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)

The diseases of the nose and paranasal sinuses (rhinosinusitis) often in combination with asthma and gastroesophageal reflux are common causes of chronic cough in patients with normal chest radiograph. The relationships between rhinosinusitis and cough are incompletely understood. We investigated modulation of the cough reflex by the inputs from the nose. We demonstrate that the cough reflex is sensitized by the intranasal administration of sensory nerve activators in animal models and in humans. Cough reflex is also sensitized in the guinea pig model of allergic nasal inflammation and in patients with allergic rhinitis. In patients with allergic rhinitis the cough sensitization is augmented during the allergen season. We conclude that the cough reflex can be sensitized from the nose. Our data indicate that this sensitization is mediated by nasal sensory nerves. We speculate that by inducing the cough reflex sensitization rhinosinusitis contributes to chronic cough. If combined with environmental or endogenous cough triggers, the cough reflex sensitization is predicted to cause excessive coughing. The potential endogenous cough triggers may be associated with rhinosinusitis (postnasal drip, aspiration of nasal secrets) or secondary to a coexistent disease such as asthma or gastroesophageal reflux.
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PMID:Mechanisms of the cough associated with rhinosinusitis. 1911 26

Dysfunction of upper and lower airways frequently coexists, and they appear to share key elements of pathogenesis. The interrelationship between upper and lower airway manifestations of allergy remains still incompletely investigated. Little is known about the critical factors that determine airway afferent nerve endings reactivity (cough sensitivity) in patients with allergic rhinitis. Subclinical inflammatory changes within the lower airways and/or chronic upper airway cough syndrome (previously referred to as postnasal drip syndrome) are probably responsible for this effect. The aim of this study was to evaluate capsaicin cough sensitivity in pollen sensitive patients with seasonal allergic rhinitis without treatment out of a grass pollen season time using the European Respiratory Society (ERS) guidelines on the assessment of cough. Cough sensitivity was defined as the lowest capsaicin concentration which evoked two (C2) or five (C5) coughs. Capsaicin aerosol in doubling concentrations (from 0.49 to 1000 micromol/l) was inhaled by a single breath method (KoKo DigiDoser; nSpire heath Inc, Louisville, CO), modified by the addition of an inspiratory flow regulator valve (RIFR; nSpire heath Inc, Louisville, CO). The seasonal rhinitis subjects (5M, 7F; mean age 23 yr) had not been complaining primarily about coughing. Their pulmonary function was within normal range. Concentrations of capsaicin causing two (C2) and five coughs (C5) were reported. Volunteers' (5M, 7F, mean age 23 yr) cough sensitivity (geometric mean and 95 % CI) for C2 was 16.5 (4.1-67.0) micromol/l vs. allergic rhinitis patients' C2 3.5 (1.9 - 6.4) (P= 0.018). Volunteers' C5 was 132.4 (41.3 - 424.5) micromol/l vs. allergic rhinitis patients' C5 13.1 (6.0 - 28.6) micromol/l (P= 0.013). We conclude that airway afferent nerve endings reactivity in pollen sensitive subjects suffering from seasonal allergic rhinitis was significantly increased out of pollen season compared with healthy volunteers.
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PMID:Cough reflex sensitivity testing in in seasonal allergic rhinitis patients and healthy volunteers. 1921 81

Chronic cough is a common presentation. Postnasal drip (PND) and gastro-oesophageal reflux are mostly implicated in the aetiology. Directly examining the larynx can often help to demonstrate laryngitis or inter-arytenoid oedema that is mostly attributed to reflux. Although "the syndrome of postnasal drip" is considered as a major cause for chronic cough, evidence of its existence is mostly difficult to elicit on examination. Furthermore, the majority of patients with "postnasal drip" seen in ENT outpatients do not complain of cough. Evidence does suggest there is a link between postnasal drip and cough. The fact that some patients present with cough in association with this syndrome and others do not is still not well understood.
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PMID:Rhinosinusitis, laryngopharyngeal reflux and cough: an ENT viewpoint. 1948 77

