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

Ten tetraplegics, 8 males and 2 females, with a median age of 32 years participated in a scheduled 6 weeks training programme with a respiratory muscle training mouth-nose-mask (RMT-mask) with a fixed expiratory and an increasing inspiratory resistance set by the tetraplegic in accordance to his/her increasing ability during the training period. During the 6 weeks the tetraplegics required to use the RMT-mask for 15 minutes three times a day. Before and after each training session they measured peak flow (PEF). Lung volumes, ventilatory and diffusion capacity were measured before and after the 6 weeks training period. The training resulted only in a significant change in the PEF, which increased with 11% from 371 l/min before to 412 l/min in average after the 6 weeks of training (p less than 0.025). This statistically significant increase was confirmed by the measurements of PEF performed by the tetraplegics themselves during the training period. In addition there was an increase in PEF from before to immediately after each 15 minutes training session, this trend reached statistically significance (p less than 0.025) in the third '2 weeks period'. These results might indicate a possibility of improving the tetraplegics ability to cough by use of a simple RMT-mask, which in turn might prevent certain lung complications including pneumonia, and atelectasia.
Paraplegia 1991 Feb
PMID:Effect of respiratory training with a mouth-nose-mask in tetraplegics. 202 75

Traumatic aneurysms of the descending thoracic aorta are a rare but lethal event, having a mortality of 85-90%. Mortality of this population remains high due to the occurrence of aortic rupture. The isthmus of the aorta, just distal to the left subclavian artery is the most frequent site of injury. Acute traumatic injury to the aorta is characterized by hemorrhagic shock symptoms due to the tear in the layers of the aortic wall. Chronic traumatic injury with aneurysmal formation may not surface with symptoms for months or years after initial trauma. Patients who have formed a chronic aneurysm after a trauma incident can experience dysphagia, chest pain, dyspnea, or cough. Surgical repair involves placing a dacron graft in the area of aneurysmal formation. Protection of the lower extremities during the surgical procedure may prevent paraplegia. In a review of ten cases of chronic traumatic aneurysms at Loyola University Medical Center during the past twenty (20) years, all patients underwent surgical repair. There was no incidence of paraplegia. Post-operative nursing care focuses on monitoring hemodynamic stability, preventing respiratory complications and controlling pain.
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PMID:Traumatic descending thoracic aneurysms: discussion and nursing care. 236 14

During the last 10 years (1975-1985), a total of 18 cases of posttraumatic aneurysm at the level of the thoracic isthmus were operated on. Six of the 18 were women (19-71 years of age) and 12 were men (17-61 years of age). The mean age at the time of injury was, respectively, 22 and 25.8 years and, at the time of operation, 34.5 and 35.5 years. The patients were all involved in a motor vehicle accident, except for 2 (1 falling, 1 crushing). Thirty-nine percent of the patients had no apparent thoracic injury and 89% had associated injuries (bony fractures, craniofacial, visceral and abdominal). Eight of the 18 were asymptomatic at the time of operation, the others had various symptoms (pain, fever, dyspnea, cough, hoarseness, murmur, or hemoptysis). Enlargement of the aortic button was present in every case. Seventeen patients were operated on electively from 4 months to 50 years after the injury. Circumferential rupture was total in 9 patients and partial (2/3 to 9/10) in the others. Complete repair was done by either prosthetic Dacron tube (3), Dacron patch (2), or direct suture (12). Protection by femoro-femoral bypass was used in 3 and simple aortic cross-clamp was used in 14. Mean time of aortic cross-clamp was 36.9 minutes (range, 16-80 min). Among these 17 patients, there was no hospital mortality and no late death. One patient had regressive paraplegia. One patient was submitted to an emergency operation for an intrapulmonary rupture of an infected aneurysm and died in the operating room before completion of the repair.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic traumatic aneurysms of the thoracic aorta. 272 61

Diagnosis of clinical AIDS can be difficult for clinicians in Africa, where there is only limited access to the sophisticated bacteriological diagnostic facilities needed for diagnoses based on the criteria laid down by the Center for Disease Control in the US. The most common presentation of AIDS in Africa is as an enteropathic condition known as 'Slim.' Based on this and other common presentations of the disease in Africa, a group of clinicians in Bangui, Central African Republic, drew up a list of criteria for the diagnosis of AIDS in Africa which are based on patient history and examination and the exclusion of other conditions rather than on serological confirmation of HIV infection. The major criteria are 1) unexplained fever for longer than 1 month; 2) unexplained diarrhea for longer than 1 month; and 3) weight loss greater than 10% of previous weight. Minor symptoms are presence of a maculopapular rash, oral candidiasis or thrush, herpes zoster or shingles, aggressive or uncontrollable herpes simplex, unexplained cough for longer than 1 month, or enlarged lymph nodes in more than 1 extrainguinal site. The finding of 2 major symptoms and at least 1 minor one is enough for diagnosis. These criteria have been found to be useful. However, they do not cover all the presentations which have been associated with AIDS. Unusual presentations of HIV infected persons which have been seen in Africa include serially developing abscesses in pyomyositis, gall bladder diseases, pericarditis or myocarditis, diseases of the Central Nervous System (cryptococcal meningitis, toxoplasmosis, non-specific leuko-encephalitis, atraumatic paraplegia, acute psychosis or chronic deterioration in mental capacity, lymphoma of the brain), prodromal illnesses, swollen lymph nodes, herpes zoster or shingles in young adults, or tumours of the lymphatic system. Differential diagnosis is extremely important.
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PMID:Clinical manifestations of AIDS in tropical countries. 319 42

