WorldWideScience

Sample records for cough

  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. 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.

  3. 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 ...

  4. 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. ...

  5. 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.

  6. 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 ...

  7. 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.

  8. 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 ...

  9. 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.

  10. [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.

  11. 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

  12. 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.

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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 - ...

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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 ...

  4. 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

  5. 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 ...

  6. 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 ...

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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. "

  13. 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) ...

  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. 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 ...

  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. 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.

  19. Cough in idiopathic pulmonary fibrosis

    NARCIS (Netherlands)

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

    2016-01-01

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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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...

  5. 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)....

  6. 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)....

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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 ( ...

  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. 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. 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

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

    OpenAIRE

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

    2002-01-01

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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  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. 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.

  5. 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 ...

  6. 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.

  7. 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 ...

  8. 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

  9. 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 ...

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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 ...

  17. 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, ...

  18. 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 ...

  19. 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.

  20. 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.

  1. 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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Whooping cough: identification, assessment and management.

    Science.gov (United States)

    Bentley, Jackie; Pinfield, Jenny; Rouse, Jo

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

  8. 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

  9. 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.

  10. 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.

  11. 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).

  12. 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.

  13. 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 ...

  14. 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 ...

  15. 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.

  16. 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.

  17. 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 ...

  18. 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 ...

  19. 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 ...

  20. 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.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  2. 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.

  3. 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.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Jennifer C. Nitz, PhD, MPhty, BPhty

    2012-12-01

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

  6. [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.

  7. 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.

  8. [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.

  9. 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.

  10. 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.

  11. 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 ...

  12. 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

  13. [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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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 ...

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. 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 ...

  5. 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

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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.)

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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.

  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. 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

  3. 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...

  4. 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,...

  5. [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.

  6. 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.

  7. 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.

  8. 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...

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Haruhiko Ogawa

    2000-01-01

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

  11. 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.

  12. 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。

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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...

  20. 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

  1. 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...

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.)

  7. 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...

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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...

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

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

    Science.gov (United States)

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

    2014-11-01

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

  20. 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 ...

  1. 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

  2. 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 ...

  3. 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 ...

  4. 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

  5. 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.

  6. 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...

  7. 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.

  8. 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

  9. 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

  10. 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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  16. 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.

  17. 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,...

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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...

  4. 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)

  5. 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.

  6. 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.

  7. 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...

  8. 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...

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Zayas Gustavo

    2012-03-01

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

  17. 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.

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

    Science.gov (United States)

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

    2008-01-01

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

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  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...... 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  14. 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

  15. 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.

  16. 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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  18. 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

  19. 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

  20. 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,…

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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...

  6. 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.

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

    Science.gov (United States)

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

    2015-08-01

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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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....

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. Pertussis vaccination and whooping cough: and now what?

    Science.gov (United States)

    Guiso, Nicole

    2014-10-01

    Pertussis or whooping cough is a respiratory disease caused by Bordetella pertussis or Bordetella parapertussis that are only known to infect humans. This severe and acute respiratory disease presents epidemic cycles and became a vaccine-preventable disease in the 1940s/1950s when developed countries introduced vaccination. The first type of vaccine developed against this disease was a whole-cell pertussis (wP) vaccine containing inactivated B. pertussis bacteria. Most developed countries produced their own vaccine and given the pediatric nature of the disease at the time of licensure, infants and toddlers were the primary targets and were thus massively vaccinated. The characterization of few virulence factors produced by B. pertussis enabled the development of second-generation pertussis vaccines called the acellular pertussis (aP) vaccines. These only contain 1-5 purified, detoxified B. pertussis proteins and were first introduced in Japan around 30 years ago. Australia, Europe and North America introduced aP vaccines approximately 15 years later, which replaced wP vaccines since then.

  18. Shattering a myth - Whooping cough susceptible to antibiotics.

    Science.gov (United States)

    Syed, Muhammad Ali; Jamil, Bushra; Bokhari, Habib

    2016-05-01

    Bordetella parapertussis is the causative agent of a milder form of pertussis or whooping cough. Little is reported about the antibiotic resistance patterns and mechanism of drug resistance of Bordetella parapertussis. The objective of this study has been to investigate antimicrobial resistance, distribution of integrons and presence of gene cassettes to quinolones (qnr) and sulfonamides (sul) among B. parapertussis strains' isolated from Pakistan. Thirty-five (35) samples were collected from various hospitals of Pakistan from children (median age 3 years) with pertussis-like symptoms, all were tested and confirmed to be B. Parapertussis. Resistance profile of Ampicillin, Cephalexin, Sulphamethoxazole, Chloramphenicol, Ofloxacin, Nalidixic acid, Gentamycin and Erythromycin were investigated through all samples. Majority of the isolates were found to be resistant to the afore-mentioned antibiotics except erythromycin. All isolates were resistant to quinolones phenotypically, but qnr genes were detected in only 25.7% (9/35) of isolates. On the other hand, 71.4% (25/35) isolates were resistant to sulfonamides phenotypically. From these 71% strains showing phenotypical resistance, 96% (24/25) were found to possess sul genes. Only two isolates were carrying class 1 integrons, which also harbored sul gene and qnr gene cassettes. It can be safely concluded that the phenotypic resistance patterns seemed mostly independent of presence of integrons. However, interestingly both integrons harboring strains were resistant to quinolones and sulfonamides and also possessed qnr and sul genes.

  19. January critical care case of the month: bad cough

    Directory of Open Access Journals (Sweden)

    Natt B

    2014-01-01

    Full Text Available No abstract available. Article truncated after 150 words. History of Present Illness A 41 year-old man was admitted with a five-day history of cough, shortness of breath, and fever to 102° F. He was recently diagnosed with a high-grade astrocytoma of the brain and had undergone resection followed by chemotherapy with temozomide (an alkylating agent and radiation therapy. PMH Renal transplantation (1993 Glioblastoma (astrocytoma grade 4 Crohn’s disease treated with budesonide and meselamine Medications Dexamethasone 2 mg PO BID Keppra 500 mg PO BID Tacrolimus 1.5 mg PO AM and 1mg PO PM Mycophenolate 750 mg PO BID Budesonide 3 mg PO daily Meselamine 1600 mg PO TID Sulfamethoxazole/trimethoprim DS PO on Mon/Wed/Fri Temozolomide 75 mg IM with radiotherapy Social History Nonsmoker, no ethanol or recreational drugs, no recent travel, and no occupational exposures. Physical Examination T 38.6°C, P 112 beats/min, RR 32-40 breaths/min, BP 119/76 mm Hg, SpO2 100% on NRB General: Fatigued, ill appearing and dyspneic. …

  20. A boy with fever, cough and gross haematuria.

    Science.gov (United States)

    Cozzi, Giorgio; Maschio, Massimo; Poillucci, Gabriele; Pennesi, Marco; Barbi, Egidio

    2017-08-28

    A 5 year-old boy presented with 2-days of fever and cough. On examination, he had mild dyspnoea and chest pain, with crackles and hypoventilation at the right lung base. Blood tests showed: WBC 39.1×10(9)/L; N 28.9×10(9)/L; Hb 11.3gr/dL; PLT 375×10(9)/L; CRP 28.7mg/dL; ESR 41mm/h. Chest x-ray confirmed a pulmonary consolidation in the right lower lobe (figure 1), with an associated pleural effusion. Bacterial pneumonia was diagnosed and intravenous ceftriaxone 100mg/kg/die was started. The following day, he developed palpebral oedema and his urine became tea coloured. His blood pressure was 126/82mmHg (>99th percentile).(1) Serum creatinine rose from 0.45mg/dl to 1.09mg/dl (39.8µmol/L - 93.4µmol/L) and C3 was 9mg/dl (n.r. 90-180mg/dl). Urinalysis revealed gross hematuria and 3+ proteinuria, with microscopicy showing dysmorphic red blood cells with casts. Ultrasounds showed enlarged kidneys with increased echogenicity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Takamitsu Asano

    2017-04-01

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

  3. 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...

  4. 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.

  5. ObserveClinicalEffectofHeatCoughSyrupwiththeClinicalEffectofAcupunctureinTreatingCoughCooperatewith AcupunctureTreatmentofCough%热咳糖浆配合针灸治疗咳嗽的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    张力文; 廖侃华; 杜洁挺

    2013-01-01

      目的观察临床中给予热咳糖浆配合针灸治疗咳嗽的临床效果。方法将我院2012年1月至2012年12月之间收录的200例咳嗽患者随机分为两组,对照组患者给予常规热咳糖浆进行治疗,而观察组的患者给予热咳糖浆配合针灸治疗,观察两组的患者临床治疗效果。结果通过两组的患者临床治疗效果对比分析,观察组的患者临床治疗总有效率明显的高于对照组的患者临床治疗总有效率(P<0.05),统计学有意义;两组的患者不良反应发生率比较无明显的差异(P>0.05),统计学无意义。结论临床中对于咳嗽患者给予热咳糖浆配合针灸治疗具有较好的临床疗效,值得临床中应用。%Objective To observe the clinical give heat cough syrup with the clinical effect of acupuncture in treating cough. Methods Between January to 2012 2012 in our hospital were collected in December 200 cases of cough patients were randomly divided into two groups, the control group were given routine heat cough syrup for treatment, while patients in observation group given heat cough syrup with acupuncture treatment, observe the effect of clinical treatment of the two groups. Results Through comparative analysis of clinical therapeutic effect in the two groups of patients with clinical observation and treatment group, the total efifciency of treatment were signiifcantly higher than control group in the total efifciency(P0.05), statistics no signiifcance. Conclusion In clinical practice, cough were treated with heat cough syrup has better clinical curative effect of acupuncture treatment, worthy of clinical application.

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

    Directory of Open Access Journals (Sweden)

    Vincent Kayina

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

  7. Measurements of airborne influenza virus in aerosol particles from human coughs.

    Directory of Open Access Journals (Sweden)

    William G Lindsley

    Full Text Available Influenza is thought to be communicated from person to person by multiple pathways. However, the relative importance of different routes of influenza transmission is unclear. To better understand the potential for the airborne spread of influenza, we measured the amount and size of aerosol particles containing influenza virus that were produced by coughing. Subjects were recruited from patients presenting at a student health clinic with influenza-like symptoms. Nasopharyngeal swabs were collected from the volunteers and they were asked to cough three times into a spirometer. After each cough, the cough-generated aerosol was collected using a NIOSH two-stage bioaerosol cyclone sampler or an SKC BioSampler. The amount of influenza viral RNA contained in the samplers was analyzed using quantitative real-time reverse-transcription PCR (qPCR targeting the matrix gene M1. For half of the subjects, viral plaque assays were performed on the nasopharyngeal swabs and cough aerosol samples to determine if viable virus was present. Fifty-eight subjects were tested, of whom 47 were positive for influenza virus by qPCR. Influenza viral RNA was detected in coughs from 38 of these subjects (81%. Thirty-five percent of the influenza RNA was contained in particles>4 µm in aerodynamic diameter, while 23% was in particles 1 to 4 µm and 42% in particles<1 µm. Viable influenza virus was detected in the cough aerosols from 2 of 21 subjects with influenza. These results show that coughing by influenza patients emits aerosol particles containing influenza virus and that much of the viral RNA is contained within particles in the respirable size range. The results support the idea that the airborne route may be a pathway for influenza transmission, especially in the immediate vicinity of an influenza patient. Further research is needed on the viability of airborne influenza viruses and the risk of transmission.

  8. Emergence of whooping cough: notes from three early epidemics in Persia.

    Science.gov (United States)

    Aslanabadi, Arash; Ghabili, Kamyar; Shad, Kaveh; Khalili, Majid; Sajadi, Mohammad M

    2015-12-01

    Whooping cough is a relatively new infectious disease afflicting human beings, compared with other infectious diseases, and is undergoing a resurgence despite decades of vaccination. The oldest known epidemic is thought to be the Paris outbreak of 1578. In this Historical Review, we describe three epidemics of whooping cough in Persia, which although arising roughly one century before the Paris outbreak, have not been examined in detail. A great amount of epidemiological detail was reported that not only distinguishes the various stages and complications of whooping cough, but also reveals unique immunological aspects of this disease. The first of these epidemics is the oldest recorded whooping cough epidemic. On the basis of epidemiological features, we propose that this whooping cough epidemic was the first to have taken place in Persia and might have been part of the first pandemic. This theory pushes back the date of first documented emergence of whooping cough by almost a century, which matches molecular data about its spread. Here, we discuss features of these early epidemics in relation to their initial emergence, potential origins, and spread to Europe.

  9. 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.

  10. Peripheral site of action of levodropropizine in experimentally-induced cough: role of sensory neuropeptides.

    Science.gov (United States)

    Lavezzo, A; Melillo, G; Clavenna, G; Omini, C

    1992-06-01

    The mechanism of action of levodropropizine has been investigated in different models of experimentally-induced cough in guinea-pigs. In particular it has been demonstrated that the antitussive drug has a peripheral site of action by injecting the drug intracerebroventricularly (i.c.v.). In these experiments levodropropizine (40 micrograms/50 microliters i.c.v.) did not prevent electrically-induced cough. On the other hand, codeine (5 micrograms/50 microliters i.c.v.) markedly prevented coughing. A difference in the potency ratio of levodropropizine and codeine has been demonstrated in capsaicin-induced cough; after oral administration, codeine was about two to three times more potent than levodropropizine. However, after aerosol administration the two compounds were equipotent. These data might suggest a peripheral site of action for levodropropizine which is related to sensory neuropeptides. Further support for the role of sensory neuropeptides in the mechanism of action of levodropropizine comes from the results obtained in capsaicin-desensitized animals. In this experimental model levodropropizine failed to prevent the vagally elicited cough in neuropeptide-depleted animals, whereas codeine did not differentiate between control and capsaicin-treated animals. In conclusion, our results support the suggestion that levodropropizine has a peripheral site of action. In addition, the interference with the sensory neuropeptide system may explain, at least in part, its activity in experimentally-induced cough.

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

    Institute of Scientific and Technical Information of China (English)

    张怡; 邱忠民

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

  13. Cough, exertional, and sexual headaches: an analysis of 72 benign and symptomatic cases.

    Science.gov (United States)

    Pascual, J; Iglesias, F; Oterino, A; Vázquez-Barquero, A; Berciano, J

    1996-06-01

    We analyzed our experience with cough, exertional, and vascular sexual headaches, evaluated the interrelationships among them, and examined the possible symptomatic cases. Seventy-two patients consulted us because of headaches precipitated by coughing (n = 30), physical exercise (n = 28), or sexual excitement (n = 14). Thirty (42%) were symptomatic. The 17 cases of symptomatic cough headache were secondary to Chiari type I malformation, while the majority of cases of symptomatic exertional headaches and the only case of symptomatic sexual headache were secondary to subarachnoid hemorrhage. Although the precipitant was the same, benign and symptomatic headaches differed in several clinical aspects, such as age at onset, associated clinical manifestations, or response to pharmacologic treatment. Although sharing some properties, such as male predominance, benign cough headache and benign exertional headache are clinically separate conditions. Benign cough headache began significantly later, 43 years on average, than benign exertional headache. By contrast, our findings suggest that there is a close relationship between benign exertional headache and benign vascular sexual headache. We conclude that benign and symptomatic cough headaches are different from both benign and symptomatic exertional and sexual headaches.

  14. Serum LDH in chronic cough: a potential marker of airway inflammation.

    Science.gov (United States)

    Faruqi, Shoaib; Wilmot, Rachel; Wright, Caroline; Morice, Alyn Hugh

    2012-04-01

    Lactate dehydrogenase (LDH) is found in almost all tissues of the body and five different isoenzymes are known (LDH-1 to LDH-5). LDH can be elevated in many pathological conditions. We have observed serum LDH to be increased in patients with chronic cough. We wanted to confirm this finding, study the reproducibility and determine the origin of the LDH. Patients prospectively seen at the Hull Cough Clinic had total and specific LDH isoenzyme levels in serum determined. A subgroup of patients also had a serum creatine phosphokinase (CK) measured. Patients completed cough symptom scores and the Hull Airway Reflux Questionnaire (HARQ). Spirometry was performed. Eighty-three patients were included. Forty-two percent had LDH values above the reference range and 78% had LDH values in the fourth quartile of the reference range or above. This increase in LDH was predominantly because of a rise in isoenzymes 4 and 5. The increase in LDH was found to be reproducible at 8 weeks. Ten percent had CK values above the normal range. There was no correlation observed between LDH values and the cough scores, HARQ scores or lung function. Serum LDH levels are elevated in a substantial proportion of patients with chronic cough. This rise is likely to be due to airway inflammation known to be associated with chronic cough. © 2011 Blackwell Publishing Ltd.

  15. Reduced exposure to coughed air by a novel ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Brand, Marek

    2012-01-01

    A novel hospital bed integrated ventilation and cleaning unit (HBIVCU) for local airflow control and cleansing, limiting the airborne spread of contagious air coughed from a sick patient in a hospital room, was developed. The performance efficiency of the unit, to successfully reduce occupants......’ exposure to coughed air, was studied in a full-scale, two-bed hospital room mock-up, 4.65 m x 4.65 m x 2.60 m (W x L x H), with two patients and a doctor. Four units were placed along the two sides of both beds close to the head. The room was ventilated by overhead mixing air distribution at 22 °C room air...... beside the bed and facing the coughing patient. The generated cough consisted of 100% CO2. The mouth was simulated by a circular opening of 0.021 m diameter. The characteristics of the cough were: peak flow - 10 L/s, cough volume - 2.5 L, duration - 0.5 s and maximum velocity - 28.9 m/s. The performance...

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

    Science.gov (United States)

    Alvarez, Rocío; Ramón, César; Pascual, Julio

    2014-10-01

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

  17. 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.

