Cough impact

Applications for synthetic character impact items include cough drops, toothpaste, chewing gum, candies, soft drinks, baked goods, gelatin deserts, ice cream, margarine, and cheese. 

A subsequent report by Marttila et al. (1994b) examined the impact of long-term exposure to the same mixture of malodorous sulfur compounds on children from these same three communities. The findings in children, i.e., nasal symptoms and cough, in the most severely polluted community were similar to those reported above and showed increased risks both for the 4-week and the 12-month intervals, although none of these risks reached statistical significance. 

Clear liquid with an odor that is a mixture of alcohol and ammonia. This material is hazardous through inhalation and ingestion, and produces local skin/eye impacts. Inhalation of the agent may cause irritation of the lower respiratory tract, coughing, difficulty in breathing and, in high concentration, loss of consciousness. It causes severe irritation in contact with the skin and eyes. If ingested it causes nausea, salivation, and severe irritation of the mouth and stomach. 

Colorless, water-white, or pale-yellow, oily liquid with a mild, skunk-like odor detectable at 0.5 ppm. This material is hazardous through inhalation and ingestion, and produces local skin/eye impacts. It causes irritation to the eyes, skin, respiratory system cough dizziness, dyspnea (breathing difficulty), lassitude (weakness, exhaustion), confusion, cyanosis abdominal pain, nausea skin sensitization. 

During the Second World War, Union Chimique Beige started producing basic pharmaceuticals such as calcium, phosphor, vitamins, insulin, and sulfamides. However, it was only in the late fifties that it launched, with limited market impact, its first real pharmaceutical products - Postafene (an anti-histamine), Atarax (a tranquilizer) and Tuclase (a cough and cold drug) - and concluded a first license agreement with Pfizer for the distribution of Atarax in the U.S. 

Particles larger than 10 pm will impact in the upper airways and are rapidly removed by coughing, swallowing and mucociliary processes. An 8 pm particle inhaled at 30 L min 1 has approximately a 50% chance of impacting on the throat. 

DPI Dry powder insufflation. Avoids coordination problems lower drug loss by impaction and no propellant problems associated with pMDIs. High inspiratory effort may be required coughing reflex may be less convenient then pMDI. More sophisticated multiple dose devices. 

Albin M, Engholm G, Hallin N, et al. 1998. Impact of exposure to insulation wool on lung function and cough in Swedish construction workers. Occup Environ Med 55 661-667. 

Particles larger than 5 pm in diameter are usually deposited by inertial impaction on the surface of the nasopharyngeal airways. They may be removed by coughing, sneezing, or nose wiping. 

After deposition, antimicrobial therapies are cleared from the lung by various mechanisms, including mucociliary clearance, coughing, and absorption into the systemic circulation. The dmg is then metabolized or eliminated, depending on its properties. The systemic concentrations are severalfold less that what would be achieved with parenteral therapy and would not be expected to cause toxicity. However, more research is warranted to evaluate the impact of patient characteristics on systemic exposure to inhaled antimicrobial therapies. In the clinical trials of the commercially available inhaled tobramycin preparation, the mean concentration achieved one hour after inhalation was approximately 1 p,g/mL. 

Question four addresses one of the most important issues in the critical assessment of economic analyses, that is, the issue of identification and inclusion/exclusion of resources. As discussed in the previous section, the actual scope of the resources included should match the (stated) perspective of the analysis. It is important to note that it is not always possible to measure and value all the costs and consequences of the alternatives however, a comprehensive list of the most important and relevant ones should be provided, along with justification for any major omissions. For example, a new drug has several side effects with similar rates of occurrence. One side effect results in a transient cough, another results in a Gl bleed. Given the scope of the total costs/resources involved, an economic analysis of this drug could probably justify non-inclusion of the treatment costs associated with the cough. However, because of the significant impact of even one hospitalisation, the costs associated with the Gl bleed must be included. 

Therefore, the particular hazards of the Gulf War have resonance to general societal issues and concerns. There is, for example, a powerful antivaccination lobby which receives frequent media coverage, as exemplified by the controversy over whooping cough vaccination, and more latterly MMR vaccination (Jefferson, 2000). Likewise, the intense concerns around the use of DU munitions seem less related to its toxic properties (those of a heavy metal), and more to the powerful emotional impact of its assumed link with radioactivity (actually weak), engendered by the term uranium . 

French CL, Irwin RS, Curley FJ, Krikorian CJ (1998) Impact of chronic cough on quahty of life. Arch Intern Med 158 1657-1661... 

The third component of the physiological effect involves the sensory impact of the cough medicine. If the medicine could be administered without any sensory impact, i.e. without the patient perceiving that any treatment had been administered, then it is doubtful that there could be any true placebo effect as this is dependent on the conscious perception that a treatment has been administered. Consciousness... 

Fig. 4 Components of the physiologicat effect. The sensory impact of the cough medicine may cause three different effects that lead to an inhibition of cough as described in the text...

The three components of the physiological effect are illustrated in Fig. 4. The physical and chemical properties of the cough medicine stimulate sensory nerves and are responsible for the sensory impact of the treatment as discussed above. The sensory impact is interpreted in terms of its meaning to the subject and if it is in the context of a positive belief about the treatment then this meaning may be cause a true placebo effect. In this respect, some components of the physiological effects may be responsible for the true placebo effect. 

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