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

A 48 year old man, employed in a grain and animal feed store for 9 years, was referred to our clinic complaining of nasal blockage, rhinorrhea, sneezing, ocular burning, coughing and wheezing occurring over the last 12 months. The man's main task was to manually load and unload the unpackaged grain and feed. Symptoms occurred only when he worked directly with oilseed rape flour and not when he worked with other types of grains. Eye and nasal symptoms appeared during the work shift, while respiratory symptoms were worse at night than during the day after exposure to rape for more than 2 consecutive days. Physical examination was normal, as were the results of the pulmonary function studies. The methacholine inhalation test, performed to measure the level of non-specific airways responsiveness, showed normal bronchial reactivity. Results of allergy skin prick tests were negative for common inhalant and food allergens, but slightly positive for the oilseed rape flour extract. Registration of the peak expiratory flow (PEF) showed slight decreases in PEF values after occupational exposure. We conclude that this case is suggestive of asthma and rhino-conjunctivitis, induced by oilseed rape flour, probably due to an allergic mechanism.
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PMID:[Asthma and rhinoconjunctivitis caused by rape flour: description of a clinical case]. 973 92

Over a 2-year period, 21 patients with clinical and radiologic evidence of persistent or recurrent frontal sinusitis who had a prior ethmoidectomy and/or frontal sinusotomy underwent an endoscopic Lothrop procedure. The patients' chief complaints were headaches (13), nasal obstruction and/or purulent rhinorrhea (4), orbital abscess/cellulitis (2), anosmia (1), and cough (1). Preoperative frontal headaches were present in 19 patients. The common frontal ostium remained patent (> 50% of intraoperative size) by flexible fiberoptic examination and transillumination 2-24 months postoperatively in 12 of 21 patients (57%). Eighteen of 21 patients (86%) had improved or resolved chief complaints. All but 4 of 19 patients (21%) with preoperative frontal headaches had improved or resolved symptoms. Two patients required additional surgery during the follow-up period. The endoscopic Lothrop procedure is a viable option before frontal sinus obliteration in patients with recurring frontal sinusitis who have failed conventional endoscopic techniques. The surgical technique and results will be presented.
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PMID:Endoscopic Lothrop procedure: the University of Miami experience. 980 33

Disseminated histoplasmosis has been recognized as a serious opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS). However, cases reported in the literature have been predominantly in adult patients. Here we report an infant with AIDS who presented with fever, cough, rhinorrhea, hepatosplenomegaly, pancytopenia and coagulopathy, and died of respiratory failure. Autopsy revealed disseminated histoplasmosis involving multiple organs including lungs, intestines, liver, spleen, bone marrow, lymph nodes, kidneys, and meninges. The diagnosis was established based on histomorphology and confirmed by blood culture.
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PMID:Disseminated histoplasmosis in an infant with acquired immunodeficiency syndrome. 989 38

Using clinical predictors, we evaluated clinical case definitions of influenza during the 1995-1996 outbreak in France. Thirty-five general practitioners collected virological specimens and clinical data. Predictors of influenza virus infection were selected with logistic regression models. The results varied with the influenza virus subtype: temperature of >38.2 degrees C, stiffness or myalgia, rhinorrhea, and cough were predictive of influenza A/H3N2, whereas fatigue, lacrimation or conjunctival injection, and the absence of stiffness or myalgia were predictive of influenza A/H1N1. On the basis of this analysis and data from the literature, 12 clinical case definitions were evaluated for their abilities to diagnose influenza virus infection. They were associated with positive predictive values of 27% to 40% and negative predictive values of 80% to 91%. We conclude that focused studies evaluating clinical case definitions of influenza with use of subsets of patients should accompany population-based disease surveillance for optimal estimates of the disease burden associated with influenza epidemics.
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PMID:Evaluation of clinical case definitions of influenza: detailed investigation of patients during the 1995-1996 epidemic in France. 1006 45

In Ismailia, Egypt, interviews with key informants and mothers of young children and presentations of a video were conducted in a suburban area with access to health facilities and in a rural village 3 km from the nearest public health clinic. The researchers wanted to assess mothers' recognition and interpretation of clinical signs of serious illness and to determine their preference of provider options by different locally defined acute respiratory infection (ARI) illnesses. Mothers heard descriptions of hypothetical cases and then reported how they would treat the children in the case scenarios. The researchers compared results from these data collection practices with the actual care-seeking practices of mothers during past childhood ARI episodes. When shown a video of 20 children with either no respiratory symptoms or mild to severe symptoms, mothers were able to correctly identify children who did not have an ARI in 56% of cases. With no prompting, they were able to correctly identify those with fast respiratory rates in 65% of cases. Mothers took their children with an ARI outside of the home for treatment in 22 of the past 30 ARI episodes. The most common reasons for taking children to a private physician in cases of serious illness rather than to a physician at a government health clinic were confidence in physician's ability and convenience, especially in hours of operation. Mothers tended to treat children with a runny nose and cough at home, regardless of age. Most did not consider fast and irregular breathing as a reason to seek treatment outside of the home. These results suggest that the National ARI Program should sponsor a media campaign to promote confidence in government providers to treat serious ARIs, call for a change in clinic schedules to increase access to care, and assume educational and managerial actions to assure quality of care and the availability of necessary drugs.
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PMID:Developing strategies to encourage appropriate care-seeking for children with acute respiratory infections: an example from Egypt. 1013 89

