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Activities of daily living decline is a predictor of lowered coughing ability and correlates with rehabilitative effect of tongue cleaning on coughing ability. Basic activities of daily living (ADL) is a critical indicator of independency in older adults. The purpose of this study is to evaluate impact of ADL decline on coughing ability, as determined by peak expiratory flow rate (PEFR), and to evaluate impact of ADL decline on the ability of tongue cleaning intervention to improve PEFR (...) . Methods: Participants comprised 95 residents of 11 group homes and nursing homes in Kumamoto, Japan. Participants were randomly assigned to cohorts with or without tongue cleaning intervention. Coughing ability was evaluated by measuring PEFR before and after 2 weeks, 4 weeks, and 3 months of intervention. Basic ADL was assessed by Barthel index (BI). Mean BI score among the participants was 59.3 ± 24.2. PEFR in a cohort with ≤ 60 BI score (LB) (1.2, 0.2-4.7 L s-1) was significantly lower than
Chronic Cough and Gastroesophageal Reflux in Children: CHEST Guideline and Expert Panel Report Whether gastroesophageal reflux (GER) or GER disease (GERD) causes chronic cough in children is controversial. Using the Population, Intervention, Comparison, Outcome (PICO) format, we undertook four systematic reviews. For children with chronic cough (> 4-weeks duration) and without underlying lung disease: (1) who do not have gastrointestinal GER symptoms, should empirical treatment for GERD be used (...) ? (2) with gastrointestinal GER symptoms, does treatment for GERD resolve the cough? (3) with or without gastrointestinal GER symptoms, what GER-based therapies should be used and for how long? (4) if GERD is suspected as the cause, what investigations and diagnostic criteria best determine GERD as the cause of the cough?We used the CHEST Expert Cough Panel's protocol and American College of Chest Physicians (CHEST) methodological guidelines and GRADE (Grading of Recommendations Assessment
Is there evidence backing the use of guaifensin for cough secondary to upper respiratory infection (URI)? Chiefs’ Inquiry Corner – 8/12/19 – Clinical Correlations Search Chiefs’ Inquiry Corner – 8/12/19 August 12, 2019 2 min read Clinicians frequently recommend symptomatic management for cough, specifically over-the-counter (OTC) medications, but the data doesn’t necessarily back it up. A 2014 Cochrane review of OTC medications for acute cough in adults and children found that among the 29 (...) randomized, placebo-controlled studies, there was poor reporting and little quantitative data. Among the three studies that specifically compared guaifensin and placebo, only one showed a significant difference, with patients taking guaifensin reporting a greater reduction in cough frequency and intensity after 3 days. Overall, only 11 of the 29 studies showed positive results for OTC medications such as guaifensin, dextromethorphan, and pseudophedrine. “Symptomatic management” may be an even more
Speech and language therapy for management of chronic cough. Cough both protects and clears the airway. Cough has three phases: breathing in (inspiration), closure of the glottis, and a forced expiratory effort. Chronic cough has a negative, far-reaching impact on quality of life. Few effective medical treatments for individuals with unexplained (idiopathic/refractory) chronic cough (UCC) are known. For this group, current guidelines advocate the use of gabapentin. Speech and language therapy (...) of the two studies included children. The duration of treatment and length of sessions varied between studies from four sessions delivered weekly, to four sessions over two months. Similarly, length of sessions varied slightly from one 60-minute session and three 45-minute sessions to four 30-minute sessions. The control interventions were healthy lifestyle advice in both studies.One study contributed HRQoL data, using the Leicester Cough Questionnaire (LCQ), and we judged the quality of the evidence
Are Antibiotics Effective in the Treatment of Children With Prolonged Wet Cough? Are Antibiotics Effective in the Treatment of Children With Prolonged Wet Cough? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages 453–455 Are Antibiotics Effective in the Treatment of Children With Prolonged Wet Cough? x Brit Long , MD (EBEM Commentator) , x Michael D. April , MD, DPhil (EBEM (...) Commentator) Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX DOI: | Publication History Published online: November 13, 2018 Expand all Collapse all Article Outline Take-Home Message Antibiotics may improve clinical cure and reduce progression of illness in children with prolonged wet cough. Methods Data Sources Authors identified trials from the Cochrane Airways Trials Register, CENTRAL, MEDLINE OvidSP, and EMBASE OvidSP through September
Clinically Diagnosing Pertussis-associated Cough in Adults and Children: CHEST Guideline and Expert Panel Report The decision to treat a suspected case of pertussis with antibiotics is usually based on a clinical diagnosis rather than waiting for laboratory confirmation. The current guideline focuses on making the clinical diagnosis of pertussis-associated cough in adults and children.The American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations (...) , Assessment, Development, and Evaluation framework were used. The Expert Cough Panel based their recommendations on findings from a systematic review that was recently published on the topic; final grading was reached by consensus according to Delphi methodology. The systematic review was carried out to answer the Key Clinical Question: In patients presenting with cough, how can we most accurately diagnose from clinical features alone those who have pertussis-associated cough as opposed to other causes
