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

Because of inspiration into the tracheo-bronchial aireays, regurgitation from purely oesophageal diseases can provoke various respiratory affections: acute broncho-pulmonary blocking broncho-pneumonia, pulmonary suppuration, night cough, fits of nocturnal suffocation, chronic bronchitis sometimes hemoptic. A mega oesophagus, a diverticulum, stenosis or oesophagus cancer are at the origin. Oesophago-bronchial fistulae are excluded. The decrease of the glottal guarde remains to be explained because it usually protects the trachea from such mishaps (part played by decubitus, sleep, secretions stagnating in the pharynx).
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PMID:[Broncho-pulmonary manifestations during non-fistulized esophageal lesions]. 61 85

Forty-five acutely ill, coughing patients, three with acute dyspnea and cardiomegaly, and 37 control subjects were placed in lateral decubitus positions for auscultation of their dependent lungs to determine if this maneuver would elicit inspiratory crackles, signs of pneumonia. In the upright position, auscultation of the lungs was normal in all control subjects and in lateral decubitus positions their dependent lungs revealed transient late inspiratory crackles in seven of the 37 (18.9%), and transient inspiratory peeling sounds in two others (5.4%). Thirteen acutely ill, coughing patients, free of prior cardiac and pulmonary diseases, had persistent late inspiratory crackles induced in one or both dependent lungs when placed in lateral decubitus positions. These dependent lungs also revealed increased numbers of crackles in three patients, late inspiratory squeaks in four, and wheezes in three others. In the upright position, auscultation of the lungs was normal in 10 of these patients, and a few basilar crackles were heard in three others. All of these abnormal findings cleared after treatment with antibiotics. Thirty-one of 32 acutely ill, coughing patients with bronchitis, sinusitis, or pharyngitis were free of induced crackles in dependent lungs in lateral decubitus positions. However, placement of two other patients in these positions appeared to have elicited the inspiratory crackles of chronic pulmonary disease and early congestive heart failure. These observations suggest that placement of acutely ill, coughing patients into lateral decubitus positions for auscultation of the dependent lungs may be a valuable maneuver for diagnosis of pneumonia.
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PMID:Detection of pneumonia by auscultation of the lungs in the lateral decubitus positions. 280 64

Recently, an esophageal balloon incorporated into a nasogastric tube was designed that allowed measurement of intraesophageal pressure. To define the performance of this nasogastric-esophageal balloon (NG-EB) system, comparative measurements were made with a standard esophageal balloon while subjects were in the sitting, supine, and left lateral decubitus and right lateral decubitus positions. Values for dynamic pulmonary compliance, pulmonary resistance, and cough pressure were not statistically different between the two systems. Mean static deflation pressure-volume (P-V) curves using the NG-EB were shifted to the left of the esophageal balloon P-V curve in all body positions, but static lung compliance (CL) was not statistically different. For both balloon systems, CL showed no significant difference between sitting and right lateral decubitus positions. Results from this study indicate that the NG-EB system acceptably reflects esophageal balloon pressure measurements and should be useful in estimating lung and chest wall mechanics in acutely ill patients requiring mechanical ventilation.
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PMID:Comparison of intraesophageal balloon pressure measurements with a nasogastric-esophageal balloon system in volunteers. 712 49

Early physicians diagnosed pleural effusion by detecting shifting percussion dullness of the chest. However, the lateral decubitus positions have not been routinely used to distinguish this condition from atelectasis or pneumonia. In this report, postural alterations of percussion dullness established the diagnosis of pleural effusion in a 49-year-old patient with a cough. Percussion in the lateral decubitus positions may enhance the value of examinations of the chest.
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PMID:Shifting percussion dullness of the chest: a sign of pleural effusion. 940 19

In this observational study of patients with multiple sclerosis (MS) admitted to a regional neurology centre we assessed the frequency of dysphagia (objectively defined), dysphagia related symptoms, bulbar signs and nutritional status. We studied 79 consecutive admissions with MS (24 at diagnostic admission and 55 more advanced cases admitted for treatment and/or rehabilitation): normative swallowing data were from 181 healthy controls. Swallowing symptoms and signs were semi-quantitatively measured and compared to healthy controls. Dysphagia was defined by a quantitative water test. Disability was determined by Kurtzke's Expanded Disability Status Scale and Barthel's index. Nutritional status was assessed by body mass index, estimated percentage body fat from skin fold thickness measurements at four sites, a global evaluation of nutrition, the presence of pressure sores and the pressure sore risk using the Waterlow score. Patients with MS were more likely to complain of abnormal swallowing, of coughing when eating, and of food 'going down the wrong way' than healthy controls (P < 0.005). These significantly associated symptoms had high specificity but relatively low sensitivity. 43% of patients had abnormal swallowing, almost half of whom did not complain of it: abnormal swallowing was associated with several factors including abnormal brainstem/cerebellar function, disability, vital capacity, and depression score. Those with abnormal swallowing had higher Waterlow scores (P < 0.001), but, overall, abnormal swallowing was not associated with a difference in nutritional indices or incidence of pressure sores. In summary, abnormal swallowing is common in MS although often not complained of. It is associated with disordered brainstem/cerebellar function, overall disability, depressed mood and low vital capacity. It was not associated with major nutritional failure or pressure sores in this study.
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PMID:Dysphagia and nutritional status in multiple sclerosis. 1046 Apr 44

