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[Chronic cough in children]
Katarzyna Ptak1, Ewa Cichocka-Jarosz2, Przemko Kwinta2
1Klinika Chorób Dzieci, Uniwersytecki Szpital Dziecięcy w Krakowie, Polska.
Insights
Chronic cough in children significantly impacts quality of life. New diagnostic and therapeutic strategies, including the concept of cough hypersensitivity syndrome, aim to improve patient outcomes.
Area of Science:
- Pulmonology
- Neurology
- Pediatrics
Background:
- Chronic cough is a common pediatric complaint with significant impact on quality of life.
- Prolonged coughing episodes lead to parental concern, increased healthcare utilization, and medication side effects.
- Current understanding necessitates updated diagnostic and therapeutic approaches.
Purpose of the Study:
- To summarize current knowledge on chronic cough pathophysiology, diagnostics, and therapeutics.
- To introduce the concept of 'cough hypersensitivity syndrome' for distinct pathophysiology.
- To present updated diagnostic and therapeutic algorithms for improved patient care.
Main Methods:
- Review of current literature on chronic cough.
- Proposal of a new term: cough hypersensitivity syndrome.
- Development of diagnostic and therapeutic algorithms.
- Discussion of novel therapeutic strategies targeting neural pathways.
Main Results:
- Chronic cough requires a multi-faceted evaluation, often needing multiple monitoring methods.
- The proposed diagnostic and therapeutic algorithms aim to expedite diagnosis and treatment.
- New therapeutic strategies focus on regulating vagal afferent nerves and neurotransmission.
Conclusions:
- The concept of cough hypersensitivity syndrome offers a new perspective on chronic cough pathophysiology.
- Integrated diagnostic and therapeutic approaches can significantly improve quality of life for children with chronic cough.
- Targeting neural pathways represents a promising avenue for future chronic cough treatments.
Abstract:
Coughing is one of the most common patient complaints at physicians' office. The majority of children experience 5 to 8 episodes of cough lasting about a week throughout the year. Episodes of cough which last longer than 4 weeks, defined as a chronic cough, result in serious parental concern, impaired quality of life, increased number of medical consultations and the adverse effects of inappropriately used medications. Overall, a chronic cough is not only a serious health problem, but also a social one. The article presented below summarizes our current knowledge on the pathophysiology of chronic cough, the latest diagnostics and most recent measurement and monitoring methods as well as recommendations for therapeutic proceedings. In order to emphasize the distinct pathophysiology of chronic cough we use a new term: cough hypersensitivity syndrome. We point out the necessity of the concurrent implementation of more than one cough monitoring method for its more adequate evaluation. This article in addition presents the diagnostic and therapeutic algorithms in the treatment of a chronic cough which shorten the time to make a proper diagnosis, enable the introduction of adequate treatment, and ultimately improve the patients' quality of life. We present new therapeutic strategies, which are based on regulating the activity of vagal afferent nerves and modifying the neurotransmiters' transmission in the brainstem and midbrain.
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