1
|
Kim JY, Davenport PW, Mou Y, Hegland K. Primary site of constriction during the compression phase of cough in healthy young adults. Respir Physiol Neurobiol 2023; 311:104033. [PMID: 36764504 PMCID: PMC10067529 DOI: 10.1016/j.resp.2023.104033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/27/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Glottal closure has been considered as the primary constriction point during the compression phase (CP); however, vocal fold adduction alone cannot resist the high pressures, providing motivation to explore other mechanisms contributing to that resistance. The goal of this study was to identify site(s) and degree of constriction during the CP of cough of varying types in healthy young adults. Twenty-five healthy young participants participated in this study. The experimental protocol was comprised of: 1) baseline pulmonary function measures; 2) cough practice to establish weak, moderate and strong coughs; 3) voluntary and reflex cough assessments with fluoroscopy and airflow measures. We used a repeated measures ANOVA to identify whether there are differences in constriction ratio between cough types. There was a significant difference in constriction of varying cough types. Degree of constriction in all cough strengths showed that the glottis was the most constricted area, followed by the laryngeal vestibule, nasopharynx, hypopharynx, oropharynx, and cervical trachea, in order, but stronger cough resulted in more constriction in all areas compared to weaker cough. Degree of constriction in reflex cough showed a similar pattern though there was greater constriction in the oropharynx than the hypopharynx. Airflow measures in voluntary cough were consistent with previous findings. Differences in upper airway constriction during the compression phase of cough may be attributed to differences in motor control between reflex and voluntary cough, and the increased constriction seen during strong cough may reflect increased muscle recruitment during that task. In the future, we can use this knowledge to develop novel methods for cough rehabilitation.
Collapse
Affiliation(s)
- Ja Young Kim
- Graduate Program in Speech-Language Pathology, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, South Korea 03722.
| | - Paul W Davenport
- Department of Physiological Sciences, University of Florida, 1333 Center Drive, Gainesville, FL 32610, USA.
| | - Yuhan Mou
- Department of Rehabilitation Science, University of Florida, 1225 Center Drive, Gainesville, FL 32610, USA.
| | - Karen Hegland
- Department of Speech, Language, and Hearing Sciences, University of Florida, 1225 Center Drive, Gainesville, FL 32610, USA.
| |
Collapse
|
2
|
Nukusbekova G, Toguzbayeva D, Hashimli R, Oguz H, Taukeleva S. Reflux Symptom Index: Translation to the Kazakh Language and Validation. J Voice 2022:S0892-1997(22)00205-3. [PMID: 35933255 DOI: 10.1016/j.jvoice.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND This research focuses on the translation and validation of the Reflux Symptom Index (RSI) in Kazakh language and the comparison of its results among patients with symptoms of Laryngopharyngeal reflux (LPR) and without LPR symptoms. OBJECTIVE This study aims to translate and validate the RSI in Kazakh language (Kz-RSI). METHODS The RSI from the original American English version has been translated according to standard procedures into Kazakh language. The study included 248 patients, 124 LPR patients, and 124 asymptomatic controls. A final version of the Kz-RSI was tested twice: on Day 0 and Day 14 for participants without LPR symptoms and on Day 0 and posttreatment for those with LPR symptoms. Reliability, validity, and internal consistency of test-retest were calculated. RESULTS The Cronbach's alpha value for Kz-RSI was 0.94, indicating excellent internal consistency. The single measurement absolute agreement of the interclass correlation coefficient was 0.90 (95% confidence interval [0.86; 0.93]), which indicates good retest reliability. The total Kz-RSI scores and each item were significantly higher in the LPR group than in the control group (P < 0.001). In the posttreatment LPR patient group, the Kz-RSI scores for each item and overall were significantly lower than the pretreatment scores (P < 0.001). CONCLUSIONS Kz-RSI has been successfully translated and validated to identify LPR among the Kazakh-speaking population. Moreover, it is an inexpensive method with strong internal consistency, high retesting rates, reliability, and optimal clinical validity.
