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PubMed1986

[Tissue respiration in chronic bronchitis].

Altogether 445 patients with chronic bronchitis were under observation. Changes in tissue respiration were monitored by shifts in the concentration of pyruvic and lactic acids, LDH and cytochrome c oxidase activity and changes in the concentration of indices of the thiol spectrum. The results obtained showed that chronic bronchitis during exacerbation was characterized by disorders of tissue respiration which did not return to normal even in the course of therapy; aerobic as well as anaerobic oxidation was disturbed. In 91 patients 10-year shifts in indices were detected, however they were less than during exacerbation. Disorders of tissue respiration can be caused by two factors: inflammatory intoxication of organs and tissues and chronic oxygen insufficiency in tissues. Drugs promoting normal tissue respiration are recommended for pathogenetic treatment of chronic bronchitis.

Adult↗
PubMed1988

[Chronic bronchitis. Development, prevention].

The adoption of an arbitrary epidemiological definition for chronic bronchitis has enabled some progress to be made in the understanding of the frequency and natural course of this disease. It is important to distinguish between chronic airflow obstruction and chronic hypersecretion of bronchial mucus. The prevalence of the disease can only be assessed in selective groups of the population and varies according to the characteristics of these groups, but is approximately 15% of men and 8% of women. There is relatively low mortality in France: 6/100,000 in 1985 and varies according to the departments, up to 38/100,000 inhabitants. These data ought to be interpreted with care and it is also important to take account of factors linked to their evolution. Longitudinal studies undertaken 20 years ago have allowed two hypotheses to be formulated to aid in a more precise understanding of the natural history of the disease: the first of these was the Dutch hypothesis which is currently undergoing a renewal of interest linked to epidemiological studies on HRB, and the English hypothesis which has the merit of emphasizing the principal risk factor in chronic bronchitis. Certain smokers are sensitive to tobacco, even though some others are not. Does the explanation of this lie in the relationship between obstructive ventilatory problems and bronchial hyper-reactivity? This association is discussed in the light of recent work as well as the relationship between bronchial hyperactivity, smoking and chronic bronchitis. Other risk factors have been studied: occupational hazards, air pollution and acute respiratory infections in childhood. But, in spite of all the work carried out to better define the risk factors and prognosis of the disease, this makes up a complex overall picture which is poorly understood and which should stimulate us to further research. The prevention of the disorder should be aimed at three levels; at the primary level (to prevent the appearance of the disorder) the only objective which may lead to a satisfactory solution in public health terms, a secondary level would be to identify those people or groups at special risk, but it is not recommended to undertake systematic examination of large populations in view of the fact that the early diagnosis of non-specific chronic pulmonary disease as well as special studies have not been shown to demonstrate the value of these procedures. The objective of prevention is to eliminate or neutralise factors linked to the disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1988

[Etiologic structure of exacerbations in chronic bronchitis].

The etiological appearance of exacerbations of chronic bronchitis was investigated in 117 patients. A combined study was aimed at the detection of viral, mycoplasmal, fungal and bacterial endobronchial infections. The etiological role of the latter was verified by a pathogen isolated from the sputum. Exacerbation of chronic bronchitis was determined by bacterial (79%) and/or viral (55%) infections, mostly by pneumococcal infection (45%), H. influenzae (30%), and influenza (31%). The role of pyogenic cocci was minimal (2%). Exacerbation of chronic purulent endobronchitis was more frequently caused by H. influenzae than in catarrhal bronchitis. In 9% of the patients the infectious etiology of an inflammatory bronchial process could not be established.

Antibodies, Bacterial↗
PubMed1988

Asthmatic bronchitis.

Asthmatic bronchitis is a term that encompasses a large number of patients who generally smoke cigarettes and demonstrates chronic mucous hypersecretion and airway hyperreactivity. These patients are frequently labelled simply as asthmatic. In this setting, however, "asthma" is a nonspecific term applied to patients with a variety of symptoms. On the basis of history, bronchodilator response, and response to bronchoprovocating agents, it is frequently difficult to differentiate between groups of chronic bronchitics and asthmatics. Subjects with chronic bronchitis clearly demonstrate bronchial hyperreactivity to bronchoprovocating agents. This response does not appear to be due to an abnormality in bronchial smooth muscle. Chronic bronchitics may also respond to a variety of bronchodilating agents, again demonstrating the presence of bronchial hyperreactivity. Potential mechanisms for the observed bronchial hyperreactivity include reduced airway caliber, reduced resistance to airway narrowing, and airway inflammation. Airway inflammation may be the common link between airflow obstruction and airway hyperreactivity frequently seen in these patients. The finding of airway hyperreactivity in chronic bronchitis has implications far beyond simple therapeutic considerations and may lead to a better understanding of bronchial hyperreactivity under any circumstance.

