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Sample records for bronchitis chronic

  1. Heredity of chronic bronchitis

    DEFF Research Database (Denmark)

    Meteran, Howraman; Backer, Vibeke; Kyvik, Kirsten Ohm

    2014-01-01

    -specific concordance rates and heritability of chronic bronchitis. The response rate was 75%. RESULTS: The prevalence of chronic bronchitis was 9.3% among men and 8.5% among women. The concordance rate for chronic bronchitis was higher in monozygotic twins than in dizygotic twins among women; 0.30 vs. 0...

  2. Chronic bronchitis in an elderly population

    DEFF Research Database (Denmark)

    Lange, Peter; Parner, Jan; Prescott, Eva

    2003-01-01

    in order to describe the prevalence and prognostic implications of chronic bronchitis in individuals 65 years or older we analysed data from The Copenhagen City Heart Study.......in order to describe the prevalence and prognostic implications of chronic bronchitis in individuals 65 years or older we analysed data from The Copenhagen City Heart Study....

  3. Bronchitis

    Science.gov (United States)

    ... coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, and allergies can worsen the ... Chronic Bronchitis (MedlinePlus) Clinical Trials Children and Clinical Studies Clinical Trials Current Research (ClinicalTrials.gov) NHLBI Clinical ...

  4. Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema

    Science.gov (United States)

    ... Submit Button NCHS Home Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Recommend on Facebook ... to emergency departments with chronic obstructive pulmonary disease (COPD): 6.9 million Source: National Hospital Ambulatory Medical ...

  5. Occupation and chronic bronchitis among Chinese women.

    Science.gov (United States)

    Krstev, Srmena; Ji, Bu-Tian; Shu, Xiao-Ou; Gao, Yu-Tang; Blair, Aaron; Lubin, Jay; Vermeulen, Roel; Dosemeci, Mustafa; Zheng, Wei; Rothman, Nathaniel; Chow, Wong-Ho

    2008-01-01

    To examine the association between occupation and chronic bronchitis among a cross section of Chinese women who participated in the Shanghai Women's Health Study. Cases were 4873 women who self-reported a physician-diagnosed bronchitis during adulthood. Controls were 9746 women randomly selected from Shanghai Women's Health Study participants and matched with the cases by year of birth and age at diagnosis. Lifetime occupational histories were obtained. Logistic regressions were used to evaluate the association between chronic bronchitis and occupation, adjusting for smoking, education, family income, and concurrent asthma. We observed excess prevalence of bronchitis for textile occupation (odds ratio, OR = 1.09; 95% CI = 1.00-1.18) and industry (OR = 1.11; 95% CI = 1.03-1.19), welders (OR = 1.40; 95% CI = 1.01-1.92), packing and baling workers (OR = 1.39; 95% CI = 1.15-1.68), and warehousing industry (OR = 1.58; 95% CI = 1.08-2.30) We also identified several new associations that may warrant further exploration and confirmation, including employment in some metal fabrication industries, postal and telecommunication industry, and a few white-collar occupations and industries. Our study indicates that the risk of chronic bronchitis among women may be increased in some occupations and industries.

  6. Pidotimod activity against chronic bronchitis exacerbations.

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    Ciaccia, A

    1994-12-01

    The efficacy of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl) carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6) in the management of infectious exacerbations of chronic bronchitis was evaluated in a double-blind, placebo-controlled study in parallel groups over 5 months (60 days of treatment and 90 days of follow-up). The study enrolled 580 patients, of whom 514 could be evaluated. The pidotimod group had fewer and shorter infectious episodes, fewer days of antibiotic therapy and fewer days unable to undertake normal activities. The difference vs. placebo was significant during the follow-up period and, in those subjects with a less severe history, during the treatment period also. Pidotimod was well tolerated.

  7. Risk of chronic bronchitis in twin pairs discordant for smoking

    DEFF Research Database (Denmark)

    Meteran, Howraman; Thomsen, Simon Francis; Harmsen, Lotte

    2012-01-01

    It is well known that smoking is a major risk factor for lung disease and respiratory symptoms. We examined the association between smoking and the risk of chronic bronchitis in a large twin sample.......It is well known that smoking is a major risk factor for lung disease and respiratory symptoms. We examined the association between smoking and the risk of chronic bronchitis in a large twin sample....

  8. Acute Bronchitis

    Science.gov (United States)

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  9. Features of Chronic Bronchitis in Different Age Groups

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    Galina L. Ignatova

    2014-03-01

    Full Text Available Background: Lung diseases are assuming greater relevance and importance today. Chronic bronchitis is a self-nosology, which may precede the development of COPD, the importance of which can hardly be overestimated. The main problem in this disease is caused by late diagnosis and treatment due to the delay by patients in seeking medical help. The aim of the work was to study the distribution and exposure to tobacco smoke, especially chronic bronchitis, depending on various factors, including age. Methods: We examined 1779 persons, including 855 men and 924 women. The mean age of the population was 35.83±8.3 years. We conducted surveys and spirometry. The outcome was assessed after a bronchodilation test was performed with salbutamol 400 mcg. We performed all statistical analysis using software package Statistica 10. Results: We identified chronic bronchitis in 9.2% of the cases in the group of younger individuals and in 14.9% of the cases in the group of older individuals, during the active detection of chronic bronchitis using questionnaires. The prevalence of cigarette smoking was slightly higher among the younger (39.5% than the older persons (33.6%; the frequency of smoking in a group of chronic bronchitis was reliably higher. Also, in this group, the performance spirometry reliably decreased. Conclusions: Outpatient survey is an effective method of identifying chronic bronchitis. Smoking is a major risk factor in the group of young respondents and the prevalence of smoking is inversely related to the education level of the respondents, regardless of age. As the decline in the Forced Expiratory Volume (FEV1 and FEV1/FVC is the main criterion diagnosis of COPD, it revealed significant declines in the FEV1 of the younger smoking individuals, which may help to predict the development of COPD in the older age group.

  10. SAFETY AND EFFECTIVENESS OF PIDOTIMOD IN ACUTE AND CHRONIC BRONCHITIS

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    A.V. Karaulov

    2010-01-01

    Full Text Available One of effective and safe immunomodulators for prophylaxis and treatment of frequently ailing children is pidotimod (Imunorix. Efficacy of the drug in pediatric practice was studied in more than 3200 patients with acute and recurrent respiratory infections. The article shows reasonability of pidotimod administration in children with acute and chronic bronchitis. This fact was confirmed with doubleblinded placebo-controlled studies. Treatment with pidotimod results in decreased terms of recovery of chronic bronchitis exacerbation, shortening of exacerbation. Realization of stable effect is related to recovery of key functions of inborn and adaptive immunity, it begins in 15 days after intake of the drug in therapeutic dose. Prophylactic doses of pidotimod should be used during next 30–60 days.Key words: children, bronchitis, pidotimod, immunity, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(6:139-143

  11. Etiologic factors of chronic bronchitis in dairy farmers. Case control study in the Doubs region of France.

    Science.gov (United States)

    Dalphin, J C; Pernet, D; Dubiez, A; Debieuvre, D; Allemand, H; Depierre, A

    1993-02-01

    Relationships were investigated between chronic bronchitis and plant dust exposure assessed by quantification of barn threshing and cattle foddering and chronic bronchitis and acute respiratory syndromes after plant mold dust exposure. Two groups of male dairy farmers were studied in the Doubs region, France: 197 with chronic bronchitis and 163 control subjects without chronic bronchitis. There was no relationship between chronic bronchitis and exposure. Thirty-three chronic bronchitis patients had semidelayed respiratory syndromes (SDRS) vs two control subjects. Twenty-seven times out of 33 (16 of 17 in the nonsmokers), the SDRS preceded chronic bronchitis. Past history of acute respiratory syndromes during barn threshing (RSBT) was more frequent in chronic bronchitis; RSBT always preceded chronic bronchitis. It is concluded that host factors are important in chronic bronchitis and that acute effects after exposure may be predisposing factors to chronic bronchitis.

  12. Predicting the risk of chronic bronchitis in teenage smokers

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    S.I. Ilchenko

    2017-05-01

    Full Text Available Background. The purpose of the study was to create a prognostic model of the risk of chronic respiratory pathology in teenage smokers comfortable to use in practical medicine. Materials and methods. 73 teenage smokers aged 14–18 years (average age is 16.4 ± 0.2 years have been exa­mined. They were divided into two groups: group 1 consisted of 36 teenage smo­kers with chronic bronchitis (average age is 16.8 ± 0.2 years and comparison group comprised 37 apparently healthy teenage smokers (average age is 15.9 ± 0.2 years. We have studied clinical-anamnestic, functiona­­linstrumental data (spirometry, radiography of chest organs, level of nitric oxide in expired breath condensate, respiratory muscles strength and molecular-genetic factors of the risk of developing chronic pathology of respiratory organs in teenage smokers — 103 characteristics overall. The method of consequent (sequential analysis of Wald and Bayes strategy were used to create a prognostic model of the risk of chronic bronchitis. Results. The principle of working with a mathematical model for predicting the risk of chronic respiratory pathology development in teenage smokers is to sum up diagnostic factors that are consistent with the signs found in the patient. When the sum of diagnostic components is +13, the deve­lopment of chronic bronchitis is diagnosed in teenage smo­kers with error probability ≤ 5 % (р < 0.05; when the sum is +20 — the probability of diagnosis is 99 % (р < 0.01. Conclusions. Our algorithm for predicting the risk of develo­ping chronic bronchitis in teenage smokers will help early detection of high-risk patients in the formation of this pathology for personalized preventive measures that will allow practitioners to prevent chronic pathological processes and to improve the quality of life.

  13. [Chronic obstructive bronchitis in a fodder farming setting].

    Science.gov (United States)

    Dalphin, J C

    1996-12-01

    Respiratory disease in agricultural workers are dominated both in terms of frequency and severity by chronic obstructive long disease. In the Doubs, in dairy cereal farmers, the prevalence of chronic bronchitis in active farm workers is around 10 per cent, and 6 per cent are non-smokers. It is twice the level of the control population of non-exposed subjects. The frequency is most elevated in the men and increases both with age and with altitude. A longitudinal study of male farm workers aged more than 45 has shown that there is an abnormally rapid loss of forced expired volume in one second (FEV1). Two different studies carried out in the Doubs have revealed epidemiological, respiratory function and immunological arguments in favour of immuno-allergic mechanisms. Notably, obstructive chronic bronchitis (OCB) occurs more frequently in agricultural workers with a previous history of farmer's lung or previous sub-acute delayed symptoms in relation to exposure. On the other hand, there are no close links between OCB and the intensity of antigenic exposure (the total quantity of fodder handled). By contrast, there is a relationship between exposure to thermophillic actinomycetes (antigen of farmer's lung) and OCB. The frequency of serum precipitins is most elevated in farm workers with OCB than in asymptomatic agricultural workers. Finally, non-smokers who are suffering from OCB without evidence of farmer's lung, have a respiratory function profile and also alveolar lavage cell pattern characteristic of extrinsic allergic alveolitis after provocation tests to mouldy hay. These arguments are in favour of immuno-allergic mechanisms in the pathogenesis of chronic bronchitis in farm workers which seems to be well differentiated from chronic bronchitis due to smoking.

  14. SAFETY AND EFFECTIVENESS OF PIDOTIMOD IN ACUTE AND CHRONIC BRONCHITIS

    OpenAIRE

    A. V. Karaulov

    2010-01-01

    One of effective and safe immunomodulators for prophylaxis and treatment of frequently ailing children is pidotimod (Imunorix). Efficacy of the drug in pediatric practice was studied in more than 3200 patients with acute and recurrent respiratory infections. The article shows reasonability of pidotimod administration in children with acute and chronic bronchitis. This fact was confirmed with doubleblinded placebo-controlled studies. Treatment with pidotimod results in decreased terms of recov...

  15. Sulfur dioxide-induced chronic bronchitis in beagle dogs.

    Science.gov (United States)

    Greene, S A; Wolff, R K; Hahn, F F; Henderson, R F; Mauderly, J L; Lundgren, D L

    1984-01-01

    This study was done to produce a model of chronic bronchitis. Twelve beagle dogs were exposed to 500 ppm sulfur dioxide (SO2) for 2 h/d, 5 d/wk for 21 wk and 4 dogs were sham-exposed to filtered ambient air for the same period. Exposure effects were evaluated by periodically examining the dogs using chest radiographs, pulmonary function, tracheal mucous clearance; and the cellular and soluble components of bronchopulmonary lavage fluids. Dogs were serially sacrificed after 13 and 21 wk of exposure and after 6 and 14 wk of recovery. Clinical signs produced in the SO2-exposed dogs included mucoid nasal discharge, productive cough, moist rales on auscultation, tonsilitis, and conjunctivitis. Chest radiographs revealed mild peribronchiolar thickening. Histopathology, tracheal mucous clearance measurements, and lavage cytology were consistent with a diagnosis of chronic bronchitis. It is concluded that repeated exposure to 500 ppm SO2 for 21 wk produced chronic bronchitis in the beagle dog. Complete recovery occurred within 5 wk following cessation of SO2 exposure.

  16. Sulfur dioxide-induced chronic bronchitis in beagle dogs

    Energy Technology Data Exchange (ETDEWEB)

    Greene, S.A.; Wolff, R.K.; Hahn, F.F.; Henderson, R.F.; Mauderly, J.L.; Lundgren, D.L.

    1984-01-01

    This study was done to produce a model of chronic bronchitis. Twelve beagle dogs were exposed to 500 ppm sulfur dioxide (SO/sub 2/) for 2 h/d, 5d/wk for 21 wk and 4 dogs were sham-exposed to filtered ambient air for the same period. Exposure effects were evaluated by periodically examining the dogs using chest radiographs, pulmonary function, tracheal mucous clearance, and the cellular and soluble components of bronchopulmonary lavage fluids. Dogs were serially sacrificed after 13 and 21 wk of exposure and after 6 and 14 wk of recovery. Clinical signs produced in the SO/sub 2/-exposed dogs included mucoid nasal discharge, productive cough, moist rales on auscultation, tonsilitis, and conjunctivitis. Chest radiographs revealed mild peribronchiolar thickening. Histopathology, tracheal mucous clearance measurements, and lavage cytology were consistent with a diagnosis of chronic bronchitis. It is concluded that repeated exposure to 500 ppm SO/sub 2/ for 21 wk produced chronic bronchitis in the beagle dog. Complete recovery occurred within 5 wk following cessation of SO/sub 2/ exposure. 43 references, 2 figures, 2 tables.

  17. Chronic bronchitis among nonsmoking farm women in the agricultural health study.

    Science.gov (United States)

    Valcin, Martin; Henneberger, Paul K; Kullman, Greg J; Umbach, David M; London, Stephanie J; Alavanja, Michael C R; Sandler, Dale P; Hoppin, Jane A

    2007-05-01

    The purpose of this study was to examine agricultural risk factors for chronic bronchitis among nonsmoking farm women. We used self-reported enrollment data from the 21,541 nonsmoking women in the Agricultural Health Study to evaluate occupational risk factors for prevalent chronic bronchitis among farm women. Odds ratios (ORs) for chronic bronchitis for occupational exposures were adjusted for age, state, and related agricultural exposures. Applying manure and driving combines were independently associated with chronic bronchitis. Off-farm job exposures associated with chronic bronchitis were organic dusts, asbestos, gasoline, and solvents. Five pesticides were associated with chronic bronchitis after multivariate adjustment and sensitivity analyses: dichlorvos (OR=1.63, 95% CI=1.01, 2.61), DDT (OR=1.67, 95% CI=1.13, 2.47), cyanazine (OR=1.88, 95% CI=1.00, 3.54), paraquat (OR=1.91, 95% CI=1.02, 3.55), and methyl bromide (OR=1.82, 95% CI=1.02, 3.24). Pesticides as well as grain and dust exposures were associated with chronic bronchitis among nonsmoking farm women.

  18. [X-ray semiotics of the morphological and functional changes in chronic bronchitis].

    Science.gov (United States)

    Khomenko, A G; Dmitrieva, L I; Polak, J; Gapon'ko, G A; Starilova, I P

    1985-01-01

    The authors analysed structural disorders of a pulmonary pattern in patients with non-obstructive, obstructive and purulent bronchitis. Characteristic x-ray symptom-complexes were singled out for each clinical variant of the disease. In addition to roentgenomorphological changes functional disorders showing changes of biomechanics in patients with chronic bronchitis were revealed at roentgenopneumopolygraphy.

  19. Chronic cough due to chronic bronchitis: ACCP evidence-based clinical practice guidelines.

    Science.gov (United States)

    Braman, Sidney S

    2006-01-01

    Chronic bronchitis is a disease of the bronchi that is manifested by cough and sputum expectoration occurring on most days for at least 3 months of the year and for at least 2 consecutive years when other respiratory or cardiac causes for the chronic productive cough are excluded. The disease is caused by an interaction between noxious inhaled agents (eg, cigarette smoke, industrial pollutants, and other environmental pollutants) and host factors (eg, genetic and respiratory infections) that results in chronic inflammation in the walls and lumen of the airways. As the disease advances, progressive airflow limitation occurs, usually in association with pathologic changes of emphysema. This condition is called COPD. When a stable patient experiences a sudden clinical deterioration with increased sputum volume, sputum purulence, and/or worsening of shortness of breath, this is referred to as an acute exacerbation of chronic bronchitis as long as conditions other than acute tracheobronchitis are ruled out. The purpose of this review is to present the evidence for the diagnosis and treatment of cough due to chronic bronchitis, and to make recommendations that will be useful for clinical practice. Recommendations for this section of the review were obtained from data using a National Library of Medicine (PubMed) search dating back to 1950, performed in August 2004, of the literature published in the English language. The search was limited to human studies, using the search terms "cough," "chronic bronchitis," and "COPD." The most effective way to reduce or eliminate cough in patients with chronic bronchitis and persistent exposure to respiratory irritants, such as personal tobacco use, passive smoke exposure, and workplace hazards is avoidance. Therapy with a short-acting inhaled beta-agonist, inhaled ipratropium bromide, and oral theophylline, and a combined regimen of inhaled long-acting beta-agonist and an inhaled corticosteroid may improve cough in patients with

  20. Prevalence and risk factors for chronic bronchitis and farmer's lung in French dairy farmers.

    Science.gov (United States)

    Dalphin, J C; Debieuvre, D; Pernet, D; Maheu, M F; Polio, J C; Toson, B; Dubiez, A; Monnet, E; Laplante, J J; Depierre, A

    1993-10-01

    The prevalence of chronic bronchitis and of clinical farmer's lung was studied in 30 districts of the French Doubs province in relation to individual (age, sex, smoking) and geographical (altitude) factors. 5703 exclusively dairy farmers (response rate 83%) participated in the study by answering a medical questionnaire. Prevalences of chronic bronchitis and clinical farmer's lung were 9.3% and 1.4% respectively. A logistic regression model was used to evaluate risk factors for chronic bronchitis and clinical farmer's lung. A risk of chronic bronchitis was associated with male sex (p < 10(-4)), age (p < 10(-4)), smoker category (p < 10(-4)), and altitude (p < 10(-4)). A risk of clinical farmer's lung was associated with non-smokers (p < 0.05), and linearly with altitude (p < 10(-4)). Also there was a strong positive relation between chronic bronchitis and clinical farmer's lung (odds ratio 19.5 (95% confidence interval 12.1-31.4) after adjustment for confounding variables. The main finding of this study is the highly significant increase of prevalence of the diseases in relation to altitude.

  1. Anti-inflammatory effect of laser therapy at complex treatment of the chronic bronchitis

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    N.A. Faradjeva

    2010-03-01

    Full Text Available The research goal is to reveal influence of laser therapy on endobronchial changes and integrated indicator of inflammatory process in complex treatment of patients with chronic bronchitis. 64 patients with chronic bronchitis divided into 2 clinical groups have been under study: 33 patients with chronic purulent obstructive bronchitis and 31 - with chronic purulent nonobstructive bronchitis. Bronchial fibroscopic investigation of mucous membrane of bronchial tubes and biochemical research of blood have been performed to reveal endobronchitis degree and integrated indicator of inflammatory process. Indicators have been expressed in points: under 1 - moderated, 1-2 - expressed and more than 2 points - sharp changes. Results have demonstrated that the combination of drug therapy with endobronchial laser irradiation has an optimum anti-inflammatory effect indicated by decrease of endobronchitis degree - 1,12 and 0,81 points and integrated indicator - 1,75 and 0,75 (Р <0,01. That allows to recommend introduction of endobronchial laser irradiation into the complex therapy of chronic bronchitis

  2. [Comparative analysis of serum proteomic profiles between patients with silicosis and chronic bronchitis].

    Science.gov (United States)

    Miao, Rongming; Ding, Bangmei; Zhang, Yingyi; Wu, Weimin; Fang, Zhonghua; Zhao, Rui; Xia, Qian; Li, Yong; Zhu, Baoli

    2015-08-01

    To analyze the differences in serum proteomic profiles between patients with silicosis and chronic bronchitis and to investigate the pathogenesis, clinical diagnosis, and treatment of these two disease. Serum samples from patients with stage I silicosis and chronic bronchitis were collected. Two-dimensional gel electrophoresis was performed and protein plots with expression differences higher than 2-fold were identified and further analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Compared with the silicosis group, the chronic bronchitis group had 11 up-regulated proteins and 23 down-regulated proteins. The chronic bronchitis group had high expression of proteins such as interferon beta precursor, apolipoprotein precursor, and transforming growth factor beta1 precursor. The silicosis group had high expression of proteins such as interleukin-6, granzyme A, cathepsin G, and glycoprotein precursor. The differentially expressed proteins are mainly involved in the activity of serine enzymes, cytotoxicity, inflammation response, and apolipoprotein transfer and play different roles in silicosis and chronic bronchitis.

  3. The use of moxifloxacin for acute exacerbations of chronic obstructive pulmonary disease and chronic bronchitis.

    Science.gov (United States)

    Wilson, Robert; Macklin-Doherty, Aislinn

    2012-11-01

    Chronic obstructive pulmonary disease is a common condition which causes considerable morbidity and mortality. It is a heterogenous disorder in which the majority of patients have chronic bronchitis. Bacterial infections are a major cause of acute exacerbations of both conditions which have a major impact on healthcare resources, quality of life and disease progression. Antibiotics are used to treat exacerbations involving purulent sputum production, together with increased breathlessness and/or sputum volume. Moxifloxacin is a quinolone antibiotic and is one of the treatment options. This article discusses pathophysiology of these diseases, moxifloxacin clinical studies and appropriate use of moxifloxacin.

  4. Early investigational antibiotics for the treatment of acute exacerbations of chronic bronchitis.

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    Falagas, Matthew E; Georgiou, Maria

    2017-03-01

    Acute exacerbations in patients with chronic bronchitis are a leading cause of hospitalizations and death. Bacteria contribute significantly to such exacerbations. The aim of this review was to explore the potential role of investigational antibiotics in the treatment of these episodes. Areas covered: The available literature in PubMed database, in websites related to investigational drugs and in websites of the producing companies has been searched. The in vitro activity against pathogens involved in acute exacerbations of chronic bronchitis and the pharmacokinetic profile of antibiotics currently under development were taken into consideration for inclusion in the review. Expert opinion: Several novel antimicrobial agents have completed preclinical and Phase I studies and were well-tolerated. Further investigation is mandatory in order to evaluate their future in treatment of chronic bronchitis exacerbations and discover potential advantages compared to already approved antimicrobials.

  5. Psychological Distress in Women with Chronic Bronchitis in a Fishing Community in the Niger Delta Region of Nigeria

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    Victor Aniedi Umoh

    2013-01-01

    Full Text Available Background. Biomass smoke exposure is a known risk factor for chronic bronchitis. Psychiatric comorbidities may have significant impact on the quality of life of patients with chronic bronchitis. Methods. Women who engage in fish preservation by drying over burning firewood in a fishing community were recruited for this survey. The British medical research questionnaire was used to determine chronic bronchitis, and psychological distress was determined using the hospital anxiety and depression scale. Results. A total of 342 women were recruited for this study and 63 of them had chronic bronchitis. 96 women had features suggestive of psychological distress: 57 (16.6% women with anxiety, 51 (14.9% women with depression and 12 women (3.5% had combined features. Psychological distress was more common among women with chronic bronchitis. Anxiety was significantly associated with chronic bronchitis and the level of biomass exposure while depression was significantly associated with chronic bronchitis, level of exposure, and a history of sleeping in the fish smoking room. Conclusion. Anxiety and depression show significant association with chronic bronchitis among women with biomass smoke exposure with the level of exposure having an aggravating effect on the relationship.

  6. The effect of beta-blockers on ventilatory function in chronic bronchitis.

    Science.gov (United States)

    Ranchod, A; Keeton, G R; Benatar, S R

    1982-03-20

    The effect of propranolol and atenolol on air-flow obstruction in patients with chronic bronchitis was evaluated by means of a double-blind, placebo-controlled cross-over trial. Fifteen patients with chronic bronchitis and mild air-flow obstruction, in whom there was no clinical suggestion of asthma, were studied. Two patients developed symptomatic increases in air-flow obstruction on propranolol and were withdrawn from the study. A symptomatically insignificant but statistically significant increase in air-flow obstruction was observed during treatment with both propranolol and atenolol.

  7. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines.

    Science.gov (United States)

    Braman, Sidney S

    2006-01-01

    The purpose of this review is to present the evidence for the diagnosis and treatment of cough due to acute bronchitis and make recommendations that will be useful for clinical practice. Acute bronchitis is one of the most common diagnoses made by primary care clinicians and emergency department physicians. It is an acute respiratory infection with a normal chest radiograph that is manifested by cough with or without phlegm production that lasts for up to 3 weeks. Respiratory viruses appear to be the most common cause of acute bronchitis; however, the organism responsible is rarely identified in clinical practice because viral cultures and serologic assays are not routinely performed. Fewer than 10% of patients will have a bacterial infection diagnosed as the cause of bronchitis. The diagnosis of acute bronchitis should be made only when there is no clinical or radiographic evidence of pneumonia, and the common cold, acute asthma, or an exacerbation of COPD have been ruled out as the cause of cough. Acute bronchitis is a self-limited respiratory disorder, and when the cough persists for >3 weeks, other diagnoses must be considered. Recommendations for this review were obtained from data using a National Library of Medicine (PubMed) search dating back to 1950, which was performed in August 2004. The search was limited to literature published in the English language and human studies, using search terms such as "cough," "acute bronchitis," and "acute viral respiratory infection." Unfortunately, most previous controlled trials guiding the treatment of acute bronchitis have not vigorously differentiated acute bronchitis and the common cold, and also have not distinguished between an acute exacerbation of chronic bronchitis and acute asthma as a cause of acute cough. For patients with the putative diagnosis of acute bronchitis, routine treatment with antibiotics is not justified and should not be offered. Antitussive agents are occasionally useful and can be offered as

  8. [Use of bronchovaxom in the treatment of patients with chronic obstructive bronchitis and bronchial asthma].

    Science.gov (United States)

    Shmelev, E I; Sokolova, L V; Kosmiadi, G A; Abramova, Z P; Filippov, V P; Evgushchenko, G V

    1995-01-01

    Polyvalent vaccine bronchovaxom (BV) was studied for efficacy against chronic obstructive bronchitis and bronchial asthma exacerbation. Good results were reported: reduction of disability duration, number of recurrences, cough intensity, discharged sputum. Laboratory tests discovered that BV brought about IgE decrease, IgA, T3, T4/T8 increase in bronchoalveolar lavage.

  9. [Treatment with thymopentine of chronic bronchitis in elderly patients during seasonal prophylaxis].

    Science.gov (United States)

    Santagata, A

    1990-02-28

    The design of the present study permits to analyse the efficacy of thymopentin treatment in seasonal prophylaxis of chronic bronchitis in elderly patients. The immunologic and symptomatic responses were observed and evaluated. The elderly female patients, observed in the present study, were followed for six months after treatment with thymopentin.

  10. A pro-inflammatory role for the Frizzled-8 receptor in chronic bronchitis

    NARCIS (Netherlands)

    Spanjer, Anita I. R.; Menzen, Mark H.; Dijkstra, Akkelies E.; van den Berge, Maarten; Boezen, H. Marike; Nickle, David C.; Sin, Don D.; Bosse, Yohan; Brandsma, Corry-Anke; Timens, Wim; Postma, Dirkje S.; Meurs, Herman; Heijink, Irene H.; Gosens, Reinoud

    Rationale We have previously shown increased expression of the Frizzled-8 receptor of the Wingless/integrase-1 (WNT) signalling pathway in COPD. Here, we investigated if the Frizzled-8 receptor has a functional role in airway inflammation associated with chronic bronchitis. Methods Acute

  11. Mortality in GOLD stages of COPD and its dependence on symptoms of chronic bronchitis

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    Nilsson Peter M

    2005-08-01

    Full Text Available Abstract Background The GOLD classification of COPD severity introduces a stage 0 (at risk comprising individuals with productive cough and normal lung function. The aims of this study were to investigate total mortality risks in GOLD stages 0–4 with special focus on stage 0, and furthermore to assess the influence of symptoms of chronic bronchitis on mortality risks in GOLD stages 1–4. Method Between 1974 and 1992, a total of 22 044 middle-aged individuals participated in a health screening, which included a spirometry as well as recording of respiratory symptoms and smoking habits. Individuals with comorbidity at baseline (diabetes, stroke, cancer, angina pectoris, or heart infarction were excluded from the analyses. Hazard ratios (HR 95% CI of total mortality were analyzed in GOLD stages 0–4 with individuals with normal lung function and without symptoms of chronic bronchitis as a reference group. HR:s in smoking individuals with symptoms of chronic bronchitis within the stages 1–4 were calculated with individuals with the same GOLD stage but without symptoms of chronic bronchitis as reference. Results The number of deaths was 3674 for men and 832 for women based on 352 324 and 150 050 person-years respectively. The proportion of smokers among men was 50% and among women 40%. Self reported comorbidity was present in 4.6% of the men and 6.6% of the women. Among smoking men, Stage 0 was associated with an increased mortality risk, HR; 1.65 (1.32–2.08, of similar magnitude as in stage 2, HR; 1.41 (1.31–1.70. The hazard ratio in stage 0 was significantly higher than in stage 1 HR; 1.13 (0.98–1.29. Among male smokers with stage 1; HR: 2.04 (1.34–3.11, and among female smokers with stage 2 disease; HR: 3.16 (1.38–7.23, increased HR:s were found in individuals with symptoms of chronic bronchitis as compared to those without symptoms of chronic bronchitis. Conclusion Symptoms fulfilling the definition of chronic bronchitis were

  12. Exposure to Outdoor Air Pollution and Chronic Bronchitis in Adults: A Case-Control Study

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    P Salameh

    2012-08-01

    Full Text Available Background: Although Lebanon is a highly polluted country, so far no study has specifically been designed to assess the association between outdoor air pollution and chronic bronchitis in this country. Objective: To assess the association between exposure to outdoor air pollution and chronic bronchitis in Lebanon. Methods: A pilot case-control study was conducted in two tertiary care hospitals. Cases consisted of patients diagnosed with chronic bronchitis by a pulmonologist and those epidemiologically confirmed. Controls included individuals free of any respiratory signs or symptoms. After obtaining informed consent, a standardized questionnaire was administered. Results: Bivariate, stratified (over smoking status and gender and multivariate analyses revealed that passive smoking at home (ORa: 2.56, 95% CI: 1.73–3.80 and at work (ORa: 1.89, 95% CI: 1.13–3.17; older age (ORa: 1.75, 95% CI: 1.55–2.39; lower education (ORa: 1.44, 95% CI: 1.21–1.72; living close to a busy road (ORa: 1.95, 95% CI: 1.31– 2.89 and to a local power plant (ORa: 1.62, 95% CI: 1.07–2.45; and heating home by hot air conditioning (ORa: 1.85, 95% CI: 1.00–3.43 were moderately associated with chronic bronchitis; an inverse association was found with heating home electrically (ORa: 0.58, 95% CI: 0.39–0.85. A positive dose-effect relationship was observed in those living close to a busy road and to a local diesel exhaust source. Conclusion: Chronic bronchitis is associated with outdoor air pollution.

  13. Correlates of COPD and chronic bronchitis in nonsmokers: data from a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Khayat G

    2012-09-01

    Full Text Available Mirna Waked,1 Joseph Salame,2 Georges Khayat,3 Pascale Salameh41Faculty of Medicine, Balamand University, and St George Hospital, Beirut, Lebanon; 2Lebanese University, Faculty of Medicine, Beirut, Lebanon; 3Faculty of Medicine, St Joseph University and Hôtel Dieu de France Hospital, Beirut, Lebanon; 4Lebanese University, Faculties of Pharmacy and Public Health, Beirut, LebanonPurpose: Our objective was to assess the prevalence of chronic bronchitis and chronic obstructive pulmonary disease (COPD and their correlates among a Lebanese nonsmoker group.Material and methods: A cross-sectional study was conducted between October 2009 and September 2010, using a multistage cluster sample throughout Lebanon including Lebanese residents aged 40 years and above with no exclusion criteria. Pre- and postbronchodilator spirometry measurements were performed and carbon monoxide level was measured in exhaled air. COPD was defined and classified according to the Global Initiative for Chronic Obstructive Lung Disease guidelines or according to the lower limit of normal (forced expiratory volume in 1 second/forced vital capacity postbronchodilator < 5th percentile of the healthy population having the same age and sex. Chronic bronchitis was defined by the declaration of morning cough and expectorations for more than 3 months a year over more than 2 years in individuals with normal spirometry.Results: Out of 2201 individuals, 732 were never-smokers: 25 (3.4% of them had COPD, and 86 (11.75% fulfilled the definition of chronic bronchitis. Correlates of COPD included a childhood respiratory disease, house heated by diesel, and older age. On the other hand, correlates of chronic bronchitis included childhood respiratory diseases, living in southern Lebanon versus other regions, heating home by gas, older age, number of smokers at work, and lower height.Conclusion: A substantial percentage of the nonsmoking population may exhibit chronic bronchitis or COPD. The

  14. Haemophilus influenzae oral vaccination for preventing acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease.

    Science.gov (United States)

    Teo, Edward; Lockhart, Kathleen; Purchuri, Sai Navya; Pushparajah, Jennifer; Cripps, Allan W; van Driel, Mieke L

    2017-06-19

    Chronic bronchitis and chronic obstructive pulmonary disease (COPD) are serious conditions in which patients are predisposed to viral and bacterial infections resulting in potentially fatal acute exacerbations. Chronic obstructive pulmonary disease is defined as a lung disease characterised by obstruction to lung airflow that interferes with normal breathing. Antibiotic therapy has not been particularly useful in eradicating bacteria such as non-typeable Haemophilus influenzae (NTHi) because they are naturally occurring flora of the upper respiratory tract in many people. However, they can cause opportunistic infection. An oral NTHi vaccine has been developed to protect against recurrent infective acute exacerbations in chronic bronchitis. To assess the effectiveness of an oral, whole-cell NTHi vaccine in protecting against recurrent episodes of acute exacerbations of chronic bronchitis and COPD in adults. To assess the effectiveness of NTHi vaccine in reducing NTHi colonising the respiratory tract during recurrent episodes of acute exacerbations of COPD. We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (2017, Issue 1), MEDLINE (1946 to January 2017), Embase (1974 to January 2017), CINAHL (1981 to January 2017), LILACS (1985 to January 2017), and Web of Science (1955 to January 2017). We also searched trials registries and contacted authors of trials requesting unpublished data. We included randomised controlled trials comparing the effects of an oral monobacterial NTHi vaccine in adults with recurrent acute exacerbations of chronic bronchitis or COPD when there was overt matching of the vaccine and placebo groups on clinical grounds. The selection criteria considered populations aged less than 65 years and those older than 65 years. Two review authors independently assessed trial quality and extracted data from original records and publications for incidence and severity of bronchitis episodes and carriage rate of

  15. Persistent and Recurrent Bacterial Bronchitis-A Paradigm Shift in Our Understanding of Chronic Respiratory Disease.

    Science.gov (United States)

    Ishak, Alya; Everard, Mark L

    2017-01-01

    The recent recognition that the conducting airways are not "sterile" and that they have their own dynamic microbiome, together with the rapid advances in our understanding of microbial biofilms and their roles in the causation of respiratory diseases (such as chronic bronchitis, sinusitis, and chronic otitis media), permit us to update the "vicious circle" hypothesis of the causation of bronchiectasis. This proposes that chronic inflammation driven by persistent bacterial bronchitis (PBB) causes damage to both the epithelium, resulting in impaired mucociliary clearance, and to the airway wall, which eventually manifests as bronchiectasis. The link between a "chronic bronchitis" and a persistence of bacterial pathogens, such as non-typable Haemophilus influenzae , was first made more than 100 years ago, and its probable role in the causation of bronchiectasis was proposed soon afterward. The recognition that the "usual suspects" are adept at forming biofilms and hence are able to persist and dominate the normal dynamically changing "healthy microbiome" of the conducting airways provides an explanation for the chronic colonization of the bronchi and for the associated chronic neutrophil-dominated inflammation characteristic of a PBB. Understanding the complex interaction between the host and the microbial communities of the conducting airways in health and disease will be a key component in optimizing pulmonary health in the future.

  16. Growth, Nutritional Status, and Pulmonary Function in Children with Chronic Recurrent Bronchitis.

    Science.gov (United States)

    Umławska, Wioleta; Lipowicz, Anna

    2016-01-01

    Bronchitis is a common health problem in children. Frequent bronchitis in infancy increases the risk of developing chronic respiratory diseases. The aim of the study was to assess the level of growth and the nutritional status in children and youths with special regard to the level of body fatness assessed by measuring skin-fold thickness. Relationships between somatic development, pulmonary function and the course of the disease were also explored. The study was carried out using anthropometric and spirometric measurements and also information on the severity and course of the disease in 141 children with chronic or recurrent bronchitis. All of the subjects were patients of the Pulmonary Medicine and Allergology Center in Karpacz, Poland. The mean body height did not differ significantly between the children examined and their healthy peers. However, the infection-prone children had excessive body fatness and muscle mass deficiency. The increased level of subcutaneous adipose tissue occurred especially in children with short duration of the disease, i.e. a maximum of 1 year. The functional lung parameters were generally normal. The presence of atopic diseases such as allergic rhinitis or atopic dermatitis did not impair the course of the children's somatic development. Also, long-term disease or the presence of additional allergic diseases did not impair lung function in the examined children. Taking appropriate preventive measures is recommended to achieve and maintain normal body weight in children who receive therapy due to bronchitis.

  17. Prulifloxacin versus levofloxacin in the treatment of severe COPD patients with acute exacerbations of chronic bronchitis.

    Science.gov (United States)

    Blasi, F; Schaberg, T; Centanni, S; Del Vecchio, A; Rosignoli, M T; Dionisio, P

    2013-10-01

    Antimicrobial therapy of chronic bronchitis exacerbations in patients with severe chronic obstructive pulmonary disease (COPD) is based on empiric antibiotic treatment. To evaluate the efficacy of prulifloxacin versus levofloxacin therapy in severe COPD patients with exacerbations of chronic bronchitis. This study involved a multicenter, parallel, double-blind, randomized clinical trial. Patients aged 40 years or older, smokers, or ex-smokers (>10 pack-years) with spirometrically confirmed severe COPD (FEV1 ≤ 50% predicted and FEV1/FVC ratio acute exacerbation of chronic bronchitis were enrolled in the study. Patients were randomized to receive prulifloxacin 600 mg once a day or levofloxacin 500 mg once a day for 7 days. The primary outcome measure was clinical assessment at the TOC visit (7-10 days after the end of treatment) of signs and symptoms of exacerbation, namely sputum purulence, sputum volume, dyspnoea, cough and body temperature assessed through semi-quantitative scales. The ITT population included 346 (174 prulifloxacin, 172 levofloxacin) out of 351 treated subjects. A total of 161 patients with prulifloxacin (92.5%) and 166 with levofloxacin (96.5%) were considered cured at TOC (the difference in the percentage of cured patients was -3.98 with 95%CI of -8.76; 0.79). At the 6-month follow-up, the rates of patients with no relapse of AECB were higher than 95% in both the prulifloxacin and levofloxacin groups. Both prulifloxacin and levofloxacin showed efficacy rates higher than 90% in the treatment of severe COPD patients with exacerbations of chronic bronchitis, with no statistically significant differences between the two antibiotics. The long-term follow-up confirmed a very low incidence of relapse, endorsing the appropriateness of this therapeutic approach. EUDRACT no. 2006-004167-56. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. [Double-blind clinical trial comparing 5 days of dirithromycin versus 7 days of diacetylmidecamycin in acute bronchitis and acute exacerbations of chronic bronchitis].

    Science.gov (United States)

    Sacristán, J A; Elviro, J; García de Lomas, J; Palomino-Nicás, J; Sobradillo, V; Sánchez Gascón, F; Valencia, A; Calbo, F; Viejo, J L; Zamarrón, C; Coca, E; Casado, M A; García Pérez, L E; Hernández, J M

    1997-01-01

    Dirythromycin has several pharmacokinetic characteristics (long half life and high tissue concentrations) which suggest the possibility of administering shorter treatments than those conventionally used. The aim of this study was to determine and compare the efficacy of a 5 day treatment with dirythromycin once a day, versus diacetylmidecamycin twice a day over 7 days in the treatment of patients with acute bronchitis and acute exacerbations of chronic bronchitis. A parallel, multicentric, randomized, double blind clinical study was carried out in 8 Spanish hospitals. One hundred seventy-four patients were included in the study, with 87 (80 evaluable) being randomly assigned to receive dirythromycin (500 mg/day over 5 days) and 87 (83 evaluable) diacetylmidecamycin (600 mg, twice daily over 7 days). A favorable symptomatic response (cure or improvement) was observed in 72/80 of the first group (90%) and in 74/83 (89.2%) of the second group. No statistically significant differences were found in the efficacy and safety between the two treatment groups in either the evaluable patients or on intention to treat analysis. The results of this study suggest that the administration of dirythromycin, once a day over 5 days, is as safe and effective as diacetylmidecamycin, twice a day over 7 days, in the treatment of acute bronchitis and acute exacerbations of chronic bronchitis.

  19. Spirometric abnormalities associated with chronic bronchitis, asthma, and airway hyperresponsiveness among boilermaker construction workers

    Energy Technology Data Exchange (ETDEWEB)

    Hauser, R.; Eisen, E,A,; Pothier, L,; Lewis, D,; Bledsoe, T,; Christiani, D.C. [Harvard University, Boston, MA (United States). School of Public Health

    2002-06-01

    In a 2-year longitudinal study of boilermaker construction workers, authors found a significant association between working at oil-fired, coal-fired, and gas-fired industries during the past year and reduced lung function. In the present study, authors investigated whether chronic bronchitis, asthma, or baseline methacholine airway responsiveness can explain the heterogeneity in lung function response to boilermaker work. Exposure was assessed with a work history questionnaire. Spirometry was performed annually to assess lung function. A generalized estimating equation approach was used to account for the repeated-measures design. One hundred eighteen boilermakers participated in the study. Self-reported history of chronic bronchitis and asthma were associated with a larger FEV1 reduction in response to workplace exposure at coal-fired and gas-fired industries. Although a high prevalence (39%) of airway hyperresponsiveness (provocative concentration of methacholine causing a 20% fall in FEVI of {lt} 8 mg/mL) among boilermakers was found, there was no consistent pattern of effect modification by airway responsiveness. Conclusions: Although chronic bronchitis and asthma were associated with a greater loss in lung function in response to hours worked as a boilermaker, and therefore they acted as effect modifiers of the exposure-lung function relationship, airway hyperresponsiveness did not. However, the high prevalence of airway hyperresponsiveness found in the cohort may be a primary consequence of long-term workplace exposure among boilermakers.

  20. The clinical impact of non-obstructive chronic bronchitis in current and former smokers.

    Science.gov (United States)

    Martinez, Carlos H; Kim, Victor; Chen, Yahong; Kazerooni, Ella A; Murray, Susan; Criner, Gerard J; Curtis, Jeffrey L; Regan, Elizabeth A; Wan, Emily; Hersh, Craig P; Silverman, Edwin K; Crapo, James D; Martinez, Fernando J; Han, Meilan K

    2014-03-01

    As the clinical significance of chronic bronchitis among smokers without airflow obstruction is unclear, we sought to determine morbidity associated with this disorder. We examined subjects from the COPDGene study and compared those with FEV1/FVC ≥ 0.70, no diagnosis of asthma and chronic bronchitis as defined as a history of cough and phlegm production for ≥ 3 months/year for ≥ 2 years (NCB) to non-obstructed subjects without chronic bronchitis (CB-). Multivariate analysis was used to determine factors associated with and impact of NCB. We identified 597 NCB and 4283 CB- subjects. NCB participants were younger (55.4 vs. 57.2 years, p NCB subjects demonstrated worse quality-of-life (SGRQ 35.6 vs. 15.1, p NCB. While longitudinal data will be needed to determine whether NCB progresses to COPD, NCB patients have poorer quality-of-life, exercise capacity and frequent respiratory events. Beyond smoking cessation interventions, further research is warranted to determine the benefit of other therapeutics in this population. Clinical Trials Registration # NCT00608764 (http://clinicaltrials.gov/show/NCT00608764). Link to study protocol: http://www.copdgene.org/sites/default/files/COPDGeneProtocol-5-0_06-19-2009.pdf. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Acute respiratory illness as a trigger for detecting chronic bronchitis in adults at risk of COPD: a primary care survey.

    Science.gov (United States)

    Roche, Nicolas; Gaillat, Jacques; Garre, Michel; Meunier, Jean-Pierre; Lemaire, Nicolas; Bendjenana, Hakim

    2010-12-01

    To evaluate the impact of chronic bronchitis in patients identified among subjects at risk of chronic obstructive pulmonary disease (COPD) but currently free from any known chronic respiratory disorder, visiting a general practitioner for an acute respiratory episode. A multicentre, cross-sectional survey carried out in primary care. Primary care practitioners (n = 772) examined 14,030 patients with acute cough (male: 56.9%, age 50.6 ± 16.5 years). Of these, 3,615 were at risk of COPD (> 40 years and tobacco use > 10 pack-years) and constituted the study population: 79.8% reported current symptoms of chronic bronchitis. Compared to patients without chronic bronchitis, they were older, more frequently exposed to occupational pollutants or to passive smoking, had more tobacco use (p Grade 2 more frequently, and had poorer quality of life as assessed by the EuroQOL-5D questionnaire. In this survey, previously unrecognised chronic bronchitis was diagnosed in a high proportion of at-risk patients with acute respiratory episodes. Chronic bronchitis was associated with significantly poorer health status. Acute respiratory illness could be an appropriate opportunity for screening those patients at risk of COPD with lung function testing.

  2. WITHDRAWN: Haemophilus influenzae oral whole cell vaccination for preventing acute exacerbations of chronic bronchitis.

    Science.gov (United States)

    Foxwell, A Ruth; Cripps, Allan W; Dear, Keith Bg

    2010-10-06

    Acute bronchitis leading to ongoing exacerbations is a serious condition predisposed to by viruses, bacteria or environmental factors. It can be fatal. Antibiotic therapy is not particularly useful. An oral Haemophilus influenzae vaccine has been developed. To assess the effects of an oral, monobacterial whole-cell, killed, nontypeable H. influenzae vaccine in protecting against recurrent acute episodes in chronic bronchitis. In this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to January Week 4 2006), EMBASE (1990 to September 2005) and ISI Current Contents (2004 to May 2006). Randomised controlled trials (RCTs) comparing the effects of the H. influenzae vaccine on patients with recurrent acute exacerbations of chronic bronchitis were included when there was overt matching of the vaccine and placebo groups on clinical grounds. Three authors extracted data and assessed trial quality independently from original records and publications for incidence and severity of bronchitis episodes and carriage rate of nontypeable H. influenzae measured in the upper respiratory tract every three months following vaccination. Six trials were included in the study with a total of 440 participants. The vaccine reduced the incidence of bronchitic episodes at three months after vaccination (rate ratio is 0.69; 95% CI 0.41 to 1.14) and at six months after vaccination (rate ratio 0.82; 95% CI 0.62 to 1.09). If these results been statistically significant, they would have represented a reduction in acute bronchitic attacks for vaccinated individuals of 31% at three months, and 18% at six. The effect had disappeared by nine months. The severity of exacerbations in the treatment group, as measured by requirement to prescribe antibiotics, was likewise reduced by 58% at three months (Peto odds ratio = 0.42; 95% CI 0.16 to 1.13), and by 65% at six months (Peto odds ratio = 0.35; 95% CI 0.16 to 0

  3. Chronic bronchitis and chronic obstructive pulmonary disease: Finnish National Guidelines for Prevention and Treatment 1998-2007.

    Science.gov (United States)

    Laitinen, L A; Koskela, K

    1999-05-01

    1. A national recommendation for the promotion of prevention, treatment and rehabilitation in relation to chronic bronchitis and COPD from 1998 to 2007 has been prepared on the basis of extensive collaboration by order of the Ministry of Social Affairs and Health. The Programme needs to be revised as necessary, because of rapid developments in medical knowledge, and in drug therapy in particular. 2. COPD is a disease characterized by slowly progressing, irreversible airways obstruction. Over 5% of the population suffer from symptomatic forms of the disease. It is estimated that a further 5% of the population may suffer from latent COPD. Most patients (75%) suffer from mild forms of the disease. The disease is often preceded by chronic bronchitis. A total of 400,000 Finns suffer from chronic bronchitis or COPD. Occurrence of these diseases in future will be particularly affected by decreased smoking by men, increased smoking by the young and by women, and aging of the population. 3. In 1997, the annual treatment costs of chronic bronchitis and COPD were estimated to be FIM 1.5 thousand million, total costs FIM 5 thousand million. Without intensification of measures to prevent and treat the diseases, costs will rise significantly. Costs arising from severe COPD (5% of patients with COPD) account for roughly 65% of costs overall and are primarily related to hospitalizations. 4. The goals of the Programme for the Prevention and Treatment of Chronic Bronchitis and COPD are as follows: (a) to decrease the incidence of chronic bronchitis; (b) to ensure that as many patients as possible with chronic bronchitis recover; (c) to maintain capacity for work and functional capacity of patients with COPD; (d) to reduce the percentage of patients with moderate to severe COPD; (e) to decrease the number of hospitalization days of COPD patients by 25% overall; and (f) to decrease annual costs per patient. 5. The following means are suggested for achieving the goals: (a) reduction in

  4. Evaluation of the efficacy of pidotimod in the exacerbations in patients affected with chronic bronchitis.

    Science.gov (United States)

    Bisetti, A; Ciappi, G; Bariffi, F; Catena, E; Rocco, V; Vaccaro, L; Grassi, V; Scarpazza, G; Bertoli, L; Cardani, A

    1994-12-01

    The efficacy and safety of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl)carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6), a new oral synthetic immunostimulating agent, were investigated in a multicentre study, performed in 10 university and hospital centres of pneumophthisiology and respiratory physiopathology, according to a double-blind vs. placebo experimental design. Primary objective of the investigation was to verify the efficacy of pidotimod against infectious exacerbations in patients affected with chronic bronchitis. 181 inpatients or outpatients (117 male, 64 female; mean age: 62.5 years), affected with chronic bronchitis, were enrolled in the study. Pidotimod 800 mg/die or placebo sachets were administered by oral route for 60 consecutive days, followed by a 60-day follow-up period. Clinical observations were performed at baseline (D 0), after 30 (D 30) and 60 (D 60) days of treatment, as well as at the end of the follow-up (D 120). Time and frequency of infectious relapses were considered as the target variable for the evaluation of the efficacy of the drug. Clinical picture, expectoration characteristics, spirometric parameters and laboratory tests were monitored to evaluate patients' conditions. The results indicate that pidotimod is significantly more effective than placebo against infectious relapses in patients suffering from chronic bronchitis. During the first month, 9% of patients treated with pidotimod were affected with an infectious relapse vs. 39.5% of patients treated with placebo (chi 2, p < 0.001). In the second month, infectious episodes were reported by 1.2% of patients treated with the drug vs. 46.1% of patients treated with placebo (chi 2, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Pulmonary strongyloidiasis presenting as chronic bronchitis leading to interlobular septal fibrosis and cured by treatment.

    Science.gov (United States)

    Mukerjee, Chitta M; Carrick, Jane; Walker, John C; Woods, Robert L

    2003-12-01

    Two patients presented with long-standing chronic bronchitis and exertional dyspnoea of 5 and 3 months' duration, respectively, and had interlobular septal fibrosis on chest high resolution CT. In the past both had lived in areas in which Strongyloides stercoralis was known to be endemic. Serological tests confirmed the diagnosis of pulmonary strongyloidiasis, and both patients were treated with anti-helminthic medications, including albendazole and ivermectin. Following this there was complete resolution of both symptomatic and radiological manifestations of their disease. An awareness of the possibility of Strongyloides infection presenting with respiratory symptoms in patients exposed to this parasite is important in the management of such patients.

  6. Acute Bronchitis.

    Science.gov (United States)

    Kinkade, Scott; Long, Natalie A

    2016-10-01

    Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. Pertussis should be suspected in patients with cough persisting for more than two weeks that is accompanied by symptoms such as paroxysmal cough, whooping cough, and post-tussive emesis, or recent pertussis exposure. The cough associated with acute bronchitis typically lasts about two to three weeks, and this should be emphasized with patients. Acute bronchitis is usually caused by viruses, and antibiotics are not indicated in patients without chronic lung disease. Antibiotics have been shown to provide only minimal benefit, reducing the cough or illness by about half a day, and have adverse effects, including allergic reactions, nausea and vomiting, and Clostridium difficile infection. Evaluation and treatment of bronchitis include ruling out secondary causes for cough, such as pneumonia; educating patients about the natural course of the disease; and recommending symptomatic treatment and avoidance of unnecessary antibiotic use. Strategies to reduce inappropriate antibiotic use include delayed prescriptions, patient education, and calling the infection a chest cold.

  7. [Therapeutic efficacy and general tolerability of 4-carbomethoxythiazolidine chlorohydrate in patients with exacerbated chronic bronchitis].

    Science.gov (United States)

    Scillieri, E

    1990-01-01

    4-carbomethoxythiazolidine HCl has been administered to 24 patients (aged between 64 and 86) suffering from new acute stages of chronic bronchitis. The patients have been submitted to a double-blind test and have been subdivided into four groups; each of them was administered a placebo or the a.m. product. Dosage: 200, 400 and 600 mg/d. The following symptoms have been evaluated: cough; dyspnea; bronchial breathings; expectoration; expectorate's viscosity; expectorate's volume. The data have been submitted to a statistic analyses, this research leads to the followings considerations. A dosage of 200 mg/d. is not significantly active on any on the considered parameters. The 400 mg dosage turns out to be noticeably more effective than the placebo on all parameters (except the difficulty in expectoration). A dosage of 600 mg/d. has a significant effect on all the measurable parameters. Finally, a 200 mg dosage of 4-carbomethoxythiazolidine three times a day results to be the best posology in the symptomatic treatment of the respiratory manifestations of chronic bronchitis.

  8. Chronic Bronchitis in Miners and Non-miners: An Epidemiological Survey of a Community in the Gold-mining Area in the Transvaal1

    Science.gov (United States)

    Sluis-Cremer, G. K.; Walters, L. G.; Sichel, H. S.

    1967-01-01

    An epidemiological survey to determine the prevalence of chronic bronchitis in a mixed mining and non-mining population of Carletonville on the Witwatersrand is described. Eight hundred and twenty-seven men over the age of 35 years were investigated. Chronic bronchitis is shown to significantly more common in miners than in non-miners for every age and smoking category with the exception of the non-smoker no significant difference exists in the prevalence of chronic bronchitis between the mining and non-mining groups. Smoking habits were found to have overwhelming effects on the prevalence of chronic bronchitis in both groups. It is suggested that a synergistic interplay of smoking and general underground aerial pollution (rather than dust inhalation alone) is responsible for the excess prevalence of chronic bronchitis in the miner who smokes. PMID:6017135

  9. Cross-sectional associations between air pollution and chronic bronchitis : an ESCAPE meta-analysis across five cohorts

    NARCIS (Netherlands)

    Cai, Yutong; Schikowski, Tamara; Adam, Martin; Buschka, Anna; Carsin, Anne-Elie; Jacquemin, Benedicte; Marcon, Alessandro; Sanchez, Margaux; Vierkoetter, Andrea; Al-Kanaani, Zaina; Beelen, Rob; Birk, Matthias; Brunekreef, Bert; Cirach, Marta; Clavel-Chapelon, Franoise; Declercq, Christophe; de Hoogh, Kees; de Nazelle, Audrey; Ducret-Stich, Regina E.; Ferretti, Virginia Valeria; Forsberg, Bertil; Gerbase, Margaret W.; Hardy, Rebecca; Heinrich, Joachim; Hoek, Gerard; Jarvis, Debbie; Keidel, Dirk; Kuh, Diana; Nieuwenhuijsen, Mark J.; Ragettli, Martina S.; Ranzi, Andrea; Rochat, Thierry; Schindler, Christian; Sugiri, Dorothea; Temam, Sofia; Tsai, Ming-Yi; Varraso, Raphaelle; Kauffmann, Francine; Kraemer, Ursula; Sunyer, Jordi; Kuenzli, Nino; Probst-Hensch, Nicole; Hansell, Anna L.

    2014-01-01

    Background This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD, SALIA, SAPALDIA) participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project. Methods

  10. Grepafloxacin in Patients with Acute Bacterial Exacerbations of Chronic Bronchitis - a Question of Speed in Bacterial Killing

    Directory of Open Access Journals (Sweden)

    Jerome J Schentag

    1998-01-01

    Full Text Available OBJECTIVE: To characterize the population pharmacokinetics and pharmacodynamics of oral grepafloxacin in patients with acute bacterial exacerbations of chronic bronchitis (ABECB, with particular attention to the speed of bacterial killing. This was possible because the study design incorporated daily cultures of the patients’ sputum.

  11. Ambroxol therapy in simple chronic bronchitis: effects on subjective symptoms and ventilatory function.

    Science.gov (United States)

    Ericsson, C H; Juhász, J; Jönsson, E; Mossberg, B

    1986-10-01

    Ambroxol, a metabolite of bromhexine, was investigated in a double-blind, controlled trial using parallel groups. We studied the effects of 60 mg and 120 mg daily versus placebo in subjects with simple chronic bronchitis. Possible therapeutic effects were evaluated by means of interviews on subjective drug effects and current respiratory symptomatology, patient diary cards, and lung function tests. Ninety-seven subjects entered the study and 92 completed satisfactorily. Comparison with the placebo group at the end of the study showed that significantly more subjects in the 120 mg ambroxol group reported improvement in respiratory symptoms, principally improved expectoration. Subjects in the 120 mg group tended to prefer the treatment period when compared to placebo but the diary cards did not indicate significant changes. Lung function values were mainly normal and did not change during treatment. We conclude that the drug had a symptomatic effect and that further studies in more severely affected patients would be worthwhile.

  12. Canadian Guidelines for the Management of Acute Exacerbations of Chronic Bronchitis

    Directory of Open Access Journals (Sweden)

    Meyer S Balter

    2003-01-01

    Full Text Available Acute exacerbations of chronic bronchitis (AECB account for over 1.5 million physician visits annually in Canada and are a cause of significant morbidity and mortality. This document represents a joint effort between respirologists, microbiologists, infectious disease specialists and family physicians to update the Canadian AECB guidelines published in 1994. Treatment recommendations are graded on the strength of evidence in the published literature where possible. The role for oral corticosteroid therapy in preventing treatment failures, speeding up recovery and delaying the time to next exacerbation is discussed. Risk factors for treatment failure were used to stratify patients into risk groups to help guide antibiotic treatment recommendations. The importance of emerging antimicrobial resistance to current antibiotics is reviewed and strategies to prevent future AECB episodes are suggested.

  13. Bronchitis (acute).

    Science.gov (United States)

    Wark, Peter

    2011-06-20

    Acute bronchitis affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens. The role of smoking or of environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear. One third of people may have longer-term symptoms or recurrence. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute bronchitis in people without chronic respiratory disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics (macrolides, tetracyclines, cephalosporins, penicillins, or trimethoprim-sulfamethoxazole [co-trimoxazole]), antihistamines, antitussives, beta(2) agonists (inhaled or oral), and expectorants/mucolytics.

  14. Environmental exposure as an independent risk factor of chronic bronchitis in northwest Russia

    Directory of Open Access Journals (Sweden)

    Tuula Toljamo

    2013-02-01

    Full Text Available Background. In some parts of the northwest Russia, Murmansk region, high exposures to heavy mining and refining industrial air pollution, especially sulphur dioxide, have been documented. Objective. Our aim was to evaluate whether living in the mining area would be an independent risk factor of the respiratory symptoms. Design. A cross-sectional survey of 200 Murmansk region adult citizens was performed. The main outcome variable was prolonged cough with sputum production that fulfilled the criteria of chronic bronchitis. Results. Of the 200 participants, 53 (26.5% stated that they had experienced chronic cough with phlegm during the last 2 years. The prevalence was higher among those subjects living in the mining area with its high pollution compared to those living outside this region (35% vs. 18%. Multivariable regression model confirmed that the risk for the chronic cough with sputum production was elevated in a statistical significant manner in the mining and refining area (adjusted OR 2.16, 95% CI 1.07–4.35 after adjustment for smoking status, age and sex. Conclusions. The increased level of sulphur dioxide emitted during nickel mining and refining may explain these adverse health effects. This information is important for medical authorities when they make recommendations and issue guidelines regarding the relationship between environmental pollution and health outcomes.

  15. Environmental exposure as an independent risk factor of chronic bronchitis in northwest Russia.

    Science.gov (United States)

    Nieminen, Pentti; Panychev, Dmitry; Lyalyushkin, Sergei; Komarov, German; Nikanov, Alexander; Borisenko, Mark; Kinnula, Vuokko L; Toljamo, Tuula

    2013-01-01

    In some parts of the northwest Russia, Murmansk region, high exposures to heavy mining and refining industrial air pollution, especially sulphur dioxide, have been documented. Our aim was to evaluate whether living in the mining area would be an independent risk factor of the respiratory symptoms. A cross-sectional survey of 200 Murmansk region adult citizens was performed. The main outcome variable was prolonged cough with sputum production that fulfilled the criteria of chronic bronchitis. Of the 200 participants, 53 (26.5%) stated that they had experienced chronic cough with phlegm during the last 2 years. The prevalence was higher among those subjects living in the mining area with its high pollution compared to those living outside this region (35% vs. 18%). Multivariable regression model confirmed that the risk for the chronic cough with sputum production was elevated in a statistical significant manner in the mining and refining area (adjusted OR 2.16, 95% CI 1.07-4.35) after adjustment for smoking status, age and sex. The increased level of sulphur dioxide emitted during nickel mining and refining may explain these adverse health effects. This information is important for medical authorities when they make recommendations and issue guidelines regarding the relationship between environmental pollution and health outcomes.

  16. Geo-climatic heterogeneity in self-reported asthma, allergic rhinitis and chronic bronchitis in Italy

    Energy Technology Data Exchange (ETDEWEB)

    Pesce, G., E-mail: giancarlo.pesce@univr.it [Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona (Italy); Bugiani, M. [Unit of Respiratory Medicine and Allergology, CPA-ASL TO-2, Turin (Italy); Marcon, A.; Marchetti, P. [Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona (Italy); Carosso, A. [Unit of Respiratory Medicine and Allergology, CPA-ASL TO-2, Turin (Italy); Accordini, S. [Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona (Italy); Antonicelli, L. [Dept of Internal Medicine, Immuno-Allergic and Respiratory Diseases, Ospedali Riuniti di Ancona, Ancona (Italy); Cogliani, E. [Casaccia Research Centre, Italian National Agency for New Technologies, Energy, and Substainable Economic Development (ENEA), Rome (Italy); Pirina, P. [Institute of Respiratory Diseases, University of Sassari, Sassari (Italy); Pocetta, G. [Dept of Experimental Medicine, University of Perugia, Perugia (Italy); Spinelli, F. [Casaccia Research Centre, Italian National Agency for New Technologies, Energy, and Substainable Economic Development (ENEA), Rome (Italy); Villani, S. [Dept of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia (Italy); Marco, R. de [Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona (Italy)

    2016-02-15

    Background: Several studies highlighted a great variability, both between and within countries, in the prevalence of asthma and chronic airways diseases. Aim: To evaluate if geo-climatic variations can explain the heterogeneity in the prevalence of asthma and respiratory diseases in Italy. Methods: Between 2006 and 2010, a postal screening questionnaire on respiratory health was administered to 18,357 randomly selected subjects, aged 20–44, living in 7 centers in northern, central, and southern Italy. A random-effects meta-analysis was fitted to evaluate the between-centers heterogeneity in the prevalence of asthma, asthma-like symptoms, allergic rhinitis, and chronic bronchitis (CB). A principal component analysis (PCA) was performed to synthetize the geo-climatic information (annual mean temperature, range of temperature, annual rainfalls, global solar radiations, altitude, distance from the sea) of all the 110 Italian province capital towns. The associations between these geo-climatic components obtained with PCA and the prevalence of respiratory diseases were analyzed through meta-regression models. Results: 10,464 (57%) subjects responded to the questionnaire. There was a significant between-centers heterogeneity in the prevalence of asthma (I{sup 2} = 59.5%, p = 0.022) and CB (I{sup 2} = 60.5%, p = 0.019), but not in that of asthma-like symptoms or allergic rhinitis. Two independent geo-climatic components explaining together about 80% of the overall geo-climatic variability were identified: the first principally summarized the climatic variables; the second the topographic ones. Variations in the prevalence of asthma across centers were significantly associated with differences in the climatic component (p = 0.017), but not with differences in the topographic one. Conclusions: Our findings suggest that climate play a role in determining the between-center heterogeneity in the prevalence of asthma in Italy, with higher prevalence in dry-hot Mediterranean

  17. [Trace elements in the pathogenesis and treatment of chronic bronchitis (a clinico-experimental study)].

    Science.gov (United States)

    Tadzhiev, F S

    1991-01-01

    Experiments on healthy male rats and those with chronic inflammation in the bronchi (CIB) were made to measure the content of testosterone, estradiol, zinc and copper in the blood and in the liquid of bronchoalveolar lavage (LBAL) as well as in the vitally important organs. Attempts were also made to equalize the content of trace elements by means of medicamentous correction in patients suffering from chronic obstructive bronchitis (COB). In CIB, there was a decrease of testosterone concentration in the blood and of zinc concentration in the plasma and formed elements of the blood, lungs, heart, liver, testes and adrenals (p less than 0.05). The zinc level in the LBAL was two times higher, that of copper was three times lower. After zinc sulfate was included into a complex of treatment measures for COB patients, zinc and copper concentrations in the plasma and formed elements of the blood returned to normal in addition to the improvement of the general health status. In the reference group of patients who received conventional symptomatic treatment, the given parameters did not noticeably change.

  18. Urbanization and Daily Exposure to Biomass Fuel Smoke Both Contribute to Chronic Bronchitis Risk in a Population with Low Prevalence of Daily Tobacco Smoking.

    Science.gov (United States)

    Miele, Catherine H; Jaganath, Devan; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Gilman, Robert H; Johnson, Caroline M; Diette, Gregory B; Wise, Robert A; Checkley, William

    2016-01-01

    Risk factors beyond tobacco smoking associated with chronic bronchitis are not well understood. We sought to describe the prevalence and risk factors of chronic bronchitis across four distinct settings in Peru with overall low prevalence of tobacco smoking yet varying degrees of urbanization, daily exposure to biomass fuel smoke and living at high altitude. We analyzed data of 2,947 participants from rural and urban Puno, Lima and Tumbes including spirometry, blood samples, anthropometry and administered questionnaires about respiratory symptoms. We used multivariable Poisson regression to assess biologic, socioeconomic and environmental risk factors associated with chronic bronchitis. Overall prevalence of chronic bronchitis was 5.9% (95%CI 5.1%-6.9%) with variation by setting: prevalence was lower in semi-urban Tumbes (1.3%) vs. highly urbanized Lima (8.9%), urban Puno (7.0%) and rural Puno (7.8%; p < 0.001). Chronic bronchitis was more common among participants with vs. without COPD based on FEV1/FVC< LLN (12.1% vs 5.6%, p < 0.01) and it was associated with increased reporting of dyspnea on exertion (p < 0.001), hospitalization (p = 0.003) and workdays missed due to respiratory symptoms (p < 0.001). Older age (Prevalence ratio [PR] = 1.23 for each 10-years of age, 95%CI 1.09-1.40) past history of asthma (PR = 2.87, 95%CI 1.80-4.56), urbanization (PR = 3.34, 95%CI 2.18-5.11) and daily exposure to biomass fuel smoke (PR = 2.00, 95%CI 1.30-3.07) were all associated with chronic bronchitis. We found important variations in the prevalence of chronic bronchitis across settings. Prevalence increased with both urbanization and with daily exposure to biomass fuel smoke. Having chronic bronchitis was also associated with worse patient-centered outcomes including dyspnea, hospitalization and missed workdays.

  19. [Effectiveness of and tolerance to ceftibuten in the treatment of chronic bacterial bronchitis exacerbations in an elderly population].

    Science.gov (United States)

    Allegra, L; Catena, E; Pozzi, E; Centanni, S

    1996-10-01

    117 patients suffering for bacterial exacerbation of chronic bronchitis were treated with ceftibuten, a new orally administered cephalosporin, at the dosage of 400 mg once a day for 7.9 days (range 5-14). The results, referring to 105 evaluable patients, underlyne ceftibutent's efficacy (good clinical results in 96.1% of 102 treated patients) and safety; before and after treatment values of spirometric tests were notable in terms of improvement of lung functions.

  20. Prevalence and incidence of chronic bronchitis and farmer's lung with respect to the geographical location of the farm and to the work of farmers.

    Science.gov (United States)

    Vohlonen, I; Tupi, K; Terho, E O; Husman, K

    1987-01-01

    Prevalence and incidence of chronic bronchitis and farmer's lung in the Finnish farming population were studied by cross-sectional and follow-up surveys of 12,056 farmers. Occurrence of both these diseases varied greatly according to geographical location of the farm. The incidence of chronic bronchitis (2,687 new cases annually per 100,000 farmers) was twice as large in southwestern as in northern Finland. Chronic bronchitis was more common among farmers in livestock production than among those in grain production. The definition of farmer's lung adopted confined the occurrence of the disease among farmers engaged in animal tending. In livestock production, chronic bronchitis was strongly associated with swine tending, but farmer's lung with both cattle and swine tending. Use of a harvester with a sack loader turned out to be characteristic of the chronic bronchitis cases, and the number of new cases was largest among farmers who used a batch type cell drier. The farmers with grain driers that use unheated air most frequently suffered from farmer's lung. Of all (147) the characteristics of farming occupation analyzed, the methods of grain handling and drying were the most important factors for predisposing farmers to chronic bronchitis and farmer's lung.

