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

In order to tackle the problems of underdiagnosis and undertreatment of asthma in childhood general practitioners need to be aware of which children in their practices have or might have asthma. In an effort to identify a cohort of asthmatic or potentially asthmatic children a trained audit facilitator studied all the medical records of children aged between one year and 15 years who were registered with 12 Tayside general practices. From a total of 10,685 medical records the frequency of 'key items' sometimes associated with asthma were as follows: one or more episodes of bronchospasm or wheeze 23.7% of children, persistent cough 23.2%, treatment with anti-asthma therapy in the past 20.0%, exercise induced cough or wheeze 5.2% and history of 'wheezy bronchitis' 4.6%. However, in only 896 children (8.4%) had a formal diagnosis of asthma been made. Of all the children, 5.4% had received a prescription for anti-asthma medication within the past three months. Only 1.2% were taking an inhaled corticosteroid and 1.0% sodium cromoglycate, but many more were taking inhaled bronchodilators (3.1%) and oral bronchodilators (1.7%). The findings suggest that a systematic review of medical records by a trained facilitator can identify those children who could benefit from clinical review. Practices who wish to know which of their children have or might have asthma should consider using medical record review to search for key items associated with asthma.
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PMID:Diagnosis and treatment of asthma in children: usefulness of a review of medical records. 129 69

To assess the immunoclinical effectiveness of a biological response immunomodulator, we used AM3 (glycophosphopeptide ), a glucomannan polysaccharide extracted from the cell wall of a strain of Candida utilis, in 20 children with asthmatic bronchitis. They received 2 envelopes (1 g) daily for 4 months. The results were compared with a control group of 20 untreated children with the same pathology. The following clinical and immunological parameters were assessed in all of them: cough, dyspnea, expectoration, frequency and intensity of the bronchospasm, time of administration of the symptomatic medication, and the delayed cutaneous cells response by means of the intradermal reaction of 5 antigens (Trichophyton, Candida albicans, tuberculin, E. coli and bacterial antigens). In the treated group, the immunoferon (AM3) reduced the symptoms, the intensity and frequency of the bronchospasm, and the symptomatic medication (table I, II and III). In basal conditions, the 40 children presented a state of 75% anergy; after 4 months of treatment, the treated group experienced a 45% decrease in their anergic situation, variation which was statistically significant when compared with the control group. In our 20 treated patients, AM3 behaved like and immunostimulant, improving the clinical situation and progress in patients with infectious respiratory disorders. We consider that the immunoferon constitutes a coadjuvant therapy to bacterial immunotherapy.
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PMID:[Immunologic clinical evaluation of a biological response modifier, AM3, in the treatment of childhood infectious respiratory pathology]. 150 86

Rhinoviruses (HRVs) were isolated from 307 children (7.1%) in the virological surveillance of 4334 children with acute respiratory tract illnesses in Morioka, Japan (September 1973-December 1983). Although HRVs were isolated throughout the year, frequency of HRV infection was significantly higher (p less than 0.001) during the April-November (233/2853; 8.2%) than during the December-March (47/1481; 5.0%). There were two peaks of incidence in May (9.5%) and September (9.1%). During the May-September, the rate of HRV infection was higher in patients under the age of 11 months than the next higher group of 1-2 years old (p less than 0.001). The incidence decreased with increasing age. The illnesses of HRV infection were analysed in 294 patients, except one patient who had symptoms of measles, from whom HRV was isolated singly. Although HRV-associated illnesses were generally mild (57.5%). Upper respiratory tract illnesses (URTIs) with fever were found in 22.1% and lower respiratory tract illnesses (LRTIs) in 20.4% of these. The rate of LRTI was higher during the epidemic period (April-September) than other periods (p less than 0.02). Major symptoms of HRV-associated illnesses observed were sore throat (87.4%), cough (84.0%), and nasal obstruction and/or discharge (72.8%). Wheezing was observed in 21.8% of these. From 19 (21.8%) of 47 patients clinically diagnosed as asthmatic bronchitis in this survey, viruses were isolated. HRV was detected most frequently in 12.8% of these patients, followed by respiratory syncytial virus (RSV, 6.4%) and adenovirus (2.1%). HRV- and RSV-associated asthmatic bronchitis were observed during April-September and November-February, respectively. Viral dual infections were detected in total 20 cases included 12 HRV-associated cases. In no case was the illness of greater severity than might have been caused by either agent acting singly.
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PMID:[Virological surveillance of acute respiratory tract illnesses of children in Morioka, Japan. II. Rhinovirus infection]. 166 66

