CHEST Guidelines-Cough-Intensity

Cough-Intensity_chest

Pdf Summary

The document discusses two primary topics related to medical research published in the journal CHEST.<br /><br />The first article, authored by Dr. Dan J. Raz, addresses the management of central carcinoid tumors, focusing on endoscopic procedures. It highlights several pitfalls in endoscopic management, such as the inability to determine lymph node status and risks of procedural bleeding. While a small percentage of patients may have hidden lymph node metastasis, which can impact prognosis, endoscopic procedures might necessitate repeated interventions throughout a patient's life. Due to these challenges, Dr. Raz recommends surgical treatment as the first-line therapy for patients with acceptable operative risk, performed by experienced surgeons. He calls for further research comparing endoscopic and surgical management of these tumors. Dr. Raz's work was supported by the National Cancer Institute.<br /><br />The second part of the document is a correspondence from Dr. Richard D. Turner regarding an article on cough intensity by Lee et al., which suggests that patients with chronic cough exhibit stronger coughs than healthy controls. Dr. Turner inquires about the role of respiratory muscle activation in cough intensity and its relationship with cough-related quality of life. Lee et al. found that increased laryngeal compression, rather than muscle strength, may contribute to stronger coughs in chronic cough patients. They used electromyography (EMG) to study muscle activation, though no statistical difference in maximum voluntary cough muscle activity was observed between patients and healthy subjects. The study did not find a direct relationship between cough intensity and quality of life, as measured by the Leicester Cough Questionnaire, due to varying influencing factors over time. Both discussions underscore the complexity of managing and understanding these conditions.

Keywords

central carcinoid tumors

endoscopic procedures

surgical treatment

lymph node metastasis

chronic cough

cough intensity

respiratory muscle activation

laryngeal compression

electromyography

Leicester Cough Questionnaire