Asthma↗
PubMed1988

Leukocyte function and chronic bronchitis.

Chronic bronchitis is a condition of mucous hypersecretion. It represents an interface between airway structures, cigarette smoke, and inflammatory cells. Chronic bronchitis is a late complication of smoking, typically occurring after 30 pack years. Stable patients have mucous hypersecretion and little evidence of acute inflammation. In contrast, during acute attacks of bronchitis, an intense accumulation of neutrophils occurs in the airways. Mechanisms of injury to airway structures include chemicals and reactive oxygen species within cigarette smoke, and secreted products of recruited neutrophils. Recent studies demonstrate that secreted products of polymorphonuclear leukocytes (PMNs) can cause secretory cell metaplasia and increase mucous production. Thus, the role of the PMN in chronic mucous hypersecretion appears to be a significant one. Cessation of cigarette smoking remains a most important aspect of caring for patients with chronic mucous hypersecretion.

Animals↗
PubMedDate not supplied

Immunobiochemical evaluation of bronchoalveolar lavage (BAL) in atopic bronchial asthma, chronic bronchitis and bronchiectasis.

The protease-antiprotease balance and concentration of immunoglobulin was evaluated in some respiratory tract diseases. Analysis was carried out on 24 patients with atopic bronchial asthma, 21 with chronic bronchitis, 27 with bronchiectasis and 18 healthy smokers volunteers. In examination of BAL fluid some selective changes of proteolytic enzymes activities and concentrations of their natural inhibitors were documented. In atopic bronchial asthma the increased activity of acid protease, acid phosphatase and concentration of alpha-2-macroglobulin was the most characteristic. In chronic bronchitis there was an increase of acid protease, alkaline phosphatase and concentration of alpha-1-antitrypsin, haptoglobin, but in bronchiectasis the increase of neutral and acid proteases activities and concentration of all examined natural inhibitors was noted. The changes in concentration of IgA and IgG confirmed their participation in local defense response. All examined BAL enzyme activities and concentrations of inhibitors and immunoglobulins were compared with the results of the parameters in serum, mentioned above. The obtained finding supports the suggestion that the proteolytic enzymes, their natural inhibitors and immunoglobulins play an important role in the respiratory tract pathology. Immunobiochemical analysis of BAL in atopic bronchial asthma, chronic bronchitis and bronchiectasis may be useful for clinical prognosis and pharmacological treatment.

Adolescent↗
PubMed1987

Anticholinergic agents in chronic bronchitis and emphysema.

Inhaled anticholinergic agents produce as much absolute increase in airflow in chronic bronchitis as in asthma, namely about 0.2-0.3 litres increase in the FEV1 and a doubling of specific airways conductance. Their major advantage in bronchitis is due to the fact that adrenergic agents are relatively poor bronchodilators in this disorder. In bronchitis and emphysema a large number of studies suggest that anticholinergic agents not only are more potent than adrenergic agents but, when given in optimal dosage, achieve all of the available bronchodilatation in these patients. Possible reasons for this are suggested. Quaternary forms, such as ipratropium, have the additional advantage that they are poorly absorbed and thus produce no systemic side effects, giving them a very wide therapeutic margin. This makes them particularly suitable for the older population of which bronchitics are composed, and who are prone to side effects from atropine itself and from other classes of bronchodilators. They can be considered as first line therapy for the relief of symptoms on a day-to-day basis in this group of patients. They may also have a role in the management of acute exacerbations of airways disease, but this has not yet been fully established.

Bronchitis↗
PubMed1988

[Prevention of infections in chronic bronchitis using vaccination and/or immunomodulation].

Polyvalent antimicrobial vaccines have been widely used in chronic bronchitis for nearly fifty years without their effect or mechanism of action always being well understood. The polysaccharide vaccines, in particular pneumococcal, are better defined chemically and in their mode of action. However, it does not seem that ordinary chronic bronchitis is a good indication for these vaccines. The immunomodulators, extracts of the cell wall of certain bacteria, are aimed at increasing the host's defence capacity in a non-specific manner. The addition of ribosomes may favour specific and non-specific immunomodulation. Certain vaccines have shown their efficacy in reduction of infective episodes in chronic bronchitis. However, other studies ought to be undertaken to obtain purified products which are not toxic and are yet more effective. Finally, it is necessary to have better knowledge of the mode of administration and of the doses administered corresponding to the optimal efficacy of the vaccines.

