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)

The proposal that some naturally occurring prostaglandins (PGs) or their by-products may be implicated in the pathogenesis of the asthmatic bronchospasm has been suggested. Other PGs may be potentially useful in the treatment of this lung disease. The present investigation compared the bronchodilator effects of PGE1 and PGE2 in pharmacologically constricted experimental animals. In pentobarbital-anesthetized, spontaneously breathing dogs, aerosols of PGE1 and PGE2, 0.0002 to 0.2%, effectively inhibited the increases in pulmonary resistance (RL) and decreases in dynamic lung compliance (CDYN) produced by PGF2 alpha (3.0 micrograms/kg i.v.). PGE2 was found to be more effective than PGE1 in preventing RL responses to PGF2 alpha; however, both bronchodilators were equally effective vs. CDYN changes. These agents inhibited central airway constriction more than peripheral. Transient decreases in systemic arterial pressure and increases in heart rate occurred especially at the higher concentrations. In a group of trained conscious dogs, effective concentrations did not evoke adverse subjective discomfort or irritation. Higher concentrations, i.e., 1.0%, did produce coughing, breathholding, restlessness and altered patterns of breathing. In normal or sensitized guinea pigs, PGE aerosols were effective in reducing the bronchopulmonary provocation produced by histamine or specific antigen. These in vivo results suggest that aerosols of the classical PGEs are effective bronchospasmolytics in laboratory animals and that irritation may be related to concentration.
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PMID:Inhibition of bronchoconstriction by aerosols of prostaglandins E1 and E2. 739 72

We performed Electrical Promontory Stimulation (EPS) for the suppression of tinnitus in 52 patients and measured Compound Action Potentials (CAP) using electrocochleography before and after EPS. We examined the relation between residual inhibition and CAP. The purpose of this study was to investigate the origin and mechanism of suppression of tinnitus. Tinnitus was suppressed in 27 patients (52%) after EPS. In the group of patients in which we suppressed tinnitus, the CAP amplitudes increased from 3.0 +/- 1.5 microV to 3.2 +/- 1.6 microV (p < 0.05), the loudness of tinnitus was reduced from 7.3 +/- 4.7 dBSL to 5.6 +/- 5.1 dBSL (p < 0.05) and the CAP latencies did not exhibit remarkable change. In the group of patients in which we did not suppress tinnitus, the CAP amplitudes, latencies and the loudness of tinnitus did not change remarkably. These data indicate that EPS affects auditory nerve fibers directly. It was reported that EPS is effective for tinnitus of peripheral origin and not for that of central origin and, that in tinnitus of peripheral origin, the spontaneous discharges of the auditory nerve increase in number. It is hypothesized that EPS affects auditory nerve fibers and suppresses tinnitus by synchronizing these spontaneous discharges. Side effects of EPS were cough and discomfort of the throat, nose, lips and oral cavity. These effects were observed only during electrical stimulation and there were no permanent side effects. In conclusion, EPS affects auditory nerve fibers directly, is effective for tinnitus of peripheral origin and is not associated with serious complications.
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PMID:[Electrocochleographic analysis of the suppression of tinnitus by electrical promontory stimulation and changes in compound action potentials]. 747 70

After thoracotomy some patients have discomfort, primarily in the rostral portion of their incisions. In this prospective, randomized study in 66 patients after lateral thoracotomy we evaluated whether, for equal fentanyl dosage in micrograms per kilogram, epidural infusion (lumbar catheter) of fentanyl 5 micrograms/mL provided better segmental analgesia (including the rostral portion of the incision) than a 10-micrograms/mL concentration infused at a rate half that used in the 5-micrograms/mL group. Ketorolac was used as an analgesic adjunct for nonincisional pain. Postoperative epidural fentanyl infusion included a 1-microgram/kg initial dose and an initial infusion rate of 1 microgram.kg-1.h-1 in both the 5-micrograms/mL and 10-micrograms/mL groups. Patients were evaluated for comfort level and pain relief while resting, taking a deep breath, coughing, and ambulating at eight times over 3 days using two visual analog scales for overall comfort and a verbal rating score (VRS) for segmental analgesia. There were no significant differences in demographics, surgical procedure, intraoperative fentanyl dose, side effects, rates of epidural fentanyl infusion, or total epidural fentanyl doses at 12, 24, 36, 48, and 60 h postbolus. Analgesia was effective in both groups. Although overall comfort levels were lower (i.e., indicated greater comfort) in the 5-micrograms/mL group in 6 of 8 visual analog scores (VASs) for comfort level and 20 of 24 VRSs for comfort level scores, and mean VRSs for the rostral portion of the incision were lower (i.e., indicated greater comfort) in the 5-micrograms/mL group at 21 of 24 evaluation subsets (one statistically significant), statistical significance was achieved in only six evaluation subsets.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Analgesia after thoracotomy: effects of epidural fentanyl concentration/infusion rate. 748 87

