Video Experimental Relacionado
Updated: Jun 9, 2026
06:22
Machine Learning-Based Cough Tone Classification: Diagnostic Exploration of Chronic Obstructive Pulmonary Disease and Respiratory Tract Infections
Published on: September 19, 2025
¿Este paciente adolescente o adulto que tosía tiene tos ferina?
Paul B Cornia1, Adam L Hersh, Benjamin A Lipsky
1Primary and Specialty Medical Care Service, Veterans Affairs Puget Sound Health Care System, and Department of Medicine, University of Washington School of Medicine, Seattle, USA.
JAMA
|August 26, 2010
Resumen
La tos ferina a menudo se pierde en adultos y adolescentes. La emesis posttussiva y el grito inspiratorio aumentan modestamente la probabilidad de tos ferina, pero el juicio clínico sigue siendo clave para el diagnóstico.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Diagnóstico Clínico El diagnóstico clínico.
- Salud Pública La salud pública.
Sus antecedentes:
- La tos ferina es frecuentemente subestimada como una causa de tos crónica en adolescentes y adultos.
- El valor diagnóstico de los síntomas clásicos de la tos ferina como la tos paroxística, la emesis posttusitiva y el grito inspiratorio no está bien establecido.
Objetivo del estudio:
- Revisar sistemáticamente la utilidad diagnóstica de los tres síntomas clásicos de la tos ferina: tos paroxística, vómitos posttusivos y grito inspiratorio.
- Para evaluar la evidencia de estos síntomas en el diagnóstico de la tos ferina en personas mayores de 5 años, adolescentes y adultos.
Principales métodos:
- Se realizó una búsqueda sistemática de la literatura en las bases de datos MEDLINE y EMBASE (1966-2010).
- Se incluyeron estudios en los que participaron pacientes con enfermedad de tos y un diagnóstico confirmado de tos ferina utilizando un estándar de referencia.
- La extracción y el análisis de los datos fueron realizados independientemente por dos autores.
Principales resultados:
- Se analizaron tres estudios prospectivos, en los que participaron pacientes mayores de 5 años, adolescentes y adultos.
- La presencia de vómitos posttusivos (LR: 1.8) o de vómitos inspiratorios (LR: 1.9) aumentaba la probabilidad de tener tos ferina.
- La ausencia de tos paroxística (LR: 0.52) o de emesis posttussiva (LR: 0.58) disminuyó la probabilidad; la ausencia de gritos inspiratorios fue menos informativa (LR: 0.78).
Conclusiones:
- La evidencia para el valor diagnóstico de los síntomas de la tos ferina clásica es limitada y de baja calidad en entornos sin brotes.
- La emesis posttussiva y el grito inspiratorio solo alteran modestamente la probabilidad de tos ferina.
- El juicio clínico es esencial para guiar más pruebas o decisiones de tratamiento empírico.
Videos de Conceptos Relacionados
01:14Atypical Pneumonia
Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...
01:30Pneumonia III: Complications and Assessment
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
01:29Pneumonia II: Pathophysiology
The pathophysiology of pneumonia involves the following steps:
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by anesthetizing...
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by anesthetizing...
01:17Pulmonary Cycle: Exhalation
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...