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

Because of the close anatomic and physiologic relationship between the heart and lungs, patients with chronic obstructive lung disease are at special risk of arrhythmias. Effective therapy hinges on identifying the mechanisms of the arrhythmias--hemodynamic, metabolic, or drug-induced. Impulsive use of antiarrhythmic agents may result only in a more complex and dangerous rhythm disorder. Extremes of pH are a major cause of arrhythmias in these patients. Respiratory alkalemia usually originates with inappropriate ventilation, often during mechanical respiration, while metabolic alkalemia generally can be traced to diuretic or bicarbonate therapy. Lidocaine or diphenylhydantoin are of little use, since the alkaline pH inside and outside heart muscle cells hampers drug distribution and activity. At the other extreme, the arrhythmias of acidemia strike patients who have severe respiratory failure with carbon dioxide retention or severe cardiac failure with shock and lactic acidemia. Arrhythmias may develop if vagal restraint is lost, which is especially likely in patients with potassium depletion. Irritant receptors along the bronchopulmonary tree can trigger arrhythmias if stimulated by cough, microembolism, or mechanical irritation, which is a hazard with endotracheal or tracheostomy tubes.
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PMID:Mechanisms of arrhythmias in chronic obstructive lung disease. 1 Feb 30

A consecutive series of 282 nurses of the University Hospital, Groningen, with complaints of the nose and/or throat associated with coughing and/or hoarseness were examined between April 1965 and February 1968. The intent was to obtain information on the incidence of viral, mycoplasma and bacterial infections, and on the relationship of these infections in nurses with chronic nonspecific lung disease (CNSLD). The following results were obtained: 1. Virus infections caused by influenza virus (A, B, and C), rhinovirus, parainfluenza virus, adenovirus, respiratory syncytial virus and/or Mycoplasma pneumoniae were confirmed in 30% of the nurses examined; if influenza was excluded, this figure was 20%. 2. Rhinovirus infections were found more often than all the other virus infections together (if influenza was excluded). 3. Approximately 25% of the nurses had signs of CNSLD. 4. In the course of the virus infections, nine out of 14 nurses with a history of chronic obstructive lung disease showed symptoms of exacerbation or recurrence of a generalized bronchial obstruction. 5. There was no difference in the incidence of virus infections in the group of nurses with and without CNSLD. 6. There were more bacterial infections (without a confirmed virus infection) in the subjects with CNSLD than in those without CNSLD. 7. There were more combined viral/bacterial infections in the patients with CNSLD than in those without CNSLD. 8. Patients with influenza did not have more bacterial infections than patients with other virus infections. This is also true for patients with CNSLD and influenza when regarded separately. The patients without CNSLD tended to have more bacterial infections with influenza than with other viral infections, but the difference was not statistically significant.
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PMID:Viral, mycoplasma and bacterial infections in nurses with symptoms of respiratory diseases. 18 86

The purpose of this study was to determine whether adult patients with chronic obstructive pulmonary disease (COPD) can safely perform pulmonary hygiene measures without compromising their arterial oxygen saturation (SaO2) levels (less than 80 per cent). In 15 male veterans with moderate-to-severe COPD an ear oximeter was used to measure SaO2 levels while subjects completed a series of percussion, deep breathing, and coughing maneuvers in the head-down position (50 degree angle). No clinically significant changes in SaO2 levels were found in 14 subjects during pulmonary hygiene measures, but potentially dangerous symptoms were noted in two subjects. Our study supports the monitoring of objective and subjective symptoms during pulmonary hygiene and discontinuance of the procedure if tachycardia, palpitations, dyspnea, chest pain, or other distressful symptoms occur that might indicate hypoxemia.
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PMID:Effect of pulmonary hygiene measures on levels of arterial oxygen saturation in adults with chronic lung disease. 24 25

Breed, age, weight, type of work performed, seasonal onset, poor ventilation and exposure to moulds in the habitat were investigated in relation to the occurrence of chronic obstructive pulmonary disease (COPD). COPD was most commonly detected in showjumping and hacking horses. The older a horse, the more likely it was to become affected although most were 6 to 10 years of age. Of the horses in this sample of the population, which was not a random one, thoroughbred horses were affected least and ponies most often. The high incidence in ponies was related to their more frequent exposure to poor quality fodder and bedding. Most horses are exposed to the hazard of moulds, but more affected horses were so exposed than those not affected with COPD. Poor ventilation of the stable increased the chance of a horse becoming affected. Sex, body weight and season of onset of coughing had no influence on the occurrence of the disease.
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PMID:Chronic obstructive pulmonary disease (COPD): factors influencing the occurrence. 48 65

Diverticulosis of the bronchial wall was found in patients not only with, but also without, chronic obstructive lung disease; it appeared to start as submicroscopic depressions and dilatations of the ducts of the bronchial gland on the mucosal surface. Multiple depressions and dilatations fused to form a diverticulum which herniated between and through the smooth-muscle cellular bundles. Rupture of the latter resulted in large diverticula. Cough and a weakened bronchial wall, from whatever causes, likely lead to bronchial diverticulosis. Exaggerated but unequal formations of bronchial diverticula at the sites of dichotomy suggest either that the effect of cough could be different between segments or subsegments, or that there are local differences in connective-tissue atrophy, inflammation, and structural defects. Mucous plugs, macrophages, red blood cells, inhaled particles, and probably carcinogens are accumulated at the bronchial diverticula, which apparently interfere with airway cleansing and also cause continuous local irritation. The relationship between bronchial diverticulosis and small-airway disease or lung cancer needs further clarification.
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PMID:Morphogenesis of human bronchial diverticulum. A scanning electron microscopic study. 81 65

