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

Exercise-induced asthma is a common but frequently undiagnosed problem. The patient may not wheeze, but rather have shortness of breath, chest tightening, and coughing. The coach and the physician must be particularly alert to the signs and symptoms of exercise-induced asthma to recognize this syndrome. Proper conditioning, warming up, inducing refractoriness, participating in sports less likely to provoke exercise-induced asthma, and the aggressive use of appropriate medications allow patients to enjoy sports and compete effectively. A rare but potentially fatal syndrome is exercise-induced anaphylaxis. Accurate diagnosis and differentiation from other exertion-related syndromes are critical, and appropriate precautions are necessary. A third clinical entity, exercise-induced cholinergic urticaria, although not life-threatening, can be quite annoying. Aggravating factors, such as increased heat, compound the problems. In summary, exercise-induced allergic phenomena are common and should be recognized by the practicing physician.
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PMID:Exercise-induced asthma, anaphylaxis, and urticaria. 178 58

In 1990, 1530 active Swiss athletes of national or international level (53% response rate) answered a questionnaire on allergies, hay fever and respiratory symptoms during or after physical effort. Compared with 1986, the prevalence of allergies among these athletes had increased from 14.7 to 18%, and of hay fever from 16.8 to 19.7%. The prevalence of respiratory symptoms was 12.1 in 1990, compared with 7.1% in 1986. Smoking was less frequent than in 1986 (7.1% against 12%). There was a significant correlation between the reported allergies and respiratory symptoms, but none between respiratory symptoms and smoking or frequency of consultations at a physician's office. The examination of 104 athletes complaining of respiratory symptoms on 10 minutes ergometry showed a decrease of FEV1 of 10% or more in 21%. Exercise induced asthma (EIA) is not as frequent as suspected in other publications. 25% of the sportsmen examined showed a cutaneous allergy to one or more of the six most frequent inhalative allergens. The typical history of dyspnea, wheezing or coughing after exercise, possibly combined with a feeling of tightness of the chest or the larynx, and the number of positive allergy skin test reactions, correlated with the decrease in FEV1 after exercise. A considerable percentage of these athletes do not treat their respiratory symptoms or ask for professional help. In medical treatment, attention must be paid to doping regulations. IOC accepts the use of salbutamol, terbutaline, orciprenaline and Cromoglycic acid in the treatment of asthma. Corticosteroids by inhalation are accepted but intramuscular injection is forbidden.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Exertional asthma in Swiss top-ranking athletes]. 843 40

Bronchoconstriction associated with exercise can occur in nearly all individuals with asthma and in 35-40% of those with allergic rhinitis/hay fever symptoms. This represents approximately 12-15% of the population. Exercise-induced asthma (EIA) is a clinical syndrome characterized by transient airflow obstruction typically 5-15 min after cessation of physical exertion. Symptoms may include chest tightness, breathlessness, coughing, and/or wheezing. Some individuals may experience delayed bronchoconstriction (late phase response) 6-10 h after completing exercise. Approximately 40-50% of those with asthma exhibit a "refractory period", i.e., diminished bronchoconstriction to exercise performed within 2 h. The pathophysiology of EIA is related to thermal events within the intrathoracic airways. Alterations in the temperature of the airways and/or osmolarity in the epithelial lining fluid cause release of mediators in the airways and the development of bronchoconstriction. Although EIA can be strongly suspected by an appropriate history, pulmonary function testing is necessary to make a specific diagnosis. Measurement of lung function is an important first diagnostic test. If there is no evidence of airflow obstruction at rest, then either bronchoprovocation testing or exercise challenge testing is indicated. Nonpharmacologic therapy includes "warm-up" exercise prior to training or competition to induce a "refractory period" and to prevent/reduce bronchoconstriction. An inhaled beta 2-adrenergic agonist, e.g., albuterol, is usually effective for preventing/treating EIA. Cromolyn sodium is an alternative class of medication that inhibits both the early and late phase responses. Other bronchodilator agents are available if combination therapy with an inhaled beta 2-adrenergic agonist and cromolyn sodium is not effective.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Exercise-induced asthma. 849 82

