Chronic cough is the most common complain during the visit to a pulmonologist. Cough is described as a protective reflex that removes excessive secretions and inhaled foreign bodies from the respiratory tract. The anatomy of respiratory tract which is plentiful of cough receptors is the reason, that the most frequently causes of chronic cough are upper airway disorders, asthma and gastroesophag...

It was with great interest that we read the article by Tutuian et al1 in a recent issue of CHEST (August 2006). The authors investigated temporal relationships between non-acid reflux and cough events in patients with persistent cough, utilizing impedance/pH monitoring and subjective recording of cough events by means of a diary and a self-operated digital data logger. Examining temporal relati...

OBJECTIVES To study motor activation patterns of voluntary and reflex cough adjusted for cough flow rates. METHODS Surface electromyography (EMG) and cough flow rate were measured in 10 healthy volunteers. Voluntary cough was assessed for 20 efforts in each quintile of increasing cough flow rate. Reflex cough was assessed for 25 efforts produced by nebulised l-tartaric acid. EMG was recorded ...

BACKGROUND Objective cough frequency measurements are increasingly applied in clinical research. Technological advances enable automated detection and counting of cough events from sound recordings of many hours' duration. A possible limitation of sound-based cough frequency measurement is the contamination of recordings by environmental coughs (coughs from persons other than the patient). This...

BACKGROUND Since the publication of the 2006 American College of Chest Physicians (CHEST) cough guidelines, a variety of tools has been developed or further refined for assessing cough. The purpose of the present committee was to evaluate instruments used by investigators performing clinical research on chronic cough. The specific aims were to (1) assess the performance of tools designed to mea...

Chronic Cough in Older Adults Clodagh M. Ryan, MD MRCPI, Assistant Professor of Medicine, Division of Respirology, University Health Network / University of Toronto,Toronto, ON. EAR, NOSE, & THROAT DISORDERS Introduction Cough is an important physiological defense mechanism that helps clear the airway of noxious substances and excess mucus or fluid. It is defined as a forced expulsive maneuver,...

BACKGROUND Paediatricians rely on cough descriptors to direct them to the level of investigations needed for a child presenting with chronic cough, yet there is a lack of published data to support this approach. A study was undertaken to evaluate (1) whether historical cough pointers can predict which children have a specific cause for their cough and (2) the usefulness of chest radiography and...

Chronic cough can be the sole presenting symptom for patients with obstructive sleep apnoea. We investigated the prevalence, severity and factors associated with chronic cough in patients with sleep-disordered breathing (SDB). We invited 108 consecutive patients who had been referred for evaluation of SDB to complete a comprehensive questionnaire on respiratory and sleep health, which included ...

Goals & Objectives: To understand the differential diagnosis and management of common causes of pediatric cough: • List the common etiologies for chronic cough in children, differentiating between specific and non-specific cough and “wet” and “dry” cough. • Understand the management of chronic, non-specific cough, including trials of therapy for cough-variant asthma and protracted bronchitis. •...

Cough effectiveness is determined by a combination of volume of air expired and maximum expiratory airflow rate. Studies of cough sensitivity identify cough thresholds based on at least 2 or 5-cough re-accelerations to a stimulus, however, to date no study has examined the interplay between the distribution of cough expired air and cough airflow rates for these induced sequential coughs. The go...