Adjuvants, Immunologic↗
PubMed1988

[Comparison of parietal smear cytology (nose/bronchus) with bronchoalveolar lavage in children with asthma and chronic bronchitis].

The aim of the study was the cytologic evaluation of both the analysis of nasal and bronchus smears compared with that of the bronchoalveolar lavage (BAL). 137 children (age: 4.8 years; 4 months - 17 years) with chronic nonspecific respiratory diseases (CNSRD) undergoing bronchologic examinations in general anesthesia were divided into 4 groups: relapsing bronchitis (n = 19), chronic bronchitis (n = 26), relapsing or chronic obstructive bronchitis (n = 81) and bronchial asthma (n = 11). Only the smear cytograms (nose, bronchus) enabled to detect allergic patients with bronchial asthma (p less than 0.001) in form of a significant eosinophilia. In contrast, BAL cytograms were too insensitive to detect eosinophilia. The BAL may be helpful in cases of interstitial lung diseases (sarcoidosis, alveolitis, lung fibrosis).

Adolescent↗
PubMed1987

Prevalence of serum precipitins against microbes in mouldy hay, and of chronic bronchitis and farmer's lung with respect to farmers' occupational health hazards.

During the farmers' occupational health study 1979-82, the work conditions of 3,358 randomly selected farmers were investigated with respect to occurrence of work-related health hazards. The farmers also underwent a health examination in their local health centre, and precipitating antibodies against four microbes present in mouldy hay were analyzed. Results of the precipitin tests and the symptoms of chronic bronchitis and farmer's lung were analyzed with respect to the occurrence of work-related exposures to biological agents and dust in farming. The prevalence of antibodies against Aspergillus umbrosus was largest (6.9%) among farmers with biological health hazards. The occurrence of antibodies against any of the four microbes was associated more with work-related biological agents than with dust exposures. Chronic bronchitis and farmer's lung were also more common among farmers with exposures to biological agents and dust than among those without such exposures. The work conditions were investigated independently of the results of the health examinations. Occurrence of chronic bronchitis and farmer's lung are associated with the work-related health hazards in farming. For proper delivery of occupational health services methods of investigating work-related health hazards need to be improved.

Antibodies, Bacterial↗
PubMed1986

[Seasonal fluctuations of the indicators of cellular and humoral immunity in persons with prenosological and nosological manifestations of chronic bronchitis].

A study was made of the tissue and humoral immunity in 276 persons with prenosological and nosological signs of chronic bronchitis among the indigenous population as well as in newcomers living under the conditions of ultracontinental climate. Seasonal fluctuations of indices of the cellular and humoral immunity were more noticeable in the former than in the latter. Persons with prenosological signs of bronchitis were characterized by less pronounced tension of the cellular immunity in autumn than healthy people whereas considerable inhibition of the cellular immunity and change in the rhythm of its seasonal fluctuations were noted in patients with chronic bronchitis.

Acclimatization↗
PubMed1986

[Incidence of chronic bronchitis in foundry workers].

A report about examinations of foundries' workers who live in the destrict Schwarzenberg is given. Hereby the prevalence of chronic bronchitis should be analyzed in comparison to nonexposed controls. In result 21.1% among foundries' workers and 10.2% among controls had symptoms of chronic bronchitis. The differences are significant. As expected it could be shown, that smoking habits and age are further factors for development of chronic bronchitis. Both the observance of occupational limit-values for dusts and other harmful materials at the work place, which have effects on the respiration system, and the medical survey of workers with the use of special methods for examination of respiratory system are necessary. In workers with findings of respiratory system the factory doctors and pulmonary physicians have to decide together the ability to work in the foundry.

Adult↗
PubMed1979

[Effects of beta blockaders on ventilatory function in chronic bronchitis].

