Search

Your search keyword '"Smith, Jaclyn A."' showing total 21 results
Start Over Author "Smith, Jaclyn A." Publisher american college of chest physicians
21 results on '"Smith, Jaclyn A."'

1. Global Physiology and Pathophysiology of Cough: Part 1: Cough Phenomenology – CHEST Guideline and Expert Panel Report

Author

Lee, Kai K., Davenport, Paul, Smith, Jaclyn A., Irwin, Richard S., McGarvey, Lorcan, Mazzone, Stuart B., Birring, Surinder S., Abu Dabrh, Abd Moain, Altman, Kenneth W., Barker, Alan F., Blackhall, Fiona, Bolser, Donald C., Brightling, Christopher, Chang, Anne B., El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Iyer, Vivek, Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Oppenheimer, John, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Maeve P., Tarlo, Susan M., Vertigan, Anne E., other, and, Lee, Kai K., Davenport, Paul, Smith, Jaclyn A., Irwin, Richard S., McGarvey, Lorcan, Mazzone, Stuart B., Birring, Surinder S., Abu Dabrh, Abd Moain, Altman, Kenneth W., Barker, Alan F., Blackhall, Fiona, Bolser, Donald C., Brightling, Christopher, Chang, Anne B., El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Iyer, Vivek, Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Oppenheimer, John, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Maeve P., Tarlo, Susan M., Vertigan, Anne E., and other, and

Abstract

The purpose of this state-of-the-art review is to update the American College of Chest Physicians 2006 guideline on global physiology and pathophysiology of cough. A review of the literature was conducted using PubMed and MEDLINE databases from 1951 to 2019 and using prespecified search terms. We describe the basic phenomenology of cough patterns, behaviors, and morphological features. We update the understanding of mechanical and physiological characteristics of cough, adding a contemporary view of the types of cough and their associated behaviors and sensations. New information about acoustic characteristics is presented, and recent insights into cough triggers and the patient cough hypersensitivity phenotype are explored. Lastly, because the clinical assessment of patients largely focuses on the duration rather than morphological features of cough, we review the morphological features of cough that can be measured in the clinic. This is the first of a two-part update to the American College of Chest Physicians 2006 cough guideline; it provides a more global consideration of cough phenomenology, beyond simply the mechanical aspects of a cough. A greater understanding of the typical features of cough, and their variations, may allow a more informed interpretation of cough measurements and the clinical relevance for patients.

Published
2021

2. Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients: CHEST Expert Panel Report

Author

Smith, Maeve P., Lown, Mark, Singh, Sonal, Ireland, Belinda, Hill, Adam T., Linder, Jeffrey A., Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Blackhall, Fiona, Birring, Surinder S., Bolser, Donald C., Boulet, Louis Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Kahrilas, Peter J., Kavanagh, Joanne, Lai, Kefang, Lilly, Craig, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Vertigan, Anne E., Weinberger, Miles, other, and, Smith, Maeve P., Lown, Mark, Singh, Sonal, Ireland, Belinda, Hill, Adam T., Linder, Jeffrey A., Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Blackhall, Fiona, Birring, Surinder S., Bolser, Donald C., Boulet, Louis Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Kahrilas, Peter J., Kavanagh, Joanne, Lai, Kefang, Lilly, Craig, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Vertigan, Anne E., Weinberger, Miles, and other, and

Abstract

Background: Evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 “Chronic Cough Due to Acute Bronchitis: American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guidelines.” Methods: Acute bronchitis was defined as an acute lower respiratory tract infection manifested predominantly by cough with or without sputum production, lasting no more than 3 weeks with no clinical or any recent radiographic evidence to suggest an alternative explanation. Two clinical population, intervention, comparison, outcome questions were addressed by systematic review in July 2017: (1) the role of investigations beyond the clinical assessment of patients presenting with suspected acute bronchitis, and (2) the efficacy and safety of prescribing medication for cough in acute bronchitis. An updated search was undertaken in May 2018. Results: No eligible studies relevant to the first question were identified. For the second question, only one relevant study met eligibility criteria. This study found no difference in number of days with cough between patients treated with an antibiotic or an oral nonsteroidal antiinflammatory agent compared with placebo. Clinical suggestions and research recommendations were made based on the consensus opinion of the CHEST Expert Cough Panel. Conclusions: The panelists suggested that no routine investigations be ordered and no routine medications be prescribed in immunocompetent adult outpatients first presenting with cough due to suspected acute bronchitis, until such investigations and treatments have been shown to be safe and effective at making cough less severe or resolve sooner. If the cough due to suspected acute bronchitis persists or worsens, a reassessment and consideration of targeted investigations should be considered.

