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

Administration of large doses of fentanyl is a popular method to provide postoperative analgesia after thoracotomy. It is however unclear whether epidural lumbar (L) or epidural thoracic (T) administration of fentanyl confers any major advantage over intravenous (iv) infusion. Using a randomized prospective study design, we compared the potential benefits of L, T, and iv fentanyl administration after thoracotomy in 50 patients. Epidural catheters were not injected during surgery. Postoperatively a fentanyl infusion (5 micrograms/ml) was started at 1 microgram.kg-1.h-1 after a bolus of 1 microgram/kg and adjusted to maintain a score < or = 30/100 at rest using a visual analog scale (VAS) for pain. Data were prospectively collected before surgery, at fixed intervals during the 48 h of fentanyl infusions, and the day of discharge. There was no difference between the groups in overall quality of analgesia at rest and after coughing, quantity of fentanyl delivered (L = 1.15 +/- 0.38, T = 1.22 +/- 0.23, iv = 1.27 +/- 0.3 micrograms.kg-1.h-1), incidence of pruritus needing treatment (L = 2, T = 1, iv = 0 patients), need to decrease fentanyl infusion rate because of side effects (L = 2, T = 2, iv = 4 patients), importance of pulmonary infiltrates, or arterial blood gas values. One patient (L group) needed naloxone (0.04 mg iv). Intravenous patients were more frequently nauseated (P = .009) and needed boluses of fentanyl more often (L = 3 +/- 9, iv = 6 +/- 12, T = 4 +/- 8; P = .04).(ABSTRACT TRUNCATED AT 250 WORDS)
Anesthesiology 1992 Dec
PMID:A randomized comparison of intravenous versus lumbar and thoracic epidural fentanyl for analgesia after thoracotomy. 836 95

The efficacy of Ketotifen was examined in the treatment of 113 infants between 6 and 36 months of age presenting with a history of cough and/or wheeze in a multicentre randomized placebo-controlled double-blind study. A 4 week no-medication baseline phase preceded the 16 week treatment phase in which infants took 2.5 mL twice daily of either placebo or Ketotifen (0.5 mg) syrup; this was followed by a 4 week wash-out phase. Diary card evaluation was performed by the parent or guardian for the duration of the study and recorded wheeze and cough twice daily as well as medication used. The percentage of symptom-free days decreased significantly in both groups (P < 0.005) with placebo-treated infants experiencing significantly more symptom-free days compared with the Ketotifen group (P < 0.01), although this difference was never more than 10% in any 4 week treatment period. Symptom severity scores and use of beta-agonist medication were also less in the placebo-treated infants but did not reach statistical significance. This study was unable to show a therapeutic advantage of Ketotifen over placebo in this group of infants with chronic cough and/or wheeze and the apparent statistical advantage of placebo is not a clinically relevant finding.
J Paediatr Child Health 1992 Dec
PMID:A multicentre randomized placebo-controlled double-blind study on the efficacy of Ketotifen in infants with chronic cough or wheeze. 146 40

In 1990, among pregnant women .1% tested positive for HIV antibodies in Amsterdam compared to 24.5% in Lusaka, Zambia. During 1990 and 1991 data were collected from 231 patients fulfilling the WHO clinical criteria for the diagnosis of AIDS in 3 hospitals of Sesheke, a rural Zambian district. 46.3% of the group was male and 53.7% was female, and the mean age of women was significantly lower than that of men (25.2 vs. 31.1 years, p 0.001). A total of 185 patients could be tested for HIV-1 antibodies using ELISA-Welcozyme and HIVCECK-Du Pont. There were 141 (81.6%) positive results, 19 (10.3%) negative results, and in 15 (8.1%) cases the outcome was not clear. Seroprevalence figures for HIV-1 in the same period were 16% for blood donors and 41% for patients attending the clinic for sexually transmitted diseases. Most patients with AIDS in Sesheke district present with a wasting syndrome, and in these cases, tuberculosis (TB), whose incidence has increased dramatically, has to be excluded. Loss of more than 10% of body weight was the most common symptom followed by chronic cough lasting for more than 1 month, fever persisting for more than 1 month, and chronic diarrhea lasting for more than 1 more. Chronic coughing was more frequent among adults than among children (P 0.001). Weight loss, chronic diarrhea, persistent coughing, generalized lymphadenopathy, generalized dermatitis, and oropharyngeal candidiasis occurred among both adults and children equally often. Only 4 patients (18%) and extrapulmonary TB in 10 patients (4%). In the district there was no registration system for the dead and the follow-up of AIDS patients were not organized well, but as of January 1, 1992, from hospital records it was established that 74 patients out of the 231 studied were decreased. The outlook for the population in Sesheke and Zambia is dim in light of the current high seroprevalence rate.
Ned Tijdschr Geneeskd 1992 Dec 05
PMID:[AIDS in a Zambian district]. 147 Feb 44

