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)

In April 1988 the Christie Hospital started using the microSelectron-HDR machine to deliver intraluminal radiotherapy (ILT) to inoperable bronchial carcinomas causing symptoms due to endobronchial disease. Results of treatment in the first 406 patients with primary non-small-cell carcinoma are presented. Three main categories of patient were defined. Category 1 consisted of 324 patients (79.8%) who were previously unirradiated and received a single fraction of ILT as their primary treatment, mostly to a dose of 1500 cGy (76%) or 2000 cGy (23%) at 1 cm from the centre of the iridium-192 treatment source. The percentage of these patients whose symptoms or signs were improved at 6 weeks following ILT were as follows: stridor 92%, haemoptysis 88%, cough 62%, dyspnoea, 60%, pain, 50% and pulmonary collapse, 46%. Approximately two-thirds of these patients (67.3%) derived long lasting palliation and required no further treatment during their lifetime. The other third of patients needed subsequent treatment at some stage because of recurrence of their symptoms and in this situation external beam radiotherapy (EB) or a repeat ILT treatment was effectively utilised. Category 2 consisted of 65 patients (16%) who had previously received EB but required ILT when their tumour recurred. At 6 weeks post-ILT levels of symptom palliation were broadly similar to those obtained if ILT was used in previously unirradiated individuals, although the improvement was not so well sustained with time and only 7% showed improvement in pulmonary collapse at 6 weeks. Category 3 consisted of 17 patients (4.2%) in whom ILT was used concurrently with EB as a combined initial treatment. Similar levels of palliation were seen when compared with patients who received a single ILT treatment only. Overall, ILT was well tolerated in terms of early and late morbidity. In conclusion, the efficiency of a single ILT treatment in palliating symptoms due to endobronchial tumour in previously unirradiated individuals is comparable with that reported in series where treatment for advanced lung cancer combines a prolonged course of EB concurrently with several ILT treatments.
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PMID:High dose rate intraluminal radiotherapy for carcinoma of the bronchus: outcome of treatment of 406 patients. 753 4

A 60-year-old woman presented with a cough, nocturnal stridor and dysphagia. Bronchoscopy showed tight compression of the right main bronchus. Digital subtraction angiography (DSA) and a computed tomographic (CT) scan showed the presence of a right-sided aortic arch with aberrant left subclavian artery. The distal right arch and proximal right-sided descending thoracic aorta were aneurysmal and were responsible for this compression. Surgical relief was accomplished by dividing the aberrant left subclavian artery and replacing the aneurysm with a vascular graft.
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PMID:Right aortic arch with aberrant left subclavian artery: aneurysmal dilatation causing symptomatic compression of the right main bronchus in an adult. 757 5

This case report describes an infant who presented with coughing and choking during breastfeeding. Comprehensive clinical evaluation of these difficulties included assessment of sucking, swallowing, and breathing. Stridor and difficulty interspersing breaths during sucking bursts were observed, although sucking mechanics were normal. Further evaluation of airway structure revealed asymmetric laryngomalacia. This structural problem, exacerbated by the breastfeeding position, impeded respiration and resulted in poor coordination of sucking, swallowing, and breathing. This case underscores the need to include respiratory function and coordination in the evaluation of breastfeeding difficulties.
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PMID:Incoordination of sucking, swallowing, and breathing as an etiology for breastfeeding difficulty. 761 70

Laryngeal paralysis is now a frequently recognized disorder, particularly in older dogs of certain breeds such as the Labrador retriever, Afghan Hound and Irish Setter. The presenting signs may consist of exercise intolerance, inspiratory stridor, inspiratory dyspnoea, gagging, coughing and dysphonia. Two forms of laryngeal paralysis exist, hereditary and acquired. The hereditary form is found in young dogs and transmitted by an autosomal dominant gene. At present little is known about the aetiology of acquired laryngeal paralysis and therefore treatment is directed at relieving the laryngeal obstruction. Recent reports indicate that arytenoid lateralization achieves the best results as a method of surgical correction.
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PMID:A review of laryngeal paralysis in dogs. 773 72

The aim of this prospective, randomised, double blind study was to evaluate whether inhaled nebulized corticosteroid is effective in the treatment of croup. Thirty-seven children (aged 0.4-4.9 years) admitted to hospital with moderate to severe croup were allocated to treatment with either 2 mg nebulized budesonide (20) or saline (17). Disease severity was assessed by a clinical croup score based on stridor, cough, retractions, dyspnoea and cyanosis, and the overall clinical assessment was scored on a visual log scale (0-100). Two hours after treatment there was a significant improvement in croup score in the group treated with budesonide (8 to 4.5), but not in the group treated with saline (8 to 8). Furthermore, the overall clinical assessment score decreased significantly (50 to 25) in the group treated with budesonide, whereas it remained constant in the placebo group (60 to 62). The results indicate that nebulised budesonide can be used as a safe and effective alternative treatment in children with moderate to severe croup.
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PMID:[Pseudocroup treated with inhaled steroid (budesonide). A double-blind placebo-controlled trial]. 783 76

