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)

Anesthetic care for patients with traumatic brain injury involves an integration of cerebral resuscitation, resuscitation of other vital organs, the provision of "anesthesia," and the prevention of harmful physiologic responses to surgery. Adverse responses to surgery such as hypertension, tachycardia, coughing, and straining can increase intracranial pressure (ICP). Airway manipulations can aggravate spinal cord injury as well as increase ICP. Anesthetic agents can exacerbate hemodynamic instability, increase cerebral blood volume and ICP, and produce respiratory depression. Cerebral resuscitation during surgery resembles that in the preoperative and postoperative periods. ICP measurement and jugular venous saturation monitoring may help define end-points for cerebral resuscitation. Various anesthetic techniques and agents have distinct advantages and disadvantages. The choice of agents and techniques is determined by the nature and severity of the patient's injuries and by pre-existing medical problems. The investigation of drugs that might protect against cerebral ischemia has included anesthetic agents but none appear to be uniformly effective. Intraoperative hypothermia is also being investigated as a cerebral protectant.
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PMID:Anesthesia and head trauma. 749 63

A total of 458 eligible patients, from 21 centres, with microscopically confirmed SCLC were allocated at random to three chemotherapy regimens, each given at 3-week intervals. In two regimens, etoposide, cyclophosphamide, methotrexate and vincristine were given for a total of either three courses (ECMV3) or six courses (ECMV6). In the third regimen, etoposide and ifosfamide were given for six courses (E16). Patients with limited disease also received radiotherapy to the primary site after the third course of chemotherapy in all three groups. As reported by clinicians, 59% of the ECMV3, 67% of the ECMV6 and 63% of the EI6 patients experienced moderate or severe adverse reactions to their chemotherapy. The major symptoms of disease, cough, haemoptysis, chest pain, anorexia, and dysphagia, were palliated in 63% or more of patients and the median duration of palliation was 63% or more of survival, the results being similar in the three groups. Among patients with poor overall condition, physical activity and breathlessness on admission, the proportions who improved were higher in the EI6 group but the differences were small. In all three groups, levels of anxiety fell substantially during treatment. Levels of depression were lower and showed little change. As assessed by patients using a daily diary card, the patterns of nausea, vomiting, activity and mood, associated with courses of chemotherapy were very similar in the three groups. In the EI6 group there was less dysphagia and better overall condition between courses, but these advantages need to be weighed against the inconvenience of the 24-h infusions required, compared with the 30-min infusions of the other two regimens. As reported in the companion paper (MRC Lung Cancer Working Party, 1993a) there was no statistically significant survival advantage to any of the three regimens, although the results do not exclude the possibility of a minor survival advantage with the two six-course regimens. In conclusion, there was no major clinical gain from continuing chemotherapy beyond three courses or from using the ifosfamide regimen.
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PMID:A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). II: Quality of life. Medical Research Council Lung Cancer Working Party. 750 4

Respiratory patients require psychotropic drug administration to treat pain, cough and respiratory distress or to treat insomnia, anxiety, depression or psychosis. Terminal patients require thoughtful and compassionate use of these drugs, even when there is an expectation that such therapy may lead to an earlier death. Most psychotropic agents can be used safely in patients with respiratory disease, and careful use of selected drugs should always be employed if indicated for treating distressful conditions that may be benefitted. Guidelines to appropriate choices and doses are provided.
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PMID:Psychotropic drugs in terminal care. 753 7

This double-blind, placebo-controlled study investigated the efficacy of intermittent doses of intrathecal fentanyl in 30 patients undergoing thoracotomy. They were allocated randomly to three groups, two of which had microspinal catheters inserted into the lumbar subarachnoid space at the end of surgery; the third group acted as a control. Intrathecal fentanyl or 0.9% saline was administered through the catheters and all patients received morphine using a patient-controlled analgesia (PCA) system. Pain scores, morphine consumption and peak expiratory flow rates (PEFR) were recorded on an hourly basis. Intrathecal fentanyl resulted in a faster onset of analgesia (mean visual analogue scale (VAS) score at 1 h = 0.9 compared with 6.3 (95% confidence intervals for the difference -6.8, -4.0) for the other groups; P < 0.001) and significantly lower pain scores at rest, on cough and on movement. PEFR values were consistently higher in the intrathecal fentanyl group. There were no cases of early or delayed respiratory depression.
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PMID:Intrathecal fentanyl for post-thoracotomy pain. 766 61

330 sheep from two different flocks were examined for respiratory manifestations including serous to mucopurulent nasal discharge dyspnoea, cough and light depression. 55 animals were sick (16.6%) and 13 died (3.9%). Samples were taken from healthy, diseases and dead cases as well. Pasteurella haemolytica A2 was identified from 18 isolates, and serotyped by rapid plate agglutination (RPA). Drug susceptibility was tested and treatment applied in line with the results.
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PMID:Pasteurella haemolytica A2 infection in two sheep flocks in Tripoli area (Libya). 770 29

Mercury toxicosis by ingestion was diagnosed in a 3-year-old Quarter Horse mare with a history of anorexia and signs of abdominal discomfort. Ten and 9 days prior to admission, an inorganic mercuric blistering agent has been applied for topical treatment of dorsal metacarpal disease. At referral, signs of depression, dependent edema, pollakiuria, nonproductive cough, and oral ulceration were noticed. Laboratory data were consistent with renal dysfunction. Mercury content of blood and urine was high, confirming the diagnosis. The horse responded to intensive care, consisting primarily of IV fluid treatment, and mercury-chelating agents. However, acute laminitis developed, and the owners elected to euthanatize the horse 18 days after mercury exposure. Necropsy findings included renal tubulonephrosis and ulcerative colitis and enteritis. Mercury concentration was highest in kidney and liver tissues. The potential for mercury toxicosis in horses currently exists, and although the prognosis is grave, some horses may recover with appropriate treatment and long-term supportive medical care.
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PMID:Mercury toxicosis caused by ingestion of a blistering compound in a horse. 775 Dec 24