Published
2020

3. Managing Chronic Cough Due to Asthma and NAEB in Adults and Adolescents: CHEST Expert Panel Report

Author

Côté, Andreanne, Russell, Richard J., Boulet, Louis Philippe, Gibson, Peter G., Lai, Kefang, Irwin, Richard S., Brightling, Christopher, Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Blackhall, Fiona, Bolser, Donald C., Birring, Surinder S., Braman, Sidney S., Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Kahrilas, Peter J., Kavanagh, Joanne, Lane, Andrew P., Lilly, Craig, Lown, Mark, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Vertigan, Anne E., Weinberger, Miles, other, and, Côté, Andreanne, Russell, Richard J., Boulet, Louis Philippe, Gibson, Peter G., Lai, Kefang, Irwin, Richard S., Brightling, Christopher, Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Blackhall, Fiona, Bolser, Donald C., Birring, Surinder S., Braman, Sidney S., Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Kahrilas, Peter J., Kavanagh, Joanne, Lane, Andrew P., Lilly, Craig, Lown, Mark, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Vertigan, Anne E., Weinberger, Miles, and other, and

Abstract

Background: Asthma and non-asthmatic eosinophilic bronchitis (NAEB) are among the commonest causes of chronic cough in adults. We sought to determine the role of non-invasive measurements of airway inflammation, including induced sputum and fractional exhaled nitric oxide, in the evaluation of cough associated with asthma, and what the best treatment is for cough due to asthma or NAEB. Methods: We undertook three systematic reviews of randomized controlled trials and observational trials of adults and adolescents > 12 years of age with a chronic cough due to asthma or NAEB. Eligible studies were identified in MEDLINE, CENTRAL, and SCOPUS and assessed for relevance and quality. Guidelines were developed and voted upon using CHEST guideline methodology. Results: Of the citations reviewed, 3/1,175, 53/656, and 6/134 were identified as being eligible for inclusion in the three systematic reviews, respectively. In contrast to established guidelines for asthma therapies in general and the inclusion in some guidelines for a role of biomarkers of airway inflammation to guide treatment in severe disease, the evidence of specific benefit related to the use of non-invasive biomarkers in patients with chronic cough due to asthma was weak. The best therapeutic option for cough in asthma or NAEB is inhaled corticosteroids followed by leukotriene receptor antagonism. Conclusions: This guideline offers recommendations on the role of non-invasive measurements of airway inflammation and treatment for cough due to asthma or NAEB based on the available literature, and identifies gaps in knowledge and areas for future research.

Published
2020

5. Chronic cough and gastroesophageal reflux in children: Chest guideline and expert panel report

Author

Chang, Anne B., Oppenheimer, John, Kahrilas, Peter J., Kantar, Ahmad, Rubin, Bruce, Weinberger, Miles, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Bolser, Donald C., Birring, Surinder S., Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Gibson, Peter, Harding, Susan M., Gold, Philip, Harnden, Anthony, Hill, Adam T., Kavanagh, Joanne, Lai, Kefang, Lim, Kaiser, Mark Madison, J., Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Metlay, Joshua P., Molasoitis, Alex, Hassan Murad, M., Narasimhan, Mangala, Newcombe, Peter, Rosen, Mark, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., other, and, Chang, Anne B., Oppenheimer, John, Kahrilas, Peter J., Kantar, Ahmad, Rubin, Bruce, Weinberger, Miles, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Bolser, Donald C., Birring, Surinder S., Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Gibson, Peter, Harding, Susan M., Gold, Philip, Harnden, Anthony, Hill, Adam T., Kavanagh, Joanne, Lai, Kefang, Lim, Kaiser, Mark Madison, J., Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Metlay, Joshua P., Molasoitis, Alex, Hassan Murad, M., Narasimhan, Mangala, Newcombe, Peter, Rosen, Mark, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., and other, and

