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At least 613 records · Page 34Linked to original sources
PubMed1980

Chronic bronchitis and decreased forced expiratory flow rates in lifetime nonsmoking grain workers.

To determine whether clinical symptoms and pulmonary function abnormalities were more common in lifetime nonsmoking grain elevator workers exposed to grain dust than in lifetime nonsmoking community control subjects who were not occupationally exposed to dust, we obtained an occupational health questionnaire, spirometric variables, and flow-volume curves on 90 lifetime nonsmoking grain workers and 90 lifetime nonsmoking community control subjects. For these groups we calculated the prevalence of chronic bronchitis, defined as daily production of phlegm for 3 months/yr for at least 2 yr. The prevalence of chronic bronchitis was higher in nonsmoking workers (23.1%) than in nonsmoking control subjects (3.3%) (p less than 0.01). Nonsmoking grain workers had lower mean values than did nonsmoking control subjects for maximal mid-expiratory flow rate (p less than 0.01) and for maximal expiratory flow at 50% of vital capacity (p less than 0.01). We conclude that exposure to grain dust inlifetime nonsmoking grain workers is associated with an increased prevalence of chronic bronchitis and evidence of airflow obstruction.

Adult↗
PubMed1982

Bronchial hyperreactivity in chronic obstructive bronchitis.

Patients with chronic obstructive bronchitis commonly suffer acute, transient exacerbations, which suggests that episodic bronchoconstriction may play a role in this disease. We studied 22 patients with chronic obstructive bronchitis and no acute improvement in pulmonary function after inhaled sympathomimetics, using methacholine bronchial provocation tests to evaluate the incidence of bronchial hyperreactivity. Patients with clinical or laboratory findings indicative of asthma were excluded. The group demonstrated significant baseline airway obstruction (mean +/- SD forced expiratory volume in one second, 0.96 +/- 0.44) and no improvement after inhalation of isoproterenol (1.68 +/- 8.54% baseline change). All patients were very sensitive to inhaled methacholine, reacting at a dose of 4.29 +/- 5.49 cumulative units. There were no normal responses. These data suggest that airway hyperreactivity may contribute to acute, transient exacerbations experienced by patients with chronic obstructive bronchitis, even in the absence of acute improvement in pulmonary function after the administration of sympathomimetics, and may warrant chronic prophylactic bronchodilator therapy.

Aged↗
PubMed1985

Almitrine improves oxygenation when both awake and asleep in patients with hypoxia and carbon dioxide retention caused by chronic bronchitis and emphysema.

Patients with chronic bronchitis and emphysema who are hypoxic when awake become more hypoxic during sleep, with a further rise in their preexisting pulmonary hypertension. Almitrine, a respiratory stimulant, improves arterial blood gas tensions in such patients when they are awake. We have used a double-blind, placebo-controlled, cross-over study to compare the effects of 50 mg almitrine given orally twice a day for 14 days on oxygen saturation (SaO2), respiratory movements, and sleep quality in 9 patients with hypoxic chronic bronchitis and emphysema (FEV1, 0.4 to 1.0 L; PaO2, 51 +/- (SEM) 2 mmHg; PaCO2, 49 +/- 1 mmHg). Almitrine improved arterial blood gas tensions when awake, mean PaO2 rising by 8 mmHg (p less than 0.001) and PaCO2 falling by 4 mmHg (p less than 0.01). Almitrine improved nocturnal oxygenation, mean SaO2 when awake rising from 83 +/- 4% to 89 +/- 3% (p less than 0.01), and the lowest SaO2 during sleep rising on average from 65 +/- 6% to 77 +/- 3% (p less than 0.02). The number of hypoxemic episodes (SaO2 falling by greater than or equal to 10% from the preceding stable baseline during sleep) and the time when SaO2 was below 80% (135 +/- 53 versus 46 +/- 35 min; p less than 0.01) also improved. Almitrine did not improve sleep quality. We conclude that almitrine improves arterial gas tensions when awake and reduces the frequency and severity of nocturnal hypoxemia without impairing sleep quality in patients with chronic bronchitis and emphysema who are both hypoxemic and hypercapnic when awake.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

The effects of chronic bronchitis and chronic air-flow obstruction on lung cell populations recovered by bronchoalveolar lavage.

