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

Three cases of allergic alveolitis due to indoor humdification systems are described. Thermoactinomyces vulgaris precipitins were detected in the serum of a 37-year-old female patient who had typical febrile attacks during exposure to cool-mist from a home humidifier. When the cause was detected and eliminated, the symptoms and signs disappeared and the woman's gas transfer factor improved from 56% to normal within six months. In a printing office a 60-year-old woman had had febrile attacks with cough for more than a year. The patient herself associated the respiratory disease with a cool-mist humidifier sometimes used at work. The water reservoir was heavily contaminated with amoebas (Amoeba proteus), which might have been the causative organisms in this case. Aspergillus fumigatus precipitins were found in the serum of a 53-year-old female printer with the clinical picture of occupational allergic alveolitis. The same organism was detected in the ambient air of the printing office.
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PMID:Humidifier-associated extrinsic allergic alveolitis. 37 86

A series of 24 adult male patients undergoing thoracotomy were found to have a reduction in their cough pressures in the immediate postoperative period to 29 percent of their preoperative values. Cough pressures still averaged only 50 percent of control values one week following surgery, with slow return toward normal over the ensuing three weeks. Pain associated with the surgical wound appeared to be primary factor in the patients' inability to cough effectively. The degree of impairment appeared to be related to the extent of the procedure, pressures being altered less in those with limited incision thoracotomies. Ultrasonically nebulized water mist was found to be effective in all but one patient in inducing significantly higher cough pressures and more effective sputum expectoration. Its use should be considered as a simple method of inducing more effective coughs in the postoperative patient.
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PMID:Cough dynamics in the post-thoracotomy state. 112 20

Croup is a common childhood disease that has no specific diagnostic test. It must be differentiated from life-threatening diseases, such as epiglottitis, that demand specific interventions. A high degree of toxicity, the presence of dysphagia and the absence of cough help distinguish epiglottitis from croup. The usefulness and safety of visualization of the epiglottis in patients with croup are controversial. Clinical recognition of respiratory distress and failure is vital. Hypoxia is common. Pulse oximetry is helpful in the assessment of hypoxia, but readings do not correlate with clinical status or respiratory failure. Although studies have not proved that mist therapy is beneficial, the efficacy of racemic epinephrine is well documented. High dose corticosteroids have proved effective in the treatment of croup. Outpatient use of racemic epinephrine and steroids remains controversial.
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PMID:Diagnosis and treatment of croup. 151 65

Intracorporal, especially pulmonary, and extracorporal deposition of pentamidine was studied following inhalation of 300 or 600 mg in 6 ml Aqua dest. each dose in six patients with one previous episode of pneumocystis carinii pneumonia. Three different nebulizers--two mechanical nebulizers (Respirgard II and Pari-IS-2) and one ultrasonic device (Portasonic) - were compared. The following results were obtained: 1.300 mg pentamidine in 6 ml Aqua dest. is a sufficient dose for prophylaxis provided an appropriately constructed nebulizer and an optimal respiratory manoeuvre (inspiratory vital capacity breathing) are employed. With the nebulizer Portasonic, the frequency of cough was higher compared with the two mechanical nebulizers, which is attributed to its higher mist density. 2. Application of 600 mg pentamidine in 6 ml Aqua dest. as an aerosol is difficult to apply owing to clinical and technical problems caused by severe respiratory tract irritation and a high viscosity of the nebulizer solution. We assume that ultrasonic nebulization is affected more by the high viscosity than mechanical pneumatic nebulization. 3. Inspiratory vital capacity breathing (12/min) leads to five- to eight-fold higher pulmonary and improved peripheral deposition rates compared with commonly used spontaneous respiration. We therefore recommend to shorten the duration of inhalation by applying this respiratory technique while maintaining a generally tolerated and optimally nebulizable concentration of pentamidine, i.e. about 300 mg in 6 ml Aqua dest.
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PMID:[Lung deposition of 300 and 600 mg pentamidine, inhaled with 3 different inhalers]. 219 32

Pneumocystis carinii pneumonia occurs at some point in the course of disease in approximately 85 per cent of patients with AIDS. Because of the frequency of P. carinii pneumonia and because it is readily treatable, prompt, accurate, and efficient diagnostic schemes are of extreme importance. The clinical presentation is generally characterized by fever, nonproductive cough, and shortness of breath. Such symptoms in a patient from a recognized HIV transmission category should prompt a diagnostic evaluation to identify P. carinii or other opportunistic infections. A chest radiograph usually provides an objective indication of lung disease. Pulmonary function tests, particularly the DLCO and lung imaging using 67Ga-citrate, are useful screening tests in patients with normal chest films. Examination of sputum induced by inhalation of a mist of hypertonic saline is a very useful means of identifying P. carinii. Bronchoalveolar lavage is nearly 100 per cent sensitive to the presence of P. carinii and should be performed in patients who have a nondiagnostic sputum examination. Transbronchial biopsy increases the overall yield for diagnoses other than P. carinii and should be performed in patients in whom bronchoalveolar lavage does not provide a diagnosis. Because of the effectiveness of sputum examinations and bronchoscopic procedures, open lung biopsy is rarely necessary. Measurements of circulating P. carinii antigen and antibodies are of no help in diagnosis.
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PMID:Diagnosis of Pneumocystis carinii pneumonia. 306 May 25

