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

One hundred and three hospitalised urban pre-school Nigerian children aged 2 weeks to 4 years with various acute lower respiratory tract infection (ALRI), were studied prospectively over a 9- month period (August 1985 - April 1986). Overlapping seasonal peaks, corresponding to the rainy/early harmattan months of August through November were most noticeable for the two major viral ALRI syndromes namely, bronchiolitis and croup. The overall M:F ratio was 1.1:1, but a corresponding ratio of 1.6:1 was recorded in the infants. The commonest ALRI symptoms were cough, breathlessness and fever while chest wall retraction, nasal flaring, tachypnoea and auscultatory crepitations were the most frequently recognised physical findings. Grunting respiration was recognised in 26 patients, majority of whom had pleural effusion and/or severe bronchopneumonia. Bronchopneumonia was the single commonest ALRI diagnosis, recorded alone or in combination with another lower respiratory syndrome, in 64 (61.2%) of the 103 cases. The croup:bronchiolitis: pneumonia ratio was 1:2.3:8.3. Nasopharyngitis was recorded in 42 (40.7%) of cases, and was frequently associated with the presumably viral ALRI syndromes of croup and bronchiolitis. Pleural effusion, frequently purulent, was the commonest respiratory complication, while heart failure and anaemia were the most frequently recognised associated conditions, found predominantly in patients with pneumonia and bronchiolitis. There was an overall ALRI case-fatality of 7.8%, representing 8 deaths, in 3 of whom measles was a co-morbid condition. All the 8 deaths had a final diagnosis of pneumonia with or without other ALRI syndromes/associated complications. While subjects with complicating pleural effusion recorded the longest mean duration of hospitalisation, those with bronchiolitis had the shortest duration of hospitalisation and no death. The epidemiologic, as well as the diagnostic and therapeutic implications of our observations are discussed.
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PMID:Acute lower respiratory infections in hospitalised urban pre-school Nigerian children: a clinical overview. 762

During October 1989 to March 1990 pediatricians and radiologists conducted a clinical study in Shunyi, Nanbu, and Shifang County Hospitals, China, of 160 healthy children and 541 children with fever and cough to examine the reliability of respiratory rate and various clinical signs in the diagnosis of radiologically confirmed pneumonia among 54 children under 5 years of age. The mean respiratory rate among children with cough and fever was 50 breaths/minute for infants aged 0-11 months and 40 breaths/minute for children aged 1-5 compared with about 40 breaths/minute and 30 breaths/minute, respectively, for healthy children . The researchers deemed these rates to be the cutoff criterion for rapid breathing. Rapid breathing could better predict pneumonia than rales could (positive predictive values, 74.5% vs. 66.9%). Nasal flaring, chest indrawing, and cyanosis of the tongue had high specificities (86.5%, 92.5%, and 93.5%, respectively). Yet these signs occurred in only a small percentage of the population (25.2% for nasal flaring and 10% for chest indrawing and cyanosis of the tongue). Based on these findings, the researchers call for village health workers to use rapid breathing to diagnose pneumonia rather than ausculatory signs, especially rales. Ausculatory signs are unreliable predictors of pneumonia.
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PMID:Respiratory rate and signs in roentgenographically confirmed pneumonia among children in China. 763 27

A double blind randomized clinical trial was performed with pigs suffering from clinical respiratory disease. The goal of the trial was to test the null hypothesis that the clinical recovery after treatment with two oxytetracycline injectables with different pharmacokinetic profiles (high peak concentration and low persistence versus low peak concentrations and long persistence) was similar. Fattening pigs (n = 529) were treated intramuscularly with either product A or product B at a dose of 20 mg OTC per kg b.w. when they showed signs of acute pneumonia, i.e., coughing, tachypnoea or dyspnoea combined with a rectal temperature of 40 degrees C or higher. When necessary, treatment was given again after 3 and/or 6 days. Both treatments resulted in a rapid fall in mean temperature and an improved clinical condition. In this trial no significant differences were found in clinical recovery between the two therapies as measured by group mean temperature, number of pigs requiring retreatment, and time to recovery. The conclusion that there was no important difference in clinical recovery between the treatment groups was made with a power of at least 90%.
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PMID:The clinical recovery of fattening pigs from respiratory disease after treatment with two injectable oxytetracycline formulations. 774 Jul 42

