Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Combustion toxicology is complex so, although victims exposed to combustion products are mainly treated symptomatically, it is important to identify those situations when specific therapeutic measures might be of importance. Victims presenting respiratory symptoms including severe cough, bronchoconstriction, hypoxia and respiratory distress should be given oxygen and ventilatory assistance or support. Furthermore, bronchoconstriction should be treated with bronchodilators (beta-2-adrenoreceptor agonists, theophylline). Corticosteroids should be considered both for inhalation and systemically due to the risk of developing toxic pulmonary oedema that may appear after a symptom-free interval that might last up to 48-72 h. Victims with impaired consciousness should be regarded as being exposed to carbon monoxide and cyanides. Apart from oxygen and optimal symptomatic treatment hyperbaric oxygen therapy should be considered in carbon monoxide poisoning. Certain cyanide antidotes, namely those with low intrinsic toxicity (as sodium thiosulphate, hydroxocobalamin) should be given liberally in these situations. Other specific therapeutic measures that might be considered when appropriate are administration of organophosphate antidotes (atropine, oximes), heavy metal chelators (e.g. dimercaptopropane sulfonate, dimercaptosuccinic acid) and methemoglobinemia antidotes (methylthionine, toluidine blue). Inhalation of hot fumes may cause upper respiratory tract oedema (e.g. laryngeal oedema) necessitating orotracheal intubation and ventilatory support.
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PMID:Hospital treatment of victims exposed to combustion products. 147 Nov 83

Upper respiratory and pulmonary complications of cocaine addiction have been increasingly reported in recent years, with most of the patients being intravenous addicts, users of freebase, or smokers of "crack." The toxicity of cocaine is complex and is exerted via multiple central and peripheral pathways. Recurrent snorting of cocaine may result in ischemia, necrosis, and infections of the nasal mucosa, sinuses, and adjacent structures. Pulmonary complications of cocaine toxicity include pulmonary edema, pulmonary hemorrhages, pulmonary barotrauma, foreign body granulomas, cocaine related pulmonary infection, obliterative bronchiolitis, asthma, and persistent gas-exchange abnormalities. Respiratory manifestations are nonspecific and include shortness of breath, cough, wheezing, hemoptysis, and chest pains. Severe respiratory difficulties have been reported in neonates of abusing mothers. In the absence of a cocaine-abuse history, it may be difficult to recognize the etiological role of cocaine, especially in the absence of needle tracks pointing to previous intravenous drug abuse and/or negative toxicology.
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PMID:Respiratory complications of cocaine abuse. 158 7

A 23-year-old male with complete collapse of the right lung due to spontaneous pneumothorax was admitted 11 days after its onset. Paying close attention to the re-expansion pulmonary edema (REPE), water seal drainage was performed. Following couple episodes of persistent severe cough, four hours later, he developed dyspnea and began to expectorate frothy massive sputum. Chest X-ray revealed pulmonary edema of the entire right lung field. Measurement of total proteins and neutrophil elastase in airway exudates showed 5.5 g/dl (ratio to plasma, 0.89) and 7000 micrograms/l, respectively. Because of marked difference of compliance between bilateral lungs, management with right and left-separated mechanical ventilation and PEEP applied only to the right lung was performed. Although transient mediastinal deviation to the left was observed, successful management was achieved by the maneuver. High concentrations of total proteins and neutrophil elastase in edema fluid suggest that increased vascular permeability due to endothelial cell injury via activated neutrophils is mainly responsible for REPE. In the present case, rapid expansion of the collapsed lung accelerated by severe cough seems to be a predisposing factor of REPE. In patient with prolonged pneumothorax, suppression of cough is thought to be important for the prevention of REPE even with water seal drainage.
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PMID:[A case of re-expansion pulmonary edema following water seal drainage for spontaneous pneumothorax--management with right and left-separated mechanical ventilation]. 163 63

