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)

Primary pulmonary adenocarcinoma with metastatic spread to the brain stem was diagnosed at necropsy in an aged Bulldog. Initial clinical signs included coughing, decreased exercise tolerance, and personality changes. Primary differential diagnoses after thoracic radiography were multicentric metastatic neoplasia or fungal disease. Later clinical signs (inappetence, unilateral facial paralysis and decreased sensation, and hemiparesis) were referable to the effect of the tumor on cranial nerves V and VII and other brain stem structures. Primary lung tumors are uncommon, as are metastatic tumors within the CNS. Radiographic appearance alone of lung lesions is insufficient for accurate diagnosis.
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PMID:Primary pulmonary adenocarcinoma with brain stem metastasis in a dog. 335 Jul 49

Extraneural metastasis of intracranial ependymoma is a rare pathological entity. Thirty one case reports were traced in the review of the literature and we record one of them. The patient was a 19-year-old male in good health until January 1981 when he was admitted to our hospital with deteriorating mental status. Admission work-up revealed bilateral papilledema, 1-hemiparesis and increased intracranial pressure signs including vomiting. CT scan demonstrated significant abnormality of enhanced mass lesion in the r-temporo-parietal area in which a displacement of the midline structure to the left occurred. R-temporo-parietal craniotomy was performed on the admission day. The globular tumor mass occupied the temporo-parietal area and invaded the cortex. Subtotal resection of the tumor and temporal lobectomy was performed. Microscopic examination of the operative specimen revealed a typical ependymoma pattern. For the next two years, he received operations twice, irradiation (total 14, 170 rads) and various chemotherapy. Two months after the fourth craniectomy, examination revealed scalp overlying the burr opening to be very tense and enlarging as if invaded by the tumor. A large mass occupied the right lateral cervical area and chest X-ray disclosed complete opacity on the right. He gradually developed severe cough and sputum and died two months later on January 1, 1984. At autopsy, the result was that tumor had invaded the subarachnoidal space and subcutaneous area. Extraneural metastases were found to be bronchial lymph nodes, C-4 vertebra, r-cervical lymph node. The histological appearance of these tumors obtained at autopsy was identical to the cerebral tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extraneural metastases of malignant ependymoma inducing atelectasis and superior vena cava syndrome--a case report and review of the literature]. 395 64

Five episodes of fungemias are described; all had occurred in children with leukemia or lymphoma between January 1, 1978 and December 31, 1990. These fungemias comprised 3.4% of the total septicemias encountered during that period. Three episodes occurred during the induction phase and two during relapse. All patients had fever of varying degree and duration. In addition to steroids, all were receiving combination antibiotics before the fungemia had occurred. All patients had severe neutropenia lasting more than one week. Bacteremia preceded fungemia in four patients. Two episodes were diagnosed antemortem. The same species were isolated from other sites in three cases. Fever, chills and gastrointestinal symptoms were the most common clinical features; other symptoms included cough, dyspnea, oliguria and azotemia. One patient experienced skin lesion, dysphagia, hoarseness and hemiparesis. Only one patient survived. The prognosis from fungemia in leukemia and lymphoma patients is very poor. Empiric antifungal therapy is indicated in neutropenic patients who have recurrent or persistent fever despite one week of broad spectrum antibiotics. Early diagnosis and treatment will aid in improving the overall poor outcome of this disease.
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PMID:Candida tropicalis fungemia in children with leukemia and lymphoma. 821 55