Disseminated histoplasmosis (DH) is recognized as an opportunistic infection in patients with the human immunodeficiency virus (HIV), especially in regions where histoplasmosis is endemic. At the Kansas University Medical Center 148 patients were hospitalized with the diagnosis of AIDS from December 1983 to March 1991; 23 of these patients (16%) had disseminated histoplasmosis. The charts of these 23 patients were reviewed. Clinical signs and symptoms included fever (91%), cough (65%), and weight loss (48%). Splenomegaly, hepatomegaly, or lymphadenopathy was present in 52% of all patients. Anemia (39%), leukopenia (65%), and thrombocytopenia (52%) were common, and 22% had pancytopenia. Diagnosis was made by peripheral smear examinations (organisms visualized on 7 of 22 smears [32%]), blood cultures (positive for H capsulatum in 16 of 20 patients, [80%]), bone marrow cultures (positive in 14 of 15 patients, [93%]), and bone marrow aspirate and biopsy examinations (organisms seen on 18 of 21 stains, [86%]). The combination of these four tests revealed the diagnosis of DH in 23 of 23 patients (100%). Induction and maintenance amphotericin B therapy was given to all but 2 patients, and currently 8 of the 23 are alive. DH is a common opportunistic infection in AIDS patients from regions endemic for histoplasmosis. When DH is suspected, a peripheral smear examination, blood cultures, bone marrow cultures and bone marrow aspirate and biopsy should be done to make the diagnosis, since suppression of the disease is possible with appropriate therapy.
South Med J 1992 Dec
PMID:Disseminated histoplasmosis in patients with AIDS. 147 Sep 57

Combustion toxicology is complex so, although victims exposed to combustion products are mainly treated symptomatically, it is important to identify those situations when specific therapeutic measures might be of importance. Victims presenting respiratory symptoms including severe cough, bronchoconstriction, hypoxia and respiratory distress should be given oxygen and ventilatory assistance or support. Furthermore, bronchoconstriction should be treated with bronchodilators (beta-2-adrenoreceptor agonists, theophylline). Corticosteroids should be considered both for inhalation and systemically due to the risk of developing toxic pulmonary oedema that may appear after a symptom-free interval that might last up to 48-72 h. Victims with impaired consciousness should be regarded as being exposed to carbon monoxide and cyanides. Apart from oxygen and optimal symptomatic treatment hyperbaric oxygen therapy should be considered in carbon monoxide poisoning. Certain cyanide antidotes, namely those with low intrinsic toxicity (as sodium thiosulphate, hydroxocobalamin) should be given liberally in these situations. Other specific therapeutic measures that might be considered when appropriate are administration of organophosphate antidotes (atropine, oximes), heavy metal chelators (e.g. dimercaptopropane sulfonate, dimercaptosuccinic acid) and methemoglobinemia antidotes (methylthionine, toluidine blue). Inhalation of hot fumes may cause upper respiratory tract oedema (e.g. laryngeal oedema) necessitating orotracheal intubation and ventilatory support.
Toxicol Lett 1992 Dec
PMID:Hospital treatment of victims exposed to combustion products. 147 Nov 83

Cough variant asthma is characterized as a persistent, nonproductive cough with minimal or no wheezing and dyspnea. The diagnosis can be overlooked or misdisagnosed. We describe the severity of cough, the misery of some patients who have this syndrome and the usefulness of a diagnostic-therapeutic trial in ten patients with cough variant asthma. We evaluated ten patients whose chief complaint was persistent nonproductive cough. During the course of evaluation, all patients received a diagnostic-therapeutic trial of prednisone for cough variant asthma after other major causes of cough had been excluded. The duration of cough ranged from 2 months to 20 years. Some patients had significant side effects from coughing including interference with social life, work and sleep, urinary incontinence, stool incontinence, hoarseness, and vomiting. After a diagnostic-therapeutic trial with prednisone, nine patients reported significant improvement of cough in three days. One patient required 2 weeks of therapy for optimal improvement. All were subsequently controlled primarily with inhaled conticosteroids. The diagnosis of cough variant asthma may not be made for a prolonged time. A short course of prednisone as a diagnostic-therapeutic trial can establish a diagnosis and be followed by an effective method of control of cough by inhaled corticosteroids.
Ann Allergy 1992 Dec
PMID:Cough variant asthma: usefulness of a diagnostic-therapeutic trial with prednisone. 836 52

