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)

Forty-five patients (25 male and 20 female) over 12 years of age with cystic fibrosis have been studied clinically, radiologically and physiologically. Their mean age at the first visit was 17 years; they were followed for a mean period of 4 years and attended at least every six months. The first symptom which developed before the age of five in 42 of the 45 patients was respiratory. Thirty-two of the 45 patients had severe lung disease (Group III) at the start of the study of the seven patients died during the study. Cough and sputum were almost universal, 23 had haemoptyses and eight pneumothoraces. Staphylococcus pyogenes, Haemophilus influenzae and Pseudomonas aeruginosa were the common pathogens isolated from sputum and the increasing prevalence of the latter was again confirmed. Acquisition of the mucoid strain of pseudomonas signified poor prognosis. Established infection was never eradicated. Forty-three patients had evidence of pancreatic insufficiency; in all but one patient the symptoms were mild and five patients abandoned dietary restriction and pancreatin without ill effect. Seven patients had symptoms of partial bowel obstruction (meconium ileus equivalent) but only one required surgical relief. The liver was enlarged in seven patients and the spleen was felt in three. Three patients had diabetes mellitus. The influence of cystic fibrosis on growth and development is reported--the growth spurt is late in the majority but growth failure is not confined to those with severe lung infection or malabsorption and in these circumstances remains unexplained. Mean weight was low in relation to height and puberty was delayed in both sexes.
 ...
PMID:Cystic fibrosis in adolescents and adults. 82 Oct 91

The treatment of nonpain symptoms is integral to good palliative care of the terminally ill elder. This article reviews the management of common physical symptoms observed during the dying process, including nausea and vomiting, dyspnea, cough, constipation, diarrhea, bowel obstruction, and xerostomia. Alleviation of these symptoms is necessary for a comfortable and tranquil death for the patient, and an uncomplicated bereavement for surviving family members.
 ...
PMID:Nonpain symptom management in terminal care. 879 50

Most patients with advanced cancer develop diverse symptoms that can limit the efficacy of pain treatment and undermine their quality of life. The present study surveys symptom prevalence, etiology and severity in 593 cancer patients treated by a pain service. Non-opioid analgesics, opioids and adjuvants were administered following the WHO-guidelines for cancer pain relief. Other symptoms were systematically treated by appropriate adjuvant drugs. Pain and symptom severity was measured daily by patient self-assessment; the physicians of the pain service assessed symptom etiology and the severity of confusion, coma and gastrointestinal obstruction at each visit. The patients were treated for an average period of 51 days. Efficacy of pain treatment was good in 70%, satisfactory in 16% and inadequate in 14% of patients. The initial treatment caused a significant reduction in the average number of symptoms from four to three. Prevalence and severity of anorexia, impaired activity, confusion, mood changes, insomnia, constipation, dyspepsia, dyspnoea, coughing, dysphagia and urinary symptoms were significantly reduced, those of sedation, other neuropsychiatric symptoms and dry mouth were significantly increased and those of coma, vertigo, diarrhea, nausea, vomiting, intestinal obstruction, erythema, pruritus and sweating remained unchanged. The most frequent symptoms were impaired activity (74% of days), mood changes (22%), constipation (23%), nausea (23%) and dry mouth (20%). The highest severity scores were associated with impaired activity, sedation, coma, intestinal obstruction, dysphagia and urinary symptoms. Of all 23 symptoms, only constipation, erythema and dry mouth were assessed as being most frequently caused by the analgesic regimen. In conclusion, the high prevalence and severity of many symptoms in far advanced cancer can be reduced, if pain treatment is combined with systematic symptom control. Nevertheless, general, neuropsychiatric and gastrointestinal symptoms are experienced during a major part of treatment time and pain relief was inadequate in 14% of patients. Cancer pain management has to be embedded in a frame of palliative care, taking all the possibilities of symptom management into consideration.
 ...
PMID:Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. 1151 84

A case of traumatic abdominal hernia is reported in a patient with a history of chronic cough. After a bout of coughing 3 months prior to her presentation, the patient developed a large herniation on the left lateral side of the abdomen. The patient presented with intestinal obstruction due to the herniation. A CT scanning confirmed the hernia and showed a peritoneal defect with herniation of most of the intestine on the left lateral side of the abdomen. An emergency midline laparotomy was performed, and the defect was corrected.
 ...
PMID:Traumatic abdominal hernia caused by cough, presenting with intestinal obstruction. 1522 46

