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)

In recent times, the incidence of allergic diseases, particularly bronchial asthma, has been increasing worldwide. However, there appears to be no published data on the prevalence of allergic diseases among school children (3 to 16 years of age) in Karachi, Pakistan, with only limited data available among few age groups under one ISAAC study. The objective of this project was to investigate the prevalence of allergic diseases among school children (3 to 16 years of age) in the city of Karachi. The questionnaire that was used for data collection had previously been used for a similar study in neighboring Saudi Arabia and the U.A.E. In 2007, a total of 3,000 surveys were distributed in various schools of Karachi, of which 2,325 completed surveys were obtained. SPSS was used to perform statistical analysis on the collected data. Survey results showed that the frequency of diagnosed (previously seen by physicians) cases of asthma stood at 15.8%, while the frequency of allergic rhinitis was found to be 28.50% among these children. Other parameters that were analyzed included dry cough (20.1%), wheezing (11.7%), breathlessness (15.40%), and eczema (21.8%). Furthermore, smoking by family members was found to be associated with asthma (p value less than 0.05), allergic rhinitis (p value less than 0.05), breathlessness (p value less than 0.05), dry cough (p value 0.002), and wheezing (p value less than 0.05). This study reveals that there is a significant number of school children in the metropolitan city of Karachi who have various allergic symptoms. It also sheds light on the fact that exposure to indoor environmental factors as well as family atopy can play a key role in increasing the chances of an individual to experience asthma and other allergy symptoms.
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PMID:Prevalence of asthma and allergic rhinitis among school children of Karachi, Pakistan, 2007. 1919 Nov 44

Increased cough reflex sensitivity is found in patients with allergic rhinitis and may contribute to cough caused by rhinitis. We have reported that cough to citric acid is enhanced in the guinea pig model of allergic rhinitis. Here we address the hypothesis that the cough reflex sensitivity is increased in this model. The data from our previous studies were analyzed for the cough reflex sensitivity. The allergic inflammation in the nose was induced by repeated intranasal instillations of ovalbumin in the ovalbumin-sensitized guinea pigs. Cough was induced by inhalation of doubling concentrations of citric acid (0.05-1.6 M). Cough threshold was defined as the lowest concentration of citric acid causing two coughs (C2, expressed as geometric mean [95% confidence interval]). We found that the cough threshold was reduced in animals with allergic rhinitis. C2 was 0.5 M [0.36-0.71 M] and 0.15 M [0.1-0.23 M] prior and after repeated intranasal instillations of ovalbumin, respectively, P<0.01, n=36). C2 was not affected in control animals (n=29). We have reported that the selective leukotriene cys-LT1 receptor antagonist montelukast inhibited cough enhancement in this model. We found that this was accompanied by inhibition of the changes in cough reflex sensitivity. C2 was reduced in animals with allergic rhinitis treated orally with vehicle (0.57 M [0.28-1.1] vs. 0.09 M [0.04-0.2 M], P<0.05, n=8), but not in animals treated with montelukast (0.57 M [0.22-1.4 M] vs. 0.52 M [0.17-1.6 M], NS, n=8). We conclude that the cough reflex sensitivity is increased in the guinea pig model of allergic rhinitis. Our results suggest that guinea pig is a suitable model for mechanistic studies of increased cough reflex sensitivity in rhinitis.
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PMID:Cough reflex sensitivity is increased in the guinea pig model of allergic rhinitis. 1921 39

Dysfunction of upper and lower airways frequently coexists, and they appear to share key elements of pathogenesis. The interrelationship between upper and lower airway manifestations of allergy remains still incompletely investigated. Little is known about the critical factors that determine airway afferent nerve endings reactivity (cough sensitivity) in patients with allergic rhinitis. Subclinical inflammatory changes within the lower airways and/or chronic upper airway cough syndrome (previously referred to as postnasal drip syndrome) are probably responsible for this effect. The aim of this study was to evaluate capsaicin cough sensitivity in pollen sensitive patients with seasonal allergic rhinitis without treatment out of a grass pollen season time using the European Respiratory Society (ERS) guidelines on the assessment of cough. Cough sensitivity was defined as the lowest capsaicin concentration which evoked two (C2) or five (C5) coughs. Capsaicin aerosol in doubling concentrations (from 0.49 to 1000 micromol/l) was inhaled by a single breath method (KoKo DigiDoser; nSpire heath Inc, Louisville, CO), modified by the addition of an inspiratory flow regulator valve (RIFR; nSpire heath Inc, Louisville, CO). The seasonal rhinitis subjects (5M, 7F; mean age 23 yr) had not been complaining primarily about coughing. Their pulmonary function was within normal range. Concentrations of capsaicin causing two (C2) and five coughs (C5) were reported. Volunteers' (5M, 7F, mean age 23 yr) cough sensitivity (geometric mean and 95 % CI) for C2 was 16.5 (4.1-67.0) micromol/l vs. allergic rhinitis patients' C2 3.5 (1.9 - 6.4) (P= 0.018). Volunteers' C5 was 132.4 (41.3 - 424.5) micromol/l vs. allergic rhinitis patients' C5 13.1 (6.0 - 28.6) micromol/l (P= 0.013). We conclude that airway afferent nerve endings reactivity in pollen sensitive subjects suffering from seasonal allergic rhinitis was significantly increased out of pollen season compared with healthy volunteers.
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PMID:Cough reflex sensitivity testing in in seasonal allergic rhinitis patients and healthy volunteers. 1921 81

