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)

This double-blind parallel trial evaluated the efficacy of cloprednol, a new synthetic glucocorticoid, in 40 patients with asthma. Patients kept daily records of wheezing, chest tightness, shortness of breath and cough. Analysis of these records showed cloprednol to be statistically significantly better than placebo for the relief of these symptoms (p values ranged from less than 0.01 to less than 0.0001). Weekly physician evaluations of asthma severity, symptoms since last visit and number of asthma attacks also showed a significant drug effect in favor of cloprednol. These subjective findings were confirmed by objective pulmonary function tests (FEV1.0, FVC and PEFR). There was a statistically significant difference favoring cloprednol for all the pulmonary function measurements. Previous studies have suggested that at equipotent anti-inflammatory doses cloprednol is less suppressive of hypothalamic-pituitary-adrenal axis function. Although plasma cortisol levels were not measured in this trial, none of the patients manifested clinically important side effects which required termination of their participation in the study.
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PMID:Comparative study of cloprednol versus placebo in asthma. 35 97

Bromhexine, 16 mg. 3-times daily, was compared with placebo in a double-blind crossover trial in 41 out-patients with chronic bronchitis and irreversible airways obstruction, and who were considered to be in a steady state. Each treatment was given for 3 weeks with a week of placebo in between; in addition, all patients took oxytetracycline, 500 mg. twice daily, starting 1 week before the trial and continuing throughout the duration of it. All patients completed the trial but the results from 5 were excluded because during the first 3 weeks they developed an influenza-like illness accompanied by a decrease in FEV1,and peak expiratory flow rate. Results from the remaining 36 patients showed a statistically significant reduction in phlegm stickiness (p smaller than 0.05) as judged by the patient, and a significant improvement in overall clinical state (p smaller than 0.05) as judged by the physician during bromhexine treatment, but no significant change in symptoms like cough, chest tightness, ease of breathing or sputum volume, peak expiratory flow rate and FEV1 etc. Five patients reported 6 side-effects, 3 with bromhexine, 1 with placebo and 1 with both treatments.
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PMID:A controlled trial of bromhexine ('Bisolvon') in out-patients with chronic bronchitis. 109 7

The upper and lower airways have complimentary roles in the ultimate object of supplying the body with oxygen whilst removing waste products of metabolism. Pathology in one area may trigger a response in another, the physiology of which, in the case of virus-induced asthma exacerbations remains poorly characterized. Viral infection of the upper airways by common cold viruses frequently triggers a response in the lower airways leading to prolonged morbidity, especially in subjects with significant pre-existing airway disease. The induction or amplification of BHR may be an important mechanism whereby asthmatic symptoms are produced although the cellular and tissue events or reflex mechanisms activated by viral illnesses and underlying BHR changes are poorly defined and may be dependent on the type and the severity of infection. Children and asthmatics tend to develop frequent colds setting in motion a sequence of events culminating in airway obstruction and symptoms of wheezing, coughing and chest tightness. This may reflect independent inflammatory changes caused by a simply additive effect of viral damage to the mucosa superimposed upon pre-existing allergic inflammation (Fig. 1). Few if any symptoms will develop in normal subjects with a mild cold whereas significant symptoms may ensue if the cold is severe and induces marked lower airway swelling, secretions and smooth muscle contraction; pathology to which children who have small calibre airways may be particularly susceptible. In asthmatics even a mild cold frequently induces exacerbation of symptoms, while serious life-threatening asthma attacks may occur associated with a severe cold. Some studies have suggested that this effect is not only additive but also synergistic and brought about by release of the mediators already present in increased quantities, the induction of IgE synthesis, or by the potentiation of neural and epithelial damage. The combined effect of both asthma and viruses may thus be amplified and result in a sustained and refractory period of airway obstruction, severe symptoms and unstable asthma. As most hospital admissions for asthma occur over the winter months and soon after the start of the school terms [115], spread of viruses through the community to susceptible individuals may be the single most important cause of sustained exacerbations of asthma. Definition of the pathological and physiological mechanisms involved will lead to better understanding and may thus provide a basis for prevention and the development of effective forms of treatment for virus-induced asthma.
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PMID:Viruses as precipitants of asthma symptoms. II. Physiology and mechanisms. 135 15

