxide donor glyceryl trinitrate which triggers attacks in many sufferers. In animal studies, glyceryl trinitrate increases neuronal activity in the trigeminovascular pathway and elevates neurotransmitter levels in the brainstem. Many migraineurs also display alterations in blink reflexes, known to involve brainstem circuits. We investigated the effect of GTN on evoked blinks in the anaesthetised rat to determine whether such reflexes may prove useful as the basis for a novel animal model to evaluate potential anti-migraine therapeutic agents. In anaesthetised rats the electromyogram associated with the reflex blink evoked by corneal airpuff was recorded. Rats were infused with glyceryl trinitrate, sumatriptan plus glyceryl trinitrate or vehicle control. Changes in the magnitude of the reflex blink-associated electromyogram following these treatments were measured. Glyceryl trinitrate potentiated the evoked reflex blink-associated EMG response from 2 h after infusion. That effect was abolished by simultaneous infusion of sumatriptan with glyceryl trinitrate. These results show that simple skin surface measurements of evoked electromyographic activity in the rat can reliably detect the evoked blink reflex that can be potentiated by nitric oxide donors. This novel model may be an effective tool for evaluating putative anti-migraine therapeutic agents.

  6. Latent class analysis of diagnostic tests for adenovirus, Bordetella pertussis and influenza virus infections in German adults with longer lasting coughs.

    Science.gov (United States)

    Sobotzki, C; Riffelmann, M; Kennerknecht, N; Hülsse, C; Littmann, M; White, A; Von Kries, R; Wirsing VON König, C H

    2016-03-01

    Laboratory tests in adult outpatients with longer lasting coughs to identify a potential causal pathogen are rarely performed, and there is no gold standard for these diagnostic tests. While the diagnostic validity of serological tests for pertussis is well established their potential contribution for diagnosing adenovirus and influenza virus A and B infections is unclear. A sentinel study into the population-based incidence of longer lasting coughs in adults was done in Rostock (former East Germany) and Krefeld (former West Germany). A total of 971 outpatients who consulted general practitioners or internists were included. Inclusion criteria were coughing for ⩾1 week and no chronic respiratory diseases. We evaluated the performance of polymerase chain reaction (PCR) as well as IgG and IgA serology, applying a latent class model for diagnosing infections with adenovirus, B. pertussis, and influenza virus A and B. The adult outpatients first sought medical attention when they had been coughing for a median of 3 weeks. In this situation, direct detection of infectious agents by PCR had a low sensitivity. Modelling showed that additional serological tests equally improved sensitivity and specificity for diagnosis for adenovirus, B. pertussis and influenza virus A and B infections. The combination of serology and PCR may improve the overall performance of diagnostic tests for B. pertussis and also for adenovirus, and influenza virus A and B infections.

  7. Cutaneous reflex modulation and self-induced reflex attenuation in cerebellar patients.

    Science.gov (United States)

    Hoogkamer, Wouter; Van Calenbergh, Frank; Swinnen, Stephan P; Duysens, Jacques

    2015-02-01

    Modulation of cutaneous reflexes is important in the neural control of walking, yet knowledge about underlying neural pathways is still incomplete. Recent studies have suggested that the cerebellum is involved. Here we evaluated the possible roles of the cerebellum in cutaneous reflex modulation and in attenuation of self-induced reflexes. First we checked whether leg muscle activity during walking was similar in patients with focal cerebellar lesions and in healthy control subjects. We then recorded cutaneous reflex activity in leg muscles during walking. Additionally, we compared reflexes after standard (computer triggered) stimuli with reflexes after self-induced stimuli for both groups. Biceps femoris and gastrocnemius medialis muscle activity was increased in the patient group compared with the control subjects, suggesting a coactivation strategy to reduce instability of gait. Cutaneous reflex modulation was similar between healthy control subjects and cerebellar patients, but the latter appeared less able to attenuate reflexes to self-induced stimuli. This suggests that the cerebellum is not primarily involved in cutaneous reflex modulation but that it could act in attenuation of self-induced reflex responses. The latter role in locomotion would be consistent with the common view that the cerebellum predicts sensory consequences of movement. Copyright © 2015 the American Physiological Society.

  8. Brainstem reflexes in patients with familial dysautonomia.

    Science.gov (United States)

    Gutiérrez, Joel V; Norcliffe-Kaufmann, Lucy; Kaufmann, Horacio

    2015-03-01

    Several distinctive clinical features of patients with familial dysautonomia (FD) including dysarthria and dysphagia suggest a developmental defect in brainstem reflexes. Our aim was to characterize the neurophysiological profile of brainstem reflexes in these patients. We studied the function of sensory and motor trigeminal tracts in 28 patients with FD. All were homozygous for the common mutation in the IKAP gene. Each underwent a battery of electrophysiological tests including; blink reflexes, jaw jerk reflex, masseter silent periods and direct stimulation of the facial nerve. Responses were compared with 25 age-matched healthy controls. All patients had significantly prolonged latencies and decreased amplitudes of all examined brainstem reflexes. Similar abnormalities were seen in the early and late components. In contrast, direct stimulation of the facial nerve revealed relative preservation of motor responses. The brainstem reflex abnormalities in FD are best explained by impairment of the afferent and central pathways. A reduction in the number and/or excitability of trigeminal sensory axons is likely the main problem. These findings add further evidence to the concept that congenital mutations of the elongator-1 protein (or IKAP) affect the development of afferent neurons including those carrying information for the brainstem reflex pathways. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Reflexivity and technology in adult learning

    Directory of Open Access Journals (Sweden)

    Neil Selwyn

    2005-03-01

    Full Text Available It is argued by influential commentators such as Ulrich Beck and Scott Lash that we now live in a ‘reflexively modern' age. People are seen to now be free of the structures of modern society and driven instead by individualised opportunities to reflexively engage with their fast-changing social worlds and identities. Taking the notion of reflexive modernisation as its starting point, this paper explores the roles that information technologies (ITs may play in supporting adults' reflexive judgements about, and reflexive engagements with, education and learning. Through an analysis of interview data with 100 adults in the UK the paper finds that whilst a minority of interviewees were using ITs to support and inform reflexive engagementwith learning, the majority of individuals relayed little sign of technology-supported reflexivity when it came to their (nonengagement with education. For most people ITs were found, at best, to reinforce pre-established tendencies to ‘drift' through the formal education system. The paper concludes by considering the implications of these findings for ongoing efforts in developed countries to establish technology-supported ‘learning societies'.

  10. Modulation of reflex responses in hand muscles during rhythmical finger tasks in a subject with writer's cramp.

    Science.gov (United States)

    Xia, Ruiping; Bush, Brian M H

    2007-03-01

    The objective of this study was to examine phase- and task-dependent modulation of stretch reflexes during repetitive finger movements in writer's cramp, and compare them with normal controls from our previous study. A subject with writer's cramp conducted two rhythmic tasks, index finger abduction (RFA) and a pen-squeezing (RPS) task akin to handwriting. Stretch reflexes were evoked by mechanical perturbations at random phases of each task. Surface electromyograms (EMG) were recorded from two hand muscles, first dorsal interosseous (FDI) and flexor digitorum superficialis (FDS). The reflex response and background EMG activity of each muscle were modulated in a phase-dependent manner in both tasks. However, they varied largely in phase during the RFA task, but in approximately inverse phase-relationship during RPS. Reflex sensitivity, as represented by the slope of the linear regression between response and background, was much lower for both muscles in the 'writing' task (RPS) than in the RFA task with its positively correlated responses. These phase- and task-related modulation patterns differed dramatically from those observed in our control subjects, where reflex responses were modulated largely in phase with background activity and reflex sensitivity was much higher, particularly in FDI during RFA and FDS during RPS. The altered reflex modulation patterns in writer's cramp may reflect deficiencies of integration of proprioceptive afferent inputs and reduced inhibition at cortical and spinal levels during writing performance. Results from this case study support clinically identified task-specific feature of focal hand dystonia.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  13. The Multiple Faces of Reflexive Research Designs

    Directory of Open Access Journals (Sweden)

    Karl H. Müller

    2015-10-01

    Full Text Available Reflexive research can be grouped into five clusters with circular relations between two elements x ↔ x, namely circular relations between observers, between scientific building blocks like concepts, theories or models, between systemic levels, between rules and rule systems or as circular relations or x ↔ y between these four components. By far the most important cluster is the second cluster which becomes reflexive through a re-entry operation RE into a scientific element x and which establishes its circular formation as x(x. Many of the research problems in these five clusters in reflexivity research are still unexplored and pose grand challenges for future research.

  14. Ranges of bimodule projections and reflexivity

    CERN Document Server

    Eleftherakis, G K

    2011-01-01

    We develop a general framework for reflexivity in dual Banach spaces, motivated by the question of when the weak* closed linear span of two reflexive masa-bimodules is automatically reflexive. We establish an affirmative answer to this question in a number of cases by examining two new classes of masa-bimodules, defined in terms of ranges of masa-bimodule projections. We give a number of corollaries of our results concerning operator and spectral synthesis, and show that the classes of masa-bimodules we study are operator synthetic if and only if they are strong operator Ditkin.

  15. [Fever, coughing and dyspnea in a 38-year-old female kidney transplant recipient].

    Science.gov (United States)

    Porsche, M; Künzli, E; Dickenmann, M; Hirsch, H H; Battegay, M; Khanna, N

    2012-12-01

    This article reports on a 38-year-old kidney transplant patient who presented with fever, coughing and dypnea. The patient was immunosuppressed with mycophenolate and prednisone. Due to the suspicion of community acquired pneumonia antibiotic treatment was initiated and the patient was admitted to the intensive care unit. Despite antibiotic treatment the condition did not improve and in the subsequently performed bronchioalveolar lavage parainfluenza virus was diagnosed.Infections with respiratory viruses can be fatal in immunosuppressed patients. Human parainfluenza virus is the third most common pathogen of viral pneumonia. Molecular genetic detection methods allow fast and sensitive diagnosis of respiratory materials. As the treatment options are limited for these infections prophylactic measurements are important.

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

    Science.gov (United States)

    Saritas Yuksel, Elif; Vaezi, Michael F

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zayas Gustavo

    2012-03-01

    Full Text Available Abstract Background The Influenza A H1N1 virus can be transmitted via direct, indirect, and airborne route to non-infected subjects when an infected patient coughs, which expels a number of different sized droplets to the surrounding environment as an aerosol. The objective of the current study was to characterize the human cough aerosol pattern with the aim of developing a standard human cough bioaerosol model for Influenza Pandemic control. Method 45 healthy non-smokers participated in the open bench study by giving their best effort cough. A laser diffraction system was used to obtain accurate, time-dependent, quantitative measurements of the size and number of droplets expelled by the cough aerosol. Results Voluntary coughs generated droplets ranging from 0.1 - 900 microns in size. Droplets of less than one-micron size represent 97% of the total number of measured droplets contained in the cough aerosol. Age, sex, weight, height and corporal mass have no statistically significant effect on the aerosol composition in terms of size and number of droplets. Conclusions We have developed a standard human cough aerosol model. We have quantitatively characterized the pattern, size, and number of droplets present in the most important mode of person-to-person transmission of IRD: the cough bioaerosol. Small size droplets ( Study design Open bench, Observational, Cough, Aerosol study

  18. △'-Reflexive Modules and Cogen(P)-Linear Compactness

    Institute of Scientific and Technical Information of China (English)

    Lin Xin

    2005-01-01

    In this paper, we introduce the notion of △'-reflexive modules. We investigate the reflexive modules with respect to a partial cotilting (bi)module and obtain a connection between △'-reflexive modules and Cogen(P)-linearly compact modules. The main results generalize the results on reflexive modules with respect to a cotilting bimodule.

