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At least 91 records · Page 5Linked to original sources
PubMed1992

[Case report of collagen lung in SLE presenting with cough variant asthma: relation between the localization of responsible receptors and cough].

A 27-year-old nonsmoking woman complained of cough and chest oppression for two years since an episode of pneumonia. Clinical tests showed decrease in FEV1.0 during attacks of coughing and evidence of bronchial hypersensitivity. While these events fitted the picture of bronchial asthma, the nonwheezing cough suggested cough variant asthma. Antinuclear antibody and anti-ds DNA antibody were increased and leukopenia was recognized, suggesting the diagnosis of systemic lupus erythematosus (SLE). Bronchoalveolar lavage showed lymphocytic alveolitis and decreased T4/T8. These results were suggestive of collagen lung induced by SLE. Inhalation challenge with capsaicin and rapid intravenous injection of lobelin and alinamin indicated that peripheral c-fiber receptors were involved in the induction of coughing. We conclude that the peripheral lesion of collagen lung stimulates the peripheral c-fiber receptors, leading to cough variant asthma.

Adult↗
PubMed1980

[Treatment of whooping cough and whooping cough syndrome by cefoperazone (author's transl)].

Clinical trial of cefoperazone (CPZ) for the treatment of whooping cough and whooping cough syndrome was performed and the following results were obtained. 1) In 18 cases suffering from whooping cough, CPZ was given 47 approximately 106 mg/kg/day (average 72 mg/kg/day) by intravenous route. The clinical efficacy rates judged by doctors in charge were 44% on the 3 rd day, 75% on the 7 th day, 86% on the period day. And in these cases, the clinical efficacy rates judged by committee members were 56%, 83% and 86%. 2) In 6 cases diagnosed as whooping cough syndrome, CPZ was given 49 approximately 96 mg/kg/day (average 59 mg/kg/day) by the same route. The clinical efficacy rates judged by doctors in charge were 67% on the 3 rd day, 80% on the 7 th day and 75% on the period day. And in these cases, those judged by committee members were 83%, 80% and 100%. 3) In 1 case, Bordetella pertussis was searched and showed 0.012 mcg/ml of MIC. It was eliminated on the 1 st day after administration. 4) Doctors in charge judged the utility of CPZ for whooping cough. Twelve cases were useful and 6 cases were slightly useful. 5) No side effects were observed except for elevation of GOT and LDH. These results suggest that CPZ might be useful drug against whooping cough.

Bordetella pertussis↗
PubMed1984

Alteration in osmolarity of inhaled aerosols cause bronchoconstriction and cough, but absence of a permeant anion causes cough alone.

To determine whether cough and bronchoconstriction result from alterations in the osmolarity or alterations in the ion concentration of inhaled aerosols and to determine if the specific ions in the aerosol are important, we had 9 subjects with mild asthma inhale various solutions while we recorded cough and measured specific airway resistance. To evaluate the effects of altering osmolarity and ion concentration separately, we administered aerosols of hypo-osmolar distilled water (0 mosm), iso-osmolar sodium chloride (308 mosm), iso-osmolar dextrose in water (308 mosm), hyperosmolar sodium chloride (1,232 mosm), and a hyperosmolar solution of dextrose and sodium chloride (1,232 mosm). To evaluate cough without bronchoconstriction, we had the subjects inhale metaproterenol before inhaling the same aerosols. To determine whether the absence of a specific ion was important in causing cough or bronchoconstriction, we had the subjects inhale iso-osmolar solutions of sodium bromide, sodium gluconate, and lysine monohydrochloride. We found that alteration in osmolarity away from iso-osmolarity of inhaled aerosols is a stimulus for bronchoconstriction in subjects with mild asthma. Absence of ions in the presence of iso-osmolarity is not a stimulus for bronchoconstriction, but the absence of a permeant anion is a stimulus for cough. Thus, we found that the responses of cough and bronchoconstriction to inhaled aerosols can be separated.

Adult↗
PubMed2005

Airway inflammation and cough sensitivity in cough-variant asthma.