  1. Prevalence of chronic bronchitis and respiratory function in a group of dairy farmers in the French Doubs province.

    Science.gov (United States)

    Dalphin, J C; Bildstein, F; Pernet, D; Dubiez, A; Depierre, A

    1989-06-01

    We used a questionnaire combined with medical history and spirometric studies to compare symptoms and respiratory function in two groups of subjects living in the French province of Doubs. A group of 250 dairy farmers was compared with 250 control subjects, matched with regard to sex, age, height, and smoking habits. The prevalence of acute bronchial infections and dyspnea was identical in the two groups. Among dairy farmers, 30 (12 percent) had chronic bronchitis vs 15 (6 percent) in the control group (p less than 0.05). Chronic bronchitis was more common in patients aged over 40 years (p less than 0.001) and in nonsmokers (p less than 0.001). All respiratory function parameters measured (expressed as a mean percentage of values measured in comparison with theoretic values) were lower in the dairy farmer group than in the control group. With regard to degree of bronchial obstruction, the difference between the two groups was more marked in patients aged 40 years and over and in nonsmokers. Dairy farmers' occupation is a risk factor of chronic bronchitis and bronchial obstruction, in particular in patients aged 40 years and over and in nonsmokers.

  2. Bronchitis - acute

    Science.gov (United States)

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflamed tissue in the main ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  3. Industrial bronchitis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000072.htm Industrial bronchitis To use the sharing features on this page, please enable JavaScript. Industrial bronchitis is swelling (inflammation) of the large airways ...

  4. Agricultural exposures and chronic bronchitis: findings from the AGRICAN (AGRIculture and CANcer) cohort.

    Science.gov (United States)

    Tual, Séverine; Clin, Bénédicte; Levêque-Morlais, Noémie; Raherison, Chantal; Baldi, Isabelle; Lebailly, Pierre

    2013-09-01

    Livestock farming has been recognized as a risk factor for chronic bronchitis (CB). The role of crop farming, however, has been less studied. We sought to assess the role of a large range of farming activities on the risk of CB in the French agricultural cohort AGRICAN (AGRIculture and CANcer). Data on respiratory health and farming activities were collected by questionnaire from 2005 to 2007. Associations between farming activities and self-reported doctor's diagnosis of CB were estimated by a logistic regression adjusted for confounders. CB was reported by 1207 farmers (8.4%). Two farming activities were associated with CB: cattle raising (odds ratio [OR] 1.24, 95% confidence interval 1.03-1.48), and potato production (OR 1.33, 95% confidence interval 1.13-1.57). Associations were more pronounced in small-scale cattle raising and in large-scale potato production, in particular among the longest exposed workers (≥20 years). Pesticide poisoning and exposure to pesticides in potato farmers were significantly associated with CB risk (OR 1.64 and OR 1.63, respectively). This analysis suggests that other agricultural settings not previously reported, such as potato production, may be a risk factor for CB. The nature and circumstances of exposure to hazardous agents need to be further explored. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. [Effects of drug cupping therapy on immune function in chronic asthmatic bronchitis patients during protracted period].

    Science.gov (United States)

    Zhang, Cai-qing; Liang, Tie-jun; Zhang, Wei

    2006-11-01

    To observe the clinical effect of drug cupping therapy (DCT, cupping therapy with pingchuan ointment made by the authors themselves in the cups) on chronic asthmatic bronchitis (CAB) during the protracted period, and explore its effect on immune function. Seventy-seven patients were randomly divided into two groups:the treated group (n=40) treated by orally taken Liuwei Dihuang Pill (LDP) and DCT and the control group (n=37) with LDP and common cupping therapy without drug in cups. The changes of T-lymphocyte subset, levels of interferon-gamma (IFN-gamma), interleukin (IL), immunoglobulin (Ig), complement 3 and 4 (C3 and C4) were detected before and after treatment. The total effective rate was higher in the treated group than that in the control group (90.0% vs. 59.5%, P < 0.01). The levels of CD4+, CD4+ /CD8+, IL-2, IFN-gamma, C3, C4, IgA, IgG and IgM increased, while the levels of IgE, IL-4, IL-10 and CD8+ decreased after treatment in both groups (P < 0.05 or P < 0.01), the improvements were better in the treated group than that in the control group (P < 0.05). DCT shows better curative effects than that of common cupping therapy without drug, it could improve the cellular and humoral immunity in CAB patients.

  6. Comparison of ceftibuten versus amoxicillin/clavulanate in the treatment of acute exacerbations of chronic bronchitis.

    Science.gov (United States)

    Aubier, M A

    1997-01-01

    The efficacy and tolerability of once- or twice-daily ceftibuten (400 mg daily) were compared with three-times daily amoxicillin/clavulanate (AMX/CA, 500 mg/125 mg) in the treatment of acute exacerbations of chronic bronchitis (AECB) in an open, parallel-group 10- to 14-day study in 443 patients. Patients were assessed at baseline and on days 5, 10-14 and after 4-6 weeks of treatment, and the clinical response defined as cured, improved, stabilized or failed. Clinical efficacy between the 3 groups was equivalent (p = 0.002) with 90% of patients in each group responding to treatment (cured or improved) and the incidence of complete cures (with no clinical signs of relapse) was also equivalent. In conclusion, this study showed that ceftibuten is clinically equivalent to a standard regimen of amoxicillin/clavulanate in the treatment of AECB, including those patients infected with Streptococcus pneumonia. Ceftibuten was better tolerated than AMX/CA and was associated with significantly fewer gastrointestinal side effects. Furthermore, once-daily was a well tolerated and effective as twice-daily ceftibuten.

  7. Burden of smoking among adults with COPD, chronic bronchitis, and emphysema in urban China.

    Science.gov (United States)

    Goren, A; Gupta, S; Dong, P; Feng, Y; Chen, C; Liu, D

    2015-09-01

    Tobacco, widely used in China, poses a major risk for chronic obstructive pulmonary disease (COPD). This study assessed health outcomes of COPD-diagnosed smokers vs. never smokers and examined treatment patterns of patients attempting to quit smoking in urban China. National Health and Wellness Survey (NHWS) 2010 and 2012 China data were analysed. Respondents self-reporting diagnosis with COPD, chronic bronchitis, or emphysema were categorised: quit attempters (current smokers 'trying to quit' or non-smokers 'in the process of quitting'), smokers (including quit attempters) and those who never smoked. Respondents reported smoking cessation treatment utilisation; health status: SF-36v2-based scores and SF-6D health utilities; Work Productivity and Activity Impairment questionnaire-based metrics; and resource utilisation. Regression modelling assessed health outcomes, controlling for covariates. Among 1421 (3.6%) diagnosed respondents, 51.6% never smoked and 35.5% smoked (of whom, 43.8% were attempting to quit). After adjustments, smokers vs. never smokers had significantly lower health utilities, lower mental/physical health status and greater absenteeism, presenteeism, overall work impairment, activity impairment, emergency room visits, hospitalisations and provider visits. Quit attempters were diagnosed an average 6.9 years (SD = 7.7) previously, with 25.3% reporting moderate/severe COPD. Most-reported main causes of COPD were: smoking (57.5%), illnesses/conditions (53.8%) and pollutants (44.3%). Among quit attempters, 82.8% smoked currently. Use of prescription cessation treatments was reported by 12.7%. Smokers experienced poorer health outcomes, reinforcing importance of prevention in mitigating disease burden. Among quit attempters, few reported using prescription cessation treatments. Given the high burden imposed by smoking in China, effective interventions may be beneficial. © 2015 John Wiley & Sons Ltd.

  8. Impact of exacerbations on health care cost and resource utilization in chronic obstructive pulmonary disease patients with chronic bronchitis from a predominantly Medicare population

    OpenAIRE

    Pasquale MK; Sun SX; Song F; Hartnett HJ; Stemkowski SA

    2012-01-01

    Margaret K Pasquale,1 Shawn X Sun,2 Frank Song,1 Heather J Hartnett,1 Stephen A Stemkowski11Competitive Health Analytics, Louisville, KY, USA; 2Health Economics and Outcomes Research, Forest Research Institute, Jersey City, NJ, USABackground: Exacerbations of chronic obstructive pulmonary disease (COPD) lead to significant increases in resource utilization and cost to the health care system. COPD patients with chronic bronchitis and a history of exacerbations pose an additional burden to the ...

  9. Diverging trends of chronic bronchitis and smoking habits between 1998 and 2010

    Directory of Open Access Journals (Sweden)

    Accordini Simone

    2013-02-01

    Full Text Available Abstract Background No study has been carried out on the time trend in the prevalence of chronic bronchitis (CB in recent years, despite its clinical and epidemiological relevance. We evaluated the trend in CB prevalence during the past decade among young Italian adults. Methods A screening questionnaire was mailed to general population samples of 20–44 year-old subjects in two cross-sectional surveys: the Italian Study on Asthma in Young Adults (ISAYA (1998/2000; n = 18,873, 9 centres and the screening stage of the Gene Environment Interactions in Respiratory Diseases (GEIRD study (2007/2010; n = 10,494, 7 centres. CB was defined as having cough and phlegm on most days for a minimum of 3 months a year and for at least 2 successive years. The prevalence rates and the risk ratios (RRs for the association between CB and each potential predictor were adjusted for gender, age, season of response, type of contact, cumulative response rate, and centre. Results CB prevalence was 12.5% (95% CI: 12.1-12.9% in 1998/2000 and 12.6% (95% CI: 11.7-13.7% in 2007/2010; it increased among never smokers (from 7.6 to 9.1%, p = 0.003, current light smokers ( Conclusions Despite the significant reduction in current smoking, CB prevalence did not vary among young Italian adults. The temporal pattern of CB prevalence can only be partly explained by the increase of unemployment/premature retirement, asthma and allergic rhinitis, and suggests that other factors could have played a role.

  10. Pidotimod in the treatment of patients affected by bacterial exacerbations of chronic bronchitis.

    Science.gov (United States)

    Pozzi, E; Dolcetti, A; Orlandi, O; Cirianni, C; Moreo, G; Piacenza, G; Rampulla, C; Fugazza, L; Scarpazza, G

    1994-12-01

    A multicentre double-blind placebo-controlled study was conducted in order to assess the effects of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl) carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6), a new synthetic biological response modifier, on the clinical picture of bacterial exacerbations of chronic bronchitis. Seven centres of respiratory diseases participated in the trial. A total of 137 patients, 103 males and 34 females (mean age: 65.0 years) were admitted to the study. The trial was subdivided into 3 phases. During the first 8-day phase (D0-D8), 68 patients received 800 mg pidotimod orally (one sachet) twice daily and an antibiotic treatment (amoxycillin plus clavulanic acid: 1 g twice daily), while 69 patients received placebo (one sachet) and antibiotic according to the same dosage schedule. In the second 7-day phase (D8-D15), while the double-blind therapy proceeded, the antibiotic treatment was stopped. The third phase (D15-D45) consisted of a 30-day follow-up period. Five clinical observations, at D0, D4, D8, D15 and D45, were scheduled. The Skin test, to evaluate immunocompetence, was carried out at D0, D15 and D45. The faster improvement of symptomatology (dyspnoea, cough, sputum, hyperpyrexia) in the patients in the pidotimod group compared with the placebo group was reflected in recovery time: mean 8.9 days in the pidotimod group versus 10.7 days in the placebo group (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Proteomic profiling differences in serum from silicosis and chronic bronchitis patients: a comparative analysis

    Science.gov (United States)

    Miao, Rongming; Ding, Bangmei; Zhang, Yingyi; Xia, Qian; Li, Yong

    2016-01-01

    Background Silicosis is a severe occupational disease characterized by pulmonary fibrosis, whereas chronic bronchitis (CB) is an acute inflammation of the airways. Differences in the mechanisms of pathogenesis of these diseases are not well understood, therefore we performed proteomic profiling of silicosis and CB patients and, compared the results. Methods Two-dimensional gel electrophoresis and MALDI-TOF-MS (matrix assisted laser desorption ionization time of flight mass spectrometry) were used to identify differentially accumulated proteins in stage I of silicosis (SI), stage II of silicosis (SII) and CB. Enzyme linked immunosorbent assay (ELISA) was employed to validate protein expression data. Results A total of 28 and 10 proteins were up- and down-regulated in SI, and 21 and 9 proteins were up- and down-regulated SII, compared with CB. Transforming growth factor beta-1 precursor and interferon beta precursor were up-regulated in CB, while interleukin 6, tumor necrosis factor (TNF) and a variant TNF receptor 13B were down-regulated in CB. Additionally, glycoprotein- and apolipoprotein-associated proteins including apolipoprotein A-IV and α-1-B-glycoprotein were up-regulated in CB, indicating an involvement in the pathogenesis of CB but not silicosis. By contrast, HLA-DRB1, medullasin and the proto-oncogene c-Fos were up-regulated in CB. Conclusions The immune, metabolism and apolipoprotein-related proteins were identified as playing specific and different roles in silicosis and CB. These proteomic profiling differences would facilitate further studies on the mechanisms underlying silicosis and CB, and may also prove useful to disease diagnosis and treatments. PMID:27076939

  12. Direct labelling of ipratropium bromide aerosol and its deposition pattern in normal subjects and patients with chronic bronchitis.

    OpenAIRE

    Spiro, S G; Singh, C A; Tolfree, S E; Partridge, M. R.; Short, M.D.

    1984-01-01

    A technique for the direct labelling of ipratropium bromide with bromine-77, with reconstitution of the drug in a metered dose inhaler so as to be identical to the commercial product, was used to study drug deposition patterns in seven normal subjects and seven patients with chronic bronchitis (mean FEV1 32% (SD 12.2%) predicted normal). The gamma camera image of the thorax was divided into a middle zone--the mediastinal zone--and the lung itself into a central zone comprising its medial thir...

  13. Bronchitis (acute)

    OpenAIRE

    Wark, Peter

    2015-01-01

    Acute bronchitis affects more than 40 in 1000 adults per year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.One third of people may have longer-term symptoms or recurrence.

  14. Current asthma contributes as much as smoking to chronic bronchitis in middle age: a prospective population-based study

    Directory of Open Access Journals (Sweden)

    Dharmage SC

    2016-08-01

    Full Text Available Shyamali C Dharmage,1 Jennifer L Perret,1,2, John A Burgess,1 Caroline J Lodge,1 David P Johns,3 Paul S Thomas,4 Graham G Giles,1,5 John L Hopper,1,6 Michael J Abramson,7,8 E Haydn Walters,3,9, Melanie C Matheson1 1Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, The University of Melbourne, 2Institute for Breathing and Sleep (IBAS, Melbourne, VIC, 3“Breathe Well” Center of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, 4Inflammation and Infection Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, 5Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, VIC, Australia; 6Department of Public Health, Seoul National University, Seoul, South Korea; 7Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, 8School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 9School of Medicine, University of Tasmania, Hobart, TAS, Australia Background and objective: Personal smoking is widely regarded to be the primary cause of chronic bronchitis (CB in adults, but with limited knowledge of contributions by other factors, including current asthma. We aimed to estimate the independent and relative contributions to adult CB from other potential influences spanning childhood to middle age.Methods: The population-based Tasmanian Longitudinal Health Study cohort, people born in 1961, completed respiratory questionnaires and spirometry in 1968 (n=8,583. Thirty-seven years later, in 2004, two-thirds responded to a detailed postal survey (n=5,729, from which the presence of CB was established in middle age. A subsample (n=1,389 underwent postbronchodilator spirometry between 2006 and 2008 for the assessment of chronic airflow limitation, from which nonobstructive and obstructive CB were defined. Multivariable and multinomial logistic regression models were used to estimate

  15. Lung flute improves symptoms and health status in COPD with chronic bronchitis: A 26 week randomized controlled trial.

    Science.gov (United States)

    Sethi, Sanjay; Yin, Jingjing; Anderson, Pamela K

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is characterized by mucus hypersecretion that contributes to disease related morbidity and is associated with increased mortality. The Lung Flute® is a new respiratory device that produces a low frequency acoustic wave with moderately vigorous exhalation to increase mucus clearance. We hypothesized that the Lung Flute, used on a twice daily basis will provide clinical benefit to patients with COPD with chronic bronchitis. We performed a 26 week randomized, non-intervention controlled, single center, open label trial in 69 patients with COPD and Chronic Bronchitis. The primary endpoint was change in respiratory symptoms measured with the Chronic COPD Questionnaire (CCQ). Secondary endpoints included health status, assessed by the St. George Respiratory questionnaire (SGRQ), BODE (Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity) index score and exacerbation frequency. While the control patients did not demonstrate any significant changes in the primary endpoint (CCQ change at 26 weeks of +0.01, p = 0.8), a trend (p = 0.08) to decrease (improvement) in the CCQ (-0.23 at 26 weeks) was seen with the Lung Flute. Furthermore, a significant improvement in the symptom domain of the CCQ was seen only with the lung flute (-0.42, p = 0.004). Health status (SGRQ) improvement, was also only seen with the Lung Flute (-3.23, p = 0.03). The BODE score increased in the control group (3.31 at baseline, 4.14 at 26 weeks), however it remained stable in the Lung Flute arm (3.16 at baseline and 26 weeks), with the changes from baseline being significantly different between the 2 arms (p = 0.01). There was a trend for less exacerbations in the Lung Flute group (p = 0.07). Adverse effects were minor, with only 1 patient discontinuing treatment because of lack of efficacy. Serious adverse effects seen were all determined to be unrelated to the device use. The Lung Flute is a safe and effective

  16. Efficacy and safety of moxifloxacin in acute exacerbations of chronic bronchitis: a prospective, multicenter, observational study (AVANTI

    Directory of Open Access Journals (Sweden)

    Chuchalin Alexander

    2013-01-01

    Full Text Available Abstract Background Acute exacerbations of chronic bronchitis (AECB, including chronic obstructive pulmonary disease (AECOPD, represent a substantial patient burden. Few data exist on outpatient antibiotic management for AECB/AECOPD in Eastern/South Eastern Europe, in particular on the use of moxifloxacin (Avelox®, although moxifloxacin is widely approved in this region based on evidence from international clinical studies. Methods AVANTI (AVelox® in Acute Exacerbations of chroNic bronchiTIs was a prospective, observational study conducted in eight Eastern European countries in patients > 35 years with AECB/AECOPD to whom moxifloxacin was prescribed. In addition to safety and efficacy outcomes, data on risk factors and the impact of exacerbation on daily life were collected. Results In the efficacy population (N = 2536, chronic bronchitis had been prevalent for > 10 years in 31.4% of patients and 66.0% of patients had concomitant COPD. Almost half the patients had never smoked, in contrast to data from Western Europe and the USA, where only one-quarter of COPD patients are non-smokers. The mean number of exacerbations in the last 12 months was 2.7 and 26.3% of patients had been hospitalized at least once for exacerbation. Physician compliance with the recommended moxifloxacin dose (400 mg once daily was 99.6%. The mean duration of moxifloxacin therapy for the current exacerbation (Anthonisen type I or II in 83.1%; predominantly type I was 6.4 ± 1.9 days. Symptom improvement was reported after a mean of 3.4 ± 1.4 days. After 5 days, 93.2% of patients reported improvement and, in total, 93.5% of patients were symptom-free after 10 days. In the safety population (N = 2672, 57 (2.3% patients had treatment-emergent adverse events (TEAEs and 4 (0.15% had serious TEAEs; no deaths occurred. These results are in line with the known safety profile of moxifloxacin. Conclusions A significant number of patients in this

  17. Efficacy and safety of moxifloxacin in acute exacerbations of chronic bronchitis: a prospective, multicenter, observational study (AVANTI).

    Science.gov (United States)

    Chuchalin, Alexander; Zakharova, Maryna; Dokic, Dejan; Tokić, Mahir; Marschall, Hans-Peter; Petri, Thomas

    2013-01-23

    Acute exacerbations of chronic bronchitis (AECB), including chronic obstructive pulmonary disease (AECOPD), represent a substantial patient burden. Few data exist on outpatient antibiotic management for AECB/AECOPD in Eastern/South Eastern Europe, in particular on the use of moxifloxacin (Avelox®), although moxifloxacin is widely approved in this region based on evidence from international clinical studies. AVANTI (AVelox® in Acute Exacerbations of chroNic bronchiTIs) was a prospective, observational study conducted in eight Eastern European countries in patients > 35 years with AECB/AECOPD to whom moxifloxacin was prescribed. In addition to safety and efficacy outcomes, data on risk factors and the impact of exacerbation on daily life were collected. In the efficacy population (N = 2536), chronic bronchitis had been prevalent for > 10 years in 31.4% of patients and 66.0% of patients had concomitant COPD. Almost half the patients had never smoked, in contrast to data from Western Europe and the USA, where only one-quarter of COPD patients are non-smokers. The mean number of exacerbations in the last 12 months was 2.7 and 26.3% of patients had been hospitalized at least once for exacerbation. Physician compliance with the recommended moxifloxacin dose (400 mg once daily) was 99.6%. The mean duration of moxifloxacin therapy for the current exacerbation (Anthonisen type I or II in 83.1%; predominantly type I) was 6.4 ± 1.9 days. Symptom improvement was reported after a mean of 3.4 ± 1.4 days. After 5 days, 93.2% of patients reported improvement and, in total, 93.5% of patients were symptom-free after 10 days. In the safety population (N = 2672), 57 (2.3%) patients had treatment-emergent adverse events (TEAEs) and 4 (0.15%) had serious TEAEs; no deaths occurred. These results are in line with the known safety profile of moxifloxacin. A significant number of patients in this observational study had risk factors for poor outcome, justifying

  18. Bronchitis (acute)

    OpenAIRE

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  19. Clinical efficacy of farcosolvin syrup (ambroxol–theophylline–guaiphenesin mixture in the treatment of acute exacerbation of chronic bronchitis

    Directory of Open Access Journals (Sweden)

    Mostafa Yakoot

    2010-07-01

    Full Text Available Mostafa Yakoot1, Amel Salem2, Abdel-Mohsen Omar31Green Clinics and Research Center, Alexandria, Egypt; 2Al-Mabarah Hospital, 3Faculty of Pharmacy, Alexandria University, Alexandria, EgyptBackground: Acute exacerbations of chronic bronchitis (AECB are defined as recurrent attacks of worsening bronchial inflammation that are marked by an increase in the volume of daily sputum produced, a change in color of the expectorated sputum, and worsening dyspnea. Farcosolvin® (Pharco Pharmaceuticals, Alexandria, Egypt is a mixture of ambroxol (15 mg; theophylline (50 mg; and guaiphenesin (30 mg, per 5 mL syrup.Objective: To test the clinical efficacy of Farcosolvin in the treatment of AECB in a randomized, single-blinded, controlled study design.Patients and methods: One hundred patients with AECB were randomized to either Farcosolvin or guaiphenesin treatment groups, in addition to the standard medical treatment for their cases. Baseline clinical symptomatolgy of breathlessness, cough, and sputum severity scoring were compared before and after 3 and 7 days of treatment in both groups and the differences compared between groups. Changes in perceived improvement were also compared between groups using the Clinical Global Impression of Improvement or Change Scale (CGIC.Results: There were statistically significant improvements in breathlessness and cough scores in both groups (pretreatment versus posttreatment at day 3 and at day 7; P < 0.05. There were highly statistically significant differences between groups in improvement in ­breathlessness and cough scores, after 3 and 7 days treatment, in favor of the Farcosolvin ­treatment group (P < 0.001. Out of 50 patients, 48 (96% in the Farcosolvin-treated group rated their ­improvement on the CGIC scale as “much” and “very much” improved, while only 41 patients (82% reported such a degree of improvement in the control group. The difference was statistically significant (P < 0.05.Conclusion: We

  20. Aspergillus bronchitis without significant immunocompromise

    National Research Council Canada - National Science Library

    Chrdle, Ales; Mustakim, Sahlawati; Bright‐Thomas, Rowland J; Baxter, Caroline G; Felton, Timothy; Denning, David W

    2012-01-01

    Aspergillus bronchitis is poorly understood and described. We extracted clinical data from more than 400 referred patients with persistent chest symptoms who did not fulfill criteria for allergic, chronic, or invasive aspergillosis...

  1. Clinical efficacy of farcosolvin syrup (ambroxol–theophylline–guaiphenesin mixture) in the treatment of acute exacerbation of chronic bronchitis

    Science.gov (United States)

    Yakoot, Mostafa; Salem, Amel; Omar, Abdel-Mohsen

    2010-01-01

    Background: Acute exacerbations of chronic bronchitis (AECB) are defined as recurrent attacks of worsening bronchial inflammation that are marked by an increase in the volume of daily sputum produced, a change in color of the expectorated sputum, and worsening dyspnea. Farcosolvin® (Pharco Pharmaceuticals, Alexandria, Egypt) is a mixture of ambroxol (15 mg); theophylline (50 mg); and guaiphenesin (30 mg), per 5 mL syrup. Objective: To test the clinical efficacy of Farcosolvin in the treatment of AECB in a randomized, single-blinded, controlled study design. Patients and methods: One hundred patients with AECB were randomized to either Farcosolvin or guaiphenesin treatment groups, in addition to the standard medical treatment for their cases. Baseline clinical symptomatolgy of breathlessness, cough, and sputum severity scoring were compared before and after 3 and 7 days of treatment in both groups and the differences compared between groups. Changes in perceived improvement were also compared between groups using the Clinical Global Impression of Improvement or Change Scale (CGIC). Results: There were statistically significant improvements in breathlessness and cough scores in both groups (pretreatment versus posttreatment at day 3 and at day 7; P < 0.05). There were highly statistically significant differences between groups in improvement in breathlessness and cough scores, after 3 and 7 days treatment, in favor of the Farcosolvin treatment group (P < 0.001). Out of 50 patients, 48 (96%) in the Farcosolvin-treated group rated their improvement on the CGIC scale as “much” and “very much” improved, while only 41 patients (82%) reported such a degree of improvement in the control group. The difference was statistically significant (P < 0.05). Conclusion: We concluded from our study that Farcosolvin syrup might be safe and effective in improving symptoms in cases of acute exacerbation of chronic bronchitis. PMID:20714379

  2. Clinical efficacy of farcosolvin syrup (ambroxol-theophylline-guaiphenesin mixture) in the treatment of acute exacerbation of chronic bronchitis.

    Science.gov (United States)

    Yakoot, Mostafa; Salem, Amel; Omar, Abdel-Mohsen

    2010-08-09

    Acute exacerbations of chronic bronchitis (AECB) are defined as recurrent attacks of worsening bronchial inflammation that are marked by an increase in the volume of daily sputum produced, a change in color of the expectorated sputum, and worsening dyspnea. Farcosolvin (Pharco Pharmaceuticals, Alexandria, Egypt) is a mixture of ambroxol (15 mg); theophylline (50 mg); and guaiphenesin (30 mg), per 5 mL syrup. To test the clinical efficacy of Farcosolvin in the treatment of AECB in a randomized, single-blinded, controlled study design. One hundred patients with AECB were randomized to either Farcosolvin or guaiphenesin treatment groups, in addition to the standard medical treatment for their cases. Baseline clinical symptomatolgy of breathlessness, cough, and sputum severity scoring were compared before and after 3 and 7 days of treatment in both groups and the differences compared between groups. Changes in perceived improvement were also compared between groups using the Clinical Global Impression of Improvement or Change Scale (CGIC). There were statistically significant improvements in breathlessness and cough scores in both groups (pretreatment versus posttreatment at day 3 and at day 7; P < 0.05). There were highly statistically significant differences between groups in improvement in breathlessness and cough scores, after 3 and 7 days treatment, in favor of the Farcosolvin treatment group (P < 0.001). Out of 50 patients, 48 (96%) in the Farcosolvin-treated group rated their improvement on the CGIC scale as "much" and "very much" improved, while only 41 patients (82%) reported such a degree of improvement in the control group. The difference was statistically significant (P < 0.05). We concluded from our study that Farcosolvin syrup might be safe and effective in improving symptoms in cases of acute exacerbation of chronic bronchitis.

  3. Urinary polyaromatic hydrocarbons are associated with adult emphysema, chronic bronchitis, asthma, and infections: US NHANES, 2011-2012.

    Science.gov (United States)

    Shiue, Ivy

    2016-12-01

    Links between environmental chemicals and human health have emerged over the last few decades, but the effects from polyaromatic hydrocarbons were less studied, compared to other commonly known environmental chemicals such as heavy metals, phthalates, arsenic, phenols, pesticides, etc. Therefore, the aim of the study was to examine the relationships of urinary polyaromatic hydrocarbons and adult respiratory health conditions using a large human sample in a national and population-based setting in recent years. Data were retrieved from United States National Health and Nutrition Examination Surveys, 2011-2012 including demographics, self-reported health conditions, and urinary polyaromatic hydrocarbons. Statistical analyses including chi-square test, t test, and survey-weighted logistic regression modeling were performed. Of 5560 American adults aged 20-80, urinary 2-hydroxyfluorene and 3-hydroxyfluorene were positively associated with emphysema (OR, 1.60, 95 % CI 1.26 to 2.03, P = 0.001 and OR, 1.42, 95 % CI 1.15 to 1.77, P = 0.003, respectively) and chronic bronchitis (OR, 1.42, 95 % CI 1.04 to 1.94, P = 0.031 and OR, 1.40, 95 % CI 1.03 to 1.91, P = 0.036, respectively), while 2-hydroxynaphthalene (2-naphthol) was likely to be borderline associated with emphysema and chronic bronchitis. Conversely, urinary 1-hydroxyphenanthrene, 3-hydroxyphenanthrene, 1-hydroxypyrene, and 4-hydroxyphenanthrene were inversely associated with asthma and infections. Urinary polyaromatic hydrocarbons are associated with adult respiratory health conditions, although the causality cannot be established. For future research, studies using large human sample across regions to longitudinally monitor would be suggested. For practice and policy-making, regulation on minimizing polyaromatic hydrocarbons exposure to protect respiratory health might need to be considered in future health and environmental policies and intervention programs.

  4. The impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities: a population-based observational study.

    Science.gov (United States)

    Accordini, Simone; Corsico, Angelo Guido; Calciano, Lucia; Bono, Roberto; Cerveri, Isa; Fois, Alessandro; Pirina, Pietro; Tassinari, Roberta; Verlato, Giuseppe; de Marco, Roberto

    2015-02-12

    Chronic respiratory diseases are a significant cause of morbidity and mortality worldwide. We sought to evaluate the impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities in adults. In the Gene Environment Interactions in Respiratory Diseases study (2007/2010), a screening questionnaire was mailed to 9,739 subjects aged 20-44 (response rate: 53.0%) and to 3,480 subjects aged 45-64 (response rate: 62.3%), who were randomly selected from the general population in Italy. The questionnaire was used to: identify the responders who had asthma, chronic bronchitis, allergic rhinitis or asthma-like symptoms/dyspnoea/other nasal problems; evaluate the total burden [use of hospital services (at least one ED visit and/or one hospital admission) and number of days with reduced activities (lost working days and days with limited, not work related activities) due to any health problems (apart from accidents and injuries) in the past three months]; evaluate the contribution of breathing problems to the total burden (hospitalizations and number of days with reduced activities specifically due to breathing problems). At any age, the all-cause hospitalization risk was about 6% among the subjects without any respiratory conditions, it increased to about 9-12% among the individuals with allergic rhinitis or with asthma-like symptoms/dyspnoea/other nasal problems, and it peaked at about 15-18% among the asthmatics with chronic bronchitis aged 20-44 and 45-64, respectively. The expected number of days with reduced activities due to any health problems increased from 1.5 among the subjects with no respiratory conditions in both the age classes, to 6.3 and 4.6 among the asthmatics with chronic bronchitis aged 20-44 and 45-64, respectively. The contribution of breathing problems to the total burden was the highest among the asthmatics with chronic bronchitis (23-29% of the hospitalization risk and 39-50% of the days with

  5. [Inter-society consensus for the management of respiratory infections: acute bronchitis and chronic obstructive pulmonary disease].

    Science.gov (United States)

    Lopardo, Gustavo; Pensotti, Claudia; Scapellato, Pablo; Caberlotto, Oscar; Calmaggi, Aníbal; Clara, Liliana; Klein, Manuel; Levy Hara, Gabriel; López Furst, María J; Mykietiuk, Analía; Pryluka, Daniel; Rial, María J; Vujacich, Claudia; Yahni, Diego

    2013-01-01

    The Argentine Society for Infectious Diseases and other national societies issued updated practical guidelines for the management of acute bronchitis (AB) and reactivations of chronic obstructive pulmonary disease (COPD) with the aim of promoting rational use of diagnostic and therapeutic resources. AB is a condition characterized by inflammation of the bronchial airways which affects adults and children without underlying pulmonary disease. It is usually caused by a virus. The diagnosis is based on clinical findings after community acquired pneumonia has been ruled out. Treatment of AB is mainly symptomatic. Antibiotics should be used in immune-compromised hosts, patients with chronic respiratory or cardiac diseases and in the elderly with co-morbidities. Reactivation of COPD is defined as an acute change in the patient's baseline clinical situation beyond normal day to day variations, with an increase in dyspnea, sputum production and/or sputum purulence, warranting a change in medication. An increase in one symptom is considered a mild exacerbation, two as moderate, and the presence of three symptoms is considered a severe exacerbation. An infectious agent can be isolated in sputum in 50 to 75% of COPD reactivations. Moderate and severe episodes must be treated with antibiotics, amoxicillin/ beta-lactamase inhibitor, macrolides and fluoroquinolones are first choice drugs.

  6. Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden

    Directory of Open Access Journals (Sweden)

    Nihlén Ulf

    2009-01-01

    Full Text Available Abstract Background There is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults. We examined associations between residential traffic and asthma and COPD in adults in southern Sweden. A postal questionnaire in 2000 (n = 9319, 18–77 years provided disease status, and self-reported exposure to traffic. A Geographical Information System (GIS was used to link geocoded residential addresses to a Swedish road database and an emission database for NOx. Results Living within 100 m of a road with >10 cars/minute (compared with having no heavy road within this distance was associated with prevalence of asthma diagnosis (OR = 1.40, 95% CI = 1.04–1.89, and COPD diagnosis (OR = 1.64, 95%CI = 1.11–2.4, as well as asthma and chronic bronchitis symptoms. Self-reported traffic exposure was associated with asthma diagnosis and COPD diagnosis, and with asthma symptoms. Annual average NOx was associated with COPD diagnosis and symptoms of asthma and chronic bronchitis. Conclusion Living close to traffic was associated with prevalence of asthma diagnosis, COPD diagnosis, and symptoms of asthma and bronchitis. This indicates that traffic-related air pollution has both long-term and short-term effects on chronic respiratory disease in adults, even in a region with overall low levels of air pollution.

  7. [Medication rules of famous veteran traditional Chinese medicine doctor in treatment of chronic bronchitis based on implicit structure model].

    Science.gov (United States)

    Chen, Li-Ping; Cai, Yong-Min; Li, Jian-Sheng

    2017-04-01

    To explore the medication rules of famous veteran traditional Chinese medicine (TCM) doctors in treatment of chronic bronchitis, a structured medical record database for famous veteran TCM doctors in modern clinical books was established. First, Lantern 3.1.2(Kongmin light) implicit structure analysis software was used to build an implicit structure model and make an implicit interpretation. Then, SAS 9.1 was adopted to mine herb-herb, herb-symptom and herb-syndrome association rules. Through the mining, 1 274 commonly used herbs for chronic bronchitis were found, including liquorice, bitter almond, pinellia, dried tangerine or orange peel, poria cocos. The medicine types included antiasthmatic medicine, qi-tonifying medicine, and heat-phlegm removing medicine. The medicine tastes included sweet, pungent and bitter. The meridian distributions included lung, spleen and stomach channels. The famous commonly used prescriptions included Xiaoqinglong decoction, Maxing Shigan decoction and Erchen decoction. The 147-herb implicit structure model for the first diagnosis was built to get 44 hidden variables, 88 hidden classes, 7 comprehensive clustering models, 9 dual herb associations, 50 triple herb associations and 89 quadruple associations. Totally 297 medical records for the second diagnosis were compared to obtain 24 herb-symptom associations, which reduced ephedra, bitter almond, pinellia and added poria cocos, atractylodes, dangshen, 20 dual herb associations and 8 triple herb associations. A model for the top 83 symptoms and top 96 herbs in the first diagnosis was built to get 50 hidden variables and 101 hidden classes. The commonly used herbs of famous veteran TCM doctors included bitter almond, pinellia, dried tangerine or orange peel, poria cocos, which feature mild property and sweet favor and enter lung, spleen, kidney meridians; the commonly herbal pairs included atractylodes and poria cocos, asarum, fructus schisandrae and pinellia, as well as poria cocos

  8. Impact of exacerbations on health care cost and resource utilization in chronic obstructive pulmonary disease patients with chronic bronchitis from a predominantly Medicare population

    Directory of Open Access Journals (Sweden)

    Pasquale MK

    2012-11-01

    Full Text Available Margaret K Pasquale,1 Shawn X Sun,2 Frank Song,1 Heather J Hartnett,1 Stephen A Stemkowski11Competitive Health Analytics, Louisville, KY, USA; 2Health Economics and Outcomes Research, Forest Research Institute, Jersey City, NJ, USABackground: Exacerbations of chronic obstructive pulmonary disease (COPD lead to significant increases in resource utilization and cost to the health care system. COPD patients with chronic bronchitis and a history of exacerbations pose an additional burden to the system. This study examined health care utilization and cost among these patients.Methods: For this retrospective analysis, data were extracted from a large national health plan with a predominantly Medicare population. This study involved patients who were aged 40–89 years, had been enrolled continuously for 24 months or more, had at least two separate insurance claims for COPD with chronic bronchitis (International Classification of Diseases, Ninth Revision, Clinical Modification code 491.xx, and had pharmacy claims for COPD maintenance medications between January 1, 2007, and March 31, 2009. Two years of data were examined for each patient; the index date was defined as the first occurrence of COPD. Baseline characteristics were obtained from the first year of data, with health outcomes tracked in the second year. Severe exacerbation was defined by COPD-related hospitalization or death; moderate exacerbation was defined by oral or parenteral corticosteroid use. Adjusted numbers of exacerbations and COPD-related costs per patient were estimated controlling for demographic and clinical characteristics.Results: The final study sample involved 8554 patients; mean age was 70.1 ± 8.6 years and 49.8% of the overall population had exacerbation, 13.9% had a severe exacerbation only, 29.1% had a moderate exacerbation only, and 6.8% had both a severe and moderate exacerbation. COPD-related mean annual costs were $4069 (all figures given in US dollars for the

  9. Cefditoren versus levofloxacin in patients with exacerbations of chronic bronchitis: serum inflammatory biomarkers, clinical efficacy, and microbiological eradication

    Directory of Open Access Journals (Sweden)

    Blasi F

    2013-02-01

    Full Text Available Francesco Blasi, Paolo Tarsia, Marco Mantero, Letizia C Morlacchi, Federico PifferDepartment of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalyBackground: The aim of this open-label, randomized, parallel-group pilot study was to evaluate the efficacy of cefditoren pivoxil and levofloxacin in terms of speed of reduction in inflammatory parameters, clinical recovery, and microbiological eradication.Methods: Forty eligible patients with acute exacerbation of chronic bronchitis (AECB were randomized to receive cefditoren 200 mg twice a day for 5 days (n = 20 or levofloxacin 500 mg once daily for 7 days (n = 20.Results: The inflammatory parameters which were significantly reduced at test-of-cure with respect to visit 1 were Krebs von den Lundgen-6 (KL-6 and interleukin-6. KL-6 decreased both in the overall study population (from 19 ± 11 UI/mL to 6 ± 8 UI/mL, P = 0.000 and in the cefditoren (from 19 ± 13 UI/mL to 8 ± 10 UI/mL, P = 0.006 and levofloxacin (from 19 ± 10 UI/mL to 5 ± 5 UI/mL, P = 0.000 arms. Similarly, interleukin-6 decreased both in the overall study population (from 13.35 ± 16.41 pg/mL to 3 ± 4.7 pg/mL, P = 0.000 and in the cefditoren (from 15.90 ± 19.54 pg/mL to 4.13 ± 6.42 pg/mL, P = 0.015 and levofloxacin (from 10.80 ± 12.55 pg/mL to 1.87 ± 1.16 pg/mL, P = 0.003 arms. At the end of treatment (test-of-cure, 6–9 days after drug initiation, the clinical success rate in the overall study population was 78%; the clinical cure rate was 80% in the cefditoren arm and 75% in the levofloxacin arm. Globally, bacteriological eradication at test-of-cure was obtained in 85% of the overall study population. Both treatments were well tolerated.Conclusion: Cefditoren represents a valid option in the treatment of mild to moderately severe cases of AECB in the outpatient care setting. Moreover, the use of this cephalosporin is associated with a significant

  10. Efficacy and safety of HL301 in the treatment of acute bronchitis and acute exacerbation of chronic bronchitis: a phase 2, randomized, double-blind, placebo-controlled, multicenter study.

    Science.gov (United States)

    Park, Myung Jae; Rhee, Chin Kook; Kim, Yee Hyung; Kim, Do Jin; Kim, Dong Gyu; Lee, Sang Yeub; Kim, Jae Yeol

    2017-05-01

    The efficacy and safety of Chinese herbs for symptomatic treatment of bronchitis is not well established. We evaluated the efficacy and safety of a combination product of seven herbs (HL301) for the treatment of acute bronchitis (AB) and acute exacerbation of chronic bronchitis (AECB) using a randomized, double-blind, placebo-controlled, multicenter trial design. A total of 160 patients with AB or with AECB were randomized to receive placebo or one of three doses of HL301 (0.6 g/day, 1.2 g/day, or 1.8 g/day) for a total of 7 days. The primary study endpoint was the change in bronchitis severity score (BSS) from the baseline visit (visit 2) to the end of treatment visit (visit 3). Other efficacy variables were percentage BSS systemic sign efficacy after treatment and change in individual BSS parameters after treatment. Changes in BSS from visit 2 to visit 3 in the three treatment groups (4.63 ± 2.24, 4.08 ± 1.63, and 4.15 ± 1.74 in the HL301 0.6 g/day, 1.2 g/day, and 1.8 g/day groups, respectively) were higher than that of the placebo group (2.88 ± 2.57) in the per protocol set (PPS) (P < .05), and it was also valid in the full analysis set (FAS). The number of participants whose symptoms (measured by BSS) improved at least 30% after treatment was higher in all three treatment groups compared to the placebo group in both the FAS and the PPS (P < .05, for all). Three different doses of HL301 (0.6 g/day, 1.2 g/day, and 1.8 g/day) were effective in decreasing the BSS index compared to placebo. HL301 may be effective for symptomatic treatment of both AB and AECB. Essential components of HL301 have not been delineated in the study and patients with AB and AECB were indiscriminately enrolled in the present study. Respective evaluation of the efficacy of HL301 for AB and AECB will be necessary in the future.

  11. Direct labelling of ipratropium bromide aerosol and its deposition pattern in normal subjects and patients with chronic bronchitis.

    Science.gov (United States)

    Spiro, S G; Singh, C A; Tolfree, S E; Partridge, M R; Short, M D

    1984-06-01

    A technique for the direct labelling of ipratropium bromide with bromine-77, with reconstitution of the drug in a metered dose inhaler so as to be identical to the commercial product, was used to study drug deposition patterns in seven normal subjects and seven patients with chronic bronchitis (mean FEV1 32% (SD 12.2%) predicted normal). The gamma camera image of the thorax was divided into a middle zone--the mediastinal zone--and the lung itself into a central zone comprising its medial third and a peripheal zone, the lateral two thirds. Measurements after 10 inhalations of labelled ipratropium bromide showed similar results for the two groups of subjects. The total lung dose inhaled was 11.2% of 203 micrograms and 11.7% of 186 micrograms in the normal subjects and the patients respectively. In contrast to the deposition patterns seen in aerosol studies using steady state inhalation methods, there was no difference in deposition pattern--that is, the distribution between the central and the peripheral lung zones--between the normal subjects and the patients with airways obstruction.

  12. [Prevention of chronic bronchitis in relation to the stage of development under current conditions of the organization of medical care].

    Science.gov (United States)

    Trubnikov, G V; Karmanova, T T

    1988-01-01

    Mass screening was used for a study of chronic bronchitis (CB) morbidity among 5107 construction workers and employees in the city of Barnaul. The rate of persons at risk of developing CB was 10.1%, with prebronchitis 7.9%, with CB 11.1%. CB stage-related individual therapeutic and prophylactic activities in outpatient clinics resulted in a decrease in morbidity rates of diseases of the respiratory organs with temporary loss of working capacity per 100 workers: from 98.3 (in 1980) to 17.5 cases (in 1984), i.e. from 1162.9 to 107.3 days, respectively, when a preventorium is engaged; without preventorium cases reduced from 93.5 to 40.0, i.e. from 1091.6 to 394.1 days, respectively. The identification during CB formation of the stage of risk of CB development, the stage of prebronchitis and CB as a nosological entity promoted the improvement of organization of therapeutic and prophylactic care.

  13. Aclidinium bromide inhalation powder for the long-term, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease including chronic bronchitis and emphysema.

    Science.gov (United States)

    Matera, Maria Gabriella; Sanduzzi, Alessandro; Alfano, Roberto; Cazzola, Mario

    2016-06-01

    Aclidinium is a twice-daily long-acting muscarinic receptor antagonist (LAMA) with an interesting pharmacological profile. Recent evidence indicates that this LAMA, in addition to causing a significant improvement in lung function and other important supportive outcomes, such as health related quality of life, dyspnea and nighttime/early morning symptoms in patients suffering from COPD, is also able to significantly reduce the rate of exacerbations of any severity, is extremely effective in controlling the COPD symptoms, is able to reduce lung hyperinflation, and has an excellent cardiovascular safety profile. Consequently, aclidinium should be considered a first-line approach at least for the symptomatic treatment of COPD although there are still few head-to-head studies comparing this LAMA with other bronchodilators. In any case, aclidinium can be taken into account in the treatment of different COPD phenotypes (emphysema, chronic bronchitis, exacerbators and patients with overlap COPD asthma).

  14. Extent and prevalence of cognitive dysfunction in chronic obstructive pulmonary disease, chronic non-obstructive bronchitis, and in asymptomatic smokers, compared to normal reference values.

    Science.gov (United States)

    Dal Negro, Roberto W; Bonadiman, Luca; Tognella, Silvia; Bricolo, Fernanda P; Turco, Paola

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) can affect cognition. The effects of other less severe chronic airway disorders on cognition remain to be clarified. This study aimed to measure and compare cognitive deterioration in subjects with COPD, subjects with chronic non-obstructive bronchitis (CNOB), and asymptomatic smokers (AS), and to relate the corresponding prevalence to several demographic and clinical variables and to normal reference values. Four hundred and two subjects (COPD n=229, CNOB n=127, and AS n=46) of comparable age were included in the study. Cognitive impairment was assessed using the Mini Mental Status test, the Clock Drawing test, and the Trail Making test A and B. The extent and prevalence of cognitive deterioration was greater in COPD subjects, followed by CNOB subjects and AS (PCOPD Assessment test scores, forced expiratory volume in the first second predicted, and arterial partial pressure of O2 and of CO2 were related to the extent and the prevalence of cognitive deterioration. COPD subjects, CNOB subjects, and AS aged 40-69 years showed the greatest cognitive impairment (PCOPD subjects. Cognitive impairment may start at the early stages of chronic airway damage and progress with a worsening of the respiratory condition. Indeed, the greatest cognitive deterioration was seen in COPD subjects. Cognition impairment may contribute to explaining the insufficient adherence to therapeutic plans and strategies, and the increasing social costs in respiratory subjects.

  15. Diagnosing and Treating Acute Bronchitis

    Science.gov (United States)

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis Questions to Ask Your Doctor about Acute Bronchitis ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  16. Cigarette tar content and symptoms of chronic bronchitis: results of the Scottish Heart Health Study.

    Science.gov (United States)

    Brown, C A; Crombie, I K; Smith, W C; Tunstall-Pedoe, H

    1991-12-01

    The aim was to determine if there was a relationship between cigarette tar yield and rates of chronic cough and chronic phlegm. 22 districts across Scotland were used for the Scottish Heart Health Study (SHHS) which was conducted between 1984 and 1986 and from which the data for this analysis were obtained. 10,359 men and women aged 40-59 years were studied. Of these, 2801 current cigarette smokers whose brand of cigarette smoked was known were selected. Data on self reported smoking habits and prevalence of chronic cough and chronic phlegm were obtained from the SHHS. Tar yield was divided into three groups: low (less than or equal to 12 mg/cigarette); middle (13-14 mg/cigarette); high (greater than or equal to 15 mg/cigarette). The average tar yield consumed per person was 13.2 mg/cigarette. Women in the middle and high tar groups had smoked for longer and had significantly higher breath carbon monoxide levels, serum thiocyanate levels, serum cotinine levels, and daily cigarette consumption than the women in the low tar group. This pattern was not seen in men for any of these five smoking variables. Rates of chronic cough and chronic phlegm were higher with higher tar yield of cigarettes smoked for women (low tar v high tar: p less than 0.001) but not for men. Daily cigarette consumption and the number of years of smoking were the most significant risk factors for chronic cough and chronic phlegm for both men and women. Tar was still a significant risk factor (p less than 0.05) for women after controlling for these two risk factors and social class. Both sexes show strong effects of daily cigarette consumption and years of smoking on respiratory symptoms; women show an additional effect of cigarette tar content while men do not. The spread of tar yield in both sexes was small but there were more women on low tar cigarettes and this may have enabled a weak effect of tar to be seen better in them. On the other hand, tar level in women was confounded with other

  17. Appropriateness of Antibiotic Prescribing for Veterans with Community-Acquired Pneumonia, Sinusitis, or Acute Exacerbations of Chronic Bronchitis

    Science.gov (United States)

    Tobia, Colleen Cook; Aspinall, Sherrie L.; Good, Chester B.; Fine, Michael J.; Hanlon, Joseph T.

    2016-01-01

    Background Previous studies evaluating antibiotic appropriateness in bacterial respiratory tract infections have focused only antibiotic choice and ignored other important aspects of prescribing such as dosing, drug-drug interactions, and duration of therapy. Objective The objectives of this study were to determine the prevalence and factors associated with inappropriate antibiotic prescribing in outpatients with community-acquired pneumonia (CAP), sinusitis, or acute exacerbations of chronic bronchitis (AECB). Methods This is a retrospective case series of the appropriateness of antibiotic prescribing in 153 outpatients with CAP, sinusitis, or AECB who were evaluated in a Veterans Affairs Emergency Department over a one year period. Data on patient characteristics, diagnosis, comorbidities, concurrent medications, and antibiotic prescribed were collected. Using the reliable and valid Medication Appropriateness Index (MAI), a trained clinical pharmacist assessed antimicrobial appropriateness. The MAI rates the appropriateness of a medication along ten criteria: indication, effectiveness, dosage, directions, practicality, drug-drug interactions, drug-disease interactions, unnecessary duplication, duration, and expensiveness. Results Overall 65% of patients had one or more antibiotic prescribing problems as assessed by the MAI. The most frequently rated problems were with expensiveness (39%), impracticality (21%), and incorrect dosage (10%). Penicillins, quinolones, and macrolides were the most inappropriately prescribed antibiotic classes. A history of alcohol abuse was associated with a lower likelihood of inappropriate prescribing (Adjusted Odds Ratio [Adj. OR] 0.32; 95% Confidence Interval [CI] 0.10-0.98), while patients who were married were more likely to receive inappropriately prescribed antibiotics (Adj. OR 2.64; 95%CI 1.25-5.59). Conclusions Inappropriate antibiotic prescribing is common in patients with bacterial respiratory tract infections and often

  18. Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema

    Directory of Open Access Journals (Sweden)

    Thornton Alison J

    2011-06-01

    Full Text Available Abstract Background Smoking is a known cause of the outcomes COPD, chronic bronchitis (CB and emphysema, but no previous systematic review exists. We summarize evidence for various smoking indices. Methods Based on MEDLINE searches and other sources we obtained papers published to 2006 describing epidemiological studies relating incidence or prevalence of these outcomes to smoking. Studies in children or adolescents, or in populations at high respiratory disease risk or with co-existing diseases were excluded. Study-specific data were extracted on design, exposures and outcomes considered, and confounder adjustment. For each outcome RRs/ORs and 95% CIs were extracted for ever, current and ex smoking and various dose response indices, and meta-analyses and meta-regressions conducted to determine how relationships were modified by various study and RR characteristics. Results Of 218 studies identified, 133 provide data for COPD, 101 for CB and 28 for emphysema. RR estimates are markedly heterogeneous. Based on random-effects meta-analyses of most-adjusted RR/ORs, estimates are elevated for ever smoking (COPD 2.89, CI 2.63-3.17, n = 129 RRs; CB 2.69, 2.50-2.90, n = 114; emphysema 4.51, 3.38-6.02, n = 28, current smoking (COPD 3.51, 3.08-3.99; CB 3.41, 3.13-3.72; emphysema 4.87, 2.83-8.41 and ex smoking (COPD 2.35, 2.11-2.63; CB 1.63, 1.50-1.78; emphysema 3.52, 2.51-4.94. For COPD, RRs are higher for males, for studies conducted in North America, for cigarette smoking rather than any product smoking, and where the unexposed base is never smoking any product, and are markedly lower when asthma is included in the COPD definition. Variations by sex, continent, smoking product and unexposed group are in the same direction for CB, but less clearly demonstrated. For all outcomes RRs are higher when based on mortality, and for COPD are markedly lower when based on lung function. For all outcomes, risk increases with amount smoked and pack-years. Limited

  19. Ambroxol for the prevention of chronic bronchitis exacerbations: long-term multicenter trial. Protective effect of ambroxol against winter semester exacerbations: a double-blind study versus placebo.

    Science.gov (United States)

    Olivieri, D; Zavattini, G; Tomasini, G; Daniotti, S; Bonsignore, G; Ferrara, G; Carnimeo, N; Chianese, R; Catena, E; Marcatili, S

    1987-01-01

    In a 6-month, double-blind multicenter trial conducted over the winter, the effects of daily administration of ambroxol retard (75 mg) were compared with those of placebo in preventing exacerbations and improving symptoms and clinical signs in chronic bronchitis patients. The trial was completed by 110 patients in the ambroxol group and by 104 in the placebo group. Initially, there were no significant differences between the groups. By the end of the 2nd month of treatment, 67.2% of the ambroxol group had had no exacerbations compared to 50.4% in the placebo group. At the end of the 6-month trial, 45.5% of the treatment group had had no exacerbations, compared to only 14.4% of the control group. These differences were statistically significant. Patients in the treatment group lost significantly fewer days through illness (442) and had fewer days when they needed antibiotic therapy (371) compared to the placebo group patients (837 and 781). Ambroxol also produced statistically significant symptomatic improvement, measured as difficulty in expectoration, coughing, presence of dyspnea and the auscultatory signs as compared to controls. Since ambroxol was well tolerated and compliance was good, it appears like a drug of choice for pharmacological prophylaxis of chronic bronchitis.

  20. Living with Chronic Bronchitis

    Science.gov (United States)

    ... condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, ... fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low- ...

  1. Acute Bronchitis - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Acute Bronchitis URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Acute Bronchitis - Multiple Languages To use the sharing features on ...

  2. Chronic Bronchitis and Current Smoking Are Associated with More Goblet Cells in Moderate to Severe COPD and Smokers without Airflow Obstruction

    Science.gov (United States)

    Kim, Victor; Oros, Michelle; Durra, Heba; Kelsen, Steven; Aksoy, Mark; Cornwell, William D.; Rogers, Thomas J.; Criner, Gerard J.

    2015-01-01

    Background Goblet cell hyperplasia is a classic but variable pathologic finding in COPD. Current literature shows that smoking is a risk factor for chronic bronchitis but the relationship of these clinical features to the presence and magnitude of large airway goblet cell hyperplasia has not been well described. We hypothesized that current smokers and chronic bronchitics would have more goblet cells than nonsmokers or those without chronic bronchitis (CB), independent of airflow obstruction. Methods We recruited 15 subjects with moderate to severe COPD, 12 healthy smokers, and 11 healthy nonsmokers. Six endobronchial mucosal biopsies per subject were obtained by bronchoscopy and stained with periodic acid Schiff-Alcian Blue. Goblet cell density (GCD) was quantified as goblet cell number per millimeter of basement membrane. Mucin volume density (MVD) was quantified as volume of mucin per unit area of basement membrane. Results Healthy smokers had a greater GCD and MVD than nonsmokers and COPD subjects. COPD subjects had a greater GCD than nonsmokers. When current smokers (healthy smokers and COPD current smokers, n = 19) were compared with all nonsmokers (nonsmoking controls and COPD ex-smokers, n = 19), current smokers had a greater GCD and MVD. When those with CB (n = 12) were compared to those without CB (n = 26), the CB group had greater GCD. This finding was also seen in those with CB in the COPD group alone. In multivariate analysis, current smoking and CB were significant predictors of GCD using demographics, lung function, and smoking pack years as covariates. All other covariates were not significant predictors of GCD or MVD. Conclusions Current smoking is associated with a more goblet cell hyperplasia and number, and CB is associated with more goblet cells, independent of the presence of airflow obstruction. This provides clinical and pathologic correlation for smokers with and without COPD. PMID:25646735

  3. Chronic bronchitis and current smoking are associated with more goblet cells in moderate to severe COPD and smokers without airflow obstruction.

    Directory of Open Access Journals (Sweden)

    Victor Kim

    Full Text Available Goblet cell hyperplasia is a classic but variable pathologic finding in COPD. Current literature shows that smoking is a risk factor for chronic bronchitis but the relationship of these clinical features to the presence and magnitude of large airway goblet cell hyperplasia has not been well described. We hypothesized that current smokers and chronic bronchitics would have more goblet cells than nonsmokers or those without chronic bronchitis (CB, independent of airflow obstruction.We recruited 15 subjects with moderate to severe COPD, 12 healthy smokers, and 11 healthy nonsmokers. Six endobronchial mucosal biopsies per subject were obtained by bronchoscopy and stained with periodic acid Schiff-Alcian Blue. Goblet cell density (GCD was quantified as goblet cell number per millimeter of basement membrane. Mucin volume density (MVD was quantified as volume of mucin per unit area of basement membrane.Healthy smokers had a greater GCD and MVD than nonsmokers and COPD subjects. COPD subjects had a greater GCD than nonsmokers. When current smokers (healthy smokers and COPD current smokers, n = 19 were compared with all nonsmokers (nonsmoking controls and COPD ex-smokers, n = 19, current smokers had a greater GCD and MVD. When those with CB (n = 12 were compared to those without CB (n = 26, the CB group had greater GCD. This finding was also seen in those with CB in the COPD group alone. In multivariate analysis, current smoking and CB were significant predictors of GCD using demographics, lung function, and smoking pack years as covariates. All other covariates were not significant predictors of GCD or MVD.Current smoking is associated with a more goblet cell hyperplasia and number, and CB is associated with more goblet cells, independent of the presence of airflow obstruction. This provides clinical and pathologic correlation for smokers with and without COPD.

  4. Loracarbef (LY163892) in the treatment of acute exacerbations of chronic bronchitis: results of U.S. and European comparative clinical trials.

    Science.gov (United States)

    Zeckel, M L

    1992-06-22

    Two controlled clinical trials compared loracarbef (LY163892 with amoxicillin/clavulanate or amoxicillin in the treatment of acute exacerbations of chronic bronchitis. Collectively, of 1,057 patients enrolled, 390 qualified for analysis: group 1 comprised 200 patients treated with loracarbef (400 mg twice daily); group 2, 120 patients treated with amoxicillin/clavulanate (500 mg three times daily); and group 3, 70 patients treated with amoxicillin (500 mg three times daily). Symptomatic and bacteriologic outcomes were assessed at post-therapy (within 72 hours of therapy completion), and at late-posttherapy (10-14 days after therapy completion). These evaluations were combined to provide an "overall" evaluation that accounted for all unfavorable outcomes occurring at either the posttherapy or late-posttherapy visit. At the posttherapy evaluation, 93.0% of group 1 patients, 95.0% of group 2 patients, and 88.6% of group 3 patients demonstrated favorable clinical outcomes (cure or improvement). "Overall" favorable clinical outcomes were achieved in 88.0% of group 1 patients, 90.0% of group 2 patients, and 81.4% of group 3 patients. Bacteriologic results from the two studies could not be merged due to marked differences in how posttherapy bacteriologic results were assessed. The clinical significance of positive posttherapy sputum cultures was doubtful: 90% of patients with a positive sputum culture at the posttherapy visit who returned for the late-posttherapy visit had successful clinical outcomes documented at the late-posttherapy evaluation. Loracarbef was associated with a lower incidence of diarrhea and a higher incidence of headache as compared with amoxicillin/clavulanate. These results suggest that 400 mg loracarbef twice daily for 7 days is effective and safe in the treatment of acute exacerbations of chronic bronchitis.

  5. Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype - a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial.

    Science.gov (United States)

    Beeh, Kai-Michael; Beier, Jutta; Candler, Henning; Wittig, Thomas

    2016-01-01

    Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients. To evaluate the effect on exacerbation, cough sputum, and general state of health of long-term treatment with ELOM-080 in COPD patients with an exacerbation history and chronic bronchitis. We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled parallel-group clinical trial of a 6-month treatment with ELOM-080 (3×300 mg) in patients with chronic bronchitis and concomitant COPD. The primary outcome was the proportion of subjects with at least one exacerbation over the 6-month study period. Secondary outcomes included the total number of exacerbations (ie, cumulative occurrence of exacerbations during the study period) and the proportion of acute exacerbations necessitating an antibiotic treatment, monthly evaluations of sputum and cough symptoms, and the general state of health and a safety analysis. Of 260 randomized subjects, 64 patients fulfilled the inclusion criteria for COPD (ELOM-080: 35, placebo: 29). Compared to placebo, ELOM-080 reduced the percentage of subjects with at least one exacerbation (29% versus 55%, P=0.031) and a reduction in the overall occurrence of exacerbations (ELOM-080: 10, placebo: 21, P=0.012) during the winter season. The percentage of asymptomatic or mildly symptomatic patients (sputum/expectoration and cough) was consistently higher in the ELOM-080 group compared to placebo, with statistical significant differences after 2 and 3 months of treatment (2 months: ELOM-080 25%, placebo

  6. Comparison of the efficacy and safety of a short course of ceftibuten with that of amoxycillin/clavulanate in the treatment of acute exacerbations of chronic bronchitis.

    Science.gov (United States)

    Guest, N; Langan, C E

    1998-04-01

    The efficay and safety of short course ceftibuten (400 mg od for 5 days; n = 163) were compared with that of amoxycillin/clavulanate (AMX/CA) (250/125 mg tds for 10 days; n = 172) in a multicentre, single-blind, parallel-group trial in 335 adults with acute exacerbations of chronic bronchitis (AECB). Clinical response was equivalent, with cure or improvement in 134/145 (92.4%) ceftibuten-treated patients and 139/150 (92.7%) AMX/CA-treated patients (95% CI: -7.00%, +6.50%). The overall eradication rates were similar (ceftibuten 88.3%; AMX/CA 87.5%) and also the incidence of adverse events which occurred in 24/163 (14.7%) ceftibuten-treated and 27/172 (15.5%) AMX/CA-treated patients. Ceftibuten 400 mg od for 5 days is as effective and well tolerated as AMX/CA 250 mg tds for 10 days in the treatment of AECB.

  7. Comparison of ceftibuten once daily and amoxicillin-clavulanate three times daily in the treatment of acute exacerbations of chronic bronchitis.

    Science.gov (United States)

    McAdoo, M A; Rice, K; Gordon, G R; Sahn, S A

    1998-01-01

    In medical practice, antibiotics are generally given empirically for the treatment of acute exacerbations of chronic bronchitis (AECB). To be effective, antibiotic therapy should be broad in spectrum, and it should also cover the common beta-lactamase-producing pathogens. In this multicenter, randomized, investigator-masked study, 469 patients with AECB were randomized (in a ratio of 2:1) to receive 400-mg oral ceftibuten capsules once daily or 500-mg amoxicillin-clavulanate tablets three times daily for 5 to 15 days. Patients receiving ceftibuten were further divided into those who took the capsule with a meal (fed) and those who took the capsule 1 hour before a meal (fasted). Clinical and microbiologic responses were evaluated after treatment at 0 to 6 days (end of treatment) and 7 to 21 days (follow-up). Overall clinical success was determined by cure/improvement of signs and symptoms of AECB at the end of treatment and at follow-up. Overall microbiologic assessment was graded as eradication, persistence, relapse, reinfection, colonization, superinfection, or unassessable. Tolerability was evaluated by grading observed adverse events. The mean duration of treatment was 10.4 days for patients who received ceftibuten and 10.1 days for patients who received amoxicillin-clavulanate. A total of 252 patients receiving ceftibuten and 117 patients receiving amoxicillin-clavulanate were evaluable for clinical efficacy, and 55 patients were evaluable for microbiologic response. Both treatments improved the signs and symptoms of bronchitis, and overall clinical success rates were equivalent for patients treated with ceftibuten (211 of 252 [84%]) and amoxicillin-clavulanate (93 of 117 [79%]) (95% confidence interval [CI], -4.5% to 13.6%). Overall microbiologic eradication rates were also similar for patients treated with ceftibuten (36 of 37 [97%]) and amoxicillin-clavulanate (12 of 14 [86%]) (95% CI, -5.2% to 21.2%). The most frequently reported treatment-related adverse

  8. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    ... adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; Chronic bronchitis - adults - discharge; Emphysema - adults - ...

  9. Randomized comparison of once-daily ceftibuten and twice-daily clarithromycin in the treatment of acute exacerbation of chronic bronchitis.

    Science.gov (United States)

    Ziering, W; McElvaine, P

    1998-01-01

    In an evaluator-blind, parallel-group, multicenter study, the efficacy and tolerability of ceftibuten 400 mg capsules once daily were compared with clarithromycin 500 mg twice daily for 7-14 days in the treatment of 309 patients with acute exacerbation of chronic bronchitis (AECB). Clinical (n = 262) and microbiological (n = 71) assessments were conducted before treatment, during days 4-6 of treatment, and at 0-6 and 7-21 days after treatment. Clinical efficacy success rates (cure/improvement) at the end of treatment (0-6 days) were 91.0% for ceftibuten and 93.0% for clarithromycin. In the intent-to-treat population, the overall clinical assessment showed a success rate of 77.6% (121/156) in the ceftibuten group and 78.4% (120/153) in the clarithromycin group (95% confidence interval, -10.8 to +9.0%). One patient in each of the ceftibuten and clarithromycin groups had a microbiological relapse and became a treatment failure. The overall success rate was 84.3% for ceftibuten and 86.7% for clarithromycin (C.I. -11.7%, +6.9). Overall eradication of the target pathogens (Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae) was 84.8% for ceftibuten and 89.5% for clarithromycin. Eradication rates for ceftibuten at 0-6 days post treatment were 95.2% (H. influenzae), 87.5% (M. catarrhalis), and 100% (S. pneumoniae), compared with 85.7%, 100% and 100%, respectively, for clarithromycin. Significantly fewer patients in the ceftibuten group experienced treatment-related adverse events than in the clarithromycin group (5.3 vs 21.9%; p ceftibuten provides a rational alternative for the treatment of AECB.

  10. Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype – a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Beeh KM

    2016-11-01

    Full Text Available Kai-Michael Beeh,1 Jutta Beier,1 Henning Candler,2 Thomas Wittig2 1Insaf Respiratory Research Institute, Wiesbaden, Germany; 2G. Pohl-Boskamp GmbH & Co KG, Hohenlockstedt, Germany Background: Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients. Aim: To evaluate the effect on exacerbation, cough sputum, and general state of health of long-term treatment with ELOM-080 in COPD patients with an exacerbation history and chronic bronchitis. Methods: We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled parallel-group clinical trial of a 6-month treatment with ELOM-080 (3×300 mg in patients with chronic bronchitis and concomitant COPD. The primary outcome was the proportion of subjects with at least one exacerbation over the 6-month study period. Secondary outcomes included the total number of exacerbations (ie, cumulative occurrence of exacerbations during the study period and the proportion of acute exacerbations necessitating an antibiotic treatment, monthly evaluations of sputum and cough symptoms, and the general state of health and a safety analysis. Results: Of 260 randomized subjects, 64 patients fulfilled the inclusion criteria for COPD (ELOM-080: 35, placebo: 29. Compared to placebo, ELOM-080 reduced the percentage of subjects with at least one exacerbation (29% versus 55%, P=0.031 and a reduction in the overall occurrence of exacerbations (ELOM-080: 10, placebo: 21, P=0.012 during the winter season. The percentage of asymptomatic or

  11. Causes of acute bronchitis (image)

    Science.gov (United States)

    ... the respiratory system that leads into the lungs. Acute bronchitis has a sudden onset and usually appears after ... and the production of thick yellow mucus. If acute bronchitis occurs because of a bacterial infection antibiotics are ...

  12. Acute bronchitis: Evaluation and management.

    Science.gov (United States)

    Blush, Raymond R

    2013-10-10

    Acute bronchitis affects millions of individuals, significantly impacting patient health and the healthcare industry. Understanding evaluation and treatment guidelines for acute bronchitis allows the nurse practitioner to practice comprehensive care for patients. This article reviews evidence-based practices when caring for the patient with acute bronchitis, promoting optimization of healthy outcomes.

