phenylephrine-hydrochloride and Cough

Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disease. First respiratory symptoms already occur within the first hours after birth. Major symptoms are an unexplained neonatal respiratory distress syndrome, situs inversus, persistant cough, and chronic nasal congestion, recurrent paranasal sinus disorders with or without polyps, bronchiectasis as well as male infertility. Diagnostics is complex and includes transmission electron microscopy, nasal NO assessment, high-speed video microscopy and genetic evaluations. This review gives an overview over the current diagnostic procedures and therapeutic options. The management of PCD is a multidisciplinary approach, which should be reserved to in highly specialized centers.

Topics: Cough; Humans; Kartagener Syndrome; Male; Nose

Chronic cough is one of the most common and troublesome nonspecific respiratory symptom for which patients seek a general practitioner and specialist advice. It is conventionally defined as a cough lasting for more than 8 weeks. Exhaled nitric oxide has proven to be a specific biomarker capable to discriminate between differential diagnoses of chronic cough and simultaneously provide information about the response to specific treatment. In this review, we will discuss the potential use of exhaled and nasal nitric oxide in the diagnosis of chronic chough.

Topics: Asthma; Biomarkers; Breath Tests; Chronic Disease; Cough; Exhalation; Humans; Nitric Oxide; Nose

The diseases of the esophagus and nose are among the major factors contributing to chronic cough although their role in different patient populations is debated. Studies in animal models and in humans show that afferent C-fiber activators applied on esophageal or nasal mucosa do not initiate cough, but enhance cough induced by inhaled irritants. These results are consistent with the hypothesis that activation of esophageal and nasal C-fibers contribute to cough reflex hypersensitivity observed in chronic cough patients with gastroesophageal reflux disease (GERD) and chronic rhinitis, respectively. The afferent nerves mediating cough sensitization from the esophagus are probably the neural crest-derived vagal jugular C-fibers. In addition to their responsiveness to high concentration of acid typical for gastroesophageal reflux (pH < 5), esophageal C-fibers also express receptors for activation by weakly acidic reflux such as receptors highly sensitive to acid and receptors for bile acids. The nature of sensory pathways from the nose and their activators relevant for cough sensitization are less understood. Increased cough reflex sensitivity was also reported in many patients with GERD or rhinitis who do not complain of cough indicating that additional endogenous or exogenous factors may be required to develop chronic coughing in these diseases.

Topics: Animals; Cough; Esophagus; Humans; Nose; Reflex

Most studies agree that post-nasal drip syndrome (PNDS), asthma, gastroesophageal reflux disease (GORD), and laryngopharyngeal reflux (LPR) are the commonest causes of chronic cough in the immunocompetent, non-smoking patient who is not taking an angiotensin-converting enzyme inhibitor. No diagnostic test has been found to define those who are said to have PNDS other than a response to a first-generation antihistamine. Examining the available evidence suggests that mechanical stimulation of the pharynx by mucus is not an adequate theory for the production of cough. Inflammatory mediators in the lower airways are raised in PNDS, cough variant asthma and GORD, and the theory that an inflammatory process is affecting 'one airway' is a plausible one. Nasal disease is more likely to result in cough from the co-existing involvement of the lower airways through an as yet undefined pathway, and eosinophil and mast cell mediation appear a likely mechanism.

Topics: Angiotensin-Converting Enzyme Inhibitors; Asthma; Bronchitis, Chronic; Chronic Disease; Cough; Eosinophilia; Esophagitis, Peptic; Gastroesophageal Reflux; Humans; Mucus; Nose; Syndrome

Topics: Antigens; Bacterial Infections; Bronchi; Cilia; Cough; Environmental Pollutants; Environmental Pollution; Genes; Histocompatibility; Humans; Immunity, Cellular; Immunoglobulin E; Lung; Lymphatic System; Lymphocytes; Mucus; Neutralization Tests; Nose; Pulmonary Alveoli; Reflex; Respiratory Tract Diseases; Respiratory Tract Infections; Sensory Receptor Cells; Sneezing; Virus Diseases

Topics: Aerosols; Air Microbiology; Animals; Bacteria; Cell Count; Child; Cough; Guinea Pigs; Humans; Infant; Infections; Mycobacterium tuberculosis; Nose; Respiratory System; Saliva; Schools; Sneezing; Speech; Staphylococcus; Streptococcus; Tuberculosis; Virus Diseases; Viruses

