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)

Occult (silent) gastroesophageal reflux disease (GER, GERD) is believed to be an important etiologic factor in the development of many inflammatory and neoplastic disorders of the upper aerodigestive tract. In order ot test this hypothesis, a human study and an animal study were performed. The human study consisted primarily of applying a new diagnostic technique (double-probe pH monitoring) to a population of otolaryngology patients with GERD to determine the incidence of overt and occult GERD. The animal study consisted of experiments to evaluate the potential damaging effects of intermittent GER on the larynx. Two hundred twenty-five consecutive patients with otolaryngologic disorders having suspected GERD evaluated from 1985 through 1988 are reported. Ambulatory 24-hour intraesophageal pH monitoring was performed in 197; of those, 81% underwent double-probe pH monitoring, with the second pH probe being placed in the hypopharynx at the laryngeal inlet. Seventy percent of the patients also underwent barium esophagography with videofluoroscopy. The patient population was divided into seven diagnostic subgroups: carcinoma of the larynx (n = 31), laryngeal and tracheal stenosis (n = 33), reflux laryngitis (n = 61), globus pharyngeus (n = 27), dysphagia (n = 25), chronic cough (n = 30), and a group with miscellaneous disorders (n = 18). The most common symptoms were hoarseness (71%), cough (51%), globus (47%), and throat clearing (42%). Only 43% of the patients had gastrointestinal symptoms (heartburn or acid regurgitation). Thus, by traditional symptomatology, GER was occult or silent in the majority of the study population. Twenty-eight patients (12%) refused or could not tolerate pH monitoring. Of the patients undergoing diagnostic pH monitoring, 62% had abnormal esophageal pH studies, and 30% demonstrated reflux into the pharynx. The results of diagnostic pH monitoring for each of the subgroups were as follows (percentage with abnormal studies): carcinoma (71%), stenosis (78%), reflux laryngitis (60%), globus (58%), dysphagia (45%), chronic cough (52%), and miscellaneous (13%). The highest yield of abnormal pharyngeal reflux was in the carcinoma group and the stenosis group (58% and 56%, respectively). By comparison, the diagnostic barium esophagogram with videofluoroscopy was frequently negative. The results were as follows: esophagitis (18%), reflux (9%), esophageal dysmotility (12%), and stricture (3%). All of the study patients were treated with antireflux therapy. Follow-up was available on 68% of the patients and the mean follow-up period was 11.6 +/- 12.7 months.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. 189 64

Although rarely considered in series of lower airway foreign bodies, endobronchial sutures can cause chronic cough or hemoptysis years after thoracic surgery. Eight endobronchial sutures were found in six patients who had undergone surgery four to 30 years prior to admission. Symptoms began two to 25 years after surgery and lasted from two to six years prior to diagnosis. Cough had been attributed to chronic bronchitis or bronchiectasis in five patients and to tracheal narrowing secondary to surgical repair of tracheomalacia in the sixth. Bronchoscopy was diagnostic in all cases. Suture removal was performed with either forceps or endoscopic suture scissors to cut the suture followed by extraction with forceps. Symptoms resolved within three days and granulation tissue by two to four weeks after suture removal. This series suggests that endobronchial suture should be considered in patients with a history (even remote) of previous thoracic surgery who present with chronic, persistent cough unresponsive to specific therapy for any underlying pulmonary disease.
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PMID:Endobronchial suture. A foreign body causing chronic cough. 142 24

Effects of indoor pollution exposure were evaluated in a general population sample (n = 3,289) living in the Po River Delta area. Prevalence rates of chronic cough in men and dyspnoea in women were significantly higher in association with the use of bottled gas (propane) for cooking instead of natural gas (methane). Chronic cough and phlegm in men and dyspnoea in women were significantly associated with the use of a stove for heating. When combining type of heating and fuel used, in men a trend toward higher prevalence rates of chronic cough and phlegm was shown in those with stove or fan heating (regardless of the fuel); in women the trend reached statistical significance for dyspnoea. The relationship between stove (regardless of fuel) and decrease in forced expirograms was statistically significant only in women. In multiple logistic models, accounting for independent effects of age, smoking, pack-years, parents' smoking, socio-economic status, body mass index, significantly increased odds ratios were found in males for the associations of: bottled gas for cooking with cough (1.66) and dyspnoea (1.81); stove for heating with cough (1.44) and phlegm (1.39); stove fuelled by natural gas and fan or stove fuelled other than by natural gas with cough (1.54 and 1.66). In females, significantly increased odds ratios were found only for dyspnoea when associated with bottled gas for cooking (1.45), stove for heating (1.46), stove fuelled by natural gas (1.58), stove or fan fuelled other than by natural gas (1.73).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of home environment on respiratory symptoms and lung function in a general population sample in north Italy. 193 29