We report a 36-year-old woman with right hemiplegia, anosognosia, and rapidly deteriorating course. She was well until the end of January, 1995 when she had an onset of fever, sputum, and cough. A 5 x 5 tumor was found in her left lower lobe. She was admitted to the Pulmonary Medicine on May 24, 1995 when she was 36-year-old. General physical examination was unremarkable. Bone scintigraphy revealed increased uptake in the skull, sternum, right scapula, vertebrae, right femur, and in ribs. Cranial CT scan revealed a large mass lesion in the right frontal subcortical region with central low density and peripheral high density areas, and small low density lesions in the right thalamic area and in the right posterior frontal region; ring enhancement was observed in the latter two lesions. On the second day of admission, she noted left-sided weakness which improved by corticosteroid treatment. On June 17, there was a sudden onset of left hemiparesis and a neurologic consultation was asked. Upon neurologic examination, she appeared somnolent but could understand verbal commands. She showed constructional apraxia, neglect of the left hemisphere, and anosognosia. Cranial nerves were unremarkable. Motor-wise, she showed flaccid left hemiplegia. Deep tendon reflexes were exaggerated on the left and the plantar response was extensor bilaterally. Nuchal stiffness was noted. Her cranial CT scan on June 17 revealed enlargement of the right frontal mass lesion. The subsequent course was complicated by DIC and progressive worsening of her consciousness. On June 18, she was comatose and pupillary light reflex was lost. She developed Cheyne-Stokes respiration and expired on that evening. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that the patient had a primary adenocarcinoma in the lung with multiple metastases including the brain. The fulminant terminal course was ascribed to hemorrhage within the tumor and subsequent central type of transtentorial herniation. Opinions were divided regarding the cause of hemorrhage; some participants thought hemorrhage was caused by DIC. Post-mortem examination revealed an adenocarcinoma arising at the S6 segment of the left lung with multiple organ metastases. In the brain, a huge hemorrhagic metastasis was found in the right frontal lobe and a non-hemorrhagic metastasis in the right thalamic region. Probably, the size of the metastases influenced the occurrence of hemorrhage. The direct cause of the death was transtentorial herniation.
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PMID:[A 36-year-old woman with acute onset left hemiplegia and anosognosia]. 912 37

Lung cancer during pregnancy is rare, although the number of case reports has been increasing in recent years. Herein, we describe two cases of lung carcinoma complicating pregnancy with different presentations and outcomes, and review the relevant literature. The first case involved a 31-year-old patient with squamous cell carcinoma with multiple bone metastases. The initial symptoms were productive cough and dyspnea on exertion during the second trimester of pregnancy, to which the patient paid little attention. Chemoradiation was started 1 month postpartum, soon after the diagnosis was made, but with little response. She died at home several days after palliative radiotherapy. The second case involved a 34-year-old patient with poorly differentiated lung carcinoma with brain metastasis. Left hemiparesis had developed initially during the third trimester. She underwent excision of the metastatic brain tumor and received radiotherapy to the left lung tumor and brain. The patient is still alive after a follow-up period of more than 1 year. Delayed diagnosis may be the main problem in the management of lung cancer during pregnancy, because of misinterpretation of common respiratory symptoms and physicians' reluctance to use radiologic imaging studies owing to concerns over the safety of the fetus. Thus, we suggest chest radiographs with abdominal lead shielding for pregnant patients with protracted cough and hemoptysis. Treatment of unresectable lung cancer during pregnancy generally consisted of radiation therapy with or without chemotherapy in previous reports, but the optimal therapy is still unknown, owing to inadequate case numbers and insufficient follow-up data.
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PMID:Lung cancer in pregnancy: report of two cases. 974 70

Cryptococcus neoformans affections during HIV-infection are frequent and serious. The aim of this study was to analyse the epidemiological, clinical, biological and therapeutic characteristics of cryptococcal meningitis in HIV-positive patients, admitted into the Center for Tropical Diseases Ho Chi Minh City (Vietnam), during a 5-month period (May-September 2001). Twenty-one patients (20 men and one woman) were included (identification of C. neoformans from the cerebrospinal fluid). The mean age was 28 years. The majority of patients had been living in Ho Chi Minh City (48%). The use of drugs and unprotected sexual relations were the principal risk factors of HIV-infection. The paucity and the confusion of clinical signs and symptoms, along with a high frequency of meningitis have been analysed. Clinical presentation features included: headache (95%), emaciation (90%), oro-pharyngeal candidiasis (90%), stiff neck (80%), nausea/vomiting (70%), fever (67%), coughing (38%), diarrhoea (33%), skin lesions (5%), convulsion (5%), photophobia (5%), and hemiparesis (5%). The severity of the prognosis was mainly linked to the delay before hospitalization, to the possible association with other opportunistic infections, and to the availability of appropriate treatment.
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PMID:[Cryptococosis and HIV/AIDS: a review of 21 cases reported in the Tropical Diseases Centre, Ho Chi Minh City (Vietnam)]. 1504 39

