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)

Smoking is the main risk factor for COPD (chronic obstructive pulmonary disease) but genetic factors are of importance, since only a subset of smokers develops the disease. Sex differences have been suggested both in disease prevalence and response to environmental exposures. Furthermore, it has been shown that acquisition of 'addiction' to smoking is partly genetically mediated. Disease cases and smoking habits were identified in 44919 twins aged >40 years from the Swedish Twin Registry. Disease was defined as self-reported chronic bronchitis or emphysema, or recurrent cough with phlegm. The results showed that chronic bronchitis seems to be more prevalent among females, and that the heritability estimate for chronic bronchitis was a moderate 40% and only 14% of the genetic influences were shared by smoking. In addition, 392 twins have been invited to a clinical investigation to evaluate: (i) to what extent genetic factors contribute to individual differences (variation) in FEV(1) (forced expiratory volume in 1 s), vital capacity and DL(CO) (diffusion capacity), taking sex into consideration, and (ii) whether smoking behaviour and respiratory symptoms influence these estimates.
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PMID:Twins studies as a model for studies on the interaction between smoking and genetic factors in the development of chronic bronchitis. 1961

To evaluate the usefulness of the COPD questionnaire of the International Primary Care Airways Group (IPAG) for screening the subjects with COPD in a given cohort, the questionnaires were given to subjects aged 40 or older, regardless of smoking habit at a general health check-up program in 4 institutions (Miyagi, Osaka, Okayama and Fukuoka) of the Japan Anti-tuberculosis Association (JATA) prefectural branch from April 1, 2007 to March 31, 2008. The questionnaires scores of 11,166 participants were collated with their FEV1/FVC, with their agreement. The prevalence of cases at high-risk of COPD receiving a score of 17 or more was 27.5%, and airflow limitation defined as FEV1/FVC < 70% was found in 6.5% among these cases, i.e. 2.7% among all subjects. The area under the curve of the receiver operating characteristic (AUC-ROC), sensitivity, and specificity were 0.755, 0.666, and 0.736, respectively. Airflow limitation was observed more frequently in those older than 59, more than 24 pack-years, and frequent wheezes but not in those of cough affected by weather, sputum in the morning, and allergies. Among 4 institutions, sensitivities of airflow limitation varied from 0.581 to 1.000 and these were remarkably elevated to 0.702 and more by excluding the subjects with P x Y0-14. This questionnaire seemed to be effective using a cut-off level of 17 for screening cases at high risk of COPD.
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PMID:[The usefulness of COPD questionnaire for screening COPD subjects]. 1999 90

A 60-year old male patient with obesity and type 2 diabetes mellitus consulted due to high blood pressure, fearful of suffering ischemic heart disease. He also had a background of smoking 20 cigarettes/day for the last 30 years, but this did not concern him. In the questioning, he reported, although he did not consider it important, that he had cough and dyspnea on moderate exertions for some years. It is very unlikely that any internal medicine physician would doubt about whether to evaluate and treat his type 2 diabetes mellitus or high blood pressure, calculate his cardiovascular risk or if he has a metabolic syndrome, attempt to reduce his obesity and to make him stop smoking. However, should we label him as having chronic bronchitis or COPD? Should we perform a spirometry and bronchodilator test, treat his probable COPD? All his current symptoms are probably only due to COPD.
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PMID:[Approach to COPD management in Internal Medicine]. 2034 75

