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PubMed2002

Patient and physician explanatory models for acute bronchitis.

OBJECTIVES: Our goals were to develop explanatory models to better understand how physicians diagnose and treat acute bronchitis; to describe patient expectations and needs when experiencing an episode of acute bronchitis; and to enhance communication between physician and patient. STUDY DESIGN: We used qualitative, semi-structured, in-depth interviews to generate patient and physician explanatory models. POPULATION: We had a purposeful, homogeneous sample of 30 family physicians and 30 adult patients. OUTCOMES MEASURED: Our multidisciplinary team of investigators used an editing style of analysis to develop patient and physician explanatory models based on the following topics: (1) what caused my illness/etiology, (2) what symptoms I had/onset of symptoms, (3) what my sickness did to me/pathophysiology, (4) how severe is my sickness/course of illness, and (5) what kind of treatment should I receive/treatment. RESULTS: We found that patient and physician models were congruous for symptoms of acute bronchitis and incongruous for etiology and course of illness. Models were congruous for treatment, although for different reasons. CONCLUSIONS: Patients may have a very vague understanding of the process of infection and the difference between bacteria and viruses. Compounding this confusion is frequent miscommunication from physicians regarding the clinical course of untreated illness. These factors and non-communicated expectations from patients and fear of missing something on the part of physicians contribute to the decision to treat with antibiotics.

Acute Disease↗
PubMed1992

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

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 (Branhamella) catarrhalis.

Acute Disease↗
PubMed1992

[Prospective epidemiological studies of chronic bronchitis in workers in a coke-processing plant].

In 1977 an epidemiological survey was carried out on incidence of chronic bronchitis in 652 workers (age 20-64) of a coking plant. The survey was repeated six years later in 300 of the original participants (56%). The aim of the study was to assess the effect of smoking, age and occupation on incidence of chronic bronchitis and dynamic change of FEV1 values during the six years. During the 6 years the incidence of chronic bronchitis rose from 22% to 43%. Mean annual decrease of FEV1 was higher in smokers as compared to nonsmokers (57.4 versus 52.6 ml per year). Higher mean falls of FEV1 values were noted in subjects with occupational risk factors present (68.4 ml) in comparison with those with low occupational exposure (51.2 ml). Susceptible subjects presented a thrice higher annual FEV1 decrease rate (142 ml).

Adult↗
PubMed1992

[Chronic bronchitis and ventilatory capacity of the lungs in relation to the function of small airways in workers in a Coke-Processing Plants in Zabrze].

In 449 male workers of the Zabrze Coking Plant (age 18-62 years) a questionnaire analysis of presence of bronchitic symptoms was carried out. The following ventilatory parameters were also assessed: FVC, FEV1, PEF, MEF75, MEF50, MEF25. Chronic bronchitis was diagnosed in 30.5% of the analysed subjects. The incidence of chronic bronchitis was four-fold higher in smoking males (33.9%) in comparison with non-smokers (8.3%). The authors did not find any relation between the character of work in subject with occupational exposure to atmospheric pollutants and incidence of chronic bronchitis. Smoking produced a decrease in flow during forced expiration especially in males older than 40 years. Subjects with higher occupational exposure to atmospheric pollutants demonstrated higher incidence of airway obstruction (21.2%) and lower mean FEV1% and flow volumes in comparison to subjects with lower occupational exposure.

Adolescent↗
PubMedDate not supplied

[Chronic bronchitis and respiratory function in those employed in primary aluminum production].

A study was carried out on a group of 323 workers of a primary aluminium production plant located in Porto Marghera (Italy) in order to assess the prevalence of chronic bronchitis and respiratory function alterations, compared with the general working population of the same industrial area. The results showed a higher prevalence of chronic bronchitis (5.6% compared with 2.6%) and a greater reduction in vital capacity but only in the non-smokers (5.4% compared with 1.7%). The highest prevalence of chronic bronchitis (20%) and reduced vital capacity (27%) was observed in the rodding section. The frequency of bronchial obstruction was similar to that observed in potroom and casting workers.

Aluminum↗
PubMedDate not supplied

[The use of hypoxic stimulation in chronic and relapsing bronchitis in young children ].

214 children of different age with various forms of bronchitis were subject to immunological and biochemical examination. Against a background of hypoxic state of patients the values of quantitative indices of cellular immunity (E-RFC, blast-transformation reaction with phytohemagglutination) were revealed to decrease and dysimmunoglobulinemia-to form. It is shown that in the period of exacerbation of clinical symptoms of bronchitis the concentration of malonic dialdehyde and resistance of erythrocyte membranes to peroxide hemolysis significantly increase. Analysis of peroxidation level against a background of improvement of clinical indices after the performed treatment indicates that there is no tendency to normalization of metabolic disorders. The above results show that it is necessary to carry out normobaric hypoxic stimulation aimed at treating and preventing bronchitis in children of early age.

