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141. Pertussis detection in children with cough of any duration. (PubMed)

Pertussis detection in children with cough of any duration. The diagnosis of pertussis in clinical practice continues to be a challenge worldwide as the symptoms are variable. We aimed to determine the prevalence of pertussis in Chinese children irrespective of cough duration and explore the clinical characteristics of children with pertussis with different cough durations.This was a prospective study of children 1 month to 11 years of age with different cough durations in one large Chinese (...) using SAS v.10 (SAS Institute Inc., USA).After exclusions we analyzed 312 children. Ninety-seven (31.1%) children had laboratory evidence of pertussis. When grouped by cough duration, few characteristics were significant between children with and without pertussis. Of the 36 isolates, 72.2% (26/36)could not be inhibited by erythromycin and azithromycin at all. The MIC50 and MIC90 to amoxicillin were 0.75 mg/L and 1 mg/L respectively, sensitive to amoxicillin by the EUCAST points.The "one-size-fits

2019 BMC Pediatrics

142. Comparison of mannitol and citric acid cough provocation tests. (PubMed)

Comparison of mannitol and citric acid cough provocation tests. Citric acid has been used as a cough provocation test for decades. However, the methods of administration have not been standardized. Inhaled mannitol is a novel cough provocation test, which has regulatory approval and can be performed utilizing a simple disposable inhaler in a standardized manner.To compare the mannitol and citric acid cough provocation tests with respect to their ability to identify subjects with chronic cough (...) and their tolerability.Subjects with chronic cough (n = 36) and controls (n = 25) performed provocation tests with mannitol and citric acid. Both tests were video recorded. Cough sensitivity was expressed as coughs-to-dose ratios (CDR) and the cumulative doses to mannitol or concentration to citric acid evoking 5 coughs (C5). Forced expiratory volume in 1 s (FEV1), visual analogue scales (VAS), test completion rates and the total cough frequencies were analysed.Mannitol and citric acid CDR both effectively separated those

2019 Respiratory medicine

143. Effect of anti-reflux treatment on gastroesophageal reflux-associated chronic cough: Implications of neurogenic and neutrophilic inflammation. (PubMed)

Effect of anti-reflux treatment on gastroesophageal reflux-associated chronic cough: Implications of neurogenic and neutrophilic inflammation. Objective: Gastroesophageal reflux disease (GERD) is an important cause of chronic cough. Substance P (SP) has been implicated in the pathophysiology of cough. Proton pump inhibitors (PPIs) and prokinetic agents are the current treatment for GER-associated cough. The aim was to evaluate the effects of anti-reflux treatment and its associations (...) with cellular and neurogenic inflammation. Methods: Thirty-seven patients with GER-associated cough suspected based on characteristic symptoms such as heartburn and worsening of cough by phonation and rising were recruited. A PPI, rabeprazole 20 mg daily, and a prokinetic agent, itopride 50 mg t.i.d., were administered for 4 weeks in a prospective, observational manner. Before and after treatment, subjective cough measures [visual analog scale (VAS) and the Japanese version of the Leicester Cough

2019 Journal of Asthma

144. A "coughed up" tissue diagnosed as type A thymoma in an 80-year-old man: A case report. (PubMed)

A "coughed up" tissue diagnosed as type A thymoma in an 80-year-old man: A case report. Thymoma is the most common primary tumor in the anterior mediastinum. All major subtypes of thymoma can be clinically aggressive. However, type A thymoma is usually benign and rarely invasive, let alone invasive to the trachea. There are no published reports of thymoma diagnosed in a "coughed up' tissue". Here, we report an 80-year-old man who coughed up a piece of tissue which was histopathologically (...) diagnosed as type A thymoma.An 80-year-old man who had a history of thymoma for 8 years was admitted in our hospital with his severe cough and dyspnea and his "coughed up" something. He felt much better after coughing up the piece of tissue. He saved the tissue and sent it to the pathology department.The clinical diagnosis was lung cancer. But the final pathological diagnosis was type A thymoma.The patient refused to get chemotherapy, or surgery, and only would like to get the traditional Chinese