This study was carried out to determine whether beta blockers could be prescribed for patients with coronary insufficiency and chronic bronchitis. The effects of intravenous infusions (30 mn) of propranolol (30 micrograms/kg), practolol 90 micrograms/kg), atenolol (90 micrograms/kg) and acebutolol (150 micrograms/kg) on vital capacity and expiratory flow rates were investigated in chronic bronchitics. Propranolol (n = 51) moderately reduced the vital capacity and FEV1, by an average 9% and a maximum of 20%. The three other infused agents given to groups of 10 patients did not change the ventilatory function. When the same patients were investigated by cross over with propranol bronchoconstriction was observed. This effect was seen in all stages of chronic bronchitis but was much less severe than in a group of 50 asthmatic patients (-23%). The respiratory tolerance of the cardioselective beta blockers seems to be better but there is considerable individual variation and the diagnosis between asthma and chronic bronchitis may itself be very difficult.

Acebutolol↗
PubMed1987

Diagnosis and management of acute bronchitis and pneumonia in the ambulatory setting.

Acute bronchitis and pneumonia are frequently encountered by primary care providers in an outpatient setting. The primary care nurse practitioner plays an active role in the diagnosis and management of acute bronchitis and pneumonia. Certain elements of the history and physical examination help separate infectious causes of acute cough from non-infectious causes. If an infectious cause is established by etiology, history and physical factors also help to identify whether acute bronchitis or pneumonia is present. Certain diagnostic tests are necessary to aid in making the diagnosis and in establishing the causative agent upon which the appropriate therapy is based. The primary care nurse practitioner must also be attuned to identifying those clients in whom respiratory illness can be a severe syndrome necessitating hospitalization and those for whom vaccination is recommended. This article addresses the practice needs of the clinician.

Acute Disease↗
PubMed1986

[Lysozyme level and rheological properties of the sputum in patients with chronic bronchitis].

The authors presented some data on the lysozyme content and adhesion features of the sputum in 31 patients: 19 patients with chronic obstructive bronchitis and 12 patients with chronic bronchitis against a background of bronchial asthma. Marked reverse correlation between the lysozyme content and sputum adhesion values (r = -0.79) was found. With the subsiding of exacerbation and remission occurrence the lysozyme content increased and a sputum adhesion value reduced. In the exacerbation phase the mean lysozyme content in the sputum was 3.6 +/- 0.1 mg/mg of protein, and in remission occurrence 6.9 +/- 0.2 mg/mg of protein. The adhesion value was 0.6 X 10(4) +/- 0.22 X 10(4) N/m2 and 0.32 X 10(4) +/- 0.01 X 10(4) N/m2, respectively. The time course of the lisozyme content in the sputum of patients with chronic bronchitis can be used as a prognostic factor to assess remission occurrence rates and the nature of change of rheological features of the sputum.

Adhesiveness↗
PubMed1986

[Etiology of acute bronchitis in adults].

A total of 126 adult patients with acute bronchitis were subjected to microbiological, virological and immunological examination. Influenza and other acute respiratory viral infections were detected in 104 (82.5%) cases of acute bronchitis. The results of microbiological examination and the study of local and systemic immunity showed that in 94.4 +/- 2.6% of the patients the development of acute bronchitis was linked with the appearance of acute pneumococcal infection irrespective of the presence, or absence, of virologically and serologically confirmed acute viral or mycoplasmal infections.

Acute Disease↗
PubMed1985

[Relation between serum and salivary IgA and oral aerobic bacterial flora in patients with chronic bronchitis].

Serum and salivary IgA and oral bacterial flora was determined in specimens collected from 28 patients with chronic bronchitis and 7 healthy persons. However, in serum IgA levels, the difference between the patients and controls was not found statistically significant, the mean salivary IgA level was significantly higher in the patients with spastic bronchitis than in infectious bronchitis and controls (p less than 0.01). The mean salivary IgA level was significantly higher in the patients from whom Haemophilus influenzae was isolated, it was lower in the specimens in which gram negative bacilli were isolated (p less than 0.01).

Bronchitis↗
PubMed1985

Recurrent acute bronchitis: the association with undiagnosed bronchial asthma.

Forty-six consecutive patients with a history of recurrent acute bronchitis (chest colds) referred from primary care clinics were studied prospectively to determine if hyperreactive airways (mild bronchial asthma) was a concomitant entity. Mild bronchial asthma was diagnosed in 30/46 (65%) patients by history, physical examination, and routine spirometry, or by methacholine bronchial provocation. The incidence of mild bronchial asthma was markedly increased in patients with a history of recurrent acute bronchitis over that seen in the general population. These results emphasize a need to investigate an underlying cause in patients with recurrent acute bronchitis.

Acute Disease↗