Emergence from general anesthesia can be associated with coughing, agitation, and hemodynamic disturbances. Remifentanil may attenuate these responses.. In a prospective, double-blind, randomized trial, we enrolled 60 adult patients undergoing nasal surgery using remifentanil-based anesthesia. During the emergence phase, the remifentanil group had remifentanil reduced to one tenth of the maintenance rate, whereas the control group had remifentanil discontinued.. Times to awakening and tracheal extubation were similar between the two groups. During emergence, the remifentanil group (infusion rate 0.014 +/- 0.011 microg x kg(-1) x min(-1)) had a significantly lower incidence (40% vs 80%, P = 0.002) and less severe coughing compared with the control group, as well as a lower incidence of nonpurposeful movement (3.3% vs 30%, P = 0.006) and slower heart rates.. Low-dose remifentanil during emergence did not prolong wake-up but reduced the incidence and severity of coughing from the endotracheal tube.

Topics: Adolescent; Adult; Analgesics, Opioid; Anesthesia Recovery Period; Anesthesia, General; Blood Pressure; Cough; Double-Blind Method; Drug Administration Schedule; Female; Heart Rate; Humans; Hypotension; Infusions, Intravenous; Intubation, Intratracheal; Male; Middle Aged; Nose; Piperidines; Prospective Studies; Psychomotor Agitation; Remifentanil; Severity of Illness Index; Tachycardia; Time Factors; Treatment Outcome; Young Adult

The purpose of the study was to assess the suitability and safety of the flexible reinforced laryngeal mask airway (FRLMA) for intranasal surgery (INS) anesthesia. A secondary objective was to compare the incidence of complications of removal of the FRLMA with tracheal extubation in awake and anesthetized patients. One hundred fourteen ASA physical status I and II patients requiring INS were randomly assigned into three groups: Group I = FRLMA, Group II = endotracheal tube (ET) extubated awake, and Group II = ET extubated deeply anesthetized. In Group I, the incidence of coughing and oxyhemoglobin desaturation at removal was significantly reduced compared with that in Groups II and III (P < 0.05). There were no episodes of postremoval laryngospasm in Group I; in Group III, the incidence was 19% (P < 0.05), whereas in Group II, it was 6% (not significantly different). The number of patients with oxyhemoglobin desaturation < or = 92% on admission to the postanesthesia care unit was 0% in Group I, 26% in Group II (P < 0.05), and 16% in Group III (not significantly different). At bronchoscopy, the incidence of blood visible in the airway was low and similar among the three groups (3%, 6%, and 3%, respectively). There were no significant differences in the incidence of airway complications between Groups II and III.. We compared airway management for intranasal surgery anesthesia using a new device, the flexible reinforced laryngeal mask airway, with the current standard of tracheal intubation. The study demonstrates that the flexible reinforced laryngeal mask airway can provide a safe, protected airway with a smoother emergence from anesthesia than tracheal intubation.

Topics: Adult; Anesthesia Recovery Period; Anesthesia, General; Bronchoscopy; Cough; Equipment Design; Female; Follow-Up Studies; Hoarseness; Humans; Incidence; Intubation, Intratracheal; Laryngeal Masks; Laryngismus; Male; Nose; Oxyhemoglobins; Pharyngitis; Pliability; Postoperative Hemorrhage; Respiration; Respiration, Artificial; Safety; Wakefulness

An 11-month-old boy with productive cough was referred to our hospital. He had nasal obstruction immediately after birth, and wheezing, wet cough, and rhinorrhea were observed daily after the neonatal period. Clinical and imaging findings revealed secretory otitis media, chronic sinusitis, and bronchiectasis. Primary ciliary dyskinesia was suspected. Transmission electron microscopy of nasal cilia showed defects of the outer and inner dynein arms. Genetic examinations of the family revealed copy number variation in PIH1 domain-containing 3 (PIH1D3) in the proband and mother. This is the first report of a Japanese patient with primary ciliary dyskinesia caused by copy number variation in PIH1D3.