  18. 100 cases Cough Powder Treating Chronic cough clinical analysis%止嗽散加减治疗慢性咳嗽100例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘光华

    2012-01-01

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

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

    Science.gov (United States)

    Asano, Takamitsu; Takemura, Masaya; Fukumitsu, Kensuke; Takeda, Norihisa; Ichikawa, Hiroya; Hijikata, Hisatoshi; Kanemitsu, Yoshihiro; Uemura, Takehiro; Takakuwa, Osamu; Ohkubo, Hirotsugu; Maeno, Ken; Ito, Yutaka; Oguri, Tetsuya; Nakamura, Atsushi; Niimi, Akio

    2017-04-01

    Cough-variant asthma (CVA) and cough-predominant asthma (CPA) are the major causes of persistent cough in Japan. The utility of fractional exhaled nitric oxide (FeNO) measurement in the differential diagnosis of persistent cough has been reported, but the influence of atopic status, which is associated with higher FeNO levels, on the diagnostic utility of FeNO has been unknown. We retrospectively analyzed 105 non-smoking patients with prolonged and chronic cough that were not treated with corticosteroids and anti-leukotrienes. CPA was diagnosed in 37 patients, CVA in 40, and non-asthmatic cough (NAC) in 28. FeNO levels were significantly higher in the CPA [35.8 (7.0-317.9) ppb] and CVA [24.9 (3.1-156.0) ppb] groups than in the NAC group [18.2 (6.9-49.0) ppb] (p ppb [area under the curve (AUC) 0.74, p ppb had AC. Meanwhile, 40% of AC patients had FeNO levels ppb. Stratified cut-off levels were 31.1 ppb (AUC 0.83) in atopic subjects vs. 19.9 ppb (AUC 0.65) in non-atopic subjects (p = 0.03 for AUC). Although high FeNO levels suggested the existence of AC, lower FeNO levels had limited diagnostic significance. Atopic status affects the utility of FeNO levels in the differential diagnosis of prolonged and chronic cough. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    1998-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

    蒋勤军

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Shahriar M

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

    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 limiting their use. After a comprehensive literature search, a meta-analysis of 7 clinical studies of levodropropizine vs. control, including a total of 1,178 patients, was performed with the aim to evaluate the overall comparative efficacy of levodropropizine in the pediatric and adult population. Three electronic databases and reference list were used to search for studies that assessed the efficacy of levodropropizine for treating cough in children and adults using as standardized efficacy parameters the cough frequency and severity, and number of night awakenings as outcome parameters. The meta-analysis of all standardized efficacy parameters showed a highly statistically significant difference in the overall antitussive efficacy in favor of levodropropizine vs. control treatments (p = 0.0015). The heterogeneity test for the efficacy outcome was not statistically significant (p = 0.0534). Seven studies met out inclusion criteria. A meta-analysis of the eligible ones showed a statistically significant difference in the overall anti-tussive effect of levodropropizine versus control (p = 0.0015). This analysis indicates that levodropropizine is an effective antitussive drug in children and adults, with statistically significant better overall efficacy outcomes vs. central antitussive drugs (codeine, cloperastine, dextromethorphan) in terms of reducing cough intensity and frequency, and nocturnal awakenings. This result further reinforces the favorable benefit/risk profile of

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

    Directory of Open Access Journals (Sweden)

    Wagner Ulrich

    2006-05-01

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

  5. The Effect of Aspirin on Angiotensin Converting Enzyme Inhibitors-Induced Cough : A Double Blind Clinical Trial

    Directory of Open Access Journals (Sweden)

    A Esmaeili Nadimi

    2005-03-01

    Full Text Available Background: Dry cough is the most common adverse effect and limiting factor of all angiotensin converting-enzyme inhibitors (ACEIs . Prostaglandins have been pinpointed as playing an important role in the genesis of this problem. This double blind clinical trial desinged to study the efficacy of 500 milligram(mg of aspirin comparing with placebo in controlling Enalapril-induced cough. Methods: The subjects were 32 patients who had developed Enalapril-induced cough.They were randomized into two groups: a group of daily dose of aspirin, 500 mg and a group of placebo for a treatment period of 4 weeks. Mean of cough severity was compared between two groups before treatment and weekly, until 4 weeks. Results: Mean of cough severity in aspirin and placebo groups before and at the end of first week of treatment did not show any significant difference. After the second ,third, and fourth weeks, cough severity scores were significantly reduced in aspirin group(p<0.001. Conclusion: 500mg aspirin, once daily, can suppress or abolish Enalapril-induced cough and this finding proposes alternative therapeutic approach for ACEIs-induced related cough. Keywords: aspirin, cough, Angiotensin-Converting Enzyme Inhibitors (ACEIs, enalapril

  6. Diagnosis of pertussis in vaccinated children of Khairpur, Sindh, Pakistan by Cough Plate Method

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    Syed Habib Bukhari

    2011-09-01

    Full Text Available Objectives: Pertussis or whooping cough is a communicable infection of upper respiratory tract that mainly affects children. Reports regarding resurgence of pertussis in vaccinated children mainly motivated us to document pertussis in the children. The aim of the study was to explore pertussis in vaccinated children using an alternative method for pertussis diagnosis.Materials and methods: A total of 700 clinical samples were collected during study period (2006-2009, from suspected whooping cough cases of Diphtheria-tetanus- whole cell pertussis (DTwP vaccinated children both male and female aged from 6 months to 84 months The classical ‘Cough Plate Method’ instead of Nasopharyngeal Swab was used for sampling to find out its potential in diagnosis of pertussis.Results: Present study reports the presence of pertussis in vaccinated children using Cough Plate Method. The method successfully isolated Bordetella pertussis from suspected patients of pertussis. A total of 28 culture confirmed cases were detected among 700 samples tested. (Total Isolation rate: 4%.The peak incidence age under risk was 48 months. However, pertussis was detected in children aged as young as 6 and 12 months.Conclusion: The ‘Cough plate’ method used for isolation proved successful and simple instead of nasopharyngeal swabs that is difficult to perform and children may be reluctant to this sampling method when tried. J Microbiol Infect Dis 2011;1 (2 : 68-72

  7. 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.

  8. Effects of an abdominal binder and electrical stimulation on cough in patients with spinal cord injury.

    Science.gov (United States)

    Lin, K H; Lai, Y L; Wu, H D; Wang, T Q; Wang, Y H

    1998-04-01

    We explored the effect of an abdominal binder, with or without electrical stimulation, on peak expiratory flow rate (PEFR) in 12 paraplegics with complete thoracic cord (T2-T12) injury (mean age 36.0 +/- 1.5 yr) and 12 quadriplegics with complete cervical cord (C4-C8) injury (mean age 36.2 +/- 1.9 yr). The cough was assessed by measuring the PEFR during forceful expiration in a sitting position. The subjects underwent the following experimental maneuvers in a random order with a 10-minute interval between any two maneuvers: 1) voluntary coughing, 2) voluntary coughing with an abdominal binder, and 3) voluntary coughing with an abdominal binder and electrical stimulation. The electrical stimulator (50 Hz with 300 microseconds pulse width) was applied to the abdominal wall. Data were analyzed using multivariate analysis of variance for repeated measures. The abdominal binder did not significantly increase PEFR in either paraplegics or quadriplegics; the abdominal binder combined with electrical stimulation significantly increased PEFR by 15% in the paraplegics and 18% in the quadriplegics. These results indicate that electrical stimulation combined with an abdominal binder improves the cough ability in patients with cervical or thoracic spinal cord injury.

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

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    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.

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

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    Carlos Shuler Nin

    2013-12-01

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

  11. High humidity leads to loss of infectious influenza virus from simulated coughs.

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    John D Noti

    Full Text Available BACKGROUND: The role of relative humidity in the aerosol transmission of influenza was examined in a simulated examination room containing coughing and breathing manikins. METHODS: Nebulized influenza was coughed into the examination room and Bioaerosol samplers collected size-fractionated aerosols (4 µM aerodynamic diameters adjacent to the breathing manikin's mouth and also at other locations within the room. At constant temperature, the RH was varied from 7-73% and infectivity was assessed by the viral plaque assay. RESULTS: Total virus collected for 60 minutes retained 70.6-77.3% infectivity at relative humidity ≤23% but only 14.6-22.2% at relative humidity ≥43%. Analysis of the individual aerosol fractions showed a similar loss in infectivity among the fractions. Time interval analysis showed that most of the loss in infectivity within each aerosol fraction occurred 0-15 minutes after coughing. Thereafter, losses in infectivity continued up to 5 hours after coughing, however, the rate of decline at 45% relative humidity was not statistically different than that at 20% regardless of the aerosol fraction analyzed. CONCLUSION: At low relative humidity, influenza retains maximal infectivity and inactivation of the virus at higher relative humidity occurs rapidly after coughing. Although virus carried on aerosol particles 40% will significantly reduce the infectivity of aerosolized virus.

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

    Science.gov (United States)

    Paul, Ian M

    2012-02-01

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

  13. Review of Epidural Spinal Cord Stimulation for Augmenting Cough after Spinal Cord Injury.

    Science.gov (United States)

    Hachmann, Jan T; Calvert, Jonathan S; Grahn, Peter J; Drubach, Dina I; Lee, Kendall H; Lavrov, Igor A

    2017-01-01

    Spinal cord injury (SCI) remains a debilitating condition for which there is no cure. In addition to loss of somatic sensorimotor functions, SCI is also commonly associated with impairment of autonomic function. Importantly, cough dysfunction due to paralysis of expiratory muscles in combination with respiratory insufficiency can render affected individuals vulnerable to respiratory morbidity. Failure to clear sputum can aggravate both risk for and severity of respiratory infections, accounting for frequent hospitalizations and even mortality. Recently, epidural stimulation of the lower thoracic spinal cord has been investigated as novel means for restoring cough by evoking expiratory muscle contraction to generate large positive airway pressures and expulsive air flow. This review article discusses available preclinical and clinical evidence, current challenges and clinical potential of lower thoracic spinal cord stimulation (SCS) for restoring cough in individuals with SCI.

  14. 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.

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

    Science.gov (United States)

    Brøndum, C O

    1992-05-18

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

  16. Management of Children With Chronic Wet Cough and Protracted Bacterial Bronchitis: CHEST Guideline and Expert Panel Report.

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    Chang, Anne B; Oppenheimer, John J; Weinberger, Miles M; Rubin, Bruce K; Grant, Cameron C; Weir, Kelly; Irwin, Richard S

    2017-04-01

    Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged ≤ 14 years) based on two key questions: (1) how effective are antibiotics in improving the resolution of cough? If so, what antibiotic should be used and for how long? and (2) when should children be referred for further investigations? We used the CHEST expert cough panel's protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation). Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus for the recommendations/suggestions made. Combining data from the systematic reviews, we found high-quality evidence in children aged ≤ 14 years with chronic (> 4 weeks' duration) wet/productive cough that using appropriate antibiotics improves cough resolution, and further investigations (eg, flexible bronchoscopy, chest CT scans, immunity tests) should be undertaken when specific cough pointers (eg, digital clubbing) are present. When the wet cough does not improve following 4 weeks of antibiotic treatment, there is moderate-quality evidence that further investigations should be considered to look for an underlying disease. New recommendations include the recognition of the clinical diagnostic entity of protracted bacterial bronchitis. Compared with the 2006 Cough Guidelines, there is now high-quality evidence for some, but not all, aspects of the management of chronic wet cough in specialist settings. However, further studies (particularly in primary health) are required. Copyright © 2017 American College of Chest Physicians. All rights reserved.

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

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    Zakir Arslan

    2016-08-01

    Full Text Available Abstract Background and objectives: There are many studies conducted on reducing the frequency and severity of fentayl-induced cough during anesthesia induction. We propose that pheniramine maleate, an antihistaminic, may suppress this cough. We aim to observe the effect of pheniramine on fentanyl-induced cough during anesthesia induction. Methods: This is a double-blinded, prospective, three-arm parallel, randomized clinical trial of 120 patients with ASA (American Society of Anesthesiologists physical status III and IV who aged ≥18 and scheduled for elective open heart surgery during general anesthesia. Patients were randomly assigned to three groups of 40 patients, using computer-generated random numbers: placebo group, pheniramine group, and lidocaine group. Results: Cough incidence differed significantly between groups. In the placebo group, 37.5% of patients had cough, whereas the frequency was significantly decreased in pheniramine group (5% and lidocaine group (15% (Fischer exact test, p = 0.0007 and p = 0.0188, respectively. There was no significant change in cough incidence between pheniramine group (5% and lidocaine group (15% (Fischer exact test, p = 0.4325. Cough severity did also change between groups. Post Hoc tests with Bonferroni showed that mean cough severity in placebo differed significantly than that of pheniramine group and lidocaine group (p < 0.0001 and p = 0.009, respectively. There was no significant change in cough severity between pheniramine group and lidocaine group (p = 0.856. Conclusion: Intravenous pheniramine is as effective as lidocaine in preventing fentayl-induced cough. Our results emphasize that pheniramine is a convenient drug to decrease this cough.

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

    Science.gov (United States)

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

    2016-01-01

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

  19. Cough induced rib fracture, rupture of the diaphragm and abdominal herniation

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    Wurl Peter

    2006-11-01

    Full Text Available Abstract Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of the diaphragm, and an abdominal wall herniation. The hernia was repaired through surgical treatment without bowel resection, the diaphragm and the internal and oblique abdominal muscle were adapted, and the abdomen was reinforced with a prolene net. Although each individual injury is well documented in the literature, the combination of rib fracture, abdominal herniation and diaphragm rupture has not been reported.

  20. Coughing leading to spontaneous pneumomediastinum and subcutaneous emphysema in a young male

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    Ruchi Sachdeva

    2015-01-01

    Full Text Available A 20-year male college student, nonsmoker, nonalcoholic, average built presented with sudden onset cough since last 1 day along with diffuse swelling in the neck, difficulty in swallowing both liquids and solid since 1 day. There was history of rhinorrhea alternating with nasal block intermittently with change of seasons since last 3-4 years. There was no history of weight lifting, drug intake, tuberculosis or trauma, or family history of allergy. A case report of self-limiting spontaneous pneumomediastinum following a sudden bout of coughing with no underlying lung lesion is being reported.

  1. Efficacy and tolerability of levodropropizine and dropropizine in children with non-productive cough.

    Science.gov (United States)

    Banderali, G; Riva, E; Fiocchi, A; Cordaro, C I; Giovannini, M

    1995-01-01

    The antitussive efficacy and tolerability of dropropizine and of its enantiomer levodropropizine were evaluated in children with non-productive cough; 258 were evaluable for tolerability and 254 for efficacy. Patients randomly received either 1 mg/kg dropropizine or 2 mg/kg levodropropizine orally, three times daily for 3 days. There were statistically significant decreases in the frequency of coughing spells and nocturnal awakenings after both levodropropizine and dropropizine treatments (P Levodropropizine is as effective as an antitussive as dropropizine, but appears to carry a lower risk of daytime somnolence.

  2. Posterolateral surface electrical stimulation of abdominal expiratory muscles to enhance cough in spinal cord injury.

    Science.gov (United States)

    Butler, Jane E; Lim, Julianne; Gorman, Robert B; Boswell-Ruys, Claire; Saboisky, Julian P; Lee, Bonsan B; Gandevia, Simon C

    2011-02-01

    Spinal cord injury (SCI) patients have respiratory complications because of abdominal muscle weakness and paralysis, which impair the ability to cough. This study aims to enhance cough in high-level SCI subjects (n = 11, SCI at or above T6) using surface electrical stimulation of the abdominal muscles via 2 pairs of posterolaterally placed electrodes. From total lung capacity, subjects performed maximum expiratory pressure (MEP) efforts against a closed airway and voluntary cough efforts. Both efforts were performed with and without superimposed trains of electrical stimulation (50 Hz, 1 second) at a submaximal intensity set to evoke a gastric pressure (P(ga)) of 40 cm H(2)O at functional residual capacity. In the MEP effort, stimulation increased the maximal P(ga) (from 21.4 ± 7.0 to 59.0 ± 5.7 cm H(2)O) and esophageal pressure (P(es); 47.2 ± 11.7 to 65.6 ± 13.6 cm H(2)O). During the cough efforts, stimulation increased P(ga) (19.5 ± 6.0 to 57.9 ± 7.0 cm H(2)O) and P(es) (31.2 ± 8.7 to 56.6 ± 10.5 cm H(2)O). The increased expiratory pressures during cough efforts with stimulation increased peak expiratory flow (PEF, by 36% ± 5%), mean expiratory flow (by 80% ± 8%), and expired lung volume (by 41% ± 16%). In every subject, superimposed electrical stimulation improved peak expiratory flow during cough efforts (by 0.99 ± 0.12 L/s; range, 0.41-1.80 L/s). Wearing an abdominal binder did not improve stimulated cough flows or pressures. The increases in P(ga) and PEF with electrical stimulation using the novel posterolateral electrode placement are 2 to 3 times greater than improvements reported in other studies. This suggests that posterolateral electrical stimulation of abdominal muscles is a simple noninvasive way to enhance cough in individuals with SCI.

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

    Science.gov (United States)

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

    2015-01-01

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

  4. 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

  5. Nocturnal Dry Cough in the First 7 Years of Life is Associated With Asthma at School Age

    NARCIS (Netherlands)

    Boudewijn, Ilse M.; Savenije, Olga E. M.; Koppelman, Gerard H.; Wijga, Alet H.; Smit, Henriette A.; de Jongste, Johan C.; Gehring, Ulrike; Postma, Dirkje S.; Kerkhof, Marjan

    2015-01-01

    Background: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

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

    NARCIS (Netherlands)

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

    1991-01-01

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

  7. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age

    NARCIS (Netherlands)

    Boudewijn, Ilse M; Savenije, Olga E M; Koppelman, Gerard H; Wijga, Alet H; Smit, Henriëtte A; de Jongste, Johan C; Gehring, Ulrike; Postma, Dirkje S; Kerkhof, Marjan

    2015-01-01

    BACKGROUND: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  8. 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.

  9. 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.

  10. Nocturnal Dry Cough in the First 7 Years of Life is Associated With Asthma at School Age

    NARCIS (Netherlands)

    Boudewijn, Ilse M.; Savenije, Olga E. M.; Koppelman, Gerard H.; Wijga, Alet H.; Smit, Henriette A.; de Jongste, Johan C.; Gehring, Ulrike; Postma, Dirkje S.; Kerkhof, Marjan

    2015-01-01

    Background: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  11. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age

    NARCIS (Netherlands)

    Boudewijn, Ilse M; Savenije, Olga E M; Koppelman, Gerard H; Wijga, Alet H; Smit, Henriëtte A; de Jongste, Johan C; Gehring, Ulrike; Postma, Dirkje S; Kerkhof, Marjan

    2015-01-01

    BACKGROUND: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  12. The Effects of Antitussive Treatment of ACE Inhibitor-Induced Cough on Therapy Compliance : A Prescription Sequence Symmetry Analysis

    NARCIS (Netherlands)

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

    2013-01-01

    Background A common adverse effect of angiotensin-converting enzyme inhibitors (ACEI) is a persistent dry cough. Physicians and pharmacists who fail to recognise dry cough to be ACEI related may prescribe antitussives, instead of recommended ACEI substitution. Objective The aim of this study was to

  13. A genome-wide association study identifies variants in KCNIP4 associated with ACE inhibitor-induced cough

    DEFF Research Database (Denmark)

    Mosley, J D; Shaffer, C M; Van Driest, S L;

    2016-01-01

    The most common side effect of angiotensin-converting enzyme inhibitor (ACEi) drugs is cough. We conducted a genome-wide association study (GWAS) of ACEi-induced cough among 7080 subjects of diverse ancestries in the Electronic Medical Records and Genomics (eMERGE) network. Cases were subjects di...

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

    NARCIS (Netherlands)

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

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

  15. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age

    NARCIS (Netherlands)

    Boudewijn, Ilse M; Savenije, Olga E M; Koppelman, Gerard H; Wijga, Alet H; Smit, Henriëtte A; de Jongste, Johan C; Gehring, Ulrike; Postma, Dirkje S; Kerkhof, Marjan

    BACKGROUND: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and

  16. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age

    NARCIS (Netherlands)

    Boudewijn, Ilse M; Savenije, Olga E M; Koppelman, Gerard H; Wijga, Alet H; Smit, Henriëtte A; de Jongste, Johan C; Gehring, Ulrike; Postma, Dirkje S; Kerkhof, Marjan

    2015-01-01

    BACKGROUND: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and

  17. Nocturnal Dry Cough in the First 7 Years of Life is Associated With Asthma at School Age

    NARCIS (Netherlands)

    Boudewijn, Ilse M.; Savenije, Olga E. M.; Koppelman, Gerard H.; Wijga, Alet H.; Smit, Henriette A.; de Jongste, Johan C.; Gehring, Ulrike; Postma, Dirkje S.; Kerkhof, Marjan

    Background: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and

  18. A genome-wide association study identifies variants in KCNIP4 associated with ACE inhibitor-induced cough

    NARCIS (Netherlands)

    Mosley, J D; Shaffer, C M; Van Driest, S L; Weeke, P E; Wells, Q S; Karnes, J H; Velez Edwards, D R; Wei, W-Q; Teixeira, P L; Bastarache, L; Crawford, D C; Li, R; Manolio, T A; Bottinger, E P; McCarty, C A; Linneman, J G; Brilliant, M H; Pacheco, J A; Thompson, W; Chisholm, R L; Jarvik, G P; Crosslin, D R; Carrell, D S; Baldwin, E; Ralston, J; Larson, E B; Grafton, J; Scrol, A; Jouni, H; Kullo, I J; Tromp, G; Borthwick, K M; Kuivaniemi, H; Carey, D J; Ritchie, M D; Bradford, Y; Verma, S S; Chute, C G; Veluchamy, A; Siddiqui, M K; Palmer, C N A; Doney, A; Mahmoud Pour, Seyed Hamidreza; Maitland-van der Zee, A H; Morris, A D; Denny, J C; Roden, D M

    2015-01-01

    The most common side effect of angiotensin-converting enzyme inhibitor (ACEi) drugs is cough. We conducted a genome-wide association study (GWAS) of ACEi-induced cough among 7080 subjects of diverse ancestries in the Electronic Medical Records and Genomics (eMERGE) network. Cases were subjects diagn

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

    Institute of Scientific and Technical Information of China (English)

    杨建民

    2014-01-01

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

  20. Efficacy and tolerability of a polysaccharide-resin-honey based cough syrup as compared to carbocysteine syrup for children with colds: a randomized, single-blinded, multicenter study

    National Research Council Canada - National Science Library

    Cohen, Herman Avner; Hoshen, Moshe; Gur, Shmuel; Bahir, Arie; Laks, Yoseph; Blau, Hannah

    2017-01-01

    .... The objective of this trial is to compare the effects of a polysaccharide-resin-honey based cough syrup, and carbocysteine syrups on nocturnal and daytime cough associated with childhood upper...

