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  1. Book ; Online ; E-Book: Cough: Pathophysiology, Diagnosis and Treatment

    Zanasi, Alessandro / Fontana, Giovanni A. / Mutolo, Donatella

    2020  

    Abstract: This book provides an updated and comprehensive overview of cough, while opening new perspectives for their treatment and management. It enables readers to not only discover new physiologic features and mechanisms but also to gain an in-depth ... ...

    Author's details edited by Alessandro Zanasi, Giovanni A. Fontana, Donatella Mutolo
    Abstract This book provides an updated and comprehensive overview of cough, while opening new perspectives for their treatment and management. It enables readers to not only discover new physiologic features and mechanisms but also to gain an in-depth understanding of the diagnostic workup of cough, still one of the most frequent and challenging symptoms in daily medical practice. The book also provides insights into cough’s features and pathogenesis, as well as into pharmacologic and non-pharmacologic treatments. The most frequent causes of chronic cough (asthma, postnasal drip, gastroesophageal reflux and chronic hypersensitivity syndrome) and different types of pediatric cough are also explored. Coughing is a common symptom, occurring in many clinical settings, and as such the book appeals a broad readership, including pulmonologists specialized in cough, general practitioners, internists, pediatricians and otorhinolaryngologists. .
    Keywords Respiratory organs—Diseases ; General practice (Medicine) ; Pediatrics ; Otorhinolaryngology ; Pharmacotherapy ; Gastroenterology  ; Pneumology/Respiratory System ; General Practice / Family Medicine ; Gastroenterology ; Tos ; Fisiologia patològica ; Diagnòstic ; Terapèutica
    Subject code 616.2
    Language English
    Size 1 online resource (X, 181 p. 13 illus. in color.)
    Edition 1st ed. 2020.
    Publisher Springer International Publishing ; Imprint: Springer
    Publishing place Cham
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    ISBN 3-030-48571-4 ; 3-030-48570-6 ; 978-3-030-48571-9 ; 978-3-030-48570-2
    DOI 10.1007/978-3-030-48571-9
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Article ; Online: Development of an Italian version of the Leicester cough questionnaire and its relationship with other symptom-specific measures for patients with chronic cough.

    Sorano, Alessandra / Fumagalli, Carlo / Cinelli, Elenia / Birring, Surinder S / Fontana, Giovanni A / Lavorini, Federico

    Respiratory medicine

    2024  Volume 227, Page(s) 107642

    Abstract: Objective: To implement subjective methods for measuring the impact of chronic cough on patients' daily life, including an Italian version of the symptom-specific, health status measure for patients with chronic cough, i.e. the Leicester Cough ... ...

    Abstract Objective: To implement subjective methods for measuring the impact of chronic cough on patients' daily life, including an Italian version of the symptom-specific, health status measure for patients with chronic cough, i.e. the Leicester Cough Questionnaire (LCQ).
    Methods: Sixty-five chronic cough patients attended a tertiary cough clinic on two separate occasions 8 weeks apart. The visual analogue scale for cough severity (VAS), the LCQ and the cough disturbance score (CDS) were administered on both occasions. The LCQ was adapted for Italian conditions following a forward-backward translation procedure. Concurrent validation, internal consistency, repeatability and responsiveness were determined.
    Results: The CDS, VAS and LCQ were correlated (r coefficients ranging from 0.69 to 0.94, p < 0.01). The internal consistency for each LCQ domain was high (alpha coefficient range 0.87-0.93), as was the 8-week repeatability of the LCQ in the patients (n = 36, 60 %) who displayed no change in CDS and VAS (intra-class correlation coefficient = 0.86, p < 001) over the same period. Patients who reported an improvement in CDS and VAS after 8 weeks (n = 29) also demonstrated significant improvements in each LCQ domain. The mean difference in LCQ total score before and after improvements was 2.26 (95 % CI: 1.58-4.47).
    Conclusions: The Italian version of the LCQ appears to be just as valid as the other language versions of the questionnaire. In addition, the CDS appears to be a clinically useful, symptom-specific measure of the overall disturbance provoked by cough.
    Language English
    Publishing date 2024-04-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2024.107642
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  3. Article ; Online: Somatically evoked cough responses help to identify patients with difficult-to-treat chronic cough: a six-month observational cohort study.

    Lavorini, Federico / Bernacchi, Guja / Fumagalli, Carlo / Noale, Marianna / Maggi, Stefania / Mutolo, Donatella / Cinelli, Eliana / Fontana, Giovanni A

    EClinicalMedicine

    2023  Volume 57, Page(s) 101869

    Abstract: Background: Recently we identified in patients with chronic cough a sensory dysregulation via which the urge-to-cough (UTC) or coughing are evoked mechanically from "somatic points for cough" (SPCs) in the neck and upper trunk. We investigated the ... ...