Bronchitis↗
PubMed1992

[Detection of antibodies to infectious bronchitis of fowl using the ELISA, hemagglutination-inhibition test and agar-gel precipitation test].

Chicks of a conventional poultry flock, Shaver Starcross 288 hybrid, were vaccinated with infectious bronchitis (IB) virus H 120 at the age of 21 days. Three weeks later, the chicks were divided into three groups and separate groups were infected with infectious bronchitis viruses M 41 and D 274 or revaccinated with virus H 120. The content of specific antibodies to antigens prepared from homologous and heterologous viruses of infectious bronchitis used for chick vaccination and infection was investigated at regular intervals in the separate groups of chicks by means of an ELISA technique and haemagglutination-inhibition test (HIT). Serotype specificity of haemagglutination-inhibition test was documented by the results; the specificity was obvious mainly after the first vaccination and two weeks after infection, or after chick revaccination (Fig. 1). The dynamics of postinfective or postvaccinal antibodies, recorded by the ELISA technique, had analogical patterns in the separate groups of chicks, and there were no larger differences in the values determined on the basis of different antigens during the investigation (Fig. 2). A total of 52 group samples of fowl serum was examined by the ELISA technique and agar-gel precipitin test (AGPT) in another part of this study. Ten serums of identical origin represented the separate groups. The result of this examination was evaluated from the percentage of samples with precipitin activity in the group, or from the average value of ELISA. Mutual comparison of the mentioned values indicated that the precipitin activity was limited by the positivity degree of ELISA reaction (Fig. 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Effects of beta-adrenoceptors blocking eye drops in patients with chronic bronchitis.

Beta-blocker eyedrops used on asthmatic patients are known to enhance asthma which is, as chronic bronchitis, an obstructive disease of the lung, and an authentic bronchoconstriction is always possible. A single blind parallel trial in 3 groups of 10 patients with grade II and III chronic bronchitis, was conducted to evaluate the cardiovascular and bronchial tolerance of 3 beta-blocker eyedrops: timolol, betaxolol and carteolol compared to placebo. The following parameters were measured during a 90 minutes period: heart rate, systolic and diastolic blood pressure, forced expiratory volume in one second, vital capacity. It appeared that only heart rate lowers significantly under the influence of the beta-blocker eyedrop, the other parameters did not change and no difference was noticed between the three eyedrops. However, comparison of individual values showed a significant decrease of forced expiratory volume in one second in certain subjects and this, although betaxolol is a beta 1 selective beta-blocker. Caution should be taken each time beta-blocker eyedrops are prescribed for glaucoma to patients with chronic bronchitis.

Adrenergic beta-Antagonists↗
PubMed1992

[Chronic bronchitis: rare etiology].

Chronic bronchitis is defined for epidemiologic and clinical purposes as the presence of productive cough for three months in each of two successive years. Based on symptoms, the term 'chronic bronchitis', therefore, does not describe one distinct disease. It is rather a collective name for the clinical manifestation of numerous different congenital or acquired chronic diseases of the trachea, the bronchi and the bronchioli. Cigarette smoking is the most consistently important (and preventable) determinant of chronic bronchitis. There are, however, other rare etiologic factors, including malformations, tumors, recurrent aspirations and bronchiectasis. The latter often occur in association with systemic disorders such as cystic fibrosis, immotile cilia syndrome, immunodeficiency, alpha 1-antitrypsin deficiency and others.

Bronchitis↗
PubMed2003

Cefaclor AF vs Clarithromycin in acute exacerbation of chronic bronchitis (B3M-PK-AJBG).

OBJECTIVE: To compare the efficacy and safety of Cefaclor AF vs Clarithromycin in the treatment of acute exacerbation of chronic bronchitis in adult subjects. PATIENTS AND METHODS: This study was conducted on 300 patients suffering from acute exacerbation of chronic bronchitis, who attended the out patient clinics of ten different hospitals throughout Pakistan. Pneumonia, bronchiectasis and tuberculosis were excluded with the help of chest radiography and sputum smear examination. Pretherapy sputum culture and sensitivity (c/s) were tested and patients were randomized and supplied with either tablet Cefaclor 375 mg or tablet Clarithromycin 250 mg to be taken twice daily. Patients were evaluated at day 0 and then at day 3-5 and day 10-11. Post therapy sputum c/s was done on day 10-11. A fourth and final visit was planned on day 20-24 which was optional. At each visit, the severity of disease and the signs and symptoms were recorded on the clinical report forms according to the preset standards. RESULTS: Of 136 patients in the Cefaclor group and 142 patients in the Clarithromycin group, cure was achieved in 44 vs 35 subjects, improvement in 78 vs 91 subjects and failure in 16 vs 18 subjects among Cefaclor vs Clarithromycin groups respectively. The overall clinical efficacy (cure and improvement combined ) was 88.4% in the Cefaclor group and 87.5% in the Clarithromycin group. Nine patients in the Cefaclor group and patients in the Clarithromycin group had one adverse event whereas twelve patients in each group had two or more adverse events. CONCLUSIONS: The above results show that both Cefaclor AF and Clarithromycin are equally effective and safe in the treatment of acute exacerbation of chronic bronchitis in adult patients.

