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

307 patients with chest injuries were treated in an outpatient clinic during a three month period. Ten patients developed complications such as hemothorax, pneumothorax and lung contusion, or late complications such as atelectases and pneumonia. 21 patients were hospitalized after initial evaluation. Two patients died. Pain was a symptom in 306 of the 307 patients. Other symptoms were coughing, hempoptysis, fever, nausea. Complications increased in 40 patients, with other symptoms or signs in addition to pain. These other symptoms had a 40% positive and 95% negative predictive value as regards complications. 45 out of 114 patients had a pathological chest x-ray. Positive chest x-ray had a 40% positive and 94% negative predictive value as regards complications. In four patients (1.3%) complicating injuries were not identified initially. Five of 24 patients (21%) were hospitalized unnecessarily. Chest x-ray should be performed in patients with additional symptoms and signs. Patients with no signs in addition to chest wall tenderness can be observed at home.
 ...
PMID:[Ambulatory evaluation and treatment of blunt thoracic injuries]. 204 51

Respiratory symptoms are a common cause of distress in patients with advanced cancer. Optimal palliative therapy requires careful assessment and the appropriate use of symptomatic measures in conjunction with specific antitumor treatments. The etiology and management of the three major respiratory symptoms, dyspnea, cough and hemoptysis, are described. The indications for antitumor treatments and surgical procedures are briefly outlined, and symptomatic treatments, including drug and nondrug measures, are discussed in detail.
J Pain Symptom Manage 1990 Oct
PMID:Long-term management of respiratory symptoms in advanced cancer. 207 81

The pharmacology, toxicity, and therapeutic effectiveness of etoposide (VP-16) given by the intrapleural route were examined in a phase I trial. Ten patients with malignant pleural effusion received 100, 150, or 225 mg/m2 VP-16 infused over 2 h into the pleural space after drainage of pleural fluid. The administration of VP-16 was tolerated well, with no local pain, increase in cough, dyspnea, or infection. Myelosuppression was mild at doses of 150 mg/m2 or less but severe at 225 mg/m2. Drug levels were followed in both plasma and pleural fluid for up to 12 h. Clearance of VP-16 from the pleural cavity was low at 2 ml/min m2. Peak pleural-fluid drug levels in patients receiving 225 mg/m2 exceeded 300 micrograms/ml, whereas peak drug concentrations in corresponding plasma samples obtained at the same time amounted to less than 10 micrograms/ml. Serial chest X-rays showed no disappearance of pleural effusion in nine evaluable patients. However, follow-up investigation of pleural fluid characteristics [carcinoembryonic antigen (CEA), lactic dehydrogenase (LDH), and cytologic examination] suggested some evidence of local therapeutic benefit.
 ...
PMID:Intrapleural etoposide for malignant effusion. 218 91