  13. Greatest International ANtiinfective Trial (GIANT with moxifloxacin in the treatment of acute exacerbation of  chronic bronchitis: subanalysis of Chinese data of a global, multicenter, noninterventional study

    Directory of Open Access Journals (Sweden)

    Yulin Feng

    2010-03-01

    Full Text Available Yulin Feng1, Faguang Jin2, Shuang Mu3, Hong Shen4, Xiaohong Yang5, Yuling Wang6, Zhenshan Wang7, Yingjun Kong8, Zuke Xiao9, Qiming Feng101Respiratory Department, West China Hospital, Sichuan University, China; 2Respiratory Department, Tang Du Hospital, China; 3Respiratory Department, Peking University People’s Hospital, China; 4Emergency Department, The General Hospital of the People’s Liberation Army, China; 5Respiratory Department, Xinjiang People’s Hospital, China; 6Respiratory Department, Shi Jiazhuang First Hospital, China; 7Respiratory Department, The Second Affiliated Hospital of Dalian Medical University, China; 8Respiratory Department, The First Clinical College of Harbin Medical University, China; 9Respiratory Department, The Jiangxi Provincial People’s Hospital, China; 10Emergency Department, Shanghai Sixth People’s Hospital, ChinaBackground and objective: A single infective acute exacerbation of chronic bronchitis (AECB has a sustained effect on health status. Although a number of clinical investigations have demonstrated the efficacy of antibiotics in AECB, increased bacterial resistance has caused concern about the efficacy of currently available antibiotic therapies. This subanalysis of a global noninterventional study aimed to evaluate the impact of AECB on the patient and the community and the effectiveness and safety of a treatment with moxifloxacin (MXF tablets in daily life clinical practice in China.Methods: This prospective, noninterventional, noncontrolled, multicenter observational study, which started in China in April 2004 and ended in February 2007, was part of the global GIANT study. Patients with a diagnosis of mild to severe AECB were treated with MXF tablets 400 mg for a period at the physician’s discretion. The observation period for each patient covered a complete treatment period with MXF. For each patient, the physician documented data at an initial visit (baseline and at least one follow-up visit

  14. A Rare Case of Idiopathic Plastic Bronchitis.

    Science.gov (United States)

    Raoufi, Mohammed; Achachi, Leila; Mrabet, Fatima Zahra; Herrak, Laila; Ftouh, Mustapha El; Bourhroum, Najoua; Ouazzani Taibi, Nezha

    2017-01-01

    Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals. Two days after bronchoscopy, the patient rejected more bronchial casts, and dyspnea improved. Control of chest x-ray revealed complete left lung aeration and the diagnosis of idiopathic plastic bronchitis was obtained. This article shows the interest in clinical practice to evoke the diagnosis of plastic bronchitis in front of a productive chronic cough. Our case illustrates a rare clinical presentation represented by an atelectasis of an entire lung.

  15. A Rare Case of Idiopathic Plastic Bronchitis

    Directory of Open Access Journals (Sweden)

    Mohammed Raoufi

    2017-01-01

    Full Text Available Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals. Two days after bronchoscopy, the patient rejected more bronchial casts, and dyspnea improved. Control of chest x-ray revealed complete left lung aeration and the diagnosis of idiopathic plastic bronchitis was obtained. This article shows the interest in clinical practice to evoke the diagnosis of plastic bronchitis in front of a productive chronic cough. Our case illustrates a rare clinical presentation represented by an atelectasis of an entire lung.

  16. Protracted bacterial bronchitis: reinventing an old disease.

    Science.gov (United States)

    Craven, Vanessa; Everard, Mark L

    2013-01-01

    Chronic cough is common in the paediatric population, yet the true prevalence of this condition remains difficult to define. Protracted bacterial bronchitis (PBB) is a disease caused by the chronic infection of the conducting airways. In many children the condition appears to be secondary to impaired mucociliary clearance that creates a niche for bacteria to become established, probably in the form of biofilms. In others, immunodeficiencies, which may be subtle, appear to be a factor. PBB causes persistent coughing and disturbed sleep, and affects exercise tolerance, causing significant levels of morbidity. PBB has remained largely unrecognised and is often misdiagnosed as asthma.

  17. Diagnostic accuracy of fractional exhaled nitric oxide measurement in predicting cough-variant asthma and eosinophilic bronchitis in adults with chronic cough: A systematic review and meta-analysis.

    Science.gov (United States)

    Song, Woo-Jung; Kim, Hyun Jung; Shim, Ji-Su; Won, Ha-Kyeong; Kang, Sung-Yoon; Sohn, Kyoung-Hee; Kim, Byung-Keun; Jo, Eun-Jung; Kim, Min-Hye; Kim, Sang-Heon; Park, Heung-Woo; Kim, Sun-Sin; Chang, Yoon-Seok; Morice, Alyn H; Lee, Byung-Jae; Cho, Sang-Heon

    2017-09-01

    Individual studies have suggested the utility of fractional exhaled nitric oxide (Feno) measurement in detecting cough-variant asthma (CVA) and eosinophilic bronchitis (EB) in patients with chronic cough. We sought to obtain summary estimates of diagnostic test accuracy of Feno measurement in predicting CVA, EB, or both in adults with chronic cough. Electronic databases were searched for studies published until January 2016, without language restriction. Cross-sectional studies that reported the diagnostic accuracy of Feno measurement for detecting CVA or EB were included. Risk of bias was assessed with Quality Assessment of Diagnostic Accuracy Studies 2. Random effects meta-analyses were performed to obtain summary estimates of the diagnostic accuracy of Feno measurement. A total of 15 studies involving 2187 adults with chronic cough were identified. Feno measurement had a moderate diagnostic accuracy in predicting CVA in patients with chronic cough, showing the summary area under the curve to be 0.87 (95% CI, 0.83-0.89). Specificity was higher and more consistent than sensitivity (0.85 [95% CI, 0.81-0.88] and 0.72 [95% CI, 0.61-0.81], respectively). However, in the nonasthmatic population with chronic cough, the diagnostic accuracy to predict EB was found to be relatively lower (summary area under the curve, 0.81 [95% CI, 0.77-0.84]), and specificity was inconsistent. The present meta-analyses indicated the diagnostic potential of Feno measurement as a rule-in test for detecting CVA in adult patients with chronic cough. However, Feno measurement may not be useful to predict EB in nonasthmatic subjects with chronic cough. These findings warrant further studies to validate the roles of Feno measurement in clinical practice of patients with chronic cough. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Antibiotics for acute bronchitis.

    Science.gov (United States)

    Smith, Susan M; Fahey, Tom; Smucny, John; Becker, Lorne A

    2017-06-19

    The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care. To assess the effects of antibiotics in improving outcomes and to assess adverse effects of antibiotic therapy for people with a clinical diagnosis of acute bronchitis. We searched CENTRAL 2016, Issue 11 (accessed 13 January 2017), MEDLINE (1966 to January week 1, 2017), Embase (1974 to 13 January 2017), and LILACS (1982 to 13 January 2017). We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov on 5 April 2017. Randomised controlled trials comparing any antibiotic therapy with placebo or no treatment in acute bronchitis or acute productive cough, in people without underlying pulmonary disease. At least two review authors extracted data and assessed trial quality. We did not identify any new trials for inclusion in this 2017 update. We included 17 trials with 5099 participants in the primary analysis. The quality of trials was generally good. At follow-up there was no difference in participants described as being clinically improved between the antibiotic and placebo groups (11 studies with 3841 participants, risk ratio (RR) 1.07, 95% confidence interval (CI) 0.99 to 1.15). Participants given antibiotics were less likely to have a cough (4 studies with 275 participants, RR 0.64, 95% CI 0.49 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) 6) and a night cough (4 studies with 538 participants, RR 0.67, 95% CI 0.54 to 0.83; NNTB 7). Participants given antibiotics had a shorter mean cough duration (7 studies with 2776 participants, mean difference (MD) -0.46 days, 95% CI -0.87 to -0.04). The differences in presence of a productive cough at follow-up and MD of productive cough did not reach statistical significance.Antibiotic-treated participants were more likely to be improved according to clinician's global assessment (6 studies

  19. Coronavirus avian infectious bronchitis virus

    National Research Council Canada - National Science Library

    Cavanagh, Dave

    2007-01-01

    Infectious bronchitis virus (IBV), the coronavirus of the chicken (Gallus gallus), is one of the foremost causes of economic loss within the poultry industry, affecting the performance of both meat-type and egg-laying birds...

  20. Endobronchial Tuberculosis in Anthracotic Bronchitis.

    Science.gov (United States)

    Rezaeetalab, Fariba; Farrokh, Donya

    2016-01-01

    Endobronchial tuberculosis (EBTB) is a serious form of pulmonary tuberculosis. In EBTB, mycobacterium tuberculosis involves trachea, large airways and bronchial trees Combustion of biomass fuels causes anthracotic bronchitis that is characterized by black pigmentation in bronchial tissue. The majority of anthracotic bronchitis are in aged patients, particularly rural women, that use biomass fuel for cooking or traditional bakery .The aim of this study was to evaluate the endobronchial tuberculosis in anthracotic bronchitis. In total, 483 EBTB patients who underwent flexible bronchoscopy (FB), for various indications, were included. Tuberculosis was confirmed by microbiological analysis of bronchoalveolar (smear and culture for Koch's bacillus) and histopathological methods. EBTB patients were divided in two groups: subjects with anthracotic bronchitis (group 1) and without anthracosis (group 2). Demographic data and important clinical, radiological and bronchoscopic findings were recorded. Chi-squre test and Spss 11.5 software were used for statistical analysis. 483 out of 1824 patients who underwent FB had EBTB. 73.7% patients had EBTB and anthracotic bronchitis (versus 27.3% EBTB without anthracosis). The mean age was significantly higher in EBTB and anthracotic bronchitis (68.45 ± 16.31 versus 49.08 ± 14.7). Female/male ratio was 1.4:4 in EBTB and anthracotic group versus 1:1 in non anthracotic patients. Dyspnea, cough, hemoptysis and wheezing were higher in group 1. History of biomass fuel was more significant in EBTB and anthracotic bronchitis. Mass, diffuse infiltration in lower lobes were revealed higher in radiography of group 1. Bronchoscopy showed the higher frequency of bronchial stenosis in EBTB with anthracosis (P value < 0.05). This study suggested significant association between EBTB and anthracotic bronchitis. Unusual findings in radiological and bronchoscopic features were seen in EBTB with anthracosis.

  1. Antibiotic prescription patterns of South African general medical practitioners for treatment of acute bronchitis.

    Science.gov (United States)

    Ncube, N B Q; Solanki, G C; Kredo, T; Lalloo, R

    2017-01-30

    Antibiotic resistance is a significant public health problem. Prudent use of antibiotics is crucial in reducing this resistance. Acute bronchitis is a common reason for consultations with general medical practitioners, and antibiotics are often prescribed even though guidelines recommend not prescribing them for uncomplicated acute bronchitis. To analyse the antibiotic prescription patterns of South African (SA) general medical practitioners in the treatment of acute bronchitis. The 2013 claims for members of 11 health insurance schemes were analysed to assess antibiotic prescription patterns for patients diagnosed with acute bronchitis. The patterns were assessed by type of bronchitis, chronic health status of the patients, sex and age group. The types of antibiotic prescribed were also analysed. Of 166 821 events analysed, an antibiotic was prescribed in more than half (52.9%). There were significant differences by type of bronchitis and chronic health status. Patients with viral bronchitis were more likely to be prescribed an antibiotic than those with bacterial bronchitis (odds ratio (OR) 1.17, 95% confidence interval (CI) 1.08 - 1.26). Patients with a chronic illness were less likely to be prescribed an antibiotic than those without (OR 0.58, 95% CI 0.57 - 0.60). More than 70% of the antibiotics prescribed were cephalosporins, penicillins and other beta-lactams. Prescription rates of antibiotics for acute bronchitis by SA general medical practitioners are high. There is an urgent need to follow the guidelines for antibiotic use for acute bronchitis to reduce the likelihood of increasing resistance to available antibiotics.

  2. [Acute bronchitis: when are antibiotics, and when is symptomatic treatment indicated?].

    Science.gov (United States)

    Gillissen, A; Gessner, C; Hammerschmidt, S; Hoheisel, G; Wirtz, H

    2006-01-12

    Acute bronchitis is usually caused by a virus, while the chronic form is due to inhalative noxae (in most cases decades of cigarette smoking). Both varieties are diagnosed on a clinical basis. Treatment of acute bronchitis is symptomatic. A sore throat is treated locally, and a troublesome, in particular nocturnal, cough with antitussive agents applied for a limited period (14 days). If bronchial mucus is viscous and difficult to clear, short-term treatment with a secretolytic or mucolytic substance is justified. Management of chronic bronchitis consists primarily in the elimination of the noxae. Treatment with antibiotics (usually oral) makes good sense only when there is a bacteriological infection of the upper or lower airways in an acute stage, such as infection-driven exacerbation of chronic obstructive bronchitis (COPD).

  3. Placebo found equivalent to amoxicillin for treatment of acute bronchitis in Nairobi, Kenya: a triple blind, randomised, equivalence trial.

    Science.gov (United States)

    Nduba, V N; Mwachari, C W; Magaret, A S; Park, D R; Kigo, A; Hooton, T M; Cohen, C R

    2008-11-01

    Antibiotic treatment is not recommended for acute bronchitis in immunocompetent patients in industrialised countries. Whether these recommendations are relevant to the developing world and to immunocompromised patients is unknown. Randomised, triple blind, placebo controlled equivalence trial of amoxicillin compared with placebo in 660 adults presenting to two outpatient clinics in Nairobi, Kenya, with acute bronchitis but without evidence of chronic lung disease. The primary study end point was clinical cure, as defined by a >or=75% reduction in a validated Acute Bronchitis Severity Score by 14 days; analysis was by intention to treat with equivalence defined as acute bronchitis is unhelpful, even in populations with a high prevalence of HIV infection.

  4. 9 CFR 113.327 - Bronchitis Vaccine.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Bronchitis Vaccine. 113.327 Section... Virus Vaccines § 113.327 Bronchitis Vaccine. Bronchitis Vaccine shall be prepared from virus-bearing... section shall be used for preparing the production seed virus for vaccine production. All serials shall be...

  5. An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD

    DEFF Research Database (Denmark)

    F. Strykowski, David; Nielsen, Anni Brit Sternhagen; Llor, Carles

    2015-01-01

    Background. In acute exacerbation of chronic obstructive pulmonary disease (AECOPD) antibiotic overprescribing leads to antimicrobial resistance and underprescribing may cause poor patient outcomes. Objective. This study aimed to evaluate changes in over- and underprescribing of antibiotics after...

  6. Acute bacterial exacerbations in bronchitis and asthma.

    Science.gov (United States)

    Chodosh, S

    1987-04-27

    Symptomatic exacerbations are frequent problems in the management of chronic bronchitis and bronchial asthma. Identification of a bacterial etiology as the cause of specific exacerbations should be based on changes in clinical symptoms and documentation of significant bronchial bacterial flora and a neutrophilic inflammatory response. Most acute bacterial exacerbations in patients with bronchitis or asthma are caused by Hemophilus influenzae, Streptococcus pneumoniae, or Branhamella catarrhalis. Treatment with ampicillins, synthetic tetracyclines, or trimethoprim/sulfamethoxazole is successful in 80 to 90 percent of bacterial exacerbations. Emergence of resistant Hemophilus species and pneumococci motivates development of new orally administered antimicrobial drugs. Appropriate treatment depends on the prompt recognition that bacterial infection is present. Once instituted, antimicrobial therapy should be continued for a minimum of 10 to 14 days, which should increase the duration of the infection-free period until the next bacterial exacerbation. Adequate response should be evaluated by the return of symptoms to pre-infectious levels and by decreased sputum bacterial flora and neutrophilic inflammation.

  7. [Approach of acute bronchitis in general practice].

    Science.gov (United States)

    Rausch, S

    2010-09-01

    Acute bronchitis is a frequent infection in general practice. Its origin is usually viral, but frequently, antibiotics are prescribed in this situation, without any clinical benefit. There are several reasons for this, the most important is probably the difficulty of GP's to distinguish on clinical ground alone between "viral type, meaning spontaneously healing ", and "bacterial type, meaning potentially dangerous" acute respiratory infections. The emergence of bacteria resistant to antibiotics is defined by the W.H.O. as a major problem of public health. One of the most important measures is the diminution of antibiotic prescriptions. The approach outlined here will help this purpose. The combination of four clinical parameters (fever acute bronchitis being sufficiently characteristic of "a viral type" of infection. In case of doubt, the measurement of the CRP, allows to avoid antibiotics if the value is normal (or slightly elevated). This approach is valuable in adults with an otherwise normal health, outside severe chronic illness (which could weaken immunity) and for adults <65 years of age.

  8. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial.

    NARCIS (Netherlands)

    Decramer, M.; Rutten-van Molken, M.P.; Dekhuijzen, P.N.R.; Troosters, T.; Herwaarden, C.L.A. van; Pellegrino, R.; Schayck, C.P. van; Olivieri, D.; Donno, M. Del; Backer, W. de; Lankhorst, I.L.M.; Ardia, A.

    2005-01-01

    BACKGROUND: Increased oxidative stress is important in the pathogenesis of chronic obstructive pulmonary disease (COPD). We postulated that treatment with the antioxidant N-acetylcysteine would reduce the rate of lung-function decline, reduce yearly exacerbation rate, and improve outcomes. METHODS:

  9. Antibiotic prescribing for acute bronchitis.

    Science.gov (United States)

    Llor, Carl; Bjerrum, Lars

    2016-07-01

    Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused by viruses. Antibiotics for acute bronchitis have been associated with an approximately half-day reduction in duration of cough. However, at follow-up there are no significant differences in overall clinical improvement inpatients treated with antibiotics compared with those receiving placebo. Despite this, antibiotics are administered to approximately two thirds of these patients. This review discusses the reason for this antibiotic overprescription. Other therapies targeted to control symptoms have also demonstrated a marginal or no effect. Expert commentary: Clinicians should be aware of the marginal effectiveness of antibiotic therapy. Some strategies like the use of rapid tests, delayed prescribing of antibiotics and the use of leaflets for patients have been associated with a reduction of their unnecessary utilization.

  10. Antibiotic prescribing for acute bronchitis

    DEFF Research Database (Denmark)

    Llor, Carl; Bjerrum, Lars

    2016-01-01

    INTRODUCTION: Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused by viruses. AREAS COVERED: Antibiotics for acute bronchitis have been associated with an approximately half......-day reduction in duration of cough. However, at follow-up there are no significant differences in overall clinical improvement inpatients treated with antibiotics compared with those receiving placebo. Despite this, antibiotics are administered to approximately two thirds of these patients. This review...... discusses the reason for this antibiotic overprescription. Other therapies targeted to control symptoms have also demonstrated a marginal or no effect. EXPERT COMMENTARY: Clinicians should be aware of the marginal effectiveness of antibiotic therapy. Some strategies like the use of rapid tests, delayed...

  11. COPD (Chronic Obstructive Pulmonary Disease)

    Science.gov (United States)

    ... To Health Topics / COPD COPD Also known as Chronic Obstructive Pulmonary Disease , Emphysema Leer en español What Is Also known as chronic obstructive pulmonary disease; chronic bronchitis; or emphysema. COPD, or chronic obstructive ...

  12. Diagnosis and management of acute bronchitis.

    Science.gov (United States)

    Knutson, Doug; Braun, Chad

    2002-05-15

    Acute bronchitis is one of the top 10 conditions for which patients seek medical care. Physicians show considerable variability in describing the signs and symptoms necessary to its diagnosis. Because acute bronchitis most often has a viral cause, symptomatic treatment with protussives, antitussives, or bronchodilators is appropriate. However, studies indicate that many physicians treat bronchitis with antibiotics. These drugs have generally been shown to be ineffective in patients with uncomplicated acute bronchitis. Furthermore, antibiotics often have detrimental side effects, and their overuse contributes to the increasing problem of antibiotic resistance. Patient satisfaction with the treatment of acute bronchitis is related to the quality of the physician-patient interaction rather than to prescription of an antibiotic.

  13. Bronchitis

    Science.gov (United States)

    ... in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, and allergies can worsen ... the oxygen levels in your blood using a sensor attached to your fingertip or toe Recommend a ...

  14. Bronchitis

    Science.gov (United States)

    ... vulnerable to infection. Over time, harmful substances in tobacco smoke permanently damage the airways, increasing the risk for emphysema, cancer, and other serious lung diseases. Smoking also causes the mucus-producing glands to ...

  15. Air pollutants, genes and early childhood acute bronchitis.

    Science.gov (United States)

    Ghosh, Rakesh; Topinka, Jan; Joad, Jesse P; Dostal, Miroslav; Sram, Radim J; Hertz-Picciotto, Irva

    2013-09-01

    Studies have reported gene-by-environment interaction for chronic respiratory conditions but none on acute illnesses in children. We investigated, longitudinally, whether genotype modifies the relationship of environmental exposures (second-hand tobacco smoke, polycyclic aromatic hydrocarbons, particulate matter acute bronchitis in children below two years. A random sample of 1133 children, born between 1994 and 1998, in two districts of the Czech Republic, was followed-up from birth, of which 793 were genotyped. Pediatric records were abstracted for respiratory illnesses. Second-hand tobacco smoke exposure from household members was obtained through questionnaires and verified using urine cotinine. Air monitoring provided estimates of ambient polycyclic aromatic hydrocarbons and PM2.5. Additionally, we collected information on a range of potential confounders including breastfeeding history, indoor fuel use, other children in household, maternal characteristics, ambient temperature etc. DNA was extracted from tissues taken from the middle of the placenta, opposite the umbilical cord. We examined six single nucleotide polymorphisms (GSTM1, GSTP1, GSTT1, CYP1A1 MspI, EPHX1 exon 3 and 4) and one (EPHX1) diplotype. To investigate effect measure modification we constructed logistic regression models using generalized estimating equations (for repeated observations) stratified by genotypes. The EPHX1 low activity diplotype consistently imparts greater susceptibility to bronchitis from second-hand tobacco smoke, polyclic aromatic hydrocarbons (PAH) and PM2.5. Each of these three classes of exposure also showed elevated risk for bronchitis in the presence of either one or two histidines at exon 3 and exon 4 of EPHX1. Additional effect modifiers include CYP1A1 and GSTT1. Several xenobiotic metabolizing genes may modify the impact of second-hand tobacco smoke and ambient air pollutants, polycyclic aromatic hydrocarbons and PM2.5, on acute bronchitis in preschool children

  16. Diagnosis and treatment of acute bronchitis.

    Science.gov (United States)

    Albert, Ross H

    2010-12-01

    Cough is the most common symptom bringing patients to the primary care physician's office, and acute bronchitis is usually the diagnosis in these patients. Acute bronchitis should be differentiated from other common diagnoses, such as pneumonia and asthma, because these conditions may need specific therapies not indicated for bronchitis. Symptoms of bronchitis typically last about three weeks. The presence or absence of colored (e.g., green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. Viruses are responsible for more than 90 percent of acute bronchitis infections. Antibiotics are generally not indicated for bronchitis, and should be used only if pertussis is suspected to reduce transmission or if the patient is at increased risk of developing pneumonia (e.g., patients 65 years or older). The typical therapies for managing acute bronchitis symptoms have been shown to be ineffective, and the U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than six years. The supplement pelargonium may help reduce symptom severity in adults. As patient expectations for antibiotics and therapies for symptom management differ from evidence-based recommendations, effective communication strategies are necessary to provide the safest therapies available while maintaining patient satisfaction.

  17. Differential diagnosis of recurrent bronchitis in children

    Directory of Open Access Journals (Sweden)

    I. I. Zakirov

    2016-01-01

    Full Text Available The interest of the doctors — pediatricians to recurrent bronchitis is caused by its high specific weight in the structure of bronchopulmonary pathology in children, the complexity and the need to search the differential selection of an individual regimen and prevention. Recurrent bronchitis with bronchoobstructive syndromes patient is regarded as a predictor of asthma, however, erroneously consider these nosological forms as the stages of a single pathophysiological chain as congenital and acquired diseases of respiratory system, pathology of gastro-intestinal tract, cardio-vascular system can masquerade as recurrent bronchitis. The aim of this work — to analyze the current medical literature on the problem of differential search causes leading recurrent respiratory syndrome in children. Materials and methods. The review publications domestic and foreign authors studied data from clinical and epidemiological studies. Results and its discussion. Anatomical physiological characteristics of the respiratory tract, complicated premorbid background, the re-infection of the child respiratory infection contribute to the recurrent course of bronchitis. The most common recurrent bronchitis is transient, recurrent bronchitis episodes completely stoped with the age of the child. Recurrent respiratory infections can fix bronchial hyperreactivity and with the presence of aggravated allergic history lead to the development of asthma. Severe bronchitis, resistance to standard scheme of therapy, the frequent recurrence of respiratory syndrome dictate the need to expand the diagnostic research to clarify the leading cause of recurrent bronchitis. Conclusion. Recurrent bronchitis is considered as a separate nosological form. At the same time, by repeated episodes of respiratory infection may be masked by malformations, hereditary diseases of respiratory system, bronchus foreign body microaspiration syndrome, pathology of the cardio-vascular system. 

  18. Anti-inflammatory drugs and experimental bronchitis.

    Science.gov (United States)

    Jeffery, P K

    1986-01-01

    Chronic bronchitis (chronic hypersecretion) and chronic bronchiolitis (small airways disease) are two conditions associated with cigarette smoking: both contribute to airflow obstruction in man, the latter associated with progressive deterioration in lung function. Mucous metaplasia and hyperplasia are characteristic histological changes. Experimentally, cigarette smoke given daily for two weeks, induces similar histological changes in the airways of specific pathogen-free rats, providing a suitable animal model for study: an early proliferation of basal cells, accompanied by mucous metaplasia of surface epithelial serous cells is followed by proliferation of newly formed mucous cells. There is also a significant increase in epithelial thickness due to cell hypertrophy without stratification or prior ulceration. Experimentally, secretory cell hyperplasia is inhibited completely or to varying degrees by prophylactic administration (intraperitoneal injection) of either indomethacin, flurbiprofen, dexamethasone, prednisolone, hydrocortisone (each at 2 or 4 mg/kg body weight) or a mucolytic drug, N-acetylcysteine(Nac), given orally as a 1% solution of the drinking water. Nac also inhibits the associated mucus-hypersecretion. It takes between 21 and 84 days, depending on airway level, for the increase in secretory cell number to return to control values (ie recover). Indomethacin and flurbiprofen (4 mg/kg, by ip injection) shorten recovery to between 4 and 9 days in intrapulmonary airways but have no effect on recovery time in the rat trachea. Nac is effective in 6 of 7 airway levels which showed cigarette smoke-induced mucous cell hyperplasia. In conclusion, in the rat, the response to cigarette smoke is one of mucous cell metaplasia and both basal and mucous cell proliferation. Cigarette smoke-induced mucous cell hyperplasia can be inhibited when selected drugs are given concurrently with the cigarette smoke: indomethacin, fluriprofen and Nac are also therapeutic.

  19. [Acute plastic bronchitis--case report].

    Science.gov (United States)

    Cavrić, Gordana; Naumovski-Mihalić, Slavica; Kardum-Skelin, Ika; Dzebro, Sonja; Jelić-Puskarić, Biljana; Sustercić, Dunja; Skurla, Bruno; Mestrović, Ivica Premuzić; Filipec-Kanizaj, Tajana; Prkacin, Ingrid; Bartolek, Dubravka; Jurić, Klara; Mosler, Domagoj

    2011-09-01

    Plastic bronchitis is a rare disorder characterized by formation and sometimes dramatic expectoration of bronchial casts. It may occur at any age, but most published cases refer to pediatric population. We report a case of an 81-year-old man hospitalized at intensive care unit, who presented with the appearance of plastic bronchitis type I. He had profuse expectoration of several pieces, a few cm long and up to 1 cm wide, of wormlike reddish-brownish "tissue". Histologically, it was a slimy purulent secretion with abundant fibrin and blood and with cytopathic effect of herpes virus. The pathogenesis of plastic bronchitis is not clear.

  20. Current management of acute bronchitis in ambulatory care: The use of antibiotics and bronchodilators.

    Science.gov (United States)

    Mainous, A G; Zoorob, R J; Hueston, W J

    1996-02-01

    To examine the treatment regimens for acute bronchitis in adults in a Medicaid population seen in ambulatory care settings. Cross-sectional sample of Kentucky Medicaid claims (July 1, 1993, through June 30, 1994). Individuals 18 years old or older seen in an ambulatory setting for acute bronchitis. Anyone with a primary diagnosis of asthma or chronic obstructive pulmonary disease within the time frame was excluded. Twelve hundred ninety-four individuals accounted for 1635 separate outpatient and emergency department encounters for acute bronchitis. Outpatient visits accounted for 89% (n=1448) of the encounters. In 22% (n=358) of the encounters, no medication was prescribed; in 61% (n=997), antibiotics alone were prescribed, in 3% (n=43), bronchodilators alone were prescribed; and in 14% (n=237), both antibiotics and bronchodilators were prescribed. Some type of medication was more likely to be prescribed in emergency departments than in outpatient settings (P=.04), and antibiotic/bronchodilator combination therapy was more likely to be prescribed in rural practices than in urban practices (Ptreatment is not usually indicated for treatment of acute bronchitis, these results indicate that antibiotics are still the predominant treatment regimen in ambulatory care. Furthermore, the evidence suggesting that bronchodilators are effective symptomatic treatments has not been widely adopted. These results have significant implications for the production of antibiotic-resistant bacteria and suggest investigation into why physicians have not used this information in their treatment of acute bronchitis.

  1. Cough Culprits: What's the Difference Between Bronchitis and Pneumonia?

    Science.gov (United States)

    ... Cough Culprits What’s the Difference Between Bronchitis and Pneumonia? En español Send us your comments Coughs help ... cough from your chest may signal bronchitis or pneumonia. Although they may have different underlying causes, their ...

  2. Evidence-based diagnosis and management of acute bronchitis.

    Science.gov (United States)

    Hart, Ann Marie

    2014-09-18

    Acute bronchitis is a common respiratory infection seen in primary care settings. This article examines the current evidence for diagnosis and management of acute bronchitis in adults and provides recommendations for primary care clinical practice.

  3. Evidence-based acute bronchitis therapy.

    Science.gov (United States)

    Tackett, Kimberly L; Atkins, Aaron

    2012-12-01

    Acute bronchitis is a disease characterized by inflammation of the large airways within the lung accompanied by a cough lasting from 1 to 3 weeks. The inflammation occurs as a result of an airway infection or environmental trigger, with viral infections accounting for an estimated 89% to 95% of cases. Symptomatic treatment of cough is primarily required for patients, though in most cases the condition is self-limiting. Therapy consists of both nonpharmacological and pharmacological options to include antibiotics and antivirals, antitussive agents, protussive agents, and beta-2-agonists. This article reviews the treatment options for acute bronchitis and recommends criteria for use.

  4. EPs 7630-solution--an effective therapeutic option in acute and exacerbating bronchitis.

    Science.gov (United States)

    Matthys, H; Heger, M

    2007-01-01

    Acute bronchitis is one of the most common diagnoses in ambulatory care medicine. Although the benefit of antibiotics for acute bronchitis, which is mostly virally induced, is disputed, they are often prescribed. A therapeutic option for respiratory tract infections that do not fall within the strict indication range for antibiotic administration is the liquid herbal drug preparation from the roots of Pelargonium sidoides, EPs 7630 (Umckaloabo), which has been tested against placebo in double-blind clinical trials. EPs 7630 has both antibacterial and immuno-modulating properties. The efficacy and tolerability of EPs 7630 was investigated in a prospective, open, multicentric outcomes study with 205 patients suffering from acute bronchitis or acute exacerbation of chronic bronchitis. The main outcome measure was the change in the total score of five symptoms typical for bronchitis (cough, expectoration, wheezing/whistling on expiration, chest pain during coughing, and dyspnoea), which were each rated using a 5-point scale (from 0=not present to 4=extremely pronounced). Further symptoms (hoarseness, headache, aching limbs and fatigue) were assessed using a four-point scale (from 0=not present to 3=very pronounced). The total score of the typical bronchitis symptoms amounted to 6.1+/-2.8 points on average at the start of treatment and decreased by 3.3+/-3.8 points to 2.8+/-2.6 points by the final examination on day 7. About 60.5% of the patients assessed their health condition at the end of the study as much improved or free from symptoms. The onset of action appeared after two days on average. Adverse events occurred in a total of 16 patients. There were no serious adverse events. Altogether, 78% of the patients were satisfied or very satisfied with the treatment.

  5. Poor congruence with guidelines in the use of antibiotics for acute bronchitis: a descriptive study based on electronic health records.

    Science.gov (United States)

    Malo, Sara; Poblador-Plou, Beatriz; Prados-Torres, Alexandra; Lallana, María Jesús; Laguna-Berna, Clara; Rabanaque, María José

    2016-10-01

    Although acute bronchitis is frequently viral in nature, antibiotics are usually inappropriately prescribed in Primary Care to treat this condition, with serious public health consequences. To determine the prevalence and predictors of appropriate management of antibiotic use in acute bronchitis processes diagnosed in outpatients in the Spanish region of Aragón. Four different electronic health databases provided demographic and clinical information pertaining to patients diagnosed with acute bronchitis in Primary Care in Aragón during 2011, as well as data for corresponding antibiotic prescriptions dispensed at pharmacies. We evaluated adherence to recommendations for antibiotic use in acute bronchitis episodes in adults collected in both international and national guidelines. Finally, regression analyses were used to identify factors associated with appropriate antibiotic management. A total of 54701 episodes of acute bronchitis were registered, 9.5% of which corresponded to patients with an underlying chronic respiratory disease. In adults, antibiotics were prescribed in 64.9% of episodes, 17.9% of which involved prescription of a first-choice agent. Overall, 48.5% of episodes were appropriately managed according to guidelines. The likelihood of appropriate treatment was higher for female patients, and lower for patients who were older, presented chronic co-morbidities or were using corticoids. We observed poor levels of adherence to recommendations for antibiotic prescribing in adults with acute bronchitis, in terms of both the decision to prescribe and the choice of antibiotic agent. Older acute bronchitis patients and those with co-morbidities were at greater risk of being inappropriately treated. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Chinese medicinal herbs for acute bronchitis.

    Science.gov (United States)

    Jiang, Lanhui; Li, Ka; Wu, Taixiang

    2012-02-15

    Acute bronchitis is one of the most common diagnoses made by primary care physicians. It is traditionally treated with antibiotics (although the evidence for their effectiveness is weak, and modest at best) and other even less effective treatments. Chinese medicinal herbs have also been used as a treatment. This review aimed to summarise the existing evidence on the comparative effectiveness and safety of Chinese medicinal herbs for treating uncomplicated acute bronchitis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4) which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 19 September 19, 2011), EMBASE (1988 to 19 September 2011) and CNKI and the Chinese Biomedical Database (CBM) (1980 to 19 September, 2011). Randomised controlled trials (RCTs) comparing Chinese medicinal herbs with placebo, antibiotics or other Western medicines for the treatment of uncomplicated acute bronchitis. At least two review authors independently extracted data and assessed trial quality. In this updated review, 74 studies involving 6877 participants were reported as RCTs by the study authors. None of them met the inclusion criteria for this review. Out of the 74 trials, we identified 39 as non-RCTs and 35 compared different Chinese herbal medicines in the intervention and control groups. There is insufficient quality data to recommend the routine use of Chinese herbs for acute bronchitis. Trial design limitations of the individual studies meant that we could not draw any conclusions about the benefits of Chinese herbs for acute bronchitis. In addition, the safety of Chinese herbs is unknown due to the lack of toxicological evidence for these herbs, although adverse events were reported in some case reports.

  7. EFFICIENCY OF HYPERTONIC SOLUTION INHALATION IN CHILDREN WITH BRONCHITIS AND BRONCHIOLITIS

    Directory of Open Access Journals (Sweden)

    O. I. Simonova

    2014-01-01

    Full Text Available Background: Chronic bronchitis and bronchiolitis in children with congenital malformation are often characterized by the severe course of disease. The efficiency of treatment of those conditions can be increased through addition of sodium chloride (NaCl, hypertonic saline which takes a hydrostatic and osmotic effect on mucous membrane of the bronchial tree in broncholytic therapy. Aim: To evaluate the efficiency of 3% NaCl hypertonic solution inhalation in children with chronic bronchitis/bronchiolitis in the setting of bronchi congenital malformation (Kartagener's syndrome and primary ciliary dyskinesia. Patients and methods: The participantsof this study were 28 children in the age of 4–17.5 years with chronic bronchitis/bronchiolitis in the setting of Kartagener's syndrome and primary ciliary dyskinesia in the first days o facute exacerbation of the disease (15 patients in treatment group and 13 patients in control group. In the therapy scheme of treatment group the 3 NaCl hypertonic solution in administered dose of 2 ml was applied 2 times/day during 14 days besides other treatment methods. Results: In patients with chronic bronchiolitis 3% NaCl hypertonic saline inhalation in administered dose of 2 ml twice a day had improved the clinical presentation of disease; by the 14th day of studythe FEV-1 value improved from 70.0 ± 2.1 to 82 ± 3.2% (p = 0.024. The side effects in form of cough aggravation were registered in 13% cases. Among additional criteria of efficiency the improvement of MОС-75 from 52.1 ± 5.2 to 71.2 ± 1.4% (p = 0.011 was also marked in patients. The adverse experience, such as shivering, hypoexcitability and sleep disturbance, were registered in 7% of cases. Conclusion: Inhalation of 3% NaCl hypertonic saline allows the fast arresting of wheezing and eliminates the mycostasis in children with chronic bronchitis/bronchiolitis.

  8. The role of pneumococcal infection in development of exacerbations in children with bronchial asthma and obstructive bronchitis

    Directory of Open Access Journals (Sweden)

    N.V. Kukhtinova

    2011-01-01

    Full Text Available Pneumococcal infection remains the key cause of severe diseases of lower airways and deaths in children. The objective: to study the role of pneumococcal infection in pathogenesis of exacerbations of recurrent obstructive pulmonary diseases. Methods: etiological structure of lower airways infections was evaluated in 125 patients 1–15 years old with bronchial asthma or recurrent bronchitis. Results: etiologic role of Streptococcus pneumoniae in development of low airways infections was detected in 48% of patients with atopic asthma, 85% — with asthma without atopy, 97% — with recurrent bronchitis. Repeated microbiological examination confirmed chronic carriage of S. рneumoniae in nasopharinx in 31% of patients. Conclusion: early active prophylaxis with vaccine against pneumococcal infection including conjugated vaccines is able to prevent further progression of a disease.Key words: children, bronchial asthma, obstructive bronchitis, exacerbation, pneumococcal infection.

  9. Significance of aerophytotherapy in complex sanatorial-climatic treatment of patients with pneumoconiosis and dust-induced bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Ostapchuk, I.F.; Dubrovina, R.M.; Akimov, Yu.A.; Kalinina, T.F.; Protsko, G.V.; Kudzi, Eh.K.; Soboleva, O.S.

    1986-09-01

    Investigation is conducted to examine effectiveness of sanatorial-climatic treatment of patients with pneumoconiosis and dust-induced bronchitis while including aerophytotherapy. Patients with both lung diseases received sanatorial, gymnastic and climatic procedures. Experimental group also received aerophytotherapy - inhalation of ester oils of lavender, anise, mint, and salvia in form of spray corresponding to their molecular composition in air. Control group did not receive aerophytotherapy. Tables present results of experiment showing changes in parameters of external breathing in patients with pneumoconiosis and in patients with dust-induced bronchitis. Tables show greater improvement in characteristics of external breathing of patients treated with inclusion of aerophytotherapy and confirm effectiveness of combined sanatorial-climatic treatment with aerophytotherapy. Patients with chronic bronchitis also experienced reduction of bronchospasm and improvement in bronchial passability. Method does not require special equipment and is economical. 9 refs.

  10. Treatment effect and safety of EPs 7630-solution in acute bronchitis in childhood: report of a multicentre observational study.

    Science.gov (United States)

    Haidvogl, M; Heger, M

    2007-01-01

    An open post-marketing surveillance study was conducted to examine the treatment effect and safety of EPs 7630-solution in the treatment of acute bronchitis in children. This study included a total of 742 children (aged between 0 and 12 years) with acute bronchitis (83.4%) or acute exacerbations of chronic bronchitis (14.3%), who were treated with different doses of the herbal drug for up to 14 days. Five bronchitis specific symptoms (BSS) were summed up to give an overall measure of disease severity. Non-specific disease symptoms (loss of appetite, diarrhoea, headache, vomiting, and fever) were also recorded, together with adverse events and overall ratings of efficacy and tolerability. The overall BSS score decreased during treatment from 6.0+/-3.0 points at baseline to 2.7+/-2.5 points after 7 days and to 1.4+/-2.1 points after 14 days. Remission or improvement in at least 80% of patients was recorded for all the individual component symptoms. The proportion of patients suffering from non-specific symptoms also substantially improved during treatment. For example, loss of appetite was present in 65.8% of patients at study begin, but only in 27.6% at the time point of last observation visit. In 88.3% of cases, the responsible physician rated the treatment as successful. Adverse events were minor and transitory. In conclusion, EPs 7630-solution was shown to be a safe and an effective treatment option for acute bronchitis or acute exacerbations of chronic bronchitis in children.

  11. Molecular cloning of S1 glycoprotein gene of infectious bronchitis ...

    African Journals Online (AJOL)

    In vitro protein expression is an important method of obtaining large amounts of viral proteins to investigate their biological properties. The S1 glycoprotein of infectious bronchitis virus, due to its effective immune-dominant role is an appropriate candidate for production of recombinant vaccine against infectious bronchitis ...

  12. Wheezy bronchitis: results of treatment with ketotifen.

    Science.gov (United States)

    Cserháti, E F; Gegesi Kiss, A; Puskás, J; Kelemen, J; Mezel, G

    1986-01-01

    The authors consider that infants and young children with recurrent obstructive bronchitis require systematic follow-up care and treatment. To evaluate the severity of the disease, a rating scale was developed. Using this criteria, the severity of the disease in 132 infants and young children was evaluated. The patients were divided into a group of more severely ill and a group of less severely ill patients. The members of the more severely ill group were given long-term prophylactic treatment with ketotifen at a dose of 0.5 to 1.0 mg twice daily, in addition to standard symptomatic medication. Treatment with ketotifen afforded a decrease, although insignificant, in the number of coughing attacks, a significant decrease in the number of episodes of dyspnoea (p less than 0.025) and a significant decrease in the number of episodes of airway obstruction (p less than 0.0005). The authors conclude that patients with recurrent severe obstructive bronchitis should be given prophylactic treatment with ketotifen either during autumn and winter or throughout the year, depending on the severity of the symptoms.

  13. Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype – a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial

    OpenAIRE

    Beeh KM; Beier J; Candler H; Wittig T

    2016-01-01

    Kai-Michael Beeh,1 Jutta Beier,1 Henning Candler,2 Thomas Wittig2 1Insaf Respiratory Research Institute, Wiesbaden, Germany; 2G. Pohl-Boskamp GmbH & Co KG, Hohenlockstedt, Germany Background: Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and ...

  14. Persistent Bacterial Bronchitis: Time to Venture beyond the Umbrella

    Directory of Open Access Journals (Sweden)

    Andrew Bush

    2017-12-01

    Full Text Available Chronic cough in children is common and frequently mismanaged. In the past, cough was diagnosed as asthma and inappropriate asthma therapies prescribed and escalated. It has been realized that persistent bacterial bronchitis (PBB is a common cause of wet cough and responds to oral antibiotics. The initial definition comprised a history of chronic wet cough, positive bronchoalveolar (BAL cultures for a respiratory pathogen and response to a 2-week course of oral amoxicillin–clavulanic acid. This is now termed PBB-micro; PBB-clinical eliminates the need for BAL. PBB-extended is PBB-micro or PBB-clinical but resolution necessitating 4 weeks of antibiotics; and recurrent PBB is >3 attacks of PBB-micro or-clinical/year. However, the airway has only a limited range of responses to chronic inflammation and infection, and neutrophilic airway disease is seen in many other conditions, such as cystic fibrosis and primary ciliary dyskinesia, both chronic suppurative lung disease endotypes, whose recognition has led to huge scientific and clinical advances. There is an urgent need to extend endotyping into PBB, especially PBB-recurrent. We need to move from associative studies and, in particular, deploy sophisticated modern –omics technologies and systems biology, rather as has been done in the context of asthma in U-BIOPRED. In summary, the use of the term PBB has done signal service in pointing us away from prescribing asthma therapies to children with infected airways, but we now need to move beyond a simple description to teasing out underlying endotypes.

  15. Acupuncture as method of treatment and arresting progress of dust-induced bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Baburina, E.B.; Bykova, E.A.

    1983-10-01

    Acupuncture is an effective therapy for treatment of dust-induced bronchitis. It can be used independently or in combination with medicaments. Fifty men were divided into two groups of 20 and 30. One group was treated by acupuncture alone, the other with combined therapy. Acupuncture produced excellent results; combined treatment, good and satisfactory results. Since acupuncture reduced the possibility of complications, allergic reactions and side effects due to medication, it is an excellent means of preventing progress of dust-induced bronchitis. Patients experience 9 months remission of symptoms after treatment with acupuncture while medical therapy alone only relieves them for 1 to 1 1/2 months. Patients with chronic dust-induced bronchitis should receive a second course of acupuncture in 6 to 8 months to prevent recurrence of symptoms and progress of disease. Because of insufficient study of lasting effects of acupuncture, final conclusions about its effectiveness cannot be made, however, current evidence indicates it is a highly useful therapy. 6 references.

  16. Risco aumentado de sintomas respiratórios e bronquite crônica em mulheres que utilizam biocombustíveis na Nigéria Increased risk of respiratory symptoms and chronic bronchitis in women using biomass fuels in Nigeria

    Directory of Open Access Journals (Sweden)

    Olufemi Olumuyiwa Desalu

    2010-08-01

    Full Text Available OBJETIVO: Determinar a associação de sintomas respiratórios e bronquite crônica com o uso de biocombustíveis entre mulheres habitantes de áreas rurais do estado de Ekiti, sudoeste da Nigéria. MÉTODOS: De janeiro a junho de 2009, realizou-se um estudo transversal com uma amostra de 269 mulheres adultas. Um questionário adaptado do European Community Respiratory Health Survey foi aplicado para a obtenção de dados sobre características sociodemográficas, tipo de combustível utilizado para a preparação de alimentos, sintomas respiratórios e história de tabagismo. Todas as participantes foram convidadas a realizar espirometria. RESULTADOS: Das 269 mulheres no estudo, 161 (59,9% utilizavam biocombustíveis para a preparação de alimentos. As mulheres que utilizavam biocombustíveis relataram mais sintomas respiratórios que aquelas que não os utilizavam - tosse (13,7% vs. 3,7%; sibilância (8,7% vs. 2,8%; dor no peito (7,5% vs. 1,9%; falta de ar (11,8% vs. 6,5%; sintomas nasais (9,3% vs. 4,6%; e bronquite crônica (10,6% vs. 2,8%. A análise multivariada por regressão logística confirmou que o uso de biocombustíveis está associado às seguintes variáveis: tosse (OR = 4,82; p = 0,01; bronquite crônica (OR = 3,75; p = 0,04; sibilância (OR = 2,22; p = 0,23; dor no peito (OR = 3,82; p = 0,09; falta de ar (OR = 1,54; p = 0,35; e sintomas nasais (OR = 2,32; p = 0,20. Todos os parâmetros espirométricos avaliados (VEF1, CVF, VEF1/CVF e PFE foram menores nas mulheres que utilizavam biocombustíveis do que naquelas que não os utilizavam. CONCLUSÕES: Nossos resultados enfatizam a necessidade de se substituir o uso de biocombustíveis nos domicílios pelo de um tipo de combustível atóxico, como eletricidade ou gás.OBJECTIVE: To determine whether respiratory symptoms and chronic bronchitis are associated with the use of biomass fuels (BMFs among women residing in rural areas of the Ekiti State, in southwestern Nigeria. METHODS

  17. Bronchitis and Its Associated Risk Factors in First Nations Children

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    Chandima P. Karunanayake

    2017-11-01

    Full Text Available Respiratory diseases, such as bronchitis and pneumonia, are common in First Nations children in Canada. The objectives are to determine prevalence and associated risk factors of bronchitis in children 6–17 years old residing in two reserve communities. The cross-sectional study was conducted in 2013 and children from two First Nations reserve communities participated. The outcome was ever presence/absence of bronchitis. Logistic regression analysis was conducted to examine the relationship between bronchitis and the individual and environmental factors. A total of 351 First Nations children participated in the study. The prevalence of bronchitis was 17.9%. While 86.6% had at least one parent who smoked, smoking inside home was 43.9%. Signs of mold and mildew in homes were high. Prevalence of houses with any damage caused by dampness was 42.2%, with 44.2% of homes showing signs of mold or mildew. Significant predictors of increased risk of bronchitis were: being obese; having respiratory allergies; exposed to parental cigarette smoking; and signs of mold and mildew in the home. There are several modifiable risk factors that should be considered when examining preventive interventions for bronchitis including obesity, smoking exposure, and home mold or dampness.

  18. Beta2-agonists for acute bronchitis.

    Science.gov (United States)

    Becker, Lorne A; Hom, Jeffrey; Villasis-Keever, Miguel; van der Wouden, Johannes C

    2011-07-06

    There are no clearly effective treatments for the cough of acute bronchitis. Beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction contributing to the symptoms. To determine whether beta2-agonists improve acute bronchitis symptoms in patients with no underlying pulmonary disease. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2011, issue 1 which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (January 1966 to February week 1, 2011) and EMBASE (1974 to February 2011). Randomised controlled trials (RCTs) in which patients (adults, or children over two years of age) with acute bronchitis or acute cough and without known pulmonary disease were allocated to beta2-agonist versus placebo, no treatment or alternative treatment. Three review authors independently selected outcomes and extracted data while blinded to study results. Two review authors independently assessed each trial for risk of bias. We analysed trials in children and adults separately. Two trials in children (n = 109) with no evidence of airway obstruction did not find any benefits from oral beta2-agonists. Five trials in adults (n = 418) had mixed results but overall summary statistics did not reveal any significant benefits from oral (three trials) nor inhaled (two trials) beta2-agonists. There were no significant differences in daily cough scores nor in the percentage of adults still coughing after seven days (control group 73%; risk ratio (RR) 0.77, 95% confidence interval (CI) 0.54 to 1.09). in one trial, subgroups with evidence of airflow limitation had lower symptom scores if given beta2-agonists. The trials that noted quicker resolution of cough with beta2-agonists were those with a higher proportion of wheezing patients at baseline. Adults given beta2-agonists were more likely to report tremor, shakiness or nervousness (RR 7.94, 95% CI 1.17 to 53.94; number needed to

  19. [Modern possibilities of the pharmacotherapy of acute bronchitis].

    Science.gov (United States)

    Zaĭtsev, A A; Kulagina, I Ts; Peredel'skiĭ, S V; Alpenidze, D N

    2011-10-01

    The obtained results reflect data of multicenter open prospective randomized comparative study that included 150 patients with acute bronchitis. The estimation of the efficacy of recombinant human interferon 2 in the form of suppositories--genferon and viferon in the treatment of acute bronchitis in adults is given. It was revealed that the usage of these medications in the treatment of acute bronchitis is accompanied by a more dynamic regression of fever and intoxication syndromes, reduces the need for the appointment of additional medications and reduces the period of temporary disability of patients.

  20. Validation of a new clinical scoring system for acute bronchitis.

    Science.gov (United States)

    Mwachari, C; Nduba, V; Nguti, R; Park, D R; Sanguli, L; Cohen, C R

    2007-11-01

    Although several clinical prediction rules exist for lower respiratory tract infection (LRTI), few are for acute bronchitis (acute bronchitis) and most have not been validated in high human immunodeficiency virus (HIV) prevalence settings. An Acute Bronchitis Severity Score (ABSS) was developed and validated during a randomized trial of antibiotic treatment for acute bronchitis. Ambulatory adults with productive cough of acute bronchitis; 129 (20%) were HIV-seropositive. The ABSS had small floor and ceiling effects (1.8/0.2) and demonstrated high internal consistency (alpha-coefficient of 0.66) and internal validity, with a mean inter item total correlation of > or =0.25. Effect sizes from baseline to subsequent follow-up visits were large (>0.5). Wheezing and chest pain were associated with higher ABSS values, whereas irrelevant clinical variables were not. The ABSS demonstrated good responsiveness, high internal consistency, good correlation with common respiratory signs and symptoms and high discriminatory validity among patients with acute bronchitis in a high HIV-seroprevalence setting.

  1. Is co-morbidity taken into account in the antibiotic management of elderly patients with acute bronchitis and COPD exacerbations?

    Science.gov (United States)

    Bont, Jettie; Hak, Eelko; Birkhoff, Christine E; Hoes, Arno W; Verheij, Theo J M

    2007-09-01

    Guidelines on acute lower respiratory tract infections recommend restrictive use of antibiotics, however, in patients with relevant co-morbid conditions treatment with antibiotics should be considered. Presently, it is unknown whether GPs adhere to these guidelines and target antibiotic treatment more often at patients with risk-elevating conditions. We assessed whether in elderly primary care patients with acute bronchitis or exacerbations of chronic pulmonary disease (COPD), antibiotics are more often prescribed to patients with risk-elevating co-morbid conditions. Using the Utrecht GP research database, we analysed 2643 episodes in patients of 65 years of age or older with a GP-diagnosed acute bronchitis or exacerbation of COPD. Multivariable logistic regression analysis was applied to determine independent determinants of antibiotic use. Antibiotic prescribing rates were high in both acute bronchitis (84%) and in exacerbations of COPD (53%). In acute bronchitis, only age was an independent determinant of antibiotic use [odds ratio (OR) 1.03, 95% confidence interval (CI) 1.003-1.048], whereas in exacerbations of COPD antibiotics were more often prescribed to male patients (OR 1.3, 95% CI 1.0-1.5), patients with diabetes (OR 1.7, 95% CI 1.1-2.4) and heart failure (OR 1.3, 95% CI 1.0-1.7). Dutch GPs prescribe antibiotics in the majority of elderly patients with acute bronchitis and in half of the episodes of exacerbations of COPD. Tailoring their antibiotic treatment according to the presence or absence of high-risk co-morbid conditions could help GPs in improving antibiotic use in patients with respiratory tract infections in primary care.

  2. Etiology and immunology of infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    LF Caron

    2010-06-01

    Full Text Available Infectious bronchitis virus (IBV of chickens is currently one of the main diseases associated with respiratory syndrome in domestic poultry, as well as with losses related to egg production. The etiological agent is a coronavirus, which presents structural differences in the field, mainly in the S1 spike protein. The immune response against this virus is complicated by the few similarities among serotypes. Environmental and management factors, as well as the high mutation rate of the virus, render it difficult to control the disease and compromise the efficacy of the available vaccines. Bird immune system capacity to respond to challenges depend on the integrity of the mucosae, as an innate compartment, and on the generation of humoral and cell-mediated adaptive responses, and may affect the health status of breeding stocks in the medium run. Vaccination of day-old chicks in the hatchery on aims at eliciting immune responses, particularly cell-mediated responses that are essential when birds are first challenged. Humoral response (IgY and IgA are also important for virus clearance in subsequent challenges. The presence of antibodies against the S1 spike protein in 3- to 4-week-old birds is important both in broilers and for immunological memory in layers and breeders.

  3. Infectious Bronchitis Vaccination Protocols for Laying Hens

    Directory of Open Access Journals (Sweden)

    A. Sulaiman

    2011-12-01

    Full Text Available A research was conducted to investigate the effects of vaccination protocols for Infectious Bronchitis (IB on egg production, egg quality, and IB antibody titres of laying hens. Different initial vaccination (Control, VicS eye, VicS spray, VicS water, A3 eye, A3 spray, and A3 water for IB were administered to day-old Isa Brown hens. Half the hens were revaccinated regularly during lay whereas the other hens were not vaccinated. Results showed that initial vaccination treatment had significant effects on hen day egg production and egg quality of egg weight, shell reflectivity, shell breaking strength, shell thickness, albumen height, Haugh Units, and IB antibody titre levels, but had no effect on percentage of shell and yolk colour. Egg weight and shell reflectivity were less favourable in the control hens. In contrast, shell breaking strength and shell thickness were highest for the group that initially received A3 vaccine in water. However, regular revaccination had some deleterious effects on egg production and egg quality. There were no significant effects of revaccination on IB antibody titres. It is concluded that there was little advantage in regularly revaccinating laying hens for IB virus, since they had received appropriate initial vaccination.

  4. Intratracheal heparin improves plastic bronchitis due to sulfur mustard analog.

    Science.gov (United States)

    Houin, Paul R; Veress, Livia A; Rancourt, Raymond C; Hendry-Hofer, Tara B; Loader, Joan E; Rioux, Jacqueline S; Garlick, Rhonda B; White, Carl W

    2015-02-01

    Inhalation of sulfur mustard (SM) and SM analog, 2-chloroethyl ethyl sulfide (CEES), cause fibrinous cast formation that occludes the conducting airways, similar to children with Fontan physiology-induced plastic bronchitis. These airway casts cause significant mortality and morbidity, including hypoxemia and respiratory distress. Our hypothesis was that intratracheal heparin, a highly cost effective and easily preserved rescue therapy, could reverse morbidity and mortality induced by bronchial cast formation. Sprague-Dawley rats were exposed to 7.5% CEES via nose-only aerosol inhalation to produce extensive cast formation and mortality. The rats were distributed into three groups: non-treated, phosphate-buffered saline (PBS)-treated, and heparin-treated groups. Morbidity was assessed with oxygen saturations and clinical distress. Blood and bronchoalveolar lavage fluid (BALF) were obtained for analysis, and lungs were fixed for airway microdissection to quantify the extent of airway cast formation. Heparin, given intratracheally, improved survival (100%) when compared to non-treated (75%) and PBS-treated (90%) controls. Heparin-treated rats also had improved oxygen saturations, clinical distress and airway cast scores. Heparin-treated rats had increased thrombin clotting times, factor Xa inhibition and activated partial thromboplastin times, indicating systemic absorption of heparin. There were also increased red blood cells (RBCs) in the BALF in 2/6 heparin-treated rats compared to PBS-treated control rats. Intratracheal heparin 1 hr after CEES inhalation improved survival, oxygenation, airway obstruction, and clinical distress. There was systemic absorption of heparin in rats treated intratracheally. Some rats had increased RBCs in BALF, suggesting a potential for intrapulmonary bleeding if used chronically after SM inhalation. © 2014 Wiley Periodicals, Inc.

  5. An update on chronic obstructive pulmonary disease

    African Journals Online (AJOL)

    Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is a chronic condition which affects the respiratory system and worsens over time. COPD encompasses two clinical entities, namely chronic bronchitis and pulmonary emphysema. As may be expected from a chronic illness, periods of ...

  6. Asthma in adult patients presenting with symptoms of acute bronchitis in general practice

    NARCIS (Netherlands)

    Thiadens, HA; Postma, DS; de Bock, GH; Huysman, DAN; van Houwelingen, HC; Springer, MP

    Objectives - To investigate the association between asthma and acute bronchitis in adults and to ascertain criteria to help general practitioners (GPs) differentiate between acute bronchitis and asthma. Design - Descriptive study. Setting - Primary health care centre in The Netherlands. Patients -

  7. Microorganisms Causing Community-Acquired Acute Bronchitis: The Role of Bacterial Infection.

    Science.gov (United States)

    Park, Ji Young; Park, Sunghoon; Lee, Sun Hwa; Lee, Myung Goo; Park, Yong Bum; Oh, Kil Chan; Lee, Jae-Myung; Kim, Do Il; Seo, Ki-Hyun; Shin, Kyeong-Cheol; Yoo, Kwang Ha; Ko, Yongchun; Jang, Seung Hun; Jung, Ki-Suck; Hwang, Yong Il

    2016-01-01

    Although acute bronchitis is quite common, there is relatively limited information regarding the microorganisms that are involved in this illness. We performed a prospective study of acute bronchitis at 31 hospitals and clinics in Korea from July 2011 to June 2012. Sputum specimens were collected for polymerase chain reaction (PCR) and culture of microorganisms. Of the 811 enrolled patients, 291 had acceptable sputum specimens that were included for analysis of the etiologic distribution. With multiplex PCR testing, viruses were identified in 36.1% (105/291), most commonly rhinovirus (25.8%) and coronavirus (3.8%). Typical bacteria were isolated in 126/291 (43.3%) patients. Among these patients Haemophilus influenzae (n = 39) and Streptococcus pneumoniae (n = 30) were isolated most commonly; atypical bacteria were identified in 44 (15.1%) patients. Bacteria-only, virus-only, and mixed infections (bacteria plus virus) accounted for 36.7% (98/291), 17.2% (50/291), and 18.9% (55/291) of infections, respectively. In particular, 52.4% of patients with viral infection had a concurrent bacterial infection, and rhinovirus was the most common virus in mixed infections (40/55). Additionally, infections with typical bacteria were more common in patients with chronic lung disease (p = 0.029), and typical bacterial infections showed a trend towards a higher prevalence with older age (p = 0.001). Bacteria were associated with almost half of community-acquired acute bronchitis cases. Additional studies are required to further illuminate the role of bacteria and to identify patient groups most likely to benefit from antibiotic treatment.

  8. Microorganisms Causing Community-Acquired Acute Bronchitis: The Role of Bacterial Infection.

    Directory of Open Access Journals (Sweden)

    Ji Young Park

    Full Text Available Although acute bronchitis is quite common, there is relatively limited information regarding the microorganisms that are involved in this illness.We performed a prospective study of acute bronchitis at 31 hospitals and clinics in Korea from July 2011 to June 2012. Sputum specimens were collected for polymerase chain reaction (PCR and culture of microorganisms.Of the 811 enrolled patients, 291 had acceptable sputum specimens that were included for analysis of the etiologic distribution. With multiplex PCR testing, viruses were identified in 36.1% (105/291, most commonly rhinovirus (25.8% and coronavirus (3.8%. Typical bacteria were isolated in 126/291 (43.3% patients. Among these patients Haemophilus influenzae (n = 39 and Streptococcus pneumoniae (n = 30 were isolated most commonly; atypical bacteria were identified in 44 (15.1% patients. Bacteria-only, virus-only, and mixed infections (bacteria plus virus accounted for 36.7% (98/291, 17.2% (50/291, and 18.9% (55/291 of infections, respectively. In particular, 52.4% of patients with viral infection had a concurrent bacterial infection, and rhinovirus was the most common virus in mixed infections (40/55. Additionally, infections with typical bacteria were more common in patients with chronic lung disease (p = 0.029, and typical bacterial infections showed a trend towards a higher prevalence with older age (p = 0.001.Bacteria were associated with almost half of community-acquired acute bronchitis cases. Additional studies are required to further illuminate the role of bacteria and to identify patient groups most likely to benefit from antibiotic treatment.

  9. Bacterial bronchitis caused by Streptococcus pneumoniae and nontypable Haemophilus influenzae in children: the impact of vaccination.

    Science.gov (United States)

    Priftis, Kostas N; Litt, David; Manglani, Sapna; Anthracopoulos, Michael B; Thickett, Keith; Tzanakaki, Georgina; Fenton, Patricia; Syrogiannopoulos, George A; Vogiatzi, Aliki; Douros, Konstantinos; Slack, Mary; Everard, Mark L

    2013-01-01

    Protracted bacterial bronchitis is a major cause of persistent cough in childhood. The organisms most commonly isolated are nontypable Haemophilus influenzae and Streptococcus pneumoniae . There are no studies addressing typing of these organisms when recovered from the lower airways. Isolates of these two organisms (identified in BAL samples from children undergoing routine investigation of a chronic cough thought to be attributable to a protracted bacterial bronchitis) were subject to typing. Samples were collected in Sheffield, England, and Athens, Greece. The majority of the children from Sheffield had received pneumococcal-conjugate vaccines 7 or 13 (PCV-7 or PCV-13) conjugate vaccine but only a minority of Greek children had received PCV-7. All 18 S pneumoniae isolates from Greek BAL samples are serotypes contained in PCV-13 while 10 are contained in PCV-7. In contrast, 28 of the 39 samples from Sheffield contained serotypes that are not included in PCV-13. All 26 of the nontypable H influenzae samples obtained in Sheffield produced distinct multilocus variable-number tandem repeat analysis profiles. There was a significant difference between children from Athens and Sheffield in the distribution of serotypes contained or not contained in the pneumococcal vaccine ( P = .04). More specifically, immunization with pneumococcal vaccine was related with isolation of S pneumoniae serotypes not included in the vaccine (OR, 0.021; CI, 0.003-0.115; P < .001). The data suggest that both vaccine and nonvaccine S pneumoniae serotypes may play a role in protracted bacterial bronchitis and provide some hints that serotype replacement may occur in response to the introduction of conjugate vaccines.

  10. Cost-Effectiveness of Decision Support Strategies in Acute Bronchitis.

    Science.gov (United States)

    Michaelidis, Constantinos I; Kern, Melissa S; Smith, Kenneth J

    2015-10-01

    A recent clinical trial suggests that printed (PDS) and computer decision support (CDS) interventions are safe and effective in reducing antibiotic use in acute bronchitis relative to usual care (UC). Our aim was to evaluate the cost-effectiveness of decision support interventions in reducing antibiotic use in acute bronchitis. We conducted a clinical trial-based cost-effectiveness analysis comparing UC, PDS and CDS for management of acute bronchitis. We assumed a societal perspective, 5-year program duration and 30-day time horizon. The U.S. population aged 13-64 years presenting with acute bronchitis in the ambulatory setting. Printed and computer decision support interventions relative to usual care. Cost per antibiotic prescription safely avoided. In the base case, PDS dominated UC and CDS, with lesser total costs (PDS: $2,574, UC: $2,768, CDS: $2,805) and fewer antibiotic prescriptions (PDS: 3.79, UC: 4.60, CDS: 3.95) per patient over 5 years. In one-way sensitivity analyses, PDS dominated UC across all parameter values, except when antibiotics reduced work loss by ≥ 1.9 days or the probability of hospitalization within 30 days was ≥ 0.9 % in PDS (base case: 0.2 %) or ≤ 0.4 % in UC (base case: 1.0 %). The dominance of PDS over CDS was sensitive both to probability of hospitalization and plausible variation in the adjusted odds of antibiotic use in both strategies. A PDS strategy to reduce antibiotic use in acute bronchitis is less costly and more effective than both UC and CDS strategies, although results were sensitive to variation in probability of hospitalization and the adjusted odds of antibiotic use. This simple, low-cost, safe, and effective intervention would be an economically reasonable component of a multi-component approach to address antibiotic overuse in acute bronchitis.

  11. Causes and clinical characteristics of chronic cor-pulmonale in ...

    African Journals Online (AJOL)

    Conclusion: Chronic persistent asthma is a frequent underlying cause of chronic obstructive pulmonary disease and chronic cor-pulmonale compared to smoking related chronic bronchitis/emphysema in Ethiopia. The preventive strategy of chronic corpulmonale includes optimal treatment of bronchial asthma, early ...

  12. β-Blockers and All-Cause Mortality in Adults with Episodes of Acute Bronchitis: An Observational Study.

    Science.gov (United States)

    Rutten, Frans H; Groenwold, Rolf H H; Sachs, Alfred P E; Grobbee, Diederick E; Hoes, Arno W

    2013-01-01

    Recent observational studies suggest that β-blockers may improve long-term prognosis in patients with chronic obstructive pulmonary disease (COPD). We assessed whether β-blocker use improves all-cause mortality in patients with episodes of acute bronchitis. An observational cohort study using data from the electronic medical records of 23 general practices in the Netherlands. The data included standardized information about daily patient contacts, diagnoses, and drug prescriptions. Cox regression was applied with time-varying treatment and covariates. The study included 4,493 patients aged 45 years and older, with at least one episode of acute bronchitis between 1996 and 2006. The mean (SD) age of the patients was 66.9 (11.7) years, and 41.9% were male. During a mean (SD) follow up period of 7.7 (2.5) years, 20.4% developed COPD. In total, 22.7% had cardiovascular comorbidities, resulting in significant higher mortality rates than those without (51.7% vs. 12.0%, pacute bronchitis. Cardioselective β-blockers, but also calcium channel blockers and statins may reduce mortality, possibly as a result of cardiovascular protective properties.

  13. Detection of antibodies to avian influenza, infectious bronchitis and ...

    African Journals Online (AJOL)

    aliyu.jibril

    2017-03-28

    Mar 28, 2017 ... *Correspondence: Tel.: +2348036658789: E-mail: ibwazkalt@yahoo.co.uk. Abstract. This study aimed at determining the possible exposure of wild birds to avian influenza (AI), infectious bronchitis (IB) and Newcastle disease (ND) viruses. Apparently healthy species of free flying wild birds were captured ...

  14. Unintended consequences of a quality measure for acute bronchitis.

    Science.gov (United States)

    Roth, Serena; Gonzales, Ralph; Harding-Anderer, Tammy; Bloom, Frederick J; Graf, Thomas; Stahl, Melissa S; Maselli, Judith H; Metlay, Joshua P

    2012-06-01

    To determine whether diagnostic coding shifts might undermine apparent improvements resulting from the 2007 Healthcare Effectiveness Data and Information Set (HEDIS) measure on avoidance of antibiotics for the treatment of adults with acute bronchitis (International Classification of Diseases, Ninth Revision, Clinical Modification code 466.0). Time series analysis within a primary care network for 3 successive winter seasons from 2006 to 2009. All initial adult visits with a primary diagnosis code of 466.0 or 490 (bronchitis, not otherwise specified) were analyzed. Multivariable analysis accounted for clustering of observations by physician. The percentage of visits treated with antibiotics declined significantly for code 466.0 (76.8% to 74.4% to 27.0% of visits over the 3-year study period; P bronchitis visits in year 1 to 84.6% of total bronchitis visits in year 3. As a result, the odds of an antibiotic prescription for codes 466 and 490 combined decreased slightly in year 3 compared with year 1 (odds ratio 0.88; 95% confidence interval 0.78-0.99). While performance on the specific HEDIS measure improved dramatically during this study period, overall antibiotic prescribing did not decline substantially. Quality measures that assess performance on specific diagnosis codes are imperfect and do not account for shifts in diagnosis coding.

  15. Are antibiotics effective in the treatment of acute bronchitis?

    Science.gov (United States)

    Singh, Manpreet; Koyfman, Alex

    2015-05-01

    In patients without underlying lung disease, antibiotics in acute bronchitis appear to decrease cough, but the clinical significance of this decrease is uncertain. Their use should be weighed against the cost and potential adverse effects for treatment of a self-limiting disease.

  16. Acute bronchitis: general practitioners' views regarding diagnosis and treatment.

    NARCIS (Netherlands)

    Verheij, T.J.M.; Hermans, J.; Kaptein, A.A.; Wijkel, D.; Mulder, J.D.

    1990-01-01

    A survey was conducted among 800 Dutch general practitioners to establish their views on the diagnosis and treatment of bronchitis and related disorders with reference to 12 theoretical patients. The answers of the 467 respondents (response rate 60%) showed no clear relationship between signs and

  17. Will chronic e-cigarette use cause lung disease?

    National Research Council Canada - National Science Library

    Rowell, Temperance R; Tarran, Robert

    2015-01-01

    ...), which encompasses both emphysema and chronic bronchitis. E-cigarettes (E-Cigs), or electronic nicotine delivery systems, were developed over a decade ago and are designed to deliver nicotine without combusting tobacco...

