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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adductor laryngeal breathing dystonia (ALBD) is a rare disorder in which patients have persistent inspiratory stridor, usually normal voice, and cough. Physical exam is characterized by paradoxical movement of the vocal cords on inspiration. These patients have involuntary action-induced spasms of the adductor laryngeal muscles on inspiration. There has been no uniformly satisfactory treatment for the disease. Speech therapy, psychotherapy, and pharmacotherapy have all had limited success. We report the successful use of botulinum toxin type A in seven patients with adductor laryngeal breathing dystonia. All patients received bilateral thyroarytenoid injections. All patients had toxin effect within 72 hours, reaching maximal effect within 2 weeks with sustained improvement for an average of 13.8 weeks. Adverse effects included breathy voice and mild choking on liquids. Both resolved, on average, within 2 weeks. This retrospective study supports the safe and effective use of botulinum toxin type A in the treatment of adductor laryngeal breathing dystonia.
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PMID:Treatment of adductor laryngeal breathing dystonia with botulinum toxin type A. 829 54

Viral croup is the most common form of upper airway obstruction in children 6 months to 6 years of age. It typically presents in the late fall or early winter, is often preceded by an upper respiratory infection, and is characterized by a low-grade fever, barking cough, and inspiratory stridor. Diagnosis is made on clinical grounds with no specific confirmatory test. The differential diagnosis of croup, including epiglottitis and retropharyngeal abscess, must always be considered in evaluating children with inspiratory stridor. Three therapeutic modalities are available for the treatment of croup: humidified air, racemic epinephrine, and adrenal corticosteroids. Maintaining at least 50% relative humidity in the child's room is recommended. If there is evidence of hypoxemia, a mist tent with supplemental oxygen may be helpful. Racemic epinephrine administered by nebulizer can quickly reverse airway obstruction in children with croup. The patient needs to be monitored for rebound airway obstruction for at least 2 hours after administration. The mainstay of treatment for severe croup is dexamethasone, administered 0.6 mg/kg, intramuscularly (IM). Dexamethasone is effective at decreasing the obstructive symptoms of croup, but its onset of action is approximately 6 hours after administration. Therefore, administration of racemic epinephrine is often helpful until the steroids begin to take effect. The correct dosage of dexamethasone is important, as lower steroid dosages have proven to be ineffective in treating croup. Dexamethasone IM, or an equivalent dose of oral prednisone, may be considered in children with moderately severe croup who do not require hospitalization.
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PMID:Croup. 833 98

We present the results of a study designed to verify the efficacy of nebulized L-Adrenaline and/or dexamethasone given intramuscularly (IM) in the treatment of croup during childhood. Sixty-six children, hospitalized for croup during the period between october 1989 and september 1990, entered the study. They received the ordinary treatment with oxygen-therapy and fluid-therapy and were randomly assigned, in a double-blind fashion, into one of four treatment groups: Group 1: Nebulized L-Adrenaline and placebo (IM). Group 2: Nebulized saline and placebo (IM). Group 3: Nebulized saline and dexamethasone (IM). Group 4: Nebulized L-Adrenaline and dexamethasone (IM). The clinical evaluation was based on a scoring system assessing the inspiratory stridor, croupy cough, retractions and cyanosis. An analysis of variance was performed on the evolution of the score for two factors (Adrenaline and dexamethasone) to verify that there was no interaction between them. Subsequently, a one-factor analysis of variance was performed on the four treatment groups. We conclude that nebulized Adrenalin is more beneficial than saline in the clinical evolution of croup (p < 0.05). However, we did not find a statistically significant improvement in the group treated with dexamethasone when compared with the group treated with the placebo IM injection.
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PMID:[Randomized double-blind study of treatment of croup with adrenaline and/or dexamethasone in children]. 843 75

The aim of this prospective, randomised, double blind study was to evaluate whether nebulised local steroid treatment is effective in the treatment of croup. Thirty six infants and children (0.4-4.9 years of age) admitted to hospital with moderate to severe croup were allocated to receive either 2 mg nebulised budesonide (20 children) or saline (16 children). Disease severity was assessed by a clinical total croup score based on stridor, cough, retractions, dyspnoea, and cyanosis. In addition the overall clinical impression was evaluated (0-100). Two hours after treatment there was a significant improvement in the total 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 impression 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 total croup score and overall clinical severity were significantly better in the group treated with budesonide than in the placebo group. No side effects were observed. The results indicate that nebulised budesonide can be used as a safe and effective alternative treatment in children and infants with moderate to severe croup.
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PMID:Treatment of croup with nebulised steroid (budesonide): a double blind, placebo controlled study. 846 37

