Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “EXPECTORANTS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed2000

Effects of anti-reflux surgery on chronic cough and asthma in patients with gastro-oesophageal reflux disease.

This two-group prospective study evaluated the effect of anti-reflux surgery (fundoplication) on 24 patients with severe gastro-oesophageal reflux disease (GORD) and concomitant asthma (n=13) or chronic cough (n=11). Twenty-four hour oesophageal pH monitoring and lung function tests (FEV1, FVC) were done before and within 1 year after anti-reflux surgery. A diary was kept by the patient during the 4-week period prior to surgery and during 4-week periods 6 and 12 months postoperatively, with daily monitoring of peak expiratory flow rate, respiratory and reflux symptoms and medication. In non-asthmatic patients, coughing was reduced by 47% and 80% during the day and night, respectively, 12 months after surgery (P < 0.01). Concomitant hoarseness and expectoration were also significantly reduced (P<0.05). No effect on lung function was seen. In patients with asthma, small, non-significant reductions in asthma symptom scores and consumption of rescue medication were seen. Twenty-two patients were completely free from their GORD symptoms after surgery. In conclusion, anti-reflux surgery in patients with GORD had a more favourable effect on concomitant cough than concomitant asthma.

Adult↗
PubMed2000

Laboratory diagnosis of nosocomial pneumonia.

The second most common nosocomial infection in the United States is pneumonia, with the highest rates seen in patients requiring mechanical ventilation. Nosocomial pneumonia is a serious disease associated with significant morbidity and mortality; crude mortality rates have been estimated at 20% to 50%. The rapid institution of appropriate antimicrobial therapy has been shown to improve mortality in patients with ventilator associated nosocomial pneumonia. Thus, the identification of nosocomial pneumonia with a timely microbiologic diagnosis is important for the management of these patients. However, the accurate diagnosis of nosocomial pneumonia, along with identification of the responsible organism(s), can be challenging. This task becomes even more difficult in patients who are mechanically ventilated. The presence of new pulmonary infiltrates along with clinical criteria including fever, cough, and purulent secretions are neither sensitive nor specific for the diagnosis of nosocomial pneumonia. The laboratory can enhance the accuracy of pneumonia diagnosis, as well as provide the identification of an etiologic organism(s). There are, however, many challenges which confront the laboratory including: the ability to identify organisms from an extensive microbiologic spectrum; distinguishing colonization from infection of predominately gram-negative oropharyngeal flora; and providing timely results. This article reviews the various diagnostic tests available for nosocomial lung infections, and in particular, ventilator associated pneumonia including: blood cultures; pleural fluid; expectorated sputum; endotracheal aspirates; and respiratory specimens obtained by more invasive techniques using bronchoscopy and transthoracic needle aspiration. Emphasis is placed on optimal specimen collection, the processing of samples in the laboratory, and on the evaluation of potential risks and benefits associated with the varying techniques.

Bacteria, Anaerobic↗
PubMed2001

Rapid diagnostic evaluation of bronchial washings in patients with suspected coccidioidomycosis.

Coccidioidomycosis is a regionally common fungal infection, primarily affecting the lung. While in the majority of cases the tempo of the disease allows for a more leisurely diagnostic plan, including multiple serologic tests and culture of respiratory secretions, occasionally, patients will present with rapidly progressive, life-threatening pulmonary illness, in whom there is an urgent need for rapid diagnosis. Evaluation of respiratory secretions including expectorated sputum as well as bronchial washings are frequently available or obtained for diagnosing pulmonary infiltrates. We compared the sensitivity of the Papanicolaou stain with 10% potassium hydroxide digestion (10% KOH) and with calcofluor white (cw). The Papanicolaou test performed the best and should be used in the evaluation of suspected patients with coccidioidomycosis.

Benzenesulfonates↗
PubMed1999

Molecular diversity of 5S-rRNA spacer domain in Fritillaria species revealed by PCR analysis.