  18. Early History of Chronic Obstructive Pulmonary Disease 1808-1980.

    Science.gov (United States)

    Watson, R Ann; Pride, Neil B

    2016-01-01

    COPD has become a more popular research area in the last 3 decades, yet the first clear descriptions of acute and chronic bronchitis were in 1808. This brief history, comprehensively referenced, leads us through the early developments in respiratory physiology and their applications. It emphasises the early history of chronic bronchitis and emphysema in the 19(th) and early 20(th) centuries, long before the dominant effects of cigarette smoking emerged. This remains relevant to developing countries today.

  19. Avian infectious bronchitis virus in Brazil: a highly complex virus meets a highly susceptible host population

    Directory of Open Access Journals (Sweden)

    PE Brandão

    2010-06-01

    Full Text Available Infectious bronchitis (IB is a highly aggressive disease for poultry in terms of symptoms and economic losses, and the control of this disease is difficult if flocks are not protected against type-specific challenges by the Avian infectious bronchitis virus (IBV. This article summarizes data presented by the author at the Workshop on Infectious Bronchitis 2009 on IB and IBV, including future developments on the field.

  20. Recurrent plastic bronchitis in a child with 2009 influenza A (H1N1) and influenza B virus infection.

    Science.gov (United States)

    Kim, Sun; Cho, Hwa Jin; Han, Dong Kyun; Choi, Yoo Duk; Yang, Eun Seok; Cho, Young Kuk; Ma, Jae Sook

    2012-09-01

    Plastic bronchitis is an uncommon disorder characterized by the formation of bronchial casts. It is associated with congenital heart disease or pulmonary disease. In children with underlying conditions such as allergy or asthma, influenza can cause severe plastic bronchitis resulting in respiratory failure. A review of the literature showed nine cases of plastic bronchitis with H1N1 including this case. We report a case of a child with recurrent plastic bronchitis with eosinophilic cast associated with influenza B infection, who had recovered from plastic bronchitis associated with an influenza A (H1N1) virus infection 5 months previously. To the best of our knowledge, this is the first case of recurrent plastic bronchitis related to influenza viral infection. If patients with influenza virus infection manifest acute respiratory distress with total lung atelectasis, clinicians should consider plastic bronchitis and early bronchoscopy should be intervened. In addition, management for underlying disease may prevent from recurrence of plastic bronchitis.

  1. Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis.

    Science.gov (United States)

    Becker, Lorne A; Hom, Jeffrey; Villasis-Keever, Miguel; van der Wouden, Johannes C

    2015-09-03

    The diagnosis of acute bronchitis is made on clinical grounds and a variety of clinical definitions have been used. There are no clearly effective treatments for the cough of acute bronchitis. Beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction (as seen in asthma or chronic obstructive pulmonary disease (COPD)) contributing to the symptoms. To determine whether beta2-agonists improve acute bronchitis symptoms in people with no underlying pulmonary disease (such as asthma, COPD or pulmonary fibrosis). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2015, Issue 5, MEDLINE (January 1966 to May 2015), EMBASE (1974 to May 2015), Web of Science (2011 to May 2015) and LILACS (1982 to May 2015). Randomised controlled trials (RCTs) which allocated people (adults, or children over two years of age) with acute bronchitis or acute cough and without known pulmonary disease to beta2-agonist versus placebo, no treatment or alternative treatment. Three review authors independently selected outcomes and extracted data while blinded to study results. Two review authors independently assessed each trial for risk of bias. We analysed trials in children and adults separately. Two trials of moderate quality in children (n = 134) with no evidence of airflow restriction did not find any benefits from oral beta2-agonists. Five trials in adults (n = 418) had mixed results but overall summary statistics did not reveal any significant benefits from oral (three trials) nor from inhaled (two trials) beta2-agonists. Three studies with low-quality evidence demonstrated no significant differences in daily cough scores, nor in the percentage of adults still coughing after seven days (control group 71%; risk ratio (RR) 0.86, 95% confidence interval (CI) 0.63 to 1.18; 220 participants). In one trial, subgroups with evidence of airflow limitation had lower symptom scores if given beta2-agonists. The

  2. β-Blockers and All-Cause Mortality in Adults with Episodes of Acute Bronchitis: An Observational Study.

    Directory of Open Access Journals (Sweden)

    Frans H Rutten

    Full Text Available Recent observational studies suggest that β-blockers may improve long-term prognosis in patients with chronic obstructive pulmonary disease (COPD. We assessed whether β-blocker use improves all-cause mortality in patients with episodes of acute bronchitis.An observational cohort study using data from the electronic medical records of 23 general practices in the Netherlands. The data included standardized information about daily patient contacts, diagnoses, and drug prescriptions. Cox regression was applied with time-varying treatment and covariates.The study included 4,493 patients aged 45 years and older, with at least one episode of acute bronchitis between 1996 and 2006. The mean (SD age of the patients was 66.9 (11.7 years, and 41.9% were male. During a mean (SD follow up period of 7.7 (2.5 years, 20.4% developed COPD. In total, 22.7% had cardiovascular comorbidities, resulting in significant higher mortality rates than those without (51.7% vs. 12.0%, p<0.001. The adjusted hazard ratio of cardioselective β-blocker use for mortality was 0.62 (95% confidence interval [CI], 0.50-0.77, and 1.01 (95% CI 0.75-1.36 for non-selective ones. Some other cardiovascular drugs also reduced the risk of mortality, with adjusted HRs of 0.60 (95% CI 0.46-0.79 for calcium channel blockers, 0.88 (95% CI 0.73-1.06 for ACE inhibitors/angiotensin receptor blockers, and 0.42 (95% CI 0.31-0.57 for statins, respectively.Cardiovascular comorbidities are common and increase the risk of mortality in adults with episodes of acute bronchitis. Cardioselective β-blockers, but also calcium channel blockers and statins may reduce mortality, possibly as a result of cardiovascular protective properties.

  3. Infectious bronchitis virus variants ? History, current situation and control measures

    OpenAIRE

    De Wit, Sjaak; Cook, Jane K A; van der Heijden, Harold M J F

    2011-01-01

    Abstract Infectious bronchitis virus (IBV) is ubiquitous in most parts of the world where poultry are reared and is able to spread very rapidly in non-protected birds. It is shed via both the respiratory tract and the faeces and can persist in the birds and the intestinal tract for several weeks or months. Outdoors, survival of IBV for 56 days in litter has been reported. Although strict biosecurity and working with a one-age system are essential control measures, normally vaccinat...

  4. Lung scintigraphy in the assessment of recurrent bronchitis and pneumonia in children

    Energy Technology Data Exchange (ETDEWEB)

    Ciofetta, G. [Second Pediatric Clinic, Rome (Italy). Lab. of Pediatric Nuclear Medicine

    1997-12-01

    Recurrent bronchitis and pneumonia in childhood are a significant factor in predisposing adults to chronic respiratory disease. Lung scintigraphy in children with recurrent respiratory problems very frequently shows regional abnormalities, even in the absence of radiological sings. Structural changes, also at the histological level, are accompanied bu functional disturbances that cause lung scan abnormalities to become stable with time and are very likely responsible for persisting disease in adulthood. Moreover, any chronic respiratory condition that has been diagnosed,like cystic-fibrosis, bronchiectasis, bronchopulmonary malformations, lung fibrosis, should be assessed and followed-up by means of lung scintigraphy. Suspected radio transparent foreign-body inhalation, radiographical hypernucleus (compensatory or pathological emphysema?), functional assessment before lung surgery, suspected mucociliary function impairment, suspected interstitial pneumonia, all of the above conditions represent important indications to lung scintigraphy in children. Finally, it is wise pointing out that, in order to avoid false positive results towards the diagnosis of structural disease, any easily reversible functional impairment should be removed before the scan, by proper patient preparation: in children this is done by at least aerosol therapy with beta-agonists, local steroids and mucolytics for 1 week - 10 days.

  5. Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults.

    Science.gov (United States)

    Grigoryan, Larissa; Zoorob, Roger; Shah, Jesal; Wang, Haijun; Arya, Monisha; Trautner, Barbara W

    2017-10-27

    Reducing inappropriate antibiotic prescribing is currently a global health priority. Current guidelines recommend against antibiotic treatment for acute uncomplicated bronchitis. We studied antibiotic prescribing patterns for uncomplicated acute bronchitis and identified predictors of inappropriate antibiotic prescribing. We used the Epic Clarity database (electronic medical record system) to identify all adult patients with acute bronchitis in family medicine clinics from 2011 to 2016. We excluded factors that could justify antibiotic use, such as suspected pneumonia, COPD or immunocompromising conditions. Of the 3616 visits for uncomplicated acute bronchitis, 2244 (62.1%) resulted in antibiotic treatment. The rates of antibiotic prescribing were similar across the years, p value for trend = 0.07. Antibiotics were most frequently prescribed in the age group of 18-39 years (66.9%), followed by the age group of 65 years and above (59.0%), and the age group of 40-64 years (58.7%), p value acute bronchitis, particularly in younger adults.

  6. [Mounier-Kuhn syndrome - a rare cause of recurrent bronchitis].

    Science.gov (United States)

    Bayer, M; Sladovnik, P; Herzog, R; Kern, L

    2014-04-01

    A 43-year-old man presented at our emergency room with progressive dyspnea and productive cough. He was in moderate respiratory distress. Symptomatic treatment had so far not led to clinical improvement. He had suffered from similar episodes since adolescence. An intensive diagnostic investigation was started to evaluate the source of infection and dyspnea. CRP levels were elevated to 26 mg/l. Arterial blood gas analysis showed a moderate hypoxemia with a pO2 of 8.35kPa (63 mmHg) and a pCO2 of 3.84kPa (29 mmHg). Computed tomography of the chest revealed the diagnosis of trachebobronchomegaly. This rare cause of recurrent bronchitis is named after Mounier-Kuhn who established this diagnosis for the first time. The patient improved under a course with antibiotics and inhaled bronchodilators. In patients with recurrent bronchitis, an underlying disease of the tracheobronchial system has to be suspected. The Mounier-Kuhn syndrome is only rarely diagnosed because the diagnosis cannot be established by conventional chest x-ray. Computed tomography is the gold standard for diagnosis. Mounier-Kuhn syndrome is likely to lead to severe venilatory failure and death, if untreated. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Ceftibuten versus cefaclor for the treatment of bronchitis.

    Science.gov (United States)

    Chirurgi, V A; Edelstein, H; Oster, S E; Karp, R; Cassano, K B; Aiken, S; Krumpe, P; McCabe, R E

    1991-10-01

    Ceftibuten is an oral third generation cephalosporin with potent antimicrobial activity against Enterobacteriaceae, beta-lactamase positive Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitidis, Neisseria gonorrheae, penicillin-susceptible pneumococci, and beta-hemolytic streptococci. To study the efficacy and safety of ceftibuten for treatment of bronchitis, 58 patients were randomized to therapy with either ceftibuten 400 mg once a day or cefaclor 250 mg every 8 h at a ratio of two to one. Of 45 clinically evaluable patients, 28 (87.5%) of the 32 ceftibuten patients and 12 (92.3%) of the 13 cefaclor patients were clinically improved or cured. Of 33 microbiologically evaluable patients, 21 (87.5%) of the 24 ceftibuten patients and eight (80%) of the ten cefaclor patients were cured. Of 56 patients evaluable for adverse effects, three (7.9%) of the 38 ceftibuten patients and one (5.6%) of the 18 cefaclor patients had adverse reactions. In this small study, once-daily ceftibuten appeared as safe and as effective as cefaclor for the treatment of bronchitis.

  8. Plastic bronchitis associated with corrected cardiac anomaly in a child

    Directory of Open Access Journals (Sweden)

    Elena M. Kamaltynova

    2017-01-01

    Full Text Available Plastic bronchitis (PB is a rare disease that causes airway obstruction with large «rubber» bronchial casts in adults and children, mainly due to concomitant cardiac or pulmonary pathology. It involves the organization of exudate or transudate, which takes the form of the respiratory tract. Mortality with PB reaches 50%. Exact epidemiological data are not known. In most patients, PB occurs in the context of major diseases, which can be conditionally divided into two groups: heart and vascular disease and secondary complication of pulmonary diseases. Usually PB manifests with episodes of dyspnea, tachycardia, hypoxia, fever and cough associated with airway obstruction. Sometimes the symptoms resemble asthma or obstructive bronchitis, accompanied by wheezing and the symptoms of respiratory failure, decreasing of saturation (of what?, the development of pneumothorax. All existing methods of treatment are symptomatic. Promising methods of therapy are the use of inhaled unfractionated heparin and a recombinant tissue plasminogen activator (TAP. The article presents a clinical case of PB in a girl of 5 years with the background of corrected cardiac anomaly.

  9. Preliminary crystallographic analysis of avian infectious bronchitis virus main protease

    Energy Technology Data Exchange (ETDEWEB)

    Li, Jun; Shen, Wei [Laboratory of Structural Biology, Tsinghua University, Beijing 100084 (China); Liao, Ming, E-mail: mliao@scau.edu.cn [Laboratory of Avian Medicine, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642 (China); Bartlam, Mark, E-mail: mliao@scau.edu.cn [Laboratory of Structural Biology, Tsinghua University, Beijing 100084 (China); National Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101 (China)

    2007-01-01

    The avian infectious bronchitis virus main protease has been crystallized; crystals diffract to 2.7 Å resolution. Infectious bronchitis virus (IBV) is the prototype of the genus Coronavirus. It causes a highly contagious disease which affects the respiratory, reproductive, neurological and renal systems of chickens, resulting great economic losses in the poultry industry worldwide. The coronavirus (CoV) main protease (M{sup pro}), which plays a pivotal role in viral gene expression and replication through a highly complex cascade involving the proteolytic processing of replicase polyproteins, is an attractive target for antiviral drug design. In this study, IBV M{sup pro} was overexpressed in Escherichia coli. Crystals suitable for X-ray crystallography have been obtained using microseeding techniques and belong to space group P6{sub 1}22. X-ray diffraction data were collected in-house to 2.7 Å resolution from a single crystal. The unit-cell parameters were a = b = 119.1, c = 270.7 Å, α = β = 90, γ = 120°. Three molecules were predicted to be present in the asymmetric unit from a calculated self-rotation function.

  10. Assessment of the effect of pharmacotherapy in common cold/acute bronchitis - the Bronchitis Severity Scale (BSS).

    Science.gov (United States)

    Kardos, P; Lehrl, S; Kamin, W; Matthys, H

    2014-08-01

    Acute bronchitis (AB) is a highly contagious infection of the airways, presenting mostly in connection with common cold (CC). There is a high variance in duration and course of symptoms which, sooner or later, also may disappear spontaneously and change during the course of the disease. Therefore, assessment of treatment outcome is difficult. Composite outcome measures are commonly used to examine the effects of pharmacotherapy in complex diseases. We discuss the features of the Bronchitis Severity Scale (BSS) on the basis of the available literature. For the BSS the five most important symptoms of AB are rated by the patient and the physician. Since its introduction in 1996, the BSS has been used in many clinical trials evaluating treatment effects of AB. Its score correlates well with clinical findings. As thorough validation analyses revealed, this applies even more to the BSS subscales "cough domain" and "sputum domain". The validated BSS appears to be a reliable tool to assess therapeutic effects in CC/AB. The BSS and its subscales are recommended as outcome measures for future drug trials in CC/AB, but also help physicians to focus their consultation in patients with CC/AB. © Georg Thieme Verlag KG Stuttgart · New York.

  11. [Ambulatory treatment with cefuroxime-axetil of infectious bronchitis in patients sixty years of age or older: comparative study of the combination of amoxicillin and clavulanic acid].

    Science.gov (United States)

    Hugonot, R; Hugonot, L; Pappo, M; Chiche, D

    1990-06-01

    The aim of this multicenter, prospective randomized trial was to compare the efficacy and safety of cefuroxime-axetil and amoxycillin/clavulanic acid for the treatment of infectious bronchitis in the elderly patient. Between January and April 1989, 157 out patients aged 60 years or more and presenting with infectious bronchitis were treated with either cefuroxime-axetil (250 mg bid), or the association amoxycillin/clavulanic acid (500 mg/125 mg bid). The two treatment groups were comparable at the time of inclusion; the mean age was 70 years, 82% of the patients were febrile, 75% presented purulent expectoration, 24% had a history of chronic bronchitis and 19% received symptomatic treatment was NSAIDs. The mean duration of treatment was 9 days. Clinical efficacy was assessed by the investigators. While fever and cough resolved similarly in the two groups, statistically fewer patients presented persistent purulent expectoration in the cefuroxime-axetil treatment group than in the group receiving amoxycillin/clavulanic acid (2% and 13%, respectively, p = 0.03). The proportion of patients who reported at least one side-effect was 3.6% in the cefuroxime-axetil treatment group against 21.6% of those who received the association (p = 0.006).

  12. Comorbidity between chronic obstructive pulmonary disease and type 2 diabetes

    DEFF Research Database (Denmark)

    Meteran, Howraman; Backer, Vibeke; Kyvik, Kirsten Ohm

    2015-01-01

    BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality and is associated with several systemic diseases, such as type 2 diabetes. It has been suggested that comorbidity between COPD and type 2 diabetes is due to shared genetic factors. AIM: To examine...... the relationship between type 2 diabetes and chronic bronchitis and COPD in adult twins, and to examine to what extent comorbidity between these diseases is explained by shared genetic or environmental factors. METHODS: Questionnaire data on chronic bronchitis and hospital discharge data on diagnosed COPD in 13......,649 twins, aged 50-71 years, from the Danish Twin Registry were cross-linked with hospital discharge diagnosis data on type 2 diabetes from the Danish National Patient Registry. RESULTS: The risk of type 2 diabetes was higher in persons with symptoms of chronic bronchitis than in those without symptoms (3...

  13. Infectious Bronchitis Virus Variants: Molecular Analysis and Pathogenicity Investigation

    Directory of Open Access Journals (Sweden)

    Shu-Yi Lin

    2017-09-01

    Full Text Available Infectious bronchitis virus (IBV variants constantly emerge and pose economic threats to poultry farms worldwide. Numerous studies on the molecular and pathogenic characterization of IBV variants have been performed between 2007 and 2017, which we have reviewed herein. We noted that viral genetic mutations and recombination events commonly gave rise to distinct IBV genotypes, serotypes and pathotypes. In addition to characterizing the S1 genes, full viral genomic sequencing, comprehensive antigenicity, and pathogenicity studies on emerging variants have advanced our understanding of IBV infections, which is valuable for developing countermeasures against IBV field outbreaks. This review of IBV variants provides practical value for understanding their phylogenetic relationships and epidemiology from both regional and worldwide viewpoints.

  14. Evaluation of an inactivated vaccine for nephropathogenic infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    T. R. Gopalakrishnamurthy

    2013-06-01

    Full Text Available Aim: To evaluate an inactivated vaccine for nephropathogenic infectious bronchitis in broiler with special reference to its ability for passing maternal antibodies to broiler chicks. Materials and Methods: An inactivated vaccine against nephropathogenic infectious bronchitis (NIB, prepared using an isolate obtained from natural outbreak of NIB was administered to broiler parents at the point of lay, leaving the control birds unvaccinated. Eggs laid below the desired weight (> 52 g by vaccinated hens were utilized for yolk serology. Chicks obtained from hens of both group were subjected for serology and challenge with wild type of nephropathogenic IB isolates. Serology of the yolk and serum was carried out using haemagglutination (HI test and ELISA. Results: Yolk serology revealed a geometric mean titre of 415.9 and 15188±768 in HI test and ELISA respectively on 28 days post vaccination (dpv as against 16.0 and 1881±86 in yolk from unvaccinated hens. The HI test and ELISA indicated that the level of maternal antibody (MAb in the chicks obtained from vaccinated hens was significantly (P< 0.01 higher on seven days of age than that of chicks from unvaccinated hens. However, the level of Mab of the chicks obtained from vaccinated hens decreased to below the level of protection at two weeks of age. Wild isolate and another isolate obtained from different geographical area were used for challenge dividing the chicks from vaccinated and unvaccinated hens equally. Mortality was observed in the challenged chicks from vaccinated (one in heterologus challenge and unvaccinated (two hens. Examination of kidney specimens collected from dead chicks revealed mottling and severe congestion grossly and inflammatory, degenerative and necrotic changes microscopically. Conclusion: The partial cross-protection against heterologous challenge and incomplete protection against homologous challenge with wild isolates were noticed. [Vet World 2013; 6(3.000: 134-138

  15. Plastic bronchitis: symptomatic improvement after pulmonary arterial stenting in four patients with Fontan circulation.

    Science.gov (United States)

    Tanase, Daniel; Ewert, Peter; Eicken, Andreas

    2015-01-01

    Plastic bronchitis is a severe complication after a Fontan procedure, with an estimated incidence around 1-2% and poor prognosis. We present the cases of four patients with plastic bronchitis after a total cavopulmonary connection with a stenosis of the left pulmonary artery that was stented successfully. In three of the four patients, symptoms improved after catheter intervention in combination with pulmonary vasodilator and inhalative treatment.

  16. Work-related chronic obstructive pulmo- nary disease

    African Journals Online (AJOL)

    definition marks a shift in previous definitions, which included the conditions of chronic bronchitis and emphysema, as employed by the American Thoracic Society,3 or 'reduced maximal expiratory flow' as included in the definition of the European Respiratory. Society.3 The disease includes the symptoms of chronic ...

  17. Evaluation of Fractioned Nitric Oxide in Chronic Cough Patients ...

    African Journals Online (AJOL)

    Introduction: Cough exceeding 3-8 weeks was defined as chronic cough in various guides. Asthma is the most common cause of chronic-specific cough. Causes other than asthma include prolonged bacterial bronchitis and upper airway cough syndrome (UACS). Nitric oxide (NO) causes vascular smooth muscle relaxation, ...

  18. The impact of persistent bacterial bronchitis on the pulmonary microbiome of children.

    Science.gov (United States)

    Cuthbertson, Leah; Craven, Vanessa; Bingle, Lynne; Cookson, William O C M; Everard, Mark L; Moffatt, Miriam F

    2017-01-01

    Persistent bacterial bronchitis (PBB) is a leading cause of chronic wet cough in young children. This study aimed to characterise the respiratory bacterial microbiota of healthy children and to assess the impact of the changes associated with the development of PBB. Blind, protected brushings were obtained from 20 healthy controls and 24 children with PBB, with an additional directed sample obtained from PBB patients. DNA was extracted, quantified using a 16S rRNA gene quantitative PCR assay prior to microbial community analysis by 16S rRNA gene sequencing. No significant difference in bacterial diversity or community composition (R2 = 0.01, P = 0.36) was observed between paired blind and non-blind brushes, showing that blind brushings are a valid means of accessing the airway microbiota. This has important implications for collecting lower respiratory samples from healthy children. A significant decrease in bacterial diversity (P < 0.001) and change in community composition (R2 = 0.08, P = 0.004) was observed among controls, in comparison with patients. Bacterial communities within patients with PBB were dominated by Proteobacteria, and indicator species analysis showed that Haemophilus and Neisseria were significantly associated with the patient group. In 15 (52.9%) cases the dominant organism by sequencing was not identified by standard routine clinical culture. The bacteria present in the lungs of patients with PBB were less diverse in terms of richness and evenness. The results validate the clinical diagnosis, and suggest that more attention to bacterial communities in children with chronic cough may lead to more rapid recognition of this condition with earlier treatment and reduction in disease burden.

  19. The impact of persistent bacterial bronchitis on the pulmonary microbiome of children.

    Directory of Open Access Journals (Sweden)

    Leah Cuthbertson

    Full Text Available Persistent bacterial bronchitis (PBB is a leading cause of chronic wet cough in young children. This study aimed to characterise the respiratory bacterial microbiota of healthy children and to assess the impact of the changes associated with the development of PBB. Blind, protected brushings were obtained from 20 healthy controls and 24 children with PBB, with an additional directed sample obtained from PBB patients. DNA was extracted, quantified using a 16S rRNA gene quantitative PCR assay prior to microbial community analysis by 16S rRNA gene sequencing.No significant difference in bacterial diversity or community composition (R2 = 0.01, P = 0.36 was observed between paired blind and non-blind brushes, showing that blind brushings are a valid means of accessing the airway microbiota. This has important implications for collecting lower respiratory samples from healthy children. A significant decrease in bacterial diversity (P < 0.001 and change in community composition (R2 = 0.08, P = 0.004 was observed among controls, in comparison with patients. Bacterial communities within patients with PBB were dominated by Proteobacteria, and indicator species analysis showed that Haemophilus and Neisseria were significantly associated with the patient group. In 15 (52.9% cases the dominant organism by sequencing was not identified by standard routine clinical culture.The bacteria present in the lungs of patients with PBB were less diverse in terms of richness and evenness. The results validate the clinical diagnosis, and suggest that more attention to bacterial communities in children with chronic cough may lead to more rapid recognition of this condition with earlier treatment and reduction in disease burden.

  20. Experience with Ivy Leaf Extract in the Treatment of Acute Obstructive Bronchitis in Children

    Directory of Open Access Journals (Sweden)

    Yu.V. Marushko

    2016-08-01

    Full Text Available According to the World Health Organization, when analyzing the structure of the causes of visi­ting to the pediatrician or general practitioner — family doctor, about 70 % of cases occur in acute respiratory infections (ARI. Among the child population, their frequency per a child is on average 6–10 cases per year, making ARI one of the most common infectious disease in the pediatric population of the world. Among the acute respiratory diseases in children acute bronchitis and acute obstructive bronchitis are among the most common diseases. The aim of our work was to study the effectiveness of ivy leaf extract in the treatment of acute obstructive bronchitis in children. Research materials. We observed 33 children aged from 4 to 8 years old who were treated for the diagnosis of acute respiratory viral infection, acute obstructive bronchitis. All patients received Pektolvan Ivy in a complex therapy. Results of the study. Complex treatment of acute obstructive bronchitis in children with the inclusion of the Pektolvan Ivy leads to softening of bronchial secretions and facilitating its discharge of on average already on the 3rd day of therapy, that manifested with decreased cough intensity, reduced its productivity and the change of dry wheezing rales into moist rales. Pektolvan Ivy has a satisfactory safety profile for the children. Conclusions. Stu­dies of using Pektolvan Ivy for the treatment of acute obstructive bronchitis showed its effectiveness. The drug can be recommended for wide use in pediatric.

  1. Pelargonium sidoides for acute bronchitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Agbabiaka, Taofikat B; Guo, Ruoling; Ernst, Edzard

    2008-05-01

    To critically assess the efficacy of Pelargonium sidoides for treating acute bronchitis. Systematic literature searches were performed in 5 electronic databases: (Medline (1950 - July 2007), Amed (1985 - July 2007), Embase (1974 - July 2007), CINAHL (1982 - July 2007), and The Cochrane Library (Issue 3, 2007) without language restrictions. Reference lists of retrieved articles were searched, and manufacturers contacted for published and unpublished materials. Study selection was done according to predefined criteria. All randomized clinical trials (RCTs) testing P. sidoides extracts (mono preparations) against placebo or standard treatment in patients with acute bronchitis and assessing clinically relevant outcomes were included. Two reviewers independently selected studies, extracted and validated relevant data. Methodological quality was evaluated using the Jadad score. Meta-analysis was performed using a fixed-effect model for continuous data, reported as weighted mean difference with 95% confidence intervals. Six RCTs met the inclusion criteria, of which 4 were suitable for statistical pooling. Methodological quality of most trials was good. One study compared an extract of P. sidoides, EPs 7630, against conventional non-antibiotic treatment (acetylcysteine); the other five studies tested EPs 7630 against placebo. All RCTs reported findings suggesting the effectiveness of P. sidoides in treating acute bronchitis. Meta-analysis of the four placebo-controlled RCTs suggested that EPs 7630 significantly reduced bronchitis symptom scores in patients with acute bronchitis by day 7. No serious adverse events were reported. There is encouraging evidence from currently available data that P. sidoides is effective compared to placebo for patients with acute bronchitis.

  2. The Relationships Between Weather and Climate and Attacks of Bronchitis

    Science.gov (United States)

    Talaia, M. A. R.; Saraiva, M. A. C.; Vieira da Cruz, A. A.

    The area of Aveiro, more concretely Aveiro lagoon, a natural laboratory has been con- sidered, for promoting the development and the application of several investigations worked. The importance of the influences of weather and climate on human health has been well known since ancient teams and many decisions concerning human be- haviour it are clearly weather related. However, decisions related to weather criteria can be important and economically significant, but the real economic effect of the weather is difficult to assess. Talaia et al. (2000) and Talaia and Vieira da Cruz (2001) have shown the possible harmful effect of certain meteorological factors on respiratory conditions. Bronchitis is a disease caused by inflammation of the bronchi as a result of infectious agents or air pollutants. In this study our attention is to relate, the be- ginning of bronchitis attacks in the services of urgency of the Hospital of Aveiro with meteorological factors, and the risk group are studied. We used the medical records and the database of meteorological factors. The obtained analysis allows to conclude that some meteorological factors have correlation with the occurrences of the disease and to allow improving the work in the urgency services in the requested periods. The knowledge that will be extracted of this study can be used later in studies that inte- grate other important components for the characterisation of the environmental impact in the area. References: Talaia, M.A.R., Vieira da Cruz, A.A., Saraiva, M.A.C., Amaro, G.S., Oliveira, C.J. and Carvalho, C.F., 2000, The Influence of Meteorological Fac- tors on Pneumonia Emergencies in Aveiro, International Symposium on Human- Biometeorology, St. Petersburg (Pushkin), Russia, pp. 67-68. Talaia, M.A.R. and Vieira of Cruz, A.A., (2001), Meteorological Effects on the Resistance of the Body to Influenza - One Study in Aveiro Region, Proceedings 2nd Symposium of Meteorol- ogy and Geophysics of APMG and 3rd Meeting

  3. Proteomic analysis of purified coronavirus infectious bronchitis virus particles.

    Science.gov (United States)

    Kong, Qingming; Xue, Chunyi; Ren, Xiangpeng; Zhang, Chengwen; Li, Linlin; Shu, Dingming; Bi, Yingzuo; Cao, Yongchang

    2010-06-09

    Infectious bronchitis virus (IBV) is the coronavirus of domestic chickens causing major economic losses to the poultry industry. Because of the complexity of the IBV life cycle and the small number of viral structural proteins, important virus-host relationships likely remain to be discovered. Toward this goal, we performed two-dimensional gel electrophoresis fractionation coupled to mass spectrometry identification approaches to perform a comprehensive proteomic analysis of purified IBV particles. Apart from the virus-encoded structural proteins, we detected 60 host proteins in the purified virions which can be grouped into several functional categories including intracellular trafficking proteins (20%), molecular chaperone (18%), macromolcular biosynthesis proteins (17%), cytoskeletal proteins (15%), signal transport proteins (15%), protein degradation (8%), chromosome associated proteins (2%), ribosomal proteins (2%), and other function proteins (3%). Interestingly, 21 of the total host proteins have not been reported to be present in virions of other virus families, such as major vault protein, TENP protein, ovalbumin, and scavenger receptor protein. Following identification of the host proteins by proteomic methods, the presence of 4 proteins in the purified IBV preparation was verified by western blotting and immunogold labeling detection. The results present the first standard proteomic profile of IBV and may facilitate the understanding of the pathogenic mechanisms.

  4. Proteomic analysis of purified coronavirus infectious bronchitis virus particles

    Directory of Open Access Journals (Sweden)

    Shu Dingming

    2010-06-01

    Full Text Available Abstract Background Infectious bronchitis virus (IBV is the coronavirus of domestic chickens causing major economic losses to the poultry industry. Because of the complexity of the IBV life cycle and the small number of viral structural proteins, important virus-host relationships likely remain to be discovered. Toward this goal, we performed two-dimensional gel electrophoresis fractionation coupled to mass spectrometry identification approaches to perform a comprehensive proteomic analysis of purified IBV particles. Results Apart from the virus-encoded structural proteins, we detected 60 host proteins in the purified virions which can be grouped into several functional categories including intracellular trafficking proteins (20%, molecular chaperone (18%, macromolcular biosynthesis proteins (17%, cytoskeletal proteins (15%, signal transport proteins (15%, protein degradation (8%, chromosome associated proteins (2%, ribosomal proteins (2%, and other function proteins (3%. Interestingly, 21 of the total host proteins have not been reported to be present in virions of other virus families, such as major vault protein, TENP protein, ovalbumin, and scavenger receptor protein. Following identification of the host proteins by proteomic methods, the presence of 4 proteins in the purified IBV preparation was verified by western blotting and immunogold labeling detection. Conclusions The results present the first standard proteomic profile of IBV and may facilitate the understanding of the pathogenic mechanisms.

  5. The role of ketotifen in children with recurrent bronchitis.

    Science.gov (United States)

    Suwanjutha, S; Chantarojanasiri, T

    1985-01-01

    The efficacy and safety of ketotifen in the treatment of recurrent bronchitis were studied in twenty Thai children with an average age of 5.3 years. Symptoms studied were cough, hypersecretion and wheezing and 4-point rating scores were assigned to each of the symptoms with regard to their frequency, severity and duration. Score per dose of the symptomatic agents used was also given. The symptoms and the use of symptomatic agents were recorded during a full year prior to ketotifen treatment and during a further full year study period. PEFR measurement was performed in the children above the age of 6 years at 2-weekly intervals under the supervision of the authors at the clinic. Assessment of efficacy was done by comparing monthly symptom scores and medication scores during the study period with the mean value of the previous year. Thirteen children received ketotifen for the whole year while seven children who were almost symptom-free after 4 months ketotifen treatment, were then only observed for a further 8 months. At the end of the study period, ketotifen treatment was rated very good and good in 85% of children, satisfactory in 10% and poor in 5%. Drowsiness was the only side-effect reported in a few cases but then only initially. There were no abnormalities in any laboratory parameters studied.

  6. Bone mineral density in children with recurrent bronchitis

    Directory of Open Access Journals (Sweden)

    Vertegel A.A.

    2016-03-01

    Full Text Available Objective: To define the L1-L4 lumbar spine and hips bone mineral density (BMD parameters in children with recurrent bronchitis (RB through dual-energy X-ray absorptiometry (DXA. Materials and methods. The study involved 45 children with RB, aged 6 to 10 years, boys — 20, girls — 25. To measure used L1-L4 lumbar spine and hips bone mineral density (BMD with the assessment Z-score. The Z-score level in the range of 0.05, except for more frequent registration decreasing of the L4 lumbar spine BMD in boys than in girls (р<0.05. The average number of reduced BMD loci was higher among boys (р<0.05. Indicators DXA in 10 children who had clinically significant fracture history, characterized by a relative increase in the number of BMD reduced sites. In boys reducing of the BMD odds ratio was higher than girls in all areas of study, particularly from the L1-L4 spine. Conclusions. Children with RB, aged 6 to 10 years have a reduction of the L1-L4 lumbar spine and hips BMD without clinical manifestations of bone deficiency.

  7. Recombination in Avian Gamma-Coronavirus Infectious Bronchitis Virus

    Directory of Open Access Journals (Sweden)

    Mark W. Jackwood

    2011-09-01

    Full Text Available Recombination in the family Coronaviridae has been well documented and is thought to be a contributing factor in the emergence and evolution of different coronaviral genotypes as well as different species of coronavirus. However, there are limited data available on the frequency and extent of recombination in coronaviruses in nature and particularly for the avian gamma-coronaviruses where only recently the emergence of a turkey coronavirus has been attributed solely to recombination. In this study, the full-length genomes of eight avian gamma-coronavirus infectious bronchitis virus (IBV isolates were sequenced and along with other full-length IBV genomes available from GenBank were analyzed for recombination. Evidence of recombination was found in every sequence analyzed and was distributed throughout the entire genome. Areas that have the highest occurrence of recombination are located in regions of the genome that code for nonstructural proteins 2, 3 and 16, and the structural spike glycoprotein. The extent of the recombination observed, suggests that this may be one of the principal mechanisms for generating genetic and antigenic diversity within IBV. These data indicate that reticulate evolutionary change due to recombination in IBV, likely plays a major role in the origin and adaptation of the virus leading to new genetic types and strains of the virus.

  8. ERS statement on protracted bacterial bronchitis in children.

    Science.gov (United States)

    Kantar, Ahmad; Chang, Anne B; Shields, Mike D; Marchant, Julie M; Grimwood, Keith; Grigg, Jonathan; Priftis, Kostas N; Cutrera, Renato; Midulla, Fabio; Brand, Paul L P; Everard, Mark L

    2017-08-01

    This European Respiratory Society statement provides a comprehensive overview on protracted bacterial bronchitis (PBB) in children. A task force of experts, consisting of clinicians from Europe and Australia who manage children with PBB determined the overall scope of this statement through consensus. Systematic reviews addressing key questions were undertaken, diagrams in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement constructed and findings of relevant studies summarised. The final content of this statement was agreed upon by all members.The current knowledge regarding PBB is presented, including the definition, microbiology data, known pathobiology, bronchoalveolar lavage findings and treatment strategies to manage these children. Evidence for the definition of PBB was sought specifically and presented. In addition, the task force identified several major clinical areas in PBB requiring further research, including collecting more prospective data to better identify the disease burden within the community, determining its natural history, a better understanding of the underlying disease mechanisms and how to optimise its treatment, with a particular requirement for randomised controlled trials to be conducted in primary care. Copyright ©ERS 2017.

  9. Airway distensibility in Chronic Obstructive Airway Disease

    DEFF Research Database (Denmark)

    Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger

    2013-01-01

    Rationale – Chronic Obstructive Pulmonary Disease (COPD) is a combination of chronic bronchitis and emphysema, which both may lead to airway obstruction. Under normal circumstances, airway dimensions vary as a function of inspiration level. We aim to study the influence of COPD and emphysema......-20% (mild), 20%-30% (moderate) or >30% (severe). Spirometry was performed annually and participants were divided into severity groups according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Data were analysed in a mixed effects regression model with log(airway lumen diameter...... and emphysema, respectively. Conclusions – Airway distensibility decreases significantly with increasing severity of both GOLD status and emphysema, indicating that in COPD the dynamic change in airway calibre during respiration is compromised. Chronic bronchitis and emphysema appear to be interacting...

  10. Use of aerosolized tissue plasminogen activator in the treatment of plastic bronchitis.

    Science.gov (United States)

    Lubcke, Nicole L; Nussbaum, Vicki M; Schroth, Mary

    2013-03-01

    To present a case of nebulized tissue plasminogen activator (t-PA) treatment for symptomatic plastic bronchitis in a pediatric patient years after a Fontan procedure. A 13-year-old boy with a history of corrected congenital heart disease was admitted to the pediatric intensive care unit after 2 weeks of worsening respiratory distress. A chest radiograph and subsequent bronchoscopy revealed extensive mucus plugging due to plastic bronchitis. Casts reaccumulated quickly after manual removal of the mucus and a regimen of aerosolized t-PA was initiated to break down the casts and prevent further cast formation over the 17-day hospital course. The treatment was successful and the patient was discharged home without evidence of bronchial casts. Plastic bronchitis is a potentially devastating condition in which pulmonary infiltrates line the bronchial tree, forming casts and prohibiting effective oxygen exchange. There are few effective treatment options for this condition. The use of aerosolized t-PA for the treatment of plastic bronchitis has been reported to be safe and effective in 4 cases but no consistent regimen, dose, or duration of treatment has been established. t-PA can be nebulized and inhaled for successful inhibition of bronchial cast formation. More information to determine the most effective dose and duration of therapy is needed to effectively improve the lives of people with plastic bronchitis.

  11. Antibiotic and bronchodilator prescribing for acute bronchitis in the emergency department.

    Science.gov (United States)

    Kroening-Roche, Jason C; Soroudi, Arash; Castillo, Edward M; Vilke, Gary M

    2012-08-01

    Although the overuse of antibiotics and underuse of bronchodilators for treatment of acute bronchitis is well known, few studies have analyzed these trends in the emergency department (ED). To characterize the antibiotic and bronchodilator prescribing practices of physicians at two academic EDs in the diagnosis of acute bronchitis, and to identify factors that may or may not be associated with these practices. A computer database was searched retrospectively for all patients with an ED discharge diagnosis of acute bronchitis, and analyzed, looking at the frequency of antibiotic prescriptions, the class of antibiotic prescribed, and several other related factors including age, gender, chief complaint, duration of cough, and comorbid conditions. During the study period, there were 836 cases of acute bronchitis in adults. Of these, 622 (74.0%) were prescribed antibiotics. Of those prescribed antibiotics, 480 (77.2%) were prescribed broad-spectrum antibiotics. Using multivariate analysis (odds ratio, 95% confidence interval), antibiotics were prescribed significantly more often in patients aged 50 years or older (1.7, 1.2-2.5) and in smokers (1.5, 1.0-2.2). Of patients without asthma, 346 (49.9%) were discharged without a bronchodilator, and 631 (91.1%) were discharged without a spacer device. Antibiotics are over-prescribed in the ED for acute bronchitis, with broad-spectrum antibiotics making up the majority of the antibiotics prescribed. Age ≥50 years and smoking are associated with higher antibiotic prescribing rates. Copyright © 2012. Published by Elsevier Inc.

  12. Primary care clinicians' perceptions about antibiotic prescribing for acute bronchitis: a qualitative study.

    Science.gov (United States)

    Dempsey, Patrick P; Businger, Alexandra C; Whaley, Lauren E; Gagne, Joshua J; Linder, Jeffrey A

    2014-12-12

    Clinicians prescribe antibiotics to over 65% of adults with acute bronchitis despite guidelines stating that antibiotics are not indicated. To identify and understand primary care clinician perceptions about antibiotic prescribing for acute bronchitis, we conducted semi-structured interviews with 13 primary care clinicians in Boston, Massachusetts and used thematic content analysis. All the participants agreed with guidelines that antibiotics are not indicated for acute bronchitis and felt that clinicians other than themselves were responsible for overprescribing. Barriers to guideline adherence included 6 themes: (1) perceived patient demand, which was the main barrier, although some clinicians perceived a recent decrease; (2) lack of accountability for antibiotic prescribing; (3) saving time and money; (4) other clinicians' misconceptions about acute bronchitis; (5) diagnostic uncertainty; and (6) clinician dissatisfaction in failing to meet patient expectations. Strategies to decrease inappropriate antibiotic prescribing included 5 themes: (1) patient educational materials; (2) quality reporting; (3) clinical decision support; (4) use of an over-the-counter prescription pad; and (5) pre-visit triage and education by nurses to prevent visits. Clinicians continued to cite patient demand as the main reason for antibiotic prescribing for acute bronchitis, though some clinicians perceived a recent decrease. Clinicians felt that other clinicians were responsible for inappropriate antibiotic prescribing and that better pre-visit triage by nurses could prevent visits and change patients' expectations.

  13. CT findings of plastic bronchitis in children after a Fontan operation

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Jhang, Won Kyoung; Kim, Young Hwee; Ko, Jae Kon; Park, In Sook [University of Ulsan College of Medicine, Department of Pediatric Cardiology, Asan Medical Center, Seoul (Korea); Park, Jeong-Jun; Yun, Tae-Jin; Seo, Dong-Man [University of Ulsan College of Medicine, Department of Pediatric Cardiac Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    Plastic bronchitis is a rare cause of acute obstructive respiratory failure in children. Life-threatening events are much more frequent in patients with repaired cyanotic congenital heart disease, and most frequent following a Fontan operation. Commonly, the diagnosis is not made until bronchial casts are expectorated. Detailed CT findings in plastic bronchitis have not been described. To describe the CT findings in plastic bronchitis in children after a Fontan operation. Three children with plastic bronchitis after a Fontan operation were evaluated by chest CT. Bronchial casts were spontaneously expectorated and/or extracted by bronchoscopy. Airway and lung abnormalities seen on CT were analyzed in the three children. CT demonstrated bronchial casts in the central airways with associated atelectasis and consolidation in all children. The affected airways were completely or partially obstructed by the bronchial casts without associated bronchiectasis. The airway and lung abnormalities rapidly improved after removal of the bronchial casts. CT can identify airway and lung abnormalities in children with plastic bronchitis after a Fontan operation. In addition, CT can be used to guide bronchoscopy and to monitor treatment responses, and thereby may improve clinical outcomes. (orig.)

  14. Changes of Treg and Th17 cells as well as cytokines in children with acute bronchitis.

    Science.gov (United States)

    Tu, Zhiqiang; Xue, Haiyan; Chen, Wei; Cao, Lanfang; Zhang, Weiqi

    2017-10-01

    The present study aimed to investigate changes of T-regulatory (Treg) and T-helper (Th)17 cells as well as cytokines in peripheral blood of children with acute bronchitis, and to explore the roles of these cells in the pathogenesis of acute bronchitis. A total of 126 children who had presented at Renji Hospital (Shanghai, China) with acute bronchitis were selected as the observation group and 30 healthy children were selected as the control group. Th17/Tregs in the peripheral blood of the children of the observation group and the control group was detected by flow cytometry. The levels of cytokines interleukin (IL)-17, IL-22, IL-10 and transforming growth factor (TGF)-β in peripheral blood serum were detected by ELISA. Compared with those in the control group, Treg cells, the Treg/Th17 ratio as well as serum IL-10 and TGF-β levels were significantly decreased in the observation group (Pacute bronchitis, suggesting that Treg and Th17 cells as well as their cytokines may be involved in the pathogenesis of acute bronchitis. It may be of certain guiding significance to detect Treg/Th17 and levels of serum cytokines in peripheral blood for clinical treatment.

  15. Biochemical characteristics of inflammatory-destructive process in dust-induced bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Shatskaya, N.N.; Palagushina, A.I.

    1984-12-01

    The diagnostic value of biochemical parameters of inflammatory-destructive process in occupational bronchitis at different stages of its development is assessed. A complex of tests to determine biochemical parameters including determination of a proteinogram, level of total protein, fibrinogen, haptoglobin, neuraminic acid and diphenylamine in blood is used. Biochemical investigation was conducted on 119 foundry workers with different stages of development of bronchitits induced by contact with quartz-containing dust. Results of tests show from early stage of disease through developed illness an increase in haptoglobin and diphenylamine levels in blood and a decrease in total protein and albumin levels. Tests determine components of albumin and glycoprotein metabolism and can be used to evaluate inflammatory destructive process in lungs in dust-induced bronchitis. Initial stages of bronchitis may be characterized on basis of biochemical facts as plasma destructive. During development of bronchitis, the complex of biochemical tests enables investigation to evaluate accompanying inflammatory syndrome which is important in determination of tactics for treatment of dust-induced bronchitis. 18 references.

  16. Bronchitis caused by Bordetella holmesii in a child with asthma misdiagnosed as mycoplasmal infection.

    Science.gov (United States)

    Katsukawa, Chihiro; Kushibiki, Chieko; Nishito, Atsumi; Nishida, Rikou; Kuwabara, Norimitsu; Kawahara, Ryuji; Otsuka, Nao; Miyaji, Yusuke; Toyoizumi-Ajisaka, Hiromi; Kamachi, Kazunari

    2013-06-01

    We report a case of a bronchitis caused by Bordetella holmesii in a 2-year-old girl with asthma. The patient had a moderate fever and productive cough, and her condition was initially diagnosed as mycoplasmal bronchitis on the basis of her clinical symptoms and rapid serodiagnosis of mycoplasmal infection. She was treated with a bronchodilator and clarithromycin, which resulted in complete recovery. However, after the initial diagnosis, nucleic acid amplification tests of her sputum showed the absence of both Mycoplasma pneumoniae and Bordetella pertussis infections. Sputum culture showed the presence of a slow-growing, gram-negative bacillus in pure culture on Bordetella agar plates; the bacillus was later identified as B. holmesii. B. holmesii infection is rare in immunocompetent children; however, the organism is a true pathogen that can cause bronchitis in young children with asthma.

  17. Can eosinophilic bronchitis be considered as an occupational disease? Medical certification aspects

    Directory of Open Access Journals (Sweden)

    Aneta Kleniewska

    2013-08-01

    Full Text Available Eosinophilic bronchitis (EB is a condition which can be associated with occupational exposure to low, as well as to high molecular weight allergens. The prevalence of occupational eosinophilic bronchitis is unknown and the data concerning its work-related etiology are available only from the case reports. However, there is a need to establish the principles, especially in the context of medical certification among workers occupationally exposed to allergens. This paper reviews current knowledge on the etiology, clinical features, and diagnostic procedures in the eosinophilic bronchitis. The importance of EB, especially in view of the problems emerging in the prophylactic care taken by occupational health services and the principles of medical certification when occupational etiology is suspected are also presented. Med Pr 2013;64(4:569–578

  18. 38 CFR 3.316 - Claims based on chronic effects of exposure to mustard gas and Lewisite.

    Science.gov (United States)

    2010-07-01

    ..., bronchitis, emphysema, asthma or chronic obstructive pulmonary disease. (3) Full-body exposure to nitrogen... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Claims based on chronic... Compensation Ratings and Evaluations; Service Connection § 3.316 Claims based on chronic effects of exposure to...

  19. Impact of Ambient Air Pollution on the Differential White Blood Cell Count in Patients with Chronic Pulmonary Disease

    OpenAIRE

    Brüske, Irene; Hampel, Regina; Socher, Martin M.; Rückerl, Regina; Schneider, Alexandra; Heinrich, Joachim; Oberdörster, Günter; Wichmann, H.-Erich; Peters, Annette

    2010-01-01

    Epidemiologic studies report associations between particulate air pollution and increased mortality from pulmonary diseases.To examine whether the exposure to ambient gaseous and particulate air pollution leads to an alteration of the differential white blood cell count in patients with chronic pulmonary diseases like chronic bronchitis, chronic obstructive pulmonary disease, and asthma.

  20. [DYNAMICS OF CYTOKINES IN INFANTS WITH ACUTE OBSTRUCTIVE BRONCHITIS AND THYMOMEGALIA].

    Science.gov (United States)

    Smiyan, O I; Plakhuta, V A; Bunda, T P; Popov, S V

    2015-01-01

    The article contains the information about pro- and anti-inflammatory cytokines in infants with acute obstructive bronchitis and thymus hypertrophy. The content of IL-6 and IL-10 has been de- termined in 101 children in acute period of disease and during early convalescence. It was found the increasing of production of proinflammatory IL-6 and a low level of anti-inflammatory IL-10 in the first days of illness in all children with thymomegalia. During convalescence in patients with acute obstructive bronchitis and thymomegalia IL-6 level was decreasing, and the level of IL-10 was in- creasing, but it did not amount to the level of healthy children.

  1. [The impact of viruses in lower respiratory tract infections of the adult. Part II: acute bronchitis, acute exacerbated COPD, pneumonia, and influenza].

    Science.gov (United States)

    Ott, S R; Rohde, G; Lepper, P M; Hauptmeier, B; Bals, R; Pletz, M W R; Schumann, C; Steininger, C; Kleines, M; Geerdes-Fenge, H

    2010-01-01

    In industrialized countries respiratory tract infections are one of the most common reasons for medical consultations. It is assumed that almost one third of these infections affect the lower respiratory tract (LRTI), e. g. acute bronchitis, acute exacerbation of chronic obstructive pulmonary disease (COPD), community- or hospital-acquired pneumonia and influenza. Due to a lack of sufficient and valid investigations on the epidemiology of respiratory viruses, their impact on the pathogenesis of LRTI has probably been underestimated for a long time. Therefore, there might have been many cases of needless antibiotic treatment, particularly in cases of acute bronchitis or acute exacerbations of COPD, because of an assumed bacteriological aetiology. Following the introduction of diagnostic procedures with increased sensitivity, such as polymerase chain reaction, it is possible to reliably detect respiratory viruses and to illuminate their role in the pathogenesis of LRTI of the adult. We have reviewed the current literature to elucidate the role of viruses in the pathogenesis of LRTI. The first part of this series described frequent viral pathogens, pathogenesis of viral LRTI, and diagnostic procedures. In this 2 (nd) part the aetiological role of viruses in the most frequent forms of LRTI will be highlighted, and the third and last part will provide an overview of therapeutic and preventive options. Georg Thieme Verlag KG Stuttgart New York.

  2. Association Between Chronic Respiratory Diseases and Helicobacter pylori: A Meta-Analysis.

    Science.gov (United States)

    Wang, Lijie; Guan, Yan; Li, Yan; Liu, Xiuju; Zhang, Yakun; Wang, Fuxia; Kong, Lingling; Guo, Qisen

    2015-06-01

    The prevalence of chronic respiratory diseases (CRDs), including chronic bronchitis and chronic obstructive pulmonary disease (COPD), has increased significantly over the past decades. Several studies suggest that Helicobacter pylori infection may be related to the development of CRDs, but the results were not consistent. We carried out a meta-analysis to evaluate the potential association of H.pylori infection with CRDs. We conducted a systematic literature search in PubMed, Embase, Ovid, Google Scholar and CNKI from inception to October 31, 2013. The following search terms were used: "chronic respiratory disease," "chronic bronchitis," "chronic obstructive pulmonary disease" or "COPD" in combination with "Helicobacter pylori" or "Campylobacter pylori." According to established inclusion criteria, we selected all eligible published papers and then extracted essential data. To evaluate the association of H.pylori with chronic bronchitis and COPD, an overall analysis and subgroup analyses were conducted. A total of 9 case-control studies comprising 782 cases and 815 controls were included in the study. Pooled ORs were 2.30 (95%CI: 1.85-2.85) in the overall analysis, 2.90 (95%CI: 2.04-4.13) in the chronic bronchitis subgroup, and 2.11 (95%CI: 1.35-3.29) in the COPD subgroup. The results of the overall analysis and subgroup analyzed suggest a significant association between H.pylori and CRDs. Further studies are needed to clarify the pathogenetic mechanisms involved. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  3. Purine Bases in Blood Plasma of Patients with Chronic Pulmonary Diseases

    Directory of Open Access Journals (Sweden)

    Larissa E. Muravluyova

    2012-09-01

    Full Text Available The article is focused on the study of purine bases and intermediates of purine catabolism in plasma of patients with chronic obstructive bronchitis and idiopathic interstitial pneumonia. Decrease of adenine and hypoxantine in plasma of patients with idiopathic interstitial pneumonia was registered. Increase of guanine in plasma of patients with chronic obstructive pulmonary disease was established.

  4. Rapid NK-cell activation in chicken after infection with infectious bronchitis virus M41

    NARCIS (Netherlands)

    Vervelde, L.; Matthijs, M.G.R.; van Haarlem, D.A.; de Wit, Sjaak; Jansen, C.A.

    2013-01-01

    Natural killer (NK) cells are cytotoxic lymphocytes and play an important role in the early defence against viruses. In this study we focussed on NK cell and interferon (IFN) responses after infection with infectious bronchitis virus (IBV). Based on surface expression of CD107+, enhanced activation

  5. Association between Ambient Air Pollution and Outpatient Visits for Acute Bronchitis in a Chinese City.

    Science.gov (United States)

    Guo, Li Juan; Zhao, Ang; Chen, Ren Jie; Kan, Hai Dong; Kuang, Xing Ya

    2014-11-01

    To investigate the short-term association between outdoor air pollution and outpatient visits for acute bronchitis, which is a rare subject of research in the mainland of China. A time-series analysis was conducted to examine the association of outdoor air pollutants with hospital outpatient visits in Shanghai by using two-year daily data (2010-2011). Outdoor air pollution was found to be associated with an increased risk of outpatient visits for acute bronchitis in Shanghai. The effect estimates of air pollutants varied with the lag structures of the concentrations of the pollutants. For lag06, a 10 μg/m(3) increase in the concentrations of PM10, SO(2), and NO(2) corresponded to 0.94% (95% CI: 0.83%, 1.05%), 11.12% (95% CI: 10.76%, 11.48%), and 4.84% (95% CI: 4.49%, 5.18%) increases in hospital visits for acute bronchitis, respectively. These associations appeared to be stronger in females (Pacute bronchitis and that the rationale for further limiting air pollution levels in Shanghai should be strengthened. Copyright © 2014 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  6. Treatment of acute bronchitis with EPs 7630: randomized, controlled trial in children and adolescents.

    Science.gov (United States)

    Kamin, Wolfgang; Ilyenko, Lidia I; Malek, Fathi A; Kieser, Meinhard

    2012-04-01

    The aim of this trial was to investigate the efficacy and tolerability of EPs 7630, a herbal drug preparation from Pelargonium sidoides, in children and adolescents suffering from acute bronchitis, outside the strict indication for antibiotics. A total of 220 patients with acute bronchitis were randomized and given either verum containing EPs 7630 (1-6 years/>6-12 years/>12-18 years: 3 × 10/3 × 20/3 × 30 drops/day) or matching placebo for 7 days. The main outcome measure was the change in the total score of bronchitis-specific symptoms (BSS) from day 0 to day 7. The decrease in the BSS total score was significantly higher for EPs 7630 compared to placebo (change day 0-day 7: 4.4 ± 1.6 vs 2.9 ± 1.4 points; P acute bronchitis in children and adolescents outside the strict indication for antibiotics. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

  7. Treatment of acute bronchitis in adults. A national survey of family physicians.

    Science.gov (United States)

    Oeffinger, K C; Snell, L M; Foster, B M; Panico, K G; Archer, R K

    1998-06-01

    The purpose of this study was to determine how family physicians in the United States treat acute bronchitis in an otherwise healthy adult. A 33-item questionnaire on the diagnosis and treatment of acute bronchitis was mailed to a random sample of 500 physicians who are members of the American Board of Family Practice. Thirty-two of the 500 sampled physicians could not be located by mail; 265 of those who received the questionnaire responded. The response rate was 57% (265/468). Sixty-three percent of responding physicians indicated that antibiotics are their first choice of treatment for the otherwise healthy, nonsmoking adult with acute bronchitis. The decision to use antibiotics as the first choice of treatment did not vary by physician's sex, age, years in practice, practice location, practice type, or percentage of HMO patients. Only 6% of responding physicians reported using beta 2 agonist bronchodilators as their first choice of treatment. Physicians in this study stated that they prescribe an antibiotic 75% of the time in treating nonsmoking patients with acute bronchitis (first choice or otherwise). If the patient is a smoker, physicians reported that they prescribe antibiotics 90% of the time (F = 110.25; df = 1; P > .0001). Physicians reported that for patients who smoke it takes longer for coughs to totally resolve and longer for them to return to a normal activity level than for nonsmokers. Family physicians report that antibiotics are their most common treatment for acute bronchitis in the otherwise healthy adult. Previous clinical trials have shown only marginal improvement in symptoms when patients with this condition are treated with an antibiotic. With antibiotic resistance emerging as a major global health problem, it is essential that other methods of treatment be evaluated.

  8. Percutaneous Lymphatic Embolization of Abnormal Pulmonary Lymphatic Flow as Treatment of Plastic Bronchitis in Patients With Congenital Heart Disease

    National Research Council Canada - National Science Library

    Dori, Yoav; Keller, Marc S; Rome, Jonathan J; Gillespie, Matthew J; Glatz, Andrew C; Dodds, Kathryn; Goldberg, David J; Goldfarb, Samuel; Rychik, Jack; Itkin, Maxim

    2016-01-01

    ... as a treatment for these patients. METHODS AND RESULTS—This is a retrospective case series of 18 patients with surgically corrected congenital heart disease and plastic bronchitis who presented for lymphatic imaging and intervention...

  9. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  10. 77 FR 59929 - Guidance for Industry on Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With...

    Science.gov (United States)

    2012-10-01

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Acute Bacterial Exacerbations of... Disease: Developing Antimicrobial Drugs for Treatment.'' This guidance addresses FDA's current thinking regarding the overall development program and clinical trial designs for drugs to support an indication for...

  11. Cross-sectional evaluation of the Bronchitis Severity Score in Egyptian children: A move to reduce antibiotics

    Directory of Open Access Journals (Sweden)

    E M I Moawad

    2017-04-01

    Full Text Available Background. Despite evidence of limited benefit of antibiotics in acute bronchitis, most paediatric patients are prescribed them. Objectives. To assess the validity of the Bronchitis Severity Score (BSS in assessing the clinical response to treatment of acute bronchitis, and determine whether clinical data and basic laboratory measurements can be used to guide antibiotic prescription. Methods. We enrolled 200 patients (age range 6 months - 12 years with clinically diagnosed acute bronchitis. They were divided into three groups according to age. All patients were evaluated three times during the bronchitis episode (days 0, 5 and 7. The primary outcome measurement was the change in the BSS from day 0 to day 7. Results. On the initial visit, the mean (standard deviation (SD BSS was 8.36 (2.6, indicating moderate severity of bronchitis. The mean BSS decreased to 4.03 (2.3 on day 5 and to 2.36 (1.45 on day 7. Initial blood tests showed anaemia (80%, leucocytosis (6%, bandaemia (3% and lymphocytosis (52%. Only four patients were positive for C-reactive protein, while the erythrocyte sedimentation rate was elevated in 98% of cases. There were significant correlations between bandaemia, fever grade (p<0.001 and white blood cell count with clinical variables such as the presence of secretions on chest auscultation (p<0.05 and toxic facies on general examination (p<0.05. Conclusions. Acute bronchitis in children is a self-limiting disease that does not require routine administration of antibiotics. The BSS is a simple and practical clinical scoring system that is useful in evaluating disease severity and monitoring disease resolution in acute bronchitis.

  12. ANESTHETIC CONSIDERATION S IN CHRONIC OBSTRUCTIVE PULMON ARY DISEASE

    Directory of Open Access Journals (Sweden)

    Awati

    2015-03-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a spectrum of diseases that includes emphysema, chronic bronchitis, and small airway disease. It i s characterized by progressive increased resistance to breathing. Patients with marked obstructive pulmonary disease are at increased risk for both intraoperative and Postoperative pulmonary complications. These patients require thorough preoperative prepa ration, meticulous intraoperative management & postoperative care. This article describes anesthetic considerations in a patient with COPD.

  13. Is C-reactive protein testing useful to predict outcome in patients with acute bronchitis?

    Science.gov (United States)

    Llor, Carl; Plana-Ripoll, Oleguer; Moragas, Ana; Bayona, Carolina; Morros, Rosa; Pera, Helena; Miravitlles, Marc

    2014-10-01

    A recent clinical trial could not find differences between anti-inflammatory drugs, antibiotics and placebo in shortening the duration of symptoms in acute bronchitis. To investigate if C-reactive protein (CRP) concentrations at presentation are predictive of symptom resolution in these patients. We performed a secondary analysis of the data from a placebo-controlled, randomized clinical trial carried out in primary care. Patients from 18 to 70 years of age presenting a respiratory tract infection of 20 mg/l (95% CI: 9-12) (P = 0.337). Among patients with uncomplicated acute bronchitis and discoloured sputum, the CRP concentrations at presentation are not helpful for predicting symptom resolution. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. SIGNIFICANCE OF ENVIRONMENTAL FACTORS AND ADAPTIVE CAPABILITIES OF CHILDREN WITH RECURRENT EPISODES OF OBSTRUCTIVE BRONCHITIS

    Directory of Open Access Journals (Sweden)

    V.V. Karpov

    2008-01-01

    Full Text Available The objective of the study was to evaluate the level of significance of environmental factors (ecological and social, their interconnection with different somatic types and adaptive capabilities, as well as with peculiarities of preschoolers immunity with recurrent episodes of obstructive bronchitis (ob to work out adequate therapy schemes for periods of exacerbation and rehabilitation. It is proven that children with recurrent ob are characterized by mesomacrosome somatotype, prevalence of vagotonia, sympathicotonia with hyper sympathicotonic type of vegetative reactivity and significant disorder of mucociliary clearance persisting after clinical recovery. The efficiency of ambroxol mugoregulator in complex therapy of ob and expedience of its long term (14–18 administration for recovery of disturbed system of mucociliary transport, were confirmed.Key words: obstructive bronchitis, children, somatotype, vegetative reactivity, immunity, ambroxol.

  15. Effect of Vaporub on the restlessness of children with acute bronchitis.

    Science.gov (United States)

    Berger, H; Madreiter, H; Jarosch, E

    1978-01-01

    In this study pneumographs of children with acute bronchitis treated with Vicks Vaporub or Petrolatum were used. Movement artifacts were used as a measure of the so-called "restlessness" of the children. The experimental schedule consisted of a 10-minute phase of recording before a 3-minute treatment with Vaporub or Petrolatum, followed by a 70-minute observation period, during which time pneumograms were also recorded. Thirty-four Vaporub-treated children showed an increase in periods without movement artifacts of up to 213.8%, the Petrolatum controls, twenty-six children, up to 62.4% as compared to the corresponding pre-treatment values. It is concluded that Vaporub is effective in decreasing restlessness in children suffering from acute bronchitis. This effect is quite marked and cannot be due solely to psychological effects of the rub therapy, or to effects of petrolatum without aromatics.

  16. A liquid phase blocking ELISA for the detection of antibodies against infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    Cardoso T.C.

    1999-01-01

    Full Text Available A liquid phase blocking ELISA (LPB-ELISA was developed for the detection and measurement of antibodies against infectious bronchitis virus (IBV. The purified and nonpurified virus used as antigen, the capture and detector antibodies, and the chicken hyperimmune sera were prepared and standardized for this purpose. A total of 156 sera from vaccinated and 100 from specific pathogen-free chickens with no recorded contact with the virus were tested. The respective serum titers obtained in the serum neutralization test (SNT were compared with those obtained in the LPB-ELISA. There was a high correlation (r2 = 0.8926 between the two tests. The LPB-ELISA represents a single test suitable for the rapid detection of antibodies against bronchitis virus in chicken sera, with good sensitivity (88%, specificity (100% and agreement (95.31%.

  17. Immune and Genetic Aspects of Anti-Inflammatory Therapy of Acute Obstructive Bronchitis in Infants

    Directory of Open Access Journals (Sweden)

    O.Ye. Abaturov

    2015-12-01

    Full Text Available The objective of the study was to improve the treatment of acute obstructive bronchitis in infants by optimizing the anti-inflammatory therapy based on the evaluation of its clinical, immunological and molecular genetic efficiency. Materials and methods. We have carried out a comprehensive examination of 80 children aged 6 months to 3 years with acute obstructive bronchitis. Patients were divided into two groups: children of the first group (n = 40 received systemic glucocorticosteroids, children of the second group (n = 40 were treated with inhaled glucocorticosteroids. Before and after the treatment, in all children we have studied the content of IFN-γ, IL-4 and IL-13 in the blood serum using enzyme linked immunosorbent assay, the concentration of total IgE — by means of electrochemiluminescent immunoassay. The level of expression of the transcription factor NF-κB in peripheral blood lymphocytes was determined using flow cytometry. Results. Transcription factor NF-κB, having almost the same effect on the concentration of IFN-γ and IgE in the blood serum, determines the characteristics of inflammation, mainly local, in acute obstructive bronchitis. Glucocorticosteroid therapy leads to the disappearance of NF-κB influence on the content of proinflammatory cytokines. Inhaled glucocorticosteroids, in addition, help to reduce the concentration of IgE in the blood serum and inhibition of the activity of pro-inflammatory intracellular cascades that, at high clinical efficacy and safety profile, justifies the appropriateness of their use in the treatment of acute obstructive bronchitis in infants as pathogenetic therapy.

  18. Evaluation of effectiveness of hydrolyzed dextran in treatment of dust-induced bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Slinchenko, N.Z.; Filipchenko, L.L.; Volkova, V.M.

    1986-05-01

    An experimental group and a control group identical in age, work experience, dust exposure and expression of disease were treated for dust-induced bronchitis. The control group received broncholytics, anti-inflammatory preparations and physiotherapy; the experimental group received same treatment plus 200 ml of rheopolyglucin, a 10% solution of dextran (water-soluble polysaccharide of glucose), twice a week for 2 to 3 weeks. In addition to general laboratory and clinical methods of investigation, cytologic analysis of sputum before and after treatment was carried out. Results of experiment are given in 3 tables showing: Dynamics of Allergic Signs after Treatment with Rheopolyglucin, Dynamics of Content of Eosinophils in Blood after Treatment, and Cytologic Characteristics of Mucus of Patients with Dust-Induced Bronchitis. Patients treated with rheopolyglucin improved more than control group in abatement of suppurative process in lungs, strengthening of specific cellular and humoral mechanisms of immune response at level of bronchopulmonary system, increased expulsion of mineral dust from lungs and significant reduction of allergic reaction. Results quantitated in tables prove advantages of adding rheopolyglucin to traditional therapy in treatment of dust-induced bronchitis. 19 refs.

  19. A cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis.

    Science.gov (United States)

    Gonzales, Ralph; Anderer, Tammy; McCulloch, Charles E; Maselli, Judith H; Bloom, Frederick J; Graf, Thomas R; Stahl, Melissa; Yefko, Michelle; Molecavage, Julie; Metlay, Joshua P

    2013-02-25

    National quality indicators show little change in the overuse of antibiotics for uncomplicated acute bronchitis. We compared the effect of 2 decision support strategies on antibiotic treatment of uncomplicated acute bronchitis. We conducted a 3-arm cluster randomized trial among 33 primary care practices belonging to an integrated health care system in central Pennsylvania. The printed decision support intervention sites (11 practices) received decision support for acute cough illness through a print-based strategy, the computer-assisted decision support intervention sites (11 practices) received decision support through an electronic medical record-based strategy, and the control sites (11 practices) served as a control arm. Both intervention sites also received clinician education and feedback on prescribing practices, as well as patient education brochures at check-in. Antibiotic prescription rates for uncomplicated acute bronchitis in the winter period (October 1, 2009, through March 31, 2010) following introduction of the intervention were compared with the previous 3 winter periods in an intent-to-treat analysis. Compared with the baseline period, the percentage of adolescents and adults prescribed antibiotics during the intervention period decreased at the printed decision support intervention sites (from 80.0% to 68.3%) and at the computer-assisted decision support intervention sites (from 74.0% to 60.7%) but increased slightly at the control sites (from 72.5% to 74.3%). After controlling for patient and clinician characteristics, as well as clustering of observations by clinician and practice site, the differences for the intervention sites were statistically significant from the control sites (P = .003 for control sites vs printed decision support intervention sites and P = .01 for control sites vs computer-assisted decision support intervention sites) but not between themselves (P = .67 for printed decision support intervention sites vs computer

  20. Update on roflumilast, a phosphodiesterase 4 inhibitor for the treatment of chronic obstructive pulmonary disease

    OpenAIRE

    Rabe, Klaus F

    2011-01-01

    Phosphodiesterase 4 (PDE4) is a member of the PDE enzyme superfamily that inactivates cyclic adenosine monophosphate and cyclic guanosine monophosphate, and is the main PDE isoenzyme occurring in cells involved in inflammatory airway disease such as chronic obstructive pulmonary disease (COPD). COPD is a preventable and treatable disease and is characterized by airflow obstruction that is not fully reversible. Chronic progressive symptoms, particularly dyspnoea, chronic bronchitis and impaire...

