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

Thirty-two confirmed and 24 highly probable cases of Legionnaires' disease occurred in Vermont between May 1 and Oct 15, 1977. Confirmed cases had positive results for direct fluorescent antibody testing of lung tissue or fourfold rise in antibody titer. Highly probable cases had one elevated titer (greater than or equal to 1:256) and a compatible illness. Forty-eight (86%) had underlying chronic disease, and 22 (39%) were immunocompromised. Prominent early symptoms were fever, cough, chills, and malaise. All but one patient had verified pneumonia. Courses ranged from a pneumonia not requiring hospitalization to respiratory failure necessitating support with mechanical ventilation. Seventeen patients died. Although the clinical presentation was variable, rapid development of high fever and leukocytosis together with negative cultures of lower respiratory tract secretions strongly suggested the diagnosis in an epidemic setting.
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PMID:Legionnaires' disease in Vermont, May to October 1977. 35 Dec 19

Chronic pulmonary histoplasmosis is best regarded as an opportunist or saprophytic infection of abnormal pulmonary spaces by a fungus of very low human pathogenicity. Tissue disease results from host immune response to dispersions of soluble antigen from these focal sources. There are two distinct types of clinical and radiological response. One is an acute or subacute illness manifested by often large segmental pneumonic lesions which tend to heal and are designated as early lesions. The other, usually developing as a complication of the first, is a chronic disease marked by persistent cavitation, low gard chronic illness, and a tendency to promote pulmonary fibrosis and often progressive pulmonary insufficiency. The early lesion is a segmental interstitial pneumonitis with central areas of infarct-like necrosis often adjacent to bullous disease and often outlining prominent emphysematous spaces which appear as radiolucencies. These radiological findings are further characterized by early clearing of the interstitial components, infarct-like contraction of the necrotic zones, obliteration of much of the contained emphysematous and bullous spaces, and healing attended by considerable loss of lung volume. Symptoms are variable but tend to be mild. Malaise, fatigability, low-grade fever, aching chest pain and mild cough lasting a few days to a few weeks are usual. Symptoms are ameliorated by rest. Rest and diminished activity are recommended as treatment. Under these circumstances, 80% of early lesions heal completely and probably most of these would heal spontaneously. Any subsequent course of the disease depends on whether or nor large air spaces, adjacent to or contained within the area of pneumonitis, become infected and persist as cavities. This occurs in 20% of early lesions. Once established, an infected cavity tends to persist and to be attended by symptoms of chronic bronchitis with chronic cough and sputum, fatigability, anorexia, and weight loss. Persisting thickwalled cavities often induce gradual development of pulmonary fibrosis, particulary in the lung bases, apparently from aspiration of antigenic material. This and the accelerated obstructive bronchopulmonary disease often lead to progressive pulmonary insufficiency. The use of amphotericin B is recommended for all persistent thick-walled cavities and in some circumstances surgical resection may be indicated.
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PMID:Chronic pulmonary histoplasmosis. 79 26

The authors reviewed the computed tomographic (CT) scans in 16 patients with pulmonary blastomycosis to describe the abnormalities seen at CT. The CT features were as follows: mass lesions (n = 14), consolidation (n = 9), air bronchograms (n = 14), intermediate-sized nodules (n = 12), satellite lesions (n = 11), pleural thickening (n = 4), small effusions (n = 2), and cavitation (n = 2). One patient had noncalcified hilar lymphadenopathy. Eight patients had acute disease, six had chronic disease, and two had acute exacerbation of a chronic illness. Fifteen patients had cough, fever, and/or dyspnea. Two patients underwent surgical resection for the presumptive diagnosis of bronchogenic carcinoma. In general, there was no correlation between the radiologic abnormalities and the clinical presentation. Consolidation occurred more frequently in acute disease. CT may be useful to help define the radiologic findings and distribution of disease. Familiarity with the characteristic CT findings of pulmonary blastomycosis may encourage an expeditious diagnostic approach to identify the disease and, possibly, prevent unnecessary surgical resection.
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PMID:Blastomycosis of the lung: CT features. 153 3