Beimu (bulbs of Fritillaria) is an important traditional Chinese herbal medicine commonly used as an antitussive and expectorant. There are about 25 species and varieties of Fritillaria that carry the name Beimu on commercial markets. The price for each Beimu may differ by more than 100-fold. However, the identification of the origin of a particular species on the market is difficult. Here, a molecular method was used to identify various species of Fritillaria regardless of their geographical origin. The 5S-rRNA coding sequence is highly conserved in higher eukaryotes, but the spacer sequence of the 5S-rRNA gene is variable among different species. Total genomic DNA from fresh leaves and bulbs of Fritillaria cirrhosa, F. puqiensis, F. anhuiensis, and F. thunbergii was extracted. The 5S-rRNA spacer region of the extracted DNAs was amplified by PCR with a pair of primers located within the conserved coding region. The isolated cDNA clones (approximately 600 bp) covering the 5S-rRNA spacer domain were sequenced. By aligning the isolated nucleotide sequences of the four Fritillaria species, sequence diversity was found in the spacer region. Furthermore, a unique EcoR I site was used for the rapid identification of different species of Fritillaria. To our knowledge, this is the first report on the detection of 5S-rRNA spacer domain sequences of Fritillaria and their use to identify species.

Base Sequence↗
PubMed2000

[Reproducibility in induced sputum in children with asthma].

In asthmatic children sputum-induction with hypertonic saline is useful to quantify the eosinophilic inflammation. However, only few data are available about feasibility and safety of the procedure in children. Therefore, taking 9 non-atopic healthy control children (mean age 11.8 years) and 34 asthmatic children (mean age 11.4 years), inhaling n = 25 Budesonid (400-1200 micrograms/die) and n = 9 DNCG (60 mg/die), sputum induction was performed twice within 6 weeks. Briefly, 10 minutes after inhalation of 200 micrograms salbutamol subjects inhaled hypertonic saline (3, 4 and 5%) for in all 30 minutes, while all 5 minutes lung function was checked and expectoration of sputum was supported. Adequate sputum plugs were separated from contaminating saliva and processed immediately employing native chamber and cytospin cell count as well as measurement of eosinophilic cationic protein (ECP). Sputum-induction could be performed in 84 out of 86 planed tests (97.7%) without any objective clinical adverse effects. The mean fall in FEV1 was 3.0%, the maximum 11.0%. The reproducibility of eosinophil, neutrophil and lymphocyte differential cell count (5-95%-values Test1: 0.0-4.2%, 0.8-11.4%, and 3.2-35.1%, respectively) was moderate for eosinophils and neutrophils (Intraclass-Correlation-Coefficient (ICC) 0.41) as well as for lymphocytes (ICC = 0.49). For ECP 5-95%-values Test1: 39.8-8000.0 micrograms/l) only a fair reproducibility (ICC = 0.24) was found. The ICC levels for total cell count (ICC = 0.31) and for weight of the sputum plug (ICC = 0.30) were also fair. Based on the procedure presented induced sputum is a feasible and safe method in childhood. The differential sputum cell count of eosinophils, neutrophils and lymphocytes can be recommended as parameters with moderate reproducibility.

Adolescent↗
PubMed2001

[Malformation of a bronchial artery with shunt into the pulmonary vascular bed - a rare cause of massive haemoptysis].

We present the case of an otherwise healthy 41-year-old woman, who was admitted after having expectorated bright red blood. While the chest roentgenogram was found to be normal, fiberoptic bronchoscopy revealed mild active bleeding originating from the apicoposterior segmental bronchus of the left upper lobe, which exacerbated during the examination. The bleeding was contained through blockade of the upper lobe bronchus by means of a double-lumen endotracheal tube. After the patient had been referred to our department, we performed a resection of the superior segmental group of the left upper lobe. The histopathological examination of the specimen revealed a malformation of the bronchial artery with an abnormal communication to a branch of the pulmonary artery. The malformation was located in close proximity to the apicoposterior segmental bronchus. Whereas arteriovenous malformations with a pulmonary artery branch as feeding vessel have been described in more than 500 cases and primarily affect patients with hereditary hemorrhagic teleangiectasia (HHT, Rendu-Osler-Weber disease), the 23 reported cases of malformations supplied by a branch of the bronchial artery show no evidence of heredity. Furthermore, clinical appearence and localisation show characteristical differences between arteriovenous malformations with pulmonary arterial supply and malformations arising from a bronchial arterial source. Therefore, it seems appropriate to make a clear-cut distinction between these two patterns of vascular malformation of the lung.