  1. Computed tomography-based subclassification of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Dirksen, Asger; Wille, Mathilde M W

    2016-01-01

    Computed tomography (CT) is an obvious modality for subclassification of COPD. Traditionally, the pulmonary involvement of chronic obstructive pulmonary disease (COPD) in smokers is understood as a combination of deleterious effects of smoking on small airways (chronic bronchitis and small airways...... disease) and distal to the airways with destruction and loss of lung parenchyma (emphysema). However, segmentation of airways is still experimental; with contemporary high-resolution CT (HRCT) we can just see the "entrance" of small airways, and until now changes in airway morphology that have been...... observed in COPD are subtle. Furthermore, recent results indicate that emphysema may also be the essential pathophysiologic mechanism behind the airflow limitation of COPD. The definition of COPD excludes bronchiectasis as a symptomatic subtype of COPD, and CT findings in chronic bronchitis...

  2. Measuring the Prevalence of Diagnosed Chronic Obstructive Pulmonary Disease in the United States Using Data From the 2012-2014 National Health Interview Survey.

    Science.gov (United States)

    Ward, Brian W; Nugent, Colleen N; Blumberg, Stephen J; Vahratian, Anjel

    This study, measuring the prevalence of chronic obstructive pulmonary disease (COPD), examined (1) whether a single survey question asking explicitly about diagnosed COPD is sufficient to identify US adults with COPD and (2) how this measure compares with estimating COPD prevalence using survey questions on diagnosed emphysema and/or chronic bronchitis and all 3 survey questions together. We used data from the 2012-2014 National Health Interview Survey to examine different measures of prevalence among 7211 US adults who reported a diagnosed respiratory condition (ie, emphysema, chronic bronchitis, and/or COPD). We estimated a significantly higher prevalence of COPD by using a measure accounting for all 3 diagnoses (6.1%; 95% CI, 5.9%-6.3%) than by using a measure of COPD diagnosis only (3.0%; 95% CI, 2.8%-3.1%) or a measure of emphysema and/or chronic bronchitis diagnoses (4.7%; 95% CI, 4.6%-4.9%). This pattern was significant among all subgroups examined except for non-Hispanic Asian adults. The percentage difference between measures of COPD was larger among certain subgroups (adults aged 18-39, Hispanic adults, and never smokers); additional analyses showed that this difference resulted from a large proportion of adults in these subgroups reporting a diagnosis of chronic bronchitis only. With the use of self- or patient-reported health survey data such as the National Health Interview Survey, it is recommended that a measure asking respondents only about COPD diagnosis is not adequate for estimating the prevalence of COPD. Instead, a measure accounting for diagnoses of emphysema, chronic bronchitis, and/or COPD may be a better measure. Additional analyses should explore the reliability and validation of survey questions related to COPD, with special attention toward questions on chronic bronchitis.

  3. Ambulatory antibiotic prescribing for acute bronchitis and cough and hospital admissions for respiratory infections: time trends analysis.

    Science.gov (United States)

    Mainous, Arch G; Saxena, Sonia; Hueston, William J; Everett, Charles J; Majeed, Azeem

    2006-07-01

    To examine the relationship between ambulatory antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA between 1996 and 2003. Analysis of data on antibiotic prescribing for episodes of acute bronchitis/cough illness in ambulatory care and hospitalization for respiratory infections for adults between 1996 and 2003 in the USA. USA: ambulatory prescribing behaviour was derived from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey while hospitalizations in acute care hospitals were assessed in the National Hospital Discharge Survey. Adults 18-64 years old. None. Proportion of visits for acute bronchitis/cough receiving a prescription for antibiotics and hospitalization for respiratory infections. Ambulatory antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections exhibited non-linear patterns over the 8 year period. However, antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections had a weak/moderate negative association. For three of the seven yearly changes in prescribing and hospitalizations as one increased the other decreased (P<0.01). Ambulatory antibiotic prescribing for respiratory tract infections was inversely associated with hospital admissions for respiratory tract infections.

  4. Acute bronchitis and volcanic air pollution: a community-based cohort study at Kilauea Volcano, Hawai'i, USA.

    Science.gov (United States)

    Longo, Bernadette M; Yang, Wei

    2008-01-01

    Eruption at Kilauea Volcano, Hawai'i, has continued since 1983, emitting sulfurous air pollution into nearby communities. The purpose of this cohort study was to estimate the relative risk (RR) of acute bronchitis over a period from January 2004 to December 2006 in communities exposed to the volcanic air pollution. A community-based case review was conducted using medical records from clinics and emergency rooms in exposed and unexposed study areas. Initial visits by local residents for diagnosed acute bronchitis were clinically reviewed. The cumulative incidence rate for the 3-yr period was 117.74 per 1000 in unexposed communities and 184.63 per 1000 in exposed communities. RR estimates were standardized for age and gender, revealing an elevated cumulative incidence ratio (CIR) of 1.57 (95% CI = 1.36-1.81) for acute bronchitis in the exposed communities. Highest risk [CIR: 6.56 (95% CI = 3.16-13.6)] was observed in children aged 0-14 yr who resided in the exposed communities. Exposed middle-aged females aged 45-64 yr had double the risk for acute bronchitis than their unexposed counterparts. These findings suggest that communities continuously exposed to sulfurous volcanic air pollution may have a higher risk of acute bronchitis across the life span.

  5. A study of clinical features and treatment of acute bronchitis by Japanese primary care physicians.

    Science.gov (United States)

    Kawamoto, R; Asai, Y; Nago, N; Okayama, M; Mise, J; Igarashi, M

    1998-06-01

    This study aimed to examine the factors affecting prescription of antibiotics for acute bronchitis in ambulatory care settings in Japan. A prospective study was conducted on 92 physicians engaged in primary care regarding their prescription behaviour for a series of 20 new patients with acute respiratory diseases seen during November 1996 and the background factors affecting the behaviour. A total of 1755 patients were registered during the study period, 302 (17.2%) of whom were diagnosed with acute bronchitis and 1165 (66.4%) with upper respiratory tract infection. Independent background factors related to diagnosis of acute bronchitis included self-care prior to visit (odds ratio 1.93, 95% CI 1.33-2.80), complaints such as cough (8.80, 4.77-16.2), sputum (2.24, 1.59-3.14) and purulent sputum (6.47, 3.02-13.9). The odds ratio was high in patients with more severe findings of the chest (5.00, 3.64-6.85), given chest X-ray (2.68, 1.33-5.38) while it was low in those feeling cold (0.68, 0.48-0.96), and those with a sore throat (0.63, 0.45-0.90), nasal symptoms (0.75, 0.54-1.04) and more severe findings of the pharynx (0.74, 0.58-0.92). In those with an upper respiratory tract infection, the odds ratio was high for complaints such as feeling cold (1.51, 1.11-2.05) and nasal symptoms (1.39, 1.04-1.86), while it was low for complaints such as cough (0.67, 0.48-0.95), sputum (0.43, 0.30-0.62), purulent sputum (0.19, 0.08-0.44), wheeze (0.34, 0.13-0.92), in those with more severe findings of the tonsil (0.36, 0.29-0.44) and the chest (0.30, 0.19-0.47) and given chest X-rays (0.29, 0.12-0.66). For acute bronchitis, antibiotics were administered to 67.5% and symptomatic therapy concurrently given to 64.9%. As for independent background factors related to prescription of antibiotics for acute bronchitis, the odds ratio was higher in physicians denying the efficacy of antibiotics for treating a cold (4.58, 1.94-10.8), and the patients with complaints such as purulent sputum

  6. A multicentre trial of cefaclor advanced formulation versus cefaclor in the treatment of acute bronchitis.

    Science.gov (United States)

    Alanis, A; Longest, K A; Senetar, J E; Dere, W H

    1992-01-01

    Two prospective randomized, double-blind, parallel studies were carried out in Europe to compare cefaclor advanced formulation (cefaclor AF) with cefaclor in the treatment of acute bronchitis caused by susceptible pathogens. A total of 1,321 patients suffering from acute bronchitis confirmed by clinical data and a negative chest X-ray were randomized for treatment in the two multicentre trials. Three doses of cefaclor AF were tested: 375 mg twice daily and 500 mg twice daily were compared with cefaclor 250 mg three times daily; and cefaclor AF 750 mg twice daily was compared with cefaclor 500 mg three times daily. Duration of therapy was seven days. Assessments (complete history, physical examination, sputum specimens for culture and Gram's stain, plus clinical and laboratory evaluations of safety) were carried out within 24 hours before the first dose, during therapy, within 72 hours after therapy completion and, in the 375 mg and 500 mg dose groups, 1-2 weeks after the end of therapy. There were no significant differences between the total evaluable cefaclor AF population and the total evaluable cefaclor population with regard to favourable post-therapy responses. Most favourable clinical and bacteriological response rates in the 375 and 500 mg doses were 80% or above. In the higher dose group, there was a favourable post-therapy symptomatic response in 100% of evaluable patients, with favourable bacteriological responses in 93.3% patients receiving cefaclor AF and 96.8% receiving cefaclor (no significant difference). Only one serious drug-related adverse event was reported (anaphylactic reaction). Adverse events related to the digestive system were reported by 4.7% of the cefaclor AF-treated patients and 4.5% of the cefaclor-treated patients during the entire study period. Cefaclor AF, at all three dose levels studies, was seen to be as safe as cefaclor in the treatment of acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae and Moraxella

  7. One size does not fit all: evaluating an intervention to reduce antibiotic prescribing for acute bronchitis.

    Science.gov (United States)

    Ackerman, Sara L; Gonzales, Ralph; Stahl, Melissa S; Metlay, Joshua P

    2013-11-04

    Overuse of antibiotics for upper respiratory tract infections (URIs) and acute bronchitis is a persistent and vexing problem. In the U.S., more than half of all patients with upper respiratory tract infections and acute bronchitis are treated with antibiotics annually, despite the fact that most cases are viral in etiology and are not responsive to antibiotics. Interventions aiming to reduce unnecessary antibiotic prescribing have had mixed results, and successes have been modest. The objective of this evaluation is to use mixed methods to understand why a multi-level intervention to reduce antibiotic prescribing for acute bronchitis among primary care providers resulted in measurable improvement in only one third of participating clinicians. Clinician perspectives on print-based and electronic intervention strategies, and antibiotic prescribing more generally, were elicited through structured telephone surveys at high and low performing sites after the first year of intervention at the Geisinger Health System in Pennsylvania (n = 29). Compared with a survey on antibiotic use conducted 10 years earlier, clinicians demonstrated greater awareness of antibiotic resistance and how it is impacted by individual prescribing decisions-including their own. However, persistent perceived barriers to reducing prescribing included patient expectations, time pressure, and diagnostic uncertainty, and these factors were reported as differentially undermining specific intervention components' effectiveness. An exam room poster depicting a diagnostic algorithm was the most popular strategy. Future efforts to reduce antibiotic prescribing should address multi-level barriers identified by clinicians and tailor strategies to differences at individual clinician and group practice levels, focusing in particular on changing how patients and providers make decisions together about antibiotic use.

  8. Serotype shift of a 793/B genotype infectious bronchitis coronavirus by natural recombination.

    Science.gov (United States)

    Zhang, Tingting; Han, Zongxi; Xu, Qianqian; Wang, Qiuling; Gao, Mengying; Wu, Wei; Shao, Yuhao; Li, Huixin; Kong, Xiangang; Liu, Shengwang

    2015-06-01

    An infectious bronchitis coronavirus, designated as ck/CH/LHLJ/140906, was isolated from an infectious bronchitis virus (IBV) strain H120-vaccinated chicken flock, which presented with a suspected infectious bronchitis virus (IBV) infection. A phylogenetic analysis based on the S1 gene clustered ck/CH/LHLJ/140906 with the 793/B group; however, a pairwise comparison showed that the 5' terminal of the S1 gene (containing hypervariable regions I and II) had high sequence identity with the H120 strain, while the 3' terminal sequence was very similar to that of IBV 4/91 strain. A SimPlot analysis of the complete genomic sequence, which was confirmed by a phylogenetic analysis and nucleotide similarities using the corresponding gene fragments, suggested that isolate ck/CH/LHLJ/140906 emerged from multiple recombination events between parental IBV strains 4/91 and H120. Although the isolate ck/CH/LHLJ/140906 had slightly higher S1 amino acid sequence identity to strain 4/91 (88.2%) than to strain H120 (86%), the serotype of the virus was more closely related to that of the H120 strain (32% antigenic relatedness) than to the 4/91 strain (15% antigenic relatedness). Whereas, vaccination of specific pathogen-free chickens with the 4/91 vaccine provided better protection against challenge with ck/CH/LHLJ/140906 than did vaccination with the H120 strain according to the result of virus re-isolation. As the spike protein, especially in the hypervariable regions of the S1 domain, of IBVs contains viral neutralizing epitopes, the results of this study showed that recombination of the S1 domain resulted in the emergence of a new serotype. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Hospital contacts for chronic diseases among danish seafarers and fishermen: a population-based cohort study

    DEFF Research Database (Denmark)

    Kaerlev, Linda; Dahl, Søren; Nielsen, Per Sabro

    2007-01-01

    and the SHCR for chronic heart diseases was statistically significantly higher in the 1999 than in the 1994 cohort. For both time periods high SHCR values were found for bronchitis, emphysema, cancer of the lung, alcohol-related liver diseases, and diabetes among male non-officers, and lung cancer among male...... officers. Among female non-officers, a high SHCR for skin melanomas was seen. Among fishermen high SHCRs for bronchitis, emphysema, lung cancer, and Raynaud's syndrome were found in both cohorts. No duration-response pattern was observed in any of the analyses, which may reflect health- and lifestyle...

  10. THE USAGE OF HALOAEROSOLOTHERAPY IN THE REHABILITATIONAL TREATMENT OF CHILDREN WITH RECCURENT BRONCHITIS

    Directory of Open Access Journals (Sweden)

    LEMKO Ivan

    2015-05-01

    Full Text Available Aim. Comparative evaluation of the effectiveness of various therapeutic complexes on the basis of haloaerosoltherapy in the rehabilitational treatment of children with recurrent bronchitis on the ground of clinical and functional data and further development of recommendations for differentiated treatment. Objectives. Children (at the age of 6-10 years with recurrent bronchitis, who received treatment in conditions of artificial rock salt aerosol medium (haloaerosoltherapy. Material and Methods. 35 children with recurrent bronchitis (RB were examined. All children’s clinical data were monitored; respiratory function was evaluated using spirography. Forced inspiratory vital capacity (FIVC, forced expiratory volume for the 1-st second (FEV1, peak expiratory flow (PEF, forced expiratory flow at the point of 25% from FIVC(FEF25, forced expiratory flow at the point of 50% from FIVC (FEF50, and forced expiratory flow at the point of 75% from FIVC (FEF75 were defined. The patients were treated with the help of two therapeutic complexes (TC. 12 children were treated by the first TC which included haloaerosoltherapy (14 procedures, in well-equipped room with the initial concentration of rock salt aerosol 40 mg/m3 and the predominance of fine powder fraction (<80%. The first procedure lasted 10 minutes, the second – 20 minutes, the third and the following ones – 30 minutes. The concentration and dispersity of haloaerosol were measured with the help of special laser optical system. 23 children underwent second TC, which included 12 procedures of singlet oxygen therapy in the form of foam additionally to the haloaerosoltherapy sessions. Results. At the beginning of the treatment children had no signs of the acute phase of the disease. Though there were some symptoms which testify that the inflammatory process and functional recovery are not finished yet after the acute phase of the recurrent bronchitis. The clinical picture was confirmed by the major

  11. Observation of the effects of the Suhuang Zhike capsule on acute bronchitis.

    Science.gov (United States)

    Yang, J

    2017-01-01

    Acute bronchitis is one of the most common diseases in the world. The Suhuang Zhike capsule is a part of Traditional Chinese Medicine (TCM) that was approved to treat acute bronchitis. In order to study the clinical effects of the Suhuang Zhike capsule on acute bronchitis subjects, the clinical data of 96 patients from the Department of Lung Disease of Zhengzhou Traditional Chinese Hospital from June 2014 to June 2014 were retrospectively analyzed. The patients were randomly divided into a control group and a Suhuang Zhike capsule treatment group, each with 48 cases. The therapeutic effects of the treatments were evaluated on the tenth day. The results showed that the total effective rate of the observation group was 95.83%, which was significantly higher when compared with the control group, which was 72.91% (P less than 0.005). The clinical signs (e.g. coughing, itchy throat, dry cough without phlegm, little sputum) of the two groups obviously decreased, and the difference was statistically significant when compared with the pretreatment scores (P less than 0.005). The decreased rate of the observation group was significantly larger when compared with the control group (P less than 0.005). The time it took for the clinical symptoms of the observation group to resolve was significantly shorter when compared with the control group (P less than 0.005). After treatment, the serum levels of c-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNF-α) of the two groups obviously decreased. There was a significant difference in these serum levels when compared with pre-treatment levels (P less than 0.005). The decreased rate of the observation group was obviously larger when compared with the control group (P less than 0.005). In the observation group, there were 3 cases with adverse reactions (nausea in 2 cases and mild vomiting in 1 case) during the observation period, with an adverse reaction rate of 6.25% In the

  12. RNA sequencing based analysis of the spleen transcriptome following the infectious bronchitis virus infection of chickens selected for different mannose-binding lectin serum concentrations

    DEFF Research Database (Denmark)

    Hamzic, Edin; Kjærup, Rikke Brødsgaard; Mach, Núria

    2016-01-01

    BackgroundAvian infectious bronchitis (IB) is an acute and highly contagious disease of the upper-respiratory tract caused by infectious bronchitis virus (IBV). Understanding the molecular mechanisms involved in the immune response to IBV infection is a crucial element for further improvements in...

  13. Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative.

    Science.gov (United States)

    Link, Tamara L; Townsend, Mary L; Leung, Eugene; Kommu, Sekhar; Vega, Rhonda Y; Hendrix, Cristina C

    Acute bronchitis is a predominantly viral illness and, according to clinical practice guidelines, should not be treated with antibiotics. Despite clear guidelines, acute bronchitis continues to be the most common acute respiratory illness for which antibiotics are incorrectly prescribed. Although the national benchmark for antibiotic prescribing for adults with acute bronchitis is 0%, a preliminary record review before implementing the intervention at the project setting showed that 96% (N = 30) of adults with acute bronchitis in this setting were prescribed an antibiotic. This quality improvement project utilized a single-group, pre-post design. The setting for this project was a large urgent care network with numerous locations in central North Carolina. The purpose was to determine whether nurse practitioners and physician assistants, after participating in a multifaceted provider education session, would reduce inappropriate antibiotic prescribing for healthy adults with acute uncomplicated bronchitis. Twenty providers attended 1 of 4 training sessions offered in October and November 2015. The face-to-face interactive training sessions focused on factors associated with inappropriate antibiotic prescribing, current clinical practice guidelines, and patient communication skills. Retrospective medical record review of 217 pretraining and 335 posttraining encounters for acute bronchitis by 19 eligible participating providers demonstrated a 61.9% reduction in immediate antibiotic prescribing from 91.7% to 29.8%. Delayed prescribing, which accounted for a small percentage of the total prescriptions given, had a small but significant increase of 9.3% after training. Overall, this multifaceted, interactive provider training resulted in significant reductions in inappropriate prescriptions.

  14. Inhalation Forms of Ambroxol in the Therapy of Respiratory Tract Secretory-Evacuation Disorders in Acute Bronchitis in Children

    Directory of Open Access Journals (Sweden)

    L.S. Ovcharenko

    2014-04-01

    Full Text Available The mucoactive therapy of children aged 1 to 5 years with acute bronchitis using drug Lasolvan solution for oral and inhalation use or syrup for oral use Lasolvan is highly effective and safe method for management of respiratory tract secretory-evacuation disorders. Given the chance of inhalation therapy, effective treatment of choice, while maintaining a high safety profile, is inhalation of Lasolvan solution for oral and inhalation use by nebulizer. More rapid decline in the clinical severity of acute bronchitis in children treated with inhaled Lasolvan associated with accelerated recovery of disturbed secretory-evacuation mechanisms of bronchial tree.

  15. Acute Kidney Injury Following Plastic Bronchitis Associated with Influenza B Virus in a Child with Nephrotic Syndrome.

    Science.gov (United States)

    Fujinaga, Shuichiro; Hara, Taichi

    2015-06-01

    Plastic bronchitis is a rare but life-threatening disorder and is usually associated with congenital heart disease or pulmonary disease. A 5-year-old boy with minimal change nephrotic syndrome who developed a relapse along with cough, fever and dyspnea. Chest X-ray showed atelectasis of right upper lobe of lung, and nasal swab was positive for influenza B virus. His respiratory condition worsened, and required ventilation; bronchoscopy revealed bronchial casts. This was followed by acute kidney injury which was successfully managed with hemodialysis. Children with nephrotic syndrome on immunosuppressive agents can develop plastic bronchitis and acute kidney injury, following influenza virus infection.

  16. Production of monoclonal antibodies against conserved components of infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    Souza C.M.

    2001-01-01

    Full Text Available Murine hybridomas producing IgG1 monoclonal antibodies (Mabs against N and S2 proteins (53KDa and 82KDa, respectively from avian infection bronchitis virus (IBV strain M41 were generated by the fusion of a myeloma cell line (Sp2/0-Ag14 with spleen cells from Balb/c mice previously immunized with whole virus IBV M41. Post-fusion screening criterion was by ELISA and 36 positive hybrids were generated after fusions. Two hybrids specific to N (N3F10 and S2 (S12B2 proteins from M41 (serotype Massachusetts were selected by western blotting. These Mabs recognized the Ark-99 (serotype Arkansas and A5968 (serotype Connecticut IBV strains in addition to M41. By ELISA, the Mab against the S2 (S12B2 recognized all reference and Brazilian strains (M41, SE-17, H52, 297, 283, PM-1, PM-2, PM-3, 351, 29-78 E 327 studied, while the Mab against N recognized only six (M41, SE-17, H52, 283, 327 e 297 strains. The Mab against S2 may become a useful tool for IBV detection on the routine diagnosis of infectious bronchitis, especially for helping the differential diagnosis of clinically and pathologically confusing diseases, while the Mab against N (N3F10 recognized a probably less conserved region among the strains and may be interesting to comparing IBV isolates.

  17. Symptomatic effect of inhaled fenoterol in acute bronchitis: a placebo-controlled double-blind study.

    Science.gov (United States)

    Melbye, H; Aasebø, U; Straume, B

    1991-09-01

    The symptomatic effect of inhaled fenoterol, a beta 2-agonist, 0.2 mg 4 times daily for 7 days, was evaluated in 80 patients with acute bronchitis examined at the Chest Clinic, Department of Medicine, University Hospital of Tromsø. Seventy-three patients completed the trial. End-point FEV1 (% predicted) showed a mean increase of 5.1% in the fenoterol group and 0.5% in the placebo group (p = 0.006). The corresponding decrease in total symptom score after one week was 67% and 51%, respectively (p = 0.06). In a subgroup of 35 patients with either bronchial hyper-responsiveness, wheezes on auscultation or FEV1 less than 80% of predicted at entry, a statistically significant difference in reduction of total symptom score in favour of fenoterol was demonstrated on the second day of the trial. No difference was found in the 38 patients with normal lung findings. Fenoterol was useful when objective signs of bronchial involvement was present and may be applicable to the treatment of acute bronchitis.

  18. Viral pathogenesis of a nephrotropic infectious bronchitis virus isolated from commercial pullets.

    Science.gov (United States)

    Kinde, H; Daft, B M; Castro, A E; Bickford, A A; Gelb, J; Reynolds, B

    1991-01-01

    Infectious bronchitis was diagnosed in 3-to-4-week-old pullets from an outbreak in a commercial flock in California. The disease was characterized by head swelling, watery discharge from the eyes and nostrils, and urates in kidneys. Mortality ranged from 1.8% to 12.5% per week. The isolation of a coronavirus from a suspension of pooled kidneys from clinically ill chickens at the fifth passage in 10-day-old chicken embryos, gross and histologic renal lesions, and seroconversion by enzyme-linked immunosorbent assay in inoculated birds suggested that the virus isolated was a nephrotrophic strain of infectious bronchitis virus (IBV). The virus isolate was found to be a previously unrecognized serotype, based on virus neutralization tests performed in embryonated chicken eggs. Nephropathogenicity of the IBV isolate was confirmed by inoculation of the viral isolate into specific-pathogen-free chicks and demonstration of renal lesions. The isolation of nephrotropic strains of IBV has not been reported previously from poultry in California.

  19. Differential diagnosis of chronic cough in children.

    Science.gov (United States)

    Weinberger, Miles; Fischer, Anthony

    2014-01-01

    A cough is considered chronic when it lasts >4 weeks. Chronic cough can be from a variety of causes. This article provides a structured approach to evaluating the child with chronic cough. Beginning with the disturbing cough that is absent once asleep, consistent with the habit cough syndrome, the diagnostic criteria for 10 causes of chronic cough are discussed. Using a structured approach to the differential diagnosis, common and uncommon causes can be identified. Well-established causes of chronic cough, such as asthma, are likely to be well known to the reader, whereas more recently identified etiologies, such as protracted bacterial bronchitis, are presented in more detail. The differential value of flexible and rigid bronchoscopy and bronchoalveolar lavage for aiding in the differential diagnosis is included for those entities where their use is essential.

  20. Acute Bronchitis

    Science.gov (United States)

    ... and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth ... and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth ...

  1. Effects of TNF-? and Leptin on Weight Loss in Patients with Stable Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Shin, Kyeong-Cheol; Chung, Jin Hong; Lee, Kwan Ho

    2007-01-01

    Background Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. Methods Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum...

  2. Prophylactic intranasal alpha 2 interferon and viral exacerbations of chronic respiratory disease.

    OpenAIRE

    Wiselka, M. J.; Nicholson, K G; Kent, J.; Cookson, J B; Tyrrell, D. A.

    1991-01-01

    BACKGROUND As respiratory virus infections often lead to exacerbations of chronic bronchitis and asthma an effective antiviral drug may be helpful in such patients. Alpha 2 interferon has been shown to give protection against rhinovirus infections in field studies. METHODS Patients with chronic respiratory disease exposed to close contacts with symptoms of upper respiratory tract infection were randomly allocated to receive nasal sprays of recombinant alpha 2 interferon (3 x 10(6) IU) or plac...

  3. Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William J.; Eliseeva, Ekaterina A.; Mendell, Mark J.

    2010-11-15

    Dampness and mold have been shown in qualitative reviews to be associated with a variety of adverse respiratory health effects, including respiratory tract infections. Several published meta-analyses have provided quantitative summaries for some of these associations, but not for respiratory infections. Demonstrating a causal relationship between dampness-related agents, which are preventable exposures, and respiratory tract infections would suggest important new public health strategies. We report the results of quantitative meta-analyses of published studies that examined the association of dampness or mold in homes with respiratory infections and bronchitis. For primary studies meeting eligibility criteria, we transformed reported odds ratios (ORs) and confidence intervals (CIs) to the log scale. Both fixed and random effects models were applied to the log ORs and their variances. Most studies contained multiple estimated ORs. Models accounted for the correlation between multiple results within the studies analyzed. One set of analyses was performed with all eligible studies, and another set restricted to studies that controlled for age, gender, smoking, and socioeconomic status. Subgroups of studies were assessed to explore heterogeneity. Funnel plots were used to assess publication bias. The resulting summary estimates of ORs from random effects models based on all studies ranged from 1.38 to 1.50, with 95% CIs excluding the null in all cases. Use of different analysis models and restricting analyses based on control of multiple confounding variables changed findings only slightly. ORs (95% CIs) from random effects models using studies adjusting for major confounding variables were, for bronchitis, 1.45 (1.32-1.59); for respiratory infections, 1.44 (1.31-1.59); for respiratory infections excluding nonspecific upper respiratory infections, 1.50 (1.32-1.70), and for respiratory infections in children or infants, 1.48 (1.33-1.65). Little effect of publication

  4. Feline aminopeptidase N is not a functional receptor for avian infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    Harbison Carole E

    2007-02-01

    Full Text Available Abstract Background Coronaviruses are an important cause of infectious diseases in humans, including severe acute respiratory syndrome (SARS, and have the continued potential for emergence from animal species. A major factor in the host range of a coronavirus is its receptor utilization on host cells. In many cases, coronavirus-receptor interactions are well understood. However, a notable exception is the receptor utilization by group 3 coronaviruses, including avian infectious bronchitis virus (IBV. Feline aminopeptidase N (fAPN serves as a functional receptor for most group 1 coronaviruses including feline infectious peritonitis virus (FIPV, canine coronavirus, transmissible gastroenteritis virus (TGEV, and human coronavirus 229E (HCoV-229E. A recent report has also suggested a role for fAPN during IBV entry (Miguel B, Pharr GT, Wang C: The role of feline aminopeptidase N as a receptor for infectious bronchitis virus. Brief review. Arch Virol 2002, 147:2047–2056. Results Here we show that, whereas both transient transfection and constitutive expression of fAPN on BHK-21 cells can rescue FIPV and TGEV infection in non-permissive BHK cells, fAPN expression does not rescue infection by the prototype IBV strain Mass41. To account for the previous suggestion that fAPN could serve as an IBV receptor, we show that feline cells can be infected with the prototype strain of IBV (Mass 41, but with low susceptibility compared to primary chick kidney cells. We also show that BHK-21 cells are slightly susceptible to certain IBV strains, including Ark99, Ark_DPI, CA99, and Iowa97 ( Conclusion We conclude that fAPN is not a functional receptor for IBV, the identity of which is currently under investigation.

  5. THE METABOLIC ACTIVITY OF THE MICROFLORA OF THE OROPHARYNX IN CHILDREN WITH BRONCHITIS AND COMMUNITY-ACQUIRED PNEUMONIA

    Directory of Open Access Journals (Sweden)

    E. A. Medvedeva

    2015-01-01

    Full Text Available Background: Given a steady increase in the number of children with recurrent  respiratory tract infections, to develop methods of their rehabilitation, it is necessary to evaluate  factors of nonspecific resistance. Aim: To study metabolic activity of oropharyngeal microflora in children  with recurrent bronchitis and community-acquired pneumonia, based on determination of spectrum  of shortchain fatty acids (SCFA. Materials and methods: This prospective  study included  60 children with recurrent  respiratory  tract  infections  aged  from 3 to 7 years, hospitalized  for inpatient  treatment of bronchitis  (n = 30 and pneumonia (n = 30. The oropharyngeal microflora was assessed by classical bacteriological  method (in mucosal smears; SCFA levels in non-stimulated saliva were measured by gas liquid chromatography. Results: There was no significant difference  in qualitative  and  quantitative composition  of the oropharyngeal microflora between children  with  bronchitis  and  pneumonia. However, assessment of metabolic  functions showed some significant differences. Children with   bronchitis  showed  signs of microflora hyperactivation  with total  SCFA production up  to  118.4% (mean from that of the reference range, with predominant activation of aerobic bacteria (anaerobic index 66.8%. In children with pneumonia, microflora was suppressed (68.13% of the normal range, the difference with the bronchitis group being significant, p < 0.05, with predominance of strictly anaerobic  bacteria (anaerobic index 110.35% from the normal range, p < 0.05. Children with recurrent respiratory tract infections had the following common characteristics: prevalence  of bacterial proteolysis (70% of patients and butyric acid deficiency (63% from the normal level in bronchitis and 33%, in pneumonia, p > 0.05. Conclusion: The data obtained could be used to make a decision on the necessity of antibacterial therapy.

  6. Chemokine Concentrations and Mast Cell Chemotactic Activity in BAL Fluid in Patients With Eosinophilic Bronchitis and Asthma, and in Normal Control Subjects

    National Research Council Canada - National Science Library

    Woodman, Lucy; Sutcliffe, Amanda; Kaur, Davinder; Berry, Mike; Bradding, Peter; Pavord, Ian D; Brightling, Christopher E

    2006-01-01

    ...: To investigate the concentration of chemokines in bronchial wash samples and BAL fluid, and the mast cell chemotactic activity in BAL fluid from subjects with asthma and eosinophilic bronchitis...

  7. Relation of ventilatory impairment and of chronic mucus hypersecretion to mortality from obstructive lung disease and from all causes.

    OpenAIRE

    Lange, P; Nyboe, J; Appleyard, M; Jensen, G; Schnohr, P

    1990-01-01

    The relation of ventilatory impairment and chronic mucus hypersecretion to death from all causes and death from obstructive lung disease (chronic bronchitis, emphysema and asthma) was studied in 13,756 men and women randomly selected from the general population of the City of Copenhagen. During the 10 year follow up 2288 subjects died. In 164 subjects obstructive lung disease was considered to be an underlying or a contributory cause of death (obstructive lung disease related death); in 73 su...

  8. Calcium channels blocked activity: Providing the basis for medicinal use of Abies pindrow in diarrhea and bronchitis

    Directory of Open Access Journals (Sweden)

    Sohaib Mushtaq

    2015-06-01

    Full Text Available Abies pindrow is widely used in traditional practice for the treatment of diarrhea and bronchitis and the present study was designed to validate its folkloric uses. The crude extract of A. pindrow inhibit spontaneously contracting (1-10 mg/mL and high K+ (80 mM-induced pre-contracted rabbit jejun-um (3 mg/mL in concentration dependent manner. A rightward shift in Ca+2 concentration response curves was seen in the presence of crude extract (0.1-0.3, similar to verapamil. In isolated tracheal tissue, A. pindrow inhibited, high K+ and carbachol (1 µM-induced contractions, at 3 mg/mL and 10 mg/mL respectively, similar to that caused by verapamil. These results indicate the presence of calcium channels blocked activity in crude extract of A. pindrow, which provide sound basis for medicinal uses of A. pindrow in diarrhea and bronchitis.

  9. "Refractoriness" of airflow obstruction associated with isolated lymphocytic bronchiolitis/bronchitis in pulmonary allografts.

    Science.gov (United States)

    Ross, D J; Marchevsky, A; Kramer, M; Kass, R M

    1997-08-01

    The clinical significance of an isolated "lymphocytic bronchiolitis/bronchitis" (grade B) as detected in transbronchoscopic biopsy specimens (TBB) is unclear. We therefore have reviewed the spirometric responses associated with isolated grade B diagnoses and contrasted them with episodes of "acute cellular rejection" (grade A); the latter are manifested by "perivascular lymphocytic infiltration." Because lymphocytic bronchiolitis/ bronchitis is considered a nonspecific histologic pattern that may be observed with either allograft rejection or respiratory infections, episodes were analyzed with respect to the presence (grade B [+] CMV) or absence (grade B [-] CMV) of cytomegalovirus infection. The maximum forced expiratory volume in 1 second (FEV1) during the preceding 3 months was used as a baseline for computing percent change in FEV1 coincident with transbronchoscopic biopsies (delta %FEV1 PRE) and maximum values obtained during the 3 months subsequent to specific therapies (delta %FEV1 POST). All episodes of acute cellular rejection (grades A1 to 4) and symptomatic lymphocytic bronchiolitis/bronchitis (grade B) were treated with "pulsed-dose" methylprednisolone, whereas intravenous ganciclovir was administered to patients at risk for recrudescence of cytomegalovirus. Between March 1, 1989, and September 1, 1995, 366 TBB procedures were performed for clinical indications in 57 lung transplant recipients. Histologic diagnoses with acceptable serial spirometric values included grade A1 (n = 9), grade A2 (n = 27), grade A3 (n = 2), grade B(-)CMV (n = 25) and grade B(+)CMV (n = 9). The delta %FEV1 PRE coincident with TBB were not statistically different for the different histologic groups. For grade A1, delta %FEV1 PRE was -14.6% +/- 5.2% (X +/- SEM); A2, -7.6% +/- 1.8%; B(-)CMV, -14.8% +/- 3.9%; and B(+)CMV, -14.8% +/- 2.3%. After treatment, the delta %FEV1 POST, relative to baseline values, were for grade A1, -8.8% +/- 7.1%, A2, +0.26% +/- 2.6%; B(-)CMV, -12

  10. Percutaneous Lymphatic Embolization of Abnormal Pulmonary Lymphatic Flow as Treatment of Plastic Bronchitis in Patients With Congenital Heart Disease.

    Science.gov (United States)

    Dori, Yoav; Keller, Marc S; Rome, Jonathan J; Gillespie, Matthew J; Glatz, Andrew C; Dodds, Kathryn; Goldberg, David J; Goldfarb, Samuel; Rychik, Jack; Itkin, Maxim

    2016-03-22

    Plastic bronchitis is a potentially fatal disorder occurring in children with single-ventricle physiology, and other diseases, as well, such as asthma. In this study, we report findings of abnormal pulmonary lymphatic flow, demonstrated by MRI lymphatic imaging, in patients with plastic bronchitis and percutaneous lymphatic intervention as a treatment for these patients. This is a retrospective case series of 18 patients with surgically corrected congenital heart disease and plastic bronchitis who presented for lymphatic imaging and intervention. Lymphatic imaging included heavy T2-weighted MRI and dynamic contrast-enhanced magnetic resonance lymphangiogram. All patients underwent bilateral intranodal lymphangiogram, and most patients underwent percutaneous lymphatic intervention. In 16 of 18 patients, MRI or lymphangiogram or both demonstrated retrograde lymphatic flow from the thoracic duct toward lung parenchyma. Intranodal lymphangiogram and thoracic duct catheterization was successful in all patients. Seventeen of 18 patients underwent either lymphatic embolization procedures or thoracic duct stenting with covered stents to exclude retrograde flow into the lungs. One of the 2 patients who did not have retrograde lymphatic flow did not undergo a lymphatic interventional procedure. A total of 15 of 17(88%) patients who underwent an intervention had significant symptomatic improvement at a median follow-up of 315 days (range, 45-770 days). The most common complication observed was nonspecific transient abdominal pain and transient hypotension. In this study, we demonstrated abnormal pulmonary lymphatic perfusion in most patients with plastic bronchitis. Interruption of the lymphatic flow resulted in significant improvement of symptoms in these patients and, in some cases, at least temporary resolution of cast formation. © 2016 American Heart Association, Inc.

  11. [Use of lozartan in patients with chronic cor pulmonale].

    Science.gov (United States)

    Butorov, I V; Butorov, S I

    2005-01-01

    The purpose of the study was to determine the effect of the angiotensin receptor blocker lozartan on clinical manifestations, gas transport, and metabolism in blood cells in patients with chronic cor pulmonale (CCP). The subjects were 53 patients with chronic obstructive bronchitis (COB) and secondary functional claa III pulmonary hypertension. Use of lozartan in complex therapy of these patients led to increase of pyruvic acid content in erythrocytes and glucose-6-phosphatdehydrogenase activity, which suggests that lozartan stimulates redox processes in blood cells. This significantly improves metabolic provision of erythrocyte functioning, phagocytosis and immunogenesis, and leads to favorable clinical effect in patients with COB and CCP.

  12. Role of Atypical Pathogens and the Antibiotic Prescription Pattern in Acute Bronchitis: A Multicenter Study in Korea.

    Science.gov (United States)

    Park, Sunghoon; Oh, Kil Chan; Kim, Ki-Seong; Song, Kyu-Tae; Yoo, Kwang Ha; Shim, Yun Su; Lee, Young Ju; Lee, Myung Goo; Yun, Jang Uk; Kim, Hyun Su; Kim, Yee Hyung; Lee, Won Jun; Kim, Do Il; Cha, Hyung Gun; Lee, Jae-Myung; Seo, Jung San; Jung, Ki-Suck

    2015-10-01

    The role of atypical bacteria and the effect of antibiotic treatments in acute bronchitis are still not clear. This study was conducted at 22 hospitals (17 primary care clinics and 5 university hospitals) in Korea. Outpatients (aged ≥ 18 yr) who had an acute illness with a new cough and sputum (≤ 30 days) were enrolled in 2013. Multiplex real-time polymerase chain reaction (RT-PCR) was used to detect five atypical bacteria. A total of 435 patients were diagnosed as having acute bronchitis (vs. probable pneumonia, n = 75), and 1.8% (n = 8) were positive for atypical pathogens (Bordetella pertussis, n = 3; B. parapertussis, n = 0; Mycoplasma pneumoniae, n = 1; Chlamydophila pneumoniae, n = 3; Legionella pneumophila, n = 1). Among clinical symptoms and signs, only post-tussive vomiting was more frequent in patients with atypical pathogens than those without (P = 0.024). In all, 72.2% of the enrolled patients received antibiotic treatment at their first visits, and β-lactams (29.4%) and quinolones (20.5%) were the most commonly prescribed agents. In conclusion, our study demonstrates that the incidence of atypical pathogens is low in patients with acute bronchitis, and the rate of antibiotic prescriptions is high.

  13. Efficacy and tolerability of EPs 7630 in patients (aged 6-18 years old) with acute bronchitis.

    Science.gov (United States)

    Kamin, W; Maydannik, V G; Malek, F A; Kieser, M

    2010-04-01

    For EPs-7630, a herbal drug preparation from Pelargonium sidoides roots, therapeutic effects in respiratory tract infections outside the strict indication for antibiotics have already been demonstrated in adults. Now, a dose-finding study for EPs-7630 was performed in children and adolescents. A total of 400 patients (aged 6-18 years) were randomized to receive either 30 mg, 60 mg or 90 mg EPs-7630 or placebo daily. Primary outcome criterion was the change in the Bronchitis Severity Score (BSS) from day 0 to day 7. After 7 days of treatment, the change in the BSS total score was significantly better in the 60 mg and 90 mg groups compared with placebo that of the without relevant differences between these two dosages. Especially 'coughing', 'sputum' and 'rales at auscultation' improved under EPs-7630. Onset of effect was faster, time of bed rest shorter and treatment outcome and satisfaction with treatment were rated better. Tolerability was comparable with placebo in all treatment groups. EPs-7630 is effective in acute bronchitis outside the strict indication for antibiotics in 6-18 years old patients, with a dose of 60 mg or 90 mg daily offering the best benefit/risk ratio. EPs-7630 significantly reduces the severity of symptoms, leads to a more favourable course of the disease and a faster recovery from acute bronchitis compared with the placebo, and is well tolerated.

  14. Occupational exposure and risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Alif, Sheikh M; Dharmage, Shyamali C; Bowatte, Gayan; Karahalios, Amalia; Benke, Geza; Dennekamp, Martine; Mehta, Amar J; Miedinger, David; Künzli, Nino; Probst-Hensch, Nicole; Matheson, Melanie C

    2016-08-01

    Due to contradictory literature we have performed a systematic review and meta-analyse of population-based studies that have used Job Exposure Matrices to assess occupational exposure and risk of Chronic Obstructive Pulmonary Disease (COPD). Two researchers independently searched databases for published articles using predefined inclusion criteria. Study quality was assessed, and results pooled for COPD and chronic bronchitis for exposure to biological dust, mineral dust, and gases/fumes using a fixed and random effect model. Five studies met predetermined inclusion criteria. The meta-analysis showed low exposure to mineral dust, and high exposure to gases/fumes were associated with an increased risk of COPD. We also found significantly increased the risk of chronic bronchitis for low and high exposure to biological dust and mineral dust. Expert commentary: The relationship between occupational exposure assessed by the JEM and the risk of COPD and chronic bronchitis shows significant association with occupational exposure. However, the heterogeneity of the meta-analyses suggests more wide population-based studies with older age groups and longitudinal phenotype assessment of COPD to clarify the role of occupational exposure to COPD risk.

  15. Changes in prevalence of chronic obstructive pulmonary disease and asthma in the US population and associated risk factors.

    Science.gov (United States)

    Halldin, Cara N; Doney, Brent C; Hnizdo, Eva

    2015-02-01

    Chronic lower airway diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are currently the third leading cause of death in the United States. We aimed to evaluate changes in prevalence of and risk factors for COPD and asthma among the US adult population. We evaluated changes in prevalence of self-reported doctor-diagnosed COPD (i.e. chronic bronchitis and emphysema) and asthma and self-reported respiratory symptoms comparing data from the 1988-1994 and 2007-2010 National Health and Nutrition Examination Surveys. To investigate changes in the severity of each outcome over the two periods, we calculated changes in the proportions of spirometry-based airflow obstruction for each outcome. Prevalence of doctor-diagnosed chronic bronchitis and emphysema decreased significantly mainly among males, while asthma increased only among females. The self-reported disease and the respiratory symptoms were associated with increased prevalence of airflow obstruction for both periods. However, the prevalence of airflow obstruction decreased significantly in the second period among those with shortness of breath and doctor-diagnosed respiratory conditions (chronic bronchitis, emphysema, and asthma). COPD outcomes and asthma were associated with lower education, smoking, underweight and obesity, and occupational dusts and fumes exposure. Chronic lower airway diseases continue to be major public health problems. However, decreased prevalence of doctor-diagnosed chronic bronchitis and emphysema (in males) and decreased prevalence of airflow obstruction in those with respiratory symptoms and doctor-diagnosed respiratory diseases may indicate a declining trend and decrease in disease severity between the two periods. Continued focus on prevention of these diseases through public health interventions is prudent. © The Author(s) 2014.

  16. Annexin A2 binds RNA and reduces the frameshifting efficiency of infectious bronchitis virus.

    Directory of Open Access Journals (Sweden)

    Hoyun Kwak

    Full Text Available Annexin A2 (ANXA2 is a protein implicated in diverse cellular functions, including exocytosis, DNA synthesis and cell proliferation. It was recently proposed to be involved in RNA metabolism because it was shown to associate with some cellular mRNA. Here, we identified ANXA2 as a RNA binding protein (RBP that binds IBV (Infectious Bronchitis Virus pseudoknot RNA. We first confirmed the binding of ANXA2 to IBV pseudoknot RNA by ultraviolet crosslinking and showed its binding to RNA pseudoknot with ANXA2 protein in vitro and in the cells. Since the RNA pseudoknot located in the frameshifting region of IBV was used as bait for cellular RBPs, we tested whether ANXA2 could regulate the frameshfting of IBV pseudoknot RNA by dual luciferase assay. Overexpression of ANXA2 significantly reduced the frameshifting efficiency from IBV pseudoknot RNA and knockdown of the protein strikingly increased the frameshifting efficiency. The results suggest that ANXA2 is a cellular RBP that can modulate the frameshifting efficiency of viral RNA, enabling it to act as an anti-viral cellular protein, and hinting at roles in RNA metabolism for other cellular mRNAs.

  17. Complete genomic sequence analysis of infectious bronchitis virus Ark DPI strain and its evolution by recombination

    Directory of Open Access Journals (Sweden)

    Gelb Jack

    2008-12-01

    Full Text Available Abstract An infectious bronchitis virus Arkansas DPI (Ark DPI virulent strain was sequenced, analyzed and compared with many different IBV strains and coronaviruses. The genome of Ark DPI consists of 27,620 nucleotides, excluding poly (A tail, and comprises ten open reading frames. Comparative sequence analysis of Ark DPI with other IBV strains shows striking similarity to the Conn, Gray, JMK, and Ark 99, which were circulating during that time period. Furthermore, comparison of the Ark genome with other coronaviruses demonstrates a close relationship to turkey coronavirus. Among non-structural genes, the 5'untranslated region (UTR, 3C-like proteinase (3CLpro and the polymerase (RdRp sequences are 100% identical to the Gray strain. Among structural genes, S1 has 97% identity with Ark 99; S2 has 100% identity with JMK and 96% to Conn; 3b 99%, and 3C to N is 100% identical to Conn strain. Possible recombination sites were found at the intergenic region of spike gene, 3'end of S1 and 3a gene. Independent recombination events may have occurred in the entire genome of Ark DPI, involving four different IBV strains, suggesting that genomic RNA recombination may occur in any part of the genome at number of sites. Hence, we speculate that the Ark DPI strain originated from the Conn strain, but diverged and evolved independently by point mutations and recombination between field strains.

  18. Live attenuated nephropathogenic infectious bronchitis virus vaccine provides broad cross protection against new variant strains.

    Science.gov (United States)

    Lim, T-H; Kim, M-S; Jang, J-H; Lee, D-H; Park, J-K; Youn, H-N; Lee, J-B; Park, S-Y; Choi, I-S; Song, C-S

    2012-01-01

    Infectious bronchitis virus (IBV) infections cause great economic losses to the poultry industry worldwide, and the emergence of new variant strains complicates disease control. The present study investigated the genetic and protectotypic features of newly emerged Korean IBV strains. A phylogenetic analysis showed that several recent isolates formed 2 different clusters (new cluster 1 and 2), which were distinct from other preexisting clusters. New cluster 1 IBV strains represented recombinants between Korean nephropathogenic strain KM91 and the QXIBV strain. New cluster 2 IBV strains showed low amino acid homology (vaccines (H120 and K2 strain) against these new isolates. In cross-protection studies, the H120 strain did not provide sufficient protection against these variants. However, highly attenuated nephropathogenic IBV vaccine, K2 strain, provided significantly higher levels of protection against variants compared with chickens vaccinated with H120 (P vaccine could be helpful for the reduction of economic losses caused by newly evolving IBV recombinants (new cluster 1) and variants (new cluster 2).

  19. Genetic characterisation and analysis of infectious bronchitis virus isolated from Brazilian flocks between 2010 and 2015.

    Science.gov (United States)

    Carranza, Claudia; Astolfi-Ferreira, Claudete S; Santander Parra, Silvana H; Nuñez, Luis F N; Penzes, Zoltan; Chacón, Jorge L; Sesti, Luiz; Chacón, Ruy D; Piantino Ferreira, Antonio J

    2017-12-01

    1. Infectious bronchitis virus (IBV) variants in Brazil were isolated during 2010-2015 for epidemiological and molecular analysis to characterise the different variants and perform a bioinformatic analysis to compare with sequences of variants collected over the previous 40 years. 2. Of the 453 samples examined, 61.4% were positive for IBV and 75.9% of these were considered to have the BR-I genotype and were detected in birds of all ages distributed in all five Brazilian regions. 3. The ratio of non-synonymous substitutions per non-synonymous site (dN) to synonymous substitutions per synonymous site (dS), i.e. dN/dS, revealed a predominance of codons with non-synonymous substitutions in the first third of the S1 gene and a dN/dS ratio of 0.67. Additionally, prediction of N-glycosylation sites showed that most of the BR-I variants (from 2003 to early 2014) had an extra site at amino acid position 20, whereas the newest variants lacked this extra site. 4. These results suggest that Brazilian IBV variants probably underwent drastic mutations at various points between 1983 and 2003 and that the selection processes became silent after achieving a sufficiently effective antigenic structure for invasion and replication in their hosts. Brazilian IBV genotype BR-I is currently the predominant genotype circulating in Brazil and South America.

  20. Prospective, longitudinal study of plastic bronchitis cast pathology and responsiveness to tissue plasminogen activator.

    Science.gov (United States)

    Heath, Lauren; Ling, Shelley; Racz, Jennifer; Mane, Gerta; Schmidt, Lindsay; Myers, Jeffrey L; Tsai, Wan C; Caruthers, Regine L; Hirsch, Jennifer C; Stringer, Kathleen A

    2011-12-01

    Plastic bronchitis (PB) is a rare disease that often occurs in patients with congenital heart disease (CHD) who have undergone staged single-ventricle palliation. It is characterized by the formation of rubbery "casts" in the airways. PB treatment frequently includes inhaled tissue plasminogen activator (tPA). However, the efficacy of tPA to reduce cast burden is unknown. This is further complicated by our lack of knowledge of cast composition. We obtained spontaneously expectorated PB casts from children (n = 4) with CHD and one adult patient with idiopathic PB. Pathological assessment was made from paraffin-preserved samples. Casts were treated with phosphate-buffered saline (PBS) or tPA. Cast response to tPA was assessed by changes in cast weight and the production of fibrin D-dimer. Independent of dose, tPA reduced cast weight compared with PBS-treatment (P = 0.001) and increased D-dimer levels. Histological staining showed that PB casts from all patients were composed of fibrin and contained notable numbers of lymphocytes. Cast composition did not change over time. Collectively, these data support that in our PB patients, casts are composed of fibrin and are responsive to tPA treatment. This makes inhaled tPA a potentially viable option for symptomatic relief of PB while we work to unravel the complexity of PB pathogenesis.

  1. Rapid NK-cell activation in chicken after infection with infectious bronchitis virus M41.

    Science.gov (United States)

    Vervelde, L; Matthijs, M G R; van Haarlem, D A; de Wit, J J; Jansen, C A

    2013-02-15

    Natural killer (NK) cells are cytotoxic lymphocytes and play an important role in the early defence against viruses. In this study we focussed on NK cell and interferon (IFN) responses after infection with infectious bronchitis virus (IBV). Based on surface expression of CD107+, enhanced activation of lung NK cells was observed at 1 dpi, whereas in blood prolonged NK-cell activation was found. IFN-α and IFN-β mRNA and proteins were not rapidly induced whereas IFN-γ production in lung, measured by Elispot assay, increased over time at 2 and 4 dpi. In contrast, IFN-γ production in blood was highest at 1 dpi and decreased over time down to levels comparable to uninfected birds at 4 dpi. Collectively, infection with IBV-M41 resulted in activation of NK cells in the lung and blood and rapid production of IFN-γ and not IFN-α and IFN-β compared to uninfected birds. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Molecular detection of infectious bronchitis and avian metapneumoviruses in Oman backyard poultry.

    Science.gov (United States)

    Al-Shekaili, Thunai; Baylis, Matthew; Ganapathy, Kannan

    2015-04-01

    Infectious bronchitis virus (IBV) and avian metapneumovirus (aMPV) are economically important viral pathogens infecting chickens globally. Identification of endemic IBV and aMPV strains promotes better control of both diseases and prevents production losses. Orophrayngeal swab samples were taken from 2317 birds within 243 different backyard flocks in Oman. Swabs from each flock were examined by RT-PCR using part-S1 and G gene primers for IBV and aMPV respectively. Thirty-nine chicken flocks were positive for IBV. Thirty two of these were genotyped and they were closely related to 793/B, M41, D274, IS/1494/06 and IS/885/00. 793/B-like IBV was also found in one turkey and one duck flock. Five flocks were positive for aMPV subtype B. Though no disease was witnessed at the time of sampling, identified viruses including variant IBV strains, may still pose a threat for both backyard and commercial poultry in Oman. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A Patient with Bronchial Asthma in Whom Eosinophilic Bronchitis and Bronchiolitis Developed during Treatment

    Directory of Open Access Journals (Sweden)

    Yasutsugu Fukushima

    2010-01-01

    Full Text Available A 56-year-old woman was referred to our hospital because of dyspnea, wheezing, and a productive cough. Eight years before presentation, bronchial asthma was diagnosed and the patient received inhaled corticosteroids plus antiasthmatic agents (a long-acting inhaled p2-agonist, leukotriene modifiers, and theophylline. Chest radiography showed small diffuse nodular shadows, and a computed tomographic scan showed thickening of the bronchi and bronchioles, with diffuse centrilobular nodules in both lung fields. A blood test and microscopic examination of the bronchoalveolar fluid revealed marked eosinophilia. Transbronchial lung biopsy and transbronchial biopsy showed eosinophilic bronchitis and bronchiolitis. After treatment with oral prednisolone (40 mg daily and inhaled corticosteroids, the symptoms, blood eosinophilia, and radiographic findings improved. Recently, several similar cases of eosinophilic bronchiolitis have been reported. Studies of further cases and elucidation of the pathophysiology of eosinophilic bronchiolitis are necessary to establish a concept for this disease and to determine whether it should be classified as a subtype of bronchial asthma or as a distinct entity.

  4. TRYPSIN-INDUCED HEMAGGLUTINATION ASSAY FOR THE DETECTION OF INFECTIOUS BRONCHITIS VIRUS

    Directory of Open Access Journals (Sweden)

    M. S. Mahmood, M. Siddique, I. Hussain and A. Khan1

    2004-04-01

    Full Text Available A trypsin-induced hemagglutination (THA assay was standardized to detect infectious bronchitis virus (IBV in allantoic fluid (AF of embryonated eggs. The test was used in 20 samples, each collected from 5 different layer farms suspected for IBV. Allantoic fluid from inoculated embryos was harvested and treated with reagent grade trypsin at the percentages of 0.25, 0.50, 1.0 and 2.0 for 30 minutes to 3 hours at pH 7.2. The IBV in trypsinized AF was identified by clear and consistent agglutination of chicken red blood cells within 5 minutes of incubation at 37oC. The results indicated that AF treated with equal volume of 1.0% reagent grade trypsin elicited the hemagglutinating (HA activity in 3.0 hours whereas 2.0% reagent grade trypsin elicited the HA activity only after 30 minutes incubation at 37oC. Sensitivity of THA was 92% as compared with 76% for agar gel precipitation test. Gross pathological lesions (curling and dwarfing in chick embryo, intracereberal inoculation of un-weaned mice and pathogenicity test in one-day-old broiler chicks showed 79, 84 and 77% sensitivity, respectively.

  5. The utility of biomarkers in differentiating bacterial from non-bacterial lower respiratory tract infection in hospitalized children: difference of the diagnostic performance between acute pneumonia and bronchitis.

    Science.gov (United States)

    Hoshina, Takayuki; Nanishi, Etsuro; Kanno, Shunsuke; Nishio, Hisanori; Kusuhara, Koichi; Hara, Toshiro

    2014-10-01

    The aim of this study is to investigate the utility of several biomarkers in differentiating bacterial community-acquired lower respiratory tract infection (CA-LRTI) from non-bacterial CA-LRTI in children and the difference of their diagnostic performance between pneumonia and bronchitis. A retrospective cohort study composed of 108 pediatric patients hospitalized for CA-LRTI was performed during 2010-2013. Based on the findings of chest X-ray and sputum samples, patients were divided into 4 categories, group of bacterial pneumonia or bronchitis, and non-bacterial (viral or etiology-unknown) pneumonia or bronchitis. Peripheral white blood cell and neutrophil counts, and serum C-reactive protein (CRP) and procalcitonin (PCT) levels were compared among the 4 groups. Finally, 54 patients were the subject of this study. In the patients with pneumonia, serum CRP and PCT levels were significantly elevated in the group of bacterial pneumonia (CRP: p = 0.02, PCT: p = 0.0008). The area under the receiver operating characteristic curve for PCT for distinguishing between bacterial and non-bacterial pneumonia was the largest, and sensitivity, specificity, positive predictive value and negative predictive value of PCT were best among 4 markers. On the other hand, in the patients with bronchitis, neutrophil count was significantly decreased in non-bacterial bronchitis whereas no significant differences of WBC count, CRP level or PCT level were seen. In conclusion, PCT was the most useful marker to differentiate bacterial pneumonia whereas neutrophil count contributed most to the discrimination of bacterial bronchitis. The diagnostic performance of biomarkers may be different between pneumonia and bronchitis. Copyright © 2014. Published by Elsevier Ltd.

  6. EFFECTIVENESS OF AUTOGENIC DRAINAGE VERSUS POSTURAL DRAINAGE ON OXYGEN SATURATION IN PATIENTS WITH CHRONIC BRONCHITIS WITH 15 MINUTES POST THERAPY

    Directory of Open Access Journals (Sweden)

    V. Kiran

    2014-12-01

    Full Text Available Background: Patients with COPD will have more amount of secretions. To clear the secretions by using of different bronchial hygiene techniques like postural drainage and autogenic drainage technique, manual hyperventilation technique ,active cycle breathing technique .Hence in this study to compare the short-term effects of postural drainage with clapping (PD and autogenic drainage (AD on level of oxygen saturation in blood, and amount of sputum recovery. Methodology: The study was done on 60 patients with COPD. Dividing Patients into two group and patients were treated with PD or AD in separate Groups. The effectiveness of the treatment was measured up to 6 days. Pulse oximetry was monitored and sputum was collected immediately after treatment and 15 minutes following each treatment. Results: The results of the study shown that there was significant difference in the amount of sputum recovered with AD (14.0±3.5 g vs PD (24.4±3.0 g and significant differences in Oxygen saturation; during PD fell from 93.3±0.7% to 91.2±0.8% (p<0.01 and required 15 min following treatment to return to baseline. Oxygen saturation did not fall during AD and increased to gradually following complete treatment days (baseline, 93.3±0.8%; p<0.01. Conclusion: Hence this study concludes that Autogenic drainage is more effective in improving spo2 in COPD & does not cause a sudden fall in spo2 as occurs in Postural drainage immediately after therapy. And it can be better tolerated by patients with COPD while producing fewer benefits in sputum clearance. In concern to mean amount of secretion removal Postural is found to be more effective

  7. EFFECTIVENESS OF AUTOGENIC DRAINAGE VERSUS POSTURAL DRAINAGE ON OXYGEN SATURATION IN PATIENTS WITH CHRONIC BRONCHITIS WITH 15 MINUTES POST THERAPY

    OpenAIRE

    V. Kiran; Dr. Bhimasen .S; E. Mastanaiah; A. Thiruppathi

    2014-01-01

    Background: Patients with COPD will have more amount of secretions. To clear the secretions by using of different bronchial hygiene techniques like postural drainage and autogenic drainage technique, manual hyperventilation technique ,active cycle breathing technique .Hence in this study to compare the short-term effects of postural drainage with clapping (PD) and autogenic drainage (AD) on level of oxygen saturation in blood, and amount of sputum recovery. Methodology: The study was done ...

  8. Current asthma contributes as much as smoking to chronic bronchitis in middle age: a prospective population-based study [Corrigendum

    Directory of Open Access Journals (Sweden)

    Dharmage SC

    2017-03-01

    Full Text Available Dharmage SC, Perret JL, Burgess JA, et al. Int J Chron Obstruct Pulmon Dis. 2016;11:1911–1920. On page 1911, the author list “Shyamali C Dharmage,1 Jennifer L Perret,1,2 John A Burgess,1 Caroline J Lodge,1 David P Johns,3 Paul S Thomas,4 Graham G Giles,1,5 John L Hopper,1,6 Michael J Abramson,7,8 E Haydn Walters,3,9 Melanie C Matheson1” should have read “Shyamali C Dharmage,1,* Jennifer L Perret,1,2,* John A Burgess,1 Caroline J Lodge,1 David P Johns,3 Paul S Thomas,4 Graham G Giles,1,5 John L Hopper,1,6 Michael J Abramson,7,8 E Haydn Walters,3,9 Melanie C Matheson1”, and was missing the following statement “*These authors contributed equally to this work”.Read the original article

  9. Development and immunogenicity of recombinant GapA(+) Mycoplasma gallisepticum vaccine strain ts-11 expressing infectious bronchitis virus-S1 glycoprotein and chicken interleukin-6.

    Science.gov (United States)

    Shil, Pollob K; Kanci, Anna; Browning, Glenn F; Markham, Philip F

    2011-04-12

    Mycoplasma gallisepticum (MG) is a major pathogen of poultry that causes chronic respiratory disease in chickens and infectious sinusitis in turkeys. A live attenuated vaccine, ts-11, has been used for the control of MG in several countries. The efficacy of this vaccine is highly dose dependent and the flock antibody response is weak. To improve the functionality of the vaccine and investigate its potential as a delivery vector for foreign antigens and immunomodulatory proteins, we developed a derivative of ts-11 expressing infectious bronchitis virus-S1 glycoprotein (IBV-S1) and releasing chicken interleukin-6 into the extracellular milieu (MG ts-11 C3 (+CS)) using a transposon-based delivery vector. Following administration of MG ts-11 C3 (+CS) to chickens by eye-drop, an antibody response to MG and IBV-S1, as determined by the rapid serum agglutination test (RSA) and Western blotting, respectively, could be detected. Birds inoculated with the recombinant vaccine had significantly enhanced weight gain and were partially protected against damage by pathogenic IBV. These results indicate that the ChIL-6 released by MG ts-11 C3 (+CS) may have had a non-specific effect on growth rate. They also suggest that ts-11 is a promising vaccine vector, capable of delivering heterologous protective antigens, and may also provide non-specific benefits when engineered to express immunomodulatory proteins. With some improvements in the expression system, it could be used to induce a targeted immune response against specific mucosal pathogens, and co-expression of several antigens would allow development of a novel multivalent vaccine. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. PREPARATION AND EVALUATION OF VITAMIN E ADJUVANTED OIL EMULSIFIED INFECTIOUS BRONCHITIS EXPERIMENTAL VACCINE

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    S. ALI, M. ARSHAD, M. SIDDIQUE AND M. ASHRAF

    2007-10-01

    Full Text Available The present study was conducted to prepare oil emulsified (OE infectious bronchitis (IB experimental vaccines. The vaccines were prepared using the vaccinal strain H-120 Infectious Bonchitis virus (IBV. The virus was cultivated in 9-day old embryonated eggs via allantoic cavity route. Allantoic-amniotic fluid (AAF was collected and inactivated with formalin @ 0.12%. Water in oil emulsion was prepared by adding one part of AAF to four parts of mineral oil containing water phase (Tween 80 and oil phase (Span 80 surfactants. Hydrophile lypohile balance (HLB of the emulsion was maintained at 7.0. Two oil emulsified experimental vaccines were prepared. Vaccine-I was prepared without vitamin E and Vaccine-II with vitamin E (300 mg/ml. A total of 120 day-old broiler breeder chickens were divided into 4 groups, A, B, C, and D, each having 30 birds. At the age of 21 days, experimental Vaccine-I, experimental vaccine-II and commercial IB killed (H-120 vaccine were inoculated @ 0.5 ml in the birds of groups A, B and C, respectively. Group D was maintained as nonvaccinated control. Efficacy of the vaccines was evaluated on the basis of humoral immune response (haemagglutination inhibition antibody titres against IB in the four groups. The seven weeks cumulative mean antibody titres (CMT of each group were calculated. The highest CMT was observed in group B (130, followed by group C (69, group A (58 and group D (17. Statistical analysis showed that haemagglutination inhibition (HI antibody titres in group B (vaccine- II were significantly higher than those of groups A, B and C (P< 0.05.

  11. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  12. Impact of clinical decision support on receipt of antibiotic prescriptions for acute bronchitis and upper respiratory tract infection.

    Science.gov (United States)

    McCullough, J Mac; Zimmerman, Frederick J; Rodriguez, Hector P

    2014-01-01

    Antibiotics are commonly recognized as non-indicated for acute bronchitis and upper respiratory tract infection (URI), yet their widespread use persists. Clinical decision support in the form of electronic warnings is hypothesized to prevent non-indicated prescriptions. The purpose of this study was to identify the effect of clinical decision support on a common type of non-indicated prescription. Using National Ambulatory Medical Care Survey data from 2006 to 2010, ambulatory visits with a primary diagnosis of acute bronchitis or URI and orders for antibiotic prescriptions were identified. Visits were classified on the basis of clinician report of decision-support use. Generalized estimating equations were used to assess the effect of decision support on likelihood of antibiotic prescription receipt, controlling for patient, provider, and practice characteristics. Clinician use of decision support increased sharply between 2006 (16% of visits) and 2010 (55%). Antibiotic prescribing for acute bronchitis and URI increased from ∼35% of visits in 2006 to ∼45% by 2010. Use of decision support was associated with a 19% lower likelihood of receiving an antibiotic prescription, controlling for patient, provider, and practice characteristics. In spite of the increased use of decision-support systems and the relatively fewer non-indicated antibiotic prescriptions resulting from the use of decision support, a secular upward trend in non-indicated antibiotic prescribing offset these improvements. The overall effect of decision support suggests an important role for technology in reducing non-indicated prescriptions. Decision support alone may not be sufficient to eliminate non-indicated prescriptions given secular trends. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Prospective, Longitudinal Study of Plastic Bronchitis Cast Pathology and Responsiveness to Tissue Plasminogen Activator (tPA)

    OpenAIRE

    Heath, Lauren; Ling, Shelley; Racz, Jennifer; Mane, Gerta; Schmidt, Lindsay; Myers, Jeffrey L.; Tsai, Wan C.; Caruthers, Regine L.; Hirsch, Jennifer C.; Stringer, Kathleen A.

    2011-01-01

    Plastic bronchitis (PB) is a rare disease that often occurs in patients with congenital heart disease (CHD) who have undergone staged single ventricle palliation. It is characterized by the formation of rubbery “casts” in the airways. PB treatment frequently includes inhaled tPA. However, the efficacy of tPA to reduce cast burden is unknown. This is further complicated by our lack of knowledge of cast composition. We obtained spontaneously expectorated PB casts from children (n=4) with CHD an...

  14. Airway distensibility in Chronic Obstructive Airway Disease

    DEFF Research Database (Denmark)

    Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger

    2013-01-01

    Rationale – Chronic Obstructive Pulmonary Disease (COPD) is a combination of chronic bronchitis and emphysema, which both may lead to airway obstruction. Under normal circumstances, airway dimensions vary as a function of inspiration level. We aim to study the influence of COPD and emphysema......-dose CT for a period of 5 years (table 1). Images were reconstructed both with high contrast resolution (3 mm, kernel C) for emphysema analysis and with high spatial resolution (1 mm, kernel D) for airway analysis. Images were analysed by in-house developed software designed to segment lungs and localize...... the interior and exterior airway wall surface in three dimensions, and branches were matched in consecutive scans by image registration. Emphysema was defined as attenuation Emphysema limits were set at

  15. Natural histories of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Rennard, Stephen I; Vestbo, Jørgen

    2008-01-01

    Concepts relating to the natural history of chronic obstructive pulmonary disease (COPD) arise most importantly from the classic study of Fletcher and colleagues (The Natural History of Chronic Bronchitis and Emphysema, Oxford University Press, New York, 1976). This study, which evaluated working...... English men over 8 years, was used to construct a proposed life-long natural history. Although this is a classic study that has greatly advanced understanding of COPD, it has a number of limitations. Its duration is relatively short compared with the duration of COPD, so it is more cross-sectional than...... longitudinal. It was unable to distinguish among varied "natural histories." It assessed primarily the FEV(1), and the natural history of other features of COPD is largely undescribed. With advances in understanding the clinical features of COPD and with the development of evaluating new tools to assess...

  16. Prolonged period of acute bronchitis with late progression to acute respiratory distress syndrome as possible result of influenza A (H1N1) virus infection.