Acute Disease↗
PubMed2003

Clinical observation in 31 cases of chronic bronchitis at remission stage treated with bufei keli.

To observe the therapeutic effects of a Chinese drug Bufei Keli ([symbol: see text] granules for invigorating the lung) in the treatment of chronic bronchitis at remission stage, 62 cases were randomly divided into a treatment group (treated with Bufei Keli) and a control group (treated with Yupingfeng Keli [symbol: see text]). The results turned out to be that the short-term clinically controlled and markedly effective rate was 77.42% and the long-term relapse-resisting markedly effective rate was 74.2% in the treatment group, which were obviously higher than 45.16% and 38.71% respectively in the control group (P < 0.05). And the increase in contents of SOD and CD3 and the decrease in LPO content in the treatment group were also bigger than that in the control group (P < 0.01). It is therefore concluded that Bufei Keli can improve qi deficiency syndrome and raise the immunity of patients with chronic bronchitis, hence its effect of resisting relapse of chronic bronchitis.

Adjuvants, Immunologic↗
PubMed1992

Bombesin/gastrin releasing peptide levels of peripheral mononuclear cells, monocytes and alveolar macrophages in chronic bronchitis.

Bombesin-related peptides (BRP), a family of neuropeptides showing carboxy-terminal homology with the amphibian bombesin, are present in humans in many body systems (CNS, lung, gastro-intestinal tract) with a variety of biological activities. In the lung, BRP are mitogens for normal bronchial epithelial cells and fibroblasts, chemoattractant for monocytes and exert bronchoconstrictive activity. Increased levels of BRP have been described in the lung of cigarette smokers and in smoking-related diseases. Moreover appreciable quantities of BRP have been recently found in lysates of peripheral monocytes and alveolar macrophages of man and guinea pig. It has therefore been inferred that these peptides may play a role in the immunological function of lung tissue. The aim of this study was to determine the amount of BRP present in peripheral-blood mononuclear cells (PBMNC), monocytes and alveolar macrophages (AM) of normal subjects (n = 36) and chronic bronchitis patients (n = 36). Patients with chronic bronchitis showed a significant increase in BRP levels in all cell types (PBMNC, monocytes and AM) (p < 0.005) in comparison with normal subjects. In addition levels of BRP in monocytes and AM were found to be nearly four times higher than in PBMNC in both groups of subjects. We can therefore confirm previous observations concerning the presence of BRP in human cells of the monocyte-macrophage lineage. Furthermore our results demonstrate that BRP levels are increased in monocytes of chronic bronchitis patients and imply a potential role for these neuropeptides in lung immunological response in smoking-related diseases.

Aged↗
PubMed2003

Evaluation of blood serum, erythrocyte and urine magnesium concentrations in babies with pneumonia or bronchial obstructive bronchitis.

Physiological properties of magnesium (Mg) as a catalyst of enzymatic processes mainly are known quite well. Still unclear, however, are the changes in its concentrations in the body that occur in the course of many diseases, among others in babies with bronchial obstructive bronchitis and pneumonia. Therefore research was undertaken to determine the concentrations of magnesium in blood serum, erythrocytes and urine in babies suffering from pneumonia (54 babies) and bronchial obstructive bronchitis (46 babies). The results found that magnesium concentrations in the blood serum, erythrocytes and urine differ significantly in the groups of sick and healthy babies. Compared to the control group significantly lowest Mg concentrations in the blood serum, erythrocytes and highest in the urine were found both before and after the treatment in the babies suffering from bronchial obstructive bronchitis.

Aerosols↗
PubMed2004

[Chronic bronchitis in children].

Current approaches to diagnosing in children a group of chronic lung diseases running with the symptoms of chronic bronchitis. Chronic bronchitis is demonstrated to be a major syndrome underlying the clinical manifestations of a number of chronic lung diseases, such as congenital malformations of the lung, chronic pneumonia, ciliary dyskinesia, immunodeficiencies running with the involvement of the lung, cystic fibrosis, etc. The paper shows it necessary to diagnose these conditions, by using various diagnostic studies (bronchological, immunological, biochemical, microbiological, etc.). Primary chronic bronchitis in childhood occurs rarely and it is diagnosed after excluding the above diseases.

Bronchiectasis↗
PubMed2004

Protective effect of a bacterial extract against acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease.