CASE 1: A 64-year-old, otherwise healthy woman was referred to the surgery clinic for a presumed umbilical hernia. On physical examination, a cutaneous nodule was noted on the umbilical region and the patient was referred to the dermatology clinic. The patient was reexamined and an erythematous nodule was observed in the umbilicus measuring 2.5 cm in diameter. The patient denied pain, change in bowel habits, or weight loss. There were no other abdominal masses, no sign of ascites, and no regional lymphadenopathy. A skin biopsy from the nodule showed mucinous adenocarcinoma. Immunohistochemical staining was positive for carcinoembryonic antigen, and negative for cytokeratin (CK)7 and CK20. These results were consistent with a Sister Mary Joseph's nodule and led to the diagnosis of an occult colon carcinoma. The patient had no risk factors for colorectal carcinoma. The patient underwent surgery in another hospital, and died 3 months after the initial diagnosis of Sister Mary Joseph's nodule. CASE 2: A 73-year-old woman was referred to the dermatology clinic for evaluation of a painful, ulcerated, 3-cm lesion in the umbilicus (Figure 1). She was otherwise asymptomatic. A skin biopsy showed neoplastic glandular cells infiltrating among collagen bundles (Figure 2). Stainings for mucin and for CK7 were positive, while staining for CK20 was negative. An abdominopelvic CT scan demonstrated a 3.5-cm space-occupying lesion in the liver. Results of gastroscopy, colonoscopy, chest computed tomographic (CT) scan, and mammography were normal. Serum levels of the tumor-associated protein CA125 were elevated to 164 units, while those of CA 19-9 and carcinoembryonic antigen were within normal range. A gynecologic examination and a transvaginal ultrasound were normal. The patient had no personal or family history of any malignancy or any risk factors for developing a carcinoma. The patient was scheduled for a palliative resection of the umbilical nodule, combined with a laparoscopic inspection in search of the undetected primary tumor. She refused surgery and was lost to follow-up. She died 4 months after the initial diagnosis of umbilical metastasis. CASE 3: A 51-year-old man was aware of a silent mass in his umbilicus for 2 years without seeking medical advice. Following 2 weeks of increasing pain in this area, he was referred to the emergency room for a suspected incarcerated umbilical hernia. Surgery revealed a mass attached to the fascia and peritoneal fat. The mass was removed and diagnosed as a poorly differentiated adenocarcinoma, staining positively for carcinoembryonic antigen, and negatively for CK20, CK7, prostate-specific antigen, and prostatic acid phosphatase. Both gastroscopy and colonoscopy failed to detect the primary tumor. An abdominopelvic CT scan was normal, but a CT scan of the chest disclosed a nodule measuring 2.5 x 1.5 cm in the lower lobe of the right lung. On bronchoscopy, it was found to be an invasive adenocarcinoma, consistent with a primary tumor of the lung. The patient was a heavy smoker (45 pack-years). The patient received 4 cycles of combined chemotherapy with carboplatine and gemcitabine, with no improvement. A month later, the patient complained of abdominal pain. Following demonstration of intra-abdominal spread of disease by CT scan, a second line chemotherapy was instituted with paclitaxel. A month later the patient's condition deteriorated and he complained of cough, sweating, and pain along the right leg. A bone scan revealed bone metastases in the right femur and left tibia. Two weeks later he was admitted to the hospital with intestinal obstruction and underwent laparotomy. He had massive intra-abdominal spread of cancer and ascites. Only a palliative colostomy was performed. The patient died 3 weeks later, 9 months after the diagnosis of adenocarcinoma of the lung. The clinical data on the three patients are summarized in Table I.
 ...
PMID:Sister Mary Joseph's nodule as a presenting sign of internal malignancy. 1695 43

Hernias are very familiar to a core surgical trainee in the setting of clinics and the surgical assessment unit. By definition, a hernia is an abnormal protrusion of a viscus from one compartment to another. In clinic, they are visible lumps, exhibiting a cough reflex often with a well definable history making them readily identifiable. In the acute setting, they are the third commonest cause of small bowel obstruction in the developed world. Ventral and inguinal hernias account for the majority of these with only a small proportion due to internal hernias. This article aims to educate the core surgical trainee on the anatomy and distinguishing clinical features of these rare but important types of internal abdominal hernias.
 ...
PMID:Internal hernias: a brief review. 2322 76