Descriptions of coronary artery bypass graft (CABG) recovery experiences were elicited for development of a preparatory discharge information intervention. A convenience sample of 15 men and 5 women were interviewed about the concerns, emotions, and physical sensations they experienced after CABG and the actions they found most useful to manage the recovery at three time points: (a) discharge; (b) 2 days after discharge; and (c) 3 weeks after discharge. Concerns of subjects centered on pain management and return to independence in activities of daily living. Reports of negative emotions increased over the first month of recovery and included depression, anger, and anxiety. Subjects most frequently reported physical sensations associated with fatigue, chest incision, sleeping, leg incision, shoulder and neck muscles, and coughing. Descriptions of the CABG recovery experience provided data for development of discharge information, that focused on concrete experiences from the viewpoint of the person having CABG surgery and included orienting information about the onset, sequence, and duration of the experiences.
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PMID:Development of discharge information for recovery after coronary artery bypass surgery. 781 70

In September 1986 an Integrated Quality Control Project (IQC) was started in the Netherlands. Over a period of 2 years a veterinary herd health scheme was applied to 21 growing and finishing pig herds. Information was collected concerning medical treatment, classified as group treatment and individual treatment, clinical observations, and housing factors. The main purpose of this project was to investigate relationships between pathological findings detected at the slaughterhouse and information gathered on the farm. Medical group treatments, clinical observations and housing did not reliably predict pathological findings. Individual medical treatment for respiratory disorders, started in the last 30 days before slaughter, proved to be positively related to the pathological findings 'pneumonia' and 'pleuritis' detected at the slaughterhouse. This may be useful for selecting pigs at the slaughterhouse that will require special treatment for the removal of the pleura parietalis. During the first year of the project the average daily gain (ADG) was 27.2 g. more than during the preceding 2 years (P < 0.0001). Coughing was negatively related with the ADG. More than 75 coughs per compartment during 10 minutes, recorded more than 50 days before slaughter, was positively related to a depression of the ADG (20 g; P < 0.05). Relationships between group medical treatments and ADG were statistically significant, when the group medical treatment was started more than 20 days before slaughter. Negative influences on the ADG were higher if the treatment was started closer to the slaughter date.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Integrated quality control project: relationships between pathological findings detected at the slaughterhouse and information gathered in a veterinary health scheme at pig farms. 798 54

Welsh Mountain ponies were inoculated with an isolate of Streptococcus pneumoniae, SPE 1618 (capsular type 3) recovered from the equine respiratory tract: 10 ml of a suspension of 10(8) or 10(9) cfu/ml were instilled intratracheally. Fever was observed after either dose but the greater concentration also produced coughing, ocular and nasal discharge, depression and enlargement of submandibular lymph nodes. Cytological evidence of infection was also observed in tracheal washings during the first week after inoculation and corresponded with isolation of S. pneumoniae from the washes. Morbid anatomical and histopathological examinations of selected animals revealed focal pneumonia affecting the ventral lung, especially the cardiac area and accessory lobe, with a propensity to affect the right lung. S. pneumoniae was isolated directly in pure culture from these lesions or was demonstrable by immunostaining of macrophages bearing specific capsular type 3 antigen. By 10 days after inoculation, the ponies were healthy and had developed antibodies to S. pneumoniae. S. pneumoniae was therefore a primary pathogen in the horse under the conditions of the challenge.
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PMID:Susceptibility of ponies to infection with Streptococcus pneumoniae (capsular type 3) 814 65

We studied 196 patients with suspicion of pulmonary embolism (PE) to evaluate the role of clinical pattern, with special reference to gender and age, in raising the suspicion. Results are that clinical and instrumental patterns, although not specific for PE, may show highly frequent symptoms and signs such as dyspnea (52%), chest pain (60%), enlargement of descending pulmonary artery (49%), diaphragmatic elevation (41%), enlargement of azygos vein (46%) and hypoxia (mean value 68 +/- 13 mm Hg) that allow to suspect PE in most patients and, therefore, to recruit more patients for diagnosis. Moreover, this study shows that gender and age may only partially influence the possibility of raising the suspicion of PE. Indeed, only hemoptysis is significantly (p < 0.02) more frequent in males; only pleuritic chest pain is significantly (p < 0.02) more frequent in youngs; few instrumental findings, such as 'sausage-like' descending pulmonary artery (p < 0.001), enlargement of cardiac shadow (p < 0.01), and hypoxia (p > 0.03) are significantly more frequent in elderly patients. Finally, a characteristic clinical and instrumental pattern of PE may allow to select a subset of patients at higher risk; in fact, previous PE, prolonged immobilization (p < 0.01) and thrombophlebitis (p < 0.001), sudden dyspnea and cough (p < 0.05), 'sausage-like' descending pulmonary artery (p < 0.001), diaphragm elevation (p < 0.02), enlargement of heart shadow, pulmonary infarction and Westermark sign (p < 0.001), S-T segment depression (p < 0.001), and hypoxia (p < 0.001) are findings significantly more frequent in patients with confirmed PE.
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PMID:Gender, age and clinical signs in patients suspected of pulmonary embolism. 817 65


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