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At least 739 records · Page 41Linked to original sources
PubMed2003

Relief of cough and nasal symptoms associated with allergic rhinitis by mometasone furoate nasal spray.

BACKGROUND: Cough commonly occurs as a symptom of seasonal allergic rhinitis (SAR), an inflammatory condition of the nasal mucous membranes that results in rhinorrhea, nasal stuffiness/congestion, nasal itching, and sneezing. Mometasone furoate nasal spray (MFNS, Nasonex, Schering, Kenilworth, NJ), an anti-inflammatory nasal corticosteroid, has been shown to be safe and effective in reducing the nasal inflammation of SAR. OBJECTIVE: To examine the effectiveness of MFNS in relieving SAR-associated cough, in addition to nasal symptoms. METHODS: This was a multicenter, randomized, double-blind study. Patients 12 years of age or older with > or = 1-year history of SAR symptoms, positive skin test to a prevailing seasonal allergen, moderate nasal symptoms, and moderate cough were treated for 14 days with MFNS 200 microg daily (n = 122) or placebo (n = 123). RESULTS: The group treated with MFNS showed significant improvement in the daytime cough severity score at endpoint compared with placebo (P = 0.049). Improvement in the nighttime cough severity score showed a trend in favor of MFNS treatment. Treatment with MFNS significantly improved total nasal symptoms in both the daytime and nighttime compared with placebo at endpoint (P < or = 0.017). Overall daytime symptom scores (cough + total nasal) improved significantly compared with placebo at endpoint (P = 0.005). Overall nighttime symptom scores improved significantly compared with placebo at endpoint (P = 0.028). Treatments were well tolerated, with no significant differences in the incidence of adverse events. CONCLUSIONS: MFNS is effective and well tolerated in the treatment of daytime cough associated with SAR.

Administration, Intranasal↗
PubMed2003

Cough sensitivity in atopic dermatitis.

The aim of study was to investigate the cough sensitivity (C2) to capsaicin (CAPS) in patients with atopic dermatitis without clinical respiratory symptoms. Cough sensitivity (C2) is defined as the lowest CAPS concentration, which evokes two or more coughs. Forty eight dermatological patients (21 M, 27 F; mean age 44 yr) and 24 healthy volunteers (14 M, 10 F; mean age 37 yr) inhaled deep breath (2 l) of CAPS aerosol in doubled concentrations (from 0.02 to 200 micromol/l) (Pari Provokationstest I, PARI WERK; mass median diameter 1.2 microm). Cough sensitivity (C2) expressed as geometric mean (95% CI) of CAPS concentration was 0.13 micromol/l (0.06-0.31) in 26 patients with atopic dermatitis (10 M, 16 F; mean age 41 yr), 5.51 micromol/l (1.33-22.90) in 22 patients with psoriasis (11 M, 11 F; mean age 46 yr) and 4.29 micromol/l (2.54-7.26) in 24 controls. There is significant difference of cough sensitivity (C2) between patients with atopic dermatitis and healthy volunteers (p<0.001) and also between patients with atopic dermatitis and psoriasis (p<0.001). Cough sensitivity (C2) in atopic dermatitis patients without clinical respiratory symptoms is significantly increased. In patients with psoriasis cough sensitivity (C2) is not significantly changed.

Adult↗
PubMedDate not supplied

Automated recognition of spontaneous versus voluntary cough.

Cough or cough epochs may be an important and persistent symptom in many respiratory diseases requiring both a continuous and objective observation. The research presented in this paper is aimed at assessing a blind data-based classification between 'spontaneous' and 'voluntary' human cough on individual sound samples. Cough sounds were registered in the free acoustic field on 3 pathological and 9 healthy non-smoking subjects, all aged between 20 and 30. Each sound is represented by the normalized power spectral density (PSD). Different transformations of the cough PSD-vector are chosen as input features to the classification algorithm. An experimental error rate comparison between different neural and fuzzy classification networks is performed. All evaluated algorithms used the Euclidean metric. This resulted in a correct class-discrimination between 'spontaneous' and 'voluntary' cough for 96% of the cough database.

Acoustics↗
PubMed2006

[Cough as a symptom--clarify or treat empirically?].

