Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “COUGH”

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 973 records · Page 54Linked to original sources
PubMed1990

A portable system for the spectral analysis of cough sounds in asthma.

A practical and portable method is described to analyze the sound spectra of coughs. The system is based upon a personal computer and simultaneously collects the sounds of cough heard both at the mouth and through the chest wall together with the airflow at the mouth produced during the cough. Subsequent analysis produce spectrographs of the cough sound linked to the corresponding airflow. The system will be used initially to examine the effects of exercise on the sound of cough in asthma. Further study of cough spectra in this way may be useful in the management of asthma either diagnostically or in the assessment of therapeutic interventions.

Asthma↗
PubMed1996

Chronic persistent cough: diagnosis and treatment update.

The approach to patients with chronic cough has been well defined and evaluated in the literature through a number of prospective studies. Meticulous attention to detail of the afferent loop of the cough reflex has helped identify the cause of cough in most patients. The most common causes appear to be similar in both children and adults and include asthma, postnasal drip syndromes, gastroesophageal reflux diseases, and aspiration. In children, recurrent viral infections and infections with atypical organisms also are very prevalent. Specific therapy directed at the cause alleviates the cough in most patients. In some patients, there may be more than one cause of cough. Invasive testing (eg, bronchoscopy and esophageal pH probing) is rarely necessary. In patients in whom a specific cause cannot be identified or in whom cough modifiers are necessary while specific therapy is taking hold, antitussives of both the narcotic and nonnarcotic variety are helpful.

Adult↗
PubMed2006

Safety and usage pattern of an over-the-counter ambroxol cough syrup: a community pharmacy-based cohort study.

INTRODUCTION: Mucoactive substances such as ambroxol, available in several countries as over-the-counter (OTC) medicines, are used for the treatment of acute and chronic bronchitis. OBJECTIVE: This study was designed to evaluate the "real life" behavior of consumers with non-prescription access to an ambroxol cough syrup with special focus on tolerability and the pattern of product usage. METHODS: Customers who bought the ambroxol syrup were recruited in 300 community pharmacies in Germany. Baseline data were collected from the participants in the pharmacy. Completing a self-administered questionnaire, participants provided information on tolerability, self-perceived effectiveness and usage pattern. RESULTS: 2,707 participants were recruited in 266 pharmacies. 2,664 questionnaires were evaluable. At baseline, the respondents reported a complex pattern of symptoms. Productive cough, congested airways, dry cough, cough irritation in the throat and soreness in the throat were the most common ones. 67 patients (2.5%) reported a total of 81 adverse events (AE) which were usually mild in nature and mostly affecting the gastrointestinal tract (n = 53) followed by skin and subcutaneous tissue disorders (n = 9). No serious or unknown AE were reported. In general, 97% of the participants assessed the safety as "very good" (51%) or "good" (46%). Overall, the respondents complied with the indications for use and the recommended dosages, with only 0.7% of the participants using the maximum daily dose. 92% of the patients assessed the self-perceived effectiveness as "very good" (29%) or "good" (63%) and 89% were willing to purchase this ambroxol cough syrup again. CONCLUSIONS: This study confirms that ambroxol is used according to the advice given in the patients' leaflet and supports the already established safety and efficacy of this product in acute bronchitis. It also demonstrates that the use of an OTC cough medication can be successfully monitored in a pharmacy-based cohort study.

Adolescent↗
PubMed2000

Cough in children.

Cough is a common presenting problem in children. A persistent moist or productive cough is always abnormal. The history, examination, chest x-ray and spirometry usually provide clues to specific causes of cough. Non-specific cough, defined as a non-productive or dry cough in the absence of identifiable respiratory disease, is poorly understood. We briefly discuss major controversies in non-specific cough and its management in children.

Child↗
PubMed1987

Cough and wheezing from beclomethasone dipropionate aerosol are absent after triamcinolone acetonide.

