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

Accidentally occurring hydrocarbon poisoning during early childhood is a frequent and in most cases benign event. Nevertheless there is a potential risk of more serious consequences. We describe such a case. Respiratory symptoms are of the greatest concern. They include cough, tachypnoea, and in the more serious cases cyanosis and respiratory failure. Moreover, symptoms from the gastrointestinal tract are common. Treatment includes prevention of aspiration, symptomatic treatment and in more serious cases respiratory support.
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PMID:[Poisoning with petroleum preparations--again!]. 801 70

To determine clinical signs that can predict pneumonia (confirmed by radiography) in infants under 2 months of age, 101 infants with pneumonia and 150 with an upper respiratory infection (but not pneumonia) were studied. Ten infants with pneumonia and 15 with an upper respiratory infection did not have the cough and/or difficult (or rapid) breathing that are recommended as 'entry criteria' by the World Health Organisation (WHO). The remaining infants met WHO entry criteria; in them sensitivity and specificity of respiratory rate > or = 60/min and/or severe chest indrawing to diagnose pneumonia was 85% and 97% respectively. Addition of four non-specific signs (stopped feeding well, looked sick, temperature < or = 38 degrees C, and abdominal distension) to respiratory rate > or = 60/min and/or chest indrawing for case identification resulted in a 7% gain in sensitivity but 22% loss of specificity. Addition of nasal flaring improved the sensitivity by 6% without loss of specificity. However, the non-specific signs were the only clue to diagnosis in five infants weighing < or = 2500 g. At age < 7 days, a weight < or = 2500 g and cyanosis were associated with significantly higher risk of mortality. These findings support the use of a respiratory rate > or = 60/min and/or chest indrawing for identification of pneumonia, and suggest addition of nasal flaring to the criteria for case identification in infants under 2 months with cough and/or difficult or rapid breathing.
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PMID:Clinical signs of pneumonia in infants under 2 months. 801 64

In 5 Viennese general practice offices we investigated patients by spirometry with the following indications: differential diagnosis of dyspnea; every 3rd smoker of more than 10 cigarettes a day (including asymptomatic ones); cough and nasal disorders of more than 4 weeks duration; indicative physical findings (cyanosis or auscultation). The sample control group was matched for age and gender and did not have any symptoms characteristic of the indication group. Nevertheless a spirometric test was also carried out in these patients. A total of 212 patients were examined in 4673 consultations on 202 workdays in the 5 offices. In the group of 109 patients 62 (56.9%) had dyspnea and/or positive signs on auscultation. Of these 62 patients 39 (62.9%) had 1 or more positive findings either from PEF or FEV 1 or both. There were significantly more referrals for X-rays in case of abnormal lung function. The control group of 103 obviously healthy persons in particular showed a significantly higher number of abnormal PEF values than expected (31 persons, 30.1%).
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PMID:[Determination of forced expiratory volume (FEV 1) and maximal peak expiratory flow within the scope of routine diagnosis in general practice]. 802 27

The hospital records of 99 children with foreign bodies in the airways (n = 51) or oesophagus (n = 48) were reviewed with respect to occurrence, course of disease and mortality. Childhood death records in Denmark over a ten year period due to asphyxiation by food were surveyed. A third of the patients with oesophageal foreign bodies had respiratory symptoms. Most children with airway foreign bodies were aged 1 to 3 years and generally had a positive history of choking. The dominating symptoms were cough, wheezing and cyanosis. Chest X-ray was normal in 25%. There were no complications during bronchoscopy. The most common foreign bodies extracted were nuts (29%). The estimated death rate due to airway foreign bodies is 0.9 per 100,000 children in Denmark per year. Rigid oesophagoscopy and bronchoscopy should be performed promptly on suspicion of foreign bodies located in the oesophagus or airways to ensure fast recovery. Nuts, tablets and other small items should not be within reach of small children.
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PMID:[Foreign bodies in the airways and esophagus in children]. 806 33

We report the experience with and evaluation of treatment strategies in fibrosing alveolitis and desquamative interstitial pneumonitis (FA/DIP) over the last 16 years by a review of all cases referred to a tertiary referral center. There were 25 cases, 16 boys and 9 girls (mean age at onset, 2.3 years; range, 7 days to 11.6 years). In each case the diagnosis was confirmed by open lung biopsy at a mean age of 3.3 years (range, 7 weeks to 15.1 years). Presently features were tachypnea (19), cyanosis (15), cough (12), exertional dyspnea (7), recurrent chest infections +/- wheezing (9), and clubbing (8). Four patients recovered without antiinflammatory medication. The others received specific treatment. Of 11 patients given only prednisolone, six improved, two did not, and three died despite treatment. Of five patients receiving only chloroquine, four responded. Five patients received both prednisolone and chloroquine; one died, two responded well. There was poor progress in the remaining two. Of the 10 patients receiving chloroquine six (60%) showed a good response. A younger presentation carried a worse prognosis, but chest radiology at presentation and outcome were not interrelated. Those with mild histological changes all survived, but severe desquamation or fibrosis at biopsy was not related to outcome. In four cases there was a family history (16%). Patients with FA/DIP probably represent a disease spectrum of multiple etiology with a variable prognosis and response to treatment.
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PMID:Fibrosing alveolitis and desquamative interstitial pneumonitis. 809 Jun 6