    Abstract Background: Recently we identified in patients with chronic cough a sensory dysregulation via which the urge-to-cough (UTC) or coughing are evoked mechanically from "somatic points for cough" (SPCs) in the neck and upper trunk. We investigated the prevalence and the clinical relevance of SPCs in an unselected population of patients with chronic cough.
    Methods: From 2018 to 2021, symptoms of 317 consecutive patients with chronic cough (233 females) were collected on four visits (V1-V4) 2 months apart at the Cough Clinic of the University Hospital in Florence (I). Participants rated the disturbance caused by the cough (0-9 modified Borg Scale). We attempted to evoke coughing and/or UTC using mechanical actions in all participants who were subsequently categorised as responsive (somatic point for cough positive, SPC+) or unresponsive (SPC-) to these actions. An association was established between chronic cough and its commonest causes; treatments were administered accordingly.
    Findings: 169 patients were SPC+ and had a higher baseline cough score (p < 0.01). In most of the patients, the treatments reduced (p < 0.01) cough-associated symptoms. All patients reported a decrease (p < 0.01) in cough score at V2 (from 5.70 ± 1.4 to 3.43 ± 1.9 and from 5.01 ± 1.5 to 2.74 ± 1.7 for SPC+ and SPC- patients respectively). However, whilst in SPC- patients the cough score continued to decrease indicating virtually complete cough disappearance at V4 (0.97 ± 0.8), in SPC+ patients this variable remained close to V2 values during the entire follow-up.
    Interpretation: Our study suggests that the assessment of SPCs may identify patients whose cough is unresponsive and are eligible for specific treatments.
    Funding: This work was funded by an unrestricted grant from Merck (Italy).
    Language English
    Publishing date 2023-02-20
    Publishing country England
    Document type Journal Article
    ISSN 2589-5370
    ISSN (online) 2589-5370
    DOI 10.1016/j.eclinm.2023.101869
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A 57-year-old chronic cougher with somatically evoked cough.

    Lavorini, Federico / Fontana, Giovanni A

    Pulmonary pharmacology & therapeutics

    2017  Volume 47, Page(s) 56–58

    MeSH term(s) Chronic Disease ; Cough/diagnosis ; Cough/etiology ; Cough/physiopathology ; Diagnosis, Differential ; Humans ; Male ; Middle Aged
    Language English
    Publishing date 2017
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1399707-5
    ISSN 1522-9629 ; 1094-5539
    ISSN (online) 1522-9629
    ISSN 1094-5539
    DOI 10.1016/j.pupt.2017.05.014
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  5. Article ; Online: Downregulation of cough by exercise and voluntary hyperpnea.

    Fontana, Giovanni A

    Lung

    2010  Volume 188 Suppl 1, Page(s) S95–8

    Abstract: No information exists on the effects of hyperpnea on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing concentrations of ultrasonically ... ...

    Abstract No information exists on the effects of hyperpnea on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing concentrations of ultrasonically nebulized distilled water (fog), and the index of cough reflex sensitivity, was assessed in 12 healthy humans in control conditions, during exercise, and during voluntary isocapnic hyperventilation (VIH) to the same level as the exercise. The intensity of the urge-to-cough (UTC), a cognitive component of coughing, was also recorded throughout the trials. The log-log relationship between inhaled fog concentrations and the correspondingly evoked UTC values, an index of the perceptual magnitude of the UTC sensitivity, was also calculated. Cough appearance was always assessed audiovisually. At an exercise level of 80% of anaerobic threshold, the mean cough threshold was increased from a control value of 1.03 +/- 0.65 to 2.25 +/- 1.14 ml/min (p < 0.01), i.e., cough sensitivity was downregulated. With VIH, the mean (+/-SD) threshold increased from 1.03 +/- 0.65 to 2.42 +/- 1.16 ml/min (p < 0.01), a similar downregulation. With exercise and VIH compared with control, mean UTC values at cough threshold were not significantly changed: control, 3.83 +/- 1.11 cm; exercise, 3.12 +/- 0.82 cm; VIH, 4.08 +/- 1.67 cm. Since the slopes of the log fog concentration/log UTC value were approximately halved during exercise and VIH compared with control, the UTC sensitivity to fog was depressed (p < 0.01). The results indicate that the adjustments brought into action by exercise-induced or voluntary hyperventilation exert inhibitory influences on the sensory and cognitive components of fog-induced cough.
    MeSH term(s) Adult ; Aerosols ; Animals ; Cough/physiopathology ; Cough/prevention & control ; Exercise/physiology ; Female ; Humans ; Hyperventilation/physiopathology ; Male ; Nerve Fibers, Unmyelinated/physiology ; Pulmonary Stretch Receptors/physiopathology ; Rabbits ; Reflex/physiology ; Sensory Thresholds/physiology ; Volition/physiology
    Chemical Substances Aerosols
    Language English
    Publishing date 2010-01-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 6165-7
    ISSN 1432-1750 ; 0341-2040
    ISSN (online) 1432-1750
    ISSN 0341-2040
    DOI 10.1007/s00408-009-9215-x
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  6. Article ; Online: Somatic points for cough and urge to cough in chronic coughers.

