Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary pulmonary tumors are infrequent in childhood, therefore an accurate diagnosis and treatment is often delayed. We review the English language literature and report the clinical and pathological features of eight tumors arising in the lungs of pre-adolescent children, accessioned between 1960 and 1991 in the pathology department of a children's hospital in South Africa. The ratio of pulmonary primary tumors to secondary neoplasms and to non-neoplastic lesions of the lung examined during this period was 1:5:60. Over the last 31 years we received three plasma cell granulomas, two pleuro-pulmonary blastomas, a mucoepidermoid carcinoma, an endobronchial fibrosarcoma, and a hemangioma. All patients presented with cough unresponsive to medical treatment. The incidence and spread of primary lung tumors in children was similar to that reported from other centers. Plasma cell granuloma is the most common primary tumor in the lungs of children. Aggressive behavior is most frequently encountered with pleuro-pulmonary blastoma and rhabdomyosarcoma, and because of their association with cystic lesions careful examination of lungs is required in such cases. Most other malignant neoplasms, such as muco-epidermoid carcinoma and primary fibrosarcoma, are usually of a low grade of malignancy. A decreasing incidence of bronchogenic carcinoma seems to be reported during the first two decades of life.
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PMID:Primary pulmonary tumors in childhood: a review of 31 years' experience and the literature. 133 97

A 61-year-old man was admitted to our hospital with cough, bloody sputum, and chest pain. Bronchoscopy showed a tumor in the truncus intermedius which biopsy and brushing cytology revealed to be squamous cell carcinoma. Also, bronchial washings grew only N. asteroides. Treatment with minocycline and trimethoprimsulfamethoxazole (TMP/SMX) over one month resulted in some improvement in pulmonary symptoms and resolution of the infiltrates in the right lower field. Then, right pneumonectomy was performed. N. asteroides was isolated from the resected tumor. Aggressive bacteriological examinations should be utilized when the possibility of pulmonary nocardiosis is considered.
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PMID:[A case of pulmonary nocardiosis with squamous cell carcinoma]. 204 Dec 63

Fourteen cases of a mediastinal neoplasm identical to solitary fibrous tumor (so-called fibrous mesothelioma) of the pleura were observed. The lesions presented with cough, chest pain, dyspnea, or as asymptomatic masses detected radiographically. Two patients had associated hypoglycemia. Eleven of the tumors were in the antero-superior mediastinum. One arose on a pedicle from the thymus, and another had entrapped thymic elements. Tumor cells were variably immunoreactive for vimentin and actin, but not for keratin, and lacked ultrastructural evidence of mesothelial or epithelial differentiation. Eight cases had highly cellular mitotically active regions of which six of seven with follow-up behaved aggressively; the exception was the pedunculated tumor. A 13-cm, histologically bland tumor has recurred twice. Aggressive behavior was more common than reported for solitary fibrous tumor of the pleura, but the same criteria (size, cellularity, mitotic activity, presence of pedicle) were of prognostic significance. The occurrence of solitary fibrous tumor in the mediastinum with the suggestion of thymic origin for some cases, combined with the immunohistochemical and ultrastructural findings, support a mesenchymal origin for this tumor. The differential diagnosis includes spindle cell thymoma, hemangiopericytoma, and peripheral nerve tumors.
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PMID:Solitary fibrous tumor of the mediastinum. A report of 14 cases. 273 90

In October 1978, a nationwide initiative to eliminate indigenous measles from the United States by October 1, 1982, was announced. The measles elimination program has three major elements: attaining and maintaining high immunization levels, aggressive and effective surveillance, and vigorous response to cases. In 1980, immunization levels in children entering school for the first time were 96%, indicating that the necessary levels have been attained in the age group. Mechanisms are in place to assure maintenance of these levels; these rely heavily on the use of immunization requirements for school attendance in each state. Aggressive surveillance systems have been developed for each state to detect suspected measles cases as soon as possible after they occur and to investigate them within 24 hr of notification. The clinical definition of measles used is fever of greater than or equal to 101 F (38.3 C); rash of three or more days duration; and cough, coryza, or conjunctivitis. The response to outbreaks involves identifying persons in the area who are at risk of contracting measles, determining those who are possibly susceptible, and ensuring that these persons are vaccinated. In school outbreaks, susceptible students are vaccinated or excluded from school until the outbreak is over. During 1981, measles morbidity reached a record low level of only 3,032 reported cases (provisional total). Epidemic measles occurred in only a few outbreaks of limited size and duration, and endemic cases were restricted to a small number. Imported cases averaged slightly more than two per week, occasionally producing limited outbreaks, but more often resulting in no secondary spread. Transmission of measles has been interrupted in most of the United States. With continued vigorous implementation of the current strategy and with additional measures to lessen the risk of importations, it appears likely that the goal to eliminate indigenous measles transmission will be attained by October 1982.
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PMID:Elimination of indigenous measles from the United States. 687 11

The oto-respiratory (O-R) reflex consists of the cough reflex produced by direct mechanical stimulation of the deep portion of the posterior wall of the external auditory meatus. Because the efferent pathways are different for coughing and bronchoconstriction, some subjects can have an O-R reflex (coughing) without the oto-bronchial (O-B) reflex (bronchoconstriction). This study also states that on stimulation of the mechanoreceptors in the external ear, 20 out of 125 normal subjects (16%) presented with the O-R reflex; in 7 of the 20 subjects, bronchoconstriction ('responders') was also documented (O-B reflex). The O-B reflex was particularly evident in 3 of the 7 responders. These normal subjects referred a family history of atopy. Only through animal experimentation can the exact nervous pathway of the O-R reflex be defined. From the physiological point of view, it is difficult to imagine how this 'irritative' reflex could have a protective function against auditory aggression.
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PMID:The oto-respiratory reflex. 714 39

