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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After several cases of occupational asthma had been reported in a coffee processing factory in England, 197 coffee workers representing 80% of the production workforce were studied to determine the factors affecting the development of work related respiratory symptoms of wheeze, cough, and dyspnoea. Two computer administered questionnaires concerning the presence of respiratory symptoms and the occurrence of work related respiratory symptoms were used. Workers underwent skin prick testing to green coffee bean extract (GCB) and 11 common inhalant allergen extracts and bronchial provocation testing with methacholine. The presence of specific immunoglobulin E (IgE) antibodies to GCB and castor bean extract (CAB) were determined by a radioallergosorbent test (RAST). The prevalence of work related respiratory symptoms was 12.7%, bronchial hyperresponsiveness 30%, atopy 54%, positive GCB skin prick test 14.7%, positive GCB RAST 14%, and positive CAB RAST 14.7%. None of the workers was sensitised to fungi present in the factory and the numbers of certain species of fungi, despite being greater than may be found out of doors or in an uncontaminated indoor environment, were fewer than are generally associated with the presence of work related respiratory symptoms among agricultural workers. Storage mites were not isolated. Green coffee bean extract and CAB RAST were significantly correlated using the McNemar test but there was limited allergenic cross reactivity in RAST inhibition studies of the two extracts. The only factors that were significantly and independently associated with work related symptoms were CAB RAST and duration of employment. Bronchial hyperresponsiveness was not independently associated with work related respiratory symptoms. The significant independent associations of bronchial hyperresponsiveness included GCB RAST, duration of employment, and resting forced expiratory volume in one second. Exposure to CAB, a highly potent antigen, may be overriding the effects of other factors such a GCB, atopy, bronchial hyperresponsiveness, and smoking. This study suggests that CAB contamination remains a potential problem in the coffee processing industry and all efforts to eliminate it from the working environment should continue.
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PMID:Factors relating to the development of respiratory symptoms in coffee process workers. 203 43

A cross sectional study was carried out to determine the prevalence of bronchial hyperresponsiveness and asthma in 3067 students aged 11-17 years in an urban and a rural area of Guangzhou (Canton), China. The methods used included a self administered questionnaire, a histamine bronchial provocation test, and allergen skinprick tests. Bronchial hyperresponsiveness was defined as a 20% fall in FEV1 and peak expiratory flow at a provoking dose of histamine (PD20) less than 7.8 mumol on two occasions four weeks apart. The response rate was 98.0% and 99.2% in the two areas. The prevalence of bronchial hyperresponsiveness was 4.1% and of diagnosed asthma 2.4% in the total population. There were no significant differences in prevalence between the urban and the rural area or between boys and girls. The 11-12 year group had a higher prevalence of bronchial hyperresponsiveness (7.6%) than the older groups. Of the 125 with bronchial hyperresponsiveness, 12.0% were defined as having severe or moderate (PD20 less than 0.8 mumol), 26% mild (0.9-3.2 mumol), and 62% slight bronchial hyperresponsiveness (3.3-7.8 mumol). The severity of bronchial hyperresponsiveness was closely related to diagnosed asthma, wheezing, and cough, though half the students with bronchial hyperresponsiveness were symptom free. The most common allergens were house dust and house dust mite in the city, and hay dust, pollen, and feathers in the rural area. The odds ratios for having respectively slight, mild or moderate, and severe bronchial hyperresponsiveness were 5.9, 21.0, and 30.4 for atopy; 1.9, 1.9, and 7.3 for early respiratory infection; and 3.1, 2.5, and 5.6 for a history of parental asthma.
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PMID:Bronchial hyperresponsiveness in young students of southern China: relation to respiratory symptoms, diagnosed asthma, and risk factors. 225 15

The prevalence and associations of bronchial hyperresponsiveness were investigated in a general practice population. The sample was obtained by using every 12th patient on the practice age-sex register, replacing non-responders with corresponding age and sex matched individuals from up to two further 1 in 12 samples. The response rate was 43%; 366 patients were studied. Doubling concentrations of methacholine were given to a maximum of 32 mg/ml or until a 20% fall in forced expiratory volume in one second (FEV1) occurred (provocation concentration, PC20FEV1). Bronchial hyperresponsiveness was defined arbitrarily as a PC20FEV1 of 2 mg/ml or less (or 11 mumol cumulative dose, PD20FEV1). The prevalence of bronchial hyperresponsiveness was 23%. Bronchial hyperresponsiveness was not associated with age but was more prevalent in women than men (31%:13%). It was also more common in those who had ever wheezed (39%) and in those who had had an attack of rhinitis in the preceding month (45%, p less than 0.1), in atopic individuals (30%), and in smokers (32%), but it was not associated with cough or dyspnoea. There was a positive correlation between PC20FEV1 and resting FEV1 (r = 0.288) and a negative correlation between PC20FEV1 and mean daily peak flow variability (r = -0.356). Stepwise binary logistic regression analysis showed significant independent effects on PC20FEV1 for mean daily peak flow variability, gender, number of positive skin test responses, resting FEV1, and mean histamine skin weal area, but no relation with smoking or mean allergen weal area. The prevalence of bronchial hyperresponsiveness was much higher than the prevalence of diagnosed asthma in the practice in 1984 (4.9%). Analysis of case notes of 169 individuals showed that those with bronchial hyperresponsiveness had not attended the practice more frequently for respiratory complaints during the previous five years.
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PMID:A general practice based survey of bronchial hyperresponsiveness and its relation to symptoms, sex, age, atopy, and smoking. 225 16

