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)

We studied the influence of changes in pressure applied to the isolated upper airway of four conscious dogs on tracheal smooth muscle tone and breathing pattern. The dogs were prepared with a permanent side-hole tracheal stoma and were trained to sleep with a snout mask hermetically sealed in place while breathing through a cuffed endotracheal tube inserted distally into the tracheal stoma. Changes in tracheal smooth muscle tone were continuously monitored by measuring the pressure in the water-filled cuff that distended the tracheal airway while pressure changes were introduced in the upper airway independently of breathing. Increases or decreases of upper airway pressure (+/- 10 cmH2O) had little effect on tracheal airway smooth muscle tone. In contrast, an oscillating pressure wave at 30 Hz and +/- 3 cmH2O amplitude (or -3 to -7 cmH2O amplitude) caused a marked increase in tracheal airway smooth muscle tone. An elevated tracheal airway tone could be maintained over many minutes when the oscillating pressure stimulus was pulsed so that there was a cycle of 0.5 s on, 0.5 s off. This stimulus did not change the functional residual capacity but resulted in coughing, swallowing, or sighing in 54% of the tests. In the remaining tests, the pressure stimulus produced a rapid, shallow, and erratic breathing pattern. The tracheal airway constrictor response (but not the ventilatory response) was completely abolished by intravenous atropine. We suggest that upper airway vibration is a potentially powerful mechanism of reflex airway smooth muscle constriction.
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PMID:Tracheal smooth muscle responses to upper airway pressure in conscious dogs. 218 62

The goal of this study was to assess the efficacy of a simple technique used for producing analgesia during any thoracic operation. Its principle consists in peroperative local anesthesia of the nervous trunk in the intercostal space exposed by the surgeon. Methods 17 patients had peridural anesthesia via a multi-hole catheter, and received a bolus injection of 1.5 mg/kg of lidocaine, with subsequent continuous drip injections by electric needle, at a rate of 50 mg/hr. Results This treatment induced no side effects. Although not complete, analgesia allowed the patient to cough and expectorate without experiencing pain block. This permits to avoid, to the greatest extent, occurrence of postoperative atelectasia and provides for carrying out very prompt, effective chest physical therapy.
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PMID:[Post-thoracotomy antalgic treatment]. 237 48

A plastic truncated conical tracheostomy plug passed down the outer cannula of a Jackson tracheostomy tube and into the lungs of a respirator-dependent man during the monthly change of the inner cannula. Despite repeated flexible and rigid bronchoscopic visualization, attempts at dislodgement were unsuccessful. An exploratory thoracotomy was also unsuccessful in recovering the plug. Seventeen days postaspiration, with percussion and postural drainage, the patient expectorated the plug, even in the absence of the cough reflex. Such plugs have now been modified by passing a ring through the hole to prevent aspiration.
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PMID:Aspiration of a tracheostomy plug. 355 6

Rises in intra-abdominal pressure are common and are accompanied by reflex contraction of the external sphincter. Voluntary contraction of the sphincter is an uncommon event but is routinely used as a measure of sphincter strength. Cough pressure and squeeze pressure were compared in 75 patients using a 4 channel perfused catheter (3 anal and 1 rectal side-hole). Maximum anal cough pressure was higher than squeeze pressure (mean 158 vs 133 cm H2O, P = 0.0015). Intra-individual variance was less using cough pressure (mean 20% vs 29%, P = 0.005). There was significant overall correlation between cough pressure and squeeze pressure (P < 0.001) although in some cases there were wide differences, suggesting that use of both cough and squeeze pressure in manometry will assess sphincter strength more reliably. Measurement of the recto-anal pressure gradient during coughing correlated significantly better with degree of incontinence than cough or squeeze pressure (P = 0.005). The presence of a positive gradient was 100% specific for incontinence but the sensitivity was only 43% suggesting that factors other than simple mechanical sphincter weakness are involved in incontinence. Measurement of cough pressure has both clinical and research importance and should be added to standard manometric protocols.
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PMID:The cough response of the anal sphincter. 816 97

The anatomic appearance and competency of internal jugular valves were investigated in both cadavers and surgical patients. In 20 cadavers, the internal jugular vein (IJV) was dissected and the appearance of the valves observed. In two adult patients, the movements of the valves were observed by endoscopic visualization using an intravascular fiberscope, ultrasound techniques, and invasive venography. Transvalvular pressure gradients were measured in 10 adult surgical patients to examine the competence of the jugular venous valve. Nineteen internal jugular valves obtained from the 20 cadavers were situated directly above the termination of the IJV in the inferior bulb and were usually bilateral. The remaining 21 valves could not be examined since they had been already dissected out for another anatomical studies. The valves in 16 of the subjects were bicuspid and semiluminar. Two valves had a single cusp. The opening and closing of the valve was visualized easily with both a fiberscope and real-time ultrasound technique. Eight patients with normal central pressure had competent valves during cough-induced transvalvular pressure gradients of 45.3 +/- 10.1 (mean +/- SD) mmHg. Four valves from two cadavers remained competent at 75.4 +/- 18.2 mmHg, but became incompetent at 5.6 +/- 4.8 mmHg after a hole was made with a 14-gauge needle. Our results indicate that the IJV valve is located 0.5-2.0 cm above the union of the subclavian vein and IJV, and plays an important role in preventing retrograde blood flow to the brain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Valve injury: a new complication of internal jugular vein cannulation. 819 55

