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)

A 23-year-old woman, who had suffered recurrent acute bronchitis, dyspnoea, and stridor, was found to have a tracheal stenosis and complete left main bronchus obstruction. Biopsy of the tumour showed an adenoid cystic carcinoma. After pneumonectomy the trachea was closed through tumour tissue. Two weeks later a right thoracotomy showed that a tumour had invaded the trachea from the carina up to 6 cm and the right stem bronchus for 1 cm. Under extracorporeal circulation 7.5 cm of the trachea and right bronchus were resected. A direct tracheal anastomosis was easy to perform. Spontaneous respiration with efficient coughing returned after five days. Unfortunately, one month later, high fever caused by a lung abscess developed, which provoked a massive haemoptysis with fatal outcome.
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PMID:Surgical treatment of adenoid cystic carcinoma of the left main bronchus and trachea by left pneumonectomy, resection of 7.5 cm of trachea, and direct reanastomosis of right lung. 22 43

A five week old male infant is treated under suspicion of whooping cough because of pertussis like cough, cyanosis, and attacks of reflex apnea. These attacks are seen up to 40 times per day. After exclusion of a cerebral genesis there was found a ventral indentation of the trachea. It was also seen by tracheoscopy, but this part of the trachea was not pulsating. In the angiography the compriming structure was identified as the innominate artery. The genesis of this anatomic variant, the often threatening symptoms in this case without inspiratoric stridor, and the diagnostic and therapeutic steps are discussed.
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PMID:[Tracheal compression by the innominate artery (author's transl)]. 39 7

Laryngotracheobronchitis (LTB) continues to occur in epidemics necessitating many hospital admissions. A short barking cough, stridor with a crowing sound on inspiration, and retractions of the intercostal respiratory muscles are hallmarks of the disease. LTB is most frequently a viral disease causing acute inflammation of the subglottic area, the trachea, and the segmental bronchus. Increasing subglottic edema and generalized fatigue of patients with this disease can cause progression of airway obstruction. Respiratory and cardiac arrest follow unless an immediate airway is established. The management of LTB is primarily medical and consists of moist air, sedation, close observation, and occasionally antibiotics. Patients with respiratory difficulties severe enough to require intubation should undergo direct laryngoscopy and bronchoscopy to rule out other causes of airway obstruction.
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PMID:Laryngotracheobronchitis--a continuing challenge in child health care. 52 58

Procaine suppresses the cough reflex, decreases laryngeal irritability, and has general anesthetic properties. For these reasons, 14 pediatric patients undergoing CO2 laser resection of laryngeal papillomas were studied in which an intravenous infusion of procaine (1 mg/kg/min) was added to N2O-O2 halothane/enflurane general anesthesia immediately following endotracheal intubation. These patients were compared to nine patients receiving the same anesthesia without procaine. The mean age of both groups was 11 years. There was no difference between the groups in duration of anesthesia or surgery. Emergence, however, averaged 15 minutes in study patients compared to 36 minutes in the control group (p less than 0.01). There was no difference in anesthetic concentrations required to maintain satisfactory operative conditions in the two groups. Muscle relaxants were required intraoperatively in seven control patients but in none of the study patients. The surgeon ranked the operative conditions excellent in all study patients but poor in seven of the nine control patients. Five of the latter required postoperative treatment of laryngeal complications, including reintubation in three. Only one of the study patients had postoperative stridor. No evidence of procaine toxicity was noted in the study patients with total doses ranging from 500--3600 mg. Intravenous procaine is useful in pediatric patients having endoscopic laryngeal operations.
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PMID:Intravenous procaine as a supplement to general anesthesia for carbon dioxide laser resection for carbon dioxide laser resection of laryngeal papillomas in children. 57 34

Croup is a syndrome of inspiratory stridor, cough, and hoarseness, due to varying degrees of laryngeal obstruction. It is a viral disease and must be differentiated from epiglottitis. In addition to a careful clinical assessment, neck films are the most valuable diagnostic tool in differentiating these two. The principle modes of therapy for croup include provision of adequate hydration, ensuring maximum available humidification, sedation, and administration of intermittent positive pressure breathing (IPPB) with nebulized racemic epinephrine. The latter mode of therapy will provide symptomatic relief and may eliminate the need for hospitalization and tracheostomy. Steroids offer little benefit in treating this disease, and antibiotics offer none.
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PMID:Recent advances in diagnosis and management of croup. 109 1

Mycoplasma pneumoniae (M. pneumoniae) infection in infants had been considered to be very rare, but recently some clinical cases have been reported. We experienced an epidemic of M. pneumoniae infection in a nursery school, and compared M. pneumoniae infection in infants with that in preschool and school children to investigate the features of infantile M. pneumoniae infection. We obtained the following clinical findings in 15 infantile patients with M. pneumoniae infection: The maximum body temperature scarcely increased to 38.5 degrees C or more and the period of high temperature and cough was shorter in infant patients than in preschool and school aged patients. Stridor occurred in 4 patients but skin disorder was not observed. In the laboratory findings, the white blood cell count tended to increase with no changes in neutrophil/lymphocyte ratio and CRP increased slightly. M. pneumoniae antibody was negative in all the patients except 3 and old hemagglutination tests were positive in only 4 patients. The chest X-ray examinations showed a mild increase in the hilar shadow. However, the sequentially located homogeneous shadow which is commonly seen in preschool and school aged patients was not detected. M. pneumoniae antibody scarcely increased in infantile patients but M. pneumoniae was isolated by throat culture from 14 of the 15 patients who were diagnosed as having M. pneumoniae infection.
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PMID:[Mycoplasma pneumoniae respiratory tract infection prevailing among infants at a nursery school]. 129 57