The aim of our study was to obtain comprehensive insight into the bacteriological and clinical profile of community-acquired pneumonia requiring hospitalization. The patient population consisted of 100 patients admitted with the diagnosis of community-acquired pneumonia (CAP), as defined by British Thoracic society, from December 1998 to Dec 2000, at the Sher- i-Kashmir institute of Medical Sciences Soura, Srinagar, India. Gram negative organisms were the commonest cause (19/29), followed by gram positive (10/29). In 71 cases no etiological cause was obtained. Pseudomonas aeruginosa was the commonest pathogen (10/29), followed by Staphylococcus aureus (7/29), Escherichia coli (6/29), Klebsiella spp. (3/29), Streptococcus pyogenes (1/29), Streptococcus pneumoniae (1/29) and Acinetobacter spp. (1/29). Sputum was the most common etiological source of organism isolation (26) followed by blood (6), pleural fluid (3), and pus culture (1). Maximum number of patients presented with cough (99%), fever (95%), tachycardia (92%), pleuritic chest pain (75%), sputum production (65%) and leucocytosis (43%). The commonest predisposing factors were smoking (65%), COPD (57%), structural lung disease (21%), diabetes mellitus (13%), and decreased level of consciousness following seizure (eight per cent) and chronic alcoholism (one per cent). Fourteen patients, of whom, nine were males and five females, died. Staphylococcus aureus was the causative organism in four, Pseudomonas in two, Klebsiella in one, and no organism was isolated in seven cases. The factors predicting mortality at admission were - age over 62 years, history of COPD or smoking, hypotension, altered sensorium, respiratory failure, leucocytosis, and staphylococcus pneumonia and undetermined etiology. The overall rate of identification of microbial etiology of community-acquired pneumonia was 29%, which is very low, and if serological tests for legionella, mycoplasma and viruses are performed the diagnostic yield would definitely be better. This emphasizes the need for further studies (including the serological tests for Legionella, mycoplasma and viruses) to identify the microbial etiology of CAP.
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PMID:Bacteriological and clinical profile of Community acquired pneumonia in hospitalized patients. 2061 35

The most important matter in pre-anesthetic evaluation for patient with COPD is not recognition of clinical staging but of severity. Because the staging is classified only by spirometric examination, we should evaluate the severity of disease in individual patients from symptoms of cough, sputum production, dyspnea, history of exposure to risk factors (smoking), exercise tolerance, complication, or weight loss. It is necessary for patients to be abstaining from smoking, be vaccinated against respiratory infections and medicated with bronchodilators (beta2-agonists) before operation. Additionally, we need to recognize COPD as a systematic disease, and consider intensive care in postoperative period.
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PMID:[Preanesthetic evaluation, preparation and prognostic prediction for chronic obstructive pulmonary disease (COPD)]. 2066 79

This exploratory study assessed the self-management learning needs, experiences, and perspectives of COPD patients treated at a Certified Federal Rural Health Clinic to inform the development of a COPD self-management DVD. A purposive, homogeneous sample of COPD patients participated in focus group interviews. Data from these interviews were referenced to edit a library of Rvision COPD self-management DVDs into a single condensed DVD containing only the most pertinent self-management topics. Patients reported a lack of knowledge and skill development related to purse lipped breathing, controlled coughing, and stress management; while medication management skills were found to be quite adequate. Engaging rural communities in formal qualitative inquiries to describe COPD specific needs for self-management may lead to future use of educational technologies aimed at improving quality of life for these rural, hard to reach populations.
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PMID:Using Exploratory Focus Groups to Inform the Development of Targeted COPD Self-Management Education DVDs for Rural Patients. 2067 21

The purpose of this study was to describe the prevalence and severity of fatigue and to investigate relationships between fatigue, and disability in elderly COPD patients. This descriptive and analytical study was conducted on 98 patients. Three instruments were used: Personal information form (PIF), visual analog scale for fatigue (VAS-F) and brief disability questionnaire (BDQ). The statistical analyses were used in order to evaluate the data: Student's t-test, Kruskall-Wallis test, Pearson correlation coefficient calculation and logistic regression analysis. All of patients in the sample experienced fatigue. The level of fatigue and disability experienced by the patients with COPD was high, their energy level was low. It was determined that as COPD patients' fatigue increases their disability also increases, that there are relationships between fatigue and marital status and that there are relationships between disability and gender. Furthermore, in this study significant differences were found in COPD patients' VAS-F and BDQ scores for some symptoms of COPD, such as dyspnea, fatigue, cough and sputum. The results of the study indicated that high levels of fatigue are experienced which impacts on patients' functional condition and needs to be professionally assessed managed.
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PMID:Fatigue and disability in elderly patients with chronic obstructive pulmonary disease (COPD). 2070 48