A 42-year-old woman presented with chronic cough and dyspnea. A leiomyoma of the right middle lobe of the bronchus was diagnosed by bronchoscopic biopsy and treated successfully by neodymium-yttrium aluminum garnet laser, via fiberoptic bronchoscope. The presentations of bronchial leiomyoma are mainly due to partial or complete occlusion of the involved bronchus. Symptoms are mainly cough, wheeze, chest pain and fever, as a result of atelectasis, consolidation, collapse or bronchiectasis. The management of this benign tumor of the lung is discussed, and the importance of early diagnosis and conservative therapy are emphasized.
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PMID:Leiomyoma of the bronchus: report of a case successfully treated by Nd-YAG laser via fiberoptic bronchoscope. 198 21

Chronic cough and/or phlegm, wheeze in the absence of colds, and rhinitis attributed to allergies are three of the most common respiratory symptoms encountered in community populations. In this study, we have determined the prevalence of these complaints in a random population sample (n = 1,109) using standardized questionnaires at two points in time, eight years apart. Cross-sectional prevalence and changes in symptom occurrence have been correlated with smoking status, allergen skin test reactivity, and total serum IgE levels. Our objective was to determine the individual and combined influence of these three variables on symptom prevalence. Initially, 19.2 percent of the population admitted to wheeze, 17.9 percent to cough, and 44.1 percent to allergic rhinitis. Cough and wheeze prevalence changed little over the eight-year period, while rhinitis increased 11 percent by the second survey. The occurrence of chronic cough was strongly correlated with smoking, and was not further influenced by either allergen skin reactivity or IgE level. Conversely, rhinitis prevalence was related to skin test reactivity with no additional association with smoking or IgE level. The occurrence of wheeze in the absence of colds was associated with both smoking and allergen skin reactivity. Among smokers, the prevalence was over 30 percent and was similar in both skin test positive (STP) and skin test negative (STN) individuals. However, on both surveys, STP ex-smokers and nonsmokers had significantly more wheeze than those who were STN. While the prevalence of wheeze in STN nonsmokers was low (6.8 percent), an IgE-wheeze relationship was also suggested on the second survey. In addition to these cross-sectional symptom relationships, changes in either smoking status or allergen skin reactivity during the study period were associated with changes in the prevalence of each symptom.
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PMID:A longitudinal study of respiratory symptoms in a community population sample. Correlations with smoking, allergen skin-test reactivity, and serum IgE. 198 38

Fiberoptic bronchoscopy (FB) has a low yield in the diagnosis of chronic cough (greater than 3 weeks) in unselected patients. We assessed the yield of FB for cough during a four-year period in patients with nonlocalizing chest roentgenograms who were refractory to diagnostic efforts and empiric bronchodilator or antitussive therapy. Seven (28 percent) of 25 patients undergoing FB for cough (of greater than 1,500 bronchoscopies) had diagnostic findings (broncholithiasis, two; tracheobronchopathia osteochondroplastica, two; and tuberculous bronchostenosis, laryngeal dyskinesia, and arytenoid polyp, one each). No tracheobronchial neoplasms were detected. Age greater than 50 years and female sex independently predicted positive results (p = 0.02 Fisher's exact test), while duration of cough (two to 240 months), airflow, and smoking status did not. When patients with prior pulmonary or extrathoracic neoplasms were excluded, seven (35 percent) of 20 studies were diagnostic. Diagnoses potentially could have been made by thoracic computed tomographic scanning in four patients and indirect laryngoscopy in two. Fiberoptic bronchoscopy has a respectable yield for diagnosis of refractory chronic cough and is a reasonable procedure in carefully selected patients.
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PMID:Fiberoptic bronchoscopy for refractory cough. 178 48

