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

Pulmonary disease caused by Mycobacterium avium complex usually occurs in patients with chronic lung disease or deficient cellular immunity, and its prevalence is increasing. We describe 21 patients (mean age, 66 years) with such infection without the usual predisposing factors, representing 18 percent of the 119 patients surveyed. Seventeen women and 4 men were given a diagnosis of M. avium complex from 1978 to 1987, with a stable incidence over the decade, on the basis of pulmonary symptoms, abnormalities on chest films, positive cultures, and in 14, biopsy evidence of invasive disease. Most of the patients (86 percent) presented with persistent cough and purulent sputum, usually without fever or weight loss. The cough was present for a mean of 25 weeks before the correct diagnosis was made. Radiographic patterns of slowly progressive nodular opacities predominated (71 percent); only five patients had cavitary disease at presentation. All patients responded initially to antimycobacterial therapy, but eight eventually relapsed when it was stopped. Four patients died of progressive pulmonary infection caused by M. avium complex. The extent of the initial pulmonary involvement was greater in patients with progressive disease than in those whose condition improved. We conclude that pulmonary disease caused by the M. avium complex can affect persons without predisposing conditions, particularly elderly women, and that recognition of this disease is often delayed because of its indolent nature.
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PMID:Infection with Mycobacterium avium complex in patients without predisposing conditions. 277 Aug 26

Irwin and co-workers have designed an anatomic approach to the diagnosis and treatment of cough. In their hands, diagnosis was consistently determined and treatment successful almost without exception, if sustained. We reviewed the results of a similar approach in 139 consecutive and unselected patients referred to pulmonary specialists in two community hospitals. Thirty-nine patients demonstrated hyperreactive airways (HA) by carbachol inhalation and/or eucapnic hyperventilation of cold air. Twenty-seven of 78 without HA had postnasal drip, and 13 of 78 had a persistent cough following acute upper airway inflammation. Other less common diagnoses included chronic bronchitis, gastro-esophageal reflux, occupational bronchitis, interstitial lung disease, and psychologic causes. We were able to find the cause of cough 88 percent of the time. Treatment adjusted for noncompliance was not always a success. While all patients with HA improved, 8 percent of patients without HA or specific diagnosis did not have an improvement in their cough upon retrospective inquiry. Based on this analysis, we find that the diagnosis and treatment of cough may not be as successful as originally reported using Irwin's approach.
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PMID:Chronic persistent cough. Experience in diagnosis and outcome using an anatomic diagnostic protocol. 292

A patient had chronic, persistent cough as the presenting symptom of the neuromuscular disorder oculopharyngeal dystrophy (OPD). The presence of a significant smoking history initially resulted in the cough incorrectly being attributed to COPD. By using a systematic diagnostic approach, the correct etiology was determined.
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PMID:Chronic cough as the presenting symptom of oculopharyngeal muscular dystrophy. 292 27

During a 12-month period, feces from 780 persons from the Townsville region were evaluated by the Kinyoun acid-fast strain, and 36 (4.6%) immunocompetent patients were found to have Cryptosporidium oocysts. Twenty-five index cases were identified; 13 (8.6%) cases from 151 patients were from Palm Island, an isolated Aboriginal community in the wet tropics and 12 (1.9%) cases from 629 patients were from the dry tropics of Townsville. All 11 secondary cases were associated with a person-to-person outbreak in the nursery of a Townsville day-care centre. Infection occurred mainly in two distinct age groups: the under five-year-old (27 cases), and the 25 to 35-year-old (six cases). A prodrome of dry cough, rhinorrhea and vomiting often preceded symptoms of fever, weight loss, abdominal pain, persistent cough and vomiting, and acute diarrhea with frequent, non-bloodstained, watery, mucous stools. Although 13 patients were hospitalised because of their illness, the infection was self-limiting and all 36 patients recovered with symptomatic treatment. Cryptosporidium was the third most commonly identified enteric pathogen after Rotavirus and Giardia. Infection did not appear to depend on seasonal variation and no animal or environmental sources of infection were identified. Cryptosporidiosis in immunocompetent persons is endemic and common in North Queensland and routine investigations for this parasite in symptomatic patients are warranted.
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PMID:Human cryptosporidiosis in North Queensland. 326 49

