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

Four hundred and forty five of 888 dairy farmers studied in an epidemiological survey four years previously were restudied to determine change in precipitins and in clinical features. Subjects answered the same questionnaire, which was filled in by the same nurse in the same winter months, and had blood withdrawn for precipitin analysis (double diffusion technique). Of the 445 subjects retested, 48 (10.8%) had been precipitin positive at the first study; of these, 34 remained positive four years later and 14 had reverted to negative. Twenty eight subjects previously negative for precipitins had become positive, so that 62 subjects in all were precipitin positive when restudied (13.9%). Of the 445 farmers, 369 were precipitin negative at both studies. The prevalence of symptoms, including cough, sputum production, wheezing, dyspnoea, and fever and chills, was similar for subjects who were consistently negative for precipitins and consistently positive and for those who changed from one to the other. Only one subject developed farmer's lung; he had precipitins in both studies. This study shows a fluctuation in the precipitin state of dairy farmers, suggesting that more farmers have precipitins at least once in their lifetime than are identified by screening at a single point in time. Relatively few develop farmer's lung or other respiratory symptoms. The presence of precipitins in a symptomless farmer appears to have no clinical importance.
Thorax 1989 Jun
PMID:The fluctuant nature of precipitating antibodies in dairy farmers. 276 56

Nebulised pentamidine was used to treat 30 patients with Pneumocystis carinii pneumonia. Fourteen patients (group 1) received pentamidine isethionate 4 mg/kg (six patients) or 8 mg/kg (eight patients) via a standard jet nebuliser (Acorn, system 22) with a flow rate of 8 l/min. The aerosol droplets had a mass median aerodynamic diameter of 2.6 microns (geometric standard deviation (GSD) 2.9) and 46% of droplets were less than 3.9 microns. A further 16 patients (group 2) received 8 mg/kg pentamidine via a jet nebuliser with baffles to limit droplet size to below 4 microns (Respirgard II). This generated aerosol droplets with a mass median aerodynamic diameter of 0.8 micron (GSD 1.5) and 98% were less than 3.9 microns. Only three of the 14 patients in group 1 responded clinically to treatment, one after the lower dose of pentamidine. Treatment was discontinued in 10 patients and one patient died at bronchoscopy from haemorrhage. Thirteen of the 16 patients in group 2 responded. Side effects occurred infrequently; two patients from group 1 had a cough, six patients (four from group 2) had contact bleeding at bronchoscopy, and two further patients had haemoptysis. The differing response rate may be due to differences in the mean droplet size of the aerosols produced by the nebulisers. Nebulised pentamidine (8 mg/kg) when delivered by Respirgard II nebuliser appears to be as effective as conventional treatment for Pneumocystis carinii pneumonia of mild to moderate severity.
Thorax 1989 Jul
PMID:Nebulised pentamidine as treatment for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. 259 28

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.
Thorax 1989 Aug
PMID:Physiotherapy after coronary artery surgery: are breathing exercises necessary? 279 43

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.
Thorax 1989 Aug
PMID:Lung function and bronchial reactivity in farmers. 279 44

In six normal subjects treatment with 4 mg nedocromil sodium failed to alter the cough and bronchoconstriction induced by inhaled capsaicin. Because nedocromil has previously been shown to inhibit reflex bronchoconstriction provoked by inhaled sulphur dioxide and inhaled bradykinin, the results suggest that inhaled capsaicin acts on different nerve fibres.
Thorax 1988 Nov
PMID:Effect of nedocromil sodium on the airway response to inhaled capsaicin in normal subjects. 285 81

Coughing was induced in seven normal and eight asthmatic subjects by giving successive inhalations of citric acid aerosols of progressively higher concentration (range 0.5-32%). A baseline cough response was obtained on each of four experimental days, and there was no significant difference between days in this respect. Then the subjects received by inhalation either a bronchodilator (salbutamol 5 mg or ipratropium 1 mg) or placebo, in a paired double blind crossover design. A second citric acid run followed and was used for paired drug-placebo comparisons. In the asthmatic subjects the cough response was diminished by both bronchodilators (p less than 0.05), and the cough threshold was significantly higher after ipratropium but not salbutamol. In normal subjects no significant effects were found. Airways calibre was assessed, by an oscillatory technique that measures the resistance of the respiratory system (Siemens Siregnost FD 5), in four of the seven normal and all eight asthmatic subjects. The mean respiratory resistance was higher in asthmatic than in normal subjects, and fell significantly after both bronchodilators. In normal subjects smaller decreases in respiratory resistance occurred, significant only with salbutamol. The simplest hypothesis which explains the results relates change in cough response to altered neuroreceptor sensitivity associated with rapid changes in bronchial calibre.
Thorax 1985 Sep
PMID:Effect of bronchodilators on the cough response to inhaled citric acid in normal and asthmatic subjects. 293 14

