Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bronchitis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMedDate not supplied

Detection of CFTR gene mutations in patients suffering from chronic bronchitis.

BACKGROUND: The purpose of the study was to examine cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in patients suffering from chronic bronchitis. METHODS: Thirty-two patients admitted to the Department of Pulmonology, Lublin School of Medicine, Lublin, Poland between 1995 and 1996 due to chronic bronchitis were included in the study. Patients were analyzed for the eight most common mutations of the CFTR gene (DeltaF508, G542X, N1303K, 1717-1(GoA)), W1282X, G551D, R553X, and DeltaI507 by the reverse-hybridization method. RESULTS: CFTR gene mutations were found in five of 32 (16%) patients, all within the DeltaF508 region of the CFTR gene. All positive samples were obtained from patients heterozygous for the DeltaF508 mutation. The presence of the DeltaF508 mutation was considered statistically significant when our study group was compared to the study of Poland's general population (p <0.05 Fisher's exact test). CONCLUSION: Our results suggest there is an increased presence of the DeltaF508 point mutation of the CFTR gene in Polish patients suffering from chronic bronchitis.

Adolescent↗
PubMed1999

[Treatment of chronic bronchitis and chronic pulmonary obstructive disease in primary care].

In spite of the recent publication of various guidelines for the treatment of chronic bronchitis and chronic obstructive pulmonary disease (COPD), no studies have investigated whether or not they are being implemented by caregivers. Our aim was to determine what treatment protocols for patients with chronic bronchitis and COPD are most commonly applied by general practitioners in Spain and to identify factors associated with the prescription of certain drugs. A standardized questionnaire was administered to 268 general practitioners working in the 17 autonomous communities of Spain. The stratified sample of respondents was selected to reflect the population of each community. Valid information on 2,414 patients was collected. Men accounted for 74% of the patients. Mean age was 67 years (SD = 10). Lung function data were available for 1,130 (47%) and mean FEV1 was 1,523 ml (56% of the theoretical reference value). Patients without lung function data in spite of having signs of severe symptoms had suffered more acute exacerbations and generated more visits to the emergency room and to their primary care doctors in the preceding year than had patients who had undergone lung function testing (p < 0.03; p < 0.001; p < 0.003, respectively). The treatments most often prescribed were short-acting inhaled beta-2 agonists (56%), inhaled corticoids (47%), theophylline-containing drugs (43%), and long-lasting beta-2 agonists (41%). Patients who had not undergone function tests received more mucolytics (47% versus 27%, p < 0.001) and fewer anticholinergics (20% versus 35%, p < 0.001). The factor most highly associated with prescription of all drugs was severity of disease measured by dyspnea. Treatment protocols for chronic bronchitis and COPD in general practice in many aspects show differences from current guidelines. Noteworthy is the extensive use of inhaled corticoid therapy and long-lasting beta-2 adrenergic agonists and the infrequent prescription of anticholinergics. The lack of lung function data is associated with poor pharmacologic management of disease and higher rates of morbidity.

Aged↗
PubMedDate not supplied

Sulfated oligosaccharides isolated from the respiratory mucins of a secretor patient suffering from chronic bronchitis.

