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At least 811 records · Page 45Linked to original sources
PubMed1988

Investigation into the effect of Fenoterol on mucociliary clearance in patients with chronic bronchitis.

We investigated the effect of Fenoterol, a selective beta 2 adrenoceptor stimulant, on mucociliary clearance in 12 patients with chronic bronchitis. Mucociliary clearance was measured with a scintillation camera after inhalation of a 99mTc labelled aerosol. Fenoterol was administered one h after acquisition commenced and imaging was maintained for a further two h. Three regions of interest (ROI) were selected over each lung to generate time activity curves. Corrections for decay, alveolar deposition (using 24 h image), cough and movement of activity through each ROI were carried out. An exponential function was fitted to the clearance curves to determine clearance rates. The increase in percentage clearance after Fenoterol administration for the left and right whole lung ROI was 35% and 36% per h respectively (P = 0.006 and 0.020). Fenoterol enhances cilial clearance in chronic bronchitis patients.

Adult↗
PubMed1981

Antigen requirements and specificity of a microplate enzyme-linked immunosorbent assay (ELISA) for detecting infectious bronchitis viral antibodies in chicken serum.

The conditions of a rapid, indirect-enzyme linked immunosorbent assay for Infectious Bronchitis Virus (IBV) antibodies have been established. Optimal sensitivity was obtained using 10 micrograms/ml protein concentration of the Mass 41 strain purified from infected allantoic fluid. Specificity was demonstrated with Newcastle Disease Virus (NDV) antigen-antibody system. Negligible crossreactions were observed. After bromelain or lipase treatment IBV had an ELISA reactivity similar to untreated particles suggesting that peripheral constituents of IBV play a minor role when whole virus is absorbed on solid phase. The method offers a simple and specific antibody assay which could be used for the laboratory diagnosis of avian infectious bronchitis.

Animals↗
PubMedDate not supplied

Rufloxacin once daily in acute exacerbations of chronic bronchitis.

In this open study the efficacy and tolerability of rufloxacin in a single dose of 400 mg the first day and 200 mg the nine consecutive days was studied in 26 patients with an acute exacerbation of chronic bronchitis. Twenty-two patients were evaluable for efficacy. Four patients stopped treatment prematurely after five days because of clinical cure. At the enrollment visit a pathogen was isolated in the sputum sample in 19 of 22 evaluable patients. The predominant pathogens were Streptococcus pneumoniae and Moraxella catarrhalis. In 17 of these 19 bacteriologically evaluable patients the initial infecting organism was eradicated from specimens obtained within 48 hours after the end of therapy. There was one case of persistent infection caused by S. pneumoniae (MIC 4 mg/l), one patient had a superinfection with Serratia marcescens (MIC 1 mg/l) susceptible to rufloxacin and therapy was stopped after five days due to clinical failure. One week after the end of therapy, 15 patients remained free from infection whilst one patient experienced reinfection with Klebsiella pneumoniae (MIC 0.5 mg/l). Clinical cure or improvement was observed in 21 of 22 patients. Mild adverse events were reported by two of 26 enrolled patients. In one patient, complaining of headache and dizziness, the adverse events were considered possibly study drug related. No abnormal laboratory findings were reported. Nadir plasma levels of rufloxacin were measured and no accumulation in plasma was observed during treatment. A ten day course of an oral single dose of rufloxacin proved efficacious and was well tolerated in patients with an acute exacerbation of chronic bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Quinolones↗
PubMed1979

A clinical comparison of ampicillin, ampicillin esters (bacampicillin and pivampicillin) and amoxycillin in acute exacerbations of chronic bronchitis.

The results of antibiotic therapy in 271 patients suffering from acute exacerbations of chronic bronchitis are presented. The effectiveness of the better absorbed ampicillin esters (pivampicillin and bacampicillin) is confirmed, but side-effects from the pivampicillin present problems whereas bacampicillin is excellently tolerated, even in twice daily doses of 1600 mg. Amoxycillin, if given in 750 mg doses three times daily by mouth, is also safe and effective against Haemophilus influenzae. However, if accurate MIC results are not available for both ampicillin and amoxycillin, the lesser degree of sensitivity to amoxycillin suggests that use of an ampicillin ester (such as bacampicillin) is to be preferred. Prophylactic use of antibiotics in chronic bronchitis patients does not seem logical to us.

Acute Disease↗
PubMedDate not supplied

Clarithromycin 250 mg b.i.d. for 5 or 10 days in the treatment of adult patients with purulent bronchitis.

