Abstracts
Cerebrospinal Fluid (CSF)
Cerebrospinal Fluid (CSF)
To assess motion of "brain" parenchyma and "cerebrospinal" fluid (CSF) with magnetic resonance (MR) phase imaging in real time.
Brain and CSF of healthy volunteers exhibited periodic motion in the frequency range of normal "heart" rate.
During the Valsalva maneuver, the brain stem showed initial "caudal" and subsequent cranial displacement of 2-3 mm. "Coughing" produced a short swing of CSF in the cephalic direction.
Brain and cerebrospinal fluid motion: real-time quantification with M-mode MR imaging. Maier, SEet al., Radiology. 1994 Nov; 193(2): 477-83.
Gastroesophageal (GE) Reflux
Gastroesophageal (GE) Reflux
We evaluated the relationship between gastroesophageal (GE) reflux and chronic cough using prolonged pH monitoring and the standard acid reflux study in a retrospective case review.
It appeared that the cough preceded GE reflux twice as often as reflux preceded cough. GE reflux does not appear to be a frequent cause of chronic cough.
Gastroesophageal reflux and chronic cough: which comes first? Laukka, MA et al., J-Clin-Gastroenterol. 1994 Sep; 19(2): 100-4.
Hyperresponsiveness in Children
Hyperresponsiveness in Children
In children, recurrent cough is a common presenting symptom that may represent asthma.
Tested the hypotheses that children with recurrent cough have increased cough-receptor sensitivity (CRS) or airway hyperresponsiveness (AHR).
During the cough-free period, there was no difference in CRS among the groups. In subjects who demonstrated AHR, the provocation dose causing a > or = 15% fall in FEV1 (PD15) during the cough period was significantly lower than that during the cough-free period.
AHR or increased CRS is present in children with recurrent cough.
Chang AB et al., Airway hyperresponsiveness and cough-receptor sensitivity in children with recurrent cough. Am J Respir Crit Care Med, 1997 Jun, 155:6, 1935-9.
Lower Respiratory Infections (Caugh)
Lower Respiratory Infections - Bangladeshi Children
Investigated the association between nutritional status, cell-mediated immune status and the incidence of acute lower respiratory infections (ALRI).
Determined the type and severity of respiratory infections, the field workers physically examined each child reporting a cough.
The incidence of ALRI was 23 episodes per 100 child-years. A
Improvement of nutritional and cell-mediated immune status in rural Bangladeshi children should reduce the incidence of ALRI.
Zaman K et al., Association between nutritional status, cell-mediated immune status and acute lower respiratory infections in Bangladeshi children. Eur J Clin Nutr, 1996 May, 50:5, 309-14.
Menthol
Menthol
"Menthol" is a commonly used ingredient in many over the counter cough remedies, but there is little objective evidence as to its efficacy.
Menthol is an effective "antitussive" agent in an evoked cough model.
Effect of inhaled menthol on citric acid induced cough in normal subjects. Morice-AH; Marshall-AE; Higgins-KS; Grattan-TJ. Thorax. 1994 Oct; 49(10): 1024-6.
Parental Reporting
Parental Reporting
Assessment of cough in the clinical setting as well as in community-based studies of respiratory epidemiology has relied on self-reports.
Questionnaires administered to parents about their childrens' coughing were compared to overnight cough recordings.
Percentage agreement between reported and recorded coughing was low, with kappa statistics ranging from 0.02-0.10.
Compared to non-smoking parents, smokers under-reported their childrens' coughing.
Dales RE et al., Parental reporting of childrens' coughing is biased. Eur J Epidemiol, 1997 Jul, 13:5, 541-5.
Pregnancy (Cough)
Pregnancy
"Pregnancy" is associated with special problems with respect in selection of medication and dosage, primarily due to potential teratogenic or toxic effects on the "fetus" by the drug itself, and secondly due to the physiologic adjustments in the mother in response to pregnancy.
Some kind of a symptomatic medication was taken by 43% of the women with no correlation of the length of pregnancy, the most common symptoms needing medication being "candidiasis", cough, reflux "esophagitis" and pregnancy-associated hyperemesis.
Use of medication during pregnancy--a prospective cohort study on use and policy of prescribing. Heikkila-AM; Erkkola-RU; Nummi-SE. Ann-Chir-Gynaecol-Suppl. 1994; 208: 80-3.