Bronchoalveolar lavage is used to evaluate parenchymal inflammation in patients with diffuse lung disease. Normal values for lavage cell counts and proteins are derived primarily from young subjects who are free from lung disease; however, older patients who undergo bronchoalveolar lavage often have used cigarettes for long periods of time and have developed variable degrees of chronic bronchitis and/or chronic air-flow obstruction. Therefore, we evaluated the effects of cigarette use, chronic bronchitis, and chronic air-flow obstruction on lavage cell populations by performing bronchoalveolar lavage in 48 male patients who were undergoing diagnostic fiberoptic bronchoscopy. Sixteen patients (33%) had elevated percentages of neutrophils (greater than or equal to 10%) in lavage fluid. Fourteen of these (87.5%) had chronic cough and/or phlegm production, but only 9 (64.3%) met criteria for definite chronic bronchitis. Patients with moderate or severe air-flow obstruction, defined spirometrically, had significantly greater percentages of lavage neutrophils and lower percentages of macrophages than did patients with mild or no air-flow obstruction. The first lavage aliquot contained the greatest proportion of neutrophils and the smallest proportion of macrophages. The percentage of neutrophils declined and the percentage of macrophages increased in sequential aliquots. The data indicate that patients with chronic cough and/or phlegm production and chronic air-flow obstruction may have increased proportions of neutrophils in bronchoalveolar lavage fluid in the absence of diffuse parenchymal lung disease or infections. These variables must be taken into account when interpreting lavage cellular analyses.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchi↗
PubMed1986

Comparisons of asthma, emphysema, and chronic bronchitis diagnoses in a general population sample.

This report is an analysis of cases of obstructive lung disease diagnosed during the first 8 yr of a community study. Of 351 subjects who received a new diagnosis of asthma, emphysema, or chronic bronchitis from community physicians, 152 (44.5%) had a prior or concomitant diagnosis of another obstructive disease. Asthma developed most often in young subjects, emphysema in older subjects, and chronic bronchitis occurred in all age groups. Among older subjects, disease groups were surprisingly similar, with wheeze, dyspnea, and attacks of shortness of breath with wheeze all occurring frequently in diagnosed subjects, including those with emphysema. The majority of subjects who developed emphysema were males. In contrast, 72.8% of the asthma and chronic bronchitis subjects were females. These results suggest that physician bias may result in labeling male patients as emphysematous and female patients as asthmatic or bronchitic.

Adolescent↗
PubMed1995

Airway neutrophilia and chemokine mRNA expression in sulfur dioxide-induced bronchitis.

Airway inflammation in acute and chronic bronchitis includes a prominent neutrophil influx. Using a rat model of sulfur dioxide (SO2)-induced bronchitis, we investigated the role of the polymorphonuclear leukocyte (PMN) chemokines macrophage inflammatory protein-2 (MIP-2) and KC. Adult female rats were exposed to 230 ppm SO2 for 5 h/day for periods of 1 day to 5 wk. Immunohistochemical identification of rat PMNs in trachea cryostat sections allowed quantitation of a marked neutrophil influx into airways of bronchitic rats (PMNs/trachea ring = 55 +/- 26.2 [1 day SO2] versus 3.6 +/- 2.7 [air]; n = 5, P < or = 0.05). Northern analysis of trachea homogenates demonstrated induction of KC and MIP-2 mRNA expression after 1 day of SO2 and persistence of increased expression after longer exposure periods examined. Pretreatment of rats with dexamethasone (0.5 mg/kg) prior to a 1-day acute SO2 exposure prevented induction of chemokine mRNA and abrogated neutrophil influx completely (PMNs/trachea ring = 6.6 +/- 8.8 versus air controls; n = 5, P = 0.96). To determine if chemokine inhibition by dexamethasone could be further studied in vitro, the rat alveolar macrophage cell line NR8383 was treated with dexamethasone (10(-7) M) before stimulation with lipopolysaccharide (10 micrograms/ml). Pretreatment with dexamethasone substantially decreased induction of both MIP-2 and KC mRNA in response to lipopolysaccharide, indicating the potential utility of in vitro systems to identify additional anti-inflammatory agents. These studies support the hypothesis that the chemokines MIP-2 and KC mediate airway neutrophil influx in both acute and chronic SO2-induced bronchitis in the rat.