Various reports indicate conclusively that antibiotics are used much too frequently and physicians often prefer broad spectrum compounds for "safety reasons". Symptoms of viral infections of the respiratory tract such as fever, cough and runny nose are often reason enough to start antibiotic regimens leading to increased costs and finally to development of resistance. Some newly developed antibiotics, often with unique properties will be discussed in this paper emphasizing potential problems associated with their uncritical use.
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PMID:[Newer antibiotics--missed efficacy in false indications]. 1035 39

Jessica, a 14-year-old girl with a history of asthma, went to her pediatrician's office because of a persistent cough. She had been coughing for at least 3 months with occasional cough-free periods of less than a few days. The cough was nonproductive and was not accompanied by fever, rhinorrhea, or facial or chest pain. Jessica and her mother observed that the cough increased with exercise and typically was not present during sleep. She has used two metered-dose inhalers--albuterol and cromolyn--without any change in the cough pattern. For the past 5 years, Jessica has had mild asthma responsive to albuterol. She enjoys running on the cross-country team, soccer, and dancing. She is an average student and denies any change in academic performance. She has never been hospitalized or had an emergency department visit for asthma or pneumonia. There has been no recent travel or exposure to a person with a chronic productive cough, tobacco smoke, or a live-in pet. Jessica lives with her mother and younger sister in a 10-year-old, carpeted apartment without any evidence of mold or recent renovation. In the process of taking the history, the pediatrician noticed that Jessica coughed intermittently, with two or three coughs during each episode. At times, the cough was harsh; at other times, it was a quiet cough, as if she were clearing her throat. She was cooperative, without overt anxiety or respiratory distress. After a complete physical examination with normal findings, the pediatrician interviewed Jessica and her mother alone. Jessica's parents had been divorced for the past 6 years. She lived with her mother but visited her father, and his new family with two young children, every weekend. She spoke about this arrangement comfortably and said that she loved her father and mother but didn't like the tension she experienced at her father's home. "I don't like adults arguing when kids are around." When asked why she thought the cough persisted so long, she commented in a neutral tone, "I don't know. It's never been like this before." Jessica's pediatrician prescribed an inhaled steroid with the albuterol. When the cough did not respond after 1 week, he ordered a chest radiograph (normal) and a tuberculin skin test (purified protein derivative-negative), and he added montelukast (a leukotriene inhibitor) and monitored airway resistance with a peak flow meter. The cough persisted, and the peak flow recording showed normal airway resistance. At this time, Jessica's pediatrician suspected a conversion reaction and contemplated the next best therapeutic strategy.
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PMID:Persistent cough in an adolescent. 1060 74

A 47-year-old man who smelled of alcohol presented with a three-day history of sore throat. He had not had fever, nausea, vomiting, diarrhea, rhinorrhea, cough, chest pain, or palpitations. On evaluation in the emergency department, he was found to have tachycardia and an irregular pulse.
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PMID:An alcoholic man with an abnormal pulse. 1061 94

People who live near industrial swine operations have reported decreased health and quality of life. To investigate these issues, we surveyed residents of three rural communities, one in the vicinity of an approximately 6,000-head hog operation, one in the vicinity of two intensive cattle operations, and a third rural agricultural area without livestock operations that use liquid waste management systems. Trained interviewers obtained information about health symptoms and reduced quality of life during the previous 6 months. We completed 155 interviews, with a refusal rate of 14%. Community differences in the mean number of episodes were compared with adjustment for age, sex, smoking, and employment status. The average number of episodes of many symptoms was similar in the three communities; however, certain respiratory and gastrointestinal problems and mucous membrane irritation were elevated among residents in the vicinity of the hog operation. Residents in the vicinity of the hog operation reported increased occurrences of headaches, runny nose, sore throat, excessive coughing, diarrhea, and burning eyes as compared to residents of the community with no intensive livestock operations. Quality of life, as indicated by the number of times residents could not open their windows or go outside even in nice weather, was similar in the control and the community in the vicinity of the cattle operation but greatly reduced among residents near the hog operation. Respiratory and mucous membrane effects were consistent with the results of studies of occupational exposures among swine confinement-house workers and previous findings for neighbors of intensive swine operations. Long-term physical and mental health impacts could not be investigated in this study.
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PMID:Intensive livestock operations, health, and quality of life among eastern North Carolina residents. 1070 29

The principal viruses implicated in pericarditis are enteroviruses. Cytomegalovirus pericarditis is quite rare and has been reported in immunocompromised patients with acquired immunodeficiency syndrome, malignant neoplasm or organ transplantation. We report a three-month-old male infant who suffered from cough and rhinorrhea for two weeks. He developed shortness of breath for three days, and fever for one day, prior to admission. Physical examination revealed tachycardia, tachypnea, pale conjunctiva, hepatomegaly, and a muffled heart sound without significant murmur. Chest radiography showed marked enlargement of the cardiac silhouette. Echocardiography demonstrated a large amount of pericardial effusion with impaired diastolic ventricular function. After pericardial drainage and supportive treatment, the fluid gradually disappeared. Viral culture of the pericardial fluid and serologic data confirmed a cytomegalovirus infection. Cytomegalovirus pericarditis should be included in the differential diagnosis of pericardial effusion in a young infant.
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PMID:Cytomegalovirus pericarditis with cardiac tamponade in a young infant. 1086 55


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