scholarly journals Upper airway cough syndrome may be the main cause of chronic cough in Japan: a cohort study

2021 ◽  
Author(s):  
Kimihiko Yasuda
Keyword(s):  
Chronic Cough ◽  
Standard Treatment ◽  
Upper Airway ◽  
Final Diagnosis ◽  
Multivariate Logistic Regression ◽  
Common Cause ◽  
Nasal Steroids ◽  
Potential Use ◽  
Post Infectious ◽  
Observation Period

Abstract BackgroundUpper airway cough syndrome (UACS) is generally considered a common cause of chronic cough but remains poorly recognised in Japan.ObjectiveThis study aimed to assess whether UACS was a common cause of chronic cough in Japan, as is true in other countries. Interview and examination items were evaluated for their potential use in UACS diagnosis.Methods All patients with chronic cough were preliminarily diagnosed with bronchial asthma, UACS, gastroesophageal reflux disease, or post-infectious prolonged cough, based on interviews and examinations. Treatment centred on nasal steroids was administered to the UACS group and standard treatment to the other groups. The observation period lasted 4 weeks. The subjective cough score at first diagnosis was set at 10, and the final diagnosis was made based on the treatment administered at the time the cough score had decreased to ≤ 2. The associations between the presence or absence of UACS and interview and examination items were statistically evaluated.Results Among 230 patients with chronic cough, 146 were diagnosed with UACS-only. Multivariate logistic regression revealed that the assessment items ‘awareness of mucus accumulating in the back of the throat’, ‘presence of abnormal echography findings’, ‘absence of associated coughing when exercising’ and ‘presence of coughing persisting after onset’ were significantly correlated with the presence or absence of UACS (p < 0.05).ConclusionsUACS may be the most common cause of chronic cough in Japan and may be effectively treated with nasal corticosteroids. Diagnosing UACS might be possible by selecting appropriate interview and examination items.

scholarly journals Upper airway cough syndrome may be the main cause of chronic cough in Japan: a cohort study

2020 ◽  
Author(s):  
Kimihiko Yasuda
Keyword(s):  
Logistic Regression ◽  
Chronic Cough ◽  
Standard Treatment ◽  
Gastrointestinal Symptoms ◽  
Upper Airway ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Common Cause ◽  
Post Infectious ◽  
Observation Period

Abstract Background: Upper airway cough syndrome (UACS) is generally considered the main cause of chronic cough, but it is rarely recognised in Japan. This study identified the causes of chronic cough and assessed whether “UACS is the most common cause of chronic cough” in Japan, as it is in other countries. Although signs and symptoms of UACS are described as nonspecific, some items of interviews and examinations might be considered potentially useful in its diagnosis, and were evaluated for their association with it. Methods: All patients with chronic cough who visited my clinic were preliminarily diagnosed based on interviews and examinations. Bronchial asthma and UACS were preferentially diagnosed. Among the excluded cases, some patients with gastrointestinal symptoms or diet-related cough were diagnosed with gastroesophageal reflux disease, while others were diagnosed with post-infectious prolonged cough. Nasal corticosteroids were administered to the UACS group, and standard treatment to the other groups. The observation period lasted 4 weeks. Subjective cough score at first diagnosis was set at 10, and final diagnosis was made based on the treatment administered when the cough score had decreased to ≤2. The association between the presence or absence of UACS and interview and examination items was statistically evaluated using a logistic regression model. Results: Among 230 patients with chronic cough, 146 were diagnosed with UACS-only. In the UACS-only group treated with nasal corticosteroids, 110 patients showed a significant improvement in cough scores within 2 weeks. Multivariate logistic regression revealed that assessment items “awareness of mucus accumulating in the back of the throat” (odds ratio [OR]: 4.613; 95% confidence interval [CI]: 1.124–18.928; P=0.034), “presence of abnormal echography findings” (OR: 15.725; 95% CI: 1.445–171.101; P=0.024), “absence of associated coughing when exercising” (OR: 0.212; 95% CI, 0.055–0.813; P=0.024), and “presence of coughing persisting after onset” (OR: 6.470; 95% CI, 1.755–23.843; P=0.005) were significantly associated with the presence or absence of UACS. Conclusions: UACS is the most common cause of chronic cough in Japan, as in other countries, and can be effectively treated with nasal corticosteroids. Diagnosing UACS might be possible by selecting appropriate interview and examination items.

