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

Tourette's syndrome is a neurological disorder consisting of chronic motor tics and involuntary vocalizations. Some of these vocalizations include coughing, grunting, and wheezing. We report two adolescents with a history of chronic coughing who presented for further evaluation of previously diagnosed asthma. A careful history suggested that Tourette's syndrome might be responsible for the patients' symptoms. Neurology evaluation confirmed the correct diagnosis of Tourette's syndrome for both patients. Treatment specific for this disease led to ablation of all symptoms. A history of repetitive coughing in adolescents may be the presenting symptom of Tourette's syndrome, thereby mimicking cough-equivalent asthma.
J Asthma 1999 May
PMID:Tourette's syndrome mimicking asthma. 1035 Feb 21

In patients with asthma, increased sensitivity of airway sensory nerves may be involved in producing bronchospasm and cough. To evaluate the effect of a leukotriene-modifying agent on cough reflex sensitivity, we measured the cough response to inhaled capsaicin before and after a 1 4-day course of therapy with zafirlukast, a cysteinyl leukotriene receptor antagonist, in a group of stable asthmatics. The concentration of capsaicin inducing two or more (C2) and five or more (C5) coughs was not altered by zafirlukast, even in those subjects demonstrating a significant change (increment or decrement) in forced expiratory volume in 1 sec (FEV1). These findings support previous evidence that cough and bronchoconstriction are modulated by distinct neural pathways.
J Asthma 1999 May
PMID:Effect of zafirlukast on cough reflex sensitivity in asthmatics. 1035 Feb 23

Asthma (Greek word that means "breathlessness" or "open-mouth breath") is a chronic inflammatory disorder of the airways, with extensive infiltration of the airway lumen and wall with eosinophils, mast cells, activated T-lymphocytes. Airway inflammation is associated with airway hyperresponsiveness, recurrent episodes of reversible airflow limitation and respiratory symptoms such as wheezing, chest tightness, breathlessness and cough with mucus production. Curiously, asthma worsens particularly at night and in the early hours of the morning. The current consensus on asthma therapy suggests that pharmacological control of asthma can be achieved with antiinflammatory "controller" medications such as inhaled glucocorticoids and cromones. Short-acting bronchodilators act as "reliever" medications and rapidly reverse acute manifestations of asthma. Asthmatic exacerbations require the repetitive administration of inhaled short-acting beta-2-agonist and the early introduction of oral glucocorticoids. Rarely the severity of exacerbation requires the administration of oxygen (that, if available, is not contraindicated), intravenous bronchodilators, glucocorticoids and epinephryne and mechanical ventilation.
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PMID:[The therapy of bronchial asthma]. 1038 May 56

Asthma and chronic obstructive pulmonary disease (COPD) are complex conditions with imprecise definitions, which make definitive morphological comparisons difficult. The airways in asthma are occluded by tenacious plugs of exudate and mucus, and there is fragility of airway surface epithelium, thickening of the reticular layer beneath the epithelial basal lamina (the last two not usually features of COPD), and bronchial vessel congestion and oedema. There is an increased inflammatory infiltrate comprising 'activated' lymphocytes and eosinophils with release of granular content in the latter, and enlargement of bronchial smooth muscle, particularly in medium-sized bronchi. CD4+ve lymphocytes predominate over CD8+ve cells and neutrophils are sparse. In contrast, three conditions contribute to COPD. In chronic bronchitis there is cough and mucous hypersecretion with enlargement of tracheobronchial submucosal glands and a disproportionate increase of mucous acini. CD8+ve lymphocytes predominate over CD4+ve cells and there are increased numbers of subepithelial macrophages and intra-epithelial neutrophils. Exacerbations of bronchitis are associated with a tissue eosinophilia, apparent absence of IL-5 protein but gene expression for IL-4 and IL-5 is present. In small or peripheral airways disease, there is inflammation of bronchioli and mucous metaplasia and hyperplasia, with increased intraluminal mucus, increased wall muscle, fibrosis, and airway stenoses (also referred to as chronic obstructive bronchiolitis). Respiratory bronchiolitis involving increased numbers of pigmented macrophages is a critically important early lesion. Increasingly severe peribronchiolitis includes infiltration of T lymphocytes in which the CD8+ subset again predominates. These inflammatory changes may predispose to the development of centrilobular emphysema and reduced FEV1 via the destruction of alveolar attachments. In emphysema there is abnormal, permanent enlargement of airspaces distal to the terminal bronchiolus (i.e. within the acinus) accompanied by destruction of alveolar walls and without obvious fibrosis. The severity of emphysema, rather than type, appears to be the most important determinant of chronic deterioration of airflow, and in this there may be significant loss of elastic recoil and microscopic emphysema prior to the observed macroscopic destruction of the acinus.
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PMID:Differences and similarities between chronic obstructive pulmonary disease and asthma. 1042 18