Exercise-induced asthma is defined as an intermittent narrowing of the airways, demonstrated by a decrease in some measure of flow, that the patient experiences as wheezing, chest tightness, coughing, and difficulty breathing that is triggered by exercise. Exercise will trigger asthma in most individuals who have chronic asthma, as well as in some who do not otherwise have asthma. Definitive diagnosis requires demonstration of a drop in flow rate, typically > or = 13-15% for forced expiratory volume in one second (FEV1) and > or = 15-20% for peak expiratory flow rate (PEFR), after exercise, associated with symptoms. Prevalence data indicate that this disorder is very common in those who participate in recreational sports as well as in highly competitive athletes, with at least 12-15% of unselected athletes having positive exercise challenges. Treatment of exercise induced asthma involves use of nonpharmacological measures (such as the use of the refractory period after exercise and prewarming air) as well as use of medications (beta-agonists, cromolyn, and nedocromil). With treatment, those who suffer from exercise-induced asthma may be able to participate and compete at the highest levels of performance.
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PMID:Exercise-induced asthma: a practical guide to definitions, diagnosis, prevalence, and treatment. 899 24

Exercise-induced asthma: diagnosis and treatment for the recreational or elite athlete. Med. Sci. Sports Exerc., Vol. 31, No. 1 (Suppl.), pp. S33-S38, 1999. Exercise-induced asthma (EIA) is found in 10-50% of recreational and elite athletes, depending on the population studied. The diagnosis may be made with symptoms (cough, wheeze, chest tightness, etc. with exercise) and with pulmonary function measurements (spirometry or peak flow measurements) before and after exercise. Most patients respond well to pre-exercise treatment with an inhaled quick-acting beta agonist. Some patients require additional therapy such as pre-exercise inhaled cromolyn, daily inhaled steroids, salmeterol, theophylline, leukotriene modifiers, or other agents. An occasional patient presents with the symptoms of EIA but responds poorly to treatment. Further investigation may lead to a totally different diagnosis such as vocal cord dysfunction. For most athletes with EIA, proper diagnosis and treatment will allow them to complete at any level.
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PMID:Exercise-induced asthma: diagnosis and treatment for the recreational or elite athlete. 992 28

Exercise-induced asthma, as recognized in asthmatic subjects, is an exaggerated airway response to airway dehydration in the presence of inflammatory cells and their mediators. The airway narrowing is primarily caused by contraction of bronchial smooth muscle. The milder airway narrowing documented in response to exercise in elite athletes and otherwise healthy subjects may simply be the result of the physiologic responses and pathologic changes in airway cells arising from dehydration injury. These changes, which include excessive mucus production and airway edema, would serve both to cause cough and to amplify the narrowing effects of normal bronchial smooth muscle contraction, resulting in symptoms. These changes are more likely to occur in healthy subjects who exercise intensely for long periods of time breathing cold air, dry air, or both. Under these conditions, the ability to humidify inspired air may be overwhelmed, causing significant dehydration of the airway mucosa and an increase in osmolarity, even in small airways. In addition to dehydration injury, airway narrowing to pharmacologic and physical agents may occur as a result of injury caused by large volumes of air containing irritant gases, particulate matter, or allergens being inspired during exercise. As a result, the airways may become inflamed, and the airway smooth muscle may become more sensitive. These events could result in the same exaggerated airway response to dehydration, as documented in asthmatic subjects.
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PMID:Exercise-induced asthma: is it the right diagnosis in elite athletes? 1098 59

Exercise induced asthma is an exaggerated airway response to airway dehydration and the following mediators release from the inflammatory cells. The airway narrowing is primarily caused by bronchial smooth muscle contraction, but in milder form mucus production, airway edema and cough can be observed. In this study we have described some previously and currently proposed hypotheses which may explain pathomechanism of this form of bronchial hyperreactivity.
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PMID:[Pathogenesis of exercise induced asthma]. 1176 10

