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Chest Apr 2017Cough 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...
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.
Topics: Adult; Cough; Evidence-Based Medicine; Humans; Lung Neoplasms
PubMed: 28108179
DOI: 10.1016/j.chest.2016.12.028 -
Pulmonary Pharmacology & Therapeutics 2002The mechanisms of actions of cough medicines are not always known. The problem is exacerbated for herbal medicines, where the effectiveness of the plant or its... (Review)
Review
The mechanisms of actions of cough medicines are not always known. The problem is exacerbated for herbal medicines, where the effectiveness of the plant or its phytochemicals have rarely been carefully evaluated. Moreover, the most active phytomedicinal constituent is difficult to identify, and the expense and difficulty of such studies discourages sponsors who may not be able to benefit by subsequent exclusive marketing of the herbal remedy. Most popular herbs used as cough medicines appear to be demulcents whose action is confined to the oropharynx. It is probable that the vast majority of allegedly effective herbal cough medicines act as non-specific emetic-expectorants. The proof of activity of even marketed herbal derivatives such as guaifenesin and codeine is difficult to obtain. It is therefore likely that herbal cough medications will never be shown to be more active than placebos. Nevertheless, these plant products will continue to be popular remedies for patients and their health care advisors.
Topics: Antitussive Agents; Cough; Humans; Phytotherapy
PubMed: 12099787
DOI: 10.1006/pupt.2002.0343 -
Biomaterials Jul 2017Transplanted islets suffer hypoxic stress, which leads to nonspecific inflammation. This is the major cause of islet graft failure during the early stage of intrahepatic...
Transplanted islets suffer hypoxic stress, which leads to nonspecific inflammation. This is the major cause of islet graft failure during the early stage of intrahepatic islet transplantation. Although bilirubin has shown potent anti-oxidative and anti-inflammatory functions, its clinical applications have been limited due to its insolubility and short half-life. To overcome this problem, novel amphiphilic bilirubin nanoparticles are designed. Hydrophilic poly(ethylene glycol) (PEG) is conjugated to the hydrophobic bilirubin molecule. Then, the PEG-bilirubin conjugates form nanoparticles via self-assembly, i.e., so-called to BRNPs. BRNPs can protect islet cells not only from chemically induced oxidative stress by scavenging reactive oxygen species molecules, but also from activated macrophages by suppressing cytokine release. Importantly, in vivo experiments demonstrate that BRNP treatment can dramatically and significantly prolong islet graft survival compared to bilirubin treatment. In addition, immunohistochemical analysis shows BRNPs have potent anti-oxidative and anti-inflammatory capabilities. Collectively, novel BRNPs can be a new potent remedy for successful islet transplantation.
Topics: Animals; Bilirubin; Demulcents; Diabetes Mellitus; Inflammation; Islets of Langerhans; Male; Mice; Mice, Inbred BALB C; Nanoparticles; Polyethylene Glycols; RAW 264.7 Cells; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Transplantation, Heterologous
PubMed: 28448818
DOI: 10.1016/j.biomaterials.2017.04.029 -
Expert Review of Gastroenterology &... Jan 2018The intestinal barrier controls the absorption of nutrients and water whilst helping to prevent the entry of toxins and pathogenic micro-organisms from the lumen into... (Review)
Review
The intestinal barrier controls the absorption of nutrients and water whilst helping to prevent the entry of toxins and pathogenic micro-organisms from the lumen into the tissues. Deficiencies in the barrier are associated with various gastrointestinal and extra digestive disorders. Areas covered: This review provides an overview of the relationship between increased intestinal permeability and disease, and considers the role of mucosal protectants (mucoprotectants) in restoring normal intestinal barrier function, with a particular focus on diarrheal disorders. Expert commentary: Impairment of the intestinal barrier characterizes a variety of diseases, and there is ongoing interest in the development of pharmacological approaches targeting the reduction of intestinal permeability. These include corticosteroids, aminosalicylates and anti-tumor necrosis factor-α (TNF-α), which act by reducing inflammation; probiotics, which modulate the production of mucin and epithelial tight junction proteins; and mucoprotectants, which form a protective film over the epithelium. Recently, preclinical and clinical data highlight, the ability of new mucoprotectants, such as gelatin tannate and xyloglucan, to protect the intestinal mucosa and to exert anti-diarrheal effects. In the future the ability of these substances to enhance the intestinal barrier may extend their use in the management of a variety of gastro-intestinal diseases associated with 'leaky gut'.