Exercise induced bronchospasm (EIB) commonly occurs several minutes into or following an exercise event. Respiratory heat loss and respiratory water loss have been suspected as the precursor to exercise-induced bronchospasm. Obstructive EIB has been reported in elite Olympic athletes as well as the recreational athlete. Although exercise-induced bronchospasm presents as wheezing, chest tightness, or dizziness during or after exercise, cough post-exercise is a common and an easily detected characteristic of EIB. When exercise induced bronchospasm is suspected in the young athlete, an exercise challenge test should be performed. A 10% or more decrease in the peak expiratory flow rate in the post-exercise period is diagnostic of EIB. Once the diagnosis of EIB has been made, both nonpharmacological and pharmacological interventions are beneficial in reducing the airway responsiveness. Nonpharmacological measures include extensive education and cardiovascular fitness evaluation. Initial pharmacological management should consist of a trial of albuterol inhaler use 15 min prior to exercise. Early identification and treatment of EIB may enhance sports performance as well as enjoyment.
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PMID:Exercise-induced bronchospasm in the young athlete: guidelines for routine screening and initial management. 140 69

The use of the histamine challenge test (HCT) for the diagnosis of asthma has so far been limited to older children who can perform spirometry consistently. Recently, wheeze detection by tracheal auscultation with analog recording into a tape recorder has been utilized in young children in place of spirometry. Wheezing can also be identified using computerized lung sounds analysis (LSA) by a typical pattern on spectral analysis. Our aim was to develop a practical computerized system in which the response to histamine could be identified in an objective manner and documented on hard copy. Lung sounds were recorded with a Hewlett-Packard HP 21050A contact sensor placed over the right upper anterior chest. Sounds were amplified, band-filtered (50 to 2,000 Hz), and digitized at a sampling rate of 5.5 kHz into a Macintosh SE computer, and spectral LSA was performed. To validate our method, six older children (ages 9 to 16 years) with mild or moderate asthma underwent HCT. The identification of typical wheezing pattern (discrete, high-amplitude power peaks) on LSA was compared to 20 percent fall in FEV1 (PC20) and symptoms (cough, wheeze, chest tightness). In five children, the histamine concentration required to produce the characteristic wheezing pattern on LSA was half that required to produce a 20 percent fall in FEV1. In the sixth patient, wheezing on LSA and PC20 occurred at the same histamine concentration. To determine the technique's applicability to young children, we then studied six young asthmatic children (age 2 to 5 years). All children showed the wheezing pattern at a histamine concentration of 25 percent or 50 percent (one or two steps prior) to that producing symptoms (cough, wheeze, chest tightness) or wheezing on tracheal auscultation. Six age- and sex-matched nonasthmatic children (control subjects) did not show this pattern on LSA and had no symptoms or tracheal wheeze with HCT. We describe a sensitive method enabling application of HCT to young children who are unable to perform spirometry. This method is as sensitive as, and often more sensitive than, conventional PC20 with spirometry or tracheal auscultation.
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PMID:Histamine challenge in young children using computerized lung sounds analysis. 151 98

The possibility that air pollution exposure can extend the duration of respiratory symptoms was examined in a diary study of student nurses. This diary study has already shown associations between air pollution and incidence rates of respiratory symptoms. After individual risk factors and temperature were controlled for, photochemical oxidants were significantly (p less than .0001) associated with the duration of episodes of coughing, phlegm, and sore throat. Some heterogeneity of response to oxidants was seen; there was little effect on asthmatics, but the impact increased as family income increased. Plots of the mean duration of symptoms, by quintiles of oxidants, for which the other covariates were controlled, showed strong signs of a dose-response relationship for coughing and phlegm and moderate signs of a monotonic dose-response relationship for sore throat. The relationships continued for concentrations below the current ambient standard for ozone. Chest tightness or discomfort was significantly associated with sulfur dioxide (p = .016), but the effect seemed mainly restricted to asthmatics. However, evidence for a dose-dependent increase was weak.
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PMID:Air pollution and the duration of acute respiratory symptoms. 156 34