We have described a patient in whom loss of ventilation and perfusion of an entire lung resulted from mucous impaction of a major bronchus. Mucous plugging was associated with the combination of asthma and decreased cough effectiveness due to paraplegia. Removal of the obstruction by bronchial aspiration followed by vigorous pulmonary physical therapy resulted in return of both ventilation and perfusion to the lung and relief of dyspnea and hypoxemia.
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PMID:Unilateral absence of ventilation and perfusion associated with a bronchial mucous plug. 382 32

Two hundred and forty-three spinal cord injured people were evaluated during 271 consecutive admissions to a spinal cord injury service over four years. These patients all had received initial medical stabilization after spinal cord injury prior to admission. Atelectasis with or without apparent pulmonary infiltrate or pleural effusion was documented in six quadriplegics, all on the left side. Five out of the six had tracheostomies. Atelectasis occurred days to months after injury and initial medical stabilization. The patients often had symptoms and findings suggestive of other illnesses and may have had more invasive diagnostic and therapeutic procedures if the diagnosis of atelectasis was not provisionally made. Associated dyspnea delayed the rehabilitation of several patients. Response to vigorous pulmonary therapy and bronchoscopy, if necessary, was prompt, with complete resolution in less than 24 hours. The inability to clear secretions that caused this problem was responsible for recurrences in three patients. Preventive and therapeutic modalities such as assisted coughing, deep breathing, incentive spirometry, chest percussion, and suctioning, if necessary, should be practiced. Atelectasis may still occur after the original injury.
J Am Paraplegia Soc 1985 Jul
PMID:Atelectasis in spinal cord injured people after initial medical stabilization. 384 81

The case of a 44-year-old black man who presented with severe dysphagia, cough and chest pain caused by a 12-cm aneurysm developing from a Kommerell's diverticulum at the origin of an aberrant retro-oesophageal left subclavian artery is reported. The aortic arch and descending thoracic aorta were right sided. Diagnosis was established before operation by computed tomography, magnetic resonance imaging and arteriography. The aneurysm extended a considerable distance down the descending aorta and therefore the risk of postoperative paraplegia was considered to be high. Accordingly selective arteriography was performed to locate the Adamkievicz's artery which arose only 2 cm below the end of the aneurysm. Resection grafting of the aneurysm including the upper third of the descending aorta via right thoractomy was performed. The patient made an uneventful recovery and was discharged 20 days later. This case appears to be the first successful operation for this pathology.
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PMID:Right-sided aortic arch: surgical treatment of an aneurysm arising from a Kommerell's diverticulum and extending to the descending thoracic aorta with an aberrant left subclavian artery. 804 14

A case is reported of osteosarcoma of the 11th rib in a 38-year-old woman who presented with dry cough and dyspnea due to bloody pleural effusion and the literature on osteosarcoma of the rib in Japan is reviewed. Osteosarcoma was suggested by roentgenologic findings and examination of a percutaneous needle biopsy specimen. Therefore, we administered chemotherapy, but the tumor showed progressive expansion and invasion, causing paraplegia. The patient died on the 282nd day of admission. We performed an autopsy and diagnosed osteosarcoma histologically. The tumor was covered by a hypervascular capsule, suggesting its association with the bloody pleural effusion. Osteosarcoma of the rib has not been previously reported in association with bloody pleural effusion. Considering the prognosis and characteristics of such tumors, we recommend prompt diagnosis in cases presenting with bloody pleural effusion.
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PMID:[A case of osteosarcoma of the rib with bloody pleural effusion]. 831 12

To determine the prevalence of respiratory symptoms in subjects with chronic spinal cord injury (SCI), 180 subjects completed a standard respiratory questionnaire modified for subjects with limited mobility. Subjects were categorized as high tetraplegia (HT:C5 and above not requiring mechanical ventilation), low tetraplegia (LT: C6-8), high paraplegia (HP: T1-7), or low paraplegia (LP: T8-L3). Overall, 68% of subjects reported one or more respiratory symptom. Breathlessness, the most prevalent complaint, was associated with level of lesion: HT = 73%, LT = 58%, HP = 43% and LP = 29%, whereas complaints of cough, phlegm, cough and phlegm, and wheeze did not differ significantly among subjects in the four groups. Breathlessness occurred significantly more often in the group with HT during rest or following exposure to hot air or passive smoke. Awareness of phlegm or wheeze was reported with increased prevalence among subjects with tetraplegia who had complete injuries. Among subjects with tetraplegia, respiratory complaints did not differ significantly in current smokers, former smokers, and non-smokers, whereas among subjects with paraplegia, phlegm and wheeze were reported more frequently, among current smokers.
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PMID:Self-reported prevalence of pulmonary symptoms in subjects with spinal cord injury. 934 93

We report a 3-year-old girl with idiopathic hypereosinophilic syndrome. She was admitted to our hospital because of fever, cough, significant eosinophilia (16,500/microliter) and an elevated serum IgE level (114,685 u/ml). After wheezes continued for several days, paraplegia, dysuria and dyschezia developed. CSF, chest roentgenogram and spinal MRI were normal, as well as motor and sensory conduction velocities of the median and tibial nerves. Flaum's hematologic score was 4. Treatment with prednisolone resulted in remission of neurological symptoms and a rapidly normalization of the eosinophil count. During the following months, eosinophilia reappeared with tapering the medication, but there was no recurrence of neurological signs. Glucocorticoid therapy was discontinued after 21 months.
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PMID:[A case of hypereosinophilic syndrome associated with paraplegia]. 1367 51


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