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

A 33-year-old albinotic woman whose parents were consanguineous was referred to our hospital with dry cough, dyspnea on exertion, and diffuse reticulonodular shadows on chest X-ray film. She had no apparent bleeding diathesis, although platelet serotonin content and ATP release were reduced. Open lung biopsy revealed pulmonary interstitial fibrosis with deposition of ceroid-like material with alveolar and interstitial macrophages. From these findings, the diagnosis of Hermansky-Pudlak syndrome (HPS) with interstitial pneumonia was mode. The reported characteristics of pulmonary interstitial pneumonia associated with HPS are occurrence of this disease in the thirties to forties, diffuse reticulonodular shadows in all lung fields with sparing of the subpleural zones, and bullous formation in the upper lobes. Progression usually occurs to diffuse interstitial fibrosis, but these is little decrease in lung volume. The prognosis of HPS with interstitial pneumonia is worse than that of uncomplicated HPS, and patients die of respiratory failure within 1 to 6 years after diagnosis. Steroid therapy is not effective.
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PMID:[Pulmonary interstitial pneumonia in association with Hermansky-Pudlak syndrome]. 180 83

A 76-year-old man with spindle cell (squamous) carcinoma of the lung developed fatal respiratory failure after limited thoracic irradiation at a total dose of 18 Gy. He developed severe pulmonary toxicity, which presented as dry cough, dyspnea, and pulmonary infiltrates extending beyond the radiation field. Microscopically, a transitional form of squamous to spindle-shaped cells was observed in the primary tumor, located at right S8. Immunohistochemical examination showed positive staining of spindle cells for keratin, vimentin, and EMA, but not for desmin. These results indicate that the spindle cells had characteristics of squamous epithelial cells, and differed from carcinosarcoma. Distant metastatic lesions were composed of only the spindle cell component.
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PMID:[A case of spindle cell (squamous) carcinoma (WHO) of the lung]. 180 85

Four hundred episodes of COPD among patients admitted to Chulalongkorn Hospital between 1982 and 1986 were analyzed. There were 193 males and 45 females with 325 and 75 episodes of admission, respectively; the average age on admission was 68.4 +/- 0.5 years. The most significant associated underlying factor was cigarette smoking in 94 per cent of the cases, with the patients smoking an average of 1.15 packs of cigarettes per day for 43 years. In our study, 26.8 per cent of the patients had a cough, with the average age at onset being 47.4 +/- 2.1 years. The most common clinical manifestation was dyspnea with 58.5, 35.2 and 0.5 per cent having dyspnea functional class II, III, IV and with the average age at onset being 61.1 +/- 0.7, 66.6 +/- 0.7 and 71.0 +/- 1.0 years, respectively. An important manifestation on admission was dyspnea functional class III and IV, which were present in of 89 per cent of the cases. The main precipitating factors which led to the patients' admission were upper respiratory tract infection, pneumonia, bronchospasms and congestive heart failure, which accounted for 48.0, 10.0, 8.5, 31.8 and 18.3 per cent of the cases, respectively. With regard to these complications, there were 16.5, 48.3, 31.1 and 12.5 per cent of the patients who suffered respiratory failure requiring assisted ventilation, corpulmonale, polycythemia and peptic ulcer, respectively. Arterial blood gas on admission revealed a pH level of 7.36 +/- 0.1, pCO2 of 53.3 +/- 23.7 torr, and PO2 of 54.2 +/- 19.9 torr.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic obstructive pulmonary disease at Chulalongkorn Hospital: an analysis of 400 episodes. 181 89