We present a 66-year old woman suffering from a chronic disorder characterized by multiple paroxysmal symptoms precipitated by coughing. These included cephalalgia, syncope, binocular photopsia phenomena with blurred vision, and an "electric-like" paroxysmal tingling of the hands. In addition to a central spinal cord cavity and hindbrain herniation, magnetic resonance imaging showed multiple skeletal anomalies and the craniospinal junction which included a narrow clivo-axial angle, basilar impression of the skull and a tight foramen magnum. Resonance magnetic imaging showed a high-signal intensity lesion on T2-weighted images at the posterior medullo-spinal junction suggesting focal demyelination. We propose that paroxysmal symptoms induced by coughing in patients bearing hindbrain ectopia and skeletal anomalies at the foramen magnum region may involve different pathogenetic mechanisms, including ectopic axonal activity and ephaptic transmission at the sensory pathways. This caused a Lhermitte-like phenomenon precipitated by coughing, rather than by forward flexion of the neck. However, increased pressure at the posterior fossa presumably underlies all these phenomena, and may therefore be potentially relieved by suboccipital decompressive craniotomy.
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PMID:[Arnold-Chiari malformation with multiple paroxysmal manifestations induced by coughing]. 845 93

Medical records, radiographs, and bronchial cytologic abnormalities of 65 cats with bronchial disease were reviewed. Bronchial disease was defined as abnormality of the lower airways to the exclusion of disease originating or mainly involving the alveoli, interstitium, vasculature, or pleura. Cats with bronchial disease were more likely to be female and older. Siamese cats were overrepresented and had more chronic disease. In order of frequency, the following clinical signs were reported: coughing, dyspnea, occasional sneezing, wheezing, and vomiting. Radiography revealed prominent bronchial markings, with some cats having collapse of the middle lobe of the right lung (n = 7), overinflation of the lungs (n = 9), or aerophagia (n = 13). Of 65 bronchial washes, 58 were considered exudative, with the predominant cell type being eosinophil in 24%, neutrophil in 33%, macrophage in 22%, and mixed population of cells in 21%. Cultures for bacteria were considered positive in 24% of the cats. Circulating eosinophilia was not helpful in predicting the predominant cell type in bronchial cytologic exudates. Hyperproteinemia without dehydration was present in a third of the cats, indicating an immunologic response. Half the cats had resolution of clinical signs, whereas half the cats required continuing medication with bronchodilators, antimicrobial agents, or corticosteroids.
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PMID:Clinical, radiographic, and bronchial cytologic features of cats with bronchial disease: 65 cases (1980-1986). 247 Jul 10

A population survey was conducted in 1982-1983 among 3,812 persons aged 65 years and older residing in East Boston, Massachusetts, a geographically defined urban community. Three measurements of peak expiratory flow rate were obtained by using calibrated mini-Wright meters. Peak expiratory flow rate was strongly related to age, sex, smoking, and years smoked. After adjustment for these factors, low peak expiratory flow rate was associated with chronic respiratory symptoms (cough, wheeze, shortness of breath, exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea; p less than 0.0001) and with certain cardiovascular variables (history of stroke, p = 0.0014; angina, p = 0.05; and high pulse rate, p = 0.004). No significant associations were found with history of myocardial infarction or systolic and diastolic blood pressures. Peak expiratory flow rate was positively related to education (p less than 0.0001) and income (p less than 0.0001). Peak expiratory flow rate also was strongly related (p less than 0.0001) to measures of functional ability and physical activity, self-assessment of health, and simple measures of cognitive function. The correlations of peak expiratory flow rate with pulmonary symptoms and other indices of chronic disease raise the possibility that peak expiratory flow rate will predict mortality in an elderly population.
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PMID:Peak expiratory flow rate in an elderly population. 278 11

Exogenous lipid pneumonia (ELP) is caused by the aspiration of animal, vegetal or, more often, mineral oils. Even though it may also be acute, ELP is most frequently a chronic disease, affecting people with predisposing factors, such as neuromuscular disorders, structural abnormalities and so on; very often exogenous lipid pneumonia is found in tracheotomized patients. The pathology of lipid pneumonia is a chronic inflammatory process evolving in foreign-body-like reaction, and eventually in "end-stage lung" condition. Clinically, most patients are asymptomatic; few cases only present with cough, dyspnea and chest pain. Eight cases of ELP, studied over the past 3 years, are described in this paper. All the patients were examined by chest radiographs and standard tomograms; 3 patients underwent CT. X-ray features were mono/bilateral consolidation of the lower zones, with air bronchogram and variable reduction in volume. CT density was not specific for fat tissue. In all cases the diagnosis was confirmed at biopsy. In 5 patients, followed for at least one year, clinical-radiological features showed no change. Thus, complications of ELP (especially malignant evolution) could be excluded. The authors conclude that lipid pneumonia must be considered in differential diagnosis of patients with history of usage of oils and compatible X-ray findings. The usefulness of an accurate follow-up is stressed.
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PMID:[Exogenous lipid pneumonia. Clinico-radiologic characteristics]. 338 10

