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)

We report a case of hepatitis C virus-associated glomerulonephropathy presenting with MPO-ANCA-positive, rapidly progressive glomerulonephritis(RPGN). A 60-year-old woman was admitted to our hospital for evaluation of RPGN. Laboratory evaluation revealed microhematuria, proteinuria(800 mg/day), anemia, renal failure(blood urea nitrogen 27 mg/dl, serum creatinine 2.2 mg/dl), cryoglobulinemia, hypocomplementemia, positive MPO-ANCA(232 EU), and hepatitis C virus infection(GOT 58 IU/l, GPT 38IU/l, HCV-RNA(PCR) 1,200 kcopy/ml, serotype 1). After admission, the patient's renal function and anemia deteriorated rapidly, then prednisolone(30 mg/day) was started. After treatment her renal function gradually improved, then a renal and liver biopsy was performed. The renal biopsy revealed six sclerosing fibrous crescentic glomeruli in twelve glomeruli. Immunofluorescent examination revealed granular deposits of IgG, C3, and fibrinogen along the glomerular basement membrane and mesangial matrix. The pathogenesis of RPGN in this case may relate to the deposition of immune complexes in the glomeruli because immunofluorescent examination was revealed to be the immune-complex type, but not pauci immune type nephritis. Liver histology revealed chronic active hepatitis with mild piecemeal necrosis and did not reveal vasculitis. Although her renal function was improved after treatment with prednisolone, she suffered from pulmonary manifestations(dry cough etc.) on the 120th hospital day. Suddenly she died because of pulmonary hemorrhage on the 180th hospital day. These findings suggest that various HCV-induced immunological abnormalities, such as positive MPO-ANCA, cryoglobulinemia and hypocomplementemia, play an important role in the pathogenesis of this RPGN, although we could not demonstrate deposition within glomeruli of immune complexes containing HCV. The effect of interferon therapy on such immunological abnormalities remains to be documented. Since interferon is known to have immunomodulatory effects, we selected corticosteroid therapy. Future studies need to focus on the optimal treatment strategy for hepatitis C virus-associated glomerulonephritis.
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PMID:[A case of hepatitis C virus-associated glomerulonephropathy presenting with MPO-ANCA-positive rapidly progressive glomerulonephritis]. 1089 95

Our previous studies have demonstrated that tussiphonogram is suitable not only for the detection of pathological condition in the respiratory tract but also for treatment effectiveness assessment. The purpose of this study was to evaluate the possibilities of tussiphonography in detection of already little pathological changes in the airways and lungs. Therefore the changes of voluntary cough sound indexes were compared with pulmonary function tests in selected group of asthmatics before and after a pulsatile electromagnetic therapy in which the effect of therapy on pulmonary function tests was minimal. After magnetotherapy in 18 patients with increased expiratory forced lung capacity by 7.3% and increased peak inspiratory flow by 31.7% in average the voluntary cough sound intensity decreased by 37.8%, the sound duration shortened by 11% and the sound pattern showed the tendency to normalization. The improvement of mentioned cough indexes was absent in 17 patients who were treated by magnetotherapy too, but at the same time suffered from respiratory viral infection and in 22 patients treated only with climatotherapy and antiasthmatics. Changes of flow-volume loops in patients were not in the close relation to other followed indices. The correlation analysis showed a functional connection in relative differences of cough sound indices and some pulmonary function tests. The results confirmed the suitability of tussiphonography to indicate even mild pathological changes in respiratory tract. (Fig. 4, Ref. 21.)
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PMID:The sensitivity of tussiphonography for assessing the effectiveness of treatment. 1103 11

Measles should be included in the differential diagnosis of patients with fever and the characteristic viral exanthem, even if a history of adequate immunization is obtained. We present the case of a 23-year-old white female who developed high fever (103 degrees F), brightly erythematous eruptions on the face, sore throat, dry cough, and myalgia 5 days after her return to the United States following a trip to Calcutta, India. The patient had extensive facial erythema from the hairline to the neck, but some areas beneath the chin were spared. Fine erythematous papules extended down the anterior neck, and white papules were seen on the buccal mucosa. The erythematous macules spread to the trunk and extremities, eventually becoming confluent and desquamating over a period of 1 week. Defervescence occurred with desquamation. Measles serology revealed the IgM antibody as positive and the IgG antibody as negative despite 2 measles, mumps, and rubella (MMR) vaccinations at ages 15 months and 7 years. Skin biopsy was consistent with viral infection.
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PMID:Vaccine era measles in an adult. 1110 18