BACKGROUND: Immunostimulating agents made from bacterial extracts represent a class of medications that contains antigens derived from several bacterial strains and their potential ability to prevent bacterial infections results from the stimulation of the nonspecific component of the immune system. The present study investigated the effect of the oral immunostimulant Broncho-Vaxom, which includes material from eight different species of bacteria that are frequently present in the lower respiratory tract, on the frequency and severity of acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease (COPD). METHODS: Ninety patients with chronic bronchitis complicated with COPD were randomly divided into groups A and B. Forty-nine subjects in group A received oral capsules containing 7 mg Broncho-Vaxom, while 41 patients in group B received similar placebo capsules. Both groups took one capsule daily for the first 10 days of each month for 3 consecutive months. The frequency of acute exacerbation, symptom scores, and lung function were recorded for the following one year period. RESULTS: There was a significant decrease in the incidence, duration, and severity of acute exacerbation, as well as a reduction in the course of antibiotics administered and in the dosage of bronchodilator and mucolytic agent in group A, as compared to group B (P < 0.05, respectively). Symptom scores for cough, sputum, dyspnea, as well as symptoms observed upon auscultation of the chest also improved significantly in group A as compared to group B (P < 0.05, respectively). The bacterial clearance rate in sputum cultures from patients who received no antibiotics for the first 3 months was also significantly higher in group A compared to group B (P < 0.01). CONCLUSIONS: Orally administered Broncho-Vaxom is associated with a decrease in the incidence of acute exacerbation and a decrease in the need for antibiotics and symptomatic relief medications in patients with chronic bronchitis accompanied by COPD. Broncho-Vaxom is also associated with a decrease in symptom scores. Without causing any apparent adverse effects, this drug may also help to eradicate pathogenic bacteria in the airways.

Adjuvants, Immunologic↗
PubMed1992

A bronchoscopic brush biopsy study of large airway mucosal pathology in smokers with chronic bronchitis and in healthy nonsmokers.

We investigated the use of bronchial brush biopsies of the bronchial epithelium as a diagnostic tool in common airway diseases. Flexible fibreoptic bronchoscopy was performed on 22 smokers with nonobstructive chronic bronchitis and on 14 healthy nonsmoking individuals. Ten of the smokers had recurrent infectious exacerbations. Cell samples were taken from carinal and subsegmental levels of the bronchial tree with a standard cytological brush, and a differential count was made of the different cell types. Smokers with chronic bronchitis had significantly more goblet cells (mean 20.0, SD 8.6), and less ciliated epithelial cells (mean 74.1, SD 9.4), than the healthy nonsmokers (mean 9.2, SD 3.9 and mean 84.7, SD 6.6, respectively). No such changes were found between the chronic bronchitis groups with or without infectious exacerbations. Thus, bronchial brush biopsies can be used as a complement to standard bronchial biopsies in the investigation of airway diseases other than pulmonary malignancies.

Biopsy↗
PubMed2004

[Effect of Eucalyptus globulus oil on lipopolysaccharide-induced chronic bronchitis and mucin hypersecretion in rats].

OBJECTIVE: To study the effect of Eucalyptus globulus oil on bronchiolitis and mucin hypersecretion in chronic bronchitis induced by lipopolysaccharide in rats. METHOD: Rat model was established by intratracheal instillation of lipopolysaccharide 0.2 mg. Pathological changes, alteration in bronchoalveolar lavage fluid (BALF) and immunohistochemistry characters were examined after 3 weeks and the effect of E. globulus oil was observed. RESULT: Characters of pathological manifestations of chronic bronchitis were found after instillation of LPS. Inflammatory cell infiltration and bronchiolitis severity were significantly reduced after administration of E. globulus oil. Especially in 300 mg x kg(-1) treated rats, there were significant decreases of mucin content in BALF and MUC5ac expression in trachea and bronchiole epithelium. Optical density and mucins area% detected by image analysis system were apparently lower than those in model group. CONCLUSION: E. globulus oil has the anti-inflammatory effect on chronic bronchitis induced by lipopolysaccharide in rats and the inhibitio effect on hypersecretion of airway mucins.

Animals↗
PubMed1992

The role of antibiotics in the management of acute exacerbation of chronic bronchitis (answers to some commonly asked questions).

More than 7 million Americans suffer from chronic bronchitis, and it has been estimated that each of these patients will experience between one and four acute exacerbations a year. This problem constitutes a major social and financial burden on our society. Despite the prevalence of this disorder there is still considerable disagreement among physicians as to appropriate treatment, especially with regard to the use of antibiotics. Though the role of antibiotics is unclear, the pharmaceutical industry is trying to obtain regulatory approval of several new antibiotics for use in exacerbations of chronic bronchitis. We examine the role of antibiotics in the management of chronic bronchitis.

Acute Disease↗