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

The acute effects of use of the Flutter on expectoration of sputum were studied in patients with chronic respiratory diseases who had problems expectorating sputum. The Flutter is a handy, simple, physiotherapy device that is easy to use. Seventeen patients were enrolled in the study. For three consecutive days, the patients were asked to use the Flutter for 15 min when they had the hardest time expectorating sputum. They were also asked to measure the volume of the expectorant obtained during those 15 min and the following 30 min. Expectoration, coughing, and breathlessness were graded with visual analogue scales designed by us. Peak expiratory flow rate was also measured. For the control condition, the patients were asked to remove the stainless steel ball from the device and then to use the device as stated above on the three consecutive days immediately before or after the experimental days. Scores of "difficulty in expectoration" and "chest discomfort" were lower on the second and third experimental days than on the control days (mean+/-SE of difficulty in expectoration on the second day: 3.8+/-0.6 vs 4.4+/-0.6, p<0.05: on the third day: 3.0+/-0.5 vs 4.2+/- 0.6, p<0.02; chest discomfort on the second day: 2.9+/-0.6 vs 3.5/+-0.7, p<0.04; on the third day: 2.3+/-0.6 vs 2.9+/-0.6, p<0.01). No significant differences were noted in cough intensity, cough frequency, breathlessness, or peak expiratory flow. Sputum volume was larger on the second and third experimental days than on the control days (second day: 13.9+/-3.6 vs 11.3+/-3.1 ml, p<0.04; third day: 13.2+/-2.8 vs 9.9+/-2.1 ml, p<0.01). We conclude that use of the Flutter can increase the expectoration of sputum and can relieve related symptoms.
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PMID:[Acute effect of use of the Flutter on expectoration of sputum in patients with chronic respiratory diseases]. 862 74

Endometriosis is ectopic endometrial tissue that responds to hormonal stimulation and is found in 8 to 15 per cent of all menstruating women. Endometrioma in a surgical scar is rare and appears in 0.1 per cent of women who have undergone cesarean section; 25 per cent of these women have concomitant pelvic endometriosis. Endometrioma in a scar can present as a painful swelling on the scar that worsens during cough and effort, with the patient's complaints resembling those of a postoperative hernia occurring in a scar. It can also mimic other lesions of the abdominal wall, such as hematomas, granulomas, abscesses, and tumors. Four cases of endometriomas in a cesarean section scar are described. Two were diagnosed preoperatively as postoperative ventral hernias, and the other two presented with an abdominal wall mass causing pain and discomfort. All patients underwent surgery, and the error of their preoperative diagnosis was revealed by histology, which confirmed endometrioma. We contend that endometrioma in scarring is a diagnostic pitfall that should be considered in the differential diagnosis of postoperative ventral hernias and various abdominal wall masses.
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PMID:Endometriosis in abdominal scars: a diagnostic pitfall. 895 45

A syndrome of acute pulmonary edema has been previously reported among scuba divers in cold, European waters. Because of the temperatures involved, the name "cold-induced pulmonary edema" was coined in the original 1989 description. We report six individuals who developed the identical syndrome, five while diving in Puget Sound and one in the Gulf of Mexico. The four women and two men ranged in age from 24 to 60 yr. They experienced one to six episodes apiece, each with the development severe dyspnea at depth without excessive exertion. Associated symptoms included cough, weakness, expectoration of froth, chest discomfort, orthopnea, wheezing, hemoptysis, and dizziness. Emergency medical evaluation of four divers revealed rales on examination and pulmonary edema on chest radiograph. In one diver with pulmonary edema on chest radiograph, pulmonary capillary wedge pressure was normal when measured acutely. Symptoms resolved either spontaneously over 1-2 days or with standard medial treatment for pulmonary edema. Prior history of cardiovascular disease was negative except for hypertension and mitral valve prolapse in one diver. Cardiac evaluations following recovery from the acute episodes were normal. Episodes in the cold waters of Puget Sound sometimes occurred despite the use of dry suits. Furthermore, one diver developed recurrent episodes in 27 degrees C water off Cozumel, Mexico. Development of pulmonary edema while scuba diving constitutes a distinct clinical entity which may occur in either "cold" or "warm" water. It is not associated with a decompression mechanism. Personnel caring for divers should be aware of the syndrome in order to provide optimal medical management.
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PMID:Pulmonary edema of scuba divers. 906 53

