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

In 80 patients with Pneumocystis pneumonitis, the intial signs and symptoms of infection were usually fever and cough, followed by tachypnea and coryza. Flaring of the nasal alae and cyanosis occurred later. Blood gas composition was markedly altered in its acid-base profile in most patients at admission. There was moderate to severe respiratory alkalosis and hypoxia. Clinical manifestations were correlated with the extent of histopathologic changes in the lung. (Deprivation of protein in the diet of rats provoked P. carinii infection.) P. carinii infection was found in children with kwashiorkor; evidence of protein-calorie malnutrition is closely associated with P. carinii pneumonitis in children wiht cancer and other primary diseases. P. carinii pneumonitis proved unique in that the causative organisms remained limited to the lungs even in fatal cases. No toxins have been identified, and systemic effects of the infection were only those that could be related to hypoxia and fever.
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PMID:Signs, symptoms, and pathophysiology of Pneumocystis carinii pneumonitis. 1 4

Three children in Bangladesh who presented with diarrhoea, cough, dyspnoea, fever, and signs of malnutrition and died in the hospital were shown at post-mortem examination to have both adenovirus infection of the intestine (by immunofluorescence) and cytomegalovirus infection of the lung (by immunoperoxidase staining). This finding of dual viral infections of the intestine and lung in patients with concomitant enteritis and pneumonia provides a basis for symptoms emanating simultaneously from these two organ systems.
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PMID:Concomitant intestinal adenovirus infection and pulmonary cytomegalovirus infection in children causing fatal enteritis and pneumonia. 132 74

Epidemiological studies strongly imply that smoking is a risk factor for back problems. The question arises as to the nature of the underlying pathomechanism. Several theories are currently discussed in the literature: it could be due to "unhealthy" life styles associated with smoking, to a rise in intraabdominal pressure caused by frequent coughing, or to osteoporosis of smokers. All of these hypotheses, however, do not stand up to a critical examination of the experimental evidence. A new theory is, therefore, put forward, claiming that smoking leads to malnutrition of the discs, which in turn renders them more vulnerable to mechanical stress. Malnutrition can be brought about by CO-Hb formation, vasoconstriction, arteriosclerotic vessel wall changes, impairment of fibrinolytic activity and changes in the flow properties of blood, all of which are known effects of smoking. The evidence for these pathomechanisms is discussed. Future studies should test the above hypothesis experimentally.
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PMID:[Smoking is a risk factor for spinal diseases. Hypothesis of the pathomechanism]. 144 60

Gastroesophageal reflux (GER) has been known to occur in infants but was thought to be normal. As a result of increased recognition of GER and a clear documentation of GER with extended (18 to 24 hour) esophageal pH monitoring, several severe complications of GER in children have become apparent. An immature cardiorespiratory system is susceptible to some complications of GER such as apnea, choking, recurrent cough or wheezing, and recurrent aspiration pneumonia. Noncardiorespiratory complications include weight loss, esophagitis, anemia, irritability, posturing, malnutrition, and developmental delays. Nursing assessment contributes to a complete clinical picture and the subsequent treatment choice of the physician. To form an accurate assessment of the child with suspected GER, the nurse must be aware of the symptoms and complications of this condition and must precisely execute diagnostic studies, particularly extended esophageal pH monitoring. Nursing responsibilities also include providing a safe yet stimulating environment for the child, teaching parents to participate in the child's care, supporting parents through hospitalization, and preparing both the parents and child for discharge and follow-up care at home.
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PMID:Nursing responsibility in the diagnosis, care, and treatment of the child with gastroesophageal reflux. 176 48

