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

A follow-up review of 45 patients with cough syncope was performed to ascertain the effect of therapy in relieving symptoms. These patients constituted 2.5% of all Mayo Clinic patients evaluated over a 3-year period for syncope. Cough syncope patients were predominantly male (43:2), the average weight was 96.1 kg, and the average age was 53.2 years. Eighty-two percent were current or ex-smokers at the time of the initial evaluation and 86% of those having pulmonary function tests demonstrated findings consistent with obstructive lung disease. Treatment was determined by their primary physician and, in general, was aimed at decreasing the cough. Cough-related symptoms were abolished or improved in 97% of patients. Smoking cessation was closely associated with decreased symptoms. Although felt by both patient and physician to be a benign disorder, cough syncope can result in severe bodily injury. Patients with a vigorous cough, especially smokers, should be questioned thoroughly about cough syncope. Treatment of cough is effective in relieving symptoms.
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PMID:Smoking and cough syncope: follow-up in 45 cases. 359 55

Mucous secretions are normally removed by ciliary beating. When this defense mechanism is impaired or overwhelmed by increased secretions, cough then becomes an important means of secretion removal. For cough to be effective, the linear velocity of gas traveling through the airways should be high. Since the linear velocity of gas is related to flow and the cross-sectional area of the airways, cough is most effective when expiratory flows are great (effort independent) and dynamic compression (effort dependent) leads to a reduction of the cross-sectional area of the larger downstream airways. Cough failures may be related to either inadequate generation of expiratory flow rates (that is, in obstructive lung disease or inspiratory muscle weakness), failure to dynamically compress the airways (that is, in expiratory muscle weakness or increased collapsibility), alterations in airway geometry (that is, in bronchiectasis), or abnormal quantity or quality of mucous production (that is, in chronic bronchitis).
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PMID:Pathophysiology of cough. 362 73

Acute bronchitis is a common syndrome characterized by upper respiratory tract infection accompanied by productive cough in persons without chronic lung disease. As a first step in investigating the potential role of pulmonary airflow disturbances in acute bronchitis, 27 adult patients with acute bronchitis performed serial pulmonary function tests and daily peak flow measurements and completed daily symptom diaries. Eleven patients (40 percent) had a forced expiratory volume of the first second (FEV1) at entry less than 80 percent of predicted. Mean FEV1, forced midexpiratory flow rate (FEF25-75), and peak flow measures showed steady improvement over the five-week period. Differences between initial and final flow rates were statistically significant. These changes were particularly evident when two groups were created by stratifying by "abnormal" (FEV1 less than or equal to 80 percent predicted) and "normal" (FEV1 greater than 80 percent predicted) initial FEV1. Total duration of cough and subjective ratings of cough severity were not predicted by initial FEV1, but work absence was significantly higher in the abnormal group. The finding of reversible airway obstruction suggests a role for bronchospasm in many cases of acute bronchitis and calls for further research regarding proof of rapid reversibility and treatment with bronchodilators.
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PMID:Pulmonary function tests in acute bronchitis: evidence for reversible airway obstruction. 362 41

Four patients with primary biliary cirrhosis (PBC) and Sjogren's syndrome presented with pulmonary disease manifested by fever, cough, and dyspnea. One patient had obstructive lung disease secondary to an autoimmune process documented by immunofluorescent staining of lung parenchyma. The other three patients had interstitial lung disease, pulmonary nodules, and multiple granulomas of the lung, respectively. Primary biliary cirrhosis is a complex autoimmune syndrome involving a disorder of the secretory immune system and its epithelial end organs. These four cases suggest that, in addition to biliary, lacrimal, intestinal, renal tubular, and salivary epithelium, lung tissue also is a possible site for autoimmune involvement in PBC.
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PMID:Pulmonary involvement in primary biliary cirrhosis. 365 77

A careful history, including smoking habits, presence of chronic lung disease in the family history and symptoms of cough, dyspnea and wheeze, will often give the first clue to the presence of chronic lung diseases. The assessment of the patient includes a physical examination and simple spirometric measurements of airflow and volume from fully inflated lungs. When symptoms and airflow abnormalities are present, concern for the patient's outcome is appropriately heightened. This will cause the health care provider to decide on additional observations or evaluation to help prevent the consequences of otherwise undetected chronic lung diseases.
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PMID:ABCs of simple pulmonary function assessment. 371 38