Exercise-induced asthma (EIA) is defined as the clinical occurrence of shortness of breath, cough or wheeze that occurs typically 5-15 minutes after the cessation of the exercise. In most patients with EIA, bronchoconstriction is followed by a refractory period, during which repeated exertion causes less bronchoconstriction. The occurrence of this type of asthma is influenced by the intensity and the duration of exercise. It is now generally believed that EIA affects all patients with asthma if challenged with exercise of sufficient intensity. The estimate prevalence varies from 7 to 15% in the general population. EIA appears also to affect 3-14% of athletes. It is now clear that hyperventilation and hypertonicity of airway-lining fluid provide the stimulus for EIA with release of constrictor mediators. Recently, incidence of new diagnoses of asthma is associated with heavy exercise in communities with high concentrations of ozone, thus, air pollution and outdoor exercise could contribute to the development of asthma in children. Beta-agonists and/or disodium cromoglycate remain the preferred first-line therapy for EIA but now antileukotrienes provide an attractive therapeutic alternative. General recommendations can help reduce its severity: warm-up; breath through mask when exercising in cold, dry conditions; in recent years some reports have suggested that training and conditioning may help athletes and non-athletes with asthma have fewer symptoms after exercise, increase the threshold of exercise necessary to induce airway obstruction and finally improve their well-being. Scuba diving stays an absolute contra-indication if asthma.
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PMID:[Asthma and exercise]. 1242 36

Exercise-induced asthma (EIA) is a possible cause of poor physical performance in children. No data are available on the value of respiratory symptoms to discriminate children with bad physical fitness from children with EIA. We evaluated respiratory symptoms in school-age children during and after exercise in relation to EIA. The population of 149 primary schools (849 classes with 15,241 children) was enrolled in the study. EIB was assessed using the 6-min free-running-test (6MFRT) in 15,241 children. At the end or at premature arrest of the 6MFRT, signs reported by the children and clinical symptoms observed by supervising physicians were recorded. Peak flow measurements were obtained before and 5 and 10 min after the 6MFRT, a decrease of 15% or more being defined as significant. The 6MFRT was positive in 7.4% of primary schoolchildren. Girls were more likely to have a positive test than boys (8.5% vs. 6.4%, P < 0.001), and children living in urban areas more than those living in rural areas (8.9% vs. 7.0%, P < 0.01). Premature arrest was seen in 3.5% (i.e., n = 353) of the children. The main reasons for premature arrest were dyspnea and chest pain. Among them, only 21% had a positive 6MFRT, while 89% with a positive 6MFRT could terminate the test. Premature arrest, breathlessness, chest tightness, wheezing, and cough had a positive predictive value to detect a EIA of 21.9%, 20.8%, 36.4%, 41.2%, and 28.3%, respectively, and a sensitivity of 10.8%, 29.5%, 14.9%, 4.8%, and 13.0%, respectively. In conclusion, EIA was detected in 7.4% of schoolchildren. A slightly higher incidence was observed in girls and children from an urban area. Neither premature arrest nor clinical signs and symptoms were good predictors of EIA in primary schoolchildren.
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PMID:Exercise-induced respiratory symptoms are poor predictors of bronchoconstriction. 1567 9

Exercise-induced asthma (EIA) affects 12% to 15% of the general population. Its symptoms include chest tightness, shortness of breath, coughing, wheezing, fatigue, and prolonged recovery times after exercise. Diagnosis depends on accurate history, physical examination, and lung function testing. Nonpharmacologic management includes modification of both activity and ambient conditions, along with rigorous patient education. Short-acting inhaled beta2 agonists are the pharmacologic treatment of choice for isolated and breakthrough EIA. Anti-inflammatory medications such as inhaled cromolyn sodium, nedocromil sodium, and corticosteroids are used to control underlying asthma as well as EIA. Other agents such as oral theophylline or long-acting beta agonists may be important but their roles aren't clearly defined.
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PMID:Diagnosis and management of exercise-induced asthma. 2008 54


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