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

Primary coccidioidomycosis, occurring in a microbiologist whose initial symptoms were cough, fever, night sweats, and chest pain, was unique, because for six months following infection his sera remained nonreactive, and his chest roentgenograms showed no lesions. Throughout this period, his sputa continued to yield Coccidioides immitis. His skin test, which showed negative results 12 days after the onset of symptoms, became positive for coccidioidomycosis eight months later. Spherule formation by C immitis cultures was demonstrated in human pleural fluid medium at 40 degrees C within four to six days and in the internal organs of a mouse inoculated with an arthrospore suspension. After six months of rest and without specific antibiotic treatment, the patient's sputa became negative and his clinical recovery was complete. We emphasize culture isolation and accurate identification of C immitis in diagnosis, and serology in the assessment of therapy.
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PMID:A case of coccidioidomycosis with unique clinical features. 68 36

This case study reports the successful use of differential attention in the treatment of chronic operant coughing of 6 months' duration in a 13-year-old boy. The boy was hospitalized, where the symptom was ignored and his adaptive age-appropriate behaviors were reinforced with points and praise. Fines were levied for self-derogatory statements. Obtrusive and unobtrusive observations revealed the cough rate higher when the patient was aware of being observed than when he was unaware of being observed. After 4 days the cough rate dropped to zero, where it remained except for a slight recurrence on the day of discharge. His parents were trained in maintaining the differential attention contingencies in effect in the hospital and were able to transfer these conditions to the home. Thus, when the cough again returned once the patient was home, they were able to immediately terminate it. Follow-up of over 36 months revealed the boy to be symptom free.
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PMID:Differential attention in the treatment of operant cough. 75 63

One year after starting work in the pharmaceutical industry a 35-year-old non-atopic maintenance engineer developed attacks of sneezing, coughing and breathlessness. These occurred at home during the evening and early morning, never at work during the day. His employment involved contact with a wide variety of chemical agents including the macrolide antibiotic spiramycin. Inhalation challenge tests carried out in hospital with gradually increasing quantities of spiramycin reproduced his symptoms and led to the development of late asthmatic reactions, during which the FEV1 fell by 25% and the FEV1/FVC ratio by 15%. No change occurred in the single breath CO transfer factor nor were crepitations heard over the lung fields which remained normal on chest X-ray. The patient showed positive immediate skin prick tests to spiramycin and developed blood eosinophilia during the late asthma attacks. Inhalation of sodium cromoglycate either before, or before and hourly after the provocation challenge for 6 hr, failed to prevent the late asthma, although its onset was further delayed. On leaving the pharmaceutical industry the patient's symptoms improved but did not finally clear until his wife, who had worked in a clerical capacity in the same factory also ceased her employment.
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PMID:Asthma due to inhaled chemical agents--the macrolide antibiotic Spiramycin. 105 35

A 22-year-old man with T cell type acute lymphoblastic leukemia in first remission underwent autologous bone marrow transplantation (BMT). The preparative regimen included cytosine arabinoside, cyclophosphamide and fractionated total body irradiation. His harvested bone marrow cells were purged with 4-hydroperoxycyclophosphamide. His serological test was positive for cytomegalovirus (CMV) before the BMT. On day 53 after the BMT, he developed dry cough and his chest X-ray film showed bilateral basilar infiltration. Bronchoalveolar lavage was performed and cytology of the specimen revealed typical cytomegaloviral inclusion bodies. DNA analysis and viral culture of the specimen were also positive for CMV. The patient was started on ganciclovir and immunoglobulin with high dose methylprednisolone. His respiratory status deteriorated, however, and the patient expired because of respiratory failure. Autopsy revealed severe interstitial pneumonitis with suppression of CMV replication from the treatment. Interstitial pneumonitis due to CMV should be considered as a significant complication of autologous BMT.
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PMID:[Cytomegaloviral interstitial pneumonia after autologous bone marrow transplantation in a case of acute lymphoblastic leukemia. Bone Marrow Transplantation Team]. 131 80

A 68-year-old male developed dry cough and exertional dyspnea after handling paint spray containing isocyanates (TDI, MDI) for three months. Initially, the symptoms fluctuated according to whether he was at work or not. He was admitted to our hospital on February 7, 1990, because of progressive worsening of symptoms. In spite of admission to hospital and cessation of exposure to isocyanates, there was no improvement of symptoms. His chest X-ray film showed diffuse small nodular and reticular shadows. Transbronchial lung biopsy revealed thickening of the alveolar walls and formation of Masson's bodies associated with mononuclear cell infiltration in alveolar spaces. High titers of TDI-HSA and MDI-HSA specific IgG antibodies were detected by ELISA, and a high level of serum soluble IL2 receptor was also detected. From these results, we diagnosed hypersensitivity pneumonitis due to exposure to isocyanates. One week administration of prednisolone caused dramatic improvement of his symptoms, chest X-ray findings, and laboratory data. His clinical course and response to prednisolone therapy indicated that long-term steroid administration could not be avoided. The prolonged symptoms and the necessity for long-term steroid therapy are discussed.
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PMID:[A case of hypersensitivity pneumonitis due to isocyanate exposure showing progression even two months after removal of the antigen]. 131 20

