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)

A 49-year-old female was complaining of persistent cough. CT-scan revealed abscess in the right hepatic lobe. Diagnostic percutaneous trans-hepatic abscessography disclosed hepatobronchial fistula, and biopsy of the lesion revealed intrahepatic bile duct carcinoma. She underwent right hepatic lobectomy, right pulmonary lower lobectomy and partial resection of the diaphragm, with removal of the fistulous tract. After operation, cough disappeared, but she died of intraabdominal hemorrhage, 40 days after operation.
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PMID:[Hepatobronchial fistula caused by intrahepatic bile duct carcinoma]. 783 14

Cough is an important symptom of many respiratory disorders. We determined the frequency and diurnal variation of cough in normal subjects and in patients with asthma or with persistent cough of unknown cause. We used a portable, solid-state, multiple-channel recorder to record cough sounds over a 24 h period. The audio-signal was recorded from a unidirectional microphone strapped over the chest wall, and electromyographic (EMG) signals from the lower respiratory muscles were simultaneously registered with surface electrodes. The recorded digital data were examined on an IBM-compatible computer, and the typical signals induced by cough (as assessed by voluntary or experimentally-induced cough) were counted. In 12 normal subjects, only 0-16 coughs were recorded over 24 h. In 21 stable asthmatics with a history of chronic cough ("asthma") the median number was 282 (ranges: 45-1,577), and in 14 patients with the predominant symptom of daily dry coughs ("chronic coughers") the median number was 794 (64-3,639). In both groups of patients, there was a diurnal variation of coughs, such that the least numbers occurred between 2 and 5 a.m. (< 3% of total). In the asthma group, there was no significant correlation between forced expiratory volume in one second (FEV1) (% predicted) or diurnal variation of peak expiratory flow and cough frequency. In the chronic coughers, there was a significant correlation between daytime cough numbers and daytime cough symptoms scores but not for the night-time values. Our data show that cough frequency is not determined by the severity of asthma in relatively stable asthmatics on inhaled steroids, and is reduced during sleep in both asthmatics and chronic cough patients. This portable cough recorder may be useful in the assessment of drug therapy for chronic cough.
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PMID:Coughing frequency in patients with persistent cough: assessment using a 24 hour ambulatory recorder. 792 2

A 69-year-old female was admitted for the evaluation of chronic persistent cough of about six week duration which was particularly worse at night and did not respond to antibiotics or cough medicines. She did not smoke and had no history of allergies or abnormal inhalations. Eosinophil counts, serum IgE, CRP, titers of cold hemagglutinin (CHA), and antibody to mycoplasma were all within normal ranges. Chest X-ray films and respiratory function tests showed no abnormalities. Because of her complaint of mild heartburn, gastroesophageal reflux (GER) was thought to be a possible cause of her chronic cough. Upper gastrointestinal X-ray films revealed barium reflux up to the cervical esophagus, and gastrointestinal fiberoscopy showed reflux esophagitis. Bronchial biopsy specimens taken by fiberoptic bronchoscopy showed chronic inflammatory changes of bronchial mucosa with focal squamous metaplasia, mucosal basement membrane thickening, and lymphocytic infiltration in the submucosa. She made favorable progress following treatment with a histamine H2 blocker and cisapride for six weeks. She met Irwin's criteria and we concluded that her cough was caused by GER. We speculate that repeated tracheobronchial microaspirations of refluxed gastric acid may cause chronic inflammatory changes of the bronchial mucosa resulting in persistent cough.
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PMID:[A case of chronic persistent cough caused by gastroesophageal reflux]. 827 65

Persistent cough leads individuals to seek for medical assistance. Clinical investigation, however, may not reveal any alteration within the clinic's sphere of action. Often enough, some professionals treat the symptom as a disease, introducing several medicines, unsuccessfully. The author's experience, as an otolaryngologist, allows to state that many of these professionals ignore the upper aerodigestive tract as a cough-generator site. The present work discusses the alterations on the mentioned tract, which may provoke the cough reflex, reviewing, initially, the cough mechanism and the localization of the specific receptors. Cough is produce by stimulus at the receptor level or far from it. In upper and lower parts of the aerodigestive tract secretions may run to several directions. Secretion from the paranasal sinus is a frequent cause of cough. Acute sinusitis may occur insidiously bringing about the chronification of the inflammation with cough being the only great apparent symptom. Nasal and dental alterations favor sinusal infection. Signs and symptoms, even if minimum, may be detected through an accurate anamnesis. Nasal allergy, laryngitis, post nasal dripping and septal deviation may also produce cough. The ORL examination is, therefore, imperative, and no radiologic examination can substitute for it. An inadequate treatment, particularly of the sinusitis, may bring about a worsening and extension of the initial condition.
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PMID:[Cough: an otorhinolaryngologist's view]. 828 Nov 98