Cocaine abuse surged in the 1980s, forcing reevaluation of its previously benign image. Snorted, smoked, and injected, the drug is more widely abused than ever and, the consequences are devastating. Medical complications are frequent and range from mild (eg, cough, itching, headache) to life-threatening (eg. stroke, seizure, cardiovascular failure). Behavioral disturbances constitute the most dramatic and widespread effects of intoxication and withdrawal. Psychopathologic responses may include perceptual disturbances (eg. hallucinations) agitation, aggression, delirium, confusion, and profound delusional ideation. The goals of treatment are abstinence, rehabilitation, and relapse prevention. Hospital care may be necessary in certain circumstances. Regardless of where treatment takes place, a comprehensive program of supportive care, behavioral therapy, urine monitoring, and often psychopharmacologic intervention is required.
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PMID:The treatment of cocaine abuse. 831 99

Chronic granulomatous disease of childhood is an inheritable disorder of phagocytic cell respiratory burst resulting in recurrent, life-threatening, catalase-positive infections. The lung is the most common site of infection, and pulmonary disease is the primary cause of death in greater than 50% of children with chronic granulomatous disease. Still, the role of surgery in management of this disease remains undefined. Between 1974 and 1990, 19 patients with chronic granulomatous disease required 31 thoracic interventions at our institution. Patients ranged in age from 2.5 to 27 years (mean age, 15 years). Seventeen of 19 patients (89%) had had previous pulmonary infections. Patients presented as toxic (temperature > 38.5 degrees C, chest pain, and cough) in 22 instances before the 31 procedures. Aggressive surgical intervention for diagnosis and extirpation of localized infections was undertaken with lobectomy/pneumonectomy with or without other procedures (5), bisegmentectomy (2), segmentectomy with or without other procedures (5), or wedge with or without other procedures (13). In five instances, an empyema was drained; a chest tube for a sterile collection was placed in one instance. There was one intraoperative death, and 3 patients died 22 to 600 days postoperatively with overwhelming sepsis. The mean hospitalization was 101 days (range, 24 to 600 days). Wound complications occurred in 5 patients, requiring 17 separate anesthetic debridements. A change in therapy was dictated by the results of the procedure in 23 of 31 instances (74%). Thoracic surgeons must be aware of this rare cause of immunosuppression in these children and, due to the unusual nature of the pulmonary infections, should follow an aggressive approach in their diagnosis and management.
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PMID:Surgical management of pulmonary infections in chronic granulomatous disease of childhood. 846 36

Nursing homes continue to be challenged with the task of caring for patients in various stages of disease. Historically, the death of a long-term care patient in this setting is not unusual; however, researchers and clinicians are focusing increasingly on the quality of life at the end of life, regardless of location. The long-term care facility is an ideal setting in which to begin to effectively address these issues, especially as individual patients in need present for care. Although the care of many of our geriatric patients meets the definition of palliative care, no where is the need greater, and more obvious, than in the patient presenting with terminal illness. Aggressive treatment of distressing symptomatology contributes to overall quality of life, and returns to the patient some of the freedom and autonomy usurped by the disease process. It is particularly rewarding for the interdisciplinary team to be successful in controlling symptoms in the patient with limited life expectancy, thus allowing the patient to complete unfinished tasks and enjoy quality time with family and friends. Often the "triumphs" in the nursing home are few and fleeting; abolishing pain, distress, and suffering is both personally and professionally satisfying for everyone involved. We presented a review of the available literature on a technique in palliative medicine which is still evolving. Additional, we presented its practical use in a frail, elderly nursing home resident admitted with end-stage metastatic breast carcinoma. The geriatric adage of "start low, and go slow" was effectively borne out in the management of this resident's most difficult symptoms, shortness of breath and paroxysmal cough leading to symptomatic atrial fibrillation. The key to the management of the frail elderly patient goes beyond " start low and go slow" to "aggressively titrate as needed but no further" in order to meet the needs of the individual patient and avoids unwanted side effects.
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PMID:Nebulized morphine for paroxysmal cough and dyspnea in a nursing home resident with metastatic cancer. 929 2

Aspergillosis is an infrequent but commonly fatal infection among HIV-infected individuals. We review 342 cases of pulmonary Aspergillus infection that have been reported among HIV-infected patients, with a focus on invasive disease. Invasive pulmonary aspergillosis usually occurs among patients with <50 CD4 cells/mm3. Major predisposing conditions include neutropenia and steroid treatment. Fever, cough, and dyspnea are each present in >60% of the cases. BAL is often suggestive, but biopsy specimens are necessary for definite diagnosis. Amphotericin B is the mainstay of treatment and mortality is > 80%. Avoiding neutropenia and judicious use of steroids may be helpful in prevention. Aggressive diagnostic approach, early initiation of treatment, adequate dosing of antifungals, and close follow-up may improve the currently dismal prognosis.
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PMID:Pulmonary aspergillosis and invasive disease in AIDS: review of 342 cases. 967 77

Primary pulmonary melanoma is a very rare disease, with only 19 cases previously reported in the English language literature. These cases suggest that melanoma can arise in the lung as a primary tumor, probably from residual melanoblasts. Primary pulmonary melanoma is frequently endobronchial and often manifests with symptoms of cough, hemoptysis, and lobar collapse. Aggressive surgical resection, irrespective of lymph node involvement, offers possible long-term survival in some patients. The diagnosis of primary pulmonary melanoma necessitates that both clinical and histologic criteria be fulfilled. Herein diagnostic criteria are proposed, and the diagnostic approach is discussed.
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PMID:Primary pulmonary melanoma: case report and literature review. 998 35


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