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

In order to tackle the problems of underdiagnosis and undertreatment of asthma in childhood general practitioners need to be aware of which children in their practices have or might have asthma. In an effort to identify a cohort of asthmatic or potentially asthmatic children a trained audit facilitator studied all the medical records of children aged between one year and 15 years who were registered with 12 Tayside general practices. From a total of 10,685 medical records the frequency of 'key items' sometimes associated with asthma were as follows: one or more episodes of bronchospasm or wheeze 23.7% of children, persistent cough 23.2%, treatment with anti-asthma therapy in the past 20.0%, exercise induced cough or wheeze 5.2% and history of 'wheezy bronchitis' 4.6%. However, in only 896 children (8.4%) had a formal diagnosis of asthma been made. Of all the children, 5.4% had received a prescription for anti-asthma medication within the past three months. Only 1.2% were taking an inhaled corticosteroid and 1.0% sodium cromoglycate, but many more were taking inhaled bronchodilators (3.1%) and oral bronchodilators (1.7%). The findings suggest that a systematic review of medical records by a trained facilitator can identify those children who could benefit from clinical review. Practices who wish to know which of their children have or might have asthma should consider using medical record review to search for key items associated with asthma.
Br J Gen Pract 1992 Dec
PMID:Diagnosis and treatment of asthma in children: usefulness of a review of medical records. 129 69

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

DNA probe-assay using the Gen-Probe kit was carried out to detect Mycoplasma pneumoniae infections. Fifteen children visited Ota General Hospital complaining of dry cough and high grade fever. Throat swabs of the patients were examined to detect M. pneumoniae ribosomal RNA by Gen-Prove kit. Five out of 15 patients were positive for DNA probe assay of M. pneumoniae. Clinical and laboratory data including serological examinations were compatible with M. pneumoniae infection in these cases. Following the improvement of clinical symptoms and signs by receiving erythromycin or minocycline, the positivity for DNA probe assay turned to negative. Among the ten patients, who were negative for DNA probe assay, 2 cases were suspected of M. pneumoniae infection on the basis of clinical and laboratory findings. One patient had already taken antibiotics. Therefore, in these two patients, there was a possibility that the bacterial numbers were too small to be detected by DNA-probe assay. The data described above support that DNA-probe assay is useful for the diagnosis of M. pneumoniae infections in the early stage. DNA-probe assay is also valuable to follow up the clinical course of the patients.
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PMID:[Evaluation of DNA-probe assay for the clinical diagnosis of Mycoplasma pneumoniae infections]. 172 43

The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.
Br J Gen Pract 1991 Jul
PMID:Patient education about cough: effect on the consulting behaviour of general practice patients. 174 68

To test the hypothesis that many children with a chronic or recurring cough have asthma, 106 children with cough were treated according to an asthma protocol. At the end of 16 weeks, all but two of the children who completed this phase of the trial were free of cough. At a two-year follow up 97 children were reviewed: 71 were now diagnosed as having an asthmatic condition, 34 of whom required regular medication. The original histories of those who developed asthma were compared with those who had no further respiratory symptoms. The results suggest that many children with a chronic or recurring cough have a mild form of asthma, known as cough variant asthma, which is responsive to asthma therapy. Many will subsequently develop mild to moderately severe asthma. Those who subsequently develop an asthmatic condition are statistically more likely to have a family history of asthma or a personal history of atopy. The children are also more likely to have exercise-induced cough or nocturnal exacerbation of their cough. Managing a persistent or recurring cough according to an asthma protocol could mean that many asthmatic children will be diagnosed and treated earlier in the natural history of their illness.
Br J Gen Pract 1991 Oct
PMID:Two-year follow up of the management of chronic or recurrent cough in children according to an asthma protocol. 177 94