An epidemiological study of 2153 workers in 15 West Yorkshire wool textile mills was conducted to determine relations between respiratory symptoms and exposure to inspirable wool mill dust. A questionnaire designed to elicit all the common respiratory symptoms was developed and tested, and administered to all workers willing to participate (85%). It was translated and administered in Urdu for the 385 workers from Pakistan whose English was not fluent. Symptoms investigated included cough and phlegm, wheezing and chest tightness, breathlessness and its variability, rhinitis, conjunctivitis, chills, nosebleeds, and chest illnesses. Additional questions were asked, where appropriate, about the times of day, days of the week, seasons, and places that the symptoms were worse or better than normal. An environmental survey was carried out at each mill, which included 629 measurements of inspirable dust, enabling estimates to be made of the airborne concentrations of inspirable dust usually experienced by each member of the workforce under current conditions. Overall symptom prevalences were: persistent cough and phlegm, 9%; wheeze, 31%; breathlessness on walking with others on level ground, 10%; persistent rhinitis, 18%; persistent conjunctivitis, 10%; persistent chills, 2%; ten or more nosebleeds a year, 2%; and three or more chest illnesses in past three years, 5%. After allowing for the effects of age, sex, smoking habit, and ethnic group, cough and phlegm, wheeze, breathlessness, rhinitis, conjunctivitis, and nosebleeds were found to be more frequent in those exposed to higher than to lower concentrations of dust. In some experiencing high concentrations (blenders and carpet yarn backwinders) cough and phlegm, wheeze, rhinitis, and conjunctivitis were related to the years worked in such jobs. Relative risks of each symptom in relation to inspirable dust concentrations were calculated by means of a logistic regression analysis. At concentrations of 10 mg/m3, the current United Kingdom standard for nuisance dusts, the risk of cough and phlegm relative to that of an unexposed worker was 1.37, that of wheeze 1.40, breathlessness 1.48, rhinitis 1.24, and conjunctivitis 1.70. Since some of these symptoms may be associated with functional impairment of the lungs, further studies of selected workers are being carried out to estimate the functional effects of exposure to dust in wool textile mills.
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PMID:Respiratory and allergic symptoms in wool textile workers. 326 11

Chronic cough is an important, sometimes frustrating problem, often encountered by the otolaryngologist-head and neck surgeon. Thirty-eight infants and children under age 16 with a normal chest roentgenogram were evaluated for chronic cough persisting for longer than 4 weeks. Specific therapy (rather than symptomatic treatment) of chronic cough lead to a resolution or control of the cough in 33 (87%). Cough-variant asthma was by far the most common cause of chronic cough, followed by sinusitis, aberrant innominate artery, psychogenic cough, and subglottic stenosis. In addition to a detailed history, physical examination, and chest roentgenogram, endoscopy, paranasal sinus roentgenograms, and pulmonary function studies with methacholine challenge testing were particularly effective for establishing a precise diagnosis. Chronic cough is best managed by determining the precise cause of the cough, then specifically treating the underlying disorder. Children with persistent cough and a normal chest roentgenogram should be referred promptly for evaluation by an otolaryngologist when the primary physician's initial efforts at diagnosis and treatment are unsuccessful. Endoscopy is under-utilized in practice and its importance is understated in the literature. It is particularly helpful in establishing a precise diagnosis in infants under 18 months of age.
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PMID:Chronic cough in infants and children. 351 41

Presented here is a case of chronic persistent cough, in a patient in whom squamous papilloma of the base of tongue was found. The cough disappeared completely after removal of the tumour.
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PMID:Vallecular papilloma simulating chronic pulmonary disease. 377 46

