Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 65-year-old woman started taking enalapril 2.5 mg daily for hypertension. Twelve days later she complained of a persistent, dry cough. Due to the coughing and a preexisting cystocele, she developed stress incontinence and a marked decline in her functional status. The coughing and incontinence resolved with the discontinuation of enalapril. During a subsequent hospitalization the patient received captopril 6.25 mg twice daily for congestive heart failure. Within 24 hours the dry cough recurred. It resolved with the discontinuation of the drug. Cough is a symptom that is generally not recognized as a drug side effect. However, increasing numbers of case reports document angiotensin-converting enzyme inhibitor-induced cough. Although the actual frequency and mechanism are currently unknown, the dry cough typically begins early in the course of therapy. It may be specific to this pharmacologic class rather than to one individual agent. Age and sex may be contributing factors. While cough has been considered a minor side effect, unnecessary hospitalizations and inappropriate treatments may easily result. Even minor adverse reactions may have an impact on a patient's quality of life.
 ...
PMID:Angiotensin-converting enzyme inhibitor-induced cough. 254 8

A total of 67 female patients with pelvic relaxation (cystocele beyond the vaginal orifice) and with no urinary incontinence were clinically and urodynamically evaluated before and after a reconstructive surgical procedure. Of these, 24 patients had a significant decrease in abdominal pressure transmission to the urethra once the cystocele was reduced by vaginal pessary (abdominal pressure transmission ratio to urethra: bladder of less than 1.0). All 24 had a revised Pereyra procedure in addition to the cystocele repair. The other 43 patients had adequate abdominal pressure transmission to the urethra once the cystocele was reduced by vaginal pessary (abdominal pressure transmission ratio to urethra: bladder of greater than or equal to 1.0). These 43 patients underwent cystocele repair only with no surgical repair to the urethra or urethrovesical junction. Evaluation was repeated at 3 to 6 months after the operation. No patient developed urinary incontinence after operation. All 67 patients had urodynamically good abdominal pressure transmission to the urethra while coughing. Women with significant genitourinary prolapse may be continent in spite of a weak urethral sphincter because of kinking of the poorly supported urethra. Urodynamic testing can identify those women at risk of developing postoperative urinary incontinence so that prophylactic measures can be undertaken.
 ...
PMID:Predicting postoperative urinary incontinence development in women undergoing operation for genitourinary prolapse. 336 1

A total of 109 patients submitted to surgery for the correction of urinary stress incontinence (USI) by two different techniques, i.e. anterior colporrhaphy (group I, n = 57) when cystocele grade II/III was present, and Burch procedure (group II, n = 52) when cystocele grade I was present, were reevaluated an average of 5 years after surgery (range: 54-66 months). The curve constructed with the reevaluation data showed a sharp superiority of the Burch technique in terms of correction of USI and associated genital prolapses. There was a progressive recurrence rate that stabilized at 5 years, with values of 78.9% in group I and 40% in group II. Anterior colporrhaphy was ineffective for the correction of any of these parameters in group I. The data clearly show the need to improve the presurgical diagnostic methods for the selection of patients that will benefit from treatment: detailed history of the current disease and auxiliary tests such as Q-tip test, transvaginal ultrasound, and urodynamic study. Other factors were associated with ineffective treatment in both groups, such as hypoestrogenism (20/109), excessive weight gain (19/109) and chronic intestinal constipation and/or coughing present in 36 patients, with recurrence in 28 of them.
 ...
PMID:Evaluation of long-term results of surgical correction of stress urinary incontinence. 869 69

This is a 1-year preliminary report of a 5-year study. Forty-six women with genuine stress incontinence (GSI) were evaluated with multichannel urodynamics before laparoscopic Burch repair and 1 year postoperatively. Reports conclude that as many as 18% of patients develop enteroceles or rectoceles in the first 5 years after Burch repair. To see if prophylactic posterior suspension could prevent this delayed complication, all women had at least a modified culdoplasty. If paravaginal defects, rectoceles, or enteroceles were present, these were also repaired laparoscopically. All patients had a quality of life questionnaire, 24-hour urolog, transperineal ultrasound, cystourethroscopy, cough stress test, and multichannel urodynamics. At 6 weeks they all had a negative ultrasound, cough stress test, and cystometrogram. At 1 year the complete evaluation was repeated. Five women were lost to follow-up. Four of 41 patients had recurrent GSI. One patient had a grade 1 cystocoele with no other signs of pelvic vault prolapse. These are cure rates of 91% and 98% for GSI and pelvic vault prolapse, respectively. The urodynamic studies appear to be comparable with those reported in laparotomy Burch repairs. These findings are encouraging for laparoscopic procedures, but they are short term and it is essential that the patients be followed for 5 years for the data to be clinically relevant.
 ...
PMID:Multichannel Urodynamics for Laparoscopic Burch and Pelvic Vault Repairs 907 27