1. Comparisons were made between the doses required of aerosol and intraperitoneally administered morphine, dextromethorphan, codeine and the specific peripherally acting mu-receptor agonist DALDA (H-Tyr-D-Arg-Phe-Lys-NH2) to suppress citric acid-induced coughing in conscious guinea pigs. 2. Estimated ID50s for inhibition of numbers of coughs induced by an aerosol of 5% citric acid were 1.0 and 2.4 mg/kg for intraperitoneally administered morphine and dextromethorphan, respectively. 3. The estimated ID50s after inhalation of morphine and dextromethorphan as aerosols were approximately 2.2 and approximately 12 micrograms/kg, respectively. 4. Aerosilized codeine (approximately 72 micrograms/kg, n = 5) significantly inhibited coughing by 62 +/- 23% whereas 3 mg/kg, i.p. was required to significantly reduce coughing by a similar degree (60 +/- 6%, n = 7). 5. Inhalation of DALDA (approximately 7.2 micrograms/kg, n = 7) also significantly inhibited coughing. 6. The antitussive effect of inhaled morphine (approximately 7.2 micrograms/kg, n = 11) was inhibited after administration of 3 mg/kg of either naloxone hydrochloride or naloxone methylbromide intraperitoneally. 7. The results support the hypothesis that effects at a peripheral site can make a major contribution to the antitussive actions of these drugs.
Gen Pharmacol 1991
PMID:Evidence for peripheral mechanisms mediating the antitussive actions of opioids in the guinea pig. 181 Aug 7

A booklet was developed in the author's practice that provided advice for parents on the home management of cough, fever, sore throat, diarrhoea and vomiting in children, and included specific recommendations about when to seek medical help. The effect of distributing this booklet on the frequency of parent-initiated consultations was evaluated in a randomized, controlled trial. The overall effect of the booklet was a statistically non-significant reduction in consultations for the symptoms that it addressed ('booklet symptoms'). However, this finding masked a statistically significant reduction in daytime home visits for booklet symptoms (especially for cough, fever and sore throat) and a significant increase in out of hours consultations (for fever, diarrhoea and vomiting). Had all the households in the practice been sent a copy of the booklet then it was estimated that over the following year some 28% fewer home visits and some 173% more out of hours consultations would have been undertaken for booklet symptoms than if none of the households had been sent a copy.
Br J Gen Pract 1991 Feb
PMID:Development and randomized controlled trial of a booklet of advice for parents. 203 37

Parents of a stratified random sample of 234 children from 21 training practices in north east England were interviewed at home. All these children had been reported in a postal questionnaire as having had a cough between six and 10 weeks before the interview. Interviews covered social characteristics of the family, the severity of the child's cough and the child's previous respiratory history. These data were analysed using the statistical technique of logistic regression. This produced a good model of consulting behaviour. The model showed that a doctor was likely to be consulted if the child had severe symptoms, or if the cough affected the child's behaviour. This suggests that most parents deciding whether to consult the doctor make careful decisions based on what they see as objective criteria. No social characteristic had a significant influence on the decision to consult the doctor over and above the influence of the characteristics and effect of the cough itself.
Br J Gen Pract 1990 Jun
PMID:Respiratory illness in children: what makes parents decide to consult? 212 Nov 88

Post-marketing surveillance in general practice represents an important part of the monitoring of adverse events associated with newly introduced drugs. Such a study of the angiotensin-converting enzyme inhibitor enalapril maleate has been undertaken in 11 710 patients with essential hypertension. Serious adverse events occurred in 1.7% of patients, though most of these were not thought to be related to the treatment. The incidence rates of death (0.09%), stroke (0.11%) and myocardial infarction (0.15%) were compatible with rates predicted from age, sex and blood pressure considerations. Other events reported were hypotension (0.3%), angioneurotic oedema (0.03%), rash (0.5%), taste disturbance (0.2%) and cough (1.0%). The degree of blood pressure reduction attained was similar to that previously reported from pre-marketing development studies, as was the overall nature and frequency of both serious and non-serious adverse events. The most frequently reported event during enalapril therapy was of an improvement in well-being (19.8%).
J R Coll Gen Pract 1987 Aug
PMID:Post-marketing surveillance of enalapril: experience in 11,710 hypertensive patients in general practice. 283 50

In a family outbreak of human parvovirus infection, a 59-year-old doctor had a prodromal illness with wheeze. This was followed by a distinct acute episode with itch and arthropathy and a two-month phase characterized by intermittent cough and wheeze.
J R Coll Gen Pract 1986 May
PMID:Parvovirus infection in a family with wheeze in an adult. 301 40


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