To identify behaviors associated with the onset of gastroesophageal reflux episodes in infants both systematically and prospectively, each of 10 patients (aged 2 to 32 weeks) was studied during 2 hours of intraluminal esophageal pH probe monitoring, using a split-screen audiovisual recording technique. Videotape analysis of eight infants who had scoreable reflux events revealed six discrete behaviors closely associated temporally (P < .001 to < .05) with the onset of reflux events: "discomfort" (crying or frowning), "emission" (of liquid or gas, i.e., regurgitation, drooling, or burping), yawning, stridor, stretching, and mouthing. Three behaviors (hiccuping, sneezing, and thumb-sucking) were infrequent but were significantly associated with onset of reflux events in one or two patients each. A tenth behavior, coughing or gagging, was significantly associated with onset of reflux events in two patients, but not in the rest, despite relatively frequent occurrence. Exploration of temporal relations between reflux and each behavior suggested that discomfort, emission, mouthing, and cough-gag may have caused reflux episodes, and that all 10 of the behaviors may have been caused by reflux episodes. These findings and a "quiet period" immediately preceding episodes in six of the infants suggest interesting pathophysiologic mechanisms in infants which require further evaluation.
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PMID:Behaviors associated with onset of gastroesophageal reflux episodes in infants. Prospective study using split-screen video and pH probe. 785 24

Gastroesophageal reflux (GER) in infants is most commonly thought of as repeated excessive vomiting and failure to thrive, with most infants responding favorably to medical therapy. However, GER may also manifest exclusively with a variety of respiratory symptoms that, if not detected and treated early, may lead to life-threatening complications. During the period of 1987 to 1992, 39 neonates and infants underwent Nissen fundoplication for the treatment of respiratory symptoms attributed to GER. Symptoms included apnea and bradycardia (64%), pneumonia (31%), cyanosis (28%), cough (18%), and stridor (15%). Most patients were ascribed at least one incorrect diagnosis to explain respiratory symptoms. These include apnea of prematurity (38%), bronchopulmonary dysplasia (31%), asthma (8%), and subglottic stenosis (8%). All patients underwent a variety of investigations and medical treatments without noticeable clinical improvement. These included bronchoscopy, esophagoscopy, and polysomnograms. Treatment such as antibiotics, theophylline, bronchodilators, steroids, and oxygen were directed at presumed primary respiratory disease. On the other hand, H2 blockers, metoclopramide, positioning, and thickened feeds were prescribed to treat GER without objective evidence of disease. Ultimately, GER was demonstrated by upper gastrointestinal series in 64%, pH probe in 61%, and both studies in 38%. All patients underwent Nissen fundoplication after failed attempts at medical therapy. A total of 95% of patients had resolution or substantial improvement of respiratory symptoms postoperatively. Preoperative hospitalization averaged 37.0 days, and postoperative stay averaged only 14.2 days. We present a series of patients with GER, all of whom presented with respiratory symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnosis and treatment of respiratory symptoms of initially unsuspected gastroesophageal reflux in infants. 794 42

A miniature flexible fiberoptic bronchoscope (FFB) (Olympus BF-N20) (2.2 mm diameter) was applied to 53 children (20 female subjects) ranging in age from 3 months to 15 years (mean, 4.19 years). Most common indications for bronchoscopy included stridor or weak cry and persistent wheezing or cough unresponsive to inhaled bronchodilators, chest physiotherapy, steroids, and antimicrobial agents. There were no complications. In 38 children (71.6 percent) it was diagnostically useful, particularly for the investigations of upper airway obstruction (66 percent). In 22 children (41.5 percent) it provided guidance for surgical interventions. The instrument was particularly useful during its application in infants with severe upper airway obstruction who otherwise would require open rigid-tube bronchoscopy in the operating room. It was of limited value when excessive bronchial secretions obstructed the view of the working field for which a bronchoscope with a built-in suction channel was needed. It is concluded that this miniature FFB is a useful diagnostic tool in infants and children particularly for obstructed upper airways but has limited applications in children with peripheral airway disease. The 2.2-mm bronchoscope may have its greatest advantage in preterm neonates and intubated infants, where the small glottic or endotracheal tube size renders the 3.5-mm bronchoscope useless.
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PMID:Usefulness of miniature flexible fiberoptic bronchoscopy in children. 795 97

We report two cases of localized tracheomalacia, one associated with esophageal atresia, and one isolated. The pathophysiology explains that the symptoms are more important during or shortly after eating, the alimentary bowl crushing the trachea against the aorta, or the innominate artery. The exact cause of tracheomalacia is unknown. Esophageal atresia is frequently associated. The tracheal compression is more often due to the innominate artery, because its origin is located on the left side of the trachea in infants. The aorta or a vascular anomaly are rarely implicated. The symptoms of tracheomalacia are largely due to airway obstruction during expiration: stridor, baking cough, and the life-threatening "dying spell". For diagnosis, the endoscopy is the most important investigation. Among the many methods of treatment which have been proposed, the aortopexy appears to be the technique giving the best results. A single acute apneic attack is an absolute indication for surgery. It is also important to rule out severe gastroesophageal reflux, which can produce the same symptoms.
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PMID:[Value of aortopexy in infants in the treatment of segmental tracheomalacia]. 801 73

We have analysed the clinical manifestations of nine patients with brief upper airway dysfunction (BUAD) who attended the thoracic department of a major teaching hospital between 1987 and 1991. Episodes of BUAD developed within 1-4 months of presentation in three patients but were undiagnosed for 2.5-12.5 years in six. The mean age at onset was 51 years ranging from 37 to 66 years. The episodes occurred at irregular intervals. They lasted approximately 1-5 min, were frightening and consisted of an initial phase of obstructive apneoa lasting a few seconds to 2 min and a second phase of respiratory distress with inspiratory stridor lasting 1-4 min. Daytime episodes occurred in all and at night in five, waking three of the patients from sleep. In most instances, throat irritability triggered the episodes which were often preceded by cough. Potential causes of throat irritability included respiratory tract infection, allergy, oesophageal reflux and obstructive sleep apnoea. After treatment of throat irritability BUAD has ceased for at least a year in six of the eight with adequate follow-up. In conclusion, BUAD has characteristics clinical features which should enable it to be recognized more frequently, ensuring successful management.
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PMID:Brief upper airway dysfunction. 814 10


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