  19. 静脉注射利多卡因对芬太尼诱导的咳嗽反应的影响%EFFECTS OF INTRAVENOUS LIDOCAINE ON FENTANYL-INDUCED COUGH

    Institute of Scientific and Technical Information of China (English)

    唐琦峰; 钱燕宁; 张洪兴

    2009-01-01

    目的:研究静脉注射利多卡因对芬太尼诱导的咳嗽反应的影响.方法:择期行全麻手术病人60例,随机分为3组,Ⅰ组在芬太尼注射前1分钟静脉注射利多卡因(1mg/kg),Ⅱ组在芬太尼注射前1分钟静脉注射利多卡因(2mg/kg),Ⅲ组为对照组.分别观察芬太尼注射后的咳嗽反射情况,咳嗽1-2次为轻微,3-4次为中等,5次以上为重度.结果:Ⅰ组、Ⅱ组和Ⅲ组咳嗽反应的发生率为分别为25%、30%和65%,Ⅰ组、Ⅱ组咳嗽反应的发生率明显低于Ⅲ组(P<0.05),Ⅰ组和Ⅱ组比较无明显差别(P>0.05).结论:芬太尼注射前1分钟静脉注射利多卡因1mg或2mg可有效减轻芬太尼诱导的咳嗽反射;芬太尼注射前1分钟静脉注射利多卡因的量对减轻芬太尼诱导的咳嗽反射区别不大.%Fentanyl is commonly used as a pre-induction adjunct because of its quick onset,short duration of action,intense analgesia,and cardiovascular stability,but a pre-induction bolus dose of fentanyl elicits cough.Fentanyl-induced cough is common but has not been viewed as a serious anesthetic problem.Intravenous lidocaine suppresses the cough reflex during endotracheal intubation,extubation,bronchography,bronchoscopy and laryngoscopy[1-3].It has been found effective when given intravenously to suppress the cough reflex of endotracheal intubation and cough induced by manual displacement of the endotracheal tube and instillation of distilled water into the trachea in anesthetized patients[2].We evaluated the different dose of lidocaine for suppression of fentanyl-induced cough in this randomized,prospective and placebo-controlled study.

  20. Entrepreneurship Teaching Conducted as Strategic Reflexive Conversation

    DEFF Research Database (Denmark)

    Kristiansson, Michael

    The paper intends exploring and ascertaining whether the concept of strategic reflexive conversation can profitably be applied to entrepreneurship. As a start, a process of conceptualisation is undertaken, which is instrumental in placing the notion of strategic reflexive conversation...... into a knowledge management perspective. Strategic reflexive conversation is presented in an enhanced and updated version, which is contrasted to entrepreneurship through reflection. The findings indicate and it can be concluded that, with some important reservations, strategic reflexive conversation can...... and empirical studies. No doubt the reported study can be enhanced and refined in a theoretical sense and be empirically supported. The paper addresses a potentially significant theme and aims to stimulate discussion, which can provide input and ideas for enhancing practice-oriented entrepreneurship...

  1. Portraying Reflexivity in Health Services Research.

    Science.gov (United States)

    Rae, John; Green, Bill

    2016-09-01

    A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. © The Author(s) 2016.

  2. On the Second Language Acquisition of Spanish Reflexive Passives and Reflexive Impersonals by French- and English-Speaking Adults

    Science.gov (United States)

    Tremblay, Annie

    2006-01-01

    This study, a partial replication of Bruhn de Garavito (1999a; 1999b), investigates the second language (L2) acquisition of Spanish reflexive passives and reflexive impersonals by French- and English-speaking adults at an advanced level of proficiency. The L2 acquisition of Spanish reflexive passives and reflexive impersonals by native French and…

  3. One minute static stretch of plantar flexors transiently increases H reflex excitability and exerts no effect on corticospinal pathways.

    Science.gov (United States)

    Budini, Francesco; Gallasch, Eugen; Christova, Monica; Rafolt, Dietmar; Rauscher, Andreas Benedikt; Tilp, Markus

    2017-08-01

    What is the central question of this study? What mediates neural responses following static stretching, and how long do these influences last? What is the main finding and its importance? This study shows that 1 min of static stretching inhibits the tendon tap reflex and facilitates the H reflex without influencing motor-evoked potentials. The results indicate that at least two different mechanisms mediate neural responses after static stretching. The purpose of this study was to determine whether the neural responses observed after static stretching are mediated by sensitivity of muscle spindles, spinal excitability or cortical excitability and how long these influences last. Nineteen volunteers (25.7 ± 5.6 years old) were tested for the tendon tap reflex (T-reflex), H reflex and motor-evoked potentials on ankle flexors and extensors immediately, 5 and 10 min after 1 min static stretching applied at individual maximal ankle dorsiflexion, as well as immediately, 5 and 10 min after a control period of the same duration. Comparison of measurements collected immediately after stretching or control conditions revealed that the T-reflex was weaker after stretching than after control (-59.2% P = 0.000). The T-reflex showed a slow recovery rate within the first 150 s after stretching, but 5 min after the inhibition had disappeared. The H reflex increased immediately after stretching (+18.3%, P = 0.036), showed a quick tendency to recover and returned to control values within 5 min from stretching. Motor-evoked potentials were not affected by the procedure. These results suggest that 1 min of static stretching primarily decreases muscle spindle sensitivity and facilitates the H reflex, whereas effects on the motor cortex can be excluded. © 2017 The Authors. Experimental Physiology © 2017 The Physiological Society.

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

    Science.gov (United States)

    Van Hirtum, A.; Berckmans, D.

    2003-09-01

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

  5. 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.

  6. Reflexive convention: civil partnership, marriage and family.

    Science.gov (United States)

    Heaphy, Brian

    2017-09-14

    Drawing on an analysis of qualitative interview data from a study of formalized same-sex relationships (civil partnerships) this paper examines the enduring significance of marriage and family as social institutions. In doing so, it intervenes in current debates in the sociology of family and personal life about how such institutions are undermined by reflexivity or bolstered by convention. Against the backdrop of dominating sociological frames for understanding the links between the changing nature of marriage and family and same-sex relationship recognition, the paper analyses the diverse and overlapping ways (including the simple, relational, strategic, ambivalent and critical ways) in which same-sex partners reflexively constructed and engaged with marriage and family conventions. My analysis suggests that instead of viewing reflexivity and convention as mutually undermining, as some sociologists of family and personal life do, it is insightful to explore how diverse forms of reflexivity and convention interact in everyday life to reconfigure the social institutions of marriage and family, but do not undermine them as such. I argue the case for recognizing the ways in which 'reflexive convention', or reflexive investment in convention, contributes to the continuing significance of marriage and family as social institutions. © London School of Economics and Political Science 2017.

  7. The passive of reflexive verbs in Icelandic

    Directory of Open Access Journals (Sweden)

    Hlíf Árnadóttir

    2011-10-01

    Full Text Available The Reflexive Passive in Icelandic is reminiscent of the so-called New Passive (or New Impersonal in that the oblique case of a passivized object NP is preserved. As is shown by recent surveys, however, speakers who accept the Reflexive Passive do not necessarily accept the New Passive, whereas conversely, speakers who accept the New Passive do also accept the Reflexive Passive. Based on these results we suggest that there is a hierarchy in the acceptance of passive sentences in Icelandic, termed the Passive Acceptability Hierarchy. The validity of this hierarchy is confirmed by our diachronic corpus study of open access digital library texts from Icelandic journals and newspapers dating from the 19th and 20th centuries (tímarit.is. Finally, we sketch an analysis of the Reflexive Passive, proposing that the different acceptability rates of the Reflexive and New Passives lie in the argument status of the object. Simplex reflexive pronouns are semantically dependent on the verbs which select them, and should therefore be analyzed as syntactic arguments only, and not as semantic arguments of these verbs.

  8. Torso flexion modulates stiffness and reflex response.

    Science.gov (United States)

    Granata, K P; Rogers, E

    2007-08-01

    Neuromuscular factors that contribute to spinal stability include trunk stiffness from passive and active tissues as well as active feedback from reflex response in the paraspinal muscles. Trunk flexion postures are a recognized risk factor for occupational low-back pain and may influence these stabilizing control factors. Sixteen healthy adult subjects participated in an experiment to record trunk stiffness and paraspinal muscle reflex gain during voluntary isometric trunk extension exertions. The protocol was designed to achieve trunk flexion without concomitant influences of external gravitational moment, i.e., decouple the effects of trunk flexion posture from trunk moment. Systems identification analyses identified reflex gain by quantifying the relation between applied force disturbances and time-dependent EMG response in the lumbar paraspinal muscles. Trunk stiffness was characterized from a second order model describing the dynamic relation between the force disturbances versus the kinematic response of the torso. Trunk stiffness increased significantly with flexion angle and exertion level. This was attributed to passive tissue contributions to stiffness. Reflex gain declined significantly with trunk flexion angle but increased with exertion level. These trends were attributed to correlated changes in baseline EMG recruitment in the lumbar paraspinal muscles. Female subjects demonstrated greater reflex gain than males and the decline in reflex gain with flexion angle was greater in females than in males. Results reveal that torso flexion influences neuromuscular factors that control spinal stability and suggest that posture may contribute to the risk of instability injury.

  9. Is the Nociceptive Blink Reflex Associated with Psychological Factors in Healthy Participants?

    DEFF Research Database (Denmark)

    Costa, Yuri; Baad-Hansen, Lene; Bonjardim, Leonardo Rigoldi;

    2016-01-01

    AIMS: To evaluate the possible association between the nociceptive blink reflex (nBR) and various pain-related psychological measures: the Anxiety Sensitivity Index-3 (ASI-3), the Fear of Pain Questionnaire III (FPQ-III), the Pain Vigilance and Awareness Questionnaire (PVAQ), the Somatosensory...

  10. High prevalence of persistent cough with angiotensin converting enzyme inhibitors in Chinese.

    OpenAIRE

    Woo, K. S.; Nicholls, M G

    1995-01-01

    1. Angiotensin converting enzyme (ACE) inhibitors are in common use for the treatment of hypertension and heart failure. Whereas they are, in general, well tolerated, a dry cough can develop which, on occasion, requires termination of therapy. The reported prevalence of cough with ACE inhibitor therapy has varied from 0.2 to 25%, depending upon methods of data collection, analysis and symptom reporting. 2. To evaluate the prevalence of cough in Chinese patients receiving ACE inhibitors, inter...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    A workshop/symposium on “Mucociliary and Cough Clearance (MCC/CC) as a Biomarker for Therapeutic Development” was held on October 21–22, 2008, in Research Triangle Park, NC, to discuss the methods for measurement of MCC/CC and how they may be optimized for assessing new therapies designed...... to improve clearance of airway secretions from the lungs. The utility of MCC/CC as a biomarker for disease progression and therapeutic intervention is gaining increased recognition as a valuable tool in the clinical research community. A number of investigators currently active in using MCC/CC for diagnostic...

  13. 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.

  14. 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.

