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

We performed a 5-year review of 40 patients less than or equal to 30 days of age with viral pneumonia. Isolates included respiratory syncytial virus (55%), enteroviruses (15%), rhinoviruses (15%), adenoviruses (10%), parainfluenza virus (7.5%) and herpes simplex virus (5%). Most infants were previously healthy but had ill family members. Nine were born at less than 37 weeks of gestation. Symptoms and signs included tachypnea, decreased feeding, cough, cyanosis, lethargy, retractions, apnea, bradycardia, seizures and depressed consciousness. Seasonality and clinical features, but not radiographic patterns, suggested specific pathogens. Patients were moderately to severely ill. The median duration of hospitalization was 7 days; therapies administered included oxygen (90%), mechanical ventilation (45%), blood transfusions (25%) and supplemental oxygen after discharge (27%). The case fatality rate was 7.5%. Prematurity, ill appearance at presentation, lobar consolidation and adenovirus infection were risk factors for severe disease.
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PMID:Viral pneumonia in the first month of life. 217 40

We compared previously healthy prematurely born infants with full-term infants hospitalized with respiratory syncytial virus (RSV) infection to evaluate the role of prematurity on the clinical course of the illness. During a 5-yr period (1984 to 1989), 484 previously healthy patients were admitted to the hospital with RSV infection. No differences were found in the presenting symptoms of respiratory distress, cough, fever or shock, although the premature group was more likely to present with apnea (p less than .001). Chest roentgenograms revealed that premature infants had a higher incidence of atelectasis/infiltrate and hyperinflation (p less than .05). Premature infants had longer hospital stays as well as a higher Physiologic Stability Index and Therapeutic Intervention Score (p less than .001). They were also more likely to receive supplemental oxygen, ICU admission, mechanical ventilation, and nothing by mouth status (p less than .001). We conclude that premature birth increases the risk of more severe and prolonged RSV disease.
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PMID:Does prematurity alter the course of respiratory syncytial virus infection? 224 9

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

Lung function was recorded in a cohort of 130 age specific children of low birth weight (under 2000 g) and a reference population of 120 unselected local schoolchildren at 7 years of age. Children of the cohort were similar in height and forced vital capacity to the reference group, but had significantly reduced forced expiratory volume in 0.75 second and expiratory flow indices. Although neonatal respiratory illness was associated with reduced airway function, we were unable to confirm that this was a consequence of oxygen treatment or mechanical ventilation. Low birth weight, however, was closely associated with poor airway function independent of neonatal respiratory illness. Other factors of importance included the male gender and maternal smoking. The reduction in airway function observed in the low birthweight children was associated with cough but not wheeze. The disparity between the relatively well preserved vital capacity and reduced airway function suggests that very low birth weight, and hence prematurity, has its greatest effect on the subsequent growth of airway function. The absence of an association between neonatal oxygen score or mechanical ventilation and childhood lung function suggests that the long term effect of neonatal respiratory treatment is small compared with that of birth weight, maternal smoking, and male sex.
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PMID:Lung function in children of low birth weight. 281 49

A total of 205 infants who were hospitalized when younger than 3 months of age for pneumonitis were followed longitudinally. Of these patients, 145 (70%) had evidence of infection with one or more pathogens. The most common etiologic agents were Chlamydia trachomatis 61/193 (36%), respiratory syncytial virus 33/142 (23%), cytomegalovirus 42/203 (20%), Pneumocystis carinii 30/171 (17%), and Ureaplasma urealyticum 21/125 (16%). The initial clinical presentation was characterized by cough, rales, normal temperature, and diffuse obstructive airways disease by chest roentgenogram. Regardless of etiology, significant association occurred for cough and cytomegalovirus, apnea and Pneumocystis, and conjunctivitis and Chlamydia. Longitudinal follow-up demonstrates a mortality of 7/205 (3.4%). Morbidity was manifest as recurrent wheezing episodes in 86/187 (46%) patients, persistently abnormal chest roentgenographic findings for at least 12 months in 17/109 (15%) patients, and abnormal pulmonary functions in 15/25 (60%) patients. These abnormalities occurred irrespective of prematurity, atopy, or the initial etiologic agent associated with the pneumonitis. These data add further evidence that respiratory infections during infancy may well be predecessors of obstructive airways disease in later life.
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PMID:Infant pneumonitis associated with cytomegalovirus, Chlamydia, Pneumocystis, and Ureaplasma: follow-up. 302 7

