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

We examined the reproducibility of capsaicin-induced cough thresholds and the influence of pharynx anaesthesia used to treat the cough. We performed cough threshold tests on ten patients with bronchial asthma and ten patients with chronic cough. The lowest level of capsaicin-induced cough threshold was defined as ten coughs. Tachyphylaxis in cough thresholds was examined three times at intervals of 30 minutes and 120 minutes after the initial test. We measured cough thresholds before and after pharynx anaesthesia with xylocainbiscus. There was no change in cough thresholds among the three times; nor was them any change in the thresholds before and after pharynx anaesthesia. But in five patients with acute pharyngitis, the cough thresholds after pharynx anaesthesia were greater than before. It was suggested that cough threshold tests had reproducibility 30 minutes and 120 minutes after indicating that tachyphylaxis did not exist. Furthermore it was suggested that pharynx anaesthesia influenced the cough threshold in patients with acute inflammation of the pharynx, but anesthesia had no influence on cough thresholds in patients without acute inflammation of the pharynx.
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PMID:[Capsaicin-induced cough. Tachyphylaxis and the effect of anaesthesia on the pharynx]. 769 79

Psychogenic cough is a barking or honking cough, which is persistent and disruptive to normal activity. The cough may be a debilitating condition that interferes with work and social relationships. Although the frequency of this condition is low, it is not rare. The majority of cases reported involve pediatric or adolescent patients. Surprisingly, there are scant data describing this condition in the adult population and no reports of biofeedback being used to treat this syndrome. We present a case report of an adult patient with psychogenic cough and review the available pediatric and adult literature. A 41-yr-old obese female presented with a complex 7-yr history of intractable, nonproductive, chronic cough. She had been avoiding social activities because of embarrassment by her repeated episodes of coughing. Extensive diagnostic work-up failed to find an organic etiology. Numerous medical and surgical treatments had failed. The patient was treated with a combination of biofeedback-assisted relaxation training, psychotherapy, and physical therapy. Review of the literature revealed only one report on adults, in which three of four patients were successfully treated with a combination of speech therapy, relaxation techniques, breathing exercises, and psychotherapy. Our success suggests a possible future use of this treatment protocol for cases of psychogenic cough.
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PMID:Psychogenic cough treated with biofeedback and psychotherapy. A review and case report. 771 Jul 31

Gastroesophageal reflux may be responsible for atypical symptoms such as chronic cough and hoarseness. Our aim was to evaluate and treat patients with severe gastroesophageal reflux and chronic cough or hoarseness with intensive antireflux therapy. Twenty-seven patients with typical heartburn symptoms in addition to significant cough or hoarseness were treated with aggressive antireflux therapy. We recorded the response of each symptom to the antireflux therapy. Two patients were lost to follow-up. Twenty of the 25 (80%) patients showed some improvement in cough or hoarseness, nine (36%) had no atypical symptoms at follow-up. The response of heartburn to therapy was strongly predictive of successful therapy for the atypical symptoms. Cough and hoarseness improved in only two of the five patients with residual heartburn symptoms compared to 18 of 20 patients with no heartburn (P < 0.04). Only patients with no heartburn symptoms at follow-up had complete resolution of atypical symptoms. There were no important differences on ambulatory pH monitoring between partial and complete responders. Improvement in atypical reflux symptoms, such as chronic cough and hoarseness, is common with aggressive antireflux therapy. There are no findings on ambulatory esophageal pH monitoring that uniquely identify patients who are likely to respond to antireflux therapy.
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PMID:Chronic cough and hoarseness in patients with severe gastroesophageal reflux disease. Diagnosis and response to therapy. 772 70