Abstract

BACKGROUND: Whether gastroesophageal reflux (GER) or GER disease (GERD) causes chronic cough in children is controversial. Using the Population, Intervention, Comparison, Outcome (PICO) format, we undertook four systematic reviews. For children with chronic cough (> 4-weeks duration) and without underlying lung disease: (1) who do not have gastrointestinal GER symptoms, should empirical treatment for GERD be used? (2) with gastrointestinal GER symptoms, does treatment for GERD resolve the cough? (3) with or without gastrointestinal GER symptoms, what GER-based therapies should be used and for how long? (4) if GERD is suspected as the cause, what investigations and diagnostic criteria best determine GERD as the cause of the cough? METHODS: We used the CHEST Expert Cough Panel's protocol and American College of Chest Physicians (CHEST) methodological guidelines and GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Delphi methodology was used to obtain consensus. RESULTS: Few randomized controlled trials addressed the first two questions and none addressed the other two. The single meta-analysis (two randomized controlled trials) showed no significant difference between the groups (any intervention for GERD vs placebo for cough resolution; OR, 1.14; 95% CI, 0.45-2.93; P ¼.78). Proton pump inhibitors (vs placebo) caused increased serious adverse events. Qualitative data from existing CHEST cough systematic reviews were consistent with two international GERD guidelines. CONCLUSIONS: The panelists endorsed that: (1) treatment(s) for GERD should not be used when there are no clinical features of GERD; and (2) pediatric GERD guidelines should be used to guide treatment and investigations.

Published
2019

6. The Neurokinin-1 Receptor Antagonist Orvepitant Is a Novel Antitussive Therapy for Chronic Refractory Cough: Results From a Phase 2 Pilot Study (VOLCANO-1).

Author

Smith, Jaclyn, Allman, David, Badri, Huda, Miller, Robert, Morris, Julie, Satia, Imran, Wood, Andrew, and K. Trower, Michael

Subjects
*COUGH, *SUBSTANCE P, *PILOT projects, *VISUAL analog scale, *RESEARCH, *ANTITUSSIVE agents, *CHRONIC diseases, *RESEARCH methodology, *EVALUATION research, *MEDICAL cooperation, *PIPERIDINE, *SEVERITY of illness index, *COMPARATIVE studies, *RANDOMIZED controlled trials, *BLIND experiment, *QUALITY of life, *PULMONARY function tests, *RESEARCH funding, *NEUROTRANSMITTER receptors, *CHEMICAL inhibitors
Abstract

Background: Substance P and the neurokinin-1 (NK-1) receptor are implicated in chronic refractory cough pathophysiology. We assessed the efficacy and safety of orvepitant, a brain-penetrant NK-1 antagonist, in an open-label study in CRC patients with chronic refractory cough.Methods: Thirteen patients with daytime cough frequency >3 to <250 coughs/h took orvepitant 30 mg once daily for 4 weeks. Objective cough frequency was measured over 24 h at baseline and weeks 1, 4, and 8. The primary end point was change from Baseline in daytime cough frequency at week 4. Secondary end points included cough severity visual analog scale (VAS) score, global ratings of change for cough frequency and severity, and Cough-specific Quality of Life Questionnaire score.Results: All patients completed the study. Mean baseline cough frequency was 71.4/h. A statistically and clinically significant improvement in objective daytime cough frequency was observed at week 4: reduction from baseline of 18.9 (26%) coughs/h (95% CI, 9.6-28.3; P < .001). This effect was apparent at week 1 (reduction from baseline of 27.0 [38%] coughs/h [95% CI, 11.4-42.7; P = .001]) and sustained after drug discontinuation at week 8 (reduction from baseline of 20.4 [29%] coughs/h [95% CI, 3.2-37.5; P = .020]). Statistically significant improvements were seen for severity VAS and quality of life. Orvepitant was safe and well-tolerated.Conclusions: Orvepitant resulted in a significant and sustained improvement in objective cough frequency, severity VAS, and quality of life; appeared safe; and merits further clinical investigation.Trial Registry: EU Clinical Trials Register; No.: 2014-003947-36; URL: www.clinicaltrialsregister.eu. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

7. Chronic Cough Due to Gastroesophageal Reflux in Adults: CHEST Guideline and Expert Panel Report

Author

Kahrilas, Peter J., Altman, Kenneth W., Chang, Anne B., Field, Stephen K., Harding, Susan M., Lane, Andrew P., Lim, Kaiser, McGarvey, Lorcan, Smith, Jaclyn, and Irwin, Richard S.