Cough is one of the most prevalent symptoms for which patients seek the attention of their physicians. Cough may serve as a protective reflex but can also impair social well-being and can profoundly and adversely affect patient's quality of life. Short and self-limited cough often does not require therapy, whereas prolonged cough is bothersome and should prompt further workup. If possible, the underlying cause should be identified and treated accordingly. Often, the patient history helps to establish a working hypothesis, such as possible post-nasal drip syndrome or gastroesophageal reflux as a cause. Asthma, another frequent cause of prolonged cough, is readily diagnosed in most cases. The response to empirical therapy often "confirms" a suspected etiology, if not, extensive workup involving function testing such as bronchoprovocation, radiology, endoscopy, and extended search for exceptional causes is warranted. Productive cough is often related to a bronchopulmonary disease, whereas an irritant cough is often of an extrapulmonary origin.

Chronic Disease↗
PubMed2000

Inhaled isotonic alkaline versus saline solution and radioaerosol clearance in chronic cough.

The aim of the present study was to test the influence of inhaled isotonic Ems salt (brine from the spa of Bad Ems, Germany) compared to isotonic saline on radioaerosol clearance (RC) in patients with chronic cough. Ems salt is an alkaline solution (pH 8.0-9.0) containing largely bicarbonate ions rather than the chloride ions present in isotonic saline (pH 6.4). RC was assessed with a radioaerosol technique using technetium-99m albumin in supine patients. After a 30-min baseline measurement of RC according to a single blind and randomized design, patients inhaled Ems salt (n=22, 20-77 yrs) or isotonic saline (n=21, 34-72 yrs) via a jet nebulizer (Pari Boy) for 10 min and were scanned for an additional 30 min. There was no difference between the two groups before intervention in terms of deposition pattern, lung function and baseline RC rate. After inhalation of Ems salt, the RC rate (1/tau) improved significantly from 0.15+/-0.14 (mean+/-SD) to 0.53+/-0.70 L.h(-1) (p<0.005); no change was found after isotonic saline (0.13+/-0.13 to 0.08+/-0.09 L.h(-1), NS). Voluntary coughs performed after 60 min had no effect on the RC rate. However, in the Ems salt group, significantly more patients reported an inhalation induced cough. Compared to the Ems salt patients, who did not cough during and after inhalation, the RC rate in the cough group was enhanced significantly (0.10+/-0.12 versus 0.73+/-0.83, p=0.017), this effect being seen more frequently in females (p=0.003). It is concluded that Ems salt improves radioaerosol clearance significantly in patients with chronic cough. The underlying mechanism, regarding whether induced cough, increased water content in the mucus or enhanced ciliary beat frequency is the leading cause of Ems salt action, remains unclear.

Adult↗
PubMed2000

Inhibiting effect of ammonia on citric acid-induced cough in pigs: a possible involvement of substance P.

The effect of ammonia on the cough response to citric acid and on substance P release from C-fibers involved in this reflex was assessed. For a period from one to four days, piglets were exposed, in an inhalation chamber, to ammonia at a concentration of 15 or 30 ppm. During exposure, cough induction tests were done every two days. Recovery of the cough reflex after ammonia exposure was also determined. In a separate group of piglets exposed for 2 days to 30 ppm ammonia, substance P content was determined in bronchial and tracheal lavage fluids and in the tracheal and bronchial mucosa. Ammonia (30 ppm) was found to inhibit coughing significantly (the cough frequency was reduced by 64%) after a two-day exposure. In animals exposed for 4 days to this ammonia concentration, the recovery ranged from 3 to 7 days (mean: 5 days). The same ammonia concentration also caused the substance P content to increase significantly in bronchoalveolar lavage fluid (to 432% of its initial value) and tracheal lavage fluid (to 149%) and to decrease significantly in the tracheal mucosa (-58%), however the content in bronchial mucosa was not significantly affected (-43%). Exposure to 15 ppm ammonia had no effect on the frequency of citric acid-induced coughing. In conclusion, ammonia inhibits citric acid-induced coughing in pigs at concentrations that can be detected in piggeries. This inhibitory effect may be related to substance-P depletion in C-fiber endings.

Ammonia↗
PubMed1996

Inhaled sodium cromoglycate to treat cough in advanced lung cancer patients.

