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22761. Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity. Full Text available with Trip Pro

Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity. In vitro studies have suggested that both the viscoelastic properties of lung secretions and the peak flow attained during simulated cough influence clearance. This study examines the possible association of the viscoelastic properties of sputum and maximum expiratory flow with measured effectiveness of mucus clearance induced by instructed cough and by forced expiration technique (...) (FET) in patients with airways obstruction.Nineteen patients (11 men and eight women) of mean (SE) age, % predicted FEV1, and daily sputum wet weight of 64 (2) years, 52 (6)%, and 37.5 (7.9) g respectively participated in the study. Mucus movement from proximal and peripheral lung regions was measured by an objective non-invasive radioaerosol technique. Each patient underwent three assessments: control, cough, and FET. During cough and FET, maximum expiratory flow was measured at the mouth level

1994 Thorax Controlled trial quality: uncertain

22762. Children with persistent cough--outcome with treatment and role of Moraxella catarrhalis? (Abstract)

Children with persistent cough--outcome with treatment and role of Moraxella catarrhalis? 52 children with severe cough persisting for more than 10 days were randomized to treatment with amoxycillin/clavulanic acid or placebo in a prospective double-blinded study. Clinically suspected cases of pertussis were excluded, yet 12 (23%) of the children had laboratory verified pertussis infection. The nasopharyngeal colonization showed a predominance of Moraxella catarrhalis which was isolated in 37 (...) (71%) children. Streptococcus pneumoniae and Haemophilus influenzae were isolated in 11 (20%) and 16 (30%) children, respectively. The antibiotic-treated group had a significantly better recovery in both the pediatrician's estimation (p = 0.02) and the independent parental judgement (p = 0.002). These findings are consistent with the view that Moraxella catarrhalis could be directly involved in the pathogenesis of persistent cough in children.

1994 Scandinavian journal of infectious diseases Controlled trial quality: uncertain

22763. Efficacy of breathing and coughing exercises in the prevention of pulmonary complications after coronary artery surgery. (Abstract)

Efficacy of breathing and coughing exercises in the prevention of pulmonary complications after coronary artery surgery. One hundred twenty patients undergoing coronary artery surgery completed a randomized controlled study designed to investigate whether prophylactic chest physiotherapy affected the incidence of postoperative pulmonary complications. Group 1 patients received no preoperative or postoperative chest physiotherapy. Group 2 patients received preoperative education and instruction (...) in breathing and coughing exercises and postoperative supervision and assistance in performing the same. These exercises were supervised by a physiotherapist twice per day on the first 2 postoperative days and once per day on the 3rd and 4th postoperative days. Physiotherapy for group 3 patients was the same as for group 2 patients except that patients were seen by a physiotherapist 4 times per day on the first 2 postoperative days and twice per day on the 3rd and 4th postoperative days. Group 2 and 3

1994 Chest Controlled trial quality: uncertain

22764. A randomized controlled trial of oral albuterol in acute cough. (Abstract)

A randomized controlled trial of oral albuterol in acute cough. Beta-agonist agents have been used for bronchospasm and cough in a variety of settings. We sought to evaluate the efficacy of oral albuterol for acute cough in ambulatory adults.We performed a prospective, randomized, controlled, double-blind clinical trial comparing albuterol 4 mg by mouth three times daily for 7 days with placebo in 104 adults. Subjects had cough of less than 4 weeks' duration and no evidence of pneumonia, asthma (...) , or chronic obstructive pulmonary disease. All subjects were enrolled at the walk-in clinic of a rural academic medical center.There was no significant difference between treated and control subjects in any measure of efficacy including cough severity score, reduction in sleepless nights, utilization of health care, or return to full activity. There were significantly more reports of "shakiness" and "nervousness" among albuterol-treated subjects than among controls.Oral albuterol should not be used