The principle of COPD diagnosis is based on establishing the presence of obstructive post-bronchodilator spirometry in an at-risk individual with appropriate symptoms. Most individuals diagnosed with COPD have substantial cigarette smoke exposure, more than 10 and usually 20 pack years. Patients with COPD usually have symptoms of cough and phlegm, exertional breathlessness, wheezing, recurrent winter bronchitis or a combination of these symptoms. A current or ex-smoker, aged over 35, with respiratory symptoms should undergo spirometry testing. The hallmark of COPD is the presence of airflow obstruction after administration of a bronchodilator. However, while normal spirometry excludes COPD, obstructive spirometry is also seen in asthma and bronchiectasis emphasising the importance of clinical features. A significant change introduced in the 2010 NICE guideline is the new grading of COPD severity. A system based on FEV alone oversimplifies disease severity and full clinical assessment should include symptoms, frequency of exacerbations and impact of disease on functioning and health status. The most important single intervention is smoking cessation as this is proven to reduce decline in FEV1 and reduce mortality. All patients should also receive influenza and pneumococcal vaccination, weight management, pulmonary rehabilitation (if breathless) and short-acting bronchodilators. The evidence base for rehabilitation is very strong with positive effects shown on breathlessness, exercise capacity, activity level, exacerbation rate, leg muscle strength and quality of life.
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PMID:Opportunistic case finding pivotal in diagnosing COPD. 2116 95

Although noninvasive ventilation (NIV) use in severe acute exacerbation of COPD has substantially reduced the need for intubation, an important number of COPD patients still are mechanically ventilated through a tracheal tube in the ICU. Intubation is a major risk factor for lower respiratory tract colonization (LRTC) in ICU patients. Other risk factors for LRTC include colonization of the oral cavity, nasopharynx, and gastric content. Aspiration of contaminated oropharyngeal secretions is increased by supine position, underinflation of tracheal cuff, coma, and sedation. Tracheal tube biofilm formation plays an important role as a reservoir for microorganisms. Reduced cough reflex, altered mucocilliary clearance, hypersecretion and retention of mucus are frequent in COPD patients. In addition, malnutrition and corticosteroid use are common in this population resulting in altered cellular, and humoral immunity and higher risk for LRTC. Incidence of LRTC varies from 22-95% of intubated patients. Pseudomonas aeruginosa is the most frequently isolated microorganism at day 3 after intubation in COPD patients. LRTC is a major risk factor for ventilator-associated pneumonia, which is associated with increased mortality and morbidity in ICU patients. Several measures could be suggested to reduce LRTC in critically ill COPD patients. NIV use in severe acute exacerbations reduces the need for intubation. In addition, the early use of NIV averts respiratory failure after extubation and could reduce the duration of invasive mechanical ventilation. Other measures might be efficient in preventing LRTC such as semirecumbent position, avoidance of gastric distension, polyurethane-cuffed tracheal tubes, silver-coated tracheal tubes, subglottic aspiration, and continuous control of cuff pressure. Further studies should determine the impact of preventive measures aiming at preventing LRTC on outcome of COPD patients requiring intubation and mechanical ventilation in the ICU.
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PMID:Pathophysiology of airway colonization in critically ill COPD patient. 2119 4

Chronic cough remains a challenge to many clinicians because there is often no diagnostic link to causation, and because indirect antitussives are largely ineffective. Chronic cough can also be a predominant symptom associated with many chronic respiratory diseases such as COPD, asthma and pulmonary fibrosis. Chronic cough itself does impair the quality of life and is associated with psychological impairment. The symptoms associated with chronic cough include persistent tickling or irritating sensation in the chest or throat, hoarse voice, dysphonia or vocal cord dysfunction. Currently, the clinical diagnosis of cough is associated with chronic cough caused by airway eosinophilic conditions such as asthma, gastrooesophageal reflux disease or post-nasal drip (or upper airway syndrome), which implies cause and effect, or with chronic cough associated with other diseases such as COPD, cancer or heart failure, that does not necessarily imply cause and effect. A recently-recognised category is idiopathic cough, with no associated or causative diagnosis. We suggest that there is a better label needed for chronic cough, that includes the common association with a hypersensitive cough response to tussive stimuli such as capsaicin or citric acid. This would invoke a hypersensitive syndrome, and there are good reasons to use a new label that would encompass the problem of chronic cough: the chronic 'cough hypersensitivity syndrome'. This would focus the problem on the cough symptomatology and lead to greater focus on understanding the mechanisms of cough sensitisation, with the ultimate aim of obtaining more effective antitussives.
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PMID:Chronic 'cough hypersensitivity syndrome': a more precise label for chronic cough. 2129 19


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