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

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 Controlled trial quality: uncertain

162. Application via mechanical dropper alleviates sufentanil-induced cough: a prospective, randomized, single-blinded trial. Full Text available with Trip Pro

Application via mechanical dropper alleviates sufentanil-induced cough: a prospective, randomized, single-blinded trial. It was reported that prolonging the injection time or diluting administration can reduce the incidence of opioid-induced cough. However, the incidence of sufentanil-induced cough (SIC) via a standardized infusion rate is unclear. A mechanical dropper is an infusion filtering device commonly used for intravenous degassing; it can also be used to administer special drugs due (...) to its temporary storage and dilution effect. This study assesses the effectiveness of administration via mechanical dropper on SIC.Two hundred patients undergoing general anesthesia were enrolled. Patients received sufentanil at a strength of 0.3 μg·kg- 1 either via T-connector (group C) or by mechanical dropper (group M) at 1 ml·s- 1. Cough severity was graded as none (0), mild (1-2), moderate (3-5), or severe (> 5), and the incidence of SIC was evaluated for 5 min after the start of sufentanil

2019 Trials Controlled trial quality: uncertain

163. Dual Tasking Influences Cough Sensorimotor Outcomes in Healthy Young Adults. (Abstract)

Dual Tasking Influences Cough Sensorimotor Outcomes in Healthy Young Adults. Purpose Reflex cough is an essential airway protective mechanism that often occurs in the context of divided attention. The effect of divided attention on measures of reflexive cough airflow and sensitivity remains unknown. We present findings from a study testing the effects of divided attention (via a dual-task paradigm) on measures of reflex cough in healthy young adults. Method Volunteers (N = 20, age = 20-40 years (...) ) underwent 4 blocks of capsaicin-induced cough challenges. Within each block, capsaicin ranging from 0 to 200 μM was presented in a randomized order. Two blocks consisted of cough testing only (single task). During the other 2 blocks, participants counted tones while simultaneously undergoing cough testing (dual task). Measures of cough motor response, self-reported urge-to-cough, cough frequency, and cough airflow were collected. Results Participants coughed more in the single-task condition compared

2019 Journal of speech, language, and hearing research : JSLHR Controlled trial quality: uncertain

164. A systematic review of methods of citric acid cough reflex testing. (Abstract)

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

165. Comparison of mannitol and citric acid cough provocation tests. (Abstract)

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

166. The evaluation ofefficacy and safety of Cough (EMA) granules used for upper respiratory disorders. (Abstract)

The evaluation ofefficacy and safety of Cough (EMA) granules used for upper respiratory disorders. Ivy leaf is used for the treatment of respiratory diseases with the intensive mucus formation, respiratory infections, and irritating cough coming from the common cold. Conferring to clinical trials, the efficacy, and tolerability of ivy leaf is good. The main compounds accountable for biological activity are triterpene and saponins. Ivy leaves show convulsive/antispasmodic, anti-inflammatory (...) , antimicrobial, analgesic, anthelmintic and anti-thrombin activity. Not only ivy but also marshmallow and mustard seeds are used for these indications. This study was conducted to evaluate the efficacy and safety of Cough (EMA; European Medicines Agency) granules used for upper respiratory disorders. This clinical trial was conducted on 150 patients, out of which 75received the Cough (EMA) granules and 75received the placebo. The age range of patients was 3 years to above 15 years. The sample paired t-test

2019 Pakistan journal of pharmaceutical sciences Controlled trial quality: uncertain

167. Efficacy of Single-Dose Dexmedetomidine Combined with Low-Dose Remifentanil Infusion for Cough Suppression Compared to High-Dose Remifentanil Infusion: A Randomized, Controlled, Non-Inferiority Trial. Full Text available with Trip Pro