Topics: Cilia; Ciliary Motility Disorders; Cough; DNA Copy Number Variations; Humans; Infant; Kartagener Syndrome; Male; Nose

Equine rhinitis B virus (ERBV) has been given little attention by practitioners compared to other respiratory viruses, mainly because of the lack of diagnostic modalities and association with clinical disease. The objective of the study was to determine the frequency of detection of ERBV in nasal secretions from 6568 horses with acute onset of respiratory signs.. ERBV-positive qPCR results from nasal secretions submitted to a molecular diagnostic laboratory from 2013 to 2019 were reviewed.. A total of 333 ERBV qPCR-positive samples (5.1%) were detected with increasing yearly frequency since the introduction of the assay in 2013. In comparison, only three of 356 (0.8%) healthy horses tested qPCR-positive for ERBV. Median age for ERBV qPCR-positive horses was 3 years of age, and fever, coughing and nasal discharge were the most common signs reported. Further, co-infections with other respiratory pathogens were reported in 73 (21.9%) of ERBV qPCR-positive samples.. ERBV is a commonly detected respiratory virus from nasal secretions of young horses presenting with fever, nasal discharge and coughing.

Topics: Animals; Bodily Secretions; Cough; Erbovirus; Female; Fever; Horse Diseases; Horses; Humans; Male; Nose; Picornaviridae Infections; Real-Time Polymerase Chain Reaction

Cerebral exteriorization through the cribriform plate during routine endotracheal suctioning (ETS) in a coughing patient without sedation with multiple complex skull base fracture; this case has never been reported in the literature.. We report the case of a polytrauma patient admitted in our ICU with severe traumatic brain injury (TBI) and multiple complex skull base fractures. After 48 hours of neurocritical care and stable neuromonitoring parameters, sedation was stopped for neurological assessment. During this period and while routine ETS was being performed, brain herniation with exteriorization through the nose occurred with a concomitant ICP elevation.. ETS can induce the coughing reflex and provoke a rise in ICP. It is a simple routine procedure that should be performed with great precautions in order to avoid iatrogenic complications, particularly in patients with skull base fractures, such as brain herniation as described in our patient.

Topics: Aged; Brain; Brain Injuries, Traumatic; Cough; Fatal Outcome; Hernia; Humans; Intracranial Pressure; Magnetic Resonance Imaging; Male; Nose; Skull Base; Skull Fractures; Suction; Tomography, X-Ray Computed; Trachea

The characteristics and risk factors of respiratory syncytial virus (RSV) infection among children has not yet been fully understood. To address the characteristics of RSV-associated illness and risk factors of RSV infection among children under 5 years of age in Suzhou, China. From April 2011 to March 2014, we conducted a prospective surveillance among children in Suzhou, China. Nasal or throat swabs were collected from outpatients with influenza-like illness (ILI) and inpatients with severe acute respiratory infections (SARI). RSV was detected by reverse-transcriptase polymerase chain reaction and direct fluorescent antibody assay for children with ILI and SARI, respectively. Multivariable logistic-regression models were constructed to explore risk factors and symptoms of RSV infection. Of 3267 ILI and 1838 SARI children enrolled in the study, 192 (5.9%) and 287 (15.6%) tested positive for RSV, respectively. Among ILI patients, children with RSV infections visited clinics more often (P = 0.005) and had longer duration of fever (P = 0.032) than those without RSV infection. All RSV-positive children had an increased risk of having cough (OR = 2.9), rhinorrhea (OR = 1.6), breathing difficulty (OR = 3.4), wheezing (OR = 3.3), and irritability (OR = 2.7). Children aged <2 years, had history of prematurity (OR = 2.0) and recent respiratory infections (OR = 1.3) were more likely to get infected by RSV. Children with SARI had higher positive rate of RSV than those with ILI. Cough, rhinorrhea, and wheezing were the most common symptoms in RSV infection. Children aged <2 years, had history of prematurity and recent respiratory infections were the potential risk factors for RSV infection.