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

    Science.gov (United States)

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

    2014-11-01

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

  16. Field test of a novel detection device for Mycobacterium tuberculosis antigen in cough

    Directory of Open Access Journals (Sweden)

    Tesfaye Ato

    2010-06-01

    Full Text Available Abstract Background Tuberculosis is a highly infectious disease that is spread from person to person by infected aerosols emitted by patients with respiratory forms of the disease. We describe a novel device that utilizes immunosensor and bio-optical technology to detect M. tuberculosis antigen (Ag85B in cough and demonstrate its use under field conditions during a pilot study in an area of high TB incidence. Methods The TB Breathalyzer device (Rapid Biosensor Systems Ltd was field tested in the outpatient clinic of Adama Hospital, Ethiopia. Adults seeking diagnosis for respiratory complaints were tested. Following nebulization with 0.9% saline patients were asked to cough into a disposable collection device where cough aerosols were deposited. Devices were then inserted into a portable instrument to assess whether antigen was present in the sample. Demographic and clinical data were recorded and all patients were subjected to chest radiogram and examination of sputum by Ziehl-Nielsen microscopy. In the absence of culture treatment decisions were based on smear microscopy, chest x-ray and clinical assessment. Breathalyzer testing was undertaken by a separate physician to triage and diagnostic assessment. Results Sixty individuals were each subjected to a breathalyzer test. The procedure was well tolerated and for each patient the testing was completed in less than 10 min. Positive breath test results were recorded for 29 (48% patients. Of 31 patients with a diagnosis of tuberculosis 23 (74%; 95% CI 55-87 were found positive for antigen in their breath and 20 (64%; 95% CI 45-80 were smear positive for acid fast bacilli in their sputum. Six patients provided apparent false positive breathalyzer results that did not correlate with a diagnosis of tuberculosis. Conclusions We propose that the breathalyzer device described warrants further investigation as a tool for studying exhalation of M. tuberculosis. The portability, simplicity of use and speed

  17. Human Cough as a Two-Stage Jet and Its Role in Particle Transport

    Science.gov (United States)

    Li, Yuguo

    2017-01-01

    The human cough is a significant vector in the transmission of respiratory diseases in indoor environments. The cough flow is characterized as a two-stage jet; specifically, the starting jet (when the cough starts and flow is released) and interrupted jet (after the source supply is terminated). During the starting-jet stage, the flow rate is a function of time; three temporal profiles of the exit velocity (pulsation, sinusoidal and real-cough) were investigated in this study, and our results showed that the cough flow’s maximum penetration distance was in the range of a 50.6–85.5 opening diameter (D) under our experimental conditions. The real-cough and sinusoidal cases exhibited greater penetration ability than the pulsation cases under the same characteristic Reynolds number (Rec) and normalized cough expired volume (Q/AD, with Q as the cough expired volume and A as the opening area). However, the effects of Rec and Q/AD on the maximum penetration distances proved to be more significant; larger values of Rec and Q/AD reflected cough flows with greater penetration distances. A protocol was developed to scale the particle experiments between the prototype in air, and the model in water. The water tank experiments revealed that although medium and large particles deposit readily, their maximum spread distance is similar to that of small particles. Moreover, the leading vortex plays an important role in enhancing particle transport. PMID:28046084

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

    Science.gov (United States)

    Catena, E; Daffonchio, L

    1997-01-01

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

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

    Science.gov (United States)

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

    2004-01-01

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

  20. Breaking the sound barrier? Pitfalls and benefits of acoustic cough monitoring.

    Science.gov (United States)

    Houghton, Lesley A; Smith, Jaclyn A

    2012-12-01

    Traditionally push-button and symptom diaries have been used to document cough events, especially when examining temporal associations between cough and reflux events. More recently, acoustic devices have allowed more accurate recording of cough events, and compared with the latter traditional techniques reported 6-18 times more coughing. Whether the differences reported between these techniques represents disparities in subject groups or cough detection and quantification methods is unknown. In this issue of the American Journal of Gastroenterology, Kavitt et al. show that listeners of such recordings have a 4-fold increase in odds of recording cough events compared with patients using push-button techniques, and that even when using a 5-min window to assess temporal concordance/discordance, over 70% of coughs were not reported by the patients. These observations have potential significant implications when assessing temporal associations between cough and reflux, and thus any clinical decision making based on these data. This editorial examines both the findings of Kavitt et al. and discusses the pitfalls and benefits of validated accurate documentation of cough.

  1. Soleus H-Reflex Operant Conditioning Changes The H-Reflex Recruitment Curve

    Science.gov (United States)

    Thompson, Aiko K.; Chen, Xiang Yang; Wolpaw, Jonathan R.

    2012-01-01

    Introduction Operant conditioning can gradually change the human soleus H-reflex. The protocol conditions the reflex near M-wave threshold. This study examined its impact on the reflexes at other stimulus strengths. Methods H-reflex recruitment curves were obtained before and after a 24-session exposure to an up-conditioning (HRup) or down-conditioning (HRdown) protocol and were compared. Results In both HRup and HRdown subjects, conditioning affected the entire H-reflex recruitment curve. In 5 of 6 HRup and 3 of 6 HRdown subjects, conditioning elevated (HRup) or depressed (HRdown), respectively, the entire curve. In the other HRup subject or the other 3 HRdown subjects, the curve was shifted to the left or to the right, respectively. Discussion H-reflex conditioning does not simply change the H-reflex to a stimulus of particular strength; it also changes the H-reflexes to stimuli of different strengths. Thus, it is likely to affect many actions in which this pathway participates. PMID:23281107

  2. Loading and reflexes : the influence of body weight and active movements on reflex responses in humans

    NARCIS (Netherlands)

    Bastiaanse, Catharina Maria

    2003-01-01

    This thesis describes six studies on the influence of active movements and body loading on reflex responses. To measure those influences healthy subjects were asked to walk with different loadings (e.g. a backpack) or with different active movements (e.g. arm swing) while different reflex responses

  3. The trigemino-cervical reflex in normal subjects.

    Science.gov (United States)

    Milanov, I; Bogdanova, D; Ishpekova, B

    2001-01-01

    There are only few reports on the trigemino-cervical reflex in humans and there is debate over the best method of reflex examination. The aim of this study was, comparing different methods, to provide a reproducible method for evaluating the trigemino-cervical reflex. The trigemino-cervical reflex was studied in 32 healthy volunteers. The stimulation was applied to the supraorbital, infraorbital or mental nerve. Recordings were performed bilaterally from the sternocleidomastoid and trapezius muscles at rest. The reflex was also examined during maximal voluntary contraction of the sternocleidomastoid muscle after supraorbital nerve stimulation. It presented as a two-component reflex if recorded from a tonically active muscle and as a one-component reflex if recorded from a relaxed muscle. The most reproducible reflex responses were obtained from the resting sternocleidomastoid muscle after stimulation of the supraorbital nerve. In conclusion, the trigemino-cervical reflex may be most easily obtained from the relaxed sternocleidomastoid muscle after supraorbital nerve stimulation.

  4. Cough and Arabinogalactan Polysaccharide from the Bark of Terminalia Arjuna.

    Science.gov (United States)

    Sivová, V; Bera, K; Ray, B; Nosáľ, S; Nosáľová, G

    2016-01-01

    In this work we investigated the antitussive activity of the medicinal tree Terminalia arjuna. We used the stem bark for extraction and preparation of water extracted isolate and its two fractions: acetone-soluble (TA-S) and acetone precipitated (TA-P) fraction. The presence of a pectic arabinogalactan was confirmed in TA-P fraction by chromatographic and spectroscopic analysis. The antitussive activity of samples was assessed after oral administration in a dose of 50 mg.kg(-1) in healthy guinea pigs, in which cough was elicited by inhalation of citric acid (0.3 mol/L) in body plethysmograph. The water extracted isolate showed a significant ability to decrease the number of cough efforts by 64.2 %; the antitussive activity on par with that of codeine phosphate. The TA-P fraction showed the antitussive activity of 54.8 %. In contrast, TA-S fraction had only a mild antitussive activity. No changes in in vivo airway resistance were noted. We conclude that arabinogalactan is an essential component of Terminalia arjuna that underlies its antitussive action.

  5. Somatic Sensitivity and Reflexivity as Validity Tools in Qualitative Research

    Science.gov (United States)

    Green, Jill

    2015-01-01

    Validity is a key concept in qualitative educational research. Yet, it is often not addressed in methodological writing about dance. This essay explores validity in a postmodern world of diverse approaches to scholarship, by looking at the changing face of validity in educational qualitative research and at how new understandings of the concept…

  6. Somatic Sensitivity and Reflexivity as Validity Tools in Qualitative Research

    Science.gov (United States)

    Green, Jill

    2015-01-01

    Validity is a key concept in qualitative educational research. Yet, it is often not addressed in methodological writing about dance. This essay explores validity in a postmodern world of diverse approaches to scholarship, by looking at the changing face of validity in educational qualitative research and at how new understandings of the concept…

  7. 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.

  8. Urethral sensory threshold and urethro-anal reflex latency in continent women.

    Science.gov (United States)

    Cavalcanti, Geraldo de Aguiar; Bruschini, Homero; Manzano, Gilberto M; Giuliano, Lydia P; Nóbrega, João Antônio M; Srougi, Miguel

    2007-01-01

    The sensory evaluation of the lower urinary tract is summarized in the bladder proprioceptive sensitivity during cystometry. Experimental studies suggest that abnormalities of the urethral innervation and micturition reflex can be related to the presence of continence disturbances. This study aimed to measure the urethral sensory threshold and the urethro-anal reflex latency in healthy volunteers, establishing reading criteria, comparing the results and technique used with the literature and verifying the effect of physiological factors. Thirty healthy female volunteers were studied. They had an absence of genital or urinary complaints and had undergone no previous pelvic or vaginal procedures. The measurement of the urethral sensory threshold and urethro-anal reflex latency were performed as described. The determination of the urethral sensory threshold and urethro-anal reflex latency were obtained in 96.6% of the volunteers. The electrophysiological parameters did not correlate with age, parity or number of vaginal deliveries. There was a positive association of the urethral sensory threshold with height. Technical aspects were considered and compared with those in the literature as well as the advantages and limitations of the method. The measurement of the urethral sensory threshold and urethro-anal reflex latency presented consistent recordings. The urethral sensory threshold should be analyzed carefully in individuals with height above the population average. Subsequent observations are necessary to clarify their function in patients with continence disturbances and to measure the urethral function, but these values can be used as normal parameters for comparison.

  9. Using ESO Reflex with Web Services

    Science.gov (United States)

    Järveläinen, P.; Savolainen, V.; Oittinen, T.; Maisala, S.; Ullgrén, M. Hook, R.