The most acidic carbohydrate chains released by alkaline borohydride treatment of the bulk of airway mucins secreted by a patient (blood group O, secretor) suffering from a mildly infected chronic bronchitis have been fractionated using high-performance anion-exchange chromatography (HPAEC) according to a protocol already described [Lo-Guidice et al., J. Biol. Chem. 269 (1994) 18794] and were analyzed using 1H-NMR spectroscopy and matrix-assisted laser-adsorption-time-of-flight (MALDI-TOF) spectrometry. Many fractions corresponded to mixtures of oligosaccharides. This confirmed the wide diversity of the post-translational processes involved in the biosynthesis of airway mucins, which had already been observed in bronchial diseases, such as chronic bronchitis and cystic fibrosis (CF). Seven fractions were directly purified by HPAEC, allowing their structural determination. Six of them corresponded to 3-O-sulfated oligosaccharide chains terminated by a sulfated N-acetyllactosamine, a sulfated Lewis X or a sulfated Lewis A determinant, and the last one corresponded to a 6-O-sulfated chain terminated by a sulfated H-2 determinant. Three oligosaccharides had core type 2 and the other four had core type 4: IIIc2-9: Gal(beta1-3)[HSO(3)-3-Gal(beta1-4)GlcNAc(beta1-6)]GalNAc-ol, IIIc2-10: Gal(beta1-3)[Fuc(alpha1-2)Gal(beta1-4)[HSO(3)-6-]GlcNAc(beta1-6)]GalNAc-ol, IIIc2-4: Fuc(alpha1-2)Gal(beta1-3)[HSO(3)-3-Gal(beta1-4)[Fuc(alpha1-3)]GlcNAc(beta1-6)]GalNAc-ol, IIIc2-8: Fuc(alpha1-2)Gal(beta1-3)GlcNAc(beta1-3)[HSO(3)-3-Gal(beta1-4)GlcNAc(beta1-6)]GalNAc-ol, IIIc2-7: Fuc(alpha1-2)Gal(beta1-3)GlcNAc(beta1-3)[Gal(beta1-4)[HSO(3)-6-]GlcNAc(beta1-6)]GalNAc-ol, IIIc2-3: Fuc(alpha1-2)Gal(beta1-3)GlcNAc(beta1-3)[HSO(3)-3-Gal(beta1-4)[Fuc(alpha1-3)]GlcNAc(beta1-6)]GalNAc-ol, IIIc1-4: Fuc(alpha1-2)Gal(beta1-3)GlcNAc(beta1-3)[HSO(3) -3-Gal(beta1-3)[Fuc(alpha1-4)]GlcNAc(beta1-3)Gal(beta1-4)GlcNAc(beta1-6)]GalNAc-ol. Like previous data concerning the airway mucins from another patient (blood group O and non-secretor) suffering from chronic bronchitis [Lo-Guidice et al., Glycoconj. J. 14 (1997) 113], no disialylated oligosaccharide and no sialylated and sulfated oligosaccharide bearing sialyl Lewis X epitope could be isolated. This is in contrast with the data obtained with the airway mucins secreted by the patient severely infected by Pseudomonas aeruginosa and suffering from CF, suggesting that important differences occur in the biosynthesis of airway mucins secreted by patients suffering from different bronchial diseases with or without severe infection.

Bronchitis↗
PubMed2005

[Aspergillus bronchitis and aspergilloma treated successfully with voriconazole].

INTRODUCTION: Aspergillus fumigatus is a ubiquitous soil-dwelling organism, which can cause both aspergillomas which develop in a preformed lung cavity, and aspergillus bronchitis. The two pathologies can occasionally co-exist, notably in patients with of cystic fibrosis. CASE REPORT: We describe a 57 year old patient, with diffuse bronchiectasis, who developed aspergillus bronchitis as well as an aspergilloma complicating a cavity caused by an atypical mycobacterial infection. After one month of therapy with voriconazole the aspergilloma had decreased in size and the endobronchial changes had resolved. CONCLUSION: This case report illustrates that in addition to its established role for the treatment of invasive aspergillosis, voriconazole is a promising new therapy for the treatment of aspergilloma and aspergillus bronchitis.

Antifungal Agents↗
PubMed2001

The place of antibiotic therapy in the management of chronic acute exacerbations of chronic bronchitis.

In the USA, more than 16 million adults are affected by chronic obstructive pulmonary disease, and chronic bronchitis has been estimated to affect up to 13 million individuals or approximately 4-6% of adults. Chronic bronchitis is an increasing cause of significant morbidity and mortality. During acute exacerbations of chronic bronchitis, subjects experience a worsening of bronchitic symptoms, with an increase from baseline in one or more or the following; dyspnoea, cough and/or sputum volume, purulence or viscosity. The severity of an exacerbation can be graded by how many of these symptoms are present. Antibiotic therapy should be initiated based on patient history and severity of the exacerbation.