1996 Journal of Family Practice Controlled trial quality: predicted high

22765. Inhaled sodium cromoglycate to treat cough in advanced lung cancer patients. Full Text available with Trip Pro

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

1996 British journal of cancer Controlled trial quality: uncertain

22766. Capsaicin cough sensitivity increases during upper respiratory infection. (Abstract)

Capsaicin cough sensitivity increases during upper respiratory infection. The mechanism of cough associated with upper respiratory infection (URI) is poorly understood. This paper reports a study of the role of altered sensitivity of capsaicin-sensitive airway nerves. In a prospective study, baseline (B) capsaicin-induced cough and methacholine-induced airway responsiveness were measured in 103 healthy volunteers. During the following year, 31 subjects reattended for challenge testing during (...) URI (I) and after recovery (R). The log concentration of capsaicin required to elicit two coughs (C2) was significantly lower during infection than recovery but not baseline [median (interquartile range) B = 0.59 (0.28-1.20), I = 0.27 (0-0.89), R = 0.89 (0.28-1.49)]. Log C5 (concentration causing five coughs) was lower during infection than baseline and recovery [B = 1.79 (1.20-2.70), I = 1.49 (0.89-2.08), R = 1.79 (1.20-2.40)]. FEV1 and PC15 methacholine values were unchanged during infection

1996 Respiratory medicine Controlled trial quality: uncertain

22767. [Clinical and experimental studies of zhenkeling oral liquor on treatment infantile cough]. (Abstract)

[Clinical and experimental studies of zhenkeling oral liquor on treatment infantile cough]. One hundred and seventy children with cough were divied into two groups at random. 120 patient were treated with Zhenkeling oral liquor (ZKL group). The other 50 children were given pectoral syrup (control group). The results showed that the total effective rates of ZKL group and control group were 96.7% and 56.0% respectively, and the markedly effective rates were 80.8%, 18.0% respectively (P < 0.001 (...) ). Animal experiments indicated Zhenkeling has the effect of relieving cough, reducing sputum and ameliorating asthma; their antibiotic and anti-inflammatory effects were discovered too. The dosage of Zhenkeling was 100 times as clinical dose in acute toxicity test and the dosage was 32, 16, 8 times as clinical dose in long term toxicity test respectively. No adverse action was found in these experiments.

1996 Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine / Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban Controlled trial quality: uncertain

22768. Terbutaline inhalation suppresses fentanyl-induced coughing. (Abstract)

Terbutaline inhalation suppresses fentanyl-induced coughing. To study the suppressive effect of inhalation of a selective beta 2-adrenergic bronchodilator terbutaline, and the effect of an intravenous anticholinergic, atropine, on fentanyl-induced coughing.We studied 131 ASA class I patients, aged 16-45 yr, scheduled for elective surgery, randomized into four groups. Fifteen minutes before bolus fentanyl (5 micrograms.kg-1, iv), patients inhaled either normal saline (4 ml; Group I, n = 30 (...) ) or terbutaline (5 mg in 2 ml normal saline; Group 2, n = 34) via a jet nebulizer. After inhalation of normal saline, patients in Group 3 (n = 32) received sterile water iv instead of fentanyl. Patients in Group 4 (n = 35) were pretreated with atropine (0.01 mg.kg-1, iv) 10 min before iv fentanyl bolus. The onset, frequency and intensity of cough were observed immediately by an anaesthetist blinded to the study.The cough frequency was higher in Groups I (43%) and 4 (46%) than in Groups 2 (3%) and 3 (0%) (P

1996 Canadian journal of anaesthesia = Journal canadien d'anesthesie Controlled trial quality: uncertain

22769. Valsartan, a new angiotensin II receptor antagonist: a double-blind study comparing the incidence of cough with lisinopril and hydrochlorothiazide. (Abstract)