Acute Disease↗
PubMed1986

Ketotifen in the treatment of infants and young children with wheezy bronchitis and bronchial asthma.

Ketotifen, an orally-administered anti-anaphylactic and antihistamine compound, was given in a dose of 0.06 mg/kg to 142 infants and young children presenting either with non-infected wheezy bronchitis or bronchial asthma to an allergy out-patient department. Treatment continued for 12 weeks. At the end of this time, ketotifen was considered to be very effective or effective in 70% of the children. The effect was more marked in non-infected wheezy bronchitis (83.55% response) than in bronchial asthma (56.5% response), perhaps because factors such as leukotrienes, prostaglandins and thromboxanes tend to produce a sustained bronchoconstriction in the latter condition. Ketotifen was not associated with any adverse effects and did not cause behavioural problems. Patients found it palatable and acceptable. The main disadvantage was that symptoms recurred within days of stopping treatment. Especially in non-infected wheezy bronchitis, ketotifen should be given for a year or longer to older children (older than 30 months) who have shown an initial good response to the drug.

Asthma↗
PubMed1996

Dornase in treatment of chronic bronchitis.

At this time, dornase is approved only for the treatment of patients with cystic fibrosis. Based on the results of the trials discussed, dornase appears to be well tolerated by patients with chronic bronchitis. However, the therapeutic benefit of dornase in chronic bronchitis remains unclear. Until further studies are published, dornase cannot be recommended as a routine treatment modality for management of patients with chronic bronchitis.

Bronchitis↗
PubMed1982

The prevalence of bronchial asthma and chronic bronchitis in an industrialized community in Northern Sweden.

The population living within a small area around a sulphite pulp factory in Northern Sweden was studied with regard to chronic obstructive lung disease. In persons in the age group 20-64 years the prevalence of bronchial asthma was found to be 3.0% for males and 3.2% for females. These figures correspond closely with previous studies in the Central and Southern Sweden. In the same age group the prevalence of chronic bronchitis was 2.8% for males and 1.0% for females, i.e. not differing much from that of other parts of Sweden. These findings, however, were far removed from the high prevalence of chronic bronchitis reported from Northern Finland, viz. 28.2% in males and 5.8% in females. The difference is probably attributable to differences in diagnostic criteria. In this study, those sulphite pulp factory workers who smoke seemed to constitute a population running a high risk of contracting chronic bronchitis.

Adult↗
PubMed1995

The long-term antimicrobial prophylaxis of chronic bronchitis exacerbations.

Infectious exacerbations are the major cause of mortality in patients with chronic bronchitis, particularly in elderly subjects. Considering that the preventive use of antibiotics has provided no clear-cut evidence of real efficacy, it has become quite common to use treatments potentially able to stimulate the immune system for prevention of exacerbations of chronic bronchitis. This treatment, based on the oral administration of bacterial extracts, should, at least in theory, stimulate the immune defenses and reduce the incidence of recurring respiratory tract infections. Although during the last few years a good effort to define better the real efficacy and role played by bacterial extracts in chronic bronchitis has been made, their clinical effectiveness is still the subject of debate and the results of some clinical trials are controversial. Particularly, its mechanism of action remains poorly understood, although a huge effort has been made in this direction.

Administration, Oral↗
PubMed2001

Factors associated with relapse after ambulatory treatment of acute exacerbations of chronic bronchitis. DAFNE Study Group.