Several respiratory complications have been described in patients with ulcerative colitis (UC), and are the subject of this review. Involvement of the bronchial tree is the most frequent of them. Chronic bronchitis (16 patients) and bilateral bronchiectasis (16 patients) are responsible for chronic disabling bronchial suppuration. Symptoms related to the bronchial disease most often develop in patients in whom the diagnosis of ulcerative colitis is already established (88% of cases). Occurrence before the diagnosis of UC is possible, but unusual. Bronchial involvement can develop in patients whose UC is in complete remission, or who have undergone coloproctectomy up to several years earlier. Impressive improvement of cough and sputum production commonly occur following inhaled steroids. This is of great diagnostic and therapeutic significance. Other complications include subacute asphyxiating tracheal obstruction due to intralumenal inflammatory overgrowth (1 patient), small airways disease and panbronchiolitis (2 patients), BOOP (4 patients), pulmonary angiitis (6 patients), desquamative interstitial pneumonitis and granulomatosis (2 and 3 patients respectively), biapical pulmonary infiltrates (2 patients) and serositis. In addition, UC patients can develop less specific pulmonary problems such as pulmonary edema, pulmonary embolism and sulfasalazopyridine-induced pneumonitis and fibrosis.
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PMID:[Respiratory manifestations of hemorrhagic rectocolitis]. 176 14

The combined thoracoabdominal procedure for patients with esophageal cancer is still associated with a high rate of pulmonary complications. Many institutions believe prophylactic postoperative mechanical ventilation to be the most effective measure against pulmonary complications. On the other hand, the duration of mechanical ventilation can have a significant influence on the incidence of pulmonary complications, which are increased after prolonged ventilatory support. Interstitial pulmonary edema is a frequent pathological finding with a poor prognosis after esophageal surgery. Increased water retention in the lung means a greater risk of atelectasis or pneumonia. At the St. Clara Hospital, Basle, patients with esophagectomy were extubated on the day of surgery. Despite early extubation there was a very low rate of minor pulmonary complications. To clarify possible factors contributing to this uncomplicated postoperative course, 20 patients with thoracoabdominal resection of the esophagus were evaluated. All patients were operated upon using a combination of thoracic epidural and light general anesthesia. At the end of the operation all were breathing spontaneously. After a short period of pressure support ventilation and continuous positive airway pressure (CPAP), the mean extubation time was 3 h 10 min postoperatively. Local anesthetics and morphine given by the epidural route and the simultaneous use of nonsteroidal anti-inflammatory drugs made possible an uneventful and pain-free postoperative course. Early extubation, the immediate use of a CPAP mask system 2-3-hourly and an effective cough were the main points of respiratory therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Complication-free early extubation following abdomino-thoracic esophagectomy]. 188 58

Simple cardiopulmonary functions were studied serially in 26 mountaineers between sea level and an altitude of 25,200 ft. Up to 12,000 ft there was no altitude sickness, though there were complaints of leech bite (26.9%) and blisters (3.8%). One member died of exhaustion, two developed pulmonary oedema, one "flu" (at 15,600 ft) and one pleural rub (at 21,000 ft). Up to 16,000 ft altitude, 4 to 7.7% developed diarrhoea or epistaxis only, but at higher levels 25 to 50% subjects developed several symptoms, besides excessive dyspnea. These included diarrhoea (35-60%), vomiting (30%) abdominal pain (35-60%), rectal bleeding (15%), chest pain (10-40%), dry cough (40-60%), giddiness (30%) and poor memory (7.7%). A small rise in blood pressure was seen (for systolic at lower and diastolic at greater altitudes). After 18,200 ft the steady increase seen in VE slowed and the rise in heart rate and respiratory rate (f) became steeper. After a small rise at 7,800 ft, FVC and FEV1 showed a gradual decline at higher altitudes. After a large initial increase in PEFR up to 12,000 ft, a gradual decline was seen. The mean weight loss during the expedition was 8 +/- 2.7 kg. These changes seem to be due to an incomplete acclimatisation, which future mountaineering teams should take into consideration to avoid health problems and improve performance.
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PMID:Cardiopulmonary functional changes in acute acclimatisation to high altitude in mountaineers. 225 31