Gastroesophageal reflux disease (GERD) may cause, trigger or exacerbate many pulmonary diseases. The physiological link between GERD and pulmonary disease has been extensively studied in chronic cough and asthma. A primary care physician often encounters patients with extra esophageal manifestations of GERD in the absence of heartburn. Patients may present with symptoms involving the pulmonary system; noncardiac chest pain; and ear, nose and throat disorders. Local irritation in the esophagus can cause symptoms that vary from indigestion, like chest discomfort and abdominal pain, to coughing and wheezing. If the gastric acid reaches the back of the throat, it may cause a bitter taste in the mouth and/or aspiration of the gastric acid into the lungs. The acid can cause throat irritation, postnasal drip and hoarseness, as well as recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis/ pneumonia. This clinical review examines the potential pathophysiological mechanisms of pulmonary manifestations of GERD. It also reviews relevant clinical information concerning GERD-related chronic cough and asthma. Finally, a potential management strategy for GERD in pulmonary patients is discussed.
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PMID:Pulmonary manifestations of gastroesophageal reflux disease. 1964 41

Persistent cough could be caused by various diseases such as postnasal drip syndrome, asthma and gastroesophageal reflux disease (GERD) or adverse event of drugs such as angiotensin-converting enzyme inhibitors. We report a case of persistent cough associated with high plasma levels of the proton pump inhibitor omeprazole in a patient with GERD. This case suggests cough as an adverse drug event to omeprazole, which is otherwise commonly prescribed for the management of GERD-related cough. Therefore, physicians should be aware of the onset or an exacerbation of cough during omeprazole therapy.
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PMID:Omeprazole-induced cough in a patient with gastroesophageal reflux disease. 1980 40

Little is known about clinical and virologic manifestations of rhinovirus (HRV) and coronavirus (HCoV) infections after hematopoietic cell transplantation (HCT). We performed surveillance for 1 year and describe the natural history of these infections during the first 100 days after allogeneic HCT, when symptom surveys and upper respiratory samples were collected weekly. Samples were tested using RT-PCR for HRVs and HCoVs (OC43, 229E, HKU1, and NL63). Among 215 patients, 64 (30%) patients had 67 infections. Day 100 cumulative incidence estimate was 22.3% for HRV and 11.1% for HCoV. Median duration of viral shedding was 3 weeks; prolonged shedding of at least 3 months occurred in 6 of 45 patients with HRV and 3 of 22 with HCoV. Six patients with HRV and 9 with HCoV were asymptomatic. HRV infection was associated with rhinorrhea, congestion, postnasal drip, sputum, and cough; HCoV infection was not associated with respiratory symptoms or hepatic dysfunction. Lower respiratory infection developed in 2 patients with HRV before day 100, and 1 each with HRV and HCoV after day 100. HRV and HCoV infections are common in the first 100 days after HCT, viral shedding lasts more than 3 weeks in half, and lower respiratory infection is rare.
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PMID:Human rhinovirus and coronavirus detection among allogeneic hematopoietic stem cell transplantation recipients. 2004 28

