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)

Because aspiration pneumonia contributes significantly to morbidity and mortality in hospitalized patients, this study was undertaken to identify risk factors for morbidity and mortality associated with aspiration pneumonia. Patients with a discharge diagnosis of aspiration pneumonia in 1985 and 1990 were studied. Factors associated with death from aspiration pneumonia were: altered mental status, cerebrovascular accident, endotracheal intubation, tachycardia, and hypoxemia. Fever, cough, and unilateral infiltrates on chest radiograph were associated with survival. Attention to proper positioning of comatose patients, aggressive treatment of gastroesophageal reflux, and strict attention to endotracheal tubes and tracheostomies should decrease the morbidity and mortality associated with aspiration pneumonia.
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PMID:Risk and outcome of aspiration pneumonia in a city hospital. 835 Mar 75

A patent foramen ovale may result in paradoxical embolization and serious morbidity. Thus a sensitive method to diagnose a patent foramen ovale is important. It is unknown whether the cough test or the Valsalva maneuver is superior in delineating right-to-left shunting through a patent foramen ovale during contrast transesophageal echocardiography. Thus we studied 73 consecutive patients (53 men and 20 women), aged 54 +/- 16 years (range 18 to 79 years), during elective transesophageal echocardiography. Contrast transesophageal echocardiography was performed from a four-chamber view during quiet respirations, Valsalva maneuver, and cough test. In the entire group the incidence of a patent foramen ovale was higher during the cough test (32/73) as compared with the Valsalva maneuver (24/73, p < 0.025) and quiet respirations (18/73, p < 0.005). All subjects with a patent foramen ovale during the Valsalva maneuver had a positive contrast transesophageal echocardiogram during the cough test. In subjects (n = 55) without a patent foramen ovale during quiet respirations, the incidence of a patent foramen ovale was higher during the cough test (15/55) as compared with the Valsalva maneuver (9/55, p < 0.05). In a subgroup (N = 17) of patients with nonhemorrhagic stroke (n = 11), transient ischemic attack (n = 2), or peripheral embolus (n = 4), the cough test had a higher yield (9/17) in delineating a patent foramen ovale as compared with the Valsalva maneuver (7/17) but did not reach statistical significance. These data demonstrate that the cough test is superior to the Valsalva maneuver in delineating a patent foramen ovale during contrast transesophageal echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The cough test is superior to the Valsalva maneuver in the delineation of right-to-left shunting through a patent foramen ovale during contrast transesophageal echocardiography. 841 16

We validated the predictive accuracy of an "old" regression model in a "new" sample of bilateral stroke patients (N = 38). Abnormal gag reflex and impaired voluntary cough accurately predicted radiographically verified aspiration in both samples. A final model, using both samples, grouped patients into three risk strata: low risk of 14% (cough and gag normal), moderate risk of 46% to 51% (one of two behaviors abnormal); and high risk of 87% (cough and gag abnormal).
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PMID:Aspiration in bilateral stroke patients: a validation study. 843 16

Fosinopril is the prodrug of the active diacid ACE inhibitor fosinoprilat. In patients with heart failure, fosinopril reduces pulmonary capillary wedge pressure, mean arterial blood pressure, mean right atrial pressure and heart rate, and increases stroke volume index and cardiac index. The drug has compensatory dual elimination routes via renal and hepatic systems and accumulates to a lesser extent than enalapril and lisinopril in patients with chronic renal insufficiency with or without heart failure. Comparative studies of 3 or 6 months' duration with fosinopril 10 to 40 mg/day have demonstrated clinical efficacy significantly superior to that of placebo in patients with heart failure [mostly New York Heart Association (NYHA) functional class II or III]. Fosinopril treatment consistently increased exercise duration and improved heart failure symptoms in these patients. Significantly fewer fosinopril than placebo recipients withdrew or were hospitalised because of worsening heart failure. Additionally, significantly more fosinopril than placebo recipients showed improvement, and fewer patients had deteriorated, in terms of NYHA functional class. Fosinopril and enalapril showed similar clinical efficacy over 6 and 12 months' treatment in patients with NYHA functional class II to IV heart failure. As yet, there are no data showing a mortality benefit with fosinopril. Fosinopril was well tolerated in clinical trials in patients with heart failure. Dizziness (11.9 vs 5.4% for placebo), cough (9.7 vs 5.1%) and hypotension (4.4 vs 0.8%) were the most commonly reported adverse events. In 6- or 12-month comparative studies, fosinopril therapy was associated with a lower incidence of dizziness and hypotension, but a higher incidence of vertigo, than enalapril therapy. 0.8% of patients discontinued the drug because of cough, which occurred to a similar extent with fosinopril and enalapril. Thus, based on available clinical evidence, fosinopril is an effective and well tolerated option for the management of patients with heart failure. Although clinical data are limited, fosinopril may be especially useful in patients with renal or hepatic impairment.
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PMID:Fosinopril. A review of its pharmacology and clinical efficacy in the management of heart failure. 921 Oct 84

