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Federico Lavorini, Elisa Chellini, Margherita Innocenti, Giacomo Campi, Colin Gerard Egan, Selene Mogavero, Giovanni A Fontana
BACKGROUND: Persistent dry cough is a well known unwanted effect of Angiotensin-Converting Enzyme inhibitors (ACE-i). Animal studies have shown that the ACE-i zofenopril has a less tussigenic effect compared to the widely used ACE-i ramipril. The aim of this study was to compare cough sensitivity to inhaled tussigens, as well as spontaneous cough in response to the administration of zofenopril and ramipril in healthy volunteers; pharmacokinetic (PK) data of both zofenopril and ramipril, as well as their respective active forms, zofenoprilat and ramiprilat, was also collected...
2014: Cough
Michael T Costanzo, Richard A Yost, Paul W Davenport
BACKGROUND: Preparation of inhaled capsaicin solutions for cough induction varies greatly from one lab to another, which creates inconsistencies between tussigenic challenge results. The addition of Tween to these capsaicin solutions provides increased solubility and stability; however, the foul taste of Tween makes inhaling the solution for any prolonged period of time unpleasant. We sought to create a standard method for preparing soluble and stable capsaicin-based solutions (in 10% ethanol/water), without the addition of Tween...
2014: Cough
Shoaib Faruqi, Robert D Murdoch, Fabrice Allum, Alyn H Morice
BACKGROUND: The pathogenesis of chronic cough is not well understood and treatment options are limited. In this study we sought to explore the current understanding and management of chronic cough across an international group of specialists. METHODS: This was an international study of cross sectional qualitative design. In depth interviews were carried out with "Respiratory Specialists" experienced in treating treating Chronic Obstructive Pulmonary Disease (COPD), idiopathic pulmonary fibrosis (IPF), idiopathic chronic cough (ICC) and/or lung cancer patients and with "Disease Experts" in the field of Chronic Cough...
2014: Cough
Claire E Kilduff, Melanie J Counter, Gareth A Thomas, Nicholas K Harrison, Benjamin D Hope-Gill
BACKGROUND: Chronic cough affects more than 70 percent of patients with Idiopathic Pulmonary Fibrosis and causes significant morbidity. Gastroesophageal reflux is the cause of some cases of chronic cough; and also has a postulated role in the aetiology of Idiopathic Pulmonary Fibrosis. A high prevalence of acid; and more recently non-acid, reflux has been observed in Idiopathic Pulmonary Fibrosis cohorts. Therefore, gastroesophageal reflux may be implicated in the pathogenesis of cough in Idiopathic Pulmonary Fibrosis...
2014: Cough
Mary Beth Scholand, Roger Wolff, Peter Fredrick Crossno, Krishna Sundar, Molly Winegar, Spencer Whipple, Patrick Carey, Nicholas Sunchild, Hilary Coon
BACKGROUND: A polymorphism (rs35705950) in the promoter region of the mucin MUC5B is associated with both familial and sporadic forms of idiopathic pulmonary fibrosis. (IPF) We hypothesize that this common MUC5B variant will impact the expression of cough, a frequent disabling symptom seen in subjects with IPF. METHODS: We genotyped 136 subjects with IPF. All living subjects were provided with a Leicester Cough Questionnaire (LCQ) to measure cough severity. We assessed allele effects of the MUC5B polymorphism on the LCQ scores using SAS General Linear Models (GLM) in the patients with IPF...
2014: Cough
Roxana K Mincheva, Tanya Z Kralimarkova, Miroslava Rasheva, Zlatko Dimitrov, Denislava Nedeva, Maria Staevska, Vera Papochieva, Penka Perenovska, Karina Bacheva, Vasil D Dimitrov, Todor A Popov
BACKGROUND: Different conditions make the proximal airways susceptible to tussigenic stimuli in the chronic cough (CC) syndrome. Leukotrienes can be implicated in the inflammatory mechanism at play in it. Montelukast is a selective cysteinyl-leukotriene receptor antagonist with proven effectiveness in patients with asthma. The aim of our real-life pilot study was to use montelukast to relieve cough symptoms in patients with CC allegedly due to the two frequent causes other than asthma - upper airway cough syndrome and gastroesophageal reflux (GER)...
