A H Morice

..The aim of the present paper is to present a clinical guideline developed in the UK through scrutiny of the literature and expert opinion, in order to aid decision making in clinicians and highlight good practice...

..These changes were thought to be due to Crohn's disease involving the lungs and responded well to treatment with cortico-steroids. We report this uncommon radiological association with Crohn's disease...

..The results correlate well with the MD challenge but offer greater intra-day and inter-day reproducibility. TRIAL REGISTRATION: Current controlled trials ISRCTN98385033...

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..The investigation and treatment of chronic cough in adults is generally rewarding, provided there is an understanding of its aetiology, particularly when it arises from sites outside the respiratory tract...

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..Evidence is presented to support the proposal that activation of the type 1 vanilloid receptor (VR1) is an important sensory mechanism in cough...

..There is currently no evidence supporting the use of antitussives in chronic treatment-resistant cough...

..The lack of any clear pathological or biochemical tests makes the syndrome both a catch-all and a dustbin...

..The novel HFA pMDI formulation of budesonide/formoterol is an equally well tolerated and effective treatment for adults and adolescents with asthma as the budesonide/formoterol DPI...

..Whilst this is also true of cough-predominant asthma, the origin of cough in chronic disease may also lie in the oesophagus, nose or sinuses leading to errors in diagnosis and treatment...

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..Tiotropium also resulted in a significant reduction in the decline in post-bronchodilator FEV(1), suggesting possible disease modification by tiotropium in younger patients with COPD...

..However, the similarities between the different phenotypes far outweigh differences in a unifying diagnosis of the cough hypersensitivity syndrome, providing a more rational understanding of chronic cough...

..Thus, the inhibition of TRPV1 activation by dexbrompheniramine may provide one potential mechanism whereby this antihistamine exerts its therapeutic effect in chronic cough...

..Failure to make, particularly this latter, diagnosis leads to enormous consequences in terms of loss of employment, healthcare utilisation and a psychosocial morbidity...

..We undertook a survey of clinicians and scientists working in the field and asked them to count examples of different coughs. The clinical definition was adopted by the majority and we suggest that it should be the gold standard...

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..We examine the evidence behind this fashion and conclude that there is a grave danger of bias and distortion of the data from this approach...

..This suggests basal pulmonary nitric oxide release occurs, as well as in response to agonist-induced contraction, but not hypoxic pulmonary vasoconstriction...

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..This suggests that an NADPH oxidase-like enzyme is involved in HPV and could act as the pulmonary oxygen sensor...

..Asthma nurse intervention appeared to increase knowledge of asthma management, maintained throughout the study period, but had no significant impact on reducing re-admissions to hospital...

..CONCLUSIONS/INTERPRETATION: These effects could be clinically important for patients using inhaled insulins who have acute or occult chronic lung disease...

..Surgical fundoplication can also be effective when performed in appropriately selected individuals...

..Oesophageal dysmotility may therefore be important in the pathogenesis of cough in these patients...

..01), and PGF2(2alpha) (1.40+/-0.14 vs. 2.47+/-0.44 mN/mm, P<0.05). Perinatal exposure to hypoxia had a profound effect upon the adult pulmonary circulation, which could predispose to cardiopulmonary diseases in adulthood...

..CONCLUSION: UII does not induce vasoconstriction in isolated human pulmonary arterial or lung preparations and is therefore unlikely to be involved in the control of pulmonary vascular tone...

..Internet diagnosis by expert algorithm provides a novel mechanism for patients to access guideline-recommended therapies and enhances dialogue between patients and physicians...

..63; 99% CI 1.13 to 2.35) were also significantly associated. CONCLUSION: Chronic cough is a common symptom in the general population. Its strong association with gastrointestinal disease may have aetiological significance...

..During CF exacerbations, EBC pH was further reduced (median 5.30, p=0.017) but Fe(NO) and NO2/NO3 were unchanged. CONCLUSIONS: These findings demonstrate a dissociation between EBC pH and Fe(NO) in inflammatory airways disease...

..It is concluded that this protocol has the potential to improve management by providing a structured approach, reducing the number of investigations performed, and minimising unnecessary delays in treatment...

..HaH care of acute exacerbations of COPD is the preferred option in suitable patients...

..Objective: To evaluate the methacholine bronchoprotection afforded by formoterol, 12 microg, delivered via Clickhaler and Aerolizer dry powder inhalers and a pressurized metered-dose inhaler (pMDI) in mild-to-moderate asthmatic patients...

..The results correlate well with an existing Mefar dosimeter challenge, but give two to three times greater cough thresholds...

..Its efficacy in altering cough reflex sensitivity has been shown in healthy volunteers. In contrast evidence for an effect on clinically important cough is poor...

..57, p < 0.0001). These findings indicate a sex difference in cough sensitivity in patients with chronic cough, as previously reported in healthy volunteers. This may explain the female preponderance in cough clinics...

..The measurement of gastric emptying did not therefore provide further insights into the mechanisms of GER-related cough or clinically relevant information that would assist in patient management...

..Increase in TRPV1 activity may have a role in the airway hypersensitivity seen in chronic cough...

..These data suggest that, contrary to previous reports, a symptom complex which is characteristic of reflux cough can be identified...

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..This effect may depend on the delivery system, which in turn alters drug deposition and adsorption. We hypothesized that adrenal suppression depends on the rate of steroid absorption rather than the total steroid dose received...

..05). The measurement of aerosol deposition from nebulisers can be performed using a simple and widely available methodology, and may improve nebuliser selection in CF patients...