In early phases of neuromuscular disease, patients are either free of respiratory symptoms or have exertional dyspnea not explained by obvious obstructive or restrictive lung disease. Physical examination may be negative because generalized muscle weakness does not correlate with the degree of respiratory muscle involvement. When the diaphragm is involved, one may detect the absence of outward excursion during inspiration or even paradoxic inward inspiratory movement of the abdomen on one side. A substantial loss of respiratory muscle strength is typically accompanied by little or no change in spirometry or arterial blood gas composition. Other characteristics are moderate loss of maximal voluntary ventilation and an increase in residual volume, yet PImax and PEmax may be as low as 50% of the predicted value. In more advanced neuromuscular disease, patients may have severe symptoms if the onset is acute or subacute; however, patients with chronic advanced generalized muscle weakness do not exercise and, therefore, may not be breathless. Many patients with advanced neuromuscular disease present with daytime somnolence as a manifestation of a sleep-related breathing disorder. Physical examination may reveal generalized muscle weakness and difficulty with speech or swallowing. Signs specific to respiratory involvement include tachypnea, use of neck inspiratory muscles and abdominal expiratory muscles, and loss of chest-abdomen synchrony. Sometimes paradoxic bilateral inward movement of the abdomen with inspiration is overt. Patients may be unable to cough effectively, have scoliosis, and lack a gag reflex. At this advanced stage, PImax and PEmax are lower than 50% of the predicted value, and the vital capacity is reduced. Maximal voluntary ventilation increases, and residual volume increases further. Patients may not yet exhibit CO2 retention during the day and may even have a low PaCO3. A sleep study may reveal significant hypopneas with severe desaturation and hypercapnia, especially during REM sleep. It is important to be aware that overt ventilatory failure can occur abruptly and that measurement of arterial blood gas composition is not a reliable indicator of this danger. Therefore, it is critically important to heed clinical phenomena, such as increasing dyspnea and tachypnea, and symptoms of sleep disturbance, such as morning headache and daytime somnolence. Physicians should make serial measurements of VC and respiratory muscle strength in patients considered to be at risk for further deterioration.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Assessment of ventilatory function in patients with neuromuscular disease. 786 89

The demographics and natural clinical history of canine congenital subaortic stenosis (SAS) were evaluated by retrospective analysis of 195 confirmed cases (1967 to 1991), 96 of which were untreated and available for follow-up evaluation. Of these, 58 dogs had left ventricular outflow systolic pressure gradients available for assessment of severity. All 195 dogs were used for demographic analysis. Breeds found to be at increased relative risk included the Newfoundland (odds ratio, 88.1; P < .001), Rottweiler (odds ratio, 19.3; P < .001), Boxer (odds ratio, 8.6; P < .001), and Golden Retriever (odds ratio, 5.5; P < .001). Dogs with mild gradients (16 to 35 mm Hg) and those that developed infective endocarditis or left heart failure were diagnosed at older ages than those with moderate (36 to 80 mm Hg) and severe (> 80 mm Hg) gradients. Of 96 untreated dogs, 32 (33.3%) had signs of illness varying from fatigue to syncope; 11 dogs (11.3%) developed infective endocarditis or left heart failure. Exercise intolerance or fatigue was reported in 22 dogs, syncope in 11 dogs, and respiratory signs (cough, dyspnea, tachypnea) in 9 dogs. In addition, 21 dogs (21.9%) died suddenly. Sudden death occurred mainly in the first 3 years of life, primarily but not exclusively, in dogs with severe obstructions (gradient, > 80 mm Hg; odds ratio, 16.0; P < .001). Infective endocarditis (6.3%) and left heart failure (7.3%) tended to occur later in life and in dogs with mild to moderate obstructions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The natural clinical history of canine congenital subaortic stenosis. 788 29

This study retrospectively reviewed those pediatric patients of acute lower respiratory tract infection with positive virus identification by direct immunofluorescence assay (Direct IF) from Jan, 1992 to Dec, 1993. One hundred and eighteen patients with 133 positive Direct IF results (107 cases with single virus identified, and 11 cases with more than one) were included. The sex ratio was 1.6:1 with males predominant; age, 22.1 (1 approximately 154.8) (months); duration of admission, 5.7 (1 approximately 69) (days); peripheral white blood cell count, 10,600 +/- 3,800/mm3; C-reactive protein, 17.0 (0 approximately 163.3) mu/ml; body temperature, 37.1 +/- 1.1 degrees C in those cases with single virus. The symptoms were cough 105 cases (98.1%), rhinorrhea 46 cases (43.0%), dyspnea and/or tachypnea 43 cases (40.2%) and diarrhea 15 cases (14.0%). The viruses identified were: Adenovirus (52 cases, 39.1%). Influenza B (45 cases, 33.8%), Parainfluenza 1 (28 cases, 20.1%), Parainfluenza 3 (19 cases 14.3%), Respiratory Syncytial virus (17 cases, 12.8%), and Influenza A (9 cases, 6.8%). The seasonal incidence rates were spring (49 cases, 36.8%), summer (46 cases, 34.6%), autumn (23 cases, 17.3%), and winter (15 cases, 11.3%). The results showed much similarity with others, except the commonest viral type (Adenovirus in this study; Respiratory Syncytial virus in others) and the seasonal incidence rate (higher in spring and summer in this study but not in others). In conclusion, most children with acute viral lower respiratory tract infection had an uneventful course and Direct IF is a reliable method for viral detection in that disease.
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PMID:Study on the children of Kaohsiung with acute viral infection of lower respiratory tract by direct immunofluorescence assay. 798 92