Valsartan, a new angiotensin II receptor antagonist: a double-blind study comparing the incidence of cough with lisinopril and hydrochlorothiazide. The present study compares the occurrence of a dry, persistent cough with doses of 80 mg of valsartan, 10 mg of lisinopril, or 25 mg of hydrochlorothiazide in patients with a history of angiotensin-converting enzyme inhibitor-induced cough. This was a randomized, double-blind, active-controlled, parallel group, multicenter trial involving 129 adult (...) outpatients with essential hypertension. After confirmation of angiotensin-converting enzyme inhibitor-induced cough during a 2 to 4 week challenge with lisinopril (followed by a washout period of 2 weeks), patients were randomized to receive 6 weeks of double-blind treatment once daily with 80 mg valsartan, 10 mg lisinopril, or 25 mg hydrochlorothiazide. Assessments were made at baseline and after 3 and 6 weeks of treatment. Comparability of response to treatment was assessed by mean sitting diastolic

1997 Journal of clinical pharmacology Controlled trial quality: uncertain

22770. Efficacy and tolerability of levodropropizine in adult patients with non-productive cough. Comparison with dextromethorphan. (Abstract)

Efficacy and tolerability of levodropropizine in adult patients with non-productive cough. Comparison with dextromethorphan. The results of a double-blind, randomized clinical trial involving 209 adult patients of either sex with moderate non-productive cough are reported. The therapeutic efficacy and the tolerability of levodropropizine syrup (60 mg t.i.d. for 5 days) was evaluated in comparison with dextromethorphan syrup (15 mg t.i.d. for 5 days). Efficacy was assessed by the number (...) of coughing spells in a 6h period, the cough frequency classes, the cough intensity and the night awakenings due to cough. Tolerability was evaluated by laboratory results, vital signs and any adverse event occurred during the clinical trial, including presence or absence of somnolence. Independently from the underlying pathology and from the degree of baseline cough severity, the number of coughing spells was significantly (P < 0.05) reduced by both levodropropizine and dextromethorphan already after

1997 Pulmonary Pharmacology & Therapeutics Controlled trial quality: uncertain

22771. Double-blind comparison of losartan, lisinopril, and metolazone in elderly hypertensive patients with previous angiotensin-converting enzyme inhibitor-induced cough. (Abstract)

Double-blind comparison of losartan, lisinopril, and metolazone in elderly hypertensive patients with previous angiotensin-converting enzyme inhibitor-induced cough. This study compared the incidence of cough with the angiotensin-converting enzyme (ACE) inhibitor lisinopril and the diuretic metolazone with angiotensin II receptor antagonist losartan in elderly hypertensive patients with previous histories of ACE inhibitor-induced cough. A randomized, double-blind, stratified, parallel-group (...) comparison of lisinopril at 10 mg, losartan at 50 mg, and metolazone at 1 mg, each given once daily for a maximum of 10 weeks, was performed in four hypertension clinics in four centers in two countries. Cough was detected by a questionnaire (the primary end point) given to elderly patients with hypertension, and the cough frequency was quantified by a visual analog scale (a secondary end point). A total of 84 elderly patients with hypertension, all who were nonsmokers with ACe inhibitor-induced cough

1997 Journal of clinical pharmacology Controlled trial quality: uncertain

22772. Sensitivity of the cough reflex in young and elderly subjects. (Abstract)

Sensitivity of the cough reflex in young and elderly subjects. To compare the sensitivity of the cough reflex--which is said to be normal in elderly people--in elderly and young subjects.20 elderly (14 female) subjects, mean (SEM) age 83 (1) years and 20 young (nine female) subjects, mean (SEM) age 27 (1) years, who were all non-smokers. None of the subjects was taking antitussive drugs and none suffered from clinically evident lung, cardiac or neurological disease. Five elderly subjects were (...) unable to perform adequate spirometry and were excluded from analysis.Each subject inhaled 10 ml of nebulized distilled water and isotonic saline (as placebo) for 30 s, 10 min apart in a randomized double-blind crossover fashion. The cough frequency induced with each treatment was recorded on a click counter.Cough frequency on inhaling distilled water was significantly lower in the elderly group than in the younger group, with a difference of 9.53 (95% confidence intervals: 3.63, 15.4; P < 0.001