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

    Directory of Open Access Journals (Sweden)

    Masters IB

    2010-11-01

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

  2. 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.

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

    NARCIS (Netherlands)

    Smit, L.A.|info:eu-repo/dai/nl/311470882; Kogevinas, M.; Antó, J.; Bouzigon, E.; González, J.R.; Le Moual, N.; Kromhout, J.|info:eu-repo/dai/nl/074385224; Carsin, A.; Pin, I.; Jarvis, D.; Vermeulen, R.C.H.|info:eu-repo/dai/nl/216532620; Janson, C.; Heinrich, J.; Gut, I.; Lathrop, M.; Valverde, M.A.; Demenais, F.; Kauffmann, F.

    2012-01-01

    BACKGROUND: Transient receptor potential (TRP) vanilloid and ankyrin cation channels are activated by various noxious chemicals and may play an important role in the pathogenesis of cough. The aim was to study the influence of single nucleotide polymorphisms (SNPs) in TRP genes and irritant exposure

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

    OpenAIRE

    Spelman, Reginald

    1984-01-01

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

  5. 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.

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

    NARCIS (Netherlands)

    Smit, L.A.; Kogevinas, M.; Antó, J.; Bouzigon, E.; González, J.R.; Le Moual, N.; Kromhout, J.; Carsin, A.; Pin, I.; Jarvis, D.; Vermeulen, R.C.H.; Janson, C.; Heinrich, J.; Gut, I.; Lathrop, M.; Valverde, M.A.; Demenais, F.; Kauffmann, F.

    2012-01-01

    BACKGROUND: Transient receptor potential (TRP) vanilloid and ankyrin cation channels are activated by various noxious chemicals and may play an important role in the pathogenesis of cough. The aim was to study the influence of single nucleotide polymorphisms (SNPs) in TRP genes and irritant exposure

  7. Personal exposure to cough released droplets in quiescent environment and ventilated spaces

    DEFF Research Database (Denmark)

    Licina, Dusan; Melikov, Arsen Krikor; Pantelic, Jovan;

    2014-01-01

    This study shows the results of an experimental investigation of personal exposure to cough released droplets. Human body is resembled by a thermal manikin with a body shape and surface temperature distribution of a real person. The objective of the study is to examine personal exposure of the ma......This study shows the results of an experimental investigation of personal exposure to cough released droplets. Human body is resembled by a thermal manikin with a body shape and surface temperature distribution of a real person. The objective of the study is to examine personal exposure...... of the manikin exposed to cough released droplets in a calm indoor environment and under uniform air patterns relative to a human body. The findings show that human body orientation relative to the direction and magnitude of invading flow from the surroundings considerably modifies personal exposure. Surrounding...... uniform flows is most of the scenarios decrease the exposure to cough droplets, however not in all scenarios. Study results show that understanding of the air patterns should be prioritized in ventilation design practice....

  8. LECTURES ON ACUPUNCTURE Part Ⅰ Clinical Acupuncture Lecture Twenty-Eight COUGH

    Institute of Scientific and Technical Information of China (English)

    XU Li; SHANG Xiukui; PAN Xingfang

    2002-01-01

    @@ Cough, a main symptom of the lung problems, may result either from invasion of the exogenous factors induced dysfunction of the lungqi in dispersion or from disorders of the lung itself or from dysfunction of other zang-fu organs affecting the lung.

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

    Science.gov (United States)

    Paz, Concepción; Suárez, Eduardo; Vence, Jesús

    2017-02-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  11. 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...

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

    NARCIS (Netherlands)

    Smit, L.A.|info:eu-repo/dai/nl/311470882; Kogevinas, M.; Antó, J.; Bouzigon, E.; González, J.R.; Le Moual, N.; Kromhout, J.|info:eu-repo/dai/nl/074385224; Carsin, A.; Pin, I.; Jarvis, D.; Vermeulen, R.C.H.|info:eu-repo/dai/nl/216532620; Janson, C.; Heinrich, J.; Gut, I.; Lathrop, M.; Valverde, M.A.; Demenais, F.; Kauffmann, F.

    2012-01-01

    BACKGROUND: Transient receptor potential (TRP) vanilloid and ankyrin cation channels are activated by various noxious chemicals and may play an important role in the pathogenesis of cough. The aim was to study the influence of single nucleotide polymorphisms (SNPs) in TRP genes and irritant

  13. Independent cough flow augmentation by glossopharyngeal breathing plus table thrust in muscular dystrophy.

    Science.gov (United States)

    Bianchi, Carlo; Carrara, Raniero; Khirani, Sonia; Tuccio, Maria Chiara

    2014-01-01

    The purpose of the present study was to compare the unassisted cough peak flow (CPF) of patients affected by muscular dystrophy with CPF augmented by various techniques, including maximal depth glossopharyngeal breathing (GPB) combined with a subsequent self-induced thoracic or abdominal thrust. All of the motorized wheelchair-dependent patients with muscular dystrophy who had previously mastered GPB were trained at home to increase their cough efficacy. This training involved maneuvering their wheelchair against the edge of a specially built table to autonomously produce a thoracic and/or abdominal thrust timed to the opening of the glottis for an independently assisted cough. Both unassisted and variously assisted CPFs were compared. The 18 patients (17 men/1 woman) with muscular dystrophy, aged 21.1 ± 5.4 yrs, achieved variously assisted CPFs that were significantly higher than the spontaneous CPF (P thrust (326.4 ± 79.5 liters/min) or by GPB and thoracoabdominal thrust (326.4 ± 87.5 liters/min) were not significantly different (P = 0.07) from the CPFs independently attained by GPB plus independently maneuvering a wheelchair for a table thrust (310.3 ± 74.7 liters/min). The independently assisted (GPB plus table thrust) CPF was comparable to the CPFs that required personal assistance for air stacking and abdominal thrusts. Therefore, for patients with muscular dystrophy, this physical medicine technique and cough-assisted techniques that require personal intervention are strongly recommended.

  14. Angiotensin converting enzyme inhibitor associated cough: a population-based case-control study.

    NARCIS (Netherlands)

    Visser, L.E.; Stricker, B.H.C.; Velden, J. van der; Paes, A.H.P.; Bakker, A.

    1995-01-01

    The objectives of this study were to determine the risk for coughing as an adverse reaction to angiotensin converting enzyme (ACE) inhibitors under everyday circumstances in a large population and to study whether this adverse effect is more common in women. A population-based case-control study was

  15. The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers.

    Science.gov (United States)

    Navarro, Laís Helena Camacho; Lima, Rodrigo Moreira e; Aguiar, Andressa Simões; Braz, José Reinaldo Cerqueira; Carness, Jeffrey M; Módolo, Norma Sueli Pinheiro

    2012-01-01

    We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU) (p = 0.02). However, at 24 hours after extubation, sore throat incidence was similar in both groups (p = 0.07). Incidence of hoarseness was similar in both groups. Intracuff pressure in the saline group increased with time while the intracuff pressure in the lidocaine group remained constant. The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

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

    Directory of Open Access Journals (Sweden)

    Derakhshan Deilami Gholamreza

    2009-10-01

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

  17. 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

  18. Fourier transform infrared and near-infrared spectroscopic methods for the detection of toxic Diethylene Glycol (DEG) contaminant in glycerin based cough syrup

    OpenAIRE

    Ahmed, M. Khalique; McLeod, Michael P.; Nézivar, Jean; Giuliani, Allison W.

    2010-01-01

    Recently there have been reports of the contamination of cough syrups with Diethylene Glycol (DEG). The consumption of such cough syrups has devastating effects on the health. In this paper we report evidence that Fourier transform infrared (FT-IR) and near-infrared (NIR) spectroscopic techniques are viable, simple, cost effective, rapid and fool proof methods for the identification and quantification of DEG in glycerin based cough syrups. The FT-IR and NIR spectra of the glycerin based cough...

  19. Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation.

    Science.gov (United States)

    Rose, Louise; Adhikari, Neill Kj; Leasa, David; Fergusson, Dean A; McKim, Douglas

    2017-01-11

    There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear. Our primary objective was to determine extubation success using cough augmentation techniques compared to no cough augmentation for critically-ill adults and children with acute respiratory failure admitted to a high-intensity care setting capable of managing mechanically-ventilated people (such as an intensive care unit, specialized weaning centre, respiratory intermediate care unit, or high-dependency unit).Secondary objectives were to determine the effect of cough augmentation techniques on reintubation, weaning success, mechanical ventilation and weaning duration, length of stay (high-intensity care setting and hospital), pneumonia, tracheostomy placement and tracheostomy decannulation, and mortality (high-intensity care setting, hospital, and after hospital discharge). We evaluated harms associated with use of cough augmentation techniques when applied via an artificial airway (or non-invasive mask once extubated/decannulated), including haemodynamic compromise, arrhythmias, pneumothorax, haemoptysis, and mucus plugging requiring airway change and the type of person (such as those with neuromuscular disorders or weakness and spinal cord injury) for whom these techniques may be efficacious. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 4, 2016), MEDLINE (OvidSP) (1946 to April 2016), Embase (OvidSP) (1980 to April 2016), CINAHL (EBSCOhost) (1982

  20. 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.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Mohammad-Ali Raeessi

    2011-04-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐俪颖; 骆仙芳; 王会仍

    2010-01-01

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

  4. 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.

  5. 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.

  6. Effect of multiple honey doses on non-specific acute cough in children. An open randomised study and literature review.

    Science.gov (United States)

    Miceli Sopo, S; Greco, M; Monaco, S; Varrasi, G; Di Lorenzo, G; Simeone, G

    2015-01-01

    Honey is recommended for non-specific acute paediatric cough by the Australian guidelines. Current available randomised clinical trials evaluated the effects of a single evening dose of honey, but multiple doses outcomes have never been studied. To evaluate the effects of wildflower honey, given for three subsequent evenings, on non-specific acute paediatric cough, compared to dextromethorphan (DM) and levodropropizine (LDP), which are the most prescribed over-the-counter (OTC) antitussives in Italy. 134 children suffering from non-specific acute cough were randomised to receive for three subsequent evenings a mixture of milk (90ml) and wildflower honey (10ml) or a dose of DM or LDP adjusted for the specific age. The effectiveness was evaluated by a cough questionnaire answered by parents. Primary end-point efficacy was therapeutic success. The latter was defined as a decrease in cough questionnaire score greater than 50% after treatment compared with baseline values. Three children were excluded from the study, as their parents did not complete the questionnaire. Therapeutic success was achieved by 80% in the honey and milk group and 87% in OTC medication group (p=0.25). Milk and honey mixture seems to be at least as effective as DM or LDP in non-specific acute cough in children. These results are in line with previous studies, which reported the health effects of honey on paediatric cough, even if placebo effect cannot be totally excluded. Copyright © 2014 SEICAP. Published by Elsevier Espana. All rights reserved.

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

    Science.gov (United States)

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

    2011-01-01

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

  8. 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.

  9. 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.

  10. Use of Management Pathways or Algorithms in Children With Chronic Cough: CHEST Guideline and Expert Panel Report.

    Science.gov (United States)

    Chang, Anne B; Oppenheimer, John J; Weinberger, Miles M; Rubin, Bruce K; Weir, Kelly; Grant, Cameron C; Irwin, Richard S

    2017-04-01

    Using management algorithms or pathways potentially improves clinical outcomes. We undertook systematic reviews to examine various aspects in the generic approach (use of cough algorithms and tests) to the management of chronic cough in children (aged ≤ 14 years) based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework. Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain the final grading. Combining data from systematic reviews addressing five KQs, we found high-quality evidence that a systematic approach to the management of chronic cough improves clinical outcomes. Although there was evidence from several pathways, the highest evidence was from the use of the CHEST approach. However, there was no or little evidence to address some of the KQs posed. Compared with the 2006 Cough Guidelines, there is now high-quality evidence that in children aged ≤ 14 years with chronic cough (> 4 weeks' duration), the use of cough management protocols (or algorithms) improves clinical outcomes, and cough management or testing algorithms should differ depending on the associated characteristics of the cough and clinical history. A chest radiograph and, when age appropriate, spirometry (pre- and post-β2 agonist) should be undertaken. Other tests should not be routinely performed and undertaken in accordance with the clinical setting and the child's clinical symptoms and signs (eg, tests for tuberculosis when the child has been exposed). Copyright © 2017 American College of Chest Physicians. All rights reserved.

  11. 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.

  12. 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

  13. Efficacy and tolerability of a polysaccharide-resin-honey based cough syrup as compared to carbocysteine syrup for children with colds: a randomized, single-blinded, multicenter study.

    Science.gov (United States)

    Cohen, Herman Avner; Hoshen, Moshe; Gur, Shmuel; Bahir, Arie; Laks, Yoseph; Blau, Hannah

    2017-02-01

    Available pediatric treatments for acute cough are limited by lack of demonstrated efficacy. The objective of this trial is to compare the effects of a polysaccharide-resin-honey based cough syrup, and carbocysteine syrups on nocturnal and daytime cough associated with childhood upper respiratory tract infections (URIs). Using a single-blind randomization design, the study recruited children from 4 general pediatric community clinics. Participants included 150 children aged 2 to 5 years with an URI, nocturnal and daytime cough and illness duration of ≤7 days. To be eligible, children had to be free of medication on the day before presentation. A survey was administered to parents on 4 consecutive days beginning from the day of presentation in clinic. Children received the study preparation on the first evening and then 3 times per day for 3 further days. Main outcome measures were cough frequency, cough severity, bothersome nature of cough, and quality of sleep for both child and parent. Both preparations were well tolerated and cough improved over the study period. After one night and on all survey days, there was a significantly better result for polysaccharide-resin-honey (Pcarbocysteine cough syrups were well tolerated in children over 2 years of age. The polysaccharide-resin-honey syrup was associated with a more rapid and greater improvement in all clinical cough symptoms measured, beginning from the first night of therapy. Both nocturnal and daytime cough improved, as did sleep quality for both children and parents.

  14. Semi-Microscale Williamson Ether Synthesis and Simultaneous Isolation of an Expectorant from Cough Tablets

    Science.gov (United States)

    Stabile, Ryan G.; Dicks, Andrew P.

    2003-03-01

    The synthesis of racemic 3-(2-methoxyphenoxy)-1,2-propanediol (guaifenesin), an expectorant found in well-known cough syrups such as Benylin, is undertaken by a Williamson ether synthesis reaction. The same compound is simultaneously isolated and characterized from commercially available Guai-Aid cough tablets. The experiment is well-suited towards the introductory part of an advanced organic laboratory course and complements typical lecture topics in a stimulating manner. Consideration is given towards reaction mechanisms, stereochemistry, optical activity, pharmaceutical synthesis, and spectroscopic analysis. Discussion of the merits or disadvantages of marketing a drug as a racemic mixture, with reference to the notorious thalidomide case study, and the concept of enantioselective synthesis is possible.

  15. Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis.

    Science.gov (United States)

    Becker, Lorne A; Hom, Jeffrey; Villasis-Keever, Miguel; van der Wouden, Johannes C

    2015-09-03

    The diagnosis of acute bronchitis is made on clinical grounds and a variety of clinical definitions have been used. There are no clearly effective treatments for the cough of acute bronchitis. Beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction (as seen in asthma or chronic obstructive pulmonary disease (COPD)) contributing to the symptoms. To determine whether beta2-agonists improve acute bronchitis symptoms in people with no underlying pulmonary disease (such as asthma, COPD or pulmonary fibrosis). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2015, Issue 5, MEDLINE (January 1966 to May 2015), EMBASE (1974 to May 2015), Web of Science (2011 to May 2015) and LILACS (1982 to May 2015). Randomised controlled trials (RCTs) which allocated people (adults, or children over two years of age) with acute bronchitis or acute cough and without known pulmonary disease to beta2-agonist versus placebo, no treatment or alternative treatment. Three review authors independently selected outcomes and extracted data while blinded to study results. Two review authors independently assessed each trial for risk of bias. We analysed trials in children and adults separately. Two trials of moderate quality in children (n = 134) with no evidence of airflow restriction did not find any benefits from oral beta2-agonists. Five trials in adults (n = 418) had mixed results but overall summary statistics did not reveal any significant benefits from oral (three trials) nor from inhaled (two trials) beta2-agonists. Three studies with low-quality evidence demonstrated no significant differences in daily cough scores, nor in the percentage of adults still coughing after seven days (control group 71%; risk ratio (RR) 0.86, 95% confidence interval (CI) 0.63 to 1.18; 220 participants). In one trial, subgroups with evidence of airflow limitation had lower symptom scores if given beta2-agonists. The

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

    Science.gov (United States)

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

    2014-02-01

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

  17. Whooping cough in Pakistan: Bordetella pertussis vs Bordetella parapertussis in 2005-2009.

    Science.gov (United States)

    Bokhari, Habib; Said, Fahad; Syed, Muhammad A; Mughal, Amjad; Kazi, Yasmeen F; Heuvelman, Kees; Mooi, Frits R

    2011-10-01

    Pertussis, or whooping cough, is an acute respiratory disease mainly affecting infants and children and is caused by Bordetella pertussis and Bordetella parapertussis. The aim of this study was to investigate the share of Bordetella species from potential whooping cough cases during 2005-2009. Eight hundred and two samples from suspected pertussis cases were collected, mainly from 2 provinces of Pakistan. Bacterial culture, identification, DNA extraction and routinely used polymerase chain reaction (PCR) methods using IS1001, IS1002 and IS481 were used to identify the Bordetella species. The results were unexpected, because all of the isolates collected from the different cities were identified as B. parapertussis (7.4%); B. pertussis was not isolated from any sample. However, PCR results indicated the presence of a small percentage (0.6%) of B. pertussis among the total cases studied. This study suggests that vaccines to protect against both B. pertussis and B. parapertussis should be considered.

  18. Cough and fear of sleep: early clinical signs of Bordetella pertussis in an adult

    Directory of Open Access Journals (Sweden)

    Thomas C. Jones

    2004-08-01

    Full Text Available Pertussis is increasing in frequency among adults, but early diagnosis requires special attention to details in the medical history. We describe a 64 year-old male with classic signs and symptoms of pertussis and documented Bordetella pertussis infection that were overlooked because he presented with a chief complaint of cough and fear of falling asleep. Coughing paroxysms and a feeling of suffocation (30-60 seconds only occurred at night after short periods of deep sleep (30-45 minutes. The physicians did not observe these episodes during daytime examinations, and the basis of the patient's fear of sleep was not explored. We recommend reassessment of how adults describe symptoms of pertussis, including fear of sleep, and we suggest the use of PCR technology to allow early diagnosis and prompt treatment.

  19. Study on loss mechanism of SMA tracheal stent subjected to cough excitation.

    Science.gov (United States)

    Zhu, Zhiwen; Li, Xinmiao; Xu, Jia

    2015-01-01

    A kind of Ti-Ni shape memory alloy (SMA) hysteretic nonlinear model is developed, and the loss mechanism of a SMA tracheal stent subjected to cough excitation is studied in this paper. Nonlinear differential items are introduced to express the hysteretic phenomena of Ti-Ni SMA, and the fitting effect of the SMA constitutive model on the experimental data is proved by the partial least-square regression method. The nonlinear dynamic model of a Ti-Ni SMA tracheal stent subjected to cough excitation is developed, and the system's dynamic response is obtained. The numerical results show that the system's vibration is little in weak excitation, becomes large with the increase of the stochastic excitation, and finally becomes little again with the further increase of the stochastic excitation; the stochastic resonance phenomenon occurs in the process, which may cause stent fracture or loss.