A group of 59 workers (41 men and 18 women) employed in swine confinement areas was studied to assess the presence of acute and chronic respiratory symptoms and the prevalence of abnormalities in ventilatory function. A control group of 46 (31 men and 15 women) unexposed workers was studied for the prevalence of chronic respiratory symptoms. For both male and female swine confinement workers complaints of chronic cough, dyspnoea, and chest tightness were significantly more frequent than among control workers. Male workers also complained more of chronic phlegm. Male swine confinement workers who were smokers had significantly higher prevalences of chronic cough, chronic phlegm, and chronic bronchitis than male non-smoking swine confinement workers. The frequency of acute symptoms associated with the workshift was high among the swine confinement workers with more than half of the workers complaining of cough and dyspnoea associated with work. Significant acute across shift reductions in lung function occurred in swine confinement workers, being largest for FEF25. All Monday preshift ventilatory capacity measurements in male confinement workers were significantly lower than predicted values; FVC and FEV1 were found to be lower than predicted values for women. The data indicate that exposure in swine confinement buildings is associated with the development of acute and chronic respiratory symptoms and impairment of lung function. Smoking appears to aggravate these changes.
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PMID:Respiratory symptoms and ventilatory capacity in swine confinement workers. 160 30

Twenty-two subjects complaining of cough, chest tightness and/or shortness of breath with normal chest radiograph and normal pulmonary function test results were challenged with methacoline. Venous histamine levels were measured before and just after methacoline challenge. For comparison, a single blood sample was obtained from 10 normal subjects. Blood histamine levels were significantly higher in subjects with respiratory symptoms regardless of methacoline challenge being positive or negative (p less than 0.001). After methacoline challenge, blood histamine increased significantly in methacoline challenge positive group (p less than 0.05). Thereafter, terfenadine, a H1 antagonist, 120 mg/day were given to patients for one month. After terfenadine therapy, there was a subjective improvement of symptoms, methacoline provocation dose (PD20) increased and there was no significant change in blood histamine level. It is concluded that nonspecific challenge increases blood histamine levels and blood histamine levels seems to be a sensitive index of bronchial hyperreactivity in subjects with respiratory symptoms of unknown origin and that terfenadine is effective in the treatment of bronchial hyperreactivity.
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PMID:Venous blood histamine levels and effect of terfenadine in patients with bronchial hyperreactivity. 161 16

The delayed health effects from accidental exposure to bromine vapors in a group of six people were evaluated. During the acute exposure, they had only some respiratory symptoms and skin burns of first to second degree involving small areas. All were treated in one hospital and released within 1-4 d. Six to 8 wk later, some still had health complaints such as cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, and memory, sleep, and sexual disturbances, but no objective laboratory or clinical evidence of effects. Mechanisms that might have led to manifestations of such complaints 1-2 mo after the accident are discussed and possible ways to alleviate similar situations are suggested.
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PMID:Delayed health sequelae of accidental exposure to bromine gas. 162 37

Reversible airways obstruction is not uncommon in the elderly, but may be overlooked because of the high prevalence of other disorders with a similar presentation. In a search for patterns of symptoms which might predict treatable airways obstruction, we carried out a survey of men and women aged 65 yrs and over. Postal questionnaires were completed by 2,161 subjects selected at random from the lists of three general practices. Almost 60% of the sample complained of one or more respiratory symptoms. Smoking was a more important risk factor than age, sex or social class, and was associated particularly with wheeze, morning phlegm and chest tightness on waking. Several groups of symptoms tended to cluster in the same individuals. The two most closely related were chest tightness and breathlessness in response to animals, dust and feathers. Responses to irritants tended to cluster according to the symptom produced (cough, breathlessness or wheeze) rather than the provoking stimulus (smoke, cold air, household chemicals or traffic fumes). There was no evidence for the existence of the "bronchial irritability syndrome" which has been linked with asthma in younger adults. The relationship of symptoms to respiratory function and bronchial reactivity will be reported in a further publication.
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PMID:A population survey of respiratory symptoms in the elderly. 186 41


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