Subjects
Adult, Evidence-Based Medicine, Cough, Chronic Disease, Gastroesophageal Reflux, Humans, Female
Abstract

We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome.Two population, intervention, comparison, outcome (PICO) questions were addressed by systematic review: (1) Can therapy for gastroesophageal reflux improve or eliminate cough in adults with chronic and persistently troublesome cough? and (2) Are there minimal clinical criteria to guide practice in determining that chronic cough is likely to respond to therapy for gastroesophageal reflux?We found no high-quality studies pertinent to either question. From available randomized controlled trials (RCTs) addressing question #1, we concluded that (1) there was a strong placebo effect for cough improvement; (2) studies including diet modification and weight loss had better cough outcomes; (3) although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, proton pump inhibitors (PPIs) demonstrated no benefit when used in isolation; and (4) because of potential carryover effect, crossover studies using PPIs should be avoided. For question #2, we concluded from the available observational trials that (1) an algorithmic approach to management resolved chronic cough in 82% to 100% of instances; (2) cough variant asthma and upper airway cough syndrome (UACS) (previously referred to as postnasal drip syndrome) from rhinosinus conditions were the most commonly reported causes; and (3) the reported prevalence of reflux-cough syndrome varied widely.The panelists (1) endorsed the use of a diagnostic/therapeutic algorithm addressing causes of common cough, including symptomatic reflux; (2) advised that although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, PPIs demonstrated no benefit when used in isolation; and (3) suggested that physiological testing be reserved for refractory patients being considered for antireflux surgery or for those in whom there is strong clinical suspicion warranting diagnostic testing.

Published
2016

8. Cough in Patients With Lung Cancer: A Longitudinal Observational Study of Characterization and Clinical Associations.

Author

Harle, Amélie S.M., Blackhall, Fiona H., Molassiotis, Alex, Yorke, Janelle, Dockry, Rachel, Holt, Kimberley J., Yuill, Danielle, Baker, Katie, and Smith, Jaclyn A.

Subjects
LUNG cancer, ASTHMA, GASTROINTESTINAL agents, COUGH diagnosis, PATHOLOGICAL physiology, ANTITUSSIVE agents, COMPARATIVE studies, COUGH, LONGITUDINAL method, LUNG tumors, RESEARCH methodology, MEDICAL cooperation, PROGNOSIS, RESEARCH, RESEARCH funding, SELF-evaluation, TIME, TUMOR classification, EVALUATION research, SEVERITY of illness index, DISEASE complications
Abstract

Background: Cough is common in patients with lung cancer, and current antitussive treatments are suboptimal. There are little published data describing cough in patients with lung cancer or work assessing clinical associations. The aim of this study is to fill that gap.Methods: This was a longitudinal prospective observational single-cohort study over 60 days. Patients were assessed through self-reported validated scales and, in a subsample, ambulatory cough monitoring at study entry (day 0), day 30, and day 60.Results: At study entry, 177 patients were included and 153 provided data at day 60. The median duration of cough was 52 weeks (interquartile range, 8.5-260). Cough was described as severe enough to warrant treatment in 62% of the patients. Depending on the scale used, performance status was associated with both cough severity and cough impact (P < .001) at study entry, whereas higher cough severity at study entry was associated with female sex (P = .02), asthma (P = .035), and reflux disease (P < .001). Cough impact at study entry was additionally associated with experiencing nausea (P = .018). Cancer characteristics (ie, cancer stage, histology) were not associated with cough severity nor cough impact; neither was smoking or COPD.Conclusions: This is the first study to describe characteristics of cough in patients with lung cancer and to identify clinical associations that may be relevant for its treatment. Our data suggest that cough is a frequent and distressing symptom and an unmet clinical need. Its association with gastrointestinal symptoms in this study may improve our understanding of pathophysiology and therapeutic options for cough occurring in patients with lung cancer. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

10. Anatomy and Neurophysiology of Cough: CHEST Guideline and Expert Panel Report

Author

Canning, Brendan J., Chang, Anne B., Bolser, Donald C., Smith, Jaclyn A., Mazzone, Stuart B., and McGarvey, Lorcan

