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HULL CHRONIC COUGH FOCUS GROUP Issue 3 1 P Hull Chronic Cough Group Newsletter 3rd edition ISSUE 04/03/2014 IN THIS ISSUE Cough Focus Group Meeting By Caroline Wright Can you believe since our last meeting we have had Christmas and its festivities and are well in to the New Year with spring on our doorstep? I hope you all enjoyed our last meeting and if you were unable to attend I hope that you find this news letter of some interest. Something which is becoming clear from our meetings is that we need the group members to take a more pro-active role in how they would like the group to run. We are here to fully support the group and can help organising speakers and update the group on new research and maybe topics that you are interested in but perhaps not closely related to cough. It might be an idea to vote for a chairperson, a social secretary or just have someone to lead the group. Financial Support At present we are in the process of trying to obtain funding for the cough focus group. We have approached a couple of drug companies and I am happy to say they didn’t dismiss the idea. They did however want a detailed report of how much support financially we required and for what purpose. So it’s time to get your thinking caps on and decide how you would like to move the group forward. NEW Study to assess diagnosis and therapy for cough Utilisiing the Nitric oxide test in determining chronic cough diagnosis and therapy. See details on pg 3. Consider how the funding could be utilized i.e. guest speakers, travelling to events or maybe promotional material to inform others about the effects of chronic cough. FOOD FOR THOUGHT Promotion = recognition Recognition = Research Thalidomide- results so far We need to make our voices heard Turn to pg 4 to look at the results from 3 patients having received 1 month treatment with Thalidomide. HULL CHRONIC COUGH GROUP NEWSLETTER 3RD EDITION Issue| 3 Once again we offered you an insight into the benefits of relaxation we hope you want to continue and expand on these sessions – Jackie Mower RGN, DIP C HYP Meetings will be held on the following dates below:- March 11th 2014 Tuesday 1pm-3pm June 10th 2014 Tuesday 1pm-3 pm September 9th 2014 Tuesday 1pm-3pm LOCATE OUR NEW FACEBOOK PAGE SEARCH THE INTERNET FOR HULL PERSISTENT COUGH FOCUS GROUP AND YOU SHOULD FIND THE FACE BOOK PAGE SHORTCUT 2 HULL CHRONIC COUGH GROUP NEWSLETTER 3RD EDITION Issue| 3 3 To look at the effectiveness of this therapy we will use a positive control in the form of oral prednisolone. HEADING 4 Prednisolone will eliminate any inflammation in the airway. The effectiveness of the therapies administered will be measured using subjective scoring from the patients and measuring cough objectively with the citric acid cough challenge and using 24 hour cough monitoring before and during treatment. Hull and east Yorkshire Pulmonary Fibrosis Support Group We have a support group which is run once every three months for those who suffer from Pulmonary Fibrosis. This is lead by Mark Major our Specialist Nurse and Dr S Hart. Dr S Hart, Consultant Physician has a special interest in pulmonary fibrosis and presents at the meetings. Guest speakers are also invited such as from Department of Works and Pensions with regards to benefits that you may be able to claim etc, Dove House Hospice - treatments on offer etc. Our next meeting is June 2014 (no specific date as yet) but if you are interested then please forwards your contact details to [email protected] or [email protected] . The Allam Lecture The Hull York Medical School will be holding the inaugural ‘Allam Lecture’ this will be taking place on Friday 11th of April 2014 at 5pm. There will be an opportunity to browse Poster presentations of some of the work the University is carrying out in Cardiology, respiratory and cough. A leaflet has been included with this newsletter. FAST FACTS Two thirds of patients attending cough clinics are Females. Sucking on a mentholated sweet could help your cough. Our research showed menthol can significantly reduce cough sensitivity. Utilisation of the Nitric oxide measurement in diagnosis of Chronic cough By Caroline Wright During inflammation, higher-thannormal levels of nitric oxide (NO) are released from epithelial cells which line the tubes in your lungs. The concentration of NO in exhaled breath, or fractional exhaled nitric oxide (FeNO), can help identify airway inflammation. In 20% of patients attending Cough specialist clinics there is evidence of eosinophillic inflammation of the airway. This is important because those patients with eosinophillic inflammation respond to ant-inflammatory medications. Neutrophillic inflammation of the airway which can also occur does not necessarily respond to antiinflammatory treatment. We propose to use the fractional exhaled Nitric oxide test when a patient first attends cough clinic and based upon the FENO measurement for the clinician to decide whether the patient would be treated more appropriately with anti-inflammatory therapy or whether other options, such as anti reflux treatment should be administered first line. The anti-inflammatory treatment we wish to study is called montelukast. This medication has been chosen because there is evidence that this treatment is highly effective at reducing cough reflex sensitivity in patients with asthmatic cough. Please let us know your thoughts on this study. This study has not been written up as a full protocol yet and your input is crucial to us, so that we ask the right questions and record the right data. HULL CHRONIC COUGH FOCUS GROUP Issue 3 1 Results of Thalidomide To date we have had 3 patients who have tried a 1 month supply of thalidomide. As part of the patients Thalidomide trial we have measured the patients cough over a 24hour period using our cough monitor. This has taken place prior to Thalidomide therapy and after 3to 4 weeks of treatment with thalidomide. We also measured cough sensitivity to citric acid, lung capacity and we asked patients to complete a number of questionnaires to look at the patient’s subjective evaluation of their cough. Below I have plotted some of the results as graphs. Hull airway reflux questionnaire score Cough Visual analogue scores (scale 0-10) 9 5.33 Baseline Thalidomide 8.66 6.5 5 4.5 2.5 1.5 Baseline 44 6.5 5 26.7 Baseline Lung volume measurements pre and post Thalidomide 4 3 Baseline 2 Thalidomide 1 0 FEV1 FVC FEF 25-75 FEV1/FVC Thalidomide Thalidomide HULL CHRONIC COUGH GROUP NEWSLETTER 3RD EDITION Hull Chronic Cough Group By [Article Author] Respiratory Medicine ,Castle Hill Hospital, Cottingham HU16 5JQ Issue| 3 5