    2008-08-01

    ESO Reflex is a prototype graphical workflow system, based on Taverna, and primarily intended to be a flexible way of running ESO data reduction recipes along with other legacy applications and user-written tools. ESO Reflex can also readily use the Taverna Web Services features that are based on the Apache Axis SOAP implementation. Taverna is a general purpose Web Service client, and requires no programming to use such services. However, Taverna also has some restrictions: for example, no numerical types such integers. In addition the preferred binding style is document/literal wrapped, but most astronomical services publish the Axis default WSDL using RPC/encoded style. Despite these minor limitations we have created simple but very promising test VO workflow using the Sesame name resolver service at CDS Strasbourg, the Hubble SIAP server at the Multi-Mission Archive at Space Telescope (MAST) and the WESIX image cataloging and catalogue cross-referencing service at the University of Pittsburgh. ESO Reflex can also pass files and URIs via the PLASTIC protocol to visualisation tools and has its own viewer for VOTables. We picked these three Web Services to try to set up a realistic and useful ESO Reflex workflow. They also demonstrate ESO Reflex abilities to use many kind of Web Services because each of them requires a different interface. We describe each of these services in turn and comment on how it was used

  10. Comparison of the Effect of Two Kinds of Iranian Honey and Diphenhydramine on Nocturnal Cough and the Sleep Quality in Coughing Children and Their Parents

    Science.gov (United States)

    Ayazi, Parviz; Mahyar, Abolfazl; Yousef-Zanjani, Mahdieh; Allami, Abbas; Esmailzadehha, Neda; Beyhaghi, Taraneh

    2017-01-01

    Coughing in a child induced by upper respiratory tract infections (URTIs) can be a problem, both for the child and its parents. Current studies show a lack of proven efficacy for over-the counter (OTC) medications, but promising data support the use of honey for children. The aim of this study was to compare the effects of two kinds of Iranian honey with diphenhydramine (DPH) on nocturnal pediatric coughs and the sleep quality of children and their parents. This was a clinical trial (registered in IRCT; No.: 28.20.7932, 15 October 2013). The study consisted of 87 patients. All the parents completed a standard previously validated questionnaire. The children were randomly assigned to one of three treatment groups: Group 1, Honey type 1 (Kimia Company, Iran) (n = 42), Group 2, Honey type 2 (Shahde-Golha, Iran) (n = 25), and Group 3, DPH (n = 20). Each group received double doses of the respective treatments on two successive nights. A second survey was then administered via a telephone interview in which the parents were asked the same questions. The mean scores for all aspects of coughs were significantly decreased in each group before and after the treatment. All three treatments improved the cough and sleep scores. Honey type 1 was superior to DPH in improving all aspects of coughs, except the frequency, and Honey type 2 was more effective than DPH in improving all aspects of coughs, except the sleep quality of the child. There was no significant difference between Honey type 1 and 2 in any aspects of cough relief in the present study. The results suggest that honey may provide better cough relief than DPH in children and improve the sleep quality of children and their parents. PMID:28103276

  11. Strain differences in baroceptor reflex in adult Wistar Kyoto rats

    Directory of Open Access Journals (Sweden)

    Vitor E. Valenti

    2010-01-01

    Full Text Available OBJECTIVES: A subset of normotensive Sprague-Dawley rats show lower baroreflex sensitivity; however, no previous study investigated whether there are differences in baroreflex sensitivity within this subset. Our study compared baroreflex sensitivity among conscious rats of this specific subtype. METHODS: Male Wistar Kyoto (WKY rats (16 weeks old were studied. Cannulas were inserted into the abdominal aortic artery through the right femoral artery to measure mean arterial pressure (MAP and heart rate (HR. Baroreflex gain was calculated as the ratio between change in HR and MAP variation (ΔHR/ΔMAP in response to a depressor dose of sodium nitroprusside (SNP, 50 µg/kg, i.v. and a pressor dose of phenylephrine (PE, 8 µg/kg, i.v.. Rats were divided into four groups: 1 low bradycardic baroreflex (LB, baroreflex gain (BG between -1 and -2 bpm/mmHg tested with PE; 2 high bradycardic baroreflex (HB, BG < -2 bpm/mmHg tested with PE; 3 low tachycardic baroreflex (LT, BG between -1 and -2 bpm/mmHg tested with SNP and; 4 high tachycardic baroreflex (HT, BG < -2 bpm/mmHg tested with SNP. Significant differences were considered for p < 0.05. RESULTS: Approximately 37% of the rats showed a reduced bradycardic peak, bradycardic reflex and decreased bradycardic gain of baroreflex while roughly 23% had a decreased basal HR, tachycardic peak, tachycardic reflex and reduced sympathetic baroreflex gain. No significant alterations were noted with regard to basal MAP. CONCLUSION: There is variability regarding baroreflex sensitivity among WKY rats from the same laboratory.

  12. Synthesis and antitussive evaluation of verticinone-cholic acid salt, a novel and potential cough therapeutic agent

    Institute of Scientific and Technical Information of China (English)

    Fang-zhou XU; Chang CHEN; Yong-hui ZHANG; Han-li RUAN; Hui-fang PI; Pong ZHANG; Ji-zhou WU

    2007-01-01

    Aim: To seek a novel and potent antitussive drug based on Shedan-Chuanbei powder, a complex of traditional Chinese medicine preparation for cough therapy.Methods: Verticinone-cholic acid (Vet-CA) salt, a novel, salifying derivative of verticinone and cholic acid, both of which are the major bioactive components in Shedan-Chuanbei powder, was synthesized. We then evaluated the antitussive activity and the acute toxicity of the salt. Results: The new compound, with good solubility in water, has much more potent antitussive activity in comparison with the same dose of single verticinone and single cholic acid. The administration 3 mg/kg of Ver-CA could result in over 50% reduction of a citric acid-induced cough.Pretreatment with naloxone (0.8 mg/kg, ip) can only partially antagonize its anti-tussive effect. On the other hand, glybenclamide (3 mg/kg, ip), an ATP-sensitive K+ channel blocker, can also significantly reduce the antitussive effect of Ver-CA.A further acute toxicity study showed that the LD50 values of Ver-CA were 3 times that of verticinone. Conclusion: Based on the studies of pharmacology and acutetoxicity, the salt has a synergic and attenuated toxicity compared with single verticinone and cholic acid. Moreover, the present study also suggests that Ver-CA, a potential novel antitussive agent, may exert its antitussive effect via both the peripheral (modulated by ATP-sensitive K+ channels) and central mechanisms(modulated by the opioid receptor).

  13. Self-medication for cough and the common cold : Information needs of consumers

    NARCIS (Netherlands)

    Kloosterboer, Sanne Maartje; McGuire, Treasure; Deckx, Laura; Moses, Geraldine; Verheij, Theo; van Driel, Mieke

    2015-01-01

    Background: Despite the high use of over-the-counter (OTC) cough and cold medicines, little is known about Australia's cough and cold medicines information needs. The aim of this study was to identify gaps in consumers' perceived knowledge and concerns, to better target consumer medicines informatio

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  15. Pharmacogenetics of ACE inhibitor-induced angioedema and cough : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mahmoudpour, Seyed Hamidreza; Leusink, Maarten; van der Putten, Lisa; Terreehorst, Ingrid; Asselbergs, Folkert W.; de Boer, Anthonius; Maitland-van der Zee, Anke H.

    2013-01-01

    Aim: Angioedema and cough are the two most important adverse effects of ACE inhibitors (ACEIs). Evidence exists that ACEI-related angioedema/cough is partly genetically determined and several genes have been identified to play a role in the development of ACEI-related adverse effects. Materials & me

  16. 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,…

  17. Use of honey associated with Ananas comosus (Bromelin) in the treatment of acute irritative cough

    Science.gov (United States)

    Peixoto, Décio Medeiros; Rizzo, José Angelo; Schor, Deborah; Silva, Almerinda Rêgo; de Oliveira, Dinaldo Cavalcanti; Solé, Dirceu; Sarinho, Emanuel

    2016-01-01

    Abstract Objective: To evaluate the immediate improvement rate of irritative cough in patients treated with the combination of Ananas comosus extract and honey (Bromelin®) compared with the use of honey alone (placebo group). Methods: Pragmatic, double-blind, randomized, parallel-group study with children aged between 2 and 15 years, with irritative cough for at least 24hours. The double-blind assessment of cough was through the number of observed coughing episodes and intensity score for a period of 10minutes of observation. The decrease of one point in the mean total score was considered as a therapeutic effect. Results: There was a reduction in coughing episodes in both groups, as well as in the cough score after 30minutes of drug or honey administration. The change in clinical score above two points, which could indicate marked improvement, occurred in five patients in the bromelin group and only in one in the placebo group, but without significant difference. There were no adverse events. Conclusions: The immediate improvement rate of irritative cough was similar in patients treated with combination of Ananas comosus extract and honey (Bromelin®) compared with the use of honey alone (placebo group). It is possible that honey has a therapeutic effect on mucus and cough characteristics (Clinical Trials: NCT01356693). PMID:27181342

  18. Self-medication for cough and the common cold : Information needs of consumers

    NARCIS (Netherlands)

    Kloosterboer, Sanne Maartje; McGuire, Treasure; Deckx, Laura; Moses, Geraldine; Verheij, Theo; van Driel, Mieke

    2015-01-01

    Background: Despite the high use of over-the-counter (OTC) cough and cold medicines, little is known about Australia's cough and cold medicines information needs. The aim of this study was to identify gaps in consumers' perceived knowledge and concerns, to better target consumer medicines

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  20. Pharmacogenetics of ACE inhibitor-induced angioedema and cough : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mahmoudpour, Seyed Hamidreza; Leusink, Maarten; van der Putten, Lisa; Terreehorst, Ingrid; Asselbergs, Folkert W.; de Boer, Anthonius; Maitland-van der Zee, Anke H.

    2013-01-01

    Aim: Angioedema and cough are the two most important adverse effects of ACE inhibitors (ACEIs). Evidence exists that ACEI-related angioedema/cough is partly genetically determined and several genes have been identified to play a role in the development of ACEI-related adverse effects. Materials & me

  1. The effect of elbow position on biceps tendon reflex

    Directory of Open Access Journals (Sweden)

    Keles Isik

    2004-07-01

    Full Text Available Background: Testing of tendon (T reflex is the basic method used in the diagnostic procedure of clinical neurology. Measurement of T reflexes precisely can be a valuable adjunct to clinical examination. Quantification of T reflexes may provide more accurate results. Aims: To analyze the effect of elbow position on biceps T reflex. Settings and Design: A self-controlled clinical trial of biceps T reflex testing at the Electrophysiology Unit of the Department of Physical Medicine and Rehabilitation. Methods and Materials: Biceps T reflex was obtained utilizing a hand-held electronic reflex hammer in 50 extremities of 25 healthy volunteers and the effect of elbow position (at 90°, 120° and 150° on reflex response was evaluated. Statistical Analysis: Repeated-measures analysis of variance by the General Linear Model and Pearson correlation test procedures. Results: Onset latency was significantly shorter at 120° of elbow position. The maximum amplitude value of biceps T reflex was obtained at 90° of elbow position. Onset latency of the reflex correlated significantly with the height and arm length but not with age. Conclusions: The electrophysiological measurement of T reflexes is an easy and useful method in the quantification of reflexes, supplying more objective data. However, when performing T reflex studies, the position of the extremity should be taken into consideration to achieve more reliable results.

  2. Reflexive Planning as Design and Work

    DEFF Research Database (Denmark)

    Lissandrello, Enza; Grin, John

    2011-01-01

    In recent years, planning theorists have advanced various interpretations of the notion of reflexivity, inspired by American pragmatism, complexity theory, hermeneutics, discursive and collaborative planning. Scholars agree that “reflexivity” has a strong temporal dimension: it not only aims...... to solve present planning problems, but to imagine and understand alternative trajectories for future action. This article explores the practical utility of reflexivity for planners, through a case study that focuses on a project to promote sustainable development in the Port of Amsterdam. Reflexivity...... in planning emerges as a new tool for generating critical knowledge and dialogue that can synthesise the perspectives of multiple actors in a common understanding, existing structural constraints and a collective imagination of alternative future possibilities. Such research highlights the potential...

  3. Human investigations into the exercise pressor reflex

    DEFF Research Database (Denmark)

    Secher, Niels H; Amann, Markus

    2012-01-01

    During exercise, neural input from skeletal muscles reflexly maintains or elevates blood pressure (BP) despite a maybe fivefold increase in vascular conductance. This exercise pressor reflex is illustrated by similar heart rate (HR) and BP responses to electrically induced and voluntary exercise....... The importance of the exercise pressor reflex for tight cardiovascular regulation during dynamic exercise is supported by studies using pharmacological blockade of lower limb muscle afferent nerves. These experiments show attenuation of the increase in BP and cardiac output when exercise is performed...... of an increase in BP during exercise with paralysed legs manifests, although electrical stimulation of muscles enhances lactate release and reduces muscle glycogen. Thus, the exercise pressor reflex enhances sympathetic activity and maintains perfusion pressure by restraining abdominal blood flow, while brain...