Collapse
Affiliation(s)
- Gulnur Nukusbekova
- Department of Otorhinolaryngology, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
| | - Dinara Toguzbayeva
- Department of Otorhinolaryngology, Kazakh-Russian Medical University, Almaty, Kazakhstan
| | - Ramil Hashimli
- Department of Otorhinolaryngology, Azerbaijan State Advanced Training Institute for Doctors named after Aziz Aliyev, Baku, Azerbaijan
| | - Haldun Oguz
- Department of Otolaryngology, Fonomer, Ankara, Turkey
| | - Saule Taukeleva
- Department of Otorhinolaryngology, Kazakh-Russian Medical University, Almaty, Kazakhstan
| |
Collapse
|
3
|
Ribeiro VV, Lopes LW, de Medeiros CMA, da Silva ACF, de Medeiros Neto AH, Behlau M. Effectiveness of the Therapy Program for Management of Chronic Cough: Preliminary Data From a Randomized Clinical Trial. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1611-1620. [PMID: 35699263 DOI: 10.1044/2022_ajslp-21-00381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study is to analyze the effectiveness of the Therapy Program for Management of Chronic Cough (TMCC) in laryngeal sensations and symptoms related to the cough in individuals with chronic refractory cough (CRC). METHOD This research is a randomized double-blind clinical trial (Register Number: RBR-4m6x29). Eleven participants were allocated to two groups by parallel randomization: The Experimental Group-consisting of six individuals who underwent the TMCC; and the Control Group-consisting of five individuals who underwent the Comprehensive Vocal Rehabilitation Program (CVRP). Two primary outcomes were analyzed: self-perception of laryngeal sensations (Newcastle Laryngeal Hypersensitivity Questionnaire [LHQ-Br]) and self-perception of symptoms of upper airway-related cough (Cough Severity Index [CSI-Br]). The two-way repeated-measures analysis of variance was used to compare the evaluation moments and intervention groups. For multiple comparisons, the Tukey test with Bonferroni correction was used. To evaluate the effect size, eta partial square was used. RESULTS There was no difference between groups for any outcomes analyzed. There was a statistically significant difference with a large effect size for the moment factor in all outcomes. A statistically significant difference was observed with a large effect size for the interaction effect between group and moment for LHQ-Br total and CSI-Br psychological and functional. CONCLUSIONS The TMCC and CVRP were effective for the rehabilitation of CRC, considering the viewpoint of the subject. The TMCC improved laryngeal sensations and psychological and functional symptoms, while CVRP was relevant to improve psychological and functional symptoms in individuals with CRC.
Collapse
Affiliation(s)
- Vanessa Veis Ribeiro
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP, Brazil
- Speech-Language Pathology Course, Universidade de Brasília - UnB, Distrito Federal, Brazil
| | - Leonardo Wanderley Lopes
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB, Cidade Universitária, Conjunto Presidente Castelo Branco III, Brazil
| | - Camila Macêdo Araújo de Medeiros
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB, Cidade Universitária, Conjunto Presidente Castelo Branco III, Brazil
| | - Allan Carlos França da Silva
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB, Cidade Universitária, Conjunto Presidente Castelo Branco III, Brazil
| | - Agostinho Hermes de Medeiros Neto
- Internal Medicine Department, Universidade Federal da Paraíba - UFPB, Cidade Universitária, Conjunto Presidente Castelo Branco III, Brazil
| | - Mara Behlau
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP, Brazil
| |
Collapse
|
4
|
Langmore SE, Scarborough DR, Kelchner LN, Swigert NB, Murray J, Reece S, Cavanagh T, Harrigan LC, Scheel R, Gosa MM, Rule DK. Tutorial on Clinical Practice for Use of the Fiberoptic Endoscopic Evaluation of Swallowing Procedure With Adult Populations: Part 1. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:163-187. [PMID: 34818509 DOI: 10.1044/2021_ajslp-20-00348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Representatives of the American Board of Swallowing and Swallowing Disorders (AB-SSD) and American Speech-Language-Hearing Association (ASHA) Special Interest Group (SIG) 13: Swallowing and Swallowing Disorders (Dysphagia) developed this tutorial to identify and recommend best practice guidelines for speech-language pathologists who conduct and interpret fiberoptic endoscopic evaluation of swallowing (FEES) procedures in adults. This document also includes proposed training needs and methods for achieving competency. Expert opinion is provided regarding indications for performing the FEES exam, potential contraindications, adverse effects and safety, equipment and personal protection, the exam protocol, interpretation and documentation of findings, and training requirements to perform and interpret the exam. CONCLUSIONS This tutorial by the AB-SSD and SIG 13 represents the first update about the FEES procedure since ASHA's position paper and technical report published in 2004. Creation of this document by members of the AB-SSD and SIG 13 is intended to guide professionals who are training for or practicing FEES in the adult population toward established best practices and the highest standards of care.