In the United States, the decades preceding the 1980s were characterized by a decline in the incidence of tuberculosis. More recently, the trend has undergone a significant reversal: Case rates have been increasing by 3% to 6% annually. In 1990, more than 25,700 cases were reported to the Centers for Disease Control. In a sense, tuberculosis is adapting to the '90s. The recent increase in its incidence tends to affect populations with identifiable characteristics. Among the most important of these groups are the populations at high risk for infection by the human immunodeficiency virus. The increase is also fueled by cases in populations that are medically underserved, including foreign-born persons from high-prevalence countries, persons with low incomes, and persons living in long-term-care facilities--especially persons with previous tuberculosis infection. Thus, factors such as homelessness, chronic alcohol or drug abuse, malnutrition, and crowded living conditions continue to favor development and transmission of disease. The increase in the incidence of tuberculosis appears to be greatest when subpopulations in such circumstances are also at high risk for HIV infection. Complex issues in the diagnosis and treatment of tuberculosis arise from these epidemiologic patterns. HIV infection is associated with unusual presentations of tuberculosis. Thus, the clinician must maintain a high index of suspicion for the disease in the setting of HIV infection or risk of the infection. The populations at greatest risk are likely to be mistrustful of the medical system, making the long-term administration of potentially toxic chemotherapy more difficult than it already is. Chronic substance abuse may complicate compliance and add further difficulties to the monitoring of chemotherapy. At the same time, the monitoring becomes even more important in the physician's effort to minimize adverse effects of the medications. Outbreaks of drug-resistant disease have recently occurred, complicating the selection of drugs and affecting the duration of treatment. Despite all of these problems, it is essential to establish a diagnosis and initiate treatment rapidly, both to arrest the disease process and to limit its transmission. Since Mycobacterium tuberculosis is spread to uninfected persons in aerosols generated by coughing or sneezing, the infectiousness of a patient with active disease can be related, at least in part, to the number of organisms seen on sputum smears. Initiation of therapy is followed by a rapid decline in infectivity.
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PMID:Tuberculosis: a disease of the 1990s. 191 97

Gastroesophageal reflux (GER) has been known to occur in infants but was thought to be normal. As a result of increased recognition of GER and a clear documentation of GER with extended (18 to 24 hour) esophageal pH monitoring, several severe complications of GER in children have become apparent. An immature cardiorespiratory system is susceptible to some complications of GER such as apnea, choking, recurrent cough or wheezing, and recurrent aspiration pneumonia. Noncardiorespiratory complications include weight loss, esophagitis, anemia, irritability, posturing, malnutrition, and developmental delays. Nursing assessment contributes to a complete clinical picture and the subsequent treatment choice of the physician. To form an accurate assessment of the child with suspected GER, the nurse must be aware of the symptoms and complications of this condition and must precisely execute diagnostic studies, particularly extended esophageal pH monitoring. Nursing responsibilities also include providing a safe yet stimulating environment for the child, teaching parents to participate in the child's care, supporting parents through hospitalization, and preparing both the parents and child for discharge and follow-up care at home.
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PMID:Nursing responsibility in the diagnosis, care, and treatment of the child with gastroesophageal reflux. 154 68

Forty-one cases of empyema thoracis admitted in hospital during April, 1985 to August, 1987 were studied. Majority were males (65.9%) and were of less than 2 years of age (70.7%). Right side (60.9%) was predominantly involved. Abdominal distension (43.9%) was very characteristic, with other usual features like fever, cough and respiratory distress. A large majority of them were victims of malnutrition (73.2%) and anaemia (53.7%) with haemoglobin level ranging from 5-9 g/dl. Mortality was high (17.1%). Therapy with parenteral cloxacillin and gentamicin and continuous intercostal tube drainage accounted for loss of 15.8 bed days (average period of hospitalisation). Staph aureus was the principal aetiopathogen (68.3%). No anaerobe could be isolated. Strains of staphylococci were mostly resistant to penicillin and ampicillin but sensitive to gentamicin, cloxacillin and erythromycin.
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PMID:Clinicobacteriological study of empyema thoracis in infants and children. 226 63

A 1 year follow-up study of 289 low birth weight infants (LBW) was carried out during 1984-85 in slums of Bombay: 151 were males and 138 were females. 52.9% of babies had birth weight less than 2.5 kg. Male children suffered 9.7 and females 8.6 episodes of sickness per year. Annual mean episodes of illness were: diarrhea 3.2, cough 5.3, and fever 4.8. Upper respiratory tract infection was considered fever. 98.6% breast fed successfully in the 1st week keeping it up for 2 months. Of 209 mothers, 88.5% had weaned their babies before 6 months. Commercial formula was used by only 1 mother whose baby had gastroenteritis and dies. Of 289 infants, bottle feeding was done in only 3 cases. Feeding with bowl and spoon was done in 71.3% of infants, 27.7% were not weaned at all with breastfeeding lasting 1 year. Most babies lost weight around the 7th and 8th months of life along with maximum episodes of sickness. Babies below 2 kg showed accelerated growth after weaning, and achieved grade I nutritional status. 2.7 to 3 kg weight babies failed to show any gain from the 5th month, thus advanced to 3rd grade malnutrition. 6 deaths occurred, 4 of which had birth weights less than 2 kg. 2 babies died of gastroenteritis and septicemia during the 4th and 5th month. Mortality in babies born less than 2 kg was 44.4% and above 2 kg birth weight was less that 1%. The infant mortality rate (IMR) was 38/1000 live births vs. the national range of 39-177. Prematurity caused 1.2% of deaths. Antenatal care, detection of at risk pregnancies, proper feeding and weaning practices, and complete immunization coverage can help reduce IMR in slums, and the goal of a rate below 60 by the year 2000 is feasible.
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PMID:Care of low birth weight babies in slums. 280 50

