ABSTRACT
Introduction: Chest Xray is one of the most frequently asked radiological examination in patients with heart or lung problems in general medical practice. There are many studies on correlation of CXR findings and other tools of investigations like CT scan, MRI and laboratory investigations like spirometry and sputum examinations etc. The present study aims at establishing a possible correlation in rural population of Eastern Uttar Pradesh. Methods: We have done a cross sectional study in a period of six months including 2500 patients coming for CXR. Patients were followed up to a point where radiological diagnosis was confirmed or otherwise after other investigations and clinical response. Results: There was fairly good correlation in patients with COPD (73.15%), tuberculosis (85.8%), interstitial lung disease (63.9%) and congestive heart failure (68.6%). Conclusion: We conclude that CXR is tool of reasonable sensitivity however there is sizeable possibility of false positive and negative cases.
ABSTRACT
RESUMEN La tos persistente es un síntoma de consulta frecuente, de origen multifactorial, que involucra a diferentes especialidades como la neumología, la gastroenterología y la otorrinolaringología. Sus causas más frecuentes son la descarga nasal posterior, tos como variante del asma y reflujo gastroesofágico/faringolaríngeo. Una vez descartadas dichas causas, cobran importancia los trastornos sensoriales del nervio vago, una entidad relativamente nueva que también es conocida como neuropatía laríngea sensitiva. En la neuropatía laríngea, una injuria a nivel neuronal aferente del reflejo de la tos produce un estado de hipersensibilidad laríngea en la que estímulos normalmente ignorados (que no producen respuesta tusígena) comienzan a gatillar el reflejo. Las características clínicas de la tos y el descarte de las causas más frecuentes permite llegar a este diagnóstico. Su tratamiento tiene como objetivo la modulación de las vías neuronales alteradas basándose en 3 pilares: educación sobre la patología, recomendaciones conductuales (higiene vocal, estrategias de reducción de tos) y los fármacos entre los que se usan los inhibidores de bomba de protones, mucolíticos y neuromoduladores.
ABSTRACT Persistent cough is a common symptom for medical consultation, it is of multifactorial origin and involves different specialties such as pneumology gastroenterology and otorhinolaryngology. The most frequent causes are postnasal drip, cough variant asthma and gastroesophageal/pharyngolaryngeal reflux. Once these causes are discarded the vagus nerve sensory disorder becomes of importance, it is a relatively new entity also known as laryngeal sensitive neuropathy. In the laryngeal neuropathy, an injury in the afferent neuronal pathway of the cough reflex produces laryngeal hypersensitivity in which normally ignored stimulus (i.e. do not cause cough) start to trigger the reflex. The clinical features of the cough and the rule out of the most frequent causes allow the diagnosis. The objective of the treatment is to modulate the altered neuronal pathways based on 3 pillars: education regarding the pathology, behavioral recommendations (vocal hygiene, cough reduction strategies) and drugs among which proton pump inhibitors, mucolytics and neuromodulators are used.
Subject(s)
Humans , Laryngeal Diseases , Cough/diagnosis , Cough/physiopathology , Vagus Nerve Diseases/physiopathology , Cough/etiology , Cough/therapy , Laryngopharyngeal Reflux , Laryngeal NervesABSTRACT
La fístula traqueo- o broncobiliar congénita o fístula hepatopulmonar congénita es una rara malformación con alta morbimortalidad si su diagnóstico no se realiza a tiempo. Existe una comunicación entre el sistema respiratorio (tráquea o bronquio) y el tracto biliar. Hasta la fecha, se han reportado solo 35 casos. Presentamos el caso de un neonato con neumopatía derecha y débito bilioso por el tubo endotraqueal. El diagnóstico se realizó mediante broncoscopía con radioscopía y la resección de la fístula broncobiliar fue por videotorascopía. Posteriormente, se requirió de una hepatectomía izquierda con anastomosis biliodigestiva en Y de Roux por presentar hipoplasia de colédoco.
