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)

Angiotensin converting enzyme inhibitors (ACEIs) constitute a safe and effective therapeutic class for the treatment of hypertension. However, they have been incriminated in the development of certain adverse effects, the most frequently reported being alteration in renal function, development of hypotension and cough. This justified the evaluation of renal function after short-term and long-term treatment with perindopril in hypertensive subjects. In patients with normal renal function, during short-term treatment (1 and 5 days), perindopril induced an increase in renal plasma flow without any modification of the glomerular filtration rate. During long-term administration (up to 18 months of treatment), no significant variation in plasma creatinine was observed. In elderly hypertensive patients or patients with chronic renal failure, the glomerular filtration rate was also preserved, apart from a few rare cases of decreased creatinine clearance, particularly after the addition of hydrochlorothiazide. A slight increase in plasma potassium, with no clinical significance, was observed when perindopril was used as single-agent therapy. Symptomatic hypotension was rarely reported with perindopril (0.2% of cases), even under conditions of salt and water depletion. Amongst the other adverse effects of ACEIs, cough, more recently identified, was investigated in detail. Its frequency was determined in a double-blind study comparing perindopril (1.2%) and captopril (2.4%). It was also evaluated in a long-term study in 632 hypertensive patients (391 treated for 1 year); its incidence was 2.9% and it was responsible for discontinuation of treatment in 8 cases. In this study, 36 patients stopped treatment prematurely because of an adverse effect (5.7%). No harmful drug interactions were reported. The combination of a thiazide diuretic potentiates the antihypertensive effect of perindopril and is perfectly tolerated. The favorable safety profile of perindopril should be related to the correct determination of effective doses.
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PMID:Tolerance and safety of perindopril. 269 Nov 32

Coughing, sneezing, talking, bed-making, turning pages of books, etc. all generate microbial aerosols which are carried and dispersed by air movements. Inhalation of these particles may cause allergic responses but whether or not infectious disease ensues depends in part on the viability and infectivity of the inhaled microbes and their landing sites. Desiccation is experienced by all airborne microbes; gram-negative bacteria and lipid-containing viruses demonstrate phase changes in their outer phospholipid bilayer membranes owing to concomitant changes in water content and/or temperature. These changes most likely lead to cross-linking reactions of associated protein moieties principally at mid to high relative humidity (RH). For lipid-free viruses these reactions of their surface protein moieties occur most rapidly at low RH. Radiation, oxygen, ozone and its reaction products and various pollutants also decrease viability and infectivity through chemical, physical and biological modification to phospholipid, protein and nucleic acid moieties. The extent of damage and the degree of repair together with the efficacy of host defence mechanisms largely controls whether the causative microbes take hold and spread disease via the airborne route. At least indoors, where desiccation is the predominant stress, the general reversibility of membrane-phase changes by vapour-phase rehydration when coupled with efficacious microbial enzymatic repair mechanisms under genetic control, virtually ensures the spread of disease by the aerobiological pathway.
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PMID:Airborne bacteria and viruses. 269 73

To evaluate urodynamic effects of modified Burch colposuspension, 24 patients with stress urinary incontinence were investigated before and 6 to 9 months after the operation. A new method of urodynamic evaluation was performed using a multitransducer-catheter, 5 microtransducers inside the urethra and 1 in the bladder, connected to a computer and graphic plotter. Single coughs were analysed with the catheter in a fixed position and the patient in the standing position. The operation, which was successful, in all but 1 patient, did not alter urethral pressure at rest, but urethral closure pressure at stress after the operation (mean 45.0 cm H2O (SD 21.6) was significantly higher (P less than 0.005) than the -3.6 cm H2O (SD 10.2) recorded before the operation. The pressure transmission ratio was less than 100% in 22 patients before the operation and more than 100% in 18 patients afterwards, the pre- and post-operative mean values being 78.9% (SD 11.9) and 109.5% (SD 17.2) respectively (P less than 0.0005). Burch colposuspension markedly improves urethral closure function as evaluated by this method, which analyses the pressure data at different points of the urethra and bladder during one single cough.
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PMID:Effect of suprapubic operation on urethral closure. Evaluation by single cough urethrocystometry. 271 20