  20. 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.

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

    Science.gov (United States)

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

    2013-04-01

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

  2. Determination of Microbial Load in Multivitamin and Cough Syrups Sold in Dhaka City

    OpenAIRE

    Abdullah Al Mamun; Tapas Kumar Shaha; Md. Murad Khan; Md. Shahidul Kabir

    2014-01-01

    The production of substandard drugs and use of inappropriate methods in manufacturing medical products in pharmaceutical industries may cause non-therapeutic effect in patients particularly in children. Hence this study was conducted to determine the microbiological quality of multivitamin and cough syrups of different brands sold in local pharmacy in Dhaka city. Microbiological analysis was carried out using spread plate technique on different culture media including nutrient agar, mannitol ...

  3. Mechanical insufflation-exsufflation. Comparison of peak expiratory flows with manually assisted and unassisted coughing techniques.

    Science.gov (United States)

    Bach, J R

    1993-11-01

    Pulmonary complications are major causes of morbidity and mortality for patients with severe expiratory muscle weakness. The purpose of this study was to compare peak cough expiratory flows (PCEFs) during unassisted and assisted coughing and review the long-term use of mechanical insufflation-exsufflation (MI-E) for 46 neuromuscular ventilator users. These individuals used noninvasive methods of ventilatory support for a mean of 21.1 h/d for 17.3 +/- 15.5 years. They relied on manually assisted coughing and/or MI-E during periods of productive airway secretion. They reported a mean of 0.7 +/- 1.2 cases of pneumonia and other serious pulmonary complications and 2.8 +/- 5.6 hospitalizations during the 16.4-year period and no complications of MI-E. A sample of 21 of these patients with a mean forced vital capacity of 490 +/- 370 ml had a mean maximum insufflation capacity (MIC) achieved by a combination of air stacking of ventilator insufflations and glossopharyngeal breathing of 1,670 +/- 540 ml. The PCEFs for this sample were: following an unassisted inspiration, 1.81 +/- 1.03 L/s; following a MIC maneuver, 3.37 +/- 1.07 L/s; with manual assistance by abdominal compression following a MIC maneuver, 4.27 +/- 1.29 L/s; and with MI-E, 7.47 +/- 1.02 L/s. Each PCEF was significantly greater than the preceding, respectively (p < 0.01). We conclude that manually assisted coughing and MI-E are effective and safe methods for facilitating airway secretion clearance for neuromuscular ventilator users who would otherwise be managed by endotracheal suctioning. Severely decreased MIC, but not necessarily vital capacity, is an indication for tracheostomy.

  4. The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers

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    Laís Helena Camacho Navarro

    2012-04-01

    Full Text Available OBJECTIVE: We evaluated whether endotracheal tube (ETT intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. METHODS: In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O. Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group, or ETT intracuff 0.9% saline (S group. The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. RESULTS: Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p < 0.001. The incidence of sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU (p = 0.02. However, at 24 hours after extubation, sore throat incidence was similar in both groups (p = 0.07. Incidence of hoarseness was similar in both groups. Intracuff pressure in the saline group increased with time while the intracuff pressure in the lidocaine group remained constant. CONCLUSION: The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

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

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 刘春丽; 罗炜; 赖克方; 钟南山

    2013-01-01

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

  6. 舒肺止咳糖浆治疗感染后咳嗽的临床观察%Clinical observation on treating post infectious cough with cough syrup

    Institute of Scientific and Technical Information of China (English)

    朱颖文; 缪晓路

    2013-01-01

      目的:观察舒肺止咳糖浆对感染后咳嗽的临床疗效.方法:选择感染后咳嗽患者75例,给予强力安喘通口服3d后,联用舒肺止咳糖浆口服,治疗3d,观察临床疗效.结果:第1个疗程后总有效率为66.7%;第2个疗程后总有效率为82.5%.两个疗程总有效率比较有统计学意义(P<0.05).结论:联用舒肺止咳糖浆对感染后咳嗽有较好的疗效.%Objective: To observe the clinical therapeutic effect of cough syrup in treating post infectious cough. Methods: 75 cases of post infectious cough patients were selected, given Asmeton’strong’ Capsules orally for 3 days and given cough syrup for another 3 days. Results: The total effective rate after the first course of treatment was 66.7%, and that of the second course of treatment was 82.5%. A significant difference were detected between the two groups (P<0.05). Conclusion: Combination use of cough syrup had an expected effect in treating post infectious cough.

  7. [Whooping cough: clinical and epidemiological characteristics of 20 confirmed cases of the Paediatric Hospital of Misiones province].

    Science.gov (United States)

    von Specht, Martha; Grenon, Sandra; Tagliaferri, Paulina; López, Oscar; Regueira, Mabel; Fosatti, Sofía; Weltman, Gabriela; Hozbor, Daniela

    2009-10-01

    Pertussis or whooping cough is a respiratory disease that has emerged in recent years in several countries including Argentina. The aim is to retrospectively describe clinical and epidemiological characteristics of 20 patients in the Pediatric Hospital of Misiones with confirmed diagnosis of whooping cough, according to criteria set by WHO and CDC, during the years 2005 and 2006. The median age was 4 months, 13 were male (65%). Fourteen patients (70%) were younger than 6 months and 9 (45%) younger than 3 months. All had cough (average duration of 7.6 days), 5 (25%) paroxysmal cough and 1 (5%) apnea and cyanosis. Two children died. Sixteen (80%) had not the three doses of vaccine quadruple, 7 children (35%) were younger than 3 months and had no dose. The disease remains a public health problem affecting not only children but also adults.

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

    Directory of Open Access Journals (Sweden)

    Ozkaya Sevket

    2012-10-01

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

  9. Persistent cough in patients using an urban chest clinic in Malawi.

    Science.gov (United States)

    Nwanyanwu, O; Nyangulu, D; Salaniponi, F

    1996-10-01

    In many sub-Saharan African countries, tuberculosis (TB) cases have been increasing steadily since 1985. In Malawi, they have increased by 38% from 1990 to 1993, and extrapulmonary TB increased by 79%. Among 385 patients with a history of persistent cough presumed to be TB, 360 (94%) initially consented to be tested for both HIV and TB. Of these, 301 completed testing and 95% returned for their test results. Among test completers (n = 301), 280 (93%) were found to be HIV-infected. Seropositivity rates were similar for males and females, and higher for urban dwellers than for rural dwellers (94% versus 79%). TB was found in only 48 (16%) patients. Among TB patients, 33 (77%) were HIV positive. This study suggests that TB may not be the main cause of persistent cough among persons using urban chest clinics in Malawi; HIV without sputum positive TB appears to be a major contributor. Clinicians in areas of high HIV prevalence should therefore suspect other HIV-related infections in a patient with persistent cough and in whom TB has been ruled out.

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

    Science.gov (United States)

    Parakh, Ankit; Singh, Varinder

    2013-01-01

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

  11. Recessive spinocerebellar ataxia with paroxysmal cough attacks: a report of five cases.

    Science.gov (United States)

    Velázquez-Pérez, Luis; González-Piña, Rigoberto; Rodríguez-Labrada, Roberto; Aguilera-Rodríguez, Raul; Galicia-Polo, Lourdes; Vázquez-Mojena, Yaimeé; Cortés-Rubio, Ana M; Trujillo-Bracamontes, Marla R; Cerecedo-Zapata, Cesar M; Hernández-Hernández, Oscar; Cisneros, Bulmaro; Magaña, Jonathan J

    2014-04-01

    Hereditary ataxias are a heterogeneous group of neurological diseases characterized by progressive cerebellar syndrome and numerous other features, which result in great diversity of ataxia subtypes. Despite the characterization of a number of both autosomal dominant and autosomal recessive ataxias, it is thought that a large group of these conditions remains to be identified. In this study, we report the characterization of five patients (three Mexicans and two Italians) who exhibit a peculiar form of recessive ataxia associated with coughing. The main clinical and neurophysiological features of these patients include cerebellar ataxia, paroxysmal cough, restless legs syndrome (RLS), choreic movements, atrophy of distal muscles, and oculomotor disorders. Brain magnetic resonance imaging (MRI) revealed cerebellar atrophy, while video polysomnography (VPSG) studies showed a severe pattern of breathing-related sleep disorder, including sleep apnea, snoring, and significant oxygen saturation in the absence of risk factors. All patients share clinical features in the peripheral nervous system, including reduction of amplitude and prolonged latency of sensory potentials in median and sural nerves. Altogether, clinical criteria as well as molecular genetic testing that was negative for different autosomal dominant and autosomal recessive ataxias suggest the presence of a new form of recessive ataxia. This ataxia, in which cerebellar signs are preceded by paroxysmal cough, affects not only the cerebellum and its fiber connections, but also the sensory peripheral nervous system and extracerebellar central pathways.

  12. 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.

  13. Recommendations for the proper use of nonprescription cough suppressants and expectorants in solid-organ transplant recipients.

    Science.gov (United States)

    Gabardi, Steven; Carter, Danielle; Martin, Spencer; Roberts, Keri

    2011-03-01

    To describe the pharmacology and safety of oral over-the-counter cough suppressants and expectorants and to present recommendations for the use of these agents in solid-organ transplant recipients based on the potential for adverse drug reactions or drug-disease interactions. Data from journal articles and other sources describing the pharmacology and safety of over-the-counter cough suppressants and expectorants, drug-drug interactions with immunosuppressive agents, and drug-disease state interactions are reviewed. Potential and documented drug-drug interactions between immunosuppressive agents and over-the-counter cough medications guaifenesin, dextromethorphan, diphenhydramine, and codeine were evaluated on the basis of pharmacokinetic and pharmacodynamic principles. Interactions between these cough medications and the physiological changes in the body following transplantation also were examined. Diphenhydramine requires additional monitoring when used to treat cough in transplant recipients owing to its anticholinergic properties and the potential for interactions with cyclosporine. Dextromethorphan can be used in most transplant recipients, although greater caution should be exercised if the patient has undergone liver transplant or has liver impairment. Guaifenesin can be used in transplant recipients but should be used with caution in patients receiving kidney or lung transplants and in patients with renal impairment. Codeine combined with guaifenesin is another option for cough and can be used in most transplant patients although those with reduced renal function should be monitored carefully for adverse events.

  14. The Development of Seabuckthorn Cough-relieving Buccal Tablet%沙棘止咳含片的研制

    Institute of Scientific and Technical Information of China (English)

    山永凯

    2012-01-01

    On the basis of the traditional folk cough-relieving prescription, taking Qinghai seabuck- thorn as the main material, complementary with winter fruit pear juice, bulbus fritillariae cirrhosae as auxiliary material, makes seabuckthorn cough-relieving buccal tablet, discusses the production process, blend the best taste with the orthogonal experiment method; Therefore, we have tested the influence of seabuckthorn cough-relieving buccal tablet in stopping cough of mice caused by aqueous ammonia and eliminating phlegm. The results shows that seabuckthorn cough-relieving buccal tablet has obvious cough-relieving and eliminating phlegm effect.%在民间传统止咳偏方的基础上,以沙棘汁为主原料,辅以冬果梨汁、川贝母、薏苡仁浸提液,制作出沙棘止咳含片,探讨了生产工艺,用正交试验法调配出最佳口味;并且试验了沙棘止咳含片对小鼠氨水所致咳嗽的镇咳作用和小鼠祛痰作用测试,结果表明:沙棘止咳含片具有明显的止咳和祛痰作用。

  15. 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.

  16. The effect of nedocromil sodium, sodium cromoglycate and codeine phosphate on citric acid-induced cough in dogs.

    Science.gov (United States)

    Jackson, D. M.

    1988-01-01

    1. The effects of nedocromil sodium, sodium cromoglycate and codeine phosphate on citric acid-induced cough have been studied in conscious tracheostomised dogs. 2. Nedocromil sodium (approximately 15 mg given as an aerosol) and codeine phosphate (5 mg kg-1, i.v.) significantly increased the time to the first cough when dogs were challenged with citric acid aerosol. The mean number of coughs in the initial period of coughing fell after treatment of dogs with nedocromil sodium or with codeine phosphate, but this reduction in mean cough number was not statistically significant. 3. Neither sodium cromoglycate (approximately 15 mg given as an aerosol) nor saline had significant effect on a citric acid challenge. 4. It is concluded that nedocromil sodium, but not sodium cromoglycate, possesses an anti-tussive action that may result from inhibition of sensory nerve activity in the lung. Nedocromil sodium may prove useful in the treatment of unproductive cough in situations where the use of a centrally-acting antitussive is undesirable. PMID:2836011

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

    Institute of Scientific and Technical Information of China (English)

    陈振甫; 周文秀; 高举先; 孙江桥

    2002-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李治昌; 吕茵; 王义; 刘小权; 楚建萍

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Deslee G

    2016-09-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  1. Whooping Cough

    Science.gov (United States)

    ... nav nav, .header-9#header-section #main-nav, #overlay-menu nav, #mobile-menu, #one-page-nav li . ... How to Care for Your Child’s TeethRead Article >>Dental Hygiene: How to Care for Your Child’s TeethSeptember ...

  2. 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

  3. Respiratory disease in the Asia-Pacific region: Cough as a key symptom.

    Science.gov (United States)

    Cho, Sang-Heon; Lin, Horng-Chyuan; Ghoshal, Aloke Gopal; Bin Abdul Muttalif, Abdul Razak; Thanaviratananich, Sanguansak; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Brnabic, Alan J M; Dehle, Francis C; Wang, De Yun

    2016-01-01

    Respiratory diseases represent a significant impact on health care. A cross-sectional, multicountry (India, Korea, Malaysia, Singapore, Taiwan, and Thailand) observational study was conducted to investigate the proportion of adult patients who received care for a primary diagnosis of asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), or rhinosinusitis. To determine the proportion of patients who received care for asthma, AR, COPD, and rhinosinusitis, and the frequency and main symptoms reported. Patients ages ≥18 years, who presented to a physician with symptoms that met the diagnostic criteria for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Patients and physicians completed a survey that contained questions related to demographics and respiratory symptoms. A total of 13,902 patients with a respiratory disorder were screened, of whom 7030 were eligible and 5250 enrolled. The highest percentage of patients who received care had a primary diagnosis of AR (14.0% [95% confidence interval {CI}, 13.4-14.6%]), followed by asthma (13.5% [95% CI, 12.9-14.1%]), rhinosinusitis (5.4% [95% CI, 4.6-5.3%]), and COPD (4.9% [95% CI, 5.0-5.7%]). Patients with a primary diagnosis of COPD (73%), followed by asthma (61%), rhinosinusitis (59%), and AR (47%) most frequently reported cough as a symptom. Cough was the main reason for seeking medical care among patients with a primary diagnosis of COPD (43%), asthma (33%), rhinosinusitis (13%), and AR (11%). Asthma, AR, COPD, and rhinosinusitis represent a significant proportion of respiratory disorders in patients who presented to health care professionals in the Asia-Pacific region, many with concomitant disease. Cough was a prominent symptom and the major reason for patients with respiratory diseases to seek medical care.

  4. 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.

  5. Simultaneous Estimation of Four Antitussive Components from Herbal Cough Syrup by HPTLC

    OpenAIRE

    Sharada L Deore; Jaju, Payal S.; Bhushan A Baviskar

    2014-01-01

    A new simple, rapid, selective and precise high performance thin layer chromatographic (HPTLC) method has been developed for simultaneous estimation of vasicine, glycyrrhizin, eugenol, and cineole in herbal cough syrup. The retention factors of vasicine, glycyrrhizin, eugenol, and cineole are 0.53, 0.44, 0.75, and 0.77, respectively. Chromatography was performed on 60F254 percolated TLC plate using n-hexane : ethyl acetate : glacial acetic acid (8.5 : 1.0 : 0.5 v/v/v). Methods are validated a...

  6. 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.

  7. 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...

  8. Reactance to a tailored multimedia intervention encouraging teachers to promote cover-the-cough.

    Science.gov (United States)

    David, Prabu; Henry, Aletheia; Srivastava, Jatin; Orcena, Jason; Thrush, Jennifer

    2012-01-01

    Teachers were presented tailored multimedia messages encouraging them to offer cover-the-cough instruction to their students. Messages were tailored by grade level (elementary, higher grade) and stage of change (preaction, action). Among teachers in the action stages, message tailoring did not make a difference. Among teachers in the preaction stages, tailored messages were rated lower than were nontailored messages. The lower ratings of the tailored messages, seemingly a reactance response, did not carry over to postintervention self-efficacy. The intervention was effective in improving self-efficacy in elementary school teachers, particularly among those in the preaction stages.

  9. 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...

  10. Síndrome coqueluchoide y tos ferina Pertussis-like syndrome and whooping cough

    Directory of Open Access Journals (Sweden)

    Carlos Dotres Martínez

    2012-12-01

    Full Text Available El síndrome coqueluchoide, cuadro parecido a la tos ferina, es uno de los síndromes respiratorios bajos más comunes en la práctica pediátrica sobre todo en los últimos años. La tos ferina sigue siendo la enfermedad inmunoprevenible más antigua de la infancia que aún causa brotes importantes, principalmente en niños, pero también en adolescentes y adultos. El objetivo de esta revisión es proporcionar información a todos los médicos generales y pediatras de atención primaria y secundaria de salud sobre este problema epidemiológico y de su actual reemergencia. El control de esta enfermedad es un problema de salud tanto en países desarrollados como en vías de desarrollo. Uno de los mayores obstáculos que ha contribuido a una tardía intervención epidemiológica y tratamiento de la tos ferina en varios países del mundo, ha sido la baja sospecha clínica de esta enfermedad en los médicos y trabajadores de la salud, y el desconocimiento de la familia, en la mayoría de las veces. En el momento actual existe una reemergencia mundial de la tos ferina, situación que es necesario conocer y aceptar para un oportuno diagnóstico y tratamiento.Pertussis-like syndrome, a clinical picture similar to whooping cough, is one of the most common lower respiratory syndromes in the pediatric practice in recent years. Whooping cough continues to be one of the oldest preventable diseases in infants, which still causes significant outbreaks mainly in children, but also in adolescents and adults. The objective of this review was to provide general physicians and pediatricians at the primary and the secondary health care levels with information about this present re-emerging epidemiological problem. The management of this disease is difficult for both the developed and the developing countries. One of the major obstacles that lead to delayed epidemiological intervention and treatment of whooping cough in several countries has been the poor clinical

  11. Children with Cough and Fever: Up-to-date Imaging Evaluation and Management.

    Science.gov (United States)

    Schooler, Gary R; Davis, Joseph T; Parente, Victoria M; Lee, Edward Y

    2017-07-01

    Cough and fever in infants and children are frequent but nonspecific symptoms. Several usual differential diagnoses are under consideration and imaging is often necessary to help arrive at an accurate diagnosis and ensure proper management. A broad spectrum of underlying disorders may be present. Radiologists must remain cognizant of the potential for immune dysfunction and underlying structural abnormalities. A clear understanding of up-to-date imaging evaluation recommendations and characteristic imaging features can assist radiologists and clinicians in arriving at the most accurate diagnosis in a timely manner and help ensure proper management and necessary follow-up imaging assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Comparative efficacy and tolerability of pholcodine and dextromethorphan in the management of patients with acute, non-productive cough : a randomized, double-blind, multicenter study.

    Science.gov (United States)

    Equinozzi, Roberto; Robuschi, Maria

    2006-01-01

    The aim of this study was to compare the efficacy and tolerability of pholcodine with that of dextromethorphan, one of the most used cough sedative products, in patients with acute, non-productive cough. 129 adults with a diagnosis of acute, frequent, non-productive cough participated in a randomized, double-blind, parallel-group, multicenter trial. Medications were in a syrup formulation and were taken orally three times daily for 3 days. The efficacy endpoints were the change from baseline in the daytime and night-time cough frequency on 5-point scales at day 3, and cough intensity. A reduction of 1.4 and 1.3 points in the mean daytime cough frequency at day 3 was seen in the pholcodine and dextromethorphan groups, respectively, in the per-protocol population. The reduction in mean night-time cough was 1.3 for both groups. Cough intensity reduction was 0.7 for pholcodine and 0.8 for dextromethorphan. These findings indicate that the efficacy of a 3-day course of pholcodine is similar to that of dextromethorphan in the treatment of adult patients with acute, non-productive cough. Both medications were well tolerated.

