scholarly journals Chronic cough: new insights and future prospects

2021 ◽  
Vol 30 (162) ◽  
pp. 210127
Author(s):  
Alyn Morice ◽  
Peter Dicpinigaitis ◽  
Lorcan McGarvey ◽  
Surinder S. Birring
Keyword(s):  
Chronic Cough ◽  
Disease Burden ◽  
Unmet Need ◽  
Standard Of Care ◽  
Underlying Disease ◽  
Disease Mechanisms ◽  
Current Review ◽  
Standard Of Care Treatment ◽  
Underlying Pathology

Chronic cough is defined in adults as a cough that lasts for ≥8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural dysregulation. Chronic cough and RCC result in a serious, often unrecognized, disease burden, which forms the focus of the current review.The estimated global prevalence of chronic cough is 2–18%. Patients with chronic cough and RCC report many physical and psychological effects, which impair their quality of life. Chronic cough also has a significant economic burden for the patient and healthcare systems. RCC diagnosis and treatment are often delayed for many years as potential treatable triggers must be excluded first and a stepwise empirical therapeutic regimen is recommended.Evidence supporting most currently recommended treatments is limited. Many treatments do not address the underlying pathology, are used off-label, have limited efficacy and produce significant side-effects. There is therefore a significant unmet need for alternative therapies for RCC that target the underlying disease mechanisms. Early clinical data suggest that antagonists of the purinergic P2X3 receptor, an important mediator of RCC, are promising, though more evidence is needed.

Fifteen-minute consultation: A structured approach to the management of chronic cough in a child

2017 ◽  
Vol 103 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Cherry Alviani ◽  
Gary Ruiz ◽  
Atul Gupta
Keyword(s):  
Chronic Cough ◽  
Respiratory Infections ◽  
School Attendance ◽  
Underlying Disease ◽  
Acute Respiratory Tract Infection ◽  
Healthy Children ◽  
Foreign Materials ◽  
Structured Approach

Coughing is a primary pulmonary defence mechanism that enhances clearance of secretions and particles from the airways and protects against aspiration of foreign materials. Coughing may affect 30% of children at any given time (1). Many are healthy children but some may have serious underlying disease. Childhood cough accounts for a large number of consultations and 80% of families who are referred to a paediatric respiratory clinic for chronic cough have sought medical advice five times or more (2). The majority of childhood coughs are secondary to an acute respiratory tract infection and will improve once the infection resolves, usually within 1 to 3 weeks. With pre-school children who may experience between 6 and 10 respiratory infections a year differentiating acute recurrent cough from chronic cough is key (Table 1). Chronic cough can significantly impact a family’s quality of life, as it affects the child’s sleep, school attendance and play. Parents experience distress and anxiety, worrying that the cough may lead to long-term chest damage or even death (3). This article aims to guide clinicians through the assessment of the child with a chronic cough. It will discuss identifying causes, use of first line investigations, initiating appropriate management and addressing parental anxiety and exacerbating factors (4,5).

scholarly journals Chronic cough: differential diagnosis and treatment

2020 ◽  
pp. 124-131
Author(s):  
N. V. Orlova
Keyword(s):  
Chronic Cough ◽  
Whooping Cough ◽  
Symptomatic Treatment ◽  
Underlying Disease ◽  
European Respiratory Society ◽  
Life Threatening ◽  
Examination Methods ◽  
Peripheral Action ◽  
Antitussive Drugs

Cough is one of the most common symptoms and is present in diseases of the respiratory, cardiovascular, digestive, endocrine and other systems. Cough is a reflex act, therefore it is caused by stimulation of cough receptors due to pathological influences. The diagnosis takes into account the nature of the cough, its duration, the results of laboratory and instrumental examination methods. The most attention is required to diagnose chronic cough and exclude life-threatening causes. Symptoms of anxiety are hemoptysis, prolonged resistant cough, prolonged intoxication syndrome, weight loss, etc. In diagnostically unclear cases, the examination schedule must include computed tomography of the chest, magnetic resonance imaging and bronchoscopy. A dry, painful intense cough can lead to the development of complications: a decrease in the quality of life, hemorrhages, pneumothorax, etc., therefore, requires symptomatic treatment. A common cause of unproductive cough is viral diseases, whooping cough, diseases leading to overactive cough receptors. The variety of coughs determines a differentiated approach to its therapy. The main efforts should be directed to the treatment of the underlying disease. In the case of a productive cough, mucoactive drugs are used. To stop unproductive cough, antitussive drugs of central and peripheral action are used. The recommendations of the European Respiratory Society present the results of clinical trials assessing the efficacy and safety of antitussive drugs with morphine-like action. The study identified side effects that limit their use. One of the most effective and safe drugs is a non-opioid drug with a central action Sinekod. The effectiveness and safety of the drug is confirmed by clinical studies.