Topics: Child, Preschool; China; Coinfection; Cough; Epidemiological Monitoring; Female; Fever; Humans; Infant; Influenza, Human; Male; Nose; Orthomyxoviridae; Outpatients; Pharynx; Polymerase Chain Reaction; Prospective Studies; Respiratory Syncytial Virus Infections; Respiratory Syncytial Viruses; Respiratory Tract Infections; Risk Factors; Virus Diseases; Viruses

Two hundred and fourteen patients who had a cough illness lasting at least 2 weeks were studied to investigate Bordetella pertussis as a cause of prolonged cough in adolescents and adults. Medical history and nasopharyngeal swab specimens for culture and polymerase chain reaction (PCR) were obtained at presentation. Three (1·4%) patients were B. pertussis culture-positive; 15 (7%) were B. pertussis PCR-positive (including the culture-positive patients) and 11 (5·1%) were Bordetella spp. PCR-positive. Symptom combinations were significantly high both in patients with pertussis and patients with indeterminate results (P < 0·05). We conclude that B. pertussis should be considered among differential diagnoses of prolonged cough in adolescents and adults and PCR and culture should be used to detect these cases and facilitate public health response.

Topics: Adolescent; Adult; Bordetella pertussis; Child; Chronic Disease; Cough; DNA, Bacterial; Female; Humans; Male; Medical History Taking; Nose; Pharynx; Turkey; Vomiting; Whooping Cough; Young Adult

Cough and angioedema are well-known adverse reactions of ACE inhibitors. However, other adverse effects of upper airways such as postnasal drainage, rhinitis and nasal blockage, are less frequently recognised. These might share the same pathophysiological mechanism: bradykinin accumulation. We present two patients with ACE inhibitor-induced upper respiratory symptoms that improved after the discontinuation of ACE-inhibitors and substitution with angiotensin II receptor blockers. The incidence of these adverse events is not accurately known, since these are not required to be reported, but it is estimated to be low. This presents challenges to the physician and demonstrates the importance of keeping it as a differential diagnosis. Most physicians are aware of ACE inhibitor-induced cough but not of ACE inhibitor-induced nasal blockage, rhinitis or postnasal drainage. Identifying these can avoid unnecessary diagnostic tests and inappropriate treatment.

Topics: Aged; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Cough; Humans; Male; Nasal Obstruction; Nose; Rhinitis

The cold-sensitive cation channel TRPM8 is a target for menthol, which is used routinely as a cough suppressant and as an additive to tobacco and food products. Given that cold temperatures and menthol activate neurons through gating of TRPM8, it is unclear how menthol actively suppresses cough. In this study we describe the antitussive effects of (-)-menthol in conscious and anesthetized guinea pigs. In anesthetized guinea pigs, cough evoked by citric acid applied topically to the tracheal mucosa was suppressed by menthol only when it was selectively administered as vapors to the upper airways. Menthol applied topically to the tracheal mucosa prior to and during citric acid application or administered continuously as vapors or as an aerosol to the lower airways was without effect on cough. These actions of upper airway menthol treatment were mimicked by cold air delivered to the upper airways but not by (+)-menthol, the inactive isomer of menthol, or by the TRPM8/TRPA1 agonist icilin administered directly to the trachea. Subsequent molecular analyses confirmed the expression of TRPM8 in a subset of nasal trigeminal afferent neurons that do not coincidently express TRPA1 or TRPV1. We conclude that menthol suppresses cough evoked in the lower airways primarily through a reflex initiated from the nose.

Topics: Animals; Antitussive Agents; Cold Temperature; Cough; Guinea Pigs; Male; Menthol; Nasal Mucosa; Neurons, Afferent; Nose; Reflex; Respiration; Trachea; Trigeminal Nerve; TRPM Cation Channels

Asthma is a chronic inflammatory disease characterized by bronchospasms accompanied with frequent coughing, the pathogenesis of which is not clear. In healthy adults deep inspirations (DIs) provide a protective effect against bronchoconstriction triggered by methacholine inhalation, which correlates with the number of accompanying cough efforts. The aim was to study the effect of deep nasal inspirations representing the voluntary equivalent of the sniff-like aspiration reflex on the capsaicin-induced cough in children with mild asthma. The cough reflex sensitivity to capsaicin was determined using a compressed air-driven nebulizer in 21 children (8 girls and 13 boys of median age 13.3 year) suffering from mild asthma (FEV(1)∼80%). The effect of five previous DIs through the nose was examined on the elicitability of two and five or more cough efforts (C2, C5). Under control conditions, the concentration of 20.86 (14.58-29.8) μmol/l of capsaicin provoked two cough efforts (C2). After five DIs similar reaction required significantly higher concentrations of capsaicin: 29.02 (18.88-44.6) μmol/l; P=0.016. Five or more cough efforts (C5) were not significantly changed after previous DIs 161.49 (77.31-337.33) μmol/l and without DIs 141.52 (68.77-291); P=0.54. A series of five deep inspirations decreases the cough reflex sensitivity to evoke two efforts (C2) in children with mild asthma. The inhibitory effect of similar DIs disappeared after repeated applications of increasing doses of capsaicin, aiming to evoke five or more cough efforts, suggesting a reflex character of protective effect of DIs.