This is a case report of a 44-year-old woman who received a 1-year-treatment with interferon-alpha for chronic hepatitis C virus infection. 3 months after cessation of the therapy she relapsed and was successfully retreated 12 months with a combination of interferon-alpha and ribavirin thereafter. During the treatment the patient developed a typical flue-like syndrome, dry cough with exertional dyspnea that was initially interpreted as a typical side effect of interferon-alpha treatment. Due to the persisting cough, further radiologic and histologic work up was done and results were significant for interstitial sarcoidosis. After interferon-treatment was stopped the pulmonary symptoms resolved completely while pathologic changes in radiographic imaging persisted. Interferon-alpha may have contributed to the development and progression of sarcoidosis by activation of cellular immunity. Although there are only few reports about pulmonary sarcoidosis associated with interferon-alpha treatment, this entity should be included in the differential diagnosis of putative side effects of interferon-alpha therapy.
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PMID:[Pulmonal sarcoidosis: A rare side effect of interferon-alpha treatment for chronic hepatitis C infection]. 1119 85

The common cold is generally considered to be an upper respiratory tract infection. We studied the lower respiratory tract in 76 otherwise healthy young adults with the common cold. Viral infection was diagnosed in 56 (74%) of the 76 subjects. Rhinovirus was detected in 42 (55%) subjects. Chest radiography (CR) and high-resolution computerized tomography (HRCT) were carried out in 40 subjects on day 7, and pulmonary function testing with bronchodilator challenge was carried out in 36 patients on days 7 and 21 of the study. Clinical examinations were carried out on days 1, 7 and 21. The subjects recorded their symptoms on a diary card for 20 d. The mean duration of cough was 8.4 (SD 6.5) d and that of sputum production 5.9 (SD 6.4) d. No abnormal findings were detected in the lungs on auscultation. CR and HRCT showed no pulmonary changes associated with the common cold. No clinically remarkable increases were seen in peak expiratory flow, forced expiration volume in 1 s or forced vital capacity after bronchodilator challenge on either days 7 or 21. All patients made a clinical recovery without antimicrobial therapy within 21 d. We conclude that the common cold in young otherwise healthy adults is an upper respiratory tract infection and that clinically important abnormalities in the lower respiratory tract are rare.
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PMID:Pulmonary imaging and function in the common cold. 1130 12

A 15-year-old girl, high school student, became febrile (38-39 degrees C) with chills, sore throat and cough on April 20, 1994. Until the onset, she was healthy and she had been camping with her classmates in a wooded mountainous area in Oku-etsu, Fukui Prefecture. She consulted a local clinic on April 21 and bacampicillin was initially administered and then changed to cefaclor on April 23. However, high body temperature continued and a maclopapular rash appeared on her face on April 24 and gradually spread to her anterior chest and back. Blood examination showed a WBC count of 2,200/microliter, and she was admitted to our hospital on April 25. On admission, peripheral blood data showed leukocytopenia (WBC 2,300/microliter) with 5% atypical lymphocytes. Titers of anti-Rickettsia typhi serum antibodies (IgM, -G) were elevated (1:80, 1:640) and she was diagnosed as having murine typhus. On the second hospital day, 200 mg of minocycline (MINO) was administered per os and her body temperature fell to within the normal limits on the third hospital day. On the 7th hospital day, the skin rash disappeared and she was discharged. Altogether, 320 high school students went camping with this patient. Among them, approximately 30 students had similar symptoms and signs as this case and had been diagnosed suspected viral infection. Twelve students of the 30 were admitted to other hospitals. It was considered that this case was part of an outbreak of murine typhus in the Oku-etsu area, Fukui Prefecture, but no further investigation was performed. Murine typhus is usually a benign disease that is controllable by the administration of MINO. In rare cases, infection can worsen to multiorganic failure, severe complications have been reported in 1-4% of cases, and death has been reported in less than 3%. Recently, it has also been reported that MINO not only has an antibiotic effect, but also play acts as a cytokine modulator in patients with rickettsial infection. Thus, in febrile patients in whom uncommon Rickettsia infection is suspected, serological test for murine typhus should be examined and the immediate administration of MINO is important.
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PMID:[Murine typhus infected in Oku-etsu area, Fukui Prefecture]. 1135 25

