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)

A new multiparametric device (RBC-7) was used for recording cough in ambulatory children over a 24 hour period. The number of coughs and the pattern of coughing can easily be studied with the aid of a personal computer and dedicated computer software. Forty one 'normal' children were recorded, identified from a primary school with the aid of a questionnaire. They were free from any respiratory infection for one month, and had a normal examination and spirometry immediately before recording. Cough frequency was 11.3, range 1 to 34, cough episodes per 24 hours. This was unaffected by passive smoking or the presence of furry pets in the home. Nocturnal and prolonged coughing was unusual in these children. The device was highly acceptable to the children, and no adverse effects were reported. Such objective data on cough outside the laboratory setting are unique, help to determine what is normal, and may help in the diagnosis and assessment of many respiratory diseases.
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PMID:How much coughing is normal? 875 31

In order to detect problems in the management of acute respiratory infection in children and to optimize training, a survey was undertaken in 1993 including 9 pediatricians, 27 general practitioners, and 58 nurses in Bujumbura, Burundi. A questionnaire including 15 main items was used. Findings showed a poor understanding of risk factors in 62% of the population, especially among general practitioners and nurses. Clinically 79% were able to make a proper diagnosis of pneumonia. Overtreatment of coryza using antimicrobial, mucolytic, and cough drugs was suspected in 88.8%. Findings were similar with regard to management of pneumonia. Wheezing was treated in accordance with WHO recommendations in only 18% of cases. For acute respiratory infection, 53.6% used penicillin A, 18% used penicillin G, 15.9% used cotrimoxazole and 2.9% used macrolides. The duration of antimicrobial therapy was unnecessarily long for 49.4%. While 70.5% of the population (100% of pediatricians) considered the state of their knowledge and practices to be sufficient, 93.6% (55.6% of pediatricians) indicated that specific training in this field would be useful. This survey suggests that training is needed for health care workers at all levels specifically in the management and prevention of acute respiratory infection in children.
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PMID:[Burundi: knowledge and practices of physicians and nursing personnel about acute respiratory infections in children]. 876 2

In this hospital-based prospective study, a total of 222 children presenting with cough and/or breathlessness were screened for presence of lower respiratory infection. All clinically-detected cases of LRI and every fifth case of URI were investigated. Pneumonia was defined as presence of abnormal shadows on chest roentgenograms, against which the clinical symptoms and signs were assessed for their utility in the diagnosis of pneumonia. Fast breathing was found to be the most useful sign predicting pneumonia in all age groups. Cut-off points at 50 breaths/min for infants including neonates, 40 breaths/min for children aged 12-35 months, and 30 breaths/min for children aged 36-60 months indicated presence of pneumonia. Crepitations on auscultation of chest was found to have good correlation with presence of radiological pneumonia. Other signs like chest indrawing and cyanosis were found to be highly specific signs in detecting pneumonia, but had low sensitivity.
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PMID:Fast breathing in the diagnosis of pneumonia--a reassessment. 881 29

Bronchus-associated Lymphoid tissue (BALT) has been reported to be present in the lungs of patients with rheumatoid arthritis (RA). However, little is known about the structure and cellular distribution of BALT in this disease, so we investigated these points using immunohistochemical methods. The subjects were eight RA patients with BALT in biopsy specimens and a histologic diagnosis of follicular bronchiolitis. Seven patients had cough and purulent sputum, and four patients had positive sputum cultures. BALT was histologically composed of four distinct regions, which were the lymphoepithelium, the dome area, the follicular area, and the parafollicular area. Surface IgM+ B cells were predominant in the follicular area, whereas IgA+ cells were scattered in the dome and parafollicular areas. T cells were mainly found in the parafollicular area (CD4+ > CD8+), and most of them expressed the T Cell receptor alpha beta (alpha beta TCR). These findings were similar to those described previously for BALT in diffuse panbronchiolitis, which manifests as a chronic respiratory infection. The present study indicated that extrinsic stimulation as well as alterations of the immune response are involved in the development of BALT in RA, although the exact mechanism requires further clarification.
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PMID:Cellular distribution of bronchus-associated lymphoid tissue in rheumatoid arthritis. 897 Mar 84

