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)

Post-poliomyelitis respiratory impairment is extremely common and entails considerable risk of morbidity and mortality. Respiratory muscle weakness is the primary etiological factor but post-poliomyelitis individuals (PPIs) also have a high incidence of scoliosis, obesity, sleep disordered breathing, and bulbar muscle dysfunction, all of which can add to the risk. One hundred forty-five PPIs were managed by noninvasive alternatives to intermittent positive pressure ventilation (IPPV) via an indwelling tracheostomy. When properly managed in this manner, acute respiratory failure requiring hospitalization, tracheal intubation, and bronchoscopies were avoided. Timely introduction of mouthpiece IPPV, nasal IPPV, manually and mechanically assisted coughing, and noninvasive blood gas monitoring in the home were the principal techniques used for optimizing quality of life and for avoiding complications.
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PMID:Management of post-polio respiratory sequelae. 761 64

A previously healthy woman aged 53 years presented with cough, night sweats and weakness. Chest roentgenogram revealed a reticulonodular infiltrate of the right upper lung. Multiple sputum cultures were positive for Mycobacterium avium-intracellulare, with no immunodeficiency disease. Fibreoptic endoscopy showed multiple tracheal cartilaginous knobs from a tracheobronchopathia osteochondroplastica. The infiltrate improved after chest physiotherapy, but sputum cultures remained positive. Despite its low incidence, tracheobronchopathia osteochondroplastica can be associated with atypical mycobacterial disease.
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PMID:Mycobacterium avium-intracellulare associated with tracheobronchopathia osteochondroplastica. 774 87

In Egypt, 400 randomly selected pregnant women attending prenatal clinics affiliated with El-Shatby Maternity Hospital, Dar El-Welada Hospital, Gamal Abdel Nasser Hospital, Boharram Bay Maternal and Child Health Center, and Bacous Maternal and Child Health Center were interviewed to determine their knowledge of and practices related to drug intake during pregnancy. 47.7% had adequate knowledge (i.e., 75% correct answers) of drug use during pregnancy. Only 14% did not use any drugs during pregnancy. The remaining 86% used drugs without a prescription. The most common drugs used were vitamins and tonics (78.8%), antacids (66.5%), analgesics (41.8%), and antiemetics (35.5%). The leading reasons for drug use included general weakness (78.8%), heart burn and indigestion (66.5%), headaches (41.8%), vomiting (35.5%), and cough and insomnia (27.5%). Factors associated with poor knowledge of drug use during pregnancy were: younger than 30, illiteracy, being a housewife, primigravidity, and history of abortion (p 0.05 for all factors). These findings indicate a need to inform pregnant women about the dangers of drug use during pregnancy, especially during the first 12 weeks of pregnancy. Nurses should play a key role in communicating these risks.
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PMID:Knowledge and practices of pregnant women in relation to the intake of drugs during pregnancy. 777 81

The effect of bilateral pudendal blockade on the urethral pressure and power generation during coughing and pelvic floor squeezing was evaluated in 10 healthy women. The measurements were carried out at the bladder neck, in the high pressure zone, and distally in the urethra before and after blockade. Strong adjunctive closure forces were demonstrated all along the urethra. They were significantly reduced by pudendal blockade except at the bladder neck during coughing. The results indicate that the pudendal innervated striated muscles contribute significantly to the adjunctively acting closure forces all along the female urethra, including the bladder neck. Some passive pressure transmission to the bladder neck seems to take place during stress episodes following pudendal blockade, but whether it occurs in healthy females remain uncertain. The findings following pudendal blockade, corroborate with those in stress incontinent women, and thereby support the concept that striated muscle weakness is of pathophysiological significance in stress urinary incontinence.
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PMID:The effect of bilateral pudendal blockade on the adjunctive urethral closure forces in healthy females. 781 67