The isolation of Aspergillus fumigatus from airway secretions from patients with cystic fibrosis (CF) is common and usually denotes asymptomatic colonization or allergic broncho-pulmonary aspergillosis (ABPA). A 12-year-old boy with CF acutely developed moderately severe symptoms of unremitting cough, fever, dyspnea, weight loss, and cyanosis. Chest radiographs demonstrated widespread unilateral infiltrates and volume loss. By bronchoscopy tenacious mucous plugs were seen occluding the left lower lobe bronchus. Cultures from sputum and sequential bronchoalveolar lavage grew Aspergillus fumigatus, but other significant criteria for diagnosing ABPA were lacking. No improvement was seen with a 3 week course of systemic corticosteroid and antibiotic therapy. Treatment with amphotericin B and short-term mechanical ventilation resulted in rapid resolution of all symptoms. This form of endobronchial aspergillosis has not been described previously.
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PMID:Unusual form of endobronchial Aspergillosis in a patient with cystic fibrosis. 841 45

We present the results of a study designed to verify the efficacy of nebulized L-Adrenaline and/or dexamethasone given intramuscularly (IM) in the treatment of croup during childhood. Sixty-six children, hospitalized for croup during the period between october 1989 and september 1990, entered the study. They received the ordinary treatment with oxygen-therapy and fluid-therapy and were randomly assigned, in a double-blind fashion, into one of four treatment groups: Group 1: Nebulized L-Adrenaline and placebo (IM). Group 2: Nebulized saline and placebo (IM). Group 3: Nebulized saline and dexamethasone (IM). Group 4: Nebulized L-Adrenaline and dexamethasone (IM). The clinical evaluation was based on a scoring system assessing the inspiratory stridor, croupy cough, retractions and cyanosis. An analysis of variance was performed on the evolution of the score for two factors (Adrenaline and dexamethasone) to verify that there was no interaction between them. Subsequently, a one-factor analysis of variance was performed on the four treatment groups. We conclude that nebulized Adrenalin is more beneficial than saline in the clinical evolution of croup (p < 0.05). However, we did not find a statistically significant improvement in the group treated with dexamethasone when compared with the group treated with the placebo IM injection.
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PMID:[Randomized double-blind study of treatment of croup with adrenaline and/or dexamethasone in children]. 843 75

The aim of this prospective, randomised, double blind study was to evaluate whether nebulised local steroid treatment is effective in the treatment of croup. Thirty six infants and children (0.4-4.9 years of age) admitted to hospital with moderate to severe croup were allocated to receive either 2 mg nebulised budesonide (20 children) or saline (16 children). Disease severity was assessed by a clinical total croup score based on stridor, cough, retractions, dyspnoea, and cyanosis. In addition the overall clinical impression was evaluated (0-100). Two hours after treatment there was a significant improvement in the total croup score in the group treated with budesonide (8 to 4.5), but not in the group treated with saline (8 to 8). Furthermore, the overall clinical impression assessment score decreased significantly (50 to 25) in the group treated with budesonide, whereas it remained constant in the placebo group (60 to 62). The total croup score and overall clinical severity were significantly better in the group treated with budesonide than in the placebo group. No side effects were observed. The results indicate that nebulised budesonide can be used as a safe and effective alternative treatment in children and infants with moderate to severe croup.
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PMID:Treatment of croup with nebulised steroid (budesonide): a double blind, placebo controlled study. 846 37

High-altitude pulmonary edema (HAPE) occurs in unacclimatized individuals who are rapidly exposed to altitudes in excess of 2450 m. It is commonly seen in climbers and skiers who ascend to high altitude without previous acclimatization. Initial symptoms of dyspnea, cough, weakness, and chest tightness appear, usually within 1-3 days after arrival. Common physical signs are tachypnea, tachycardia, rales, and cyanosis. Descent to a lower altitude, nifedipine, and oxygen administration result in rapid clinical improvement. Physiologic studies during the acute stage have revealed a normal pulmonary artery wedge pressure, marked elevation of pulmonary artery pressure, severe arterial unsaturation, and usually a low cardiac output. Pulmonary arteriolar (precapillary) resistance is elevated. A working hypothesis of the etiology of HAPE suggests that hypoxic pulmonary vasoconstriction is extensive but not uniform. The result is overperfusion of the remaining patent vessels with transmission of the high pulmonary artery pressure to capillaries. Dilatation of the capillaries and high flow results in capillary injury, with leakage of protein and red cells into the alveoli and airways. HAPE represents one of the few varieties of pulmonary edema where left ventricular filling pressure is normal.
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PMID:High-altitude pulmonary edema: current concepts. 871 81

A total of 30 patients (27 males and 3 females) with a mean age of 62.6 +/- 3.9 years, suffering from chronic obstructive pulmonary disease were recruited into this open study to evaluate the clinical efficacy and the safety of a short course of treatment with 100 mg acebrophylline, twice daily for 14 days. To assess the effectiveness of the drug, symptoms and signs, such as cough intensity and frequency, auscultatory pattern, dyspnoea, cyanosis, difficulty of expectoration, sputum quantity, appearance and density, were evaluated at baseline and after 1, 3, 5, 7, 10 and 14 days of therapy. In addition the rheological properties of the bronchial mucus (viscosity and spinnability) were measured and respiratory function tests were performed before and after treatment. There was a progressive improvement of all evaluated symptoms and signs, resulting in improvement of the auscultatory pattern, as well as dyspnoea. This was accompanied by improvement or normalization of the respiratory function indices, which showed statistically significant differences (P < 0.01) between the baseline and the endpoint values, apart from total lung capacity. Blood-gas analysis demonstrated a significant increase of PaO2 and a significant decrease of PaCO2 values at the end of the treatment period (both P < 0.01). In general, acebrophylline was well tolerated. No clinically relevant or significant changes in any of the routine laboratory parameters were found on comparing the values obtained before and after treatment. Only three patients complained of epigastric pain, but this was not so severe or long-lasting as to require the discontinuation of the treatment.
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PMID:Effects of a short course of treatment with acebrophylline on the mucus rheological characteristics and respiratory function parameters in patients suffering from chronic obstructive pulmonary disease. 872 93


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