C-fibres probably represent the common final pathway in both ACE inhibitors and neoplastic cough. A recent report demonstrated that inhaled sodium cromoglycate is an effective treatment for ACE inhibitors' cough; this effect might be due to the suppression of afferent unmyelinated C-fibres. We tested the hypothesis that inhaled sodium cromoglycate might also be effective in lung cancer patients who presented with irritative neoplastic cough. Twenty non-small-cell lung cancer (NSCLC) patients complaining of cough resistant to conventional treatment were randomised to receive, in a double-blind trial, either inhaled sodium cromoglycate or placebo. Patients recorded cough severity daily, before and during treatment, on a 0 to 4 scale. The efficacy of treatment was tested with the Mann-Whitney U-test for non-parametric measures, comparing the intergroup differences in the measures of summary of symptom scores calculated in each patient before and after treatment. We report that inhaled sodium cromoglycate can reduce cough, also in NSCLC patients and that such reduction, observed in all patients treated, is statistically significant (P < 0.001). Inhaled sodium cromoglycate appears to be a cost-effective and safe treatment for lung cancer-related cough.

Administration, Inhalation↗
PubMed2003

Inhibition of guinea-pig and human sensory nerve activity and the cough reflex in guinea-pigs by cannabinoid (CB2) receptor activation.

1. There is considerable interest in novel therapies for cough, since currently used agents such as codeine have limited beneficial value due to the associated side effects. Sensory nerves in the airways mediate the cough reflex via activation of C-fibres and RARs. Evidence suggests that cannabinoids may inhibit sensory nerve-mediated responses. 2. We have investigated the inhibitory actions of cannabinoids on sensory nerve depolarisation mediated by capsaicin, hypertonic saline and PGE2 on isolated guinea-pig and human vagus nerve preparations, and the cough reflex in conscious guinea-pigs. 3. The non-selective cannabinoid (CB) receptor agonist, CP 55940, and the selective CB2 agonist, JWH 133 inhibited sensory nerve depolarisations of the guinea-pig vagus nerve induced by hypertonic saline, capsaicin and PGE2. These responses were abolished by the CB2 receptor antagonist SR144528, and unaffected by the CB1 antagonist SR141716A. Similarly, JWH 133 inhibited capsaicin-evoked nerve depolarisations in the human vagus nerve, and was prevented by SR144528. 4. Using a guinea-pig in vivo model of cough, JWH 133 (10 mg kg-1, i.p., 20 min) significantly reduced citric acid-induced cough in conscious guinea pigs compared to those treated with the vehicle control. 5. These data show that activation of the CB2 receptor subtype inhibits sensory nerve activation of guinea-pig and human vagus nerve, and the cough reflex in guinea-pigs, suggesting that the development of CB2 agonists, devoid of CB1-mediated central effects, will provide a new and safe antitussive treatment for chronic cough.

Animals↗
PubMed1999

Double-blind comparison of eprosartan and enalapril on cough and blood pressure in unselected hypertensive patients. Eprosartan Study Group.

The effects of a new angiotensin receptor antagonist, eprosartan (200 or 300 mg b.i.d.) and enalapril (5-20 mg u.i.d.) on cough and blood pressure were compared in a 26-week, double-blind, randomised, parallel-group, multicentre, international study involving 528 patients with hypertension. Uptitration of doses was based on clinic blood pressure measurements during the first 12 weeks, after which hydrochlorothiazide (12.5-25 mg/day) could be added. The frequency and intensity of cough was assessed by a standardised questionnaire administered at each clinic visit. The primary end-point was the incidence of persistent, dry cough not due to upper respiratory infection; change in sitting diastolic blood pressure and overall incidence of cough were secondary end-points. During the first 12 weeks of double-blind therapy, enalapril treatment was associated with a 3.45-fold higher risk of definite cough (14/261 vs 4/259, P = 0.018). Overall cough incidence (from spontaneous reports from patients, or investigator's observation) was also more frequent with enalapril, as compared to eprosartan. Both agents reduced blood pressure significantly compared to baseline, although the eprosartan-treated group had a slightly higher response rate (defined as sitting diastolic blood pressure <90 mm Hg, or at least a 10 mm Hg reduction from baseline), both at end of titration (70.3% vs 62.6%, P < 0.05) and after 26 weeks (81.7% vs 73.5%, P= 0.018). These data suggest that, in unselected hypertensive patients, eprosartan is associated with less cough and a somewhat higher responder rate than enalapril.

Acrylates↗
PubMed2001

Quality of life and cough on antihypertensive treatment: a randomised trial of eprosartan, enalapril and placebo.