Collapse
Affiliation(s)
- Susan E Langmore
- Department of Otolaryngology-Head & Neck Surgery, Boston University School of Medicine, MA
| | | | - Lisa N Kelchner
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | | | | | | | | | | | - Rebecca Scheel
- Mass General Brigham/Spaulding Rehabilitation Hospital, Boston, MA
| | | | - Denise K Rule
- Dynamic Dysphagia Solutions & Speech Pathology, Inc., West Sacramento, CA
| |
Collapse
|
5
|
Sandage MJ, Ostwalt ES, Allison LH, Cutchin GM, Morton ME, Odom SC. Irritant-Induced Chronic Cough Triggers: A Scoping Review and Clinical Checklist. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1261-1291. [PMID: 33989029 DOI: 10.1044/2021_ajslp-20-00362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The primary aim of this review was to identify environmental irritants known to trigger chronic cough through the life span and develop a comprehensive clinically useful irritant checklist. Method A scoping review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews, checklist, and explanation. English-language, full-text resources were identified through Medline, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertations and Theses Global. Results A total of 1,072 sources were retrieved; of these, 109 were duplicates. Titles of abstracts of 963 articles were screened, with 295 selected for full-text review. Using the exclusion and inclusion criteria listed, 236 articles were considered eligible and 214 different triggers were identified. Triggers were identified from North America, Europe, Africa, Asia, and Australia. Occupational exposures were also delineated. Conclusions A clinically useful checklist of both frequently encountered triggers and idiosyncratic or rare triggers was developed. The clinical checklist provides a unique contribution to streamline and standardize clinical assessment of irritant-induced chronic cough. The international scope of this review extends the usefulness of the clinical checklist to clinicians on most continents.
Collapse
Affiliation(s)
- Mary J Sandage
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
| | | | - Lauren H Allison
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
| | - Grace M Cutchin
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
| | | | - Shelby C Odom
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
| |
Collapse
|
6
|
Baikampady SV. Vata dynamics with special reference to cardiac disorders - A cross-disciplinary approach. J Ayurveda Integr Med 2020; 11:432-439. [PMID: 33218848 PMCID: PMC7772479 DOI: 10.1016/j.jaim.2020.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 11/25/2022] Open
Abstract
Vata is one of the fundamental patho-physiological entities with unique and dynamic properties. All actions inside the body, whether voluntary or involuntary, are governed by Vayu. Actions involved during natural physiological calls or urges, are involuntary, but partially under voluntary control. Classical texts from Ayurveda state that such natural urges (NU) should be strictly attended without disturbing their natural flow. Some urges can be intentionally or inadvertently initiated (Udiran) or suppressed (Dhaaran), redirecting the normal flow of Vayu, leaving scopes for severe morbidities in the heart causing cardiovascular disorders (CVD). Since Vata has unique attribute of Vega (locomotion) that moves in a specific direction, its intensities can be quantified with the help of modern techniques. Few studies have objectively evaluated the intensities of NU like belching, sneezing, expulsion of flatus, etc. during normalcy, which may help us to determine their altered activity during morbidity. In spite of such studies, their relevance to CVD is inadequately explored. Hence, this article addresses details of such NU that lead to CVD alone, from classical texts of Ayurveda, conventional medicines and technology that quantify their intensities. Citing research articles from various journals using keywords were done to understand their mechanism along with their intensities. It was found that objective estimation of few NU was performed extensively whereas some had limitations. Theories from the classical texts confirm that physiological NU, if allowed to flow freely without any impedance, assures good health. It would certainly benefit the mankind if their pathologic state is timely detected so as to prevent disease progression in CVD.
