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)

Angiotensin converting enzyme (ACE) inhibitor plays an important role not only as an antihypertensive drug but also for prevention of various complications related to geriatric syndrome. Pneumonia in the disabled elderly is mostly due to silent aspiration of oropharyngeal bacterial pathogens to the lower respiratory tract. Aspiration is related to the dysfunction of dopaminergic neurons by cerebrovascular disease, resulting in impairments in both the swallowing and cough reflexes. ACE inhibitor can increase in the sensitivity of the cough reflex particularly in older post-menopausal women, and improvement of the swallowing reflex. In a 2-year follow-up study in stroke patients, patients who did not receive ACE inhibitors had a higher risk of mortality due to pneumonia than in stroke patients who were treated with ACE inhibitor. Moreover, the mortality of pneumonia was significantly lower in older hypertensive patients given ACE inhibitors than in those treated with other antihypertensive drugs. On the other hand, we found a new benefit of ACE inhibitor on the central nervous system. The mortality in Alzheimer's disease patients who received brain-penetrating ACE inhibitor was lower than in those who received other antihypertensive drugs. In a 1-year follow-up study, cognitive decline was lower in patients receiving brain-penetrating ACE inhibitors than in patients receiving a non-brain-penetrating ACE inhibitor or a calcium channel blocker. Brain-penetrating ACE inhibitors may slow cognitive decline in patients with mild to moderate Alzheimer's disease. ACE inhibitor might be effective for the disabled elderly, resulting in the prevention of aspiration pneumonia and Alzheimer's disease for the elderly.
 ...
PMID:[The benefit of angiotensin converting enzyme inhibitor for geriatric syndrome in the elderly]. 1782

In this study, the effects of atropine sulfate (atropine) on swallowing and cough reflex were evaluated in the two experimental models in conscious dogs. To evaluate the effects of atropine on swallowing, 1 mL of marker (contrast medium) was injected into the pharynx under X-ray exposure to induce swallowing. Baclofen, used as a positive control, caused marker congestion in the upper esophagus. In our experimental model, atropine (0.02 and 0.1 mg/kg, i.v.) dose-dependently increased not only the number of marker congestions but also that of the swallows. In addition, atropine significantly shortened the onset of first swallowing. In the evaluation of atropine effects on electrically evoked cough reflex induced by two electrodes implanted into the trachea, atropine strongly inhibited the number of coughs at 0.01 or 0.05 mg/kg accompanied with 0.01 or 0.05 mg/kg per hour (i.v.), respectively. These findings indicate that atropine has the potential of causing aspiration pneumonia through induction of swallowing disorder and inhibition of the cough reflex.
 ...
PMID:Swallowing disorder and inhibition of cough reflex induced by atropine sulfate in conscious dogs. 1834 13

A two-year-old male entire border collie dog was evaluated for a short history of mixed bowel diarrhoea, coughing, vomiting and stranguria. Physical examination revealed dyspnoea with increased ventral lung sounds and a flaccidly distended bladder. Neurological examination revealed poor pupillary light reflexes, an absent gag reflex and a poor anal tone. Thoracic radiography was consistent with megaoesophagus and aspiration pneumonia. Clinicopathological testing revealed an elevated muscular nicotinic acetylcholine receptor antibody titre. The dog was euthanased because of clinical deterioration. Cerebrospinal fluid (CSF) collected immediately post-mortem revealed macrophagic pleocytosis. Post-mortem histopathological examination was consistent with dysautonomia. This is the first report of coexisting autoimmune myasthenia gravis and dysautonomia in a non-human species. The concomitant diseases may suggest a common immunopathological aetiology.
 ...
PMID:Autoimmune myasthenia gravis and dysautonomia in a dog. 1868 49