Topics: Demulcents; Diarrhea; Gelatin; Glucans; Humans; Inflammatory Bowel Diseases; Intestinal Absorption; Intestinal Mucosa; Permeability; Tannins; Treatment Outcome; Xylans
PubMed: 28946778
DOI: 10.1080/17474124.2018.1378573 -
Current Pharmaceutical Biotechnology 2020Parmelia that belongs to the Parmeliaceae Family is a foliose lichen combined with one or two groups of fungi in Phylum Ascomycota or Basidiomycota and algae, which... (Review)
Review
Parmelia that belongs to the Parmeliaceae Family is a foliose lichen combined with one or two groups of fungi in Phylum Ascomycota or Basidiomycota and algae, which might be green algae or blue-green algae (cyanobacteria). It is generally called "Stone Flower," "Charila," "Pattharphool," or "Shilaaapushpa" in India. Lichen can be generally found growing on walls, old trees and spread largely across India, especially in the mountain area. It is a source of edible organisms for people residing in some regions of Nepal and it is also cultivated in hillsides of Kashmir. It has been found that lichen contains a lot of distinctive chemical compounds such as evernic acid, lecanoric acid, lobaric acid, norstictic acid, physodic acid, and salazinic acid. Some species of this lichen are recommended traditionally for controlling diseases such as boils, bronchitis, inflammations, excessive salivation, toothache, vomiting, etc. It has also applied as an indicator for biomonitoring, astringent, carminative, demulcent, bitter, resolvent, emollient, laxative, sporofic, sedative, diuretic and considered for treating sores, bronchitis, excessive salivation, vomiting, tooth-ache, boils and inflammations. It has been utilized for preparing traditional food and acts as a bioindicator for air pollution and radiation. It shows antibacterial, antioxidant, antimycobacterial and antifungal activities, including haemolytic, anaesthetic, spasmolytic and antispasmodic and antitumour activities. It also has several unique phytoconstituents that could be in charge of different therapeutic activities, but the majority of them are still unexplored. The review mainly focuses on various facets, such as common names, synonyms, traditional uses, botanical descriptions, and pharmacological activities of seven species of Parmelia.
Topics: Depsides; Humans; Hydroxybenzoates; Lactones; Medicine, Traditional; Parmeliaceae; Salicylates
PubMed: 32250223
DOI: 10.2174/1389201021666200406105212 -
Pharmacognosy Reviews Jul 2013Sphaeranthus indicus Linn. is from the aroma family Asteraceae. It is also known with other synonyms such as Munditika, Mundi, Shravana, Bhikshu, Tapodhana,... (Review)
Review
Sphaeranthus indicus Linn. is from the aroma family Asteraceae. It is also known with other synonyms such as Munditika, Mundi, Shravana, Bhikshu, Tapodhana, Mahashravani, Shravanahva, Shravanashirshaka. It is abundantly distributed in damp areas in plains and also as a weed in the rice fields. In the Indian system of medicine, the plant as a whole plant or its different anatomical parts viz., leaf, stem, bark, root, flower and seed are widely used for curing many diseases. The plant is bitter, stomachic, restorative, alterative, pectoral, demulcent and externally soothing. The whole plant and its anatomical parts have been reported with different types of secondary metabolites which include eudesmanolides, sesquiterpenoids, sesquiterpene lactones, sesquiterpene acids, flavone glycosides, flavonoid C-glycosides, isoflavone glycoside, sterols, sterol glycoside, alkaloid, peptide alkaloids, amino acids and sugars. The essential oils obtained from the flowers and whole plants were analyzed by different authors and reported the presence of many monoterpene hydrocarbons, oxygenated monoterpenes, sesquiterpene hydrocarbons and oxygenated sesquiterpenes. The whole plants, its isolated secondary metabolites and different anatomical parts have been reported for ovicidal, antifeedant, anthelmintic, antimicrobial, antiviral, macrofilaricidal, larvicidal, analgesic, antipyretic, hepatoprotective, antitussive, wound healing, bronchodilatory, mast cell stabilizing activity, anxiolytic, neuroleptic, immunomodulatory, anti-diabetic, antihyperlipidemic and antioxidant, antioxidant, central nervous system depressant, anti-arthritic, nephroprotective, anticonvulsant activities and many other activities. It is also effective on psoriasis. In the present paper, the plant is reviewed for its phytochemical and pharmacological reports in detail.
PubMed: 24347924
DOI: 10.4103/0973-7847.120517 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2012Herbal medicines have been used in cough due to their antitussive and expectorant activity. Antitussives act either centrally on the cough center of the brain or... (Review)
Review
Herbal medicines have been used in cough due to their antitussive and expectorant activity. Antitussives act either centrally on the cough center of the brain or peripherally on the cough receptors in the respiratory passages. The antitussive effect of many herbs results from the content of mucilage, which exerts protective and demulcent activity. The activity of expectorant herbs results primarily from their influence on the gastric mucose (saponins and ipec alkaloids). This proves reflex stimulation which leads to an increase in the secretion of bronchial glands. Volatile-oil type expectorant herbs exert a direct stimulatory effect on the bronchial glands by means of local irritation with antibacterial activity. In colds and flu, herbs containing volatile oil can be used; also, volatile oils are ingredients of syrups and liquids as well as external phytomedicines in the form of liniments, ointments, and inhalations. The paper shows the herbs and phytomedicines present on the Polish market used for the treatment of respiratory tract diseases.
