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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cough associated with upper respiratory tract disorders is a common and troublesome problem in children and little is known about the etiology of this type of cough. This study examined the capsaicin cough sensitivity (CS) in children suffering from allergic rhinitis (AR) and upper respiratory tract infection (URI), comparing it with that in healthy children taken as controls (C). CS to capsaicin, spirometry, skin prick tests, and nose-throat examination were performed in 61 children grouped by the diagnosis of AR, URI, and C. The results, in order of C vs. AR vs. URI, expressed as a geometric mean (+/-95% CI) log(10) muM of capsaicin for C2 (the lowest concentration of capsaicin in mumol/l required to induce >or=2 coughs) were: 1.8 (1.6-1.9) vs. 1.0 (0.8-1.2) vs. 0.48 (0.2-0.8), P<0.001 and for C5 (the lowest concentration of capsaicin in mumol/l required to induce >or=5 coughs) 2.9 (2.8-2.9) vs. 2.6 (2.5-2.6) vs. 2.1 (2.0-2.3), P<0.05. We found that CS in children with AR, even when tested out of pollen season, was significantly heightened compared with controls. CS in children with URI was extremely high compared with both C and AR groups. We conclude that pathological processes in the nose of any etiology could cause a sensitization of the cough reflex with decreased cough threshold during asymptomatic period of AR. Cough also is enhanced by acute inflammation in the upper airways in nonatopic children.
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PMID:Testing of cough reflex sensitivity in children suffering from allergic rhinitis and common cold. 1707 57

This is a retrospective study of the medical records of asthamtics using a predesigned form. The purpose of the study is to define the number of patients registered as asthamatics at a random selection of primary health care centers (PHCCs) in Riyadh and to describe sociodemographic, clinical and management characteristics of this population of asthmatics with a view to recommending changes which might improve the care for asthma patients. Patients from 60 primary health care centers were studied. There were 2081 asthamatic patients found in the studied PHCCs (out of 255,145 surveyed), giving a rate of 0.8%. Out of all the patients, 32.8% were children 16 years of age or below and 24.7% were above 5 years of age. The male to female ratio was 1.2:1. The presenting symptoms were cough in 82.3% and shortness of breath 64.8%. Atopic disorders such as eczema and allergic rhinitis were recorded in 27.7%. PHCCs diagnosed 61.9% depending on history and clinical examination. Out of all patients, 10.6% did not utilize a PHCC, 29.5% were referred to a specialist and 8.7% needed admission to the hospital one or more times. Oral salbutamol was used in more than 45.7% of the patients. The number of registered bronchial asthma patients at the PHCCs was very low. Even when registered, asthmatic patients are getting suboptimal care. The present study provides a basis for intervention and a baseline from which to measure the benefits of intervention. It also provides the strongest possible support for the Ministry of Health, who recently initiated a National Asthma Program.
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PMID:Care of asthmatic patients in primary health care centers. 1737 97

Study of the chronobiology of allergic rhinitis (AR) and bronchial asthma (BA) and the chronopharmacology and chronotherapy of the medications used in their treatment began five decades ago. AR is an inflammatory disease of the upper airway tissue with hypersensitivity to specific environmental antigens, resulting in further local inflammation, vasomotor changes, and mucus hypersecretion. Symptoms include sneezing, nasal congestion, and runny and itchy nose. Approximately 25% of children and 40% of adults in USA are affected by AR during one or more seasons of the year. The manifestation and severity of AR symptoms exhibit prominent 24-h variation; in most persons they are worse overnight or early in the morning and often comprise nighttime sleep, resulting in poor daytime quality of life, compromised school and work performance, and irritability and moodiness. BA is also an inflammatory medical condition of the lower airways characterized by hypersensitivity to specific environmental antigens, resulting in greater local inflammation as well as bronchoconstriction, vasomotor change, and mucus hypersecretion. In USA an estimated 6.5 million children and 15.7 million adults have BA. The onset and worsening of BA are signaled by chest wheeze and/or croupy cough and difficult and labored breathing. Like AR, BA is primarily a nighttime medical condition. AR is treated with H1-antagonist, decongestant, and anti-inflammatory (glucocorticoid and leukotriene receptor antagonist and modifier) medications. Only H1-antagonist AR medications have been studied for their chronopharmacology and potential chronotherapy. BA is treated with some of the same medications and also theophylline and beta2-agonists. The chronopharmacology and chronotherapy of many classes of BA medications have been explored. This article reviews the rather extensive knowledge of the chronobiology of AR and BA and the chronopharmacology and chronotherapy of the various medications used in their treatment.
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PMID:Chronobiology and chronotherapy of allergic rhinitis and bronchial asthma. 1790 Jul 48