Subjects
Male, Nerve Fibers, Unmyelinated, Evidence-Based Medicine, Bronchial Spasm, Guidelines as Topic, Vagus Nerve, Sensitivity and Specificity, Respiratory Muscles, respiratory tract diseases, Cough, Reflex, Respiratory Mechanics, Humans, Female, Nervous System Physiological Phenomena, Expert Testimony, Mechanoreceptors
Abstract

Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves innervating other viscera, as well as somatosensory nerves innervating the chest wall, diaphragm, and abdominal musculature regulate cough patterning and cough sensitivity. The responsiveness and morphology of the airway vagal sensory nerve subtypes and the extrapulmonary sensory nerves that regulate coughing are described. The brainstem and higher brain control systems that process this sensory information are complex, but our current understanding of them is considerable and increasing. The relevance of these neural systems to clinical phenomena, such as urge to cough and psychologic methods for treatment of dystussia, is high, and modern imaging methods have revealed potential neural substrates for some features of cough in the human.

Published
2014

12. Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer: CHEST Guideline and Expert Panel Report.

Author

Molassiotis, Alex, Smith, Jaclyn A., Mazzone, Peter, Blackhall, Fiona, Irwin, Richard S., and Chest Expert Cough Panel

Subjects
*LUNG cancer patients, *COUGH treatment, *SYSTEMATIC reviews, *COUGH, *LUNG tumors, *RESEARCH funding, *EVIDENCE-based medicine, *DISEASE complications, DISEASES in adults
Abstract

Background: Cough among patients with lung cancer is a common but often undertreated symptom. We used a 2015 Cochrane systematic review, among other sources of evidence, to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.Methods: The CHEST methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework were used. The Expert Cough Panel based their recommendations on data from the Cochrane systematic review on the topic, uncontrolled studies, case studies, and the clinical context. Final grading was reached by consensus according to the Delphi method.Results: The Cochrane systematic review identified 17 trials of primarily low-quality evidence. Such evidence was related to both nonpharmacologic (cough suppression) and pharmacologic (demulcents, opioids, peripherally acting antitussives, or local anesthetics) treatments, as well as endobronchial brachytherapy.Conclusions: Compared with the 2006 CHEST Cough Guideline, the current recommendations and suggestions are more specific and follow a step-up approach to the management of cough among patients with lung cancer, acknowledging the low-quality evidence in the field and the urgent need to develop more effective, evidence-based interventions through high-quality research. [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

13. Objective Cough Frequency, Airway Inflammation, and Disease Control in Asthma.

Author

Marsden, Paul A., Satia, Imran, Ibrahim, Baharudin, Woodcock, Ashley, Yates, Lucy, Donnelly, Iona, Jolly, Lisa, Thomson, Neil C., Fowler, Stephen J., and Smith, Jaclyn A.

Subjects
COUGH diagnosis, ASTHMA treatment, NITRIC oxide, SPIROMETRY, METHACHOLINE chloride, ASTHMA diagnosis, INFLAMMATION, SYMPTOMS, NITRIC oxide analysis, ASTHMA, BREATH tests, BRONCHIAL provocation tests, COUGH, LONGITUDINAL method, QUESTIONNAIRES, RESEARCH funding, STATISTICS, TIME, DISEASE management, VITAL capacity (Respiration), DIAGNOSIS
Abstract