Non-invasive ventilation refers to the technique of providing ventilatory support to a patient without an endo/orotracheal airway. It is a promising and rapidly upcoming new technique and is being used as first line therapy in a wide variety of conditions causing respiratory failure. The major indications for its use include respiratory failure due to a variety of causes (chest wall abnormalities, neuromuscular disease, COPD), weaning and stabilization of cardio-respiratory status before and after surgery. Patients who are candidates for this modality usually have a hypercapnic respiratory failure but are able to protect the airway and cooperate with treatment. The biggest advantage of the technique is its simplicity and avoidance of complications of intubation like trauma, infection and delayed complications like tracheal stenosis. Patient comfort is significantly improved and important functions like speech, swallowing and cough are preserved. Several purpose built ventilators are available for use including pressure preset and volume present machines, each of which have their own advantages and disadvantages in clinical practice. A range of patient interfaces is available. The initiation of non-invasive ventilation is much easier as compared to invasive ventilation and can be done for most patients in an intermediary care unit thereby cutting down treatment costs and saving precious intensive care beds. Titration of ventilatory parameters can usually be done using simple tests like oxymetry and blood gases. Several technique related problems like skin pressure sores, nasal symptoms and abdominal distension can be managed with simple measures. Non invasive ventilation has got a special and evolving role in management of COPD, both in acute exacerbations and chronic respiratory failure. In short, the advantages of this form of ventilation are numerous and physicians must familiarize themselves with this new technique, facilities for which should be available in all hospitals admitting patients with respiratory failure.
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PMID:Non invasive ventilation. 1127 77

Tumors on the carina are uncommon, and their anesthetic management can present a considerable challenge. The principle anesthetic consideration is ventilation and oxygenation in the face of an open airway. A 60-year-old man patient suffered a carinal tumor, which occupied 70% of the both main bronchi and bled spontaneously while coughing. Surgical resection and reconstruction were done. The carinal surgical approach was a right posterolateral thoracotomy, and the patient was placed in the left decubitus position. Because we could not insert the jet catheter past the mass, high frequency jet ventilation to ventilate the dependent lung could not be applied. Our choice was differential lung ventilation with a combination of conventional and high frequency jet ventilation modes to preserve oxygenation during tumor excision and tracheal reconstruction. An episode of desaturation was successfully treated during removal of tumor. The postoperative course was uneventful. The patient was sent to the intensive care unit after surgery and discharged on the 11th day. He received further combined chemotherapy and radiotherapy during his next admission. Fiberoptic examination on the 5 months later no evidence of recurrence. In summary, we described our airway management on carinal tumor excision, especially the tumor was so large that dependent lung jet ventilation could not employ.
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PMID:Combined conventional and jet ventilation in airway management in tracheal tumor. 1156 53

An iatrogenic venous air embolism caused by computed tomography (CT) injector occurred in a 74-year-old man undergoing abdominal-pelvic CT for evaluation of an abdominal aortic aneurysm (AAA). During the initial inspection scan of the thoracic part, a large amount of air was detected in the right ventricle, but no contrast medium was noted in the aorta. Surface oxygen was given immediately, and the patient was placed in the left lateral decubitus position on the CT bed. During that time he had no symptoms except coughing. CT revealed no air in the brain or pulmonary vein, and he was returned to his room 55 minutes after the incident. There were no complications during a six-month follow-up period. The importance of daily risk management and immediate proper after care to prevent such accidents was reconfirmed.
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PMID:Iatrogenic venous air embolism caused by CT injector--from a risk management point of view. 1546 49

Prolonged cough could be a diagnostic and therapeutic dilemma. We present here the case of an elder man who suffered from a dry cough and malaise during four weeks, followed by a fever of unknown origin. After many studies and review of symptoms, a biopsy of the temporal artery confirmed a giant cell arteritis. Cough and malaise could be an early symptom of temporal arteritis in elderly patients. Pain in the outer ear on the lateral decubitus could be another interesting symptom in this disease.
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PMID:[Prolonged cough as initial symptom of temporal arteritis]. 1842 65

The RTX respirator is a biphasic external cuirass-style ventilator that supports both inspiration and expiration at various cycle rates and pressures, as well as allowing application of the vibration and cough modes. With this respirator, the duration and pressure can be altered in both the inspiratory and expiratory phases, and it can promote the removal of secretions by switching between the vibration mode (which involves external high-frequency oscillation: EHFO) and the cough mode. We used this respirator to remove secretions in two elderly patients with extensive atelectasis. They were nursed in the lateral decubitus position with the cuirass attached to one side of the chest only. The vibration mode removed secretion to reduce the viscosity of secretions and loosen impacted bronchial secretions. The cough mode interrupts the vibration mode and forces secretions towards the pharynx. The lateral decubitus position was useful for postural drainage. The extensive atelectasis of both patients was improved by this procedure. The RTX respirator may be a useful tool for the management of elderly patients with sputum retention.
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PMID:Marked improvement of extensive atelectasis by unilateral application of the RTX respirator in elderly patients. 1968 90


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