    Science.gov (United States)

    Homsi, Samer; Milojkovic, Natasa; Alawad, Bashar; Homsi, Yamen

    2012-09-01

    Young adults with underlying medical conditions who are infected with the H1N1 virus are at risk of quickly progressing from mild upper airways infection to severe ARDS within 4 to 5 days after the onset of the illness. Here, we report the case of a 46-year-old morbidly obese and diabetic woman infected with the H1N1 virus who developed acute bronchitis that lasted for 4 weeks and then progressed to ARDS. We discuss the month-long persistence of the H1N1 viral bronchitis and its late progression to ARDS which may reflect prolonged viral activity. Such a prolonged, rather than quick, course of deterioration can cause clinicians to misdiagnose the etiology of the ARDS and may cause the patient to receive a prolonged treatment with steroids to treat bronchitis symptoms. These steroids may cause increased viral replication and promote parenchymal involvement and the development of ARDS.

  17. [Efficacy and safety of acute bronchitis treatment in adults--a comparison of Bronchosol® syrup and synthetic preparations with ambroxol. Results of observational study].

    Science.gov (United States)

    Fal, Andrzej M; Schönknecht, Karina

    2015-01-01

    Upper respiratory tract infections (URTI), including acute bronchitis, are the frequent health problems and the most common reason for acute cough in adults. Even though the infections are caused mainly by viruses, and their course is usually not complicated, febrifuges, i.a. mucokinetics, or antitussives are used in the treatment of URTI in order to improve the quality of life and safety of patients. To evaluate the efficacy and safety of Bronchosol® herbal syrup in comparison to ambroxol preparations in the treatment of acute bronchitis in adult patients. The Bronchosol®/2013 study was a non-interventional, prospective, open-label, observational study. Data from adult patients treated with Bronchosol® syrup for acute bronchitis were collected and compared with data from patients treated for the same condition with ambroxol preparations. The severity of bronchitis symptoms was evaluated with the BSS (Bronchitis Severity Score) scale, and patients'quality of life wasassessed with the VAS (Visual Analogue Scale) scale. Between visits patients conducted self-observations and filled out observation diaries. Moreover, the data on adverse events were collected. In 87.68% of patients the infections were cured. Most of patients considered the studied drugs to be the agent decreasing the duration of infection and its intensity. The percentage of patients who declared that they had a less intense cough than during earlier infections was higher in the group of patients treated with Bronchosol® syrup in comparison to ambroxol treated patients (60.22% vs. 45.03%). 91.94% of patients treated with Bronchosol® considered this syrup to be very safe; in the ambroxol group such a declaration was made by 76.61% of patients. Bronchosol® syrup is an efficient, well-tolerated, and safe drug. Its efficacy in the treatment of acute bronchitis symptoms in adult patients is similar to the efficacy of ambroxol preparations.

  18. Ameliorative effect of a microbial feed additive on infectious bronchitis virus antibody titer and stress index in broiler chicks fed deoxynivalenol.

    Science.gov (United States)

    Ghareeb, K; Awad, W A; Böhm, J

    2012-04-01

    Although acute mycotoxicoses are rare in poultry production, chronic exposure to low levels of mycotoxins is responsible for reduced productivity and increased susceptibility to infectious diseases. Deoxynivalenol (DON) is known to modulate immune function, but only a few studies have investigated the effect of DON on the vaccinal immune response. In addition, the effects of Mycofix select (Biomin GmbH, Herzogenburg, Austria) supplementation to DON-contaminated broiler diets have not yet been demonstrated. Therefore, an experiment with 1-d-old male broilers (Ross 308) was carried out to examine the effects of feeding DON-contaminated low-protein grower diets on performance, serum biochemical parameters, lymphoid organ weight, and antibody titers to infectious bronchitis vaccination in serum and to evaluate the effects of Mycofix select dietary supplementation in either the presence or absence of DON in broilers. In total, thirty-two 1-d-old broiler chicks were randomly assigned to 1 of the 4 dietary treatments for 5 wk. The dietary treatments were 1) control; 2) artificially contaminated diets with 10 mg of DON/kg of diet; 3) DON-contaminated diets supplemented with Mycofix select; and 4) control diet supplemented with Mycofix select. Feeding of contaminated diets decreased (P = 0.000) the feed intake, BW (P = 0.001), BW gain (P = 0.044), and feed efficiency during the grower phase. Deoxynivalenol affected the blood biochemistry, whereas plasma total protein and uric acid concentrations in birds fed contaminated grains were decreased compared with those of the controls. Moreover, in birds fed contaminated feeds, there was a tendency to reduce triglycerides in the plasma (P = 0.090), suggesting that DON in the diets affected protein and lipid metabolism in broiler chickens. The feeding of contaminated diets altered the immune response in broilers by reducing the total lymphocyte count. Similarly, the antibody response against infectious bronchitis vaccination

  19. Use of serial rigid bronchoscopy in the treatment of plastic bronchitis in children.

    Science.gov (United States)

    Soyer, Tutku; Yalcin, Şule; Emiralioğlu, Nagehan; Yilmaz, Ebru Arik; Soyer, Ozge; Orhan, Diclehan; Doğru, Deniz; Sekerel, Bülent Enis; Tanyel, Feridun Cahit

    2016-10-01

    Plastic bronchitis (PB) is a rare disorder characterized by formation of bronchial casts (BC) in the tracheobronchial tree with partial or complete airway obstruction. Although lysis of casts with several fibrinolytic agents has been reported, removal of BC with bronchoscope provides better clearance of airways. A retrospective study was performed to evaluate the use of serial rigid bronchoscopy (RB) in the treatment of PB in children. Between 2011 and 2015, children with partial or complete airway obstruction with PB were evaluated for age, gender, underlying disease, clinical findings, results of bronchoscopic interventions and histopathologic findings. Five patients with 14 RB interventions were evaluated. The mean age of the patients was 7.8years (min: 3years - max: 14years) and male-female ratio was 4:1. All of the patients were diagnosed as asthma and none of them had underlying cardiac disease. Suction of mucus plaques and bronchoalveolar lavage were performed in all patients with flexible bronchoscopy. Also, aerosolized tissue plasminogen activator was used in two patients. During follow-up serial RB was indicated in patients with persistent atelectasis and severe airway obstruction. The most common localization of BC was left main stem bronchus and bilateral cast formation was detected in 7 interventions. Although, removal of BC was challenging in two patients because of cast friability and fragmentation, most of the plugs were successfully removed with optical forceps and rigid suctioning. Two patients underwent repeated RB (min: 3 - max: 8) for recurrent symptoms. Histopathologic evaluation of BC revealed Charcot-Leyden crystals with inflammatory cells in all patients. The time interval between RB interventions was one to five months. BC are tenacious mucus plugs which are firmly wedged to the tracheobronchial tree. The use of optical forceps with rigid suction provides adequate removal of BC during RB. Because of underlying disease, it is difficult to

  20. Polymorphism of the genes of pro-and anti-inflammatory cytocins and acute bronchitis in children

    Directory of Open Access Journals (Sweden)

    O. I. Pikuza

    2017-01-01

    Full Text Available Certain role in the development of respiratory diseases is played by cytokines that possess both pro-and anti-inflammatory activity, and the balance of these factors influences the course of the disease. As shown by studies in recent years, the negative influence of environmental factors, as a rule, implemented against the background of the individual genetic predisposition in virtually any known to date pathology. Objective research: to identify molecular genetic risk factors for the development of acute bronchitis and community-acquired pneumonia in children on the basis of the analysis of polymorphisms of pro- and anti-inflammatory interleukins. A complex clinicallaboratory and instrumental examination of 110 children aged 6 to 15 years with acute bronchitis (the main group was carried out. The control group included 163 conditionally healthy children of the same age. Significant differences were revealed by the polymorphism of the TNFA gene, which has pro-inflammatory properties. At the same time, analysis of the frequency allocation of alleles and genotypes of polymorphism (-174C/G of IL6 and + 3953C/T gene IL1B did not reveal significant differences with the control. The results of the study can be used in the development of prognostic markers of acute pathology in children and optimization of treatment tactics and preventive measures with an individual approach for each patient.

  1. The treatment of acute bronchitis by general practitioners in the UK. Results of a cross sectional postal survey.

    Science.gov (United States)

    Stocks, Nigel P; Fahey, Tom

    2002-07-01

    In Australia and the UK acute bronchitis is a common presenting problem in general practice. When symptoms persist management can be difficult and despite evidence that antibiotics are usually ineffective their use is widespread. To describe prescribing behaviour for acute bronchitis by general practitioners in the United Kingdom. Cross sectional postal survey of UK GPs. Four hundred and nineteen (73%) GPs responded. Purulent sputum, fever and crepitations/crackles on chest examination were the most important reasons for prescribing antibiotics: 89% of GPs said the colour of the sputum influenced their decision; amoxycillin was the first choice; 40% of GPs believed that at least one in five consultations for ARI were affected by patient factors, usually to maintain patient satisfaction. 47% of GPs advised the use of bronchodilators, and 96% recommended the symptomatic use of paracetamol and fluids. General practitioners are influenced to use antibiotics by patient symptoms and signs for which there is little evidence. Patient psychosocial factors influence prescribing. Until clearer research findings from new studies are available, GPs may opt for a 'just in case' prescription.

  2. What is chronic cough in children?

    Directory of Open Access Journals (Sweden)

    Iulia eIOAN

    2014-08-01

    Full Text Available The cough reflex is modulated throughout growth and development. Cough – but not expiration reflex – appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children. Prolonged acute cough is usually related to the long-lasting effects of a previous viral airway infection or to the particular entity called protracted bacterial bronchitis. Cough pointers and type may orient towards specific aetiologies, such as barking cough in croup or tracheomalacia, paroxystic whooping cough in Pertussis. Cough is productive in protracted bacterial bronchitis, sinusitis or bronchiectasis. Cough is usually associated with wheeze or dyspnea on exertion in asthma; however, it may be the sole symptom in cough variant asthma. Thus, paediatric cough has particularities differentiating it from adult cough, so the approach and management should be developmentally specific.

  3. Detection and strain differentiation of infectious bronchitis virus in tracheal tissues from experimentally infected chickens by reverse transcription-polymerase chain reaction. Comparison with an immunohistochemical technique

    DEFF Research Database (Denmark)

    Handberg, Kurt; Nielsen, O.L.; Pedersen, M.W.

    1999-01-01

    Oligonucleotide pairs were constructed for priming the amplification of fragments of nucleocapsid (N) protein and spike glycoprotein (S) genes of avian infectious bronchitis virus (IBV) by reverse transcription-polymerase chain reaction (RT-PCR). One oligonucleotide pair amplified a common segment...

  4. Acute bronchitis therapy with ivy leaves extracts in a two-arm study. A double-blind, randomised study vs. an other ivy leaves extract.

    Science.gov (United States)

    Cwientzek, Ute; Ottillinger, Bertram; Arenberger, Petr

    2011-10-15

    Ivy leaves extracts are authorised in medicinal products for the treatment of acute bronchitis. Different studies and the long experience on the market show safety and efficacy of this drug. A double-blind, randomised study was conducted to assess the efficacy and tolerability of ivy leaves soft extract with an other ivy leaves extract. 590 patients with acute bronchitis participated in this study. They were treated with test or comparator for 7 days (±1). The Bronchitis Severity Score (BSS) decreased gradually and to a similar extent from Day 1 to Day 7 in both treatment groups. Starting from values of 6.2-6.3±1.2, the BSS decreased by approximately 4.7-4.9 points until Day 7, so that patients left the study with a mean BSS of 1.4-1.6. The BSS subscales cough, sputum, rhales/rhonchi, chest pain during coughing, and dyspnoea improved to a similar extent in both treatment groups. Overall, 2.7% of patients (per group and overall) experienced an adverse event, all of which were non-serious. Fewer patients younger than ten years had adverse events than would have been expected from their share of the study population (p=0.015; Fisher's exact test). As a conclusion, the test product with ivy leaves soft extract proved to be non-inferior to the comparator ivy leaves extract in improving symptoms of acute bronchitis. Copyright © 2011 Elsevier GmbH. All rights reserved.

  5. Persistent and Recurrent Bacterial Bronchitis—A Paradigm Shift in Our Understanding of Chronic Respiratory Disease

    Science.gov (United States)

    Ishak, Alya; Everard, Mark L.

    2017-01-01

    The recent recognition that the conducting airways are not “sterile” and that they have their own dynamic microbiome, together with the rapid advances in our understanding of microbial biofilms and their roles in the causation of respiratory diseases (such as chronic bronchitis, sinusitis, and chronic otitis media), permit us to update the “vicious circle” hypothesis of the causation of bronchiectasis. This proposes that chronic inflammation driven by persistent bacterial bronchitis (PBB) causes damage to both the epithelium, resulting in impaired mucociliary clearance, and to the airway wall, which eventually manifests as bronchiectasis. The link between a “chronic bronchitis” and a persistence of bacterial pathogens, such as non-typable Haemophilus influenzae, was first made more than 100 years ago, and its probable role in the causation of bronchiectasis was proposed soon afterward. The recognition that the “usual suspects” are adept at forming biofilms and hence are able to persist and dominate the normal dynamically changing “healthy microbiome” of the conducting airways provides an explanation for the chronic colonization of the bronchi and for the associated chronic neutrophil-dominated inflammation characteristic of a PBB. Understanding the complex interaction between the host and the microbial communities of the conducting airways in health and disease will be a key component in optimizing pulmonary health in the future. PMID:28261574

  6. Infectious bronchitis in Brazilian chickens: current data and observations of field service personnel

    Directory of Open Access Journals (Sweden)

    EN Silva

    2010-09-01

    Full Text Available The infectious bronchitis virus (IBV was detected for the first time in Brazil by Hipólito in 1957 in chickens sold life in the municipal market of Belo Horizonte, MG, when commercial poultry production was just starting in that country. The Massachusetts (Mass serotype was identified. However, the clinical disease was only observed in 1975, when poultry production was intensely growing. The extensive outbreak produced the classical condition in layers and breeders, affecting egg production and quality, whereas broilers presented respiratory and "nephritis-nephrosis" signs. The disease rapidly spread to all poultry-producing regions in the country, and in 1979, both the imports and the manufacturing of live vaccines against IB strains Mass, H120 and H52, were licensed. In 1980, inactivated vaccines were introduced. Molecular techniques, particularly PCR, started to bed in the identification of IBV. A retrospective analysis showed that, up to 1989, the main IBV strain circulating in Brazil was Mass. However, other studies shows the presence of a wide diversity of IBV strains in Brazil since the first strains were isolated, even before vaccination was introduced. Most researchers agree that the incidence of IBV different from Mass has increased, including of exclusively Brazilian genotypes, different from those described in other countries. Indeed, during the last few years, the number of genotypical variants has been much higher than that of the classical Mass serotype. Clinically, in addition of the classic presentations, atypical forms such as testicular atrophy and stones in the epidydimis associated to low fertility have been described. Serological techniques started to be used in vaccination monitoring and as a diagnostic tool. Serological response standards were developed, and have shown to be very useful to determine the expected profile in vaccination programs and when clinical disease is suspected. However, the immuno-enzymatic test

  7. Airway wall thickening and emphysema show independent familial aggregation in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Patel, Bipen D; Coxson, Harvey O; Pillai, Sreekumar G

    2008-01-01

    RATIONALE: It is unclear whether airway wall thickening and emphysema make independent contributions to airflow limitation in chronic obstructive pulmonary disease (COPD) and whether these phenotypes cluster within families. OBJECTIVES: To determine whether airway wall thickening and emphysema (1...... the severity of airway wall thickening and emphysema. MEASUREMENTS AND MAIN RESULTS: A total of 3,096 individuals were recruited to the study, of whom 1,159 (519 probands and 640 siblings) had technically adequate high-resolution computed tomography scans without significant non-COPD-related thoracic disease....... Airway wall thickness correlated with pack-years smoked (P chronic bronchitis (P emphysema at -950...

  8. Low incidence of bronchus-associated lymphoid tissue (BALT) in chronically inflamed human lungs.

    Science.gov (United States)

    Delventhal, S; Brandis, A; Ostertag, H; Pabst, R

    1992-01-01

    The relevance of bronchus-associated lymphoid tissue (BALT) in man is still under discussion. Animal experiments indicate that the development of BALT is dependent on microbial stimulation. Therefore, the incidence of BALT was investigated retrospectively in specimens removed during surgical procedures on patients with chronic pulmonary inflammation. All these patients had severe chronic bronchitis and bronchiectasis, but BALT was found in only 8%. In patients with BALT and a malignant tumor, occlusion of a bronchus with poststenotic pneumonia was always present and BALT was observed exclusively in areas peripheral to the occlusion. In man other compartments of the lung must be responsible for the immune function of BALT found in animals.

  9. Adjuvant Activity of Sargassum pallidum Polysaccharides against Combined Newcastle Disease, Infectious Bronchitis and Avian Influenza Inactivated Vaccines

    Directory of Open Access Journals (Sweden)

    Li-Jie Li

    2012-11-01

    Full Text Available This study evaluates the effects of Sargassum pallidum polysaccharides (SPP on the immune responses in a chicken model. The adjuvanticity of Sargassum pallidum polysaccharides in Newcastle disease (ND, infectious bronchitis (IB and avian influenza (AI was investigated by examining the antibody titers and lymphocyte proliferation following immunization in chickens. The chickens were administrated combined ND, IB and AI inactivated vaccines containing SPP at 10, 30 and 50 mg/mL, using an oil adjuvant vaccine as a control. The ND, IB and AI antibody titers and the lymphocyte proliferation were enhanced at 30 mg/mL SPP. In conclusion, an appropriate dose of SPP may be a safe and efficacious immune stimulator candidate that is suitable for vaccines to produce early and persistent prophylaxis.

  10. Genetic diversity of avian infectious bronchitis viruses in Japan based on analysis of s2 glycoprotein gene.

    Science.gov (United States)

    Mase, Masaji; Inoue, Toshikazu; Yamaguchi, Shigeo; Imada, Tadao

    2009-03-01

    To understand the genetic diversity of the S2 gene of infectious bronchitis viruses (IBV) isolated in Japan, we determined the nucleotide sequences of these IBVs using the reverse transcriptase polymerase chain reaction method coupled with direct sequencing. IBV isolated in Japan were classified into six different groups by phylogenetic analysis based on the S2 gene. However, the classification based on the S2 gene of IBV isolated in Japan was different for some of the strains from those obtained with our previous analysis of the S1 gene. This suggested that genetic recombination between the virus strains classified into different genetic groups had occurred in poultry, and that recombinant viruses might be epidemic in Japan.

  11. Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure

    Directory of Open Access Journals (Sweden)

    Grzegorz Lis

    2014-01-01

    Full Text Available Plastic bronchitis (PB, although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enalapril maleate. The child also received nebulized 3% NaCl solution, which proved to be beneficial. In children submitted to Fontan-type procedures, physicians must be alert for PB, which can be triggered by respiratory tract infection.

  12. Sialic Acid Binding Properties of Soluble Coronavirus Spike (S1 Proteins: Differences between Infectious Bronchitis Virus and Transmissible Gastroenteritis Virus

    Directory of Open Access Journals (Sweden)

    Christine Winter

    2013-07-01

    Full Text Available The spike proteins of a number of coronaviruses are able to bind to sialic acids present on the cell surface. The importance of this sialic acid binding ability during infection is, however, quite different. We compared the spike protein of transmissible gastroenteritis virus (TGEV and the spike protein of infectious bronchitis virus (IBV. Whereas sialic acid is the only receptor determinant known so far for IBV, TGEV requires interaction with its receptor aminopeptidase N to initiate infection of cells. Binding tests with soluble spike proteins carrying an IgG Fc-tag revealed pronounced differences between these two viral proteins. Binding of the IBV spike protein to host cells was in all experiments sialic acid dependent, whereas the soluble TGEV spike showed binding to APN but had no detectable sialic acid binding activity. Our results underline the different ways in which binding to sialoglycoconjugates is mediated by coronavirus spike proteins.

  13. Elisa evaluation of the levels of antibodies against Infectious Bronchitis Virus in laying hens using egg yolk as substrate

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    RH Rauber

    2004-06-01

    Full Text Available The present work was carried out to compare Infectious Bronchitis Virus (IBV antibody titers in serum and egg yolk samples from laying hens. Sixty paired blood and egg samples were collected from laying hens of two farms. Serum samples were frozen, while egg yolk samples were diluted (1:500 before freezing. Serum and yolk samples were tested for the presence of IBV antibodies by indirect ELISA (commercial kit and titers were compared by a correlation test (alpha=0.05. There was a high correlation (r=0.62 between the two kinds of samples, which means that titers of IBV antibodies in the egg yolk and in serum samples are quite the same. Considering that blood collection causes deep stress that leads to economic losses, and since eggs are collected daily on the farm, results reported here are of importance to poultry production.

  14. Bridging Lung Development with Chronic Obstructive Pulmonary Disease. Relevance of Developmental Pathways in Chronic Obstructive Pulmonary Disease Pathogenesis.

    Science.gov (United States)

    Boucherat, Olivier; Morissette, Mathieu C; Provencher, Steeve; Bonnet, Sébastien; Maltais, François

    2016-02-15

    Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation. This generic term encompasses emphysema and chronic bronchitis, two common conditions, each having distinct but also overlapping features. Recent epidemiological and experimental studies have challenged the traditional view that COPD is exclusively an adult disease occurring after years of inhalational insults to the lungs, pinpointing abnormalities or disruption of the pathways that control lung development as an important susceptibility factor for adult COPD. In addition, there is growing evidence that emphysema is not solely a destructive process because it is also characterized by a failure in cell and molecular maintenance programs necessary for proper lung development. This leads to the concept that tissue regeneration required stimulation of signaling pathways that normally operate during development. We undertook a review of the literature to outline the contribution of developmental insults and genes in the occurrence and pathogenesis of COPD, respectively.

  15. Haemophilus "influenzae" (Pfeiffer) als ubiquitaire verwekker van acute en chronische etterige bronchitis

    NARCIS (Netherlands)

    Mulder, Jacob

    1937-01-01

    For about nine years the author has made a systematic study of the incidence and the pathogenicity of the haemoglobinophilic bacteria in acute and chronical diseases of the respitratory tract and of the lungs. Part of these investigations have been performed in the Natives and Europeans, employed by

  16. FEATURES OF IMMUNE RESPONSE AND METABOLIC CHANGES IN LYMPHOCYTES FROM PERIPHERAL BLOOD IN YOUNGER CHILDREN WITH RECURRENT OBSTRUCTIVE BRONCHITIS

    Directory of Open Access Journals (Sweden)

    L. M. Kurtasova

    2017-01-01

    Full Text Available The aim of the work was to study the parameters of T-cells, humoral immunity and activity of NAD(P- dependent dehydrogenases in lymphocytes from peripheral blood at young children with recurrent obstructive bronchitis (ROB. Patients and Methods: Fifty-four children at the age of 1-3 years with ROB were observed. The control group consisted of 35 healthy children at similar age. The numbers of СD3+, СD4+, СD8+, СD19+ cells in peripheral blood were determined by flow cytofluorimetric technique. IgA, IgM, and IgG concentrations in blood serum were evaluated by G. Mancini et al. (1965; circulating immune complexes (CIC, by V. Haskova et al. (1978; total IgE test was performed with “Total IgE – IFA Best” system (Russia. Relative activity of NAD (P-dependent dehydrogenase in peripheral blood lymphocytes was studied according to A. Savchenko et al.(1989. The results of this study have revealed changed phenotypic spectrum of peripheral blood lymphocyte populations; a statistically significant reduction in IgA concentration, and a tendency for increased IgE levels in blood serum in the children with ROB. An increase of ribose-5-phosphate- and NADPdependent metabolic processes; reduced lactate dehydrogenase anaerobic reactions; a switch from lipid catabolism products to glycolysis; a shunt role of malate/aspartate in cell energy supply, and for glutathione reductase activity; elevated levels of substrate flow along Krebs cycle in peripheral blood lymphocytes were registered as well. It may be concluded that the change of phenotype and enzymatic activity of blood lymphocytes, selective IgA deficiency in blood serum could be shown in the younger children with recurrent obstructive bronchitis.

  17. Otras enfermedades obstructivas: bisinosis, bronquitis crónica y EPOC de origen laboral y bronquitis eosinofílica Other obstructive diseases: byssinosis, chronic bronchitis and occupational COPD and eosinophilic bronchitis

    OpenAIRE

    F. J. Michel de la Rosa; B. Fernández Infante

    2005-01-01

    Además del asma ocupacional y las enfermedades derivadas de la inhalación aguda, otras enfermedades obstructivas también reconocen un origen laboral. Aunque en la actualidad la bisinosis es una enfermedad rara en España, describimos las características de la misma por su interés histórico dentro de las enfermedades respiratorias de origen laboral y porque todavía sigue vigente en los países en vías de desarrollo. La bronquitis crónica también puede estar relacionada con la exposición laboral ...

  18. The Nature and Causes of Chronic Obstructive Pulmonary Disease: A Historical Perspective

    Directory of Open Access Journals (Sweden)

    C Peter W Warren

    2009-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is the currently favoured name for the diseases formerly known as emphysema and bronchitis. COPD has been recognized for more than 200 years. Its cardinal symptoms are cough, phlegm and dyspnea, and its pathology is characterized by enlarged airspaces and obstructed airways. In the 19th century, the diagnosis of COPD depended on its symptoms and signs of a hyperinflated chest, and reduced expiratory breath sounds. The airflow obstruction evident on spirometry was identified in that century, but did not enter into clinical practice. Bronchitis, and the mechanical forces required to overcome its obstruction, was believed to be responsible for emphysema, although the inflammation present was recognized. The causes of bronchitis, and hence emphysema, included atmospheric and domestic air pollution, as well as dusty occupations. Cigarette smoking only became recognized as the dominant cause in the 20th century. The lessons learned of the risks for COPD in 19th-century Britain are very pertinent to the world today.

  19. Bronchoalveolar lavage fluid and serum canine surfactant protein A concentrations in dogs with chronic cough by bronchial and interstitial lung diseases.

    Science.gov (United States)

    Yamaya, Yoshiki; Suzuki, Kazuyuki; Watari, Toshihiro; Asano, Ryuji

    2014-04-01

    We measured bronchoalveolar lavage fluid (BALF) and serum canine surfactant protein (cSP)-A concentrations in dogs with chronic cough. There were no significant differences between bronchial and interstitial lung diseases in BALF cSP-A concentrations. However, serum cSP-A concentrations in dogs with the interstitial lung disease as diffuse panbronchiolitis and idiopathic pulmonary fibrosis were significantly higher than those in dogs with the bronchial disease as chronic bronchitis. These results suggest that serum cSP-A concentrations may be a useful and noninvasive biomarker to understand the existence of interstitial lung damage in dogs with chronic cough.

  20. High-resolution CT in patients with chronic airflow obstruction: correlation with clinical diagnosis and pulmonary function test

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Ki Taek; Kang, Eun Young; Rhee, Ji Yong; Kim, Jin Hyung; Choi, Jung Ah; Cho, Jae Yoen; Oh, Yu Whan; Suh, Won Hyuck [College of Medicine, Korea University, Seoul (Korea, Republic of)

    2000-06-01

    To determine the utility of HRCT in the diagnosis of chronic airflow obstruction and to correlate the morphologic abnormalities revealed by this modality with functional impairment in patients with chronic airflow obstruction. This study involved 80 patients with chronic airflow obstruction who underwent HRCT and a pulmonary function test. Final clinical diagnosis in these patients was determined by a chest physician on the basis of clinical features, bronchoscopy, pulmonary function test, and HRCT. In order to diagnose and determine the extent of areas of decreased attenuation revealed by HRCT (the CT score), the findings of HRCT were retrospectively reviewed by two radiologists, who reached a consensus. Clinical and HRCT diagnoses were then compared, and the rate of agreement between them was calculated. The relationship between the extent of areas of decreased attenuation revealed by HRCT and by FEV1/FVC was evaluated using Correl's account and Student's unpaired t-test. The agreement rate between clinical and HRCT diagnoses was 77.5% (62/80). The rates for bronchiectasis (88.9%, 24/27), emphysema (93.9%, 31/33), and bronchiolitis obliterans (100%, 6/6) were considerably higher than those for chronic bronchitis and bronchial asthma. The correlation rate between CT score and FEV1/FVC was significant in bronchiectasis (p less than 0.05; r: -0.76) and bronchiolitis obliterans (p less than 0.01; r: -0.66), but not in cases involving emphysema, bronchial asthma, or chronic bronchitis (p greater than 0.05). HRCT is valuable in the diagnosis and prediction of physiologic impairment in patients with bronchiectasis and bronchiolitis obliterans, but has limited value in those with emphysema, chronic bronchitis or asthma. (author)

  1. Up-regulation of serum periostin and squamous cell carcinoma antigen levels in infants with acute bronchitis due to respiratory syncytial virus.

    Science.gov (United States)

    Nakamura, Hiroaki; Akashi, Kenichi; Watanabe, Masako; Ohta, Shoichiro; Ono, Junya; Azuma, Yoshinori; Ogasawara, Noriko; Yamamoto, Keisuke; Shimizu, Norikazu; Tsutsumi, Hiroyuki; Izuhara, Kenji; Katsunuma, Toshio

    2017-11-06

    Periostin and squamous cell carcinoma antigen (SCCA) are involved in the pathogenesis of asthma. Acute bronchitis due to respiratory syncytial virus (RSV) infection during infancy exhibits an asthma-like pathogenesis, suggesting that it may be associated with the subsequent development of asthma. However, the mechanism by which RSV infection leads to development of asthma has not yet been fully elucidated. Infants younger than 36 months were enrolled and classified into three groups. Group I included patients hospitalized with RSV-induced bronchitis. These patients were further stratified into two sub-groups according to whether the criteria for the modified Asthma Predictive Index (mAPI) had been met: Group I consisted of mAPI (+) and mAPI (-) patients; Group II included patients with food allergy as a positive control group; and Group III included children with no allergy as a negative control group. Serum periostin and SCCA levels were measured in the groups. This study was registered as a clinical trial (UMIN000012339). We enrolled 14 subjects in Group I mAPI (+), 22 in Group I mAPI (-), 18 in Group II, and 18 in Group III. In Group I, the serum periostin and SCCA levels were significantly higher during the acute phase compared with the recovery phase. However, no significant differences were found between Group I mAPI (+) and mAPI (-). The serum periostin and SCCA levels increased during acute RSV bronchitis. Both periostin and SCCA may play a role in the pathogenesis of acute bronchitis due to RSV. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  2. Chronic Diarrhea

    Science.gov (United States)

    ... can infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... may represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  3. A multi-centre, randomised, double-blind, placebo-controlled clinical trial on the efficacy and tolerability of GeloMyrtol® forte in acute bronchitis.

    Science.gov (United States)

    Gillissen, A; Wittig, Th; Ehmen, M; Krezdorn, H G; de Mey, C

    2013-01-01

    GeloMyrtol® forte (Myrtol®) is a phytomedicine obtained by distillation from essential oils. The trial was conducted to confirm the efficacy of Myrtol® in the treatment of acute bronchitis. Patients with acute bronchitis and without confounding co-morbidity or co-medication were randomly assigned to treatment with either Myrtol® 300 mg 4 times daily or matched placebo in double-blind, parallel-group fashion. Signs and symptoms were evaluated by the investigator at baseline and after 7, 10 and 14 days of treatment; intake of medication, wellbeing and symptoms were recorded daily by the patient in the patients' diaries. 413 patients were enrolled and randomised (Myrtol®: 202; Placebo: 211); 398 had at least one on-treatment efficacy evaluation (Myrtol®: 196; Placebo: 202). The mean change in coughing fits from D01 (baseline) to D07-D09 (after about one week treatment) was 62.1% (95% CI: 57.6-66.6%) and 49.8% (95% CI: 44.6-55.0%) for treatment with Myrtol® and placebo, respectively (pbronchitis severity score and subscores) and significant more patients had a clinically satisfying response to the investigational treatment.Both treatments were generally well tolerated. Myrtol® is statistically significantly superior to placebo in treating acute bronchitis. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Study on clinical effect and immunologic mechanism of infants capillary bronchitis secondary bronchial asthma treated with bacterial lysates Broncho-Vaxom.

    Science.gov (United States)

    Han, R-F; Li, H-Y; Wang, J-W; Cong, X-J

    2016-05-01

    To study the clinical effects and immunologic mechanism of infant capillary bronchitis secondary bronchial asthma treated with bacterial lysates (Broncho-Vaxom OM-85BV). Between February 2013 and February 2014, 136 infant capillary bronchitis secondary bronchial asthma cases were chosen. This research was approved by Ethics Committee in our hospital and obtained the informed consent right from patients and guardians. Patients were divided into the control group (n = 62) and the observation group (n = 74) using random number table method. Patients in the control group were treated with normal glucocorticoid atomizing inhalation, aminophylline and antibiotic treatment. In the observation group besides the abovementioned treatment, we added Broncho-Vaxom OM-85BV, qd po for 10 days continuously and quitted it for 20 days. This continued for a total of 3 months. Follow-ups were set for about one year to compare the effects. The onset frequency and duration of capillary bronchitis and asthma in observation group declined remarkably compared with control group and the differences were statistically significant (p bronchial asthma, relating to the reduced inflammation reaction. It also regulated the immunologic function of Th1/Th2, and lowered the α7nAChR level.

  5. Changes in early-career family physicians' antibiotic prescribing for upper respiratory tract infection and acute bronchitis: a multicentre longitudinal study.

    Science.gov (United States)

    Magin, Parker J; Morgan, Simon; Tapley, Amanda; Henderson, Kim M; Holliday, Elizabeth G; Ball, Jean; Davis, Joshua S; Dallas, Anthea; Davey, Andrew R; Spike, Neil A; McArthur, Lawrie; Stewart, Rebecca; Mulquiney, Katie J; van Driel, Mieke L

    2016-08-01

    Inappropriate antibiotic prescription and subsequent antibacterial resistance are major threats to health worldwide. We aimed to establish whether early-career 'apprenticeship-model' experience in family practice influences antibiotic prescribing for respiratory tract infections and to also establish other associations of antibiotic prescribing changes during this early-career experience. A longitudinal analysis (2010-2014) of a cohort study of Australian GP registrars' (vocational trainees') consultations. Registrars from five regional training programs recorded data from 60 consecutive consultations, once each 6-month training Term, including the diagnoses managed and medications prescribed. The outcomes were whether an antibiotic was prescribed for the diagnoses 'upper respiratory tract infection (URTI)' and 'acute bronchitis/bronchiolitis'. Generalized linear mixed modelling was used to account for repeated measures on registrars and to include the time component: 'Term'. A total of 856 registrars recorded 108759 consultations, including 8715 'URTI' diagnoses (5.15% of diagnoses) and 2110 'acute bronchitis/bronchiolitis' diagnoses (1.25%). Antibiotics were prescribed in 16.3% [95% confidence interval (CI) 14.9-17.8] of URTI and 72.2% (95% CI 69.6-74.6) of acute bronchitis/bronchiolitis diagnoses. Moving from an earlier to later term did not significantly influence registrars' antibiotic prescribing for URTI [adjusted odds ratio (OR) 0.95; 95% CI 0.87, 1.04, P = 0.27] or acute bronchitis/bronchiolitis [OR 1.01 (95% CI 0.90-1.14), P = 0.86]. Significant associations of antibiotic prescribing for URTIs were the registrar being non-Australian educated, greater patient age, practices not privately billing patients, pathology being ordered, longer consultation duration and the registrar seeking in-consultation information or advice (including from their supervisor). Early-career experience/training failed to produce rational antibiotic prescribing for URTI and acute

  6. Reference gene selection for gene expression study in shell gland and spleen of laying hens challenged with infectious bronchitis virus.

    Science.gov (United States)

    Khan, Samiullah; Roberts, Juliet; Wu, Shu-Biao

    2017-10-27

    Ten reference genes were investigated for normalisation of candidate target gene expression data in the shell gland and spleen of laying hens challenged with two strains of infectious bronchitis virus (IBV). Data were analysed with geNorm, NormFinder and BestKeeper, and a comprehensive ranking (geomean) was calculated. In the combined data set of IBV challenged shell gland samples, the comprehensive ranking showed TATA-box binding protein (TBP) and tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein zeta (YWHAZ) as the two most stable, and succinate dehydrogenase complex flavoprotein subunit A (SDHA) and albumin (ALB) as the two least stable reference genes. In the spleen, and in the combined data set of the shell gland and spleen, the two most stable and the two least stable reference genes were TBP and YWHAZ, and ribosomal protein L4 (RPL4) and ALB, respectively. Different ranking has been due to different algorithms. Validation studies showed that the use of the two most stable reference genes produced accurate and more robust gene expression data. The two most and least stable reference genes obtained in the study, were further used for candidate target gene expression data normalisation of the shell gland and spleen under an IBV infection model.

  7. Molecular mechanisms of primary and secondary mucosal immunity using avian infectious bronchitis virus as a model system.

    Science.gov (United States)

    Guo, Xueshui; Rosa, Artur J M; Chen, Ding-Geng; Wang, Xiuqing

    2008-02-15

    Although mucosal immune responses are critical for protection of hosts from clinical illness and even mortality caused by mucosal pathogens, the molecular mechanism of mucosal immunity, which is independent of systemic immunity, remains elusive. To explore the mechanistic basis of mucosal protective immunity, gene transcriptional profiling in mucosal tissues was evaluated after the primary and secondary immunization of animals with an attenuated avian infectious bronchitis virus (IBV), a prototype of Coronavirus and a well-characterized mucosal pathogen. Results showed that a number of innate immune factors including toll-like receptors (TLRs), retinoic-acid-inducible gene-1 (RIG-1), type I interferons (IFNs), complements, and interleukin-1 beta (IL-1beta) were activated locally after the primary immunization. This was accompanied or immediately followed by a potent Th1 adaptive immunity as evidenced by the activation of T-cell signaling molecules, surface markers, and effector molecules. A strong humoral immune response as supported by the significantly up-regulated immunoglobulin (Ig) gamma chain was observed in the absence of innate, Th1 adaptive immunity, or IgA up-regulation after the secondary immunization, indicating that the local memory response is dominated by IgG. Overall, the results provided the first detailed kinetics on the molecular basis underlying the development of primary and secondary mucosal immunity. The key molecular signatures identified may provide new opportunities for improved prophylactic and therapeutic strategies to combat mucosal infections.

  8. Proteomic analysis of chicken embryonic trachea and kidney tissues after infection in ovo by avian infectious bronchitis coronavirus

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    Kong Xiangang

    2011-03-01

    Full Text Available Abstract Background Avian infectious bronchitis (IB is one of the most serious diseases of economic importance in chickens; it is caused by the avian infectious coronavirus (IBV. Information remains limited about the comparative protein expression profiles of chicken embryonic tissues in response to IBV infection in ovo. In this study, we analyzed the changes of protein expression in trachea and kidney tissues from chicken embryos, following IBV infection in ovo, using two-dimensional gel electrophoresis (2-DE coupled with matrix-assisted laser desorption/ionization time-of-flight tandem mass spectrometry (MALDI-TOF-TOF MS. Results 17 differentially expressed proteins from tracheal tissues and 19 differentially expressed proteins from kidney tissues were identified. These proteins mostly related to the cytoskeleton, binding of calcium ions, the stress response, anti-oxidative, and macromolecular metabolism. Some of these altered proteins were confirmed further at the mRNA level using real-time RT-PCR. Moreover, western blotting analysis further confirmed the changes of annexin A5 and HSPB1 during IBV infection. Conclusions To the best of our knowledge, we have performed the first analysis of the proteomic changes in chicken embryonic trachea and kidney tissues during IBV infection in ovo. The data obtained should facilitate a better understanding of the pathogenesis of IBV infection.

  9. Currently available cough suppressants for chronic cough.

    Science.gov (United States)

    Chung, Kian Fan

    2008-01-01

    Chronic cough is a common symptom but only a fraction of patients seek medical attention. Addressing the causes of chronic cough may lead to control of cough; however, this approach is not always successful since there is a certain degree of failure even when the cause(s) of cough are adequately treated; in idiopathic cough, there is no cause to treat. Persistent cough may be associated with deterioration of quality of life, and treatment with cough suppressants is indicated. Currently available cough suppressants include the centrally acting opioids such as morphine, codeine, and dextromethorphan. Peripherally acting antitussives include moguisteine and levodropropizine. Early studies report success in reducing cough in patients with chronic bronchitis or COPD; however, a carefully conducted study showed no effect of codeine on cough of COPD. Success with these cough suppressants can be achieved at high doses that are associated with side effects. Slow-release morphine has been reported to be useful in controlling intractable cough with good tolerance to constipation and drowsiness. There have been case reports of the success of centrally acting drugs such as amitryptiline, paroxetine, gabapentin, and carbamezepine in chronic cough. New opioids such as nociceptin or antagonists of TRPV1 may turn out to be more effective. Efficacy of cough suppressants must be tested in double-blind randomised trials using validated measures of cough in patients with chronic cough not responding to specific treatments. Patients with chronic cough are in desperate need of effective antitussives that can be used either on demand or on a long-term basis.

  10. [Chronic cough in pediatrics: Review and analysis].

    Science.gov (United States)

    Sacre Hazouri, José Antonio

    2010-01-01

    To review and to analyze the existing literature regarding chronic cough in children. We searched published articles in PubMed using the key words: cough, chronic cough, chronic cough in children, persistent cough, gastroesophageal reflux in children. Cough in children is common; the majority of cases reflect respiratory infections. Cough is rarely associated to a serious disorder. All children with cough persisting for more than 8 weeks should be evaluated. A careful history, physical examination, chest x-ray, and spirometry (in an able child) are recommended for all children with chronic cough. If a diagnosis is no evident (nonspecific cough), then an approach based on characterizing the cough as "wet" or "dry" is helpful. In each case, specific etiology-based treatment is recommended when possible; otherwise, a therapeutic trial is indicated with inhaled corticosteroids (ICS) for children with dry cough (for possible asthma) and antibiotics for wet cough (for possible protracted bacterial bronchitis [PPB] or sinusitis). The treatment should be reviewed within the specified time frame for normal response. If no effect is obvious, the treatment should be stopped and alternative diagnosis considered. Multiple etiologies may need to be treated concomitantly. Every effort should be made to identify the underlying cause. Data suggests potential harmful effects of medications used for symptomatic relief of acute or chronic cough in children. Medical history and physical examination, together with appropriate investigations allow the correct diagnosis of chronic cough. The diagnostic approach is summarized in Figures 1 and 2. Most cases can be managed with this algorithm. For the difficult, complex and rare cases referral to a Pediatric specialist in Allergy, Clinical Immunology and Respiratory Diseases is warranted.

  11. A comparative and descriptive study of asthma in chronic rhinosinusitis with nasal polyps

    DEFF Research Database (Denmark)

    Håkansson, Kåre; Thomsen, Simon Francis; Konge, Lars

    2014-01-01

    strength is uncertain. Here, we aimed to examine the association between CRSwNPs and asthma in collaboration between the neighboring specialities: otorhinolaryngology and respiratory medicine. METHODS: A prospective clinical study was performed comprising 40 CRS patients scheduled for functional endoscopic......: Compared with previous studies, we found a very high prevalence of asthma and, frequently, asthma was undiagnosed. Furthermore, CRSwNPs was associated with chronic bronchitis and, in those with asthma, lower airway obstruction. These results call for a closer collaboration between otorhinolaryngology...

  12. Effects of TNF-alpha and leptin on weight loss in patients with stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Shin, Kyeong-Cheol; Chung, Jin Hong; Lee, Kwan Ho

    2007-12-01

    Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum tumor necrosis factor-alpha (TNF-alpha) were measured in all the study participants. The difference and correlation of these parameters were investigated between the two groups. Emphysematous patients were characterized by a lower body mass index (BMI) and fat-mass (FM) compared with the chronic bronchitis patients (p leptin levels, as corrected for the FM, were not different between the COPD patients and healthy controls (78.3 +/- 30.9 pg/mL/kg vs. 70.9 +/- 17.3 pg/mL/kg, respectively), and the plasma leptin levels, as adjusted for the FM, were also not different between the two groups of COPD patients. In the chronic bronchitis patients, the plasma leptin concentration was correlated with the BMI (r = 0.866, p COPD patients than those in the controls, but there was no statistical difference (10.7 +/- 18.6 pg/mL vs. 7.2 x 3.5 pg/mL, respectively, p0.05). The leptin concentration was well correlated with the BMI and %FM in the patients with chronic bronchitis and the leptin concentration was only correlated with the %FM (r = 0.450, p = 0.027) in emphysema patients. There was no correlation between the plasma leptin concentration, as adjusted for the fat mass, and the activity of the TNF-alpha system. The interaction of leptin and the activity of the TNF-alpha system in the pathogenesis of tissue depletion may not play an important role in chronic stable COPD patients.

  13. Effects of TNF-α and Leptin on Weight Loss in Patients with Stable Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Shin, Kyeong-Cheol; Chung, Jin Hong

    2007-01-01

    Background Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. Methods Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum tumor necrosis factor-alpha (TNF-α) were measured in all the study participants. The difference and correlation of these parameters were investigated between the two groups. Results Emphysematous patients were characterized by a lower body mass index (BMI) and fat-mass (FM) compared with the chronic bronchitis patients (pleptin levels, as corrected for the FM, were not different between the COPD patients and healthy controls (78.3±30.9 pg/mL/kg vs. 70.9±17.3 pg/mL/kg, respectively), and the plasma leptin levels, as adjusted for the FM, were also not different between the two groups of COPD patients. In the chronic bronchitis patients, the plasma leptin concentration was correlated with the BMI (r=0.866, pCOPD patients than those in the controls, but there was no statistical difference (10.7±18.6 pg/mL vs. 7.2×3.5 pg/mL, respectively, p0.05). The leptin concentration was well correlated with the BMI and %FM in the patients with chronic bronchitis and the leptin concentration was only correlated with the %FM (r=0.450, p=0.027) in emphysema patients. There was no correlation between the plasma leptin concentration, as adjusted for the fat mass, and the activity of the TNF-α system. Conclusions The interaction of leptin and the activity of the TNF-α system in the pathogenesis of tissue depletion may not play an important role in chronic stable COPD patients. PMID:18309683

  14. Chronic respiratory diseases and quality of life in elderly nursing home residents.

    Science.gov (United States)

    Carreiro-Martins, Pedro; Gomes-Belo, Joana; Papoila, Ana Luísa; Caires, Iolanda; Palmeiro, Teresa; Gaspar-Marques, João; Leiria-Pinto, Paula; Mendes, Ana Sofia; Paulo-Teixeira, João; Botelho, Maria Amália; Neuparth, Nuno

    2016-08-01

    Few studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (Chronic bronchitis, frequent cough, current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents. © The Author(s) 2016.

  15. Comparative analyses of thoracic radiographs and bronchoalveolar lavage of dogs and cats with chronic bronchial diseases

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    Mariana Pavelski

    2017-06-01

    Full Text Available There is a high incidence of bronchitis and asthma cases in veterinary medicine. Thoracic radiographs and bronchoalveolar lavage (BAL are commonly performed for definitive diagnosis in dogs and cats with suspected bronchitis and asthma. It is believed that a combination of diagnostic tools is the best choice to achieve a diagnosis. The aim of this study was to evaluate the efficacy of thoracic radiographs and BAL in the diagnosis of chronic bronchial disease (CBD in dogs and cats and whether there is any specific radiographic finding that could influence the indication for bronchoalveolar lavage. It was performed a cross-sectional, prospective, observational study including forty client-owned dogs and cats with lower respiratory tract signs and positive radiographic opacities that were evaluated with BAL followed by cytology and culture. The radiographic results compared with BAL culture showed a sensitivity of 38%, specificity of 95% and accuracy of 65% in detecting patients with pneumonia associated with chronic bronchial disease. Thoracic radiographs were effective in diagnosing 65% of the patients, radiographs plus BAL cytology diagnosed 75% of patients and the combination of radiographs, BAL cytology and culture diagnosed 95% of the patients with chronic bronchial disease. In conclusion, the combination of radiographic examination with BAL followed by cytological and microbiological analyses increases diagnostic success in CBD.

  16. Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia.

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    Jordi Almirall

    Full Text Available BACKGROUND: The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP. We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, COPD or asthma and CAP may affect early outcome of the acute pneumonic episode. METHODS: Over 1-year period, all population-based cases of CAP in patients with chronic bronchitis, COPD or asthma were registered. Use of inhaled steroids were registered and patients were followed up to 30 days after diagnosis to assess severity of CAP and clinical course (hospital admission, ICU admission and mortality. RESULTS: Of 473 patients who fulfilled the selection criteria, inhaled steroids were regularly used by 109 (23%. In the overall sample, inhaled steroids were associated with a higher risk of hospitalization (OR=1.96, p = 0.002 in the bivariate analysis, but this effect disappeared after adjusting by other severity-related factors (adjusted OR=1.08, p=0.787. This effect on hospitalization also disappeared when considering only patients with asthma (OR=1.38, p=0.542, with COPD alone (OR=4.68, p=0.194, but a protective effect was observed in CB patients (OR=0.15, p=0.027. Inhaled steroids showed no association with ICU admission, days to clinical recovery and mortality in the overall sample and in any disease subgroup. CONCLUSIONS: Treatment with inhaled steroids is not a prognostic factor in COPD and asthmatic patients with CAP, but could prevent hospitalization for CAP in patients with clinical criteria of chronic bronchitis.

  17. Tanreqing injection for acute bronchitis disease: A systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Pei; Liao, Xing; Xie, Yan-Ming; Chai, Yan; Li, Ling-Hui

    2016-04-01

    Acute bronchitis (AB) is one of the common diseases. Tanreqing injection (TRQ) was widely used to treat patients with acute bronchitis, and many randomized controlled trials have been conducted to investigate its efficacy. The purpose of this systematic review is to evaluate the efficacy and safety of TRQ for AB. Eight English and Chinese electronic databases, up to October 2014, were searched to identify randomized controlled trials on TRQ for AB. Two reviewers independently extracted data and assessed the quality of each trial by using Cochrane handbook. Meta-analysis was carried out by using Review Manager software. A total of 49 trials with 5131 participants were collected. Data of three main outcomes were pooled and analyzed as following: (1) effective rates: TRQ versus antibiotics (RR 1.12; 95% CI 1.05, 1.18; P=0.0002); TRQ plus antiviral drugs versus antiviral drugs (RR: 5.12; 95% CI 3.03, 8.66; P<0.00001); TRQ plus antibiotics versus antibiotics (RR 3.46; 95% CI 2.59, 4.62; P<0.00001); TRQ versus antibiotics plus antiviral drugs (RR 2.03; 95% CI 1.10, 3.74; P=0.02); TRQ plus conventional therapy versus conventional therapy alone (RR 1.21; 95% CI 1.15, 1.27; P<0.00001). (2) Time for fever resolution: TRQ plus antiviral drugs versus antiviral drugs (MD: -1.08; 95% CI -1.59, -0.57; P<0.00001); TRQ plus antibiotics versus antibiotics (MD -1.33; 95% CI -1.81, -0.86; P<0.00001); TRQ versus antibiotics plus antiviral drugs (MD -0.88; 95% CI -1.25, -0.51; P<0.00001); TRQ plus conventional therapy versus conventional therapy alone (MD -1.06; 95% CI -1.13, -0.98; P<0.00001). (3) Resolution of cough: TRQ plus antiviral drugs versus antiviral drugs (MD: -2.09; 95% CI -3.11, -1.43; P<0.00001); TRQ plus antibiotics versus antibiotics (MD: -2.65; 95% CI -2.88, -2.42; P<0.00001); TRQ plus conventional therapy versus conventional therapy alone (MD -1.84; 95% CI -2.85, -0.83; P=0.0003). Four trials described the adverse drug reactions of TRQ, while no severe adverse drug

  18. Bioinformatics and evolutionary insight on the spike glycoprotein gene of QX-like and Massachusetts strains of infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    Abro Shahid

    2012-09-01

    Full Text Available Abstract Background Infectious bronchitis virus (IBV is a Gammacoronavirus of the family Coronaviridae and is a causative agent of an economically important disease in poultry. The spike glycoprotein of IBV is essential for host cell attachment, neutralization, and is involved in the induction of protective immunity. Previously obtained sequence data of the spike gene of IBV QX-like and Massachusetts strains were subjected to bioinformatics analysis. Findings On analysis of potential phosphorylation sites, the Ser542 and Ser563 sites were not present in Massachusetts strains, while QX-like isolates did not have the Ser534 site. Massachusetts and QX-like strains showed different cleavage site motifs. The N-glycosylation sites ASN-XAA-SER/THR-55, 147, 200 and 545 were additionally present in QX-like strains. The leucine-rich repeat regions in Massachusetts strains consisted of stretches of 63 to 69 amino acids, while in the QX-like strains they contained 59 amino acids in length. An additional palmitoylation site was observed in CK/SWE/082066/2010 a QX-like strain. Primary structure data showed difference in the physical properties and hydrophobic nature of both genotypes. The comparison of secondary structures revealed no new structural domains in the genotypic variants. The phylogenetic analyses based on avian and mammalian coronaviruses showed the analysed IBV as closely related to turkey coronaviruses and distantly related to thrush and munia coronaviruses. Conclusion The study demonstrated that spike glycoprotein of the Massachusetts and the QX-like variants of IBV are molecularly distinct and that this may reflect in differences in the behavior of these viruses in vivo.

  19. Phylogeny and S1 Gene Variation of Infectious Bronchitis Virus Detected in Broilers and Layers in Turkey.

    Science.gov (United States)

    Yilmaz, Huseyin; Altan, Eda; Cizmecigil, Utku Y; Gurel, Aydin; Ozturk, Gulay Yuzbasioglu; Bamac, Ozge Erdogan; Aydin, Ozge; Britton, Paul; Monne, Isabella; Cetinkaya, Burhan; Morgan, Kenton L; Faburay, Bonto; Richt, Juergen A; Turan, Nuri

    2016-09-01

    The avian coronavirus infectious bronchitis virus (AvCoV-IBV) is recognized as an important global pathogen because new variants are a continuous threat to the poultry industry worldwide. This study investigates the genetic origin and diversity of AvCoV-IBV by analysis of the S1 sequence derived from 49 broiler flocks and 14 layer flocks in different regions of Turkey. AvCoV-IBV RNA was detected in 41 (83.6%) broiler flocks and nine (64.2%) of the layer flocks by TaqMan real-time RT-PCR. In addition, AvCoV-IBV RNA was detected in the tracheas 27/30 (90%), lungs 31/49 (62.2%), caecal tonsils 7/22 (31.8%), and kidneys 4/49 (8.1%) of broiler flocks examined. Pathologic lesions, hemorrhages, and mononuclear infiltrations were predominantly observed in tracheas and to a lesser extent in the lungs and a few in kidneys. A phylogenetic tree based on partial S1 sequences of the detected AvCoV-IBVs (including isolates) revealed that 1) viruses detected in five broiler flocks were similar to the IBV vaccines Ma5, H120, M41; 2) viruses detected in 24 broiler flocks were similar to those previously reported from Turkey and to Israel variant-2 strains; 3) viruses detected in seven layer flocks were different from those found in any of the broiler flocks but similar to viruses previously reported from Iran, India, and China (similar to Israel variant-1 and 4/91 serotypes); and 4) that the AVCoV-IBV, Israeli variant-2 strain, found to be circulating in Turkey appears to be undergoing molecular evolution. In conclusion, genetically different AvCoV-IBV strains, including vaccine-like strains, based on their partial S1 sequence, are circulating in broiler and layer chicken flocks in Turkey and the Israeli variant-2 strain is undergoing evolution.

  20. Efficacy of Add-on Montelukast in Nonasthmatic Eosinophilic Bronchitis: The Additive Effect on Airway Inflammation, Cough and Life Quality

    Science.gov (United States)

    Bao, Wuping; Liu, Ping; Qiu, Zhongmin; Yu, Li; Hang, Jingqing; Gao, Xiaohua; Zhou, Xin

    2015-01-01

    Background: The efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB. Methods: A prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared. Results: The control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05). Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05). Conclusions: MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB. PMID:25563311

  1. Infectious bronchitis corona virus establishes productive infection in avian macrophages interfering with selected antimicrobial functions.

    Science.gov (United States)

    Amarasinghe, Aruna; Abdul-Cader, Mohamed Sarjoon; Nazir, Sadiya; De Silva Senapathi, Upasama; van der Meer, Frank; Cork, Susan Catherine; Gomis, Susantha; Abdul-Careem, Mohamed Faizal

    2017-01-01

    Infectious bronchitis virus (IBV) causes respiratory disease leading to loss of egg and meat production in chickens. Although it is known that macrophage numbers are elevated in the respiratory tract of IBV infected chickens, the role played by macrophages in IBV infection, particularly as a target cell for viral replication, is unknown. In this study, first, we investigated the ability of IBV to establish productive replication in macrophages in lungs and trachea in vivo and in macrophage cell cultures in vitro using two pathogenic IBV strains. Using a double immunofluorescent technique, we observed that both IBV Massachusetts-type 41 (M41) and Connecticut A5968 (Conn A5968) strains replicate in avian macrophages at a low level in vivo. This in vivo observation was substantiated by demonstrating IBV antigens in macrophages following in vitro IBV infection. Further, IBV productive infection in macrophages was confirmed by demonstrating corona viral particles in macrophages and IBV ribonucleic acid (RNA) in culture supernatants. Evaluation of the functions of macrophages following infection of macrophages with IBV M41 and Conn A5968 strains revealed that the production of antimicrobial molecule, nitric oxide (NO) is inhibited. It was also noted that replication of IBV M41 and Conn A5968 strains in macrophages does not interfere with the induction of type 1 IFN activity by macrophages. In conclusion, both M41 and Con A5968 IBV strains infect macrophages in vivo and in vitro resulting productive replications. During the replication of IBV in macrophages, their ability to produce NO can be affected without affecting the ability to induce type 1 IFN activity. Further studies are warranted to uncover the significance of macrophage infection of IBV in the pathogenesis of IBV infection in chickens.

  2. Infectious bronchitis corona virus establishes productive infection in avian macrophages interfering with selected antimicrobial functions.

    Directory of Open Access Journals (Sweden)

    Aruna Amarasinghe

    Full Text Available Infectious bronchitis virus (IBV causes respiratory disease leading to loss of egg and meat production in chickens. Although it is known that macrophage numbers are elevated in the respiratory tract of IBV infected chickens, the role played by macrophages in IBV infection, particularly as a target cell for viral replication, is unknown. In this study, first, we investigated the ability of IBV to establish productive replication in macrophages in lungs and trachea in vivo and in macrophage cell cultures in vitro using two pathogenic IBV strains. Using a double immunofluorescent technique, we observed that both IBV Massachusetts-type 41 (M41 and Connecticut A5968 (Conn A5968 strains replicate in avian macrophages at a low level in vivo. This in vivo observation was substantiated by demonstrating IBV antigens in macrophages following in vitro IBV infection. Further, IBV productive infection in macrophages was confirmed by demonstrating corona viral particles in macrophages and IBV ribonucleic acid (RNA in culture supernatants. Evaluation of the functions of macrophages following infection of macrophages with IBV M41 and Conn A5968 strains revealed that the production of antimicrobial molecule, nitric oxide (NO is inhibited. It was also noted that replication of IBV M41 and Conn A5968 strains in macrophages does not interfere with the induction of type 1 IFN activity by macrophages. In conclusion, both M41 and Con A5968 IBV strains infect macrophages in vivo and in vitro resulting productive replications. During the replication of IBV in macrophages, their ability to produce NO can be affected without affecting the ability to induce type 1 IFN activity. Further studies are warranted to uncover the significance of macrophage infection of IBV in the pathogenesis of IBV infection in chickens.

  3. Increased expression of Interleukin-6 related to nephritis in chickens challenged with an Avian infectious bronchitis virus variant

    Directory of Open Access Journals (Sweden)

    Filipe S. Fernando

    2015-03-01

    Full Text Available A Brazilian field isolate (IBV/Brazil/PR05 of avian infectious bronchitis virus (IBV, associated with development of nephritis in chickens, was previously genotyped as IBV variant after S1 gene sequencing. The aim of this study was to evaluate the levels of IL-6 in kidneys and trachea of birds vaccinated and challenged with IBV/Brazil/PR05 strain, correlating these results with scores of microscopic lesions, specific IBV antigen detection and viral load. The up-regulation of IL-6 and the increased levels of viral load on renal and tracheal samples were significantly correlated with scores of microscopic lesions. Reduced levels of viral load were detected in kidneys of birds previously vaccinated and challenged, compared to non-vaccinated challenged group, although markedly microscopic lesions were observed for both groups. The expression of IL-6, present both in the kidney and in the tracheas, was dependent on the load of the virus present in the tissue, and the development of lesions was related with IL-6 present in the tissues. These data suggest that variant IBV/Brazil/PR05 can induce the expression of proinflammatory cytokines in a manner correlated with viral load and increased IL-6 is involved in the tissue with the influx of inflammatory cells and subsequent nephritis. This may contribute with a model to the development of immunosuppressive agents of IL-6 to prevent acute inflammatory processes against infection with IBV and perhaps other coronaviruses, as well as contribute to the understanding of the immunopathogenesis of IBV nephropatogenic strains.

  4. Attenuation mechanism of virulent infectious bronchitis virus strain with QX genotype by continuous passage in chicken embryos.

    Science.gov (United States)

    Huo, Ya-fei; Huang, Qing-hua; Lu, Mei; Wu, Jia-qiang; Lin, Shu-qian; Zhu, Fengzhu; Zhang, Xiu-mei; Huang, Yan-yan; Yang, Shao-hua; Xu, Chuan-tian

    2016-01-02

    The virulent isolate SDZB0808 of QX-type infectious bronchitis virus (IBV) was continuously passaged in chicken embryos for 110 generations. The safety and immune efficacy of the 110th generation of IBVs (P110) were evaluated. Damage was not found in the appearance of the 3-day-old specific-pathogen-free (SPF) chicks immunized with 10(4.5) EID50 (median embryo infective dose) of P110 by intranasal and ocular administration. At 14 d after the vaccination with 10(4.5) EID50 of P110, all the 3-day-old SPF chicks were immune from the attack of the homologous virulent strain SDZB0808 and the heterologous virulent strain SDIB821/2012. The whole genome sequencing of SDZB0808 of different generations (P1-P110) indicated that the replicase 1a sequences of P60-P110 all lost a length of 30bp in the same region. Specific primers were designed according to the differences in the genomes of P1-P110. SYBR Green I real-time quantitative PCR was adopted to analyze the proportion of the viruses with 30bp deletion in P60, P100, and P110. Results showed that with the passage in chicken embryos, the proportion of the viruses with 30bp deletion gradually increased. Almost 100% of the viruses in the P110 had 30bp deletion in the replicase 1a sequence. Therefore, the attenuation of IBV's virulence may be the outcome of directional screening in the chicken embryos. This work confirmed the high safety and immune efficacy of P110 in SPF chickens. Thus, P110 can serve as an attenuated IBV vaccine candidate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Minimum Infectious Dose Determination of the Arkansas Delmarva Poultry Industry Infectious Bronchitis Virus Vaccine Delivered by Hatchery Spray Cabinet.

    Science.gov (United States)

    Leyson, Christina M; Hilt, Deborah A; Jordan, Brian J; Jackwood, Mark W

    2017-03-01

    The Arkansas Delmarva Poultry Industry (ArkDPI) infectious bronchitis virus (IBV) vaccine is effective when administered by eye drop, where the vaccine virus is able to infect and replicate well in birds and is able to induce protection against homologous challenge. However, accumulating evidence indicates that the ArkDPI vaccine is ineffective when applied by hatchery spray cabinet using the same manufacturer-recommended dose per bird. For this study, we aimed to determine the minimum infectious dose for the spray-administered ArkDPI vaccine, which we designate as the dose that achieves the same level of infection and replication as the eye drop-administered ArkDPI vaccine. To this end, we used increasing doses of commercial ArkDPI vaccine to vaccinate 100 commercial broiler chicks at day of hatch, using a commercial hatchery spray cabinet. The choanal cleft of each bird was swabbed at 7 and 10 days postvaccination, and real-time reverse-transcriptase PCR was performed. We observed that the level of infection and replication with spray vaccination matches with that of eye drop vaccination when chicks received 100 times the standard dose for the commercial ArkDPI vaccine. We further examined the S1 spike gene sequence from a subset of reisolated ArkDPI vaccine virus samples and observed that certain nucleotide changes arise in vaccine viruses reisolated from chicks, as previously reported. This suggests that the ArkDPI vaccine has a certain virus subpopulation that, while successful at infecting and replicating in chicks, represents only a minor virus subpopulation in the original vaccine. Thus, the minimum infectious dose for the ArkDPI vaccine using a hatchery spray cabinet appears to be dependent on the amount of this minor subpopulation reaching the chicks.

  6. Evaluation of Blood Alcohol Concentrations after Oral Administration of a Fixed Combination of Thyme Herb and Primrose Root Fluid Extract to Children with Acute Bronchitis.

    Science.gov (United States)

    Ludwig, S; Stier, H; Weykam, S

    2016-02-01

    The application of alcohol-containing medicinal products to children has been a subject of discussion for many years. A safety threshold of 0.125‰ blood alcohol concentration following the administration of a single dose has been recommended by the European Medicines Agency.The aim of this clinical study was to prove the safety of administering a fixed combination of thyme herb and primrose root fluid extract (Bronchicum(®) Elixir) containing 4.9% ethanol. The herbal drug was administered for a period of 7-9 days to 16 children (ages 1-12 years) suffering from acute bronchitis for ≤ 48 h. After 3-5 days, a blood sample was taken 45 min (children ≥ 5 years: also 0 and 90 min) after application of the drug. The efficacy was assessed using the Bronchitis Severity Score. Global efficacy and tolerability were rated by the investigator and patients. All measured blood ethanol concentrations were below the threshold (mean value after 45 min: 0.0029 ± 0.0057‰ and after 90 min: 0.0051 ± 0.0078‰). The Bronchitis Severity Score decreased from 6.6 ± 1.0 to 0.9 ± 1.6 points. Global efficacy was assessed as "very good" and "good" in 60% (investigator) and 80% (patients) of cases. Global tolerability was rated as "very good" and "good" in more than 90% of cases. In conclusion, oral administration of the drug containing 4.9% ethanol to children (age 1-12 years) demonstrated a favourable risk/benefit ratio of the drug. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Effectiveness of anti-inflammatory treatment versus antibiotic therapy and placebo for patients with non-complicated acute bronchitis with purulent sputum. The BAAP Study protocol.

    Science.gov (United States)

    Llor, Carl; Moragas, Ana; Bayona, Carolina; Morros, Rosa; Pera, Helena; Cots, Josep M; Fernández, Yvonne; Miravitlles, Marc; Boada, Albert

    2011-06-21

    Acute bronchitis is one of the most prevalent respiratory infections in primary care, and in more than 90% of the cases antibiotics are prescribed, mainly when purulent expectoration is present. However, this process is usually viral in origin and the benefits of antibiotic treatment are marginal. On the other hand, in recent years bronchitis has been considered more as an inflammatory than an infectious process. Thus, the aim of this study is to evaluate the clinical effectiveness of a schedule of an oral anti-inflammatory compared with an antibiotic regimen and another group assigned to receive a placebo. A total of 420 patients from 15 to 70 years of age with no associated comorbidity, presenting respiratory tract infection of at least one week of evolution, with cough as the predominant symptom, the presence of purulent expectoration and at least one other symptom of the respiratory tract (dyspnoea, wheezing, chest discomfort or pain), with no alternative explanation such as pneumonia, will be included in a prospective, randomised and controlled, clinical trial with placebo. The patients will be randomised to receive one of three treatments: ibuprofen, amoxycillin and clavulanic acid or placebo for 10 days. The main outcome measure is the number of days with frequent cough defined by the symptom diary with a score of 1 or more. This trial is designed to evaluate the number of days with frequent cough with anti-inflammatory treatment compared with antimicrobial treatment and placebo in previously healthy patients with a clinical picture of acute bronchitis and purulent expectoration. It is hypothesized that anti-inflammatory treatment is more effective than antibiotic treatment to reduce cough, which is the most disturbing symptom for patients with this infection. ISRCTN07852892.

  8. Effectiveness of anti-inflammatory treatment versus antibiotic therapy and placebo for patients with non-complicated acute bronchitis with purulent sputum. The BAAP Study protocol

    Directory of Open Access Journals (Sweden)

    Fernández Yvonne

    2011-06-01

    Full Text Available Abstract Background Acute bronchitis is one of the most prevalent respiratory infections in primary care, and in more than 90% of the cases antibiotics are prescribed, mainly when purulent expectoration is present. However, this process is usually viral in origin and the benefits of antibiotic treatment are marginal. On the other hand, in recent years bronchitis has been considered more as an inflammatory than an infectious process. Thus, the aim of this study is to evaluate the clinical effectiveness of a schedule of an oral anti-inflammatory compared with an antibiotic regimen and another group assigned to receive a placebo. Methods and design A total of 420 patients from 15 to 70 years of age with no associated comorbidity, presenting respiratory tract infection of at least one week of evolution, with cough as the predominant symptom, the presence of purulent expectoration and at least one other symptom of the respiratory tract (dyspnoea, wheezing, chest discomfort or pain, with no alternative explanation such as pneumonia, will be included in a prospective, randomised and controlled, clinical trial with placebo. The patients will be randomised to receive one of three treatments: ibuprofen, amoxycillin and clavulanic acid or placebo for 10 days. The main outcome measure is the number of days with frequent cough defined by the symptom diary with a score of 1 or more. Discussion This trial is designed to evaluate the number of days with frequent cough with anti-inflammatory treatment compared with antimicrobial treatment and placebo in previously healthy patients with a clinical picture of acute bronchitis and purulent expectoration. It is hypothesized that anti-inflammatory treatment is more effective than antibiotic treatment to reduce cough, which is the most disturbing symptom for patients with this infection. Trial registration ISRCTN07852892

  9. The Role of α-Defensins 1–3 in Antimicrobial Protection Forming in Children with Recurrent Bronchitis Caused by Bacteria of the Genus Haemophilus

    Directory of Open Access Journals (Sweden)

    G.O. Lezhenko

    2013-03-01

    Full Text Available The level of α-defensins 1–3 (HNP 1–3 has been analyzed in the blood plasma of children with recurrent bronchitis caused by bacteria of the genus Haemophilus. It is shown that the level of HNP 1–3 in the blood plasma depends on the form of Haemophilus. Trigger of HNP 1–3 outflow for neutrophils was the presence of bacterial capsule while presence of L-forms of Haemophilus influenzae wasn’t associated with increase in synthesis of antimicrobial peptides that could be one of the factors of forming of Haemophilus antibiotic resistance.