Adult↗
PubMed2003

Identification of bulb from Fritillaria cirrhosa by PCR with specific primers.

Bulb of Fritillaria cirrhosa is an important traditional Chinese herbal medicine. According to the Chinese Pharmacopoeia (1995), it is commonly used as an antitussive and expectorant. Many young bulbs from species of Fritillaria are similar to those of F. cirrhosa, but they are different in price and quality. Therefore, there are many young bulbs from species of Fritillaria that could fake those of F. cirrhosa on the commercial market. The coding region of 5S-rRNA is highly conserved in higher eukaryotes. The 5S-rRNA spacer region sequences of F. thunbergii, F. pallidiflora, F. ussuriensi, F. delavayi, F.cirrhosa, F. anhuiensis, F. puqiensis were cloned by PCR with a pair of primers located within the conserved coding region. Based on sequences analyses of the 5S-rRNA spacer region from the 7 species, a specific sequence was found in F. cirrhosa. A pair of specific primers was designed for differentiating the bulbs of F. cirrhosa from each other by PCR. This result indicated that the method is rapid, more accurate and applicable in identification of the bulbs of F. cirrhosa at the DNA level.

Base Sequence↗
PubMed2003

Effects of baicalein, berberine, curcumin and hesperidin on mucin release from airway goblet cells.

Baicalein, berberine, curcumin and hesperidin are the major components derived from Scutellaria baicalensis, Coptis japonica, Curcuma longa and Poncirus trifoliata, respectively. These plants have been used for the treatment of diverse chronic inflammatory diseases including respiratory disease in oriental medicine and their respective major components were reported to have various biological effects including anti-inflammatory activity. In the present study, we investigated whether these four natural products affect mucin release from airway goblet cells and compared the possible activities of these agents with the inhibitory action on mucin release by PLL and the stimulatory action by ATP. Confluent primary hamster tracheal surface epithelial (HTSE) cells were metabolically radiolabeled using 3H-glucosamine for 24 h and chased for 30 min in the presence of varying concentrations of each agent to assess the effects on 3H-mucin release. The results were as follows: (i) baicalein did not affect mucin release significantly; (ii) berberine, curcumin and hesperidin increased mucin release at the highest concentration (10 - 4 M); (iii) PLL inhibited and ATP increased mucin release. We conclude that berberine, curcumin and hesperidin can increase mucin release by directly acting on airway mucin-secreting cells and suggest that these agents be further studied for possible use as mild expectorants during the treatment of chronic airway diseases. Abbreviations. PLL:poly- L-lysine ATP:adenosine triphosphate HTSE:hamster tracheal surface epithelial DMSO:dimethylsulfoxide IL-12:interleukin-12 PBS:phosphate-buffered saline

Animals↗
PubMed2004

[Plastic bronchitis].

Bronchitis plastica is a rare disorder that can occur at any age. It is characterised by formation of large, branching bronchial casts, which are often expectorated, but may be discovered only by bronchoscopy. In most cases, bronchial casts are secondary to underlying diseases of the lung, heart or lymph vessels. We report a case of plastic bronchitis associated with bilateral chylothorax. Progressive respiratory failure could be controlled by repeated bronchoscopic extraction of casts and inhalation of 20,000 units of heparin twice a day. Inhalation of heparin should be considered, when treatment of the underlying disorders is not successful and the casts consist largely of fibrin. Histological examination of the casts may be useful for therapeutic decisions and can point additionally to an underlying disease.

Asthma↗
PubMed2004

[Unexpected cause of a tarsal destruction in a diabetic patient].

