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

We examined the prevalence of chronic sinusitis among children who presented to allergy clinics with chronic (> or = 3 months) respiratory symptoms. Ninety-one patients, ranging from 2 to 17 years of age with 62% male and 72% white, completed the study. Fifty-nine percent of patients had positive skin test results, and 25.3% had chronic asthma. Paranasal sinuses were examined by coronal sinus computed tomographic scan. Sixty-three percent (58 to 91) had chronic sinusitis, 5.5% (5 of 91) had concha bullosa, 1% (1 of 91) had foreign body, and 19% (19 of 91) had deviated nasal septums. Among symptoms of sneezing, nasal congestion, postnasal drip, coughing, wheezing, rhinorrhea, and headache, no single symptom was an acceptable predictor of abnormality on computed tomographic scan examinations. Combining the symptoms of moderate to severe rhinorrhea and cough with minimum sneezing had a specificity of 95% and a sensitivity of 38% in predicting the presence of chronic sinusitis. Allergic rhinitis (p = 0.27), mild deviated nasal septum (p = 0.11), unobstructive concha bullosa (p = 0.13), and passive exposure to cigarette smoke (p = 0.53) were not risk factors associated with sinus abnormalities. Age (r = 0.30, p = 0.004) in pediatric patients with chronic respiratory symptoms was the single risk factor significantly associated with abnormalities on sinus computed tomographic scan. Seventy-three percent of children 2 to 6 years of age, 74% of children 6 to 10 years of age, and 38% of children older than 10 had chronic sinusitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic sinusitis among pediatric patients with chronic respiratory complaints. 825 16

Functional endoscopic sinus surgery (FESS) has gained widespread support as the treatment of choice for chronic sinusitis in children. Seven developmentally delayed children were evaluated for chronic sinusitis with symptoms of cough, chronic rhinorrhea, and head banging because of pain. All seven were nonresponsive to repeated courses of oral and sometimes intravenous antibiotics; computed tomography scans on all revealed sinus disease. FESS was performed on all of them. Three children had marked respiratory difficulty at the end of the procedure, with two requiring reintubation. Two children were not able to take oral feedings postoperatively. Because of the complicated postoperative course, a second-look procedure was performed in only two children. We believe that FESS for developmentally delayed children should be tailored accordingly and that a second-look procedure should not be a routine.
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PMID:Endoscopic sinus surgery in the developmentally delayed child. 858 37

Diffuse panbronchiolitis (DPB), an important cause of progressive obstructive lung disease in the Far East, represents a distinctive sinobronchial syndrome with typical radiologic and histologic features. We have identified DPB in five citizens of the United States, three with histologic confirmation, who have never traveled to the Far East. There were four men and one woman, whose ages ranged from 46 to 75 yr at the time of diagnosis. All had a prior history of chronic sinusitis and presented with cough, dyspnea, and sputum production. Three were never smokers and two were current smokers. Pulmonary function testing revealed severe airflow limitation (the FEV1 ranging from 22% to 56% of predicted), and overdistention. All patients had high-resolution computed tomographic (HRCT) scans indicating centrilobular nodules with adjoining thickened and dilated bronchioles. In the three patients in whom open lung biopsy was performed, there was bronchiolocentric infiltration of lymphocytes, plasma cells, and foamy macrophages. Three patients remain alive and are being treated with chronic macrolide therapy. The clinical, radiographic, and histologic features of these patients closely resemble those described in Japanese patients. DPB must be considered in the differential diagnosis of sinopulmonary syndromes, bronchiolitis, and cryptic cases of obstructive lung disease among United States citizens, since therapy now offers an improved prognosis.
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PMID:Diffuse panbronchiolitis in the United States. 919 26

Chronic rhinosinusitis occurs to 5% of the population with upper respiratory infections. The objective of this study is to know the main symptoms in a pediatric population younger than 14 years with the diagnosis of chronic rhinosinusitis, to know age and sex distribution and evolution. We did a medical history, physical examination, nasal cytology, skin tests and sinus X rays in each of 100 patients. Results the main symptoms were: cough, halitosis, postnasal discharge, fever, headache, sore throat, facial sensitivity and periorbital edema. This findings predominated in males and the average evolution time was 1-2 years.
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PMID:[Chronic rhinosinusitis: predominant symptoms in children under 14 years of age who were seen at the Regional Center for the Prevention and Treatment of Allergic Diseases]. 905 30

Sinusitis affects up to 14% of Americans. Traditionally, most patients with sinusitis are evaluated and treated by either primary care physicians or otolaryngologists. In order to gain information regarding the characteristics at presentation and the outcome of treatment of sinusitis by an allergist, the records of 200 consecutive patients seen at the Institute for Asthma and Allergy at the Washington Hospital Center for chronic sinusitis were reviewed. The most common presenting symptoms were nasal congestion, postnasal drip, purulent rhinorrhea, headache, cough, facial pressure, anosmia or hyposmia, hypogeusia, and throat clearing. Initial abnormal physical exam findings included abnormal transillumination, purulent secretions, nasal mucosal swelling, nasal polyps, and nasal crusting. Treatment included 4 weeks of oral antibiotics, nasal corticosteroids, nasal lavage, and topical decongestants. All of the presenting symptoms (23-75% of the patients) and signs (50-84% of patients) improved with medical management. Patients have been followed for 1 to 27 months, with a mean of 6 months, and 6% have required surgery, with one complication of cerebrospinal fluid leak. These findings indicate that medical management of chronic sinusitis in an allergist's office is effective.
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PMID:Sinusitis in an allergist's office: analysis of 200 consecutive cases. 919 44

