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

Gastroesophageal reflux (GER) has been known to occur in infants but was thought to be normal. As a result of increased recognition of GER and a clear documentation of GER with extended (18 to 24 hour) esophageal pH monitoring, several severe complications of GER in children have become apparent. An immature cardiorespiratory system is susceptible to some complications of GER such as apnea, choking, recurrent cough or wheezing, and recurrent aspiration pneumonia. Noncardiorespiratory complications include weight loss, esophagitis, anemia, irritability, posturing, malnutrition, and developmental delays. Nursing assessment contributes to a complete clinical picture and the subsequent treatment choice of the physician. To form an accurate assessment of the child with suspected GER, the nurse must be aware of the symptoms and complications of this condition and must precisely execute diagnostic studies, particularly extended esophageal pH monitoring. Nursing responsibilities also include providing a safe yet stimulating environment for the child, teaching parents to participate in the child's care, supporting parents through hospitalization, and preparing both the parents and child for discharge and follow-up care at home.
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PMID:Nursing responsibility in the diagnosis, care, and treatment of the child with gastroesophageal reflux. 154 68

A total of 36 patients (16 male and 20 female) with tracheobronchial tuberculosis were admitted during the last nine years and were evaluated for their clinical features. The chief complaint in three quarters of the patients was intractable cough, in particular, in those with tracheal tuberculosis. One of three patients who suffered from wheezing was prescribed steroid, being diagnosed as having bronchial asthma instead of tuberculosis. Plain chest X-rays of two patients revealed no abnormality. Pleural effusion was observed in three patients, and miliary tuberculosis in two patients. Bronchial biopsy was carried out in 23 patients, however, in only 11 patients a histopathological diagnosis of tracheobronchial tuberculosis could be made. In contrast, in all 36 patients smear and/or culture for tubercle bacilli were positive. Therefore, bronchial biopsy was considered not to be essential in making a definite diagnosis of bronchial tuberculosis, although it did not exacerbate the lesion to lead to endobronchial stenosis. Only seven out of 36 patients were in the habit of smoking but three of the four had already broken the habit at least one year before being diagnosed as having the disease. The remaining four patients were still smoking but less than 10 cigarettes a day, with one exceptional patient who was smoking 30 cigarettes on average a day. It has been well known that there is a sexual difference in the incidence of bronchial tuberculosis, namely among females with relatively low population of smokers, the incidence is high. Another probable reason for the higher female incidence is assumed to be due to the structural susceptibility of the bronchus with smaller diameter lumen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Active bronchial tuberculosis--a clinical study on 36 cases]. 192 Oct 91

We investigated the relationship of three phenotypic markers of atopy (allergy skin test reactivity, serum IgE level, and eosinophilia) to the prevalence of respiratory symptoms in 1,071 middle-aged and older men participating in the Normative Aging Study. Participants had all been health screened at the onset of the study in the 1960s to exclude individuals with asthma or other chronic respiratory diseases. Respiratory symptoms were grouped into three categories: asthma (adult onset) and other wheezing syndromes; cough and phlegm production; and hay fever. Multivariate logistic regression models were utilized to assess the independent relationship of each phenotypic marker to symptom prevalence adjusted for age, cigarette smoking, and the competing influence of the other markers. In this population, the prevalence of each symptom increased with serum total IgE concentration, this relationship being strongest for asthma. Skin test positivity (greater than or equal to 5 mm induration to one or more aeroallergens) was strongly associated with hay fever but was not significantly associated with symptoms of wheeze or cough and phlegm. Eosinophilia was associated with asthma and with phlegm production. The association of eosinophilia with phlegm production was present in skin test-negative as well as skin test-positive subjects and remained significant even after current smokers and individuals with asthma or hay fever were excluded. These data support the concept that asthma and hay fever are related to different immunologic host factors as reflected by expression of atopy phenotypes. Future investigations of immunologic factors in respiratory disease susceptibility should include, at a minimum, an assessment of all three phenotypic markers of atopy.
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PMID:Asthma, hay fever, and phlegm production associated with distinct patterns of allergy skin test reactivity, eosinophilia, and serum IgE levels. The Normative Aging Study. 192 48