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

    Institute of Scientific and Technical Information of China (English)

    徐娅; 许青青

    2012-01-01

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

  14. A genome-wide association study identifies variants in KCNIP4 associated with ACE inhibitor-induced cough.

    Science.gov (United States)

    Mosley, J D; Shaffer, C M; Van Driest, S L; Weeke, P E; Wells, Q S; Karnes, J H; Velez Edwards, D R; Wei, W-Q; Teixeira, P L; Bastarache, L; Crawford, D C; Li, R; Manolio, T A; Bottinger, E P; McCarty, C A; Linneman, J G; Brilliant, M H; Pacheco, J A; Thompson, W; Chisholm, R L; Jarvik, G P; Crosslin, D R; Carrell, D S; Baldwin, E; Ralston, J; Larson, E B; Grafton, J; Scrol, A; Jouni, H; Kullo, I J; Tromp, G; Borthwick, K M; Kuivaniemi, H; Carey, D J; Ritchie, M D; Bradford, Y; Verma, S S; Chute, C G; Veluchamy, A; Siddiqui, M K; Palmer, C N A; Doney, A; MahmoudPour, S H; Maitland-van der Zee, A H; Morris, A D; Denny, J C; Roden, D M

    2016-06-01

    The most common side effect of angiotensin-converting enzyme inhibitor (ACEi) drugs is cough. We conducted a genome-wide association study (GWAS) of ACEi-induced cough among 7080 subjects of diverse ancestries in the Electronic Medical Records and Genomics (eMERGE) network. Cases were subjects diagnosed with ACEi-induced cough. Controls were subjects with at least 6 months of ACEi use and no cough. A GWAS (1595 cases and 5485 controls) identified associations on chromosome 4 in an intron of KCNIP4. The strongest association was at rs145489027 (minor allele frequency=0.33, odds ratio (OR)=1.3 (95% confidence interval (CI): 1.2-1.4), P=1.0 × 10(-8)). Replication for six single-nucleotide polymorphisms (SNPs) in KCNIP4 was tested in a second eMERGE population (n=926) and in the Genetics of Diabetes Audit and Research in Tayside, Scotland (GoDARTS) cohort (n=4309). Replication was observed at rs7675300 (OR=1.32 (1.01-1.70), P=0.04) in eMERGE and at rs16870989 and rs1495509 (OR=1.15 (1.01-1.30), P=0.03 for both) in GoDARTS. The combined association at rs1495509 was significant (OR=1.23 (1.15-1.32), P=1.9 × 10(-9)). These results indicate that SNPs in KCNIP4 may modulate ACEi-induced cough risk.

  15. In vivo antitussive activity of Coccinia grandis against irritant aerosol and sulfur dioxide-induced cough model in rodents

    Directory of Open Access Journals (Sweden)

    Shakti Prasad Pattanayak and Priyashree Sunita

    2009-12-01

    Full Text Available Coccinia grandis (Cucurbitaceae has extensively used to get relief from asthma and cough by the indigenous people of India. The antitussive effect of aerosols of two different concentrations (2.5%, 5% w/v of methanol extract of C. grandis fruits were tested by counting the numbers of coughs produced due to aerosols of citric acid, 10 min after exposing the male guinea pigs to aerosols of test solutions for 7 min. In another set of experiment methanol extract was investigated for its therapeutic efficacy on a cough model induced by sulfur dioxide gas in mice. The results showed significant reduction of cough number obtained in the presence of both concentrations of methanol extract as that of the prototype antitussive agent codeine phosphate. Also, methanol extract exhibited significant antitussive effect at 100, 200 and 400 mg/kg, per orally by inhibiting the cough by 20.57, 33.73 and 56.71% within 90 min of performing the experiment respectively.

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

    Institute of Scientific and Technical Information of China (English)

    刘立新

    2011-01-01

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

  17. Safety and efficacy analysis of PHOTIFED-M Children Cough Syrup for children cough%澳特斯小儿止咳露治疗小儿咳嗽的疗效及安全性分析

    Institute of Scientific and Technical Information of China (English)

    刘静慧

    2011-01-01

    Objective To explore the efficacy and safety of PHOTIFED-M Children Cough Syrup for Children Cough.Methods 80 patients with respiratory infections and moderate to severe cough were divided into experimental group and control group by number of parity.The experimental group was given PHOTIFED-M Children Cough Syrup,and the control group was given Compound Children Cough Syrup.The treatment effect,time of symptoms disappearance,and adverse reactions were observed.Results The experimental group had higher efficacy,shorter symptoms disappeared time,and fewer adverse reactions (P<0.05).Concltsion PHOTIFED-M Children Cough Syrup has a good effect,is safe and suitable for children.It is worth to be used in the pediatric clinic.%目的 探讨澳特斯小儿止咳露治疗小儿咳嗽的疗效及安全性.方法 将80例呼吸道感染伴中度以上咳嗽患儿按就诊号奇偶分成试验组和对照组,试验组给予澳特斯小儿止咳露治疗,对照组给予复方小儿止咳露,观察两组治疗效果、症状消失时间及不良反应情况.结果 试验组总有效率、症状消失时间及不良反应发生率方面均优于对照组.结论 澳特斯小儿止咳露是一种适合小儿服用、疗效较好、安全可靠的的化痰止咳剂,值得在儿科临床中推广使用.

  18. Pediatric Cough Mixture in the Treatment of Children with Cough Variant Asthma%小儿肺咳合剂治疗儿童咳嗽变异性哮喘

    Institute of Scientific and Technical Information of China (English)

    刘丹丹

    2015-01-01

    Objective To explore pediatric lung cough mixture treating children cough variant asthma effect. Method Choose 100 cases of children cough variant asthma were divided into two groups,which give control group routine treatment,while the observation group with pediatric lung cough mixture treatment,analysis of therapeutic effect. Results Treatment group total effective rate was 94%,and the total effective rate was 80%in the control group treatment,compare the difference between groups was statistical y significant(P<0.05). Conclusion The clinical use of pediatric lung cough mixture treating children cough variant asthma,less adverse reaction,the effect is remarkable,is worth promoting.%目的:探析小儿肺咳合剂治疗儿童咳嗽变异性哮喘的效果。方法选取咳嗽变异性哮喘患儿100例分为两组,其中给予对照组常规治疗,而观察组则运用小儿肺咳合剂治疗,对比分析治疗效果。结果观察组的治疗总有效率为94%,而对照组的治疗总有效率为80%,组间比较差异有统计学意义(P<0.05)。结论临床上运用小儿肺咳合剂治疗儿童咳嗽变异性哮喘,不良反应小、效果显著,值得推广。

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

    Institute of Scientific and Technical Information of China (English)

    李兰; 樊红; 何海兰; 李敏; 陈昌辉

    2012-01-01

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

  20. A Numerical Model of Viscoelastic Layer Entrainment by Airflow in Cough

    Science.gov (United States)

    Mitran, Sorin M.

    2008-07-01

    Coughing is an alternative mode of ensuring mucus clearance in the lung when normal cilia induced flow breaks down. A numerical model of this process is presented with the following aspects. (1) A portion of the airway comprising the first three bronchus generations is modeled as radially reinforced elastic tubes. Elasticity equations are solved to predict airway deformation under effect of airway pressure. (2) The compressible, turbulent flow induced by rapid lung contraction is modeled by direct numerical simulation for Reynolds numbers in the range 5,000-10,000 and by Large Eddy Simulation for Reynolds numbers in the range 5,000-40,000. (3) A two-layer model of the airway surface liquid (ASL) covering the airway epithelial layer is used. The periciliary liquid (PCL) in direct contact with the epithelial layer is considered to be a Newtonian fluid. Forces modeling cilia beating can act upon this layer. The mucus layer between the PCL and the interior airflow is modeled as an Oldroyd-B fluid. The overall computation is a fluid-structure interaction simulation that tracks changes in ASL thickness and airway diameters that result from impulsive airflow boundary conditions imposed at bronchi ends. In particular, the amount of mucus that is evacuated from the system is computed as a function of cough intensity and mucus rheological properties.

  1. [Diagnosis of whooping cough by serology and real-time PCR].

    Science.gov (United States)

    Mikešová, Romana; Stiborová, Ivana; Richter, Josef; Rajnohová Dobiášová, Lucie; Král, Vlastimil

    2013-09-01

    The goal of this study is to summarize the results of the detection of Bordetella pertussis (BP) and Bordetella parapertussis (BPP) by a real-time polymerase chain reaction (RT-PCR) assay and serological methods. In 2008-2010, 73 patients of the Department of Clinical Immunology and Allergology of the Centre for Immunology and Microbiology, Public Health Institute in Ústí nad Labem were screened for pertussis. They were selected according to the WHO and ECDC criteria, i. e. they presented with a persistent cough lasting more than two weeks. Direct detection of BP and BPP DNA from nasopharyngeal wash specimens was performed using a RT PCR assay. The serological responses were evaluated by a direct agglutination test for the detection of total antibodies and by enzyme-linked immunosobent assay (ELISA) for the detection of IgG, IgA, and IgM antibodies against pertussis toxin. Forty-two patients were positive for BP and/or BPP, 19 of them by RT-PCR (group A) and 23 by serology (group B). Ten group A patients (52.6%) were also positive by serology. Our results show that pertussis needs to be a consideration in persistent cough. We believe that increased awareness of the medical community, along with improved laboratory tests will result in increased detection of pertussis that is still considered by many physicians as a childhood infection.

  2. Simultaneous determination of phenylephrine hydrochloride, guaifenesin, and chlorpheniramine maleate in cough syrup by gradient liquid chromatography.

    Science.gov (United States)

    Amer, Sawsan M; Abbas, Samah S; Shehata, Mostafa A; Ali, Nahed M

    2008-01-01

    A simple and reliable high-performance liquid chromatographic method was developed for the simultaneous determination of mixture of phenylephrine hydrochloride (PHENYL), guaifenesin (GUAIF), and chlorpheniramine maleate (CHLO) either in pure form or in the presence of methylparaben and propylparaben in a commercial cough syrup dosage form. Separation was achieved on a C8 column using 0.005 M heptane sulfonic acid sodium salt (pH 3.4 +/- 0.1) and acetonitrile as a mobile phase by gradient elution at different flow rates, and detection was done spectrophotometrically at 210 nm. A linear relationship in the range of 30-180, 120-1800, and 10-60 microg/mL was obtained for PHENYL, GUAIF, and CHLO, respectively. The results were statistically analyzed and compared with those obtained by applying the British Pharmacopoeia (2002) method and showed that the proposed method is precise, accurate, and can be easily applied for the determination of the drugs under investigation in pure form and in cough syrup formulations.

  3. Afebrile pneumonia (whooping cough syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007

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    Dolly Villegas

    2012-06-01

    Full Text Available Introduction: Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries. Objective: To describe children with afebrile pneumonia syndrome.Methods: Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the child’s birth, breastfeeding, vaccination status, symptoms, signs, diagnosis, treatment, and complications.Results: We evaluated 101 children with this entity, noting a stationary presentation: June-August and NovemberDecember. A total of 73% of the children were under 4 months of age; the most common symptoms were: cyanotic and spasmodic cough (100%, respiratory distress (70%, and unquantified fever (68%. The most common findings: rales (crackles (50%, wheezing and expiratory stridor (37%; 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the children received macrolides. Conclusions: These data support the hypothesis that most of these patients acquired the disease by airway, possibly caused by viral infection and did not require the indiscriminate use of macrolides.

  4. Leicester Cough Questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil.

    Science.gov (United States)

    Felisbino, Manuela Brisot; Steidle, Leila John Marques; Gonçalves-Tavares, Michelle; Pizzichini, Marcia Margaret Menezes; Pizzichini, Emilio

    2014-01-01

    To translate the Leicester Cough Questionnaire (LCQ) to Portuguese and adapt it for use in Brazil. Cross-cultural adaptation of a quality of life questionnaire requires a translated version that is conceptually equivalent to the original version and culturally acceptable in the target country. The protocol used consisted of the translation of the LCQ to Portuguese by three Brazilian translators who were fluent in English and its back-translation to English by another translator who was a native speaker of English and fluent in Portuguese. The back-translated version was evaluated by one of the authors of the original questionnaire in order to verify its equivalence. Later in the process, a provisional Portuguese-language version was thoroughly reviewed by an expert committee. In 10 patients with chronic cough, cognitive debriefing was carried out in order to test the understandability, clarity, and acceptability of the translated questionnaire in the target population. On that basis, the final Portuguese-language version of the LCQ was produced and approved by the committee. Few items were questioned by the source author and revised by the committee of experts. During the cognitive debriefing phase, the Portuguese-language version of the LCQ proved to be well accepted and understood by all of the respondents, which demonstrates the robustness of the process of translation and cross-cultural adaptation. The final version of the LCQ adapted for use in Brazil was found to be easy to understand and easily applied.

  5. A randomized, placebo-controlled, double-blind trial on the management of post-infective cough by inhaled ipratropium and salbutamol administered in combination.

    Science.gov (United States)

    Zanasi, Alessandro; Lecchi, Marzia; Del Forno, Manuela; Fabbri, Elisa; Mastroroberto, Marianna; Mazzolini, Massimiliano; Pisani, Lara; Pandolfi, Paolo; Nava, Stefano; Morselli-Labate, Antonio Maria

    2014-12-01

    Post-viral cough is a type of cough originating from upper respiratory tract infections that persists after the infection is resolved. Although it was hypothesized that bronchodilators might have a role in the management of post-viral cough, a clear demonstration of their efficacy is missing. Therefore, we tested the efficacy of a combination of a β-agonist and an anticholinergic agent in reducing post-viral cough with a randomized, double blind, placebo controlled clinical trial. Patients were treated for 10 days with either a nebulized combination of salbutamol 1.875 mg/0.5 mL and ipratropium bromide 0.375 mg/0.5 mL, or a placebo, and followed up for another 10 days. Daytime and nighttime cough severity and spirometry testing were assessed before starting treatment, after 10 and 20 days. Ninety-two patients were randomized to receive placebo (n = 46) or the active treatment (n = 46); nine of them (4 in the placebo group, 5 in the active treatment group) dropped out from the study. Daytime and nighttime cough severity were significantly reduced in both groups during the study period, but the reduction was more prominent in the active treatment group vs. placebo after 10 days of treatment (P = 0.003 for day cough; P = 0.061 for night cough), whereas at the end of follow-up period cough severity was comparable between the two groups. Small but significant increases in spirometric parameters were observed in the active treatment vs. placebo group, although at the end of follow-up these values returned to be comparable to placebo. The frequency of adverse events was not significantly different between the two groups of patients. We concluded that a combination of a β-agonist and an anticholinergic agent can effectively reduce post-viral cough, and can thus represent a valid option for this type of cough.

  6. Treating Child Cough through Spleen and Kidney%从脾肾论治小儿咳嗽

    Institute of Scientific and Technical Information of China (English)

    李宏宇

    2012-01-01

    Cough is a common disease in children, Based on the children's special physiological and pathological conditions, this paper discusses the treatments of child cough through the spleen and kidney and then types the disease into different patterns.%咳嗽是儿科常见疾病,文章从小儿特殊的生理病理出发,由脾肾论治小儿咳嗽,对从脾肾论治的小儿咳嗽病症进行了分型和讨论.

  7. [An introduction to literature on infantile asthmatic coughing in the period of Sui - Tang to Song dynasties].

    Science.gov (United States)

    Wan, F; Liu, Y

    2000-07-01

    Records in Zhu bing yuan hou lun are the primary accumulation of materials on infantile asthmatic coughing. The material from Bei ji qian jin yao fang and Qian jin yi fang were based on the author's life - long practical experience and applied by later generations. The guideline based on differential diagnosis of zheng for treating this ailment was established by Xiao er yao zheng zhi jue. While You you xin shu contains the most rich and detailed materials for this ailment before the Song dynasty, which, exerting profound influence on later generations in this field, is a milestone in the history of academic development of infantile asthmatic coughing.

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

    余刚; 李昌崇; 张海邻

    2008-01-01

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

  10. Effects of four antitussives on airway neurogenic inflammation in a guinea pig model of chronic cough induced by cigarette smoke exposure.

    Science.gov (United States)

    Luo, Yu-long; Li, Pei-bo; Zhang, Chen-chen; Zheng, Yan-fang; Wang, Sheng; Nie, Yi-chu; Zhang, Ke-jian; Su, Wei-wei

    2013-12-01

    The effects of four antitussives, including codeine phosphate (CP), moguisteine, levodropropizine (LVDP) and naringin, on airway neurogenic inflammation and enhanced cough were investigated in guinea pig model of chronic cough. Guinea pigs were exposed to CS for 8 weeks. At the 7th and 8th week, the animals were treated with vehicle, CP (4.8 mg/kg), moguisteine (24 mg/kg), LVDP (14 mg/kg) and naringin (18.4 mg/kg) respectively. Then the cough and the time-enhanced pause area under the curve (Penh-AUC) during capsaicin challenge were recorded. The substance P (SP) content, NK-1 receptor expression and neutral endopeptidase (NEP) activity in lung were determined. Chronic CS exposure induced a bi-phase time course of cough responsiveness to capsaicin. Eight weeks of CS exposure significantly enhanced the airway neurogenic inflammation and cough response in guinea pigs. Two weeks of treatment with CP, moguisteine, LVDP or naringin effectively attenuated the chronic CS-exposure enhanced cough. Only naringin exerted significant effect on inhibiting Penh-AUC, SP content and NK-1 receptor expression, as well as preventing the declining of NEP activity in lung. Chronic CS-exposed guinea pig is suitable for studying chronic pathological cough, in which naringin is effective on inhibiting both airway neurogenic inflammation and enhanced cough.

  11. Asthma, smoking and chronic cough in rural and urban adult communities in The Gambia.

    Science.gov (United States)

    Walraven, G E; Nyan, O A; Van Der Sande, M A; Banya, W A; Ceesay, S M; Milligan, P J; McAdam, K P

    2001-11-01

    Asthma is reported to be rare in traditional rural communities, but is thought to be increasing as lifestyles become more urbanized or 'western'. A community-based survey of non-communicable diseases was conducted from October 1996 to June 1997, and included comparison of the prevalence of asthma, smoking and chronic cough in rural and urban Gambia. A cluster sample survey was conducted in a random sample of rural and urban adults (> or = 15 years of age). Subjects were asked about respiratory symptoms using a locally adapted version based on the IULTD questionnaire. Spirometry (basal, methacholine provocation and reversibility with a bronchodilator) and skin prick tests were performed on a randomly selected subsample of all subjects and those who, when interviewed, said they wheezed or had been diagnosed as asthmatic by a doctor. Out of 2166 participants in the urban population, 4.1% reported having had wheezing or whistling in the chest in the previous 12 months, 3.6% reported doctor-diagnosed asthma, and 0.6% chronic cough. In the rural population with 3223 participants these figures were 3.3%, 0.7% and 1.2%, respectively. Wheeze was more common in women, cough for 3 months of the year was more common in the age-groups 45+. Those who reported that they currently smoked accounted for 34% in urban and 42% in rural men. Figures were much lower for women (1.5% and 6.0%). Seven out of 574 randomly selected subjects (1.4%) exhibited bronchial hyper-responsiveness to methacholine challenge. Four of 133 (3.0%) people with self-reported wheeze and 3/69 (4.3%) participants with doctor-diagnosed asthma reacted positively on bronchial provocation with methacholine. There was a remarkably high prevalence of positive skin prick tests to aeroallergens: 38% in participants with a history of wheeze and 27% in those without. The prevalence of wheeze (particularly in association with bronchial hyper-responsiveness) was low in both rural and urban Gambia. This is in contrast to the

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

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    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

  13. Observation of clinical effect by Qinbaohong cough mixture in the treatment of pediatric cough%芩暴红止咳合剂治疗小儿咳嗽的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈洁

    2016-01-01

    目的:探讨芩暴红止咳合剂治疗小儿咳嗽的临床疗效及安全性。方法96例咳嗽患儿,根据诊治方法不同分成观察组和对照组,各48例。对照组给予消炎、抗病毒药物及氨溴索止咳化痰,雾化吸入进行诊治,观察组在对照组基础上给予中药芩暴红止咳合剂治疗。观察两组的临床疗效。结果观察组临床总有效率100.00%高于对照组91.67%(P<0.05)。结论芩暴红止咳合剂具有清泄肺热、平喘止咳之功效,且费用低廉、安全有效,值得临床推广使用。%Objective To investigate clinical effect and safety by Qinbaohong cough mixture in the treatment of pediatric cough. Methods A total of 96 children with pediatric cough were divided by different diagnosis and treatment measures into observation group and control group, with 48 cases in each group. The control group received anti-inflammation, antiviral drugs, and ambroxol for relieving cough and reducing sputum by aerosol inhalation, and the observation group receive additional Qinbaohong cough mixture for treatment. Clinical effects were compared between the two groups.Results The observation group had higher total effective rate as 100.00% than 91.67% in the control group (P<0.05).Conclusion Qinbaohong cough mixture shows effect in eliminating heat from the lung and relieving cough and asthma. This method is low-cost, safe and effective, and it is worth clinical promotion and application.

