title: Cough and asthma diagnosis: physicians' diagnosis and treatment of patients complaining of acute, subacute and chronic cough in rural areas of Japan.
abstract: BACKGROUND
  Cough is one of the most common reasons for visiting a clinic. The causes of cough differ according to the duration of cough. Infectious disease is commonly observed in acute cough while noninfectious disease is commonly observed in chronic cough. On the other hand, cough is frequently observed in patients with asthma/cough variant asthma (CVA).
  
  
  OBJECTIVE
  In this study, we investigated the causes of cough in a rural region in Japan and the clinical examination and treatment for the patients diagnosed as asthma/CVA.
  
  
  METHODS
  We analyzed 124 patients who complained of cough.
  
  
  RESULTS
  The most common reason for acute cough was respiratory tract infection while asthma/CVA is the most common reason for subacute and chronic cough. The diagnostic procedure for asthma/CVA depends on clinical symptoms in asthmatic patients with acute cough. While in asthmatic patients with subacute and chronic cough, diagnosis of asthma depends on clinical examinations including chest radiogram, immunoglobulin E, white blood cells counts, sputum examination or spirometry as well as symptoms. For the treatment of asthma, the use of long-acting beta(2)-stimulant was dominant in asthmatic patients with acute cough while the use of leukotriene receptor and inhaled corticosteroid were dominant in asthmatic patients with subacute or chronic cough.
  
  
  CONCLUSIONS
  Diagnosis and treatment for asthma differs according to the duration of cough. Simple guidelines for asthma/CVA according to the duration of cough might be necessary for diagnosis and treatment of asthma/CVA for general physicians especially in rural areas.
authors.affiliation: Third Department of Internal Medicine.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamasaki
authors.forename: Keichi
authors.initials: K
authors.lastname: Hanaki
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Tomita
authors.forename: Masanari
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hasagawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Okazaki
authors.forename: Miki
authors.initials: M
authors.lastname: Yamamura
authors.forename: Kouji
authors.initials: K
authors.lastname: Fukutani
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sugimoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kodani
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Ikeda
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Konishi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tokuyasu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yajima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sejima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Isobe
authors.forename: Eiji
authors.initials: E
authors.lastname: Shimizu
references.citation: Fam Pract. 2002 Aug;19(4):365-8
references.pmid: 12110556
references.citation: Lancet. 2006 Aug 26;368(9537):814
references.pmid: 16935692
references.citation: Med J Aust. 1976 Oct 2;2(SP1):15-23
references.pmid: 994888
references.citation: Respirology. 2005 Mar;10(2):201-7
references.pmid: 15823186
references.citation: Anticancer Res. 2000 May-Jun;20(3B):1995-7
references.pmid: 10928140
references.citation: N Engl J Med. 1979 Mar 22;300(12):633-7
references.pmid: 763286
references.citation: Cough. 2007 Jan 08;3:1
references.pmid: 17210085
references.citation: Allergy. 1982 Aug;37(6):397-406
references.pmid: 7137534
references.citation: Chest. 2006 May;129(5):1142-7
references.pmid: 16685003
references.citation: Chest. 2001 Jan;119(1):105-14
references.pmid: 11157591
references.citation: Respirology. 2006 Sep;11 Suppl 4:S135-86
references.pmid: 16913879
references.citation: Chest. 2006 Jan;129(1 Suppl):1S-23S
references.pmid: 16428686
references.citation: Minerva Pediatr. 1994 Mar;46(3):113-6
references.pmid: 8035757
references.citation: Arerugi. 1999 Jul;48(7):713-8
references.pmid: 10481355
references.citation: J Asthma. 2005 Mar;42(2):107-11
references.pmid: 15871442
references.citation: Prim Care Respir J. 2006 Feb;15(1):20-34
references.pmid: 16701756
references.citation: Respirology. 2005 Jun;10(3):354-8
references.pmid: 15955149
references.citation: Eur Respir J. 2007 Jun;29(6):1256-76
references.pmid: 17540788
references.citation: Arch Intern Med. 1997 Sep 22;157(17):1981-7
references.pmid: 9308510
references.citation: Vital Health Stat 13. 1999 Nov;(142):i-vi, 1-122
references.pmid: 10597666