Between August 1982 and December 1985, seven patients at a children's hospital developed hospital-acquired pneumonia caused by Legionella pneumophila. Demographic data included the following: mean age 12.3 years (range 9 months to 20.5 years); male/female ratio 5:2; all patients were white. Some previously identified risk factors present in our patients included high-dose corticosteroid therapy (five patients), other immunosuppressive therapy (four), and chronic lung (five) or kidney (three) disease. Symptoms and signs included rapid onset, fever, cough, pleuritic chest pain, dyspnea, abdominal pain, diarrhea, and headache. Rhinitis, myalgia, and neurologic abnormalities were not noted. Chest roentgenograms revealed single-lobe consolidation in three patients, diffuse bilateral alveolar infiltrates in three, and pleural effusion in three. All patients were treated with erythromycin; three patients also received rifampin. Tracheal intubation and mechanical ventilation were required by four patients. Six patients improved after therapy. One child died of persistent lung disease 1 month after the onset of legionnaires disease. L. pneumophila was isolated from potable water in the hospital. Aerosol equipment cleansed with tap water and the showers were implicated as means of exposure by patients to contaminated potable water. No new nosocomial cases were seen after immunocompromised children were prohibited from taking showers, and sterile water was used to cleanse equipment for administering aerosol medications.
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PMID:Nosocomial legionnaires disease in a children's hospital. 273 94

Two cases of Pneumocystis carinii pneumonia occurred in human immunodeficiency virus infected patients who were diagnosed by the aspiration-lung-biopsy. They were treated with 4 mg/kg of pentamidine isethionate intravenously administered followed by pentamidine aerosol inhalation. Although clinical and laboratory findings were improved by the fifth or seventh day of intravenous therapy, substantial leukocytopenia, from 3,000/cmm to 600/cmm and from 2,700/cmm to 1,000/cmm, occurred. At this point, the method of pentamidine administration was switched to inhalation. Pentamidine 600 mg in 30 ml distilled water was aerosolised using ultrasonic nebuliser and exposed for a 30-minute period once daily. In both cases, chest x-rays showed improvements: The disappearance of P. carinii were obtained in two weeks. Mild coughing was the sole adverse reaction encountered during the course of aerosol inhalation.
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PMID:Two cases of Pneumocystis carinii pneumonia occurred in human immunodeficiency virus infected patients: supplemental treatment with aerosolised pentamidine isethionate. 278

Bronchial hyperreactivity is studied for the evaluation of airways' response to stimuli that provoke bronchoconstriction in hyperreactive subjects. Exercise is often used, especially in children. This method in simple, sufficiently tolerated and reproducible. The inhalation of ultrasonically-nebulized distilled water is a simple, reproducible and rapid to perform in the majority of adult patients test; in childhood it is poorly inquired. Pharmacological tests (with histamine or methacholine) have a greater sensitivity and reproducibility. Aspecific bronchoprovocation with methacholine is a diagnostic method that allows the diagnosis of bronchial hyperreactivity in asymptomatic subjects with asthma, recurrent cough and recurrent bronchopneumonia.
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PMID:[Bronchial hyperreactivity. II. Diagnostic methods]. 287 44

The effect of inhibition of angiotensin-converting enzyme (ACE) on standard cough challenge was investigated in a double-blind, randomised study in sixteen normal volunteers. Captopril (25 mg) or matched placebo was given by mouth 2 h before inhalation of nebulised distilled water, citric acid, and incremental doses of capsaicin (0.5-20 mumol/l). Distilled water and citric acid challenge were not significantly changed by captopril pretreatment. However, captopril significantly shifted the dose-response curve to capsaicin inhalation. The geometric mean dose of capsaicin causing 20 coughs/min was 1.3 mumol/l for captopril and 2.8 mumol/l for placebo pretreatment (p = 0.04). Cough is a recognised side-effect of ACE inhibitors; the observation that cough challenge is changed by these drugs in normal subjects implies a role for ACE in the cough reflex, possibly by metabolism of substrates other than angiotensin I.
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PMID:Angiotensin-converting enzyme and the cough reflex. 289 21