scholarly journals The effects of nasal breathing on the development of snoring and apnea

2020 ◽  
pp. 89-94
Author(s):  
Svetlana E. Yaremchuk
Keyword(s):  
Sleep Quality ◽  
Nasal Congestion ◽  
Upper Airway ◽  
Case Control Studies ◽  
Nasal Breathing ◽  
Adequate Treatment ◽  
Randomized Controlled ◽  
Breathing Disorders ◽  
Nasal Steroids ◽  
Improve Sleep Quality

Since the nose is the entrance gate of the upper airway, its stuffiness can contribute to sleep disturbance. The results of a number of case-control studies have shown that nasal congestion frequency associated with snoring and mild OSA. However, there is no strong correlation between the degree of nasal obstruction and the severity of OSA. Randomized controlled trials have shown that in patients with rhinitis, both allergic and non-allergic, the use of nasal steroids can improve sleep quality and may be useful for patients with mild OSA, but they themselves are not an adequate treatment. Surgical correction of nasal breathing disorders also reduces the apnea index and improves sleep quality.

Effect of intranasal steroids on chronic cough caused by upper airway cough syndrome

2014 ◽  
Vol 2 (5) ◽  
pp. 362
Author(s):  
Gun-Wung Na ◽  
Dong-Gyu Lee ◽  
Jun-Young Kim ◽  
Won-Il Park ◽  
Kyung-Been Lee ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Upper Airway ◽  
Intranasal Steroids

Effect of topical mometasone furoate on adenoidal lymphoid tissue: a light microscopic study

2019 ◽  
Vol 133 (2) ◽  
pp. 106-109 ◽  
Author(s):  
M R Ahmed ◽  
A S Abou-Halawa ◽  
I H Ibrahim ◽  
R F Zittoon ◽  
E F Y Makary
Keyword(s):  
Nasal Spray ◽  
Lymphoid Tissue ◽  
Topical Steroid ◽  
Upper Airway ◽  
Mometasone Furoate ◽  
Control Group ◽  
Adenoid Hypertrophy ◽  
Nasal Steroids ◽  
Grade 3 ◽  
Adenoidal Tissue

AbstractBackgroundAdenoid hypertrophy is a common cause of upper airway obstruction, and adenoidectomy is one of the most frequently performed operations in children. Topical nasal steroids can act directly on nasopharyngeal lymphoid tissue to decrease its reactive inflammatory changes and potentially reduce its size.ObjectiveTo study the light microscopic changes in adenoidal lymphoid tissue after one month of topical steroid use.MethodsTwenty-six children with adenoid hypertrophy grade 3 scheduled for adenoidectomy were randomly divided into two equal groups: one group received mometasone furoate aqueous nasal spray (Nasonex) 100 mcg/day for four weeks, and a control group received nasal normal saline 0.9 per cent for four weeks. The removed adenoids were examined histopathologically.ResultsAdenoidal tissue from the mometasone group had less reactive germinal centres and less spongiosis compared to the control group. The latter showed proliferating, reactive, variable sized and shaped lymphoid follicles, with congested blood vessels in the interfollicular areas.ConclusionThe use of intranasal mometasone furoate aqueous nasal spray (Nasonex) for one month reduced adenoidal tissue reactive cellular changes and its vascularity. This is, however, a pilot study; a longer treatment period is needed to assess the effect of treatment on adenoidal size.

scholarly journals 713 Common Cause of Chronic Cough in Children

2010 ◽  
Vol 68 ◽  
pp. 361-361
Author(s):  
M Sadeghi-Shabestari ◽  
Jabari Y Mogaddam
Keyword(s):  
Chronic Cough ◽  
Common Cause

Analysis of the effectiveness of medical and laser treatment of patients with diabetic retinopathy

2012 ◽  
Vol 93 (4) ◽  
pp. 594-597
Author(s):  
V V Kuzovnikov ◽  
V A Nevmerzhitskaya ◽  
V I Lazarenko
Keyword(s):  
Diabetic Retinopathy ◽  
Laser Treatment ◽  
Standard Treatment ◽  
Central Field ◽  
Nonproliferative Diabetic Retinopathy ◽  
Field Of Vision ◽  
New Treatment ◽  
One Year ◽  
Positive Effect ◽  
Observation Period