Illness associated adenovirus infection is described in 15 immunocompromised patients. Patients were immunocompromised by severe underlying disease, immunosuppressive or corticosteroid therapy or by age (prematurity). Evidence of adenovirus infection was obtained by either viral isolation or, in two cases, characteristic adenovirus inclusion bodies at postmortem study. All clinical illness was associated with high fever (temperature greater than 39 degrees C). Eighty per cent of the patients had severe systemic complaints including malaise, lethargy, fatigue and night sweats; a similar number of gastrointestinal symptoms. Pulmonary complaints were described in 11 of 15 cases and included cough (67 per cent) and tachypnea (53 per cent). Roentgenologic evidence of pneumonia was demonstrated in 12 of 15 patients (80 per cent). Elevation of serum hepatic enzyme levels (serum glutamic pyruvic transaminase (SGPT)) occurred in eight of 11 patients (73 per cent) and was moderate to severe (serum glutamic pyruvic transaminase greater than 450 IU/liter) in five of 11 (45 per cent). Nine patients died; seven after a rapid downhill course and two after a prolonged illness. Evidence of adenovirus infection microscopically by autopsy in the lung, liver or both is demonstrated in four patients with fulminant systemic illness. Adenovirus infection should be considered in the etiology of severe overwhelming illness in the immunocompromised host.
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PMID:Adenovirus infection in the immunocompromised patient. 624 99

Five infants who had been patients in the same Neonatal Intensive Care Unit (NICU) were readmitted with respiratory illness. The illness was characterized by cough, congestion, apnea, and infiltration of the lungs revealed by radiographic examination. Only one infant was febrile. All five patients recovered; however, one infant required prolonged intubation and mechanically assisted ventilation. Investigation revealed that the illness was associated with prematurity and contact with ill family members. Illness was not associated with exposure to ill personnel in the NICU, low birth weight, or previous lung disease. This outbreak demonstrates the dangers involved in sending premature infants home when respiratory illness is prevalent in the family.
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PMID:Family-acquired respiratory disease in high-risk infants. 736 36

Gastroesophageal reflux (GER) in infants is most commonly thought of as repeated excessive vomiting and failure to thrive, with most infants responding favorably to medical therapy. However, GER may also manifest exclusively with a variety of respiratory symptoms that, if not detected and treated early, may lead to life-threatening complications. During the period of 1987 to 1992, 39 neonates and infants underwent Nissen fundoplication for the treatment of respiratory symptoms attributed to GER. Symptoms included apnea and bradycardia (64%), pneumonia (31%), cyanosis (28%), cough (18%), and stridor (15%). Most patients were ascribed at least one incorrect diagnosis to explain respiratory symptoms. These include apnea of prematurity (38%), bronchopulmonary dysplasia (31%), asthma (8%), and subglottic stenosis (8%). All patients underwent a variety of investigations and medical treatments without noticeable clinical improvement. These included bronchoscopy, esophagoscopy, and polysomnograms. Treatment such as antibiotics, theophylline, bronchodilators, steroids, and oxygen were directed at presumed primary respiratory disease. On the other hand, H2 blockers, metoclopramide, positioning, and thickened feeds were prescribed to treat GER without objective evidence of disease. Ultimately, GER was demonstrated by upper gastrointestinal series in 64%, pH probe in 61%, and both studies in 38%. All patients underwent Nissen fundoplication after failed attempts at medical therapy. A total of 95% of patients had resolution or substantial improvement of respiratory symptoms postoperatively. Preoperative hospitalization averaged 37.0 days, and postoperative stay averaged only 14.2 days. We present a series of patients with GER, all of whom presented with respiratory symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnosis and treatment of respiratory symptoms of initially unsuspected gastroesophageal reflux in infants. 794 42

Bronchiolitis, a lower respiratory tract illness most often caused by respiratory syncytial virus, generally affects children under two years of age, commonly during the winter months. Necrosis of epithelial cells in the small airways leads to inflammation and airway obstruction, causing decreased oxygen saturation, with cough and wheezing. Hospital admission should be considered for children with pulse oximetry levels less than 95 percent at rest. Treatment consists of humidified oxygen, intravenous hydration and administration of nebulized albuterol. Infants with mild disease who are identified early in the course of illness should be reevaluated in 24 hours. Infants with congenital heart disease, bronchopulmonary dysplasia or a history of prematurity, who are at high risk for severe disease, should be treated with ribavirin.
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PMID:Bronchiolitis. 784 31

The mucosa covering the interarytenoid space at the entrance to the larynx contains specialized nerve endings (receptors) that are stimulated when a fluid comes into contact with the mucosal surface. These receptors mediate several aspiration preventive reflex responses, which include swallowing, cessation of breathing, airway constriction or closure, and coughing. The laryngeal receptors are more sensitive to water than to saline, and therefore the combined reflex response to receptor stimulation is termed the "laryngeal chemoreflex." This reflex can be activated during regurgitation of gastric contents into the pharynx, in which case the several components of the reflex serve to prevent intrapulmonary aspiration of gastric fluid. In certain infants a hyperactive laryngeal chemoreflex may cause episodic prolonged apnea. Such reflex-mediated apnea has been implicated in several kinds of prolonged infantile apnea, including apea of prematurity, gastric regurgitation-related apnea, and apnea associated with upper respiratory infection.
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PMID:Reflux associated apnea in infants: evidence for a laryngeal chemoreflex. 942 36


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