Cough is a common symptom in the smoking and non-smoking patient seeking medical attention from the office-based physician. Often, a comprehensive history and physical examination suggest the correct diagnosis, and specific therapy can be directed to the underlying disease. A chest roentgenogram is an essential part of the workup; it may suggest tuberculosis, chronic fungal infection, bronchiectasis, or lung abscess. In addition, bronchogenic carcinoma, which is increasing in frequency in the population, has several common manifestations that can be recognized on the chest roentgenogram. Pulmonary function studies are often helpful in the workup of the patient with chronic cough. A pattern of obstructive lung disease is seen with asthma, chronic bronchitis, and bronchiectasis. Diseases that cause lung fibrosis, such as idiopathic pulmonary fibrosis, sarcoidosis, and pneumoconiosis, give a restrictive ventilatory defect. Bronchoprovocation testing can be helpful when baseline pulmonary function tests are normal and the diagnosis of postviral bronchitis or cough-variant asthma is suggested. If the bronchial inhalation challenge is negative, these diagnoses can be excluded. Chronic rhinosinusitis with associated postnasal drip is one of the most common causes of chronic cough and is often difficult to confirm because the physical examination and roentgenogram of the paranasal sinuses may be normal. In a great majority of patients with chronic cough, a diagnosis can be established by simple, clinical and laboratory procedures used in the outpatient setting.
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PMID:Chronic cough. Diagnosis and treatment. 384 18

Juvenile laryngotracheal papillomatosis spreads to involve the lungs in less than 1% of cases, and when this occurs, the prognosis is poor. In seven such cases, the lung lesions, which appeared either solid or cystic on radiographs, proved to be benign squamous cell proliferations or papillomas, with central cavities containing debris or air. They seemed to grow centrifugally, using the alveolar walls as scaffolding with central coalescence and lung destruction. Papillomas spread inferiorly from the larynx by direct extension as far as the major bronchi, but rarely beyond. However, the parenchymal lesions were widely scattered, and some were subpleural. This discrepancy suggests that fragments become detached, particularly during endoscopic resection, and are carried down the airways by airflow. Those that lodge proximal to the respiratory bronchioles may be removed by mucociliary action and cough. Those that travel more distally are poorly cleared and may grow. If enough lung parenchyma is destroyed, the patient can develop symptoms of restrictive lung disease in addition to signs of upper airway obstruction.
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PMID:Pulmonary manifestations of juvenile laryngotracheal papillomatosis. 387 22

In developed countries tuberculosis has not yet been eradicated and diagnostic problems still remain. The purpose of this study was to analyze the clinical pattern, epidemiological data and risk factors in 85 patients (59 males and 26 females, mean age 41 +/- 15 years) seen from 1975-1984 in the medical outpatient clinic of Basle with the diagnosis of tuberculosis. The organ distribution of the tuberculosis was as following: lung n = 54, cervical lymph nodes n = 9, pleura n = 7, peritoneum n = 3, endometrium n = 2, bones n = 2, pericardium n = 1, middle ear n = 1, urinary tract n = 1, skin n = 1, cerebrum n = 1, miliary tuberculosis n = 3. In the younger age group (20-40 years) cervical lymph node tuberculosis predominated, whereas in the age group over 50 pulmonary tuberculosis was most frequent. The leading symptoms were: cough (59%), expectoration (48%), fever (39%), night sweat (24%). Risk factors were: cigarette smoking in 51%, alcoholism in 37%, preexisting lung disease in 20%, past tuberculosis in 19%. In pulmonary tuberculosis the most accurate diagnostic procedure was examination of bronchial secretion, followed by examination of sputum and gastric juice. Histological examination was the most appropriate procedure in tuberculosis of lymph nodes and peritoneum. In all patients treatment was as follows: isoniacid (INH), rifampicin and ethambutol for the first 4 months, followed by isoniacid and ethambutol for 6-10 months. In summary, tuberculosis has no typical clinical pattern and biochemical tests are unhelpful in establishing diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical manifestations of tuberculosis today]. 395 78

Residual lung function abnormalities have been investigated in 9 children (4 boys and 5 girls) a mean 2.7 years after surviving severe adult respiratory distress syndrome (ARDS). All patients had been artificially ventilated for an average of 9.4 days with a FiO2 greater than 0.5 for 34 hours and maximal PEEP levels in the range of 8-20 cm H2O. Since the ARDS, 3 children had presented recurrent respiratory symptoms (moderate exertional dyspnea and cough) and 2 had had evidence of fibrosis on chest radiographs. In all patients abnormal lung functions were found, i.e. ventilation inequalities (8), hypoxemia (7), and obstructive (2) and restrictive (1) lung disease. A significant correlation between respirator therapy and residual lung function was found (duration of FiO2 greater than 0.5 in hours and inspiratory plateau pressure during respirator therapy vs. ventilation inequalities and hypoxemia).
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PMID:[Residual lung function changes following adult respiratory distress syndrome (ARDS) in children]. 397 78

The case is reported of a 40-year-old woman who developed an eosinophilic lung infiltration during malaria prophylaxis with pyrimethamine-sulfadoxine (Fansidar). The patient had a severe condition with cough, fever, chills, dyspnea, weight loss and an unusual but characteristic radiologic picture. Corticosteroid medication was followed by a dramatic improvement in symptoms and complete resolution of the radiographic opacities within a few days. There was no recurrence after cessation of steroids. The authors believe that the cause of this lung disease was an allergic reaction to pyrimethamine-sulfadoxine (Fansidar). Some aspects of drug-induced eosinophilic pulmonary infiltrations are discussed.
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PMID:[Eosinophilic lung infiltration during malaria prophylaxis with pyrimethamine-sulfadoxine (Fansidar)]. 404 13


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