STUDY OBJECTIVE: To test the hypothesis that patients with asthma who develop cough and wheezing after the use of beclomethasone aerosol would have a better tolerance for triamcinolone aerosol. DESIGN: Randomized, double-blinded, crossover trial. SETTING: Pulmonary function laboratory. PATIENTS: Volunteer sample of 24 patients attending an asthma clinic who had developed cough, with or without wheezing, after inhaling beclomethasone aerosol. All patients completed the study. INTERVENTIONS: Aerosols were used in habitual manufacturers' preparations and canisters, but both were administered in three puffs through the delivery system used for triamcinolone. The preparations differed in drug (beclomethasone dipropionate or triamcinolone acetonide), propellant (trichloromonofluoromethane and dichlorodifluoromethane, or dichlorodifluoromethane alone, respectively) and dispersant (oleic acid or dehydrated alcohol, respectively). PATIENTS inhaled three puffs of one aerosol on one day and three of the other on the next. MEASUREMENTS AND MAIN RESULTS: Forced expiratory volume in one second (FEV1) was measured before and after each aerosol application. The FEV1 decreased a mean of 17.7% from baseline after inhalation of beclomethasone, and 0.8% after triamcinolone (difference, 16.9; 95% confidence limits, 12.36 to 21.34; p less than 0.001). Coughs were counted after each puff. The mean number of coughs after beclomethasone aerosol inhalation was 35.8, and after triamcinolone, 0.5 (difference, 35.3; 95% confidence limits, 22.62 to 47.98, p less than 0.001). CONCLUSIONS: Asthmatic patients who are unable to inhale beclomethasone aerosol due to cough or wheezing can inhale triamcinolone aerosol without difficulty. Our investigation does not determine the exact cause of the coughing and wheezing with the beclomethasone aerosol, but we suspect the dispersant as the source.

Adult↗
PubMed1999

[The diagnostic role of the methacholine inhalation challenge in adult patients with chronic persistent cough].

Chronic persistent cough (CPC) is a common medical problem. We determined the value of the methacholine inhalation challenge (MIC) in the evaluation of CPC. We also sought other clinical factors that affect MIC. Patients were selected for the study if 1) CPC was the only presenting symptom, 2) a current roentgenogram did not contribute to the diagnosis, and 3) spirometry revealed a normal FEV1. We measured the minimum dose of methacholine (bronchial sensitivity, Dmin) by the "Asthograph" method. We determined the correlation between log Dmin and demographic and clinical variables, i.e. age, %FVC, %FEV1, FEV1%, %V50, %V25, eosinophil count in peripheral blood, and serum IgE level. The causes of CPC in 51 patients (20 men and 31 women, mean age 41 years) were cough-variant asthma in 29 patients, postinfectious persistent cough in 13 patients, atopic cough in 6 patients, and others in 3 patients. Log Dmin significantly but weakly correlated with %V25 (4 = 0.31, p = 0.02). The sensitivity and specificity of Dmin (< 10 units) in diagnosing cough-variant asthma was 93% and 87%, respectively. Demographic or clinical variables other than Dmin were not useful for the diagnosis of cough-variant asthma. We conclude that MIC is useful for the differential diagnosis of CPC while the usefulness is limited in some cases.

Adult↗
PubMed2000

[Physiology of cough].

Cough is a reflex phenomenon occurring when sensitive receptors located in the larynx and upper airways are activated. These receptors generate information which reaches the central nervous system. The central organization of the cough reflex loop is poorly understood. The afferent pathways originate in receptors situated under and between airway epithelial cells. Most are rapidly adapting receptors (RAR) linked to myelinized fibers of the vagus nerve which can be directly stimulated by cough-inducing agents. Other receptors generate information carried by non-myelinized C fibers. When activated, these receptors release neuropeptides leading to neurogenic inflammation which can also activate RARs. The threshold of the cough reflex and its expression thus depends on a complex interaction between RARs and C fiber receptors with peripheral and central components. A better understanding of the mechanisms triggering cough and its control would be most useful for optimal management of patients with cough problems.

Animals↗
PubMed2002

[Coughing. Pathognomic significance and therapeutic options].

