Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of postural drainage, exercise, and cough on mucus clearance were compared in 8 patients with chronic bronchitis. A bolus of 99mTc albumin aerosol was inhaled at a high inspiratory flow rate to enhance proximal deposition. Retention of deposited aerosol in the lung, as a function of time, was quantified using a gamma camera and subsequent computer analysis. Coughing greatly accelerated total lung (P less than 0.005) and peripheral (P less than 0.005) mucus clearance. Exercise resulted in much smaller changes than did cough, but significantly increased total lung clearance (P less than 0.005). Postural drainage in which coughing was prohibited did not alter clearance. These results have therapeutic implications and stress the importance of controlling cough when evaluating therapeutic interventions by these techniques.
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PMID:Effects of postural drainage, exercise, and cough on mucus clearance in chronic bronchitis. 50 5

Pulmonary radioaerosol distribution at different inhalation regimens was studied in 11 patients with chronic nonspecific pulmonary disease and 28 individuals without respiratory abnormalities by radionuclide assay by employing 99mTc-labelled human albumin. Respiration rate had the most significant action on the penetration of inhaled particles in the preset values. During inhalation, cough was an important determinant of inhaled aerosol distribution. Causes of these influences are considered in the paper.
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PMID:[Effect of various factors on the distribution of inhaled substances]. 178 Dec 23

Animal studies have shown that frequent coughing may damage the mucociliary apparatus in flow-limiting segments of the central airways. To determine whether mucociliary clearance in humans is affected by repeated dynamic compression associated with forced expirations, we measured pulmonary deposition and mucociliary clearance for 2 h of inhaled [99Tcm]albumin. The subjects inhaled [99Tcm]albumin on 2 study days (randomized) using (A) slow inspirations and forced expirations, while inhalation using (B) forced inspirations and slow expirations served as control. The study was conducted using 10 patients with chronic hypersecretory/obstructive bronchitis and six normal subjects. We found that inhalation of [99Tcm]albumin by the two manoeuvres (A and B) resulted in similar patterns of aerosol deposition. There was no significant difference in retention of radioactivity in the central lung region at 1 h in the patients with chronic bronchitis after inhalation with manoeuvre A (102%) and with manoeuvre B (91.5%), or in the healthy subjects after manoeuvre A (74%) and manoeuvre B (77%). There was also no difference in the retention at 2 h or in overall mucociliary clearance in any of the groups. We conclude that dynamic compression in the central airways associated with forced expiration does not affect bronchial clearance in the airways of healthy subjects or in patients with chronic bronchitis.
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PMID:The effect of forced expirations on mucociliary clearance in patients with chronic bronchitis and in healthy subjects. 193 40

In order to characterize intraluminal airway inflammation in subjects with chronic bronchitis, bronchoscopy and bronchoalveolar lavage were performed in 28 subjects with chronic bronchitis with fixed airway obstruction and, for comparison, 15 asymptomatic smokers and 25 normal nonsmoking volunteers. The chronic bronchitics had a cough productive of sputum on most days of the month for 6 months in the preceding 2 yr, had at least one exacerbation requiring medical intervention in each of the previous 2 yr, and had an FEV1 less than 76% of predicted without response to bronchodilator. During bronchoscopy the airways were assessed for visual evidence of inflammation by assigning them a score, the bronchitis index, that graded the airways according to the apparent severity of airway edema, erythema, friability, and secretions. Bronchoalveolar lavage was performed by sequentially instilling and retrieving with gentle suction five 20-ml aliquots of sterile normal saline into each of three separate lobes. The first aliquots, the "bronchial" sample, were pooled and processed separately from the final four aliquots, the "distal" sample. Cell counts, cell differentials, and albumin were determined for both the bronchial and distal samples. In order to correlate inflammation with clinical parameters, sputum was collected for 24 h prior to bronchoscopy; spirometry was performed just prior to bronchoscopy, and smoking histories were obtained. Visual inspection of the airways, as quantified by the bronchitis index, demonstrated significantly more evidence for inflammation in the chronic bronchitics than in either the asymptomatic smokers or the normal subjects. The bronchial sample lavage fluids from the chronic bronchitics tended to contain more cells (6.1 +/- 2.2 x 10(6) cells) than the bronchial sample fluids from the asymptomatic smokers (3.6 +/- 0.6 x 10(6) cells) or normal subjects (3.7 +/- 0.5 x 10(6) cells). Furthermore, the chronic bronchitics had a higher percentage of neutrophils in their bronchial lavage fluid (35.8 +/- 5.6%) than did either the asymptomatic smokers (20.7 +/- 2.6%, p = 0.0001) or the normal subjects (10.3 +/- 5.6%). The distal sample lavage fluid also recovered more neutrophils from both the chronic bronchitics (15.0 +/- 4.2%, p = 0.0012) and asymptomatic smokers (5.7 +/- 1.3%, p = 0.002) than from the normal subjects (2.8 +/- 0.4%). The chronic bronchitics were divided into two groups: those with low (less than 20%) and those with high (greater than 20%) bronchial sample neutrophils. Those with higher bronchial sample neutrophils had significantly more sputum production and lower FEV1, FEV1/FVC, and FEF25-75 than did the subjects with lower bronchial sample neutrophils.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Intraluminal airway inflammation in chronic bronchitis. Characterization and correlation with clinical parameters. 260 84