Four cases are described of a distinctive morphologic variant of thymic carcinoid that was characterized by abundant stromal mucin admixed with the neuroendocrine elements resulting in a histologic picture reminiscent of metastatic mucin-secreting carcinoma. The patients were three men and a woman, aged 22 to 43 years. The tumors presented with symptoms of chest discomfort, cough, and dyspnea and were described as large anterior mediastinal masses on chest radiographs and computerized scans. Histologically, all cases showed nests and strands of tumor cells embedded in an abundant lightly eosinophilic, mucinous stroma with small cellular clusters as well as scattered single tumor cells seen floating in the mucin. The mucinous matrix was negative for periodic acid Schiff's and mucicarmine stains; alcian blue stains at pH 2.5 showed strong positivity of the mucinous material; this reaction was abolished by treatment with hyaluronidase, indicating the presence of nonepithelial stromal mucosubstances. Immunohistochemical stains showed strong positivity of the tumor cells with CAM 5.2, chromogranin, synaptophysin, and neuron-specific enolase, and negative staining with carcinoembyronic antigen and epithelial membrane antigen. Electron microscopy done in one case showed abundant dense-core cytoplasmic neurosecretory granules; there was no evidence of glandular secretory activity by the tumor cells. The tumors in two patients behaved in a highly aggressive fashion, with invasion of the chest wall, recurrence, and metastases to the lungs, pleura, and axillary, retroperitoneal, and mesenteric lymph nodes. Thymic carcinoid should be considered in the differential diagnosis of mediastinal neoplasms displaying prominent mucinous features. Application of immunostains and electron microscopy will be of value for establishing the correct diagnosis in this setting.
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PMID:Thymic carcinoid with prominent mucinous stroma. Report of a distinctive morphologic variant of thymic neuroendocrine neoplasm. 757 90

Southwest Metropolitan Mexico City (SWMMC) preadolescent children have been exposed to a highly polluted urban atmosphere most of their lives. The main objective of this study was to determine by nasal lavage (NAL) the acute inflammatory nasal influx elicited in these children upon exposure to three different polluted days. Ozone, the main criteria pollutant for SWMMC, varied both in the number of hours above the National Ambient Air Quality Standard (NAAQS), which is 0.12 ppm as a 1-h maximum concentration not to be exceeded more than once per year, and in the maximal concentrations in the preceding three NAL sampling dates. Nasal neutrophilic influx, the surface expression of the B2 integrin CD11b on the nasal polymorphonuclear leukocytes (PMNs), rhinoscopic findings, respiratory symptoms, and nasal cytologies were evaluated in the 38 exposed children and in the 28 control children living in a nonpolluted Pacific coast port. SWMMC children had an average daily outdoor exposure of 7.7 h and complained of nasal mucus secretion, epistaxis, intermittent nasal obstruction, diurnal cough episodes, and chest discomfort. Nasal mucosal atrophy by rhinoscopy was present in 37/38, and all children had an abnormal nasal cytology. Exposed children had significantly higher nasal PMNs and nasal PMN-CD11b expression than controls. PMN median values in exposed children were higher than controls on all sampling dates (November 12, p < .001; November 17, p < .001; and November 24, p < .00001). Interestingly, a lower nasal neutrophilic response (p < .0004) was recorded in the SWMMC children 18 h after exposure to the highest O3 concentrations (up to 0.307 ppm) and the largest number of hours with O3 > 0.12 ppm (7 h). The question of a competing inflammatory response at the bronchioalveolar level with structural damage is raised. These NAL findings underscore the need to restrict outdoor activity in SWMMC children during the months of greater potential exposure to ozone.
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PMID:Nasal inflammatory responses in children exposed to a polluted urban atmosphere. 764 30

Conventional medical treatment of COPD patients with acute respiratory failure (ARF) was associated with an overall mortality ranging 12-29%. When conservative treatment fails, ARF is usually managed by means of mechanical ventilation (MV) via an endotracheal tube (ET) or tracheostomy. Mortality of COPD patients with ARF treated with invasive MV ranged 21-54%. Invasive MV is associated with several complications. Positive pressure ventilation (PPV) by means of facial or nasal masks have been used in place of endotracheal intubation in ARF: the results are promising. Advantages of mask ventilation include the possibility of intermittent delivery of ventilation, use of different modalities of ventilation, the ability to undertake normal swallowing, feeding and speech, the possibility of physiological air warming and humidification, the possibility of coughing, and an easier weaning whilst still maintaining possibilities of ET intubation. Reported side-effects during mask PPV include mask discomfort, skin reddening, dry nose, air leaks, eye irritation and gastric distension. Mortality of COPD patients treated with noninvasive PPV ranged 6-25%. The level of severity of basal acidosis and blood gas response to a short trial of noninvasive PPV were predictive of success of this modality of MV. Preliminary results suggest that one year mortality after MV is reduced with noninvasive PPV in comparison to ET ventilation.
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PMID:Ventilation techniques: invasive versus noninvasive. 771 93