Background: Cough is recognized as an important troublesome symptom in the diagnosis and monitoring of asthma. Asthma control is thought to be determined by the degree of airway inflammation and hyperresponsiveness but how these factors relate to cough frequency is unclear. The goal of this study was to investigate the relationships between objective cough frequency, disease control, airflow obstruction, and airway inflammation in asthma.Methods: Participants with asthma underwent 24-h ambulatory cough monitoring and assessment of exhaled nitric oxide, spirometry, methacholine challenge, and sputum induction (cell counts and inflammatory mediator levels). Asthma control was assessed by using the Global Initiative for Asthma (GINA) classification and the Asthma Control Questionnaire (ACQ). The number of cough sounds was manually counted and expressed as coughs per hour (c/h).Results: Eighty-nine subjects with asthma (mean ± SD age, 57 ± 12 years; 57% female) were recruited. According to GINA criteria, 18 (20.2%) patients were classified as controlled, 39 (43.8%) partly controlled, and 32 (36%) uncontrolled; the median ACQ score was 1 (range, 0.0-4.4). The 6-item ACQ correlated with 24-h cough frequency (r = 0.40; P < .001), and patients with uncontrolled asthma (per GINA criteria) had higher median 24-h cough frequency (4.2 c/h; range, 0.3-27.6) compared with partially controlled asthma (1.8 c/h; range, 0.2-25.3; P = .01) and controlled asthma (1.7 c/h; range, 0.3-6.7; P = .002). Measures of airway inflammation were not significantly different between GINA categories and were not correlated with ACQ. In multivariate analyses, increasing cough frequency and worsening FEV1 independently predicted measures of asthma control.Conclusions: Ambulatory cough frequency monitoring provides an objective assessment of asthma symptoms that correlates with standard measures of asthma control but not airflow obstruction or airway inflammation. Moreover, cough frequency and airflow obstruction represent independent dimensions of asthma control. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
View/download PDF

16. Tools for assessing outcomes in studies of chronic cough: CHEST guideline and expert panel report.

Author

Boulet, Louis-Philippe, Coeytaux, Remy R, McCrory, Douglas C, French, Cynthia T, Chang, Anne B, Birring, Surinder S, Smith, Jaclyn, Diekemper, Rebecca L, Rubin, Bruce, Irwin, Richard S, and CHEST Expert Cough Panel

Abstract

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 measure cough frequency, severity, and impact in adults, adolescents, and children with chronic cough and (2) make recommendations or suggestions related to these findings.Methods: By following the CHEST methodologic guidelines, the CHEST Expert Cough Panel based its recommendations and suggestions on a recently published comparative effectiveness review commissioned by the US Agency for Healthcare Research and Quality, a corresponding summary published in CHEST, and an updated systematic review through November 2013. Recommendations or suggestions based on these data were discussed, graded, and voted on during a meeting of the Expert Cough Panel.Results: We recommend for adults, adolescents (≥ 14 years of age), and children complaining of chronic cough that validated and reliable health-related quality-of-life (QoL) questionnaires be used as the measurement of choice to assess the impact of cough, such as the Leicester Cough Questionnaire and the Cough-Specific Quality-of-Life Questionnaire in adult and adolescent patients and the Parent Cough-Specific Quality of Life Questionnaire in children. We recommend acoustic cough counting to assess cough frequency but not cough severity. Limited data exist regarding the performance of visual analog scales, numeric rating scales, and tussigenic challenges.Conclusions: Validated and reliable cough-specific health-related QoL questionnaires are recommended as the measurement of choice to assess the impact of cough on patients. How they compare is yet to be determined. When used, the reporting of cough severity by visual analog or numeric rating scales should be standardized. Previously validated QoL questionnaires or other cough assessments should not be modified unless the new version has been shown to be reliable and valid. Finally, in research settings, tussigenic challenges play a role in understanding mechanisms of cough. [ABSTRACT FROM AUTHOR]

Published
2015
Full Text
View/download PDF

17. Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.

Author

Canning, Brendan J, Chang, Anne B, Bolser, Donald C, Smith, Jaclyn A, Mazzone, Stuart B, McGarvey, Lorcan, and CHEST Expert Cough Panel

Abstract

Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves innervating other viscera, as well as somatosensory nerves innervating the chest wall, diaphragm, and abdominal musculature regulate cough patterning and cough sensitivity. The responsiveness and morphology of the airway vagal sensory nerve subtypes and the extrapulmonary sensory nerves that regulate coughing are described. The brainstem and higher brain control systems that process this sensory information are complex, but our current understanding of them is considerable and increasing. The relevance of these neural systems to clinical phenomena, such as urge to cough and psychologic methods for treatment of dystussia, is high, and modern imaging methods have revealed potential neural substrates for some features of cough in the human. [ABSTRACT FROM AUTHOR]

Published
2014
Full Text
View/download PDF

18. Chronic cough: relationship between microaspiration, gastroesophageal reflux, and cough frequency.

Author

Decalmer S, Stovold R, Houghton LA, Pearson J, Ward C, Kelsall A, Jones H, McGuinness K, Woodcock A, Smith JA, Decalmer, Samantha, Stovold, Rachel, Houghton, Lesley A, Pearson, Jeff, Ward, Chris, Kelsall, Angela, Jones, Helen, McGuinness, Kevin, Woodcock, Ashley, and Smith, Jaclyn A