The physiopathology of chronic cough remains obscure. We evaluated the possibility that chronic cough in nonasthmatic subjects is associated with airway inflammation, and if this is so, what the relationship between this inflammation and the possible etiology of cough might be, as well as its response to inhaled steroids. Nineteen nonsmoking, nonasthmatic subjects referred for a persistent cough (mean: 3.8 yr) were evaluated and compared with 10 normal subjects. The evaluation included a respiratory questionnaire, a physical examination, allergy skin-prick tests, chest and sinus radiographs, esophageal pH monitoring, measurements of expiratory flows, methacholine and citric acid challenges, and flexible bronchoscopy for bronchoalveolar lavage (BAL) and bronchial biopsies. Fourteen subjects further accepted participation in a randomized, double-blind crossover trial of inhaled beclomethasone (500 micrograms four times daily) and a placebo for 1 mo each. Four groups of subjects were identified according to the presence of postnasal discharge (n = 4), gastroesophageal reflux (n = 6), both conditions (n = 5), or neither (n = 4). Subjects with chronic cough had an increased number of inflammatory cells in their bronchoalveolar lavage fluid (BALF), but there was no significant difference between the four subgroups of coughers. As compared with control subjects, the bronchial biopsies of subjects with chronic cough showed increased epithelial desquamation (p = 0.004) and inflammatory cells (p = 0.005), particularly mononuclear cells (p < 0.01), in addition to submucosal fibrosis, squamous-cell metaplasia, and loss of cilia. These findings were not significantly different between the different etiologic groups. In subjects with chronic cough, basement-membrane thickness was normal and not different from that of control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Airway inflammation in nonasthmatic subjects with chronic cough. 830 50

Two cross sectional surveys, 24 years apart, using the same respiratory questionnaire, were carried out to examine changes in prevalence rates of cough, phlegm, and wheeze and to relate changes in wheeze to objective peak expiratory flow rates (PEFRs). The surveys were done in towns in southern and northern England and South Wales in schoolchildren aged 6.0-7.5 years; n = 1655 in 1966 and n = 2323 in 1990. Parents reported on winter cough and winter phlegm (early morning or day/night) and wheeze; PEFRs were also measured. The proportion of children reported as wheezing on most days or nights increased from 3.9% to 6.1% (95% confidence interval (CI) for increase -0.2 to 4.6), with a smaller increase in the prevalence of those who had ever wheezed. The proportion of children with day or night time cough increased from 21.1% to 33.3% (95% CI for increase 3.8 to 20.6) and the proportion with day or night time phlegm increased from 5.8% to 10.0% (95% CI for increase 0.4 to 8.0). Smaller increases in the prevalence of persistent cough (from 9.0% to 12.4%) and persistent phlegm (from 2.4% to 3.5%) were also observed, while morning cough and morning phlegm showed little change. The increases in cough and phlegm were apparent in subjects with and without a history of wheeze. Both absolute and proportional changes in symptom prevalence were generally greater in the north than in the south. Similar social class trends were seen in each survey. The mean difference in PEFR between subjects with and without wheeze was smaller in 1990 than in 1966, but this result could be influenced by a greater proportion of subjects receiving antiasthmatic treatment in the 1990 survey. These apparent increases in the prevalence of persistent wheeze, day and night time cough and phlegm, occurring over a period during which outdoor air pollution levels have decreased substantially, deserve further investigation.
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PMID:Time trends in respiratory symptoms in childhood over a 24 year period. 833 60