Infectious croup is a viral or bacterial syndrome characterized by a barking cough, hoarseness, and stridor. Three separate conditions will be discussed: laryngotracheobronchitis, spasmotic croup, and bacterial tracheitis. Each clinical entity will be defined and its treatment reviewed. Current treatment regimens for infectious croup involve various combinations of mist therapy, racemic epinephrine, corticosteroids, and syrup of ipecac. Tradition, rather than science, appears to be the basis of many of these treatments. Despite the frequent occurrence of infectious croup, no treatment has proved consistently successful. Prevention and better treatment methods are the keys for reducing the high cost of infectious croup to the medical care system.
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PMID:Infectious croup: a critical review. 310 93

A plethysmographic method was employed to assess the airway resistance of conscious, free-breathing guinea-pigs. Using this method animals sensitized by inhalation of ovalbumin and appropriate controls were assessed for their responsiveness to histamine and methacholine in vivo. The cough frequency on exposure to citric acid mist in the two groups was also assessed. Tracheal spirals from these animals were subsequently tested for their responsiveness to histamine, methacholine and prostaglandin D2 in vitro. Sensitization increased responsiveness to histamine, methacholine and citric acid in vivo but only histamine responses were affected in vitro. These changes were accompanied by a significant eosinophilia in the airways as assessed by bronchoalveolar lavage. We conclude that sensitization of the airways to ovalbumin results in responsiveness changes in bronchial smooth muscle accompanied by signs of airway inflammation.
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PMID:Active sensitization of guinea-pig airways in vivo enhances in vivo and in vitro responsiveness. 322 83

Hypersensitivity pneumonitis is an unusual complication of using humidification devices. It is characterized by the acute onset of dyspnea, cough, fever, and chills after exposure to an offending antigen. This report describes a 54-year-old female laryngectomee who had repeated hospitalizations for postoperative dyspnea with normal chest roentgenograms and sputum cultures, but findings and history consistent with acute hypersensitivity pneumonitis. This seems to be the first reported case of hypersensitivity pneumonitis in a laryngectomee using a home mist machine. When repeated episodes of dyspnea occur in such patients, hypersensitivity pneumonitis should be considered in the differential diagnosis.
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PMID:Hypersensitivity pneumonitis from home mist machine after laryngectomy. 356 52

The effects of chronic exposure to a nebulized mist of salbutamol on the capacity of systemic salbutamol to prolong the time taken for inhaled histamine to produce bronchospasm in guinea-pigs have been examined. Initially a reproducible cough time to inhalation of histamine acid phosphate (0.5 ml ml-1) in 100% O2 was established. Antagonism of this response by intraperitoneal salbutamol or ipratropium Br was assessed to establish submaximal responses to these drugs. A fresh group of animals was then exposed to a persistent mist of nebulized water for 16 days, before and during which each animal was tested by exposure to histamine mist either alone or shortly after salbutamol (10 micrograms kg-1 i.p.) or ipratropium Br (5 micrograms kg-1 i.p.). The nebulized water had no effect on the response to the drugs. The same animals were rested for 7 days and then exposed to nebulized salbutamol solution (5 mg ml-1) for 15 days, during which time tachyphylaxis developed to salbutamol (i.p.) but not to ipratropium Br. At the end of the 15 days the animals were anaesthetized and total lung resistance (RL) measured. At this time, the protective effect of intravenous salbutamol was also diminished by comparison with untreated guinea-pigs while the response to ipratropium Br was unaffected. A separate group exposed to 1 mg ml-1 of nebulized salbutamol for 20 days developed selective tachyphylaxis to intraperitoneal salbutamol. The animals were then allowed to breathe room air and the response to intraperitoneal salbutamol after 13 days returned to normal as did the effects of intravenous salbutamol on the RL response to histamine.
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PMID:The effects of chronic inhalation of salbutamol on the acute airway responsiveness to salbutamol and ipratropium bromide in the conscious and the anaesthetized guinea-pig. 615 85

The effects of long-term exposure to sulfuric acid mist on the teeth and respiratory system were studied in 248 workers in five plants manufacturing lead acid batteries. The prevalence of cough, phlegm, dyspnea, and wheezing as determined by questionnaire were not associated with estimates of cumulative acid exposure. There was only one case of irregular opacities seen on the chest radiographs. There was no statistically significant association of reduced FEV1, peak flow, FEF50, and FEF75 with acid exposure although the higher exposed group had lower mean values. FVC in the high exposure group showed a statistically significant reduction compared to the low exposure group, but there was no significant association when exposure was analyzed as a continuous variable. The ratio of observed to expected prevalence of teeth etching and erosion was about four times greater in the high acid-exposure group. The earliest case of etching occurred after 4 months exposure to an estimated average exposure of 0.23 mg/m3 sulfuric acid.
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PMID:Epidemiological-environmental study of lead acid battery workers. III. Chronic effects of sulfuric acid on the respiratory system and teeth. 638 52


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