Mounier-Kuhn syndrome is a congenital abnormality of the trachea and main bronchi characterized by atrophy or absence of elastic fibers and thinning of muscle, which allows the trachea and main bronchi to become flaccid and markedly dilated on inspiration with narrowing or collapse on expiration or cough. The abnormal airway dynamics and pooling of secretions in broad outpouchings of redundant musculomembranous tissue between the cartilaginous rings predispose to the development of chronic pulmonary suppuration, bronchiectasis, emphysema, and pulmonary fibrosis. A broad spectrum of clinical abnormalities has been documented in Mounier-Kuhn syndrome, ranging from minimal disease with good preservation of pulmonary function to progressive disease leading to respiratory failure and death. In the appropriate clinical setting, Mounier-Kuhn syndrome is diagnosed in women from chest radiographs when the transverse and sagittal diameters of the trachea exceed 21 mm and 23 mm, respectively, and when the transverse diameters of the right and left main bronchi exceed 19.8 mm and 17.4 mm, respectively. In men it is diagnosed when the transverse and sagittal diameters of the trachea exceed 25 mm and 27 mm, respectively, and when the transverse diameters of the right and left main bronchi exceed 21.1 mm and 18.4 mm, respectively. The diagnosis can be confirmed easily by computed tomography.
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PMID:Congenital tracheobronchomegaly (Mounier-Kuhn syndrome): a report of 10 cases and review of the literature. 185 95

Tumor-associated carbohydrate antigens, CA19-9 and SLEX have been used clinically as markers for malignancy. However, it is also known that these antigens are frequently elevated in the serum of patients with benign lung diseases. We have experienced two cases of interstitial pneumonitis with marked increase of carbohydrate antigens in serum, the level of which changed according to their clinical course. Case 1. A 64-year-old woman was admitted because of a cough and exertional dyspnea. Despite treatment with various antibiotics and prednisolone, she died of respiratory failure approximately two months after admission. Her CA19-9 and SLEX in serum elevated from 500 U/ml to 5506 U/ml and 167 U/ml to 1187 U/ml respectively in accordance with clinical deterioration. Autopsy revealed no malignancy. Case 2. A 57-year-old woman, who had been suffering from interstitial pneumonitis associated with rheumatoid arthritis, was admitted with a cough and fever. She responded to prednisolone therapy, however two years later she readmitted because of exacerbation and died of respiratory failure. The initial CA19-9 level in serum was 876 U/ml and dropped to 42 U/ml with prednisolone therapy. The serum antigen level again increased during the period of exacerbation, and showed 133 U/ml immediately before death. An immunohistochemical study of CA19-9 and SLEX in various tissues obtained by autopsy was performed in case 1. The distribution of these antigens in tissue was similar to that of normal individuals. The exceptions were the expression of these antigens on epithelial cells of microscopic honeycombing and on mucinous exudates in air spaces.
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PMID:[Two cases of interstitial pneumonitis with marked increase of tumor-associated carbohydrate antigens in serum]. 188 2

Spinal cord injury increases the risk of many life-threatening medical problems, including respiratory failure, pulmonary embolism, and renal failure. Respiratory failure results from paralysis of muscles of inspiration (which impairs oxygen transport to alveoli) and of expiration (which impairs cough and predisposes to pneumonia and atelectasis). Respiratory failure in patients with spinal cord injury can be prevented by proper positioning of the patient, training of ventilatory muscles, pulmonary toilet, and aggressive use of antibiotics and bronchodilators. When respiratory failure occurs, it can be managed by administration of oxygen, intubation, and mechanical ventilation, and in instances of paralysis of the diaphragm, by diaphragmatic pacing. The risk of deep vein thrombosis and pulmonary embolism in acute spinal cord disease is increased by the immobilization of the patient and abnormalities in clotting factors. Thrombotic disease in spinal cord disease can be prevented by intermittent calf compression and heparinization. If pulmonary embolism develops, the patient should be started on a regimen of warfarin for at least 3 months. If anticoagulation is contraindicated, a Greenfield filter can be placed. However, concurrent use of quad cough places the patient at increased risk for complications from the Greenfield filter. Chronic pyelonephritis and systemic amyloidosis are the most common causes of renal failure in the patient with spinal cord disease. Renal failure can be prevented by maintaining a low postvoid residual volume, avoidance of indwelling catheters, use of medications that are not nephrotoxic, and rapid treatment of infection. Hemodialysis and peritoneal dialysis can extend the life of the patient with spinal cord disease in whom renal failure develops, and successful use of renal transplantation has recently been reported.
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PMID:Medical complications of spinal cord disease. 192 58