Adult Outpatients With Acute Cough Due to Suspected Pneumonia or Influenza: CHEST Guideline and Expert Panel Report Patients commonly present to primary care services with upper and lower respiratory tract infections, and guidelines to help physicians investigate and treat acute cough due to suspected pneumonia and influenza are needed.A systematic search was carried out with eight patient, intervention, comparison, outcome questions related to acute cough due to suspected pneumonia (...) or influenza.There was a lack of randomized controlled trials in the setting of outpatients presenting with acute cough due to suspected pneumonia or influenza who were not hospitalized. Both clinical suggestions and research recommendations were made on the evidence available and CHEST Expert Cough Panel advice.For outpatient adults with acute cough due to suspected pneumonia, we suggest the following clinical symptoms and signs are suggestive of pneumonia: cough; dyspnea; pleural pain; sweating, fevers
Effect of Tramadol Pretreatment on Sufentanil-Induced Cough. To investigate the effect of tramadol pretreatment on the incidence and severity of sufentanil-induced cough.Randomized controlled trial.Adults of both genders (N = 304; 18 to 65 years old, American Society of Anesthesiologists physical status I to II), scheduled for elective surgery, were randomized into two groups (n = 152): intravenous administration of tramadol 1 mg/kg (group T) or normal saline (group C). Then sufentanil bolus (...) 0.3 mcg/kg was administered intravenously in 5 seconds. The incidence and severity of cough were observed for 1 minute. Mean arterial pressure, heart rate, nausea, vomiting, and truncal rigidity during induction were also recorded.Patient characteristics were similar between the two groups. The incidence of cough was significantly lower in group T when compared with group C (7.9% vs 18.4%, P < .05); there were nine patients coughing severely in group C, whereas no severe cough occurred in group T
The impacts of cough: a cross-sectional study in a Finnish adult employee population Given the very high prevalence of cough, little is known about its impacts. A questionnaire was sent via e-mail to all public service employees in two towns in Finland. There were 373 subjects with acute cough, 174 with subacute cough and 421 with chronic cough. Cough-related quality of life was assessed with the Leicester Cough Questionnaire (LCQ) and depressive symptoms with Patient Health Questionnaire-2 (...) . In addition, data on doctor's visits and sick leave days were collected. Mean LCQ (95% CI) total scores were 16.2 (15.9-16.5), 14.5 (14.1-15.0) and 14.6 (14.3-14.9) among subjects with acute, subacute and chronic cough, respectively (p<0.001). The prevalence of depressive symptoms was 5.4%, 7.5% and 4.8%, respectively, and 5.0% among subjects without current cough (p=0.50). The respective proportions of subjects with at least one doctor's visit due to cough during the previous year were 27.6%, 44.8%, 49.6
Treatment of Interstitial Lung Disease Associated Cough: CHEST Guideline and Expert Panel Report Chronic cough in interstitial lung disease (ILD) causes significant impairment in quality of life. Effective treatment approaches are needed for cough associated with ILD.This systematic review asked: Is there evidence of clinically relevant treatment effects for therapies for cough in ILD? Studies of adults aged > 18 years with a chronic cough ≥ 8 weeks' duration were included and assessed (...) for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using CHEST guideline methodology.Eight randomized controlled trials and two case series (≥ 10 patients) were included that reported data on patients with idiopathic pulmonary fibrosis, sarcoidosis, and scleroderma-related ILD who received a variety of interventions. Study quality was high in all eight randomized controlled trials. Inhaled corticosteroids were not supported for cough associated
Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance: CHEST Expert Panel Report Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance CHEST Expert Panel Report Adam T. Hill, MD; Alan F. Barker, MD, FCCP; Donald C. Bolser, PhD; Paul Davenport, PhD; Belinda Ireland, MD; Anne B. Chang, MBBS, PhD, MPH; Stuart B. Mazzone, PhD; and Lorcan McGarvey, MD BACKGROUND: Inbronchiectasisduetocystic?brosis(CF)andothercauses (...) ,airwayclearanceis oneofthemainstaysofmanagement.Weconductedasystematicreviewonairwayclearanceby using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough. METHODS: The systematic search for evidence examined the question, “Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?” Populations selected were all patients