The objective of this study was to compare the quality of life and incidence of dry cough with the angiotensin II antagonist eprosartan, the ACE-inhibitor enalapril, and placebo, in hypertensive patients with a history of ACE-inhibitor cough. The study was a multicentre, randomised, double-blind, parallel group controlled trial. A total of 136 patients judged to have ACE-inhibitor cough during single-blind enalapril treatment which was lost during a subsequent placebo washout phase, were randomised to receive either eprosartan 300 mg twice daily, or enalapril 20 mg once daily, or placebo for 6 weeks. Self-completion questionnaires assessing quality of life and cough were examined at baseline and end of study. At study end point 23% of patients in the enalapril group and 5% in the eprosartan and placebo groups reported cough (which included definite, probable and possible coughs) (P = 0.02). After adjusting for multiple comparisons, the eprosartan group was not significantly different from either placebo or enalapril. There were no significant differences in the Psychological General Wellbeing Index (PGWB). In conclusion the incidence of self-reported cough on eprosartan was similar to that on placebo, and lower than on enalapril but this difference was not significant when adjustments were made for multiple comparisons. There were no differences in quality of life.

Acrylates↗
PubMed1987

Autonomic mechanisms in the heart rate response to coughing.

To differentiate between the possible reflex and mechanical components in the heart rate response to cough, eight healthy subjects performed a standardized cough test before and after pharmacological autonomic blockade; to test the clinical usefulness of the cough manoeuvre two groups of diabetic patients (without and with autonomic neuropathy) were compared with a group of age-matched normal subjects. Because of the use of abdominal and expiratory muscles during cough, the cardioacceleratory response was compared with that induced by an intense contraction of the arm muscles (handgrip). The cardioacceleratory response was completely abolished by atropine while propranolol failed to affect it. The diabetic patients with autonomic neuropathy showed a response similar to that after cholinergic blockade. The response was similar to that induced by muscular contraction for 4 s, after which it differed showing a continued cardioacceleration. The patterns of recovery were not different. The cough-induced cardioacceleration is essentially reflex in nature and under cholinergic control; initially the mechanism may be partially related to the intense contraction of abdominal and expiratory muscles; later, the arterial hypotension related to the cough may contribute to the more sustained shortening of the R-R interval. The cough test may be useful for the evaluation of cardiac parasympathetic integrity.

Adult↗
PubMed1988

Effects of pH and osmolarity on aerosol-induced cough in normal volunteers.

1. The chemosensitivity of cough receptors stimulated by inhalation of aqueous aerosols was evaluated in 21 normal volunteers in three experiments. 2. The pH of isotonic saline was altered using small amounts of phosphate or glycine buffers to produce solutions with a pH range of 2.6-10.0. These solutions were nebulized ultrasonically and breathed for 1 min periods by seven subjects in random order and on separate days. Cough frequency during each 1 min inhalation was recorded. Only the two solutions of extreme pH (2.6 and 10.0) caused cough. 3. The effect of altering the osmolarity of the inhaled aerosol on cough was assessed using D-glucose over a range of 77-1232 mosmol/l. Saline solutions over the same range of osmolarity were also tested. The pH of D-glucose was raised to match that of saline by adding small amounts of sodium hydroxide. All solutions were nebulized and inhaled by seven subjects as described above for 1 min periods during which cough frequency was recorded. Forced expired volume in 1 s was recorded after each inhalation and did not alter in any subject by more than 10%. Subjects coughed when inhaling all the D-glucose solutions over the whole range of osmolarity. Cough occurred with saline solutions only at low chloride concentration and at the highest concentration. 4. In order to clarify whether the response to hypertonic saline was due to the high ionic content of the solutions or to its hypertonicity, two other solutions were tested. These were an isotonic and a hypertonic mixture of D-glucose and saline, containing 'normal' (150 mmol/l) ionic content.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Cardiovascular response to coughing: its value in the assessment of autonomic nervous control.

1. The relationship between blood pressure and heart rate responses to coughing was investigated in 10 healthy subjects in three body positions and compared with the circulatory responses to commonly used autonomic function tests: forced breathing, standing up and the Valsalva manoeuvre. 2. We observed a concomitant intra-cough increase in supine heart rate and blood pressure and a sustained post-cough elevation of heart rate in the absence of arterial hypotension. These findings indicate that the sustained increase in heart rate in response to coughing is not caused by arterial hypotension and that these heart rate changes are not under arterial baroreflex control. 3. The maximal change in heart rate in response to coughing (28 +/- 8 beats/min) was comparable with the response to forced breathing (29 +/- 9 beats/min, P greater than 0.4), with a reasonable correlation (r = 0.67, P less than 0.05), and smaller than the change in response to standing up (41 +/- 9 beats/min, P less than 0.01) and to the Valsalva manoeuvre (39 +/- 13 beats/min, P less than 0.01). 4. Quantifying the initial heart rate response to coughing offers no advantage in measuring cardiac acceleratory capacity; standing up and the Valsalva manoeuvre are superior to coughing in evaluating arterial baroreflex cardiovascular function.