Congenital tracheo-or-bronchobiliary fistula or congenital he-patopulmonary fistula is a rare malformation with high morbidity and mortality if the diagnosis is not made early. The tracheo-or-bronchobiliary fistula is a communication between the respiratory (trachea or bronchus) and biliary tract. To date, only 35 cases have been published worldwide. We report a case of a neonate with right pneumonia and bilious fluid in the endotracheal tube. Diagnosis was made using bronchoscopy with fluoroscopy. Videothoracoscopy was used to remove the bronchobiliary fistula. Subsequently, a left he-patectomy with Roux-en-Y biliary-digestive anastomosis was performed as bile ductus hypoplasia was present.
Subject(s)
Humans , Male , Infant, Newborn , Biliary Fistula/surgery , Biliary Fistula/congenital , Biliary Fistula/diagnosis , Bronchial Fistula/surgery , Bronchial Fistula/congenital , Bronchial Fistula/diagnosisABSTRACT
JUSTIFICATIVA E OBJETIVOS: A tosse persistente representa uma condição comum e causa frequente de procura por atendimento médico, podendo alterar a rotina diária do paciente afetado. O objetivo deste estudo foi avaliar a resposta clínica e laboratorial à terapia de tosse persistente, utilizando uma combinação de eucaliptol, gomenol, guaifenesina, cansilato de sódio e cloridrato de lidocaína.MÉTODO: Foram obtidos dados referentes a 60 pacientes atendidos no Serviço de Pneumologia do Hospital das Clínicas de Teresópolis Constantino Otaviano, incluindo informações demográficas, resultados de exames físicos, laboratoriais e de espirometria, avaliações do médico e do paciente, bem como uma avaliação através do Cough-specific Quality of Life Questionnaire (CQLQ) que foram analisadas antes, durante e após sete dias de terapia. RESULTADOS: Não houve alterações clinicamente significativas nos exames físicos. Os exames laboratoriais e testes de espirometria permaneceram dentro das respectivas faixas de normalidade e nenhuma diferença significativa nos valores entre as avaliações foi observada. Vinte e nove eventos adversos foram registrados em 22 pacientes, todos com gravidade leve a moderada. As pontuações das avaliações de condição geral do médico e do paciente melhoraram significativamente na Avaliação 3 em relação à Avaliação 1 (Qui-quadrado = 121,1; GL= 16; p < 0,0001, e Qui-quadrado = 61,86; GL = 16; p < 0,0001, respectivamente). As pontuações no CQLQ da Avaliação 3 melhoraram de forma significativa em relação às da Avaliação 1 (t = 6,746; GL = 58; p < 0,0001), indicando melhora substancial na qualidade de vida.CONCLUSÃO: Com base nos resultados obtidos, concluiu-se que a combinação de eucaliptol, gomenol, guaifenesina, cansilato de sódio e cloridrato de lidocaína foi segura e eficaz em pacientes com processos pulmonares produtivos acompanhados de tosse, com impacto positivo na qualidade de vida dos pacientes tratados.
BACKGROUND AND OBJECTIVES: Persistent cough represents a common ailment for which medical attention is often sought, and may cause significant disruption of the affected patient's routine. The objective of this study was to evaluate clinical and laboratory response to persistent cough therapy using a combination of eucalyptol, gomenol, guaifenesin, sodium camsilate, and lidocaine hydrochloride. METHOD: We collected data from 60 patients attended at the Pneumology Service of the Hospital de Clínicas de Teresópolis Constantino Otaviano, including demographic information, physical exams, laboratory, and spirometry exam results, physician and patient evaluations, and a quality-of-life assessment (CQLQ) which were analyzed before, during, and after seven days of therapy. RESULTS: There were no clinically significant changes regarding physical exams. Laboratory exams and spirometry tests remained within the respective normal ranges, and no statistically significant difference in values among study assessments was observed. Twenty-nine adverse events were recorded among 22 patients, all of which were mild to moderate in severity. The scores of the physician and patient evaluation of overall condition improved significantly in Assessment 3 in relation to Assessment 1 (Chi-square = 61.86; Degree of Freedom = 16; p < 0.0001 and Chi-square = 121.1; DF= 16; p < 0.0001, respectively). CQLQ total scores from Assessment 3 improved significantly in relation to those of Assessment 1 (t = 6.746; DF = 58; p < 0.0001), indicating a substantial improvement in quality-of-life. CONCLUSION: Based on the results of this analysis, we conclude that the combination of eucalyptol, gomenol, guaifenesin, sodium camsilate, and lidocaine hydrochloride, was safe and effective in patients with productive pulmonary processes accompanied by cough, positively impacting quality-of-life of the treated patients.