Rational approach to diagnosis and management of recurrent respiratory infections is needed, or else the child is subjected to unnecessary investigations and multiple drugs. Repeated respiratory symptoms do not mean a respiratory infection. A diagnosis of viral infection does not justify prescription of an antibiotic. Recurrent viral infections are part of the growing up process of any child. Giving antibiotics at every episode to cover "so-called superadded bacterial infections" will lead to "recurrent antibiotics" and adverse effects on growth. Systematic approach should be used to find the underlying cause. An otoscopic examination of a child should form part of a pediatric examination in all cases of respiratory infections. Antibiotics should be judiciously chosen depending on age, socioeconomic status, severity of infection and the type of organism expected and always given in adequate doses and proper duration. Treatment should be specific and symptomatic. Adequate drainage of the sinuses is an important adjuvant therapy. Use of cough syrups with various combinations should be avoided. Efforts should be made to diagnose and treat manifestations of hyperactive airway or allergy, role of CEA (cough equivalent asthma) and WLRI (Wheeze associated lower respiratory infections). Investigations are needed in recent lower respiratory infections and adverse effect on growth, school performance, abnormal physical findings. CBC, CRP, ESR, nasal smear, appropriate cultures, tests for TB, X-Rays, barium studies, milk scan, ultra sound, CT, MRI, bronchoscopy in selected cases.
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PMID:Approach to recurrent respiratory infections. 1141 74

In a 59-year-old male patient, chronic dry cough and dyspnoea on exertion preexisting for several years became rapidly progressive within a few weeks prior to hospitalisation. He died one month after admission from respiratory failure. Three months before admission, history, pulmonary function tests, and computed tomography (CT) of the chest revealed no evidence of asthma, COPD, or any other lung disease. Clinical examination showed no clubbing, but end-inspiratory velcro-rales were audible over both lungs. Inhaled steroids and diuretics did not bring clinical amelioration. On admission there were basal consolidations, bronchiectases, and predominant fibrotic changes with honeycombing and subpleural thickening over both lungs, in the absence of any ground-glass pattern in the CT. At the same time lymphocytosis predominated in bronchoalveolar lavage (BAL). The search for pneumonia, viral infection, tumour, vasculitis, or a drug-related disorder remained negative. Pathological examination at autopsy showed nonuniform fibrosing alveolitis.
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PMID:[Rapidly progressing respiratory insufficiency of uncertain etiology]. 1168 68

Cough is an important defensive reflex of the upper airway and is also a very common symptom of respiratory disease. Cough following an upper respiratory viral infection is transient, and persistent cough is associated with a whole range of conditions, such as asthma, rhino-sinusitis and gastro-oesophageal reflux. Treatment directed at these conditions may improve the associated cough. There is often a need, however, to control cough itself whatever the cause. The most effective drugs in this class are the opioids, such as morphine, codeine or pholcodeine, but at effective doses they have side effects including drowsiness, nausea, constipation and physical dependence. Investigations into the cough reflex and into the potential mechanisms of sensitised cough reflex have uncovered several potential targets for novel drugs. New opioids apart from mu-agonists such as kappa- and delta -receptor agonists, have been developed, in addition to non-opioids such as nociceptin. Neurokinin receptor antagonists, bradykinin receptor antagonists, vanniloid receptor VR-1 antagonists may be beneficial by blocking effects of tachykinins and sensory nerve activation. Local anaesthetics, blockers of sodium-dependent channels and maxi-K Ca2+-dependent channel activators of afferent nerves are inhibitors of the cough reflex. Some of these novel agents may act centrally or peripherally or at both sites as antitussives. Large scale trials of these novel compounds have not been carried out in cough in man but there is a serious need for more effective antitussives devoid of side effects.
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PMID:Cough: potential pharmacological developments. 1208 6

Cough is an important defensive reflex of the upper airway and is also a very common symptom of respiratory disease. Cough after an upper respiratory virus infection is transient, and persistent cough is associated with a whole range of conditions such as asthma, rhino-sinusitis, gastro-oesophageal reflux. Treatment directed at these conditions may improve the associated cough. There is often a need, however, to control cough itself, whatever the cause. The most effective drugs in this class are the opioids, such as morphine, codeine or pholcodeine, but at effective doses they have side-effects such as drowsiness, nausea, constipation and physical dependence. Investigations into the cough reflex and into the potential mechanisms of sensitised cough reflex have uncovered several potential targets for novel drugs. New opioids such as k- and d-receptor agonists apart from m-agonists have been developed, in addition to non-opioid, nociceptin. Neurokinin receptor antagonists, bradykinin receptor antagonists, vanilloid receptor VR-1 antagonists may be beneficial by blocking effects of tachykinins, and sensory nerve activation. Local anaesthetics, blockers of sodium-dependent channels, and maxi-K CA2+-dependent channel activators of afferent nerves are inhibitors of the cough reflex. Some of these novel agents may act centrally or peripherally or at both sites as antitussives. Large scale trials of these novel compounds have not been tried in cough in man, but there is a serious need for more effective antitussives devoid of side-effects.
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PMID:Therapy for cough: active agents. 1209 88


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