    Mannini, Claudia / Bernacchi, Guja / Bonti, Viola / Cinelli, Elenia / Mutolo, Donatella / Fontana, Giovanni A / Lavorini, Federico

    Respiratory medicine

    2022  Volume 200, Page(s) 106929

    Abstract: In patients with chronic cough and age-matched control subjects, we attempted to evoke coughing and/or an urge to cough (UTC) by finger pressure along the sternocleidomastoid and sternum, on the lower cervical or first dorsal vertebrae, the jugular notch ...

    Abstract In patients with chronic cough and age-matched control subjects, we attempted to evoke coughing and/or an urge to cough (UTC) by finger pressure along the sternocleidomastoid and sternum, on the lower cervical or first dorsal vertebrae, the jugular notch as well as with maximum neck extension and flexion These mechanical actions were ineffective in controls but reproducibly evoked coughing or UTC in about 50% of chronic coughers; sternal and spinal responses were abolished temporarily by local cooling. The results may disclose a novel paradigm of cough sensitisation possibly involving central convergence of somatic and visceral neural stimuli.
    MeSH term(s) Chronic Disease ; Cough ; Humans
    Language English
    Publishing date 2022-07-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2022.106929
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  7. Article ; Online: Inhaler technique and patient's preference for dry powder inhaler devices.

    Lavorini, Federico / Fontana, Giovanni A

    Expert opinion on drug delivery

    2014  Volume 11, Issue 1, Page(s) 1–3

    Abstract: Inhaled therapy has a central place in the management of obstructive lung diseases, but a large number of patients are unable to use their inhalers correctly with a consequent reduction in therapeutic benefit. Correct use of inhalers is, therefore, ... ...

    Abstract Inhaled therapy has a central place in the management of obstructive lung diseases, but a large number of patients are unable to use their inhalers correctly with a consequent reduction in therapeutic benefit. Correct use of inhalers is, therefore, crucial for efficient therapy, and acceptance of the device can improve patients' compliance. The choice of the most appropriate inhaler for a given patient is often not straightforward. The ease-of-use and performance characteristics of the inhaler will markedly influence patients' acceptance of the device, as well the patients' attitudes to their illness and chronic medication use in general. Choosing the most appropriate inhaler for a specific patient and regular assessment of ability to correctly use their inhaler will promote better adherence to therapy with improved disease outcome. Further, patients' preference for a particular inhaler should be taken into consideration. In patients with obstructive airway diseases, inhaler choice is as critical as the choice of medication itself.
    MeSH term(s) Administration, Inhalation ; Asthma/drug therapy ; Dry Powder Inhalers ; Humans ; Patient Compliance ; Patient Preference ; Pulmonary Disease, Chronic Obstructive/drug therapy
    Language English
    Publishing date 2014-01
    Publishing country England
    Document type Editorial
    ZDB-ID 2167286-6
    ISSN 1744-7593 ; 1742-5247
    ISSN (online) 1744-7593
    ISSN 1742-5247
    DOI 10.1517/17425247.2014.846907
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Before we get started: what is a cough?

    Fontana, Giovanni A

    Lung

    2007  Volume 186 Suppl 1, Page(s) S3–6

    Abstract: Cough is an airway defensive reflex consisting of an inspiratory phase followed by a forced expiratory effort initially against a closed glottis, followed by active glottal opening and rapid expiratory flow. The expiration reflex (ER) differentiates from ...

    Abstract Cough is an airway defensive reflex consisting of an inspiratory phase followed by a forced expiratory effort initially against a closed glottis, followed by active glottal opening and rapid expiratory flow. The expiration reflex (ER) differentiates from cough for the lack of a preparatory inspiration. The reflexes subserve different functions: cough will clear the lower airways from debris and mucus, while the expiration reflex will prevent aspiration. Clinically, a cough epoch is a sequence of motor acts resulting from a combination of true coughs and ERs that need to be accurately identified and measured for adequate quantitative description.
    MeSH term(s) Cough/physiopathology ; Electromyography ; Exhalation/physiology ; Humans ; Reflex/physiology ; Respiratory Muscles/physiopathology
    Language English
    Publishing date 2007-10-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 6165-7
    ISSN 1432-1750 ; 0341-2040
    ISSN (online) 1432-1750
    ISSN 0341-2040
    DOI 10.1007/s00408-007-9036-8
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  9. Article: Downregulation of Cough by Exercise and Voluntary Hyperpnea

    Fontana, Giovanni A

    Lung. 2010 Jan., v. 188, no. 1

    2010  

    Abstract: No information exists on the effects of hyperpnea on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing concentrations of ultrasonically ... ...