Subject(s)
Humans , Male , Female , Middle Aged , Cough , Quality of LifeABSTRACT
We evaluated the use of a combination of menthol, guaiacol, terpineol, eucalyptol, gomenol, and camphor injection in patients presenting persistent cough who were submitted to a 7-day treatment regimen with daily doses of the medication and a series of clinical and laboratory evaluations, including a quality-of-life questionnaire, spirometry, and assessments of overall condition by the patient and the physician, performed prior to the first dose of medication, after three days of treatment, and at the end of the 7-day treatment period. The use of concomitant medications and the incidence, severity and duration of adverse events were also evaluated. A total of sixty-one patients were included in the study. There were no clinically significant changes in vital signs, laboratory tests, or spirometry throughout the treatment period. A statistically significant improvement (p<0.0001) in the assessments of overall condition by the patient and physician was observed, and there was a statistically significant improvement in the scores of the quality-of-life questionnaire (p<0.0001). While adverse events were recorded, none were serious and all were resolved by the end of the treatment period. Based on the results of this study, we conclude that the combination of menthol, guaiacol, terpineol, eucalyptol, gomenol, and camphor in the form of an intramuscular injection was safe and effective ameliorating the effects of persistent cough in the quality of life of the patient population evaluated.
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Tourette's syndrome (TS) is a neuropsychiatric disorder characterized by the presence of involuntary motor and phonic tics. Phonic tics can mimic respiratory system disorders such as asthma, and upper and lower respiratory system infections. We report on twins with chronic persistent cough (CPC) : one of whom was followed as an asthmatic for a year and the other was diagnosed with recurrent respiratory tract infection. A careful history and neurologic assessment suggested that TS might be responsible for the first twin's symptoms but that the second one was probably in early TS. All the symptoms of the first patient diagnosed as TS showed a complete improvement with pharmacological treatment in two weeks. Since the history of CPC may in reality be TS, we recommend that TS should be considered in the differential diagnosis of pediatric CPC.
Subject(s)
Child , Humans , Male , Chronic Disease , Cough/diagnosis , Diagnosis, Differential , Tourette Syndrome/complicationsABSTRACT
Objective: Bakumondo-to (Mai men dong tang, B), a traditional Chinese blended medicine, has notable antitussive activity in bronchitic guinea-pigs. In this study, we examined whether or not B was effective in treating postinfectious cough.<br>Methodology: Consenting, non-smoking patients who met the following diagnostic criteria were selected as subjects: (1) those who had been coughing continuously for more than two weeks postinfectiously; (2) who did not use angiotensin-converting enzyme (ACE) inhibitors orally; (3) who had no history of nasal and/or paranasal disease, chronic pulmonary disease, atopy or gastroesophageal reflux disease; and (4) who had normal chest X-rays, respiratory function, peripheral eosinophil counts, levels of C-reactive protein, and serum IgE concentrations. Subjects were randomized into two groups: those given a daily dose of 9g of B extract granules orally for one week, and those given a daily dose of 60mg dextromethorphan hydrobromide (D) orally for one week. Using a cough diary (in which cough was scored from 0 to 9 points), we compared and studied the antitussive effects between the two groups.<br>Results: Group B was comprised of thirteen patients, and Group D, twelve. There were no significant differences between the two groups with respect to age, sex, cough scores at the time of hospital visits, duration of continuous coughing, and test results. Significant antitussive effects were seen in both groups. However, cough scores decreased significantly from the second day for the B group, and on the third, sixth and seventh day for the D group. Compared with the D group subjects, those in the B group showed higher antitussive effects on the second days (P<0.05). No serious side effects were observed for either group.<br>Conclusion: In this randomized open trial, we concluded that Bakumondo-to is an effective treatment in non-smoking patients with postinfectious cough, and it appears to demonstrate an antitussive action immediately after administration.