This study aimed to identify the risk factors for relapse after ambulatory treatment of acute exacerbations of chronic bronchitis (AECB) that can easily be used in a primary care setting. Data were prospectively collected on 2,414 ambulatory patients with AECB from 268 general practices located throughout Spain. A multivariate model to identify risk factors independently associated with failures was developed and validated from the information recorded at the inclusion visit and at 30-days follow-up visit. A total of 507 patients relapsed (21%); of these, 84 required admission (16.5%). The multivariate model for prediction of the risk of relapse included 2,414 cases: 1,689 for the developmental sample and 725 in the validation sample. The model obtained contained three readily-obtainable variables: ischaemic heart disease (odds ratio (OR)=1.63; 95% confidence interval (CI)=1.07-2.47), degree of dyspnoea (OR = 1.31; 1.14-1.50) and number of visits to the general practitioner the previous year (OR = 1.07; 1.04-1.10). The model calibrated well in developmental and validation samples (goodness-of-fit tests: p = 0.295 and p = 0.637, respectively). Severity of the exacerbation was not associated with increased risk of relapse in either univariate or multivariate analysis. The present results suggest that baseline characteristics of the patients such as degree of dyspnoea, coexisting ischaemic heart disease and number of previous visits to the general practitioner for respiratory problems are strongly associated with increased risk of relapse after ambulatory treatment of acute exacerbations of chronic bronchitis. In contrast, exacerbation severity was not associated with clinical failure. Guidelines for management of acute exacerbations of chronic bronchitis should consider such risk factors and advocate intensive broad spectrum treatment and closer follow-up of patients exhibiting them.

Aged↗
PubMed2001

Changes in bronchial inflammation during acute exacerbations of chronic bronchitis.

There are little data describing noncellular changes in bronchial inflammation during exacerbations of chronic bronchitis. The relationship between sputum colour and airway inflammation at presentation has been assessed during an exacerbation in patients with chronic bronchitis and a primary care diagnosis of chronic obstructive pulmonary disease. Sputum myeloperoxidase, neutrophil elastase, leukotriene B4 (LTB4), interleukin-8 (IL-8), sol:serum albumin ratio and serum C-reactive protein were measured in patients presenting with an exacerbation and mucoid (n = 27) or purulent sputum (n = 42). Mucoid exacerbations were associated with little bronchial or systemic inflammation at presentation, and sputum bacteriology was similar to that obtained in the stable state. Purulent exacerbations were associated with marked bronchial and systemic inflammation (p < 0.025 for all features) and positive sputum cultures (90%). Resolution was related to a significant reduction in LTB4 (p < 0.01), but no change in IL-8, suggesting that LTB4 may be more important in neutrophil recruitment in these mild, purulent exacerbations. In the stable state, IL-8 remained higher in patients who had experienced a purulent exacerbation (2p < 0.02). The presented results indicate that exacerbations of chronic bronchitis, defined by sputum colour, differ in the degree of bronchial and systemic inflammation. Purulent exacerbations are related to bacterial infection, and are associated with increased neutrophilic inflammation and increased leukotriene B4 concentrations.

Acute Disease↗
PubMed2005

Patient stratification in the management of acute bacterial exacerbation of chronic bronchitis: the role of levofloxacin 750 mg.