Adult↗
PubMed1990

Importance of inspiratory flow rate in the cough response to citric acid inhalation in normal subjects.

1. The cough response to inhalation of citric acid is produced mainly by irritation of the larynx and trachea. Variations in the inspiratory flow rate might lead to changes in deposition of the drug, and consequently in the cough threshold. 2. We have studied the effect of three different inspiratory flow rates in 11 normal, non-smoking subjects (nine males, aged 23-39 years), who inhaled nebulized citric acid (2.5-640 mg/l). The test finished when a cough was produced at each inhalation (cough threshold) or the maximum concentration was reached. 3. The inspiratory flow rate was limited with a fixed resistance and displayed on a screen so that the subjects could reach a constant inspiratory flow rate of 50, 100 and 150 l/min with a submaximal inspiratory effort. 4. The mean (SD) inspiratory flow rates achieved were 51.4 (5.3), 86.2 (16.6) and 134.4 (22.9) l/min. Baseline forced expiratory volume in 1 s and functional vital capacity were not different on the 3 study days. 5. The cough threshold (geometric mean and 95% confidence intervals) was 21 (9-54) mg/l at an inspiratory flow rate of 50 l/min and 43 (13-141) mg/l at 150 l/min (P less than 0.05). The amount of drug tolerated by the subjects before the cough threshold was achieved was 5.2 (2.0-13.8) mg at an inspiratory flow rate of 50 l/min and 11.6 (3.4-39.8) mg at 150 l/min (P less than 0.05). The number of coughs per inhalation was 1.6 (1.1-2.0) at an inspiratory flow rate of 50 l/min and 1.1 (0.7-1.5) at 150 l/min (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

Diagnostic testing and discharge coding for whooping cough in a children's hospital.

OBJECTIVE: To evaluate the diagnostic pathways for whooping cough in a large urban paediatric hospital to inform assessment of the relative merits of notification and hospitalization data for measuring pertussis disease burden in Australian children. METHODS: All laboratory requests for Bordetella pertussis (BP) culture or serology between 30 June 1997 and 30 June 1999 were reviewed and cross-checked against discharge diagnoses with International Classification of Disease (ICD) codes A37.0, 033.0 (whooping cough due to BP) or 37.9, 033.9 (whooping cough due to unspecified organisms). Culture-positive (CP) cases were defined as a positive culture or polymerase chain reaction for BP. Culture-negative (CN) cases either fulfilled the current Australian clinical case definition (>/=14 days of cough with one or more of paroxysms, whoop, post-tussive vomiting), or had a cough illness with either positive BP serology or documented contact with an individual coughing for >14 days. In infants <6-months-old, a coughing illness with apnoea and negative investigations for other causes was also accepted. Culture positive and CN cases were cross-referenced with notification data. RESULTS: During the study period, laboratory tests for BP were performed in 677 children, of whom 230 were hospitalized and 71 (31%) had an eligible ICD code at discharge; 29 were CP, 40 CN, and two (3%) were misclassified. A further 14 CP children were not admitted. Although 61 hospitalized cases (88%) fulfilled notification criteria, including 32 (80%) of CN cases, only 26 (90%) of CP and eight (20%) of CN cases were notified. CONCLUSIONS: Notifications substantially under-enumerate hospitalized infant cases, especially those without positive laboratory tests. Hospital discharge data add significantly to surveillance for pertussis, particularly in infancy where most severe cases occur.

Age Distribution↗
PubMed2000

Acoustic parameters of voluntary cough in healthy non-smoking subjects.

