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

The clinical courses of 14 children with acute pulmonary blastomycosis were studied. All the patients had a remarkably similar illness limited to the lungs with fever, malaise, and respiratory symptoms (cough, sputum production, chest pain, and vomiting). Despite eventual recovery with treatment in all instances, 13 of the 14 children persisted in having abnormal roentgenograms. Three children have demonstrated persistent mild obstructive airway disease for two to 12 months after completion of therapy. These data suggest that the initial illness following childhood infections with Blastomyces dematitidis is usually an acute pulmonary disease without systemic dissemination. Evidence of residual lung abnormalities conflicts with the recent concept of this being a benign, self-limited illness. Our findings suggest the importance of long-term follow-up as well as a need for more complete understanding of the full clinical spectrum and prognosis of acute pulmonary blastomycosis.
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PMID:Acute pulmonary blastomycosis in children: clinical course and follow-up. 58 67

Initially a right sided pulmonary hypoplasia was diagnosed in our patient at the age of 9 years. The previous years were characterized by recurrent pneumonia, bronchitis and daily coughing fits. Findings of the chest radiograph suggested the diagnosis of right sided hypoplasia. The right hemithorax was small with mediastinal structures being pushed to the right and a clearly reduced blood flow on the same side. DSA of the arteria pulmonalis showed hypoplasia of the right arteria pulmonalis and confirmed our diagnosis. In addition to that an obstructive airway disease was assessed by measurement of lung function. Since the time when the diagnosis was found our patient has inhaled DSCG and beta 2-adrenergic drugs and no surgical treatment has been required as there have been no further episodes of pneumonia.
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PMID:[Right-sided lung hypoplasia in a 13-year-old boy]. 232 50

In a study of early-life risk factors for the development of adult obstructive airway disease, respiratory symptoms, disease and smoking histories, and spirometry were obtained for 650 children 5 to 9 yr of age and their families in East Boston, Massachusetts. Persistent wheezing was the most frequently reported chronic symptom, occurring in 9.2% (60/650) of the population. Children with persistent wheezing were more likely to report cough and phlegm (p < 0.001), a history of asthma (p < 0.001), hay fever (p < 0.02), or past hospitalization with a respiratory illness (p < 0.001) than their asymptomatic peers. Prospective evaluation of a subsample of the 650 children confirmed a greater occurrence of acute lower respiratory illness in those children with persistent wheeze. Parental cigarette smoking was linearly related to the occurrence of persistent wheezing (p = 0.012) and lower degrees of mean normalized forced expiratory flow during the middle half of the forced vital capacity (FEF-Z score). A multiple linear regression identified the mother's current smoking status and current persistent wheeze as significant predictors of the children's mean FEF-Z score. Other variables, such as the father's smoking, children's personal smoking, a doctor's diagnosis of asthma, and a past history of lower respiratory illness were not significant predictors of the FEF-Z score.
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PMID:Persistent wheeze. Its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a population sample of children. 744 54

The clinical usefulness of bland, mucolytic, and antimicrobial aerosols in the management of obstructive airway disease or bronchopulmonary infections was critically reviewed at th last Conference on th Scientific Basis of Respiratory Therapy in 1974. From the information available at that time, it was cocluded that there was little scientific basis for these therapeutic modalities. It was also suggested that the value of aerosol therapy should be evaluated by objective tests. The relatively few studies reported during the last 5 years have not generated new data in support of such aerosol therapy. Three criteria have been used to assess the efficacy of bland and mucolytic aerosols: respiratory function, mucociliary function, and subjective symptoms. Although respiratory and mucociliary function have generally been found to remain unaltered or to deteriorate after administration of bland or mucolytic aerosols, some investigators have observed facilitated expectoration or improved cough efficiency. The effectiveness of antimicrobial aerosols is more difficult to evaluate, and their value in patients with bacterial or fungal pulmonary infections remains to be demonstrated. Considering the cost and potential hazards of aerosol therapy, its use should be restricted to forms of aerosols whos clinical value has been objectively demonstrated; a reassessment of the literature suggests that bland and currently used mucolytic and antimicrobial aerosols do not meet this requirement.
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PMID:Clinical indications for and effects of bland, mucolytic, and antimicrobial aerosols. 745 53