A 64-year-old male was admitted to our hospital with complaints of the development of high fever, cough and dyspnea 5-6 hours after painting automobiles. His chest X-ray film showed interstitial shadows in both lungs. Pulmonary function test demonstrated reduction of diffusion capacity; and blood gas analysis demonstrated hypoxemia and an increase in alveolar-arterial oxygen tension difference. Marked lymphocytosis and a striking decrease in CD4/CD8 ratio were observed in the bronchoalveolar lavage fluid. Transbronchial lung biopsy specimens showed alveolitis and Masson's bodies. We suspected that the patient was suffering from hypersensitivity pneumonitis induced by isocyanates contained in the urethane paint he used. Immunological studies were performed using chemical compounds of three species of isocyanate molecules (TDI, MDI, HDI) and human serum albumin (HSA). The results were as follows: skin tests were positive for TDI-HSA and MDI-HSA; lymphocyte-stimulation tests on peripheral blood were positive for TDI-HSA; precipitation reaction was negative for all the isocyanates studies; enzyme-linked immunosorbent assay (ELISA) demonstrated the existence of specific IgG antibodies for TDI, MDI and HDI; inhalation challenge test by TDI-HSA was negative, but environmental provocation was considered to be positive. We diagnosed his pulmonary disorder as hypersensitivity pneumonitis due to isocyanates. Type III and Type IV allergic reactions of Gell-Coombs were suggested to be involved in the pathogenesis, however, there remains the possibility that the instability of isocyanate compounds as antigen modified the results of our immunological studies.
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PMID:[A case of hypersensitivity pneumonitis in which serum specific antibodies for three species of isocyanate molecules were demonstrated]. 131 21

Between Sept.1, 1989 and Feb.28, 1990, 19 patients received renal allografts, and all of them were examined by serological tests for CMV infection before and after the transplantation. Six patients who had some clinical symptoms such as fever and cough were monitored for anti-CMV antibodies by the ELISA method during the first 3 months after the transplantation. Five of the 6 patients complained of mild clinical symptoms but their condition was not serious. The other patients, a 42-year-old man developed serious CMV infection. His serological CMV antibody titer had decreased one month after the transplantation compared to that before the transplantation. By contrast, the other patients showed either elevation or no change of CMV antibody titer. Therefore, special attention should be paid to the case of decrease rather than increase in CMV antibody titer one month after the transplantation in patients with severe symptoms.
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PMID:[Relationship between the symptomatic cytomegalovirus infection and the fluctuation of anti-CMV antibodies in patient after renal transplantation]. 131 99

An outbreak of Mycoplasma pneumoniae (MP) infection occurred during the period March-May 1989 among the personnel of the Accident and Emergency Department of the Kuopio University Hospital, Kuopio, Finland. The index patient was a young male orderly, who fell ill with severe pneumonia. His tracheal mucus sample proved to be strongly positive for MP when tested by a commercial DNA-RNA hybridization test (Gen-Probe). After the index patient two additional staff members (an orderly and a nurse) fell ill with pneumonia and 66 others showed symptoms of upper respiratory infection or fever. The most frequent symptoms were a sore throat, a cough, rhinitis and headaches. All 97 employees of the department were tested for the presence of MP in April-May 1989 using throat swabs as test material. Forty-three (44%) were found to be positive for MP by the 'Gen-Probe' test. Eight (19%) of the MP positive staff were completely asymptomatic. The MP positive staff were retested about 3 weeks later, whereupon 40 (93%) had become negative. Most of the persons involved in this outbreak suffered only from mild respiratory symptoms, suggesting that MP outbreaks like the present one may easily pass unnoticed.
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PMID:Outbreak of Mycoplasma pneumoniae infection among hospital personnel studied by a nucleic acid hybridization test. 135 13

A case of life-threatening adverse effects following intravenous administration of a non-ionic contrast medium is reported. The patient, a 68-year-old diabetic hypertensive male with dyspnoea and cough had an abnormal chest radiograph, revealing congestive heart failure and an enlarged right hilum. Computed tomography (CT) of the chest was performed using 100 cm3 of intravenous iopamidol. Within half an hour the patient developed abdominal cramping, vomiting, and diarrhoea, followed by hypotension, tachycardia, fever to 40 degrees C, and delirium. His course was complicated by disseminated intravascular coagulation, rhabdomyolysis, renal failure, respiratory arrest, and atrial fibrillation. There was no evidence of infection, neoplastic disease, or myocardial infarction. Over the next month the patient slowly recovered. One other case report implicates a contrast agent with a similar syndrome. The features of this case fulfil the criteria for a probable adverse drug reaction of a type and severity rarely encountered.
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PMID:Case report: multisystem failure following intravenous iopamidol. 139 88

A 62-year-old male was admitted with lumbago and gait disturbance for 3 months. He had complained of a cough for 3 years. His admission chest radiography revealed tumor shadow in right lower lung field. The patient was diagnosed as adenocarcinoma of the lung by transbronchial biopsy. Bone scintigraphy revealed multiple bone metastases with rib, lumbar and pelvic bone. Clinical staging was IV and performance status was 3. The patient was treated by combined chemotherapy with epirubicin 20 mg/m2, mitomycin C 8 mg/m2 and carboplatin 350 mg/m2. After 2 cycles he was able to walk by himself and the lung tumor regressed in 40% of pretreated size. This combined chemotherapy could be performed for outpatients because of the mild gastrointestinal side effects and little hydration.
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PMID:[Successful treatment of adenocarcinoma of the lung with bone metastases by combined chemotherapy with epirubicin, mitomycin C and carboplatin]. 141 18


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