In early phases of neuromuscular disease, patients are either free of respiratory symptoms or have exertional dyspnea not explained by obvious obstructive or restrictive lung disease. Physical examination may be negative because generalized muscle weakness does not correlate with the degree of respiratory muscle involvement. When the diaphragm is involved, one may detect the absence of outward excursion during inspiration or even paradoxic inward inspiratory movement of the abdomen on one side. A substantial loss of respiratory muscle strength is typically accompanied by little or no change in spirometry or arterial blood gas composition. Other characteristics are moderate loss of maximal voluntary ventilation and an increase in residual volume, yet PImax and PEmax may be as low as 50% of the predicted value. In more advanced neuromuscular disease, patients may have severe symptoms if the onset is acute or subacute; however, patients with chronic advanced generalized muscle weakness do not exercise and, therefore, may not be breathless. Many patients with advanced neuromuscular disease present with daytime somnolence as a manifestation of a sleep-related breathing disorder. Physical examination may reveal generalized muscle weakness and difficulty with speech or swallowing. Signs specific to respiratory involvement include tachypnea, use of neck inspiratory muscles and abdominal expiratory muscles, and loss of chest-abdomen synchrony. Sometimes paradoxic bilateral inward movement of the abdomen with inspiration is overt. Patients may be unable to cough effectively, have scoliosis, and lack a gag reflex. At this advanced stage, PImax and PEmax are lower than 50% of the predicted value, and the vital capacity is reduced. Maximal voluntary ventilation increases, and residual volume increases further. Patients may not yet exhibit CO2 retention during the day and may even have a low PaCO3. A sleep study may reveal significant hypopneas with severe desaturation and hypercapnia, especially during REM sleep. It is important to be aware that overt ventilatory failure can occur abruptly and that measurement of arterial blood gas composition is not a reliable indicator of this danger. Therefore, it is critically important to heed clinical phenomena, such as increasing dyspnea and tachypnea, and symptoms of sleep disturbance, such as morning headache and daytime somnolence. Physicians should make serial measurements of VC and respiratory muscle strength in patients considered to be at risk for further deterioration.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Assessment of ventilatory function in patients with neuromuscular disease. 786 89

A variety of mechanical devices may be used to provide assistance when ventilation and cough are severely impaired by progressive respiratory weakness caused by neuromuscular disease. Traditionally, positive pressure ventilation via a tracheostomy has been used, but if upper airway function is adequate, a variety of noninvasive devices also may be considered. Although positive pressure ventilation is the preferred noninvasive mode for assisting ventilation, other modes may be selected depending on patient needs, preferences, and physical characteristics.
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PMID:Options for mechanical ventilation in neuromuscular diseases. 786 90

Side reactions following ivermectin treatment were evaluated in sixty males with high density bancroftian microfilaremia (GM 1388/ml). Following a single oral dose of ivermectin of different strengths (20, 50, 100 or 200 micrograms/kg), microfilariae clearance and side reactions were monitored in a double blind fashion. Microfilaria levels fell rapidly after ivermectin administration in all dosage groups and 98% of pretreatment microfilariae was cleared after 12 h of treatment. The rate of microfilaria (mf) clearance was slower with 20 micrograms/kg than with the highest dose (200 micrograms/kg) administered. Forty-six patients (77%) became amicrofilaraemic within 2 weeks of treatment. Side reactions were noted in 97% of cases. The most common reactions were fever, headache, weakness, myalgia and cough which appeared by 12 h and subsided by 72 h following treatment. The frequency and intensity of side reactions were related to pretreatment mf densities and were independent of the dose administered. Unusual side reactions were noted in a few patients with high density microfilaraemia. These included intense cough, shortness of breath, blood tinged mucoid expectoration associated with patchy pneumonitis of the lung. Itchy rashes, lymphatic nodules and raised alkaline phosphatase level were also observed in some patients. These side reactions were transient, self limiting and were not serious enough to warrant any treatment. These exaggerated unusual reactions were possibly due to allergic response of the susceptible host to rapid killing of large number of microfilariae.
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PMID:Side reactions following ivermectin therapy in high density bancroftian microfilaraemics. 790 35