A wide range of disease processes may present with cough and definitive treatment depends on making an accurate diagnosis of the cause. Acute or short-lived cough, which most commonly occurs in association with viral upper respiratory tract infection, is of a little consequence, usually resolving in a matter of days. The most common chronic causes of cough are post-nasal drip, asthma, gastro-esophageal reflux and chronic bronchitis. The different conditions that cause cough have in common the fact that are mediated by the vagus nerves, with sensory receptors in and under the epithelium from the larynx to the smaller bronchii. The receptors are polymodal, responding to a large variety of stimuli, including mechanical and chemical irritants, inflammatory mediators, intraluminal material and large volume changes of the lung. Intensive treatment of underlying cause usually leads to improvement or resolution of cough. However, in a minority of patients, no underlying cause is identified despite appropriate investigation: in these subjects or when cough interferes with patient's health or sleep is indicated a non specific treatment with antitussive therapy.

Acute Disease↗
PubMed2002

The natural history of acute cough in children aged 0 to 4 years in primary care: a systematic review.

Professional and parental uncertainty regarding the natural history of cough and respiratory tract infection (R77) in pre-school children may in part be responsible for the high consultation, reconsultation, and antibiotic prescribing rates in this age group. The aim of the study was to review the evidence about the natural history of acute cough in children aged between 0 and 4 years presenting to primary care in terms of illness duration and complications. The study was a systematic review, with qualitative and quantitative data synthesis, of control and placebo arms of systematic reviews, randomised controlled trials (RCTs), and cohort studies set in primary care. Searches were done of MEDLINE (between 1966 and June 1998), EMBASE (between 1988 and September 1998), and the Cochrane Library databases, using the MeSH terms 'respiratory tract infection, 'cough, and 'bronchitis, and the textwords 'cough' 'bronchitis, and 'chest infection, limited to children aged between 0 and 4years, and English language articles. Eight RCTs and two cohort studies met the review criteria. At one week, 75% of children may have improved but 50% may be still coughing and/or have a nasal discharge. At two weeks up to 24% of children may be no better. Within two weeks of presentation, 12% of children may experience one or more complication, such as rash, painful ears, diarrhoea, vomiting, or progression to bronchitis/pneumonia. This review offers parents and clinicians more prognostic information about acute cough in pre-school children. Illness duration may be longer and complications higher than many parents and clinicians expect. This may help to set more realistic expectations of the illness and help parents to decide when and if to reconsult. This information may be useful to those designing patient information and self-help resources.

Acute Disease↗
PubMed2002

[Unrecognized causes of chronic cough].

Chronic cough is defined as persistence of the symptom for longer than one month. It is a common reason for consultation. A systematic diagnostic approach based on the history, clinical examination and a number of investigations (chest x-ray, lung function tests, oesophageal pH monitoring and sinus x-rays) reveals the cause in most cases. The main aetiologies are post-nasal drip, gastro-oesophageal reflex, asthma, chronic bronchitis, and the use of angiotensin converting enzyme inhibitors. Nevertheless, in some cases, the cause is not found. In this situation it is necessary to search for less common pathologies where cough is just a symptom of systemic disease, such as connective tissue disorder (Sjogren's syndrome, atrophic polychondritis), vasculitis (Wegener's granulomatosis), Horton's syndrome (cluster headaches), amyloidosis and inflammatory bowel disease. It may also be a matter of local pathology of the tracheo-bronchial tree, such as tracheo-bronchomegaly, tracheopathia osteoplastica, rare or unrecognized infections (whooping cough, post-viral cough, bronchial tuberculosis), reactive bronchial dysfunction, eosinophilic bronchitis or radiologically occult bronchial carcinoma. Il is also necessary to consider vocal cord dysfunction and cough due to medication before accepting a diagnosis of psychogenic cough.

Bronchial Diseases↗
PubMed2002

Duration of cough in acute upper respiratory tract infections.

OBJECTIVE: To determine the duration of cough in patients without pre-existing respiratory problems presenting to general practitioners with acute upper respiratory tract infections (URTIs). METHOD: Patients without chronic chest problems who presented to two general practices with an URTI during the winter of 1999 were surveyed to assess the duration of cough. RESULTS: One hundred and seventy-nine patients were recruited, of whom 131 could be followed until their cough ceased. Of these, 93% developed a cough, 78% coughed for at least one week, 58% for at least two weeks, 35% for three weeks, and one continued into the tenth week. CONCLUSION: The acute cough associated with an URTI often continues for several weeks. There may be benefits from educating the community and medical profession about this natural history.