  4. Reflexive Planning as Design and Work

    DEFF Research Database (Denmark)

    Lissandrello, Enza; Grin, John

    2011-01-01

    In recent years, planning theorists have advanced various interpretations of the notion of reflexivity, inspired by American pragmatism, complexity theory, hermeneutics, discursive and collaborative planning. Scholars agree that “reflexivity” has a strong temporal dimension: it not only aims...... to solve present planning problems, but to imagine and understand alternative trajectories for future action. This article explores the practical utility of reflexivity for planners, through a case study that focuses on a project to promote sustainable development in the Port of Amsterdam. Reflexivity...... in planning emerges as a new tool for generating critical knowledge and dialogue that can synthesise the perspectives of multiple actors in a common understanding, existing structural constraints and a collective imagination of alternative future possibilities. Such research highlights the potential...

  5. Reflexive structures an introduction to computability theory

    CERN Document Server

    Sanchis, Luis E

    1988-01-01

    Reflexive Structures: An Introduction to Computability Theory is concerned with the foundations of the theory of recursive functions. The approach taken presents the fundamental structures in a fairly general setting, but avoiding the introduction of abstract axiomatic domains. Natural numbers and numerical functions are considered exclusively, which results in a concrete theory conceptually organized around Church's thesis. The book develops the important structures in recursive function theory: closure properties, reflexivity, enumeration, and hyperenumeration. Of particular interest is the treatment of recursion, which is considered from two different points of view: via the minimal fixed point theory of continuous transformations, and via the well known stack algorithm. Reflexive Structures is intended as an introduction to the general theory of computability. It can be used as a text or reference in senior undergraduate and first year graduate level classes in computer science or mathematics.

  6. Orthodoxy and reflexivity in international comparative analysis

    DEFF Research Database (Denmark)

    Lind, Jens; Valkenburg, Ben

    2002-01-01

    project, in which we have tried to deal with these consequences. Fourth, and hopefully as a result of the first three aims, we want to argue that a reflexive approach of international, comparative research is not only desirable, but attainable as well. In order to do so, we begin with a short discussion...... upon the consequences on the level of empirical research. We want to avoid that, so our second and third subject will be the practical implications of reflexivity for empirical research as well as for social policy. Our discussion on these subjects is based on the practical experiences in the INPART...... on the main issues in the so-called ?reflexive approach? and consider the main consequences of this approach for both social science and social policy. Against this background we will discuss the implications for comparative research and the experiences of the INPART project end up with a few central issues...

  7. New molecular knowledge towards the trigemino-cardiac reflex as a cerebral oxygen-conserving reflex.

    Science.gov (United States)

    Sandu, N; Spiriev, T; Lemaitre, F; Filis, A; Schaller, B

    2010-05-04

    The trigemino-cardiac reflex (TCR) represents the most powerful of the autonomous reflexes and is a subphenomenon in the group of the so-called "oxygen-conserving reflexes". Within seconds after the initiation of such a reflex, there is a powerful and differentiated activation of the sympathetic system with subsequent elevation in regional cerebral blood flow (CBF), with no changes in the cerebral metabolic rate of oxygen (CMRO2) or in the cerebral metabolic rate of glucose (CMRglc). Such an increase in regional CBF without a change of CMRO2 or CMRglc provides the brain with oxygen rapidly and efficiently. Features of the reflex have been discovered during skull base surgery, mediating reflex protection projects via currently undefined pathways from the rostral ventrolateral medulla oblongata to the upper brainstem and/or thalamus, which finally engage a small population of neurons in the cortex. This cortical center appears to be dedicated to transduce a neuronal signal reflexively into cerebral vasodilatation and synchronization of electrocortical activity; a fact that seems to be unique among autonomous reflexes. Sympathetic excitation is mediated by cortical-spinal projection to spinal preganglionic sympathetic neurons, whereas bradycardia is mediated via projections to cardiovagal motor medullary neurons. The integrated reflex response serves to redistribute blood from viscera to the brain in response to a challenge to cerebral metabolism, but seems also to initiate a preconditioning mechanism. Previous studies showed a great variability in the human TCR response, in special to external stimuli and individual factors. The TCR gives, therefore, not only new insights into novel therapeutic options for a range of disorders characterized by neuronal death, but also into the cortical and molecular organization of the brain.

  8. A comparison of risk factors for wheeze and recurrent cough in preschool children

    DEFF Research Database (Denmark)

    Hermann, Christian; Westergaard, Tine; Pedersen, Bo V

    2005-01-01

    In a study of 2,978 Danish children aged 5 years from two suburban counties of Copenhagen, carried out in 1998, the authors compared risk factor profiles for wheeze and recurrent cough without wheeze by using polytomous logistic regression to clarify whether the two conditions are likely to have...... the same etiology. Data were obtained 1) by a mailed parental questionnaire (International Study of Asthma and Allergies in Childhood questions and supplementary questions on cough, sociodemography, perinatal factors, and environmental exposure); 2) through general practitioners (familial allergic disease......); and 3) from the National Medical Birth Register (birth weight). Wheeze (WH) was defined as more than one episode of wheeze within the last 12 months (irrespective of cough status) and recurrent cough without WH (RC) as cough occurring outside colds and usually lasting for periods of more than 1 week...

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Patel Girish

    2013-10-01

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

  12. Fuzzy approach for improved recognition of citric acid induced piglet coughing from continuous registration

    Science.gov (United States)

    Van Hirtum, A.; Berckmans, D.

    2003-09-01

    A natural acoustic indicator of animal welfare is the appearance (or absence) of coughing in the animal habitat. A sound-database of 5319 individual sounds including 2034 coughs was collected on six healthy piglets containing both animal vocalizations and background noises. Each of the test animals was repeatedly placed in a laboratory installation where coughing was induced by nebulization of citric acid. A two-class classification into 'cough' or 'other' was performed by the application of a distance function to a fast Fourier spectral sound analysis. This resulted in a positive cough recognition of 92%. For the whole sound-database however there was a misclassification of 21%. As spectral information up to 10000 Hz is available, an improved overall classification on the same database is obtained by applying the distance function to nine frequency ranges and combining the achieved distance-values in fuzzy rules. For each frequency range clustering threshold is determined by fuzzy c-means clustering.

  13. Cough syncope in a 43-year-old woman with glomus jugulare tumor

    Directory of Open Access Journals (Sweden)

    Susanta Bandyopadhyay

    2014-01-01

    Full Text Available We present an unusual case of recurrent cough syncope in a 43-year-old woman, which was initially thought to be seizures. Syncopal episodes were triggered by paroxysms of cough and were characterized by unresponsiveness and myoclonic jerks in her extremities. She had a left-sided glomus jugulare tumor that extended into the posterior cranial fossa with evidence of worsening communicating hydrocephalus on brain imaging. We postulate that bouts of cough produced increased intracranial pressure both by raising intrathoracic and intraabdominal pressures as well as by transient obstruction to cerebrospinal fluid flow secondary to intermittent tonsillar herniation during cough. This resulted in diffuse decrease in cerebral blood flow causing syncope. The patient's syncopal episodes decreased in frequency once an external ventricular drain was placed followed by a ventriculoperitoneal shunt. Search for factors that can increase intracranial pressure seems warranted in patients with recurrent cough syncope.

  14. The correlation of respiratory muscle strength and cough capacity in stroke patients.

    Science.gov (United States)

    Jo, Myeong-Rae; Kim, Nan-Soo

    2016-10-01

    [Purpose] The purpose of this study was to investigate the correlation between respiratory muscle strength and cough capacity in stroke patients. [Subjects and Methods] Forty-two stroke patients were assigned to 2 different groups (intervention group=21, control group=21). Both groups participated in a conventional stroke rehabilitation program, with the intervention group also receiving respiratory muscle training for 20 to 30 minutes a day, 3 times a week for 8 weeks. Respiratory muscle strength (maximal inspiratory pressure, maximal expiratory pressure), forced vital capacity, and cough capacity were measured. [Results] The intervention group showed significant increases in maximal inspiratory pressure, maximal expiratory pressure, forced vital capacity, and cough capacity. The change in maximal inspiratory pressure, maximal expiratory pressure, and forced vital capacity showed a significant correlation with cough capacity, with maximal expiratory pressure showing the highest correlation. [Conclusion] The present study showed that the increase in maximal expiratory pressure plays an important role in improving the cough capacity of stroke patients.

  15. Stuttering or reflex seizure? A case report.

    Science.gov (United States)

    Michel, Véronique; Burbaud, Pierre; Taillard, Jacques; Gaida, Tsouria; Joseph, Pierre Alain; Duché, Bernard; Bioulac, Bernard

    2004-09-01

    Stuttering is characterized by involuntary syllabic repetitions and interruption in the smooth flow of speech. The exact cause of primary stuttering remains a matter of debate but a frontal dysfunction has been evoked. On the other hand, acquired stuttering is uncommon. We report a case of reflex epilepsy in which seizures were triggered by reading aloud or stressful conversation. Each paroxysmal event in left frontal region was associated clinically with a language disorder mimicking stuttering. Our observation suggests that reflex frontal focal epilepsy could be a putative etiology for acquired stuttering.

  16. [The vegetative component of a conditioned reflex].

    Science.gov (United States)

    Ordzhonikadze, Ts A; Pkhakadze, L D

    1975-01-01

    Defensive and alimentary conditioned reflexes were studied on normal cats and cats with neural isolation of the neocortex. The cardiac component of the conditioned reflexes is elaborated in decorticated animals at a similar rate and is as steady as in normal cats. Motor conditioned reactions in decorticated cats are difficult to elaborate. Both in normal and decorticated cats unconditioned pain stimulation evokes tachycardia, while a conditioned signal, paired with this unconditioned stimulus, produces bradicardia. Ban assumption has been made that the primary conditioned reaction consists in the appearance of a certain emotional state which changes the cardiac rhythm in a typical way.

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

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 赖克方; 罗炜; 刘春丽; 钟南山

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Masaki Fujimura

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    马献中; 王世彪; 王保平

    2014-01-01

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

  20. Charitable giving and reflexive individuals: How personal reflexivity mediates between structure and agency.

    Science.gov (United States)

    Sanghera, Balihar

    2017-03-01

    This article examines how individuals are reflexive beings who interpret the world in relation to things that matter to them, and how charitable acts are evaluated and embedded in their lives with different degrees of meaning and importance. Rather than framing the discussion of charitable practices in terms of an altruism/egoism binary or imputing motivations and values to social structures, the article explains how reflexivity is an important and neglected dimension of social practices, and how it interacts with sympathy, sentiments and discourses to shape giving. The study also shows that there are different modes of reflexivity, which have varied effects on charity and volunteering.

  1. An evaluation of the finger flexion, Hoffman's and plantar reflexes as markers of cervical spinal cord compression - A comparative clinical study.

