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101. Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report (Full text)

Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment approaches are needed for CACC. We conducted a systematic review on the management of CACC to update the recommendations and suggestions of the CHEST 2006 guideline on this topic.This systematic review of randomized controlled trials (RCTs) asked

2017 EvidenceUpdates PubMed

102. Antibiotic prescription strategies and adverse outcome for uncomplicated lower respiratory tract infections: prospective cough complication cohort (3C) study. (Full text)

Antibiotic prescription strategies and adverse outcome for uncomplicated lower respiratory tract infections: prospective cough complication cohort (3C) study. Objective To assess the impact on adverse outcomes of different antibiotic prescribing strategies for lower respiratory tract infections in people aged 16 years or more.Design Prospective cohort study.Setting UK general practice.Participants 28 883 patients with lower respiratory tract infection; symptoms, signs, and antibiotic

2017 BMJ PubMed

103. Chronic cough and obesity. (PubMed)

Chronic cough and obesity. With respective prevalence of 13% and 9.6%, obesity and chronic cough are two common conditions worldwide. The crucial role of obesity has been highlighted in the development and progression of many respiratory diseases. According to the results of epidemiological studies, obesity, particularly abdominal obesity, may also be associated with chronic cough (CC). CC seems to be more severe in obese patients compared to normal-weight subjects. The management of CC may (...) differ slightly in obese patients compared to non-obese patients. Indeed, asthma and reflux diseases, which are considered key factors in the onset of CC, are characterised by more severe symptoms in obese patients. Asthma is associated with a resistance to usual treatments in obese patients but no data are available on the effect of inhaled therapies in obese subjects with cough variant asthma. Other emergent causes of CC have been reported in obese patients. Obstructive sleep apnoea and diabetes

2019 Pulmonary Pharmacology & Therapeutics

104. Comparison of therapeutic effects of inhaled corticosteroids on three subtypes of cough variant asthma as classified by the impulse oscillometry system. (Full text)

Comparison of therapeutic effects of inhaled corticosteroids on three subtypes of cough variant asthma as classified by the impulse oscillometry system. Cough variant asthma (CVA) is one of the most common causes of chronic persistent cough, and early treatment with inhaled corticosteroids (ICSs) is recommended to attenuate the inflammation and remodeling. The impulse oscillometry system (IOS) is a novel device for respiratory functional assessment that has not yet been assessed in terms of CVA (...) . Therefore, we investigated the relationship between CVA and IOS, and the difference in therapeutic effects of ICSs among the subtype classifications by IOS.The following ICSs were randomly prescribed in daily medical care: coarse-particle ICS (fluticasone propionate [FP]), fine-particle ICS (mometasone furoate [MF]), and moderate-particle ICS (budesonide [BUD]). Treatment effects were assessed by the Leicester cough questionnaire (LCQ) and were compared among three separated subtypes based on IOS

2019 Respiratory research PubMed

105. Non-pharmacological interventions for chronic cough: The past, present and future. (PubMed)

Non-pharmacological interventions for chronic cough: The past, present and future. Non-pharmacological interventions have been explored in people with refractory chronic cough. Normally delivered by Physiotherapists and or Speech and Language Therapists, these interventions aim to educate patients about their cough, provide them with cough suppression techniques and breathing exercises, improve vocal/laryngeal hydration and psychoeducational counselling to help them gain greater control (...) of their cough. Six key studies have been completed over the past 12 years that have consistently found non-pharmacological interventions help to improve quality of life and reduce cough frequency. Some studies also found improvements in cough reflex sensitivity and severity. Despite promising results there now needs to be further work to optimise these interventions. There is a need to standardise terminology used such as relabelling the intervention as cough control therapy and move away from uni

2019 Pulmonary Pharmacology & Therapeutics

106. Speech Pathology Intervention for Chronic Refractory Cough: A Pilot Study Examining the Benefit of Using Prerecorded Videos as an Adjunct to Therapy. (PubMed)

Speech Pathology Intervention for Chronic Refractory Cough: A Pilot Study Examining the Benefit of Using Prerecorded Videos as an Adjunct to Therapy. Speech pathology intervention is effective for chronic refractory cough (CRC). Speech pathology treatment for CRC includes therapy exercises to teach cough suppression and reduce laryngeal closure during respiration.The aim of this study was to evaluate the benefit of providing patients with supplemental pre-recorded videos of speech pathology (...) exercises for chronic refractory cough (CRC) to assist with patients' independent practice. These videos were pre-made recordings of the treating speech pathologist demonstrating specific exercises for chronic cough suppression.This study was a prospective randomized controlled trial design. Participants included 18 adult patients attending a speech pathology outpatient clinic in a tertiary referral hospital for treatment of CRC. Participants were randomized to receive either standard speech pathology