  14. Professor SUN Yu-xin treats coughing from damp%孙玉信教授从湿论治咳嗽

    Institute of Scientific and Technical Information of China (English)

    刘博; 王鹏; 孙玉信

    2013-01-01

    Professor SUN Yu-xin considers that damp pathogen is an important factor in coughing, and divides coughing into three different types, including Fengshi coughing, Xire coughing and Hanshi coughing. In clinic, herbs of effects in invigorating the spleen, including fried Semen Raphani, raw Semen Coicis, Pericarpium Citri Reticulatae and Poria are added, and satisfied efficacy is achieved.%  孙玉信教授认为湿邪是咳嗽的重要病因,并将湿邪咳嗽主要分为风湿咳嗽、湿热咳嗽和寒湿咳嗽,临床治疗中多加用炒卜子、生薏苡仁、陈皮、茯苓等健脾胃的药物,取得良好的疗效。

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

    Science.gov (United States)

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

    2016-09-01

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

  16. 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.

  17. Prospective study of the efficacy of antibiotics versus antitussive drugs for the management of URTI-related acute cough in children.

    Science.gov (United States)

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

    2016-01-01

    Acute cough is one of the most frequent symptoms prompting a visit to a health care provider, usually following a viral upper respiratory tract infection (URTI). The disproportionate use of antibiotics in children with URTIs, recently highlighted in the medical literature, could lead to associated side effects, without any beneficial effect. Although an early, albeit inappropriate, antibiotic prescription increases parental satisfaction, URTIs are predominantly viral infections and are generally self-limiting. Therefore the aim of this study was to analyze the effectiveness of antibiotics compared to symptomatic drugs (central and peripheral antitussives) on URTI-related cough in a pediatric population. This is a prospective observational study of 330 children who required pediatric consultation for acute cough. Severity, frequency and type of cough were assessed at baseline and after 6 days of treatment (antitussives n = 123, antibiotics n = 89 or combination of them n = 38) or no treatment (n = 80). The outcome of cough management after 6 days was analyzed in terms of resolution, improvement, no change or worsening of symptoms. Study assessments were performed using a standardized questionnaire administered to parents. Between children treated with antitussives or antibiotics, there was a statistically significant difference in the resolution of cough. Moreover, if considering peripheral antitussives, the resolution of cough was significantly higher with antitussives than with antibiotics (p cough resolution between children treated with antitussives and those receiving a combination of antibiotics and antitussives, either central and peripheral antitussives. Antibiotics are generally not useful nor appropriate in treating acute cough due to the common cold. Furthermore, inappropriate antibiotic use introduces the possibility of adverse side effects as well as promotion of antibiotic resistance. The findings of the present study suggest that

  18. 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.

  19. [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.

  20. 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.

  1. Social suffering and anxiety: deciphering coughs and colds at Akan anti-witchcraft shrines in Paris.

    Science.gov (United States)

    Parish, Jane

    2011-12-01

    In treating illness and suffering, the Akan anti-witchcraft shrine is often presented as a model of unchanging, tightly bounded and antiquated ideals. This fails to acknowledge the extensive repertoire of Ghanaian witchcraft discourses and contemporary divinatory practices uncovered at Akan anti-witchcraft shrines. This paper analyses how one of the most popular Akan anti-witchcraft shrine in Europe, in an eastern banlieue of Paris, diagnoses the seemingly common and innocuous coughs and colds suffered by recently arrived, unskilled female Ghanaian migrants as something more socially and economically malignant, witchcraft. Successful treatment combines divinatory techniques, paracetamol medicines and positive thinking in order to empower clients and present them with the possibility of new social and gainful employment prospects.

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

    Directory of Open Access Journals (Sweden)

    Hemang Yadav

    2016-01-01

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

  3. [New insights into the role of pholcodine in the treatment of cough in 2013?].

    Science.gov (United States)

    Blanchard, Elodie; Tunon de Lara, Manuel

    2013-01-01

    Pholcodine is an opioid that has been widely used worldwide since 1950 for the treatment of non-productive cough in children and adults. The results of early preclinical studies but also those of recent clinical trials have shown the antitussive efficacy of pholcodine to be superior to that of codeine, of longer duration, and with an equivalent or safer toxicity profile. Also, there is no risk of addiction. Concern had been raised over a possible cross-sensitisation with neuromuscular blocking agents. While a recent assessment of the available data by the European Medicines Agency (EMA) has confirmed the favourable risk-benefit ratio of pholcodine, further studies are needed to clear this point.

  4. Purple drank prevalence and characteristics of misusers of codeine cough syrup mixtures.

    Science.gov (United States)

    Agnich, Laura E; Stogner, John M; Miller, Bryan Lee; Marcum, Catherine D

    2013-09-01

    A mixture of codeine cough syrup with alcohol and/or a soft drink known as "purple drank" has gained media attention in recent years as a drug associated with professional athletes and southern rap music. The existing research on purple drank consumption has primarily utilized samples of African Americans residing in the Houston, Texas area. This is the first scholarly study of purple drank use outside of the Houston, Texas area among a general population of young adults, and indicates that purple drank use is not limited to African American males. The findings depict higher odds of the use of purple drank among other racial and ethnic groups, males, and homosexual, bisexual, and transgender college students from urban areas.

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

    Science.gov (United States)

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

    2011-01-01

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

  6. An increase in the threshold of citric acid-induced cough during chest wall vibration in healthy humans.

    Science.gov (United States)

    Kondo, T; Kobayashi, I; Hayama, N; Ohta, Y

    1998-10-01

    This study tested the hypothesis that the afferent input from the respiratory muscles may be involved in the neural mechanisms inducing cough responses. Coughing was evoked in conscious healthy humans by the inhalation of citric acid aerosol of several concentrations either during or not during chest wall vibration (100 Hz) at the right second intercostal space or during vibration of the right thigh. The mean threshold citric acid concentration to induce coughing was significantly higher during chest wall vibration (geometric mean, 131.8 mg/ml) than without vibration (75.9 mg/ml). Vibration after topical anesthesia of the chest wall skin did not significantly change the threshold concentration of citric acid. The threshold citric acid concentration during vibration of the right thigh did not significantly differ from that without vibration. We concluded that inputs from the chest wall afferent, presumably from the intercostal muscle or costovertebral joint, may have an inhibitory effect on the initiation of coughing at the higher neural structure in conscious humans.

  7. Evaluation of microbial and physico-chemical qualities of some cough syrups marketed in Sana’a city, Yemen.

    Directory of Open Access Journals (Sweden)

    Ali G. Al−Kaf

    2015-08-01

    Full Text Available Context: Microbial contamination of cough syrups can bring clinical hazards to the users or patients as well as physical and chemical changes in the product. Aims: To evaluate the microbial and physicochemical characteristics of two hundred samples of four different types of cough syrups marketed in Sana’a city, Yemen. Methods: All collected samples were subjected to the following examinations: the total microbial count, type of isolated microorganisms, physical parameters, and concentration of active ingredients were identified and assessed by standard techniques described in US Pharmacopeia. Results: All the cough syrup samples used contained viable microbial load within acceptable limit according Pharmacopeia specifications. Bacillus subtilis, Micrococcus fulvum, and Staphylococcus epidermidis were the most commonly recovered bacteria. However, Aspergillus niger, Aspergillus fumigatus, Penicillium notatum, Mucor sp., and Aspergillus flavus were the most fungi isolated. The physical properties represented in the appearance, density, and pH of the analyzed samples complied with Pharmacopoeia standards. The concentrations of diphenhydramine HCl (92,51 – 108,78%, pseudoephedrine HCl (94,55 – 109,07%, and triprolidine HCl (98,20 – 104,19% were recorded. Conclusions: All cough syrups marketed in Sana’a City had good microbiological and physico-chemical qualities.

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

    Directory of Open Access Journals (Sweden)

    Zhan-Wei Hu

    2016-01-01

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

  9. Effect of jute dust exposure on ventilatory function and the pertinence of cough and smoking to the response.

    Science.gov (United States)

    Chattopadhyay, B P; Alams, J; Gangopadhyay, P K; Saiyed, H N

    1995-06-01

    The ventilatory capacity of 32 men exposed to jute dust in the jute industry, was estimated at the beginning and end of shifts on the first day and last day of a working week. A detailed occupational, clinical and smoking history was recorded and a more detailed questionnaire on respiratory symptoms was completed prior to the pulmonary function tests. The presence of a productive cough among workers was noted. A mean decrease of forced expiratory volume at one second (FEV1) was observed among workers according to processes, concentration of dust exposure and smoking habit on the first day and last day of the week. The mean difference of values was observed in most of the comparisons but only a few were statistically significant. Low mean values of FEV1 were observed in workers having high dust exposure, a smoking history and productive cough in comparison to the low dust exposure group, non-smokers and workers without cough symptoms. The significant deterioration of FEV1 was found between before shift and after shift values of the low dust exposed group of workers who had a cough and smoking history. The relevance of these factors on the ventilatory function is observed and discussed.

  10. Afebrile pneumonia (whooping cough syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007

    Directory of Open Access Journals (Sweden)

    Dolly Villegas

    2012-06-01

    Full Text Available 14.00 800x600 Normal 0 21 false false false ES-CO X-NONE X-NONE MicrosoftInternetExplorer4 Introduction: Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries. Objective: To describe children with afebrile pneumonia syndrome. Methods: Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the child’s birth, breastfee­ding, vaccination status, symptoms, signs, diagnosis, treatment, and complications. Results: We evaluated 101 children with this entity, noting a stationary presentation: June-August and November- December. A total of 73% of the children were under 4 months of age; the most common symptoms were: cya­notic and spasmodic cough (100%, respiratory distress (70%, and unquantified fever (68%. The most common findings: rales (crackles (50%, wheezing and expiratory stridor (37%; 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the chil­dren received macrolides. Conclusions: These data support the hypothesis that most of these patients acquired the disease by airway, possi­bly caused by viral infection and did not require the indiscriminate use of macrolides.

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

    Science.gov (United States)

    Lin, Horng-Chyuan; Cho, Sang-Heon; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak Bin Abdul; Thanaviratananich, Sanguansak; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Cahill, Camilla L; Hamrosi, Kim K; Wang, De Yun

    2016-07-01

    Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases (APBORD) study was a cross-sectional, observational study which examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across Asia-Pacific using 1 standard protocol. Here we report symptoms, healthcare resource use (HCRU), work impairment, and associated cost in Taiwan.Consecutive participants aged ≥ 18 years presenting to a physician with symptoms meeting the diagnostic criteria for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed surveys detailing respiratory symptoms, HCRU, work productivity, and activity impairment. Costs including direct medical costs and indirect costs associated with lost work productivity were calculated.The study enrolled 1001 patients. AR was the most frequent primary diagnosis (31.2%). A quarter of patients presented with a combination of respiratory diseases, with AR and asthma being the most frequent combination (14.1%). Cough or coughing up phlegm was the primary reason for the medical visit for patients with asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the primary reasons for AR and rhinosinusitis. Specialists were the most frequently used healthcare resource by patients with AR (26.1%), asthma (26.4%), COPD (26.6%), and rhinosinusitis (47.3%). The mean annual cost per patient with a respiratory disease was US$4511 (SD 5395). The cost was almost double for employed patients (US$8047, SD 6175), with the majority attributable to lost productivity.Respiratory diseases have a significant impact on disease burden in Taiwan. Treatment strategies that prevent lost work productivity could greatly reduce the economic burden of these diseases.

  12. [Acellular vaccines (DTPa/dTpa) against whooping cough, protection duration].

    Science.gov (United States)

    Rigo-Medrano, M Vicenta; Mendoza-García, José L; Gimeno-Gascón, Adelina; Roda-Ramón, Jorge; Cremades-Bernabeú, Israel; Antequera-Rodríguez, Pedro; Alcalá-Minagorre, Pedro J; Ortiz-de la Tabla, Victoria; Rodríguez-Díaz, Juan Carlos

    2016-01-01

    An increase in whooping cough in most of the developed countries has been detected in the last decade. To determine whether the administration of dTpa vaccine instead of DTPa fifth dose is contributing to the appearance of these cases. A descriptive study based on cases of whooping cough reported during an epidemic period in the city of Alicante in the first 5 months of 2014. Only pertussis cases confirmed by PCR were included in the study, and only those vaccinated with 5 doses were included in the analysis of the period of protection. A total of 104 cases of pertussis confirmed by PCR were reported, with 85 cases (82%) having had 5 doses of vaccine. The mean time and standard deviation (SD) of protection was 2.1±1.1 years with dTpa, and 5.1±1.5 years with DTPa (p<.001). In the protection, adjusted for age, it was observed that, after 3 years, only 47.6% of people vaccinated with dTpa were still protected, while people vaccinated with DTPa were 100% protected (P<.001). This study found that people who were properly vaccinated against pertussis and received their last re-vaccination dose with dTpa had a shorter period of protection than those who were vaccinated with DTPa. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

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

    Science.gov (United States)

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

    2017-01-01

    Background Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation–exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. Methods We conducted a cross-sectional study of 20 patients with ALS and 20 healthy age-matched and sex-matched volunteers. We used video-recorded flexible transnasal fibre-optic laryngoscopy during MI-E undertaken according to a standardised protocol, applying pressures of ±20 to ±50 cm H2O. Laryngeal movements were assessed from video files. ALS type and characteristics of upper and lower motor neuron symptoms were determined. Results At the supraglottic level, all patients with ALS and bulbar symptoms (n=14) adducted their laryngeal structures during insufflation. At the glottic level, initial abduction followed by subsequent adduction was observed in all patients with ALS during insufflation and exsufflation. Hypopharyngeal constriction during exsufflation was observed in all subjects, most prominently in patients with ALS and bulbar symptoms. Healthy subjects and patients with ALS and no bulbar symptoms (n=6) coordinated their cough well during MI-E. Conclusions Laryngoscopy during ongoing MI-E in patients with ALS and bulbar symptoms revealed laryngeal adduction especially during insufflation but also during exsufflation, thereby severely compromising the size of the laryngeal inlet in some patients. Individually customised settings can prevent this and thereby improve and extend the use of non-invasive MI-E. PMID:27174631

  14. Occurrence of autoantibodies to cilia in lambs with a 'coughing syndrome'.

    Science.gov (United States)

    Niang, M; Rosenbusch, R F; Andrews, J J; Lopez-Virella, J; Kaeberle, M L

    1998-07-31

    A respiratory disease of lambs that has been termed the 'coughing syndrome' has been observed in the mid-western region of the United States of America. Mycoplasma ovipneumoniae (M. ovipneumoniae) and Mycoplasma arginini (M. arginini) were routinely isolated from the respiratory tract of lambs with this disease. A high level of antibodies reactive with ovine cilia of the upper respiratory tract was detected in the sera from many of the lambs in affected flocks but not in sera of lambs from unaffected flocks. The reactivity of these antibodies with cilia was demonstrated by ELISA and confirmed by indirect immunofluorescent staining and western immunoblotting. These antibodies were predominantly of the IgG isotype. They were distinct from cold or warm agglutinins and could be absorbed from the sera with cilia but not with antigens of common bacterial pathogens of the sheep respiratory tract including M. ovipneumoniae, M. arginini, Pasteurella haemolytica, Pasteurella multocida or Neisseria ovis. In addition, their occurrence appeared to be independent of the specific antibodies to M. ovipneumoniae and M. arginini. Western immunoblotting indicated that the antibodies were directed primarily against an antigen with apparent molecular weight of 50 kDa. In one flock from which serial serum samples were collected from the same lambs over a 10-month period, antibodies to ovine cilia developed before the onset of the clinical disease and persisted for a period of several months until most of the lambs had apparently recovered. However, colonization of the respiratory tract of the lambs by M. ovipneumoniae preceded the production of these antibodies. Sequential serum samples taken from another flock, with no known history of this coughing, showed no such antibodies throughout the sampling period. It is suggested that an immunopathologic mechanism involving production of autoantibodies directed against a ciliary antigen of the lambs could be a contributing factor to the

  15. 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.

  16. 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.

  17. Clinical and haematological predictors of antibiotic prescribing for acute cough in adults in Swiss practices--an observational study.

    Science.gov (United States)

    Streit, Sven; Frey, Peter; Singer, Sarah; Bollag, Ueli; Meli, Damian N

    2015-02-06

    Acute cough is a common problem in general practice and is often caused by a self-limiting, viral infection. Nonetheless, antibiotics are often prescribed in this situation, which may lead to unnecessary side effects and, even worse, the development of antibiotic resistant microorganisms worldwide. This study assessed the role of point-of-care C-reactive protein (CRP) testing and other predictors of antibiotic prescription in patients who present with acute cough in general practice. Patient characteristics, symptoms, signs, and laboratory and X-ray findings from 348 patients presenting to 39 general practitioners with acute cough, as well as the GPs themselves, were recorded by fourth-year medical students during their three-week clerkships in general practice. Patient and clinician characteristics of those prescribed and not-prescribed antibiotics were compared using a mixed-effects model. Of 315 patients included in the study, 22% were prescribed antibiotics. The two groups of patients, those prescribed antibiotics and those treated symptomatically, differed significantly in age, demand for antibiotics, days of cough, rhinitis, lung auscultation, haemoglobin level, white blood cell count, CRP level and the GP's license to self-dispense antibiotics. After regression analysis, only the CRP level, the white blood cell count and the duration of the symptoms were statistically significant predictors of antibiotic prescription. The antibiotic prescription rate of 22% in adult patients with acute cough in the Swiss primary care setting is low compared to other countries. GPs appear to use point-of-care CRP testing in addition to the duration of clinical symptoms to help them decide whether or not to prescribe antibiotics.

  18. Efficacy of Add-on Montelukast in Nonasthmatic Eosinophilic Bronchitis: The Additive Effect on Airway Inflammation, Cough and Life Quality

    Institute of Scientific and Technical Information of China (English)

    Wuping Bao; Ping Liu; Zhongmin Qiu; Li Yu; Jingqing Hang; Xiaohua Gao; Xin Zhou

    2015-01-01

    Background:The efficacy of montelukast (MONT),a cysteinyl leukotriene receptor antagonist,in nonasthmatic eosinophilic bronchitis (NAEB),especially its influence on cough associated life quality is still indefinite.We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality,suppressing airway eosinophilia and cough remission in NAEB.Methods:A prospective,open-labeled,multicenter,randomized controlled trial was conducted.Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg,bid) or BUD plus oral MONT (10 μg,qn) for 4 weeks.Leicester cough questionnaire (LCQ) life quality scores,cough visual analog scale (CVAS) scores,eosinophil differential ratio (Eos),and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.Results:The control and MONT groups contained 33 and 32 patients,respectively,with similar baseline characteristics.Significant with-in group improvement in CVAS,LCQ scores,Eos,and ECP was observed in both groups during treatment.After 2-week treatment,add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05).Similar results were seen at 4-week assessment (both P < 0.05).4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).Conclusions:MONT combined with BUD was demonstrated cooperative effects in improvement of life quality,suppression ofeosinophilic inflammation,and cough remission in patients with NAEB.