Abstract

Background: Microaspiration is often considered a potential cause of cough. The aim of this study was to investigate the relationship between microaspiration, the degree and type of gastroesophageal reflux, and the frequency of coughing in patients with chronic cough.Methods: One hundred patients with chronic cough (mean [± SD] age, 55.8 years [± 11.0 years]; 65 women) and 32 healthy volunteers (median age, 43.5 years [interquartile range (IQR), 30-50.8 years]; 16 women) were recruited. Patients with chronic cough performed 24-h objective cough frequency with simultaneous esophageal impedance/pH monitoring and measurement of pepsin concentrations in sputum and BAL. Twelve healthy volunteers underwent bronchoscopy/BAL, and 20 underwent impedance/pH monitoring.Results: Patients with chronic cough had significantly more reflux episodes than healthy volunteers (median, 63.5 reflux episodes [IQR, 52.5-80.0] vs 59.0 [IQR, 41.8-66.0]; P = .03), although the absolute difference was small, and there was no difference in numbers of events extending into the proximal esophagus (median, 17.2% [IQR, 8.0%-26.0%] vs 20.3% [IQR, 5.1%-32.1%]; P = .36). BAL pepsin levels were also similar in chronic cough to control subjects (median, 18.2 ng/mL [range, 0-56.4 ng/mL] vs 9.25 ng/mL [range, 0-46.9 ng/mL]; P = .27). Sputum but not BAL pepsin weakly correlated with the number of proximally occurring reflux events (r = 0.33, P = .045) but was inversely related to cough frequency (r = −0.52, P = .04). Sputum pepsin was, therefore, best predicted by combining the opposing influences of cough and proximal reflux (r = 0.50, P = .004).Conclusions: Proximal gastroesophageal reflux and microaspiration into the airways have limited roles in provoking chronic cough. Indeed, coughing appears to be protective, reducing pepsin concentration in the larger airways of patients with chronic cough. [ABSTRACT FROM AUTHOR]

Published
2012
Full Text
View/download PDF

19. Chronic Cough.

Author

Decalmer, Samantha, Stovold, Rachel, Houghton, Lesley A., Pearson, Jeff, Ward, Chris, Kelsall, Angela, Jones, Helen, McGuinness, Kevin, Woodcock, Ashley, and Smith, Jaclyn A.

Subjects
GASTROESOPHAGEAL reflux, COUGH, PATIENTS, ESOPHAGUS, AIRWAY (Anatomy)
Abstract

The article examines the relationship among microaspiration, the degree and type of gastroesophageal reflex and the frequency of coughing among patients with chronic cough. The authors report that patients with chronic cough had more reflux episodes compared with healthy subjects, but the number of events extending into the proximal esophagus showed no difference. They conclude that proximal gastroesophageal reflux and microaspiration into the airways have limited roles in provoking cough.

Published
2012
Full Text
View/download PDF

20. Antitussive Effects of Memantine in Guinea Pigs.

Author

Smith, Jaclyn A., Hilton, Emma C. Y., Saulsberry, Loren, and Canning, Brendan J.

Subjects
*MEMANTINE, *ANTITUSSIVE agents, *METHYL aspartate receptors, *ALZHEIMER'S disease treatment, *ALZHEIMER'S patients
Abstract

The article discusses a study which examined the antitussive effects of memantine. The study analyzed the effectiveness and tolerance of memantine, a low-affinity, uncompetitive N-methyl D-aspartate receptors (NMDAR) channel blocker for the treatment of Alzheimer disease. Study authors concluded that memantine can be a potential safeand effective antitussive agent.

Published
2012
Full Text
View/download PDF

21. Patient Misreporting May Lead to Underestimation to Cough Events.

Author

Decalmer, Samantha, Woodcock, Ashley A., and Smith, Jaclyn A.

Subjects
LETTERS to the editor, THERAPEUTICS
Abstract

A letter to the editor is presented in response to the article "Non-acid reflux in patients with chronic cough on acid-suppressive therapy," by Samantha Decalmer and Jaclyn A. Smith in the August 2006 issue.

Published
2007
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results