During the period 1977-95, 20 patients underwent surgery for carcinoid tumour in the bronchus at the University Hospital of Trondheim (n = 16) and Innherred County Hospital (n = 4). All the tumours were typical carcinoid tumours. Median age of the patients was 41 years (range 16-78 years). The observation period averaged 7.5 years (0.5-18 years). The most common symptoms were cough, dyspnoea, wheezing and pneumonia. One patient had carcinoid syndrome. Chest X-ray were negative in three of the patients. Bronchoscopy was carried out in all the patients. Biopsies were taken in ten of them, and the diagnosis was conclusive in five cases. Lateral thoracotomy was performed in all the patients. The surgical procedures were lobectomy (15), segmental/wedge resection (3), bronchotomy with tumour resection (1) and sleeve resection (1). 19 patients were still alive at the time of follow-up, with no tumour recurrence. One patient died from cerebral stroke eight years after surgery. Good long-term results were found, and the study supports the use of limited lung resection or bronchoplasty operations to treat carcinoid tumour in the bronchus if the primary tumour is localised and there are no metastases.
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PMID:[Surgical treatment of carcinoid bronchial tumor]. 923 5

Candesartan is a highly potent, long-acting and selective angiotensin II type 1 (AT1) receptor blocker. It is administered orally as the inactive prodrug candesartan cilexetil which is rapidly and completely converted to candesartan during gastrointestinal absorption. In vitro studies have shown that candesartan acts as an insurmountable angiotensin II receptor antagonist, binding tightly to and dissociating slowly from the AT1 receptor. The above characteristics are thought to contribute to the marked and long-lasting antihypertensive effects of candesartan cilexetil in several animal models of hypertension. These included rodent models of renal hypertension in which candesartan cilexetil also demonstrated efficacy equivalent to or greater than enalapril. In other animal models, candesartan cilexetil reduced the incidence of stroke, renal dysfunction and renal disease while reducing cardiac and vascular hypertrophy. Furthermore, candesartan cilexetil conferred some protection against cerebral and renal damage at a dose that had no blood pressure-lowering effect. In toxicity and general pharmacology studies, candesartan cilexetil was shown to possess a 'clean' profile with a large safety margin. Also it did not potentiate chemical- or autocoid-induced cough or anaphylactoid reactions.
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PMID:Candesartan cilexetil: a review of its preclinical pharmacology. 933 Sep 99

The risk of stroke and the risk of recurrent strokes in patients with patent foramen ovale (PFO) need a prevention that still remains a therapeutic problem. There are 4 preventive treatments: anti-agregants, anti-coagulants, transcatheter closure, and surgical closure of PFO. The aim of this study was to demonstrate that surgical closure of PFO is safe and useful for prevention of strokes. Eight patients with stroke and PFO diagnosed by transesophageal echography (TEE) were prospectively selected for surgical closure. It was necessary to be younger than 70 years, not to have another cause of stroke, and to have either recurrent strokes or several ischemic lesions on MRI, isolated for PFO associated with an atrial septal aneurysm, and to have a Valsalva maneuver or cough inducing the stroke. For these reasons, these patients were considered to be an homogenous group with a strong relationship between the PFO and the stroke, and with a high risk of recurrence of stroke. The 8 patients had a direct suture of the PFO with a cardiopulmonary bypass. All patients were followed-up with clinical, MRI and TEE examinations during 12 months after surgery. No surgical complications were observed. After one year, without any anticoagulant treatment, no recurrent stroke or transient ischemic attack, no new ischemic lesions on MRI, nor neuropsychological disturbance were noted. No post-surgical inter-atrial right-to-left shunting was observed. In the absence of controlled studies to guide therapeutic options, our data suggest that surgical closure of PFO in patients with stroke, is safe and efficacious to prevent recurrent stroke without any anticoagulants in the first year of follow-up. Further studies are needed to evaluate the long-term role of surgical closure of PFO as an alternative to prolonged anti-thrombotic treatment.
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PMID:The interest of surgical closure of patent foramen ovale after stroke: a preliminary open study of 8 cases. 961 91