HISTORY: A 56-year-old male patient has suffered from increasing pain in the left foot which limited the ability of walking since 18 months. There was a soft and painful swelling below the left inner ankle. In addition the patient reported back pain, but no neurological symptoms. Insulin dependent diabetes type II was known for 20 years, and a diabetic foot syndrome was suspected. 6 months prior the patient consulted his physician because of repeated acute bronchitis with expectoration and no improvement following antibiotic therapy. INVESTIGATIONS: Osteolytic destruction of the left middle foot and the tarsal with soft tissue infiltration according to MR, a spondylodiscitis of the lumbar vertebra I and II (MR) and mixed interstitial/alveolar infiltrates throughout the lung with a predominance in both upper lobes were found. The microbiological examination of sputum and biopsy of inflamed soft tissue of the left ankle revealed infection with mycobacterium tuberculosis. DIAGNOSIS: Open lung tuberculosis with concomitant bone tuberculosis and tuberculous arthritis of the left middle foot and spondylodiscitis. THERAPY AND CLINICAL COURSE: The antibiotic therapy consisted of a combination of five antibiotic drugs for 2 weeks and of a four drug combination for further 3.5 months. After that there will be a consolidation therapy with a two drug regime for 6 months. An orthopaedist is also involved. Surgical procedures with respect to the left foot will not be considered as long as the antibiotic therapy has not been finished. CONCLUSION: A combination of symptoms resulting from inflammatory bone processes and pulmonary symptoms is always suspicious for a hematogenic dissemination of a pulmonary tuberculosis.

Diabetes Mellitus, Type 2↗
PubMed2005

[Diagnosis of haemoptoe/haemoptysis].

Haemoptysis and haemoptoe mainly differ in the amount of expectorated blood. Causes of haemoptysis are diverse and include bronchitis, bronchiectasis, carcinoma, tuberculosis and other infectious pulmonary disease. Haemoptysis almost exclusively involves bronchial arteries, rarely vessels of the pulmonary-artery circuit. Asphyxia rather than the loss of blood ist life-threatening. 20 - 30 % of bronchopulmonary bleeding happens without any identifiable cause, about 90 % of haemoptyses are self-terminating. Chest X-ray is an integral part in each evaluation, as is bronchoscopy. Fiberoptic bronchoscopy is easily performed, although rigid bronchoscopy considerably extends the armamentarium of diagnostic and therapeutic measures. (Pulmangio-) chest CT scan as well as echocardiography and angiographic procedures provide extended diagnostic and therapeutic options. Surgery may be required in severe bleeding complications or during stable disease as a diagnostic approach.

Bronchoscopy↗
PubMed2006

Salivary IgA response to intermittent and continuous exercise.

Current evidence would support a view that intense exercise increases whereas moderate exercise reduces the susceptibility to illness, predominately upper respiratory tract infections. Concentrations of IgA and cortisol in saliva may be used to reflect changes in immune function. The aim of this study was to determine if the type of exercise (soccer-specific intermittent or continuous exercise at the same average work-rate and duration) affects salivary IgA (s-IgA) and cortisol responses. In a randomized, counterbalanced design, eight healthy males completed two trials one week apart at the same time of day on a motorized treadmill. One session entailed soccer-specific intermittent exercise, the other involved continuous exercise at the same overall work-rate. Diet and activity were standardized for 48 hours prior to and following each trial. Unstimulated saliva samples were collected via passive expectoration during the week prior to commencement of exercise, before, at half-time, immediately post-exercise, and 6 hours, 24 hours, and 48 hours post-exercise. No significant difference was observed in heart rate between the two exercise conditions (Intermittent: 142 +/- 14; Continuous: 141 +/- 16 beats x min (-1)). Average rating of perceived exertion was higher (p < 0.05) in intermittent exercise (11.9 +/- 0.8) than during continuous exercise (10.8 +/- 1.2). The pattern of change in salivary responses, including solute secretion rate, IgA concentration, IgA secretion rate, IgA to osmolality ratio, cortisol, and cortisol secretion rate did not differ between the two trials (p > 0.05). Concentrations of s-IgA for the intermittent and continuous protocols were 131.6 +/- 61.2 vs. 146.4 +/- 107.6 before, 148.4 +/- 82.5 vs. 229.2 +/- 159.6 after, and 125 +/- 78.7 vs. 131.1 +/- 80.7 48 h post-exercise, respectively. Saliva flow rate decreased and osmolality increased significantly across all time points (p < 0.05). In conclusion, soccer-specific intermittent exercise did not suppress the salivary IgA response or alter cortisol secretion compared to continuous exercise performed at the same overall work-rate.

Adult↗
PubMed2006

Turban pin aspiration: non-asphyxiating tracheobronchial foreign body in young islamic women.