Congenital bronchoesophageal fistula is a rare clinical entity in adults. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking, and even hemoptysis. The fistula can cause symptoms in childhood but may not appear until adulthood. We recently experienced a case of congenital bronchoesophageal fistula associated with esophageal diverticulum in an adult. A 63-year-old woman was admitted to our hospital due to chest discomfort, sore throat and coughing bouts when eating. An empyema with lung abscess had occurred eight years previously. Results of the physical examination were unremarkable. A Barium swallowing revealed a medium-sized diverticulum at the right anterior aspect of the esophagus, which had developed a fistulous connection with the right lower lobe bronchus. The patient was treated by fistulectomy and lobectomy of the right lower lobe. The postoperative course was smooth and uneventful.
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PMID:Congenital bronchoesophageal fistula associated with esophageal diverticulum in the adult. 933 35

An 83-year-old female patient with a giant thymic cyst that was successfully treated by percutaneous aspiration and ethanol injection. The patient had complained of coughing and chest discomfort for several years. A chest X-ray film revealed the shadow of a large abnormal mass in the anterior mediastinum. We diagnosed it as a thymic cyst. The patient refused surgery because of her age. We chose a less invasive therapy, namely, ethanol sclerosis of the cyst. The cyst was successfully treated without any complications, and no recurrence was found at the one-year follow-up. This therapy may be one of the best treatments for thymic cysts, especially in very elderly patients.
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PMID:Ethanol sclerosis: one of the best treatments for thymic cyst in very elderly patients? 937 34

Malignant pleural effusions are a common problem in cancer patients with advanced disease. Patients typically present with progressive dyspnea, cough, and/or chest pain that significantly compromises their quality of life. Treatment is often palliative, usually consisting of sequential thoracenteses or tube thoracostomy with or without sclerotherapy. The traditional method of treatment--tube thoracostomy with large-bore chest tubes connected to continuous wall suction--requires hospitalization, is expensive, limits patient mobility, and can cause significant patient discomfort. More recent trials have explored new techniques, including thoracoscopic insufflation of talc and small-bore catheters. Most of these studies have been performed on inpatients, although a recent multi-institutional trial was initiated to evaluate the feasibility and efficacy of ambulatory (outpatient) pleural drainage and sclerotherapy using small-bore catheters. All patients fulfilling eligibility criteria had a small-bore catheter placed in the pleural space that was then connected to a closed gravity drainage bag system. When daily tube drainage was <100 mL, sclerotherapy was performed. Response rates at our institution demonstrated 10 patients (53%) had a complete response, 5 (26%) had a partial response, and 4 (21%) had progressive disease at 30-day follow-up. These preliminary results suggest ambulatory sclerotherapy is a safe, viable alternative to conventional inpatient treatment of malignant pleural effusions in a select group of patients.
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PMID:Malignant pleural effusions: recent advances and ambulatory sclerotherapy. 943 94

A phase III, open label randomized study was conducted in 50 patients comparing halothane and sevoflurane for paediatric day case surgery. A graded inhalational induction resulted in only slightly more rapid induction with sevoflurane (3.34 +/- 0.92 versus 3.85 +/- 1.02 minutes; P > 0.05). In children receiving sevoflurane, systolic blood pressure decreased to a lesser extent during induction (143 +/- 19.2 versus 26.9 +/- 10.9 percent decrease from resting values; P < 0.01) and heart rate was maintained. Respiratory events (coughing, breath-holding, bronchospasm, laryngospasm) were more common during induction with halothane, and excitement more common in children receiving sevoflurane. Emergence times were significantly more rapid in children who had received sevoflurane (21.4 +/- 10.9 versus 33.1 +/- 13.7 minutes; P < 0.01). Objective pain/discomfort scores were higher in patients receiving sevoflurane at 10, 20, 30 and 40 minutes after arrival in the recovery room, and the incidence of excitement during emergence was higher in this group. It is concluded that sevoflurane is well tolerated for inhalational induction and has an improved cardiovascular profile compared to halothane. Emergence was significantly more rapid following sevoflurane.
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PMID:A comparison of sevoflurane with halothane for paediatric day case surgery. 945 47