Transdiaphragmatic intercostal hernia (TIH) caused by violent coughing is a rare clinical diagnosis. Most patients diagnosed with TIH have a chronic condition consisting of a hernia that can be reduced completely by surgical intervention. Our patient presented with acute abdomen resulting from mechanical bowel obstruction secondary to an incarcerated hernia. Acute TIH presents a diagnostic challenge because of its rarity and lack of specific signs or symptoms in the differential diagnosis of acute abdomen. We recommend performing diagnostic computed tomography (CT) early if there is suspicion of TIH. Surgical intervention is always needed. Surgical intervention was complicated in this case, necessitating both transthoracic and abdominal exposure to resect the ischemic bowel segment. Nonetheless, the patient recovered uneventfully.
...
PMID:Strangulation of chronic transdiaphragmatic intercostal hernia. 2488 31

Management of nonpain symptoms can improve quality of life for patients at the end of life and their family members. Constipation is the most common nonpain symptom. It can be related to opioid therapy and/or medical conditions. After abdominal examination to detect masses or evidence of bowel obstruction and rectal examination to exclude fecal impaction, constipation should be managed with a stimulant laxative (eg, senna) or an osmotic laxative (eg, sorbitol). Dyspnea also is common, and often improves with use of a fan to blow air into the face, as well with breathing and relaxation exercises. However, many patients require titrated doses of opioids to address respiratory depression, and anxiolytics such as haloperidol may be needed to manage dyspnea-related anxiety. Oxygen typically is not effective in dyspnea management in nonhypoxemic patients at the end of life. Cough is managed with antitussives. Nausea and vomiting occur in 70% of patients in palliative care units. If no reversible etiology can be identified, dopamine antagonists and motility-enhancing drugs can be used. There are no clearly effective treatments to manage noisy respiratory secretions, but position change, decrease in fluid intake, and drugs such as scopolamine or glycopyrrolate may be effective.
 ...
PMID:Care of Patients at the End of Life: Management of Nonpain Symptoms. 2749 69

Lumbar hernia is a rare condition in which intra or extraperitoneal tissue protrudes through a defect in the posterolateral region of the flank. Incarceration is uncommon but represents a surgical emergency when present. A 54-year-old-male presented to the ED after sudden onset left flank pain after coughing. He was in significant distress secondary to pain and vomiting, and his physical exam revealed a tender mass in his left lateral lumbar region near the site of a previous stab wound. Bedside ultrasound revealed a fluid-filled structure, and CT scan demonstrated herniation of small bowel though the inferior lumbar triangle with associated small bowel obstruction. The patient underwent emergent surgical reduction with mesh repair and recovered uneventfully. Incarcerated lumbar hernia represents a rare diagnosis that may not be at the forefront of most practitioners' differential diagnoses. CT scan is useful to distinguish hernia from solid mass, abscess, or other pathology, while bedside ultrasound may prompt an attempt at immediate reduction. The presence of incarcerated bowel or obstruction warrants immediate surgical consultation.
 ...
PMID:Inferior lumbar triangle hernia with incarceration. 3102 34

Malaria is the most common tropical disease in Sudan, which is caused by an infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito. Headache, fever, cough, fatigue, malaise, shaking chills, arthralgia and myalgia are the cardinal features of malaria, but occasionally, it has an atypical presentation. Intestinal obstruction as a complication is an extremely rare presentation. Here within, we describe a 28-year-old Sudanese man who has presented with of colicky abdominal pain, absolute constipation for two days and fever. Blood film for malaria was positive for Plasmodium falciparum. Intravenous artesunate injections have resulted in the resolution of symptoms of bowel obstruction. In conclusion, malaria should be suspected in any febrile patient with the features of bowel obstruction especially in an endemic area or if the patient has recently travelled to an endemic area with malaria. Treatment of malaria will result in the resolution of symptoms of functional bowel obstruction.
 ...
PMID:A case of Falciparum malaria presenting with features of functional bowel obstruction. 3313 27


1 2 Next >>