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

Meobentine (sulfate) has antifibrillatory and antiarrhythmic activity in canine models. The antiarrhythmic, pharmacokinetic, and adrenergic neuronal blocking effects of meobentine were assessed in 15 patients with chronic, high-frequency ventricular ectopic depolarizations (VEDs). Eleven of the 15 patients had recurrent nonsustained ventricular tachycardia. The patients were given a series of gradually increasing single doses of meobentine; six received oral meobentine and nine had infusions. The antiarrhythmic efficacy of meobentine was assessed by a comparison of arrhythmia frequency during placebo given on days just prior to meobentine. Oral therapy with meobentine at dosages above 20 mg/kg caused diarrhea, and well-tolerated dosages achieved peak concentrations of 0.69 micrograms/ml (range 0.5-1.0 micrograms/ml). Antiarrhythmic activity was seen in only one patient with oral meobentine. In contrast, intravenous infusions (6.75-34.2 mg/kg) achieved concentrations ranging from 1.3-9.8 micrograms/ml. There was a linear relationship between pseudo-steady-state plasma concentrations and dosage, r = 0.82, p less than 0.01. Antiarrhythmic activity was seen in four of nine patients who received intravenous meobentine over a range of concentrations from 2.5-4.5 micrograms/ml. Four patients developed evidence of adrenergic neuronal blockage (loss of the venous reflex response); two at dosages of 16.2 mg/kg, one at 24.3 mg/kg, and one at 34.2 mg/kg. In one individual (24.3 mg/kg), the adrenergic neuronal blockade was associated with an acute episode of shortness of breath, orthopnea, and cough. With intravenous meobentine, there was a linear relationship between dosage and AUC, and the elimination half-life ranged from 11-27 h.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol
PMID:The antiarrhythmic activity of meobentine sulfate in man. 620 20

The records of 103 male and 39 female patients with unexplained diaphragmatic paralysis were reviewed. A probable cause of the paralysis was not revealed by the initial history, physical examination, or review of plain chest roentgenograms. Paralysis occurred on the left in 82 patients (58%), on the right in 58 (41%), and bilaterally in two (1%). Initially, 64 patients (45%) had symptoms; dyspnea, cough, and chest wall pain were the most common. Long-term follow-up showed the best prognosis to be for patients with chest wall pain and cough (improvement in 82% and 78%, respectively); dyspnea improved in only 34% of patients with this complaint. Intrathoracic malignant lesions with phrenic nerve involvement were subsequently diagnosed in five patients (3.5%) and progressive neurogenic atrophy in one (0.7%). Roentgenographic follow-up showed return of normal diaphragmatic position in only 12 instances (9.2%). Patients with unexplained diaphragmatic paralysis are unlikely to have an underlying occult malignant or neurologic process, but recovery of diaphragmatic function is also unlikely and subsidence of related symptoms is variable.
J Thorac Cardiovasc Surg 1982 Dec
PMID:Unexplained diaphragmatic paralysis: a harbinger of malignant disease? 629 83

Open heart surgery is associated with postoperative sternal pain, which is exacerbated by cough, deep breathing and movement, thus limiting the physical activity of the patient. Transcutaneous electrical nerve stimulation (TENS) was administered to 40 patients suffering from persistent chest pain immediately following open heart surgery, and to ten other patients complaining of pain between three and eight weeks after operation. The efficacy of TENS was assessed by the subjective recordings, analgesic drug requirement, capability to carry out deep inspirations with an "Incentive Deep Breathing Exerciser" apparatus, and repeated chest X-ray examinations. We conclude that TENS is a useful method of pain control and should be used more frequently in patients after open heart surgery, especially in the older patient and in patients with chronic lung disease.
J Cardiovasc Surg (Torino)
PMID:Transcutaneous electrical nerve stimulation (TENS) after open heart surgery. 633 86

Approximately 8% of all mediastinal tumors are benign teratomas. We reviewed 86 cases of benign teratoma seen at the Mayo Clinic from 1930 through 1981. The mean age of the patients was 28 years and the sex distribution was approximately equal. The most common symptoms were chest, back, or shoulder pain, dyspnea, and cough, but 36% were asymptomatic at the time of presentation. Chest roentgenograms showed a well-circumscribed anterior mediastinal mass which often protruded into one lung field. Detectable calcification was observed in 22 patients: a calcified tumor wall in seven, bone or teeth in the mediastinum of seven, and nonspecific calcifications in eight. Surgical excision remains the best means of diagnosing and treating this benign tumor. Though the tumors are histologically benign, they may present difficult surgical problems because of the vital structures involved. Since 1952 there has been a change in the clinical presentation of patients with this entity: More patients are asymptomatic and have smaller tumors and fewer complications than prior to 1952.
J Thorac Cardiovasc Surg 1983 Nov
PMID:Benign teratomas of the mediastinum. 663 45

We report a case in a 38-year-old white woman of a benign primary intratracheal neurilemoma that recurred 12 years after an initial endoscopic excision. Of the 12 intratracheal neurilemomas that have previously been reported, all occurred in white persons in an age range of 6 to 71 years and most were located in the lower trachea and produced symptoms of cough and wheezing.
J Thorac Cardiovasc Surg 1983 Feb
PMID:Primary intratracheal neurilemoma. 682 50