The benefits of antibiotic treatment and a nasopharyngeal culture in children with longstanding cough were analysed in a prospective randomized open study. Clinically suspected pertussis was excluded. Of 40 children given erythromycin for 7 days, 35 (88%) recovered in one week, compared with 17/47 (36%) untreated (p < 0.0001). Erythromycin eliminated Moraxella catarrhalis from the nasopharynx in 21/31 children (68%), compared with spontaneous disappearance in 7/35 (20%) untreated controls (p < 0.001). Purulent bronchitis or otitis media occurred in 2 children (5%) in the treatment group and in 21 (45%) in the control group (p < 0.01). To evaluate the clinical role of isolated pathogens, the 47 untreated subjects were studied. Seven of 35 children harbouring M. catarrhalis recovered, compared with 8/12 in whom this bacterium was absent (p < 0.01). No correlation was found between the isolation of Haemophilus influenzae or Streptococcus pneumoniae and the clinical outcome. Children with persistent cough > 10 days may benefit from erythromycin treatment. M. catarrhalis in the nasopharynx indicates prolonged symptoms and increased risk of bacterial complications.
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PMID:Erythromycin treatment is beneficial for longstanding Moraxella catarrhalis associated cough in children. 836 28

Cough is one of the most prevalent symptoms of bronchopulmonary diseases. If cough persists ( > 6 weeks), further workup is mandatory. The most common causes of persistent cough in nonsmokers presenting with a normal CXR are postnasal drip due to chronic rhinitis-sinusitis, cough equivalent asthma or gastroesophageal reflux. The response to empirical therapy may confirm one of these etiologies. Other causes of chronic cough need further extensive workup involving radiologic, functional and endoscopic procedures.
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PMID:[Cough--work-up and therapy]. 852 38

1. Angiotensin converting enzyme (ACE) inhibitors are in common use for the treatment of hypertension and heart failure. Whereas they are, in general, well tolerated, a dry cough can develop which, on occasion, requires termination of therapy. The reported prevalence of cough with ACE inhibitor therapy has varied from 0.2 to 25%, depending upon methods of data collection, analysis and symptom reporting. 2. To evaluate the prevalence of cough in Chinese patients receiving ACE inhibitors, interviews were carried out in 191 patients in Hong Kong who were taking therapy which included captopril or enalapril for hypertension or heart failure, and 382 patients matched for sex and age receiving alternative medications which excluded an ACE inhibitor (controls). Patients and controls were interviewed in a blinded manner by the same interviewer using a common adverse-effect questionnaire. 3. Persistent cough was reported in 44% of patients taking an ACE inhibitor (46% of those receiving captopril and 41.8% of patients taking enalapril), and in 11.1% of the controls (P < 0.001). The prevalence of other adverse reactions was similar, with no significant difference between the two treatment groups. The complication of cough was not related significantly to age, sex, underlying disease, drug dosage or smoking status. 4. This study indicates that cough is a common side effect of treatment with ACE inhibitors in Hong Kong Chinese, although in most patients cessation of therapy is not required. Whether Chinese are particularly susceptible to ACE-inhibitor cough requires a formal prospective study comparing Chinese and non-Chinese patients.
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PMID:High prevalence of persistent cough with angiotensin converting enzyme inhibitors in Chinese. 856 96

The objective has been to identify the different etiologies and elaborate a diagnostic and therapeutical methodology for patients with chronic cough. During one year we studied prospectively 83 patients with persistent cough of daily appearance with an evolution of four or more weeks and no previous etiologic diagnosis. We worked on three diagnostic (D) levels. D1: Based on the anamnesis and physical examination. D2: Sequential incorporation of complementary exams. D3: Evaluation of the response to the specific treatment. We divided the population into 2 groups: G1 healthy children, G2 children followed in our hospital for different conditions. The mean age was 4.7 years (range, 3 months to 15 years), and the average duration of cough was 4.9 months (range, 1 to 36 months). In G1 the following causes were identified in 78 children: cough variant asthma 41 (52%), asthma+upper respiratory tract infections 8 (10%), asthma+lower respiratory tract infections 6 (7%), postnasal drip syndrome (sinusitis, adenoiditis) 5 (6%), psychogenic 6 (7%), undetermined 4 (5%), gastroesophageal reflux 2, asthma+cigarette 2, AIDS 1, Sjogren syndrome 1, vascular ring 1, cricopharyngeal foreign body 1. In G2 out of 5 children we have found: 2 children with chronic encephalopathies who had swallowing disorders and gastroesophageal reflux, 1 patient with Down syndrome presenting hypogammaglobulinemia and bronchiectasis, 1 tracheaesophageal fistula in H in a child with recurrent pneumonia, 1 lymphocytic pneumonia in an AIDS patient. The D1 was correct in 92% of the cases. The specific therapy has proved useful for achieving the remission of the symptoms. Although asthma is the most frequent cause of chronic cough, other etiologies exist and must be ruled out.
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PMID:[Chronic cough in pediatrics]. 872 72


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