A five year retrospective review of all exposures to a high concentration phenol disinfectant (Creolin Disinfectant 26% phenol) reported to a regional poison center located 96 cases, with 16 cases lost to follow up. There were 60 oral-only exposures, 7 dermal-only exposures and 12 oral/dermal exposure. One patient was an inhalation exposure. Fifty-two cases (65%) were evaluated in a hospital. Eleven patients with oral exposures (14%) experienced rapid CNS depression, but no seizures occurred. Vomiting, coughing, and stridor was noted in 14, 7 and 4 patients respectively. Burns were noted in 17 of 72 (24%) patients with oral exposure and 5 of 19 (26%) with dermal exposure. Seventeen patients underwent endoscopy. Tissue sloughing was noted in one case. All other burns were first degree. No cardiovascular complications occurred. Twenty-eight patients (35%) were followed at home via telephone with one episode of vomiting and one episode of dermal irritation occurring. CNS toxicity from exposure to a high concentration phenol containing cleaning product appears to be rapid in onset. The absence of serious toxicity and major chemical burns in this series does not eliminate concern with the corrosive and systemic risks of phenol poisoning.
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PMID:A five year evaluation of acute exposures to phenol disinfectant (26%). 849 43

Respiratory complications of gastroesophageal reflux disease that have been reported include hoarseness, wheezing, bronchospasm, stridor, laryngitis, and chronic cough. Syncope as a manifestation of gastroesophageal reflux disease-induced cough has not been described in the literature. We present an unusual case of gastroesophageal reflux that resulted in frequent cough-induced syncope. Treatment ultimately consisted of a laparoscopic Nissen fundoplication which resulted in sustained relief from both cough and syncope.
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PMID:Gastroesophageal reflux-induced cough syncope. 854 May 17

Gastro-oesophageal reflux (GOR) has been implicated in such clinical phenomena as aspiration pneumonia, bronchospasm or wheezing, apnea, stridor, and hoarseness. Various tests have been used as an aid to diagnosing patients with chronic respiratory disease where GOR is a causal factor. Different forms of conservative treatment have been tried for GOR, including cisapride. Several studies have evaluated its effect on the pH profile and respiratory symptoms in patients with chronic respiratory disease and have demonstrated improvement of nocturnal wheezing, cough, and irritability. Our experience with cisapride is positive in children with GOR. Patients refractory to medical treatment have been surgically treated with good results.
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PMID:Gastro-oesophageal reflux and chronic respiratory disease in infants and children: treatment with cisapride. 854 28

A 52-year-old woman had a 14-year history of stridor attacks. Pulmonary function tests revealed reversible airway obstruction, and bronchial asthma was diagnosed. She also has bilateral ptosis, diplopia, and moderate weakness of all four limbs; a positive edrophonium test confirmed the diagnosis of myasthenia gravis. Although the parasympathetic system plays an important role in the regulation of bronchial tone, in this patient the edrophonium test did not provoke an asthmatic attack or exacerbate pulmonary function, except for increases in sputum production and in frequency of cough. The general weakness was usually worse in the afternoon. The decrease in grip strength and the shortening of arm elevation time also occurred after asthma attacks, which means that general muscle fatigue was caused by the work of breathing. Furthermore, dyspnea increased and pulmonary function worsened when an anti-cholinesterase inhibitor was discontinued, probably because of respiratory muscle weakness. Accordingly, the clinical status of bronchial asthma seemed to change in parallel with that of the myasthenia gravis.
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PMID:[Bronchial asthma complicated by myasthenia gravis]. 869 67

A case report of a 40-year-old female dental technician with a 13-year history of methyl methacrylate exposure is presented. Symptoms of dyspnea, wheezing, coughing and rhinorrhea occurred 6-8 months after the first occupational contact with methyl-methacrylate containing substances. Skin tests performed with a battery of common allergens produced negative results. While performing a provocation test with methyl-methacrylate, the patient developed severe stridor and dyspnea with concomitant decrease in I second forced expiratory volume (FEV1) and peak respiratory flow (PEF). The increase in leukocytes, eosinophils, basophils, albumin, eosinophil cationic protein (ECP) and mast cell tryptase occurred in nasal lavage fluid after bronchial provocation test. The authors conclude that methyl-methacrylate may cause asthma (probably non-atopic) in persons occupationally exposed to its effect.
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PMID:[Bronchial asthma with inflammation of the nose mucous membrane induced by occupational exposure to methyl methacrylate in a dental technician ]. 876 May 10

Croup is an acute infectious illness usually occurring in children; it is characterized by brassy cough and stridor. The main pathogens include mainly parainfluenza and influenza viruses. Recently there have been reports of prolonged croup caused by the herpes simplex viruses. We report two cases of prolonged croup due to herpes simplex types 1 and 2. We also review and summarize the reported pediatric cases of herpetic croup.
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PMID:Herpetic croup: two case reports and a review of the literature. 883 94


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