Collapse
|
7
|
陈 慧, 朱 刚, 张 欣. [Advances of the treatments and diagnosis for sensory laryngeal neuropathy]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 34:281-284. [PMID: 32791602 PMCID: PMC10127843 DOI: 10.13201/j.issn.2096-7993.2020.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Indexed: 04/30/2023]
Abstract
Sensory laryngeal neuropathy(SLN) is a kind of peripheral neuropathy presenting globus pharyngeus, chronic cough, increased mucus, dry throat, sore throat, frequent clearing of the throat, etc. When the sensory nerve of the larynx is affected by chemical, biological, mechanical or nutritional factors. Because of its nonspecific signs and symptoms, SLN is easy to be misdiagnosed as chronic pharyngitis or laryngopharyngeal reflux disease. SLN was came up to ENT physician in recent years and there are rare systematic reports currently, therefore, this review aims to summarize the etiology, clinical manifestations, diagnosis and treatment of SLN, to raise awareness of this disease among our colleagues.
Collapse
Affiliation(s)
- 慧红 陈
- 中南大学湘雅医院耳鼻咽喉头颈外科 耳鼻咽喉重大疾病湖南省重点实验室(长沙,410008)
| | | | - 欣 张
- 中南大学湘雅医院耳鼻咽喉头颈外科 耳鼻咽喉重大疾病湖南省重点实验室(长沙,410008)
| |
Collapse
|
8
|
Kamimura M, Mouri A, Takayama K, Mizutani T, Hamamoto Y, Iikura M, Furihata K. Cough related to swallowing in asthma patients. Asia Pac Allergy 2019; 9:e31. [PMID: 31720242 PMCID: PMC6826117 DOI: 10.5415/apallergy.2019.9.e31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 10/10/2019] [Indexed: 11/04/2022] Open
Abstract
Background Occurrence of cough during swallowing is common among asthma patients, but has not been investigated in detail. Objective We conducted an observational study to determine the prevalence of swallowing-related cough (SRC) and its characteristics in asthma patients. Methods Asthma patients attending our outpatient department between May 2005 and April 2007 were interviewed to investigate if they had ever experienced SRC, as well as postnasal drip or heartburn and cough related to these conditions. Results Among 417 patients who completed the questionnaire, 121 patients (29.0%) had experienced SRC. Spicy and sour foods were the most frequent tussigenic foods, causing cough in 76.0% and 53.7% of the 121 patients, respectively. In patients without SRC, the prevalence rates of postnasal drip and postnasal drip-induced cough were 35.8% (106 of 296) and 7.8% (23 of 296), respectively. The corresponding prevalence rates in patients with SRC were 50.4% (61 of 121) and 37.2% (45 of 121), which were both significantly higher than in patients without cough (p = 0.006 and p < 0.001 respectively). In patients without SRC, the prevalence rates of heartburn and heartburn-induced cough were 22.2% (66 of 296) and 2.4% (7 of 296), respectively. The corresponding prevalence rates in patients with SRC were 45.5% (55 of 121) and 16.5% (20 of 121), with both being significantly higher than in patients without cough (p = 0.002 and p < 0.001, respectively). Conclusion SRC was frequent in asthma patients, and was closely related to postnasal drip and heartburn. Irritable larynx is one of the possible underlying mechanisms of SRC. This study was registered with the University Hospital Medical Information Network clinical trials registry (registration number: UMIN000017426).