Seventy-five patients scheduled for major abdominal operations were randomly divided into four groups, each with a different postoperative analgesic regime. Group I: buprenorphine 4 micrograms/kg was injected i.v. every 4 h. Groups II-IV: all patients were preoperatively supplied with a thoracic epidural catheter that, however, was not used during the operation. Group II: bupivacaine 0.15 ml/kg was injected epidurally every 2 h, the first dose being 0.5%, the top-ups 0.25%. Group III: buprenorphine 4 micrograms/kg in 10 ml saline was given via the catheter and repeated on request. Group IV: these patients received a combined regime. Bupivacaine was injected as in group II, and in addition buprenorphine was added epidurally in the doses and time intervals of group I. After extubation the patients categorized the intensity of postoperative pain twice, first while lying immobile and then after coughing vigorously, using a rating scale with pain scores from 0 to 10. Thereafter, the analgesic regime described above commenced. One hour later the patients' pain scores were again determined. In addition to pain scores, heart rate (HR), mean arterial pressure (MAP) and paCO2 were recorded at the same points in time. The investigation was then interrupted overnight. The analgesic regime continued as described for groups I and II. Patients in group III received 0.15 mg buprenorphine on request i.v., and in group IV bupivacaine was given as in group II with no further buprenorphine. The study recommenced the next morning at 7:00 a.m. After the initial values (pain scores, HR, MAP, paCO2) had been recorded the analgesic program, as scheduled for each patient, restarted. In group IV buprenorphine was again added to bupivacaine and repeated every 4 h, whereas bupivacaine was injected every 2 h. All values were registered hourly until 7:00 p.m., when the investigation was terminated. RESULTS. On the day of operation and during the first few hours on the morning thereafter, analgesia in groups II and IV was considerably better compared to groups I and III (P less than 0.001). We could not statistically demonstrate, however, that analgesia in group IV was superior to that in group II despite the fact that pain scores were lowest in this group, with a median at rest of 0 throughout the study time. In group III (n = 20), epidural buprenorphine failed to produce any acceptable analgesic effect in 6 patients despite correct catheter position. For this reason they were dropped from the study. No patient in any of the other groups, however, was dropped (P less than 0.01). Later in the 1st postoperative day analgesia in groups II and IV lost its superiority at rest, but coughing continued to be less painful in comparison to groups I and III. We noticed that the duration of action of 0.25% bupivacaine, injected as a bolus, was considerably shorter than expected (less than 2 h) and that several patients experienced pain before the next top-up was given...
 ...
PMID:[Postoperative peridural analgesia via catheter following abdominal surgery. Peridural bupivacaine versus buprenorphine]. 219 6

50 non-premedicated ASA class I or II patients were allocated randomly into two groups and received either a variable infusion of propofol or midazolam for sedation during orthopaedic surgery with regional blockade. To achieve a well-sedated patient with eyes closed and able to follow commands, the dose requirements for propofol were 1.25 mg/kg +/- 0.5 as a loading dose followed by a mean infusion rate of 3.17 mg kg-1 h-1 +/- 1.4 and for midazolam 0.073 mg/kg +/-0.02 and 0.074 mg kg-1 h-1 +/- 0.14. Steady-state plasma concentrations of propofol averaged 1.23 micrograms/kg +/- 0.75 and of midazolam 134 ng/ml +/- 62. Recovery was significantly shorter for propofol: 3.42 +/- 2.5 versus 8.05 min +/6.2 for midazolam. Perioperative cooperation was similar in both groups providing good or excellent conditions in 76% with propofol and in 52% with midazolam. 2h after discontinuation of the infusion 92% of the propofol patients were alert, while 36% of the midazolam were sleeping again. Cardiovascular effects of both drugs were minimal; however significant respiratory depression and/or airway obstruction developed in both groups (propofol 48%, midazolam 52%) requiring therapeutic intervention. Additional undesirable effects were: severe cough (propofol 40%, midazolam 20%), inadvertent movements (propofol 36%, midazolam 24%), confusion (propofol 24%, midazolam 20%), euphoria (propofol 44%), pain on injection (propofol 32%). The results of the study indicate that both drugs are useful and controllable sedative agents for surgery under regional anaesthesia, provided that measures for continuous monitoring of respiration and emergency care are guaranteed.
 ...
PMID:[Propofol infusion for sedation in regional anesthesia. A comparison with midazolam]. 220 73

Prolonged (several days or repeated) exposure to nitrous oxide (N2O) can cause injury or death. To assess whether relatively prolonged anesthesia with N2O in normal patients might similarly cause untoward effects, we investigated whether the addition of N2O to isoflurane anesthesia caused injury to patients having surgical resection of acoustic neuroma lasting approximately 10 h. Twenty-six patients undergoing surgical resection of acoustic neuroma were randomly assigned to a regimen that included or excluded N2O (50%-60%) during isoflurane anesthesia plus intravenous adjuvants. On average, slightly less isoflurane (0.24%) was used during anesthesia with N2O. We measured standard clinical variables (blood pressure, heart rate), oxygen saturation, neurologic status, pain, and the incidence and type of morbid outcomes. Exposure to N2O did not increase the incidence of morbid outcomes (including hepatic injury, infection, or hypoxemia), prolong hospitalization, or increase common postoperative complaints such as nausea, vomiting, coughing, or headache. Patients anesthetized with either regimen were equally satisfied with their anesthetic.
 ...
PMID:Effect on outcome of prolonged exposure of patients to nitrous oxide. 224 Jun 28

