Cough ; etiology ; therapy ; Humans ; Practice Guidelines as Topic

Chronic Disease ; Cough ; diagnosis ; etiology ; therapy ; Humans

The manifestations of pediatric gastroesohageal reflux (GER) are varied and complex. Extra-oesophageal symptoms, including GER-related respiratory diseases, ear, nose and throat diseases, oral diseases and neuropsychiatric symptoms, are thought to be major manifestations of pediatric GER, but the causal relationship between GER and these extra-oesophageal symptoms is still unclear. Therefore, we describe the progress of research on the relationship between GER and asthma, chronic cough, laryngitis, pharyngitis, laryngeal papilloma, sinusitis, otitis media, dental erosion, apparent life-threatening event, and the crying baby syndrome in this review. It provides new strategies for the diagnosis and treatment of GER-related diseases in children.
Asthma ; etiology ; Cough ; etiology ; Gastroesophageal Reflux ; complications ; Humans ; Laryngitis ; etiology ; Sinusitis ; etiology ; Tooth Erosion ; etiology

OBJECTIVETo analyze the etiological diagnosis and efficacy of specific therapy of chronic cough.

METHODSTotally 106 patients with chronic cough were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association, which included history inquiry, physical examination, pulmonary function tests, X-ray or CT of paranasal sinuses or chest, 24-hour esophageal pH monitoring, and sputum cell differentials. The etiological diagnosis was made according to clinical manifestations, examination results, and response to specific therapy.

RESULTSThe cause of chronic cough was confirmed in 101 patients (95.3%). Cough due to a single cause was found in 81 patients (80.2%), and due to multiple causes in 20 patients (19.8%). The causes included cough variant asthma (CVA) in 66 patients (62.3%), postnasal drip syndrome (PNDs) in 15 patients (14.1%), gastroesophageal reflux (GERC) in 11 patients (10.4%), post-infection cough (PIC) in 4 patients (3.8%), angiotensin converting enzyme inhibitor (ACEI) induction in 3 patients (2.8%), and eosinophilic bronchitis (EB) in 2 patients (1.9%). Five patients (4.7%) had not been definitely diagnosed. After specific therapy based on diagnosis, cough disappeared in 92 patients (91.1%) and alleviated in 9 patients (8.9%).

CONCLUSIONSCVA, PNDs, and GERC are the most common causes of chronic cough. Specific therapy based on definite cause can result in good outcome.

Child ; China ; epidemiology ; Chronic Disease ; Cough ; diagnosis ; etiology ; therapy ; Humans

Child ; Cough ; etiology ; therapy ; Female ; Humans ; Mental Disorders ; complications ; Psychotherapy

BACKGROUNDThe current diagnostic algorithms for chronic cough require the establishment of the primary presumptive causes followed by the confirmation of diagnosis with the specific therapies. The aim of the study was to investigate the discrepancy between presumptive and definite causes and its clinical implication.

METHODSA total of 109 patients with chronic cough underwent laboratory investigations to identify the cause of cough; including sinus computerized tomography (if needed), histamine bronchial provocation, induced sputum cytology and 24-hour esophageal pH or multi-channel intraluminal impedance combined with pH monitoring. The presumptive causes were confirmed by treating them sequentially. The difference between presumptive and definite causes of chronic cough was compared.

RESULTSSingle cause was more frequent in the definite diagnosis than in the presumptive diagnosis (78.9% vs. 54.1%, χ(2) = 15.01, P = 0.0001). In contrast, multiple causes were significantly fewer in definite diagnosis than in the presumptive diagnosis (15.6% vs. 37.6%, χ(2) = 13.53, P = 0.0002). There was a discrepancy between definite and presumptive causes in 30 patients (27.5%). Compared with the presumptive causes, definite upper airway cough syndrome (24.8% vs. 11.9%, χ(2) = 6.0, P = 0.01) and gastroesophageal reflux disease (6.4% vs. 0, χ(2) = 7.23, P = 0.007) was more frequent as a single cause of chronic cough while cough variant asthma plus gastroesophageal reflux disease (3.7% vs. 11.9%, χ(2) = 5.17, P = 0.02) and upper airway cough syndrome plus nonasthmatic eosinophilic bronchitis (0 vs. 9.2%, χ(2) = 10.48, P = 0.001) were fewer as multiple causes of chronic cough.

CONCLUSIONSA discrepancy was common between presumptive and definite causes of chronic cough. To treat presumptive causes sequentially may be a suitable solution for avoidance of erroneous multiple causes and possible over-treatment.

Adult ; Cough ; etiology ; Female ; Humans ; Larynx ; Pharyngitis ; complications ; parasitology ; Pharynx ; Pruritus ; etiology

OBJECTIVE: To analysis the causes and treatment for postnasal drip syndrome. METHOD: One hundred patients were tested by routine examination of otolaryngology, nasal endoscopy, fiberoptic laryngoscopy and nasal sinuses CT. Choice allergen test and nasopharynx X-ray were taken based on the symptoms and signs. Patients were treated accordingly for different causes, such as flushing the nasal cavity by herbal liquid, using glucocorticoid locally, taking medicine of improving the sticky film cilium function, immunotherapeutic or operation. RESULT: The causes included chronic rhinitis 22 cases (22%), chronic sinusitis or nasal polyp 31 cases (31%), allergic rhinitis 28 cases (28%), adenoid vegetation 16 cases (16%), chronic nasopharyngitis 3 cases (3%). All patients were treated accordingly and total cure rate was 82% after 6 months follow up. CONCLUSION The causes of postnasal drip syndrome are complicated. It is critical to check the cause and chose adaptable therapy for good result.
Adolescent ; Adult ; Aged ; Child ; Chronic Disease ; Cough ; etiology ; therapy ; Female ; Humans ; Immunotherapy ; Male ; Middle Aged ; Nose Diseases ; etiology ; therapy ; Rhinitis ; etiology ; therapy ; Sinusitis ; etiology ; therapy ; Young Adult

Cough ; etiology ; Female ; Hemangioendothelioma, Epithelioid ; complications ; diagnosis ; Humans ; Lung Neoplasms ; complications ; diagnosis ; Middle Aged ; Multiple Pulmonary Nodules ; etiology