  19. 苏黄止咳胶囊治疗儿童咳嗽变异性哮喘的临床疗效观察%Clinical observation Suhuang cough capsule in the treatment of children with cough variant asthma

    Institute of Scientific and Technical Information of China (English)

    韩淑慧

    2013-01-01

    目的 通过对苏黄止咳胶囊治疗儿童咳嗽变异性哮喘的疗效进行观察.方法 选取108例儿童咳嗽变异性哮喘者且按照1:1比例将其分为两组,即常规治疗组(对照组)和苏黄止咳胶囊治疗组(试验组)、每组54例,同时对两组患儿临床治疗效果、中医症候改善效果、生活质量等内容进行观察且对所统计的数据加以分析.结果 试验组患儿临床治疗受益率、中医症候改善总有效率高于对照组,P<0.05,临床症状改善时间较对照组缩短,P<0.05.结论 苏黄止咳胶囊治疗儿童咳嗽变异性哮喘效果显著且安全可靠.%Objective To observe the curative effect of Suhuang cough capsule in treatment of children with cough variant asthma. Methods 108 children with cough variant asthma were randomly and evenly divided into two groups. The control group was given the conventional treatment, and the experiment group was treated with Suhuang cough capsule. The clinical outcomes, TCM symptoms, and quality of life were observed and compared between the two groups. Results The clinical benefit rate and total efficiency were higher in the experiment group than in the control group with significant difference ( P <0. 05 ). The improved time of clinical symptoms was obviously shorter in the experiment group than in the control group ( P <0. 05 ). Conclusion Suhuang cough capsule is a safe and reliable method in the treatment of children with cough variant asthma, which is worthy of widely clinical application and deeply study.

  20. 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

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

    Science.gov (United States)

    Turner, Richard D; Bothamley, Graham H

    2016-03-03

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

  2. 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。

  3. Incidence of Captopril–Induced Cough in Newly Diagnosed Hypertensive Patients: Incidence in an Outpatient Medical Clinic Population in Iran in 2011-2012

    Directory of Open Access Journals (Sweden)

    Javad Azimivaghar

    2014-08-01

    Results: The overall incidence of captopril-induced cough was 15.5%, with a significant difference between females and males and obviously a higher rate in females (P=0.017. In addition, cough was significantly more common in females than males in 36- to 45-year-old group (46.42% vs. 24.71%. The incidence of cough after treatment with captopril decreased by increasing age of patients and this reduction in both male and female patients was statistically significant (P

  4. The influence of coughing on cerebrospinal fluid pressure in an in vitro syringomyelia model with spinal subarachnoid space stenosis

    Directory of Open Access Journals (Sweden)

    Martin Bryn A

    2009-12-01

    Full Text Available Abstract Background The influence of coughing, on the biomechanical environment in the spinal subarachnoid space (SAS in the presence of a cerebrospinal fluid flow stenosis, is thought to be an important etiological factor in craniospinal disorders, including syringomyelia (SM, Chiari I malformation, and hydrocephalus. The aim of this study was to investigate SAS and syrinx pressures during simulated coughing using in vitro models and to provide information for the understanding of the craniospinal fluid system dynamics to help develop better computational models. Methods Four in vitro models were constructed to be simplified representations of: 1 non-communicating SM with spinal SAS stenosis; 2 non-communicating SM due to spinal SAS stenosis with a distensible spinal column; 3 non-communicating SM post surgical removal of a spinal SAS stenosis; and 4 a spinal SAS stenosis due to spinal trauma. All of the models had a flexible spinal cord. To simulate coughing conditions, an abrupt CSF pressure pulse (~ 5 ms was imposed at the caudal end of the spinal SAS by a computer-controlled pump. Pressure measurements were obtained at 4 cm intervals along the spinal SAS and syrinx using catheter tip transducers. Results Pressure measurements during a simulated cough, showed that removal of the stenosis was a key factor in reducing pressure gradients in the spinal SAS. The presence of a stenosis resulted in a caudocranial pressure drop in the SAS, whereas pressure within the syrinx cavity varied little caudocranially. A stenosis in the SAS caused the syrinx to balloon outward at the rostral end and be compressed at the caudal end. A >90% SAS stenosis did not result in a significant Venturi effect. Increasing compliance of the spinal column reduced forces acting on the spinal cord. The presence of a syrinx in the cord when there was a stenosis in the SAS, reduced pressure forces in the SAS. Longitudinal pressure dissociation acted to suck fluid and tissue

  5. Predicting the presence of bacterial pathogens in the airways of primary care patients with acute cough

    Science.gov (United States)

    Teepe, Jolien; Broekhuizen, Berna D.L.; Loens, Katherine; Lammens, Christine; Ieven, Margareta; Goossens, Herman; Little, Paul; Butler, Chris C.; Coenen, Samuel; Godycki-Cwirko, Maciek; Verheij, Theo J.M.

    2017-01-01

    BACKGROUND: Bacterial testing of all patients who present with acute cough is not feasible in primary care. Furthermore, the extent to which easily obtainable clinical information predicts bacterial infection is unknown. We evaluated the diagnostic value of clinical examination and testing for C-reactive protein and procalcitonin for bacterial lower respiratory tract infection. METHODS: Through a European diagnostic study, we recruited 3104 adults with acute cough (≤ 28 days) in primary care settings. All of the patients underwent clinical examination, measurement of C-reactive protein and procalcitonin in blood, and chest radiography. Bacterial infection was determined by conventional culture, polymerase chain reaction and serology, and positive results were defined by the presence of Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Bordetella pertussis or Legionella pneumophila. Using multivariable regression analysis, we examined the association of diagnostic variables with the presence of bacterial infection. RESULTS: Overall, 539 patients (17%) had bacterial lower respiratory tract infection, and 38 (1%) had bacterial pneumonia. The only item with diagnostic value for lower respiratory tract infection was discoloured sputum (area under the receiver operating characteristic [ROC] curve 0.56, 95% confidence interval [CI] 0.54–0.59). Adding C-reactive protein above 30 mg/L increased the area under the ROC curve to 0.62 (95% CI 0.59–0.65). For bacterial pneumonia, comorbidity, fever and crackles on auscultation had diagnostic value (area under ROC curve 0.68, 95% CI 0.58–0.77). Adding C-reactive protein above 30 mg/L increased the area under the ROC curve to 0.79 (95% CI 0.71–0.87). Procalcitonin did not add diagnostic information for any bacterial lower respiratory tract infection, including bacterial pneumonia. INTERPRETATION: In adults presenting with acute lower respiratory tract infection, signs, symptoms and C

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

    Directory of Open Access Journals (Sweden)

    Kim, Eun-Gon

    2003-12-01

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

  7. Clinical features of Japanese patients with chronic cough induced by gastroesophageal reflux

    Directory of Open Access Journals (Sweden)

    Katsuya Fujimori

    1997-01-01

    Full Text Available Gastroesophageal reflux (GER has been reported as a cause of chronic cough (CC in the United States. It has been reported that 5–21% of CC cases are induced by GER. In Japan, however, detailed clinical features of CC induced by GER have not been described. The present study reports on six Japanese patients with GER-induced CC. The subjects were all females, with a mean age of 72 years. The average body mass index was 37 kg/m2, indicating obesity. No abnormalities were found with regard to concentrations of C-reactive protein, peripheral eosinophil counts, serum IgE concentrations, serum titers of cold agglutinins or antibodies to Mycoplasma pneumoniae, chest radiograph findings, respiratory function tests or blood gas analyses. Bronchial biopsy was performed in three patients and showed chronic inflammation characterized by lymphocytic infiltration, squamous metaplasia and mucosal basement membrane thickening. In the study population (Japanese patients, GER-induced CC tended to occur in elderly obese women and may be attributable to airway inflammation.

  8. Attitudes, knowledge and perceptions towards whooping cough and pertussis vaccine in hospitalized adults.

    Science.gov (United States)

    Ridda, Iman; Gao, Zhanhai; Macintyre, C Raina

    2014-02-19

    Whooping cough or pertussis is a major cause of morbidity and mortality for adults and children around the world. There has been a rise in pertussis-related deaths in the elderly; pertussis vaccination is not currently routinely recommended in adults, excepting new parents and other adults household members including grandparents and care-givers of young children. Currently, there is lack of clear vaccine recommendations after the age of 50 years. Given the increase in adult pertussis, adult vaccine recommendations are a policy consideration. The study surveyed a convenience sample of patients previously recruited in a case control study designed to examine the burden of influenza with and without AMI in adults aged ≥ 40 years. Our findings showed that only 9.6% had received the pertussis vaccination within the past five years and 79.4% of participants had no knowledge of the pertussis adult booster vaccine, and 30.7% of participants who had regular contact with children under the age of two years in the past 12 months. The results showed that even though there is general acceptance of prevention by vaccines, there is low awareness about pertussis vaccination. This lack of knowledge presents a barrier against pertussis vaccination thus it is imperative that any future adult immunisation policy recommendations around pertussis vaccine include awareness programs in the target population.

  9. Live attenuated B. pertussis as a single-dose nasal vaccine against whooping cough.

    Directory of Open Access Journals (Sweden)

    Nathalie Mielcarek

    2006-07-01

    Full Text Available Pertussis is still among the principal causes of death worldwide, and its incidence is increasing even in countries with high vaccine coverage. Although all age groups are susceptible, it is most severe in infants too young to be protected by currently available vaccines. To induce strong protective immunity in neonates, we have developed BPZE1, a live attenuated Bordetella pertussis strain to be given as a single-dose nasal vaccine in early life. BPZE1 was developed by the genetic inactivation or removal of three major toxins. In mice, BPZE1 was highly attenuated, yet able to colonize the respiratory tract and to induce strong protective immunity after a single nasal administration. Protection against B. pertussis was comparable to that induced by two injections of acellular vaccine (aPV in adult mice, but was significantly better than two administrations of aPV in infant mice. Moreover, BPZE1 protected against Bordetella parapertussis infection, whereas aPV did not. BPZE1 is thus an attractive vaccine candidate to protect against whooping cough by nasal, needle-free administration early in life, possibly at birth.

  10. A 66-year-old woman with fever, cough, and a tongue lesion.

    Science.gov (United States)

    Gandhi, Viral; Singh, Amteshwar; Woods, Gail L; Epelbaum, Oleg

    2015-04-01

    A 66-year-old woman presented with acute onset of fever, chills, and productive cough associated with right-sided chest pain. During a recent hospitalization for dyspnea, she had been diagnosed with Coombs-positive autoimmune hemolytic anemia and had been taking a tapering dose of prednisone starting approximately 6 weeks prior to admission. In the interim, her dyspnea had resolved on treatment with steroids. At the time of presentation, her prednisone dose was 40 mg. Additional medical history included VTE, for which the patient was receiving anticoagulation therapy, and steroid-induced diabetes mellitus. Many years earlier, she had been treated for TB in her home country. The patient had immigrated to Queens, New York, from a Nepalese village 8 years prior. While still in Nepal, she had worked on a farm and had been in close proximity to cows. In Queens, she lived with her family in a house with a small garden but had no pets. Recent travel included a visit to Nepal 9 months ago and a trip to Syracuse, New York, one month prior to presentation. She was a never smoker and did not consume alcohol.

  11. Fat dogs and coughing horses: K-12 programming for veterinary workforce development.

    Science.gov (United States)

    San Miguel, Sandra F; Carleton Parker, Loran; Adedokun, Omolola A; Burgess, Wilella D; Cipriani Davis, Kauline S; Blossom, Thaddaeus D; Schneider, Jessica L; Mennonno, Ann M; Ruhl, Joseph D; Veatch, Jennifer H; Wackerly, Amy J; Shin, Soo Yeon; Ratliff, Timothy L

    2013-01-01

    Workforce development strategies to educate, inform, and diversify the veterinary profession of the future must begin with children in elementary school. This article provides a description of the Fat Dogs and Coughing Horses program, which takes a multifaceted approach toward informing young students, beginning in first grade, about the interesting work and career opportunities available in the field of veterinary medicine. The program, a collaboration among Purdue University and Indiana public schools, is supported by a Science Education Partnership Award from the Office of Research Infrastructure Programs, a component of the National Institutes of Health. The overall goal of the program is to provide formal and informal educational opportunities for students, parents, teachers, and the public about the science involved in keeping people and their animals healthy. Examples of health concerns that impact both people and their pets are used to inform and excite children about careers in the health sciences. The program resulted in (1) curricula for students in Grades 1-3, 6, and 9; (2) four children's books and a set of collectible cards which highlight veterinarians, veterinary technicians, and research scientists who work with animals; and (3) four traveling museum-level quality exhibits. Preliminary assessment data has shown that the implementation of the curricula enhanced student science learning and science attitudes and interests. The program provides evidence that partnerships among professionals in veterinary medicine and K-12 education can result in impactful workforce development programs.

  12. [Risks of non-prescription medication. Clobutinol cough syrup as a recent example].

    Science.gov (United States)

    Rottlaender, D; Hoppe, U C

    2008-01-01

    The arbitrary use of additional drugs other than prescribed medication is known to be a huge part of drug sales. However, the interactions of such non-prescription medication with any daily medication or concomitant diseases remain often unclear. Recently, in accordance with the decision of the competent authority in Germany, clobutinol (e.g. Silomat), a drug against non-productive cough was withdrawn in all countries worldwide in which this medication had been available. The drug had first been approved in 1961 and estimated to have had 200 million patient exposures. A recent clinical study revealed that clobutinol can prolong the QT interval compared to placebo and may thus cause cardiac tachyarrhythmias. Even in therapeutic doses (240 mg daily) this effect was seen in healthy volunteers. Furthermore, this study was prematurely discontinued because of an epileptic grand mal seizure in one volunteer, suggesting neurological side effects of clobutinol. Clobutinol prolongs the QT interval and may cause life-threatening arrhythmias. This should serve as a warning to doctors to be careful when prescribing non-prescription medication. Non-prescription drugs can be a potential risk for patients who are also taking other pharmaceutical preparations or having concomitant disease. This is because such drugs may cause harmful interactions, most of them previously unknown. All doctors should avoid unsupervised use of non-prescription medication.

  13. High performance liquid chromatographic determination of some guaiphenesin-containing cough-cold preparations

    Directory of Open Access Journals (Sweden)

    Mohamed A. Korany

    2011-04-01

    Full Text Available This paper presents different HPLC methods for the simultaneous determination of some guaiphenesin-containing cough-cold preparations. Three pharmaceutically available combinations were analyzed: salbutamol sulfate (SAL and guaiphenesin (GUA, combination I; ascorbic acid (ASC, paracetamol (PAR and guaiphenesin (GUA, combination II; and theophylline anhydrous (THE, guaiphenesin (GUA and ambroxol hydrochloride (AMB, combination III. A 250 × 4.6 mm C-18 column was used for all combinations. The mobile phase for the three combinations consisted of a mixture of methanol and 0.01 M aqueous phosphate buffer solution. The pH of the mobile phase was adjusted to 3.2, 6.2 and 3.8 for combinations I, II and III, respectively. The proposed HPLC methods were successfully applied to the determination of the investigated drugs, both in synthetic mixtures and in pharmaceutical preparations, without any matrix interference and with high precision and accuracy. Different aspects of analytical validation are presented in the text.

  14. Diagnosis of whooping cough in Switzerland: differentiating Bordetella pertussis from Bordetella holmesii by polymerase chain reaction.

    Science.gov (United States)

    Pittet, Laure F; Emonet, Stéphane; François, Patrice; Bonetti, Eve-Julie; Schrenzel, Jacques; Hug, Melanie; Altwegg, Martin; Siegrist, Claire-Anne; Posfay-Barbe, Klara M

    2014-01-01

    Bordetella holmesii, an emerging pathogen, can be misidentified as Bordetella pertussis by routine polymerase chain reaction (PCR). In some reports, up to 29% of the patients diagnosed with pertussis have in fact B. holmesii infection and invasive, non-respiratory B. holmesii infections have been reported worldwide. This misdiagnosis undermines the knowledge of pertussis' epidemiology, and may lead to misconceptions on pertussis vaccine's efficacy. Recently, the number of whooping cough cases has increased significantly in several countries. The aim of this retrospective study was to determine whether B. holmesii was contributing to the increase in laboratory-confirmed cases of B. pertussis in Switzerland. A multiplex species-specific quantitative PCR assay was performed on 196 nasopharyngeal samples from Swiss patients with PCR-confirmed Bordetella infection (median age: 6 years-old, minimum 21 days-old, maximum 86 years-old), formerly diagnosed as Bordetella pertussis (IS481+). No B. holmesii (IS481+, IS1001-, hIS1001+) was identified. We discuss whether laboratories should implement specific PCR to recognize different Bordetella species. We conclude that in Switzerland B. holmesii seems to be circulating less than in neighboring countries and that specific diagnostic procedures are not necessary routinely. However, as the epidemiological situation may change rapidly, periodic reevaluation is suggested.

  15. Diagnosis of whooping cough in Switzerland: differentiating Bordetella pertussis from Bordetella holmesii by polymerase chain reaction.

    Directory of Open Access Journals (Sweden)

    Laure F Pittet

    Full Text Available Bordetella holmesii, an emerging pathogen, can be misidentified as Bordetella pertussis by routine polymerase chain reaction (PCR. In some reports, up to 29% of the patients diagnosed with pertussis have in fact B. holmesii infection and invasive, non-respiratory B. holmesii infections have been reported worldwide. This misdiagnosis undermines the knowledge of pertussis' epidemiology, and may lead to misconceptions on pertussis vaccine's efficacy. Recently, the number of whooping cough cases has increased significantly in several countries. The aim of this retrospective study was to determine whether B. holmesii was contributing to the increase in laboratory-confirmed cases of B. pertussis in Switzerland. A multiplex species-specific quantitative PCR assay was performed on 196 nasopharyngeal samples from Swiss patients with PCR-confirmed Bordetella infection (median age: 6 years-old, minimum 21 days-old, maximum 86 years-old, formerly diagnosed as Bordetella pertussis (IS481+. No B. holmesii (IS481+, IS1001-, hIS1001+ was identified. We discuss whether laboratories should implement specific PCR to recognize different Bordetella species. We conclude that in Switzerland B. holmesii seems to be circulating less than in neighboring countries and that specific diagnostic procedures are not necessary routinely. However, as the epidemiological situation may change rapidly, periodic reevaluation is suggested.

  16. Cough variant asthma%咳嗽变异型哮喘

    Institute of Scientific and Technical Information of China (English)

    蒋超英

    1999-01-01

    @@ 支气管哮喘的主要临床表现有发作性呼吸困难、喘息、咳嗽和两肺闻及广泛的哮鸣音.对于具备上述典型临床表现的支气管哮喘确诊并不困难.但有部分哮喘者仅表现为长期顽固性咳嗽,无发作性呼吸困难,并且肺部听诊缺乏哮鸣音,而被称为咳嗽变异型哮喘 (Cough variant asthma,CVA)[1].目前认为这类哮喘是早期支气管哮喘的一种特殊临床类型[2].自1981年CVA的概念正式提出以来,日益受到临床工作者的重视,对CVA的诊断提出了较系统的方法步骤,从而可减少对CVA病人的误诊.