scholarly journals Daily Lifestyle Modifications to Improve Quality of Life and Survival in Glioblastoma: A Review

2021 ◽  
Vol 11 (5) ◽  
pp. 533
Author(s):  
Sarah Travers ◽  
N. Scott Litofsky
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Animal Studies ◽  
Standard Of Care ◽  
Active Role ◽  
Lifestyle Changes ◽  
Comprehensive Treatment ◽  
Lifestyle Modifications ◽  
Standard Of Care Treatment

Survival in glioblastoma remains poor despite advancements in standard-of-care treatment. Some patients wish to take a more active role in their cancer treatment by adopting daily lifestyle changes to improve their quality of life or overall survival. We review the available literature through PubMed and Google Scholar to identify laboratory animal studies, human studies, and ongoing clinical trials. We discuss which health habits patients adopt and which have the most promise in glioblastoma. While results of clinical trials available on these topics are limited, dietary restrictions, exercise, use of supplements and cannabis, and smoking cessation all show some benefit in the comprehensive treatment of glioblastoma. Marital status also has an impact on survival. Further clinical trials combining standard treatments with lifestyle modifications are necessary to quantify their survival advantages.

scholarly journals Therapy of Chagas Disease: Implications for Levels of Prevention

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Sergio Sosa-Estani ◽  
Lisandro Colantonio ◽  
Elsa Leonor Segura
Keyword(s):  
Chagas Disease ◽  
Disease Burden ◽  
Current Knowledge ◽  
Standard Of Care ◽  
Current Evidence ◽  
Primary Health Care System ◽  
Primary Health ◽  
Health Strategy ◽  
Different Levels

This paper reviews the evidence supporting the use of etiological treatment for Chagas disease that has changed the standard of care for patients withTrypanosoma cruziinfection in the last decades. Implications of this evidence on different levels of prevention as well as gaps in current knowledge are also discussed. In this regard, etiological treatment has shown to be beneficial as an intervention for secondary prevention to successfully cure the infection or to delay, reduce, or prevent the progression to disease, and as primary disease prevention by breaking the chain of transmission. Timely diagnosis during initial stages would allow for the prescription of appropriate therapies mainly in the primary health care system thus improving chances for a better quality of life. Based on current evidence, etiological treatment has to be considered as an essential public health strategy useful to reduce disease burden and to eliminate Chagas disease altogether.

scholarly journals Disease burden and quality of life of patients with chronic cough in Japan: a population-based cross-sectional survey

2021 ◽  
Vol 8 (1) ◽  
pp. e000764
Author(s):  
Takekazu Kubo ◽  
Keisuke Tobe ◽  
Kotoba Okuyama ◽  
Masashi Kikuchi ◽  
Yirong Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Cough ◽  
Sleep Problems ◽  
Unmet Need ◽  
Resource Utilisation ◽  
Activity Impairment ◽  
Cross Sectional ◽  
Underlying Diseases ◽  
The Impact

BackgroundCough lasting 3–8 and >8 weeks are defined as subacute/prolonged cough and chronic cough (CC), respectively. Studies have revealed that CC negatively impact patients’ quality of life (QoL). In Japan, there is limited data on the impact of CC on health-related quality of life (HRQoL), work productivity and activity impairment (WPAI) and healthcare resource utilisation (HRU) using validated instruments. This study aimed to estimate the burden of CC and to compare the burden among patients with CC between subgroups.MethodsData from two cross-sectional online surveys conducted between September and November 2019 were combined for the analysis. Eligible patients with cough were propensity score matched to non-cough respondents. Comparisons of general HRQoL, WPAI, HRU and other symptoms experienced were conducted between matched non-cough respondents and patients with cough. Among patients with CC, subgroup comparisons were performed to understand general HRQoL, WPAI, HRU, cough-related QoL (Leicester Cough Questionnaire and Hull Airway Reflux Questionnaire) between patients with CC of different severities, patients with refractory CC and patients with non-refractory CC and patients with CC whose underlying diseases were unknown and others.ResultsPatients with CC (n=568) in Japan reported significantly poorer HRQoL, increased WPAI, more HRU and higher proportion of psychological and sleep problems, compared with matched non-cough respondents selected from 21 415 non-cough respondents. More patients with severe CC reported significantly poorer HRQoL, increased WPAI and worse cough-related QoL. Patients with refractory CC experienced significantly greater burden measured by cough-related QoL. No significant differences were observed between patients with CC whose underlying diseases were unknown and other patients with CC in terms of general HRQoL and cough-related QoL.ConclusionsThis study showed that patients with CC in Japan experienced significant burden compared with non-cough respondents. Patients with more severe cough and refractory CC experienced worse cough-related QoL. These results highlighted the unmet need for better interventions and treatments to reduce the burden among patients with CC.