Fungal rhinosinusitis is an important clinical problem with diverse manifestations. Although many literatures had found low recurrence rate after surgical treatment of fungus ball rhinosinusitis, patient satisfaction and treatment outcomes (symptom-free and symptom improvement rate, etc.) for fungus ball sinusitis are not yet well established. The purpose of this study is to estimate the patient satisfaction and treatment outcome in patients with fungus ball rhinosinusitis undergoing functional endoscopic sinus surgery (FESS). Medical records of consecutive patients with diagnosed fungus ball rhinosinusitis treated by FESS between 1995 and 2005 were reviewed retrospectively. The post-operative improvement in individual symptom was assessed by chart review and telephone visiting. Ninety consecutive patients (21 men and 69 women) were eligible for the study. Six patients (7%) presented bilateral fungus ball rhinosinusitis. Multiple paranasal sinus fungus ball involvements were found in 48 patients (53%). Complete resolution of complaints with respect to nasal discharge, postnasal drip, cough with sputum, nasal bleeding, fetid odor of nose, olfactory dysfunction, nasal obstruction, headache, and facial pain or pressure were described in 74 patients (82%). The overall patient satisfaction rate was 96%. The estimated recurrence rate of fungus ball rhinosinusitis treated with FESS was 3%, with a mean follow-up of 81 months. Treatment protocol of fungus ball rhinosinusitis with FESS and without postoperative antifungal drugs is efficient because of very low recurrence rate, high patient satisfaction, and very high symptom-free rate. Furthermore, the obvious difference of symptom-free rate between fungus ball rhinosinusitis and chronic rhinosinusitis highlights the need of further studies to discover the pathophysiology of fungal sinusitis.
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PMID:Patient satisfaction and treatment outcome of fungus ball rhinosinusitis treated by functional endoscopic sinus surgery. 2053 88

We present two cases of sinolith in the ethmoid sinus. The first was a 52-year-old woman who complained of nasal dyspnea, postnasal drip and dry cough. Computed tomography (CT) showed a smooth-margined oval stone embedded in the middle meatus and occupying the bulla ethmoidalis, which was destroyed. The second was a 71-year-old man who had had repeated polypectomies. An oval calcified mass was revealed on CT in the anterior ethmoid sinus adjacent to the left lamina papyracea. All pertinent literature were reviewed and only one further case of ethmoid sinolith was encountered. The etiology, radiological features, differential diagnosis and treatment are discussed.
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PMID:Sinolith in the ethmoid sinus: report of two cases and review of the literature. 2059 72

Yellow nail syndrome is characterized by nail changes, respiratory disorders, and lymphedema. In a yellow nail patient with a skeletal titanium implant and with gold in her teeth, we found high levels of titanium in nail clippings. This study aims to examine the possible role of titanium in the genesis of the yellow nail syndrome. Nail clippings from patients with one or more features of the yellow nail syndrome were analyzed by energy dispersive X-ray fluorescence. Titanium was regularly found in finger nails in patients but not in control subjects. Visible nail changes were present in only half of the patients. Sinusitis with postnasal drip and cough was the most common complaint. The dominant source of titanium ions was titanium implants in the teeth or elsewhere. The titanium ions were released through the galvanic action of dental gold or amalgam or through the oxidative action of fluorides. In other patients the titanium was derived from titanium dioxide in drugs and confectionary. Stopping galvanic release of titanium ions or canceling exposure to titanium dioxide led to recovery. In one patient with a titanium implant, the symptoms recurred after renewed exposure to titanium. Yellow nail syndrome is caused by titanium.
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PMID:Titanium, sinusitis, and the yellow nail syndrome. 2080 68

After exclusion of diverse pulmonary illnesses, the remaining explanations for chronic cough include medication with angiotensin-converting enzyme (ACE) inhibitor, gastroesophageal reflux disease (GERD), and post-nasal drip. Different clinics report shifting frequencies for both the causes of chronic cough and the success of treatment. However, after all evaluations, differential diagnosis still leaves a group of patients with unexplained cough. This unexplained cough is also known as chronic idiopathic cough (CIC), though there are widely varying opinions as to its existence. Among patients previously diagnosed with CIC, a subgroup has been identified with both upper and lower airway symptoms, including cough induced by odours and chemicals, and with increased cough sensitivity to inhaled capsaicin, which is known to stimulate the airway sensory nerves. A suggested explanation for this condition is a hyperreactivity of the sensory nerves of the entire airways, and hence the condition is known as sensory hyperreactivity (SHR). SHR affects more than 6% of the adult population in Sweden. It is a longstanding condition, and is clearly associated with significant social and psychological impacts.
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PMID:The airway sensory hyperreactivity syndrome. 2093 2


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