Asthma prevalence in children has increased 58% since 1980. Mortality has increased by 78%. The burden of the disease is most acute in urban areas and racial/ethnic minority populations. Hospitalization and morbidity rates for nonwhites are more than twice those for whites. Asthma is characterized by recurrent wheezing, breathlessness, chest tightness, and coughing. Research in the past decade has revealed the importance of inflammation of the airways in asthma and clinical treatment to reduce chronic inflammation. Asthma is associated with production of IgE to common environmental allergens including house dust mite, animal dander, cockroach, fungal spores, and pollens. Some interventions to reduce symptoms through control of dust mite and animal dander have had positive results. Control of symptoms through interventions to reduce exposures to cockroach antigen has not been reported. Studies illustrating causal effects between outdoor air pollution and asthma prevalence are scant. Increases in asthma prevalence have occurred at the same time as general improvements in air quality. However, air quality appears to exacerbate symptoms in the child who already has the disease. Decreased pulmonary function has been associated with exposure to particulates and bronchial hyperresponsiveness to smoke, SO(2) and NO(2). Symptoms have been correlated with increased levels of respirable particulates, ozone, and SO(2). Interventions that reduce the negative outcomes in asthma associated with outdoor environmental factors have not been reported. Control of asthma in children will entail the collaborative efforts of patients, family, clinical professionals, and school personnel, as well as community-wide environmental control measures and conducive national and local policies based on sound research.
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PMID:Childhood asthma. 1042 88

During the spring of 1995, schoolchildren aged 7-13 y who lived in a rural area in Israel were studied. These children lived in two communities: in one community, the population was exposed to pollution from a cement factory and quarries; the population of the second community was not exposed to pollution from these sources. The children from participating schools performed forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, forced expiratory flow at 50%, and forced expiratory flow at 25%. Parents completed an American Thoracic Society-National Heart and Lung Institute health questionnaire, which included information about respiratory symptoms and diseases of the children and information about background variables. A trend of higher prevalence of most respiratory symptoms occurred in 638 children who were growing up in the community that bordered the industrial zone, compared with 338 children from the unexposed community. Cough without cold, sputum without cold, and cough accompanied by sputum were the most prevalent symptoms. Asthma diagnosed by a physician was reported more frequently for children who lived near the polluting sources. No consistent trend of reduced pulmonary function tests was observed among children who lived in the polluted community; however, peak expiratory flow was significantly lower among these children. Odds ratio values, calculated from logistic regressions in which we controlled for respiratory problems among parents, mothers who smoked, crowding index, education of mothers, and residential heating, were 3.6 (p value for model = .244) for cough without cold, 4.0 (p value for model = .333) for asthma, and 2.2 (p value for model = .753) for asthma and/or bronchitis in the polluted area, compared with 1.0 in the low-pollution community. Total suspended particulate matter and levels of airborne particles less than 10 microns, measured in the community bordering the industrial zone, very often violated the relevant 24-h Israeli standards of 200 microg/m3 and 150 microg/m3, respectively.
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PMID:Respiratory problems associated with exposure to airborne particles in the community. 1044 37

Frictional stress from air flowing through narrowed airways may damage the airway mucosa and thereby increase airway inflammation and airway obstruction. To investigate the levels of frictional stress that might occur in the airway, we measured the frictional stress in three physical airway models (model 1: normal state; models 2 and 3: narrowed states with cross-sectional area half and one-fourth of model 1, respectively) at tracheal expiratory flow rates of 1, 2, 3, 4, 5, 6, 7, and 8 L/sec. Frictional stress measured at stations in the trachea (A), two each in the left (B and C) and right (D and E) major bronchi, and one in the right secondary bronchus (F) indicated that at higher flow rates, high values of the frictional stress seen in model 3 (highest value being 139.2 N/m2 at 8 L/sec at station) could well damage the airway wall, especially during episodes of cough, and particularly when the mucosa is inflamed and friable as it is in asthmatic patients. Conversely, control of cough may have anti-inflammatory benefits in asthmatic patients.
J Asthma 1999 Aug
PMID:Relationship of flow and cross-sectional area to frictional stress in airway models of asthma. 1046 31