States of airflow obstruction are common disorders which span the spectrum from asthmatic-chronic bronchitis to emphysema. Asthmatic and chronic bronchitic states are at least potentially reversible by systematic, pharmacologically oriented therapy focusing on bronchodilators and corticosteroids. Both asthmatic bronchitis, particularly when it is not adequately treated, and emphysema result in the final common pathway of COPD. These are generally progressive states, unless smoking cessation can be achieved in early or mild stages of disease. The future focuses on the great challenge of early identification, classification, and intervention. Thus, all patients with cough, dyspnea, and wheeze should be carefully evaluated by health workers who understand the history, physical examination, and simple pulmonary function tests in the context of chest radiology. These clinical methods together can help define the disease states characterized by airflow obstruction. Often, a final definition of disease cannot be made until aggressive attempts at the treatment of the airflow obstruction and its attendant symptoms complex have been vigorously pursued by experienced clinicians.
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PMID:Definitions in chronic obstructive pulmonary disease. 220 36

Anamnestic findings and clinical signs of wheezing attacks, which respond to beta-2-agonists, are the most important criteria in deciding whether a wheezy bronchitis is already a part of bronchial asthma. In this scope advanced lung function testing permits to search for functional abnormalities already in early childhood. Clinically, a study, carried out in ten ambulatory practices on about 1000 schoolchildren has shown that three diagnostic elements have to be distinguished. An "obstructive element" is based on the presence of clinical signs like cough, wheezing and rales. The "chronic element" is defined by the duration of the wheezing attacks and the number of attacks. Finally a third element, the "pulmonary hyperinflation" must clinically be recognized. The critical goals in the long term management of children with asthma are freedom of symptoms and optimal lung function. In this approach stratification into different aetiopathogenetic groups based on anamnestic, clinical and immuno-allergic findings is helpful and the follow-up of subclinical functional sequelae must be considered by repeated lung function tests. Only by these measures can the ongoing immuno-allergic process of airway inflammation be handled.
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PMID:[Etiopathogenetic aspects of allergic pulmonary diseases in childhood]. 279 37

During September-November, 1985, four employees of a factory were seen at the occupational clinic complaining of cough, shortness of breath, and wheezing. All four worked in the same area of the factory where an adhesive containing toluene diisocyanate (TDI) was applied to velcro-like tape during manufacturing. To confirm the diagnosis of TDI-induced asthma and determine the prevalence among workers, 38 workers were interviewed and examined (84%) in the factory. Air samples were also taken from several areas in the factory to determine the TDI concentration. For analysis, the factory was divided into three areas based on the concentration of TDI: low (0.012 +/- 0.002 ppm), medium (0.021 +/- 0.006 ppm), and high (0.047 +/- 0.054 ppm). The distribution of workers with symptoms of asthmatic bronchitis was highly associated with TDI concentration (p less than 0.001). After stopping work for a period of 10 days, workers in areas with a high concentration of TDI showed marked improvement in pulmonary function tests (PFTs). After isolation of the exposure site, improvement of the ventilation system, and substitution of the TDI with less volatile diphenylmethane diisocyanate (MDI), air concentration of isocyanates was usually below 0.007 ppm. Three of the four clinically overt asthma cases went back to work without any difficulty. The PFTs of affected workers showed a significant improvement 5 months later. We conclude that TDI was responsible for the occupational asthma among velcro-like tape manufacturers and that the TDI-induced impairment of pulmonary functions was at least partially reversible.
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PMID:Occupational asthma due to toluene diisocyanate among velcro-like tape manufacturers. 284 49