A multiple inert gas elimination method was used to study the mechanism of impaired gas exchange in 23 patients with advanced chronic obstructive pulmonary disease (COPD). Three patterns of ventilation-perfusion (Va/Q) inequality were found: (a) A pattern with considerable regions of high (greater than 3) VA/Q, none of low (less than 0.1) VA/Q, and essentially no shunt. Almost all patients with type A COPD showed this pattern, and it was also seen in some patients with type B. (b) A pattern with large amounts of low but almost none of high VA/Q, and essentially no shunt. This pattern was found in 4 of 12 type B patients and 1 of type A. (c) A pattern with both low and high VA/Q areas was found in the remaining 6 patients. Distributions with high VA/Q areas occurred mostly in patients with greatly increased compliance and may represent loss of blood-glow due to alveolar wall destruction. Similarly, well-defined modes of low VA/Q areas were seen mostly in patients with severe cough and sputum and may be due to reduced ventilation secondary to mechanical airways obstruction or distortion. There was little change in the VA/Q distributions on exercise or on breathing 100% O2. The observed patterns of VA/Q inequality and shunt accounted for all of the hypoxemia at rest and during exercise. There was therefore no evidence for hypoxemia caused by diffusion impairment. Patients with similar arterial blood gases often had dissimilar VA/Q patterns. As a consequence the pattern of VA/Q inequality could not necessarily be inferred from the arterial PO2 and PCO2.
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PMID:Ventilation-perfusion inequality in chronic obstructive pulmonary disease. 83 71

A statistical correlation between anamnestic and hemodynamic data was performed in 40 patients with chronic obstructive lung disease and pulmonary hypertension at rest. Cardiopulmonary hemodynamic performance was significantly correlated with some of the assessed parameters, especially duration of illness and symptoms generally related with airway obstruction as dyspnea, cough and sputum.
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PMID:Some anamnestic and clinical parameters correlated to longterm pulmonary hypertension development in patients with chronic obstructive lung disease. 93 90

Because a number of "early tests" may now be used to measure abnormalities of lung function in cigarette smokers with normal airflow rates, we evaluated the symptoms of cough, sputum, wheezing, and shortness of breath in 60 nonsmokers and 49 smokers to determine whether these symptoms correlated with measurements of lung function that are believed to be altered by mild obstruction. One or more symptoms were present in 5 per cent of the nonsmokers and 90 per cent of the smokers. Individual symptoms, sums of symptoms (symptoms score), and various combinations of symptoms correlated poorly or not at all to measured values for dynamic lung compliance, closing volume, closing capacity, slope of Phase III, and helium flow-volume curves. The symptoms score correlated negatively (P less than 0.05) with forced maximal expiratory flow at 50 per cent of vital capacity. Inasmuch as the serious consequences of chronic airway obstruction are related to abnormalities of lung function, it is likely the function tests will prove more useful than symptoms to reveal smokers at risk to develop chronic obstructive pulmonary disease. Symptoms cannot be used to detect smokers who are liable to have functional abnormalities suggestive of mild peripheral airway obstruction.
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PMID:The relationship between symptoms and functional abnormalities in clinically healthy cigarette smokers. 97 22

For years, halothane has been the anesthetic agent of choice for patients with chronic obstructive pulmonary disease (COPD) and reversible airway disease (asthma). Enflurane was compared with halothane in 100 patients with COPD substantiated by spirometry and history. Intraoperative and postoperative complications in each relatively homogenous 50-patient group were assessed. Spirometry, blood gases, chest x-rays, incidence of complications involving secretions, coughing, wheezing, and cardiovascular problems were similar in both groups. Enflurane appears to be equivalent to halothane as an anesthetic in such patients.
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PMID:Enflurane as a primary anesthetic agent for patients with chronic obstructive pulmonary disease. 103 96

A series of 111 index subjects with chronic obstructive pulmonary disease (COPD) who had forced expiratory volume in 1 second (FEV1) of 70% or less of that predicted were matched on the basis of age, sex, occupation, and smoking history with control subjects who had an FEV1 of 85% or more of that predicted. Index and control subjects with seasonal or reversible airway disease were excluded. Men outnumbered women by a ratio of 4.5 to 1. Thirty-five percent of the women and 2% of the men were nonsmokers (0 pack-years). There were three PiZ phenotypes in the index group (two nonsmokers) and none in the controls. PiMZ phenotypes in the index group outnumbered those in the controls by 8 to 5. Host factors that might be important in these closely matched pairs were sought by history, physical examination, and a large battery of laboratory tests. A standard respiratory questionnaire revealed the anticipated significantly higher frequency of cough, phlegm, noisy respiration, and all grades of dyspnea in index subjects. Previous lower respiratory tract infections also were more frequent in index subjects than in controls. There were no detectable differences between groups in the frequency of upper airway infections, nasal polyps, sinus surgery, or reported allergy to any substance. If the British Medical Research Council's definition of chronic bronchitis were applied to our study, about two-thirds of our index subjects and almost one-third of our controls would be considered to have chronic bronchitis. Pack-years of smoking were not significantly associated with the amount and duration of cough and expectoration in male or female index subjects or controls. Significant differences between index and control groups on physical examination included the audible forced expiratory flow time over the trachea, the estimated maximal midexpiratory flow, breath sounds, rales, and total excursion of the hemidiaphragms. An endocrine questionnaire and measurement of blood sex hormones did not give any clues as to the propensity of males to develop COPD. Women with airway obstruction similar to that of men had histories of significantly fewer pack-years than did the men, and there was a much larger proportion of women who never smoked. Further studies, specifically on genetic and immunologic characteristics, are under way to identify potential host factors.
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PMID:Host factors in chronic obstructive pulmonary disease in an upper Midwest rural community. Design, case selection, and clinical characteristics in a matched-pair study. 108 34


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