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

Questionnaires were sent to patients who had tracheal intubation for periods longer than three days in a large multidisciplinary Intensive Care Unit. The information sought was of complaints related to talking, breathing, coughing, swallowing and chest infection. Of patients who had been intubated for seven days or less, 63 per cent of the 52 patients responding had no complications while only one of the remainder had a major complication requiring surgical removal of a granuloma. Forty-eight per cent of patients intubated for more than seven days had no complaints and the rest of the patients had minor complaints which did not persist. Most complained of hoarseness. Of patients who had a tracheostomy following prolonged intubation, only 23 per cent were free of complications. From this it is concluded that tracheal tubes can be left in place for seven days and at this time direct laryngoscopy should be done. If no significant laryngeal pathology is seen at this examination, tracheal intubation may be continued.
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PMID:Late complications of prolonged tracheal intubation. 63 27

Five cases of congenital H-type tracheo-oesophageal fistula are presented. The clinical features common to all were choking and coughing precipitated by feeds, recurrent chest infections, and episodes of abdominal distension. The usefulness of repeated oesophagograms in diagnosing the condition is emphasized. Operation in all cases was by the cervical approach. The single postoperative death was related to pre-existent severe chest infection, and no postoperative complications were encountered in the other patients.
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PMID:Congential H-type tracheo-oesophageal fistula. 121 58

One hundred of the 192 survivors of repaired oesophageal atresia at the Royal Children's Hospital, Melbourne, aged one year and over on 1 November 1973, were reviewed to determine the frequency of respiratory complications. 78 children suffered from more than 3 attacks of bronchitis per year during the first 3 years of life and 48% of the children aged over 8 years were having more than three attacks per year. Episodes of cough persisting longer than 2 weeks were also common. In the year preceding review, about half the children had more than 3 such episodes. 58 children had been admitted to hospital on at least one occasion for chest infection. It is suggested that recurrent inhalation of milk and food, consequent upon disordered oesophageal motility, is the major factor causing these respiratory complications.
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PMID:Respiratory complications in long-term survivors of oesophageal atresia. 127 40

Congenital tracheo-oesophageal fistula (TEF) is rare in adults. Patients who present with repeated attacks of chest infection since birth or cough, choking and cyanosis during feeding should be investigated for TEF. It should be possible to detect all cases of tracheo-oesophageal fistulae using bronchoscopy, oesophagoscopy and CT either singly or in combination. These investigations also help in deciding on the route of exploration and the type of surgery. Disconnection of the abnormal fistulous tract brings dramatic relief of symptom and prevents further pulmonary damage.
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PMID:Congenital tracheo-oesophageal fistula in a young adult. 161 Mar 31

We report a case of primary diffuse tracheobronchial amyloidosis in a 72-year-old lady who presented with a long history of recurrent cough, dyspnoea, wheezing, haemoptysis and chest infection. She was treated successfully with three sessions of laser therapy. There were improvements in both clinical symptoms and measurements of airway obstruction. Bronchodilators and oral prednisolone were not required after treatment.
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PMID:A case of primary diffuse tracheobronchial amyloidosis treated by laser therapy. 162 Nov 31

One hundred and ten men undergoing coronary artery bypass grafting took part in a prospective randomised study comparing three physiotherapy protocols. All patients were taught self supported huffing and coughing by a physiotherapist and encouraged to move about. This comprised the sole treatment for the 37 control patients (group 3). Additional physiotherapy included breathing exercises for the 35 patients in group 1 and use of an incentive spirometer for the 38 patients in group 2. Functional residual capacity (FRC) was measured daily at the bedside until the fifth postoperative day and arterial blood gas tensions were measured on the second and fourth postoperative days. After surgery patients developed a severe restrictive ventilatory defect and profound arterial hypoxaemia. There were no differences between the three groups. Mean FRC on day 2 was 1.90 litres (61% of the preoperative value), increasing to 2.32 1 by day 5 (76% of the preoperative value). The mean arterial oxygen tension was 7.37 kPa on day 2 and 8.58 kPa on day 4. Four patients in group 1, two in group 2, and five in group 3 developed a chest infection. It is concluded that the addition of breathing exercises or incentive spirometry to a regimen of early mobilisation and huffing and coughing confers no extra benefit after uncomplicated coronary artery bypass grafting.
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PMID:Physiotherapy after coronary artery surgery: are breathing exercises necessary? 279 43

