Comparison of safety and efficacy of dextromethorphan and levocloperastine in treatment of dry cough: a randomized open label phase IV clinical trial

Background: To compare safety and efficacy of dextromethorphan and levocloperastine in treatment of dry cough.Methods: Patients fulfilling the selection criteria were randomized into two groups. Patients in group A were administered dextromethorphan cough lozenges (5 mg) thrice daily for 7 days. Patients in group B were administered syrup levocloperastine (20 mg/5 ml) 5 ml thrice daily for 7 days. Severity and frequency of cough, and Leicester Cough Questionnaire (LCQ) score were assessed at the end of day 7.Results: Levocloperastine significantly decreased (p<0.5) severity and frequency of cough compared to dextromethorphan at day 7. Levocloperastine also significantly increased LCQ score compared to dextromethorphan at day 7.Conclusions: Levocloperastine is significantly more effective compared to dextromethorphan in treatment of dry cough.

Mammomonogamus laryngeus: a human case report in florianopolis, Santa Catarina, Brazil

Mammomonogamus laryngeus (sin.: Syngamus laryngeus) is a nematode which parasites the respiratory tract of some animals. It is occasionally seen in humans, who present symptoms similar to other diseases with respiratory manifestations, such as a chronic dry cough and chest pain, in addition to a "foreign body" sensation in the throat. It can be diagnosed through rhinolaryngoscopy or bronchoscopy examinations, but this often occurs only after spontaneous expectoration of the worms, a long period of symptomatology and the use of several types of medication. In this report, we describe a case of syngamosis in Florianópolis (Santa Catarina, Brazil). The patient consulted several health professionals during the course of the disease and was prescribed numerous drugs. Diagnosis was eventually reached after the spontaneous expectoration of a nematode couple

Captopril augments acetylcholine-induced bronchial smooth muscle contractions in vitro via kinin-dependent mechanisms.

Angiotensin converting enzyme (ACE) inhibitors therapy is aassociated with bothersome dry cough as an adverse effect. The mechanisms underlying this adverse effect are not clear. Therefore, influence of captopril (an ACE inhibitor) on acetylcholine (ACh)-induced bronchial smooth muscle contractions was investigated. Further, the mechanisms underlying the captopril-induced changes were also explored. In vitro contractions of rat bronchial smooth muscle to cumulative concentrations of ACh were recorded before and after exposure to captopril. Further, the involvement of kinin and inositol triphosphate (IP3) pathways for captopril-induced alterations were explored. ACh produced concentration-dependent (5-500 μM) increase in bronchial smooth muscle contractions. Pre-treatment with captopril augmented the ACh-induced contractions at each concentration significantly. Pre-treatment with aprotinin (kinin synthesis inhibitor) or heparin (inositol triphosphate, IP3-inhibitor), blocked the captopril-induced augmentation of bronchial smooth muscle contractions evoked by ACh. Further, captopril-induced augmentation was absent in calcium-free medium. These results suggest that captopril sensitizes bronchial smooth muscles to ACh-induced contractions. This sensitization may be responsible for dry cough associated with captopril therapy.

Ortner’s syndrome: a case report and literature review / Síndrome de Ortner: relato de caso e revisão da literatura

AbstractThe authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner’s syndrome.

ResumoRelatamos um caso de paciente do sexo feminino, 55 anos, hipertensa, tabagista, apresentando disfonia, disfagia e tosse seca persistente. À videolaringoscopia foi observada paralisia da prega vocal esquerda. A tomografia computadorizada mostrou aneurisma sacular da parede inferior do arco aórtico, no local de deflexão do nervo laríngeo recorrente, permitindo diagnosticar a síndrome de Ortner.

A Randomized, Open Label, Multicentre Study to Evaluate the Safety and Efficacy of Cough Mixture CS1 (Pholcodeine and Promethazine - Tixylix) Versus CS2 (Noscapine, Ammonium Chloride, Sodium Citrate) in Treatment of Children with Dry Cough.

The objective of this study was to compare the efficacy and safety of cough mixture containing pholcodeine and promethazine - Tixylix (CS1) to a cough mixture which has noscapine, ammonium chloride, and sodium citrate (CS2) as its constituents in treatment of children suffering from dry cough. A total of 208 patients were enrolled at 4 sites. Of these, 179 (94 receiving CS1 and 99 receiving CS2) completed the study. Results of this study suggest that both the cough mixtures were comparable as per evaluation of their primary parameters. According to global assessment for efficacy and tolerability by parents on Day 7, Group CS1 performed better than CS2. It was also observed that no AE was reported in Group CS1 as compared to 2 AEs in Group CS2. To conclude, cough mixture combination of pholcodeine and promethazine - Tixylix exhibited efficacy and safety that was comparable with cough mixture which has noscapine, ammonium chloride, and sodium citrate. It was proven to be efficacious, safe and well tolerated in the select population.

Relación entre tos seca nocturna y atopia en niños entre 3 y 14 años / Relationship between night dry cough and atopy in children between 3 and 14 years

Fundamento: A pesar de los múltiples mecanismos implicados en la tos seca nocturna y a la amplia gama de factores etiológicos asociados, esta continúa siendo en el paciente atópico en edad pediátrica un equivalente del síndrome respiratorio alérgico en su forma bronquial. Objetivo: Determinar la relación entre tos seca nocturna y atopia en niños entre 3 y 14 años en Camagüey. Método: Se realizó un estudio caso control 1:1 con el objetivo de en el período de enero de 2006 a julio de 2008, en muestra de cien enfermos y cien sanos, que se les realizó valoración clínica e inmunológica (PT e IgE total). Para el procesamiento de los datos se aplicaron cálculos de medidas de probabilidad con sus intervalos de confianza. Resultados: Las edades más frecuentes se encuentran en el grupo de 3 a 6 años, con 36 casos en el masculino y 30 en el femenino. Los antecedentes familiares de atopia se observan en el 64 por ciento de los pacientes (OR= 16,00 IC 95 por ciento 7,01, 37,44 p<0.05).