Though the techniques for surgical treatment after postintubation tracheal stenoses are well defined, the management of major airway obstruction by tracheal tumor, external compression, or diffuse intrinsic tracheal disease below the thoracic inlet still presents a difficult problem. Existing methods do not provide safe and effective relief at the level of the distal trachea, carina, and main bronchi. This report describes a bifurcated silicone rubber stent initially designed to preserve patency of the airways in a patient after severe and diffuse scalding injury to the trachea and main bronchi. This stent has since been used to provide relief from airway obstruction by tracheal or mediastinal tumors below the thoracic inlet. The method for insertion by tracheostomy with guide bougies passed under direct bronchoscopic vision past the obstructing lesion is described in detail and illustrated by reference to two patients with tracheobronchial obstruction. Once the tube is in place, the patient breathes normally through the mouth and nose and can speak, cough, or clear his own airway by suction if necessary. This method has proved a safe and effective means to restore patency of the major airways and provide relief from asphyxia while further treatment is planned or healing ensues. Our initial experience indicates that the tube may be allowed to remain in position for several months without adverse effects.
J Thorac Cardiovasc Surg 1982 Mar
PMID:A bifurcated silicone rubber stent for relief of tracheobronchial obstruction. 706 52

Eight patients in whom new respiratory symptoms developed following pulmonary resection have been evaluated. The bronchial stumps in all of these patients had been closed with Tevdec suture material. The total number of pulmonary resections using Tevdec suture from January, 1971, to January, 1980, was 180, yielding an incidence of the complication of 4.4%. No patient had empyema or bronchopleural fistula. Symptoms included nonproductive cough (eight patients), hemoptysis (five patients), wheezing (two patients), and coughing up suture material (two patients). The underlying disease necessitating pulmonary resection was carcinoma in five patients, carcinoid adenoma in one patient, tuberculosis in one patient, and bronchiectasis in one patient. The median time interval between resection and development of respiratory symptoms was 18 months, with a range of 8 to 57 months. The chest roentgenograms showed no change from earlier postoperative films. Bronchoscopy under general anesthesia was performed in all eight patients. Granulation tissue around loosened Tevdec sutures was present in all patients so examined. No residual tumor or specific infection was identified. Immediate and sustained relief of symptoms was obtained in seven of eight patients by removal of the loosened sutures. One patient has had recurrence of minor hemoptysis 18 months following suture removal but has refused further endoscopy. Stainless steel staples have been used for bronchial stump closure in over 100 pulmonary resections since 1977 and no such complications have been seen.
J Thorac Cardiovasc Surg 1981 Apr
PMID:Bronchoscopic diagnosis and treatment of bronchial stump suture granulomas. 720 61

Fifty-three patients underwent 55 post-thoracotomy bupivacaine epidural analgesia experiences for pain control. Hospital records of all patients were analyzed for effectiveness of pain relief, changes in vital signs, and complications. In most instances, pain relief was adequate and patients were able to move, cough, and deep breathe unusually well in the postoperative period. Correlations were tested among changes in blood pressure, pulse, respiration, the actual value for low blood pressure, and subsequent elevation, age, sex, thoracotomy side, primary diagnoses, a secondary diagnoses, metastases, and complications. Systolic blood pressure reduction was greater in older patients who received epidural bupivacaine, with a correlation coefficient which attained significance (p less than 0.04). Patients who underwent thoracotomies for chronic pulmonary inflammation (p less than 0.04) or patients who had previous myocardial infarctions (p less than 0.05) also demonstrated significant reduction in systolic blood pressure. However, the number of patients in each group (six and four, respectively) makes their significance questionable. Although there were no serious complications or deaths attributable to this technique of pain control, possible morbidity is discussed. Removal of the epidural catheters was without incident. There was no evidence of irritation, pain, or infection at the catheter placement sites.
J Thorac Cardiovasc Surg 1981 Dec
PMID:Epidural analgesia for post-thoracotomy patients. 730 Apr 19

Circumferential support of the trachea and main bronchi is a new surgical method of preventing the collapse of the major airways. Heavy Marlex mesh is applied around the trachea and main bronchi and fixed with a Histoacryl adhesive. A severely asthmatic woman with total tracheal collapse during coughing underwent such a surgical application treatment successfully.
Scand J Thorac Cardiovasc Surg 1981
PMID:New surgical correction of central airway collapse in an asthmatic patient. 734 9

Quantitative studies of cough strength seem to be valuable in evaluating cough dynamics and the effectiveness of various procedures designed to raise the cough force. To evaluate cough strength in 20 patients after thoracotomy intrapleural cough pressures were measured with a balloon catheter inserted in the ipsilateral pleural space toward the apex. A balloon catheter designed to measure intraluminal esophageal pressure was used in this study. The balloon was inflated with 1 ml of air and the transmitted intrapleural pressure was measured during the maximum voluntary cough effort in the supine and/or sitting position. The pressure change during coughing seems to serve as an index in evaluating the strength of the respiratory muscles. It was observed that the cough pressure increased progressively following thoracotomy, and that it was higher in the sitting position than in the supine position. The most effective procedure to raise the maximum cough pressure was manually assisted compression of the chest wall in the sitting position during voluntary coughing. Epidural anesthesia following thoracotomy seemed to be effective in inducing higher cough pressure changes.
J Thorac Cardiovasc Surg 1980 Oct
PMID:Intrapleural cough pressure in patients after thoracotomy. 742 Dec 93


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