Topics: Adolescent; Asthma; Capsaicin; Cough; Female; Humans; Inhalation; Male; Nose; Reflex

Suppression of cough during emergence after nasal surgery is practical to avoid bleeding from the surgical site. Previously recommended effect-site concentration of remifentanil for preventing cough during emergence is restricted to female patients undergoing thyroid surgery, so we evaluated effective effect-site concentration of remifentanil for preventing cough during emergence for men undergoing nasal surgery.. Twenty-four American Society of Anesthesiologists (ASA) physical status I or II, between the ages of 18 and 60 years old, non-smoker male patients undergoing nasal surgery were enrolled in this study. The effective effect-site concentration for 50% of patients (EC(50) ) and and that for 95% of patients (EC(95) ) of remifentanil for preventing cough were determined by Dixon's up-and-down method and by isotonic regression method with a bootstrapping approach. Haemodynamic variables were compared in patients with cough and without cough during emergence.. The EC(50) of remifentanil for preventing cough during emergence by Dixon's method was 2.17 ng/ml [standard deviation (SD) 0.38]. The estimated EC(50) and EC(95) of remifentanil using isotonic regression model with a bootstrapping approach were 2.35 ng/ml [95% confidence interval (CI) 1.89-2.66] and 2.94 ng/ml (95% CI 2.83-2.97), respectively. Mean arterial pressure and heart rate were significantly higher in patients with cough during emergence. Three out of 13 patients that received more than 2.5 ng/ml of remifentanil experienced a brief episode of bradypnea.. The EC(95) of remifentanil for preventing cough in men after nasal surgery is 2.94 ng/ml. Remifentanil target-controlled infusion with established effect-site concentration could suppress cough in men during emergence from sevoflurane anaesthesia after nasal surgery, though reversible respiratory depression might arise at high effect-site concentration of remifentanil.

Topics: Adolescent; Adult; Anesthesia, Inhalation; Anesthetics, Inhalation; Blood Pressure; Cough; Heart Rate; Humans; Male; Methyl Ethers; Middle Aged; Nose; Piperidines; Remifentanil; Sevoflurane

Topics: Cough; Eye; Female; Foreign Bodies; Humans; Middle Aged; Nose

Topics: Cough; Esophageal Fistula; Esophagoscopy; Female; Gastroscopy; Humans; Middle Aged; Nose; Posture

Possible health hazards of fumes and aerosols of bitumen are in discussion, and data on their adverse effects on human airways under current exposure conditions are limited. To assess the irritative effects of exposure to fumes and aerosols of bitumen on the airways, a cross-sectional cross-shift study was conducted including external and internal exposure measurements, spirometry and especially non-invasive methods like nasal lavage collection and induction of sputum in order to identify and evaluate more precisely inflammatory process in the upper and lower airways. The cross-shift study comprised 74 mastic asphalt workers who were exposed to fumes and aerosols of bitumen and 49 construction workers without this exposure as reference group. Questionnaire, spirometry, ambient monitoring and urinary analysis were performed. Humoral and cellular parameters were measured in nasal lavage fluid (NALF) and induced sputum. For data analysis, a mixed linear model was performed on the different outcomes with exposure group, time of measurement (pre-, post-shift), current smoking, German nationality and age as fixed factors and subjects as random factor. Based on personal exposure measurements during shift, mastic asphalt workers were classified into a low (< or =10 mg/m(3); n = 46) and a high (>10 mg/m(3); n = 28) exposure group. High exposure was accompanied by significant higher urinary post-shift concentrations of 1-hydroxypyrene and the sum of hydroxyphenanthrenes. Acute respiratory symptoms were reported more frequently in the high exposure group after shift. Significant cross-shift declines in lung function parameters (forced expiratory volume in 1 s [FEV(1) (% predicted)] and forced vital capacity [FVC (% predicted)]) were measured in mastic asphalt workers. Pre-shift FEV(1) (% predicted) and FVC (% predicted) were higher in the low exposure group. In pre- and post-shift NALF samples, interleukin (IL)-1beta-, IL-8- and total protein concentrations were lower in the low exposure group compared to the reference and the high exposure group. Pre- and post-shift neutrophil percentages in both nasal and sputum samples were also lower in the low exposure group. Significantly higher pre- and post-shift sputum concentrations of IL-8, IL-6, nitrogen oxide (NO) derivatives and total protein were detected especially in highly exposed workers. Irritative effects of exposure to fumes and aerosols of bitumen on the upper and lower airways were apparent, especially in mas