This study analyzes patient demand in a regional public health pulmonology practice. The following data were recorded for all first-visit patients for a period of two years: age, sex, referral source, initial diagnosis by the referring physician, final diagnosis by the pulmonologist, and destination. The service studied 1,486 patients (men/women: 1.5). Most (71%) were between 40 and 80 years old. Referrals were from the family doctor (60%), health center (9%), emergency service (10%), hospital (12%), other specialists (6%), and others (3%). The most frequent reasons for remission were upper airway disease (UAD) (36%), specifically chronic obstructive pulmonary disease (COPD) and asthma, and the presentation of symptoms (28%) such as dyspnea, cough, hemoptysis and chest pain. Analysis of the final diagnoses for the patients presenting with symptoms showed that no disease could be detected in one third of those with dyspnea and hemoptysis or in half of those who complained of chest pain; acute respiratory infection was diagnosed in 45% of those complaining of persistent cough. UAD was the most frequent cause of symptoms. The index of doctor's visit/inhabitant was 0.97% for patients referred by family doctors and 0.38% for those from health centers, but the initial and final diagnosis profiles of these patients were not statistically different. Patients referred by emergency services had significantly more (p < 0.001) in number of radiological findings and hemoptysis. Those sent from hospitals more often suffered pneumonia. In conclusion, this profile of a regional public health pulmonology practice shows that: 1) UAD and clinical symptoms are the most frequent reasons for patient remission; 2) family doctors generate three times mor demand for services than do health centers, and 3) 14% of patients can be considered normal.
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PMID:[Profile of a pneumology regional health service]. 906 82

Rhabdomyolysis is not common in the elderly. Two elderly patients with rhabdomyolysis and respiratory infection with Streptococcus pneumoniae. The first patient was a 71-year-old woman with bronchiectasis who admitted to our hospital due to pneumonia. The second patient was an 84-year-old man who was admitted because of appetite loss, fever, and a cough producing of yellowish sputum. In both patients, sputum cultures were positive for S. pneumoniae, but blood cultures were not. The serum creatine kinase levels peaked on the day of admission at levels ten to thirty times higher than fold above the upper limit of normal; the serum lactate dehydrogenase levels were 1.5 times higher than the upper limit of normal. The creatine kinase levels returned to normal 5 to 7 days after admission, treated with antibiotics and recovered from pneumonia. The cases of these two patients, along with those described in previous reports of rhabdomyolysis associated with pneumococcal pneumonia indicate that measuring the serum creatine kinase level is important in detecting rhabdomyolysis, especially in elderly patients with respiratory infection caused by S. pneumoniae, and detection may help to prevent renal failure.
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PMID:[Two elderly patients with Rhabdomyolysis and respiratory infection with Streptococcus pneumoniae]. 907 5

There has been no detailed study of cough sensitivity during acute lower respiratory infection. The aim of this study was to clarify cough sensitivity in Mycoplasma pneumonia, which is a well known acute lower respiratory infection with persistent nonproductive cough. We examined cough sensitivity to inhaled capsaicin and tartaric acid in both the acute and the convalescent phases of Mycoplasma pneumonia, cell differentials in bronchoalveolar lavage fluid, and pathologic findings of transbronchoscopic bronchial biopsy specimens. Although dry cough was observed in all patients during Mycoplasma pneumonia, cough sensitivity in the acute phase [capsaicin: 19.8 (GSEM, 0.214) microM, tartaric acid: 0.26 (GSEM, 0.356) M] were not enhanced compared with those in both control subjects [capsaicin: 27.9 (GSEM, 1.24) microM, tartaric acid: 0.316 (GSEM, 0.079) M] and patients in the convalescent phase [capsaicin: 15.7 (GSEM, 0.219) microM, tartaric acid: 0.50 (GSEM, 0.326) M] when all symptoms including cough had disappeared. The percentage of lymphocytes and neutrophils in bronchoalveolar lavage fluid BALF was significantly greater than in the control subjects, and lymphocyte-dominant bronchitis was observed in biopsied specimens. We conclude that cough threshold to inhaled capsaicin or tartaric acid was not enhanced during acute Mycoplasma pneumonia with lymphocyte-predominant bronchitis. This is the first report examining cough sensitivity in patients with acute lower respiratory infection with pneumonia.
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PMID:Cough receptor sensitivity to capsaicin and tartaric acid in patients with Mycoplasma pneumonia. 961 44