We report here a 13-year-old woman with cough, sputum and fever. The patient had both chronic sinusitis and bronchitis. Chest X-ray and computed tomographic scan of the chest revealed mucous bronchial filling and bronchiectasia in bronchi of bilateral lower lobes, right middle lobe and left upper lobe. Aerosol inhalation scintigraphy with 99mTechnetium demonstrated delays of the discharged tracer. On the basis of these findings, primary ciliary dyskinesia was suggested. This was confirmed by the findings from nasal biopsy with transmission electron microscopy where all of the microtubules were segmentally defected near the basal body in the cilia. On the basis of these findings, we diagnosed the patient with primary ciliary dyskinesia which may be due, at least in part, to segmental defect of ciliary microtubules.
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PMID:A possible mechanism of primary ciliary dyskinesia: a case of a segmental defect in ciliary microtubules. 1043 69

A 52-year-old man with a 4-year history of rheumatoid arthritis, and who had an episode of suspected BOOP in early 1994, was admitted to our hospital because of cough and fever. A chest X-ray film on admission showed small patchy infiltrates, and a computed tomographic (CT) scan showed centrilobular nodules and patchy infiltrates with thickened broncho-vascular bundles in both lungs. Transbronchial and thoracoscopic lung biopsies disclosed the coexistence of interstitial pneumonia with BOOP pattern, follicular bronchiolitis, and diffuse panbronchiolitis-like purulent and obliterative bronchiolitis. Due to findings of chronic sinusitis, the patient was treated with erythromycin for 8 weeks, and the abnormal CT shadows regressed. This was an interesting case of various pulmonary lesions associated with rheumatoid arthritis, and successfully treated with erythromycin.
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PMID:[Rheumatoid arthritis-associated bronchiolitis successfully treated with erythromycin]. 1084 1

This review explores the literature dealing with the relation between the upper and lower airways, including the possible link between chronic sinus disease and asthma, and between chronic sinus disease and cough. Imaging studies, microbiology, epidemiology, animal studies, and effects of treatment are discussed. Available studies do not prove that upper airway disease directly causes lower airway pathology. Allergic rhinitis causing nasal blockage needs treatment, as does symptomatic sinus disease. Where there is concurrent disease of the upper and lower airways, both conditions need to be treated adequately. Further research is required to establish the relation between upper and lower airways, and animal models may help to unravel the mechanisms and impact of treatment. Randomized, blinded, controlled trials are needed in both children and adults to assess therapies of chronic sinusitis and the response of asthma.
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PMID:Current controversies: sinus disease and the lower airways. 1118 Jun 93

Clearance of mucus and other debris from the airways is achieved by 3 main mechanisms: mucociliary activity, coughing, and alveolar clearance. Disorders of ciliary structure or function results in impaired clearance, and result in chronic sinopulmonary disease manifested as chronic sinusitis, otitis media, nasal polyposis, and ultimately bronchiectasis. In addition, situs inversus, dextrocardia, and infertility can be associated with dysfunctional ciliary activity. The term primary ciliary dyskinesia has been proposed for the spectrum of these diseases. The term Kartagener syndrome applies to this syndrome when accompanied by infertility and dextrocardia or situs inversus. The more common types of ciliary dysmotility syndromes are characterized by missing dynein arms, central microtubule pairs, inner sheath, radial spokes, or nexin links. In addition to structural defects within the cilia, disordered ciliary beating and disordered ciliary arrays on epithelial cell surfaces have been described in this syndrome. Treatment includes rigorous lung physiotherapy, prophylactic and organism-specific antibiotics, and immunization against common pulmonary pathogens. Late stages of the disease may require surgical intervention for bronchiectasis or lung transplant for end-stage lung disease.
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PMID:Disorders of ciliary motility. 1120 77

Chronic sinusitis, especially maxillary sinusitis is a common disorder in humans. Seromucous sinusitis is rarely described in the literature. The present study deals with the clinical and laboratory characteristics of a group of patients suffering from the above disorder. During the last 10 years, 32 patients suffering from seromucous maxillary sinusitis were enrolled in the study. Patients' charts were reviewed and tabulated according to age, sex, history, clinical symptoms and laboratory findings. Treatment was based on punction and drainage of the seromucous effluent. Results were also statistically evaluated. Flight trips and atypical episodes of nasal infection were the predisposing factors for seromucous maxillary sinusitis. The only clinical manifestation was coughing, for at least 12 weeks before diagnosis. Sinus effluent was composed by serous and mucous constituents with glue like structure. There were no differences between sexes in predisposing factors, or x-ray findings. The treatment is paracentesis and drainage and in one case of recurrence, middle meatotomy and sinus endoscopy.
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PMID:Seromucous maxillary sinusitis (SMMS): a clinicophysiological approach. 1125 94


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