Acute rhinosinusitis (ARS) is a highly prevalent condition with substantial public health implications. The disease is associated with a high degree of disability, impairment of quality of life, and school and workplace absenteeism. Acute rhinosinusitis is most often precipitated by a viral upper respiratory infection or an episode of allergic rhinitis. Typical signs and symptoms include nasal congestion, purulent nasal discharge, headache, cough, and facial pain or tenderness. Diagnosis is usually based on patient history and physical examination. Specialist consultation is indicated for intractable or complicated disease, signified by signs or symptoms suggestive of orbital, intraosseous, or intracranial extension of sinus disease. Most cases of ARS in the ambulatory setting are viral. In the absence of severe or rapidly worsening symptoms, antibiotic prescription should be delayed until an appropriate surveillance period has elapsed. Symptomatic therapy is the most efficient approach for uncomplicated ARS. There is a paucity of data supporting use of commonly used symptomatic therapies, with the exception of intranasal corticosteroids, which have demonstrated rapid improvement of the symptoms of ARS and return to normal functioning when used as monotherapy or as an adjunct to antibiotics.
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PMID:Diagnosis and management of acute rhinosinusitis. 1949 44

Churg Strauss Syndrome (CSS) is a form of primary vasculitis that is characterized by severe eosinophilia and often granulomatous inflammation as well as history of asthma or allergy. Previously, the association between cysteinyl leukotrien receptor antagonists (LTRAs), corticosteroid withdrawal or a sudden change in its used method and CSS had been established. We report three cases that have been referred because of dyspnea, wheezing and cough with a history of allergic rhinitis and nasal polypectomy. After polypectomy, disseminated skin purpuric rashes appeared on their forelegs, abdomen and all of them had experienced neuropathic signs in their extremities. Clinical findings, marked eosinophilia in blood and skin biopsies finally led to the diagnosis of CSS. The patients have been free of symptoms after receiving prednisolone; routine examinations and blood tests have rended regular results. Here, we report a probable occurrence of an association between nasal polypectomy and CSS on the basis of our findings. Further, extended researches are required to establish this correlation.
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PMID:Churg Strauss Syndrome after polypectomy in asthmatic and allergic patients. 1967 41

Peripheral and tissue eosinophilia can occur in a wide variety of disease processes that include infectious, allergic, and primary hematologic disorders, and other more rare diseases such as hypereosinophilic syndromes (HES). We describe a case of a patient with severe eosinophilia and left bundle branch block. A 21-year-old woman with asthma and allergic rhinitis presented with neck pain and cough for >6 months with no other complaints. Physical exam was normal except for fever and minimal expiratory wheezes. Chest CT revealed diffuse airway inflammation with bronchiectasis. Admission electrocardiogram (EKG) was normal. Initial laboratory tests showed an absolute eosinophil count of 30,000 cells/mL. A thorough workup for eosinophilia was initiated, but the patient subsequently left against medical advice. The next day, in the outpatient pulmonary clinic, she was found to be tachycardic and an EKG showed sinus tachycardia with a new left bundle branch block. Laboratory tests revealed an eosinophil count of 33,200 cells/mL and elevated troponins. She was started on i.v. Solu-Medrol (Pfizer, Inc.). The next day, her EKG returned to normal. Three days later her absolute eosinophil count normalized. Identifying the cause of marked, persistent eosinophilia is a challenging problem. Excluding the more common causes of severe eosinophilia is required before making a diagnosis of HES and early therapeutic intervention can prevent morbidity from the disease.
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PMID:Twenty-one year old woman with severe eosinophilia and left bundle branch block. 1984 9