Studies concerning the respiratory effects of oil mists are sparse and contradictory. The aim of this study was to determine the respective effects of occupational exposure to straight cutting oils and soluble mineral oils on the prevalence of respiratory symptoms, ventilatory impairment, and bronchial reactivity. The population study consisted of 308 male workers of a large French car-making plant, including 40 subjects chronically exposed to straight cutting oils (group S), 51 subjects chronically exposed to soluble mineral oils (group E), 139 subjects with chronic dual exposure to straight cutting oils and soluble mineral oils (group D), and 78 unexposed assembly workers used as a control group (group C). Worker evaluation included a standardized questionnaire, measurement of pulmonary function, and a methacholine challenge. Oil mist concentration at the work place was determined by gravimetric analysis. The arithmetic mean concentration was 2.6 +/- 1.8 mg/m3. The geometric mean concentration was 2.2 +/- 1.9 mg/m3. The prevalence of respiratory symptoms did not differ significantly among the four groups. However, the subjects exposed to straight cutting oils (group S + group D) had a significantly higher prevalence of chronic cough and/or phlegm than the others (group E + group O): 25.7% vs. 16.3% (p = 0.048). Furthermore, the prevalence of cough and/or phlegm increased significantly (p = 0.03) with increasing duration of exposure to straight cutting oils after adjustment on smoking categories. Lung function tests did not differ significantly among the four groups but we observed a significant decrease of forced expiratory volume in 1 sec (FEV1), forced expiratory flow during the middle half of forced vital capacity (FEF25-75), and maximal flow rate at 50% and 25% of exhaled forced vital capacity (V50 and V25) according to duration of exposure among smokers exposed to straight cutting oils, suggesting a synergistic effect of tobacco and insoluble oils. No effect of exposure to mineral oils on bronchial reactivity was demonstrated. It is concluded that despite low levels of pollution by oil mists, the present study has shown tenuous adverse chronic effects of straight cutting oils on respiratory symptoms and lung function. However, no adverse effect of soluble mineral oils was demonstrated. These results suggest that threshold limit values for mineral oils should be reassessed.
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PMID:Respiratory symptoms, ventilatory impairment, and bronchial reactivity in oil mist-exposed automobile workers. 925 98

Although the literature on subacute bacterial endocarditis from both the preantibiotic and antibiotic eras mentions cough as a symptom, neither bacteremia nor endocarditis is listed in reviews on chronic cough. Herein we describe a 74-year-old man who underwent an extensive workup as an outpatient because of chronic cough of 7 months' duration. Chest roentgenography, chest and sinus computed tomography, fiberoptic bronchoscopy, gallium scan, transthoracic echocardiography, and other studies revealed no apparent cause for his nonproductive cough. Because of a persistently increased erythrocyte sedimentation rate and associated weight loss, blood cultures were obtained, all of which grew Streptococcus constellatus. A transesophageal echocardiogram revealed mitral valve vegetation. After antibiotic therapy was administered, the patient's cough completely resolved. He has experienced no coughing for more than 14 months. Bacteremia in conjunction with endocarditis should be added to the list of uncommon causes of chronic cough. The mechanism of cough is unknown.
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PMID:Chronic cough associated with subacute bacterial endocarditis. 779 89

Chronic cough is a common symptom presenting to all clinicians. Every effort should be made to determine the cause(s) of cough because specific therapy has a higher likelihood of success than empiric therapy. Evaluation begins with a complete history, physical examination, routine health screen laboratory testing, chest film, and pulmonary function testing. Further investigation should be guided by the response to treatment of the most likely diagnostic possibilities: postnasal drip, cough-variant asthma, gastroesophageal reflux, chronic bronchitis, bronchiectasis, and ACE inhibitor induced. The majority of each patient's workup can be performed and ordered by the primary care physician.
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PMID:Chronic cough. 787 96

This study was performed in the Sereer region 150 km to the east of Dakar, the capital of Senegal. The population of the region is characterised by large seasonal migration, a high divorce rate (41% of marriages end in divorce) and frequent polygamy (1.8 married women per married man). We organised the medical centres in the region to monitor actively the epidemiology of HIV infection. Three populations were targeted: pregnant women presenting for their first prenatal consultation; patients presenting with STD; and people with chronic (more than three weeks) cough. The patients consulting for STD were recruited two ways: those presenting spontaneously and those identified during home interviews by the team performing a parallel sociological study of behaviour. Overall, the prevalence of HIV seropositivity was 0.2% of the women and 1.3% of the men (the difference is not significant). The seropositive individuals identified were 2 pregnant women and 5 patients (3 of 409 women and 2 of 84 men) with STD. There was no significant difference between the sex, age, marital status, or type of recruitment (spontaneous or identified by the sociological survey) of the HIV seropositive and seronegative individuals. The prevalence of treponema antibodies was 1.8% among pregnant women, 2% among STD patients and 2.4% among patients with chronic cough. There was no significant difference according to age, sex, marital status or motivation for consultation. More than half the patients consulting for STD presented biomedical disease. The majority of the STD patients were women: 70% of those spontaneous consulting; 90% of those identified by the survey; and 92% of those with biomedical disease were women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the risks of sexually transmitted diseases and HIV infection in a rural region of Senegal in 1991]. 789 29