    Science.gov (United States)

    Tejus, M N; Singh, Vikram; Ramesh, Ananthakrishnan; Kumar, V R Roopesh; Maurya, Ved Prakash; Madhugiri, Venkatesh S

    2015-07-01

    This study aimed at determining the frequency of abnormal finger flexion, Hoffman's and extensor plantar (Babinski) response in healthy adults and to determine the sensitivity and specificity of these tests as markers of spinal cord compression in symptomatic patients. Patients attending the neurosurgery clinic with neck related complaints formed the case group. The control group consisted of consenting patient attenders and volunteers drawn from the students and faculty of our institute. All subjects underwent examination of the finger flexion, Hoffman's and plantar reflexes and an MRI as per standard protocol. The frequency of the reflexes in the control group, sensitivity and specificity of the reflexes to detect cord compression in the case group were computed. The frequency of the reflexes in healthy controls were finger flexion - 1%, Hoffman's - 0.3% and Babinski sign - 0%. None of the controls with positive reflexes had any abnormality on MR imaging. A combination of the three reflexes had a sensitivity of 91.7%, specificity of 87.5%, PPV of 95.7% and NPV of 77.8% in detecting spinal cord compression. A combination of finger flexion, Hoffman's and plantar reflexes could be used effectively as a marker of spinal cord compression in symptomatic individuals. They cannot, however, be depended on as screening tests in asymptomatic individuals. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. How many theta roles in a reflexive verb?

    NARCIS (Netherlands)

    Dimitriadis, Alexis; Everaert, Martin

    2014-01-01

    While purely syntactic approaches to reflexivization have characterized reflexive verbs in terms of detransitivization, we show that there is a discrepancy between syntactic and semantic arity. Reflexive verbs are syntactically intransitive, but semantically they are two-place predicates: both

  3. Prevalence of cough among patients treated with angiotensin converting enzyme inhibitors

    Directory of Open Access Journals (Sweden)

    Gebrehiwot Teklay

    2014-12-01

    Full Text Available Purpose: The aim of this study was to assess the prevalence of cough, its causality and impact on patient adherence in patients taking angiotensin converting enzyme inhibitors. Methods - A cross sectional study was conducted in Ayder Referral Hospital, northern Ethiopia from April to June 2014. Patients who started either captopril or enalapril were interviewed for the occurrence of cough and its characteristics. Data were entered to EPI-info and analyzed using SPSS for windows version 16 statistical software. Logistic regression model was used to analyze variations in occurrence of cough among different factors. P value of less than 0.05 was considered statistically significant. Results - One hundred two patients were participated in this study. Of which, 54(52.9% were females. About half of the respondents (53% were between the ages of 40 to 60. Cough was observed in 30 (29.4% patients. According to World Health Organizations causality scale, the reported cough was certain (drug induced in 5 (7.1% patients; possible in 10 (25% patients; probable in 12 (10.7% patients and unlikely in 3 (57.1% patients. Significant statistical difference was observed between occurrence of cough and durations of treatment (P<0.05. There was no statistically significant difference in occurrence of cough with age, sex, ethnicity, residence, dose and type of ACEI. Conclusion – In this study, dry cough was more prevalent among patients on angiotensin converting enzyme inhibitors. Troublesome cough may affect patient’s sleep and overall adherence to treatment. Health professionals should aware of the characteristics cough and manage accordingly.

  4. Exhaled air dispersion during coughing with and without wearing a surgical or N95 mask.

    Directory of Open Access Journals (Sweden)

    David S Hui

    Full Text Available OBJECTIVES: We compared the expelled air dispersion distances during coughing from a human patient simulator (HPS lying at 45° with and without wearing a surgical mask or N95 mask in a negative pressure isolation room. METHODS: Airflow was marked with intrapulmonary smoke. Coughing bouts were generated by short bursts of oxygen flow at 650, 320, and 220L/min to simulate normal, mild and poor coughing efforts, respectively. The coughing jet was revealed by laser light-sheet and images were captured by high definition video. Smoke concentration in the plume was estimated from the light scattered by smoke particles. Significant exposure was arbitrarily defined where there was ≥ 20% of normalized smoke concentration. RESULTS: During normal cough, expelled air dispersion distances were 68, 30 and 15 cm along the median sagittal plane when the HPS wore no mask, a surgical mask and a N95 mask, respectively. In moderate lung injury, the corresponding air dispersion distances for mild coughing efforts were reduced to 55, 27 and 14 cm, respectively, p < 0.001. The distances were reduced to 30, 24 and 12 cm, respectively during poor coughing effort as in severe lung injury. Lateral dispersion distances during normal cough were 0, 28 and 15 cm when the HPS wore no mask, a surgical mask and a N95 mask, respectively. CONCLUSIONS: Normal cough produced a turbulent jet about 0.7 m towards the end of the bed from the recumbent subject. N95 mask was more effective than surgical mask in preventing expelled air leakage during coughing but there was still significant sideway leakage.

  5. Electrical stimulation of abdominal muscles to produce cough in spinal cord injury: effect of stimulus intensity.

    Science.gov (United States)

    McBain, Rachel A; Boswell-Ruys, Claire L; Lee, Bonsan B; Gandevia, Simon C; Butler, Jane E

    2015-05-01

    Surface electrical stimulation of the abdominal muscles, with electrodes placed in the posterolateral position, combined with a voluntary cough can assist clearance of airway secretions in individuals with high-level spinal cord injury (SCI). To determine whether an increase in stimulus intensity of the trains of electrical stimuli delivered to the expiratory muscles has an increasing effect on a stimulated voluntary cough and to determine at which stimulus intensity a plateau of cough peak expiratory flow occurs. In 7 healthy individuals with a SCI at and above C7, gastric pressure (P(ga)), esophageal pressure (P(es)), peak expiratory cough flow (PEF(cough)), and expiratory volume were measured as participants coughed voluntarily with simultaneous trains of electrical stimuli delivered over the abdominal muscles (50 Hz, 1-s duration). The intensity of the stimulation was increased incrementally. A plateau in PEF(cough) occurred in all 7 individuals at a mean of 211 ± 29 mA (range 120-360 mA). Peak values reached for P(ga), P(es), and PEF(cough) were 83.0 ± 8.0 cm H2O, 66.1 ± 5.6 cm H2O, and 4.0 ± 0.4 l/s respectively. The plateau in expiratory cough flow that was associated with increasing expiratory pressures is indicative of dynamic airway compression. This suggests that the evoked cough will be effective in creating more turbulent airflow to further assist in dislodging mucus and secretions. © The Author(s) 2014.

  6. Classification of chronic cough by systematic treatment cascade trial starting with beta agonist

    Science.gov (United States)

    2013-01-01

    Background Chronic cough is one of the most challenging symptoms to diagnose and treat, not only because of the variety of underlying disorders but also its varying susceptibility to treatments. Etiological studies of chronic cough vary depending on the clinical settings and the particular interests of investigators. Objectives The purposes of this study were first to categorize the etiology of chronic cough by its response to systematic diagnostic treatments starting from the β2 agonist and second to sub-categorize β2 agonist responsive cough (BRC) by the airway hyperresponsiveness. Methods One hundred and eighty-four never-smokers received the maximal dose of procaterol to diagnose BRC. BRC was sub-categorized into two groups with or without airway hyperresponsiveness measured by the methacholine challenge test. Sinobronchial syndrome (SBS) was diagnosed by postnasal drip symptoms and by the response to clarythromycin and carbocysteine. Atopic cough (AC) was diagnosed by the evidence of atopy and the response to cetirizine hydrochloride. Gastroesophageal reflux disease (GERD) was diagnosed by the response to rabeprazole sodium. Since we did not investigate eosinophil counts in the tissue or in the induced sputum, no diagnosis of eosinophilic bronchitis was made. Results One hundred and nine patients had BRC. Twenty-three of them had bronchial asthma (BA), 53 had cough variant asthma (CVA) and 33 had non-hyperresponsive BRC (NHBRC). Thirty-one patients had GERD, 27 had AC and 14 had SBS. Twenty-five patients had more than one diagnosis in combination, while 6 had other miscellaneous diseases. Twelve patients were undiagnosed and 11 dropped out of the study. Conclusions The majority of chronic cough was BRC. NHBRC was a new chronic cough entity. GERD is a common cause of chronic cough in Japan, as in Western countries. AC and SBS are also causes of chronic cough in Japan. Trial registration University hospital medical information network (UMIN 000007483) PMID

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

    Directory of Open Access Journals (Sweden)

    Smit Lidwien AM

    2012-03-01

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

  8. Epidemiology of whooping cough & typing of Bordetella pertussis.

    Science.gov (United States)

    Hegerle, Nicolas; Guiso, Nicole

    2013-11-01

    Bordetella pertussis is a Gram-negative human-restricted bacterium that evolved from the broad-range mammalian pathogen, Bordetella bronchiseptica. It causes whooping cough or pertussis in humans, which is the most prevalent vaccine-preventable disease worldwide. The introduction of the pertussis whole-cell vaccination for young children, followed by the introduction of the pertussis acellular vaccination (along with booster vaccination) for older age groups, has affected the bacterial population and epidemiology of the disease. B. pertussis is relatively monomorphic worldwide, but nevertheless, different countries are facing different epidemiological evolutions of the disease. Although it is tempting to link vaccine-driven phenotypic and genotypic evolution of the bacterium to epidemiology, many other factors should be considered and surveillance needs to continue, in addition to studies investigating the impact of current clinical isolates on vaccine efficacy.

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

    Science.gov (United States)

    Uijen, Johannes HJM; van Duijn, Huug J; Kuyvenhoven, Marijke M; Schellevis, François G; van der Wouden, Johannes C

    2008-01-01

    Background GPs are often consulted for respiratory tract symptoms in children. Aim To explore characteristics of children, their parents, and their GPs that are correlated with consulting a GP for cough, sore throat, or earache. Design of study Second Dutch National Survey of General Practice (DNSGP-2) with a health interview and an additional questionnaire. Setting Children aged 0–17 years registered with 122 GPs in Dutch general practice. Method Characteristics of patients and their GPs were derived from the DNSGP-2 health interview and a questionnaire, respectively. Characteristics of the illness symptoms and GP consultation were acquired by means of an additional questionnaire. Data were analysed using multivariate logistic regression. Results Of all children who completed the questionnaire, 550 reported cough, sore throat, or earache in the 2 weeks preceding the interview with 147 of them consulting their GP. Young children more frequently consulted the GP for respiratory symptoms, as did children with fever, longer duration of symptoms, those reporting their health to be ‘poor to good’, and living in an urban area. When parents were worried, and when a child or their parents were cued by someone else, the GP was also consulted more often. GP-related determinants were not associated with GP consultation by children. Conclusion This study emphasises the importance of establishing the reasons behind children with respiratory tract symptoms consulting their GP. When GPs are aware of possible determinants of the decision to consult a GP, more appropriate advice and reassurance can be given regarding these respiratory symptoms, which are generally self-limiting. PMID:18387228

  10. Analysis of muscle fiber conduction velocity enables reliable detection of surface EMG crosstalk during detection of nociceptive withdrawal reflexes.