Treatments for subacute cough in primary care: systematic review and meta-analyses of randomised clinical trials Subacute cough following a non-specific viral infection lasting 3-8 weeks is common. However, despite many treatment options there are no systematic reviews evaluating these.To provide a systematic overview of treatment options and outcomes evaluated in randomised clinical trials (RCTs).Systematic review and meta-analyses assessing the overall effects of any treatment for subacute (...) cough.The authors systematically searched PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials (last search March 2017) for RCTs in adult patients with subacute cough. The authors considered trials evaluating any outcome of any drug or non-drug treatments, apart from traditional Chinese and Asian medicines. They combined treatment effects on cough-related outcomes in random effects meta-analyses.Six eligible RCTs including 724 patients were identified. These assessed montelukast
Upper airway cough syndrome Upper airway cough syndrome - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Upper airway cough syndrome Last reviewed: February 2019 Last updated: September 2018 Summary Chronic cough that occurs with coexisting upper airway symptoms, including abnormal sensations arising from the throat and a postnasal drip sensation. Sensations attributed to nasal disease may actually be manifestations (...) of a sensory neuropathic process and not relate to rate or quantity of nasal discharge. Most common cause of chronic cough in adults. No pathognomonic findings exist; diagnosis should be determined by considering a combination of criteria, including the history, physical exam, imaging, and, ultimately, the response to therapy. Trial of empirical therapy with a first-generation antihistamine plus a decongestant is both diagnostic and therapeutic. Non-pharmacological therapies also form part of the treatment
Chronic Cough Related to Acute Viral Bronchiolitis in Children Chronic Cough Related to Acute Viral Bronchiolitis in Children CHEST Expert Panel Report Anne B. Chang, MBBS, PhD, MPH; John J. Oppenheimer, MD; Bruce K. Rubin, MD; Miles Weinberger, MD, FCCP; and Richard S. Irwin, MD, Master FCCP; on behalf of the CHEST Expert Cough Panel BACKGROUND: Acute bronchiolitis is common in young children, and some children develop chronic cough after their bronchiolitis. We thus undertook systematic (...) reviews based on key questions (KQs) using the PICO (Population, Intervention, Comparison, Outcome) format. The KQs were: Among children with chronic cough (> 4 weeks) after acute viral bron- chiolitis, how effective are the following interventions in improving the resolution of cough?: (1) Antibiotics. If so what type and for how long? (2) Asthma medications (inhaled steroids, beta 2 agonist, montelukast); and (3) Inhaled osmotic agents like hypertonic saline? METHODS: We used the CHEST expert cough
Antibiotics for prolonged wet cough in children. Cough is a frequent symptom presenting to doctors. The most common cause of childhood chronic (greater than fours weeks' duration) wet cough is protracted bacterial bronchitis (PBB) in some settings, although other more serious causes can also present this way. Timely and effective management of chronic wet or productive cough improves quality of life and clinical outcomes. Current international guidelines suggest a course of antibiotics (...) is the first treatment of choice in the absence of signs or symptoms specific to an alternative diagnosis. This review sought to clarify the current evidence to support this recommendation.To determine the efficacy of antibiotics in treating children with prolonged wet cough (excluding children with bronchiectasis or other known underlying respiratory illness) and to assess risk of harm due to adverse events.We undertook an updated search (from 2008 onwards) using the Cochrane Airways Group Specialised
Comparison of the effects of pretreatment intravenous fentanyl or intravenous lidocaine on suppression of fentanyl-induced cough in children: a randomized, double-blind, controlled clinical trial The injection of fentanyl usually causes coughing during induction of anesthesia. Based on a few studies about effects of lidocaine and the fact there is no study concerning the effect of fentanyl on fentanyl-induced cough in pediatric patients, the aim of this study was to compare the effectiveness (...) of low dose of fentanyl with lidocaine in prevention of fentanyl-induced cough in children.This randomized double-blind controlled clinical trial study was conducted at Motahari Hospital between February and August 2017 in Urmia (Iran). One hundred patients, aged 2-10 years, of class I or II ASA status who were candidates for elective herniorrhaphy under general anesthesia were enrolled in this study. They were randomly divided into three groups. One minute before the administration of 2 μg/kg
Whooping cough infection common in school aged children with stubborn coughs Whooping cough infection common in school aged children with stubborn coughs Discover Portal Discover Portal Whooping cough infection common in school aged children with stubborn coughs Published on 26 June 2014 doi: This NIHR-funded study found that almost a fifth of children aged five to 15 years who visited their GP with persistent cough showed signs of recent whooping cough infection, despite having a booster (...) vaccination before school age. These data, from 22 GP practices in Thames Valley UK, describe the duration of vaccine-induced immunity and the burden of disease in adolescents. This may inform policy discussion about the potential need for a national adolescent whooping cough booster programme in the UK. Share your views on the research. Why was this study needed? Whooping cough (pertussis) is one of the most common vaccine preventable diseases causing almost 300,000 childhood deaths a year worldwide