Abdominal surgery, especially upper abdominal surgical procedures are known to adversely affect pulmonary function. Pulmonary complications are the most frequent cause of postoperative morbidity and mortality. This review article aimed to analyse the incidence and risk factors for postoperative pulmonary morbidity and their prevention. The most important means for preoperative assessment is the clinical examination; pulmonary function tests (spirometry) are not reliably predictive for postoperative pulmonary complications. Age, type of surgical procedure, smoking and nutritional state have all been identified as potential predictors for postoperative complications. However, usually there is not enough preoperative time available to obtain beneficial effects of stopping smoking and improvement of nutritional state. In patients with COPD, a preoperative multidisciplinary evaluation including the primary care physician, pulmonologist/intensivist, anesthesiologist and surgeon is required. Consensus as to preoperative physiologic state, therapeutic preparation, and postoperative management is essential. Simple spirometry and arterial blood gas analysis are indicated in patients exhibiting symptoms of obstructive airway disease. There are no values that contra-indicate an essential surgical procedure. Smoking should stop at least 8 weeks preoperatively. Preoperative therapy for elective surgery with antibiotics, beta2-agonist, or anticholinergic bronchodilator aerosols, as well as training in cough and lung expansion techniques should begin at least 24 to 48 hours preoperatively. Postoperative therapy should be continued for 3 to 5 days. Usually, anaesthesia is responsible for early complications, whereas surgical procedures are often associated with delayed morbidity. Laparoscopic procedures are recommended, as postoperative morbidity and hospital stay seem reduced in patients without COPD. Regional anaesthesia is given as having less adverse effects on pulmonary function than general anaesthesia. However, for unknown reasons these benefits are not associated with a decrease in postoperative respiratory complications. Moreover, the quality or the type of postoperative analgesia does not influence postoperative respiratory morbidity. Postoperatively, oxygen administration increases SaO2, but cannot abolish desaturation due to obstructive apnea. The various techniques of physiotherapy (chest physiotherapy, incentive spirometry, continuous positive airway pressure breathing) seem to be equivalent in efficacy; but intermittent positive pressure breathing has no advantages, compared with the other treatments and could even be deleterious. Chest physiotherapy and incentive spirometry are the most practical methods available for decreasing secretion contents of airways, whereas continuous positive airway pressure breathing is efficient on atelectasis. In stage II or III COPD patients, admission in a intensive therapy unit and prolonged mechanical ventilation may be required.
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PMID:[Prevention of respiratory complications after abdominal surgery]. 903 57

To assess the relationship between chronic bronchitis and obstructive sleep apnoea, a postal survey was performed. A postal questionnaire was sent to 523 subjects identified as having chronic bronchitis or long-standing cough and sputum production in the Obstructive Lung Disease in Northern Sweden Study I (OLIN I). In 1986-88, all 6610 adults born in 1919-20, 1934-35 and 1949-50 living in representative areas in Northern Sweden were screened for airway diseases according to different methods. A random sample of healthy adults identified in the screening were chosen as references (n = 625). Subjects were asked about a variety of airway symptoms, smoking habits and symptoms related to obstructive sleep apnoea syndrome (OSAS). In the bronchitic group, 20% did not report bronchitic symptoms in the present study, and 26% of the formerly healthy reference group reported at least one bronchitic symptom in the present study. Snoring, apnoea and liability to 'nod off' during activity were much more common in the bronchitic group in both men and women, and most common in men, as expected. Snoring was reported by 29% of the men in the bronchitic group and by 14% in the reference group. In women, the corresponding figures were 14 and 8%, respectively, and for apnoea, the figures were 25 vs. 11% in men and 6 vs. 4% in women. The prevalence of OSAS symptoms was similar in subjects with attacks of breathlessness, long-standing cough, sputum production and recurrent wheezing. Bronchitic symptoms may influence quality of sleep and contribute to daytime tiredness, but this does not fully explain the high prevalence of snoring and apnoea reported by subjects in this cohort. This study indicates a positive correlation between chronic bronchitis and OSAS, but sleep studies are required to confirm this.
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PMID:Symptoms related to snoring and sleep apnoea in subjects with chronic bronchitis: report from the Obstructive Lung Disease in Northern Sweden Study. 906 11