Cough is a common presenting symptom of many patients managed by allergists. For patients with chronic cough who are nonsmokers, have normal spirometry, and are not being treated with an ACE inhibitor, diagnosis usually focuses on differentiation between postnasal drip syndrome, asthma, gastroesophageal reflux disease, and nonasthmatic eosinophilic bronchitis, alone or in combination. Patients with severe COPD or GERD should be referred to appropriate specialists for those conditions. The management of conditions commonly treated by allergists (e.g., allergic rhinitis, asthma, sinusitis) follows the recommendations of current guidelines and/or practice parameters.
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PMID:Chronic cough: the allergist's perspective. 1795 6

Allergic rhinitis is one of the most common causes of chronic cough. The characteristic feature of allergic rhinitis is eosinophilic nasal inflammation. This study was determined to find the relation between airway eosinophils and chemically-induced cough in guinea pigs with antigen-induced rhinitis at the early and late allergic phases. Forty animals were sensitized with ovalbumin (OVA) and divided into four separated groups. Four weeks later, the sensitized animals were either once or repeatedly (6 times at 7-day intervals) intranasally challenged with OVA to develop experimental allergic rhinitis. The control group was given saline. Cough was elicited by inhalation of citric acid aerosols and evaluated at 30 min (early phase) or 24 h (late phase) after the 1st or 6th nasal challenge (NC) in the sensitized animals. The citric acid-induced cough was significantly increased in the sensitized animals in the early allergic phase after the first and repeated NC compared with the control values [14(9-19) vs. 16(10-17) vs. 8(6-10); P=0.049], whereas there was no significant increase in the cough response tested in the late allergic phase. A correlation between the cough intensity and the number of eosinophils from nasal mucosa only (P=0.008) was found.
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PMID:Experimental allergic rhinitis-related cough and airway eosinophilia in sensitized guinea pigs. 1820 16

Asthma is suspected from a history of key symptoms, including cough, wheezing, dyspnea, chest tightness, and increased mucus production. A positive family or personal history of atopic diseases and diseases that are comorbid with asthma, such as allergic rhinitis and rhinosinusitis, is also important. The differential diagnosis of asthma is broad and includes potentially life-threatening diseases. Pediatric asthma and psychiatric mimics require special attention to prevent misdiagnosis. Differentiating asthma from these other disease states by history alone is not always possible. Because accurate diagnosis is critical to successful treatment, objective testing by spirometry and methacholine challenge should be employed.
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PMID:Asthma history and presentation. 1832 75

Neurokinins are known to induce neurogenic inflammation related to respiratory diseases. The effects of CS-003 ([1-{2-[(2R)-(3,4-dichlorophenyl)-4-(3,4,5-trimethoxybenzoyl)morpholin-2-yl]ethyl}spiro[benzo[c]thiophene-1(3H),4'-piperidine]-(2S)-oxide hydrochloride]), a novel triple neurokinin receptor antagonist, on several respiratory disease models were evaluated in guinea pigs. As we have already shown that CS-003 is intravenously effective, we first determined if CS-003 was orally effective. CS-003 dose-dependently inhibited substance P-induced tracheal vascular hyperpermeability, neurokinin A- and neurokinin B-induced bronchoconstriction with ID(50) values of 3.6, 1.3 and 0.89 mg/kg (p.o.), respectively. CS-003 (10 mg/kg, p.o.) inhibited the number of coughs induced by capsaicin aerosol (P<0.01) and the antitussive effect was comparable to that of codeine. CS-003 (10 mg/kg, p.o.) also inhibited airway hyperresponsiveness to methacholine chloride in ovalbumin-induced asthma models (P<0.01), a milder one and a severer one. On the other hand, montelukast (10 mg/kg, p.o.), a leukotriene receptor antagonist, significantly inhibited the hyperresponsiveness only in the milder model (P<0.05). In an ovalbumin-induced rhinitis model, oral administration of CS-003 inhibited nasal blockade in a dose-dependent manner and the inhibitory effect was comparable to that of dexamethasone (10 mg/kg, p.o.). CS-003 (i.v.) also dose-dependently inhibited cigarette smoke-induced bronchoconstriction, tracheal vascular hyperpermeability and mucus secretion. These data show that CS-003, a potent orally active triple neurokinin receptor antagonist, may be useful for the treatment of respiratory diseases associated with neurokinins, such as allergic asthma, allergic rhinitis, chronic obstructive pulmonary disease and cough.
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PMID:Novel triple neurokinin receptor antagonist CS-003 inhibits respiratory disease models in guinea pigs. 1870 8