Acute Disease↗
PubMed1989

Observations on sputum production in patients with variable airflow obstruction; implications for the diagnosis of asthma and chronic bronchitis.

There are few clinical studies on hypersecretion in asthma, defined as variable airflow obstruction. One hundred and thirty defined asthmatics were questioned in detail about their clinical features, with special reference to sputum production. Other clinical and laboratory data were obtained from the hospital notes. Thirty (23%) denied sputum production at any time. Of the hundred patients reporting sputum, 55 reported the largest volume when an attack of asthma was at its worst and 42 reported most sputum during recovery. Three patients reported unchanging sputum volumes regardless of asthma attacks. There was an association between greater sputum volumes and increased absenteeism due to respiratory symptoms (P less than 0.01) and negative prick skin tests (P less than 0.001). Cigarette smoking and bronchopulmonary aspergillosis were uncommon among our patients, and did not alone account for the sputum production rates. Sixty-eight per cent of patients reported that their pattern or volume of sputum production during attacks had not changed substantially since the onset of their asthma. Patients also fulfilling the Medical Research Council (MRC) criteria for chronic bronchitis (n = 56) were more likely to have smoked than those who did not (P less than 0.005), although 32 (57%) of the asthmatics with chronic bronchitis had smoked little or not at all. Moreover the lability of peak flow measurements was similar in asthmatic patients with and without chronic bronchitis (Lability index 43 and 42% respectively). The prevalence of persistent airflow limitation (PAL) in addition to a variable component related to duration of asthma but not to smoking. The relation between PAL and sputum production was complex.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Symptoms related to snoring and sleep apnoea in subjects with chronic bronchitis: report from the Obstructive Lung Disease in Northern Sweden Study.

To assess the relationship between chronic bronchitis and obstructive sleep apnoea, a postal survey was performed. A postal questionnaire was sent to 523 subjects identified as having chronic bronchitis or long-standing cough and sputum production in the Obstructive Lung Disease in Northern Sweden Study I (OLIN I). In 1986-88, all 6610 adults born in 1919-20, 1934-35 and 1949-50 living in representative areas in Northern Sweden were screened for airway diseases according to different methods. A random sample of healthy adults identified in the screening were chosen as references (n = 625). Subjects were asked about a variety of airway symptoms, smoking habits and symptoms related to obstructive sleep apnoea syndrome (OSAS). In the bronchitic group, 20% did not report bronchitic symptoms in the present study, and 26% of the formerly healthy reference group reported at least one bronchitic symptom in the present study. Snoring, apnoea and liability to 'nod off' during activity were much more common in the bronchitic group in both men and women, and most common in men, as expected. Snoring was reported by 29% of the men in the bronchitic group and by 14% in the reference group. In women, the corresponding figures were 14 and 8%, respectively, and for apnoea, the figures were 25 vs. 11% in men and 6 vs. 4% in women. The prevalence of OSAS symptoms was similar in subjects with attacks of breathlessness, long-standing cough, sputum production and recurrent wheezing. Bronchitic symptoms may influence quality of sleep and contribute to daytime tiredness, but this does not fully explain the high prevalence of snoring and apnoea reported by subjects in this cohort. This study indicates a positive correlation between chronic bronchitis and OSAS, but sleep studies are required to confirm this.

Adult↗
PubMed2006

[Bacterial etiology of chronic bronchitis exacerbations treated by primary care physicians].

