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

Pulmonary infection due to the filariform larvae of Strongloides stercoralis may occur in immunocompromised patients residing in endemic areas of the United States. Such infection usually presents as dyspnea with a cough that sometimes results in bloody sputum. Although the chest roentgenogram often reveals a patchy bilateral alveolar infiltrate, acute respiratory distress is unusual. We report a patient who experienced severe exacerbation of his underlying obstructive lung disease that was associated with chest infiltrates and recovery of S stercoralis from his sputum. Although initial improvement was accomplished with Thiobendazole treatment, a re-exacerbation occurred when antiparasitic therapy was completed. The persistence of his infection is correlated to factors that are commonly employed in the treatment of COPD but may be overlooked as predisposing causes of hyperinfection with S stercoralis.
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PMID:Exacerbation of chronic obstructive pulmonary disease due to hyperinfection with Strongyloides stercoralis. 234 69

We investigated the role of the viscoelastic and adhesive properties of mucus gel simulants on the clearance of mucus by simulated cough. Mucus-like gels with widely varying viscoelastic properties were prepared from polysaccharides crosslinked with sodium borate. Cough was simulated by opening a solenoid valve connecting a model trachea to a pressurized tank. The clearance of gels lining the model trachea was quantified by observing marker particle transport. Viscosity elastic modulus, relaxation time and yield stress were measured with a steady-shear viscoelastometer. Spinnability (thread formation) was determined with a filancemeter. Adhesivity (surface tension) was measured by the platinum ring technique. The viscoelastic and adhesive properties of the mucus gel simulants spanned the ranges observed for bronchial secretions from patients with COPD. The relationship between simulated cough clearance and the viscoelastic and adhesive properties of the gels was analyzed by stepwise linear regression of the non-zero data matrix. The major independent variable relating to clearance was viscosity. Secondary, but highly significant dependences, were also found for spinnability and adhesivity. Elastic modulus, relaxation time and yield stress had no independent effect on cough clearance over the investigated range. The results indicate that, in the absence of airway surface liquid, cough-type clearance relates primarily with mucus gel viscosity. For a given viscosity, clearance is also impaired by spinnability, i.e. the capacity of the mucus to form threads. At constant viscosity and spinnability, clearance is further impaired by an increase in the adhesivity of the mucus. The negative dependence of each of these physical factors can be rationalized in terms of their inhibitory effect on wave formation in the mucus lining layer during high velocity airflow interaction.
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PMID:The role of mucus gel viscosity, spinnability, and adhesive properties in clearance by simulated cough. 261 67

Mycoplasma pneumoniae is a pathogenic micro-organism frequently held responsible for acute respiratory infection. The disease is ubiquitous and often proceeds in epidemics among small communities of young people (families, army barracks, universities). Its usual clinical manifestations consist of a stubborn cough symptomatic of tracheo-bronchitis with or without fever, and inflammation of the upper respiratory tract. Cases where chest X-rays show a pulmonary infiltrate are less frequent, but they differ from other lung diseases in that the respiratory signs at physical examination are discreet. The presence of cold agglutinins is not specific, but it contributes to the diagnosis. Cutaneous, neuromeningeal, cardiovascular and osteo-articular manifestations are rare, usually delayed and of lesser importance. Diagnosis rests on positive cultures of tracheo-bronchial or pharyngeal samples and/or on a significant increase in the titers of serum antibodies directed against M. pneumoniae. The disease is usually benign. Antibiotic therapy with macrolides or tetracyclines shortens its duration and reduces the incidence of complications. The latter chiefly concern elderly subjects and patients with COLD for whom M. pneumoniae infection constitutes a major risk of respiratory failure.
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PMID:[Mycoplasma pneumoniae infections]. 266 46

This is a review of physiological and clinical aspects on training of the respiratory muscles in chronic obstructive pulmonary disease (COPD) patients. Three types of exercise training have been used: strength, endurance, and co-ordination. With each type, intensity of the stimulus, specificity and the proper evaluation of the training are important. The rationale for training respiratory muscles is not well defined in the literature. It should include increase in strength of expiratory muscles to produce an effective cough and of inspiratory muscles to increase their force reserve. Training in endurance by breathing against resistances is appropriate, because it mimics some lung pathology, such as bronchospasms. Training for co-ordination of respiratory muscles allows maximization of the use of abdominal muscles as inspiratory accessory muscles and of the lips to regulate the closing pressure point of the airways as in pursed-lips breathing. Reviews of work done on training the respiratory muscles in COPD patients often show partial objectives, non-specific techniques of evaluation, absence of control groups, subthreshold loads, and neglect of dyspnoea and nutrition. There is enough information proving that respiratory muscles can be trained both for endurance and strength, and sufficient evidence that new imaginative training programmes can improve the quality of life of COPD patients.
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PMID:Inspiratory muscle training in COPD patients. 267 5

