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)

This study looked at the effects of natural antigenic exposure on non-specific airway responsiveness (NSAR) in pollen-sensitized non-asthmatic subjects with seasonal rhinitis. Eight subjects had daily recordings of their respiratory symptoms and peak flow rates during and out of the pollen season. Airway response to methacholine was measured at 1-week to 2-week intervals. Pre-season spirometry and NSAR were normal in all subjects. Their PC20 methacholine ranged from 64 to greater than 256 mg/mL. During natural pollen exposure, all subjects had symptoms of rhinoconjunctivitis. The only chest symptom observed was coughing. No significant change in peak flow rates was observed throughout the study. A significant increase in bronchial responsiveness to methacholine occurred in five subjects although it did not reach the asthmatic range (less than 16 mg/mL). This change in NSAR was reproduced after antigen (tree pollen) challenge in the laboratory in one of the subjects. A significant increase in blood eosinophils was observed during seasonal pollen exposure. This study shows that following natural antigenic exposure, NSAR can increase in non-asthmatic subjects with allergic rhinitis, although it may not reach the "hyperresponsive range," and is associated with the development of a cough. These data suggest that natural exposure in non-asthmatic atopics may induce an inflammatory reaction in the airways to a degree that may increase NSAR.
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PMID:Bronchial responsiveness increases after seasonal antigen exposure in non-asthmatic subjects with pollen-induced rhinitis. 266 66

Non-traumatic cerebrospinal-fluid rhinorrhoea is a rare condition. Its insidious onset may occur with a sneezing or coughing episode which may lead to an incorrect diagnosis of allergic rhinitis or vasomotor rhinorrhoea. Two cases that occurred in association with primary empty-sella syndrome are described--in the second case, the fistula arose from the pituitary fossa. The history, incidence, clinical profile, investigation and management of this condition are reviewed.
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PMID:Non-traumatic cerebrospinal-fluid rhinorrhoea in cases of primary empty-sella syndrome. 271 86

The authors report 18 patients who presented to the ENT department with isolated cough, which had begun one month to 14 years previously. As the ENT examination was negative, the patients were referred to the Department of General Medicine where a bronchial reactivity test with acetylcholine was found to be positive, leading to a diagnosis of airway hyperreactivity. The group was predominantly female (15/18) and atopy was rare; indeed, only one patient, who had a history of allergic rhinitis, was found to be atopic. Bronchodilators and inhaled steroids cured or helped the cough in 16/18 patients. When a patient presents with chronic cough without other respiratory symptoms it is important to consider a diagnosis of airway hyperreactivity and to confirm this with a challenge test of bronchoconstriction.
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PMID:Cough as the sole manifestation of airway hyperreactivity. 276 May 22

Allergic rhinitis in children is often complicated by bacterial sinusitis, which can lead to chronic illness and dysfunction. Sinus disease manifests differently in children than in adults, with cough, rhinorrhea, and middle ear disease being common and pain, headache, and fever being uncommon. Sinusitis may exacerbate asthma, and as many as 70% of children with allergy and chronic rhinitis have abnormal findings on sinus x-ray studies. Nasal cytologic specimens showing large numbers of polymorphonuclear cells with intracellular bacteria are also evidence of sinusitis. Obstruction of the nasal airways by allergic rhinitis or enlarged adenoids can lead to deviations in facial growth, specifically increased facial length. With the removal of the obstruction and a return to nasal breathing, facial length may become more normal. Sinusitis in children is treated with antibiotics, usually for 3 to 4 weeks, to eliminate the infection. Adjunctive therapy with antihistamines, decongestants, cromolyn, and corticosteroids may also be helpful. Topical steroids, such as flunisolide and beclomethasone, can be very useful in pediatric patients. These steroids decrease edema and prevent the release of allergic mediators that may be responsible for an environment favoring the bacterial infection causing sinusitis.
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PMID:The role of nasal airway obstruction in sinus disease and facial development. 305 46

Seven hundred sixty-five patients, living in France and suffering from allergic rhinitis (eg, with positive skin tests to various antigens), agreed to self-rate (visual analog scales), four times daily, symptoms such as sneezing, stuffy or blocked nose, runny nose, itchy nose, itchy eyes, wheeze, or cough. Despite acute symptoms, patients did not take medications of any kind by any route during 36 hours. Several statistical methods (eg, Student's t test, analysis of variance, cosinor, chi-square, etc.) were used to validate both circadian and circannual rhythms of these symptoms in the group as a whole, as well as in subgroups related to age, sex, etc. Large-amplitude circadian rhythms with early morning peak times (eg, approximately 6 AM) were validated for sneezing, stuffy nose, and runny nose (with p less than 0.0001) but not for wheeze or cough. Such time-dependent changes were related neither to age (from 10 to 80 years) nor to sex. However, small differences were observed in subgroups sorted with regard to duration of disease (old versus new cases), smoking habits, and geographic location (north versus south France). Reanalysis of data taking into account interindividual differences revealed that the respective peak times of the three major symptoms occurred in the early morning in about 60% to 70% of the patients. Annual changes were validated as well with the annual peak time being January to April. The proposed interpretation of both circadian and circannual rhythms suggests taking into account endogenous component rhythms (eg, involving metabolic, immunologic, and endocrine systems), since they contribute to time-dependent changes in the human susceptibility to antigens. In addition, the elevated severity of symptoms in the morning experienced by 60% to 70% of patients should serve as a guide to individually optimize dosing time(s) of medications, such as antihistamines.
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PMID:Circadian and circannual rhythms of allergic rhinitis: an epidemiologic study involving chronobiologic methods. 333 91