The Tuberculosis Control Program began its reorganization in 1979, when the Honduran Ministry of Public Health designated tuberculosis as one of its priority problems. Administrative and logisitical problems faced by the program were exacerbated by the public's negative image of the disease and the consequent rejection of anything related to it, including medical diagnosis and treatment. A baseline investigation was carried out to determine the knowledge, attitudes and behaviors of the public, patients and patients' relatives regarding tuberculosis (TB). Sampled were 361 healthy adults, 75 tuberculosis patients, 55 relatives of patients, 20 health personnel, 12 nurses in 12 health centers, and 3 epidemiologists. Data was gathered using surveys (healthy population), focus groups (healthy population, patients) unstructured interviews (relatives, health personnel, nurses and epidemiologists) and focused interviews (relatives). The investigation confirmed the existence of social rejection toward TB. The disease is considered quite contagious, and is associated with extreme poverty, filth and malnutrition. The patients stated that this rejection is 1 of the greatest burdens of their disease; they considered themselves a danger to others and expressed feelings of guilt. The most recognized symptom was coughing and expectoration. A person with a persistent cough does not however, want to think of TB, except as a very remote possibility. Health personnel also fail to perceive a persistent cough as a respiratory symptom and possible indicator of TB. Cough syrups and bronchial decongestants are the most widely distributed medicines in rural health centers. Both the patients and the general population queried knew that TB is curable, although they doubted that the patient could recover his/her full health. Patients' fear was that the long period of treatment would inevitably lead to their neighbors discovering that they had the disease and rejecting them. The health system's capacity to diagnose and treat TB was also analyzed. Several problems were detected in the diagnosis of respiratory cases, e.g., difficulties leading to long delays in the collection and analysis of sputum samples and in the subsequent reporting of the findings. Moreover, instructions given to the patient are quite vague as to exactly what quality sputum is needed and how best to obtain it. These problems affect the number of patients who are diagnosed and treated, but seem to have little bearing on those already being treated. An education campaign was prepared based on these findings. Its goals were toinform the population at large that TB patients no longer transmit the disease, that they can be completely cured if treatment is begun promptly, and that a persistent cough lasting for more than 15 days may be a symptom. A pamphlet has been developed to better educate the patients and their relatives. It is concluded that an understanding of and familiarity with the client's perspective can help educational programmers identify exactly which facts or opinions must be reinforced or modified so that beneficial health services are utilized.
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PMID:Integrating the client's perspective in planning a tuberculosis education and treatment program in Honduras. 407 1

A community study of respiratory disease on Karkar Island sampled 1734 people. Both sexes showed abnormalities, especially those over 35 years. 33% had a positive loose cough, 29% had adventitious sounds, and 11% had persistent cough. Smoking was universal by age 30. A local cigar made from the same type of tobacco (Brus) as commercial cigarettes (Nicotiana tobaccum) was the favorite smoke. Store bought cigarettes were used by 8% men, .8% women. 1.8% men and 12% women who smoked local tobacco inhaled, compared to 56% men who smoked commercial tobacco. Inhalers showed a higher frequency of symptoms than noninhalers. Nonsmokers had consistently higher values for lung function tests. However, differences in lung function were significant only in the FEV percentage in women. Wider use of commercial tobacco will likely increase inhalation leading to an increase in lung disease.
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PMID:Smoking habits and their relationship to chronic lung disease in a tropical environment in Papua New Guinea. 444 55

Pertussis, though uncommon in people older than 9 years, does occur (in girls and women primarily) and should be considered in the differential diagnosis of persistent cough. Earlier this year in British Columbia a 12-year-old girl contracted the disease, even though she had been fully vaccinated against it at the appropriate ages. The source of her infection was unknown. The clinical picture was classic except that the girl experienced intense headaches, lasting up to an hour, after the episodes of paroxysmal coughing. Canadian physicians and public health practitioners should encourage vaccination against pertussis.
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PMID:Pertussis in a vaccinated 12-year-old girl. 649 2


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