Background: In spite of multiple mechanisms implied in the night dry cough and to the wide range of associated etiologic factors, it continues being in the atopic patient in pediatric age an equivalent of the allergic respiratory syndrome in their bronchial form. Objective: To determine the relationship between night dry cough and atopy in children between 3 and 14 years in Camagüey. Method: A 1:1 case control study was carried out, also clinical and immunologic valuation was performed (PT and total IgE). For data processing the probability measures calculations were applied with its reliance intervals. Results: The most frequent ages are in the group from 3 to 6 years, with 36 cases in the masculine sex and 30 in the feminine one. The family antecedents of atopy are observed in 64 prcent of the patients (OR= 16,00 IC 95 percent 7,01, 37,44 p<0.05).

Clinical Characteristics and Treatment Analysis of Dry Cough in the Aged People / 国际中医中药杂志

The symptoms of dry cough in the aged people differs due to different cause, age, individual difference, and medication. Clinically, the disease mainly shows as asthenia type (qi deficiency of lung and kidney or deficiency of both qi and yin), or complication of sthenia and asthenia (invasion of external pathogens combined with internal pathogens), besides it affected by many factors (such as medicines, constipation, stroke, diabetes, and palpitation). Therefore, medicines should be used in lights dose and smartly to prevent accidents caused by induced factors.

Primeira descrição de singamose brônquica ocorrida no Estado do Espírito Santo / First description of human bronchial syngamosis in the State of Espírito Santo

Relatamos o caso de um homem de 48 anos, que evoluiu durante 4 meses com quadro de tosse seca associada à dor torácica. Após serem descartadas as etiologias mais prováveis, realizou-se uma broncofibroscopia que revelou a presença de um casal de Syngamus laringeus no brônquio do lobo superior esquerdo. O paciente tornou-se assintomático após a retirada do nematóide.

We report the case of a 48-year-old man who presented progressive dry cough associated with chest pain over a four-month period. After ruling out the most probable etiologies, bronchofibroscopy was performed and showed a pair of Syngamus laringeus inside the left upper lobe bronchus. The patient became asymptomatic after the nematodes had been removed.

Experimental Application of Jiin-koka-to to Cases of Bronchial Asthma / 日本東洋医学雑誌

The source of the herbal mixture named Jiin-koka-to is Wan bing hui chun. Jiin-koka-to has been used mainly as a decoction for the treatment of bronchitis and tuberculosis. The cases of bronchial asthma treated with Jiin-koka-to in this report had similar symptoms: abnormal sensations in the throat and irritation. We investigated the efficacy of Jiin-koka-to in 11 asthma patients having both symptoms. Improvements were observed in all patients; these improvements included reduction of peripheral eosinophil count and serum IgE, loss in quantity of prednisolone, increment of peak expiratory flow rate, and cessation or decrease of asthma attacks. Thus, it is possible that Jiin-koka-to is a controller rather than a reliever in the treatment of bronchial asthma. Abnormal sensations in the throat and irritation might be one of the indications for Jiin-koka-to.

The Study of the Dry Cough Incidence Rate about Imidapril, the Angiotensin Converting Enzyme Inhibitor

BACKGROUND AND OBJECTIVES: Imidapril, one of the ACE inhibitor, has been used to treate hypertension, congestive heart failure, diabetes mellitus and renal disease. ACE inhibitor, however often causes dry cough and this adverse effect affects the compliance rate negatively. This report aimed to examine the incidence rate of coughing caused by Imidapril treat-ment. And we compared the results with the incidence and tendency of dry cough caused by the other ACE inhibitors. MATERIALS AND METHOD: This study enrolled 38 patients who followed up at internal medicine and took Imidapril from the period of May 9, 1997 to December 17, 1997. We tested its effectiveness, safety and tolerance. The initial dosage of it was 5mg/day and the maximum dosage according to blood pressure was 10mg/day for 8 weeks. The tendency and the incidence of dry cough have been analyzed and compared with recently published Korean reports. RESULTS: The 5 mg dosage of Imidapril showed 68.1% in lowering blood pressure rate and it went up to 81.8% during the 8 weeks treatment perriod. The blood pressure regularity rate was 36.3% after the 8 weeks treatment. The overall rate of adverse effect occurrence was 26.1% (6/23) and 8.7% of them were likely to cough. One of the patients who showed nausea stopped medication. The recent articles reported that the incidence of dry cough had been reduced: Enalapril (33.8%), Fosinopril (16%), Ramipril (15%), Imidapril (7.8 - 8.7%), Losartan (4.3%). CONCLUSION: Imidapril is as safe and effective as other ACE inhibitors. Various ACE inhibitors that were newly developed show their effectiveness in lessening incidence rate of dry cough, and Imidapril is thought to be an excellent drug for this matter. Even though Losartan shows the lowest incidence rate of dry cough, it needs to more regular usages since it is still on the stage of its medical adaptation.