Survival of the patient with cystic fibrosis has been considerably extended in the last two decades due to improved therapy of pulmonary infection, nutritional management, and an organized system of centralized care. Psychological and social aspects of cystic fibrosis may be intensified during adolescence: developing independence in the face of required daily care; developing self-esteem in the face of illness-associated problems such as discolored teeth, malabsorption, short stature, and cough; and participating in group activities despite physical limitations and the disruption in peer relationships when recurrent acute illness is interposed. Pubertal delay is more common in the cystic fibrosis population than the general population, and attendant psychologic dysfunction may be particularly common in males. Comparative studies suggest that this pubertal delay is a function of malnutrition rather than intrinsic to the disease. Normal growth potential may be postulated from somatomedin studies and has been demonstrated in patients treated with long-term aggressive nutritional management. Intervention utilizing testosterone enanthate in males with cystic fibrosis and pubertal delay has resulted in improved rate of growth, progression through puberty, and self-image.
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PMID:Short stature and pubertal delay in cystic fibrosis. 333 Dec 6

The Tuberculosis Control Program began its reorganization in 1979, when the Honduran Ministry of Public Health designated tuberculosis as one of its priority problems. Administrative and logisitical problems faced by the program were exacerbated by the public's negative image of the disease and the consequent rejection of anything related to it, including medical diagnosis and treatment. A baseline investigation was carried out to determine the knowledge, attitudes and behaviors of the public, patients and patients' relatives regarding tuberculosis (TB). Sampled were 361 healthy adults, 75 tuberculosis patients, 55 relatives of patients, 20 health personnel, 12 nurses in 12 health centers, and 3 epidemiologists. Data was gathered using surveys (healthy population), focus groups (healthy population, patients) unstructured interviews (relatives, health personnel, nurses and epidemiologists) and focused interviews (relatives). The investigation confirmed the existence of social rejection toward TB. The disease is considered quite contagious, and is associated with extreme poverty, filth and malnutrition. The patients stated that this rejection is 1 of the greatest burdens of their disease; they considered themselves a danger to others and expressed feelings of guilt. The most recognized symptom was coughing and expectoration. A person with a persistent cough does not however, want to think of TB, except as a very remote possibility. Health personnel also fail to perceive a persistent cough as a respiratory symptom and possible indicator of TB. Cough syrups and bronchial decongestants are the most widely distributed medicines in rural health centers. Both the patients and the general population queried knew that TB is curable, although they doubted that the patient could recover his/her full health. Patients' fear was that the long period of treatment would inevitably lead to their neighbors discovering that they had the disease and rejecting them. The health system's capacity to diagnose and treat TB was also analyzed. Several problems were detected in the diagnosis of respiratory cases, e.g., difficulties leading to long delays in the collection and analysis of sputum samples and in the subsequent reporting of the findings. Moreover, instructions given to the patient are quite vague as to exactly what quality sputum is needed and how best to obtain it. These problems affect the number of patients who are diagnosed and treated, but seem to have little bearing on those already being treated. An education campaign was prepared based on these findings. Its goals were toinform the population at large that TB patients no longer transmit the disease, that they can be completely cured if treatment is begun promptly, and that a persistent cough lasting for more than 15 days may be a symptom. A pamphlet has been developed to better educate the patients and their relatives. It is concluded that an understanding of and familiarity with the client's perspective can help educational programmers identify exactly which facts or opinions must be reinforced or modified so that beneficial health services are utilized.
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PMID:Integrating the client's perspective in planning a tuberculosis education and treatment program in Honduras. 407 1


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