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

Chronic cough is a fairly common pediatric complaint. Usually, it is secondary to irritation of the airways following a respiratory viral infection. In these cases, the cough tends to diminish over time. There may, however, be a subsequent development of bronchial hyperreactivity. Asthma is common in the pediatric population. From 50% to 90% of chronic coughers may have hyperreactive airways. In the absence of a pulmonary function laboratory to test for this, a trial of bronchodilator therapy is warranted. Other conditions discussed may also cause chronic cough and a thorough history and physical examination with some simple radiologic investigations can help pinpoint the cause. Specific therapy can then be used to manage the problem. In addition to specific therapy, care must be taken to explain to the parents and patient the physiology of the cough and why it is present. Anxieties and fears should be dealt with in a caring and direct manner. Occasionally, non-specific therapy is needed to allow the parents and child some rest and relief.
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PMID:The approach to chronic cough in childhood. 273 64

Five-thousand portable or posterior-anterior-lateral radiographs of acute care emergency department patients were interpreted. They revealed serious disease in 35% of patients with chest symptoms, in 27% of all patients examined, and in 18% of patients with noncardiorespiratory symptoms. The highest incidence of abnormal radiographs (42%-79%) occurred in patients with symptoms of congestive heart failure, dyspnea, hemoptysis, dysrhythmia, and hypertension. Asthma (14%) and trauma (5%) presented the lowest incidence of significant findings. Radiographs of patients suspected of having pneumonia were abnormal in 25% of cases, and in those patients with either cough or fever alone, the incidences of pneumonia were 13% and 18%. Whereas 24% of patients with dyspnea alone had radiographic findings of congestive heart failure, 52% of those with congestive heart failure diagnosed on clinical grounds had abnormal radiographs. The chest radiograph continues to be a significantly important examination in the diagnosis of disease, the prevention of overtreatment, and the redirection of clinical investigation in the acute care emergency department unit.
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PMID:Five thousand acute care/emergency department chest radiographs: comparison of requisitions with radiographic findings. 317 Nov 20

The effect of passive smoking on respiratory symptoms of children aged 5 to 11 years was investigated in over 4000 English children and nearly 800 Scottish children participating in the National Study of Health and Growth in 1982. After adjusting for associations of respiratory symptoms with age, sex, and a number of potentially confounding variables, significant associations were found of wheeze, both occasional and persistent, day or night cough, and bronchitis attacks with number of cigarettes smoked by parents at home for English children and for occasional wheeze in Scottish children. Asthma attacks and cough first thing in the morning showed positive but not statistically significant associations in English children. The presence of at least one condition was statistically significant in both English and Scottish children. The largest relative risk for exposure to 20 cigarettes a day compared to no exposure was 1.60 for persistent wheeze in English children (95% confidence interval 1.17-2.18).
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PMID:Passive smoking and respiratory conditions in primary school children. 322 Nov 59

Asthma has been defined as variable airflow obstruction. The symptoms of asthma are not specific for the condition and, therefore, the presence of variable airflow obstruction needs to be objectively confirmed. When airflow obstruction is present and when it can be completely reversed with treatment, confirmation of the diagnosis is easy. When spirometry is normal or when there is chronic airflow limitation, however, other methods of investigation are required. These methods include inhalation tests with histamine or methacholine, diurnal variation of peak flow rates and tests with exercise or hyperventilation. When spirometry is normal, methacholine or histamine tests appear to be the most sensitive method but, if results are normal, they do not exclude past or future asthma. However, when there is chronic airflow limitation neither variable airflow obstruction nor methacholine or histamine hyperresponsiveness are specific for asthma; tests with hyperventilation (and probably others that act through mediator release) may be more specific. The presence of asthma probably requires the release of chemical mediators, from mast cells and other cells, which can produce inflammation. This has been particularly studied after inhalation of allergens or chemical sensitizers which can trigger both early and late asthmatic responses. The late responses are associated with prolonged increases in airway responsiveness and are considered to be a result of the cellular phase of inflammation. It is possible that persistent or recurrent inflammation, due to these and other stimuli, is the cause of the persisting airway hyperresponsiveness and variable airflow obstruction in asthma, as well as the other features of cough and sputum, but this requires further investigation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Asthma and the role of inflammation. 353 88

Out of 2.513 clinical files of allergic children, we have found 200 pollen-allergic patients, which represent 7.9% of the total allergic pathology in children, in our environment. We have studied in these 200, the most important epidemiological parameters and the influence that this can cause upon the characteristics of this disease. A male predominance has been found (70%) and it has been discovered that 52% of the total were born in spring (p less than 0.0005). An hundred per cent have shown grass-pollen sensitiveness and 52% have also shown other kinds of pollen hypersensitivity. It has been found familiar allergic background in 76.5% of the cases and in 32.5% familiar allergic history of pollinosis. Unexpectedly, those who were in lack of familiar allergic history began their clinical symptoms earlier; 51.06% before 6 years of age (p less than 0.05). Other kinds of allergic manifestations were found in 51%, being respiratory symptoms the most important (35.5%), followed by the cutaneous (23.5%) and digestive ones (10.5%). Allergy to drugs was found in 10.5%. The more frequent symptoms of pollinosis were in order of importance: rhinitis (86.5%), conjunctivitis (77%), asthma (48%), spasmodic cough (27.5%) and urticaria (4%). Asthma induced by grass-pollen hypersensitivity was equally suffered by the males as by the females, and this was more frequent among the patients who had previously suffered from non-pollinic respiratory allergies.
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PMID:[Natural history of pollinosis in childhood]. 370 20