In July-August 1989, 2 primary health care (PHC) workers (nurses and nurse's assistants) and a pediatrician used WHO case management protocol to assess the conditions of 362 2-59 month old children who came to Mbabane Government Hospital and the Salvation Army Clinic in Mbabane, Swaziland, with coughing (99%) and difficulty in breathing (29%). The PHC workers had earlier undergone a 5-day training period on identifying signs and symptoms of pneumonia. A consulting pediatrician and a public health official conducted this study to compare the ability of the PHC workers to recognize the clinical signs of pneumonia with that of the pediatrician (gold standard). 64% of the children had a history of fever, but only 12% had a fever (38.3 degrees Celsius) at admission. 4 children had had convulsions. The PHC workers did not do well at recognizing the danger signs of stridor and abnormal sleepiness (sensitivity 50% and 0-14%, respectively). They were able to correctly recognize the danger sign of severe undernutrition in 2 children, however. They correctly identified most children with true fever (sensitivity 73-76%), yet they also claimed that many children with normal temperature had a fever (specificity 62-78%). Thus they would have administered antipyretics to 2-3 times too many children. The nursing assistants detected audible wheeze in only 4 of 14 children with audible wheeze (sensitivity 29%), while the nurses only detected 2 such children (sensitivity 14%). Further, they diagnosed audible wheeze in 18 children who actually had blocked nostrils. They correctly identified fast breathing in almost 75% of cases. Nurses were more likely to correctly diagnose chest wall indrawing than the nursing assistants (sensitivity 68% vs. 34%; p = .0048). Overall, the training helped the PHC workers to diagnose pneumonia quit well (sensitivity 71-83%, specificity 84-85%). Future training programs must focus on recognition of 2 danger signs, stridor and abnormal sleepiness, however.
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PMID:Recognition of pneumonia by primary health care workers in Swaziland with a simple clinical algorithm. 136 98

A specific entity known as a subglottic hemangioma may present in a six to 12-week-old baby with gradual onset of a two-way stridor. A cough may be present. The voice and feeding may be normal, until severe airway obstruction occurs. A barium swallow with fluoroscopy should be performed by a radiologist or technician experienced with babies to rule out other lesions such as a vascular ring. Direct examination is then performed using a 3.0 mm Storz-Hopkins bronchoscope under general anesthetic as a method of choice. Other methods are discussed. Ideal treatment is probably best undertaken in a large center, using a carbon dioxide laser through a subglottiscope again under general anesthesia with the child breathing spontaneously. Airway support may be necessary at any stage. Alternative treatments are discussed.
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PMID:Subglottic hemangioma: a practical approach. 149 84

A patient's tolerance of fiberoptic bronchoscopy depends on the effectiveness of local anesthesia. This study compares the three different methods of local anesthesia in common use After sedation, patients (n = 53) received either 4 ml of 2.5 percent cocaine by intratracheal injection (TI) (n = 18), by bronchoscopic injection (BI) (n = 19), or had 4 ml of 4 percent lidocaine delivered by nebulizer 20 min before the procedure (NEB) (n = 16). Patients and bronchoscopists scored the procedure using visual analog (VAS) and severity scales. Objective measurements of cough counts and episodes of stridor were recorded by phonopneumography. Patients' VAS scores showed a clear preference for the transtracheal method compared with either bronchoscopically injected cocaine (p less than 0.001) or nebulized lidocaine (p less than 0.001). Patients also reported that the TI method produced less cough during intubation of the larynx and inspection of the airways (BI and NEB, p less than 0.01). The TI method was also preferred by the bronchoscopists (BI and NEB, p less than 0.001); they reported less cough and easier tracheal intubation. The mean cough count was significantly lower for the TI group, 49 (43) compared with 95 (52) for BI (p less than 0.01), and 81 (43) for the NEB group (p less than 0.05). Patients' and bronchoscopists' VAS showed significant correlation with cough (r = 0.63-69, p less than 0.01). Stridor occurred in only two patients after TI, compared with 15 in the other two groups. Extra local anesthesia was required by 16 patients after BI, by all the NEB group, but by only one patient after TI. Subjective and objective measurement shows that 4 ml of 2.5 percent cocaine injected into the trachea produced excellent local anesthesia for fiberoptic bronchoscopy, there were no extra complications, and it was the method preferred by both patients and bronchoscopists.
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PMID:Comparison of three different methods used to achieve local anesthesia for fiberoptic bronchoscopy. 151 90

A retrospective analysis was completed of the charts of the 1,727 patients with the diagnosis of croup seen during two years (1985 and 1986) in the Emergency Department of The Hospital for Sick Children in Toronto. Cough (91.4%) was the most common presenting symptom. Other presenting signs and symptoms included stridor (57.5%), chest wall retraction (38%), coryza and wheezing (18.5%) and tracheal tug (15%). The majority of patients were treated on an ambulatory basis while 377 (21.7%) were admitted for further management. Inpatient treatment included racemic epinephrine (120 patients) and parenteral steroids (17). Twelve (12) patients required airway support (endotracheal intubation). No tracheotomy for tracheitis was performed during this two year period. No deaths occurred in this patient population.
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PMID:Tracheitis: outcome of 1,700 cases presenting to the emergency department during two years. 156 45


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