Thirty-two workers in an electroplating plant accidently drank water contaminated with nickel sulfate and chloride (1.63 g Ni/liter). Twenty workers promptly developed symptoms (e.g., nausea, vomiting, abdominal discomfort, diarrhea, giddiness, lassitude, headache, cough, shortness of breath) that typically lasted a few hours but persisted 1-2 days in 7 cases. The Ni doses in workers with symptoms were estimated to range from 0.5 to 2.5 g. In 15 exposed workers who were tested on day 1 postexposure, serum Ni concentrations ranged from 13 to 1,340 micrograms/liter and urine Ni concentrations ranged from 0.15 to 12 mg/g creatinine. Ten subjects (with initial urine Ni concentrations greater than 0.8 mg/g creatinine) were hospitalized and treated for 3 days with intravenous fluids to induce diuresis, resulting in a mean elimination half-time (T1/2) for serum Ni of 27 hours (SD +/- 7 hour), which was significantly shorter (p less than .001) than the mean T1/2 of 60 hours (SD +/- 11 hours) in 11 subjects who did not receive intravenous fluids. Laboratory tests showed transiently elevated levels of blood reticulocytes (N = 7), urine albumin (N = 3), and serum bilirubin (N = 2). All subjects recovered rapidly, without evident sequellae, and returned to work by the eighth day after exposure.
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PMID:Acute nickel toxicity in electroplating workers who accidently ingested a solution of nickel sulfate and nickel chloride. 318 43

The study is a retrospective analysis of the clinical features of 122 patients from Finland, whose serum showed in immunoelectrophoresis (IEP) a cathodic elongation of the albumin line, "tailing albumin" (TA), not associated with an M-component. One hundred and seventeen of these cases were found among about 40,000 consecutive routine serum IEP examinations in two laboratories during 1967-1980. Five further cases were detected during the collection of the control series. Only a few TA cases of corresponding type have been reported from elsewhere. Previous studies of some of the patients of the present series had shown that the TA phenomenon was due to complexes between albumin and IgG class autoantibodies against albumin. Clinical data were collected mainly from the hospital records. The chest radiographic findings were classified by the ILO (International Labour Office) method. The author herself examined 33 of the patients during the current disease or during the follow-up. One hundred and ten patients were followed up for a period of three months to nine years (mean 2.5 years). The patients were mostly elderly, and 93% of them were women. Most of the patients had one or more previously diagnosed chronic illnesses, for which they were receiving one or several drugs as long-term therapy. Eighty percent of the patients were receiving nitrofurantoin (NF) as prophylaxis for recurrent urinary tract infections. However, urinary tract infection was not a current problem in any of the cases. There was evidence of a role of NF in the development of both the immunologic abnormalities and the clinical disease in the TA patients. On the basis of long-term NF treatment the patients were divided into two groups: 1) 97 patients with NF therapy (NF+ group) and 2) 25 patients without NF therapy (NF- group). The patients had mostly undergone the examinations because of cough, dyspnoea, and general symptoms (fatigue, weakness, malaise, loss of weight). The symptoms had usually started insidiously, and in 50% of the patients they had lasted for at least three months. Eight of the patients had been hospitalized because of various acute diseases (e.g. cerebral stroke). Ten of the patients were subjectively symptomless. The most common pathologic laboratory findings were high erythrocyte sedimentation rate (over 100 mm/h in 47%), IgG class antinuclear antibodies (in 88%; the titre was greater than or equal to 1000 in 56%), high serum IgG (mean 30.6 g/l), and elevated levels of serum aminotransferases (in 54% of the patients examined).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Immunoelectrophoretic tailing albumin phenomenon. Associations with clinical characteristics of the patients and with nitrofurantoin treatment. 320 74

We performed bronchoalveolar lavage in a patient with pulmonary lymphoma and IgM lambda monoclonal serum gammopathy previously not diagnosed accurately by histologic examination and not treated for 5 yr after detection of a pulmonary infiltrate. The infiltrate increased slowly in size accompanied by coughing and sputum and a gradual increase in serum IgM throughout the 5-yr period. High IgM in the lavage fluid was noted with an IgM/albumin ratio 4.8 times higher in the lavage fluid than in the serum. Protein immunoelectrophoresis of the lavage fluid was identical to that of the serum. A primary pulmonary lymphoma was diagnosed on the basis of findings in the lavage fluid. The patient showed decreased serum IgM and marked improvement of the infiltrate by chemotherapy and radiation. Thus, bronchoalveolar lavage, including analysis of the proteins in lavage fluids, appears to be a simple and useful method for diagnosing primary pulmonary lymphomas.
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PMID:Bronchoalveolar lavage in primary pulmonary lymphoma with monoclonal gammopathy. 335 5