Incidence of foreign body aspiration in tracheobronchial tree is rare, however the foreign body aspiration can lead to severe illness and even death if not diagnosed and treated promptly. We retrospectively analyzed forty five patients who underwent ventilation bronchoscope under general anesthesia for suspected aspirated foreign bodies in our hospital. In thirty eight patients, foreign body was confirmed in tracheobronchial tree, while in seven patients foreign body was not confirmed with bronchoscope. The thirty eight patients ranged in age from 10 months to 73 years; the peak incidence of foreign body aspiration occurred in children under 3 years of age. Twenty five of thirty eight patients were male. Food or food derivatives were the causative agents in 68% of the patients, with 65% due to a portion of peanut. The foreign body was located in the right and left bronchus with almost equal frequency. The main symptoms were coughing (72%), wheezing (53%), and dyspnea (25%). The radiographic abnormality was seen in eighteen of thirty eight patients. A radio-opaque material was seen in 18%. Children at age 6 years of younger (90%) had been witnessed to choke on identifiable foreign body, but only 40% were diagnosed within 24 hours. Twelve of these children were treated unnecessarily for asthma, pneumonia, or so on. We conclude that it is most important to take history carefully considering the possibility of foreign body aspiration in the patients with coughing, wheezing, or dyspnea.
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PMID:[Statistical analysis of tracheobronchial foreign bodies]. 194 19

The first stage of a 2-year survey of respiratory morbidity in primary school children was conducted in two districts of Hong Kong in April/May 1989. One group (2009) of children was from Kwai Tsing District, which had high levels of exhaust emission from factories. The other group (1837) was from Southern District where atmospheric pollution was considered to be relatively low. After adjustment for gender, age, socioeconomic factors, child smoking and exposure to parental smoking, the prevalence ratios of sore throat, evening cough, cough for more than 3 months, morning phlegm and wheezing were found to be significantly higher in Kwai Tsing. The difference between the districts is likely to be related to the environmental air quality. The study, which is continuing, will provide the basis for an evaluation of the impact of new low sulphur fuel regulations introduced in July 1990.
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PMID:Studies on the respiratory health of primary school children in urban communities of Hong Kong. 194 6

This study was carried out in the framework of a health monitoring system set up in the vicinity of a 1400 megawatt coal-fired power plant in Israel. Second- and fifth-grade school children were followed up every 3 years; they performed pulmonary function tests (PFT), and their parents filled out American Thoracic Society-National Heart and Lung Institute health questionnaires. Among the cohort of second graders (in 1983) living in the area expected to be most polluted, a significant increase in the prevalence of part of the respiratory symptoms (such as cough and sputum, wheezing with and without cold and wheezing accompanied by shortness of breath) was evident in 1986. The prevalence of asthma among fifth graders in this area doubled (p = 0.0273) compared with prevalence when they were second graders. Among the children from the older cohort (fifth graders in 1983) living in this community, a similar although milder trend could be observed, especially in regard to an increased prevalence of asthma in 1986 compared with 1983 (13.9% versus 8.1%). Annual increases in PFT in the four groups of children (boys and girls from both cohorts) were found to be higher in the community expected to be polluted (especially in the younger cohort) compared with the two other communities. The discrepancy between the increased prevalence of respiratory symptoms and diseases and the higher annual increase in PFT among children from the expected more polluted community may be partly attributable to differential annual increase in height and to different distribution of background variables (such as socioeconomic status, passive smoking, heating, and respiratory diseases among parents) in the three communities.
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PMID:Follow-up of schoolchildren in the vicinity of a coal-fired power plant in Israel. 195 18

Although both cromolyn (C) and inhaled corticosteroids are anti-inflammatory therapies for childhood asthma, there are few controlled comparisons of these medications for asthma therapy in children. None were conducted in the United States, and none specifically study triamcinolone acetonide (T) versus C. This 12-week evaluation followed 31 youths, aged 8 to 18 years, with moderate asthma who were assigned to receive C or T according to a prerandomized and blinded code. Patients were instructed to take two inhalations from the study metered-dose inhaler (active T or placebo) and to inhale the contents of one study-provided ampule (C, 20 mg, or placebo) from a compressor-driven home nebulizer three times per day. Patients also used albuterol, two inhalations from a metered-dose inhaler, three times a day (before study medication) and, additionally, if needed. Patients maintained a daily diary, recording extra medication use, adverse experiences, peak flow rates morning and night, and asthma symptom scores. Laboratory assessment of pulmonary function was done at 1, 4, 8, and 12 weeks. Cosyntropin challenge and methacholine bronchoprovocation challenge were performed at the beginning and end of the study. C and T provided similar, adequate asthma control. Symptoms of wheezing, cough, and chest tightness decreased, and daily peak expiratory flow rate increased with both regimens compared to during a 2-week baseline when patients received medication only as needed. There was no significant change in methacholine sensitivity and no change in endocrine function, as measured with fasting plasma control before and after administration of cosyntropin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cromolyn versus triamcinolone acetonide for youngsters with moderate asthma. 843 85