1997 Age and ageing Controlled trial quality: predicted high

22773. Humidification reduces coughing and breath-holding during inhalation induction with isoflurane in children. Full Text available with Trip Pro

Humidification reduces coughing and breath-holding during inhalation induction with isoflurane in children. Inhalation induction using isoflurane is associated with airway irritability, coughing, breath-holding and laryngospasm. These complications are more common in children. This study was designed to determine if humidification of isoflurane in oxygen/nitrous oxide would reduce respiratory complications and hypoxic episodes at induction.Fifty-nine unpremedicated children, aged three months (...) to 12 yr, were enrolled in the study and randomised to receive either humidified isoflurane (n = 27, Group A), or non-humidified isoflurane (n = 32, Group B). All inductions of anaesthesia were with isoflurane 4% in 50% oxygen/nitrous oxide. Subjects were observed for the occurrence of breath-holding, coughing, laryngospasm, bronchospasm, secretions, and hiccoughs. The severity of each complication was graded on a scale of 0-3. The need to administer 100% oxygen and/or succinylcholine was also

1996 Canadian journal of anaesthesia = Journal canadien d'anesthesie Controlled trial quality: uncertain

22774. Cetirizine treatment of allergic cough in children with pollen allergy. (Abstract)

Cetirizine treatment of allergic cough in children with pollen allergy. Cetirizine, an antihistamine widely used in the treatment of allergic rhinoconjunctivitis, also has antiallergic activity. The present study aimed to evaluate cetirizine as a treatment for children with allergic cough due to pollen allergy. This was a parallel-group, double-blind, placebo-controlled, randomized study. Twenty children with pollinosis were enrolled: they were subdivided into two groups receiving a 1-month (...) treatment during the pollen season. The following variables were monitored: 1) clinical symptoms and respiratory data (spirometry and PEF) evaluated at baseline and at the end of the study by allergists and by a daily diary card, and 2) pollen count. This study shows that cetirizine treatment reduces cough intensity (P < 0.05) and frequency (P < 0.01). In conclusion, cetirizine does clinically improve cough due to pollen allergy.

1997 Allergy Controlled trial quality: uncertain

22775. Assessment of the antitussive efficacy of codeine in cough associated with common cold. (Abstract)

Assessment of the antitussive efficacy of codeine in cough associated with common cold. Codeine is generally accepted as the standard antitussive against which new antitussive medications are compared. This presents a problem because the support for codeine's antitussive activity comes from studies on cough in animals, and chronic and induced cough models in man, whereas antitussives are almost exclusively used for the treatment of cough associated with acute upper respiratory tract infection (...) (URTI). The aims of this study were twofold. Firstly, to study the antitussive efficacy of codeine in cough associated with URTI and, secondly, to validate a sound meter as tool for quantifying cough. The efficacy of codeine was assessed in a double-blind, stratified, placebo-controlled, parallel-group, clinical trial using three different measures of cough: cough sound-pressure levels (CSPLs) measured on a sound meter; subjective scores of cough severity; and cough frequency recorded by means

1997 The Journal of pharmacy and pharmacology Controlled trial quality: uncertain

22776. Chronic cough responsive to ibuprofen. (Abstract)

Chronic cough responsive to ibuprofen. A 57-year-old woman believed that ibuprofen, prescribed for back pain, improved her idiopathic chronic cough that had been resistant to inhaled and oral corticosteroids. To confirm this observation, we performed an n-of-1 clinical trial with four treatment periods, each separated by a 4-day washout. Ibuprofen 1800 mg/day for 6 days or placebo was randomly allocated in a double-blind fashion with a block size of 4. The number of coughs during the first 30 (...) minutes after awakening were counted daily throughout the study using a tape recorder. Sixty-two coughs/hour occurred while taking ibuprofen, compared with 164 with placebo. We conclude that ibuprofen may be effective in idiopathic chronic cough, and suggest that prostaglandins may be pathogenic factors in some patients.

