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

The exact incidence of gastroesophageal reflux (GER) is unknown, although it is estimated that at least 25% of patients with GER have head and neck symptoms alone. These symptoms may consist of one or more of the following: excess salivation, hoarseness, "post-nasal drip," voice change, persistent coughing, food sticking in the throat, globus hystericus, otalgia, throat clearing, neck pain, sore throats, the sensation of a lump in the throat, choking spells, and bronchospasm. Carcinoma of the larynx and upper aerodigestive tract may be a consequence of chronic reflux. GER, especially when the classic symptoms of reflux are absent, is frequently overlooked as a cause of these problems. This article reviews the symptoms and pathophysiology of these conditions. The diagnostic and therapeutic modalities available to us in managing these patients are also discussed.
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PMID:Otolaryngologic manifestations of gastroesophageal reflux. 205 16

The clinical characteristics of acute otitis media in relation to coexisting respiratory virus infection were studied in a 1-year prospective study of 363 children with acute otitis media. Respiratory viruses were detected using virus isolation and virus antigen detection in nasopharyngeal specimens of 42% of the patients at the time of diagnosis. Rhinovirus (24%) and respiratory syncytial virus (13%) were the two most common viruses detected. Adenovirus, parainfluenza viruses, and coronavirus OC43 were found less frequently. The mean duration of preceding symptoms was 5.9 days before the diagnosis of acute otitis media. Ninety-four percent of the children had symptoms of upper respiratory tract infection. Fever was reported in 55% and earache in 47% of cases. Patients with respiratory syncytial virus infection had fever, cough, and vomiting significantly more often than patients with rhinovirus infection or virus-negative patients. No significant differences were found in the appearance of the tympanic membrane and outcome of illness between virus-negative and virus-positive patients with acute otitis. Most patients respond well to antimicrobial therapy despite the coexisting viral infection. If the symptoms of infection persist, they can be due to the underlying viral infection, and viral diagnostics preferably with rapid methods may be clinically useful in these patients.
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PMID:Clinical role of respiratory virus infection in acute otitis media. 217 35

Lingual tonsillitis can cause various signs and symptoms including nocturnal or supine cough, constant discomfort in the throat, glossal pain, and otalgia. Most patients with lingual tonsillitis have already had palatine tonsillectomy. A lingual tonsil may be visible only by using a laryngeal mirror. An embedded foreign body can cause recurrent tonsillitis with abscess formation, and life-threatening airway obstruction may result. Aberrant lingual thyroid may be the only functioning thyroid tissue. Cryosurgery and the CO2 laser have made lingual tonsillectomy a safe and simple procedure. An abscess of a lingual tonsil should be drained under general anesthesia, and lingual thyroid should be treated conservatively unless it produces obstructive symptoms.
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PMID:Lingual tonsillitis. 374 99

Nasal septal deviation (DNS) occurs more frequently during childhood although it occurs at any age due to trauma. Recently, it has been increasingly recognized that nasal septal deviation is seen also at birth and a number of explanations for this occurrence is forwarded. Awareness of such occurrence and its recognition at birth both by pediatricians and obstetricians is essential for early interventional management of this condition in close collaboration with the otorhinolaryngologists. Closed surgical intervention of this defect carried out early after it was detected at birth benefitted the afflicted in terms of nasal airway improvement and its maintenance resulting in normalization of its anatomy and physiology in long term follow-up. Septal deviation detected at birth if left alone without interventional procedure continues to persist. It is furthermore accompanied by statistically valied symptoms like upper respiratory infections, cough, earache, ear discharge, fever, mouth breathing and at times feeding difficulty during infancy and childhood. Long term follow-up of children who underwent closed surgical correction of DNS at birth, revealed no untoward effects such as nasofacial disproportion or retardation of facial growth. Early interventional management of DNS detected at birth therefore appears to be a safe procedure. It can even be performed by neonatologists or an obstetrician. Such an intervention procedure early in life can prevent septoplasty surgery at a latter date besides preventing a number of nasal airway-related conditions.
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PMID:Nasal septal deviation: effective intervention and long term follow-up. 381 92

A retrospective analysis of direct laryngoscopies performed at our institution in 1978 was undertaken utilizing computer technology. The population which consisted of 54% males and 46% females had an average age of 50.4 years. The most common symptom was hoarseness (83.6%). The most frequent benign and malignant diagnoses were vocal cord polyp and squamous cell carcinoma, respectively. Males predominated in all disease entities except vocal cord polyps. Benign disease entities presented most frequently with one or two symptoms, while malignant pathology presented with a varied array and number of symptoms. The indications: "tumor" seen on indirect laryngoscopy, sore throat, dysphagia, otalgia, upper respiratory tract obstruction, hemoptysis, cough and leukoplakia were most frequently associated with malignancy. Voice abuse occupations were most commonly associated with vocal cord polyps and tobacco and alcohol use was most frequently associated with laryngeal cancer. Eighty-five percent of direct laryngoscopies were done under general anesthesia with two-thirds utilizing direct suspension microlaryngoscopy.
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PMID:Direct laryngoscopy: a retrospective analysis. 666 56