OBJECTIVE: Few studies have been carried out to determine the prevalence of microorganisms causing exacerbations of chronic bronchitis in the community setting. The aim of the present study was to determine the bacterial etiology of chronic bronchitis exacerbations in patients not requiring hospitalization. PATIENTS AND METHODS: This observational, cross-sectional, multicenter study was carried out at the primary care level during 2 weeks (in November 2001 and January 2002). All laboratory work was carried out at a single center. We studied 1,947 patients with mild-moderate exacerbations treated by 650 primary care physicians. All the sputum samples received for centralized processing were subject to Gram staining, microscopic examination, and bacterial culture. RESULTS: Out of 1,537 cultures of sputum samples collected, 498 had good cell quality for microscopic examination (32.4%). Of the 498 good quality samples analyzed, 246 (49.4%) were positive and 468 isolates were obtained. The most commonly isolated germ was Streptococcus pneumoniae (163 cases, 34.8%), followed by Moraxella catarrhalis (112, 23.9%), and Haemophilus influenzae (59, 12.6%). In 1.2% of the S. pneumoniae isolates resistance was found to amoxicillin; resistance to macrolides was found in 34.3%. The antibiotics most commonly prescribed, however, were macrolides (38.3% of the prescriptions). CONCLUSIONS: S. pneumoniae was the microorganism most frequently isolated in cases of chronic bronchitis exacerbation treatable in this outpatient setting.

Acute Disease↗
PubMed2000

Assessing patient outcomes in acute exacerbations of chronic bronchitis: the measure your medical outcome profile (MYMOP), medical outcomes study 6-item general health survey (MOS-6A) and EuroQol (EQ-5D).

There is little published information on the measurement of health status or quality of life in acute exacerbations of chronic bronchitis. The measure yourself medical outcome profile (MYMOP), the medical outcomes study 6-item general health survey (MOS-6A), and EuroQoL (EQ-5D) were evaluated in 81 patients with acute exacerbations of Type-1 chronic bronchitis presenting at a single general practice centre in Glasgow. The questionnaires were administered at the first clinic visit and at a second visit within 1 week of treatment completion. Item scores for MYMOP were generally more responsive than those for the other instruments, as assessed by standardised response means and an index of responsiveness for those patients reporting minimal change between visits. Construct validity was demonstrated for the MYMOP by the gradient in score change with the patient's perceived change in clinical condition and by the relationship between score change and the physician's assessment of clinical outcome. This study demonstrated that the MYMOP is a valid and potentially useful instrument for the assessment of patient outcomes in acute exacerbations of chronic bronchitis and is more responsive than the MOS-6A or EQ-5D in this setting. The choice of instrument will vary according to the objective of the study.

Adult↗
PubMed2003

Validity of the St George's respiratory questionnaire at acute exacerbation of chronic bronchitis: comparison with the Nottingham health profile.

The purpose of the study is to compare a generic and a specific quality of life (QoL) instrument in the assessment of QoL in chronic bronchitis. Data from 320 patients were collected at acute exacerbation of chronic bronchitis (AECB), and from 230 patients during a subsequent stable phase (non-AECB), utilising both the specific St George's respiratory questionnaire (SGRQ) and the generic Nottingham health profile (NHP). Patients (maximum n = 200) reported significantly poorer QoL at AECB than at non-AECB for all domains except the SGRQ symptom domain (SRM = 0.02). The SGRQ was more sensitive than the NHP to QoL differences between patients. The correlations between the scores across the two assessments were generally higher for the SGRQ, with the correlations between the NHP and SGRQ being lower at AECB, suggesting that the instruments are measuring different constructs at AECB, with the SGRQ being less responsive to QoL change. Indeed, the NHP was generally more responsive to QoL change in terms of 'risk' and clinical factors, with the SGRQ symptom domain appearing particularly non-responsive. In conclusion, this study suggests that the condition-specific SGRQ, and particularly its symptom domain, is less responsive than the generic NHP to QoL change accompanying AECB. This reflects the construct of the symptom domain which measures chronic bronchitis symptoms over the previous year.

Acute Disease↗
PubMed2004

Psychological distress and depressed mood in employees with asthma, chronic bronchitis or emphysema: a population-based observational study on prevalence and the relationship with smoking cigarettes.