Adolescent↗
PubMed2003

[Clinical analysis of gastroesophageal reflux induced cough].

OBJECTIVE: To investigate the clinical features, diagnosis and management of gastroesophageal reflux induced cough (GERC). METHODS: The continuous ambulatory esophageal pH measurement was performed for 24 hour in 41 cases with chronic cough who had normal chest roentgenographic presentation, negative histamine provocation test and no abnormality of nasal cavity. The symptom association probability (SAP) was adopted to analyze the correlation of cough with gastroesophageal reflux. The anti-reflux treatment was given for 12 weeks to those patients with Demeester score >or= 14.72 and/or SAP >or= 75%. RESULTS: Twenty six out of 41 cases were diagnosed as patients with gastroesophageal reflux. The cough was completely cured in 12 cases after antireflux treatment. The SAP of cough in this cured group (proximal probe 0.75 +/- 0.21, distal probe 0.91 +/- 0.12, respectively) was significantly higher than that of patients who failed in response to antireflux treatment (proximal probe 0.36 +/- 0.31, distal probe 0.47 +/- 0.30, respectively, P < 0.05). CONCLUSION: The gastroesophageal reflux may be an independent factor which could induce chronic cough. Not only the frequency and severity of gastroesophageal reflux but also the SAP were helpful in making the diagnosis of GERC. Satisfied effect was achieved after sufficient anti-reflux treatment in patients with GERC.

Adult↗
PubMed1992

[Cough during treatment with angiotensin-converting enzyme inhibitors is gender related].

In a Norwegian, double-blind, double-dummy multicenter study, 828 patients with mild to moderate hypertension were randomized to treatment by either lisinopril or nifedipine. One of the aims of the study was to specifically investigate the frequency of side effects. Spontaneously reported coughing reached 8.5% for lisinopril, as against 3.1% for nifedipine. In two patients coughing led to withdrawal from the study, and in another three it contributed partially to discontinuation of the treatment. A significant sex difference was found for spontaneously reported coughing among patients on lisinopril; 12.6% of the women and 4.4% of the men. A similar difference between the sexes was found for specific questioning about coughing. Use of a visual analogue scale by both patient and spouse revealed similar frequency of coughing as when reported spontaneously. The reason for sex being an important determinant for lisinopril-induced coughing remains obscure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1992

Airway responsiveness and cough induced by angiotensin converting enzyme inhibition.

Dry cough is one of the most common side-effects of angiotensin converting enzyme inhibitors. The mechanism of cough induced by ACE inhibitors is not completely understood and may be related to bronchial hyperreactivity and/or an accumulation of kinins. In a placebo-controlled, double-blind randomised study, the effect of captopril on lung function and bronchial reactivity to histamine and bradykinin was investigated in eight asthmatic and 12 hypertensive patients (six with and six without cough during previous ACE inhibition). Lung function did not change in any patient after a single (25 mg) or short-term (2 x 25 mg for two weeks) administration of captopril. Bronchial reactivity to histamine and bradykinin remained unaltered in all groups. In hypertensive patients with cough, reactivity to histamine tended to be more pronounced and bronchial hyperreactivity to be more frequent than in those without cough. In conclusion, the present results do not support a major role for kinins in cough induced by ACE inhibition. On the other hand, bronchial hyperreactivity may be important in some patients. Additionally, these results demonstrate that treatment with ACE inhibitors is safe in most patients with bronchial asthma.

Adult↗
PubMedDate not supplied

[Characteristics of bronchial inflammation in children with chronic non-productive cough].