2019 Medicine

145. Association between postoperative cough and thyroidectomy: a prospective study. (PubMed)

Association between postoperative cough and thyroidectomy: a prospective study. This study sought to determine whether thyroidectomy is associated with self-reported cough through a prospective analysis.Patients undergoing unilateral thyroidectomy were prospectively enrolled. The control group was selected to avoid the effect of general anaesthesia. The experimental group consisted of 300 patients (202 females and 98 males) who underwent thyroidectomy, with a mean age of 48.6 years (...) , and the control group consisted of 103 patients (53 females and 50 males) who underwent other head and neck operations, with a mean age of 50.3 years. All patients were required to complete the Leicester Cough Questionnaire (LCQ) preoperatively and 2 weeks postoperatively.The postoperative mean total LCQ scores in the experimental and control groups were 17.9 ± 5.0 and 19.8 ± 4.2, respectively; the difference was significant (p = 0.014). Adverse event analysis showed that patients in the experimental group

2019 BMC Cancer

146. A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial. (PubMed)

A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial. Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia.This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total (...) . Then, sufentanil 0.5 μg/kg was injected within 5 s and the number of coughs that occurred within 1 min after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 min after administration (T1), 1 min after intubation (T2

2019 BMC Anesthesiology

147. The Neurokinin-1 Receptor Antagonist Orvepitant is a Novel Antitussive Therapy for Chronic Refractory Cough: Results From a Phase 2 Pilot Study (VOLCANO-1). (PubMed)

The Neurokinin-1 Receptor Antagonist Orvepitant is a Novel Antitussive Therapy for Chronic Refractory Cough: Results From a Phase 2 Pilot Study (VOLCANO-1). Substance P and the neurokinin-1 (NK-1) receptor are implicated in chronic refractory cough pathophysiology. We assessed the efficacy and safety of orvepitant, a brain-penetrant NK-1 antagonist, in an open-label study in CRC patients with chronic refractory cough.Thirteen patients with daytime cough frequency >3 to <250 coughs/h took (...) orvepitant 30 mg once daily for 4 weeks. Objective cough frequency was measured over 24 h at baseline and weeks 1, 4, and 8. The primary end point was change from Baseline in daytime cough frequency at week 4. Secondary end points included cough severity visual analog scale (VAS) score, global ratings of change for cough frequency and severity, and Cough-specific Quality of Life Questionnaire score.All patients completed the study. Mean baseline cough frequency was 71.4/h. A statistically and clinically

2019 Chest

148. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. (PubMed)

ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity has allowed an umbrella term that explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach. Thus adults with chronic cough now have a firm physical explanation for their symptoms based on vagal afferent (...) hypersensitivity. Different treatable traits exist with cough variant asthma/eosinophilic bronchitis responding to anti inflammatory treatment and non acid reflux being treated with promotility agents rather the anti acid drugs. An alternative antitussive strategy is to reduce hypersensitivity by neuromodulation. Low dose morphine is highly effective in a subset of patients with cough resistant to other treatments. Gabapentin and pregabalin are also advocated but in clinical experience they are limited

2019 European Respiratory Journal

149. A 63-Year-Old Woman With Pulmonary Micronodules and Chronic Cough. (PubMed)

A 63-Year-Old Woman With Pulmonary Micronodules and Chronic Cough. A 63-year-old woman presented with a 2-year history of nonproductive cough. She denied the presence of shortness of breath, chest pain, arthralgia, muscle weakness, weight loss, night sweats, and fatigue. She was a never smoker and had a history of arterial hypertension and diabetes. There was no history of asthma, allergic rhinitis, nasal polyps, or gastroesophageal reflux disease, known malignancy, or collagen tissue disease

2019 Chest

150. Open Airway Surgery in a Paraplegic: The Importance of an Adequate Cough. (PubMed)

Open Airway Surgery in a Paraplegic: The Importance of an Adequate Cough. To describe a case of open airway surgery with postoperative respiratory complications in a paraplegic woman and to review the unique respiratory physiology seen in patients with a history of cervical or thoracic spinal cord injury (SCI).Case report and literature review.We describe the case of a 25-year-old paraplegic who developed tracheal stenosis after tracheotomy, eventually requiring tracheal resection and re (...) -anastomosis. Her postoperative course was complicated by mucus plugging and severe atelectasis, necessitating reintubation. After extubation, the patient reported difficulty expectorating secretions ever since her SCI, requiring manual abdominal pressure from her family members to assist her when she needed to cough.This first report of cricotracheal resection in a patient with paraplegia following SCI highlights the importance of an adequate cough and demonstrates the unique respiratory management