To investigate whether the high prevalence of symptoms related to obstructive sleep apnoea syndrome (OSAS) in a bronchitic cohort is correlated with the bronchitic symptoms or lung function impairment we examined two cohorts with bronchitic symptoms (n = 357 and 82) and a reference group who had reported no respiratory symptoms in a previous survey in 1986 (n = 140). The study was a part of the Obstructive Lung Disease in Northern Sweden Study and included clinical examination and lung function tests. Although lung function measured as FEV1 percentage predicted was correlated with bronchitic symptoms we found that bronchitic symptoms and body mass index but not lung function impairment were correlated with symptoms related to obstructive sleep apnoea. According to our findings it was the various bronchitic symptoms such as longstanding cough, wheezing, sputum production and chronic productive cough that were correlated with OSAS symptoms. This might be due to increased upper airway swelling or increased upper airway resistance, and lung function impairment does not seem to be responsible for the high prevalence of symptoms related to obstructive sleep apnoea in this bronchitic cohort.
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PMID:Are symptoms of obstructive sleep apnoea syndrome related to bronchitic symptoms or lung function impairment? Report from the Obstructive Lung Disease in Northern Sweden Study. 961 27

Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.
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PMID:Intermittent cranial lung herniation in two dogs. 1750 8

A 70-year-old male smoker, with a three-month status of post-balloon angioplasty for ischaemic heart disease, presented with a one-week history of fever, haemoptysis and chest discomfort on coughing. The patient did not report any loss of weight or appetite. On examination, he was febrile. Pulmonary function tests revealed obstructive airway disease. High resolution computed tomography of the lungs revealed fibrosis with bronchiectasis in both the upper lobes, and a spiculating subpleural mass in the posterior aspect of the right lung apex. Subsequent bronchoalveolar lavage (BAL) culture yielded the Scopulariopsis species. Our patient was treated with a four-week course of amphotericin B, followed by itraconazole. At the 24-month follow-up, the patient was asymptomatic. Subsequent BAL cultures revealed no fungal growths, and radiological studies showed a regression in the lesion.
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PMID:Pulmonary Scopulariopsis in a chronic tobacco smoker. 2084 53

Persons with spinal cord injury (SCI) have secondary medical consequences of paralysis and/or the consequences of extreme inactivity. The metabolic changes that result from reduced activity include insulin resistance with carbohydrate disorders and dyslipidemia. A higher prevalence of coronary artery calcification was found in persons with SCI than that in matched able-bodied controls. A depression in anabolic hormones, circulating testosterone and growth hormone, has been described. Adverse soft tissue body composition changes of increased adiposity and reduced skeletal muscle are appreciated. Immobilization is the cause for sublesional disuse osteoporosis with an associated increased risk of fragility fracture. Bowel dysmotility affects all segments of the gastrointestinal tract, with an interest in better defining and addressing gastroesophageal reflux disease and difficulty with evacuation. Developing and testing more effective approaches to cleanse the bowel for elective colonoscopy are being evaluated. The extent of respiratory dysfunction depends on the level and completeness of SCI. Individuals with higher spinal lesions have both restrictive and obstructive airway disease. Pharmacological approaches and expiratory muscle training are being studied as interventions to improve pulmonary function and cough strength with the objective of reducing pulmonary complications. Persons with spinal lesions above the 6th thoracic level lack both cardiac and peripheral vascular mechanisms to maintain blood pressure, and they are frequently hypotensive, with even worse hypotension with upright posture. Persistent and/or orthostatic hypotension may predispose those with SCI to cognitive impairments. The safety and efficacy of anti-hypotensive agents to normalize blood pressure in persons with higher level cord lesions is being investigated.
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PMID:31st g. Heiner sell lectureship: secondary medical consequences of spinal cord injury. 2345 98


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