The aim of study was to correlate the bronchoalveolar lavage (BAL) cell subpopulations in light microscopy and clinical-functional parameters in 20 children with chronic nonproductive cough (potentially evolving to asthma) in comparison with 20 children with mild and moderate stable asthma. The results revealed a different BAL cell profile of chronic coughing children, characterized by a lower percent of total cells (0.279 +/- 0.055 x 10(6)/ml), eosinophils (0.97 +/- 0.80%), lymphocytes (6.02 +/- 0.85%) and epithelial cells (28.52 +/- 5.15%) and higher percent of macrophages (46.05 +/- 7.94%) and neutrophils (18.27 +/- 4.93%). Eosinophilic inflammation in BAL and bronchial hyper-responsiveness (PC20 methacholine = 1.73 +/- 0.15 mg/ml) were revealed in three cases with chronic cough. Based on these reasons, they were included in "cough variant asthma". In conclusion, children with nonproductive chronic cough represent a heterogenous group, with different underlying causes. Only a minority of these patients has "cough variant asthma", with a favorable response to inhaled corticotherapy.

Asthma↗
PubMed1992

Adaptation of cough reflex with different types of stimulation.

Inhalation cough challenge has become an accepted method of investigating antitussive agents. It is, therefore, important to examine the degree of tachyphylaxis seen with repeated cough challenge. In addition, different types of challenge may reveal important differences in the neuronal pathways involved in the cough reflex. Citric acid, distilled water and capsaicin were examined to determine adaptation of the cough response during acute and long-term inhalation studies in healthy subjects. To study acute tachyphylaxis two separate one minute continuous inhalation challenges (n = 13) were performed. Long-term tachyphylaxis (n = 10) was examined using citric acid and capsaicin inhalation at 10 min intervals for 40 min, and at 4 and 6 h. Cross-tachyphylaxis to citric acid and capsaicin was examined in a separate randomized crossover study (n = 10). Highly significant adaptation occurred between the first and last 10 s of the one minute challenge with citric acid (90-100%) and distilled water (74-84%), but was less pronounced with capsaicin (37-49%, at 2 microM). Cough during the whole of the second test was significantly reduced for citric acid (50%). During long-term challenge cough was attenuated over 40 min both with citric acid (100 mM, p less than 0.05; 300 mM, p less than 0.001; 1 M, p less than 0.001) and with capsaicin (3 microM, p less than 0.01; 10, 30, 100 microM, p less than 0.001 each). With higher doses, tachyphylaxis was still present at 180 min with both citric acid (300 mM, p less than 0.05) and capsaicin (100 microM, p less than 0.008).(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed2004

[Summary of the practice guideline 'Acute cough' from the Dutch College of General Practitioners].

In most cases acute cough has an infectious, often viral, cause. When the coughing lasts longer than 3 weeks, the diagnosis has to be reconsidered. The effectiveness of cough medicines has not been proven. For the management of acute cough it is important to distinguish between non-serious and serious lower respiratory tract infections. A serious lower respiratory tract infection is: a lower respiratory tract infection with a higher risk of a complicated course: when pneumonia is suspected, in infants and the elderly, and in patients with relevant co-morbidity. The prescription of antibiotics for acute cough is not useful in the majority of the patients; antimicrobial therapy can be indicated, but only in the case of lower respiratory tract infections with a higher risk of a complicated course. Specific management has to be considered in the case of: whooping cough, bronchiolitis and croup. In the case of pneumonia, antimicrobial therapy is indicated; follow-up is necessary. In the case of moderate to severe croup, a single dose of corticosteroids is recommended.

Acute Disease↗
PubMed2004

A coughing child: could it be asthma?

BACKGROUND: A child presenting with cough is common in general practice. Usually the cough is due to an upper respiratory tract infection, however, parents are often concerned that the cough may be asthma. OBJECTIVE: This article focusses on identifying various causes of persistent cough, especially asthma. DISCUSSION: Significant causes of an acute cough need to be considered such as inhaled foreign bodies, aspiration, infections such as pertussis and pneumonia, and asthma. Clinical history, followed by physical examination and consideration of special investigations will guide the diagnosis. Cough as the sole symptom of asthma is unusual. There is usually associated wheeze and shortness of breath. A family or personal history of atopic symptoms lend weight to the possibility of asthma. In children with asthma, physical examination and even spirometry may be normal between episodes. In some cases where asthma is suspected, a trial of bronchodilation with formal assessment of response may be appropriate.

Asthma↗