Aspiration pneumonia is a major cause of death in patients with dysphagia, often accompanied by psychiatric symptoms. The inhibition of swallowing and cough reflexes, which contribute to a significant risk for aspiration, may be related to decreased levels of substance P. Clinical studies indicate a strong association of an increased mortality in psychiatric patients with the use of antipsychotics. The present study documented fewer positive episodes of swallowing reflex in patients treated with haloperidol for schizophrenia (7/11; 63.6%) than those treated with risperidone (10/11; 90.9%). In addition, patients treated with risperidone had serum substance P levels comparable with control subjects (29.0 +/- 7.8 pg/mL, 29.6 +/- 7.6, respectively; p = 0.9), while patients treated with haloperidol had significantly lower serum substance P levels (20.6 +/- 5.5 pg/mL; p < 0.01). Among patients on haloperidol, those with negative episodes of reflex (4/11; 36.4%) had serum substance P levels at 15.8 +/-1.0 pg/mL, in contrast with those with positive episodes (7/11; 63.6%) who had serum levels at 23.4 +/- 4.9 pg/mL. However, in the patient group treated with risperidone, serum substance P levels in the majority of patients with positive episodes of reflexes (10/11, 90.9%; 30.1 +/- 7.2 pg/mL) was found to be as high as in control subjects, all with positive episodes (5/5, 100%; 29.6 +/- 7.6 pg/mL) (p = 0.866), and higher than in one patient with negative reflex (1/11, 9.1%; 18.0 +/- 0.0 pg/mL). These results suggest that the decreased serum substance P levels are strongly associated with the use of haloperidol, as well as decreased swallowing reflexes. This suggests that serum substance P levels may be a useful predictive marker for the increased risk of developing aspiration, or subsequently aspiration pneumonia. Moreover, this increased incidence of aspiration may contribute to an increased mortality in patients following antipsychotic therapy. Risperidone, which has little influence on serum substance P productions, may be a more appropriate first-line drug of choice for treatment of schizophrenia.
 ...
PMID:Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics. 1872 97

Prevention of complications is the primary goal in patients with dysphagia. The most common complications of dysphagia are aspiration pneumonia, malnutrition and dehydration; other possible complications, such as intellectual and body development deficit in children with dysphagia, or emotional impairment and social restriction have not been studied thoroughly. Pulmonary complications of dysphagia should be viewed as an impaired balance between defence mechanisms (cough and mucociliary action, lymphatic clearance and cellular immune defences) and food and secretions aspiration. The main pulmonary complications are aspiration pneumonia, toxic aspiration syndromes, bacterial infections and pulmonary fibrosis. The risk of aspiration pneumonia is increased by poor oral status and health status, dependency for oral care and oral feeding; nonetheless, compliance with feeding recommendations of the dysphagia team, may reduce the risk of pulmonary complications. Malnutrition and dehydration are common in patients with dysphagia; however, enteral nutrition may significantly impact on both. Even though a relationship between malnutrition, dehydration and dysphagia exists, the real impact of one on the others is not known.
 ...
PMID:What we don't know about dysphagia complications? 1876 23

The aim of treating head and neck cancer is to eliminate the tumor and save functions as much as possible. Despite all efforts the vital (swallowing) and communicative (phonation, articulation) functions can be injured. The treatment of dysphagia is the most important in the rehabilitation, because it can lead to fatal complications: aspiration pneumonia (for example aspiration of saliva), dehydration, malnutrition. According to the localization of the lesion we distinguish oropharyngeal and esophageal dysphagia. The aspiration may be pre-, intra- and post-deglutition. The aspiration without coughing is called silent aspiration which is mainly seen in neurogenic dysphagia, but can also happen in head and neck cancer patients. There are different possibilities to compensate the failing functions in the phoniatric rehabilitation. The swallowing therapy includes causal, compensatory and dietary strategies. In addition to the swallowing therapy the treatment of communicative dysfunctions with articulation exercises will also improve the quality of life of the patients.
 ...
PMID:[Phoniatrics in the rehabilitation for head and neck cancer]. 1884