Topical beta-adrenergic blocking agents are commonly used to treat glaucoma. Exacerbations of asthma and bronchospasm caused by topical beta-adrenergic ophthalmic preparations are well known. We describe a 67-year-old woman who had aspiration pneumonitis characterized by a nodular infiltrate in the right middle lobe of the lung and nocturnal coughing after beginning topical application of an ointment (Lacri-Lube) for treatment of xerophthalmia. Bronchial washing demonstrated lipid-laden pulmonary alveolar macrophages. After the use of Lacri-Lube was discontinued, her cough and the chest roentgenographic abnormality totally disappeared. We postulate that the topical ophthalmic preparation, which contains mineral oil and petrolatum, drained into the nasopharynx, trachea, and bronchial tree through the nasolacrimal duct and caused lipoid pneumonitis from aspiration of the oil contents. To our knowledge, this is the first report of pulmonary complications caused by Lacri-Lube. We briefly review the pulmonary complications, including pulmonary edema, apnea from paralysis of respiratory muscles, bronchospasm from non-beta-adrenergic blocking drugs, and electrolyte abnormalities, attributable to topically and systemically administered ophthalmic medications.
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PMID:Pulmonary complications from ophthalmic preparations. 237 76

Three cases of high altitude pulmonary edema (Hurtado's disease) are described. The onset of the symptoms occurred within 72 hours after arrival from the sea level. Their main clinical features were dry cough, shortness of breath, tachycardia, progressive dyspnea and weakness. Rales and obstructive bronchial signs were detected on chest auscultation. Treatment included oxygen administration, diuretics and bed rest, with satisfactory clinical evolution within four days. Hurtado's disease is a form of noncardiogenic pulmonary edema, increased pulmonary vascular pressure and permeability are, probably, the main factors in its development. It has been suggested that both factors could a be consequence of hypobaric hypoxia.
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PMID:[Pulmonary edema in high altitude]. 248 89

An 81-year-old woman had chills, fever, nausea, vomiting, and epigastric pain. On day 3 she had hematuria and was treated with trimethoprim-sulfamethoxazole. On day 5 she had a cough, hypotension, anemia, azotemia, and elevated hepatic enzyme levels. Her condition deteriorated with thrombocytopenia, anuria requiring dialysis, edema, and hypoalbuminemia. Treatment with chloramphenicol and doxycycline was started on day 10. By day 11, she was in hypotensive shock; on day 12 she had seizures and died. Murine typhus was diagnosed by demonstration of antibodies to Rickettsia typhi by indirect immunofluorescence. Necropsy revealed interstitial pneumonia, pulmonary edema, hyaline membranes, alveolar hemorrhages, petechiae and vasculitis in the central nervous system, interstitial myocarditis, multifocal interstitial nephritis and hemorrhages, splenomegaly, portal triaditis, and mucosal hemorrhages in urinary tract. Immunofluorescent R. typhi were demonstrated in the lungs, brain, kidneys, liver, and heart. This unusual death occurred in an elderly patient without rash who was treated too late with antirickettsial drugs.
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PMID:Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus. 249 81

A 52 year-old male farmer was admitted to our hospital because of cough, sputum and dyspnea on exertion. Chest X-ray showed pulmonary edema and arterial blood gas analysis showed hypoxemia. Silo-fillers' disease was diagnosed because he had allegedly inhaled yellowish gas in the silo. The day following steroid therapy, symptoms and pulmonary edema improved. Silo-fillers' disease is chemical pneumonitis due to exposure to the oxides of nitrogen which are produced in silos. Although reported cases of silo-fillers' disease in Japan are rare it should be kept in mind in areas involved with dairy farming.
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PMID:[A case of silo-fillers' disease]. 261 1


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