OBJECTIVE: The aim of this study was to explore cough in healthy subjects. METHODOLOGY: We studied 234 coughs generated by 24 (12 males) healthy non-smokers (forced expiratory volume in 1 s (FEV1) 103+/-8% of predicted), who had no significant differences in FEV1 and age between males and females. For each subject, several bouts of voluntary coughing were recorded using a personal computer with an A/D converter (sampling rate 10 kHz, 8 bit resolution) and the first and second coughs of each bout were analysed using short-time Fast Fourier Transformation. For each cough we studied the three phases that are produced. In particular, we studied the duration of the three parts, loudest frequency in the first part, lowest and highest frequencies, number of continuous frequencies and lowest and highest continuous frequencies in the second part, and the loudest frequency of the third part if present. RESULTS: We found significant differences between males and females in length of the first part (41.4+/-14 vs 44.7+/-10.4 msec, P = 0.04), loudest frequency of the first part (362+/-145 vs 449+/-145 Hz), lowest frequencies (282+/-100 vs 348+/-135 Hz) and highest continuous frequencies (3877+/-571 vs 4147+/-362 Hz; P < 0.001) of the second part. An interesting finding was that healthy males and females had the same number of continuous frequencies. Different frequencies are probably a consequence of anatomical differences in airway geometry involved in the cough. CONCLUSION: In cough frequency spectrum studies the differences between the two sexes should be taken into account to reduce the variability of the results.

Acoustics↗
PubMedDate not supplied

Pathophysiological changes occurring during Escherichia coli endotoxin and Pasteurella multocida challenge in piglets: relationship with cough and temperature and predicitive value for intensity of lesions.

The aims of this study were (1) to correlate cough and body temperature (BT) with the severity of bronchopneumonia in pigs, (2) to determine whether these clinical signs can be used to early diagnose bronchopneumonia and (3) to assess the predictive values of cough and BT regarding lung lesions. Bronchopneumonia was induced by administering E. coli endotoxin (LPS) combined with Pasteurella multocida type A (PmA) in the trachea of 13 piglets. Saline-instilled negative controls (n = 8), PmA inoculated (n = 6) and LPS instilled (n = 5) groups were also constituted. Cough and BT were recorded daily while the bronchopneumonia severity was assessed using bronchoalveolar lavage fluid (BALF) cytology, cytokines and measurement of lung lesion volume. Changes in expiratory breathing pattern were also measured (Penh). The combination of LPS and PmA induced a subacute bronchopneumonia characterised by macrophage, neutrophil, and lymphocyte infiltration, changes in Penh and an increase in the mRNA level of IFN-gamma while IL8, IL-18 and TNF-alpha mRNA levels remained unchanged. The daily body weight gain of infected animals was significantly reduced. Cough and BT changes were proportional to the intensity of the lung inflammatory process, functional respiratory changes and to the extent of macroscopic lesions. When comparing the individual values of cough and BT to thresholds defined for both parameters, an early diagnosis of pneumonia was possible. Considering the pooled data of each group, it was possible to define thresholds allowing an early segregation between the groups of diseased and healthy piglets. The daily values of cough and BT were predictive for the volume of lung lesions recorded at the end of the trial. In conclusion, cough and BT appear as potential indicators for the intensity and the evolution of the respiratory disease. They also seem to be good predictors for the magnitude of lung lesions and weight gain recorded at the study endpoint.

Animals↗
PubMed2000

Baclofen-induced cough suppression in cervical spinal cord injury.

OBJECTIVE: To determine the effect of the GABA-agonist baclofen on cough reflex sensitivity in subjects with cervical spinal cord injury (C-SCI). Baclofen has been shown to inhibit the cough reflex in able-bodied volunteers. DESIGN: Prospective, nonrandomized control trial. SETTING: Veterans Affairs medical center with large outpatient SCI population. PARTICIPANTS: Twelve adult males (11 outpatients) with C-SCI chronically maintained on oral baclofen for the treatment of muscle spasm. INTERVENTION: Subjects underwent cough challenge testing with inhaled capsaicin. The concentrations (microM) of capsaicin inducing 2 or more (C2) and 5 or more (C5) coughs were determined. Mean values for log C2 and log C5 were compared with a control group of outpatients with C-SCI not receiving baclofen. RESULTS: Subjects treated with baclofen had a significantly higher cough threshold (diminished cough reflex sensitivity) than control subjects. Mean (+/- standard error of the mean) values for log C2 in study subjects and controls were 1.28 +/- .16 and .65 +/- .15, respectively (p = .009). Mean values for log C5 in subjects receiving baclofen and in control subjects were 2.20 +/- .22 and 1.43 +/- .23, respectively (p = .024). Subjects and controls did not differ in terms of age, spirometric parameters, or duration of injury. CONCLUSIONS: The results suggest that chronic therapy with baclofen diminishes cough reflex sensitivity in subjects with C-SCI. The clinical significance of this finding remains to be elucidated.

Adult↗