The "Timing Principle" utilises a single bolus of non-depolarising neuromuscular blocking drug followed by thiopentone given at the onset of clinical weakness. The purpose of this study was to compare the intubating conditions after succinylcholine and after atracurium used according to the "timing principle." Eighty patients were randomly assigned to four groups of 20. Three study groups were given atracurium 0.5, 0.75 or 1 mg.kg-1 (Groups I, II and III respectively) and the control group (Group IV) received succinylcholine 1.5 mg.kg-1. The study groups received fentanyl 1 microgram.kg-1, atracurium three minutes later, followed by thiopentone 4-6 mg.kg-1 at the onset of ptosis. The control group had a defasciculating dose of atracurium (0.025 mg.kg-1) and fentanyl (1 microgram.kg-1) followed by thiopentone (4-6 mg.kg-1) and succinylcholine three minutes later. The trachea was intubated one minute after thiopentone was given. The intubating conditions were then graded by a laryngoscopist who was unaware of the induction sequence. All patients were interviewed on the day after surgery. Intubation scores of patients in Group I were worse than in Groups II, III and IV (P < 0.005) but there were no differences between Groups II, III and IV. The technique was not associated with severe haemodynamic changes. All patients, except one were able to cough well after administration of atracurium, before induction of anaesthesia with thiopentone. Patients were generally satisfied with this method of induction. It is concluded that atracurium, when used according to the timing principle, can be an alternative to succinylcholine during rapid-sequence induction.
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PMID:Rapid tracheal intubation with atracurium: the timing principle. 792 16

A 22-year-old male was admitted to our hospital because of progressive weakness of bilateral lower limbs on October 29, 1992. He also complained of cough, sputum and back pain for 6 months. He had no history of underlying disease. His family history disclosed that his elder brother had tuberculous peritonitis. Chest radiogram on admission showed an abnormal shadow around the right first arch. Computerized tomogram revealed osteolytic lesions of the vertebral corpus and posterior elements at the level of C3, Th5, and Th11. Metastatic bone tumor was strongly suspected and surgical decompression was done on November 12. Histologic findings of the bone showed caseation and Langhans's giant cells, and acid fast bacilli were isolated. He was treated with anti-tubercular chemotherapy and showed remarkable relief of his symptoms over a period of 6 months therapy. This was a case of atypical tuberculous spondylitis. The main locus existed at the posterior elements of the vertebra and the distribution of vertebral lesions was multiple including cervical spine.
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PMID:[A case report of atypical tuberculous spondylitis]. 793 Jul 91

This paper investigates the role of carnitine in the etiology and treatment of dilated cardiomyopathy in boxers. Two boxers were diagnosed as having dilated cardiomyopathy on the basis of clinical presentation, chest radiographs, electrocardiography and echocardiography. In one dog, carnitine was administered at 6.0 g (or approximately 250 mg/kg live weight (LW) daily per os, and this dog remained asymptomatic for 4 mo until it presented for anorexia, coughing and weakness. Necropsy and histologic findings were consistent with boxer cardiomyopathy in both dogs. Cardiac carnitine concentration was 567 nmol/g wet weight in the unsupplemented dog, which is below the normal mean +/- SD concentration of 1493 +/- 141 nmol/g wet weight. Low cardiac carnitine concentrations appear to be a consistent finding for dilated cardiomyopathy in boxers. However, in the dog that received carnitine therapy, cardiac carnitine was 2802 nmol/g wet weight, and all tissues assayed in the supplemented dog had higher carnitine concentrations than normal dogs. Elevation of tissue carnitine failed to ameliorate dilated cardiomyopathy in this dog. Oral carnitine supplementation in these therapeutic doses appears not to resolve dilated cardiomyopathy in all boxers.
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PMID:Case report: efficacy of oral carnitine therapy for dilated cardiomyopathy in boxer dogs. 799 70


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