This is the first prospective clinical trial in which patients with acute bacterial exacerbation of chronic bronchitis have been stratified by degree of underlying illness. Uncomplicated patients were randomised to levofloxacin 750 mg once daily (q.d.) for 3 days or azithromycin q.d. for 5 days. Complicated patients were randomised to levofloxacin 750 mg q.d. for 5 days or amoxicillin 875 mg/clavulanate 125 mg twice daily for 10 days. Regardless of therapy, complicated patients demonstrated lower clinical and microbiological success than uncomplicated patients. Clinical success for clinically evaluable patients was similar for levofloxacin and azithromycin (93.0 versus 90.1%, respectively), and levofloxacin and amoxicillin/clavulanate (79.2 versus 81.7%, respectively). For microbiologically evaluable patients, clinical response to levofloxacin for 3 days was superior to azithromycin for 5 days (96.3 versus 87.4%, respectively), and levofloxacin for 5 days was similar to amoxicillin/clavulanate for 10 days (81.4 versus 80.9%, respectively). Microbiological eradication was superior for levofloxacin for 3 days compared with azithromycin for 5 days (93.8 versus 82.8%, respectively), and similar for levofloxacin and amoxicillin/clavulanate for 10 days (81.4 versus 79.8%, respectively). In conclusion, levofloxacin 750 mg for 3 days was comparable to azithromycin for 5 days for uncomplicated patients with acute bacterial exacerbation of chronic bronchitis, while 5 days of 750 mg levofloxacin was comparable to 10 days of amoxicillin/clavulanate for complicated acute bacterial exacerbation of chronic bronchitis.

Administration, Oral↗
PubMed1995

Repeatability of airway deposition and tracheobronchial clearance rate over three days in chronic bronchitis.

Previous investigations on tracheobronchial clearance in chronic bronchitis or chronic obstructive pulmonary disease (COPD) have usually referred to measurements during a short time-period, i.e. a few hours. The purpose of this study, therefore, was to study regional particle deposition and tracheobronchial clearance during 72 h. In 14 patients with chronic bronchitis clearance of 111In-labelled 3.6 micrograms Teflon particles and lung function were measured on two occasions, with an interval of 2 weeks. Lung retention of test particles was measured at 0, 24, 48 and 72 h using a profile scanner. The weight of expectorated sputum samples was measured after the two clearance measurements. The particle retentions at all time-points were reproducible, as seen from the two measurements ( r > 0.90). The fast clearance phase was completed within 72 h. No correlation between sputum volume and clearance was seen. There was a significant negative correlation between airway resistance and the 72 h retention (r= -0.66), and an even better correlation between specific airway resistance and the 72 h retention (r = -0.82), indicating more central deposition in obstructed airways. There was no significant correlation between lung function tests reflecting smaller airways and the 72 h retentions. Deposition data agreed well with theoretical calculations and experimental data in healthy subjects. In spite of earlier findings that mucociliary transport is usually severely impaired in chronic bronchitis and COPD, the present results indicate that overall tracheobronchial mucus clearance in these patients is fairly effective, probably due to a productive cough. Alveolar deposition may be estimated by measurements of the 72 h retention in subjects with chronic obstructive pulmonary disease. The 72 h retention is dependent mainly on the calibre of larger airways. The present method of studying airway clearance during 3 days is highly reproducible.

Adult↗
PubMed1996

Effects of rhDNase on purulent airway secretions in chronic bronchitis.

Recombinant human deoxyribonuclease (rhDNase) has been demonstrated to reduce in vitro the viscosity and to improve the transport capacity of purulent respiratory mucus in cystic fibrosis. During episodes of exacerbation of chronic bronchitis, the patients generally expectorate purulent mucus. Purulence of mucus is associated with an increased deoxyriboneucleic acid (DNA) concentration. We analyzed in vitro the potential effect of rhDNase on chronic bronchitis mucus transport by the ciliary activity (frog palate model) and by simulated cough (cough machine model), as well as the effect on mucus viscosity (controlled stress rheometer) and surface properties (contact angle). Purulent sputa collected from patients with chronic bronchitis (n = 15) during an episode of exacerbation were incubated for 30 min at 37 degrees C with either rhDNase at two different concentrations (final concentration 2 or 4 micrograms.mL-1) or placebo. The median mucociliary transport rate was significantly improved by rhDNase from 0.68 with placebo to 0.79 and 0.83 with 2 and 4 micrograms.mL-1 of rhDNase, respectively. A significant improvement in mucus cough transport was also induced by rhDNase from 25.5 mm with placebo to 27.0 mm with either 2 or 4 micrograms.mL-1 rhDNase. These improvements in mucus transport capacity were associated with alterations in the physical properties of the mucus. The mucus median control viscosity (511.4 Pa.s) and median contact angle (0.85 rd) significantly decreased to 112.5 Pa.s and 0.74 rd, respectively, in the presence of 4 micrograms.mL-1 of rhDNase. These findings demonstrate that recombinant deoxyribonuclease may exert a beneficial effect on mucus clearance in vitro by altering the viscosity and surface properties of the purulent chronic bronchitic sputum samples.