This Phase III, double-blind, randomized, multicenter study compared the safety and efficacy of clarithromycin, 250 mg b.i.d. administered for either 5 or 10 days, in the treatment of 221 adult patients with purulent bronchitis. Clinical evaluations were performed pre-treatment, during treatment, post-treatment, and at a follow-up visit. Both regimens were well tolerated and effective. No significant differences were observed between patients treated for 5 days and those treated for 10 days in post-treatment, clinical success (98%, 83/85; 99%, 73/74, respectively), or bacterial eradication (100%, 37/37; 94%, 33/35) rates, or in the number of patients reporting drug-related adverse events (16%, 18/112; 24%, 26/109, respectively). Clarithromycin administered for 5 days was at least as safe and as effective as a 10-day regimen in the treatment of purulent bronchitis.

Adolescent↗
PubMed1989

Mediator release from human lung mast cell subtypes in chronic bronchitis and emphysema.

Human lung mast cells were obtained from pulmonary tissue of normal individuals and patients with chronic bronchitis or emphysema by enzymatic dispersion. Based on their density two mast cell subtypes, a formalin-sensitive (FS) and a formalin-insensitive (FI) cell type, could be separated. Although differences in anti-IgE-induced histamine release could be demonstrated for the mast cell subtypes of normal individuals, these experiments could not be performed for both mast cell subtypes from both patient groups. LTC4 and PGD2 release could be demonstrated for the FS- and FI-mast cell respectively. The release of PGD2 from FI-mast cells of patients with chronic bronchitis was enhanced as compared with normal subjects.

Aged↗
PubMed1991

Treatment of chronic bronchitis with terbutaline inhaled from a cone spacer with and without positive expiratory pressure.

Patients with chronic bronchitis were randomly allocated to 4 weeks treatment with terbutaline 0.5 mg inhaled through a cone spacer with an expiratory resistance creating a positive expiratory pressure (+PEP group) or without (-PEP group). The patients recorded their symptoms in a diary and peak expiratory flow (PEFR) was measured before and after each inhalation. PEFR increased significantly after inhaled terbutaline both with and without PEP. The mean increase in PEFR after terbutaline inhalations was significantly greater (p less than 0.0001) in the +PEP group (24 L/min) compared to the -PEP group (17 L/min). The +PEP group had less sputum and less difficulty with coughing up sputum compared to the -PEP group. This study showed a small but significant enhancement of the bronchodilation and a beneficial effect on symptoms when inhalation of beta-2-agonist was combined with PEP in patients with chronic bronchitis.

Bronchitis↗
PubMed2005

[Chronic bronchitis, COPD].

Chronic bronchitis is part and precursor of COPD, a complex disease triggered mostly by exposure to cigarette smoke. However COPD develops only in patients with specific susceptibility probably determined by genetic factors or additional risk factors. A specific type of inflammation resides in the bronchial and bronchiolar walls, that infers damage not only to airway structure but also to surrounding alveolar attachments and thus to the lung parenchyma. Chronic bronchitis, fibrosing bronchiolitis and emphysema constitute the three main stems of pathology of the disease but may coexist with varying extent. The clinical picture is therefore quite variable. Treatment exists largely in bronchodilation combining different mechanisms and using long acting drugs usually applied by inhalation. Acute exacerbations promote progression of the disease, which must be counteracted by adaptation and intensification of therapy, in some cases including non invasive or invasive ventilation. Several non-pharmacologic measures such as smoking cessation, rehabilitation, nutritional support, long term oxygen therapy, lung volume reduction and possibly lung transplantation may be available for appropriate patients and have to be considered.

Air Pollutants↗
PubMed2003

Resolution of plastic bronchitis with atrial pacing in a patient with fontan physiology.

We describe a 5-year-old boy with Fontan physiology and a ventricular pacemaker who developed severe plastic bronchitis. Evaluation by cardiac catheterization revealed profoundly altered hemodynamics, which improved with atrial pacing. Following implantation of an atrial pacemaker, which restored atrioventricular (A-V) synchrony, the patient's hemodynamics greatly improved and his plastic bronchitis resolved.

Bronchitis↗
PubMedDate not supplied

Fenestration of the Fontan circuit as treatment for plastic bronchitis.

Plastic bronchitis is a rare, potentially life-threatening condition in which protein casts form within and occlude the bronchus, resulting in pulmonary failure, and has been identified as a complication after the Fontan procedure. We present a case of a 5-year-old girl who had undergone an extracardiac fenestrated Fontan repair as a component of staged palliation for tricuspid atresia. Six weeks following surgery, the patient presented with airway obstruction, coughing a bronchial cast. Medical therapies to optimize heart function and attempt to control cast formation were implemented, with little clinical impact. Following cardiac catheterization to stent open the fenestration, the symptoms of plastic bronchitis resolved. Cast expectoration recurred following spontaneous closure of the stented fenestration and again resolved with recreation of the baffle defect. Fenestration of the Fontan circuit alters hemodynamics, thereby providing an additional therapeutic option for this devastating disorder.

