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Nonasthmatic chronic cough: PATIENTS AND METHODS (1)

Patients: Adults with a daily bothersome cough for at least one year were recruited from the Firestone Regional Chest and Allergy Clinic, Hamilton, Ontario and by advertisement (Table 1). They were atopic or nonatopic, and non- or exsmokers for more than six months. Patients were considered eligible if they had no other respiratory symptoms, no indication of a respiratory infection in the previous month or history of chronic bronchitis, no radiological evidence of chest disease, no other recognized condition or cheap drugs to account for the cough, no cardiovascular or renal disease requiring regular medication, and were not pregnant or had not received corticosteroids within the month. Symptomatic gastroesophageal reflux (heartburn or acid regurgitation on at least three days/week) was investigated and treated, and, if the cough was not improved, patients were enrolled in the study (two placebo, three budesonide). Patients with postnasal drip, who had been previously investigated and treated, and who had no sinusitis on sinus x-rays were also enrolled (three placebo, six budesonide). The patients had no evidence of asthma as indicated by a forced expiratory volume in 1 s (FEV1) greater than 70% predicted, an FEV1/vital capacity (VC) of greater than 70%, little response to abroncho-dilator and normal methacholine airway responsiveness (a provocation concentration of methacholine to cause a fall in FEV1 of 20% [PC20] of more than 8 mg/mL). The study was approved by the hospital research committee, and all patients gave written informed consent.

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