A questionnaire concerning health and living conditions was sent to the parents of 1387 children aged 0-15 years to answer the question if children living in homes built with large amounts of particle board had more headaches and respiratory and skin symptoms than other children. There were 1376 possible respondents, and of those 1036 (75.3)% returned the questionnaire. Of the questionnaires returned, 972 (70.6%) were analyzable. The children lived in homes with much particle board (group A); little particle board, or homes as group A but treated in a special way (group B); and homes with no particle board (group C). For the 0- to 5-year-old children, living in homes with much particle board was a risk factor for developing wheezy bronchitis, eye and nose irritation, and coughing. For the 6- to 15-year-old children, living in a home with much particle board was not a risk factor. Risk factors for headache, irritation of the throat, and need for daily antiasthmatic medication were analyzed for all the children collectively. Living in a home with much particle board was a risk factor for all three conditions.
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PMID:Is particle board in the home detrimental to health? 292 55

The efficacy of nebulised sodium cromoglycate (SCG) used as a prophylactic treatment of wheezy bronchitis in children aged 1 to 4 years was evaluated in a multicentre double-blind placebo controlled, group comparative study. Fifty-four patients completed the 10-week trial (29 treated with SCG and 25 treated with placebo), preceded by 4-8 weeks baseline. Nebulised SCG did not prove significantly superior to placebo in reducing day wheezing, day coughing, or sleep disturbance due to wheezing or coughing at night. Neither was there significant difference in the use of supportive medicine (beta 2-agonist and theophylline) between the groups. Extra doctor visits, hospital admissions, and parental preference did not show significant difference either.
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PMID:Nebulised sodium cromoglycate in the treatment of wheezy bronchitis. A multicentre double-blind placebo controlled study. 309 89

The link between chest illnesses in childhood to age 7 and the prevalence of cough and phlegm in the winter reported at age 23 was investigated in a cohort of 10,557 British children born in one week in 1958 (national child development study). Both pneumonia and asthma or wheezy bronchitis to age 7 were associated with a significant excess in the prevalence of chronic cough and phlegm at age 23 after controlling for current smoking. This excess was largely attributable to the association of cough and phlegm at age 23 with a history of asthma or wheezy bronchitis from age 16. When adjustment was made for recent wheezing, current cigarette consumption, previous smoking habit, and passive exposure to smoke the relative odds of cough or phlegm, or both, in subjects with a history of childhood chest illness was 1.11 (95% confidence interval 0.97 to 1.27). When analysed separately asthma, wheezy bronchitis, and pneumonia up to age 7 did not significantly increase the prevalence of either cough or phlegm. The explanation for the observed continuity between chest illness in childhood and respiratory symptoms in later life may lie more in the time course of functional disturbances related to asthma than in the persistence of structural lung damage.
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PMID:Asthma as a link between chest illness in childhood and chronic cough and phlegm in young adults. 312 62

44 children under 2 years of age suffering from recurrent or persistent wheezy bronchitis, completed a double-blind crossover trial comparing nebulised sodium cromoglycate and matching placebo. Analysis showed that treatment response was age-related. Sodium cromoglycate proved significantly superior to placebo in reducing night cough, sleep disturbance, wheeze and activity limitation in the 24 patients aged 12 months and above (mean 17.3) on entry to the study. Whereas no significant differences were observed in the 20 children below 12 months of age (mean 8.3). These findings were confirmed by weekly clinical assessment. Both age groups spent fewer days in hospital during the active treatment period. Final subjective assessments showed that the older age group, parents favoured cromoglycate treatment, whereas in the younger age group, parents favoured placebo, although neither reached statistical significance. Both age groups showed marked placebo response to nebulised water.
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PMID:Nebulised sodium cromoglycate in the treatment of wheezy bronchitis in infants and young children. 681 Apr 23


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