BACKGROUND: Foreign body aspiration is rare in adults. However, in recent years, the aspiration of pins which are used for securing turbans (headscarves) is seen frequently in young women. The aim of this article was to review 105 patients who were admitted to our hospital for turban pin aspiration. METHODS: Chest X-rays were used for diagnosis. Various methods of treatment were performed: laryngoscopy in 6 patients, flexible fiberoptic bronchoscopy in 16, rigid bronchoscopy in 93, and thoracotomy in one patient, while in the other patient the turban pin was spontaneously expectorated. RESULTS: Localization of the pin in the right bronchial system was common (52%). In 6 patients, turban pins located in the larynx were extracted successfully by direct laryngoscopy. Turban pins were successfully removed with a flexible fiberoptic bronchoscope in 4 patients of the 16 (25%) and by rigid bronchoscope in 93 patients of 94 (99%). The average time until discharge was 18 hours and there was no mortality. CONCLUSIONS: Turban pin aspiration is common in Islamic populations and treatment usually requires bronchoscopic procedures. In order to minimize turban pin aspiration frequency, we recommend that turbans should be secured by traditional fastening methods or with an apparatus which cannot be aspirated.

Adolescent↗
PubMed2006

Authentication of Pinellia ternata and its adulterants based on PCR with specific primers.

Tubers of Pinellia ternata are one of the well known traditional Chinese medicines. According to the Chinese Pharmacopoeia, the remedy is commonly used as an antitussive and expectorant. The shapes of young tubers from species of P. ternata are similar to those of P. pedatisecta and Arisaema heterophyllum, but different in medicinal properties. In order to provide molecular evidence for genuine origin identification of P. ternata species, the mannose-binding lectin sequences of P. ternata and its adulterants P. pedatisecta and A. heterophyllum were cloned using genomic walker technology. Based on the sequence analyses, we designed a pair of species-specific primers to authenticate P. ternata. For PCR-selective restriction (PCR-SR), we identified two distinctive sites which can be recognized by the restriction endonucleases BAMHI and NCOI in the open reading frame sequences of P. ternata, P. pedatisecta and A. heterophyllum. Our results indicate that the methods of PCR and PCR-SR are effective, accurate and applicable for identification of the bulbs of P. ternata.

Base Sequence↗
PubMed1989

[Conservative treatment of chronic sinusitis. Success of oral bacterial lysate therapy].

In a multicenter randomized double-blind study, 284 patients with chronic purulent sinusitis were treated with an oral immunostimulant or placebo in addition to standard therapy (antibiotics, mucolytics, inhalants). Treatment lasted for three ten-day periods in three consecutive months. At the start and during the therapy as well as after six months, symptoms were assessed on the basis of a scoring system and the X-rays of the nasal sinuses evaluated. During the course of therapy and the follow-up period, improvement of the major symptoms headache, purulent nasal discharge, cough, and expectoration was statistically significant in the immunostimulant group as compared with the placebo group, objective evidence being provided by the X-ray examinations and the number of reinfections during the period of observation.

Adjuvants, Immunologic↗
PubMed1990

Effect of topical cyclosporine rinse on oral lichen planus. A double-blind analysis.

BACKGROUND: Oral lichen planus is a relatively common disorder of the mouth that can be debilitating. It is frequently palliated with topical or systemic corticosteroids and retinoids. These treatments require prolonged use, however, and are not always effective. METHODS: In a double-blind trial, 16 patients with symptomatic oral lichen planus were randomly assigned to receive either topical cyclosporine or its vehicle. The patients swished and expectorated 5 ml of medication (containing 100 mg of cyclosporine per milliliter) three times daily. RESULTS: After eight weeks, the eight recipients of cyclosporine had marked improvement in erythema (P = 0.003), erosion (P = 0.02), reticulation (presence of white lacelike lesions; P = 0.007), and pain (P = 0.002), whereas the eight recipients of vehicle had no change or minimal improvement. After a switch to cyclosporine for eight weeks, the vehicle-treated patients had improvement similar to that seen in the patients who initially received cyclosporine. There were no systemic side effects. In most cases blood cyclosporine levels were low or undertectable. Cyclosporine levels present in specimens of oral mucosa at the end of therapy four hours after the patients swished were similar to the levels previously reported in psoriatic lesions after treatment with systemic cyclosporine (14 mg per kilogram of body weight per day). CONCLUSIONS: As a topical preparation, cyclosporine may be useful in the treatment of oral lichen planus and possibly other cutaneous disorders.