The correlation of Waters view radiographs and A-mode ultrasound for diagnosing sinusitis was evaluated in 75 subjects with allergic rhinitis who presented with signs and symptoms suggesting sinus disease. All patients had Waters view radiographs, which were read by a radiologist (E. G.) who was not provided with historical information. Ultrasound tracings were obtained by registered nurses who were trained to perform this procedure. Tracings were interpreted by two representatives of American Electromedics Corporation, the manufacturer of the Echosine ultrasound machine used in this study. Most common symptoms among the patients were cough and rhinorrhea. The complaint of headache correlated negatively (p = 0.001) with an abnormal radiograph, whereas physical findings of copious and purulent rhinorrhea correlated positively (p = 0.05 and 0.001, respectively). Middle ear abnormalities on examination and tympanometry were more common in those with abnormal radiographs, p less than 0.05 and p less than 0.01, respectively. If the radiograph is considered to be a "gold standard," sensitivity of ultrasound varied from 44% to 58% and specificity from 55% to 61%, dependent on which criteria are applied to the radiograph to consider it normal. A-mode ultrasound is not sufficiently comparable to radiography to be used as its substitute for diagnosing sinus disease.
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PMID:Blinded comparison of maxillary sinus radiography and ultrasound for diagnosis of sinusitis. 351 Nov 25

The clinical records of 100 cases of headshaking in horses were reviewed. Possible causes of the abnormal behaviour were identified in 11 animals; these included ear mite infestation, otitis interna, cranial nerve dysfunction, cervical injury, ocular disease, guttural pouch mycosis, dental periapical osteitis and suspected vasomotor rhinitis. However, in only two of these could it be shown that correction of the abnormality led to elimination of the headshaking. The additional clinical signs exhibited by the other idiopathic cases of headshaking included evidence of nasal irritation, sneezing and snorting, nasal discharge, coughing and excessive lacrimation. Many of these horses also showed a marked seasonal pattern with respect to the onset of the disease and the recurrence of signs in subsequent years. The clinical presentation of idiopathic headshakers and the seasonal incidence of the signs closely resemble allergic rhinitis in man.
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PMID:Observations on headshaking in the horse. 362 62

A single capsule of sustained release pseudoephedrine (SUDAFED S.A., Burroughs Wellcome Co.) was shown by objective and subjective measurements to be superior to placebo in relieving nasal congestion associated with allergic rhinitis. The drug had no discernible effect on (1) the degree of wetness perceived in the mouth or nose, (2) a complex of symptoms which included sneezing, coughing, sniffing, swallowing, itching of eyes and nose or (3) number of nose blows. The study was marked by an absence of serious adverse reactions.
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PMID:A study of sustained action pseudoephedrine in allergic rhinitis. 617 54

The effect of intranasally administered corticosteroid (budesonide) on nasal symptoms, mode of respiration (nasal versus mouth breathing), and asthma was investigated in 37 asthmatic children who were mouth breathers because of chronic nasal obstruction. After a 2-wk run-in period, the children were allocated randomly to 4 wk of intranasal therapy with either budesonide (400 micrograms/day) or placebo spray. A double-blind, parallel design was used. Diaries for peak expiratory flow, asthma, and rhinitis symptom scores and degree of mouth breathing were recorded at home. Nasal eosinophilia, nasal airway resistance at a flow of 0.2 L/s (NAR0.2), and lung function at rest and after exercise challenge were assessed at the clinic immediately before and at end of the 4-wk treatment. Budesonide, when compared with placebo, significantly decreased nasal obstruction (p less than 0.05), secretion (p less than 0.01), and eosinophilia (p less than 0.02), as well as NAR0.2 (p less than 0.05) and mouth breathing (p less than 0.01). The improvement in nasal obstruction correlated closely to the changes in mouth breathing (r = 0.80, n = 17, p less than 0.001). Furthermore, intranasally administered budesonide resulted in less exercise-induced asthma (EIA) (p less than 0.02) and decreased cough and asthma severity significantly. Pulmonary mechanics were only marginally improved. The present study showed that intranasally administered budesonide is effective in the treatment of perennial allergic rhinitis. An attenuation of EIA and a tendency to less asthma after budesonide therapy suggest a decrease in bronchial reactivity, but the results gave no clear evidence of an association between nasal airway function and asthma.
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PMID:Effect of an intranasally administered corticosteroid (budesonide) on nasal obstruction, mouth breathing, and asthma. 650 97

Antihistamines and decongestants often are used interchangeably and in combination for a variety of upper respiratory illnesses ranging from allergic rhinitis to the common cold; yet, these two classes of drugs have distinct therapeutic actions. When administered alone, antihistamines are of no value in reducing nasal stuffiness. Therefore, many allergy products also contain decongestants. Conversely, cough-cold remedies often contain antihistamines despite their lack of efficacy in these conditions. Nasal congestion, on the other hand, regardless of its cause, responds quite well to decongestants. The topical route provides a faster and more intense decrease in nasal airway resistance, but has a shorter duration and the potential to produce rebound congestion in patients with allergic rhinitis, whereas oral agents do not. Phenylpropanolamine, pseudoephedrine, and phenylephrine are the most common decongestants. Although all are sympathomimetic amines, their efficacy varies. In particular, phenylephrine is subject to first-pass metabolism and therefore is not bioavailable in currently recommended doses. In addition, phenylpropanolamine and pseudoephedrine, but not phenylephrine, are effective decongestants. Slow-release formulations allow a longer dosing interval, especially during the night. However, most formulations available in the United States are manufactured and sold without Food and Drug Administration scrutiny. Since the in vitro dissolution of many of these products differs, it is possible that some of the generic formulations are not bioequivalent to established brand-name products. Therefore, pharmacists should not substitute formulations without discussing the matter with the prescriber.
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PMID:Selecting a decongestant. 750 90


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