Collapse
Affiliation(s)
- Mitsuhiro Kamimura
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Atsuto Mouri
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Kazuo Takayama
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Tomonori Mizutani
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Yoichiro Hamamoto
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Motoyasu Iikura
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Kaneyuki Furihata
- Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| |
Collapse
|
9
|
Erkan SO, Tuhanioğlu B, Özdaş T, Erkan ZA, Tüzün K, Özden G, Şenkal ÖA. Allerjik rinitin tıbbi tedavileri sonrası objektif ve subjektif ses değişikliklerinin karşılaştırılması. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.522250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
10
|
The Effects of Endotracheal Suctioning in the Pediatric Population: An Integrative Review. Dimens Crit Care Nurs 2018; 37:44-56. [PMID: 29194174 DOI: 10.1097/dcc.0000000000000275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Critically ill pediatric patients with endotracheal tubes routinely receive endotracheal tube suctioning to clear secretions and ensure tube patency. This common practice can result in adverse effects. OBJECTIVES The aim of this study was to evaluate the research literature on the stressors of endotracheal suctioning and consequent effect on the pediatric patient. METHODS An integrative review was conducted using the Whittemore and Knafl modified framework for integrative reviews, and article selection was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram. A literature search was conducted via PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus. Selected articles were evaluated to present the current evidence on the stressors of endotracheal suctioning in the pediatric population. RESULTS This review includes 14 articles, with a total of 849 patients, ranging in age from premature neonates to 17 years of age. The available literature aligned into 3 categories: neurovascular effects, respiratory systems effects, and pain related to endotracheal tube suctioning. Pain was the most prevalent category, with half of the studies using endotracheal suctioning as a painful procedure to validate pain assessment tools rather than examining the effect of suctioning. A majority of the studies (67%) were conducted in the premature neonate population. Children with congenital cardiac or pulmonary defects, genetic syndromes, or neurological injuries were frequently excluded. CONCLUSIONS Literature regarding the effects of endotracheal suctioning in children is limited. There are many extrapersonal, interpersonal, and intrapersonal stressors associated with endotracheal suctioning that merit future research.
Collapse
|
11
|
Sex differences in cough reflex. Respir Physiol Neurobiol 2017; 245:122-129. [DOI: 10.1016/j.resp.2016.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 12/31/2022]
|
12
|
Abstract
OBJECTIVE To investigate the prevalence and type of laryngeal abnormalities in dogs examined because of cough that did not have signs of upper airway disease and to compare the prevalence of those abnormalities among dogs with various respiratory tract diseases. DESIGN Prospective study. ANIMALS 138 dogs with cough that did not have signs of upper airway disease. PROCEDURES The study was conducted between July 2001 and October 2014 and included dogs examined for cough that had laryngoscopic and bronchoscopic examinations performed by 1 examiner. Laryngeal hyperemia and swelling were recorded, and laryngeal function was assessed before and after doxapram stimulation when indicated. Results were compared among dogs on the basis of cough duration (acute [< 2 weeks], subacute [2 weeks to 2 months], and chronic [> 2 months]) and disease diagnosed (inflammatory airway disease, airway collapse, lower respiratory tract infection, and eosinophilic bronchopneumopathy). RESULTS Laryngeal hyperemia was detected in 73 of 134 (54%) dogs with cough of subacute or chronic duration, and its prevalence did not vary significantly among dogs with various diseases. Thirteen dogs had laryngeal paresis, and 13 dogs had laryngeal paralysis; dysphonia (n = 2) and stridor (1) were uncommon findings in those dogs. The prevalence of laryngeal dysfunction (paresis or paralysis) did not differ significantly among diseases. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that 26 of 138 (19%) dogs examined because of cough alone had laryngeal dysfunction, which suggested that a complete laryngoscopic examination should be included in the diagnostic evaluation of dogs with cough.