Carious and periodontal disease is strongly associated with pulmonary infections. Aspiration pneumonia often develops lung abscess and/or empyema, and sometimes leads to death in elderly patients. It is often repeatedly seen in most of elderly patients, which leads to general weakness, prolonged bed rest, and several complications. There are two pathophysiological factors for aspiration pneumonia. One is due to odontogenic infections: aspirated oral microorganisms reach pulmonary alveoli, grow, and develop their pathogenicity. The other is host factors: alcoholism, diabetes, or bedridden status reduces cough reflex, airway clearance, and functions of phagocytes. The prevention of aspiration pneumonia is significant from medical, social, and economical viewpoints, although the main management of pneumonia is antimicrobial chemotherapy. "Oral care" has recently been of interest as a control means for odontogenic infections and aspiration pneumonia. A dental hygienist and speech therapists in our hospital have implemented active intervention in oral care of patients with risk of aspiration pneumonia, which has made considerable achievements.
 ...
PMID:[Effects and management of odontogenic infections on pulmonary infections]. 1995 22

We present a case of combined general anesthesia with muscle relaxant and epidural analgesia for hemicolectomy in a 56-year-old woman with Pompe disease. Progressive pulmonary function loss predisposes Pompe disease patients to an increased risk of aspiration pneumonia, atelectasis, and all pulmonary infections. Given the impaired cough resulting from abdominal muscle weakness, patients with Pompe disease who undergo abdominal major surgery are prone to great risks of postoperative pulmonary complications. In our case, to optimize the patient's pulmonary toilet during the postoperative period, epidural block was provided as well as general anesthesia. Although she had a severe scoliotic spine and a worst pulmonary function test, the attempt of epidural block provided excellent pain control and pulmonary toilet care.
 ...
PMID:Combined general and epidural anesthesia for major abdominal surgery in a patient with Pompe disease. 2061 46

Oropharyngeal dysphagia is a major complaint among older people. Dysphagia may cause two types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration. Videofluoroscopy (VFS) is the gold standard to study the oral and pharyngeal mechanisms of dysphagia in older patients. Up to 30% of older patients with dysphagia present aspiration-half of them without cough, and 45%, oropharyngeal residue; and 55% older patients with dysphagia are at risk of malnutrition. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in older patients. Diagnosis and management of oropharyngeal dysphagia need a multidisciplinary approach.
 ...
PMID:Diagnosis and management of oropharyngeal Dysphagia and its nutritional and respiratory complications in the elderly. 2081 45

A respiratory failure (RF) rating scale has been developed to objectify indications for artificial ventilation (AV). The scale consists of three blocks gauging the level of consciousness, the degree of swallowing problems, cough, airway patency, and lung parenchymatous injury. The scale was tested in the period December 2009 to March 2010. Selection of patients in accordance with the chosen study inclusion and exclusion criteria allowed 15 patients to be enrolled in the study. Of them there were 8 (53%) women and 7 (47%) men. The patients' age was 25 to 68 years; median age was 42 years. There were cerebrovascular aneurysms and brain tumors of various locations and histology in 7 and 8 cases, respectively. Three groups of patients were identified. The first two groups included patients with successful extubation, but Group 2 patients were further reintubated because of neurological deterioration. In Group 3 patients, extubation was unsuccessful, i.e. these required reintubation within 48 hours after extubation. Groups 2 and 3 patients developed inflammatory complications, such as nosocomial pneumonia and sepsis; there were worse outcomes. If the tactics of AV initiation were determined from scale scores, it should not differ in Groups 1 and 2. Based on the scale scores, AV should be regained much more early than was practised. The developed scale allows one to optimize the time of AV initiation. Single patient assessment can ascertain a direct cause of respiratory failure (RF) while dynamic assessment can determine the sequence of changes in the magnitude of individual determinants of RF. In patients with unsuccessful tracheal intubation, the scale will optimize the time of reintubation, thereby reducing the incidence of nosocomial and aspiration pneumonia.
 ...
PMID:[A respiratory failure rating scale in neurosurgical patients]. 2092 47


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>