The induction and intubation with high concentrations of sevoflurane (4% or 6.4%) were investigated in 180 children with ages ranging from 1 to 6yr 12m. Average induction time (duration between the start of induction and loss of consciousness) with 4% sevoflurane was 56 sec and that with 6.4% was 47 sec. Eight patients out of 90, to whom 4% sevoflurane was applied, could not be intubated due to closure of vocal cord, cough or closure of mouth. The most serious side effect was convulsion during induction, of which incidence was 6% of all patients, and occurred more frequently with 6.4% sevoflurane. The convulsion spread from hand on one side to all over the body, and disappeared spontaneously within 30 sec. There was no significant side effect in cardiovascular system, such as hypotension, arrhythmia or bradycardia. In conclusion, smooth intubation was possible without use of muscle relaxants with high concentrations of sevoflurane. This can be one of the choices for induction of children, though there is a possibility of occurrence of convulsion.
Masui 1992 Dec
PMID:[Anesthetic induction of children with high concentrations of sevoflurane]. 147 63

To establish data on the patient's reasons for a contact, as a part of data on content of Icelandic family practice, a prospective practice audit was made of 16 Icelandic health centres with computerized contact data from 1 January to 31 December 1988. The study comprised 16 community health centres in Iceland and their target population, 12 rural and four urban. The reasons for contact in the study group are analysed. A total of 284348 reasons for contact were analysed; 36-39% were for symptoms and 44-50% were initiated by health professionals. The latter included renewal of prescriptions, which comprised 17-18% of all reasons for contact. Musculoskeletal symptoms were the most common symptomatic complaint, 6.6-7.3% of all reasons for contact. The five most often stated symptoms were: rash, cough, cold, lower limb symptoms, and fever. A "reason for contact" record increases the understanding of the patient's presenting complaint, as well as the patient's agenda in each contact. This record gives an opportunity to follow the presenting complaint in the continuous process of care i. e. reason for contact diagnosis, management, and follow-up. We are reminded that common things are common in family practice; nevertheless more research is needed to understand the process of care.
Scand J Prim Health Care 1992 Dec
PMID:Reasons for contact in family practice. An Icelandic multicentre study on content of practice. 148 Aug 63

A prospective evaluation was made of an algorithm for a selective use of throat swabs in patients with sore throat in general practice. The algorithm states that a throat swab should be obtained (a) in all children younger than 15 years; (b) in patients aged 15 years or more who have pain on swallowing and at least three of four signs (enlarged or hyperaemic tonsils; exudate; enlarged or tender angular lymph nodes; and a temperature > or = 38 degrees C); and (c) in adults aged 15-44 years with pain on swallowing and one or two of the four signs, but not both cough and coryza. Group A streptococci were found by laboratory culture in 30% of throat swabs from 1783 patients. Using these results as the reference, the algorithm was 95% sensitive and 26% specific, and assigned 80% of the patients to be swabbed. Its positive and negative predictive values in this setting were 36% and 92%, respectively. It is concluded that this algorithm may be useful in general practice.
Scand J Prim Health Care 1992 Dec
PMID:An algorithm for a selective use of throat swabs in the diagnosis of group A streptococcal pharyngo-tonsillitis in general practice. 148 Aug 70

Trichomonads of the oral cavity were found in 9 of 60 investigated horses. Apart from dental tartar, the oral cavity showed no clinical signs in all positive horses. The clinical investigation of these horses additionally revealed colic in 4 and coughing in 4 horses as well as lumbago in 1 animal. By means of scanning electron microscopy the trichomonads were shown to be round or piriform with an average length of 7.6 microns and greatest width of 6.3 microns. They had 4 anterior flagella with an average length of 8.3 microns, an undulating membrane measuring 8.7 microns with no trailing flagellum as well as an axostyle extending on average 7.8 microns beyond the body, and therefore have to be placed into the genus Trichomonas.
Tierarztl Prax 1992 Dec
PMID:[Trichomonad infections of the oral cavity in horses in southern Germany]. 148 Dec 16


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