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Upper Airway Cough Syndrome

UACS


Presentation

  • Post nasal drip syndrome (41-58%) PowerPoint Presentation: Percentage of cases presenting one, two, three and four causative factors Palombini BC et al.[authorstream.com]
  • From Ganfyd Upper airway cough syndrome (UACS, postnasal drip syndrome (PNDS)-induced cough, allergic rhinitis induced cough, vasomotor rhinitis induced cough, chronic sinusitis induced cough is a term introduced to describe about 40% of chronic cough presentations[ganfyd.org]
  • Suspect Postnasal Drip When Cobblestoning Is Present When attempting to diagnose upper airway cough syndrome (UACS; previously called postnasal drip syndrome), the best history question to ask is as follows. "Do you have frequent throat clearing?"[practicalreviews.com]
  • Ankara University, School of Medicine Department of Allergy – PowerPoint PPT presentation Number of Views: 389 Avg rating: 3.0/5.0 less Transcript and Presenter's Notes Title: CHRONIC COUGH rhinitis-postnasal drip syndrome Upper airway cough syndrome[powershow.com]
  • All patients reported a history of allergic rhinitis, showed persistent dry cough or small amounts of viscid sputum with a time course of 2-60 months (median 7 months), and presented with symptoms and signs of rhinitis, normal lung function, and airway[ncbi.nlm.nih.gov]
Malaise
  • […] watery secretions but only if patient is symptomatic Exclude structural problems (polyps, deflected nasal septum) Others : nasal voice, constant mouth breathing, frequent snoring, coughing, repetitive sneezing, chronic open gape of the mouth, weakness, malaise[authorstream.com]
Cough
  • If you have a persistent cough that won’t go away, contact Dr. Mandel Sher at Center for Cough to have your cough evaluated and begin cough treatment targeted specifically to your cough: 727-393-8067.[centerforcough.com]
  • […] stimulate cough receptors and produce cough independently of or in addition to any associated PND.[scinapse.io]
  • Presentation on theme: "UPPER AIRWAY COUGH SYNDROME"— Presentation transcript: 1 UPPER AIRWAY COUGH SYNDROME Berna USLU COŞKUN SBU SİSLİ HAMİDİYE ETFAL E. A.[slideplayer.com]
Dry Cough
  • All patients reported a history of allergic rhinitis, showed persistent dry cough or small amounts of viscid sputum with a time course of 2-60 months (median 7 months), and presented with symptoms and signs of rhinitis, normal lung function, and airway[ncbi.nlm.nih.gov]
  • All patients reported a history of allergic rhinitis, showed persistent dry cough or small amounts of viscid sputum with a time course of 2–60 months (median 7 months), and presented with symptoms and signs of rhinitis, normal lung function, and airway[link.springer.com]
  • Symptoms of upper airway cough syndrome include: a dry cough that persists for 8 weeks or more; post-nasal drip; and abnormal, unpleasant sensations in the throat (such as the feeling of something being stuck in the throat, something tickling or irritating[mydr.com.au]
Nasal Congestion
  • Allergic Fungal Sinusitis: Rhinitis medicamentosa A term that is specific for the nasal congestion caused, paradoxically, by the persistent use of a drug, the immediate effect of which is the relief of nasal congestion via local vasoconstriction .[authorstream.com]
  • R09.8 Other specified symptoms and signs involving the circulatory and respiratory systems NON-BILLABLE BILLABLE R09.81 Nasal congestion BILLABLE R09.82 Postnasal drip BILLABLE R09.89 Other specified symptoms and signs involving the circulatory and respiratory[icd.codes]