2019 Journal of voice : official journal of the Voice Foundation

107. Comparison of topical lidocaine spray with forced coughing in pain relief during colposcopic biopsy procedure: a randomised trial. (PubMed)

Comparison of topical lidocaine spray with forced coughing in pain relief during colposcopic biopsy procedure: a randomised trial. Our objective was to compare the effectiveness of local lidocaine spray (LS) compared to forced coughing (FC) for relieving the pain during colposcopically guided cervical biopsies (CGBs). The study was a randomised study, which included patients with abnormal cervical cytologic results requiring a colposcopic biopsy procedure. The patients were randomly assigned (...) cervical biopsy is a painful procedure and different techniques have been proposed to relieve this pain with conflicting results. Studies have demonstrated that a forced coughing is a good and easy method for relieving pain with some disadvantages. Local lidocaine spray (LS) is another option for pain relief during the biopsy procedure. However, no randomised study has compared these two methods yet. What the results of this study add? The results from this randomised study suggest that LS has

2019 Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology

108. Why chronic cough in children is different. (PubMed)

Why chronic cough in children is different. Recently, there have been robust changes in our knowledge of the neurophysiology of cough and novel clinical etiologies. Specifically, cough hypersensitivity in adults and protracted bacterial bronchitis (PBB) in children have been increasingly investigated, and differences between chronic cough in children and adults have been widely reported. In young children, postinfectious cough, bronchiectasis, airway malacia, PBB, and asthma appear (...) to be the main causes of cough; however, by adolescence, the causes of cough are more likely to become those common in adults, namely, gastroesophageal reflux, asthma, and upper airway syndrome. These differences are attributed to changes in various characteristics of the respiratory tract, immune system, and nervous system between children and adults. New knowledge about the neural aspects of cough has revealed a complex network of pathways that initiate cough. The effect of inflammation on cough neural

2019 Pulmonary Pharmacology & Therapeutics

109. Chinese herbal medicine for the treatment of cough variant asthma: a study protocol for a double-blind randomized controlled trial. (Full text)

Chinese herbal medicine for the treatment of cough variant asthma: a study protocol for a double-blind randomized controlled trial. Cough variant asthma (CVA) is one of the leading causes of chronic coughing. The main treatment is currently anti-inflammatory medication. However, the coughing may return or be aggravated and lung function may deteriorate once the anti-inflammatory treatment is stopped. The effect of Chinese herbal medicine (CHM) on chronic coughing is remarkable, but high-quality (...) into the experimental or control group in a ratio of 1:1. Patients in the experimental group will take CHM granules (4.9 g twice daily), while patients in the control group will be given a matched placebo. An administration of salmeterol/fluticasone propionate combination for 12 weeks will be the basic therapy for the two groups. The primary outcome is the cough visual analog scales (CVAS). The secondary outcomes include quality of life, rate of symptom relapse, lung function, and blood tests. A safety assessment

2019 Trials PubMed

110. Cough in exercise and athletes. (PubMed)

Cough in exercise and athletes. In the general population, particularly in individuals with asthma, cough is a common symptom, often reported after exertion, although regular exercise may be associated with a reduction in the prevalence of cough. In athletes, exercise-induced cough is also a particularly frequent symptom. The main etiologies of cough in athletes are somewhat similar to non-athletes, including asthma/airway hyperresponsiveness, upper airways disorders such as allergic or non (...) -allergic rhinitis, and exercise-induced laryngeal obstruction, although these conditions are more frequently observed in athletes. In these last, this symptom can also be related to the high ventilation and heat exchange experienced during exercise, particularly during exposure to cold/dry air or pollutants. However, gastroesophageal reflux, a common cause of cough in the general population, despite being highly prevalent in athletes, has not been reported as a main cause of cough in athletes. Cough

2019 Pulmonary Pharmacology & Therapeutics

111. Randomised clinical trial: gabapentin vs baclofen in the treatment of suspected refractory gastro-oesophageal reflux-induced chronic cough. (Full text)