Efficacy of Single-Dose Dexmedetomidine Combined with Low-Dose Remifentanil Infusion for Cough Suppression Compared to High-Dose Remifentanil Infusion: A Randomized, Controlled, Non-Inferiority Trial. Background: Combination of dexmedetomidine and opioid may be an alternative to high-dose opioid in attenuating cough during emergence from anesthesia, while also reducing the adverse effects of high-dose opioid. We tested the hypothesis that a single-dose of dexmedetomidine combined with low-dose (...) remifentanil infusion during emergence would not be inferior to high-dose remifentanil infusion alone in attenuating cough after thyroidectomy. Methods: One hundred sixty-nine patients undergoing thyroidectomy were enrolled and randomized in a 1:1 ratio into group DR or group R. Each patient received an infusion of dexmedetomidine (0.5 μg/kg) and low-dose remifentanil infusion of effect-site concentration (Ce) at 1 ng/mL or normal saline and high-dose remifentanil infusion of Ce at 2 ng/mL for 10 min

2019 International journal of medical sciences Controlled trial quality: uncertain

168. Optimal dose of ropivacaine for relieving cough-pain after video-assisted thoracoscopic lobectomy by single intrapleural injection: A randomized, double-blind, controlled study. (Abstract)

Optimal dose of ropivacaine for relieving cough-pain after video-assisted thoracoscopic lobectomy by single intrapleural injection: A randomized, double-blind, controlled study. Pain due to coughing after thoracoscopic surgery remains a clinical problem, and its relief by intrapleural analgesia has not been extensively studied. This study attempts to determine the suitable volume of 0.75% ropivacaine needed for intrapleural analgesia after thoracoscopic surgery.A double-blind, randomized (...) , controlled trial was performed. Forty-five patients were randomly divided into three groups: R20, R15, and R10 (n = 15); 20 ml, 15 ml, or 10 ml of 0.75% ropivacaine was injected into the pleural cavity of each patient in the 3 groups, respectively, when the pain score from postoperative coughing was ≥4. The primary outcome was pain score upon coughing (C-NRS), and the secondary outcomes were pain score at rest (R-NRS), morphine consumption, time of onset, and duration of intrapleural analgesia.All

2019 International journal of surgery (London, England) Controlled trial quality: predicted high

169. Effect of pregabalin for the treatment of chronic refractory cough: A case report. Full Text available with Trip Pro

Effect of pregabalin for the treatment of chronic refractory cough: A case report. Chronic refractory cough (CRC) is a common clinical problem which is more likely associated with some physical problems. Although many patients have received satisfactory treatment, there were still many patients suffered from long-term cough symptoms after standardized treatment.A patient suffered from postherpetic neuralgia (PHN) and also he complained CRC for more than 20 years.The patient was diagnosed

2019 Medicine

170. Optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough suppression: a prospective randomized controlled trial. Full Text available with Trip Pro

Optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough suppression: a prospective randomized controlled trial. To investigate the optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough (FIC) suppression.Patients of 180 undergoing elective surgery with general anesthesia, aged 18-65 years, BMI 18.5-30 kg/m2, ASA I or II, were equally randomized into four groups (n = 45) to receive intravenous pretreatment of dexmedetomidine with 0 (group 1), 0.3 (group 2), 0.6 (group (...) 3) and 0.9 (group 4) mcg/kg over 10 mins, respectively. After the pretreatment, all patients were given a 5-s intravenous injection of fentanyl 4 mcg/kg. The symptoms of irritating cough including the severity and onset time were recorded for 1 min after fentanyl injection. General anesthesia induction was completed with midazolam, propofol and cisatracurium, then endotracheal tube or laryngeal mask was inserted and connected to an anesthesia machine. MAP, HR and SpO2 at the beginning

2019 BMC Anesthesiology Controlled trial quality: uncertain

171. Transmission of bacteria in bronchiectasis and chronic obstructive pulmonary disease: Low burden of cough aerosols. Full Text available with Trip Pro

Transmission of bacteria in bronchiectasis and chronic obstructive pulmonary disease: Low burden of cough aerosols. Aerosol transmission of Pseudomonas aeruginosa has been suggested as a possible mode of respiratory infection spread in patients with cystic fibrosis (CF); however, whether this occurs in other suppurative lung diseases is unknown. Therefore, we aimed to determine if (i) patients with bronchiectasis (unrelated to CF) or chronic obstructive pulmonary disease (COPD) can aerosolize P (...) . aeruginosa during coughing and (ii) if genetically indistinguishable (shared) P. aeruginosa strains are present in these disease cohorts.People with bronchiectasis or COPD and P. aeruginosa respiratory infection were recruited for two studies. Aerosol study: Participants (n = 20) underwent cough testing using validated cough rigs to determine the survival of P. aeruginosa aerosols in the air over distance and duration. Genotyping study: P. aeruginosa sputum isolates (n = 95) were genotyped using