The airways are cleared by mucociliary action and coughing. Mucociliary clearance depends on normal active beating cilia coupled to a mucous layer, the physical properties of which permit efficient cephalic movement. Optimal viscosity and elasticity are important. Coughing, essentially a reserve mechanism most efficient in the central airways, relies on a high linear airflow velocity generated by ample flow, and airway narrowing with a two-phase, air-liquid flow regime. This regime may be curtailed because of inadequate flow in patients with chronic obstructive pulmonary disease (COPD). Failure of these two mechanisms may lead to sputum retention in the post-operative state or acute-on-chronic bronchitis, with respiratory failure. In e.g. primary ciliary dyskinesia, as in Kartagener's syndrome (sinusitis, bronchiectasis and situs inversus) and Young's syndrome (primary male infertility), the cardinal features are related to mucociliary insufficiency. Similarly, in asthmatics sputum plugging may occur, even in mild asthma. Clearance may be improved by drugs such as beta 2-agonists, theophylline, corticosteroids and mucolytics in various disease states. Physical means, such as gravitational postural drainage, and the forced expiration technique (FET) used for chest physiotherapy, may also be effective.
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PMID:Rationale of airway clearance. 267 8

237 out-patients suffering from chronic obstructive lung disease (COLD) were selected from 7 Italian clinical centers. They were randomly allocated to either placebo or bromhexine 30 mg b.i.d. p.o., in a double-blind fashion. Sputum volume and quality, facility of expectoration, cough, dyspnea, auscultatory thoracic symptoms, forced expiratory volume, peak expiratory flow rate and residual volume were evaluated. Bromhexine showed a statistically significant therapeutic activity in comparison to placebo. This action was rapid, marked and effective in determining a modulation of bronchial secretions.
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PMID:Italian multicenter study on the treatment of chronic obstructive lung disease with bromhexine. A double-blind placebo-controlled trial. 269 Feb 35

Numerous studies have documented the effects of smoking and reduced pulmonary function on all-cause mortality. The effects of respiratory symptoms are less well studied. This paper examines the joint effects of respiratory symptoms, lung function, and smoking using 11-year mortality data on 698 subjects aged 25 years and older. Copies of death certificates were obtained for all 120 confirmed deaths, and cause of death was coded by a nosologist using the rules of the International Classification of Diseases, Ninth Revision. Symptoms of cough/phlegm, wheeze, and dyspnea were significantly associated with all-cause mortality in separate univariate analyses. On a cause-specific basis, these associations appeared to hold for chronic obstructive pulmonary disease, lung cancer, and vascular disease. Further analysis indicated that, for both smokers and nonsmokers, the presence of chronic cough and/or sputum production was related to mortality only in the presence of wheezing. In addition, among smokers, the presence of both cough/phlegm and wheeze. In addition, among smokers, the presence of both cough/phlegm and wheeze was significantly associated with mortality only among subjects with low initial lung function. Although the limited number of deaths and the nonrandom nature of the cohort limit the generalizability of our findings, it seems clear, based on these results and other published studies, that symptoms of cough, phlegm, and/or wheeze have important adverse health implications even in the absence of smoking and reduced lung function. More studies using common methodological approaches are needed.
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PMID:Respiratory symptoms, lung function, and mortality in a screening center cohort. 272 54

The predictive value of cough, mucus hypersecretion, breathlessness, chronic bronchitis and forced expiratory volume in one second (FEV1) for hospitalization and medication were examined in a random population sample of 876 men, 46-69 yrs of age. All of the men were examined in 1974 with interview and lung function tests. Information on hospitalization in the period 1977-1986 was obtained from the Danish National Patient Register, and information on drug usage was obtained from 567 men in a questionnaire survey ultimo 1985. FEV1 was a strong predictor of both hospitalization and medication. Respiratory symptoms were good predictors of hospitalization due to either respiratory disease in general (odds ratios 2.56-3.29), or chronic obstructive pulmonary disease (COPD), (odds ratios 4.16-5.75). They contained predictive values in addition to that provided by FEV1. Respiratory symptoms were good predictors of medication for airway obstruction, relative risks 3.56-4.70, and/or airway disease in general, relative risks 2.67-4.69. After controlling for FEV1, cough was still significantly associated with treatment for airway disease in general and both cough, mucus hypersecretion and chronic bronchitis were significantly associated with treatment for airway obstruction. We conclude that apart from FEV1, respiratory symptoms are independent predictors of hospitalization and medication due to respiratory disease.
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PMID:Respiratory symptoms and FEV1 as predictors of hospitalization and medication in the following 12 years due to respiratory disease. 280 92

The effects of prazosin therapy were recently evaluated in ambulatory patients with essential hypertension and chronic obstructive pulmonary disease. Both the ability of prazosin to control high blood pressure and its effects on pulmonary function were observed. Systolic and diastolic blood pressures were significantly reduced at the end of the maintenance period. Of the 17 patients completing the trial, 82.4 percent attained a target diastolic blood pressure of less than 90 mm Hg, and 70.6 percent attained a diastolic reduction of greater than 10 mm Hg. Results of six-hour pulmonary function tests showed no significant differences after dosing with placebo or with prazosin. There was a significant increase in the number of patients who noted increased wheezing, but these patients did not have any increase in cough or sputum symptoms.
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PMID:Prazosin in hypertensive patients with chronic bronchitis and asthma: a brief report. 291 77

A patient had chronic, persistent cough as the presenting symptom of the neuromuscular disorder oculopharyngeal dystrophy (OPD). The presence of a significant smoking history initially resulted in the cough incorrectly being attributed to COPD. By using a systematic diagnostic approach, the correct etiology was determined.
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PMID:Chronic cough as the presenting symptom of oculopharyngeal muscular dystrophy. 292 27


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