Topics: Antitussive Agents; Cough; Gastric Mucosa; Humans; Oils, Volatile; Phytotherapy; Plant Preparations; Plants, Medicinal; Poland; Respiratory Tract Diseases
PubMed: 23289257
DOI: No ID Found -
Pulmonary Pharmacology & Therapeutics 2002Placebo treatment has been reported to improve subjective and objective measures of disease in up to 30-40% of patients with a wide range of clinical conditions. A... (Review)
Review
Placebo treatment has been reported to improve subjective and objective measures of disease in up to 30-40% of patients with a wide range of clinical conditions. A review of 8 clinical trials on the effects of antitussive medicines on cough associated with acute upper respiratory tract infection shows that 85% of the reduction in cough is related to treatment with placebo, and only 15% attributable to the active ingredient Treatment with a cough medicine can be viewed as consisting of three components: pharmacological, physiological (demulcent) and placebo. The placebo effect is related to belief in the effectiveness of the treatment and this idea must in some way influence the central control of cough. Studies on the placebo effect of analgesics indicate that the placebo effect may be mediated by endogenous opioid neurotransmitters and this may explain the analgesic potency of opioid medicines such as morphine. In the present paper a model is proposed to explain the antitussive effects of placebo treatment on the basis of endogenous opioid neurotransmitters. With active pharmacological ingredients contributing only 15% to the effects of cough treatment it seems reasonable to conduct more research on the other components of treatment such as placebo.
Topics: Antitussive Agents; Cough; Humans; Placebos; Receptors, Opioid
PubMed: 12099783
DOI: 10.1006/pupt.2002.0364 -
West African Journal of Medicine Sep 2022Cough from URTI is common, leads to discomfort, sleep loss and stress in caregivers, leading to use of ineffective and potentially harmful over-the-counter medications.... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND AND OBJECTIVE
Cough from URTI is common, leads to discomfort, sleep loss and stress in caregivers, leading to use of ineffective and potentially harmful over-the-counter medications. Honey is cost-effective and safe for children above one year of age. It is readily available and is a potentially valuable demulcent for treatment of childhood cough. The study aimed to determine the effect of honey on cough frequency and severity among children with URTI in outpatient setting.
METHODS
A single-blind randomised control trial involving children presenting with cough from URTI attending the GOPC of FMC Keffi. Eighty-four children presenting with cough from URTI were recruited, randomised into two groups of 42 and administered Honey (intervention) and Diphenhydramine (control) in three consecutive bedtime doses. Socio-demographic and clinical data including cough frequency, severity and impact on children and caregivers was collected using Paediatric Cough Questionnaire and Kingston Caregiver Stress Scale tool. Data was analysed using SPSS version 25. A p<0.05 was considered statistically significant.
RESULTS
Majority (56.0%) of the participants were males, with a mean age +SD of 4±1.47 years. Median cough frequency score for intervention and control groups pre and post intervention decreased (5.00 and 0.00 vs 5.00 and 3.00, p<0.001). Median cough severity score decreased (4.00 and 0.00 vs 4.00 and 3.00, p<0.001), Post intervention pooled caregivers' burden significantly reduced, (5.00 and 11.00 for intervention and control respectively) and sleep pattern improved among children and caregivers (0.00, 2.00 p<0.001; and 0.00, 2.00 p<0.001, for children and caregivers respectively.
CONCLUSION
Night-time honey doses given to children with cough from URTI significantly reduces symptoms and improves children and caregivers sleep compared to Diphenhydramine DPH.
Topics: Antitussive Agents; Child; Cough; Demulcents; Diphenhydramine; Female; Honey; Humans; Male; Respiratory Tract Infections; Single-Blind Method
PubMed: 36126325
DOI: No ID Found -
Phytotherapy Research : PTR Mar 2020Malvaceae family is typical from the Mediterranean region, contains 240 genera and more than 4,200 species. They are most commonly used as ornamental plants, although... (Review)
Review
Malvaceae family is typical from the Mediterranean region, contains 240 genera and more than 4,200 species. They are most commonly used as ornamental plants, although they can also be conceived as a food resource and remedy for various diseases, such as digestive, respiratory, genitourinary, throat infections, and skeletal and skin disorders, as also injuries where they are profoundly applied for skin care and as antiseptic and demulcent. They also possess diuretic, lenitive, spasmolytic, and laxative effects, besides to be used as antidiarrheal. Thus, the present review provides in-depth data on Malva spp. potential applications and phytochemical composition for food and pharmaceutical industries. Habitat and cultivation conditions and the clinical reports related to its biological effects are also emphasized. Malva spp. possess a wide variety of chemical constituents (such as polysaccharides, coumarins, flavonoids, polyphenols, vitamins, terpenes, and tannins) found in different plant organs, especially in leaves and flowers, connected to their biological activity. In general, Malva spp. have rather moderate antimicrobial activity, high antiinflammatory and wound healing activities, strong antioxidant activity, and anticancer properties. Results from in vitro and in vivo experiments encourage more in-depth studies, namely clinical trials, towards to improve knowledge on the use of Malva spp. for the treatment of various health conditions in humans.
Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Antineoplastic Agents; Antioxidants; Coumarins; Flavonoids; Humans; Malva; Medicine, Traditional; Oils, Volatile; Phytochemicals; Plant Extracts; Plants, Medicinal; Polysaccharides; Tannins; Terpenes; Vitamins
PubMed: 31713320
DOI: 10.1002/ptr.6550