Digital storage of urodynamic signals such as detrusor pressure and flowrate at a sufficiently high sampling rate (10 samples per second) to allow subsequent analysis requires considerable computer memory. A procedure for compressing these data by deleting redundant samples (the fan method of adaptive sampling) was tested. The method allows a flexible adaptation to specific hardware and a compromise between storage requirements and accuracy. In this study the number of samples required for adequate reconstruction of the detrusor pressure signal could be varied from 80% to 4% of the original number of samples by varying the average difference between reconstructed and original signal from 0.01 to 2 cm H2O. Fast components of the measurements (for example cough peaks) which were lost if a lower sampling rate or averaging was used to obtain equally low storage requirements were unaffected by this compression technique.
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PMID:Efficient storage of urodynamic signals by computer: application of FAN adaptive sampling. 292 92

Water instilled into the pharynx of sleeping human infants elicits a range of chemoreflex responses that, occasionally, includes prolonged apnea (defined as absence of ventilation for at least 20 s, or for a shorter period if accompanied by bradycardia of less than or equal to 100 b.p.m. or cyanosis). To learn more about airway receptors mediating this prolonged apneic response and factors determining its occurrence, we examined the importance of stimulus location and associations between prolonged apnea, bradycardia, and upper airway responses. A total of 29 episodes of prolonged apnea were recorded after water stimulation in 12 infants. Bradycardia (HR less than 100) followed stimulus delivery but was always preceded by apnea and did not appear as an independent chemoreflex response. Behavioral arousal and prolonged apnea were not mutually exclusive responses and recovery from prolonged apnea was not always closely linked with arousal. Occurrence of prolonged apnea was greater after pharyngeal than nasal stimulation, and was frequently associated with coughing, but not with sneezing, suggesting that prolonged apnea is elicited from a sensory site close to, or the same as, one mediating cough. We conclude, using this water stimulus method, that the predominant receptors for chemoreflex-prolonged apnea are located in the pharynx or larynx rather than in the nose.
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PMID:Characteristics of upper airway chemoreflex prolonged apnea in human infants. 292 68

We have studied the antitussive effects of two anticholinergic agents, oxitropium bromide (200 micrograms) and ipratropium bromide (80 micrograms), and a combined beta-agonist and anticholinergic preparation containing fenoterol hydrobromide (200 micrograms) and ipratropium bromide (80 micrograms), in 16 normal and ten asthmatic volunteers in a double-blind, randomized, placebo-controlled crossover trial. Cough was induced by inhalation of ultrasonically nebulized distilled water and hypotonic saline solution. All treatments significantly reduced the cough response to inhaled distilled water aerosol when compared with placebo (p less than 0.001). There was no difference between oxitropium bromide and ipratropium bromide (p greater than 0.05), but the combination preparation displayed a greater antitussive effect than either oxitropium bromide (p less than 0.05) or ipratropium bromide (p less than 0.025). Cough frequencies in response to hypotonic 0.18 and 0.32 percent saline aerosol were lower than those obtained with distilled water (p less than 0.005) for all treatments. Asthmatic patients coughed less frequently than normal volunteers in response to all solutions when placebo was given (p less than 0.05), but there is no evidence to suggest that the response to treatment was different in the two groups. Our results suggest that inhaled anticholinergic bronchodilators alone or in combination with beta 2-adrenergic agonists might be effective in the treatment of pathologic cough.
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PMID:Antitussive properties of inhaled bronchodilators on induced cough. 296 64


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