OBJECTIVES: To evaluate if employees with asthma, chronic bronchitis or emphysema can be characterized as a population of patients with a high prevalence of psychological distress and/or depressed mood. Above all, we wanted to examine the influence of smoking status on the relationship between chronic disease and psychological distress/depressed mood. METHODS: A postal survey was conducted among 12,103 employees participating in the Maastricht Cohort Study. RESULTS: Smoking employees, who reported having asthma, chronic bronchitis or emphysema were more likely to report suffering from depressed mood compared to smokers with no long-lasting disease (prevalence rate, PR: 29.3 and 9.0%, respectively; OR for depressed mood = 4.04; 95% CI: 2.56-6.39) and when compared to smoking employees with a history of heart disease, hypertension or myocardial infarction (PR: 18.1%; OR: 1.99; 95% CI: 1.07-3.68), or rheumatoid arthritis (PR: 20.1%; OR: 1.73; 95% CI: 0.96-3.11). CONCLUSION: These findings provide health care professionals with additional evidence regarding the importance for including the assessment of psychological distress and depressed mood in the routine evaluation of the patient with asthma, chronic bronchitis or emphysema, especially with regard to smoking cessation.

Age Distribution↗
PubMed1999

Health-based selection for asthma, but not for chronic bronchitis, in pig farmers: an evidence-based hypothesis.

In cross-sectional surveys among pig farmers an elevated prevalence of chronic bronchitis is usually reported, but not of asthma, despite many factors promoting the manifestation of asthma. To investigate this apparent contradiction a postal questionnaire survey was performed among 239 pig farmers and 311 rural controls. Pig farmers reported an elevated prevalence of symptoms of chronic bronchitis (20.2 versus 7.7%, p<0.001), but not of asthma (5.9 versus 5.5% for chest tightness). Among pig farmers the use of disinfectants (prevalence odds ratio (POR) 9.4, 95% confidence interval (CI) 1.6-57.2 for quaternary ammonium compounds) and aspects of the disinfecting procedure were associated with the prevalence of asthma symptoms. Compared with controls, pig farmers reported fewer allergies to common allergens (4.6 versus 14.6%, p<0.001 for pollen) and fewer symptoms of atopy in childhood (9.9 versus 17.2, p<0.05 for one or more of four symptoms). Atopy in childhood was strongly associated with the prevalence of asthma symptoms (POR 4.1, 95% CI 2.2-7.7), but not with chronic bronchitis. Health-based selection of nonasthmatics for pig farming, which tends to mask a work-related hazard for asthma, is offered as an explanation for these results.

Adult↗
PubMed1999

Respiratory tract inflammation during the induction of chronic bronchitis in rats: role of C-fibres.

The hypothesis that chronic stimulation of C-fibres by inhaled irritants contributes to the inflammatory changes that occur during the development of chronic bronchitis was tested. The effect of neonatal capsaicin pretreatment on the development of respiratory tract inflammation was examined in a rat model of chronic bronchitis induced by SO2 exposure. Adult capsaicin- and vehicle-treated rats were exposed to SO2 (250 parts per million (ppm) 5 h x day(-1)) for one day, 2 weeks or 4 weeks. Nasal (NL), airway (AL) and bronchoalveolar (BAL) lavages were performed and the number and types of cells in the lavage fluids measured. SO2-induced changes in ventilation were also measured on day 1 of SO2 exposure and in the 3rd and 5th week of exposure. In the vehicle-treated rats, neutrophils became elevated in NL after just one day of SO2 exposure, in AL after 2 weeks, and in the BAL after 4 weeks. In comparison to vehicle animals, more neutrophils were recovered in the AL of capsaicin-treated rats after one day of SO2 (p=0.012), and in the BAL after 2 or 4 weeks (p=0.004 and p=0.01, respectively). On day 1, SO2 caused a transient increase in tidal volume and a sustained decrease in frequency that was not different in capsaicin- and vehicle-treated rats. With continued exposure, these ventilatory responses to SO2 were attenuated in both groups of rats. These data support the hypothesis that the presence of C-fibres limits or delays the inflammation that occurs during the development of chronic bronchitis induced by SO2 exposure. The protective effect of C-fibres is not the result of ventilatory responses to stimulation of these afferents.