2014: Cough
Anne E Vertigan, Sarah L Bone, Peter G Gibson
BACKGROUND: Laryngeal hypersensitivity may be an important component of the common disorders of laryngeal motor dysfunction including chronic refractory cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. Patients with these conditions frequently report sensory disturbances, and an emerging concept of the 'irritable larynx' suggests common features of a sensory neuropathic dysfunction as a part of these disorders. The aim of this study was to develop a Laryngeal Hypersensitivity Questionnaire for patients with laryngeal dysfunction syndromes in order to measure the laryngeal sensory disturbance occurring in these conditions...
2014: Cough
Joanna Elizabeth Smith, Jaymin Bhagwanji Morjaria, Alyn Hugh Morice
BACKGROUND: Chronic cough is a common and distressing symptom. Gastro-oesophageal reflux is a common cause of chronic cough however the symptom complex in cough is not confined to classic peptic symptoms. Dyspeptic symptoms have previously been shown to respond to dietary modifications and weight loss. We hypothesised that weight reduction maybe a useful non-pharmacological strategy in reducing reflux cough in the obese. METHODS: Subjects with cough were recruited from Hull Cough Clinic...
2013: Cough
Heikki O Koskela, Minna K Purokivi
BACKGROUND: The mechanisms of chronic cough are unclear. Many reactive oxygen species affect airway sensory C-fibres which are capable to induce cough. Several chronic lung diseases are characterised by cough and oxidative stress. In asthma, an association between the cough severity and airway oxidative stress has been demonstrated. The present study was conducted to investigate whether airway oxidative stress is associated with chronic cough in subjects without chronic lung diseases...
2013: Cough
Juergen Fischer, Uwe Dethlefsen
OBJECTIVE: Cineole has mucolytic, bronchodilating and anti-inflammatory properties and reduces the exacerbation rate in patients suffering from COPD, as well as ameliorates symptoms in patients suffering from asthma and rhinosinusitis. Based on these effects, we therefore postulated the hypothesis that patients with acute bronchitis would also benefit from therapy with Cineole. METHODS: As part of a double-blind, placebo-controlled, multi-center-study, a total of 242 patients with confirmed acute bronchitis was randomly selected to participate...
2013: Cough
Tsai-Yu Wang, Yu-Lun Lo, Wen-Te Liu, Shu-Min Lin, Ting-Yu Lin, Chih-Hsi Kuo, Fu-Tsai Chung, Pai-Chien Chou, Po-Jui Chang, Yung-Lun Ni, Shu-Chuan Ho, Horng-Chyuan Lin, Chun-Hua Wang, Chih-Teng Yu, Han-Pin Kuo
BACKGROUND: Obstructive sleep apnoea (OSA) has recently been identified as a possible aetiology for chronic cough. The aim of this study was to compare the incidence of chronic cough between patients with and without OSA and the impact of continuous positive airway pressure (CPAP) treatment in resolving chronic cough. METHODS: Patients referred to the sleep laboratory from January 2012 to June 2012 were retrospectively enrolled. Clinical data, treatment course and resolution of chronic cough were analysed...
2013: Cough
Nicholas P Mason
Altitude-related cough is a troublesome condition of uncertain aetiology that affects many visitors to high altitude. The traditionally held belief that it was due solely to the inspiration of cold, dry air was refuted by observations and experiments in long duration hypobaric chamber studies. It is likely that altitude-related cough is a symptom of a number of possible perturbations in the cough reflex arc that may exist independently or together. These include loss of water from the respiratory tract; respiratory tract infections and sub-clinical high altitude pulmonary oedema...
2013: Cough
Naohiro Kashiwazaki, Satoru Ebihara, Peijun Gui, Norihiro Katayama, Kumiko Ito, Ryuhei Sato, Chika Oyama, Takae Ebihara, Masahiro Kohzuki
BACKGROUND: Non-pharmacological options for symptomatic management of cough are desired. Although chest wall mechanical vibration is known to ameliorate cough reflex sensitivity, the effect of mechanical vibrations on perceptions of urge-to-cough has not been studied. Therefore, we investigated the effect of mechanical vibration of cervical trachea, chest wall and femoral muscle on cough reflex sensitivity, perceptions of urge-to-cough as well as dyspnea. METHODS: Twenty-four healthy male never-smokers were investigated for cough reflex sensitivity, perceptions of the urge-to-cough and dyspnea with or without mechanical vibration...