Fifty-one patients (22 male, 29 female) aged 22-60 years (mean age 41.2 years), predominantly extrinsic asthmatics, took part in this study, a follow-up to a 28-day, double-blind trial (Lal et al., Thorax 1984: 39: 809). Forty-four patients completed 12 months of treatment after a 4-week baseline; seven withdrew. A number of symptoms (e.g. coughing, wheezing, sore throat) were reported but none appeared particularly frequently; most were attributable to the technique of inhalation. After 4 weeks of treatment with nedocromil sodium (Tilade 4 mg q.i.d.), patients were encouraged to reduce use of inhaled corticosteroids (48 patients) and sodium cromoglycate (16). Inhaled bronchodilators were to be used as required and other medication was to continue as before. At the end of the study, 28 patients had stopped using inhaled steroids and 10 had significantly reduced the dosage (p less than 0.001, week 5 to end). Ten patients had stopped using sodium cromoglycate. Inhaled bronchodilator use was significantly reduced (p less than 0.001, weeks 1-8; p less than 0.05, weeks 9-12) early in the study but returned to baseline as inhaled steroid usage was reduced. Diary card assessments of wheezing and shortness of breath showed significant improvement, particularly in the early part of the study. Diary card PEFRs showed no marked changes but significant decreases, though small, were found in FEV1, FVC and PEFR on clinic visits. Clinical assessment showed improvement in the first half of the study; the differences were less marked as inhaled steroid usage declined. Final opinions of treatment effectiveness significantly favoured nedocromil sodium. This study demonstrates the acceptability, tolerability and safety of nedocromil sodium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An open assessment study of the acceptability, tolerability and safety of nedocromil sodium in long-term clinical use in patients with perennial asthma. 302 87

Nocardia organisms were cultured from the sputum of 11 patients at the central hospitals in Harare, Zimbabwe, over a 12 month period. Pulmonary nocardiosis was diagnosed in one further patient on the basis of direct microscopy. Among the nine patients available for follow up, pulmonary nocardiosis was considered to be the major clinical problem in six. The patients usually presented with a chronic pulmonary infection with fever and cough without evidence of dissemination of underlying systemic disease. The chest radiograph showed consolidation in any part of the lung, and this was seen to extend slowly over several months. Prolonged diagnostic delay was a frequent problem. Haemoptysis, alcohol abuse, and empirical treatment for tuberculosis commonly featured in the history. Treatment with sulphonamides was generally successful in those patients who complied. Nocardiosis is a treatable lung disease that may be more common in developing countries than is currently recognised.
Thorax 1988 Nov
PMID:Nocardiosis: a neglected chronic lung disease in Africa? 306 75

Storage mites (acarid mites) are related to the house dust mite but are usually found in agricultural environments. They have been shown to cause allergic symptoms in Scottish farmworkers exposed to stored hay, but whether farmworkers who grow and store grain are also at risk is unknown. One hundred and one farmworkers on 22 Essex farms with grain storage facilities (88% of the available workforce) participated in a survey of respiratory symptoms, with skin tests and determination of serum levels of IgE specific for mite species, including storage mites. Of the 101 workers, 21 reported attacks of cough, wheeze, or breathlessness after exposure to stored grain and 15 reported nasal symptoms after grain exposure. Storage mite specific IgE was found in 59% of farmworkers with work related respiratory symptoms, in 60% with work related nasal symptoms, and in only 9% of symptomless farmworkers. Work related respiratory and nasal symptoms were also significantly associated with atopy, and with positive skin test responses and serum IgE specific for Dermatophagoides pteronyssinus. Storage mites were found in grain samples from 16 farms in which grain was sampled, whereas D pteronyssinus was not found in any. The close association between serum storage mite specific IgE and occupational respiratory symptoms suggests that storage mites may be responsible for respiratory symptoms in these Essex farmworkers exposed to grain.
Thorax 1988 Sep
PMID:Respiratory symptoms in arable farmworkers: role of storage mites. 319 76

The cough reflex has been investigated in insulin dependent diabetic patients with and without autonomic neuropathy. The cough response to inhaled citric acid was determined in eight patients with diabetes who had severe autonomic neuropathy and compared with that in 10 who had no evidence of neuropathy. The patients with autonomic neuropathy had a higher median threshold for the cough response to citric acid (median 50%, range 20- greater than 100%) than non-neuropathic control patients (median 10%, range 2-20%). These results suggest that vagal innervation of the bronchial tree is damaged by diabetic autonomic neuropathy.
Thorax 1988 Jul
PMID:Cough threshold to citric acid in diabetic patients with and without autonomic neuropathy. 321 54


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