Bronchial hyperresponsiveness is a constant feature of asthma even when airflow obstruction is absent. Detecting nonspecific bronchial hyperresponsiveness is useful when the diagnosis of asthma has not been confirmed or when a patient describes symptoms of cough, chest tightness, and dyspnea that cannot be ascribed to other causes. Also, because wheezing is a symptom of other disorders, inhalation challenge tests can be useful in defining its cause when reversible airflow obstruction has not been documented. A number of easy and safe techniques are available to detect nonspecific bronchial hyperresponsiveness. The histamine and methacholine challenge have had the most widespread use in the clinical pulmonary function laboratory. The exercise and cold air challenges are limited by expense. The osmotic challenge may gain more acceptance as experience with this technique grows. These different agents have the advantage of simplicity, reproducibility, a low number of adverse effects, and a high degree of specificity and sensitivity. A limited number of asthmatics show bronchial hyperresponsiveness to specific agents such as chemical sensitizers in the workplace, aeroallergens, aspirin, nonsteroidal anti-inflammatory agents, and sulfiting agents. Bronchoprovocation testing with these agents is usually reserved for the hospital laboratory because severe or delayed reactions may occur. These tests, however, can be extremely useful in defining a population of sensitive asthmatics.
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PMID:Bronchoprovocation testing. 266 Nov 16

The purpose of this study was to evaluate the prevalence and type of lung function disorders in Danish farmers. Three samples of farmers were drawn from a group of unselected farmers who had participated in an epidemiological study. Group I (47 persons) was a sample of the 8% of all farmers who had reported that they had asthma; group II (63 persons) was a sample of the 28% of farmers who had had wheezing, shortness of breath, or cough without phlegm; and group III (34 persons) a sample of the farmers (64% of the total) who had no asthma and no respiratory symptoms. The farmers with symptoms (groups I and II) had low mean levels of FEV1 and high values for residual volume, whereas the symptomless farmers had normal lung function and no airways obstruction. The proportion of farmers with an FEV1 below the 95% confidence limit for predicted values was 43% in group I and 23% in group II; there were none in group III. Bronchial hyperreactivity to histamine occurred in 96% of asthmatic farmers, 67% of farmers with wheezing or shortness of breath, and 59% of symptomless farmers. A low level of FEV1 was associated with the number of years in pig farming and bronchial hyperreactivity in group II but not group I or III. Most of the bronchial hyperreactivity was explained in the multiple regression analysis by a low FEV1, though this was significant only for farmers in group II. Thus farmers who reported asthma, wheezing, shortness of breath, or a dry cough in general had airways obstruction with an increased residual volume, whereas symptomless farmers had normal lung function. Severe bronchial hyperreactivity was mostly explained by a diagnosis of asthma and poor lung function, though some farmers with normal lung function and no respiratory symptoms had increased bronchial reactivity.
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PMID:Lung function and bronchial reactivity in farmers. 279 44

Bronchial hyperreactivity is studied for the evaluation of airways' response to stimuli that provoke bronchoconstriction in hyperreactive subjects. Exercise is often used, especially in children. This method in simple, sufficiently tolerated and reproducible. The inhalation of ultrasonically-nebulized distilled water is a simple, reproducible and rapid to perform in the majority of adult patients test; in childhood it is poorly inquired. Pharmacological tests (with histamine or methacholine) have a greater sensitivity and reproducibility. Aspecific bronchoprovocation with methacholine is a diagnostic method that allows the diagnosis of bronchial hyperreactivity in asymptomatic subjects with asthma, recurrent cough and recurrent bronchopneumonia.
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PMID:[Bronchial hyperreactivity. II. Diagnostic methods]. 287 44

Bronchial hyperreactivity was studied in 79 patients who gave a history of allergic symptoms. Twenty-nine of them suffered from rhinitis, 28 from eczema, 21 from urticaria and one from gastrointestinal allergy. Forced expiration in the first second (FEV1) was measured in each. If FEV1 was greater than 1 l a histamine challenge was done. Histamine (0.6 mg/ml) was inhaled by tidal breathing for one minute. FEV1 was measured before the inhalation and two min after cessation of the inhalation. If FEV1 dropped greater than 20% the inhalation was assessed as positive and the provocation was stopped. If the challenge was not positive another inhalation with histamine (2.4 mg/ml, l min) was done. If FEV1 dropped greater than 20% when measured two min after the inhalation the provocation was called positive. Twenty-two patients with rhinitis had a negative bronchial challenge, six had a positive. One of them had asthma, three suffered also from cough and/or serous sputum production, and two had hay fever. Out of 28 with eczema, 20 had negative histamine challenge and five a positive. Four of these suffered from daily cough and/or serous sputum production, one had no airway symptoms. Fifteen out of 21 suffering from urticaria had a negative histamine challenge, three had a positive. Two of them suffered from asthma and one complained of daily cough and/or serous sputum production. It is concluded that allergic subjects without symptoms from the airways, have a bronchial reactivity to inhaled histamine similar to the general population.
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PMID:Bronchial hyperreactivity in allergic subjects. 346 10