Randomised clinical trial: gabapentin vs baclofen in the treatment of suspected refractory gastro-oesophageal reflux-induced chronic cough. Neuromodulators are considered potential therapeutic options for refractory gastro-oesophageal reflux-induced chronic cough.To compare the efficacy of gabapentin and baclofen in patients with suspected refractory gastro-oesophageal reflux-induced chronic cough.Two hundred and thirty-four patients with suspected refractory gastro-oesophageal reflux-induced (...) chronic cough, who failed an 8-week course of omeprazole and domperidone, were recruited into the open-labelled study and randomly assigned to receive either gabapentin (maximum daily dose of 900 mg) or baclofen (maximum daily dose of 60 mg) for 8 weeks as add-on therapy to the previous treatment. The primary end point was the successful rate of cough resolution; and the secondary end-points included cough sensitivity to capsaicin and gastro-oesophageal reflux disease questionnaire score and reported

2019 Alimentary Pharmacology & Therapeutics PubMed

112. Idiopathic chronic productive cough and response to open-label macrolide therapy: An observational study. (PubMed)

Idiopathic chronic productive cough and response to open-label macrolide therapy: An observational study. Adult patients with chronic productive cough of unknown cause are commonly seen in respiratory clinics. We have previously described a subgroup of these patients who have a short-lived response to standard antibiotic treatment but a prolonged response to 3 months of low-dose azithromycin therapy.This observational study describes the physiological, radiological and pathological features (...) Cough Questionnaire (LCQ) score (-6.3 points, P < 0.00001), reduction in median 24-h sputum volume (-5.8 mL, P = 0.0003) and improvement in sputum colour (P = 0.003). Patients responsive to azithromycin (n = 22) demonstrated neutrophilic or paucigranulocytic airway inflammation, whereas five subjects with eosinophilic airways inflammation did not respond symptomatically to azithromycin.We describe a cohort of patients with chronic productive cough not adequately described by existing disease labels

2019 Respirology

113. Increased expression of lung TRPV1/TRPA1 in a cough model of bleomycin-induced pulmonary fibrosis in Guinea pigs. (Full text)

Increased expression of lung TRPV1/TRPA1 in a cough model of bleomycin-induced pulmonary fibrosis in Guinea pigs. Chronic cough is a difficult-to-treat comorbidity of idiopathic pulmonary fibrosis (IPF), and significantly impacts on the quality of life of patients with IPF. Transient receptor potential (TRP) channel proteins may play an important role in chronic cough. However, expression of these proteins in lung of IPF is largely unknown.Guinea pig model of pulmonary fibrosis was established (...) by single intratracheal delivery of bleomycin. Respiratory ungated micro-CT scans were performed on days 7, 14, 21 and 28 to assess progression of pulmonary fibrosis. Cough sensitivity to capsaicin was evaluated in conscious animals on days 13 and 27. Real-time PCR (qPCR) and immunohistochemistry were employed to measure expression of TRPV1 and TRPA1 in lung tissue.Micro-CT showed that lung consolidation was detectable from day 7 distributing mainly in the middle and lower lung fields, which

2019 BMC pulmonary medicine PubMed

114. Diagnostic value of fractional exhaled nitric oxide in cough-variant asthma: an updated meta-analysis. (PubMed)

Diagnostic value of fractional exhaled nitric oxide in cough-variant asthma: an updated meta-analysis. We aimed to evaluate the diagnostic value of fractional exhaled nitric oxide (FeNO) in cough-variant asthma (CVA) detection.Relevant studies on the FeNO test in patients with CVA were retrieved from electronic databases including PubMed, Medline, Springer, Elsevier Science Direct, the Cochrane Library, and Google Scholar, up to August 2018. Meta-analysis for sensitivity, specificity, positive

2019 Journal of Asthma

115. Allergen challenge increases capsaicin evoked cough responses in allergic asthma. (Full text)

Allergen challenge increases capsaicin evoked cough responses in allergic asthma. Cough is a common and troublesome symptom in asthmatic patients, but little is known about the neuronal pathways that trigger cough. The mechanisms by which airway inflammation, airway hyperresponsiveness, and variable airflow obstruction cause cough are unclear.We sought to investigate the effects of allergen exposure on cough reflex sensitivity.We performed a 9-visit, randomized, single-blind, placebo-controlled (...) , 2-way crossover study comparing cough responses to inhaled capsaicin in patients with mild atopic asthma after allergen challenge compared with diluent control. Full-dose capsaicin challenge was performed at screening to determine the capsaicin dose inducing a half-maximal response, which was subsequently administered at 30 minutes and 24 hours after inhaled allergen/diluent challenge. Spontaneous coughing was measured for 24 hours after allergen/diluent. Methacholine challenge and sputum