Upper-airway cough syndrome often coexists with other diseases that elicit chronic cough. However, the concomitant conditions are not always relevant to chronic cough, which complicates the cause diagnosis of chronic cough. The objective of this study was to explore the diagnosis and clinical implication of upper-airway cough syndrome with latent eosinophilic bronchitis. Eleven patients with upper-airway cough syndrome and latent eosinophilic bronchitis were retrospectively analyzed for their clinical manifestations, changes of eosinophilia in induced sputum, and cough threshold with capsaicin defined as capsaicin concentration that elicits two or more coughs (C2) and five or more coughs (C5) between pretreatment and post-treatment. All patients reported a history of allergic rhinitis, showed persistent dry cough or small amounts of viscid sputum with a time course of 2-60 months (median = 7 months), and presented with symptoms and signs of rhinitis, normal lung function, and airway responsiveness. Initial eosinophil percentage in induced sputum was 3.5-8.0%. Cough disappeared after 2-5 (3 +/- 1) weeks of only oral antihistamine. With successful treatment, cough threshold C2 increased from 1.73 +/- 1.45 to 4.43 +/- 4.50 micromol/L (t = 2.64, P = 0.025) and C5 increased from 2.79 +/- 2.16 to 10.10 +/- 8.22 micromol/L (t = 3.10, P = 0.011). However, there was no significant change of eosinophil percentage in induced sputum (4.8 +/- 1.5% vs. 4.4 +/- 1.4%, t = 0.84, P = 0.427). Upper-airway cough syndrome with latent eosinophilic bronchitis is a unique condition. The recognition of the entity may avoid unnecessary use of corticosteroids.
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PMID:Upper-airway cough syndrome with latent eosinophilic bronchitis. 1986 73

Cough is a major symptom in some children with asthma, but the relationship between cough and the severity of asthma is defined insufficiently. As cough represents common problem of pediatrics, several objective methods for its assessment were developed. Cough reflex sensitivity (CRS) test with capsaicin is one of the most important tools for studying cough. In the present study, we aimed to study the CRS in various phenotypes of childhood asthma. We found that, in general, CRS was increased in asthmatic children compared with controls. The most evident increase of CRS was observed during acute asthma exacerbation, in children suffering from asthma with concomitant allergic rhinitis, and in atopic asthmatics. Interestingly, we noted a significant decline in lung function after capsaicin CRS. Various laboratory and clinical characteristics of asthmatic children influence cough sensitivity to a different extent. Cough reflex sensitivity measurement can add valuable information beside the commonly used spirometric and inflammometric methods in the management of asthmatic children.
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PMID:Cough reflex sensitivity in various phenotypes of childhood asthma. 2013 41

Cough and sneezing are upregulated during the upper airway diseases, most likely to enhance airway defense. The aim of this study was to assess the expiration reflex (ER), another expulsive defensive airway reflex, during allergic rhinitis (AR) and intranasal (i.n.) capsaicin challenge. Thirty male guinea pigs, sensitized to ovalbumin were used in the study. They were divided into 3 groups of 10 animals each: AR group (i.n. ovalbumin), capsaicin group (i.n. capsaicin 50 microM, 15 microl), and controls without any challenge. The animals were anesthetized with urethane (1.1 mg/kg) and allowed to breath spontaneously via tracheostomy. Metal canula was introduced into the right hemithorax to assess intrapleural pressure. ER was elicited by mechanical stimulation of the vocal folds using a thin nylon loop introduced upwards via tracheostomy. Maximal expiratory effort of ER (MEE) and the count of post-ER laryngeal coughs were evaluated. Mechanical stimulation of the vocal folds in controls produced isolated ER. They were followed by post-ER cough only in 11% of provocations. AR and capsaicin challenge increased MEE compared with that in controls (P<0.05). In these two groups of animals, the ER was followed by post ER-cough in 75% of provocations. The count of post-ER coughs in the group order control/AR/capsaicin was 0-2/2-4/1-3, respectively; P<0.05). The ER from the vocal folds is upregulated in a similar manner as is cough and sneeze. The central neuronal mechanisms are proposed to mediate this effect, but the spread of inflammation from upper airways to the larynx, verified histologically in the present study, may contribute as well.
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PMID:Influence of stimulation of nasal afferents on expiration reflex evoked from vocal folds. 2013 47

Over the past 10 years, there has been increasing recognition of the interaction between the upper and lower airways in patients with a variety of infectious and inflammatory illnesses, including allergic rhinitis, rhinosinusitis, and asthma. Epidemiologic and mechanistic links have been proposed to demonstrate these relationships and to offer possible etiologic explanations to account for these observations. Among patients with upper respiratory illnesses, cough can be seen as a common symptom, both from the direct influences of upper airway inflammation, which incite reflex changes and bronchospasm, and from the exacerbation of associated pulmonary processes, such as asthma. Despite this increasing awareness of interaction between the upper and lower airways, the influence of both upstream and downstream respiratory inflammatory processes on laryngeal pathophysiology has not been extensively studied. Research suggests, however, that both direct stimulatory effects on the larynx and secondary effects of mucus production and mucus trafficking can create a range of laryngeal symptoms, including cough. This review discusses the interaction of the upper and lower airway in respiratory disease, and focuses on the effect of these respiratory processes on laryngeal inflammation, function, and symptoms.
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PMID:Rhinogenic laryngitis, cough, and the unified airway. 2017 61


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