A questionnaire study was conducted to assess the prevalence and severity of symptoms suggestive of esophageal disorders in a general population. The study included 407 randomly selected subjects, evenly distributed in terms of sex and age, within the age span of 20-79 years. A total of 337 subjects replied (85%). Symptoms suggestive of gastroesophageal reflux were found among 25% of the participants. Cough on swallowing was common (27%), as was globus (16%) and chest pain (13%). In addition, dysphagia was reported by 10% and vomiting by 9%. The symptoms were usually mild, and moderate to severe symptoms were reported only occasionally (1-4%). No statistical correlation was found between esophageal symptoms and age, sex, or the reported consumption of tobacco, alcohol, or non-steroidal anti-inflammatory drugs. The frequency of heartburn and/or acid regurgitation was twice as common among those with symptoms of respiratory disease as among those with no respiratory complaints. A stepwise logistic regression analysis showed that a chronic cough and/or breathing difficulties were significantly related to the presence of symptoms suggestive of gastroesophageal reflux.
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PMID:The prevalence of symptoms suggestive of esophageal disorders. 200 1

Prevalence rates of respiratory symptoms and diseases in a large group of Anglos and Mexican-Americans were analyzed. Each subject completed a questionnaire. Among current smokers, chronic productive cough and dyspnea were significantly higher in both ethnic groups; wheezy symptoms were higher in Anglos. There were no significant differences in the symptom prevalence rates between the two groups, after stratifying by current cigarette consumption and CRT. The spirometric values were not significantly different. In both ethnic groups, the prevalence rates of wheeze, SOBWHZ and asthma were significantly higher in those who had CRT. Among Anglos, less educated smokers had significantly higher prevalence rates of SOBWHZ and dyspnea; nonsmokers with less education had higher prevalence rates of cough, chronic cough and dyspnea. Our results confirm the importance of CRT and lower educational level as risk factors for respiratory symptoms. Ethnicity is not associated with symptomatology or lung function impairment.
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PMID:Respiratory symptoms and risk factors in an Arizona population sample of Anglo and Mexican-American whites. 200 95

Cough is a symptom frequently encountered by the otolaryngologist--head and neck surgeon. Although most coughs are self limited, chronic cough often proves to be a frustrating problem. Seventy-two infants and children under age 16 with a normal chest radiogram have now been evaluated for chronic cough persisting for longer than 4 weeks. Cough-variant asthma was the most common cause of cough, followed by sinusitis, gastroesophageal reflux, aberrant innominate artery, psychogenic cough, and subglottic stenosis. Chronic cough is best managed by first following an individualized diagnostic protocol designed to determine the etiology of the cough. This is followed by specific therapy to treat the underlying disorder. Children with persistent cough and normal chest radiograph are best served when referred promptly for evaluation by an otolaryngologist when the primary physician's initial efforts at diagnosis and treatment are not effective. Endoscopy is underutilized in practice and its importance understated in the literature. It is particularly helpful in establishing a precise diagnosis in infants under 18 months of age.
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PMID:Chronic cough in infants and children: an update. 204 39

Disagreement exists on how to define asthma in population studies. Features characteristic of asthma also have been demonstrated in nonasthmatic subjects. For example, although in a random sample of 339 subjects investigated in the Netherlands, subjects with a history of asthmatic attacks, wheeze and/or dyspnea, or chronic dry cough on average were the most responsive (mean PD20 values for histamine of 11.5, 17.0, and 15.0 mg/ml) and asymptomatic subjects were the least responsive (mean PD20, 45.4 mg/ml), the distributions of PD20 values in all groups overlapped considerably. The best way to investigate the association between exposure and disease is in a cohort study. It is argued that follow-up studies in patients may have limited meaning because of a high risk for selection bias. Furthermore, in general, diagnostic disease entities will not represent homogeneous exposure groups. It is concluded that end points of disease should be defined as objectively as possible, for instance, as the level of FEV1, or as simple respiratory symptoms such as dyspnea, wheeze, or chronic cough. Terms such as "asthma," "COPD," or "CNSLD" will not be helpful in defining end points because there is a risk that they could introduce bias, misclassification, and hence confusion.
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PMID:Is it useful to distinguish between asthma and chronic obstructive pulmonary disease in respiratory epidemiology. 204 37


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