A multicenter double-blind randomized trial was performed in 22 teaching hospitals to compare the clinical effectiveness of the combination of amoxicillin (CAS 26787-78-0) plus bromhexine (CAS 3572-43-8) versus amoxicillin alone given 4 times a day for 5 to 7 days in the treatment of clinically diagnosed community-acquired bacterial lower respiratory tract infections. 392 adult patients diagnosed clinically to have acute bronchitis or pneumonia of bacterial etiology were recruited for the study with 192 subjects given amoxicillin (250 mg) plus bromhexine (8 mg) (Drug AB) and 200 receiving amoxicillin (250 mg) (Drug AA) alone 4 times a day for 5 to 7 days. Clinical response, improvement in symptom scores using a visual analogue scale, and bacteriologic response were monitored at Days 3, 5 and 7 of treatment. Results showed that although 180/192 (94%) given Drug AB and 185/200 (93%) given Drug AA had favorable clinical response at the end of treatment, the infection was completely resolved for 89/192 (46%) among the Drug AB group and in 67/200 (34%) of patients on Drug AA (p = 0.022). Also, patients given Drug AB had significantly greater reduction of their symptom scores at Day 3 for symptoms of cough discomfort, cough frequency, ease of expectoration and sputum volume. Among the subset of patients with pneumonia, the cure rates for Drug AB and Drug AA were 24/50 (47%) and 11/50 (22%), respectively (p = 0.008). A respiratory pathogen was cultured in only 72/392 (18%) of subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical effectiveness of a combination of bromhexine and amoxicillin in lower respiratory tract infection. A randomized controlled trial. 774 82

Diesel exhaust is a common air pollutant and work exposure has been reported to cause discomfort and affect lung function. The aim of this study was to develop an experimental setup which would allow investigation of acute effects on symptoms and lung function in humans exposed to diluted diesel exhaust. Diluted diesel exhaust was fed from an idling lorry through heated tubes into an exposure chamber. During evaluations of the setup we found the size and the shape of the exhaust particles to appear unchanged during the transport from the tail pipe to the exposure chamber. The composition of the diesel exhaust expressed as the ratios CO/NO, total hydrocarbons/NO, particles/NO, NO2/NO, and formaldehyde/NO were almost constant at different dilutions. The concentrations of NO2 and particles in the exposure chamber showed no obvious gradients. New steady state concentrations in the exposure chamber were obtained within 5-7 min. In a separate experiment eight healthy nonsmoking subjects were exposed to diluted exhaust at a median steady state concentration of 1.6 ppm NO2 for the duration of 1 h in the exposure chamber. All subjects experienced unpleasant smell, eye irritation, and nasal irritation. Throat irritation, headache, dizziness, nausea, tiredness, and coughing were experienced by some subjects. Lung function was not found to be affected during the exposure. The experimental setup was found to be appropriate for creating different predetermined steady state concentrations in the exposure chamber of diluted exhaust from a continuously idling vehicle. The acute symptoms reported by the subjects were relatively similar to what patients reported at different workplaces.
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PMID:Evaluation of an exposure setup for studying effects of diesel exhaust in humans. 780

The purpose of the present phase IV multicentre trial was to evaluate general patient tolerance to Omnipaque 350 mgI/ml (iohexol) supplied in polypropylene containers compared to that of the same product supplied in routinely used glass vials, with emphasis on allergy-like adverse events. Polypropylene is a pure plastic material with practically no additives, and has been tested in vitro as a contrast medium packaging material for several years. Handling of these containers is easier and safer than handling of glass vials. Iohexol was administered to 1481 patients undergoing urography (741 patients in the glass vial group, 740 in the polypropylene container group), all of whom successfully participated in the trial. Six centres, representing four European countries, participated. Patients were randomized to receive iohexol from either polypropylene containers or traditional glass vials according to a double blind, parallel design. Pre-established inclusion and pre-admission exclusion criteria were followed, as well as routine procedures for preparation of the patients and conduct of the urography examinations at each hospital. Patient tolerance was assessed by recording all adverse events experienced over a period of up to 1 h after the procedure. Allergy-like events were defined as coughing, sneezing, nausea, vomiting, urticaria or itching. No adverse events were experienced by 56.5% of the patients in the glass vial group, nor by 58.0% of those in the polypropylene group. Discomfort (mainly a sensation of warmth) was reported by 39.4% and 38.6% of the patients, and adverse events other than discomfort by 7.4% and 5.9% of the patients, respectively. There seemed to be a correlation between the speed of injection and the frequency of discomfort (an increase with increasing speed), both of which varied a lot between centres. There was no significant difference in the incidence of allergy-like events between the two groups. Such reactions were seen in 2.0% of patients in the glass vial group and 1.9% of those in the polypropylene container group. There was no significant difference between the patients' tolerance to iohexol supplied in traditional glass vials or in polypropylene containers. Therefore, the new polypropylene container can be recommended as a container for Iohexol.
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PMID:Iohexol in patients undergoing urography: a comparison of polypropylene containers (Unique Soft Pack) and glass vials. 783 73

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


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