Animals↗
PubMed2001

Pre-protachykinin-A mRNA is increased in the airway epithelium of smokers with chronic bronchitis.

OBJECTIVE: Tachykinins are neuropeptides present in sensory nerves in the lung. Aside from their role as neurotransmitters, these peptides exert pro-inflammatory and protective effects in the airways. Although tachykinins may be released from sensory nerves, there is increasing evidence that they are also produced by non-neuronal cells. The net effect of tachykinins will likely result from relative changes in the levels of tachykinins, tachykinin receptors and tachykinin degrading enzymes. We investigated whether tachykinins might be produced locally in human airway epithelium in vivo, and whether mRNA levels for either tachykinins, their receptors, or for the tachykinin degrading enzyme neutral endopeptidase (NEP) were altered in subjects with chronic bronchitis compared to normals. METHODOLOGY: We used reverse transcription polymerase chain reaction analysis of brush biopsy samples to detect mRNAs of interest. We then developed a semi-quantitative approach to compare subject groups. RESULTS: We detected a signal for preprotachykinin A (PPT-A) mRNA as well as for tachykinin receptors and NEP in patients with airways disease and normal subjects. We found a relative 10-fold increase in PPT-A mRNA in smokers with chronic bronchitis, along with similar increases in mRNA for the inflammatory markers intercellular adhesion molecule-1 and interleukin-8. In contrast, NEP and NK1 tachykinin receptor mRNA levels were not different between the groups. CONCLUSION: These findings imply that up-regulation of tachykinin production by cells present in the airway epithelium contributes to the pathophysiology of chronic bronchitis.

Actins↗
PubMed2000

The safety and efficacy of short course (5-day) moxifloxacin vs. azithromycin in the treatment of patients with acute exacerbation of chronic bronchitis.

Chronic bronchitis is common among adults and infectious exacerbations contribute considerably to morbidity and mortality. We aimed to compare the safety and efficacy of moxifloxacin to azithromycin for the treatment of patients with acute exacerbations of chronic bronchitis (AECB) of suspected bacterial origin. Between October 1998 and April 1999, 567 patients with AECB were enrolled at 37 centers across the United States and Canada of which 280 (49%) had acute bacterial exacerbation of chronic bronchitis (i.e. pretherapy pathogen). Patients were randomized to either oral moxifloxacin 400 mg administered once daily for 5 days or azithromycin for 5 days (500 mg qd x 1, then 250 mg qd x 4). For the purpose of study blinding, all patients received encapsulated tablets. The main outcome measure was clinical response at the test-of-cure visit (14-21 days post-therapy). Secondary measures included bacteriologic response and a time-course of bacteriological eradication (one center only). Three patient populations were analysed for efficacy: clinically-valid, microbiologically-valid (i.e. those with a pretherapy pathogen), and intent-to-treat (i.e. received at least one dose of study drug). For the efficacy-valid group, clinical response at the test-of-cure visit was 88% for patients in each treatment group. In 237 microbiologically-valid patients, corresponding clinical resolution rates were 88% for 5-day moxifloxacin vs. 86% for 5-day azithromycin. Bacteriological eradication rates at the end of therapy were 95% for 5-day moxifloxacin and 94% for the azithromycin group. Corresponding eradication rates at the test-of-cure visit were 89% and 86%, respectively. Of note, eradication rates at test-of-cure for Haem. philos influenzae and H. parainfluenzae for moxifloxacin were 97% and 88% compared to 83% and 62% respectively for azithromycin. Among 567 intent-to-treat patients (283 moxifloxacin and 284 azithromycin), drug-related events were reported for 22% and 17%, respectively. Diarrhea and nausea were the most common drug-related events reported in each treatment group. Moxifloxacin 400 mg once daily for 5 days was found to be clinically and bacteriologically equivalent to 5-day azithromycin for the treatment of AECB of proven bacterial etiology. Given its excellent in-vitro activity, especially against antibiotic-resistant respiratory pathogens, and its acceptable safety profile, moxifloxacin should be considered an effective alternative therapy for patients with AECB of suspected bacterial origin.