2019 Journal of Allergy and Clinical Immunology PubMed

116. Lund-Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients. (PubMed)

Lund-Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients. A remarkable relationship between upper airway conditions and lung diseases has been reported. At the same time, sinonasal findings in chronic cough patients have not been fully examined.The purpose of this study is to show paranasal sinus findings and lung function in chronic cough patients without asthma and chest X-ray abnormalities.A total of 1412 patients (...) with persistent cough were enrolled in this study. Of these patients, 376 patients were evaluated for further examination, as the patients with asthma and/or chest X-ray abnormality were excluded from the study. Normal control subjects without any chronic respiratory symptoms were also recruited. Pulmonary function was examined by spirometry. A bronchial obstruction reversibility test was applied. The Lund-Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E

2019 American journal of rhinology & allergy

117. Etiology analysis of nonspecific chronic cough in children of 5 years and younger. (PubMed)

Etiology analysis of nonspecific chronic cough in children of 5 years and younger. This study aims to analyze the etiology of nonspecific chronic cough in children of 5 years and younger, in order to improve the diagnostic and treatment levels of pediatricians for nonspecific chronic cough in young children.The clinical data of 85 cases of children of 5 years old and below, who suffered from nonspecific chronic cough between the period of January 2015 and August 2016 were retrospectively (...) analyzed.The etiology distribution of 85 cases of children with nonspecific chronic cough were as follows: 27 cases had cough variant asthma (31.8%), 32 cases had upper airway cough syndrome (37.6%), 16 cases had cough after infection (18.8%), 3 cases had gastroesophageal reflux cough (3.5%), 2 cases had allergic cough (2.4%), and 5 cases had unknown causes of cough (5.9%).The main composition ratio of the etiology of chronic cough in children of 5 years old and below is as follows (in sequence): upper

2019 Medicine

118. Posture and firmness changes in a pressure-relieving air mattress affect cough strength in elderly people with dysphagia. (Full text)

Posture and firmness changes in a pressure-relieving air mattress affect cough strength in elderly people with dysphagia. Dysphagia is the major pathophysiologic mechanism leading to aspiration pneumonia in the elderly. Elderly people with dysphagia who show low levels of the cough peak flow (CPF) are at greater risk for aspiration pneumonia. It has been reported that CPF values were significantly lower in the "soft" versus "hard" mode of a pressure-relieving air mattress in healthy volunteers (...) in a supine position. Parameters such as spinal curvature, however, were not evaluated in detail. In this study, we clarified whether the changes in posture associated with two different firmness levels of a pressure-relieving air mattress were associated with cough production and related factors in the elderly with dysphagia. The body sinking distance, pelvic tilt angle, and immersion of the lumbar spine were measured to evaluate changes in posture. Forty subjects met the study criteria for dysphagia

2018 PLoS ONE PubMed

119. The diagnostic role of triple endoscopy in pediatric patients with chronic cough. (PubMed)

The diagnostic role of triple endoscopy in pediatric patients with chronic cough. Multi-disciplinary aero-digestive centers provide high quality health care through improved outcomes and treatment costs over separate sub specialty clinics. These outcomes are often the result of a common investigative tool known as triple endoscopy: a rigid bronchoscopy performed by an otolaryngologist, flexible bronchoscopy and lavage obtained by a pulmonologist, and an endoscopy with guided biopsies performed (...) by a gastroenterologist. Combining such procedures into one 'triple endoscopy' allows for diagnoses which otherwise might have been missed with just one procedure. The goal of our study was to describe the efficacy of the triple endoscopy procedure in diagnosing recalcitrant aero-digestive conditions, specifically chronic cough.Retrospective chart review METHODS: Multiple charts from children who underwent the triple endoscopy for chronic cough were retrospectively reviewed from 2005 and 2017. Complete data from

2019 International Journal of Pediatric Otorhinolaryngology

120. Honey + coffee versus systemic steroid in the treatment of persistent post-infectious cough.

Honey + coffee versus systemic steroid in the treatment of persistent post-infectious cough. Honey + coffee versus systemic steroid in the treatment of persistent post-infectious cough. – Less Is More Search for: Simpler & Better Medicine Menu / Summary: For patients with post-infectious cough (persisting 3 or more weeks after an upper respiratory infection), treatment for one week with honey + coffee three times daily may be associated greater reduction in cough frequency compared to treatment

2018 Less Is More Blog

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