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)

Information on long-term respiratory symptoms in prematurely born children is scanty. We studied an unselected population of 9- to 11-year-old schoolchildren. A self-administered questionnaire was distributed to the parents. Children underwent lung function testing, cold air challenge, and skin prick tests. A gestational age < 37 weeks in children with a birth weight < or = 2500 gm was reported by 5% of the parents. Premature girls had significantly more current asthma (odds ratio (OR) 2.6; 95% confidence interval (CI) 1.4, 4.7; p < 0.05), recurrent wheezing (OR 1.7; 95% CI 1.1, 2.7; p < 0.001), recurrent shortness of breath (OR 2.4; 95% CI 1.5, 3.9; p < 0.001), and frequent cough with exercise (OR 1.8; 95% CI 1.1, 2.9; p < 0.05) than term girls, especially if they required mechanical ventilation after birth. No such differences could be shown in boys. More prematurely born children who required mechanical ventilation (OR 3.7; 95% CI 2.2, 6.4; p < 0.0001) had a family history of asthma than children born at term. Significant decrements could be demonstrated for different measurements of lung function in premature girls. These results remained significant after control for confounders in a multivariate regression analysis. No difference was found between groups for bronchial hyperresponsiveness to cold, dry air or for atopic sensitization. We conclude that a family history of asthma may predispose premature children to more severe respiratory disease. Respiratory symptoms and decrements in lung function seen in girls may reflect abnormalities of lung function in survivors of severe neonatal respiratory disease.
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PMID:Prematurity as a risk factor for asthma in preadolescent children. 834 17

The Chronic Obstructive Pulmonary Disease Early Intervention Trial, or Lung Health Study, is a multicenter randomized clinical trial sponsored by the Division of Lung Diseases of the National Heart, Lung, and Blood Institute. The hypothesis being tested is that over a 5-year period, a comprehensive intervention program can reduce both the rate of decline in pulmonary function and the rates of respiratory morbidity and mortality in middle-aged smokers with mild to moderate airflow obstruction. The primary outcome variable of the trial is the annual rate of decline of maximum postbronchodilator FEV1. Secondary outcomes are the development of respiratory and nonrespiratory morbidity and mortality. After screening 73,694 cigarette smokers, aged 35 to 60 years, 5,887 participants were randomized into three equal groups: usual care, smoking intervention with daily use of a metered-dose inhaler with ipratropium bromide, and smoking intervention with inhalation of placebo. Eligible participants had a ratio of FEV1 to forced vital capacity (FVC) of 70 percent or less, were free of known life-limiting conditions, expressed willingness to enter the intervention program if so randomized, and gave written informed consent prior to entry into the trial. Spirometry, methacholine challenge, and questionnaires were strictly standardized within and across centers. The purpose of this report is to describe the characteristics of randomized participants at the time of entry into the study. For both sexes, three measures of lung function--average cross-sectional FEV1/FVC ratio, FEV1, and FEV1 percentage of predicted normal--showed slight downward trends for each successively older 5-year age cohort. The increase in FEV1 after isoproterenol was 15 percent or more in only 2.4 percent of men and 2.8 percent of women. A positive response to methacholine (defined as a fall in FEV1 of > 20 percent from baseline at concentrations up to 25 mg/ml) occurred in 63 percent of men and 87 percent of women. The cross-sectional prevalences of cough, phlegm, wheeze on most days or nights, and shortness of breath were 49 percent, 43 percent, 32 percent, and 43 percent, respectively. Respiratory symptoms were reported by a higher proportion of participants in the younger age groups than in the older age groups. Participants who reported cough, phlegm, and/or wheeze averaged lower FEV1 percent predicted and higher probability of positive response to methacholine than participants who did not. Shortness of breath appeared to be significantly associated with lower lung function and higher reactivity in men but not in women.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Chronic Obstructive Pulmonary Disease Early Intervention Trial (Lung Health Study). Baseline characteristics of randomized participants. 840 77

Respiratory symptoms are common in childhood with as many as 25% of children aged 7-10 years being troubled by recurrent episodes of cough and wheeze. Subjects with and without asthma differ both in the ease with which airway narrowing is produced by inhalation of nonallergic or nonsensitizing stimuli. A few epidemiologic studies are concerned with the prevalence of bronchial hyperresponsiveness in unselected children. Although increased airway responsiveness is predominantly reported in atopic individuals, even children with no history of atopy or symptoms suggesting asthma produce a bronchial obstruction being challenged by physical exercise, inhalation of cold air or distilled water and pharmacologic stimuli. The relationship between responsiveness to different challenges was investigated in 2 large epidemiological studies on school aged children. The following reports are an informative survey on acceptance, sensitivity, specificity and predictive value of epidemiologic instruments estimating bronchial responsiveness.
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PMID:[Bronchial hyperreactivity and epidemiology of bronchial asthma in childhood]. 846 55