The potential cause of stress fractures of the rib in elite rowers was examined by a retrospective review of 14 fractures in 10 patients. Fractures occurred on the antero- to posterolateral aspects of ribs 5 through 9 and were most often associated with long-distance training and heavy load per stroke. A review of the literature yields striking similarities between these stress fractures and fractures caused by cough. It is suggested that actions of the serratus anterior and external oblique muscles on the rib cause stress fracture because of the repetitive bending forces in both rowing and coughing. A technique involving less use of both muscles through a truncated arm pull-through and a decreased layback position at the end of the stroke, and equipment changes to decrease length of the lever arm, should yield a decreased risk of rib stress fractures in rowing.
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PMID:Rib stress fractures in elite rowers. A case series and proposed mechanism. 968 70

Most antihypertensives have advantages and disadvantages. The ideal antihypertensive drug should be effective in lowering blood pressure, well tolerated, safe in the long term, and easy to use. Ideally, it should be relatively inexpensive. Most importantly it should reduce the risk of the adverse effects of high blood pressure, such as myocardial infarction, sudden death, stroke, heart failure, renal damage, and retinal changes. Most antihypertensive drugs effectively reduce blood pressure, are available as once daily preparations, and are safe long-term. Unfortunately, most antihypertensive drugs cause adverse effects in some patients and for few drugs is there good evidence that they protect the heart, the brain, the kidney, and the eye? Reducing the effects of Angiotensin II (using an ACE inhibitor) has been shown to reduce the incidence of coronary events, sudden death, heart failure, renal damage, and fundal changes. AT1 blocking drugs offer the same pharmacological advantages but also very good tolerability, in particular no cough. Therefore, they have the potential to meet all the criteria for an ideal antihypertensive drug.
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PMID:Therapeutic advantages of AT1 blockers in hypertension. 983 62

The purposes of this article are to report a case with temporal arteritis (TA) and to summarize and reanalyze the cases of temporal arteritis associated with fever in published articles for understanding better the clinical features of TA. A case with biopsy-proven TA is reported. The publications with TA and fever were searched by using MEDLINE in English from 1966 to 1999. Three hundred sixty cases of temporal arteritis associated with fever were reanalyzed. The results showed that a case of biopsy-proven TA with typically clinical manifestation was initially misdiagnosed and that the reanalysis of 360 cases revealed that the common clinical findings at presentation were abnormal temporal arteries, headache, low fever, loss of weight, polymyalgia rheumatica, jaw claudication, vision disorder, arthralgis or myalyias, and ear pain and that the uncommon clinical findings at presentation were high fever, malaise, anorexia, breast pain, transient ischemic attack/stroke, cough, mental disorder, diarrhea, and uterine prolapse, etc. Laboratory findings were the range of erythrocyte sedimentation rate (ESR) 14 to 149 with a mean of 97.0 mm/hr, white blood cells being normal or increased in the range of 10.9 to 22.9 x 10(9)/L, hemoglobin level 7 to 16 g/dL, the platelets count increased to 785 x 10(9)/L, and microscopic hematuria. The diagnosis was made by a combination of clinical features, an increased ESR, a response to steroids, and, most specifically, temporal artery biopsy. The initial diagnosis was misdiagnosed in 38.2% of patients. In conclusion, the features of TA associated with fever have not been widely appreciated yet. TA is a common cause of fever of unknown origin (FUO) in the elderly. TA should be considered when patients complain of common and uncommon manifestations. An elevated ESR will aid in the diagnosis of TA, and temporal artery biopsy will provide certainty.
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PMID:Temporal arteritis and fever: report of a case and a clinical reanalysis of 360 cases. 1110 64


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