Acute Disease↗
PubMed2001

In patients with chronic bronchitis a four week trial with inhaled steroids does not attenuate airway inflammation.

Systemic corticosteroids have been recommended as a therapeutic option in patients with moderate to severe COPD. In an early stage of the disease, i.e. chronic bronchitis with mild or no airflow obstruction, a trial with inhaled steroids could reveal potential benefits, particularly in terms of a modulation of airway inflammation. We therefore investigated the effect of inhaled fluticasone (1000 microg day(-1)) on markers of airway inflammation in 19 patients with chronic bronchitis (mean+/-SEM FEV1, 83.4+/-3.0% predicted; FEV1/VC, 67.5+/-2.4%) in a double-blind, cross-over, placebo-controlled manner. Visits were performed before and after two 4-week treatment periods. separated by a 4-week washout period. Lung function, the concentration of exhaled nitric oxide, differential cell counts in induced sputum and the number of cells positive for iNOS, as well as the levels of LDH, ECP, neutrophil elastase and IL-8 in sputum supernatants were determined. Although the total cell number decreased significantly after fluticasone (geometric mean 12.3 vs. 7.7 x 10(6)/ml; P<0.05) it was not significantly different from the change observed after placebo (14.2 vs. 10.6 x 10(6)/ml; n.s.). None of the other parameters showed statistically significant changes after fluticasone or placebo and the results did not depend on the presence of airway hyperresponsiveness. We conclude that in patients with chronic bronchitis short-term treatment with inhaled corticosterids did not improve lung function or inflammatory parameters to an extent which was statistically significant as compared to spontaneous variability.

Administration, Inhalation↗
PubMed2001

Asthma, chronic bronchitis and respiratory symptoms among adults in Estonia according to a postal questionnaire.

Epidemiological studies indicate a lower prevalence of asthma in Eastern than Western Europe. This study of the prevalence of asthma, chronic bronchitis, and respiratory symptoms was performed in three different regions of Estonia, a state incorporated in the Soviet Union until 1991. A postal questionnaire was sent to a random sample of 24,307 of the population aged 15-64 years. The response rate was 77.6%. The prevalence of physician-diagnosed asthma was 2.0% or considerably lower than in Northern and Western European countries. The prevalence of wheezing last 12 months, 21.7%, recurrent wheeze, 13.3%, and attacks of shortness of breath, 12.5%, were similar or even higher compared with prevalence rates found in the Nordic countries. The prevalence of physician-diagnosed chronic bronchitis was 10.7%, and was higher among women than in men, although the proportion of current smokers among men, 57%, was considerably greater than in women, 28%. A possible explanation to the high prevalence of respiratory symptoms also among non-smoking women may be exposure to environmental tobacco smoke in small, crowded Estonian homes. Diagnostic criteria based on the Soviet-time definitions is discussed as a possible explanation to the low prevalence of physician-diagnosed asthma and high prevalence of chronic bronchitis in Estonia compared with other Northern European countries.

Adolescent↗
PubMed2000

Chronic bronchitis: the role of viruses.

Mucus is produced by the epithelial cells in the glands, gland ducts, and the cells lining the airway lumen in the lower airways. The chronic cough and sputum production that defines chronic bronchitis is associated with an inflammatory reaction involving this mucus-secreting apparatus. Respiratory viral infections target the epithelial cells of the lung producing desquamation, microvascular dilatation, edema, and an inflammatory cell infiltrate. These changes predispose the lower airways to bacterial infection by interfering with mucociliary clearance and reducing bacterial killing by macrophages. The exact role of those infections in the pathogenesis of chronic bronchitis has not been clearly determined but they probably play a critical role in inducing bacterial colonization and initiating acute exacerbations of COPD. This article reviews the classification of the viral agents responsible for respiratory tract infection and the nature of the changes they produce in the normal airways and in the airways of patients with chronic bronchitis during acute infections.

Bronchitis↗