Asthma and chronic bronchitis are diseases that may present similar symptoms. Because eosinophil granulocytes play an important role in the pathogenesis of asthma, the assessment of eosinophilic inflammation may be useful in making a differential diagnosis of these two diseases. This study investigated the serum and sputum eosinophil cationic protein (ECP) levels in children with asthma and chronic bronchitis and compared them with controls. Fifty asthmatic patients being treated for mild or moderately severe asthma at a university hospital were enrolled in the study. Fifteen children with symptoms of cough and sputum production lasting more than 3 months were studied in the chronic bronchitis group and 25 healthy children were included in the control group. Asthmatic patients were divided into subgroups according to the presence or absence of asthmatic exacerbations. Clinical evaluation and determination of ECP concentrations in serum and sputum were performed for each group. Increased activity of eosinophils was found in patients with asthma as assessed by high serum ECP (mean 21.44 +/- 20.33 microg/L) and sputum ECP (mean 129.65 +/- 125.01 microg/L) levels. In patients diagnosed with chronic bronchitis, serum ECP levels were similar to those of the control group (mean serum ECP 11.04 +/- 10.23 microg/L and 12.07 +/- 6.12 microg/L, respectively). More importantly, sputum ECP levels of the chronic bronchitis group were much lower (mean 53.36 +/- 55.43 microg/L) than those in patients with asthma (mean 129.65 +/- 125.01 microg/L). The serum and sputum ECP levels of the asthmatic patients who were evaluated during an acute exacerbation were also higher than those in the chronic bronchitis group. Sputum ECP levels may be helpful in the differential diagnosis of asthma and chronic bronchitis in children.
J Asthma 1999 Sep
PMID:The significance of sputum ECP levels in differential diagnosis of asthma in children. 1049 44

A number of risk factors for the development and severity of asthma in childhood are known. Particularly, there is information on allergens, excessive use of beta2- agonists, and indoor environmental pollutants. Similar information on elderly patients is lacking. We examined the risk factors for current asthma and for the severity of asthma in 95 elderly subjects (>65 years old) compared to 274 elderly subjects with obstructive spirometry who did not have asthma as defined by the following criteria: symptoms of episodic wheeze, cough, or chest tightness and forced expiratory volume in 1 sec/vital capacity (FEV1/VC) <70% with >15% or 200 mL reversibility in FEV1 to 200 microg salbutamol given from a metered-dose inhaler. The severity of airflow limitation was graded on the basis of the FEV1/VC ratio as mild (60%-70%), moderate (40%-60%), and severe (<40%). Asthma history was collected using the Medical Research Council respiratory questionnaire and a follow-up postal questionnaire. Data were analyzed using multiple logistic regression and the overall goodness-of-fit of the model was checked using the Hosmer-Lemeshow (HL) statistic. History of allergy (to one or more of the following allergens: cat, house dust, or grass or tree pollen) (odds ratio [OR] 25; 95% confidence interval [CI] 13-51; p = 0.0001) and history of childhood wheeze (OR 8; 95% CI 4-9; p = 0.004) were strong predictors of current asthma. Duration of wheezing, smoking history, indoor heating, history of working in coal mines, and sex were not predictors (HL 6.75, degrees of freedom [df] = 8, p = 0.56). Use of >4 puffs of salbutamol/ day (OR 5.3; 95% CI 2-14; p = 0.005), more than 10 years of asthma symptoms (OR 4.2; 95% CI 4.1-36.2; p = 0.0001), and >500 mL reversibility in FEV1 (OR 4.2; 95% CI 1.2-14.3; p = 0.05) were independent predictors of moderate to severe asthma. History of atopy was the strongest predictor of asthma in the elderly population studied. Indoor heating, presence of pets at home, sex, smoking history, and history of working in coal mines were not predictors of asthma. The severity of asthma as assessed by measurement of airflow limitation was related to the frequency of use of beta2-agonists, duration of symptoms of asthma, and increased reversibility of FEV1 to beta2-agonist.
J Asthma 1999 Oct
PMID:Predictors of asthma severity in the elderly: results of a community survey in Northeast England. 1052 45

The impact of inner city air pollution on the development of respiratory and atopic diseases in childhood is still unclear. In a cross sectional study in Dresden, Germany, 5,421 children in two age groups (5-7 yrs and 9-11 yrs) were studied according to the International Study of Asthma and Allergies in Childhood (ISAAC) phase II protocol. The prevalences of wheezing and cough as well as doctor diagnosed asthma and bronchitis were assessed by parental questionnaires. Children also underwent skin-prick testing, venipuncture for the measurement of serum immunoglobulin (Ig)E, lung function testing and a bronchial challenge test (4.5% saline) to assess airway hyperresponsiveness. Exposure was assessed on an individual basis by relating mean annual air pollution levels (SO2, NO2, CO, benzene, and O3) which had been measured on a 1 km2 grid, to the home and school address of each study subject. After adjusting for potential confounding factors an increase in the exposure to benzene of 1 microg x m3 air was associated with an increased prevalence of morning cough (adjusted odds ratio (aOR)): 1.15; 1.04-1.27) and bronchitis (aOR: 1.11; 1.03-1.19). Similar associations were observed for NO2 and CO. In turn, the prevalences of atopic sensitization, symptoms of atopic diseases and bronchial hyperresponsiveness were not positively associated with exposure to any of these pollutants. It is concluded that in this study a moderate increase in exposure to traffic-related air pollution was associated with an increased prevalence of cough and bronchitis, but not with atopic conditions in children.
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PMID:Inner city air pollution and respiratory health and atopy in children. 1054 91


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