Pulmonary edema is a frequent and common cause of death in patients in critical care settings. It is seen as a complication of myocardial infarcts, hypertension, pneumonia, smoke inhalation, and high-altitude pulmonary edema. Pulmonary edema occurs when there are alterations in Starling forces and capillary permeability, opposition to lymphatic flow in the lungs, decreased plasma oncotic pressure, central nervous system lesions, and following some types of strenuous exercise. Pulmonary edema presents initially with crackles, wheezing, and dry cough and progresses to tachypnea, dyspnea, orthopnea, pink frothy sputum, and cyanosis. Treatment involves supportive therapy, reduction in blood volume, and oxygen therapy.
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PMID:Pathophysiology of pulmonary edema. 800 Sep 33

Accidentally occurring hydrocarbon poisoning during early childhood is a frequent and in most cases benign event. Nevertheless there is a potential risk of more serious consequences. We describe such a case. Respiratory symptoms are of the greatest concern. They include cough, tachypnoea, and in the more serious cases cyanosis and respiratory failure. Moreover, symptoms from the gastrointestinal tract are common. Treatment includes prevention of aspiration, symptomatic treatment and in more serious cases respiratory support.
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PMID:[Poisoning with petroleum preparations--again!]. 801 70

We prospectively studied 110 adult patients coming to Black Lion Hospital between August 1987 and July 1989 with community acquired pneumonia (CAP) for various etiologic agents and clinical and radiographic presentation. Streptococcus pneumoniae was the most common offending pathogen in 72% and 67.5% from sputum and lung aspirate (LA) Gram stain respectively, and in 41% by pneumococcal serotyping of sputum. Blood and LA culture grew Streptococcus pneumoniae in 4 (6%), Staphylococcus aureus in 4 (6%), Enterobacteriaceae in (3%), Pseudomonas, Klebsiella and Streptococcus viridans in one case each. Non-bacterial pathogens included Mycoplasma pneumoniae in 3 (3%), Influenza A in 4 (4%), Influenza B in 3 (3%) and psittacosis/LGV in 4 (4%). Fever, cough, chest pain, tachypnea and coarse crepitations/bronchial breathing were the most common presenting signs and symptoms. Thirty per cent had associated diarrhoea and vomiting initially and 9% had altered state of consciousness at admission. Six patients came in a state of shock. Thirty-nine per cent had underlying illnesses. Ninety-three per cent had either segmental or lobar consolidation. Parapneumonic effusion occurred in 14%. The mortality was 11%. Tachypnea, the presence of underlying illness, altered state of consciousness, extreme leucocytosis and the presence of bilateral and multilobar lung involvement were found to be signs of poor prognosis. Our finding is similar to those from other African countries, except that we are reporting psittacosis/LGV for the first time in Africa.
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PMID:Community acquired pneumonia in adults in Addis Abeba: etiologic agents, clinical and radiographic presentation. 803 77

The purpose of the study was to administer therapeutic aerosol generated by metered-dose inhalers to horses exhibiting clinical signs of heaves using a compact inhalation device developed for human medicine. It was fitted to a custom face mask in order to study the effect of an inhaled beta 2-agonist, fenoterol. Pulmonary function testing was performed on six horses following an acute exacerbation of heaves, characterized by tachypnea, wheezes, crackles, and spasmodic cough. Horses inhaled fenoterol in 1 mg increments administered as one 200 microgram puff every 5-10 s with the recording of data 5 min after the cessation of drug inhalation. A significant effect of fenoterol was shown for maximum change in transpulmonary pressure, dynamic compliance, lung resistance, and work of breathing, and the wheezes and crackles disappeared when auscultation was performed at the end of the test. This study demonstrates a novel, highly effective method for the rapid administration of inhaled medication in horses.
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PMID:The rapid and effective administration of a beta 2-agonist to horses with heaves using a compact inhalation device and metered-dose inhalers. 805 32


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