The relation between air pollution and the exacerbation of childhood asthma was studied in a panel of 71 children (aged 5 to 7 yr) with mild asthma who resided in the northern part of mexico City. During the follow-up, ambient measures of particulate matter less than 10 microns (PM10, 24-h average) and ozone (1-h maximum) frequently exceeded the Mexican standards for these contaminants. The peak expiratory flow rate (PEFR) was strongly associated with PM10 levels and marginally with ozone levels. Respiratory symptoms (coughing, phlegm production, wheezing, and difficulty breathing) were associated with both PM10 and ozone levels. An increase of 20 micrograms/m3 of PM10 was related to an 8% increase in lower respiratory illness (LRI) among children on the same day (95% confidence interval [CI] = 1.04-1.15), and an increase of 10 micrograms/m3 in the weekly mean of particulate matter less than 2.5 microns (PM2.5) was related to a 21% increase in LRI (95% CI = 1.08-1.35). A 50 parts per billion (ppb) increase in ozone was associated with a 9% increase in LRI (95% CI = 1.03-1.15) on the same day. We concluded that children with mild asthma are affected by the high ambient levels of particulate matter and ozone observed in the northern part of Mexico City.
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PMID:Effects of air pollution on the respiratory health of asthmatic children living in Mexico City. 875 98

One hundred seventy-two preschool children, aged three to six years, who attended municipal day-care centers in central and suburban areas of Helsinki, were followed up for seven weeks during the winter season and for eight weeks during the spring season in 1991. For each child, the weekly average NO2 exposure was estimated using passive samplers attached to the outer garments of the children during their everyday activities. Respiratory symptoms were recorded in daily diaries by the parents. The median of personally measured seasonal NO2 exposures was 21 micrograms/m3 (range 11-45.8 micrograms/m3). The seasonal median NO2 exposure was significantly larger (p < 0.001) in the central area (27.4 micrograms/m3) than in the suburban area (18.2 micrograms/m3), reflecting a difference in exposure caused by automobile traffic. There also were significantly (p < 0.001) more days with stuffed nose (26% vs. 20%) and cough (18% vs. 15%) in the central area than in the suburban area. At the individual level, there was a nonsignificant positive correlation between personal NO2 exposure and cough during the spring season. Thus the areal difference in these symptoms was partly, but not completely, due to the difference in exposure to NO2.
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PMID:Seasonal exposure to NO2 and respiratory symptoms in preschool children. 879 97

This study was undertaken to assess the long-term respiratory health consequences of smoke inhalation in patients who are burns survivors. Patients with smoke inhalation resulting from domestic flame or fire were studied. Medical records were the primary source for the selection of the patients. Smoke inhalation was diagnosed on the basis of the visual appearance of the airways on the reported bronchoscopy. Patients who participated in the study were compared on important characteristics with those who did not participate. The participants were then assessed by questionnaire, physical examination, chest radiograph and pulmonary function tests. Twenty three out of 45 patients who had survived smoke inhalation participated in the study. Participants and nonparticipants were comparable with respect to gender, age, time since injury, aetiology of injury, and total body surface burned. Participants had more facial burns, more severe bronchoscopic findings of smoke inhalation and required intubation more frequently. Respiratory symptom assessment and pulmonary function tests were performed 45 +/- 23 months after smoke inhalation. Four patients reported an increase in dyspnoea, one an increase in cough and one an increase in phlegm. All the patients had pulmonary function tests and bronchial responsiveness (provocative concentration of histamine resulting in a 20% fall in forced expiratory volume in one second (PC20) > 16 mg.mL-1) within normal limits. The four patients complaining of increased dyspnoea had results within normal limits for cardiac and respiratory variables on maximal exertion. The present study indicates that, in burn patients, smoke inhalation resulting from a single domestic fire does not necessarily imply long-term respiratory health consequences.
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PMID:Combined smoke inhalation and body surface burns injury does not necessarily imply long-term respiratory health consequences. 883 61

Health hazards associated with wood dust exposure have been investigated in various industries. This study surveyed wood dust exposure levels and pulmonary effects among joss stick workers. Greater dust concentrations, as measured by six-stage cascade impactors, were observed in work areas where joss sticks were produced and incense was mixed than in other work areas. Total dust concentrations for these two high dust activities ranged from 9.9 to 42.7 mg/m3, and respirable proportions were between 2.0% and 54.6%. Higher dust levels were observed for dry joss stick production methods than for wet production methods. Dust levels for all other performance areas were lower than the permissible exposure level of 10 mg/m3. Although symptoms of cough and phlegm were higher in smoking workers than in nonsmoking workers, the prevalence of respiratory symptoms for exposed workers was not significantly higher than for the controls. The prevalence of pulmonary function deficits and the values of FEF25% and FEF75% in the exposed workers were significantly worse than those in the controls. But no difference was found between the male controls and the male exposed workers, the high-exposure group. Respiratory symptoms and pulmonary function also did not show a dose-response trend with the exposure levels estimated by correlation with worker job titles and duration of employment. No suspected case of pneumoconiosis was found from the chest radiographs. These results suggest that wood dust exposure in the joss stick industries might not lead to significant pulmonary damage.
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PMID:Respiratory symptoms and pulmonary function among wood dust-exposed joss stick workers. 891 42