When I (Weber) was three, my father had a total laryngectomy. His stoma did not bother me, and it was common to see him cough through his neck, though I never became used to the excessive secretions produced. My father mastered esophageal speech well, so communication was normal. No one in my family can remember what his voice was like before the operation. Knowing that people stared and whispered about my father, I warned new friends that my dad had a hole in his neck so he could breathe and that he might sound funny to them because he had no voice box. I did not want my friends to be frightened by a stoma that many people see as revolting.
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PMID:Laryngectomy: Grieving disfigurement and dysfunction. 845 72

Twelve days after subtotal thyroidectomy, an air pocket developed in a patient's neck. The pressure in this pocket had gradually increased as small amounts of air, probably associated with coughing, came out of a tiny hole in the trachea to form a pneumocoele. This produced limited surgical emphysema, causing venous congestion and oedema of the soft tissues of the larynx, which in turn led to increasing airway obstruction. We believe that this is the first reported case of a pneumocoele that gradually increased in size, causing airway obstruction that was almost certainly due to secondary laryngeal oedema.
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PMID:An unusual case of stridor after thyroidectomy. 1207 Nov 59

A 12 year old boy was admitted to emergency service with loss of consciousness, convulsions and anisocoria of the right eye along the history of upper respiratory tract infection for the last four days. Two months ago he was hospitalized at the intensive care unite due to motorcycle accident with frontal fracture and minimal frontal pneumocephalus. He was treated for ten days and discharged without any neurological impairment. The last computerized tomography showed right frontal air of 5x5x7 cm. multiple airs in the ventricular system and in the upper central canal of the cervical region. The air was removed immediately through a right frontal burr-hole with a bedside procedure. The patient's neurological status rapidly improved and ten days after computerized tomography showed clearly resolution of the air. The presented case is an interesting example of post traumatic pneumocephalus due to herniation and widespread intracranial air. The situation can be explained with acute penetration of huge amount of air into the cranium through the frontobasal fracture and torn dura by strong Valsalva 's maneuver resulting from coughing and sneezing in the course of upper respiratory tract infection. We suggest close follow up, frequent control computerized tomography scans, preventive and effective treatment respiratory tract infections along 3-6 months in similar cases.
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PMID:[Posttraumatic tension pneumocephalus causing herniation]. 1258 62

The punched-hole and the paper disc diffusion methods were used in screening for the antimicrobial activity of six common ingredients used locally in cough mixtures, against the following bacteria: Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus. Enterococcus faecalis, Escherichia coli, Salmonella spp, Salmonella paratyphi, Shigella dysenteria, Shigella sonnei and Candida albicans. The results, evaluated as the diameter of zone of inhibition of microbial growth, showed that lime, garlic onion, onion and honey were active against Staphylococcus aureus, Streptococcus faecalis, Candida albicans, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Salmonella spp and Shigella dysenteriae. Bitter-kola nut extract and palm kernel oil showed no antimicrobial activities against any of the tested organisms. None of the extracts inhibited the growth of Salmonella paratyphi and Shigella sonnei and the most susceptible organisms were Escherichia coli and Salmonella spp.
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PMID:Antimicrobial activity of extracts of local cough mixtures on upper respiratory tract bacterial pathogens. 1464 97

The aim of this study was to evaluate the analgesic efficacy, safety, opioid sparing effects and improvement of respiratory function when using 0.2% ropivacaine continuous wound infiltration after major intra-abdominal surgery. Forty patients undergoing major intra-abdominal surgery requiring a midline incision of > or = 20 cm were enrolled into this IRB-approved, randomized, prospective controlled study. Group 1: 20 patients, parenteral analgesia (control group). Group II: 20 patients, with local anesthetic wound infiltration (pain pump group). At the end of the procedure, in the pain pump group of patients, a multi hole, 20-gauge catheter was inserted percutaneously, above the fascia. An initial dose of 10 ml of 0.2% ropivacaine was injected in the wound through the catheter. A device provided continuous delivery of 0.2% ropivacaine; the infusion was initiated at 6 ml/h for the following two days. The total "rescue" morphine and oxycodone/acetaminophen tablets administered were significantly lower in the pain pump group. At all time intervals, resting pain scores were significantly lower in the pain pump group when compared with the control group. However, at the 4-48 and 12-48 hours pain scores generated after leg raise and coughing, respectively, were significantly lower in group II. The patient vital capacities were insignificantly higher in group II. We conclude that after major abdominal surgery, infiltration and continuous wound instillation with 0.2% ropivacaine decreases postoperative pain, opioid requirements and oral analgesia. Early patient rehabilitation, hastening convalescence, and preventing respiratory complications are expected outcomes of this approach.
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PMID:Efficacy of postoperative continuous wound infiltration with local anesthetic after major abdominal surgery. 2212 18


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