We carried out a prospective study to analyse if it would be possible to predict the coexistence of acute otitis media on the basis of symptoms and signs of infection. Of the 658 patients admitted to hospital during the period concerned, 197 (29.9%) had otitis media. For each child with otitis, the next patient of the same age was chosen as a control. The risk of having otitis media was increased among patients with cough, rhinitis and earache. All three variables together correctly classified 67% of those not having otitis media and 63% of those with acute otitis, compared with the 50% which would theoretically be achieved by chance alone. Prediction was worst (55%) among patients younger than 2 years of age not having otitis media and best among older patients who had otitis media, i.e. 78%. Prediction on these grounds would have caused significant over-treatment, and one-third of the otitis cases among the youngest group would have been missed. Thus it is important to always examine the ears of a child with an infection in order to reliably exclude the possibility of acute otitis media.
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PMID:Prediction of acute otitis media with symptoms and signs. 773 9

A 36-year-old man with hemophilia A was admitted to hospital because of otalgia, hearing loss, nasal obstruction, nonproductive cough, and high fever. His laboratory data showed high-grade acute inflammatory reactions. His chest X-ray and CT films showed multiple cavitary masses in the right lower lung field. Bronchoscopy performed at our institution revealed bronchial nodules in the intermediate truncus, and BAL revealed increases in the neutrophils and an IgG index (BAL IgG/albumin divided by serum IgG/albumin). Biopsy specimens obtained from nasal mucosa showed epithelioid granulomas with Langerhans' giant cells and necrotizing vasculitis. Antineutrophil cytoplasmic antibodies were also positive, but no evidence of glomerulonephritis was observed. The diagnosis of limited Wegener's granulomatosis was thus made. He was treated with standard therapy (daily cyclophosphamide and glucocorticoids), but within 1 month he had complications of empyema with herpes zoster, and bronchopleural fistula. The complications resolved with appropriate treatment.
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PMID:[A case of limited Wegener's granulomatosis with hemophilia A, complicated by empyema, bronchopleural fistula and herpes zoster during therapy]. 781 60

What are the associations and risk factors for otitis media with effusion (glue-ear)? A 1 year case control study in 5-7 year old children from four south-west Hampshire schools examined some of the factors highlighted by the literature. A history of frequent ear problems over the previous year, a history of earache at any time in the child's life, bottle feeding, a red drum at otoscopy and the new finding of night cough all carried an increased relative risk.
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PMID:Risk factors in otitis media with effusion. A 1 year case control study in 5-7 year old children. 784 16

Much literature supports the value of performance-based tests for obtaining an overall assessment of clinical skills; however, these tests can also identify specific deficits in medical curriculum and student learning. This study, conducted over a period of 2.5 years, used standardized patients to identify deficiencies in medical students' evaluation of a patient with "hoarseness and cough." Each of 230 students performed a physical examination and took a medical history, and each was evaluated on 29 items according to predetermined criteria. We conclude the following: (1) When examining a patient complaining of hoarseness and cough, students frequently did not screen for hemoptysis, thyroid problems, and otalgia; (2) Overall test performance correlated positively with the time of year of the rotation, but screening for certain items (including hemoptysis, thyroid problems, and otalgia) appeared not to depend on rotation; (3) Several important items significantly differentiated the more knowledgeable student from the less knowledgeable student.
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PMID:Use of standardized patients to identify deficits in student performance and curriculum effectiveness. 802

From 1982 to 1991, we experienced 76 patients with Mycoplasma pneumoniae pneumonia which were confirmed by serologic tests. There were 32 (42%) male and 44 (58%) female patients. One patient had underlying disease of diabetes mellitus while the other patients were in good health. The age ranged from 9 months old to 72 years old. All the patients complained of fever and coughing; 63% had dry cough and 37% had sputum production. Upper respiratory tract complaints such as rhinorrhea, sore throat, or earache were noted in 57% of the patients. Fifty-five percent of the patients had GI symptoms of anorexia, nausea, vomiting, or diarrhea. Other complaints included myalgia/arthralgia (29%), headache (30%), and general malaise (32%). Dyspnea (17%) and chest pain (20%) were occasional complaints. Seventy-one percent of the patients had WBC counts < 10000/cu mm and 29% > 10000/cu mm. The mean value of C-reactive protein (CRP) was 53.1 micrograms/ml, while 16% of the patients had a CRP value above 100 micrograms/ml. Thirty-one percent of the patients were noted to have a transient elevation of serum transaminase. Four different patterns of infiltration were seen in chest radiographic manifestation: 1) peribronchial and perivascular interstitial infiltrates (18.4%), 2) nonhomogeneous patchy consolidations (22.4%), 3) homogeneous acinar consolidations (27.6%), and 4) mixed interstitial and alveolar infiltrates (27.6%). Interstitial infiltration was more commonly seen in pediatric than adult patients (46% vs 20%). Other features of the radiologic manifestation were as follows: unilateral lesions in 80% of patients, single lobe lesions in 77%, lower lobe predominant in 69%, pleural effusion in 7%, and radiographic deterioration in 10%. Mycoplasmal pneumonia should be considered in the differential diagnosis of community-acquired pneumonias.
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PMID:Clinical study of Mycoplasma pneumoniae pneumonia. 832 Jul 55


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