A 62-year-old man was referred to our department because of exertional dyspnea and a 6-year history of coughing and sputum production. He had never smoked, and had had an operation for chronic paranasal sinusitis. Coarse crackles and rhonchi were audible over both lower lung fields. The cold hemagglutinin titers were high. pulmonary function tests showed airflow obstruction, and a sputum culture revealed Hemophilus influenzae A chest X-ray film and a CT scan showed diffuse micronodular shadows in the centrilobular regions, mild ectasis of bronchioles mainly in the lower lung fields, and mild hyperinflation. A specimen of lung tissue was obtained by thoracoscopic biopsy, and histologic examination showed bronchiolitis obliterans, with bronchiolar narrowing or obliteration due to submucosal fibrosis and inflammation. Rheumatoid arthritis was diagnosed 14 months after the operation. The patient was treated with clarithromycin for 3 years. Respiratory symptoms were relieved and pulmonary function gradually improved.
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PMID:[Bronchiolitis obliterans preceding rheumatoid arthritis: effect of clarithromycin]. 897 86

Respiratory symptoms and ventilatory capacity were studied in 97 women carpet weavers in a hand-made carpet weaving industry in Umtata, Transkei, South Africa. The controls were from a bottling plant in the same city. Both groups were Black Africans from the Xhosa-speaking population. The population we studied were non-smokers and there was no significant difference in age, race or height between the groups. The exposed weavers had significantly lower forced expiratory indices than the control group. Mean forced expiratory volume in 1 second (FEV1), forced mid-expiratory flow (FEF 25-75%), forced expiratory flow between 200 ml and 1200 ml of forced vital capacity (FEF 200-1200), and peak expiratory flow (PEF) were: 26.0%, 39.0%, 36.4% and 28.5% lower respectively in the exposed group compared with the controls. Mean forced vital capacity (FVC) and forced expiratory ratio (FEV1/FVC x 100) were 22.0% and 6.6% lower respectively in the exposed group compared with the controls. The percentage predicted (%pred) values of FVC, FEV1, FEV1/FVC ratio, FEF 25-75%, FEF 200-1200, and PEF in the exposed group were 82.9%, 77.1%, 95.6%, 64.6%, 72.2% and 82.8%, respectively. The prevalence of FEV1/FVC ratio less than 70% in the exposed group was 37.2%, while in the controls it was 12%. The exposed group reported a significantly higher prevalence of respiratory symptoms compared to the control. The prevalence of nasal symptoms and cough was 62.8% and 58.1%, respectively in the weavers. Weavers who reported cough, breathlessness, and wheezing had significantly (p < 0.01) lower pulmonary function than those who did not report these symptoms. The present study demonstrates that the continual exposure to dust in weavers in this industry is associated with significantly lower pulmonary function, higher prevalence of respiratory symptoms, and weavers show signs of airway obstruction compared to workers not exposed to this type of dust. Women in the weaving industry have a significant occupationally related respiratory impairment.
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PMID:Respiratory symptoms and pulmonary function in a group of women weavers in South Africa. 923 35

Respiratory symptoms are the most common cause of general practitioner (GP) consultation, and hospital-based specialists are often called on to provide management guidelines, particularly in the area of antibiotic prescribing. The present authors have assessed factors associated with antibiotic use by 115 GPs when managing 1089 adults with an acute lower respiratory tract illness, including cough. They prescribed antibiotics to three-quarters of patients, but felt antibiotics to be definitely indicated in less than one-third of these cases and not needed in one-fifth. Univariate analysis revealed that antibiotics were prescribed more frequently by older GPs for older patients in the presence of underlying disease, discoloured sputum, shortness of breath, wheeze, fever, signs on chest examination, and 'other factors'. Multivariate logistic regression confirmed an independent effect for all these findings except for the presence of underlying disease, shortness of breath and wheeze. 'Other factors' included patient 'pressure' and social factors, and GP work pressure or prior experience with the patient. These factors were an important influence on prescribing, especially if the GP felt an antibiotic was not indicated. Amoxycillin was the first choice (58% of total) except where the patient had recently received antibiotics for the same illness. Broader spectrum antibiotics were used more commonly in patients with chronic lung disease, discoloured sputum, chest signs on examination and where the GP felt antibiotics were indicated. However, these antibiotics were also prescribed to 14% of previously well patients. General practitioners used a wide variety of terms to describe the illness with little consistency or structure. The decision concerning the use and choice of antibiotics and the confidence with which the GP makes that decision is a complex interaction between patient, doctor and disease, being affected not only by clinical features but also by the social and psychological elements of the presenting problem. Such issues need to be appreciated by hospital specialists when called on to advise on developing relevant guidelines for primary care.
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PMID:Contemporary use of antibiotics in 1089 adults presenting with acute lower respiratory tract illness in general practice in the U.K.: implications for developing management guidelines. 932 45


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