BACKGROUND: Mechanisms underlying cough and bronchoconstriction in patients with cough-variant asthma (CVA) are not well established. Differences in location or degree of activation of eosinophils and allergic cytokines have been suggested as the likely causes. To address this issue, we have carried out a comparative study of airway inflammatory markers between patients with CVA and classic asthma (CA). The relationship between these markers with airway hyperresponsiveness (AHR) and cough sensitivity has also been studied. METHODS: Twenty-seven non-smokers and steroid-naive patients with CVA (12) and CA (15) were examined. Capsaicin challenge, histamine bronchoprovocation test, nitric oxide levels in exhaled air and sputum induction were performed in all of them. Differential cell sputum recount and supernatant concentrations of eosinophil granule-derived cationic proteins (ECP), interleukin (IL)5, IL8 and tumour necrosis factor (TNF)-alpha were also measured. RESULTS: There were no significant differences in either the inflammatory pattern of soluble markers or differential cell counts between CA and CVA. Histamine PC20 was correlated with IL-5 in CVA, whereas it was associated with sputum eosinophilia in CA. Cough sensitivity (log C5) and histamine PC20 were inversely related in CA. CONCLUSIONS: Although the pattern of inflammatory sputum markers in patients with asthma and cough-variant asthma is similar, its relation with bronchial hyperreactivity and cough sensitivity is different in each group.

Adult↗
PubMed1979

Evidence of whooping-cough-vaccine efficacy from the 1978 whooping-cough epidemic in Hertfordshire.

The question of the efficacy of whooping-cough immunisation was central to the controversy that started in 1974. Definitive answers were not possible at the time because of the very low levels of whooping-cough in the preceding years and the absence of up-to-date information. The widespread abandonment of whooping-cough immunisation and the subsequent epidemic of whooping-cough have provided a natural epidemiological experiment. Figures from Hertfordshire in 1978 show that for children aged 4 years and under whooping-cough immunisation conferred 92% protection.

Child Health Services↗
PubMed2004

[Psychogenic cough: Another etiology for persistent cough].

The most common causes of persistent cough are upper respiratory tract disease (postnasal drip syndrome, infections) and asthma. In the last year, six patients (four boys and two girls), aged 7-12 years old, with a diagnosis of hard-to-manage asthma and/or persistent cough were referred to our department. All the patients had undergone treatment with multiple drugs for long periods without favorable clinical response. The findings of physical examination, radiology, basal pulmonary function and post-bronchodilation and fibrobronchoscopy were normal. Organic disease was ruled out and a psychiatric evaluation was performed. Intelligence quotient was in the lower normal range and generalized anxiety order was identified, thus establishing a diagnosis of psychogenic cough. Treatment consisted of relaxation techniques and psychopedagogic support with favorable outcome. To avoid diagnostic errors and inappropriate treatment, psychogenic cough should be included in the differential diagnosis of persistent cough and hard-to-manage asthma.

Asthma↗
PubMed1998

[Will chronic nonproductive cough with bronchial hyperresponsiveness be cough variant asthma?].

OBJECTIVE: The clinical characteristics of the patients suffered from chronic nonproductive cough with bronchial hyperresponsiveness were analyzed, so as to evaluate the value of measurement of bronchial responsiveness in diagnosis of cough variant asthma (CVA). METHOD: 124 patients with chronic nonproductive cough were divided into two groups after the measurement of bronchial responsiveness: cough bronchial hyperresponsiveness positive group (CBH-P, n = 35) and cough bronchial hyperresponsiveness negative group (CBH-N, n = 33). Routine pulmonary function, positive rate of antigen-skin pitting lest, count of blood eosinophil cells, level of blood IgE, positive rate of prednisone test and the number of development of classical asthma in two-year following up were studied. RESULT: The percentage of FEV1.0 in group CBH-P was significantly lower than in group CBH-N, but antigen-skin pitting test, count of blood eosinophil cells, prednisone test and the number of development of classic asthma in two-year following up were all higher than in the latter group. In group CBH-P, there was no significant difference in positive rate of antigen-skin pitting test, routine pulmonary function, reacting threshold(Dmin) and wheezing threshold (DCW/Dmin) between the patients who developed classic asthma and those who did not. CONCLUSION: The measurement of bronchial responsiveness is important for the diagnosis of CVA, but it is not the only diagnostic criteria and should be combined with other clinical data.

Adult↗
PubMed1993

Cough in spinal cord injured patients: comparison of three methods to produce cough.