These three cases are presented as additional evidence that vomiting can be a dominant symptom of asthma. Coughing and wheezing can be overlooked or ignored. Asthma must be considered in the differential diagnosis of vomiting.
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PMID:Vomiting as a dominant symptom of asthma. 381 27

In a randomized, double-blind, group comparative study, 100 asthmatic patients known to be responsive to cromolyn sodium were treated either with pelletized cromolyn (cromolyn sodium, 20 mg) or with cromolyn blend, Intal (cromolyn sodium, 20 mg + lactose, 20 mg). There was no statistically significant difference between the two treatment groups for asthma severity, breathlessness on exertion, cough, the number of inhalations needed to obtain the dose from the capsule, and morning peak flow. No local or systemic side effects were encountered during the 6-month duration of the study. It is concluded that pelletized cromolyn offers most of the advantages of cromolyn therapy without the need for the patients to inhale lactose at the same time. Also, pelletized cromolyn has a distinct therapeutic advantage for use in lactose-in-tolerant patients.
J Asthma 1985
PMID:A double-blind comparative study of pelletized cromolyn versus cromolyn blend in the treatment of asthma. 393 44

This study compares the respiratory health of Mexican-American and non-Mexican-American white school children. Using responses to questionnaires, the point prevalences of physician-confirmed asthma, attacks of shortness of breath with wheeze (without a diagnosis of asthma), and cough were compiled for each ethnic group. Using the results of yearly pulmonary function testing, initial and serial pulmonary function were also calculated. Asthma was reported by 6.5 percent of the non-Mexican-American children and 1.9 percent of the Mexican-American subjects (p less than 0.01 by chi 2). The rates of respiratory symptoms were nearly equal in the two groups. Initial and serial testing of pulmonary function showed non-Mexican-American children had significantly lower maximum expiratory flows (Vmax50%) in each year of testing. These results confirm other reports of differences in both rates of asthma and pulmonary function in Mexican-Americans and non-Mexican-Americans. Inherent differences in the size of the airways could explain these findings.
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PMID:A comparison of the respiratory health of Mexican-American and non-Mexican-American white children. 662 11

Signs, symptoms, and radiographic abnormalities of sinusitis are frequent in children with asthma; it is not known whether sinus inflammation is associated with bacterial infection or other mechanisms. Eight asthmatic patients with exacerbation of asthma despite bronchodilator therapy were studied after maxillary sinusitis was confirmed by radiographs. All had cough, wheezing, nasal stuffiness, rhinorrhea and were afebrile. Four patients had headaches, and two had facial pain. Maxillary sinus aspirates were obtained, and bacterial cultures were positive in five: Branhamella catarrhalis (2), nontypeable Hemophilus influenzae (2), Streptococcus pneumoniae (1). Nose and throat cultures did not correlate with sinus cultures. All patients received bronchodilators, and four of eight patients received steroids. All were treated for 14 to 28 days with antibiotics during which seven of the eight patients improved clinically including all with positive sinus cultures. Asthma-symptoms diary scores were kept by five; all demonstrated improvement. Pulmonary-function tests improved in five of seven patients after the antibiotic and asthma therapy including the four patients with positive cultures. Sinus radiographs cleared in three, improved in three, and were unchanged in two patients after antibiotic therapy.
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PMID:Asthma and bacterial sinusitis in children. 674 40

Fourteen steroid-dependent and 16 steroid-independent asthmatic patients received aerosol triamcinolone acetonide for 12 weeks (two 200-micrograms inhalations four times daily). The mean daily oral steroid dose for the steroid-dependent patients was reduced from 12.5 mg at baseline to 1.34 mg after 12 weeks of aerosol therapy. In both groups of patients, FEV1.0, FVC and FEF25-75% values improved during therapy, usually at a statistically significant rate. Highly significant improvement occurred in shortness-of-breath, wheezing tightness-in-chest, and cough symptoms in all patients. However, changes in serum cortisol levels were not statistically significant. Side effects included transient hoarseness (seven patients), dry throat (one), and sore throat (one). No oral candidiasis was observed and no patient discontinued therapy because of side effects. Steroid withdrawal symptoms, which gradually abated, were experienced by half of the steroid-dependent patients. Aerosolized triamcinolone acetonide was therefore considered a safe and effective modality in the management of chronic asthma.
J Asthma 1982
PMID:Efficacy and safety of aerosolized triamcinolone acetonide in steroid-dependent and steroid-independent chronic asthmatic patients. 708 56


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