Collapse
|
13
|
Lin L, Chen Z, Cao Y, Sun G. Normal saline solution nasal-pharyngeal irrigation improves chronic cough associated with allergic rhinitis. Am J Rhinol Allergy 2017; 31:96-104. [PMID: 28452705 DOI: 10.2500/ajra.2017.31.4418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Upper airway inflammation is one of the most commonly identified causes of chronic cough, although the underlying mechanism is not clear. This study compared normal saline solution nasal-pharyngeal irrigation (NSNPI) and fluticasone propionate nasal spray (FPNS) treatment for chronic cough associated with allergic rhinitis (AR). METHODS Patients with suspected AR to house-dust mite were enrolled, and the symptom of cough was assessed by a cough symptom score and the Leicester Cough Questionnaire, and cough response to capsaicin was evaluated. AR was assessed by using the visual analog scale (VAS) and the Mini Juniper Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Mediators, including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein from nasal lavage fluid (NLF) were examined. The patients were treated with NSNPI (the NSNPI group) or FPNS (the FPNS group) for 30 days, after which they were reassessed. RESULTS Forty-five of 50 patients completed this study. The scores of the cough symptom and the Leicester Cough Questionnaire, and the capsaicin cough threshold all improved statistically after NSNPI but did not change after FPNS. There were statistically significant changes in the evaluations of the MiniRQLQ and the mediators, including histamine and leukotriene C4, in the NLF in the NSNPI group. However, significant changes were found in the assessments of VAS, MiniRQLQ, and all above mediators including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein in the NLF of the FPNS group. Furthermore, the assessments of VAS and all the mediators were reduced more in the FPNS group compared with those in the NSNPI group. CONCLUSION The patients with suspected AR to house-dust mite reported a better relief of the cough symptom after 30 days of treatment with NSNPI compared with that after nasal corticosteroid.
Collapse
Affiliation(s)
- Lin Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | | | | | | |
Collapse
|
14
|
Relationship Between Cerebrospinal Fluid and Catarrh According to Avicenna. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.36431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
15
|
Szema A, Mirsaidi N, Patel B, Viens L, Forsyth E, Li J, Dang S, Dukes B, Giraldo J, Kim P, Burns M. Proposed Iraq/Afghanistan War-Lung Injury (IAW-LI) Clinical Practice Recommendations: National Academy of Sciences' Institute of Medicine Burn Pits Workshop. Am J Mens Health 2015; 11:1653-1663. [PMID: 26669772 DOI: 10.1177/1557988315619005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
High rates of respiratory symptoms (14%) and new-onset asthma in previously healthy soldiers (6.6%) have been reported among military personnel post-deployment to Iraq and Afghanistan. The term Iraq/Afghanistan War-Lung Injury (IAW-LI) is used to describe the constellation of respiratory diseases related to hazards of war, such as exposure to burning trash in burn pits, improvised explosive devices, and sandstorms. Burnpits360.org is a nonprofit civilian website which voluntarily tracks medical symptoms among soldiers post-deployment to the Middle East. Subsequent to initiation of the Burnpits360.org website, the Department of Veterans Affairs started the Airborne Hazards and Open Burn Pit registry. This paper: (a) analyzes the latest 38 patients in the Burnpits360.org registry, validated by DD214 Forms; (b) compares strengths and weaknesses of both registries as outlined at the National Academy of Sciences Institute of Medicine Burn Pits Workshop;
Collapse
Affiliation(s)
- Anthony Szema
- 1 Hofstra North Shore-LIJ School of Medicine at Hofstra University, Department of Occupational and Environmental Medicine, Preventive Medicine, and Epidemiology, Hempstead, NY, USA.,2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Niely Mirsaidi
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Bhumika Patel
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Laura Viens
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Edward Forsyth
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Jonathan Li
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Sophia Dang
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Brittany Dukes
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | - Jheison Giraldo
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| | | | - Matthew Burns
- 2 Stony Brook University, Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook, NY, USA
| |
Collapse
|
16
|
Cough in interstitial lung disease. Pulm Pharmacol Ther 2015; 35:122-8. [DOI: 10.1016/j.pupt.2015.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 12/15/2022]
|
17
|