Aim. To evaluate the effectiveness of traditional medical and laser treatment of nonproliferative and preproliferative diabetic retinopathy. Methods. Examined was a total of 80 eyes of 66 patients with nonproliferative and preproliferative diabetic retinopathy. In accordance with the stage of the disease and the type of treatment, all patients were divided into two groups. The first group consisted of 34 individuals (39 eyes) with nonproliferative diabetic retinopathy who received medical treatment, the second group - 32 individuals (41 eyes) with preproliferative diabetic retinopathy who received medical and laser treatment. The patients had visual acuity measurement, biomicroscopy, ophthalmoscopy, refractometry, perimetry, a study of the central field of vision, and rheoophthalmography performed before surgery, after surgery (at discharge), 10 days, 6 months and 1 year postoperatively. Results. The indices of visual functions, the hemodynamic and electrophysiological parameters have the same dynamics in the first and second groups throughout the observation period. In both groups a positive effect of the performed treatment was noted, which is almost entirely offset by 6-month post-treatment, and by one year after treatment a negative dynamic develops, which is associated with the progressive course of the disease. Conclusion. The lack of effectiveness of the standard treatment of nonproliferative and preproliferative diabetic retinopathy is the justification for a search for new treatment methods.

scholarly journals Refractory Abdominal Pain in a Patient with Chronic Lymphocytic Leukemia: Be Wary of Acquired Angioedema due to C1 Esterase Inhibitor Deficiency

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Abdullateef Abdulkareem ◽  
Ryan S. D’Souza ◽  
Joshua Mundorff ◽  
Pragya Shrestha ◽  
Oluwaseun Shogbesan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Chronic Lymphocytic Leukemia ◽  
Upper Airway ◽  
Recurrent Abdominal Pain ◽  
Final Diagnosis ◽  
Lymphocytic Leukemia ◽  
C1 Inhibitor Deficiency ◽  
Acquired Angioedema ◽  
C1 Esterase Inhibitor ◽  
Esterase Inhibitor

Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions. In this article, we present the case of a 62-year-old male with a history of recently diagnosed chronic lymphocytic leukemia (CLL) who presented to our hospital with recurrent abdominal pain, initially suspected to haveClostridium difficilecolitis and diverticulitis. He received a final diagnosis of acquired angioedema due to C1 esterase inhibitor deficiency due to concomitant symptoms of lip swelling, cutaneous nonpitting edema of his lower extremities, and complement level deficiencies. He received acute treatment with C1 esterase replacement and icatibant and was maintained on C1 esterase infusions. He also underwent chemotherapy for his underlying CLL and did not experience further recurrence of his angioedema.

scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

scholarly journals Upper Airway Cough Syndrome in Pathogenesis of Chronic Cough

2020 ◽  
pp. S35-S42
Author(s):  
M. Lucanska ◽  
A. Hajtman ◽  
V. Calkovsky ◽  
P. Kunc ◽  
R. Pecova
Keyword(s):  
Chronic Cough ◽  
Sensory Nerve ◽  
Upper Airway ◽  
Vagal Afferents ◽  
Upper Airways ◽  
Cough Reflex ◽  
Postnasal Drip ◽  
Common Causes ◽  
Lower Airways ◽  
Human Airways

Cough is one of the most important defensive reflexes. However, extensive non- productive cough is a harmful mechanism leading to the damage of human airways. Cough is initiated by activation of vagal afferents in the airways. The site of their convergence is particularly the nucleus of the solitary tract (nTS). The second-order neurons terminate in the pons, medulla and spinal cord and there is also the cortical and subcortical control of coughing. Upper airway cough syndrome (UACS) – previously postnasal drip syndrome - is one of the most common causes of chronic cough together with asthma and gastroesophageal reflux. The main mechanisms leading to cough in patients with nasal and sinus diseases are postnasal drip, direct irritation of nasal mucosa, inflammation in the lower airways, upper airway inflammation and the cough reflex sensitization. The cough demonstrated by UACS patients is probably due to hypersensitivity of the upper airways sensory nerve or lower airways sensory nerve, or a combination of both. Further studies are needed to clarify this mechanism.

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