2019 Respirology

172. Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery. Full Text available with Trip Pro

Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery. Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery.One hundred eighty patients undergoing thyroid surgeries were randomly allocated (...) to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 μg/kg loading, 0.4 μg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The primary outcomes of cough were recorded. Secondary outcomes included hemodynamic variables, awareness time, volume of drainage, the postoperative visual analogue scale and adverse effects were recorded.The incidence of cough were significantly lower in the LIDO group (28.3

2019 BMC Anesthesiology Controlled trial quality: uncertain

173. Cohort Study on Laryngeal Cough Reflex, Respiratory Disease, and Death: A Mediation Analysis. (Abstract)

Cohort Study on Laryngeal Cough Reflex, Respiratory Disease, and Death: A Mediation Analysis. To estimate quantitatively whether the presence of cough associated with dysphagia (laryngeal cough reflex) increased mortality through respiratory disease among community-dwelling older Japanese.A 6-year follow-up prospective cohort study (from 2010 to 2017).Thirteen municipalities in Japan.Community-dwelling individuals aged 65 years or older (N = 32,682).The baseline survey was conducted through (...) self-reported questionnaire. Exposure was experience of laryngeal cough reflex while drinking. The outcome was all-cause mortality. All covariates were selected from demographic, socioeconomic variables, baseline health and functional status, smoking, alcohol drinking, number of remaining teeth, and stroke. The mediator variable was respiratory disease. Cox proportional hazards regression was used to estimate hazard ratios (HRs) for mortality. Parametric mediation analysis was conducted to estimate

2019 Journal of the American Medical Directors Association

174. Update on the clinical development of gefapixant, a P2X3 receptor antagonist for the treatment of refractory chronic cough. (Abstract)

Update on the clinical development of gefapixant, a P2X3 receptor antagonist for the treatment of refractory chronic cough. Chronic cough, or cough lasting >8 weeks, is often associated with underlying medical conditions (ie, asthma, gastroesophageal reflux disease, nonasthmatic eosinophilic bronchitis, and upper-airway cough syndrome). In some patients with chronic cough, treatment of these underlying conditions does not resolve the cough (refractory chronic cough [RCC]), or none (...) of these conditions are present (unexplained chronic cough [UCC]). Despite appropriate medical evaluation, patients with RCC or UCC frequently experience cough persisting for many years, as there are currently no targeted pharmacological approaches approved for the treatment of these conditions. However, the adenosine triphosphate (ATP)-gated P2X3 receptor, a key modulator of the activation of sensory neurons central to the cough reflex, has recently garnered attention as a potential therapeutic target

2019 Pulmonary Pharmacology & Therapeutics

175. Why chronic cough in children is different. (Abstract)

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

176. Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities: the case of the Western Cape, South Africa. Full Text available with Trip Pro

Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities: the case of the Western Cape, South Africa. This study aimed to analyse the patient predictors of health-seeking behaviour for persons coughing for more than 2 weeks to better understand this vulnerable and important population.The study analysed data from a cohort study (SOCS - Secondary Outcome Cohort Study) embedded in a community randomised trial ZAMSTAR (...) (Zambia and South Africa TB and AIDS Reduction Study) in eight high-burden TB communities in the Western Cape, South Africa. These datasets are unique as they contain TB-related data as well as data on health, health-seeking behaviour, lifestyle choices, employment, socio-economic status, education and stigma. We use uni- and multivariate logistic regressions to estimate the odds ratios of consulting for a cough (of more than 2 weeks duration) for a range of relevant patient predictors.Three hundred

2019 BMC health services research Controlled trial quality: uncertain

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

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 Controlled trial quality: uncertain

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

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 Controlled trial quality: uncertain

179. Chinese herbal medicine for the treatment of cough variant asthma: a study protocol for a double-blind randomized controlled trial. Full Text available with Trip Pro

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 Controlled trial quality: predicted high

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

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

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