Ulcerative Colitis
Ulcerative Colitis
"Ulcerative colitis" is frequently associated with extraintestinal "inflammatory" manifestations. In the respiratory tract these usually take the form of chronic "bronchitis", which occasionally develops into bronchiectasis. This case confirms that the "inflammation" can also involve the "larynx" and large airways.
Severe inflammatory upper airway stenosis in ulcerative colitis. Rickli, H et al., Eur-Respir-J. 1994 Oct; 7(10): 1899-902.
Vitamin A (1) - Sudanese Children
Vitamin A (1) - Sudanese Children
The relationship of vitamin A deficiency and child survival has been documented in a number of studies but not in others and so remains controversial.
Examined the relationship of dietary vitamin A intake and the incidences of diarrhea and respiratory infection among 28,753 Sudanese children between the ages of 6 mo and 6 y.
Total dietary vitamin A intake was strongly and inversely associated with the risk of diarrhea; also observed a strong inverse association with the risk of having cough and fever.
Further noted a significantly positive association of dietary vitamin A intake and incidence of cough alone, perhaps a sign of a healthy respiratory epithelium.
Vitamin A intake was also negatively associated with the risk of measles.
Fawzi WW et al., Dietary vitamin A intake and the incidence of diarrhea and respiratory infection among Sudanese children. J Nutr, 1995 May, 125:5, 1211-21.
Vitamin A (2) - Indonesian Neonates
Vitamin A (2) - Indonesian Neonates
Determined whether vitamin A supplementation at birth could reduce infant morbidity and mortality.
Received either 52 micromol (50,000 IU) orally administered vitamin A or placebo on the first day of life. Infants were followed up at 1 year to determine the impact of this intervention on infant mortality.
The impact was stronger among boys, infants of normal compared with low birth weight, and those of greater ponderal index. Among infants examined at 4 months of age, the 1-week period prevalence of common morbidities was similar for vitamin A and control infants. However, during this same 4-month period, 73% and 51% more control infants were brought for medical treatment for cough and fever, respectively.
Neonatal vitamin A supplementation may reduce the infant mortality rate and the prevalence of severe respiratory infection among young infants.
Humphrey JH et al., Impact of neonatal vitamin A supplementation on infant morbidity and mortality. J Pediatr, 1996 Apr, 128:4, 489-96.
Whooping Cough
Whooping Cough
Time series analysis of the London Bills of Mortality, 1701-1812, reveals that whooping cough appeared as a lethal endemic disease after 1700 with epidemics of progressively increasing amplitude after 1720. The interepidemic period changed from 5 years (1720-1750) to 3 years (1750-1785) before returning to 5 years during 1785-1812.
Suggest that the epidemics were driven in 1720-1785 by fluctuating seasonal temperatures which interacted with oscillations in wheat prices to produce an oscillation in susceptibility, but after 1785 the dynamics escaped from the pattern predicted by mathematical theory and the epidemics were apparently driven only by the wheat prices which generated a regular oscillation in susceptibility.
Results emphasize the importance of an adequate nutritive level in combating whooping cough in the Third World today where it remains a lethal disease in children because of immunodeficiency linked to fluctuating and severe malnutrition which is often a consequence of crop cycles.
Duncan CJ et al., Whooping cough epidemics in London, 1701-1812: infection dynamics, seasonal forcing and the effects of malnutrition. Proc R Soc Lond B Biol Sci, 1996 Apr 22, 263:1369, 445-50.
Zinc - Ecuador
Zinc - Ecuador
Assessed the effect of zinc supplementation on respiratory tract disease, immunity and growth in malnourished children.
Children (supplemented, S group # 25) received 10 mg/day of zinc as zinc sulfate, and 25 (nonsupplemented, NS group) received a placebo during 60 days.
Daily the clinical presence of cough, respiratory tract secretions, and fever, was recorded.
The cutaneous delayed-type hypersensitivity (DTH) to multiple antigens, and anthropometric parameters were assessed. Serum zinc levels were also measured.
DTH was significantly larger (20.8 +/- 7.1 vs 16.1 +/- 9.7 mm), and serum zinc levels were significantly higher (118.6 +/- 47.1 vs 83.1 +/- 24.5 micrograms/dl) in the S group than in the NS group.
Sempertegui F et al., Effects of short-term zinc supplementation on cellular immunity, respiratory symptoms, and growth of malnourished Equadorian children. Eur J Clin Nutr, 1996 Jan, 50:1, 42-6.
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