Recent prevalence data for childhood asthma in Switzerland suggest a substantial underdiagnosis which seems to be more pronounced in girls. We further analysed our data trying to specify risk factors for underdiagnosis and undertreatment. Our special interest was focused on female sex as there is evidence for a sex-dependent diagnosis and treatment of chronic disease in adults, called the Yentl syndrome. The data are derived from a parent completed questionnaire survey of a stratified cluster sample of schoolchildren aged 7, 12, and 15 years. Besides the 12 months prevalence of asthma symptoms and bronchodilator treatment, the lifetime prevalence of an asthma diagnosis was noted. With a response rate of 97%, a total of 4353 completed questionnaires were analysed. While age was not associated with undertreatment (except for exercise-induced symptoms in adolescents), the lack of a formal diagnosis of asthma and atypical asthma symptoms other than wheeze such as chronic night cough were confirmed as significant risk factors for undertreatment. Of all boys reporting asthma symptoms 31% received bronchodilator treatment compared with only 15% of the symptom-reporting girls (P < 0.001). For all particular asthma-related symptoms (except wheeze), significantly more boys than girls (approximately double) received treatment. The physiological and psychological bases for these findings are discussed and suggest that gender is an important risk factor for underdiagnosis and undertreatment of asthma. Our research indicates that the Yentl syndrome may exist for childhood asthma.
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PMID:The Yentl syndrome in childhood asthma: risk factors for undertreatment in Swiss children. 779 17

We report the results of a retrospective analysis of 120 patients with sarcoidosis admitted for the first time to the Clinical Hospital for Pulmonary Diseases "Jordanovac" from 1982 to 1983. Eighty-two women and 38 men (2,2:1) participated in the study. The most common symptoms at the time of hospitalization were cough (35%), erythema nodosum (32.5%), fever (28.3%) and dyspnea (20.9%). The peripheral lymph nodes were enlarged in 10% of the cases, liver in 10.8%, and spleen in 1.7%. Elevated sedimentation rate was found in 40.8% of the patients, hypercalcemia in 3.6%, and hypercalciuria in 23.4%. Peripheral lymphogenia was present in 59.2% of the patients, and hypergammaglobulinemia in 65.5%. Other biochemical parameters were followed, as well. According to the radiological classification, 65 (54.2%) were classified as belonging to Stage I, 51 (42.5%) as belonging to Stage II, and one as belonging to Stage III at the time of diagnosis. 50.8% of the patients presented with an acute onset of the disease, 37.2% had chronic disease, while 12 (10%) patients were detected accidentally. The diagnosis was based on typical clinical and radiologic features along with histological and/or cytological evidence of granuloma usually provided from the tissue biopsy specimens obtained during bronchoscopy (93.3%). Extrathoracic sarcoidosis most usually involved the liver, skin, joints and peripheral lymph nodes. Fifty-eight of the 120 (48.3%) patients were yielded to spontaneous healing. Twenty-seven patients were followed up from 2 to 6 years, and two (7.4%) patients later showed a chronic form of the disease. Corticosteroid therapy was administered to 62 (51.7%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Characteristics and outcome of pulmonary sarcoidosis]. 817 Feb 75

Medical records of 21 horses with summer pasture-associated obstructive pulmonary disease were reviewed, and history, signalment, clinical signs, radiographic signs, clinicopathologic data, and therapeutic response were determined. Most affected horses were used as pleasure horses, and for the most part, remained at pasture when not in use. The mean age (+/- SD) was 13.7 +/- 3.6 years. Clinical signs included intermittent nasal discharge, cough, tachypnea, labored expiratory effort, and crackles and wheezes on auscultation. Radiography frequently revealed interstitial patterns in the lung fields; in horses with chronic disease, pulmonary overinflation was evident. Hemogram was usually normal, and transtracheal wash fluid was characterized by nondegenerate neutrophils.
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PMID:Summer pasture-associated obstructive pulmonary disease in horses: 21 cases (1983-1991). 845 16


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