As part of a study of the morphology of hyperreactive airways, 22 heavy smokers (67 +/- 31 pack-years), all male, were challenged with histamine, questioned on symptoms and skin-tested for common allergens before thoracic surgery, mainly for cancer. Histamine was delivered with a hand operated nebulizer in a total dose of 7.8 mumol or a 20% fall from the baseline FEV1. The PD20 (dose of histamine which causes a 20% fall of FEV1) was determined on a semi-log dose-response curve. Symptoms were recorded by physician-administered questionnaire and skin tests were performed with 8 common allergens. Values for FEV1%VC ratio and response to salbutamol were taken from preoperative spirometric studies. Bronchial hyperresponsiveness (BHR) was found in 45% of the patients. The PD20 was in the range of asthma. Past symptoms of airway allergy did not enhance BHR risk. Half of the 13 subjects with airway obstruction (FEV1%VC of less than 2 SD of the predicted value) had normal bronchial responsiveness; however, PD20 correlated well with FEV1 (% predicted) in the hyperresponsive group (r = 0.90, p less than 0.001). The degree of BHR was unrelated to tobacco consumption, number of positive skin tests and response to salbutamol. Symptoms were those of chronic bronchitis and bronchoconstriction (wheezing, morning chest tightness, sudden dyspnea), as well as cough. They were experienced, to some extent, by 82% of patients, only half of whom had BHR. These smokers with BHR differed from asthmatics in that half of them did not report bronchoconstriction symptoms and none experienced chest discomfort during provocation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Relation between respiratory function, bronchial reactivity and symptoms in heavy smokers]. 376 98

An epidemiologic health study was carried out on 652 cedar mill workers and a control group of 440 male office workers not exposed to air contaminants. Participants completed a medical-occupational questionnaire with trained interviewers, had allergy skin tests, performed spirometry, and had bronchial reactivity assessed by methacholine inhalation testing. After adjusting for differences in age, race, and smoking, cedar workers were found to have significantly higher prevalences of cough, phlegm, and dyspnea than did office workers. Symptoms of asthma and work-related asthma, but not persistent wheeze or doctor-diagnosed asthma, were reported in a significantly higher proportion of cedar workers than of office workers. Cedar workers also had significantly lower lung function test results than did office workers after controlling for height, age, race, and smoking. Bronchial hyperreactivity, defined by a methacholine PC20 less than 8 mg/ml, was more prevalent among cedar workers than among office workers, with the increase being limited to the nonatopic subgroup of workers. The prevalence of bronchial hyperreactivity increased with duration of employment among cedar workers but not among office workers. We conclude that exposure to western red cedar dust is harmful to the respiratory health of the workers, causing asthma and other respiratory symptoms, bronchial hyperreactivity, and lower levels of lung function.
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PMID:Symptoms, pulmonary function, and bronchial hyperreactivity in western red cedar workers compared with those in office workers. 650 1

Bronchial hyperresponsiveness is present in 40-60% of adult patients with cystic fibrosis (CF). Drugs which alter airway hyperresponsiveness have not yet been studied in CF. In this randomized placebo-controlled study, we investigated the effects of an inhaled corticosteroid, budesonide, on lung function and bronchial hyperresponsiveness in adult CF patients, with proven bronchial hyperresponsiveness to histamine. Twelve patients were treated with budesonide, 1600 micrograms day-1, and with placebo during two periods of 6 weeks in a randomized, double-blind, cross-over study. Drug effects were assessed with regard to bronchial hyperresponsiveness to histamine, spirometry and clinical symptom scores. After treatment with budesonide, no significant differences in spirometry were seen, however, bronchial hyperresponsiveness to histamine significantly improved as compared to baseline. Fifty-eight percent of the patients showed at least one doubling-dose increase in PC20 histamine. Daily symptom scores showed small, but statistically significant, improvements in dyspnoea and cough after budesonide treatment. There is increasing evidence suggesting that excessive inflammatory responses contribute to the pulmonary damage that characterizes CF. Treatment with oral corticosteroids improved the clinical course of selected CF patients, but was associated with unacceptable adverse effects. We conclude that daily inhalation of 1600 micrograms day-1 budesonide for 6 weeks induced a small, but significant, improvement in bronchial hyperresponsiveness to histamine, and symptoms of cough and dyspnoea in adult CF patients. Longer observations are needed to establish whether inhaled corticosteroids improve the long term outcome of CF.
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PMID:The effects of the inhaled corticosteroid budesonide on lung function and bronchial hyperresponsiveness in adult patients with cystic fibrosis. 774 14


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