Pacheco A, de Diego A, Domingo C, Lamas A, Gutierrez R, Naberan K, Garrigues V, López Vime R. Tos crónica. Arch Bronconeumol 2015; 51:579-89. [DOI: 10.1016/j.arbres.2015.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 03/21/2015] [Accepted: 03/23/2015] [Indexed: 12/16/2022]
|
18
|
Gibson PG, Vertigan AE. Gabapentin in chronic cough. Pulm Pharmacol Ther 2015; 35:145-8. [PMID: 26141016 DOI: 10.1016/j.pupt.2015.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/22/2015] [Accepted: 06/26/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chronic cough is regarded as a challenging clinical problem due to its frequency and often limited therapeutic options. Chronic cough that remains refractory to usual medical treatment causes significant quality of life impairment. METHODS Recent developments in the treatment of cough include the use of speech pathology and pharmacotherapy with gabapentin. Relevant randomised control trials, reviews and case reports were identified through a PubMed and SCOPUS search of English-language literature referring to these concepts over the last eight years. RESULTS The effectiveness of neuromodulating medications such as gabapentin and pregabalin in the treatment of cough has been supported primarily through case series, case reports, prospective reviews and a double blind randomised controlled trial. Gabapentin results in a reduction in cough frequency and cough severity. It improves cough related quality of life. The effect is greatest in patients with features of central reflex sensitisation such as laryngeal paraesthesia, hypertussia and allotussia. These symptoms can be measured using the Newcastle Laryngeal Hypersensitivity Questionnaire. Side effects of gabapentin include somnolence and dizziness. CONCLUSION Recent additions in the treatment of chronic cough have been significant as they consider cough to have a unifying diagnosis of cough hypersensitivity with or without the presence of a neuropathic basis. Effective treatments for refractory chronic cough that target these areas include behavioural treatment such as speech pathology and pharmaceutical treatment with neuromodulating medications such as gabapentin.
Collapse
Affiliation(s)
- Peter G Gibson
- Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, NSW 2305, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia.
| | - Anne E Vertigan
- Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, NSW 2305, Australia; Speech Pathology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
| |
Collapse
|
19
|
Tuzuner A, Demirci S, Bilgin G, Cagli A, Aydogan F, Ozcan KM, Samim EE. Voice Assessment After Treatment of Subacute and Chronic Cough With Inhaled Steroids. J Voice 2015; 29:484-9. [PMID: 25704467 DOI: 10.1016/j.jvoice.2014.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Inhaled steroids are widely used for persistent cough treatment. Although the side effects of long-term inhaled steroids have been well described in the literature, their laryngeal side effects after short-term use have not yet been defined. The aim of this study was to evaluate the effect of 1 month application of inhaled steroid treatment on voice parameters in patients with subacute or chronic cough. Furthermore, the efficacy of inhaled steroids on cough was investigated, as well. MATERIAL AND METHODS This study included 46 patients (27 females and 19 males) with a persistent cough lasting at least 3 weeks and treated with inhaled steroids. All patients were examined by a pulmonologist and lung auscultation where a posteroanterior chest X-ray and spirometry were performed. The patients were also examined by an otolaryngologist. Anterior rhinoscopy, flexible fiberoptic nasopharyngoscopy, and laryngostroboscopy were performed. Also, the patients' acoustic voice analyses were performed and recorded using a multidimensional voice program. Cough symptom index (CSI) scores were used to evaluate the response to treatment. Patients with an underlying disease that was unresponsive to inhaled steroids were excluded from study. The 46 patients were administered inhaled budesonide 400 mcg twice a day, for 1 month, and their acoustic voice analyses were performed again at the end of the treatment. In addition, CSI scores were determined after stopping medication. RESULTS When pretreatment and posttreatment acoustic voice analysis parameters (Fo, Jita, Jitt, Shim, APQ, vAm, and NHR) were compared, statistically significant differences were detected for vAm (P = 0.001) and F0 (P0.003). After treatment with inhaled steroids, the CSI score reduced from 3 to 1 (median), and the difference was statistically significant. CONCLUSIONS Inhaled budesonide treatment in the proper dose seems to be an effective treatment for persistent cough, in the selected patient group. In addition, short-term budesonide application did not cause any negative effects on the voice parameters in these patients. These findings may be related to the steroid formulation used, the application method, and the duration of treatment. Further studies are needed on a larger group of patients with different formulations of inhaled steroids to clarify aforementioned issues.