Sixty-two black children were prospectively followed up for 1-7 years after pneumonia contracted at a median age of 17 months. In 55% of cases the pneumonia was measles-associated and 27% had serological evidence of infection with other respiratory viruses. Recurrence of cough or wheeze for more than 6 months occurred in 85% with just over 50% having recovered during the follow-up period. While the highest incidence of persistent symptoms occurred in children after measles superinfected with another virus, this was not significant. Abnormal radiographic features persisted in 53% of children and consisted of peribronchial and/or parenchymal lesions. Abnormal large and small airway calibre and/or bronchial hyperreactivity were found in one-third of children, and were significantly more common in those children whose main symptom was recurrent wheezing. Clinical and lung function abnormalities years after lower respiratory tract infection in this group of disadvantaged children compare with reports from more privileged groups. Recognition that long-term sequelae occur may prevent inappropriate subsequent management of symptomatic children.
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PMID:Prolonged after-effects of pneumonia in children. 198 91

Measuring peak expiratory flow rates (PEFR) several times a day can provide an objective assessment of functional changes relative to environmental or occupational exposures. This report describes the pattern of diurnal changes in PEFR in a reference population, and defines ranges of "normal" between- and within-day variability. An index of diurnal changes was defined as the ratio between maximal and minimal values, where the maximal value was restricted to PEFR measured at noon or in the evening (N, E) and the minimal value was restricted to the morning or at bedtime (M, B). A ratio greater than normal represented an exaggeration of the normal diurnal pattern in PEFR. Normal limits, based on the ninety-fifth percentile in the reference population, were larger for children (130%) than for adults 15 to 35 yr of age (117%) and those older than 35 yr of age (118%). The meaningfulness of excessive diurnal changes in PEFR was examined by relating this ratio (Max/Min), and a similar measure (the amplitude percent mean) to chronic respiratory symptoms and diseases in 938 adults and children who recorded PEFR values 2 to 4 times per day for as long as 14 days. There was a strong relationship of diurnal changes in PEFR that exceed normal limits with physician-confirmed asthma (relative risk of 2.99 with Max/Min), with exertional dyspnea (Grade 2+), and with more frequent reporting of acute symptoms of wheeze, attacks of wheezing dyspnea, cough, and chest colds. In addition, those exceeding the normal limits had about 2.9 times greater risk of having a FEV1 below 80% of predicted, and nearly 7 times greater risk of being below 70%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The normal range of diurnal changes in peak expiratory flow rates. Relationship to symptoms and respiratory disease. 199 Sep 47

In some countries a diagnosis of occupational asthma for medicolegal purposes is made when a questionnaire is suggestive and the individual is exposed to a product known to be a sensitizer. The value of an open questionnaire administered by physicians with experience in occupational asthma is unknown, however. We prospectively assessed all subjects (162) referred to our clinic because their physicians thought their asthma might be work related. The medical questionnaire included questions about the nature of the symptoms (dyspnea, wheezing, cough, and chest tightness) and the timing (worse at work or after a shift at work or improved during weekends or holidays). An initial clinical assessment was set by the physician on a scale that ranged from highly probable to probable, uncertain, unlikely, or absent. Subjects then underwent objective assessment with specific inhalation challenges (n = 72), serial monitoring of peak expiratory flow rates for periods at work and away from work (n = 29), or both (n = 61), to confirm or rule out the diagnosis of occupational asthma. A total of 75 subjects (46%) were shown to have occupational asthma. Symptoms alone (type and timing) did not provide a satisfactory differentiation between those subjects with and those without occupational asthma. For example, 66 of 75 (88%) subjects with occupational asthma said that their symptoms improved during holidays, but 66 of 87 (76%) subjects without occupational asthma experienced a similar improvement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is the clinical history a satisfactory means of diagnosing occupational asthma? 200 Oct 62


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