Pulmonary complications are the major causes of morbidity and mortality for persons with cervical spinal cord injury. Diminished ability to cough constitutes a major contribution to the high incidence of pulmonary morbidity in this population. This article reports preliminary results for a new technique for providing assisted cough in this population. In this study, efficacy of cough (as measured by peak expiratory flow rate) was measured under three conditions: volitionally with no assistance, with manual assist of a therapist, and with electrical stimulation of abdominal muscles. Coughs produced by electrical stimulation were approximately as effective as manually assisted coughs. The results suggest this technique is worthy of more detailed study and may be a potentially effective new modality for assisting spinal cord injured persons to clear their airways.

Abdominal Muscles↗
PubMed2007

Metoclopramide aborts cough-induced headache and ameliorates cough--a pilot study.

Metoclopramide (MTCL) can abort attacks of migraine headache. I report swift resolution of cough-induced headache as well as suppression of cough in six male patients following parenteral administration of MTCL. A similar unexpected rapid antitussive action of MTCL was also observed in 12 of 14 other patients (13 male and 1 female) with severe paroxysmal cough without headache. Use of MTCL primarily for analgesia is reviewed, and the pharmacological basis for its antinociceptive action is proposed. As a nonopiate agent with potential to stimulate endogenous opiate-mediated mechanisms, MTCL appears to have additional valuable roles in clinical practice. This is the first report of an antitussive action of MTCL. Further controlled studies are required to confirm the therapeutic role of MTCL in cough-induced headache as well as its potential antitussive and general analgesic actions.

Adult↗
PubMed2003

Cough . 2: Chronic cough in children.

Chronic cough is a common problem in childhood. Viral infections are the most prevalent cause, but other rarer disorders should be excluded whenever cough appears unusually severe and/or frequent, and when there is evidence of failure to thrive and growth retardation. The younger the child, the more the need to exclude underlying disease at an early stage. Passive smoking is an important contributor to chronic cough in children. Chronic productive cough with purulent sputum is always reason for concern in children and is not common as a symptom of asthma. More or less specific diagnoses in children include cystic fibrosis, aspirated foreign body, congenital anatomic abnormalities and primary ciliary dyskinesia.

Algorithms↗
PubMed2005

Characteristics of patients with chronic cough who developed classic asthma during the course of cough variant asthma: a longitudinal study.

BACKGROUND: Some patients develop asthmatic symptoms such as wheezing and dyspnea during the course of cough variant asthma (CVA), which are considered precursors of classical asthma. OBJECTIVES: To identify the characteristics of such patients, we investigated the nature of CVA patients with or without developing bronchial asthma in the longitudinal study. METHODS: In 28 CVA patients whom we could observe over 5 years, duration of coughing, physical examination findings, pulmonary function and bronchial hyperresponsiveness to inhaled methacholine were retrospectively assessed. RESULTS: Of these patients with CVA, 10 developed the asthmatic symptoms of wheezing and dyspnea (precursors of classical asthma) over 5 years. All these 10 patients showed marked bronchial hyperresponsiveness; however, there were no significant differences in the bronchial responsiveness to methacholine between patients with precursors of classical asthma and pure CVA patients who did not wheeze. The duration of coughing had a significant relationship with precursors of classical asthma. Seven patients with precursors of classical asthma developed wheezing in the first year and 1 patient each in the second, third and fourth year. CONCLUSIONS: These findings of a 5-year observation suggest that longer duration of coughing may be an important factor that develops precursors of classical asthma in patients with CVA.

Adult↗
PubMed1999

Treatment of persistent dry cough: if possible, treat the cause; if not, treat the cough.

Persistent dry cough is a common presenting symptom which may be associated with considerable morbidity. In the majority of patients, systematic investigation reveals an underlying cause, usually asthma, postnasal drip, gastrooesophageal reflux or various combinations of these conditions. Intensive treatment of the underlying cause usually leads to improvement or resolution of the cough. However, in a minority of patients, no underlying cause is identified despite appropriate investigation. In these patients with idiopathic persistent dry cough, cough sensitivity to inhaled tussigens is enhanced, suggesting that increased sensitivity of airway sensory nerves is important in pathogenesis. An ideal antitussive would reduce this increased sensitivity to normal levels without significant adverse effects but currently available antitussives fall short of this expectation. This review discusses the currently available antitussive therapy and explores potential avenues for the development of future novel antitussive therapies.