  • Chest 2006 12933S47S 15 Upper airway cough syndrome History Cough Post nasal drip Tickle in the throat Frequent throat cleaning Nasal congestion, discharge Hoarseness Silent Physical exam Mucoid/muco-purulent secretions Cobblesto appearance 16 Upper airway[powershow.com]
  • congestion (When AR is the causative agent in UACS) 34 Empiric treatment Good Partial No Response 35 Good: Continue treatment Partial: Continue treatment and further investigate (Sinus imaging and prolonged ab) Bad: Search for other causes; undergo sinus[slideplayer.com]
  • In addition, cough can be associated with a “drip,” or drainage down the back of your throat, as well as nasal congestion (“stuffy nose”), nasal drainage (“runny nose”) and sneezing.[aaaai.org]
Rhinorrhea
  • : Clinical Manifestations Nasal congestion Postnasal drainage Nasal pruritus Ear symptoms Watery rhinorrhea Eye symptoms Repetitive sneezing Others PowerPoint Presentation: Moderate-severe one or more items abnormal sleep impairment of daily activities[authorstream.com]
  • What’s more, the absence of any of the usual clinical findings—eg, rhinorrhea and excess sputum production—should not preclude an empiric trial with a first-generation antihistamine-decongestant combination such as brompheniramine/sustained-release pseudoephedrine[mdedge.com]
  • ., rhinorrhea, sneezing, nasal obstruction, and postnasal drip), with or without fever , lacrimation, and irritation of the throat, and when a chest examination is normal.[antimicrobe.org]
Nasal Voice
  • Allergic shiner Dennie Morgan line Allergic crease Allergic salute Nasal mucosa may appear normal or pale bluish, swollen with watery secretions but only if patient is symptomatic Exclude structural problems (polyps, deflected nasal septum) Others : nasal[authorstream.com]
Malocclusion
  • PowerPoint Presentation: DENTAL MALOCCLUSION DUE TO CHRONIC MOUTH BREATHING IN ALLERGIC RHINITIS PowerPoint Presentation: Nonallergic rhinitis: Vasomotor rhinitis Excessive,thin watery secretions often in reponse to odors, changes in temperature or humidity[authorstream.com]
Cutis Laxa
  • laxa of bilateral upper eyelid; Left upper dermatochalasis; Left upper dermatochalasis (eye condition) ICD-10-CM Diagnosis Code H02.834 Dermatochalasis of left upper eyelid 2016 2017 2018 2019 Billable/Specific Code[icd10data.com]
Xanthelasma
  • […] of right upper eyelid Bilateral upper eyelid xanthelasma; R upper eyelid xanthelasma; Right upper xanthelasma; Xanthelasma of bilateral upper eyelids ICD-10-CM Diagnosis Code H02.61 Xanthelasma of right upper eyelid 2016 2017 2018 2019 Billable/Specific[icd10data.com]
Chemosis
  • […] coughing, repetitive sneezing, chronic open gape of the mouth, weakness, malaise, irritability PowerPoint Presentation: Dennie Morgan line Allergic shiners Allergic Salute PowerPoint Presentation: Marked erythema of palpebral and bulbar conjunctivae Chemosis[authorstream.com]
Monoplegia
  • […] of lower limb following other nontraumatic intracranial hemorrhage ( I69.24- ) monoplegia of upper limb following other nontraumatic intracranial hemorrhage ( I69.23- ) Use Additional code to identify type of paralytic syndrome, such as: locked-in state[icd10data.com]
Quadriplegia
  • […] following other nontraumatic intracranial hemorrhage ( I69.24- ) monoplegia of upper limb following other nontraumatic intracranial hemorrhage ( I69.23- ) Use Additional code to identify type of paralytic syndrome, such as: locked-in state ( G83.5 ) quadriplegia[icd10data.com]
Foster-Kennedy Syndrome
  • syndrome , left eye Left foster-kennedy syndrome ICD-10-CM Diagnosis Code H47.142 Foster-Kennedy syndrome, left eye 2016 2017 2018 2019 Billable/Specific Code Foster-Kennedy syndrome , unspecified eye Foster-kennedy syndrome ICD-10-CM Diagnosis Code[icd10data.com]