    Abstract No information exists on the effects of hyperpnea on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing concentrations of ultrasonically nebulized distilled water (fog), and the index of cough reflex sensitivity, was assessed in 12 healthy humans in control conditions, during exercise, and during voluntary isocapnic hyperventilation (VIH) to the same level as the exercise. The intensity of the urge-to-cough (UTC), a cognitive component of coughing, was also recorded throughout the trials. The log-log relationship between inhaled fog concentrations and the correspondingly evoked UTC values, an index of the perceptual magnitude of the UTC sensitivity, was also calculated. Cough appearance was always assessed audiovisually. At an exercise level of 80% of anaerobic threshold, the mean cough threshold was increased from a control value of 1.03 ± 0.65 to 2.25 ± 1.14 ml/min (p < 0.01), i.e., cough sensitivity was downregulated. With VIH, the mean (±SD) threshold increased from 1.03 ± 0.65 to 2.42 ± 1.16 ml/min (p < 0.01), a similar downregulation. With exercise and VIH compared with control, mean UTC values at cough threshold were not significantly changed: control, 3.83 ± 1.11 cm; exercise, 3.12 ± 0.82 cm; VIH, 4.08 ± 1.67 cm. Since the slopes of the log fog concentration/log UTC value were approximately halved during exercise and VIH compared with control, the UTC sensitivity to fog was depressed (p < 0.01). The results indicate that the adjustments brought into action by exercise-induced or voluntary hyperventilation exert inhibitory influences on the sensory and cognitive components of fog-induced cough.
    Language English
    Dates of publication 2010-01
    Size p. 95-98.
    Publisher Springer-Verlag
    Publishing place New York
    Document type Article
    ZDB-ID 6165-7
    ISSN 1432-1750 ; 0341-2040
    ISSN (online) 1432-1750
    ISSN 0341-2040
    DOI 10.1007/s00408-009-9215-x
    Database NAL-Catalogue (AGRICOLA)

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    In stock of ZB MED Bonn / Germany

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  10. Article ; Online: Extended Exhaled Nitric Oxide Analysis in Interstitial Lung Diseases: A Systematic Review.

    Cameli, Paolo / Bargagli, Elena / Bergantini, Laura / d'Alessandro, Miriana / Pieroni, Maria / Fontana, Giovanni A / Sestini, Piersante / Refini, Rosa Metella

    International journal of molecular sciences

    2020  Volume 21, Issue 17

    Abstract: Fractional exhaled nitric oxide (FeNO) is a well-known and widely accepted biomarker of airways inflammation that can be useful in the therapeutic management, and adherence to inhalation therapy control, in asthmatic patients. However, the multiple-flows ...

    Abstract Fractional exhaled nitric oxide (FeNO) is a well-known and widely accepted biomarker of airways inflammation that can be useful in the therapeutic management, and adherence to inhalation therapy control, in asthmatic patients. However, the multiple-flows assessment of FeNO can provide a reliable measurement of bronchial and alveolar production of NO, supporting its potential value as biomarker also in peripheral lung diseases, such as interstitial lung diseases (ILD). In this review, we first discuss the role of NO in the pathobiology of lung fibrosis and the technique currently approved for the measurement of maximum bronchial flux of NO (J'awNO) and alveolar concentration of NO (CaNO). We systematically report the published evidence regarding extended FeNO analysis in the management of patients with different ILDs, focusing on its potential role in differential diagnosis, prognostic evaluation and severity assessment of disease. The few available data concerning extended FeNO analysis, and the most common comorbidities of ILD, are explored too. In conclusion, multiple-flows FeNO analysis, and CaNO in particular, appears to be a promising tool to be implemented in the diagnostic and prognostic pathways of patients affected with ILDs.
    MeSH term(s) Biomarkers/analysis ; Bronchi/chemistry ; Early Diagnosis ; Exhalation ; Humans ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/metabolism ; Nitric Oxide/analysis ; Prognosis ; Pulmonary Alveoli/chemistry ; Severity of Illness Index
    Chemical Substances Biomarkers ; Nitric Oxide (31C4KY9ESH)
    Language English
    Publishing date 2020-08-27
    Publishing country Switzerland
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms21176187
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