Predictors of objective cough frequency in pulmonary sarcoidosis

Sinha, Aish; Lee, Kai K.; Rafferty, Gerrard F.; Yousaf, Nadia; Pavord, Ian D.; Galloway, James; Birring, Surinder S.

doi:10.1183/13993003.01369-2015

Cited by 46 publications

(63 citation statements)

References 40 publications

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“…We found no evidence of a diurnal pattern in aerosol Mtb production. While this might reflect a bias of hospitalisation disrupting natural diurnal rhythm, a diurnal pattern of cough pattern was observed that is concordant with other studies 10,11,13 . It is also interesting that 53 positive aerosol samples were collected from participants that were directly observed to be sleeping for the full hour of sampling.…”

Section: Discussionsupporting

confidence: 91%

Twenty-four hour face mask sampling in pulmonary tuberculosis reveals three distinct patterns of bacterial aerosol production dissociated from conventional markers of transmission risk

Williams

Abdulwhhab

Birring

et al. 2018

Preprint

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Rationale: Although tuberculosis (TB) is transmitted by Mycobacterium tuberculosis (Mtb) in aerosols, little is known of the dynamic characteristics of spontaneous output of bacilli in this form. We have developed and implemented a mask aerosol sampling system (MASS) for longitudinal capture and study of spontaneous aerosol.Objective: To determine patterns of Mtb output in aerosols, captured using the MASS over 24 hours and their association with existing criteria used to assess transmission risk in patients with pulmonary TB.Methods: Twenty-four hospitalised patients with newly diagnosed pulmonary TB recruited in Pretoria, South Africa, wore FFP1 masks for one hour out of every three for 24 hours. Aerosol was captured in a gelatine filter processed for Mtb quantitation by PCR. Serial sputum was collected and objective cough frequency monitoring performed over the same period.Measurements and Main Results: Mtb was detected in 86.5% of 192 mask samples and 20.7% of 38 assessable sputum samples obtained from the cohort. Mtb was detected by MASS in all but two patients. Three dynamic patterns of expression were identifiable in Mtb aerosol producers: i. variable high; ii. consistent; and iii. variable low. No diurnal variation was apparent and there was no correlation between mask Mtb and either sputum Mtb levels or cough frequency. Sputum smear status, culture time to positivity and chest radiographic characteristics also failed to associate with MASS bacillary output.Conclusions: Conventional markers of tuberculosis case infectivity do not predict bacillary aerosols detected by the MASS. The MASS provides a novel, non-invasive tool for tuberculosis diagnosis and control.

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Section: Discussionsupporting

confidence: 91%

Twenty-four hour face mask sampling in pulmonary tuberculosis reveals three distinct patterns of bacterial aerosol production dissociated from conventional markers of transmission risk

Williams

Abdulwhhab

Birring

et al. 2018

Preprint

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“…Cough is frequently preceded by an urge-to-cough, a sensation of irritation or itching in the throat, which is also called laryngeal paresthesia 31. The frequency of allotussia or urge-to-cough varies according to population and methodology, but it is reported to occur in ~99% of these patients 23453132. Moreover, these characteristics of cough are similar to those of pain, such as allodynia, which is the pain caused by stimuli that do not normally provoke pain 28.…”

Section: Evidence For Neuropathology In Cough Hypersensitivity Syndromementioning

confidence: 99%

Cough Hypersensitivity Syndrome: A Few More Steps Forward

Song

Morice

2017

Allergy Asthma Immunol Res

112

110

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Cough reflex is a vital protective mechanism against aspiration, but when dysregulated, it can become hypersensitive. In fact, chronic cough is a significant medical problem with a high degree of morbidity. Recently, a unifying paradigm of cough hypersensitivity syndrome has been proposed. It represents a clinical entity in which chronic cough is a major presenting problem, regardless of the underlying condition. Although it remains a theoretical construct, emerging evidence suggests that aberrant neurophysiology is the common etiology of this syndrome. Recent success in randomized clinical trials using a P2X3 receptor antagonist is the first major advance in the therapeutics of cough in the past 30 years; it at last provides a strategy for treating intractable cough as well as an invaluable tool for dissecting the mechanism underpinning cough hypersensitivity. Additionally, several cough measurement tools have been validated for use and will help assess the clinical relevance of cough in various underlying conditions. Along with this paradigm shift, our understanding of cough mechanisms has improved during the past decades, allowing us to continue to take more steps forward in the future.

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“…Furthermore, there was a significant association between the frequency of cough measured objectively with 24-h cough monitoring and health-related quality of life. In the study by Sinha et al, 9 cough reflex sensitivity assessed with capsaicin was the only independent predictor of the frequency of coughing. Lung function, disease activity, and severity were not predictors of cough frequency.…”

mentioning

confidence: 87%

“…[6][7][8] Cough is also a common symptom in patients with pulmonary sarcoidosis. A study by Sinha et al 9 reported that 50% of patients had a chronic cough and this was associated with poor health-related quality of life. Furthermore, there was a significant association between the frequency of cough measured objectively with 24-h cough monitoring and health-related quality of life.…”

mentioning

confidence: 99%