The aim of the study was to introduce an anatomical classification for the management of urinary dysfunction based on the Integral Theory, a new connective tissue theory for female incontinence. Eighty-five unselected patients, aged 27-83 years, 12 with pure stress symptoms and 73 with mixed incontinence symptoms, were classified as having laxity in the anterior, middle or posterior zones of the vagina, using specific symptoms, signs and urodynamic parameters summarized in a pictorial algorithm. Special ambulatory surgical techniques, which included the creation of neoligaments, repaired specific connective tissue defects in the anterior (intravaginal slingplasty (IVS), n = 85), middle (cystocele repair, n = 6), or posterior zones (uterine prolapse repair, n = 31, or infracoccygeal sacropexy, n = 33). Almost all patients were discharged within 24 hours of surgery, without postoperative catheterization, returning to fairly normal activities within 7-14 days. At (mean) 21-month follow-up cure rates were: stress incontinence 88% (n = 85), frequency 85% (n = 42), nocturia 80% (n = 30), urge incontinence 86% (n = 74), emptying symptoms 50% (n = 65). Mean objective urine loss (cough stress test) was reduced from 8.9 g preoperatively to 0.3 g postoperatively, and mean residual urine >50 ml from 110 ml to 63 ml, P = <0.02. Pre- and postoperative urodynamics indicated that detrusor instability was not associated with surgical failure. Two new directions, based on the Integral Theory, are presented for the management of female urinary dysfunction, an anatomical classification which delineates three zones of vaginal damage, and a series of ambulatory surgical operations which repair these defects. The operations are fairly simple, safe, effective and easily learnt by any practising gynecologist.
 ...
PMID:New ambulatory surgical methods using an anatomical classification of urinary dysfunction improve stress, urge and abnormal emptying. 955 90

Functional results of surgical correction of genital prolapse were compared with those of transvaginal implantation of the prolift in 26 and 22 women, respectively. Standard protocol required gynecological examination, cough test, complex urodynamic investigation. Patients of both groups were matched by anthropometric parameters. All the patients were reexamined 1, 3 and 6 months after surgery. Comparison of the results showed that most of the urodynamic parameters changed insignificantly in patients treated surgically for prolapse of the urinary bladder. Moreover, there was no significant association between these findings and surgical methods of the prolapse treatment. Stress urinary incontinence arose in 13.64% (3/22) patients who had undergone prolift implantation and in 3.85% (1/26) patients after colporraphy. Postoperative overactive bladder was observed in 9.09% (2/22) and 11.54% (3/26) patients, respectively. No significant difference by the above symptoms between the groups were registered in relation to the operation type. Similar data were obtained in respect of incidence of lower urinary tract infections. Thus, it is found that prolift plastic operations for cystocele do not increase the incidence of urinary incontinence, overactive bladder, lower urinary tract infection. Further studies with greater number of patients and longer follow-up are needed.
 ...
PMID:[Effects of synthetic materials used for the treatment of genital prolapse on lower urinary tract function]. 2227 81

The pelvine organ prolapse (POP) is a condition affecting million of women, with a major impact upon the social and professional life of the patients. According to various studies, it affects approximately 40% of the women aged over 50 years. About 10% of women with POP require a surgical procedure for POP or urinary incontinence. Our study comprised a number of 14 patients, aged between 55 and 70 years, hospitalized and treated in the Clinic of Urology within the Emergency County Hospital of Craiova, Romania, between 2011 and 2013, for second-degree cystocele. Of these, 11 (78.57%) patients had more than two natural deliveries, 10 suffered more than three abortions, and eight (57.14%) women suffered from obesity. The increase of abdominal pressure, induced by chronic coughing, constipation or hard physical work, was identified in more patients. Thus, six (42.8%) patients presented chronic bronchitis, four (28.57%) patients were smokers, eight (57.14%) patients presented chronic constipation, and 10 (71.42%) patients stated that they had performed hard physical work. The presence of effort urinary incontinence, associated to the cystocele, was found in eight (57.14%) cases. The surgical intervention consisted in the performance of a direct cystopexia with a synthetic tent, placed in a transobturatory way, in a "tension free" manner (Perigee System). The post-operatory evolution was a good one; the results after six months showed that 12 (85.71%) women were cured, two (14.29%) cases of cystocele relapsed, while in two patients there maintained the effort urinary incontinence. The histopathological examination of the anterior vaginal wall fragments, harvested during the surgical intervention, showed the presence of a chronic inflammatory infiltrate in the lamina propria of the uterine mucosa, which may cause the post-operatory relapses. We consider that the reduction of the inflammatory process through the administration of anti-inflammatory drugs could reduce the POP onset and progress.
...
PMID:Etiopathogenic, therapeutic and histopathological aspects upon the anterior vaginal wall prolapse. 2642 70