Topics: Adult; Aerosols; Air Pollutants, Occupational; Cough; Cross-Sectional Studies; Eye; Germany; Humans; Hydrocarbons; Interleukin-6; Interleukin-8; Irritants; Middle Aged; Nasal Lavage Fluid; Nitrites; Nose; Occupational Exposure; Phenanthrenes; Picrates; Pyrenes; Respiratory Function Tests; Spirometry; Sputum; Surveys and Questionnaires

Cough and sniff are both spontaneous respiratory behaviors that can be initiated voluntarily in humans. Disturbances of cough may be life threatening, while inability to sniff impairs the sense of smell in neurological patients. Cortical mechanisms of voluntary cough and sniff production have been predicted to exist; however, the localization and function of supramedullary areas responsible for these behaviors are poorly understood. We used functional magnetic resonance imaging to identify the central control of voluntary cough and sniff compared with breathing. We determined that both voluntary cough and sniff require a widespread pattern of sensorimotor activation along the Sylvian fissure convergent with voluntary breathing. Task-specific activation occurred in a pontomesencephalic region during voluntary coughing and in the hippocampus and piriform cortex during voluntary sniffing. Identification of the localization of cortical activation for cough control in humans may help potential drug development to target these regions in patients with chronic cough. Understanding the sensorimotor sniff control mechanisms may provide a new view on the cerebral functional reorganization of olfactory control in patients with neurological disorders.

Topics: Adult; Brain; Brain Mapping; Cough; Female; Humans; Image Processing, Computer-Assisted; Inhalation; Magnetic Resonance Imaging; Male; Nose

Topics: Cough; Electroencephalography; Epilepsy, Temporal Lobe; Humans; Motor Activity; Nose; Prospective Studies

The bedside assessment of dysphagia may be difficult, due to the inability to witness the act of swallowing directly. The milk test described in this paper gives a good assessment of swallowing, is cheap and easily portable and allows an instant decision to be made without recourse to special investigations.

Topics: Animals; Cough; Deglutition; Deglutition Disorders; Endoscopy; Humans; Milk; Nose; Pharynx; Tongue

Topics: Animals; Cough; Humans; Infant; Infant, Newborn; Laryngeal Nerves; Lung; Mechanoreceptors; Nerve Fibers; Nose; Oropharynx; Reflex; Respiration; Respiratory Muscles; Sudden Infant Death

The incidence of respiratory reactions to stimulation of the nasal and propharyngeal mucose was studied in 44 newborn premature infants. The inhalation of menthol fumes or the administration of drops of Mukoseptonex to the nasal mucosa caused transient respiratory arrest or a drop in the respiration rate. The heart rate rose during chemical stimulation of the nasal mucosa, possibly in association with a general arousal reaction. Mechanical stimulation of the nasal mucosal with a nylon fibre elicited an expulsive reaction in 95% of the cases. As distinct from experimental animals, sneezing was not preceded by a deep initial inspiration. Stimulation of the oropharyngeal region produced transient apnoea in 24.5% of the cases, in 18% expiratory reactions reminiscent of the expiration reflex, in 33% independent, intensive inspiratory reactions and in 24.5% cough. Cough from both the oropharyngeal and the laryngeal region had a pronounced inspiratory component. Independent inspiratory reactions may to some extent be co-responsible for the high incidence of aspirations in the neonatal period.

