Simple Cough Research Articles

Increased F-18 FDG Pulmonary Uptake in Contrast Medium Aspiration on PET/CT Imaging

This case illustrates the possibility of increased FDG uptake in persistent lesions resulting from asymptomatic barium aspiration, which provokes a mild acute inflammatory and edematous reaction within hours, followed by macrophage accumulation, granulomatous inflammation, and fibrosis over succeeding days and months. Barium aspiration occurred during an esophagram 6 months before PET/CT scanning in a 54-year-old man who was seen for suspicion of recurrence of head and neck cancer. In case of minor aspiration, a simple cough is generally observed, but large amounts of barium aspiration can be fatal, especially in elderly people.

Reproducibility and validity of a Yan-style portable citric acid cough challenge

Although many different methods of measuring cough reflex sensitivity have been published, few are simple enough to use outside of a hospital or laboratory environment. The aim of this study was to develop a simple, quick, and portable cough challenge, assess its reproducibility, and compare its results with those measured by an existing established hospital protocol. Twenty-five volunteers performed cough challenges based on an established hospital dosimeter protocol, and, on a separate occasion, by a protocol inhaling citric acid from DeVilbiss 40 hand-held nebulisers (citric acid concentrations of 10–3000 mM). Reproducibility of the hand-held cough challenge was assessed in 11 volunteers. Cough thresholds were consistently higher by the hand-held method than by the hospital dosimeter method. The geometric mean citric acid concentrations causing two coughs (threshold D 2) were 3.14 and 2.77 log mM, respectively ( p<0.001). The geometric mean (95% CI) difference between the tests was 0.51 log mM (0.18–0.83) of the average of the two values. Cough D 2 thresholds attained by the two techniques did, however, show significant correlation ( r=0.95, p<0.0001). The coefficient of repeatability for the hand-held method was 0.40 log mM. Administering citric acid from DeVilbiss 40 hand-held nebulisers offers a rapid, portable, and reproducible cough challenge in healthy volunteers. The results correlate well with an existing Mefar dosimeter challenge, but give two to three times greater cough thresholds.

Lymphangioleiomyomatosis: A Case Report and Review of the Literature

Lymphangioleiomyomatosis, a rare disease of unknown etiology that is seen almost exclusively in women of childbearing age, generally presents with features of pulmonary involvement. It may be associated with tuberous sclerosis. Its clinical pulmonary manifestations vary from simple cough to the development of recurrent pneumothorax, hemoptysis, and even complicated pleural effusions. Progressive dyspnea develops as the disease evolves. Most patients eventually require lung transplant. This wide array of symptoms and signs makes the differential diagnosis extensive, and the clinician must be familiar with this disorder to arrive promptly to the correct diagnosis. Here we report a case of a 35-year-old woman with a history of pleuritic effusion with associated dyspnea before being diagnosed with lymphangioleiomyomatosis. A review of the literature pertinent to this case is also provided.

Enhanced cough response to hyperpnea with cold air challenge in chronic cough patients showing increased cough sensitivity to inhaled capsaicin.

Although many chronic cough patients have complained of an induced cough by cold air contact, the clinical relevance of cold air to inducing a cough and the diagnostic value of a hyperpnea with cold air (HCA) challenge to detect a hyperreactive cough reflex have not yet been investigated. Recordings of cough counts after a 2-min HCA challenge were performed in 49 chronic cough patients and 15 healthy controls. Capsaicin cough provocation tests, which determine the threshold concentration of capsaicin that induces five or more consecutive coughs (C5), were also administered. After comparing the results from the capsaicin cough provocation tests of the patients and the controls, the chronic cough patients were divided into two groups: an increased cough sensitivity (ICS) group (n = 28) (C5 < 32 micromol/l) and a normal cough sensitivity (NCS) group (n = 21) (C5 >or= 32 micromol/l). The median value of induced cough counts after a HCA challenge was 11 coughs in patients with ICS and was a significantly enhanced cough response compared to that of the patients with NCS and healthy controls (four coughs, respectively). A simple cough provocation test using a HCA challenge may be useful for detecting ICS. It also suggests that hyperreactive cough reflexes may be one of the mechanisms of inducing chronic cough.

A household survey on morbidity and treatment of acute respiratory infections in communities in Vietnam.

To ascertain the extent of under-utilization and insufficiency or inappropriateness in provision of health services as one of the possible causes of high mortality from pediatric pneumonia in pilot areas in Vietnam. The household survey on morbidity and treatment of acute respiratory infections, simple cough, and cold and pneumonia, was conducted in two communities with 10% sampling of the child population. Both under-treatment of "fast breathing", a proxy for pneumonia, and over-treatment of simple cough and cold with antimicrobials by health workers, mothers, and private practitioners were common. A household survey on morbidity and treatment was found to be useful to clarify actual practices in the treatment of acute respiratory infections in the community, which cannot be obtained by mere interview with health workers or mothers. Since a change of knowledge did not automatically lead to change of practice, the training of health workers, health education of mothers and provision of antimicrobials at village health stations would not guarantee improved practice of health workers and mothers. Therefore, constant supervision for health workers, continued health education of mothers and involvement of private practitioners are needed to improve the situation.

Child health Winter Colds

How can you tell the difference between a simple winter cold or cough and more serious illnesses requiring hospital treatment? Dr Robert Walker has some advice.

Relation of Chronic Cough to Atopy and Defects in Host Defense

The background and etiology of chronic cough were investigated by comparing three groups of children under 6 years of age, 60 of whom had simple cough, 60 of whom had asthma, and 60 of whom were used as controls. Both cough and asthma were more common in boys and associated with a history of eczema, chest deformity, and skin reactivity to inhaled allergens, but these findings were more prevalent in conjunction with asthma than with cough. House dust mite sensitivity was found in 34 (57%) of the children who had simple cough, 45 (75%) of those who had asthma, and 6 (10%) of the control subjects.

Pneumomediastinum

Pneumomediastinum is an entity in which free air is found within the mediastinum. It occurs principally in healthy young men and parturient women and is found most frequently without apparent precipitatory cause. Functionally, however, alveolar hyperpressure, pulmonary capillary hypotension, or aveolar wall defects on a localized basis may occur as a result of, or may be associated with an acute, transient, respiratory obstruction, a type found most commonly in parturition, simple cough, emesis, or asthma. The most common symptoms are pain and dyspnea. Fever and leukocytosis without apparent infection are also frequently encountered. With obvious extrathoracic sources of mediastinal air excluded, the criteria for the diagnosis of pneumomediastinum should include the combination of roentgenographic free mediastinal air and subcutaneous emphysema.

Pneumomediastinum. A report of 28 cases and review of the literature.

Pneumomediastinum is an entity in which free air is found within the mediastinum. It occurs principally in healthy young men and parturient women and is found most frequently without apparent precipitatory cause. Functionally, however, alveolar hyperpressure, pulmonary capillary hypotension, or aveolar wall defects on a localized basis may occur as a result of, or may be associated with an acute, transient, respiratory obstruction, a type found most commonly in parturition, simple cough, emesis, or asthma. The most common symptoms are pain and dyspnea. Fever and leukocytosis without apparent infection are also frequently encountered. With obvious extrathoracic sources of mediastinal air excluded, the criteria for the diagnosis of pneumomediastinum should include the combination of roentgenographic free mediastinal air and subcutaneous emphysema.