  10. Eggshell apex abnormalities in a free-range hen farm with mycoplasma synoviae and infectious bronchitis virus in Rio de Janeiro state, Brazil

    OpenAIRE

    FC dos Santos; MDM Brandão; CC da Silva; LS. Machado; MV Soares; ML Barreto; ER do Nascimento; Pereira VLA

    2014-01-01

    A farm with 3,000 free-range hens between 24 and 65 weeks of age was investigated. These hens were separated in small flocks of 400 to 700 birds, presenting 10 to 23% egg production reduction. Twenty serum samples were collected during the period of drop in egg production and three weeks later for the investigation of Mycoplasma synoviae (MS), M. gallisepticum (MG) and Infectious Bronchitis Virus (IBV) antibodies using ELISA. At the time of the second collection, egg production had resumed to...

  11. Chronic cholecystitis

    Science.gov (United States)

    Acute cholecystitis is a painful condition that leads to chronic cholecystitis. It is not clear whether chronic cholecystitis causes any symptoms. Symptoms of acute cholecystis can include: Sharp, cramping, or dull pain ...

  12. Chronic Sinusitis

    Science.gov (United States)

    ... weeks, despite treatment attempts. Also known as chronic rhinosinusitis, this condition interferes with drainage and causes mucus ... Regular exposure to pollutants such as cigarette smoke Complications Chronic sinusitis complications include: Meningitis. This infection causes ...

  13. Chronic Pain

    Science.gov (United States)

    ... over. There are two types: acute pain and chronic pain. Acute pain lets you know that you may ... have problem you need to take care of. Chronic pain is different. The pain may last for weeks, ...

  14. Evaluation of efficacy and tolerability of a fixed combination of dry extracts of thyme herb and primrose root in adults suffering from acute bronchitis with productive cough. A prospective, double-blind, placebo-controlled multicentre clinical trial.

    Science.gov (United States)

    Kemmerich, Bernd

    2007-01-01

    The objective of the study was to assess the efficacy and tolerability of a fixed combination of dry extracts of thyme herb and primrose root (thyme-primrose combination) and matched placebo in patients suffering from acute bronchitis with productive cough. In a double-blind, placebo-controlled, multicentre Phase IV study, 361 outpatients with acute bronchitis and > or = 10 coughing fits during the day, onset of bronchial mucus production with impaired ability to cough up at a maximum of 2 days prior to recruitment, and a Bronchitis Severity Score (BSS) > or = 5 score points were randomly assigned to an 11-day treatment (1 tablet three times daily) with either thyme-primrose combination (Bronchipret TP FCT; N = 183) or placebo (N = 178). After the baseline examination (Visit 1 = Day 0), 2 control examinations were scheduled (Visit 2 = Day 4; Visit 3 = Day 10/end of treatment). The efficacy of the study treatment on acute bronchitis was evaluated by the patient's daily counting of coughing fits during the daytime (manual counter), assessment of acute bronchitis related symptoms and by the investigator's assessment of the most important symptoms of acute bronchitis using the BSS. Evaluation of tolerability was based upon adverse event (AE) monitoring, measurement of vital signs as well as the patient's and investigator's global judgement of tolerability at study end. Primary outcome was the change in frequency of coughing fits during daytime on days 7-9 according to patient's accurate daily recording with a manual counter and documentation in the diary. Treatment effects were analysed by analysis of variance (ANOVA) adjusted for centre effects. Due to significant deviation from the "preconditions" of the ANOVA, the Mann-Whitney-Wilcoxon test (stratified by centre) was carried out additionally. The mean reduction in coughing fits on days 7 to 9 relative to baseline (primary endpoint) was 67.1% under thyme-primrose combination compared to 51.3% under placebo (p acute

  15. Evolutionary and bioinformatic analysis of the spike glycoprotein gene of H120 vaccine strain protectotype of infectious bronchitis virus from India.

    Science.gov (United States)

    Kamble, Nitin Machindra; Pillai, Aravind S; Gaikwad, Satish S; Shukla, Sanjeev Kumar; Khulape, Sagar Aashok; Dey, Sohini; Mohan, C Madhan

    2016-01-01

    The infectious bronchitis virus is a causative agent of avian infectious bronchitis (AIB), and is is an important disease that produces severe economic losses to the poultry industry worldwide. Recent AIB outbreaks in India have been associated with poor growth in broilers, drop in egg production, and thin egg shells in layers. The complete spike gene of Indian AIB vaccine strain was amplified and sequenced using a conventional reverse transcription polymerase chain reaction and is submitted to the GenBank (accession no KF188436). Phylogenetic analysis revealed that the vaccine strain currently used belongs to H120 genotype, an attenuated strain of Massachusetts (Mass) serotype. Nucleotide and amino acid sequence comparisons have shown that the reported spike gene from Indian isolates have 71.8%-99% and 71.4%-96.9% genetic similarity with the sequenced H120 strain. The study identifies live attenuated IBV vaccine strain, which is routinely used for vaccination, for the first time. Based on nucleotide and amino acid relatedness studies of the vaccine strain with reported IBV sequences from India, it is shown that the current vaccine strain is efficient in controlling the IBV infection. Continuous monitoring of IBV outbreaks by sequencing for genotyping and in vivo cross protection studies for serotyping is not only important for epidemiological investigation but also for evaluation of efficacy of the current vaccine. © 2014 International Union of Biochemistry and Molecular Biology, Inc.

  16. Selection of reference genes for gene expression analysis by real-time qPCR in avian cells infected with infectious bronchitis virus.

    Science.gov (United States)

    Batra, Ambalika; Maier, Helena J; Fife, Mark S

    2017-04-01

    Infectious bronchitis virus (IBV) causes infectious bronchitis in poultry, a respiratory disease that is a source of major economic loss to the poultry industry. Detection and the study of the molecular pathogenesis of the virus often involve the use of real-time quantitative PCR assays (qPCR). To account for error within the experiments, the levels of target gene transcription are normalized to that of suitable reference genes. Despite publication of the MIQE (Minimum Information for Publication of Quantitative Real-Time PCR Experiments) guidelines in 2009, single un-tested reference genes are often used for normalization of qPCR assays in avian research studies. Here, we use the geNorm algorithm to identify suitable reference genes in different avian cell types during infection with apathogenic and pathogenic strains of IBV. We discuss the importance of selecting an appropriate experimental sample subset for geNorm analysis, and show the effect that this selection can have on resultant reference gene selection. The effects of inappropriate normalization on the transcription pattern of a cellular signalling gene, AKT1, and the interferon-inducible, MX1, were studied. We identify the possibility of the misinterpretation of qPCR data when an inappropriate normalization strategy is employed. This is most notable when measuring the transcription of AKT1, where changes are minimal during infection.

  17. Valuing the Economic Costs of Allergic Rhinitis, Acute Bronchitis, and Asthma from Exposure to Indoor Dampness and Mold in the US.

    Science.gov (United States)

    Mudarri, David H

    2016-01-01

    Two foundational methods for estimating the total economic burden of disease are cost of illness (COI) and willingness to pay (WTP). WTP measures the full cost to society, but WTP estimates are difficult to compute and rarely available. COI methods are more often used but less likely to reflect full costs. This paper attempts to estimate the full economic cost (2014$) of illnesses resulting from exposure to dampness and mold using COI methods and WTP where the data is available. A limited sensitivity analysis of alternative methods and assumptions demonstrates a wide potential range of estimates. In the final estimates, the total annual cost to society attributable to dampness and mold is estimated to be $3.7 (2.3-4.7) billion for allergic rhinitis, $1.9 (1.1-2.3) billion for acute bronchitis, $15.1 (9.4-20.6) billion for asthma morbidity, and $1.7 (0.4-4.5) billion for asthma mortality. The corresponding costs from all causes, not limited to dampness and mold, using the same approach would be $24.8 billion for allergic rhinitis, $13.5 billion for acute bronchitis, $94.5 billion for asthma morbidity, and $10.8 billion for asthma mortality.

  18. Bronquite infecciosa das galinhas: conhecimentos atuais, cepas e vacinas no Brasil Infectious bronchitis of chickens: current knowledge, strains and vaccines in Brazil

    Directory of Open Access Journals (Sweden)

    Juliana Figueiredo Pitangui Mendonça

    2009-11-01

    Full Text Available A bronquite infecciosa das galinhas (IB é uma doença viral aguda e altamente contagiosa que provoca grandes perdas econômicas à indústria avícola em todo o mundo. Considerando que surtos têm ocorrido no Brasil com emergência de novas variantes de IBV, desafiando as estratégias de vacinação atuais, este trabalho objetiva revisar os conhecimentos sobre IB e IBV, a sua distribuição, as cepas e as vacinas utilizadas no Brasil.Infectious bronchitis (IB is an acute, highly contagious disease of chickens, caused by infectious bronchitis virus (IBV, which results in great economic losses to the poultry industry worldwide, despite the routine use of vaccines. Several outbreaks do occur periodically in densely populated poultry regions in Brazil and there are constant emergence of new variants. The aim of this paper is to review the current knowledge about IBV and IB, the distribution, strains and vaccines in Brazil.

  19. Chronic arsenic toxicity: Studies in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Debendranath Guha Mazumder

    2011-09-01

    Full Text Available Chronic arsenic toxicity (arsenicosis as a result of drinking arsenic-contaminated groundwater is a major environmental health hazard throughout the world, including India. A lot of research on health effects, including genotoxic effect of chronic arsenic toxicity in humans, have been carried out in West Bengal during the last 2 decades. A review of literature including information available from West Bengal has been made to characterize the problem. Scientific journals, monographs, and proceedings of conferences with regard to human health effects, including genotoxicity, of chronic arsenic toxicity have been reviewed. Pigmentation and keratosis are the specific skin diseases characteristic of chronic arsenic toxicity. However, in West Bengal, it was found to produce various systemic manifestations, such as chronic lung disease, characterized by chronic bronchitis, chronic obstructive and/or restrictive pulmonary disease, and bronchiectasis; liver diseases, such as non cirrhotic portal fibrosis; polyneuropathy; peripheral vascular disease; hypertension; nonpitting edema of feet/hands; conjunctival congestion; weakness; and anemia. High concentrations of arsenic, greater than or equal to 200 μg/L, during pregnancy were found to be associated with a sixfold increased risk for stillbirth. Cancers of skin, lung, and urinary bladder are the important cancers associated with this toxicity. Of the various genotoxic effects of arsenic in humans, chromosomal aberration and increased frequency of micronuclei in different cell types have been found to be significant. Various probable mechanisms have been incriminated to cause DNA damage because of chronic arsenic toxicity. The results of the study in West Bengal suggest that deficiency in DNA repair capacity, perturbation of methylation of promoter region of p53 and p16 genes, and genomic methylation alteration may be involved in arsenic-induced disease manifestation in humans. P53 polymorphism has been

  20. How Is Bronchitis Treated?

    Science.gov (United States)

    ... condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, ... fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low- ...

  1. What Causes Bronchitis?

    Science.gov (United States)

    ... condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, ... fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low- ...

  2. Boilermakers' bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Levy, B.S.; Hoffman, L.; Gottsegen, S.

    1984-08-01

    Severe respiratory tract irritation occurred in at least 74 of 100 boilermakers who were exposed to high levels of vanadium pentoxide fume during oil-to-coal conversion of a utility company power plant in a rural area of western Massachusetts. Many were welders working in confined areas with inadequate ventilation. Most frequent symptoms were productive cough, sore throat, dyspnea on exertion, and chest pain or discomfort. The illness was severe enough to cause 70 workers to consult physicians and most of them to lose time from work (medium, five days). Wheezing (in 39%) was the most frequent finding on physical examination. Mild hypoxemia was noted in several workers; most (72%) had normal chest x-ray films. Expiratory flow rate over the middle 50% of the forced vital capacity was the pulmonary function test most remarkably affected (median, 57% of predicted for 24 workers tested). The Occupational Safety and Health Administration documented levels of vanadium pentoxide fume at or above the permissible exposure limit in all eight air samples taken from inside the boiler; it cited the company for inadequate mechanical ventilation and an inadequate respiratory protection program for workers. The report of this outbreak may help prevent future problems by drawing attention of physicians, workers, and managers to the potential pulmonary hazards in power plant conversion.

  3. [Study of the clinical phenotype of symptomatic chronic airways disease by hierarchical cluster analysis and two-step cluster analyses].

    Science.gov (United States)

    Ning, P; Guo, Y F; Sun, T Y; Zhang, H S; Chai, D; Li, X M

    2016-09-01

    To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis. A population sample of adult patients in Donghuamen community, Dongcheng district and Qinghe community, Haidian district, Beijing from April 2012 to January 2015, who had wheeze within the last 12 months, underwent detailed investigation, including a clinical questionnaire, pulmonary function tests, total serum IgE levels, blood eosinophil level and a peak flow diary. Nine variables were chosen as evaluating parameters, including pre-salbutamol forced expired volume in one second(FEV1)/forced vital capacity(FVC) ratio, pre-salbutamol FEV1, percentage of post-salbutamol change in FEV1, residual capacity, diffusing capacity of the lung for carbon monoxide/alveolar volume adjusted for haemoglobin level, peak expiratory flow(PEF) variability, serum IgE level, cumulative tobacco cigarette consumption (pack-years) and respiratory symptoms (cough and expectoration). Subjects' different clinical phenotype by hierarchical cluster analysis and two-step cluster analysis was identified. (1) Four clusters were identified by hierarchical cluster analysis. Cluster 1 was chronic bronchitis in smokers with normal pulmonary function. Cluster 2 was chronic bronchitis or mild chronic obstructive pulmonary disease (COPD) patients with mild airflow limitation. Cluster 3 included COPD patients with heavy smoking, poor quality of life and severe airflow limitation. Cluster 4 recognized atopic patients with mild airflow limitation, elevated serum IgE and clinical features of asthma. Significant differences were revealed regarding pre-salbutamol FEV1/FVC%, pre-salbutamol FEV1% pred, post-salbutamol change in FEV1%, maximal mid-expiratory flow curve(MMEF)% pred, carbon monoxide diffusing capacity per liter of alveolar(DLCO)/(VA)% pred, residual volume(RV)% pred, total serum IgE level, smoking history (pack-years), St.George's respiratory questionnaire

  4. Efficacy and tolerability of a fluid extract combination of thyme herb and ivy leaves and matched placebo in adults suffering from acute bronchitis with productive cough. A prospective, double-blind, placebo-controlled clinical trial.

    Science.gov (United States)

    Kemmerich, Bernd; Eberhardt, Reinhild; Stammer, Holger

    2006-01-01

    To assess the efficacy and tolerability of a fixed fluid extract combination of thyme and ivy leaves (thyme-ivy combination) and matched placebo in patients suffering from acute bronchitis with productive cough. In a double-blind, placebo-controlled, multicentre Phase IV study 361 outpatients with acute bronchitis and > or =10 coughing fits during the day, onset of bronchial mucus production with impaired ability to cough up at a maximum of 2 days prior to recruitment, and a Bronchitis Severity Score (BSS) > or =5 score points were randomly assigned to an 11-day treatment (5.4 ml three times daily) with either thyme-ivy combination syrup (Bronchipret Saft; N=182) or placebo syrup (N=179). After the baseline examination (Visit 1 = Day 0), 2 control examinations were scheduled (Visit 2 = Day 4; Visit 3 = Day 10/end of treatment). The efficacy of study treatment on acute bronchitis was evaluated by the patient's daily counting of coughing fits during the daytime (manual counter), assessment of acute bronchitis related symptoms and by the investigator's assessment of the most important symptoms of acute bronchitis using the BSS. Evaluation of tolerability was based upon adverse event (AE) monitoring, measurement of vital signs as well as the Primary outcome was the change in frequency of coughing fits during daytime on days 7-9 according to patient's accurate daily recording with a manual counter and documentation in the diary. Treatment effects were analysed by analysis of variance (ANOVA) adjusted for centre effects. Due to significant deviation from the "preconditions" of the ANOVA, the Wilcoxon test (stratified by centre) was carried out additionally. The mean reduction in coughing fits on days 7 to 9 relative to baseline was 68.7% under thyme-ivy combination compared to 47.6 % under placebo (p frequency or severity of AEs between thyme-ivy combination and placebo groups. Severe or serious AEs were not reported. Oral treatment of acute bronchitis with thyme

  5. Evaluation of pharmacodynamic activities of EPs® 7630, a special extract from roots of Pelargonium sidoides, in animals models of cough, secretolytic activity and acute bronchitis.

    Science.gov (United States)

    Bao, Yanyan; Gao, Yingjie; Koch, Egon; Pan, Xin; Jin, Yahong; Cui, Xiaolan

    2015-04-15

    EPs(®) 7630 is a proprietary aqueous-ethanolic extract from roots of Pelargonium sidoides DC and has been demonstrated to dispose among others of antibacterial, antiviral, immunomodulatory, antioxidant, and tissue-protective activity. It is an approved medicinal product in more than 50 countries for the treatment of airway infections such as acute bronchitis, common cold, and sinusitis. While the pharmacological effects of EPs(®) 7630 have extensively been evaluated in diverse in vitro test systems, the number of publications reporting results from in vivo models is limited. In the present study antitussive, secretolytic, and anti-inflammatory effects of EPs(®) 7630 were assessed in animal experiments following oral administration at human equivalent doses. Antitussive effects were evaluated using ammonia- and citric acid-induced models of cough in mice (20, 40, 120 mg/kg) and guinea pigs (10, 20, 45 mg/kg), respectively. For the determination of secretolytic activity tracheobronchial secretion of intraperitoneally injected phenol red was determined in mice, while antiinflammatory action was assessed in an acute bacterial bronchitis model in rats. A significant and dose-dependent reduction of cough frequency was observed in both cough models, which was accompanied by a prolongation of cough latency time. Similarly, the extract exerted a marked secretolytic activity in mice. Induction of acute bacterial bronchitis caused characteristic histopathological changes in lung tissue adjacent to trachea and bronchi. The degree of these lesions was significantly reduced in rats treated with EPs(®) 7630 at doses of 30 and 60 mg/kg. This protective effect at least partially seems to be mediated by an up-regulation of superoxide dismutase and a subsequent protective effect against oxidative stress as indicated by a reduced serum level of malondialdehyde. The present data further support the therapeutic use of EPs(®) 7630 in respiratory tract infections and provide a basis

  6. Chronic pancreatitis.

    Science.gov (United States)

    Yang, Dennis; Forsmark, Chris E

    2017-09-01

    Summarize key clinical advances in chronic pancreatitis reported in 2016. Early diagnosis of chronic pancreatitis remains elusive. Recent studies suggest that endoscopic ultrasound may be less accurate than previously thought and new MRI techniques may be helpful. Genetic predisposition may independently affect the clinical course of chronic pancreatitis and the risk for pancreatic cancer. Cigarette smoking may have a greater negative impact on chronic pancreatitis than previously thought and moderate alcohol consumption may be protective. A multidisciplinary approach is necessary for the treatment of type 3 diabetes and nutritional deficiencies in chronic pancreatitis. Although endoscopic therapy remains a reasonable first-line option in treating chronic pancreatitis and its complications, early surgical intervention may be indicated for pain in select patients. Newer endoscopic ultrasound and MRI techniques are being evaluated to help with the early diagnosis of chronic pancreatitis. Both genetic predisposition and cigarette smoking are increasingly recognized as having a major impact in the course of the disease and the risk for pancreatic cancer. Endoscopic therapy is well tolerated and effective for the treatment of chronic pancreatitis and its complications although an early surgical approach for pain may be associated with improved clinical outcomes.

  7. Peak flow as predictor of overall mortality in asthma and chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Hansen, Ejvind Frausing; Vestbo, Jørgen; Phanareth, K

    2001-01-01

    Lung function is a strong predictor of overall mortality in asthma and chronic obstructive pulmonary disease (COPD). FEV1 is considered to be the "gold standard," whereas peak expiratory flow (PEF) is mostly used in absence of FEV1 measurements. We compared the predictive power of PEF and FEV1...... reflecting different components of COPD, i.e., chronic bronchitis, small airways disease, and emphysema. Furthermore, extrapulmonary components such as muscle mass and general "vigour" probably affect PEF to a greater extent than they affect FEV1......., measured after maximal bronchodilation, which included a short course of oral corticosteroids. The study population comprised 491 asthmatics and 1,095 subjects with COPD. Pulmonary function tests were performed between 1983 and 1988, and survival data were obtained by September 1997, when 127 asthmatics...

  8. Burden of smoking on quality of life in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Galaznik, Aaron; Chapnick, Jonathan; Vietri, Jeffrey; Tripathi, Shivani; Zou, Kelly H; Makinson, Geoffrey

    2013-12-01

    The objective of this study was to assess the impact of smoking on health-related quality of life, Work Productivity and Activity Impairment (WPAI) in chronic obstructive pulmonary disease (COPD) patients. Respondents of the 2009/2010 US National Health and Wellness Survey (NHWS), aged ≥ 40 years, with COPD, chronic bronchitis or emphysema, were included in the study. Current and former (had not smoked for ≥ 11 years) smokers were compared. Physical component summary (PCS) and mental component summary (MCS) scores from the Short Form-12 version 2 (SF-12v2), health utilities (SF-6D) and WPAI were evaluated. Differences between current (n = 1685) and former (n = 1932) smokers were revealed: MCS (44.80, 46.73; p smoke have poorer health-related quality of life, impaired productivity and higher healthcare costs than former smokers.

  9. Effect of decimeter range waves in combination with drug electroaerosols on immunoinflammatory processes during chronic nonspecific lung diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ayrapetova, N.S.; Tkachenko, A.F.

    An attempt was made to optimize the therapy of chronic nonspecific pulmonary diseases using a combination of decimeter range waves (DRW) and broncholytic electroaerosols. The electroaerosols penetrate rapidly deep into the lungs up to the aveoli, combining the action of an electric charge with the pharmaceutical effect. In all, 232 patients were studied (94.8% with chronic bronchitis, 5.2% with chronic pneumonia) manifesting an active inflammatory process, disturbance of the immune status and diminished glucocorticoid activity. After 15 procedures of combined therapy, 88.5% of the patients showed improvement in their clinical status; 65.4% of the control group (receiving only the electroaerosol) also showed improvement. In this combined therapy, the antiinflammatory and immunosuppressive effect were achieved due to the action of DRW; the electroaerosols had a positive effect on the function state of the cardiorespiratory system. 11 references.

  10. The retrospective evaluation of pneumonia and bronchitis cases in infants and small children with atopic dermatitis in the practice of a family doctor - personal observations.

    Science.gov (United States)

    Frankowska, J; Kamer, B; Trznadel-Budźko, E; Rotsztejn, H

    2010-01-01

    The purpose of the work is to estimate the occurrence of lower respiratory tract infections in infants and small children with atopic dermatitis and to compare them with a group of children at the same age without features of allergy. The study has been conducted on the basis of the retrospective analysis of medical documentation of individual history of disease among children born in 2005 - 2008 treated in an outpatient clinic. Children suffering from atopic dermatitis are more prone to pneumonia and bronchitis. They are also more often hospitalized due to these reasons. Also, this group of patients is more liable to wheezing in the time of infection. Infants and small children with atopic dermatitis are more prone to lower respiratory tract infections. Recurrence of infections within the respiratory system may be an important risk factor for asthma.

  11. Experimental study on histopathological changes and tissue tropism of Iranian infectious bronchitis serotype 793/B-like virus in SPF chickens

    Directory of Open Access Journals (Sweden)

    Peyman Bijanzad

    2013-02-01

    Full Text Available Avian infectious bronchitis virus (IBV is prevalent in all countries with intensive poultry flocks. This disease is characterised primarily by respiratory signs, but some IBV strains may also infect other organs such as the intestinal and urogenital tracts. The aim of this study was to characterise the histopathological lesions and tissue tropism of Iranian isolate IR/773/2001(793/B of avian infectious bronchitis virus in different organs of experimentally infected SPF chickens. Forty-two one-day-old, specific pathogen-free (SPF chicks were divided randomly into two groups (21 chicks to each group. At the age of 12 days, one group was inoculated intra-ocularly with 103 EID50 of the 793/B isolate, and the other was kept as the control group. Tissue samples were collected at 2, 4, 6, 8, 10 and 12 days post-inoculation (PI. The IBV virus was detected in the caecal tonsils and cloaca from the 2nd to the 12th day PI. The virus was also detected in the kidneys from days 4–10 PI and in the bursa of Fabricius from days 4–12 PI. The virus was detected in the trachea, lungs and thymus. The most obvious histopathological lesions were found in the trachea, kidney, lungs and bursa of Fabricius. Amongst the lymphoid tissues, histopathological changes were found most frequently in the bursa of Fabricius. The results of this study indicated that the 793/B serotype of IBV is unlikely to cause mortality, severe clinical signs or gross lesions in infected chickens, but its replication in some tissues including the bursa of Fabricius could render birds susceptible to other micro-organisms.

  12. Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial.

    Science.gov (United States)

    Llor, Carl; Moragas, Ana; Bayona, Carolina; Morros, Rosa; Pera, Helena; Plana-Ripoll, Oleguer; Cots, Josep M; Miravitlles, Marc

    2013-10-04

    To evaluate the efficacy of oral anti-inflammatory or antibiotic treatment compared with placebo in the resolution of cough in patients with uncomplicated acute bronchitis and discoloured sputum. Multicentre, parallel, single blinded placebo controlled, randomised clinical trial. Nine primary care centres in Spain. Adults aged 18 to 70 presenting symptoms associated with respiratory tract infection of less than one week's duration, with cough as the predominant symptom, the presence of discoloured sputum, and at least one other symptom of lower respiratory tract infection (dyspnoea, wheezing, chest discomfort, or chest pain). Patients were randomised to receive either ibuprofen 600 mg three times daily, amoxicillin-clavulanic acid 500 mg/125 mg three times daily, or placebo three times daily for 10 days. The duration of symptoms was measured with a diary card. Number of days with frequent cough after the randomisation visit. 416 participants were randomised (136 to ibuprofen, 137 to antibiotic, and 143 to placebo) and 390 returned their symptom diaries fully completed. The median number of days with frequent cough was slightly lower among patients assigned to ibuprofen (9 days, 95% confidence interval 8 to 10 days) compared with those receiving amoxicillin-clavulanic acid (11 days, 10 to 12 days) or placebo (11 days, 8 to 14 days), albeit without statistically significant differences. Neither amoxicillin-clavulanic acid nor ibuprofen increased the probability of cough resolution (hazard ratio 1.03, 95% confidence interval 0.78 to 1.35 and 1.23, 0.93 to 1.61, respectively) compared with placebo. Adverse events were observed in 27 patients, and were more common in the antibiotic arm (12%) than ibuprofen or placebo arms (5% and 3%, respectively; Pacute bronchitis and discoloured sputum treated with ibuprofen, amoxicillin-clavulanic acid, or placebo. Current Controlled Trials ISRCTN07852892.

  13. Update on roflumilast, a phosphodiesterase 4 inhibitor for the treatment of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Rabe, Klaus F

    2011-05-01

    Phosphodiesterase 4 (PDE4) is a member of the PDE enzyme superfamily that inactivates cyclic adenosine monophosphate and cyclic guanosine monophosphate, and is the main PDE isoenzyme occurring in cells involved in inflammatory airway disease such as chronic obstructive pulmonary disease (COPD). COPD is a preventable and treatable disease and is characterized by airflow obstruction that is not fully reversible. Chronic progressive symptoms, particularly dyspnoea, chronic bronchitis and impaired overall health are worse in those who have frequent, acute episodes of symptom exacerbation. Although several experimental PDE4 inhibitors are in clinical development, roflumilast, a highly selective PDE4 inhibitor, is the first in its class to be licensed, and has recently been approved in several countries for oral, once-daily treatment of severe COPD. Clinical trials have demonstrated that roflumilast improves lung function and reduces exacerbation frequency in COPD. Furthermore, its unique mode of action may offer the potential to target the inflammatory processes underlying COPD. Roflumilast is effective when used concomitantly with all forms of bronchodilator and even in patients treated with inhaled corticosteroids. Roflumilast thus represents an important addition to current therapeutic options for COPD patients with chronic bronchitis, including those who remain symptomatic despite treatment. This article reviews the current status of PDE4 inhibitors, focusing on the pharmacokinetics, efficacy and safety of roflumilast. In particular, it provides an overview of the effects of roflumilast on lung function and exacerbations, glucose homoeostasis and weight loss, and the concomitant use of long-acting beta(2)-adrenergic receptor agonists and short-acting muscarinic receptor antagonists. © 2011 The Author. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  14. Chronic obstructive lung diseases and risk of non-small cell lung cancer in women.

    Science.gov (United States)

    Schwartz, Ann G; Cote, Michele L; Wenzlaff, Angela S; Van Dyke, Alison; Chen, Wei; Ruckdeschel, John C; Gadgeel, Shirish; Soubani, Ayman O

    2009-03-01

    The link between lung cancer and chronic obstructive lung diseases (COPD) has not been well studied in women even though lung cancer and COPD account for significant and growing morbidity and mortality among women. We evaluated the relationship between COPD and non-small cell lung cancer in a population-based case-control study of women and constructed a time course of chronic lung diseases in relation to onset of lung cancer. Five hundred sixty-two women aged 18 to 74, diagnosed with non-small cell lung cancer and 564 population-based controls matched on race and age participated. Multivariable unconditional logistic regression models were used to estimate risk associated with a history of COPD, chronic bronchitis, or emphysema. Lung cancer risk increased significantly for white women with a history of COPD (odds ratios [OR] = 1.85; 95% confidence intervals [CI]: 1.21-2.81), but this was not seen in African American women. Risk associated with a history of chronic bronchitis was strongest when diagnosed at age 25 or earlier (OR = 2.35, 95% CI: 1.17-4.72); emphysema diagnosed within 9 years of lung cancer was also associated with substantial risk (OR = 6.36, 95% CI: 2.36-17.13). Race, pack-years of smoking, exposure to environmental tobacco smoke as an adult, childhood asthma, and exposure to asbestos were associated with a history of COPD among lung cancer cases. In women, COPD is associated with risk of lung cancer differentially by race. Untangling whether COPD is in the causal pathway or simply shares risk factors will require future studies to focus on specific COPD features, while exploring underlying genetic susceptibility to these diseases.

  15. Distribution and etiology of chronic respiratory diseases in primary healthcare departments in Cape Verde.

    Science.gov (United States)

    Carreiro-Martins, P; Rosado-Pinto, J; do Céu Teixeira, M; Neuparth, N; Silva, O; Papoila, A L; Khaltaev, N; Bousquet, J; Annesi-Maesano, I

    2015-10-01

    Data on chronic respiratory diseases (CRD) are scarce or unavailable in most African countries. We aimed to determine the prevalence of CRD and associated risk factors in Cape Verde, at the primary healthcare level. In the frame of the Global Alliance Against Chronic Respiratory Diseases, a cross-sectional study was carried out in October 2006 in 3256 outpatients (2142 women) (median age of 30 years) seeking care at primary healthcare departments, through a standardized interview questionnaire during two weeks. The prevalence of emphysema, tuberculosis, chronic bronchitis, rhinoconjunctivitis and asthma were 0.7%, 2%, 4.5%, 12.3% and 6.2%, respectively. Current smoking was associated with emphysema (OR: 3.36; 95% CI: 0.97-11.40) and tuberculosis (OR: 2.14; 95% CI: 1.07-4.30), ever exposed to a dusty workplace with chronic bronchitis (OR: 2.20; CI 95%: 1.50-3.21) and rhinoconjunctivitis (OR: 1.56; CI 95%: 1.23-1.98) and cooking or heating using an open fire with asthma (OR: 1.59; CI 95%: 1.16-2.19). The estimates of attributable risks percent indicated that, in the sample, a noticeable part of CRD could be attributed to active smoking, exposure to dust and biomass. Results varied according to gender, particularly regarding current smoking which was more important for men. Tobacco smoking, exposure to dust at work and using an open fire were important risk factors for CRD. Our results suggest that if actions were taken in order to reduce the aforementioned exposures, an important CRD decrease could be achieved. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Chronic Pain

    Science.gov (United States)

    ... have shown that there are higher levels of endorphins in cerebrospinal fluid following acupuncture. Investigators are studying the effect of stress on the experience of chronic pain. Chemists are synthesizing new analgesics and discovering painkilling ...

  17. Chronic pancreatitis

    NARCIS (Netherlands)

    Bruno, Marco J.

    2005-01-01

    In the past 20 years, endoscopic ultrasonography has been added to the already large armamentarium of diagnostic tests for chronic pancreatitis. This article discusses its potential and possible limitations

  18. Chronic Pelvic Pain

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Chronic Pelvic Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  19. [Chronic diarrhea].

    Science.gov (United States)

    Stelzer, Teresa; Heuss, Ludwig Theodor

    2014-09-01

    Defined by lasting more than four weeks - is a common but often challenging clinical scenario. It is important to be aware that diarrhoea means different things to different patients. The evaluation of chronic diarrhoea depends on taking an excellent history and careful physical examination as well as planning investigations thoughtfully. Functional diarrhea ist the most common cause of chronic diarrhea in the developed countries and motility disorders are more common than inflammatory, osmotic or secretory causes. In some cases categorizing patients by their stool characteristics can be helpful in directing further evaluation.

  20. RNA sequencing-based analysis of the spleen transcriptome following infectious bronchitis virus infection of chickens selected for different mannose-binding lectin serum concentrations.

    Science.gov (United States)

    Hamzić, Edin; Kjærup, Rikke Brødsgaard; Mach, Núria; Minozzi, Guilietta; Strozzi, Francesco; Gualdi, Valentina; Williams, John L; Chen, Jun; Wattrang, Eva; Buitenhuis, Bart; Juul-Madsen, Helle Risdahl; Dalgaard, Tina Sørensen

    2016-01-27

    Avian infectious bronchitis is a highly contagious disease of the upper-respiratory tract caused by infectious bronchitis virus (IBV). Understanding the molecular mechanisms involved in the interaction between innate and adaptive immune responses to IBV infection is a crucial element for further improvements in strategies to control IB. To this end, two chicken lines, selected for high (L10H line) and low (L10L line) serum concentration of mannose-binding lectin (MBL) were studied. In total, 32 birds from each line were used. Sixteen birds from each line were infected with IBV and sixteen were left uninfected. Eight uninfected and infected birds from each line were euthanized at 1 and 3 weeks post infection. RNA sequencing was performed on spleen samples from all 64 birds and differential gene expression analysis was performed for four comparisons: L10L line versus L10H line for uninfected birds at weeks 1 and 3, respectively, and in the same way for infected birds. Functional analysis was performed using Gene Ontology (GO) Immune System Process terms specific for Gallus gallus. Comparing uninfected L10H and L10L birds, we identified 1698 and 1424 differentially expressed (DE) genes at weeks 1 and 3, respectively. For the IBV-infected birds, 1934 and 866 DE genes were identified between the two lines at weeks 1 and 3, respectively. The two most enriched GO terms emerging from the comparison of uninfected birds between the two lines were "Lymphocyte activation involved in immune response" and "Somatic recombination of immunoglobulin genes involved in immune response" at weeks 1 and 3, respectively. When comparing IBV-infected birds between the two lines, the most enriched GO terms were "Alpha-beta T cell activation" and "Positive regulation of leukocyte activation" at weeks 1 and 3, respectively. Healthy birds from the two lines showed significant differences in expression profiles for subsets of adaptive and innate immunity-related genes, whereas comparison of the

  1. Efficacy and tolerability of EPs 7630 in children and adolescents with acute bronchitis - a randomized, double-blind, placebo-controlled multicenter trial with a herbal drug preparation from Pelargonium sidoides roots.

    Science.gov (United States)

    Kamin, W; Maydannik, V; Malek, F A; Kieser, M

    2010-03-01

    The study aim was to demonstrate the efficacy and to investigate the tolerability of EPs 7630, a herbal drug preparation from Pelargonium sidoides roots, in the treatment of patients (1 - 18 years) with acute bronchitis outside the strict indication for antibiotics. A total of 200 patients were randomized to receive either active drug containing EPs 7630 (1 - 6 years: 3 x 10 drops/d; > 6 - 12 years: 3 x 20 drops/d; > 12 - 18 years: 3 x 30 drops/d) or placebo for 7 consecutive days. change in the total score of bronchitis-specific symptoms (BSS) from Day 0 to Day 7. Main secondary outcome measures: treatment outcome, patients' satisfaction with treatment, onset of effect, bed rest. From baseline to Day 7, the mean BSS score improved significantly more for EPs 7630 compared with placebo (3.4 +/- 1.8 vs. 1.2 +/- 1.8 points, p acute bronchitis in children and adolescents outside the strict indication for antibiotics with patients treated with EPs 7630 perceiving a more favorable course of the disease and a good tolerability as compared with placebo.

  2. HOSPITAL CONTACTS FOR CHRONIC DISEASES AMONG DANISH SEAFARERS AND FISHERMEN

    DEFF Research Database (Denmark)

    Kaerlev, Linda; Dahl, Søren; Nielsen, Per Sabro

    cohort. For both time periods high SHCR values were found for bronchitis, emphysema, cancer of the lung, alcohol-related liver diseases and diabetes among non-officers, and lung cancer among officers. Among fishermen high SHCRs for bronchitis, emphysema, lung cancer and Raynaud's syndrome were found...

  3. Chronic myelogenous leukemia (CML)

    Science.gov (United States)

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... nuclear disaster. It takes many years to develop leukemia from radiation exposure. Most people treated for cancer ...

  4. Chronic gastritis.

    Science.gov (United States)

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-06-01

    Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understanding of the bizarre epidemiology and course of the disease. A life-long and aggressive inflammation in gastritis results in destruction (atrophic gastritis) of stomach mucosa with time (years and decades). The progressive worsening of atrophic gastritis results subsequently in dysfunctions of stomach mucosa. Atrophic gastritis will finally end up in a permanently acid-free stomach in the most extreme cases. Severe atrophic gastritis and acid-free stomach are the highest independent risk conditions for gastric cancer known so far. In addition to the risks of malignancy and peptic ulcer, acid-free stomach and severe forms of atrophic gastritis may associate with failures in absorption of essential vitamins, like vitamin B12, micronutrients (like iron, calcium, magnesium and zinc), diet and medicines.

  5. Chronic prostatitis.

    Science.gov (United States)

    Batstone, G Richard D; Doble, Andrew; Batstone, D

    2003-01-01

    This review covers recent developments in the classification, epidemiology, aetiology, diagnosis and treatment of patients diagnosed with chronic prostatitis (NIH classification types II, IIIa/IIIb and IV prostatitis) in the period of review (2001-2002). Recent studies highlight some of the problems with the 1995 NIH classification. Epidemiological studies have confirmed that "prostatitis" is common, with a prevalence of 10-15%. Associations of prostatitis include benign prostatic hyperplasia, sexually transmitted disease, lower urinary tract symptoms, stress, and reduced sunlight exposure. Elevated levels of cytokines in the seminal plasma and prostatic secretions have been detected in men with chronic prostatitis compared with normal individuals, suggesting an active inflammatory process in the male genital tract. This inflammatory reaction may be mediated by an adaptive immune response directed against a genital tract antigen(s) (autoimmunity). Increased levels of bacterial 16S ribosomal DNA in the prostates of men with chronic prostatitis compared with controls are compatible with the notion that a bacterial inflammatory event initiates an auto-immune process; however, the role of bacteria in the continuation of symptoms is unknown. The aetiology of chronic pelvic pain syndrome is still not certain, although an auto-immune process is favoured. Further research is required to determine the putative auto-antigen, the immune responses of patients, the role of bacteria in the inflammatory process, and the patients' pain response to genitourinary insults. As yet no diagnostic tests (other than to eliminate other pathology) and few treatments for chronic prostatitis can be recommended on the basis of scientific evidence.

  6. Chronic Obstructive Pulmonary Disease; Jeg faar ikke puste!

    Energy Technology Data Exchange (ETDEWEB)

    Smith-Sivertsen, Eline Randers

    2004-07-01

    Many people are struggling with work-related asthma every day, which may lead to COPD, Chronic Obstructive Pulmonary Disease. COPD may be caused by illnesses like chronic bronchitis, emphysema, asthma. In serious cases of COPD, the breathing resistance has increased considerably and those suffering from it are breathing heavily. Asthma can be linked with working conditions in many ways. Exertion, cold air, and some chemical substances like sulphur dioxide can start asthma attacks. The results of early treatment or prophylactic treatment of asthma are good, but COPD is much more difficult. Although smoking is the most important cause of COPD, people who have been working for many years in highly polluted environments run a higher risk of contracting COPD. However, little is known about which specific substances are causing the disease. Particularly at risk are bakers, industrial painters, and people working in electrolysis halls in the aluminium industry. There is no effective medical treatment for COPD once the lungs have been damaged, but many hospitals offer rehabilitation.

  7. Prevalence of chronic obstructive pulmonary disease among adult male cigarettes smokers: a community-based study in Jordan.

    Science.gov (United States)

    Al Omari, Mousa; Khassawneh, Basheer Y; Khader, Yousef; Dauod, Ali Shakir; Bergus, George

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The prevalence of COPD among cigarette smokers in the Middle East is not well studied. A prospective descriptive study was performed in the north of Jordan. Male cigarette smokers (≥ 10 pack-year) aged 35 years and older were recruited from the community. They completed a questionnaire and a postbronchodilator spirometry. Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria (postbronchodilator forced expiratory volume in 1 second COPD. A total of 512 subjects completed the study protocol. According to the GOLD criteria, 42 subjects (8.2%) had COPD. Of those, 27 subjects (64.3%) had symptomatic COPD. Using the GOLD criteria, eight subjects (19%) with COPD had mild disease, 24 (57.1%) had moderate disease, eight (19%) had severe disease, and two (4.8%) had very severe disease. Only 10.6% were aware of COPD as a smoking-related respiratory illness, and 6.4% had received counseling about risk for COPD by a physician. Chronic bronchitis (cough for 3 months in 2 consecutive years) was reported by 15% of the subjects, wheezes by 44.1%, and dyspnea by 65.2%. Subjects with COPD reported having more chronic bronchitis 18/42 (42.9%) and wheezing 28/42 (66.7%) than subjects without COPD. The prevalence of COPD increased with increased number of pack-years smoked. In conclusion, COPD prevalence among cigarette-smoking men in Jordan is lower than in the developed world. COPD was largely underdiagnosed, despite the majority of participants being symptomatic and having moderate to severe disease.

  8. Genetic diversity of avian infectious bronchitis virus California variants isolated between 1988 and 2001 based on the S1 subunit of the spike glycoprotein.

    Science.gov (United States)

    Schikora, B M; Shih, L M; Hietala, S K

    2003-01-01

    Twenty-nine isolates of avian infectious bronchitis virus (IBV) recovered from commercial chicken flocks in California between 1988 and 2001 and identified as California variants by serotype and direct automated cycle sequencing of the IBV spike glycoprotein S1 subunit, were further characterized phylogenetically and by nucleotide sequence comparison. California variants were grouped according to production type of chicken, by comparison with public access sequence databases (NCBI GenBank and EMBL), or based on phylogenetic analysis. Fisher's Exact test was used to compare mutations per year, purifying and positive selection, predictive antigenicity, and a > or = 6 bp deletion between California variant groups.A high number of mutations at the nucleotide level ( p = 0.013) and a > or = 6 bp deletion in the nucleotide sequence ( p = 0.006) was significantly associated with broiler-type chickens. However, 88% of significant comparisons at the amino acid level such as purifying and positive selection were seen in layer-type chickens. A pronounced predictive antigenicity in the HVR2 region was also associated with layer-type chickens ( p = 0.001). The study indicates that IBV in California is in a phase of slow evolution with different evolutionary patterns being associated with the production type of chicken.

  9. Increased level of protection of respiratory tract and kidney by combining different infectious bronchitis virus vaccines against challenge with nephropathogenic Brazilian genotype subcluster 4 strains.

    Science.gov (United States)

    De Wit, J J; Brandao, P; Torres, C A; Koopman, R; Villarreal, L Y

    2015-10-01

    Genotyping of seven infectious bronchitis virus (IBV) strains isolated in Brazil showed that all belonged to the common Brazilian genotype and that these strains were closest to the subcluster of strain IBV/Brazil/2007/USP-19. Pathotyping of four selected Brazilian strains showed that they all caused a considerable level of ciliostasis in the trachea but at a somewhat lower level than did M41 and Brazilian strains 50/96, 57/96, 62/96 and 64/96 representing four different serotypes that had been reported earlier. In contrast to the M41 challenge strain, all Brazilian isolates replicated in kidney tissue in a high percentage of non-vaccinated challenged birds, clearly showing that they are nephropathogenic. As for the tracheal protection, the results using Massachusetts (Mass) vaccination against the recent strains seemed to show protection higher on average than for the strains reported earlier. A single or twofold vaccination with a Mass vaccine resulted in a mean tracheal protection level against the four challenge strains of 92% and 90%, respectively, whereas a single and twofold vaccination with a Mass vaccine halved the percentage of infected kidneys (14% and 13%, respectively, P protection of 99% and a reduction of the percentage of infected kidneys to a mean of 2%. This was a significantly (P protection than that achieved by a single or twofold Mass vaccination, showing the added value of the 793B vaccination following priming with a vaccine of the Mass type.

  10. Microwave or autoclave treatments destroy the infectivity of infectious bronchitis virus and avian pneumovirus but allow detection by reverse transcriptase-polymerase chain reaction.

    Science.gov (United States)

    Elhafi, G; Naylor, C J; Savage, C E; Jones, R C

    2004-06-01

    A method is described for enabling safe transit of denatured virus samples for polymerase chain reaction (PCR) identification without the risk of unwanted viable viruses. Cotton swabs dipped in avian infectious bronchitis virus (IBV) or avian pneumovirus (APV) were allowed to dry. Newcastle disease virus and avian influenza viruses were used as controls. Autoclaving and microwave treatment for as little as 20 sec destroyed the infectivity of all four viruses. However, both IBV and APV could be detected by reverse transcriptase (RT)-PCR after autoclaving and as long as 5 min microwave treatment (Newcastle disease virus and avian influenza viruses were not tested). Double microwave treatment of IBV and APV with an interval of 2 to 7 days between was tested. After the second treatment, RT-PCR products were readily detected in all samples. Swabs from the tracheas and cloacas of chicks infected with IBV shown to contain infectious virus were microwaved. Swabs from both sources were positive by RT-PCR. Microwave treatment appears to be a satisfactory method of inactivating virus while preserving nucleic acid for PCR identification.

  11. Effect of diurnal temperature range on the outpatient visits for acute bronchitis in children: a time-series study in Hefei, China.

    Science.gov (United States)

    Xie, M-Y; Ni, H; Zhao, D-S; Cheng, J; Wen, L-Y; Li, K-S; Yang, H-H; Wang, S-S; Zhang, H; Wang, X; Su, H

    2017-03-01

    To determine the relationship between diurnal temperature range (DTR) and outpatient visits for childhood acute bronchitis (AB) in Hefei, China, to analyze whether DTR effect was delayed, and to explore the susceptible populations. An ecological study. A Poisson generalized linear regression model combined with a distributed lag non-linear model was used to analyze the relationship between DTR and childhood AB from Hefei, China during 2010-2013, after adjusting for long-term trend and seasonality, mean temperature and relative humidity. An adverse effect of DTR on childhood AB was observed, and the impact of DTR was greatest at three days lag, with a 1.0% (95% confidence interval = 0.5-1.6%) increase of AB cases per 1 °C increment of DTR. Female children and children aged 0-4 years appeared to be more vulnerable to DTR effect than other children. Our study suggests that large DTR may increase the incidence of childhood AB in Hefei, particularly for those who are female and young. Caregivers and health practitioners should be made aware of the potential threat posed by large DTR. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Molecular detection of infectious bronchitis virus and it is relation with avian influenza virus (H9 and Mycoplasma gallisepticum from different geographical regions in Iraq

    Directory of Open Access Journals (Sweden)

    A.H. Al-Dabhawe

    2013-12-01

    Full Text Available Infectious bronchitis virus (IBV, Avian influenza virus (AIV and Mycoplasma gallisepticum (MG have been recognized as the most important pathogens in poultry cause acute respiratory infection and serous economic problems in Iraq and many other countries all over the world. This study was conducted to investigate the distribution of these diseases in commercial chicken flocks in different geographical region in middle part of Iraq by using qPCR. Tracheal swabs and tissue specimens from trachea, lung and kidney were taken from 38 different cases from commercial broiler chicken flocks in (Najaf, Hilla, Muthana and Theqaar governorates in the period from November 2010 to June 2011, all these flocks were showed respiratory symptoms and mortality about 20-90%. The results showed that 92.1% of samples collected from these flocks were infected with IBV, 20% of samples were infected with IB alone and 45.71% of samples with IB combined with both GM and AIV subtype H9 and 25.71% of samples were positive to both IBV and AIV(H9. No samples were positive to AIV (H9 or MG alone. Because of importance of respiratory diseases as a most common conditions noted in commercial flocks in Iraq and no previous study detecting this pathogens by molecular techniques, this study come to detect and confirm the diagnosis of this pathogens by qPCR as new technique used in this field in Iraq.

  13. Inhaler use in adolescents and adults with self-reported physician-diagnosed asthma, bronchitis, or emphysema in the city of Pelotas, Brazil

    Directory of Open Access Journals (Sweden)

    Paula Duarte de Oliveira

    2013-06-01

    Full Text Available OBJECTIVE: To evaluate the characteristics of users of inhalers and the prevalence of inhaler use among adolescents and adults with self-reported physician-diagnosed asthma, bronchitis, or emphysema. METHODS: A population-based study conducted in the city of Pelotas, Brazil, involving 3,670 subjects ≥ 10 years of age, evaluated with a questionnaire. RESULTS: Approximately 10% of the sample reported at least one of the respiratory diseases studied. Among those individuals, 59% reported respiratory symptoms in the last year, and, of those, only half reported using inhalers. The use of inhalers differed significantly by socioeconomic status (39% and 61% for the lowest and the highest, respectively, p = 0.01. The frequency of inhaler use did not differ by gender or age. Among the individuals reporting emphysema and inhaler use, the use of the bronchodilator-corticosteroid combination was more common than was that of a bronchodilator alone. Only among the individuals reporting physician-diagnosed asthma and current symptoms was the proportion of inhaler users higher than 50%. CONCLUSIONS: In our sample, inhalers were underutilized, and the type of medication used by the individuals who reported emphysema does not seem to be in accordance with the consensus recommendations.

  14. Eggshell apex abnormalities in a free-range hen farm with mycoplasma synoviae and infectious bronchitis virus in Rio de Janeiro state, Brazil

    Directory of Open Access Journals (Sweden)

    FC dos Santos

    2014-06-01

    Full Text Available A farm with 3,000 free-range hens between 24 and 65 weeks of age was investigated. These hens were separated in small flocks of 400 to 700 birds, presenting 10 to 23% egg production reduction. Twenty serum samples were collected during the period of drop in egg production and three weeks later for the investigation of Mycoplasma synoviae (MS, M. gallisepticum (MG and Infectious Bronchitis Virus (IBV antibodies using ELISA. At the time of the second collection, egg production had resumed to normal levels; however, with 10.23% of the eggs showed eggshell abnormalities limited to the apex. Eggshell strength was significantly different between normal and those with eggshell apex abnormalities, but not other egg-quality parameters. ELISA tests showed that MS and IBV titers increased during the evaluated period. MS infection was confirmed by culture and by PCR of tracheal swabs. All samples were negative for MG by ELISA and PCR. Further studies with larger samples to ensure the occurrence of this disease in industrial layer flocks in Brazil are under way.

  15. About Chronic Kidney Disease

    Science.gov (United States)

    ... Advocacy Donate A to Z Health Guide About Chronic Kidney Disease Tweet Share Print Email Chronic kidney disease (CKD) ... Learn about Glomerular Filtration Rate (GFR) What is chronic kidney disease (CKD)? Chronic kidney disease includes conditions that damage ...

  16. Chronic Pancreatitis in Children

    Science.gov (United States)

    ... Information Children/Pediatric Chronic Pancreatitis in Children Chronic Pancreatitis in Children What symptoms would my child have? ... will develop diabetes in adolescence. Who gets chronic pancreatitis? Those at risk for chronic pancreatitis are children ...

  17. Chronic Beryllium Disease

    Science.gov (United States)

    ... Science Education & Training Home Conditions Chronic Beryllium Disease Chronic Beryllium Disease Make an Appointment Find a Doctor Ask a ... MD, MSPH, FCCP (February 01, 2016) What is chronic beryllium disease (CBD)? Chronic beryllium disease (CBD) is a disease ...

  18. Chronic Myelogenous Leukemia

    Science.gov (United States)

    Chronic myelogenous leukemia Overview Chronic myelogenous leukemia (CML) is an uncommon type of cancer of the blood cells. The term "chronic" in chronic myelogenous leukemia indicates that this cancer ...

  19. Occupational risk factors for chronic respiratory disease in a New Zealand population using lifetime occupational history.

    Science.gov (United States)

    Hansell, Anna; Ghosh, Rebecca E; Poole, Suzanne; Zock, Jan-Paul; Weatherall, Mark; Vermeulen, Roel; Kromhout, Hans; Travers, Justin; Beasley, Richard

    2014-03-01

    To investigate associations between respiratory disease and occupational exposures in a New Zealand urban population, the Wellington Respiratory Survey. Multiple regression analyses in a population sample of 1017 individuals aged 25 to 74 years with spirometry and questionnaire information, including a lifetime occupational history. Chronic bronchitis symptoms were associated with self-reported exposure to hairdressing, paint manufacturing, insecticides, welding, detergents and with ALOHA Job Exposure Matrix-assessed gases/fumes exposure. The strongest association was for hairdressing (odds ratio 6.91; 95% confidence interval: 2.02 to 23.70). Cumulative exposure to mineral dust and gases/fumes was associated with higher FEV₁% (forced expiratory volume in the first second of expiration) predicted. Analyses were limited by relatively small numbers of cases. Increased risks of objectively defined respiratory disease, which have been previously documented, were not seen. Nevertheless, the study suggested increased risk of respiratory symptoms with various occupational exposures as well as likely healthy worker effect.

  20. Estimated effect of ventilation and filtration on chronic health risks in U.S. offices, schools, and retail stores.

    Science.gov (United States)

    Chan, W R; Parthasarathy, S; Fisk, W J; McKone, T E

    2016-04-01

    We assessed the chronic health risks from inhalation exposure to volatile organic compounds (VOCs) and particulate matter (PM2.5) in U.S. offices, schools, grocery, and other retail stores and evaluated how chronic health risks were affected by changes in ventilation rates and air filtration efficiency. Representative concentrations of VOCs and PM2.5 were obtained from available data. Using a mass balance model, changes in exposure to VOCs and PM2.5 were predicted if ventilation rate were to increase or decrease by a factor of two, and if higher efficiency air filters were used. Indoor concentrations were compared to health guidelines to estimate percentage exceedances. The estimated chronic health risks associated with VOC and PM2.5 exposures in these buildings were low relative to the risks from exposures in homes. Chronic health risks were driven primarily by exposures to PM2.5 that were evaluated using disease incidence of mortality, chronic bronchitis, and non-fatal stroke. The leading cancer risk factor was exposure to formaldehyde. Using disability-adjusted life years (DALYs) to account for both cancer and non-cancer effects, results suggest that increasing ventilation alone is ineffective at reducing chronic health burdens. Other strategies, such as pollutant source control and the use of particle filtration, should also be considered. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Occupation, smoking, and chronic obstructive respiratory disorders: a cross sectional study in an industrial area of Catalonia, Spain

    Science.gov (United States)

    Jaén, Ángeles; Zock, Jan Paul; Kogevinas, Manolis; Ferrer, Antonio; Marín, Albert

    2006-01-01

    Background Few studies have investigated the independent effects of occupational exposures and smoking on chronic bronchitis and airflow obstruction. We assessed the association between lifetime occupational exposures and airflow obstruction in a cross-sectional survey in an urban-industrial area of Catalonia, Spain. Methods We interviewed 576 subjects of both sexes aged 20–70 years (response rate 80%) randomly selected from census rolls, using the ATS questionnaire. Forced spirometry was performed by 497 subjects according to ATS normative. Results Lifetime occupational exposure to dust, gases or fumes was reported by 52% of the subjects (63% in men, 41% in women). Textile industry was the most frequently reported job in relation to these exposures (39%). Chronic cough, expectoration and wheeze were more prevalent in exposed subjects with odds ratios ranging from 1.7 to 2.0 being highest among never-smokers (2.1 to 4.3). Lung function differences between exposed and unexposed subjects were dependent on duration of exposure, but not on smoking habits. Subjects exposed more than 15 years to dusts, gases or fumes had lower lung function values (FEV1 -80 ml, 95% confidence interval (CI) -186 to 26; MMEF -163 ml, CI -397 to 71; FEV1/FVC ratio -1.7%, CI -3.3 to -0.2) than non-exposed. Conclusion Chronic bronchitis symptoms and airflow obstruction are associated with occupational exposures in a population with a high employment in the textile industry. Lung function impairment was related to the duration of occupational exposure, being independent of the effect of smoking. PMID:16476167

  2. Plasma leptin and insulin-like growth factor I levels during acute exacerbations of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Kythreotis, Prokopis; Kokkini, Ageliki; Avgeropoulou, Stavrina; Hadjioannou, Argyro; Anastasakou, Efgenia; Rasidakis, Antonis; Bakakos, Petros

    2009-04-05

    Recent studies have provided evidence for a link between leptin and tumor necrosis factor-alpha (TNF-alpha). Insulin-like growth factor I (IGF-I) mediates the metabolic effects of growth hormone (GH). The GH axis is believed to be suppressed in chronic obstructive pulmonary disease (COPD). The aim of this study is to find out whether acute exacerbations of COPD are followed by changes in plasma leptin and insulin-like growth factor I (IGF-I) levels and furthermore, whether these changes are related to systemic inflammation. We measured serum leptin, IGF-I, TNF-alpha, interleukin 1 beta (IL-1 beta), interleukin 6 (IL-6) and interleukin 8 (IL-8) levels in 52 COPD patients with acute exacerbation on admission to hospital (Day 1) and two weeks later (Day 15). 25 healthy age-matched subjects served as controls. COPD patients were also divided into two subgroups (29 with chronic bronchitis and 23 with emphysema). Serum leptin and IGF-I were measured by radioimmunoassay and TNF-alpha, IL-1 beta, IL-6 and IL-8 were measured by ELISA. Serum leptin levels were significantly higher and serum IGF-I levels significantly lower in COPD patients on Day 1 than in healthy controls (p leptin and TNF-alpha on Day 1 (r = 0.620, p leptin levels along with decreased IGF-I levels occurred during acute exacerbations of COPD. Compared to chronic bronchitis, patients with emphysema had lower circulating IGF-I levels both at the onset of the exacerbation and two weeks later.

  3. Plasma leptin and insulin-like growth factor I levels during acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Rasidakis Antonis

    2009-04-01

    Full Text Available Abstract Background Recent studies have provided evidence for a link between leptin and tumor necrosis factor-alpha (TNF-α. Insulin-like growth factor I (IGF-I mediates the metabolic effects of growth hormone (GH. The GH axis is believed to be suppressed in chronic obstructive pulmonary disease (COPD. The aim of this study is to find out whether acute exacerbations of COPD are followed by changes in plasma leptin and insulin-like growth factor I (IGF-I levels and furthermore, whether these changes are related to systemic inflammation. Methods We measured serum leptin, IGF-I, TNF-α, interleukin 1β (IL-1β, interleukin 6 (IL-6 and interleukin 8 (IL-8 levels in 52 COPD patients with acute exacerbation on admission to hospital (Day 1 and two weeks later (Day 15. 25 healthy age-matched subjects served as controls. COPD patients were also divided into two subgroups (29 with chronic bronchitis and 23 with emphysema. Serum leptin and IGF-I were measured by radioimmunoassay and TNF-α, IL-1β, IL-6 and IL-8 were measured by ELISA. Results Serum leptin levels were significantly higher and serum IGF-I levels significantly lower in COPD patients on Day 1 than in healthy controls (p Conclusion Inappropriately increased circulating leptin levels along with decreased IGF-I levels occured during acute exacerbations of COPD. Compared to chronic bronchitis, patients with emphysema had lower circulating IGF-I levels both at the onset of the exacerbation and two weeks later.

  4. Quaternized chitosan nanoparticles loaded with the combined attenuated live vaccine against Newcastle disease and infectious bronchitis elicit immune response in chicken after intranasal administration.

    Science.gov (United States)

    Zhao, Kai; Li, Shanshan; Li, Wei; Yu, Lu; Duan, Xutong; Han, Jinyu; Wang, Xiaohua; Jin, Zheng

    2017-11-01

    Newcastle disease (ND) and infectious bronchitis (IB) are important diseases, which cause respiratory diseases in chickens, resulting in severely economic losses in the poultry industry. In this study, N-2-hydroxypropyl trimethyl ammonium chloride chitosan (N-2-HACC) and N,O-carboxymethyl chitosan (CMC) were synthesized as adjuvant and delivery carrier for vaccine antigens. N-2-HACC-CMC/NDV/IBV nanoparticles (NPs) (NDV/La Sota and IBV/H120 encapsulated in N-2-HACC-CMC NPs) and N-2-HACC-CMC/NDV-IBV NPs (the mixing of N-2-HACC-CMC/NDV NPs and N-2-HACC-CMC/IBV NPs in a ratio of 1:1) were prepared by the polyelectrolyte composite method, respectively. Both nanoparticles exhibited lower cytotoxicity and higher stability. Their bioactivities were maintained when they were stored at 37 °C for three weeks. Release assay in vitro showed that both NDV and IBV could be sustainably released from the nanoparticles after an initial burst release. In vivo immunization of chickens showed that N-2-HACC-CMC/NDV/IBV NPs or N-2-HACC-CMC/NDV-IBV NPs intranasally induced higher titers of IgG and IgA antibodies, significantly promoted proliferation of lymphocytes and induced higher levels of interleukine-2 (IL-2), IL-4 and interferon-γ (IFN-γ) than the commercially combined attenuated live vaccine did. This is the first study in the field of animal vaccines demonstrating that intranasal administration of chickens with antigens (NDV and IBV) encapsulated with chitosan derivative could induce humoral, cellular, and mucosal immune responses, which protected chickens from the infection of highly virulent NDV and IBV. This study indicated that N-2-HACC-CMC could be used as an efficient adjuvant and delivery carrier for further development of mucosal vaccines and drugs and could have an immense application potential in medicine.

  5. Prevalence and global initiative for chronic obstructive lung disease group distribution of chronic obstructive pulmonary disease detected by preoperative pulmonary function test.

    Directory of Open Access Journals (Sweden)

    Sun Mi Choi

    Full Text Available Despite being a major public health problem, chronic obstructive pulmonary disease (COPD remains underdiagnosed, and only 2.4% COPD patients are aware of their disease in Korea. The objective of this study was to estimate the prevalence of COPD detected by spirometry performed as a preoperative screening test and to determine the Global Initiative for Chronic Obstructive Lung Disease (GOLD group distribution and self-awareness of COPD.We reviewed the medical records of adults (age, ≥ 40 years who had undergone spirometry during preoperative screening between April and August 2013 at a tertiary hospital in Korea. COPD was defined as a postbronchodilator forced expiratory volume in 1 s/forced vital capacity ratio of 40 years who had undergone spirometry as a preoperative screening test, 474 (15.6%; 404 men; median age, 70 years; range, 44-93 years were diagnosed with COPD. Only 26 (5.5% patients reported previous diagnosis of COPD (2.1%, emphysema (0.8%, or chronic bronchitis (2.5%. The GOLD group distribution was as follows: 63.3% in group A, 31.2% in group B, 1.7% in group C, and 3.8% in group D.The prevalence of COPD diagnosed by preoperative spirometry was 15.6%, and only 5.5% patients were aware of their disease. Approximately one-third of the COPD patients belonged to GOLD groups B, C, and D, which require regular treatment.

  6. Efficacy and tolerability of EPs 7630 tablets in patients with acute bronchitis: a randomised, double-blind, placebo-controlled dose-finding study with a herbal drug preparation from Pelargonium sidoides.

    Science.gov (United States)

    Matthys, H; Lizogub, V G; Malek, F A; Kieser, M

    2010-06-01

    Acute bronchitis is one of the most frequent health complaints for which patients seek medical advice. Although viral infections prevail, antibiotics are commonly prescribed. In this study, the efficacy and tolerability of EPs 7630 tablets, a herbal drug preparation from the roots of Pelargonium sidoides, were investigated in adults with acute bronchitis outside the strict indication for antibiotics. In this randomised, double-blind, placebo-controlled, multicentre dose-finding trial using an adaptive group-sequential design, 406 patients were randomly assigned to one of four parallel treatment groups (10 mg EPs 7630 tablets three times a day (30-mg group), 20 mg EPs 7630 tablets three times a day (60-mg group), 30 mg EPs 7630 tablets three times a day (90-mg group) or placebo three times a day) for a treatment period of 7 days. Primary endpoint was the change in the total score of bronchitis-specific symptoms (BSS) from baseline to day 7. Between day 0 and day 7, the mean BSS score decreased by 2.7 +/- 2.3 (placebo), 4.3 +/- 1.9 (30-mg group), 6.1 +/- 2.1 (60-mg group), and 6.3 +/- 2.0 points (90-mg group), respectively. The differences between the EPs 7630 groups and placebo were statistically significant (p < 0.0001, each). The secondary endpoints showed comparable results. EPs 7630 was well-tolerated. All documented adverse events were of mild to moderate intensity; their frequency was dose-dependent. No serious adverse events were reported. This study demonstrated statistically significant and clinically relevant superiority of all three tested dosages of EPs 7630 over placebo. All dosages of EPs 7630 were well-tolerated. Taking into account both efficacy and safety, the results of this study indicate that the 20 mg tablets of EPs 7630 taken three times daily constitute the optimal dose with respect to the benefit-risk ratio.

  7. Chronic respiratory disease among the elderly in South Africa: any association with proximity to mine dumps?

    Science.gov (United States)

    Nkosi, Vusumuzi; Wichmann, Janine; Voyi, Kuku

    2015-04-03

    There is increasing evidence that environmental factors such as air pollution from mine dumps, increase the risk of chronic respiratory symptoms and diseases. The aim of this study was to investigate the association between proximity to mine dumps and prevalence of chronic respiratory disease in people aged 55 years and older. Elderly persons in communities 1-2 km (exposed) and 5 km (unexposed), from five pre-selected mine dumps in Gauteng and North West Province, in South Africa were included in a cross-sectional study. Structured interviews were conducted with 2397 elderly people, using a previously validated ATS-DLD-78 questionnaire from the British Medical Research Council. Exposed elderly persons had a significantly higher prevalence of chronic respiratory symptoms and diseases than those who were unexposed., Results from the multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma (OR = 1.57; 95% CI: 1.20 - 2.05), chronic bronchitis (OR = 1.74; 95 CI: 1.25 - 2.39), chronic cough (OR = 2.02; 95% CI: 1.58 - 2.57), emphysema (OR = 1.75; 95% CI: 1.11 - 2.77), pneumonia (OR = 1.38; 95% CI: 1.07 - 1.77) and wheeze (OR = 2.01; 95% CI: 1.73 - 2.54). Residing in exposed communities, current smoking, ex-smoking, use of paraffin as main residential cooking/heating fuel and low level of education emerged as independent significant risk factors for chronic respiratory symptoms and diseases. This study suggests that there is a high level of chronic respiratory symptoms and diseases among elderly people in communities located near to mine dumps in South Africa.

  8. Impact of ambient air pollution on the differential white blood cell count in patients with chronic pulmonary disease.

    Science.gov (United States)

    Brüske, Irene; Hampel, Regina; Socher, Martin M; Rückerl, Regina; Schneider, Alexandra; Heinrich, Joachim; Oberdörster, Günter; Wichmann, H-Erich; Peters, Annette

    2010-02-01

    Epidemiologic studies report associations between particulate air pollution and increased mortality from pulmonary diseases. This study was performed to examine whether the exposure to ambient gaseous and particulate air pollution leads to an alteration of the differential white blood cell count in patients with chronic pulmonary diseases like chronic bronchitis, chronic obstructive pulmonary disease, and asthma. A prospective panel study was conducted in Erfurt, Eastern Germany, with 12 repeated differential white blood cell counts in 38 males with chronic pulmonary diseases. Hourly particulate and gaseous air pollutants and meteorological data were acquired. Mixed models with a random intercept adjusting for trend, meteorology, weekday, and other risk variables were used. In this explorative analysis, we found an immediate decrease of polymorphonuclear leukocytes in response to an increase of most gaseous and particulate pollutants. Lymphocytes increased within 24 h in association with all gaseous pollutants but showed only minor effects in regard to particulate air pollution. Monocytes showed an increase associated with ultrafine particles, and nitrogen monoxide. The effect had two peaks in time, one 0-23 h before blood withdrawal and a second one with a time lag of 48-71 h. The increase of particulate and gaseous air pollution was associated with multiple changes in the differential white blood cell count in patients with chronic pulmonary diseases.

  9. Atypical Chronic Myelogenous Leukemia

    Science.gov (United States)

    ... myeloproliferative neoplasms, leukemia , and other conditions . Chronic Myelomonocytic Leukemia Key Points Chronic myelomonocytic leukemia is a disease ... chance of recovery) and treatment options. Chronic myelomonocytic leukemia is a disease in which too many myelocytes ...

  10. Chronic Kidney Disease (CKD)

    Science.gov (United States)

    ... store Donate Now Give Monthly Give In Honor Chronic kidney disease (CKD) www.kidneyfund.org > Kidney Disease > Chronic Kidney ... treated? Kidney-friendly diet for CKD What causes chronic kidney disease (CKD)? Anyone can get CKD. Some people are ...