The diseases of the nose and paranasal sinuses (rhinosinusitis) often in combination with asthma and gastroesophageal reflux are common causes of chronic cough in patients with normal chest radiograph. The relationships between rhinosinusitis and cough are incompletely understood. We investigated modulation of the cough reflex by the inputs from the nose. We demonstrate that the cough reflex is sensitized by the intranasal administration of sensory nerve activators in animal models and in humans. Cough reflex is also sensitized in the guinea pig model of allergic nasal inflammation and in patients with allergic rhinitis. In patients with allergic rhinitis the cough sensitization is augmented during the allergen season. We conclude that the cough reflex can be sensitized from the nose. Our data indicate that this sensitization is mediated by nasal sensory nerves. We speculate that by inducing the cough reflex sensitization rhinosinusitis contributes to chronic cough. If combined with environmental or endogenous cough triggers, the cough reflex sensitization is predicted to cause excessive coughing. The potential endogenous cough triggers may be associated with rhinosinusitis (postnasal drip, aspiration of nasal secrets) or secondary to a coexistent disease such as asthma or gastroesophageal reflux.
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PMID:Mechanisms of the cough associated with rhinosinusitis. 1911 26

We report the case of a 17-year-old boy who experienced 4 episodes of exercise-induced anaphylactic reaction after ingestion of lentil and 2 episodes of anaphylaxis following ingestion of chickpea. His medical history revealed that he had allergic rhinitis with positive results after skin prick tests (SPT) with mites. His SPTs and specific immunoglobulin E antibody testing with lentil and chickpea were positive. Oral challenge with chickpea was not performed due to patient refusal. Treadmill exercise challenge tests in the fasting state and 1 hour after a meal not containing lentil were negative. However, an exercise challenge test 1 hour after intake of lentil soup resulted in pruritus of the hands, forearms, shoulders, and back, urticarial lesions on the face and shoulders, mild angioedema of the lips, and mild hoarseness and cough. To our knowledge, this is the first case of food-dependent exercise-induced anaphylaxis due to lentil.
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PMID:Food-dependent exercise-induced anaphylaxis to lentil and anaphylaxis to chickpea in a 17-year-old boy. 1912 39

A 40-year-old white male had a two-year history of right sided upper back pain without dyspnea or coughing. His past history was significant for allergic rhinitis and asthma. Conservative outpatient management of the back pain including medications, rest and physical therapy were ineffective. CT scan of the chest revealed a mass in the lower lobe of the right lung. Bronchial biopsy and lavage revealed eosinophilic and neutrophilic inflammation without tissue invasion. A pure culture of Bipolaris australiensis was confirmed by DNA typing. Hematological, serological and radiological studies were not compatible with Allergic Bronchopulmonary Mycosis (ABPM), fungus ball, hypersensitivity pneumonitis or invasive fungal infection. However, the mucus plugging may have represented an atypical localized form of ABPM. Resolution of the endobronchial mucus impaction occurred after three bronchoscopies with vigorous suction, anti fungal therapy and prednisone.
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PMID:Back pain associated with endobronchial mucus impaction due to Bipolaris australiensis colonization representing atypical Allergic Bronchopulmonary Mycosis. 1918 Jul 52


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