The coughing paroxysms of patients with cystic fibrosis may occasion neurological symptoms. Although cough syncope is well-known, and is associated with headache and paralysis, a migrainous mechanism has not been reported. We reviewed the medical records, autonomic testing results, and responses to treatment in two cystic fibrosis patients with similar presentations of cough-induced impairment of consciousness followed by headache and paralysis. A 24-year-old woman and an unrelated 38-year-old man, both with cystic fibrosis, developed post-tussive neurologic deficits. Both patients reported infrequent dramatic spells, always preceded by major hemoptysis, and associated with left-sided paralysis, transient blindness, nausea, and severe pulsating headaches. Autonomic testing demonstrated only postural tachycardia and a near-vasodepressor episode in the woman, and mild, generalized sympathetic dysfunction in the man. Treatment for presumptive migraine with aura with verapamil nearly eradicated symptoms in both patients. Discontinuation of verapamil in the woman was associated with symptom recurrence and a stroke, with significant persistent residual left hemiparesis. In conclusion, cough-induced neurologic deficits were previously reported with cystic fibrosis, without clear understanding of the mechanism of impairment of consciousness. Based on the hemiparesis, nausea, and throbbing headache, which repeatedly followed the events in both patients, and based on the response to verapamil, we hypothesize a migrainous mechanism in both of our patients. The pathophysiology that links the hemoptysis to the spells deserves further investigation.
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PMID:Cough-induced hemiplegic migraine with impaired consciousness in cystic fibrosis. 1637 53

A 16-year-old girl arrived intubated to the emergency department. She had shortness of breath and cough for 2 days with leg pain. On arrival, she was hemodynamically stable with an unremarkable physical exam. Electrocardiogram revealed a prolonged QT interval; laboratory work-up was normal except for an elevated dimerized plasmin fragment D. Acute pulmonary embolism was confirmed by a chest computed tomography scan. A lower extremity duplex scan was negative and echocardiogram revealed a patent foramen ovale with bidirectional shunting. An inferior vena cava filter was placed to prevent acute recurrence and unfractionated heparin was initiated. The next day she was noted to have right hemiparesis. Stroke was confirmed by magnetic resonance imaging. The patient underwent mechanical clot retrieval and was discharged on anticoagulation therapy to a brain rehabilitation unit.
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PMID:A case of pulmonary embolism and stroke in a 16-year-old girl. 2261 72

A 76-year-old Japanese man was admitted to our department because of aphasia and right hemiparesis. Brain magnetic resonance imaging showed cerebral infarction caused by occlusion of the left middle cerebral artery, and alteplase therapy was started. Thrombectomy was subsequently performed, resulting in recanalization. On day 4 after admission, he complained of epigastric pain when coughing. On day 8, contrast-enhanced computed tomography showed a left abdominal rectus sheath hematoma without extravasation. We carefully followed up the patient with conservative therapy, and the rectus sheath hematoma was ameliorated. Rectus sheath hematomas present as acute abdominal pain and are often misdiagnosed. Although several predisposing factors for rectus sheath hematomas have been identified, whether recombinant tissue-type plasminogen activator causes rectus sheath hematomas, remains unclear. This case highlights the need to consider a rectus sheath hematoma as a differential diagnosis of abdominal pain following treatment with recombinant tissue-type plasminogen activator.
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PMID:Rectus Sheath Hematoma Following Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator for Cerebral Infarction: A Case Report. 3012 29

A carotid-jugular fistula is a direct communication between the carotid artery and the jugular vein. Both congenital and spontaneous internal carotid-jugular fistulas are extremely rare. We describe the first case of successful endovascular treatment for a congenital internal carotid-jugular fistula. We report a 64-year-old woman who presented with a pulsatile mass swelling over the left cervical region and right hemiparesis after cough. Digital subtraction angiography confirmed the diagnosis of left high-flow internal carotid-jugular fistula. The fistula was successfully treated by fractional stent-assisted embolization.
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PMID:Endovascular Treatment of Congenital Internal Carotid-Jugular Fistula. 3061 70


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