Collapse
Affiliation(s)
- Arzu Tuzuner
- Department of Otorhinolaryngology - Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Sule Demirci
- Department of Otorhinolaryngology - Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Gulden Bilgin
- Department of Pulmonology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ali Cagli
- Department of Otorhinolaryngology - Head and Neck Surgery, Ministry of Health, Islahiye State Hospital, Gaziantep, Turkey
| | - Filiz Aydogan
- Department of Otorhinolaryngology - Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Kursat Murat Ozcan
- Department of Otorhinolaryngology - Head and Neck Surgery, Ministry of Health, Numune Training and Research Hospital, Ankara, Turkey
| | - Etem Erdal Samim
- Department of Otorhinolaryngology - Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
20
|
Ryan NM, Gibson PG. Recent additions in the treatment of cough. J Thorac Dis 2014; 6:S739-47. [PMID: 25383209 DOI: 10.3978/j.issn.2072-1439.2014.03.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/04/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND Worldwide, cough is regarded as a challenging clinical problem due to its frequency and often limited therapeutic options. Chronic cough that remains refractory to usual medical treatment causes significant quality of life impairment in people with this problem. METHODS We have examined current evidence on recent additions in the treatment of cough, specifically treatment of refractory chronic cough with speech pathology and gabapentin. Relevant randomised control trials, reviews and case reports were identified through a PubMed and SCOPUS search of English-language literature referring to these concepts over the last eight years. SUMMARY Of the one hundred and two articles comprising this review the majority investigated the role of the transient receptor potential (TRP) receptors TRP Vanilloid 1 (TRPV1) and TRPA1 in cough and the potential of TRP antagonists as effective anti-tussives. However, these have only been tested in the laboratory and therefore their clinical effectiveness is unknown. Behavioural treatments such as speech pathology have gained momentum and this was evident in the increasing number of articles investigating its positive effect on cough. Investigation on the effectiveness of neuromodulating medications in the treatment of cough have been supported primarily through case series reports and prospective reviews however; their use (particularly gabapentin) has been significantly advanced through recently conducted randomised controlled trials. CONCLUSIONS Recent additions in the treatment of chronic cough have been significant as they consider cough to have a unifying diagnosis of cough hypersensitivity with or without the presence of a neuropathic basis. Primarily, effective treatments for chronic cough target these areas and include behavioural treatment such as speech pathology and pharmaceutical treatment with neuromodulating medications such as gabapentin.
Collapse
Affiliation(s)
- Nicole M Ryan
- 1 Priority Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle, NSW 2308, Australia ; 2 VIVA, Level 2 West Wing, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Peter G Gibson
- 1 Priority Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle, NSW 2308, Australia ; 2 VIVA, Level 2 West Wing, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| |
Collapse
|
21
|
Gong SD, Cui LH. Advances in understanding pathogenesis of gastroesophageal reflux-related cough. Shijie Huaren Xiaohua Zazhi 2014; 22:2665-2670. [DOI: 10.11569/wcjd.v22.i19.2665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Gastroesophageal reflux-related cough (GERC) refers to chronic cough caused by gastroesophageal reflux disease (GERD) and is one of the common causes of chronic cough in adults. Compared with typical GERD, GERC has its own characteristics in the pathogenesis of cough. The main mechanisms involve direct refluxate stimulation and indirect esophageal-bronchial reflection. In addition, the high sensitivity of cough receptors, acid-producing bacteria, nongastric H+/K+-ATPases and psychological factors are also important in the pathogenesis of GERC. GERC may be the result of the combined effects of multiple factors.
Collapse
|