Topics: Cough; Electrocardiography; Esophagus; Heart Rate; Humans; Infant, Newborn; Infant, Premature; Manometry; Nose; Oropharynx; Physical Stimulation; Pressure; Reflex; Respiration; Sneezing; Stimulation, Chemical

An experimental set-up is described permitting the evaluation and quantification under controlled conditions of retention efficiencies of surgical mask materials and different types of masks, using bacterial aerosols standardized both quantitatively and qualitatively. Screening of various materials used in one-way surgical paper masks has shown that, apart from the one-layered thin models, present paper masks with bacterial transmittance under 1% are far superior to the muslin masks of the past. For meeting the aseptical requirements in hospital operating rooms, adaptable masks (green exterior) provided with multi-layered polyester filter pads have proven most suitable by their virtual impenetrability for bacteria. After several hours use and heavy wetting of the filters layers, no increase of bacterial transmittance was observed.

Topics: Bacteria; Cough; Humans; Masks; Mouth; Nose; Sneezing

Rhinovirus was transmitted from experimentally infected volunteers (donors) to susceptible recipients and the efficiencies of spread by hand-to-hand contact and large- and small-particle aerosols compared. Transmission of infection was very efficient by the hand route: 11 of 15 hand-contact exposures initiated infection, compared with one of 12 large-particle (P less than 0.005) and none of 10 small-particle (P less than 0.005) exposures. Rhinovirus was present in nine of 18 (50%) nasal swab specimens, 28 of 43 (65%) hand rinses, and seven of 18 (39%) saliva specimens of donors; geometric mean titers of positive specimens were 10(1.5), 10(1.4), and 10(1.2) tissue culture infectious dose 50/ml (TCID 50/ml), respectively. Rhinovirus was present in 20 of 43 (46%) recipient hand rinses, with a geometric mean titer of 10(1.4)TCID50/ml. Virus on donors' hands was transferred to recipients' fingers during 20 of 28 (71%) 10-second hand-contact exposures. These findings support the concept that hand contact/self-inoculation may be an important natural route of rhinovirus transmission.

Topics: Adolescent; Aerosols; Common Cold; Cough; Hand; Humans; Nose; Rhinovirus; Sneezing

Topics: Acetone; Air Pollution; Asthma; Central Nervous System; Cough; Cyanates; Dermatitis, Occupational; Environmental Exposure; Eye; Headache; Hearing Disorders; Humans; Maximum Allowable Concentration; Mucous Membrane; Noise; Nose; Occupational Diseases; Paint; Petroleum; Pharynx; Plastics; Respiratory Function Tests; Toluene; Ventilation; Xylenes

Topics: Adolescent; Adult; Aged; Airway Obstruction; Anesthesia, Intravenous; Carcinoma, Squamous Cell; Cough; Epistaxis; Female; Fracture Fixation, Internal; Fractures, Bone; Hemorrhage; Humans; Ketamine; Male; Mandibular Neoplasms; Nose; Orthopedic Fixation Devices; Pharynx; Reflex; Surgery, Oral

Topics: Adult; Airway Obstruction; Airway Resistance; Anesthesia, General; Bronchi; Cilia; Cough; Deglutition; Female; Gagging; Glottis; Humans; Intubation, Intratracheal; Larynx; Male; Middle Aged; Nasopharynx; Nose; Pharynx; Reflex; Respiration; Respiratory System; Trachea; Tracheotomy

Topics: Aged; Arm; Cough; Drug Eruptions; Facial Dermatoses; Female; Humans; Nose; Potassium Iodide

Topics: Adolescent; Adult; Aged; Analgesia; Anesthesia, General; Anesthesia, Local; Arteries; Blood Pressure; Catheterization; Child; Cocaine; Cough; Epinephrine; Female; Hemorrhage; Humans; Hypoxia; Intubation, Intratracheal; Larynx; Lidocaine; Male; Methods; Middle Aged; Nasopharynx; Nose; Oxygen; Oxygen Inhalation Therapy; Posture; Preanesthetic Medication