The effect of indomethacin on postoperative pain was studied in 60 adult patients undergoing thoracotomy in a prospective, randomized, double-blind manner. Patients receiving indomethacin required significantly less opioid after operation and had significantly lower pain scores compared with the control group. Pain on movement and on coughing were reduced also. No major adverse effects were encountered.
 ...
PMID:Effect of indomethacin on pain relief after thoracotomy. 224 38

A modified posterolateral thoracotomy is described that combines the advantages of complete muscle sparing through a thoracolumbar fascial slide with excellent exposure. The technique is easy to perform. The procedure was associated with relatively little postoperative pain, coughing was effective, and early ambulation was achieved. Experience with this approach in the first 49 patients suggests that it offers an attractive alternative to the standard muscle cutting posterolateral thoracotomy approach for elective procedures.
 ...
PMID:Modified muscle sparing posterolateral thoracotomy. 228 26

Management of postoperative pain has been shown to be inadequately controlled, and, in fact, can have significant deleterious effects on a patient's early postoperative recovery. Continuous epidural analgesia has recently been used to control postoperative pain. This mode of analgesia controls postoperative pain without the delays inherent in the PRN administration of systemic narcotics. This was a multidisciplinary, prospective, randomized, double-blind study of various epidural analgesic agents in 53 thoracic and 81 abdominal surgery patients. The focus of the study was to identify the benefits and problems of continuous epidural analgesia for postoperative pain management and the implications for the nursing care of the patients. Evaluation of the effectiveness of the analgesia was based on the following measures: (1) pain measured at regular intervals in the 72-hour period with a visual analog; (2) pain as measured after 72 hours with the word descriptor section of the McGill Pain Questionnaire; (3) amount of supplemental systemic narcotic analgesic needed; (4) recovery of ambulatory and respiratory function, including ability to perform coughing and deep-breathing exercises; (5) occurrence of adverse effects; and (6) the type and distribution of nursing care problems associated with continuous epidural infusions. The results of this study showed that the level of pain relief and recovery of postoperative function was superior to that provided by the more widely used (PRN) systemic administration of narcotics. With the exception of the report of back pain by patients receiving the normal saline epidural solution, complications did not occur in a significantly greater proportion when using the epidural route. Although some nursing care problems were identified, patients who received epidural analgesia were able to be cared for on general care units with no adverse effects reported.
 ...
PMID:Efficacy of continuous epidural analgesia and the implications for patient care in the early postoperative phase. 228 19

Ventilation and gas exchange lung functions were studied in 110 patients with severe closed chest trauma. In chest trauma that was not accompanied by intrapulmonary traumatic changes the main pathogenetic mechanism of gas exchange damage was marked pain syndrome. Such patients did not suffer from severe arterial hypoxemia and their intrapulmonary shunting did not exceed 15%. Analgesia and, if necessary, lung decompression improved considerably respiratory parameters and prevented the onset of severe pulmonary failure. Patients with intrapulmonary traumatic changes (lung contusion, intrapulmonary hematomas) were characterized by progressing arterial hypoxemia due to a considerable increase in intrapulmonary shunting. These patients are managed mainly by preventive therapy of pulmonary hyperhydration, thorough tracheobronchial cleansing, cough stimulation, prevention of pneumonia.
 ...
PMID:[The effect of severe closed chest trauma on gas exchange]. 228 31


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>