Eight patients, five with chronic granulocytic leukaemia and three with severe aplastic anaemia, developed moderately severe airflow obstruction after allogeneic bone marrow transplantation. All eight had clinically and radiologically normal lungs before undergoing transplantation. Treatment in the patients with chronic granulocytic leukaemia before transplantation included high dose total body irradiation. All eight patients developed acute and chronic graft versus host disease after transplantation. The pulmonary syndrome consisted of cough, dyspnoea, and wheezing beginning six to 20 weeks after transplantation, with ratios of forced expiratory volume in one second (FEV1) to vital capacity (VC) falling to 60% or less of predicted values. The three patients with severe aplastic anaemia had relatively mild graft versus host disease and acute chest infection may have initiated or contributed to their airways obstruction, which subsequently resolved. The five patients with chronic granulocytic leukaemia had more severe graft versus host disease and more progressive respiratory problems; two died and three continued to have persistent airflow obstruction 11, 15, and 20 months after transplantation. None of those with chronic granulocytic leukaemia improved. Transfer factor (TLCO) was reduced in all patients after bone marrow transfer and did not improve; in the patients with chronic granulocytic leukaemia the reduction in TLCO preceded the fall in FEV1/VC ratio. Open lung biopsy in one of the patients with chronic granulocytic leukaemia showed obliterative bronchiolitis with lymphocytic infiltration consistent with graft versus host disease. Bronchodilators were of no benefit in the management of these patients, but prompt treatment of infection and early use of corticosteroids may have contributed to the improvement seen in the patients with severe aplastic anaemia.
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PMID:Airways obstruction associated with graft versus host disease after bone marrow transplantation. 639 15

We report the clinical features, electrocardiographic and chest X-ray findings, and Doppler-measured pulmonary artery pressures in 22 children admitted to Goroka Base Hospital with primary pulmonary hypertension and compare them with findings in 10 controls. Symptoms frequently reported by patients were recurrent cough (95%) and shortness of breath (77%). 82% of the patients had increased intensity of the pulmonary component of the second heart sound. 45% of the patients had clinical evidence of right heart failure. Chest X-rays were readable in 14 patients: the mean cardio-thoracic ratio was 65% and in the controls 58%; the mean diameter of the descending branch of the right pulmonary artery was 9 mm and in the controls 6.4 mm. 13 patients and 8 controls had electrocardiograms: 11 patients had right axis deviation, 2 a normal axis, and all showed evidence of right ventricular hypertrophy; 7 controls had a normal axis, 1 had right axis deviation, and 3 controls had right ventricular hypertrophy. Pulmonary artery pressures in the patients ranged from 41 to 137 mmHg with a mean of 79 mmHg. The control group had a mean pulmonary artery pressure of 28 mmHg, but 5 of the 10 controls had pulmonary artery pressures greater than the accepted norm (peak systolic pressure less than 30 mmHg). Altitude and chest infection may be playing a role in the pathogenesis of pulmonary hypertension in patients in the highlands but further studies need to be done to define the causes and the pathological changes in the pulmonary vasculature, as well as to determine local norms and the natural history of pulmonary hypertension in highland children.
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PMID:Unexplained pulmonary hypertension in children in the highlands of Papua New Guinea. 857 77

Collaboration between clinicians and microbiologists revealed that many patients with subsequently proven urinary tract infection (UTI) present with symptoms suggestive of chest infection. A retrospective analysis was performed on patients over 50 years old with community acquired bacteraemic UTI proven by blood cultures. The main presenting features were confusion (30%), cough (27%), dyspnoea (28%) and new urinary symptoms (20%). The initial clinical diagnosis was UTI in 43% and chest infection in 24%. Chest infection was diagnosed more often in those over 70 years old than those aged 50-70 years old (chi 2 = 7.2, p = 0.007). The majority had pyuria but less than half of the urine samples arrived in the laboratory on the day of admission, fewer from the older patients than the younger (chi 2 = 2.57, p = 0.10). These results demonstrate that UTI frequently presents with respiratory features and that the diagnosis of UTI is often delayed. Sampling the urine with a catheter may be justified to enable diagnosis on the day of admission.
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PMID:Delay in the diagnosis of bacteraemic urinary tract infection in elderly patients. 867 May 41

In India, an estimated 80% of children are infected with tubercle bacillus by 10 years of age. Elimination of tuberculosis depends on finding all infectious patients and providing them with curative chemotherapy. Pulmonary tuberculosis--the most common form in children--is diagnosed when a child presents with fever, prolonged cough, weight loss, recurrent wheezing, or chest infection; the chest x-ray is suggestive of tuberculosis; and three or more of the following conditions exist: 1) Mantoux test result of 10 mm or more, 2) tuberculosis lymphadenitis by fine needle aspiration cytology, 3) grade III malnutrition, 4) no BCG vaccination, 5) positive family history of tuberculosis, and 6) recent history of pertussis or measles. Recommended, for children with pulmonary tuberculosis, is a regimen of isoniazid, rifampicin, and pyrazinamide daily for 2 months, followed by the first two drugs daily for an additional 4 months. The poor tuberculosis cure rates in most developing countries reflect patient non-compliance with treatment regimens.
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PMID:Current concept in the diagnosis and treatment of childhood pulmonary tuberculosis. 914 78


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