A descriptive retrospective study conducted in 62 villages in Western Niger in July-August 1994, examined the prevalence of postpartum cardiac failure (PCF). This condition, the most frequent clinical form of heart failure in hospitalized women in Sudanese-Sahelian Africa, has not previously been investigated in a field study. Meetings with village leaders were used to identify women who had just given birth and those who were ill. Through this method, 60 ill women who had given birth in the preceding 9 months were identified. PCF was diagnosed in 28 of these women from 27 villages on the basis of predefined symptoms (dyspnea and cough) and physical signs (edema of the legs) of congestive heart failure during the 6 months after delivery. The prevalence of PCF was 1.40/1000 women of childbearing age; likely an underestimate since the field identification criteria did not take into account women who had already died. The mean age of identified patients was 28 years, with a mean parity of 4. Low socioeconomic status, postpartum ablutions with hot water, and a high sodium intake were common in these women. A comparison of 17 clinical and epidemiological factors in this series with those of 66 patients who previously had PCF confirmed at Niamey National Hospital did not reveal any significant differences in the incidence of symptoms between the 2 groups, although functional discomfort was more severe in the hospital study. Untreated cardiac failure is usually a fatal disease. Timely identification of PCF is hindered, however, by well-tolerated symptoms.
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PMID:Postpartum cardiac failure in Sudanese-Sahelian Africa: clinical prevalence in western Niger. 954 11

Five distinct clinical syndromes of pulmonary angiitis and granulomatosis are currently recognized: Wegener granulomatosis, lymphomatoid granulomatosis, necrotizing sarcoid granulomatosis, bronchocentric granulomatosis, and allergic angiitis and granulomatosis (Churg-Strauss syndrome). Patients typically present in middle age with fever, cough, hemoptysis, dyspnea, or chest discomfort. Upper airway involvement such as sinusitis suggests Wegener granulomatosis. Medical renal disease is associated with Wegener granulomatosis and Churg-Strauss syndrome. Asthma may be present in bronchocentric granulomatosis and Churg-Strauss syndrome. Pathologic examination of these entities demonstrates vasculitis, granulomatous inflammation, and parenchymal necrosis. The radiologic manifestations of pulmonary disease are varied, but the most typical appearance is that of multiple nodules or masses that may demonstrate cavitation. Diffuse multifocal air-space opacities with or without cavitation may also be seen. Pulmonary hemorrhage is a well-known presenting manifestation of Wegener granulomatosis and, less commonly, of Churg-Strauss syndrome. Because of the multifocal lung involvement in these diseases, pulmonary metastases and infectious causes are often considered in the differential diagnosis. Affected patients are treated with cytotoxic agents and corticosteroids. The prognosis is variable, depending on the specific syndrome, but may be favorable in the absence of significant complications.
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PMID:Pulmonary angiitis and granulomatosis: radiologic-pathologic correlation. 959 92

Urinary incontinence, corresponding to the definition of involuntary urine leaks, due to alteration of the physiological mechanisms of continence, experienced as discomfort in everyday life affects approximately 10% of the female population. The main predisposing factors are age, child-birth (particularly the first), recurrent urinary tract infections, and obesity. Pathophysiologically, urine leak occurs when the forces of expulsion resulting from abdominal straining or detrusor contraction, exceed the physiological (urethral sphincter device) and pathological (obstruction) continence forces. These two mechanisms correspond to two types of incontinence, stress and urge incontinence, which are primarily diagnosed on the basis of the clinical interview, which must also strive to evaluate the volume of urine leaks, the circumstances inducing incontinence, and associated urinary symptoms such as dysuria and frequency. Clinical examination, in women in the gynaecological position, demonstrates incontinence on coughing and control of incontinence by supporting the bladder neck (Bonney's manoeuvre); it also evaluates vulval trophicity and the quality of perineal musculature; it analyses the components of possible vaginal prolapse. The objective of complementary investigations is not to confirm the data of the clinical interview and clinical examination, but to complete them by providing additional elements. Radiological examinations have largely been replaced by urodynamic examinations, able to detect detrusor instability and evaluate the quality of sphincter tone, which largely determines the success of surgery. Surgery remains the reference treatment for stress incontinence with a success rate of almost 90%; the main mechanism consists of supporting the bladder neck, allowing it to close during efforts increasing the abdominal pressure. Perineo-sphincter rehabilitation must be tried first, although its results are less lasting. Currently, the only effective medical treatment is anticholinergic drugs in urge incontinence.
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PMID:[Female urinary incontinence. Which assessments? Which treatment?]. 959 38


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