Airway Obstruction↗
PubMed2000

Pseudomembranous aspergillus bronchitis in a double-lung transplanted patient: unusual radiographic and CT features.

Pseudomembranous aspergillus bronchitis is considered as an early form of invasive pulmonary aspergillosis, a well-known airway infection in immunocompromised patients. Radiologic features concerning invasive aspergillosis of the airways have been reported. However, we describe here an unusual feature of invasive aspergillus bronchitis, never reported to date, observed in a double-lung transplanted patient. Chest radiograph and CT revealed significant peribronchial thickening without any parenchymal involvement.

Adult↗
PubMed2003

Chronic bronchitis in immunocompromised patients: association with a novel Mycoplasma species.

Patients with primary antibody deficiency are prone to recurrent bronchitis, often caused by nonencapsulated Haemophilus influenzae and streptococcal infection. Productive cough often persists even after elimination of these organisms with antibiotics. During an investigation into the cause of unexplained chronic bronchitis in these patients, a novel Mycoplasma species (designated A39) was first isolated from the sputum of a man with X-linked agammaglobulinaemia. Screening of sputa from a further 45 patients with primary antibody deficiency showed that 10 were positive for a similar organism using culture and/or a polymerase chain reaction based on sequences within the 16S ribosomal RNA gene. A comparison of the sequence data showed that the organism was distinct from but similar to Mycoplasma pneumoniae and other closely related mycoplasmas found in humans and animals. Electron microscopy showed some unique morphological characteristics. Although respiratory symptoms improved after elimination of A39 from the sputum of the patient with X-linked agammaglobulinaemia, further work is needed to establish the organism as a pathogen.

Adult↗
PubMed1991

Treatment of acute exacerbations of chronic bronchitis: state of the art.

Effective treatment of acute bacterial exacerbations of chronic bronchitis (ABE) reduces the number of such exacerbations in such patients and may decrease or eliminate background symptoms and improve pulmonary function. The pathologic and physiologic abnormalities of the bronchial system in chronic bronchitis that predispose to bacterial infection probably include impaired mucociliary clearance, obstructed bronchioles, and bacterial infections of the bronchial epithelium. Exacerbations of bronchopulmonary symptoms are usually observed with ABE, although these symptoms are not unique to ABE. While culture and sensitivity testing is not usually required, microscopic examination of sputum is critical to determine the presence of bacterial infection. Bacteria in numbers significantly above the levels present when the patient's condition is stable and at least a doubling of the sputum neutrophil inflammatory level are essential criteria. Bacterial species observed with ABE include Haemophilus influenzae, Haemophilus parainfluenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Neisseria species, with a lesser incidence of Klebsiella and Pseudomonas species. One or more elements of background therapy for ABE should accompany antimicrobial therapy, for example, physiotherapy, bronchodilators, and so forth. Ampicillin is effective, safe, economical, and thus remains the drug of choice for ABE. Quinolones are an effective alternative when ampicillin cannot be tolerated or if organisms are resistant. Dosing is at the upper range of recommendations, and the chosen drug should be given for a 10-14-day regimen. Patients should be reevaluated if symptoms and physical findings do not return to baseline after 5-7 days.

Acute Disease↗
PubMed1991

Use of quinolones for the treatment of acute exacerbations of chronic bronchitis.

The availability of a new generation of quinolones expands the choices of antimicrobials for therapy of acute exacerbations of chronic bronchitis. These agents have broad antimicrobial activity, including good in vitro activity against respiratory pathogens, and advantageous pharmacokinetic characteristics, including bronchial tissue penetration. Ciprofloxacin, enoxacin, ofloxacin, and temafloxacin have been evaluated in a number of clinical trials, compared to the reference agents ampicillin, amoxicillin (with and without clavulanate), cefaclor, doxycycline, and erythromycin. Ciprofloxacin, ofloxacin, and temafloxacin have generally demonstrated greater clinical success than enoxacin. While these agents are effective against many respiratory pathogens, Streptococcus pneumoniae and Pseudomonas aeruginosa infections appear to pose problems. Temafloxacin and ciprofloxacin have been compared; temafloxacin eradicated S. pneumoniae more efficiently and did not interact with theophylline. Fluoroquinolones are an important addition to the agents useful for bacterial exacerbations of chronic bronchitis.