    Science.gov (United States)

    Jensen, Michael Brun; Manresa, José Alberto Biurrun; Frahm, Ken Steffen; Andersen, Ole Kæseler

    2013-03-26

    The nociceptive withdrawal reflex (NWR) is a polysynaptic spinal reflex that induces complex muscle synergies to withdraw a limb from a potential noxious stimulus. Several studies indicate that assessment of the NWR is a valuable objective tool in relation to investigation of various pain conditions. However, existing methodologies for NWR assessment evaluate standard surface electromyography (sEMG) measured over just one muscle and do not consider the possible interference of crosstalk originating from adjacent active muscles. The present study had two aims: firstly, to investigate to which extent the presence of crosstalk may affect NWR detection using a standardized scoring criterion (interval peak z-score) that has been validated without taking crosstalk into consideration. Secondly, to investigate whether estimation of muscle fiber conduction velocity can help identifying the propagating and non-propagating nature of genuine reflexes and crosstalk respectively, thus allowing a more valid assessment of the NWR. Evaluation of interval peak z-score did apparently allow reflex detection with high sensitivity and specificity (0.96), but only if the influence of crosstalk was ignored. Distinction between genuine reflexes and crosstalk revealed that evaluation of interval peak z-score incorporating a z-score threshold of 12 was associated with poor reflex detection specificity (0.26-0.62) due to the presence of crosstalk. Two different standardized methods for estimation of muscle fiber conduction velocity were employed to demonstrate that significantly different muscle fiber conduction velocities may be estimated during genuine reflexes and crosstalk, respectively. This discriminative feature was used to develop and evaluate a novel methodology for reflex detection from sEMG that is robust with respect to crosstalk. Application of this conduction velocity analysis (CVA) entailed reflex detection with excellent sensitivity (1.00 and 1.00) and specificity (1.00 and 0

  11. Team Reflexivity and Innovation: The Moderating Role of Team Context

    OpenAIRE

    Dawson, J.; Schippers, M; M. West

    2012-01-01

    Team reflexivity, the extent to which teams collectively reflect upon and adapt their working methods and functioning, has been shown to be an important predictor of team outcomes, notably innovation. As described in the current article, the authors developed and tested a team-level contingency model of team reflexivity, work demands, and innovation. They argue that highly reflexive teams will be more innovative than teams low in reflexivity when facing a demanding work environment. A field s...

  12. Spinal Reflexes and Windup In Vitro: Effects of Analgesics and Anesthetics.

    Science.gov (United States)

    Rivera-Arconada, Ivan; Roza, Carolina; Lopez-Garcia, Jose A

    2016-02-01

    The spinal cord is the first relay center for nociceptive information. Following peripheral injury, the spinal cord sensitizes. A sign of spinal sensitization is the hyper-reflexia which develops shortly after injury and can be detected in the isolated spinal cord as a "memory of pain." In this context, it is easy to understand that many analgesic compounds target spinally located sites of action to attain analgesia. In vitro isolated spinal cord preparations have been used for a number of years, and experience on the effects of compounds of diverse pharmacological families on spinal function has accumulated. Recently, we have proposed that the detailed study of spinal segmental reflexes in vitro may produce data relevant to the evaluation of the analgesic potential of novel compounds. In this review, we describe the main features of segmental reflexes obtained in vitro and discuss the effects of compounds of diverse chemical nature and pharmacological properties on such reflexes. Our aim was to compare the different profiles of action of the compounds on segmental reflexes in order to extract clues that may be helpful for pharmacological characterization of novel analgesics. © 2015 John Wiley & Sons Ltd.

  13. A positive Babinski reflex predicts delayed neuropsychiatric sequelae in Chinese patients with carbon monoxide poisoning.

    Science.gov (United States)

    Zou, Jian-Fang; Guo, Qiming; Shao, Hua; Li, Bin; Du, Yuxiu; Liu, Maofeng; Liu, Fengling; Dai, Lixin; Chung, Min-Hsien; Lin, Hung-Jung; Guo, How-Ran; Yang, Tzu-Meng; Huang, Chien-Cheng; Hsu, Chien-Chin

    2014-01-01

    As the human population increased in China, the carbon monoxide is a serious environmental toxin in public health. However, predicting the delayed neuropsychiatric sequelae (DNS) of carbon monoxide poisoning (COP) has not been well studied. We investigated the independent predictors of DNS in patients with COP. This study was conducted at four hospitals in China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. DNS was the primary endpoint. A positive Babinski reflex was the independent predictor for DNS: sensitivity = 53.8% (95% confidence interval [CI]: 26.1-79.6), specificity = 88.6% (95% CI: 83.7-92.1), positive predictive value (PPV) = 20.0% (95% CI: 9.1-37.5), and negative predictive value (NPV) = 97.3% (95% CI: 94.0-98.9). The area under the receiver operating characteristic curve = 0.712 (95% CI: 0.544-0.880). A positive Babinski reflex was very memorable, immediately available, and applicable in clinical practice. Even when the sensitivity and PPV of a positive Babinski reflex were unsatisfactory, it had a good specificity and NPV for excluding the risk of DNS. In patients without a positive Babinski reflex, the risk for DNS was only 2.7%. This finding may help physicians make decisions about dispositions for patients with COP.

  14. A Positive Babinski Reflex Predicts Delayed Neuropsychiatric Sequelae in Chinese Patients with Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Jian-Fang Zou

    2014-01-01

    Full Text Available As the human population increased in China, the carbon monoxide is a serious environmental toxin in public health. However, predicting the delayed neuropsychiatric sequelae (DNS of carbon monoxide poisoning (COP has not been well studied. We investigated the independent predictors of DNS in patients with COP. This study was conducted at four hospitals in China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. DNS was the primary endpoint. A positive Babinski reflex was the independent predictor for DNS: sensitivity = 53.8% (95% confidence interval [CI]: 26.1–79.6, specificity = 88.6% (95% CI: 83.7–92.1, positive predictive value (PPV = 20.0% (95% CI: 9.1–37.5, and negative predictive value (NPV = 97.3% (95% CI: 94.0–98.9. The area under the receiver operating characteristic curve = 0.712 (95% CI: 0.544–0.880. A positive Babinski reflex was very memorable, immediately available, and applicable in clinical practice. Even when the sensitivity and PPV of a positive Babinski reflex were unsatisfactory, it had a good specificity and NPV for excluding the risk of DNS. In patients without a positive Babinski reflex, the risk for DNS was only 2.7%. This finding may help physicians make decisions about dispositions for patients with COP.

  15. Influence of gravity on cat vertical vestibulo-ocular reflex

    Science.gov (United States)

    Tomko, D. L.; Wall, C., III; Robinson, F. R.; Staab, J. P.

    1988-01-01

    The vertical vestibulo-ocular reflex (VOR) was recorded in cats using electro-oculography during sinusoidal angular pitch. Peak stimulus velocity was 50 deg/s over a frequency range from 0.01 to 4.0 Hz. To test the effect of gravity on the vertical VOR, the animal was pitched while sitting upright or lying on its side. Upright pitch changed the cat's orientation relative to gravity, while on-side pitch did not. The cumulative slow component position of the eye during on-side pitch was less symmetric than during upright pitch. Over the mid-frequency range (0.1 to 1.0 Hz), the average gain of the vertical VOR was 14.5 percent higher during upright pitch than during on-side pitch. At low frequencies (less than 0.05 Hz) changing head position relative to gravity raised the vertical VOR gain and kept the reflex in phase with stimulus velocity. These results indicate that gravity-sensitive mechanisms make the vertical VOR more compensatory.

  16. Multisensory Control of Stabilization Reflexes

    Science.gov (United States)

    2012-08-22

    direction of motion sensitive neurons. In: Rhythmogenesis in Neurons and Networks. Eds. N. Elsner, D.W. Richter, Thieme , Stuttgart 1992, 306. A2. Krapp H...Eds. N. Elsner, M. Heisenberg, Thieme , Stuttgart 1993, 357. A3. Krapp H., Hengstenberg B., and Hengstenberg R.: Correspondence of dendritic field...Göttingen Neurobiology Conference, Vol. II. Eds. N. Elsner, H. Breer, Thieme , Stuttgart 1994, 447. A4. Krapp H. and Hengstenberg R.: Comparison

  17. Control of reflexive saccades following hemispherectomy.

    Science.gov (United States)

    Reuter-Lorenz, Patricia A; Herter, Troy M; Guitton, Daniel

    2011-06-01

    Individuals who have undergone hemispherectomy for treatment of intractable epilepsy offer a rare and valuable opportunity to examine the ability of a single cortical hemisphere to control oculomotor performance. We used peripheral auditory events to trigger saccades, thereby circumventing dense postsurgical hemianopia. In an antisaccade task, patients generated numerous unintended short-latency saccades toward contralesional auditory events, indicating pronounced limitations in the ability of a single hemicortex to exert normal inhibitory control over ipsilateral (i.e., contralesional) reflexive saccade generation. Despite reflexive errors, patients retained an ability to generate correct antisaccades in both directions. The prosaccade task revealed numerous contralesional express saccades, a robust contralesional gap effect, but the absence of both effects for ipsilesional saccades. These results indicate limits to the saccadic control capabilities following hemispherectomy: A single hemicortex can mediate antisaccades in both directions, but plasticity does not extend fully to the bilateral inhibition of reflexive saccades. We posit that these effects are due to altered control dynamics that reduce the responsivity of the superior colliculus on the intact side and facilitate the release of an auditory-evoked ocular grasp reflex into the blind hemifield that the intact hemicortex has difficulty suppressing.

  18. Dilemmas and Deliberations in Reflexive Ethnographic Research

    Science.gov (United States)

    Robinson, Janean Valerie

    2014-01-01

    This paper traces insights into the challenges and dilemmas experienced whilst researching students' interpretations and understandings of the Behaviour Management in Schools policy in Western Australia. Journal records, supported by student transcripts, are woven together in a reflexive ethnographic journey--from the beginning phase of…

  19. The Reflexive Modernization of Australian Universities

    Science.gov (United States)

    Pick, David

    2004-01-01

    The profound changes occurring in Australian higher education are viewed here in the context of the social, cultural, political and economic effects of globalization. Particular attention is paid to providing a theoretical foundation for understanding these effects using the reflexive modernization perspective. Highlighted are some of the…

  20. A reflexive perspective in problem solving

    Directory of Open Access Journals (Sweden)

    Chio, José Angel

    2013-01-01

    Full Text Available The objective of this paper is to favour the methodological process of reflexive analysis in problem solving in the general teaching methods that concentrates in strengthening the dimensional analysis, to gain a greater preparation of the students for the solution of mathematical problems.

  1. Taking Control of Reflexive Social Attention

    Science.gov (United States)

    Ristic, Jelena; Kingstone, Alan

    2005-01-01

    Attention is shifted reflexively to where other people are looking. It has been argued by a number of investigators that this social attention effect reflects the obligatory bottom-up activation of domain-specific modules within the inferior temporal (IT) cortex that are specialized for processing face and gaze information. However, it is also the…

  2. The reflexive self and culture: a critique.

    Science.gov (United States)

    Adams, Matthew

    2003-06-01

    This article attempts to engage with a tendency in the theorization of social change and self-identity, evident in the work of a number of contemporary social theorists, to place an extended process of reflexivity at the heart of modern identity. As symptomatic of 'neo-modern' accounts of selfhood, critical readings of Giddens, Beck, Castells and some aspects of social theory more generally, and their account of modern reflexivity's relationship to culture, are assessed. In light of these criticisms, ways in which culture might still play an important part in the shaping of identity are considered. The relationship between language, culture and reflexivity, drawing from philosophy, sociology and G. H. Mead's own brand of social psychology, are all utilized in establishing a critique of the role Giddens and others designate for culture in the constitution of the contemporary self. By potentially repositioning self-identity in its connection to culture, the overall bearing of reflexivity upon the processes of self-identity is thus questioned. It is argued that a culturally-situated, yet fluid and multifarious account of self-identity is a necessary analytical and normative alternative.