A fifty year-old female who had previously been well presented with a productive cough and a high fever. Her initial chest X-ray film showed no abnormal lung shadows. Despite partial improvement of the fever and the serum level of acute phase reactant (CRP) in response to intravenous administration of piperacillin, she complained of increasing severity of cough and dyspnea. Follow-up chest X-ray films taken five days after therapy with piperacillin showed diffuse nodular shadows in the mid-to-lower lung fields bilaterally. Chest CT scan disclosed diffuse miliary nodules at the lung periphery and thickening of bronchovascular markings. Chest auscultation revealed late inspiratory coarse crackles and expiratory wheezing, and the patient's arterial oxygen tension was 61 mmHg. Suspected of suffering from primary atypical pneumonia, she was started on therapy with intravenous minocyclin (200 mg/day), two days after treatment her symptoms began improving significantly. Anti-mycoplasma antibody was found to be x 1280, and cold hemoagglutinin x 1024, establishing the diagnosis of Mycoplasma pneumoniae infection. The patient's condition completely recovered following a one week treatment with minocyclin. We concluded that her respiratory infection was caused by piperacillin-sensitive mico-organism, and also Mycoplasma pneumoniae which brought about hypoxic acute bronchiolitis to the patient.
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PMID:[A case of hypoxemic acute bronchiolitis presenting with diffuse nodular shadows caused by Mycoplasma pneumoniae]. 984 28

The aim of this study was to investigate whether budesonide, for 10 d, administered at the first sign of an upper respiratory tract infection, could reduce asthma symptoms in 1-3-y-old children with asthma during infections. The primary efficacy variable was symptom scores. The study had a multicentre, randomized, double-blind, placebo-controlled design with parallel groups. Fifty-five children with a mean age of 26 months received either budesonide or placebo via a spacer with a facemask. Each child was monitored for 1 y. Budesonide was given 400 microg q.i.d. for the first 3 d and b.i.d. for 7 d. Symptoms (cough, wheeze, noisy breathing and breathlessness) were scored (0-3) daily by the parents. Asthma symptom scores were lower in children treated with budesonide than in those given placebo. The effect was most pronounced for cough and noisy breathing, but it did not affect the need for hospital care. In conclusion, treatment with budesonide, started at the first sign of a respiratory infection, reduced asthma symptoms in toddlers with episodic asthma.
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PMID:Prophylactic intermittent treatment with inhaled corticosteroids of asthma exacerbations due to airway infections in toddlers. 1009 May 46

In Ismailia, Egypt, interviews with key informants and mothers of young children and presentations of a video were conducted in a suburban area with access to health facilities and in a rural village 3 km from the nearest public health clinic. The researchers wanted to assess mothers' recognition and interpretation of clinical signs of serious illness and to determine their preference of provider options by different locally defined acute respiratory infection (ARI) illnesses. Mothers heard descriptions of hypothetical cases and then reported how they would treat the children in the case scenarios. The researchers compared results from these data collection practices with the actual care-seeking practices of mothers during past childhood ARI episodes. When shown a video of 20 children with either no respiratory symptoms or mild to severe symptoms, mothers were able to correctly identify children who did not have an ARI in 56% of cases. With no prompting, they were able to correctly identify those with fast respiratory rates in 65% of cases. Mothers took their children with an ARI outside of the home for treatment in 22 of the past 30 ARI episodes. The most common reasons for taking children to a private physician in cases of serious illness rather than to a physician at a government health clinic were confidence in physician's ability and convenience, especially in hours of operation. Mothers tended to treat children with a runny nose and cough at home, regardless of age. Most did not consider fast and irregular breathing as a reason to seek treatment outside of the home. These results suggest that the National ARI Program should sponsor a media campaign to promote confidence in government providers to treat serious ARIs, call for a change in clinic schedules to increase access to care, and assume educational and managerial actions to assure quality of care and the availability of necessary drugs.
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PMID:Developing strategies to encourage appropriate care-seeking for children with acute respiratory infections: an example from Egypt. 1013 89


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