Animals↗
PubMed1998

[Cough variant asthma among patients with chronic persistent cough and its clinical outcome].

Thirty-nine patients with chronic persistent cough continuing more than eight weeks were examined regarding to their airway responsiveness to methacholine challenge using the Astograph (TCK-6100H, Chest Corp. Japan). Of these, twenty-three individuals (59%) had airway hyperresponsiveness, leading to diagnose as having cough variant asthma (CVA). Patients with CVA had a higher percentage of eosinophils in peripheral blood and a lower forced expiratory volume in one second than those in non-CVA group. Furthermore, four patients (17%) developed the classic signs and symptoms of asthma, whereas 7 cases (30%) resolved their cough without further treatment and 12 cases (52%) continued to have CVA. These data suggested that a significant proportion of patients with chronic persistent cough had CVA and some of them may develop to classic wheezing asthma.

Asthma↗
PubMedDate not supplied

Inhalation cough challenge in the investigation of the cough reflex and antitussives.

Inhalation cough challenge is a useful tool in the physiological and pharmacological investigation of the cough reflex. There are three types of challenge used, capsaicin and the vanilloids, organic acids, and distilled water challenge. In addition, challenge may be administered in a single dose or cumulative dose fashion. The correct combination of inhalation technology and tussive stimulus produces a sensitive and specific method for estimating the cough reflex.

Antitussive Agents↗
PubMed2003

Cough. 3: chronic cough and gastro-oesophageal reflux.

The pathogenesis and clinical features of gastro-oesophageal reflux related cough are complex and the diagnostic tests available are of limited reliability. Treatment needs to be tailored to the specific needs of individual patients and other possible causes of chronic cough should be investigated. Treatment should only be considered to have failed when cough persists after administration of proton pump inhibitors at an adequate dosage for a sufficient length of time.

Barium↗
PubMed2004

Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents.

OBJECTIVES: To determine whether the commonly used over-the-counter medications dextromethorphan and diphenhydramine are superior to placebo for the treatment of nocturnal cough and sleep difficulty associated with upper respiratory infections and to determine whether parents have improved sleep quality when their children receive the medications when compared with placebo. METHODS: Parents of 100 children with upper respiratory infections were questioned to assess the frequency, severity, and bothersome nature of the nocturnal cough. Their answers were recorded on 2 consecutive days, initially on the day of presentation, when no medication had been given the previous evening, and then again on the subsequent day, when either medication or placebo was given before bedtime. Sleep quality for both the child and the parent were also assessed for both nights. RESULTS: For the entire cohort, all outcomes were significantly improved on the second night of the study when either medication or placebo was given. However, neither diphenhydramine nor dextromethorphan produced a superior benefit when compared with placebo for any of the outcomes studied. Insomnia was reported more frequently in those who were given dextromethorphan, and drowsiness was reported more commonly in those who were given diphenhydramine. CONCLUSIONS: Diphenhydramine and dextromethorphan are not superior to placebo in providing nocturnal symptom relief for children with cough and sleep difficulty as a result of an upper respiratory infection. Furthermore, the medications given to children do not result in improved quality of sleep for their parents when compared with placebo. Each clinician should consider these findings, the potential for adverse effects, and the individual and cumulative costs of the drugs before recommending them to families.

Adolescent↗
PubMed2004

Cough mixtures: not always for cough.

BACKGROUND: Opioid based cough mixtures are readily available to the public and are generally used safely. However, like alcohol, their use can sometimes be a significant part of a dependence problem. OBJECTIVE: This case study provides practical information for general practitioners in the detection, assessment and management of patients with cough mixture opioid dependence. DISCUSSION: Opioid dependence is generally considered synonymous with heroin dependence or dependence on prescribed opioid analgesics. However, cough mixtures are a readily available source of opioids. People who become dependent on these mixtures commonly do not present for medical assistance until the problem is severe.

Adult↗
PubMed1987

Chronic cough and cough mixtures in a private paediatric practice.

A survey of 256 private practice paediatric patients with chronic cough revealed that 50% were asthmatic, 28% had upper respiratory infections including bronchiolitis and bronchopneumonia, while 22% had whooping cough despite being fully immunised. Diagnosis and management were discussed. The only cough mixture of real value appears to be a bronchodilator.

Adolescent↗