Topics: Adult; Aged; Animals; Autopsy; Bronchi; Child, Preschool; Cough; Culture Techniques; Fluorescent Antibody Technique; Haplorhini; Humans; Immune Sera; Infant; Influenza, Human; Kidney; Lung; Middle Aged; Nasopharynx; Nose; Respiratory Syncytial Viruses; Trachea

Sampling of human subjects, who had been in contact with animals infected with foot-and-mouth disease (FMD) virus, showed that virus could be recovered from the nose, throat, saliva and from air expelled during coughing, sneezing, talking and breathing. The amounts of virus recovered paralleled those collected with a large-volume sampler and multistage impinger and these findings confirmed that the highest recovery of airborne virus was from infected pigs followed by cattle and sheep. More virus was found in the noses of those examining infected animals than in those operating the samplers, but there was variation between the subjects. In the majority there was a 1.8 log fall in titre by 3.5 hr., but virus persisted in the nose of one subject for 28 hr. Nose blowing or washing the nostrils did not remove virus completely, nor were cloth or industrial masks completely effective in preventing inhalation of virus. It was possible to transmit virus from infected subjects to others on one occasion. No clinical cases of FMD in man resulted from exposure, nor was there any rise in antibody. Use was made of these findings in determining sites of aerosol excretion in animals, and the results are discussed in relation to FMD in man and to the spread of respiratory viruses by the airborne route.

Topics: Air Microbiology; Animals; Aphthovirus; Cattle; Cattle Diseases; Cough; Foot-and-Mouth Disease; Humans; Masks; Nose; Pharynx; Respiration; Saliva; Sheep; Sheep Diseases; Sneezing; Swine; Swine Diseases

1. The effects of mechanical stimulation in the nose, epipharynx, laryngopharynx and tracheobronchial tree, and of chemical irritation of the nasal mucosa, were studied on various somatic and autonomic functions in cats.2. Action potentials were recorded from the diaphragm and rectus abdominis muscles of spontaneously breathing cats, and from the phrenic and lumbar nerves of paralysed, artificially ventilated cats. Expulsive processes such as sneezing and coughing evoked from the nasal, laryngopharyngeal and tracheobronchial mucosae were characterized by strong diaphragmatic and abdominal expiratory discharges; synchronous discharges in these antagonistic respiratory muscles and their motoneurones often occurred especially during laryngopharyngeal stimulation of coughing.3. The ;aspiration reflex' elicited from the epipharynx was characterized by brief bursts of high-frequency activity in the phrenic nerve and diaphragm, and was usually not followed by any expiratory activity in the rectus abdominis or its motoneurones.4. In paralysed, artificially ventilated cats stimulation of the laryngeal and tracheobronchial regions caused large increases both in total lung resistance and in tracheal constrictor nerve fibre activity, indicating reflex tracheo-bronchoconstriction; similar stimulation of the epipharyngeal and nasal mucosae decreased both total lung resistance and tracheal constrictor nerve fibre activity, indicating reflex bronchodilation.5. In paralysed cats, stimulation of each of the four sites in the respiratory tract caused a reflex increase in systemic blood pressure, the largest hypertensive response coming from the epipharynx. Nervous activity in cervical sympathetic efferent fibres was increased by the stimulations, especially those of the epipharyngeal and laryngopharyngeal regions.6. There was good correlation in time and magnitude between the changes in total lung resistance and in bronchoconstrictor fibre activity, and also between the changes in blood pressure and in efferent sympathetic discharge, although the mechanical changes lagged behind the nervous ones.7. In anaesthetized, spontaneously breathing cats stimulation of the respiratory tract evoked large variations in blood pressure accompanying the spasmodic respiratory efforts, probably by mechanical effects.

Topics: Action Potentials; Animals; Blood Pressure; Bronchi; Cats; Cough; Diaphragm; Electromyography; Larynx; Motor Neurons; Muscles; Nasal Mucosa; Nasopharynx; Nose; Paralysis; Pharynx; Phrenic Nerve; Reflex; Respiratory Physiological Phenomena; Sneezing; Trachea

Topics: Cough; Humans; Lung Diseases; Nose; Physiology; Pneumonectomy; Respiration; Rhinitis

Topics: Anti-Bacterial Agents; Child; Cough; Dermatologic Agents; Humans; Infant; Nasopharyngeal Diseases; Nose