  3. A Testbed for Autonomous Reflexive Grasping

    Science.gov (United States)

    1993-03-01

    written in C. The tactile sensor is neural network causes the reflex layer of the a 10 x 10 Tekscan sensor with an active area subsumption architecture to...Doctoral Thesis, March 1990. [9] J. G. Webster, Tactile Sensors for Robotics and Medicine, John Wiley & Sons, 1988 [10] Tekscan Inc., " Tekscan Corporate

  4. A Reflexive Model for Teaching Instructional Design.

    Science.gov (United States)

    Shambaugh, Neal; Magliaro, Susan

    2001-01-01

    Documents a five-year study of two instructors who collaborated on formally studying their teaching of a master's level instructional design course. Outlines their views on learning, teaching, and instructional design (ID), describes the ID course, and explains the reflexive instructional model used, in which the teachers examined their teaching…

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

    Science.gov (United States)

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

    2015-05-13

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

  6. New Molecular Knowledge Towards the Trigemino-Cardiac Reflex as a Cerebral Oxygen-Conserving Reflex

    Directory of Open Access Journals (Sweden)

    N. Sandu

    2010-01-01

    Full Text Available The trigemino-cardiac reflex (TCR represents the most powerful of the autonomous reflexes and is a subphenomenon in the group of the so-called “oxygen-conserving reflexes”. Within seconds after the initiation of such a reflex, there is a powerful and differentiated activation of the sympathetic system with subsequent elevation in regional cerebral blood flow (CBF, with no changes in the cerebral metabolic rate of oxygen (CMRO2 or in the cerebral metabolic rate of glucose (CMRglc. Such an increase in regional CBF without a change of CMRO2 or CMRglc provides the brain with oxygen rapidly and efficiently. Features of the reflex have been discovered during skull base surgery, mediating reflex protection projects via currently undefined pathways from the rostral ventrolateral medulla oblongata to the upper brainstem and/or thalamus, which finally engage a small population of neurons in the cortex. This cortical center appears to be dedicated to transduce a neuronal signal reflexively into cerebral vasodilatation and synchronization of electrocortical activity; a fact that seems to be unique among autonomous reflexes. Sympathetic excitation is mediated by cortical-spinal projection to spinal preganglionic sympathetic neurons, whereas bradycardia is mediated via projections to cardiovagal motor medullary neurons. The integrated reflex response serves to redistribute blood from viscera to the brain in response to a challenge to cerebral metabolism, but seems also to initiate a preconditioning mechanism. Previous studies showed a great variability in the human TCR response, in special to external stimuli and individual factors. The TCR gives, therefore, not only new insights into novel therapeutic options for a range of disorders characterized by neuronal death, but also into the cortical and molecular organization of the brain.

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

    Science.gov (United States)

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

    1996-07-01

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

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

    Science.gov (United States)

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

    1996-01-01

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

  9. Comorbid trends in World Trade Center cough syndrome and probable posttraumatic stress disorder in firefighters.

    Science.gov (United States)

    Niles, Justin K; Webber, Mayris P; Gustave, Jackson; Cohen, Hillel W; Zeig-Owens, Rachel; Kelly, Kerry J; Glass, Lara; Prezant, David J

    2011-11-01

    We describe the relationship between World Trade Center (WTC) cough syndrome symptoms, pulmonary function, and symptoms consistent with probable posttraumatic stress disorder (PTSD) in WTC-exposed firefighters in the first year post-September 11, 2001 (baseline), and 3 to 4 years later (follow-up). Five thousand three hundred sixty-three firefighters completed pulmonary function tests (PFTs) and questionnaires at both times. Relationships among WTC cough syndrome, probable PTSD, and PFTs were analyzed using simple and multivariable models. We also examined the effects of cofactors, including WTC exposure. WTC cough syndrome was found in 1,561 firefighters (29.1%) at baseline and 1,186 (22.1%) at follow-up, including 559 with delayed onset (present only at follow-up). Probable PTSD was found in 458 firefighters (8.5%) at baseline and 548 (10.2%) at follow-up, including 343 with delayed onset. Baseline PTSD symptom counts and probable PTSD were associated with WTC cough syndrome at baseline, at follow-up, and in those with delayed-onset WTC cough syndrome. Similarly, WTC cough syndrome symptom counts and WTC cough syndrome at baseline were associated with probable PTSD at baseline, at follow-up, and in those with delayed-onset probable PTSD. WTC arrival time and work duration were cofactors of both outcomes. A small but consistent association existed between pulmonary function and WTC cough syndrome, but none with PTSD. The study showed a moderate association between WTC cough syndrome and probable PTSD. The presence of one contributed to the likelihood of the other, even after adjustment for shared cofactors such as WTC exposure.

  10. The Interrater Reliability of Subjective Assessments of the Babinski Reflex.

    Science.gov (United States)

    Dafkin, Chloe; Green, Andrew; Kerr, Samantha; Veliotes, Demetri; Olivier, Benita; McKinon, Warrick

    2016-01-01

    The Babinski reflex is a clinical diagnostic tool; however, the interrater reliability of this tool is currently greatly contested. A comparison between rater groups with objective measurements of the Babinski reflex was therefore conducted. Fifteen recorded Babinski reflexes were assessed by 12 neurologists and 12 medical students as being either pathological or nonpathological. Kinematic and electromyographic variables were collected and used to assess which aspects of the Babinski reflex predict classification. Substantial interrater agreement within the neurologist and student groups (κ = .72 and .67, respectively) was shown; however, there were some differing aspects between what neurologists and students used to assess the reflex as determined by objective kinematic measurements.

  11. Simultaneous determination of pseudoephdrine, pheniramine, guaifenisin, pyrilamine, chlorpheniramine and dextromethorphan in cough and cold medicines by high performance liquid chromatography.

    Science.gov (United States)

    Louhaichi, M R; Jebali, S; Loueslati, M H; Adhoum, N; Monser, L

    2009-05-15

    A new simple, rapid and sensitive liquid chromatographic method has been developed and validated for the simultaneous determination of pseudoephdrine, pheniramine, guaifenisin, pyrilamine, chlorpheniramine and dextromethorphan in cough and cold pharmaceuticals. The separation of these compounds was achieved within 13 min on a Kromasil C18 column using an isocratic mobile phase consisting of methanol-dihydrogenphosphate buffer at pH 3 (45:55, v/v). The analysis was performed at a flow rate of 1 mL min(-1) and at a detection wavelength of 220 nm. The selectivity, linearity of calibration, accuracy, within and between-days precision and recovery were examined as parts of the method validation. The concentration-response relationship was linear over a concentration range of 5-50 microg mL(-1) for pseudoephdrine, pheniramine, chlorpheniramine and 50-600 microg mL(-1) for guaifenisin, pyrilamine, dextromethorphan, methylparaben and sodium benzoate with correlation coefficients better than 0.998. The standard deviations of the intraday and interday were all less than 2%. The proposed liquid chromatographic method was successfully applied for the routine analysis of these compounds in different cough and cold pharmaceutical preparations such as syrups, capsules, tablets and sachets. The presence of preservatives (sodium benzoate and methylparaben) and other excipients did not show any significant interference on the determination of these compounds.

  12. 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

    The exposure of a doctor and a second patient to coughed air by an infected patient was studied in a simulated two-bed hospital patient room. The air temperature in the room, ventilated at two air change rates (3 h-1 and 6 h-1) was kept 22 oC. Thermal manikin with realistic body shape and surface...... temperature distribution was used as the doctor standing 0.55, 1.1 or 2.8 m downstream the cough. A coughing thermal dummy, lying in one bed and a second thermal manikin in the other bed (1.3 m away), were used as the “sick” and the “exposed” patients. The cough consisted of 100% CO2. The doctor...... hospital standards as minimum ventilation rate in hospital patient rooms, resulted in elevated exposure to coughed air for the doctor, suggesting increased risk from airborne cross-infection. Displacement air distribution does not reduce the risk from cross-infection....

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

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Godtfredsen, Nina; Jørgensen, Torben

    2008-01-01

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

  14. Evaluation of Clinical Efficacy and Tolerance of Khasceeze –SF Cough Syrup

    OpenAIRE

    S Satam; Jain, R; J Dagaonkar; C Chotalia; Suthar, A.; Joshi, R

    2011-01-01

    Fifty patients of either sex aged 15 - 65 years entered the study to test the efficacy and tolerability of a herbal preparation known as Khasceeze-SF Cough Syrup. They were studied for cough and related symptoms such as sore throat, sneezing, breathlessness and fever. Substantial improvement, i.e., excellent to good response, in relief of cough and other symptoms was noted over 84% out of 50 patients and fair response in 11.64%. Only 4.10% patients showed poor relief in symptoms hence suggest...

  15. An Experimental Study of Human Exhalation during Breathing and Coughing in a Mixing Ventilated Room

    DEFF Research Database (Denmark)

    Liu, Li; Lia, Yuguo; Nielsen, Peter V.;

    2009-01-01

    This study investigates the characteristics of human exhalation during breathing and coughing. Experiments employing one breathing thermal manikin are conducted in a full-scale test room with a mixing ventilation system. Two artificial lungs are used to generate discontinuous airflows with specific...... flow rates and temperatures for breathing and coughing, respectively. Smoke visualizations are conducted to show the formation, movement and vanishing of the exhalation jets from nose and mouth separately. The transient velocity distribution generated by breathing and coughing in different places...

  16. An Experimental Study of Human Exhalation during Breathing and Coughing in a Mixing Ventilated Room

    DEFF Research Database (Denmark)

    Liu, Li; Lia, Yuguo; Nielsen, Peter V.

    2009-01-01

    This study investigates the characteristics of human exhalation during breathing and coughing. Experiments employing one breathing thermal manikin are conducted in a full-scale test room with a mixing ventilation system. Two artificial lungs are used to generate discontinuous airflows with specific...... flow rates and temperatures for breathing and coughing, respectively. Smoke visualizations are conducted to show the formation, movement and vanishing of the exhalation jets from nose and mouth separately. The transient velocity distribution generated by breathing and coughing in different places...

  17. Modulation of the initial light reflex during affective picture viewing.

    Science.gov (United States)

    Henderson, Robert R; Bradley, Margaret M; Lang, Peter J

    2014-09-01

    An initial reflexive constriction of the pupil to stimulation-the light reflex-is primarily modulated by brightness, but is attenuated when participants are under threat of shock (i.e., fear-inhibited light reflex). The present study assessed whether the light reflex is similarly attenuated when viewing emotional pictures. Pupil diameter was recorded while participants viewed erotic, violent, and neutral scenes that were matched in brightness; scrambled versions identical in brightness were also presented as an additional control. Compared to viewing neutral scenes, the light reflex was reliably modulated by hedonic content, with significant attenuation both when viewing unpleasant as well as pleasant pictures. No differences in the light reflex were found among scrambled versions. Thus, emotional modulation of the initial light reflex is not confined to a context of fear and is not indicative of brightness differences when viewing pictures of natural scenes. Copyright © 2014 Society for Psychophysiological Research.

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

    Science.gov (United States)

    Rehman, Hina; Naveed, Safila; Usmanghani, Khan

    2016-05-01

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

  19. 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.

  20. Whooping cough in 2014 and beyond: an update and review.

    Science.gov (United States)

    Hartzell, Joshua D; Blaylock, Jason M

    2014-07-01

    Pertussis, or whooping cough, has had a dramatic resurgence in the past several years and is the most common vaccine-preventable disease in the world. The year 2012 marked the most cases in the United States in > 50 years. Large outbreaks have occurred in multiple states, and infant deaths have drawn the attention of not only health-care providers but also the media. Although the disease is theoretically preventable by vaccination, it remains a challenge to control. New vaccination strategies have been implemented across different age groups and populations of patients, but vaccine coverage remains dismally low. Acellular vaccines, although safe, do not afford the same long-lasting immunity as the previously used whole-cell vaccine. Ultimately, improvements in the development of vaccines and in vaccination coverage will be essential to decrease the burden of pertussis on society. This article provides a review of pertussis infection and discusses advances related to the epidemiology, diagnosis, treatment, and prevention of infection, as well as continued areas of uncertainty.