2013: Cough
Zoltan Tomori, Viliam Donic, Roman Benacka, Jan Jakus, Sona Gresova
Various diseases often result in decompensation requiring resuscitation. In infants moderate hypoxia evokes a compensatory augmented breath - sigh and more severe hypoxia results in a solitary gasp. Progressive asphyxia provokes gasping respiration saving the healthy infant - autoresuscitation by gasping. A neonate with sudden infant death syndrome, however, usually will not survive. Our systematic research in animals indicated that airway reflexes have similar resuscitation potential as gasping respiration...
2013: Cough
Agreta Gecaj-Gashi, Zorica Nikolova-Todorova, Vlora Ismaili-Jaha, Musli Gashi
OBJECTIVE: Fentanyl-induced cough is usually mild and transitory, but it can be undesirable in patients with increased intracranial pressure, open wounds of the eye, dissecting aortic aneurism, pneumothorax, and reactive airway disease. The aim of this study is to evaluate the efficacy of lidocaine in suppressing fentanyl-induced cough in children during induction in general anesthesia. METHODS: One hundred and eighty-six children of both sexes, aged between 4-10 years, ASA physical status I and II, and scheduled for elective surgery, were recruited for the study...
2013: Cough
Krishna M Sundar, Sarah E Daly, Alika M Willis
BACKGROUND: Chronic cough patients are rendered therapies for gastro-esophageal reflux (GERD), upper airway cough syndrome (UACS) and cough-variant asthma (CVA) with varying benefit. Idiopathic or unexplained cough has emerged as an important clinical entity in both primary care and subspecialty clinics. Recent evidence points to a link between chronic cough and untreated obstructive sleep apnea (OSA). METHODS: A prospective observational study was done to evaluate the effect of OSA therapy in patients with chronic cough...
2013: Cough
Kefang Lai, Jiayu Pan, Ruchong Chen, Baojuan Liu, Wei Luo, Nanshan Zhong
Cough is one of the most common complaints for which patients seek medical attention. Misdiagnosis and mistreatment of cough exist commonly in China. The prevalence of acute cough caused by upper airway infection fluctuates between 9% and 64% in the community, for chronic cough, the prevalence >10% in most surveys, ranging from 7.2%-33%. The common causes of chronic cough are upper airway cough syndrome (previously called as post nasal drip syndrome [PNDS]), cough variant asthma (CVA), gastroesophageal reflux related cough (GERD) and eosinophilic bronchitis (EB)...
2013: Cough
Peter Ma Calverley
Over the last 40 years the assessment and treatment of chronic obstructive pulmonary disease has focused primarily on airflow obstruction with little significance given to the problem of cough. The reasons for this include a view that cough arises simply from the direct irritant and inflammatory effect of cigarette smoke or the presence of excess mucus in the airways. Doubt that cough is of any consequence to patients or responsive to current therapies has reinforced this opinion. At odds with this is the emerging evidence that cough impacts adversely on patients' health status and forms an important component of recently validated quality of life instruments...
2013: Cough
Guri S Sandhu, Romana Kuchai
About 40% of the population will experience chronic cough at some point during their lives and it tends to be more common in women (Thorax 58:901-7, 2003). Post-nasal drip (or upper airway cough syndrome), gastro-esophageal reflux disease and asthma are considered the most common causes. Yet only a small percentage of patients with these common conditions experience chronic cough. Also there is no agreed measure of post-nasal drip and controversy exists about the diagnosis of reflux above the upper esophageal sphincter (laryngopharyngeal reflux) based on observable changes to the larynx...
2013: Cough
Heikki O Koskela, Minna K Purokivi
BACKGROUND: Many patients with chronic cough respond to treatment with inhaled corticosteroids but it is difficult to predict which patients are likely to respond. The primary aim of the present study was to define the capability of hypertonic saline cough provocation test to predict the responsiveness to inhaled corticosteroids in chronic cough. The secondary aim was to assess the ability of the saline test to monitor the healing of cough during corticosteroid treatment. METHODS: Forty-three patients with chronic cough were recruited...
2013: Cough
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