  11. Work and chronic health effects among fishermen in Chioggia, Italy.

    Science.gov (United States)

    Casson, F F; Zucchero, A; Boscolo Bariga, A; Malusa, E; Veronese, C; Boscolo Rizzo, P; Chiereghin, F; Boscolo Panzin, C; Mancarella, P; Mastrangelo, G

    1998-01-01

    To evaluate whether there is an association between deep-sea fishing and common chronic disease. The study was cross-sectional, simultaneously considering groups of fishermen and non-fishermen. Information on life-style and work was collected by means of questionnaires, and clinical data were collected by specialists in: Internal Medicine (general clinical examination), Cardiology (ECG, measurement of arterial pressure), Pneumology (measurement of spirometric volumes), ENT (clinical examination of the ear, nose and throat, including audiometry), Ophthalmology (examination of lens). Beside the common statistical methods, the logistic stepwise regression analysis was used in order to find the risk factors of the diseases, and to correct the risk estimates for the confounding variables. Fisherman had prolonged hours of continuous work, which were found to be correlated with high cigarette and alcohol consumption. Significant associations were found between, on the one hand, work accidents, noise-induced hearing loss, solar keratosis, cataracts, obstructive bronchitis, rhino-sinusitis, otitis media with tympanic perforation, ECG alterations, and, on the other hand, various aspects of fisherman occupation, mainly fishing in high sea and work duration as fisherman. Deep-sea fishing is a stressful and risky work; a reduction in the number of years at sea with reduced exposure to noise, poor weather conditions and sun, and a lower consumption of cigarettes and alcohol might result in fewer skin, eye respiratory and cardiovascular diseases, and injuries.

  12. Chronic urticaria

    Directory of Open Access Journals (Sweden)

    Sandeep Sachdeva

    2011-01-01

    Full Text Available Chronic urticaria (CU is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ′idiopathic′ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.

  13. Chronic Meningitis.

    Science.gov (United States)

    Coyle

    2000-07-01

    Treatment of chronic meningitis depends on the underlying cause. Once a specific cause has been established, appropriate targeted therapy is initiated. When the cause is unknown, a decision must be made whether to employ empiric therapy while the diagnostic evaluation is ongoing. This decision is based on three factors: 1) the clinical status of the patient; 2) the most likely cause based on demographic, historical, examination, and initial laboratory data; and 3) the risk-to-benefit ratio of the proposed treatment regimen. Initial efforts focus on deciding whether the meningitis is infectious or noninfectious. When a decision is made to start empiric therapy, antituberculous treatment is generally given for several weeks to judge therapeutic response. Patients who do not respond to antituberculous therapy are next treated with broad-spectrum antibiotics for unusual bacterial pathogens such as Actinomyces (penicillin), the Lyme disease spirochete Borrelia burgdorferi (ceftriaxone), Brucella (doxycycline plus rifampin), or Francisella tularensis (streptomycin plus gentamicin). Antifungal therapy is generally reserved for patients who are at particular risk for mycotic infection (owing to underlying immunosuppression or an extraneural infection site). Finally, empiric glucocorticoids are generally reserved for patients with consistently negative culture results and a probable noninfectious cause.

  14. Features of cardiac disorders in children with chronic respiratory diseases associated with aerogenic exposure to chemical environmental factors

    Directory of Open Access Journals (Sweden)

    О.А. Maklakova

    2016-03-01

    Full Text Available The study has involved 43 children living in areas with poor air quality due to public health indicators. In 24 % of cases during the remission the children (with bronchial asthma and recurrent bronchitis, associated with exposure to anthropogenic chemicals such as suspended solids, aromatic and oxygenated hydrocarbons, formaldehyde demonstrated peripheral signs of obstruction and the presence of functional cardiac disorders. Being under exposure to adverse effects of environmental chemical factors, the children with chronic respiratory diseases suffer from the developing of the cardiac type of vegetative dysfunction, which was manifested in bradycardia and tachycardia, eytonic and/or sympathicotonic baseline autonomic tone, hypersympathicotonic /astimpathicotonic autonomic reactivity. In 17.9 % of the children it was manifested in transient diastolic dysfunction of right ventricle and in excessive systolic blood pressure in pulmonary artery.

  15. Patients with chronic obstructive pulmonary disease: management considerations for the dental team.

    Science.gov (United States)

    Devlin, J

    2014-09-01

    Chronic obstructive pulmonary disease (COPD) affects an estimated 3 million people in the United Kingdom, and is most common among elderly smokers. Patients may present with recurrent coughing of mucoid secretions (chronic bronchitis) or breathlessness caused by destruction of the airways (emphysema). If possible, it is advisable to treat the severely affected patients with them sitting upright in the dental chair as they may find it difficult to breathe when lying in the horizontal position. Periodontal bacteria can be carried into the lung where they can cause respiratory infection; therefore oral hygiene instruction should be emphasised in these patients. The objective of this article is to describe the oral and dental implications of chronic obstructive pulmonary disease. In particular, there have been a number of recent developments in the management of patients with COPD that have direct relevance to the dentist. The drug regime used in the treatment of patients with COPD can have profound implications for clinical dental practice, manifested as dry mouth or oral candidiasis. There is also increasing evidence of a link between COPD and both gastro-oesophageal reflux disease and periodontal disease.

  16. Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes.

    Science.gov (United States)

    Aryal, Shambhu; Diaz-Guzman, Enrique; Mannino, David M

    2014-01-01

    Chronic obstructive pulmonary disease (COPD), one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research.

  17. Effect of a live Mycoplasma synoviae vaccine on the production of eggshell apex abnormalities induced by a M. synoviae infection preceded by an infection with infectious bronchitis virus D1466.

    Science.gov (United States)

    Feberwee, A; Morrow, C J; Ghorashi, S A; Noormohammadi, A H; Landman, W J M

    2009-10-01

    An experimental study was conducted to assess the effect of a live Mycoplasma synoviae vaccine (Vaxsafe MS; Bioproperties Pty Ltd, Ringwood, Victoria, Australia) on M. synoviae-induced eggshell apex abnormalities (EAA). Four experimental groups of specified-pathogen-free white laying hens were made. All groups were inoculated with infectious bronchitis virus D1466 at 18 weeks of age. One group did not receive further treatment (non-vaccinated non-challenged (NVNC)). Two groups were vaccinated at 14 weeks of age against M. synoviae, and one of these groups was also challenged with an EAA-inducing M. synoviae strain 5 days after infectious bronchitis virus challenge (vaccinated non-challenged (VNC) and vaccinated challenged group (VC), respectively). The fourth group was not vaccinated but was challenged with M. synoviae (non-vaccinated challenged (NVC)). Eggs with EAA eggs were produced only in the NVC and VC groups. However, the proportion of eggs with EAA and the mean daily production of eggs with EAA per chicken was significantly lower (Peggshell strength of eggs with EAA (22.8 N) was significantly lower (Peggshell strength of non-affected eggs in the NVC group was significantly lower (P<0.05) compared with that of non-affected eggs from the flock of origin (33.7 versus 41.2 N), but not different from the other groups. It can be concluded from the present study that vaccination with a live M. synoviae vaccine reduces the occurrence of M. synoviae-induced EAA significantly.

  18. 24-HOUR ARTERIAL STIFFNESS VALUES IN MEN WITH DIFFERENT PHENOTYPES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE CONCURRENT WITH HYPERTENSION

    Directory of Open Access Journals (Sweden)

    N. A. Karoli

    2015-01-01

    Full Text Available Objective: to study the specific features of the daily arterial stiffness (AS profile in men with different phenotypes of chronic obstructive pulmonary disease (COPD concurrent with hypertension. Subjects and methods. The investigation enrolled 78 male patients with COPD and hypertension. The patients were divided according to COPD phenotypes into 2 groups: 1 COPD patients with emphysema; 2 those with bronchitis. The exclusion criteria were less than 40 years and more than 80 years of age; diabetes mellitus; coronary heart disease; vascular diseases; an exacerbation of chronic diseases; bronchial and pulmonary diseases of another etiology. The patients underwent 24-hour blood pressure and AS monitoring, external respiratory function testing: spirography with a short-acting β2-agonist test, a six-minute walk test at baseline and after a hemoglobin oxygen saturation test, and a CAT test. Results. The patients of both groups were observed to have a statistically significant increase in (dP/dtmax as compared to those of the control group (p < 0.05; p < 0.01 in both the daytime and nighttime. In these periods, the COPD patients with emphysema had a higher AIx than those with bronchitis (p < 0.001. There was a statistically significantly (p < 0.001 higher AIx in the nighttime than in the daytime in Groups 1 and 2 patients. Conclusion. The patients with different COPD phenotypes were noted to have impaired arterial elastic properties, circadian AS changes with predominantly nocturnal impaired vascular stiffness. Relationships were found between 24-hour AS values and clinicoanamnestic findings. 

  19. An observational study of PM10 and hospital admissions for acute exacerbations of chronic respiratory disease in Tasmania, Australia 1992-2002.

    Science.gov (United States)

    Mészáros, D; Markos, J; FitzGerald, D G; Walters, E H; Wood-Baker, R

    2015-01-01

    Particulate matter with a diameter below 10 µ (PM10) has been a major concern in the Tamar Valley, Launceston, where wood heaters are extensively used. We examined the relationship between PM10 levels, meteorological variables, respiratory medications and hospital admissions for respiratory disease over the decade 1992-2002. PM10 levels were provided by the Department of Primary Industry Water, Parks and Environment, and meteorological variables from the Bureau of Meteorology. We obtained hospital discharge codes for the Launceston General Hospital. Poisson regression was used for statistical analyses. Mean daily PM10 levels declined from 50.7 to 16.5 μg/m(3). Hospitalisations for asthma decreased from 29 to 21 per month, whereas chronic obstructive pulmonary disease (COPD) increased and bronchitis/bronchiolitis remained unchanged. We found a 10 μg/m(3) increase in PM10 to be associated with a 4% increase in admissions for acute bronchitis/bronchiolitis (p0.05), but no association with asthma or COPD was found. All respiratory diseases showed seasonal patterns of hospitalisation. This is the first long-term study in Australia to demonstrate an association between PM10 levels and respiratory diseases. Reducing exposure to PM10 may decrease hospital admissions for respiratory diseases. Better preventive measures, including sustained public health initiatives to combat air pollution, are required to reduce respiratory morbidity.

  20. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Harmsen, L; Thomsen, S F; Sylvan Ingebrigtsen, Truls

    2010-01-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals.......Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals....

  1. Using Correction Equations Based on Measured Height and Weight Weakens Associations between Obesity Based on Self-Reports and Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Cynthia L. Murray

    2013-01-01

    Full Text Available Objective. Researchers have established a preponderance of height overestimation among men and weight underestimation among women in self-reported anthropometric data, which skews obesity prevalence data and obscures obesity-chronic disease relationships. The objective of this study was to reevaluate associations between obesity and chronic diseases using body mass index (BMI correction equations derived from measured data. Methods. Measured height and weight (MHW data were collected on a subsample of the 17,126 Atlantic Canadians who participated in the 2007-2008 Canadian Community Health Survey (CCHS. To obtain corrected BMI estimates for the 17,126 adults, correction equations were developed in the MHW subsample and multiple regression procedures were used to model BMI. To test obesity-chronic disease relationships, logistic regression models were utilized. Results. The correction procedure eliminated statistically significant relations (P<0.05 between obesity and chronic bronchitis and obesity and stroke. Also, correction attenuated many relationships between adiposity and chronic disease. For example, among obese adults, there was a 13%, 12%, and 7% reduction in the adjusted odds ratios for asthma, urinary incontinence, and cardiovascular disease, respectively. Conclusion. Further research is needed to fully understand how the usage of self-reported data alters our understanding of the relationships between overweight or obesity and chronic diseases.

  2. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B.; Nikolajsen, L.; Kehlet, H.

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies Udgivelsesdato: 2008/3...

  3. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  4. How Can Bronchitis Be Prevented?

    Science.gov (United States)

    ... condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming. Air pollution, infections, ... fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low- ...

  5. [Chronic otitis mediaChronic Otitis Media].

    Science.gov (United States)

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

    There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss. Georg Thieme Verlag KG Stuttgart · New York.

  6. People Experiencing Chronic Homelessness

    Science.gov (United States)

    ... Home Goals Ending Chronic Homelessness Share Ending Chronic Homelessness Last updated on August 04, 2017 We can ... the USICH newsletter. We know how to end homelessness. Let's do it, together. Sign up for our ...

  7. Chronic Kidney Diseases

    Science.gov (United States)

    ... Weight for Me? Your Teeth Heart Murmurs Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases Print A ... pressure at a healthy level. continue Kinds of Kidney Diseases Like any complicated machine, not all kidneys work ...

  8. Diet - chronic kidney disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002442.htm Diet - chronic kidney disease To use the sharing features on this page, ... make changes to your diet when you have chronic kidney disease (CKD). These changes may include limiting fluids, eating ...

  9. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000371.htm Chronic thyroiditis (Hashimoto disease) To use the sharing features on this page, ... Hashimoto Images Endocrine glands Thyroid enlargement - scintiscan Hashimoto's disease (chronic thyroiditis) Thyroid gland References Amino N, Lazarus JH, ...

  10. Anemia of chronic disease

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000565.htm Anemia of chronic disease To use the sharing features on this page, ... There are many types of anemia. Anemia of chronic disease (ACD) is anemia that is found in people ...

  11. Chronic Diarrhea in Children

    Science.gov (United States)

    ... Digestive System & How it Works Zollinger-Ellison Syndrome Chronic Diarrhea in Children View or Print All Sections Definition & Facts Chronic diarrhea is passing loose, watery stools three or more ...

  12. Chronic Daily Headaches

    Science.gov (United States)

    ... chronic migraine or chronic tension-type headache Hemicrania continua These headaches: Affect only one side of your ... development of migraine-like symptoms In addition, hemicrania continua headaches are associated with at least one of ...

  13. Managing your chronic pain

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000516.htm Managing your chronic back pain To use the sharing features on this page, please enable JavaScript. Managing chronic pain means finding ways to make your back pain ...

  14. Chronic tophaceous gout

    Directory of Open Access Journals (Sweden)

    Thappa D

    1993-01-01

    Full Text Available A rare case of chronic tophaceous gout, in a 27-year-old female on diuretics for chronic congestive cardiac failure with characteristic histopathological and radiological changes is reported.

  15. Levocloperastine in the treatment of chronic nonproductive cough: comparative efficacy versus standard antitussive agents.

    Science.gov (United States)

    Aliprandi, P; Castelli, C; Bernorio, S; Dell'Abate, E; Carrara, M

    2004-01-01

    The medical and social impact of cough is substantial. Current antitussive agents at effective doses have adverse events such as drowsiness, nausea and constipation that limit their use. There is also recent evidence that standard antitussive agents, such as codeine, may not reduce cough during upper respiratory infections. Therefore, there is a need for more effective and better-tolerated agents. The efficacy of levocloperastine, a novel antitussive, which acts both centrally on the cough center and on peripheral receptors in the tracheobronchial tree in treating chronic cough, was compared with that of other standard antitussive agents (codeine, levodropropizine and DL-cloperastine) in six open clinical trials. The studies enrolled patients of all ages with cough associated with various respiratory disorders including bronchitis, asthma, pneumonia and chronic obstructive pulmonary disease. Levocloperastine significantly improved cough symptoms (intensity and frequency of cough) in all trials, and improvements were observed after the first day of treatment. In children, levocloperastine reduced nighttime awakenings and irritability, and in adults it was effective in treating cough induced by angiotensin-converting enzyme inhibitors. When compared with other antitussive agents, levocloperastine had improved or comparable efficacy, with a more rapid onset of action. Importantly, no evidence of central adverse events was recorded with levocloperastine, whereas drowsiness was reported by a significant number of patients receiving codeine. Levocloperastine is an effective antitussive agent for the treatment of cough in patients of all ages. It has a more rapid onset of action than standard agents with an improved tolerability profile.

  16. The evidence for the use of oral mucolytic agents in chronic obstructive pulmonary disease (COPD).

    Science.gov (United States)

    Davies, L; Calverley, P M A

    2010-01-01

    Oral mucolytics are now recommended in some treatment guidelines for the management of chronic obstructive pulmonary disease (COPD). This article reviews the evidence for their use and their possible benefits. The review is based upon peer reviewed publications relating to the use of mucolytics in COPD cited in PubMed. Much of the published evidence is of somewhat poor quality and many studies include patients with both chronic bronchitis and COPD. Mucolytics reduce exacerbations by up to 0.8 exacerbations per year, but have little additional benefit in those on standard maximum therapy. Data that mucolytics improve symptoms, alter mucus or impact health-related quality of life in COPD patients receiving other standard therapy are unconvincing. In those on little or no other treatment, they may reduce exacerbation rate. The use of mucolytics to treat acute exacerbations is promising. Head-to-head trials of mucolytics versus long-acting bronchodilators and/or inhaled corticosteroids are lacking. Even in patients with severe COPD who remain symptomatic despite maximal inhaled therapy the role of mucolytics remains unproven.

  17. Prevalence and characteristics of three clinical phenotypes of chronic obstructive pulmonary disease (COPD).

    Science.gov (United States)

    Izquierdo-Alonso, José Luis; Rodriguez-Gonzálezmoro, Jose Miguel; de Lucas-Ramos, Pilar; Unzueta, Irune; Ribera, Xabier; Antón, Esther; Martín, Antonio

    2013-05-01

    To determine the prevalence and analyze the most relevant clinical characteristics of three clinical phenotypes of COPD: emphysema (type 1), chronic bronchitis (type 2) or COPD-asthma (type 3). Observational, multicenter study performed with 331 COPD patients recruited in pulmonology outpatient services. The stratification in three phenotypes was performed with imaging tests, pulmonary function, and a standardized clinical questionnaire. The 43.2% presented an emphysematous phenotype, 44.7% were chronic bronchitic and the other 12.1% presented a phenotype showing mixed characteristics with asthma. There were no significant differences in the smoking level, in the gasometric values or time of disease evolution. Type 1 patients showed lower FEV1 values in comparison with types 2 and 3, 46.6% (21.1), 55.2% (21.2) and 54.4% (21.8), respectively (p COPD), or in the number of hospital admittances. Type 2 patients showed a greater prevalence of cardiovascular comorbidities and of sleep apnea syndrome (4.9%, 23.6% and 12.5%, respectively, p COPD, emphysematous patients present worse pulmonary function and greater dyspnea, although there were no differences in the use of hospital health care resources. The greater comorbidity in Group 2 patients may require specific strategies in this subgroup of patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Correlation between high-resolution computed tomography features and patients′ characteristics in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Gupta Prem

    2008-01-01

    Full Text Available Background: During the last few decades, high-resolution computed tomography (HRCT has come up as a new diagnostic modality to diagnose emphysematous and chronic bronchitis components of chronic obstructive pulmonary disease (COPD. The present study was undertaken to evaluate for various quantitative and qualitative HRCT features in patients with COPD, and to detect patients′ characteristics that correlate with these HRCT features. Materials and Methods: Forty male patients with COPD attending the COPD clinic at a tertiary referral hospital and postgraduate medical institute were included in the study. Various HRCT features, including tracheal index, thoracic cage ratio, sterno-aortic distance, thoracic cross-sectional area, vascular attenuation, vascular distortion, mosaic attenuation pattern, and directly visible small airways, were evaluated and correlated with patients′ characteristics, including age, duration of illness, quantum of smoking, dyspnea score, quality-of-life index, and various spirometric indices. Results: We found significant correlations of various quantitative and qualitative HRCT features with age, duration of illness, quantum of smoking, quality-of-life index, and the spirometric indices showing the extent of airways obstruction. Conclusions: Various quantitative and qualitative HRCT features were found to correlate with patients′ characteristics, spirometric indices, and health-related quality-of-life score, suggesting that HRCT is useful not only in detecting emphysema and its various subtypes but also in predicting the extent and severity of COPD

  19. Approaching chronic sinusitis.

    Science.gov (United States)

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

  20. Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes

    Directory of Open Access Journals (Sweden)

    Aryal S

    2014-10-01

    Full Text Available Shambhu Aryal,1 Enrique Diaz-Guzman,2 David M Mannino3 1Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, 2Division of Pulmonary, Allergy and Critical Care, University of Alabama, Birmingham, AL, 3Department of Preventive Medicine and Environmental Health, University of Kentucky, Lexington, KY, USA Abstract: Chronic obstructive pulmonary disease (COPD, one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research. Keywords: chronic obstructive lung disease, sex, smoking, comorbidity, sex bias

  1. Pulmonary arterial hypertension and cor pulmonale associated with chronic domestic woodsmoke inhalation

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, J.; Salas, J.; Martinez-Guerra, M.L.; Gomez, A.; Martinez, C.; Portales, A.; Palomar, A.; Villegas, M.; Barrios, R. (Instituto Nacional de Cardiologia, Ignacio Chavez, Mexico City (Mexico))

    1993-01-01

    We describe the clinical, radiologic, functional, and pulmonary hemodynamic characteristics of a group of 30 nonsmoking patients with a lung disease that may be related to intense, long-standing indoor wood-smoke exposure. The endoscopic and some of the pathologic findings are also presented. Intense and prolonged wood-smoke inhalation may produce a chronic pulmonary disease that is similar in many aspects to other forms of inorganic dust-exposure interstitial lung disease. It affects mostly country women in their 60s, and severe dyspnea and cough are the outstanding complaints. The chest roentgenograms show a diffuse, bilateral, reticulonodular pattern, combined with normalized or hyperinflated lungs, as well as indirect signs of pulmonary arterial hypertension (PAH). On the pulmonary function test the patients show a mixed restrictive-obstructive pattern with severe hypoxemia and variable degrees of hypercapnia. Endoscopic findings are those of acute and chronic bronchitis and intense anthracotic staining of the airways appears to be quite characteristic. Fibrous and inflammatory focal thickening of the alveolar septa as well as diffuse parenchymal anthracotic deposits are the most prominent pathologic findings, although inflammatory changes of the bronchial epithelium are also present. The patients had severe PAH in which, as in other chronic lung diseases, chronic alveolar hypoxia may play the main pathogenetic role. However, PAH in wood-smoke inhalation-associated lung disease (WSIALD) appears to be more severe than in other forms of interstitial lung disease and tobacco-related COPD. The patients we studied are a selected group and they may represent one end of the spectrum of the WSIALD.

  2. How to unveil chronic respiratory diseases in clinical practice? A model of alliance between general practitioners and pulmonologists.

    Science.gov (United States)

    Benfante, Alida; Messina, Riccardo; Milazzo, Vito; Scichilone, Nicola

    2017-06-01

    Asthma and COPD are under-diagnosed and undertreated in adult populations, mainly due to the discrepancy between guideline recommendations and clinicians' practices. One of the reasons of this discrepancy is the difficulty encountered in real life in sharing the management of chronic respiratory diseases between general practitioners (GPs) and respiratory physicians. An explorative, population-based investigation was performed to test whether, and to what extent, an active collaboration between GPs and pulmonologists increases the diagnosis and proper treatment of chronic obstructive airway diseases. The "COPD action" involved an in-house intervention by pulmonologists who trained GPs on how to diagnose the disease and interpret the spirometry, yielding a final agreed diagnosis. A total of 210 subjects (M/F: 156/54; age: 62.5 ± 13.8, mean ± SD) were consecutively invited by 20 GPs and classified in a) healthy, b) symptomatic with no airway obstruction, and 3) affected by chronic respiratory diseases. 11% of previously defined "healthy" subjects were diagnosed with COPD, and symptomatic subjects were diagnosed with asthma (20%) or COPD (23%). In addition, in those who already carried a diagnosis of chronic respiratory diseases as judged by GPs, the diagnosis of COPD decreased significantly after respiratory specialist intervention (p = 0.001), in favor of asthma and chronic bronchitis. Furthermore, following the clinical and lung function assessments performed by the respiratory physicians, changes in inhaled treatments were statistically significant for each therapeutic category (test-retest reliability: r = 0.42; p < 0.001). In conclusion, the collaboration between GPs and pulmonologists based on a pro-active approach to the individuals attending the primary care offices followed by an in-house intervention by specialists may largely improve the diagnosis and management of chronic respiratory diseases. Copyright © 2017 Elsevier Ltd. All rights

  3. The association between serological features of chronic Chlamydia pneumoniae infection and markers of systemic inflammation and nutrition in COPD patients.

    Science.gov (United States)

    Paplińska-Goryca, Magdalena; Rubinsztajn, Renata; Nejman-Gryz, Patrycja; Przybyłowski, Tadeusz; Krenke, Rafał; Chazan, Ryszarda

    2017-12-01

    Chlamydia pneumoniae is an obligatory human pathogen involved in lower and upper airway infections, including pneumonia, bronchitis. Asymptomatic C. pneumoniae carriage is also relatively common. The association of C. pneumoniae infections with the chronic obstructive pulmonary disease (COPD) course is unclear. The aim of the study was to investigate the association between chronic C. pneumoniae infection and clinical features of COPD, markers of inflammation and metabolic dysfunction. The study included 59 patients with stable COPD who had no, or had ≥2 acute exacerbations during last year. The level of IgA and IgG antibody against C. pneumoniae, IL-6, IL-8, resistin, insulin, adiponectin and acyl ghrelin was measured in serum by enzyme-linked immunosorbent assay (ELISA). No differences in clinical and functional data were observed between COPD patients without serological features of C. pneumoniae infection and chronic C. pneumoniae infection. The level of anti C. pneumoniae IgA significantly correlated with IL-8, IL-6, resistin concentration in group of frequent exacerbators. IgG level correlated negatively with acetyl ghrelin and body mass index (BMI) in patients without frequent exacerbations, in contrast to frequent COPD exacerbation group where significant correlations between IgG level and BMI was demonstrated. Serum IL-6 correlated positively with resistin and insulin and negatively with adiponectin in group of patients with serological features of chronic C. pneumoniae infection only. Our study showed that chronic C. pneumoniae infection does not influence the clinical course of COPD in the both study groups. Chronic C. pneumoniae infections might be associated with a distinct COPD phenotype that affects metabolic dysfunction.

  4. Chronic granulomatous disease associated with chronic glomerulonephritis

    DEFF Research Database (Denmark)

    Frifelt, J J; Schønheyder, Henrik Carl; Valerius, Niels Henrik

    1985-01-01

    A boy with chronic granulomatous disease (CGD) developed glomerulonephritis at the age of 12 years. The glomerulonephritis progressed to terminal uraemia at age 15 when maintenance haemodialysis was started. The clinical course was complicated by pulmonary aspergillosis and Pseudomonas septicaemia...

  5. Prevalence and global initiative for chronic obstructive lung disease group distribution of chronic obstructive pulmonary disease detected by preoperative pulmonary function test.

    Science.gov (United States)

    Choi, Sun Mi; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yim, Jae-Joon; Kim, Young Whan; Han, Sung Koo; Yoo, Chul-Gyu

    2015-01-01

    Despite being a major public health problem, chronic obstructive pulmonary disease (COPD) remains underdiagnosed, and only 2.4% COPD patients are aware of their disease in Korea. The objective of this study was to estimate the prevalence of COPD detected by spirometry performed as a preoperative screening test and to determine the Global Initiative for Chronic Obstructive Lung Disease (GOLD) group distribution and self-awareness of COPD. We reviewed the medical records of adults (age, ≥ 40 years) who had undergone spirometry during preoperative screening between April and August 2013 at a tertiary hospital in Korea. COPD was defined as a postbronchodilator forced expiratory volume in 1 s/forced vital capacity ratio of COPD questionnaires for the assessment of the frequency of acute exacerbation over the previous year and dyspnea severity using the modified Medical Research Council dyspnea scale and COPD assessment test. Among 3029 patients aged >40 years who had undergone spirometry as a preoperative screening test, 474 (15.6%; 404 men; median age, 70 years; range, 44-93 years) were diagnosed with COPD. Only 26 (5.5%) patients reported previous diagnosis of COPD (2.1%), emphysema (0.8%), or chronic bronchitis (2.5%). The GOLD group distribution was as follows: 63.3% in group A, 31.2% in group B, 1.7% in group C, and 3.8% in group D. The prevalence of COPD diagnosed by preoperative spirometry was 15.6%, and only 5.5% patients were aware of their disease. Approximately one-third of the COPD patients belonged to GOLD groups B, C, and D, which require regular treatment.

  6. Olodaterol for the treatment of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Ramadan, Wijdan H; Kabbara, Wissam K; Abilmona, Rosa M

    2016-08-01

    Published data on the pharmacology, pharmacokinetics, efficacy, and safety of the once-daily, long-acting β2-agonist (LABA) olodaterol are reviewed. Olodaterol (Striverdi Respimat, Boehringer Ingelheim), a LABA with high selectivity for β2-adrenergic receptors, is indicated for the treatment of chronic obstructive pulmonary disease (COPD); the recommended dose is 5 μg, to be delivered once daily via the Respimat inhaler. In 48- and 6-week Phase III clinical trials of olodaterol evaluating various lung function and symptomatic outcomes in patients with moderate to very severe COPD, olodaterol use was associated with significant improvements in spirometry outcomes, such as postbronchodilator forced expiratory volume in one second (FEV1), as well as dyspnea severity and quality-of-life measures. Other clinical trials demonstrated that olodaterol produced beneficial effects on FEV1 measures throughout the 24-hour dosing interval. A meta-analysis of data from 20 published research reports indicated that olodaterol's efficacy was comparable to that of the once-daily LABA indacaterol and that the combination of olodaterol and tiotropium provided improvements in lung function greater than those provided by tiotropium alone. Analysis of pooled data from four long-term trials showed that olodaterol's safety profile was comparable to that of formoterol; the most frequently reported adverse effects associated with olodaterol use were bronchitis, nasopharyngitis, and upper respiratory tract infection. Once-daily olodaterol 5 μg is an effective therapy in improving lung function and symptomatic outcomes in patients with moderate to very severe COPD receiving other maintenance therapy, with a satisfactory safety profile. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. Using Health Utility Index (HUI for Measuring the Impact on Health-Related Quality of Life (HRQL Among Individuals with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Frank Mo

    2004-01-01

    Full Text Available Quality of life is an important indicator in assessing the burden of disease, especially for chronic conditions. The Health Utilities Index (HUI is a recently developed system for measuring the overall health status and health-related quality of life (HRQL of individuals, clinical groups, and general populations. Using the HUI (constructed based on eight attributes: vision, hearing, speech, mobility, dexterity, cognition, emotion, and pain/discomfort to measure the HRQL for chronic disease patients and to detect possible associations between HUI system and various chronic conditions, this study provides information to improve the management of chronic diseases.This study is of interest to data analysts, policy makers, and public health practitioners involved in descriptive clinical studies, clinical trials, program evaluation, population health planning, and assessments. Based on the Canadian Community Health Survey (CCHS for 2000–01, the HUI was used to measure the quality of life for individuals living with various chronic conditions (Alzheimer/other dementia, effects of stroke, urinary incontinence, arthritis/rheumatism, bowel disorder, cataracts, back problems, stomach/intestinal ulcers, emphysema/COPD, chronic bronchitis, epilepsy, heart disease, diabetes, migraine headaches, glaucoma, asthma, fibromyalgia, cancers, high blood pressure, multiple sclerosis, thyroid condition, and other remaining chronic diseases. Logistic Regression Model was employed to estimate the associations between the overall HUI scores and various chronic conditions. The HUI scores ranged from 0.00 (corresponding to a state close to death to 1.00 (corresponding to perfect health; negative scores reflect health states considered worse than death. The mean HUI score by sex and age group indicated the typical quality of life for persons with various chronic conditions. Logistic Regression results showed a strong relationship between low HUI scores (≤ 0.5 and 0.06

  8. Plasma leptin is related to proinflammatory status and dietary intake in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Schols, A M; Creutzberg, E C; Buurman, W A; Campfield, L A; Saris, W H; Wouters, E F

    1999-10-01

    Chronic obstructive pulmonary disease (COPD) is a syndrome of chronic wasting, in part associated with a chronic inflammatory response. The aim of this study was to investigate cross-sectionally and prospectively the potential role of leptin in relation to systemic inflammation in the regulation of the energy balance in COPD. Body composition by deuterium dilution, resting energy expenditure (REE) by indirect calorimetry, and plasma concentrations of leptin and soluble tumor necrosis factor (TNF) receptors (sTNF-R) 55 and 75 by ELISA were measured in 27 male patients with emphysema and 15 male patients with chronic bronchitis (disease-subtype defined by high-resolution computed tomography [HRCT]). Emphysematous patients were characterized by a lower body mass index due to a lower fat mass (FM) (p = 0.001) and by lower mean (detectable) leptin concentrations (p = 0.020) compared with bronchitic patients. Leptin was exponentially related to FM in emphysema (r = 0.74, p leptin and sTNF-R55 adjusted for FM and oral corticosteroid use was seen in emphysema (r = 0.81, p COPD, baseline plasma leptin divided by FM was in addition logarithmically inversely related to baseline dietary intake (r = -0.50, p = 0.047) and to the degree of weight change after 8 wk of nutritional support (r = -0.60, p = 0.017). This proposed cytokine-leptin link in pulmonary cachexia may explain the poor response to nutritional support in some of the cachectic patients with COPD and may open a novel approach in combating this significant comorbidity in COPD. Schols AMWJ, Creutzberg EC, Buurman WA, Campfield LA, Saris WHM, Wouters EFM. Plasma leptin is related to proinflammatory status and dietary intake in patients with chronic obstructive pulmonary disease.

  9. Mathematical model of mean age, mean arsenic dietary dose and age-specific prevalence rate from endemic chronic arsenic poisoning: a human toxicology study

    Energy Technology Data Exchange (ETDEWEB)

    Zald' ivar, R.; Ghai, G.L.

    1980-01-01

    The aim of this investigation was to develop a mathematical model of mean age, mean arsenic dietary dose, and age-specific prevalence rate for endemic chronic arsenic poisoning. Data on mean age (years), mean arsenic dietary dose (mg/kg body weight/day), and age-specific prevalence rate per 100,000 population for endemic chronic arsenic poisoning in Antofagasta Commune, northern Chile, for the 1968 to 1971 period, were collected. Endemic chronic arsenic poisoning means here chronic arsenical dermatosis associated with marked or sever symptoms (or signs) of chronic arsenic poisoning (chronic diarrhea, hepatic cirrohsis, chronic bronchitis, bronchiectasis, recurrent broncho-pneumonia, cardiomegaly, systemic occlusive arterial disease, cerebral thrombosis, etc.). There was a strong positive correlation between age-specific pevalence rate per 100,000 population and mean arsenic dose (r = + 0.9593) and a negative correlation between prevalence rate and mean age (r = 0.8789). These findings show that the prevalence rate declines with the advancing age and increases with the increase of arsenic dose. A multiple linear regression model E(y) = alpha + beta X1 + gamma X2, where y represents the age-specific prevalence rate per 100,000 population, X1 the mean arsenic dose, and X2 the mean age, was fitted to the data. The estimates of the parameters (alpha, beta, and gamma) were obtained by minimizing the residual sum of squares sigma(y - alpha - beta X1 - gamma X2)2. The following multiple linear regression equation was obtained: Y = 202.161 + 8452.455 X1 - 2.394 X2. Of the total variability in the prevalence rate, 96.22 percent was accounted for by the multiple regression.

  10. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Woods, J Andrew; Wheeler, James S; Finch, Christopher K; Pinner, Nathan A

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic and progressive disease that affects an estimated 10% of the world's population over the age of 40 years. Worldwide, COPD ranks in the top ten for causes of disability and death. Given the significant impact of this disease, it is important to note that acute exacerbations of COPD (AECOPD) are by far the most costly and devastating aspect of disease management. Systemic steroids have long been a standard for the treatment of AECOPD; however, the optimal strategy for dosing and administration of these medications continues to be debated. To review the use of corticosteroids in the treatment of acute exacerbations of COPD. Literature was identified through PubMed Medline (1950-February 2014) and Embase (1950-February 2014) utilizing the search terms corticosteroids, COPD, chronic bronchitis, emphysema, and exacerbation. All reference citations from identified publications were reviewed for possible inclusion. All identified randomized, placebo-controlled trials, meta-analyses, and systematic reviews evaluating the efficacy of systemic corticosteroids in the treatment of AECOPD were reviewed and summarized. The administration of corticosteroids in the treatment of AECOPD was assessed. In comparison to placebo, systemic corticosteroids improve airflow, decrease the rate of treatment failure and risk of relapse, and may improve symptoms and decrease the length of hospital stay. Therefore, corticosteroids are recommended by all major guidelines in the treatment of AECOPD. Existing literature suggests that low-dose oral corticosteroids are as efficacious as high-dose, intravenous corticosteroid regimens, while minimizing adverse effects. Recent data suggest that shorter durations of corticosteroid therapy are as efficacious as the traditional treatment durations currently recommended by guidelines. Systemic corticosteroids are efficacious in the treatment of AECOPD and considered a standard of care for patients

  11. Impact of customized videotape education on quality of life in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Petty, Thomas L; Dempsey, Edward C; Collins, Timothy; Pluss, William; Lipkus, Isaac; Cutter, Gary R; Chalmers, Robin; Mitchell, Amy; Weil, Kenneth C

    2006-01-01

    To compare the impact of a library of pulmonary rehabilitation videotapes versus an older videotape and usual care on quality of life and ability to perform activities of daily living in persons with chronic obstructive pulmonary disease. Two hundred fourteen patients diagnosed with chronic obstructive pulmonary disease, emphysema, or chronic bronchitis were recruited and randomized to receive customized videotapes, standard videotapes, or usual care. Outcome measures included the Fatigue Impact Scale, Seattle Obstructive Lung Disease Questionnaire, and the SF-36(R) Health Survey. Differences in coping skills and emotional functioning on the Seattle Obstructive Lung Disease Questionnaire were found among the 174 subjects who completed the study. The customized videotape group improved by 8.6 and 4.8 points, respectively, whereas the score of the other groups decreased by less than 1 point for the coping skills, and the scores of the standard video and the control groups decreased by 3.0 and 2.1 points, respectively, for emotional functioning (P Impact Scale also improved for the customized videotape group, whereas the scores of the others remained unchanged. Videotape users demonstrated better conversion to and retention of exercise habits, with over 80% of customized videotape subjects who reported exercise habits at baseline continuing the habits as compared with 40% in the usual care group. Sedentary subjects at baseline were more likely to begin and maintain exercise if randomized to videotapes. These findings demonstrate increased quality of life, lower fatigue, and better compliance with a prescribed exercise regimen among subjects using the customized videotapes. There was a significant improvement in emotional functioning and coping skills among customized videotape subjects.

  12. Chronicity and control

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2012-01-01

    over the years. It suggests a pragmatic analysis that places people's perceptions and practices within a field of possibilities shaped by policy, health care systems, and life conditions. In this field, the dimensions of chronicity and control are the distinctive analytical issues. They lead...... on to consideration of patterns of sociality related to chronic conditions and their treatment....

  13. Chronic gastritis - an update.

    Science.gov (United States)

    Varbanova, Mariya; Frauenschläger, Katrin; Malfertheiner, Peter

    2014-12-01

    Helicobacter pylori is the main aetiologic factor for chronic gastritis worldwide. The degree of inflammation and the evolution of this form of chronic gastritis can vary largely depending on bacterial virulence factors, host susceptibility factors and environmental conditions. Autoimmune gastritis is another cause of chronic inflammation in the stomach, which can occur in all age groups. This disease presents typically with vitamin B12 deficiency and pernicious anaemia. The presence of anti-parietal cell antibodies is highly specific for the diagnosis. The role of H. pylori as a trigger for autoimmune gastritis remains uncertain. Other rare conditions for chronic gastritis are chronic inflammatory conditions such as Crohn's disease or on the background of lymphocytic or collagenous gastroenteropathies. Copyright © 2014. Published by Elsevier Ltd.

  14. [Chronic migraine: treatment].

    Science.gov (United States)

    Pascual, Julio

    2012-04-10

    We define chronic migraine as that clinical situation in which migraine attacks appear 15 or more days per month. Until recently, and in spite of its negative impact, patients with chronic migraine were excluded of the clinical trials. This manuscript revises the current treatment of chronic migraine. The first step should include the avoidance of potential precipitating/aggravating factors for chronic migraine, mainly analgesic overuse and the treatment of comorbid disorders, such as anxiety and depression. The symptomatic treatment should be based on the use of nonsteroidal anti-inflammatory agents and triptans (in this case treatment includes a 'transitional' treatment with nonsteroidal anti-inflammatory agents or steroids, while preventive treatment exerts its actions. Even though those medications efficacious in episodic migraine prevention are used, the only drugs with demonstrated efficacy in the preventive treatment of chronic migraine are topiramate and pericranial infiltrations of Onabotulinumtoxin A.

  15. The Chronic Responsibility

    DEFF Research Database (Denmark)

    Ravn, Iben M; Frederiksen, Kirsten; Beedholm, Kirsten

    2016-01-01

    This article reports on the results of a Fairclough-inspired critical discourse analysis aiming to clarify how chronically ill patients are presented in contemporary Danish chronic care policies. Drawing on Fairclough’s three-dimensional framework for analyzing discourse, and using Dean’s concepts...... of governmentality as an interpretative lens, we analyzed and explained six policies published by the Danish Health and Medicines Authority between 2005 and 2013. The analysis revealed that discourses within the policy vision of chronic care consider chronically ill patients’ active role, lifestyle, and health...... behavior to be the main factors influencing susceptibility to chronic diseases. We argue that this discursive construction naturalizes a division between people who can actively manage responsible self-care and those who cannot. Such discourses may serve the interests of those patients who are already...

  16. Testing for Chronic Diarrhea.

    Science.gov (United States)

    Raman, M

    Chronic diarrhea is a frequently encountered symptom in clinical practice. The etiologies for chronic diarrhea are diverse and broad with varying clinical implications. A useful method of categorizing chronic diarrhea to guide a diagnostic work-up is a pathophysiology-based framework. Chronic diarrhea may be categorized as malabsorptive, secretory, osmotic, and inflammatory or motility related. Frequently, overlap between categories may exist for any given diarrhea etiology and diagnostic testing must occur with an understanding of the differential diagnosis. Investigations to achieve a diagnosis for chronic diarrhea range from screening blood and stool tests to more directed testing such as diagnostic imaging, and endoscopic and histological evaluation. The pathophysiology-based framework proposed in this chapter will allow the clinician to select screening tests followed by targeted tests to minimize cost and complications to the patient, while providing a highly effective method to achieve an accurate diagnosis. © 2017 Elsevier Inc. All rights reserved.

  17. Stages of Chronic Lymphocytic Leukemia

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Lymphocytic Leukemia Go to Health Professional Version Key Points Chronic ...

  18. Stages of Chronic Myelogenous Leukemia

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Myelogenous Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Myelogenous Leukemia Go to Health Professional Version Key Points Chronic ...

  19. Chronic respiratory effect of narguileh smoking compared with cigarette smoking in women from the East Mediterranean region

    Directory of Open Access Journals (Sweden)

    Yousser Mohammad

    2008-10-01

    Full Text Available Yousser Mohammad, Mouna Kakah, Yasser MohammadDepartment of Internal Medicine, Tishreen University School of Medicine, Lattakia, SyriaAbstract: Narguileh is a water pipe. Narguileh smoking is a traditional pattern of smoking among Eastern Mediterranean women, publicly considered as a harmless entertainment. We performed a survey aimed at tracking chronic respiratory symptoms and alteration in respiratory functions in 77 female narguileh smokers, 77 cigarette smokers, and controls. A questionnaire about respiratory symptoms, quantity, and duration of smoking was completed by each woman, and a flow-volume loop was performed with all women. Women were then categorized in subgroups according to a cumulative smoking duration of over 5 years, and cumulative quantity of 50 kilograms smoked. We obtained 8 subgroups for quantity and 10 for duration. Results showed a higher proportion of chronic bronchitis in narguileh smokers compared with cigarette smokers for both quantity and duration (p value < 0.001, as well as quasi-permanent alteration in maximum mid-expiratory flow (MMEF 25%–75% in narguileh smokers compared with cigarette smokers (p value < 0.001. Forced expired volume in one second was more altered in cigarette smokers than in narguileh smokers (p value > 0.001. These results will help to raise health authority awareness that narguileh smoking is also dangerous for women.Keywords: sheesha, narguileh, narguile, COPD, MMEF, smoking in women

  20. HIGH-Resolution CT in Chronic Pulmonary Changes after Mustard Gas Exposure

    Energy Technology Data Exchange (ETDEWEB)

    Bagheri, M.H.; Mostafavi, S.H. [Shiraz Univ. of Medical Siences (Iran, Islamic Republic of). Dept. of Radiology; Hosseini, S.K. [Shiraz Univ. of Medical Siences (Iran, Islamic Republic of). Dept. of Internal Medicine; Alavi, S.A. [Medical Center for Chemical Warfare Victims Foundation, Shiraz (Iran, Islamic Republic of)

    2003-05-01

    Purpose: To identify the findings of high-resolution CT (HRCT) of the lung in patients with previous sulfur mustard gas exposure, and to correlate these findings with clinical and chest X-ray (CXR) results. Material and Methods: 50 consecutive patients were studied prospectively. The clinical data were recorded. Standard p.a. CXR and HRCT of the lung and spirometry were performed. The findings of CXR, HRCT and clinical and spirometry results were scored between 0 and 3 according to the severity of the findings. Results: HRCT abnormality was detected in all 50 patients (100%), while CXR was abnormal in 40 patients (80%). The most common HRCT findings was airway abnormalities (bronchial wall thickening in 100% of cases). Other important findings were suggestive of interstitial lung disease (ILD) (80%), bronchiectasis (26%), and emphysema (24%). A statistically significant correlation was found between the severity of clinical presentation and that of the HCTR scores in patients with bronchiectasis, bronchitis and ILD (p< 0.05), but not with severity scores of HRCT in patients with emphysema. No significant correlation was found between severity scores of CXR findings. HRCT evidence of bronchial wall thickening and with a lower frequency ILD were present despite normal CXR in 20% of the patients. Conclusion: The results of this study suggest that bronchial wall thickening, ILD and emphysema are common chronic pulmonary sequelae of sulfur mustard injury. HRCT of the chest should be considered as the imaging modality of choice in chemical war injury.

  1. Role of a proprietary propolis-based product on the wait-and-see approach in acute otitis media and in preventing evolution to tracheitis, bronchitis, or rhinosinusitis from nonstreptococcal pharyngitis

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2016-11-01

    Full Text Available Francesco Di Pierro,1 Alberto Zanvit,2 Maria Colombo3 1Scientific Department, Velleja Research, 2Biological Dentistry Department, Italian Stomatology Institute, 3ATS, District 5, Milan, Italy Abstract: Antipyretics and/or anti-inflammatory drugs along with a wait-and-see approach are the only treatments recommended in early acute otitis media (AOM or viral pharyngitis. Propolis has been widely investigated for its antibacterial, antiviral, and anti-inflammatory properties and could perhaps be administered as an add-on therapy during watchful waiting in AOM or for better control of symptoms in nonstreptococcal pharyngitis. However, propolis has well-known problems of poor solubility and low oral bioavailability. We therefore analyzed a proprietary propolis-based product (Propolisina® developed to overcome these limitations, in a retrospective, open-label, controlled study of Streptococcus pyogenes-negative children with a diagnosis of AOM or pharyngitis. Our results show that the use of propolis supplement for 72 hours lessens the severity of AOM and viral pharyngitis, reduces the use of antipyretics and anti-inflammatory drugs, and decreases the rate of evolution to tracheitis, bronchitis, and rhinosinusitis. Our study shows that propolis could be used as a safe add-on therapy in case of AOM and/or viral pharyngitis. Keywords: pediatric infections, cogrinding, bioavailability, propolis

  2. Chronic Arsenic poisoning.

    Science.gov (United States)

    Ahsan, Tasnim; Zehra, Kaneez; Munshi, Alia; Ahsan, Samiah

    2009-02-01

    Chronic Arsenic Toxicity may have varied clinical presentations ranging from non-cancerous manifestations to malignancy of skin and different internal organs. Dermal lesions such as hyper pigmentation and hyperkeratosis, predominantly over palms and soles are diagnostic of Chronic Arsenicosis. We report two cases from a family living in Sukkur who presented with classical skin lesions described in Chronic Arsenicosis. The urine, nail and hair samples of these patients contained markedly elevated levels of arsenic. Also the water samples from their household and the neighbouring households were found to have alarming levels of inorganic Arsenic.

  3. Inflammation in Chronic Wounds.

    Science.gov (United States)

    Zhao, Ruilong; Liang, Helena; Clarke, Elizabeth; Jackson, Christopher; Xue, Meilang

    2016-12-11

    Non-healing chronic wounds present a major biological, psychological, social, and financial burden on both individual patients and the broader health system. Pathologically extensive inflammation plays a major role in the disruption of the normal healing cascade. The causes of chronic wounds (venous, arterial, pressure, and diabetic ulcers) can be examined through a juxtaposition of normal healing and the rogue inflammatory response created by the common components within chronic wounds (ageing, hypoxia, ischaemia-reperfusion injury, and bacterial colonisation). Wound bed care through debridement, dressings, and antibiotics currently form the basic mode of treatment. Despite recent setbacks, pharmaceutical adjuncts form an interesting area of research.

  4. Chronic dysimmune neuropathies: Beyond chronic demyelinating polyradiculoneuropathy

    Directory of Open Access Journals (Sweden)

    Khadilkar Satish

    2011-01-01

    Full Text Available The spectrum of chronic dysimmune neuropathies has widened well beyond chronic demyelinating polyradiculoneuropathy (CIDP. Pure motor (multifocal motor neuropathy, sensorimotor with asymmetrical involvement (multifocal acquired demylinating sensory and motor neuropathy, exclusively distal sensory (distal acquired demyelinating sensory neuropathy and very proximal sensory (chronic immune sensory polyradiculopathy constitute the variants of CIDP. Correct diagnosis of these entities is of importance in terms of initiation of appropriate therapy as well as prognostication of these patients. The rates of detection of immune-mediated neuropathies with monoclonal cell proliferation (monoclonal gammopathy of unknown significance, multiple myeloma, etc. have been facilitated as better diagnostic tools such as serum immunofixation electrophoresis are being used more often. Immune neuropathies associated with malignancies and systemic vasculitic disorders are being defined further and treated early with better understanding of the disease processes. As this field of dysimmune neuropathies will evolve in the future, some of the curious aspects of the clinical presentations and response patterns to different immunosuppressants or immunomodulators will be further elucidated. This review also discusses representative case studies.

  5. What Is Chronic Pain?

    Medline Plus

    Full Text Available ... Learned Going to the ER Communication Tools Pain Management Programs Videos Resources FAQs Glossary Surveys Resource Guide to Chronic Pain Treatments The Art of Pain Management Partners for Understanding Pain Pain Awareness Toolkits September ...

  6. Chronic fatigue syndrome

    National Research Council Canada - National Science Library

    Gonthier, Ariane; Favrat, Bernard

    2015-01-01

    Chronic fatigue syndrome (CFS) is a debilitating disorder, characterized by a severe, persistant and unexplained fatigue, which can be associated with diffuse pain, sleep difficulties, neurocognitive and neurovegetative troubles...

  7. Coping with Chronic Illness

    Science.gov (United States)

    ... be able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not understand why this is happening to them. These changes can cause stress, anxiety, and anger. If they do, it is important ...

  8. Chronic Kidney Disease

    Science.gov (United States)

    ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged and ... people don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are ...

  9. What Is Chronic Pain?

    Medline Plus

    Full Text Available ... the pain will go away. Part of the problem with chronic pain is that when we start ... is that the presence of a severe pain problem which exists for some period of time can ...

  10. Sleep and Chronic Disease

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Sleep and Sleep Disorders Note: Javascript is disabled or is not ... Data Source Projects and Partners Resources For Clinicians Sleep and Chronic Disease Recommend on Facebook Tweet Share ...

  11. Chronic pelvic pain

    National Research Council Canada - National Science Library

    Slawomir Wozniak

    2016-01-01

    [b][/b][b]Introduction. [/b]Chronic pelvic pain (CPP) affects about 10–40% of women presenting to a physician, and is characterised by pain within the minor pelvis persisting for over 6 months. [b...

  12. Chronic Fatigue Syndrome

    Science.gov (United States)

    ... light, eye pain) Psychological symptoms (irritability, mood swings, panic attacks, anxiety) Chills and night sweats Low grade ... Research Phone Number: 775-682-8250 Chronic fatigue syndrome > A-Z Health Topics The Office on Women's ...

  13. Chronic Condition Data Warehouse

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Condition Data Warehouse (CCW) provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across...

  14. Low back pain - chronic

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007422.htm Low back pain - chronic To use the sharing features on this page, please enable JavaScript. Low back pain refers to pain that you feel in your ...

  15. Chronic sinusitis (image)

    Science.gov (United States)

    ... and cartilage and lined with a mucous membrane. Sinusitis occurs when the membranes becomes inflamed and painful, ... a result of a blocked sinus opening. Chronic sinusitis is often caused by inflammation and blockage due ...

  16. CHRONIC UNEXPLAINED OROFACIAL PAIN

    Directory of Open Access Journals (Sweden)

    Aleš Vesnaver

    2002-04-01

    Full Text Available Background. Chronic unexplained orofacial pain is frequently the cause of prolonged suffering for the patient and an unsolvable problem for the therapist. Pathophysiology of the onset of this type of pain is virtually unknown. Still, it is possible to divide chronic orofacial pain into several separate categories, according to its onset, symptoms and therapy. All forms of this type of pain have a strong psychological component.Methods. A retrograde review was conducted, in which patients’ records, treated in 1994 for chronic unexplained orofacial pain, were followed through a 5 year period. The modalities of treatment then and at present were compared.Conclusions. Except for trigeminal neuralgia, where carbamazepine remains the first choice drug, treatment of chronic facial pain has changed considerably.

  17. Chronic penile strangulation

    Directory of Open Access Journals (Sweden)

    Lopes Roberto I

    2003-01-01

    Full Text Available Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to exteriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examination revealed lymphedema of the penis, phimosis and a stricture in the penile base. The patient was submitted to circumcision and the lymphedema remained stable 10 months postoperatively. Chronic penile incarceration usually causes penile lymphedema and urinary disturbance. Treatment consists of removal of foreign devices and surgical treatment of lymphedema.

  18. Chronic Fatigue Syndrome

    Science.gov (United States)

    Chronic fatigue syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that ... activities. The main symptom of CFS is severe fatigue that lasts for 6 months or more. You ...

  19. Chronic Traumatic Encephalopathy

    Science.gov (United States)

    ... com/home. Accessed Jan. 29, 2016. Concussion: Mayo's multidisciplinary approach. Mayo Clinic Neuroscience Update. 2013;10:2. ... al. Clinical appraisal of chronic traumatic encephalopathy: Current perspectives and future directions. Current Opinion in Neurology. 2011; ...

  20. What Is Chronic Pain?

    Medline Plus

    Full Text Available Already a member? Log In or Sign Up Home About Us Support the ACPA Contact Us Shop ... Pain Awareness Toolkits September is Pain Awareness Month Home Pain Management Tools Videos What Is Chronic Pain? ...

  1. What Is Chronic Pain?

    Medline Plus

    Full Text Available ... chronic pain there may be no apparent physical injury or illness to explain it. The physician and ... expected period of healing for an illness or injury. You can experience pain even if you are ...

  2. Chronic inflammatory demyelinative polyneuropathy

    DEFF Research Database (Denmark)

    Said, Gérard; Krarup, Christian

    2013-01-01

    Chronic inflammatory demyelinative polyneuropathy (CIDP) is an acquired polyneuropathy presumably of immunological origin. It is characterized by a progressive or a relapsing course with predominant motor deficit. The diagnosis rests on the association of non-length-dependent predominantly motor ...

  3. What Is Chronic Pain?

    Medline Plus

    Full Text Available ... With chronic pain there may be no apparent physical injury or illness to explain it. The physician ... We comply with the HONcode standard for trustworthy health information: Verify here Certified by: Independent Charities of ...

  4. Chronic Conditions Chartbook

    Data.gov (United States)

    U.S. Department of Health & Human Services — Chronic Conditions among Medicare Beneficiaries is a chartbook prepared by the Centers for Medicare and Medicaid Services and created to provide an overview of...

  5. What Is Chronic Pain?

    Medline Plus

    Full Text Available ... Covington, MD, director of the Cleveland Clinic Pain Management Program, explains some of the physiology of pain. Narrator: Most pain is temporary and manageable, but chronic pain is different. And because it is different, we need to ...

  6. Tips for Chronic Pain

    Science.gov (United States)

    Patient Education Sheet Tips for Chronic Pain The SSF thanks Stuart S. Kassan, MD, FACP, Clinical Professor of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, for authoring ...

  7. Employees with Chronic Pain

    Science.gov (United States)

    ... Stroke, 2011). How is chronic pain treated? Medications, acupuncture, local electrical stimulation, and brain stimulation, as well ... services Provide access to a refrigerator Depression and Anxiety: Develop strategies to deal with work problems before ...

  8. Chronic Fatigue Syndrome

    Science.gov (United States)

    ... people with CFS should avoid heavy meals, alcohol, caffeine, and large quantities of junk food. Some people ... to address problems. Write it down. If your memory and concentration are affected by chronic fatigue, it ...

  9. What Is Chronic Pain?

    Medline Plus

    Full Text Available ... went away several years earlier. Narrator: We don’t know everything that there is to know about ... physiological or neurological basis even when we don’t know what it is. Chronic pain is real. ...

  10. Omalizumab for chronic urticaria

    DEFF Research Database (Denmark)

    Ivyanskiy, Ilya; Sand, Carsten; Thomsen, Simon Francis

    2012-01-01

    urticaria. We present a case series of 19 patients with chronic urticaria treated in a university department with omalizumab and give an overview of the existing literature comprising an additional 59 cases as well as a total of 139 patients enrolled in two randomized controlled trials comparing omalizumab...... with placebo. The collective evidence points to omalizumab as a safe and effective treatment option for patients with chronic urticaria who do not sufficiently respond to standard therapy as recommended by existing guidelines....

  11. Chronic adult asthma care – maxi- mising the potential of the ...

    African Journals Online (AJOL)

    2009-01-29

    wheezy bronchitis' and even ... CONFIRM DIAGNOSIS OF ASTHMA. In particular differentiate clearly between asthma and ..... organisations can assist with raising awareness, reducing stigma and supporting adherence. Patients ...

  12. Chronic pain after childbirth.

    Science.gov (United States)

    Landau, R; Bollag, L; Ortner, C

    2013-04-01

    With over four million deliveries annually in the United States alone and a constant increase in cesarean delivery rate, childbirth is likely to have a huge impact on the occurrence of acute and possibly chronic postpartum pain. Recent awareness that chronic pain may occur after childbirth has prompted clinicians and researchers to investigate this topic. Current evidence points towards a relatively low incidence of chronic pain after cesarean delivery, with rates ranging between 1% and 18%. To provide a potential mechanistic explanation for the relatively low occurrence of chronic pain after cesarean delivery compared with that after other types of surgery, it has been proposed that endogenous secretion of oxytocin may confer specific protection. Clinical interventions to reduce the incidence and severity of chronic post-surgical pain have not been consistently effective. Likely explanations are that the drugs that have been investigated were truly ineffective or that the effect was too modest because with a low incidence of chronic pain, studies were likely to be underpowered and failed to demonstrate an effect. In addition, since not all women require preventive therapies, preoperative testing that may identify women vulnerable to pain may be highly beneficial. Further research is needed to identify valid models that predict persistent pain to allow targeted interventions to women most likely to benefit from more tailored anti-hyperalgesic therapies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. What Is the Prevalence of Symptomatic Obstructive Sleep Apnea Syndrome in Chronic Spinal Pain Patients? An Assessment of the Correlation of OSAS with Chronic Opioid Therapy, Obesity, and Smoking.

    Science.gov (United States)

    Pampati, Sanjana; Manchikanti, Laxmaiah

    2016-05-01

    patients with combined back and neck pain compared to patients with thoracic pain only or back pain only (16.3% versus 8.2% to 11%). Prevalence also varied by body mass index (BMI): 32.4% in morbidly obese patients, 20.3% in severely obese patients, 15.7% in obese patients, 9.2% in those who were overweight, and only 5.7% in those with normal weight. A significant correlation with OSAS was also observed in patients smoking more than 40 pack years and multiple respiratory symptoms except for chronic bronchitis and multiple cardiovascular ailments. The retrospective nature of the assessment. This retrospective assessment of over 4,000 patients suffering from chronic pain and receiving chronic opioid therapy indicated a prevalence of sleep apnea syndrome as 13.8%. Multiple risk factors including obesity, chronic obstructive pulmonary disease (COPD), chronic sinus and nasal discharge, and multiple comorbidities including cardiovascular and related ailments have been identified. Obstructive sleep apnea syndrome, chronic pain, chronic spinal pain, chronic opioid therapy, obesity, smoking, cardiovascular risk factors, pulmonary risk factors.

  14. Chronic Obstructive Pulmonary Disease and its association with sleep and mental disorders in the general population.

    Science.gov (United States)

    Ohayon, Maurice M

    2014-07-01

    To assess the prevalence of insomnia symptoms in Chronic Obstructive Pulmonary Disease (COPD) participants, their association with psychiatric disorders and their impact on health care utilization and quality of life. It is a cross-sectional telephone study using a representative sample consisting of 10,854 non-institutionalized individuals aged 15 or over living in Germany, Spain and the United Kingdom. Interviews were managed by the Sleep-EVAL expert system. The questionnaire included questions on sleeping habits, life habits, health, DSM-IV mental disorders, DSM-IV and ICSD sleep disorders. COPD was defined as chronic bronchitis or emphysema (treated or not) diagnosed by a physician. A total of 2.5% [2.1%-2.8%] of the sample reported having been diagnosed with COPD. As many as 48.1% of COPD had insomnia symptoms, which was twice higher than the rate observed in non-COPD (OR: 2.4). Only 11.8% of COPD addressed their sleep difficulties to their physician. Mental disorders were higher in COPD compared to non-COPD participants: Major Depressive disorder (AOR: 2.8); Generalized Anxiety Disorder (AOR: 11.0); Panic Disorder (AOR: 7.1) and Specific Phobia (AOR: 3.7). As many as 84.4% of COPD with depression and 59.7% of those with an Anxiety Disorder had associated insomnia symptoms. The co-occurrence of both conditions increased by five times the likelihood of hospitalizations in the previous year among COPD. Both conditions were associated with a diminished Quality of Life in COPD. COPD is a debilitating disease accompanied with psychiatric disorders and sleep disturbances in the overwhelming majority of cases. This high comorbidity is associated with greater health care utilization and great deterioration of the quality of life. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. The Use of Chinese Herbal Medicine in the Treatment of Chronic Obstructive Pulmonary Disease (COPD).

    Science.gov (United States)

    Liao, Yen-Nung; Hu, Wen-Long; Chen, Hsuan-Ju; Hung, Yu-Chiang

    2017-01-01

    In Oriental countries, combinations of Chinese herbal products (CHPs) are often utilized as therapeutic agents for chronic obstructive pulmonary disease (COPD). The effects of CHPs on COPD have been previously reported. This study aimed to analyze the frequency of prescription and usage of CHPs in patients with COPD in Taiwan. In this nationwide population-based cross-sectional study, 19,142 patients from a random sample of one million individuals in the Longitudinal Health Insurance Database 2000 (LHID 2000) of the National Health Insurance Research Database (NHIRD) were enrolled from 2000 to 2011. The multiple logistic regression method was used to evaluate the adjusted odds ratios for the utilization of CHPs. For patients with COPD, there was an average of 6.31 CHPs in a single prescription. The most frequently prescribed CHP for COPD was Xiao-Qing-Long-Tang (XQLT) (2.6%), and the most commonly used combination of two formula CHPs was XQLT with Ma-Xing-Gan-Shi-Tang (MXGST) (1.28%). The most commonly used single CHP for COPD was Bulbus Fritillariae (3.65%), and the most commonly used combination of two single CHPs was Bulbus Fritillariae with Puerariae Lobatae (1.09%). These results provide information regarding personalized therapies and may promote further clinical experiments and pharmacologic research on the use of CHPs for the management of COPD. Furthermore, we found that TCM usage was more prevalent among men, younger, manual workers, residents of Northern Taiwan, and patients with chronic bronchitis and asthma. This information on the distribution of TCM usage around the country is valuable to public health policymakers and clinicians.

  16. The clustering of other chronic inflammatory diseases in inflammatory bowel disease: a population-based study.

    Science.gov (United States)

    Bernstein, Charles N; Wajda, Andre; Blanchard, James F

    2005-09-01

    We aimed to discern the relative risk for several chronic inflammatory conditions in patients with ulcerative colitis (UC) and Crohn's disease. We used the population-based University of Manitoba IBD Database that includes longitudinal files on all patients from all health system contacts identified by International Classification of Diseases, 9th revision, Clinical Modification codes for visit diagnosis. From the provincial database we extracted a control cohort matching the IBD patients 10:1 by age, sex, and geography. We considered a potential comorbid disease to be present if the patient had 5 or more health system contacts for that diagnosis. The comorbid disease period prevalence was analyzed separately for patients with UC and Crohn's disease and a prevalence ratio was calculated comparing the IBD populations with the matched cohort. There were 8072 cases of IBD from 1984 to 2003, including UC (n = 3879) and Crohn's disease (n = 4193). There was a mean of approximately 16 person-years of coverage for both patients and control patients. Both UC and Crohn's disease patients had a significantly greater likelihood of having arthritis, asthma, bronchitis, psoriasis, and pericarditis than population controls. An increased risk for chronic renal disease and multiple sclerosis was noted in UC but not Crohn's disease patients. The most common nonintestinal comorbidities identified were arthritis and asthma. The finding of asthma as the most common comorbidity increased in Crohn's disease patients compared with the general population is novel. These may be diseases with common causes or complications of one disease that lead to the presentation with another. Studies such as this should encourage further research into the common triggers in the organ systems that lead to autoimmune diseases.

  17. Octogenarian patients with chronic obstructive pulmonary disease: Characteristics and usefulness of prognostic indexes.

    Science.gov (United States)

    Golpe, Rafael; Suárez-Valor, María; Veres-Racamonde, Alejandro; Cano-Jiménez, Esteban; Martín-Robles, Irene; Sanjuán-López, Pilar; Pérez-de-Llano, Luis

    2017-10-30

    Most studies on chronic obstructive pulmonary disease (COPD) exclude octogenarian patients. Therefore, the disease is not well characterized in this age group. The objective of this study is to analyze the clinical characteristics of octogenarian patients with COPD and the usefulness of the prognostic indexes used most frequently in this age group. Retrospective study of consecutive patients seen at a clinic between 2009 and 2017. The following variables were analyzed: lung function parameters, distribution of clinical phenotypes, income history, mortality, comorbidities and usefulness of the Charlson, BODEX, COTE and CODEX indexes to predict mortality. The sample comprised 698 patients, 82 aged (11.7%)≥80 years old. Mean follow-up time was 47.9±21.8 months. In octogenarian patients, the severity of the COPD, assessed by means of the FEV1% or BODEX index, was similar to that of younger patients, but dyspnea was worse in the elderly group. In these patients, the chronic bronchitis and frequent exacerbator phenotypes were the most frequent, whilst the emphysema phenotype was the least common. Octogenarians had a greater prevalence of cardiovascular comorbidities and renal diseases. Moreover, hospital admissions were more frequent and mortality was higher in these elderly patients. Most prognostic indexes were useful in predicting mortality in elderly patients. CODEX was the most useful index to predict mortality, both in octogenarian and younger patients. Octogenarian patients with COPD have differential characteristics which could imply the need for different therapeutic approaches. Prognostic indexes are useful for predicting mortality in this population. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  18. Lifetime environmental tobacco smoke exposure and the risk of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Balmes John

    2005-05-01

    Full Text Available Abstract Background Exposure to environmental tobacco smoke (ETS, which contains potent respiratory irritants, may lead to chronic airway inflammation and obstruction. Although ETS exposure appears to cause asthma in children and adults, its role in causing COPD has received limited attention in epidemiologic studies. Methods Using data from a population-based sample of 2,113 U.S. adults aged 55 to 75 years, we examined the association between lifetime ETS exposure and the risk of developing COPD. Participants were recruited from all 48 contiguous U.S. states by random digit dialing. Lifetime ETS exposure was ascertained by structured telephone interview. We used a standard epidemiologic approach to define COPD based on a self-reported physician diagnosis of chronic bronchitis, emphysema, or COPD. Results Higher cumulative lifetime home and work exposure were associated with a greater risk of COPD. The highest quartile of lifetime home ETS exposure was associated with a greater risk of COPD, controlling for age, sex, race, personal smoking history, educational attainment, marital status, and occupational exposure to vapors, gas, dusts, or fumes during the longest held job (OR 1.55; 95% CI 1.09 to 2.21. The highest quartile of lifetime workplace ETS exposure was also related to a greater risk of COPD (OR 1.36; 95% CI 1.002 to 1.84. The population attributable fraction was 11% for the highest quartile of home ETS exposure and 7% for work exposure. Conclusion ETS exposure may be an important cause of COPD. Consequently, public policies aimed at preventing public smoking may reduce the burden of COPD-related death and disability, both by reducing direct smoking and ETS exposure.

  19. Three clinically distinct chronic pediatric airway infections share a common core microbiota.

    Science.gov (United States)

    van der Gast, Christopher J; Cuthbertson, Leah; Rogers, Geraint B; Pope, Christopher; Marsh, Robyn L; Redding, Gregory J; Bruce, Kenneth D; Chang, Anne B; Hoffman, Lucas R

    2014-09-01

    DNA-based microbiological studies are moving beyond studying healthy human microbiota to investigate diverse infectious diseases, including chronic respiratory infections, such as those in the airways of people with cystic fibrosis (CF) and non-CF bronchiectasis. The species identified in the respiratory secretion microbiota from such patients can be classified into those that are common and abundant among similar subjects (core) versus those that are infrequent and rare (satellite). This categorization provides a vital foundation for investigating disease pathogenesis and improving therapy. However, whether the core microbiota of people with different respiratory diseases, which are traditionally associated with specific culturable pathogens, are unique or shared with other chronic infections of the lower airways is not well studied. Little is also known about how these chronic infection microbiota change from childhood to adulthood. We sought to compare the core microbiota in respiratory specimens from children and adults with different chronic lung infections. We used bacterial 16S rRNA gene pyrosequencing, phylogenetic analysis, and ecological statistical tools to compare the core microbiota in respiratory samples from three cohorts of symptomatic children with clinically distinct airway diseases (protracted bacterial bronchitis, bronchiectasis, CF), and from four healthy children. We then compared the core pediatric respiratory microbiota with those in samples from adults with bronchiectasis and CF. All three pediatric disease cohorts shared strikingly similar core respiratory microbiota that differed from adult CF and bronchiectasis microbiota. The most common species in pediatric disease cohort samples were also detected in those from healthy children. The adult CF and bronchiectasis microbiota also differed from each other, suggesting common early infection airway microbiota that diverge by adulthood. The shared core pediatric microbiota included both

  20. Chronic daily headaches

    Directory of Open Access Journals (Sweden)

    Fayyaz Ahmed

    2012-01-01

    Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.