Dextromethorphan, a common ingredient in cough syrups, has rarely been described to cause toxicity. The authors describe an unusual case of a known asthmatic presenting with somnolence, who appeared to be in end-stage respiratory failure. Her partial response to routine naloxone, 1 mg, was surprising. However, additional naloxone was required to completely normalize the patient's mental status. The authors suggest naloxone be administered in doses of 0.4 mg or more intravenously in suspected dextromethorphan overdose.
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PMID:Dextromethorphan poisoning reversed by naloxone. 201 93

Various cardiorespiratory and electrophysiological parameters were analysed in a model of acute respiratory failure induced by inhalation of pure nitrogen in approximately 150 anaesthetized cats. Initial hyperventilation leading to apnoea was characterized by extreme hypoxaemia, marked bradycardia and flattening of electrocortical (ECoG) activity. Artificial ventilation applied at the stage of marked mydriasis usually spontaneously prevented cardiovascular failure and normalized vital functions. Up to seven successive apnoeic attacks could be induced in the same cat. During the first 30 or 60 s of apnoea, nasopharyngeal stimulation usually elicited a typical gasp-like aspiration reflex, while tracheobronchial stimulation provoked a weak cough only in 28 and 34% of cases for 30- and 60-s apnoea, respectively. The aspiration reflex could be elicited at very low and even isoelectric ECoG activity, and its periodic provocation (without artificial ventilation) resulted, more frequently than did gasping, in recovery from hypoxic apnoea. Arousal and resuscitation induced by the aspiration reflex can provide a useful model to study the mechanisms of reversible respiratory failure and restitution of vital functions.
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PMID:Hypoxic apnoea induced by N2 inhalation can be reversed by the aspiration reflex in anaesthetized cats. 203 38

Several well controlled epidemiologic and hemodynamic studies suggest that about 20% of sleep apnea syndrome (SAS) patients will have chronic obstructive pulmonary disease (COPD), and the majority of these patients (with combined diseases) will have pulmonary hypertension. Indeed it has been suggested that only patients with underlying hypoxemia, such as that from COPD, will develop right heart failure in the OSA setting. Experience shows that apnea/COPD patients will have severe hypersomnolence associated with the OSA, cough and dyspnea with the airways disease, and edema and plethora related to chronic hypoxemia. Many patients present with respiratory failure and are diagnosed at the time of initial intubation and mechanical ventilation. Episodic nocturnal hypoxemia may be worsened by a steeper rate of desaturation due to lower alveolar and blood oxygen stores, and longer apneas perhaps contributed to by depressed chemosensitivity. Daytime hypoxemia may also add to the severe hemodynamic disturbances. Since COPD cannot be cured, aggressive treatment of SAS is critical. Past studies have shown that tracheostomy or nasal CPAP in this setting not only leads to resolution of episodic nocturnal desaturation but may lead to rapid improvement in daytime oxygenation in many patients. Pulmonary hypertension and other measures of cardiopulmonary function improve when apnea is cured. Elimination of the SAS may disclose nonapneic REM related desaturation that could require supplemental oxygen therapy in addition to tracheostomy or nasal CPAP. Pulmonary function testing in SAS patients with smoking histories, followed by aggressive treatment of SAS, is recommended.
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PMID:Chronic lung disease in the sleep apnea syndrome. 211 88

Miliary tuberculosis presenting as fatal adult respiratory distress syndrome is reported in a 69-year-old man. Idiopathic thrombocytopenic purpura led to splenectomy 2 years before admission and was currently treated with corticosteroids. Moderate dyspnea, a dry cough and weight loss were presenting clinical features, preceding respiratory failure by only a few days. In these patients with atypical symptoms early diagnosis and prompt antituberculous chemotherapy are life-saving. The diagnosis of miliary tuberculosis should be systematically considered in ARDS of unknown origin.
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PMID:Adult respiratory distress syndrome and miliary tuberculosis. 216 16


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