Bronchitis↗
PubMed2000

YM-40461 improves airway clearance in guinea pigs with induced subacute bronchitis.

The effects of the surfactant secretagogue YM-40461 on the mucociliary transport (MCT) velocity were examined in guinea pigs with induced bronchitis. Guinea pigs were exposed to SO2 gas (900 ppm, 3 h/d) for 5 d. MCT velocity was measured by the movement of a 30% gelatin solution containing Evans blue dye placed on the tracheal mucosal surface. Repeated doses of YM-40461 improved the MCT guinea pigs with bronchitis within 5 d after the completion of SO2 exposure, with an ED50 value of 3.1 mg/kg p.o. At a dose of 10 mg/kg p.o., YM-40461 restored MCT to the control level (98.0% recovery). Ambroxol, bromhexine and salbutamol also improved MCT, but were far less effective than YM-40461. Airway fluid collected from bronchitic animals revealed increased disaturated phosphatidylcholine (DSPC, a major component of surfactants)-to-protein ratio and decreased surface tension produced by YM-40461 treatment (10 mg/kg). These results suggest that YM-40461 ameliorates MCT dysfunction in animals with SO2 gas-induced bronchitis by increasing the DSPC-to-protein ratio in the airway.

Animals↗
PubMed2003

Quality of life, distress and self-esteem: a focus group study of people with chronic bronchitis.

Chronic bronchitis (a form of chronic obstructive pulmonary disease or COPD) is a common cause of morbidity and mortality resulting in around 5% of deaths in the UK. Over recent years, there has been an increased emphasis on patient-based evaluation of health and social care, which has led to a rapid growth in quality of life measures and an increase in measuring quality of life for COPD patients. However, less attention has been paid to patients' perceptions and experiences of everyday life, specifically their active engagement in the psychological, emotional and social aspects of adjustment and adaptation to living with chronic bronchitis. This study employs a series of four focus groups (N = 20) to identify key experiences of living with chronic bronchitis. The results, obtained through using both thematic and conceptual qualitative analysis, within a broadly symbolic interactionist framework, describe the subjective and sometimes contradictory ways in which the disease leads to psychological distress, dependency on medication, and disruption to social and family relationships, and has a negative impact on self-esteem. The study further argues for greater awareness of qualitative approaches to the broad view of quality of life as complementary to quality of life assessments.

Adult↗
PubMed2024

One-pot Golden Gate Assembly of an avian infectious bronchitis virus reverse genetics system.

Avian infectious bronchitis is an acute respiratory disease of poultry of particular concern for global food security. Investigation of infectious bronchitis virus (IBV), the causative agent of avian infectious bronchitis, via reverse genetics enables deeper understanding of virus biology and a rapid response to emerging variants. Classic methods of reverse genetics for IBV can be time consuming, rely on recombination for the introduction of mutations, and, depending on the system, can be subject to genome instability and unreliable success rates. In this study, we have applied data-optimized Golden Gate Assembly design to create a rapidly executable, flexible, and faithful reverse genetics system for IBV. The IBV genome was divided into 12 fragments at high-fidelity fusion site breakpoints. All fragments were synthetically produced and propagated in E. coli plasmids, amenable to standard molecular biology techniques for DNA manipulation. The assembly can be carried out in a single reaction, with the products used directly in subsequent viral rescue steps. We demonstrate the use of this system for generation of point mutants and gene replacements. This Golden Gate Assembly-based reverse genetics system will enable rapid response to emerging variants of IBV, particularly important to vaccine development for controlling spread within poultry populations.

Infectious bronchitis virus↗