Aged↗
PubMed1999

Intermittent administration of inhaled tobramycin in patients with cystic fibrosis. Cystic Fibrosis Inhaled Tobramycin Study Group.

BACKGROUND AND METHODS: We conducted two multicenter, double-blind, placebo-controlled trials of intermittent administration of inhaled tobramycin in patients with cystic fibrosis and Pseudomonas aeruginosa infection. A total of 520 patients (mean age, 21 years) were randomly assigned to receive either 300 mg of inhaled tobramycin or placebo twice daily for four weeks, followed by four weeks with no study drug. Patients received treatment or placebo in three on-off cycles for a total of 24 weeks. The end points included pulmonary function, the density of P. aeruginosa in sputum, and hospitalization. RESULTS: The patients treated with inhaled tobramycin had an average increase in forced expiratory volume in one second (FEV1) of 10 percent at week 20 as compared with week 0, whereas the patients receiving placebo had a 2 percent decline in FEV1 (P<0.001). In the tobramycin group, the density of P. aeruginosa decreased by an average of 0.8 log10 colony-forming units (CFU) per gram of expectorated sputum from week 0 to week 20, as compared with an increase of 0.3 log10 CFU per gram in the placebo group (P<0.001). The patients in the tobramycin group were 26 percent (95 percent confidence interval, 2 to 43 percent) less likely to be hospitalized than those in the placebo group. Inhaled tobramycin was not associated with detectable ototoxic or nephrotoxic effects or with accumulation of the drug in serum. The proportion of patients with P. aeruginosa isolates for which the minimal inhibitory concentration of tobramycin was 8 microg per milliliter or higher increased from 25 percent at week 0 to 32 percent at week 24 in the tobramycin group, as compared with a decrease from 20 percent at week 0 to 17 percent at week 24 in the placebo group. CONCLUSIONS: In a 24-week study of patients with cystic fibrosis, intermittent administration of inhaled tobramycin was well tolerated and improved pulmonary function, decreased the density of P. aeruginosa in sputum, and decreased the risk of hospitalization.

Administration, Inhalation↗
PubMed2002

Argon beam coagulation for post-tonsillectomy hemostasis.

OBJECTIVE: The study goal was to evaluate the effectiveness of argon beam coagulation (ABC) in the prevention of post-tonsillectomy hemorrhage. ABC provides monopolar coagulation by arcing ionized argon gas to the target tissue; it is not a laser. METHODS: Two consecutive studies were performed as follows. In the first, a retrospective analysis of post-tonsillectomy bleeding in 344 patients was conducted. Final tonsil fossa hemostasis was achieved with ABC (257 patients) or with electrocoagulation (EC) (87 patients). In the second, a prospective, randomized, patient-blind study of post-tonsillectomy bleeding was conducted in 88 patients. Final hemostasis was achieved using ABC in one fossa and EC in the other fossa, with the sides chosen at random. RESULTS: Post-tonsillectomy hemorrhage was defined as the expectoration of fresh blood, as opposed to blood-streaked saliva. The rates of bleeding for the 2 studies were as follows. In study 1 for EC, 20% for adults, 6.5% for children, and 10.3% for total; for ABC, 4.7% for adults, 0.6% for children, and 1.9% for total. In study 2 for EC, 19.2% for adults, 1.6% for children, and 6.8% for total; for ABC, 7.7% for adults, 0.0% for children, and 1.1% for total. The rates of hospital admission for observation or reoperation to treat the bleeding in study 1 for EC were 8% for adults, 6.5% for children, and 6.9% for total; for ABC, 1.2% for adults, 0.6% for children, and 0.7% for total. Corresponding rates for study 2 for EC were 15.4% for adults, 1.6% for children, and 5.7% for total; for ABC, 3.8% for adults, 0.0% for children, and 1.1% for total. CONCLUSION: ABC is more effective than EC for hemostasis after tonsillectomy. The costs of ABC use vs the savings achieved from reduced bleeding are discussed.

Adolescent↗