Acute Disease↗
PubMed1992

Lomefloxacin versus amoxicillin in the treatment of acute exacerbations of chronic bronchitis: an Italian multicenter study.

Nine centers in Italy participated in a worldwide, multicenter study comparing the effectiveness and safety of lomefloxacin and amoxicillin in patients with acute exacerbations of chronic bronchitis caused mainly by gram-negative pathogens. The 157 enrolled patients received either 400 mg lomefloxacin once daily (n = 78) or 500 mg amoxicillin every 8 hours (n = 79) for 7-10 days. A total of 131 patients were evaluable for bacteriologic efficacy and 154 for clinical efficacy. At 2-4 days after the conclusion of treatment, the bacterial eradication rate was 84.8% for lomefloxacin-treated patients and 64.6% for amoxicillin-treated patients (p = 0.0065); the clinical success rate (cure plus improvement) for lomefloxacin was 94.7% and for amoxicillin was 83.3% (p = 0.0212). The reinfection rate was lower in the lomefloxacin group than in the amoxicillin group (3.0% vs 13.8%, p = 0.0382). Both drug regimens were well tolerated. Once-a-day treatment with 400 mg lomefloxacin was more effective than 500 mg amoxicillin three times daily for the treatment of acute exacerbations of chronic bronchitis caused by gram-negative pathogens.

Acute Disease↗
PubMed1992

Safety and efficacy of lomefloxacin versus cefaclor in the treatment of acute exacerbations of chronic bronchitis.

In two multicenter trials, lomefloxacin and cefaclor were compared as treatments for acute bacterial exacerbations of chronic bronchitis. In total, 522 adult outpatients were enrolled at 50 centers in the United States. Patients were randomized to treatment groups receiving either 400 mg lomefloxacin orally once daily (n = 259) or 250 mg cefaclor every 8 hours (n = 263) for 7-10 days. Both groups were comparable in terms of age, severity of exacerbation, smoking history, theophylline use, and baseline pathogens. The most common baseline pathogens were Haemophilus influenzae, found in 32% of patients in the lomefloxacin group and in 29% in the cefaclor group, Pseudomonas aeruginosa (13% and 16%, respectively), Moraxella (Branhamella) catarrhalis (12% and 13%), and Streptococcus pneumoniae (10% in both groups). Bacterial eradication rates 1-4 days after the completion of treatment for all patients with baseline pathogens were 81.8% in the lomefloxacin group and 62.7% in the cefaclor group (p less than 0.001). Clinical success (disappearance or improvement of presenting signs and symptoms) was noted in 80.0% of patients in the lomefloxacin group and 64.7% in the cefaclor group (p = 0.002). Eradication rates for the subgroup of patients who had pathogens susceptible in vitro to both study drugs and who completed treatment were 97.1% for lomefloxacin and 84.6% for cefaclor (p = 0.002). Clinical success rates in this subgroup were 92.4% for lomefloxacin and 90.1 for cefaclor (p = 0.585). Treatment-related adverse events were reported for 7% of patients in the lomefloxacin group and 5% in the cefaclor group. The most common adverse events in both groups were nausea and diarrhea. Six patients were withdrawn from treatment with lomefloxacin and four from the cefaclor group because of adverse events. There was no clinical or laboratory evidence of theophylline interaction with either treatment. Once-daily oral administration of 400 mg lomefloxacin was an effective, well-tolerated alternative to 250 mg of cefaclor three times daily in the treatment of acute exacerbations of chronic bronchitis.

Acute Disease↗
PubMed1992

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

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

Acute Disease↗
PubMed1981

A comparison of antibody responses to Admune inactivated influenza vaccine in serum and respiratory secretions of healthy non-smokers, healthy cigarette-smokers and patients with chronic bronchitis.

Admune inactivated influenza vaccine was administered intramuscularly to 31 healthy subjects (18 non-smokers and 13 cigarette smokers) and 30 patients with chronic bronchitis. Homologous haemagglutination inhibition (HI) antibody titres were measured in serum and respiratory secretions over a three-month post-vaccination period. Clinical reactions to the vaccine were recorded during the week following vaccination. Among healthy subjects cigarette smoking did not influence HI antibody responses in serum and nasal secretion following vaccination. Chronic bronchitics produced at least as much serum and nasal antibody as healthy subjects and their sputum and nasal secretion antibody responses were comparable. Clinical reactions to the vaccine were mild and well tolerated in all groups but seven patients with chronic bronchitis (23%) experienced increased respiratory symptoms during the week following vaccination.

Adult↗