Clinical studies were performed in 27 consecutive patients with high-altitude pulmonary edema who were transported from the mountains to Shinshu University Hospital, Matsumoto, Japan. The altitude of onset was 2,680 m to 3,190 m above sea level. Symptoms included marked dyspnea, cough, and stridor. Physical findings included cyanosis, tachycardia, and rales. Neurologic disturbances, which were seen in 17 patients, included headache, vomiting, memory disturbance, clouding of consciousness, or coma. Chest roentgenograms revealed patchy infiltrates throughout the pulmonary fields, often in an asymmetric pattern, and enlargement of the right ventricle. Hemodynamic studies by right cardiac catheterization showed that high-altitude pulmonary edema was noncardiogenic. Scintiscans of the lungs with technetium-99m-macroaggregated albumin (99mTc-MAA) performed in one patient showed decreased perfusion of 99mTc-MAA in the area of infiltrates. Pulmonary edema fluid collected through the endotracheal tube in two patients was rich in protein. Computerized tomograms of the brain showed small ventricles and cisterns, disappearance of sulci, and diffuse low density of the cerebrum, indicating cerebral edema in eight of nine cases. Retinal hemorrhage and papilledema were observed in five patients.
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PMID:Clinical features of patients with high-altitude pulmonary edema in Japan. 366 94

We investigated in a double-blind study the acute effect of the inhaled beta 2-adrenergic agent salbutamol on mucociliary clearance in man. Subjects were 20 patients with chronic bronchitis (10 receiving the drug and 10 placebo) and 6 healthy individuals (3 receiving the drug and 3 placebo). Mucociliary clearance was evaluated after inhalation of a pressurized 99mTc-labelled a albumin aerosol (median mass aerodynamic diameter 2.85 microns). Particle deposition and clearance was determined by external recording with a large-field gamma camera and dedicated computer, for three consecutive hours without moving the subject. After 1 h baseline clearance recording the subject was given either salbutamol (500 micrograms) or vehicle alone from a commercial pressurized nebulizer; recording was then continued for a further 2 h (test period). Both patients and normals treated with salbutamol showed a significant increase in the rate of clearance when compared with their respective control group receiving placebo. Clearance rates (percentage activity cleared per hour) from the lungs in the hour after salbutamol inhalation averaged 33.1% +/- 13.5 (SD) per hour, for patients (control 12.2% +/- 5.6 (SD) per hour, p less than 0.001) and 16.1% +/- 4.3 (SD) per hour for normals (control 7.8% +/- 2.0 (SD) per hour, (p less than 0.005). Significant differences were also found in clearance rate before and after salbutamol inhalation in both treated groups. Cough events did not produce any significant effect on average mucociliary clearance. However, visualization of serial computer images in individual patients showed that cough may generate appreciable upward, downward or even lung-to-lung movements of radioactive boli.
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PMID:Acute effect of inhaled salbutamol on mucociliary clearance in health and chronic bronchitis. 672 56

Angiotensin-converting enzyme (ACE) inhibitor therapy has recently been shown to be effective in the treatment of post-renal transplant erythrocytosis (PTE). In an attempt to assess the effect of drug treatment on serum erythropoietin level, glomerular filtration rate, and urinary protein excretion, we prospectively evaluated 8 consecutive cadaveric renal transplant recipients with PTE treated with ACE inhibitor therapy for 3 months. In response to ACE inhibition, the mean hematocrit (HCT) value decreased from 53.7 +/- 0.6% before treatment to 42.7 +/- 2.2% at the conclusion of the study (p = 0.03). However, 1 patient failed to respond to ACE inhibition (HCT > 50%), and 2 patients with PTE developed anemia (HCT < 35%) while maintained on drug treatment. Although the mean serum erythropoietin level decreased during ACE inhibition (from 22.8 +/- 8.4 to 9.4 +/- 5.3 mU/ml; p = 0.06), a consistent change in individual erythropoietin levels was not identified. At the conclusion of the study, the serum erythropoietin levels were undetectable in 4 patients, decreased in 1, unchanged in 2, and increased in the only patient with PTE who failed to respond to drug treatment. All patients tolerated the ACE inhibitor therapy without developing cough or hyperkalemia. In addition, serum creatinine levels, 125I-iothalamate clearances, and mean arterial blood pressures were unchanged throughout the study. Microalbuminuria (spot urinary albumin/creatinine ratio between 30 and 200 mg/g) developed in 5 patients with PTE and coincided with the onset of erythrocytosis (25.2 +/- 7 mg/g before PTE and 76.3 +/- 36.7 mg/g at the time of PTE detection).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Association of post-renal transplant erythrocytosis and microalbuminuria: response to angiotensin-converting enzyme inhibition. 757 90


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