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

    Directory of Open Access Journals (Sweden)

    Cynthia Wong, BMBS

    2016-09-01

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

  18. Content validity of CASA-Q cough domains and UCSD-SOBQ for use in patients with Idiopathic Pulmonary Fibrosis.

    Science.gov (United States)

    Gries, Katharine Suzanne; Esser, Dirk; Wiklund, Ingela

    2013-09-16

    The study objective was to assess the content validity of the Cough and Sputum Assessment Questionnaire (CASA-Q) cough domains and the UCSD Shortness of Breath Questionnaire (SOBQ) for use in patients with Idiopathic Pulmonary Fibrosis (IPF). Cross-sectional, qualitative study with cognitive interviews in patients with IPF. Study outcomes included relevance, comprehension of item meaning, understanding of the instructions, recall period, response options, and concept saturation. Interviews were conducted with 18 IPF patients. The mean age was 68.9 years (SD 11.9), 77.8% were male, and 88.9% were Caucasian. The intended meaning of the CASA-Q cough domain items was clearly understood by most of the participants (89-100%). All participants understood the CASA-Q instructions; the correct recall period was reported by 89% of the patients, and the response options were understood by 76%. The intended meaning of the UCSD-SOBQ items was relevant and clearly understood by all participants. Participants understood the instructions (83%) and all patients understood the response options (100%). The reported recall period varied based on the type of activity performed. No concepts were missing, suggesting that saturation was demonstrated for both measures. This study provides evidence for content validity for the CASA-Q cough domains and the UCSD-SOBQ for patients with IPF. Items of both questionnaires were understood and perceived as relevant to measure the key symptoms of IPF. The results of this study support the use of these instruments in IPF clinical trials as well as further studies of their psychometric properties.

  19. Protective effect of levodropropizine against cough induced by inhalation of nebulized distilled water in patients with obstructive lung disease.

    Science.gov (United States)

    Bariffi, F; Tranfa, C; Vatrella, A; Ponticiello, A

    1992-01-01

    Levodropropizine is a recently developed, peripherally active antitussive agent which is widely used in clinical practice. In order to obtain further information on the spectrum of activity of this compound in experimental clinical models, a double-blind controlled study was carried out to evaluate the potential effect of the drug against cough and bronchoconstriction induced by inhalation of an ultrasonically nebulized solution of distilled water in patients with obstructive lung disease. Twenty patients were randomly divided into two groups, which received levodropropizine (60 mg t.i.d.) or placebo respectively for 7 consecutive days. Parameters evaluated at baseline and on the last day of treatment included (i) results of respiratory function tests (FEV1, IVC, FVC, TIFF, PEF, MEF75, MEF50, MEF25) performed before the stimulation test with nebulized water; (ii) total number of coughs during a 2-hour period after the stimulation test; (iii) bronchial responsiveness, quantified by calculating the volume of nebulized water required to induce a 20% reduction of FEV1 below the basal level. At pretreatment, the tussive response was very similar in the two groups. A significant decrease in number of coughs (from 34.4 +/- 8.4 at baseline to 15.6 +/- 4.9 post-treatment, p less than 0.01) was observed after administration of levodropropizine, whereas placebo treatment produced no significant effect (number of coughs: 29.6 +/- 4.9 at baseline vs 24.8 +/- 9.6 post-treatment, N.S.). Bronchial responsiveness decreased significantly (compared to baseline) in both treatment groups, without any significant difference between drug and placebo. Respiratory function tests were not significantly affected by either treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. LONGITUDINAL ASSOCIATION BETWEEN RESPIRATORY MUSCLE STRENGTH AND COUGH CAPACITY IN PERSONS WITH SPINAL CORD INJURY : AN EXPLORATIVE ANALYSIS OF DATA FROM A RANDOMIZED CONTROLLED TRIAL

    NARCIS (Netherlands)

    Postma, Karin; Vlemmix, Lonneke Y.; Haisma, Janneke A.; de Groot, Sonja; Sluis, Tebbe A. R.; Stam, Henk J.; Bussmann, Johannes B. J.

    2015-01-01

    Objective: To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. Design: Longitudinal analyses. Subjects: Forty persons with recent spinal cord injury and impaired pulmonary function. Methods: Measurements were perfor

  1. LONGITUDINAL ASSOCIATION BETWEEN RESPIRATORY MUSCLE STRENGTH AND COUGH CAPACITY IN PERSONS WITH SPINAL CORD INJURY : AN EXPLORATIVE ANALYSIS OF DATA FROM A RANDOMIZED CONTROLLED TRIAL

    NARCIS (Netherlands)

    Postma, Karin; Vlemmix, Lonneke Y.; Haisma, Janneke A.; de Groot, Sonja; Sluis, Tebbe A. R.; Stam, Henk J.; Bussmann, Johannes B. J.

    2015-01-01

    Objective: To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. Design: Longitudinal analyses. Subjects: Forty persons with recent spinal cord injury and impaired pulmonary function. Methods: Measurements were perfor

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

    Institute of Scientific and Technical Information of China (English)

    王屹; 崔振泽; 黄燕

    2011-01-01

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

  3. LONGITUDINAL ASSOCIATION BETWEEN RESPIRATORY MUSCLE STRENGTH AND COUGH CAPACITY IN PERSONS WITH SPINAL CORD INJURY : AN EXPLORATIVE ANALYSIS OF DATA FROM A RANDOMIZED CONTROLLED TRIAL

    NARCIS (Netherlands)

    Postma, Karin; Vlemmix, Lonneke Y.; Haisma, Janneke A.; de Groot, Sonja; Sluis, Tebbe A. R.; Stam, Henk J.; Bussmann, Johannes B. J.

    Objective: To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. Design: Longitudinal analyses. Subjects: Forty persons with recent spinal cord injury and impaired pulmonary function. Methods: Measurements were

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

    Science.gov (United States)

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

    2017-01-01

    Objectives To investigate the efficacy and safety of CS1002, an over-the-counter cough treatment containing diphenhydramine, ammonium chloride and levomenthol in a cocoa-based demulcent. Design A multicentre, randomised, parallel group, controlled, single-blinded study in participants with acute upper respiratory tract infection-associated cough. Setting 4 general practitioner (GP) surgeries and 14 pharmacies in the UK. Participants Participants aged ≥18 years who self-referred to a GP or pharmacist with acute cough of <7 days' duration. Participant inclusion criterion was cough severity ≥60 mm on a 0–100 mm visual analogue scale (VAS). Exclusion criteria included current smokers or history of smoking within the past 12 months (including e-cigarettes). 163 participants were randomised to the study (mean participant age 38 years, 57% females). Interventions Participants were randomised to CS1002 (Unicough) or simple linctus (SL), a widely used cough treatment, and treatment duration was 7 days or until resolution of cough. Main outcome measures The primary analysis was intention-to-treat (157 participants) and comprised cough severity assessed using a VAS after 3 days' treatment (prespecified primary end point at day 4). Cough frequency, sleep disruption, health status (Leicester Cough Questionnaire (LCQ-acute)) and cough resolution were also assessed. Results At day 4 (primary end point), the adjusted mean difference (95% CI) in cough severity VAS between CS1002 and SL was −5.9 mm (−14.4 to 2.7), p=0.18. At the end of the study (day 7) the mean difference in cough severity VAS was −4.2 mm (−12.2 to 3.9), p=0.31. CS1002 was associated with a greater reduction in cough sleep disruption (mean difference −11.6 mm (−20.6 to 2.7), p=0.01) and cough frequency (mean difference −8.1 mm (−16.2 to 0.1), p=0.05) compared with SL. There was greater improvement in LCQ-acute quality of life scores with CS1002 compared with SL: mean

  5. Comparison of Usefulness of Ketamine and Magnesium Sulfate Nebulizations for Attenuating Postoperative Sore Throat, Hoarseness of Voice, and Cough.

    Science.gov (United States)

    Rajan, Sunil; Malayil, George Jacob; Varghese, Rekha; Kumar, Lakshmi

    2017-01-01

    Postoperative sore throat (POST) is a complication that is unresolved in patients undergoing endotracheal intubation. To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths, on the incidence and severity of POST, hoarseness, and cough. Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospective, randomized, double-blinded study. Patients in each group were nebulized with the respective study drug 15 min prior to the surgery, i.e., ketamine in Group K, magnesium sulfate 250 mg, and 500 mg in Group M1 and Group M2, respectively, and normal saline as control in Group C. A standardized anesthesia protocol was followed for all patients. After extubation, the patients were asked to grade POST, hoarseness, and cough at 0, 2, 4, 12, and 24 h. One-way analysis of variance, Chi-square test, Fisher's exact test, paired t-tests, and Wilcoxon's signed-rank test as applicable. Ketamine and magnesium sulfate 500 mg demonstrated a statistically significant decrease in POST at 0, 2, and 4 h, and postoperative hoarseness at 0 h. There was decrease in the incidence and severity of sore throat, hoarseness, and cough at all periods in the study groups as compared with control. Nebulization with ketamine 50 mg and magnesium sulfate 500 mg, 15 min before induction of general anesthesia and intubation, reduce the incidence and severity of POST and hoarseness of voice.

  6. Effect of Qingqi Huatan decoction on serum indicators and induced sputum indicators in children with cough variant asthma

    Institute of Scientific and Technical Information of China (English)

    Jing Huang

    2016-01-01

    Objective:To analyze the effect of Qingqi Huatan decoction on serum indicators and induced sputum indicators in children with cough variant asthma.Methods:A total of 118 cases of children with cough variant asthma were included for study, and all were treated in our hospital from August 2012 to December 2014. According to random principle, included children were divided into observation group (n=59) and control group (n=59). Control group received conventional treatment, observation group received conventional treatment combined with Qingqi Huatan decoction treatment, and then serum, induced sputum and airway anatomy indicators were compared between two groups.Results:ECP, SP, NGF, IL-5 and IL-13 levels in induced sputum of observation group after treatment were lower than those of control group, and TLR2 level was higher than that of control group; serum MIP-1α, Eotaxin, SAA, SIgE and TIgE values of observation group after treatment were lower than those of control group; serum leukotriene B4, leukotriene C4 and leukotriene D4 levels of observation group after treatment were lower than those of control group; AI, AO, T, WA and WA% values of observation group after treatment were lower than those of control group.Conclusion:Qingqi Huatan decoction for children with cough variant asthma can effectively reduce systemic inflammatory response and allergy-related factor generation and reverse airway remodeling process, and it has active clinical significance.

  7. Airway inflammation, cough and athlete quality of life in elite female cross-country skiers: A longitudinal study.

    Science.gov (United States)

    Kennedy, M D; Davidson, W J; Wong, L E; Traves, S L; Leigh, R; Eves, N D

    2016-07-01

    The aim of this study was to investigate the effect of a season of cross-country training and racing on airway inflammation, cough symptoms, and athlete quality of life in female skiers. Eighteen elite female skiers performed sputum induction and completed the Leicester Cough Questionnaire (LCQ) and the Recovery-Stress Questionnaire (REST-Q) at three time points (T1 - May/Jun, T2 - Oct/Nov, T3 - Jan-Mar) during the year. No changes were observed between T1 and T2. However, an increase in sputum eosinophils and lymphocytes (P < 0.05) and a significant change in all three domains of the LCQ were observed between T1 and T3 (P < 0.05). A significant association was found between the total yearly hours of training and the change in the total cell count (r(2)  = 0.74; P = 0.006), and a number of other sputum cell counts between T1 and T3. No changes were observed for any domain of the REST-Q. The results of this study demonstrate that airway inflammation and cough symptoms are significantly increased in elite female cross-country skiers across a year of training and racing. The increase in airway inflammation is related to the total amount of training and is worse during the winter months when athletes are training and racing in cold, dry air.

  8. Does additional antimicrobial treatment have a better effect on URTI cough resolution than homeopathic symptomatic therapy alone? A real-life preliminary observational study in a pediatric population

    OpenAIRE

    Zanasi, Alessandro; Cazzato, Salvatore; Mazzolini, Massimiliano; Ierna, Carla Maria Sofia; Mastroroberto, Marianna; Nardi, Elena; Morselli-Labate, Antonio Maria

    2015-01-01

    Background The effectiveness of a homeopathic syrup on cough has been demonstrated in an adult population in a previous double-blind randomized study. The present prospective observational study investigated children affected by wet acute cough caused by non-complicated URTIs, comparing those who received the homeopathic syrup versus those treated with the homeopathic syrup plus antibiotic. Objectives The aims were: 1) to assess whether the addition of antibiotics to a symptomatic treatment h...

  9. Survey in the Emergency Department of Parents’ Understanding of Cough and Cold Medication Use in Children Younger Than 2 Years

    Science.gov (United States)

    2012-09-01

    children gave various drug classes including analgesics, antihistamines , antipyretics, cough suppressants, expectorants, and decongestants. One hundred...FACEP,*Þ Vikhyat S. Bebarta, MD, FACEP, FACMT,*þ Rebecca L. Pitotti, MSN, RN,§ and Toni E. Vargas, PA-C§ Objectives: In August 2007, the Food and Drug ...CCM use in children younger than 2 years. Most thought CCMs were safe and effective. KeyWords: cough and cold medications, Food and Drug

  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. Spontaneously Migrated Tip of an Implantable Port Catheter into the Axillary Vein in a Patient with Severe Cough and the Subsequent Intervention to Reposition It

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Kyung Sik; Yoo, Kweon; Cha, In Ho; Seo, Tae Seok [Korea University Guro Hospital, Seoul (Korea, Republic of)

    2008-07-15

    Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring

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

    Institute of Scientific and Technical Information of China (English)

    崔翠林; 张雪

    2015-01-01

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

  13. Prevalence and genotype distribution of Pneumocystis jirovecii in Cuban infants and toddlers with whooping cough.

    Science.gov (United States)

    Monroy-Vaca, Ernesto X; de Armas, Yaxsier; Illnait-Zaragozí, María T; Toraño, Gilda; Diaz, Raúl; Vega, Dania; Alvarez-Lam, Ileana; Calderón, Enrique J; Stensvold, Christen R

    2014-01-01

    This study describes the prevalence and genotype distribution of Pneumocystis jirovecii obtained from nasopharyngeal (NP) swabs from immunocompetent Cuban infants and toddlers with whooping cough (WC). A total of 163 NP swabs from 163 young Cuban children with WC who were admitted to the respiratory care units at two pediatric centers were studied. The prevalence of the organism was determined by a quantitative PCR (qPCR) assay targeting the P. jirovecii mitochondrial large subunit (mtLSU) rRNA gene. Genotypes were identified by direct sequencing of mtLSU ribosomal DNA (rDNA) and restriction fragment length polymorphism (RFLP) analysis of the dihydropteroate synthase (DHPS) gene amplicons. qPCR detected P. jirovecii DNA in 48/163 (29.4%) samples. mtLSU rDNA sequence analysis revealed the presence of three different genotypes in the population. Genotype 2 was most common (48%), followed in prevalence by genotypes 1 (23%) and 3 (19%); mixed-genotype infections were seen in 10% of the cases. RFLP analysis of DHPS PCR products revealed four genotypes, 18% of which were associated with resistance to sulfa drugs. Only contact with coughers (prevalence ratio [PR], 3.51 [95% confidence interval {CI}, 1.79 to 6.87]; P = 0.000) and exposure to tobacco smoke (PR, 1.82 [95% CI, 1.14 to 2.92]; P = 0.009) were statistically associated with being colonized by P. jirovecii. The prevalence of P. jirovecii in infants and toddlers with WC and the genotyping results provide evidence that this population represents a potential reservoir and transmission source of P. jirovecii.

  14. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Cover Your Cough! A Short and Simple Activity to Demonstrate the Antimicrobial Effect of Desiccation

    Directory of Open Access Journals (Sweden)

    Jennifer Cook Easterwood

    2013-08-01

    Full Text Available Many undergraduate microbiology laboratory manuals include exercises demonstrating the antimicrobial effects of physical agents, such as UV light and heat, and chemical agents, such as disinfectants and antibiotics (3, 4. There is, however, a lack of exercises examining the effects of desiccation on bacterial growth and survival. This particular form of antimicrobial control is especially relevant today with an increased emphasis on coughing and sneezing into one’s sleeve or a tissue, where microbes will not contaminate hands and will eventually desiccate and die (2. Desiccation can have bacteriostatic or bactericidal effects depending on the species, the material on which the organism has desiccated, and the length of time. The absence of water can damage many cellular components, including enzymes, nucleic acids, and cell membranes (1. However, many prokaryotes have some degree of resistance to desiccation, with Escherichia coli surviving around 24 hours and Bacillus species surviving upwards of 300 years, though these numbers can vary due to a number of confounding factors (5. Some of these factors include the method by which desiccation occurred, whether desiccation occurred in a natural or laboratory situation, and the species itself (5. To address the effects of desiccation on bacterial growth and survival, a short, simple exercise was developed. By inoculating various materials with bacterial cultures and allowing them to air-dry for 24 hours, students can visualize the effects of desiccation by analyzing the growth, or lack thereof, when organisms are transferred to nutrient agar plates. This exercise has been used in a health professions microbiology course as well as a microbiology course for biology and biochemistry majors. It is short enough to be conducted during a standard lecture period or during a longer laboratory period in conjunction with other experiments demonstrating the effectiveness of physical agents on microbial

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

    Institute of Scientific and Technical Information of China (English)

    张晓波; 农光民

    2011-01-01

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

  18. [Comparative study of two antitussive drugs in the treatment of acute dry cough of infectious origin (prospective, randomized, single blind study)].

    Science.gov (United States)

    Pujet, J C; Keddad, K; Sévenier, F; Jolivet-Landreau, I

    2002-01-01

    The objective was to compare, during a 5-day therapy, the efficacy and tolerability of an antihistaminic antitussive syrup, oxomemazine, combining a small quantity of guaifenesine (T), with a centrally acting antitussive, clobutinol (S), in adult patients aged from 18 to 70 years and presenting with a dry cough of infectious origin. This study was performed by 22 general practitioners and 130 ambulatory patients were enrolled. The primary criterion of this multicenter, randomized, single blind study was to compare the evolution of cough intensity using a Visual Analog Squale (VAS) graduated from 0 to 10 cm. Nine secondary criteria including tolerability were also assessed. With regard to cough intensity, the treatments were not equivalent. A greater reduction was observed with T (-5.2 +/- 2.3 versus -4.3 +/- 2.3). This result was confirmed by a further reduction in cough intensity at days: 2 (p = 0.04), 4 (p = 0.05), and 5 (p = 0.02). The frequency of cough disappearance before the end of the study was significantly greater for T than for S: 46% versus 29% (p = 0.05). The time before disappearance of the cough was 4.0 + 1.1 days for both medicines. Induction of sleep and the frequency of nocturnal wakening were significantly better for T from day 4 (p = 0.02). The drowsiness induced by T meant that diurnal quality of life was better with S on days 1 (p = 0.002) and 2 (p = 0.01). Tolerability was similar for both medicines. In conclusion, as a symptomatic treatment of dry cough, T is efficient and well tolerated. Moreover, we have observed a tendency towards superior efficacy of T than S. T is therefore a useful alternative in the therapeutic armamentarium available to the general practitioner.

  19. 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

  20. 浅谈小儿百日咳的治疗%To Explore the Treatment of Children With Whooping Cough

    Institute of Scientific and Technical Information of China (English)

    史湘英

    2015-01-01

    Objective To explore the treatment of children with whooping cough.MethodsRetrospective analysis of 30 cases with pertussis from 2012 January to 2014 January in our hospital.Results 30 children were completely cured and no serious had complications. There were 22 cases with convulsive cough and the symptoms disappeared during 1 to 2 months. there were 8 cases with no spasm cough symptoms.Conclusion Pertussis is a common respiratory disease in infant. It is effective to improve the affections of therapeutic and to alleviate the suffering of children by early detection and treatment.%目的:对小儿百日咳的治疗方法以及疗效进行探讨。方法选取我院2012年1月~2014年1月间收治的百日咳患儿30例进行回顾分析。结果30例患儿都已痊愈,且无严重并发症发生。其中有22例患儿出现痉咳症状,并在1个月~2个月间消失,有8例患儿无痉咳症状。结论百日咳为婴幼儿常见呼吸系统疾病,对其早发现早治疗可有效的提高治疗效果,减轻患儿的痛苦。