Workup

  • Further workup may include allergy testing for allergic rhinitis or sinus CT scan for sinusitis, as indicated.[emedicine.medscape.com]
  • […] examination findings, radiographic findings, and response to specific therapy Specific treatment should be directed at the cause of cough Empiric therapy for UACS with 1st generation antihistamine/decongestan should be prescribed before extensive diagnostic workup[powershow.com]
  • […] undergo sinus imaging 41 ACCP RECOMMENDATION 6: In patients whom a spesific etiology of chronic cough is not apparent, empiric therapy for UACS in the form of a first generation A/D preparation should be prescribed before beginning an extensive diagnostic workup[slideplayer.com]
  • […] patients without an apparent cause of chronic cough, clinicians should first prescribe empiric therapy for upper airway cough syndrome in the form of a first-generation antihistamine and decongestant preparation, before embarking on an extensive diagnostic workup[medpagetoday.com]
  • Empirical treatment directed at the three aforementioned etiologies is thus of considerable value in the initial workup.[readbyqxmd.com]

Treatment

  • Physicososyal Score, Before After Before After Before After Treatment Treatment Treatment French CL.[powershow.com]
  • Prompt cough evaluation and cough treatment plan minimize your and your loved ones’ concerns that something more serious can be going on.[centerforcough.com]
  • While the general principles involved in treating UACS are similar throughout the world, the specific details of treatment differ.[ncbi.nlm.nih.gov]
  • Data from a variety of studies support the concept that newer-generation H1 antihistamines are not useful in the treatment of cough due to UACS.[ncbi.nlm.nih.gov]

Prognosis

  • Management Following the patient’s diagnosis, her future management and prognosis should be sensitively discussed.[guidelinesinpractice.co.uk]

Etiology

  • Empirical treatment directed at the three aforementioned etiologies is thus of considerable value in the initial workup.[readbyqxmd.com]
  • METHODS: MEDLINE search (through May 2004) for studies published in the English language since 1980 on human subjects using the medical subject heading terms "cough," "causes of cough," "etiology of cough," "postnasal drip," "allergic rhinitis," "vasomotor[ncbi.nlm.nih.gov]
  • Methods: MEDLINE search (through May 2004) for studies published in the English language since 1980 on human subjects using the medical subject heading terms "cough," "causes of cough," "etiology of cough," "postnasal drip," "allergic rhinitis," "vasomotor[scinapse.io]
  • Treatment of cough depends on the underlying etiology.[amboss.com]
  • Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies[scholars.northwestern.edu]

Epidemiology

  • Epidemiological evidence The association of cough hypersensitivity with clinically important chronic cough is perhaps best illustrated by the epidemiological evidence of cough hypersensitivity in the sexes.[coughjournal.biomedcentral.com]
  • The Epidemiologic Survey Committee of the Korean Otorhinolaryngologic Society prepared a protocol for the diagnosis of chronic laryngitis.[journals.lww.com]
  • Defining chronic cough: A systematic review of the epidemiological literature. Allergy Asthma Immunol Res 2016;8:146-55. 2. Gibson P, Wang G, McGarvey L, Vertigan AE, Altman KW, Birring SS; CHEST Expert Cough Panel.[thoracicmedicine.org]
  • Defining chronic cough: a systematic review of the epidemiological literature. Allergy Asthma Immunol Res 2016; 8 (2): 146–155. Morice A, McGarvey L, Pavord I. BTS Guidelines. Recommendations for the management of cough in adults.[guidelinesinpractice.co.uk]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology References: [1] [2] [3] [4] [5] [6] [7] Overview References: [8] [9] [10] [11] Approach References: [8] [6] [12] [13] [14] [15] Diagnostics Miscellaneous Close history taking and physical examination are sufficient to diagnose the cause[amboss.com]
  • Anatomy and neuro-pathophysiology of the cough reflex arc. Multidiscip Respir Med 2012;7:5. 6. Ando A, Farrell MJ, Mazzone SB. Cough-related neural processing in the brain: A roadmap for cough dysfunction? Neurosci Biobehav Rev 2014;47:457-68. 7.[thoracicmedicine.org]

Prevention

  • […] inflammatory factors such as histamin This increases cough sensitivity 24 Increased neural sensitivity in the pharynx or larynx Bucca, proposed the concept of larynx hyper-resposiveness (LHR) This is a protective reflex-laryngeal chemical reflex can prevent[slideplayer.com]
  • Fortunately, there is a now a new safe and effective whooping cough vaccine that can prevent adults from contracting this disease."[medpagetoday.com]
  • Among the important causes which one need to be aware of are: Occasionally patient may have whooping cough which is not always easy to diagnose, but diagnosis is critical as early treatment can help reduce complications, and prevent the spread to others[allergyasthmasinusctr.com]
  • GINA report, global strategy for asthma management and prevention [cited 2013 January 24th]. Available from: www.ginasthma.org ; 2012. Accessed October 2015. 16.[journals.lww.com]

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