Cough is an important symptom of many respiratory disorders. We determined the frequency and diurnal variation of cough in normal subjects and in patients with asthma or with persistent cough of unknown cause. We used a portable, solid-state, multiple-channel recorder to record cough sounds over a 24 h period. The audio-signal was recorded from a unidirectional microphone strapped over the chest wall, and electromyographic (EMG) signals from the lower respiratory muscles were simultaneously registered with surface electrodes. The recorded digital data were examined on an IBM-compatible computer, and the typical signals induced by cough (as assessed by voluntary or experimentally-induced cough) were counted. In 12 normal subjects, only 0-16 coughs were recorded over 24 h. In 21 stable asthmatics with a history of chronic cough ("asthma") the median number was 282 (ranges: 45-1,577), and in 14 patients with the predominant symptom of daily dry coughs ("chronic coughers") the median number was 794 (64-3,639). In both groups of patients, there was a diurnal variation of coughs, such that the least numbers occurred between 2 and 5 a.m. (< 3% of total). In the asthma group, there was no significant correlation between forced expiratory volume in one second (FEV1) (% predicted) or diurnal variation of peak expiratory flow and cough frequency. In the chronic coughers, there was a significant correlation between daytime cough numbers and daytime cough symptoms scores but not for the night-time values. Our data show that cough frequency is not determined by the severity of asthma in relatively stable asthmatics on inhaled steroids, and is reduced during sleep in both asthmatics and chronic cough patients. This portable cough recorder may be useful in the assessment of drug therapy for chronic cough.
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PMID:Coughing frequency in patients with persistent cough: assessment using a 24 hour ambulatory recorder. 792 2

We evaluated the relationship between gastroesophageal (GE) reflux and chronic cough using prolonged pH monitoring and the standard acid reflux study in a retrospective case review. Ten patients were referred to our clinical esophageal laboratory for prolonged pH monitoring to determine whether GE reflux was the cause of chronic cough. In addition, we report one patient referred for a standard acid reflux test as a clear example of spontaneous cough inducing GE reflux. Of the 10 patients having prolonged pH monitoring, 182 of 221 (80.9 +/- 4.6%) of cough episodes had no correlation with GE reflux (p = 0.0001). Of those cough episodes that appeared to be related to GE reflux, 27 of 39 (69.2 +/- 11.7%) occurred before GE reflux and 12/39 (30.8 +/- 10.3%) occurred after GE reflux (p = 0.06). In the single patient GE reflux after spontaneous cough occurred five of seven times during a standard acid reflux test. In our series, cough and reflux were not related in the majority of episodes. Where there was a relationship, it appeared that the cough preceded GE reflux twice as often as reflux preceded cough. We conclude that GE reflux does not appear to be a frequent cause of chronic cough.
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PMID:Gastroesophageal reflux and chronic cough: which comes first? 796 52

Prolonged ambulatory pH monitoring was performed on 89 patients with previous diagnosis of asthma (27 patients), chronic cough (28 patients), noncardiac chest pain (34 patients), and on 27 healthy control subjects. The extent of gastroesophageal reflux (GER) was determined using a catheter containing two antimony pH electrodes positioned 5 cm and 20 cm above the superior border of the manometrically determined lower esophageal sphincter. Reflux was defined as a drop in pH to < 4 in the distal esophagus. We compared both pH < 4 and pH < 5 as the beginning of reflux episodes for the proximal esophagus. Considering the confidence interval of 95% in healthy control subjects as a normality criterion, we found a prevalence of abnormal distal GER in 44% of asthmatics, 50% of patients with cough, and 53.8% of patients with noncardiac chest pain. Abnormal proximal acid exposure was found in 24% of asthmatics, 10.7% of patients with cough and 44.1% of patients with chest pain. Distal acid exposure was significantly longer than proximal esophageal acid exposure in all patient groups (p < 0.05). There were no differences in the evaluation of proximal GER comparing pH < 4 with pH < 5. The data also indicate a tendency toward upright, rather than supine acid exposure. These results support the use of 24-h pH monitoring in patients with chest complaints and indicate that GER may frequently be involved in the pathogenesis. They do not support the theory that proximal GER is a specific etiologic factor in chronic cough or asthma.
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PMID:Frequency and site of gastroesophageal reflux in patients with chest symptoms. Studies using proximal and distal pH monitoring. 798 2


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