2019 Rhinology and Laryngology

151. A systematic review of methods of citric acid cough reflex testing. (PubMed)

A systematic review of methods of citric acid cough reflex testing. This systematic review summarises and appraises methods of citric acid cough reflex testing (CRT) documented in published literature.Electronic databases, MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus were searched up to and including 11th February 2018. Studies reporting a method of citric acid CRT, published in peer-reviewed journals in English or Spanish, were assessed for the inclusion criteria. Of the selected studies (...) , information on the instrumentation and CRT protocol was extracted.A total of 129 studies were included. Instrumentation and protocols differed widely across studies. Reporting of methods of citric acid CRT was sub-standard, with many crucial methodological components omitted from published manuscripts, preventing their full replication.Considerable methodological variability exists for citric acid CRT in published literature. The findings suggest that caution is warranted in comparing citric acid cough

2019 Pulmonary Pharmacology & Therapeutics

152. The "Cough Trick" Reduces Pain During Removal of Closed-suction Drains after Total Knee Arthroplasty: A Randomized Trial. (PubMed)

The "Cough Trick" Reduces Pain During Removal of Closed-suction Drains after Total Knee Arthroplasty: A Randomized Trial. Drain removal after TKA can be painful. Prior research suggests that the "cough trick," in which a patient coughs at the same time she or he receives an injection, effectively decreases pain. To our knowledge, this intervention has not been evaluated as a way to reduce pain during other brief but painful interventions, such as removal of closed-suction drains after (...) orthopaedic surgery.Does the cough trick reduce pain while a surgeon is removing a closed-suction drain after TKA?Fifty-six patients with primary osteoarthritis who underwent primary TKA were randomized into two groups: drain removal as the patient coughed (n = 28 patients; three men, 25 women) or drain removal using the usual process, without the cough trick (n = 28 patients; three men, 25 women). The study groups were not different in terms of gender, BMI, surgical time, or other baseline variables

2019 Clinical Orthopaedics and Related Research

153. Tools to help cut antibiotic prescribing for children with coughs and RTI

Tools to help cut antibiotic prescribing for children with coughs and RTI Tools to help cut antibiotic prescribing for children with coughs and RTI | Primary Care Respiratory Society ") The Primary Care Respiratory Society Inspiring best practice in respiratory care Search This website is for healthcare professionals only Tools to help cut antibiotic prescribing for children with coughs and RTI Tools to help cut antibiotic prescribing for children with coughs and RTI This article introduces

2017 Primary Care Respiratory Society

154. Mechanical insufflation-exsufflation assisted coughing in neuromuscular diseases

Mechanical insufflation-exsufflation assisted coughing in neuromuscular diseases Mechanical insufflation-exsufflation assisted coughing in neuromuscular diseases Mechanical insufflation-exsufflation assisted coughing in neuromuscular diseases Secco A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation Secco A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L. Mechanical insufflation-exsufflation assisted coughing in neuromuscular diseases. Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Documentos de Evaluación de Tecnologías Sanitarias, Informe de Respuesta Rápida N° 445. 2015 Authors' conclusions The existing evidence on mechanical insufflation-exsufflation

2015 Health Technology Assessment (HTA) Database.

155. Inhaled corticosteroids for subacute and chronic cough in adults. (PubMed)

Inhaled corticosteroids for subacute and chronic cough in adults. Persistent cough is a common clinical problem. Despite thorough investigation and empirical management, a considerable proportion of those people with subacute and chronic cough have unexplained cough, for which treatment options are limited. While current guidelines recommend inhaled corticosteroids (ICS), the research evidence for this intervention is conflicting.To assess the effects of ICS for subacute and chronic cough (...) in adults.We searched the Cochrane Airways Group Register of Trials, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and ClinicalTrials.gov in December 2012 and conducted handsearches.Two authors independently assessed all potentially relevant trials. All published and unpublished randomised comparisons of ICS versus placebo in adults with subacute or chronic cough were included. Participants with known chronic respiratory disease and asthma were excluded. Studies of cough-variant asthma