1992 Pharmacotherapy Controlled trial quality: uncertain

22777. Cough induced by ACE-inhibitors. A kinin related phenomenon? (Abstract)

Cough induced by ACE-inhibitors. A kinin related phenomenon? Cough induced by ACE-inhibitors may be related to bronchial hyperreactivity and/or to an accumulation of kinins. In a placebo-controlled, double-blind randomized study in asthmatic and hypertensive patients lung function and bronchial reactivity to histamine and bradykinin remained unaltered although 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. The findings do not support a major role of kinins in ACE inhibitor-induced cough.

1992 Agents and actions. Supplements Controlled trial quality: uncertain

22778. The effect of oral terfenadine on the sensitivity of the cough reflex in normal volunteers. (Abstract)

The effect of oral terfenadine on the sensitivity of the cough reflex in normal volunteers. Antihistamines have been reported to have antitussive actions in allergic rhinitis which may be due to an effect of the drug on the cough reflex. We have studied the effect on induced cough in normal volunteers. Ten volunteers inhaled capsaicin at concentrations between 0.78 and 200 microM, in increasing dose order, until they coughed more than five times. The challenge was performed three times before (...) and three times each at 2 and 4 h after 120 mg terfenadine or matched placebo tablet in a double-blind, randomized, cross-over study. Neither affected the capsaicin cough challenge. Thus, any antitussive effect of terfenadine is more likely to be via an indirect mechanism such as inhibition of released histamine rather than on the cough reflex itself.

1992 Pulmonary pharmacology Controlled trial quality: uncertain

22779. Prospective trial on captopril-related cough. (Abstract)

Prospective trial on captopril-related cough. Quantify and characterize cough as an adverse reaction secondary to captopril.Cohort analytic study: six-month prospective trial including two-week, placebo, run-in period; five-month, single-blind, active treatment; and two-week, dechallenge period.Outpatient clinic.199 previously treated or newly diagnosed untreated patients with mild to moderate hypertension.Captopril 50 mg/d during five months.Self-questionnaires, interviews, dechallenge (...) , and rechallenge periods. Naranjo's algorithm.(1) Cumulative incidence of captopril-induced cough over a five-month period was 7.1 percent (95 percent C.I., 6.8-7.4 percent). Incidence of drug withdrawal secondary to severe cough was 1.0 percent; this figure is somewhat similar to first reports about the reaction. (2) Cough was a generally mild to moderate symptom, present day and night in 71.4 percent of patients and resistant to antitussive agents. Cough was not statistically related to sex, age, or smoking

1992 The Annals of pharmacotherapy Controlled trial quality: uncertain

22780. Efficacy and safety of levodropropizine and dihydrocodeine on nonproductive cough in primary and metastatic lung cancer. (Abstract)

Efficacy and safety of levodropropizine and dihydrocodeine on nonproductive cough in primary and metastatic lung cancer. Nonproductive cough is a frequent and distressing symptom in patients with lung cancer, and it is not even relieved by palliative chemotherapy. A double-blind, randomized clinical trial regarding the treatment of nonproductive cough was performed in 140 adults with primary lung cancer or metastatic cancer of the lungs. The therapeutic efficacy and the tolerability of a 7-day (...) treatment with levodropropizine drops (75 mg t.i.d.) were evaluated in comparison with dihydrocodeine drops (10 mg t.i.d.; 7 days). Efficacy was assessed on the basis of cough severity scores, number of night awakenings due to cough, and overall estimate of antitussive efficacy. Tolerability was evaluated by laboratory results, vital signs and any adverse event occurring during the clinical trial, including presence or absence of somnolence. Subjective cough severity was significantly reduced during

1998 The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology Controlled trial quality: uncertain

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