Chronic Refractory Cough: A Case Study

2017 ◽  
Vol 2 (3) ◽  
pp. 57-62
Author(s):  
Anna Maria Siciliano
Keyword(s):  
Quality Of Life ◽  
Adult Female ◽  
Chronic Cough ◽  
Treatment Regime ◽  
Speech Language Pathology ◽  
Old Adult ◽  
Language Pathology

This paper presents a successful behavioral case study in treatment of chronic refractory cough in a 60-year-old adult female. The efficacy for speech-language pathology treating chronic cough is discussed along with description of treatment regime. Discussion focuses on therapy approaches used and the patient's report of changes in quality of life and frequency, duration, and severity reduction of her cough after treatment.

Reduce Disease Burden of Human Schistosomiasis in Asia Through Biological Control

2020 ◽  
Vol 20 (12) ◽  
pp. 1118-1132
Author(s):  
Sidra Saleem ◽  
Haroon Ahmed ◽  
Tooba Siddiqui ◽  
Seyma Gunyakti Kilinc ◽  
Aisha Khan ◽  
...  
Keyword(s):  
Biological Control ◽  
Geographical Distribution ◽  
Disease Burden ◽  
Management Practices ◽  
Control Strategies ◽  
Parasitic Disease ◽  
Asian Countries ◽  
Neglected Disease ◽  
Current Review ◽  
Near Future

Schistosomiasis is a chronic parasitic disease caused by a trematode blood fluke of the genus Schistosoma that belongs to the Schistosomatidae family. It is a neglected disease in different regions of Asia. In this review, 218 articles (between 2000 and 2017) related to the topic were collected from PubMed and Google scholar and reviewed. After thoroughly reading collected articles, due to irrelevant topic requirements, 94 articles were excluded. Articles that have data associated with Asian regions are considered. In Asia, the disease is prevalent in China, Philippines, Indonesia, Yemen, Nepal and Laos, etc. While in Pakistan, India and Bangladesh, the disease is not endemic and very few cases were reported. The disease was eliminated from Japan and Iran. The current review highlights the geographical distribution among Asian countries, transmission patterns, diagnosis, control strategies based on the use of anthelmintic plants and management practices implemented in Asia for the control of schistosomiasis. However, new implementations to treat schistosomiasis in humans should be proved to eliminate the disease finally in the future. This review emphasizes the biological control of schistosomiasis for the eradication of the disease from Asia in the near future.

scholarly journals Use of an advanced collagen matrix dressing on patients with complex chronic lower extremity ulcers: A case series

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110136
Author(s):  
Afsaneh Alavi ◽  
Jeannine Archer ◽  
Patricia Coutts
Keyword(s):  
Wound Healing ◽  
Lower Extremity ◽  
Ethylenediaminetetraacetic Acid ◽  
Case Series ◽  
Standard Of Care ◽  
Collagen Matrix ◽  
Contact Layer ◽  
Complete Healing ◽  
Average Decrease

The objective of this case series was to assess the wound healing effectiveness of a collagen matrix wound dressing containing partially denatured collagen, carboxymethyl cellulose, alginate and ethylenediaminetetraacetic acid in chronic lower extremity ulcers. A total of nine patients with refractory lower extremity ulcers were treated with the collagen contact layer in addition to standard of care. Wound healing progress was measured at 2, 4 and 8 weeks. An average decrease in wound size of 73% was achieved across patients at week 8, with complete healing in two patients. The intervention was easy to use and well tolerated by patients. The results of this study, although preliminary, suggest that the advanced collagen matrix dressing represents an effective and safe treatment strategy for healing refractory chronic lower extremity ulcers of varying etiologies. Further investigation is needed to evaluate efficacy in a larger randomized clinical trial with focus on cost-effectiveness and impact on patient’s quality-of-life.

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