2013 Cochrane

156. Palliative care - cough

Palliative care - cough Palliative care - cough - NICE CKS Clinical Knowledge Summaries Share Palliative care - cough: Summary Cough is a defensive reflex that occurs in response to stimulation of irritant receptors which are found in the airways. It has two functions — to prevent foreign material entering the lower respiratory tract, and to clear secretions from the lungs and airways. Cough in people with cancer is most commonly associated with cancer of the airways, lungs, pleura (...) , and mediastinum, but tumours metastasizing to the thorax can also cause cough. In people with cancer, the most common cause of acute cough is respiratory tract infection. Other possible non-malignant causes include post-nasal drip, asthma, chronic obstructive pulmonary disease, and gastro-oesophageal reflux disease. When assessing someone with cough in palliative care, the following should be elicited: The impact on the person's quality of life. The severity, time of onset, and duration of the cough

2017 NICE Clinical Knowledge Summaries

157. Effectiveness of proton pump inhibitor in unexplained chronic cough. (Full text)

Effectiveness of proton pump inhibitor in unexplained chronic cough. Current guidelines recommend that patients with unexplained chronic cough undergo empirical proton pump inhibitor (PPI) treatment, but scientific evidence for this treatment is lacking. We investigated the effectiveness and appropriate dose of PPI therapy in chronic cough.We included 27 patients with unexplained chronic cough after excluding subjects with positive response to postnasal drip medication. Subjects were randomized (...) to a placebo, standard, and high dose of PPI groups with blinding. The drug or placebo was administered orally for 8 weeks, and the Leicester Cough Questionnaire (LCQ) score and visual analogue scale (VAS) scores were collected.The LCQ score in the PPI group significantly improved from 0 weeks (11.4 ± 1.4) to 4 weeks (14.8 ± 1.4) and to 8 weeks (17.1 ± 1.4), whereas that in the placebo group did not improve from 0 weeks (13.7 ± 1.1) to 8 weeks (11.8 ± 1.4); the difference between the 2 groups

2017 PLoS ONE PubMed

158. Human Cough as a Two-Stage Jet and Its Role in Particle Transport. (Full text)

Human Cough as a Two-Stage Jet and Its Role in Particle Transport. The human cough is a significant vector in the transmission of respiratory diseases in indoor environments. The cough flow is characterized as a two-stage jet; specifically, the starting jet (when the cough starts and flow is released) and interrupted jet (after the source supply is terminated). During the starting-jet stage, the flow rate is a function of time; three temporal profiles of the exit velocity (pulsation, sinusoidal (...) and real-cough) were investigated in this study, and our results showed that the cough flow's maximum penetration distance was in the range of a 50.6-85.5 opening diameter (D) under our experimental conditions. The real-cough and sinusoidal cases exhibited greater penetration ability than the pulsation cases under the same characteristic Reynolds number (Rec) and normalized cough expired volume (Q/AD, with Q as the cough expired volume and A as the opening area). However, the effects of Rec and Q/AD

2017 PLoS ONE PubMed

159. Lack of desensitization of the cough reflex in ovalbumin-sensitized rabbits during exercise. (Full text)

Lack of desensitization of the cough reflex in ovalbumin-sensitized rabbits during exercise. Cough is a major symptom of asthma frequently experienced during exercise but little is known about interactions between cough and exercise. The goal of our study was to clarify the potential modulation of the cough reflex (CR) by exercise in a spontaneously breathing anaesthetized animal model of airway eosinophilic inflammation.Ten ovalbumin (OVA) sensitized adult rabbits and 8 controls were studied (...) desensitization needs to be further investigated but it might contribute to the exercise-induced cough in asthmatics.

2017 PLoS ONE PubMed

160. Chronic Cough

Chronic Cough Rotation Prep | NEJM Resident 360 Social Login Email Login Log in via Email Create Your Account We will not share your email with anyone. Password must be at least 8 characters. Show or Hide the password you are typing. Request to Join has invited you to join this group Your browser does not support video tags Welcome! NEJM Resident 360 helps you prepare for your next rotation quickly and efficiently, provides support for coping with the pressures of resident life, and equips you

2016 Now@NEJM

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