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Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents. Methods: Cohorts collected data between 1992 and 2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large-scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD). Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than non-allergic asthma. Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers. [ABSTRACT FROM AUTHOR]

Chronic cough is defined as persistent cough for more than eight weeks without a defined diagnosis. Irwin and other authors have identified sinusitis, asthma and gastroesophageal reflux as the most common causes of chronic cough. Objectives: To know the clinical spectrum and the most common causes of chronic cough, as well as lo perform a comparative analysis with the literature. Material and methods: A retrospective and transversal study was performed analyzing the clinical records of patients attending consultation because of chronic cough at Dr. Jose E. Gonzalez University Hospital at the Autonomous University of Nuevo Leon, and the Clínica Cuauhtemoc y Famosa, in Monterrey, Nuevo Leon, Mexico, from January, 1998, to December, 2000. The main symptoms and signs of each patient were analyzed, as well as the final diagnosis of the cough's cause and the response to treatment. In addition, a comparative analysis of the data found. In this population and those reported by Irwin et al on the main cause of this symptom. For the statistical analysis, multivarianza analysis, x2 test and Mantel Haenszel with 2x2 table were used considering a p < 0 05 as significant. Results: One hundred eight records were reviewed, but only 91 were included. The most common final diagnoses were gastroesophageal reflux in 75 patients (82%), followed by sinusitis in 34 cases (37%) and mixed causes (more than two) in 25 subjects (27%) (p = 0 016). All patients responded properly to specific treatment directed to the identified base-disease, with which symptoms were solved. Conclusions: In our population, unlike described by Irwin, the most frequent cause of chronic cough is gastroesophageal reflux, followed by sinusitis and mixed causes. [ABSTRACT FROM AUTHOR]

Background: Cough is a common reason for patients to visit general practices. So-called post-infectious cough is defined as lasting 3 to 8 weeks after an upper respiratory tract infection. It can be disabling in daily activities, with substantial impact on physical and psychosocial health, leading to impaired quality of life and increased health care costs. Recommendations for the management of post-infectious cough in primary care are scarce and incoherent. A systematic review and meta-analysis of randomized clinical trials (RCT) assessing patient-relevant benefits and potential harms of available treatments identified six eligible RCTs assessing different treatment regimens (i.e. inhaled fluticasone propionate, inhaled budesonide, salbutamol plus ipratropium-bromide, montelukast, nociception-opioid-1-receptor agonist, codeine, gelatine). No RCT found clear patient-relevant benefits and most had an unclear or high risk of bias. Post-infectious cough is thought to be mediated by inflammatory processes that are also present in exacerbations of asthma or chronic obstructive pulmonary diseases for which there is strong evidence that oral corticosteroids provide patient-relevant benefit without relevant harm. We therefore plan to conduct the first RCT evaluating the effectiveness of oral corticosteroids for post-infectious cough.Methods: We are conducting a triple-blinded randomized-controlled and multicentred superiority trial in primary health care practices in Switzerland. We will include 204 adult patients who consult their general practitioner (GP) for a cough lasting 3 to 8 weeks following an upper respiratory tract infection. Participants will be randomly allocated to either the 5-day treatment with oral corticosteroids or placebo. The primary outcome is cough-related quality of life assessed by the Leicester Cough Questionnaire score 14 days after randomization. Secondary outcomes include cough-related quality of life at several time points, overall cessation of cough and adverse events.Discussion: This RCT will provide evidence on whether oral corticosteroids are beneficial and safe in patients with post-infectious cough. Results can have a substantial impact on the well-being and management of these patients in Switzerland and beyond. An evidence-based treatment for this condition may reduce re-consultations with GPs and spending for antitussive drugs, thus possibly having an impact on health care spending.Trial Registration: ClinicalTrials.gov NCT04232449 . Prospectively registered on 18 January 2020. [ABSTRACT FROM AUTHOR]