Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bronchitis”

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

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

At least 1,045 records · Page 58Linked to original sources
PubMed1999

Economic evaluation of ciprofloxacin compared with usual antibacterial care for the treatment of acute exacerbations of chronic bronchitis in patients followed for 1 year.

OBJECTIVE: To undertake a 1-year prospective economic evaluation of ciprofloxacin compared with usual antibacterial care (any antibacterial other than a quinolone) for the treatment of acute exacerbations of chronic bronchitis (AECB) in adults presenting with a type I or type II AECB. DESIGN: Patients entered the study with an initial AECB and were randomised to the ciprofloxacin group or the usual care group. The following measurements were taken at the end of each AECB and every 3 months: resource utilisation, St. George's Respiratory Questionnaire, Nottingham Health Profile and Health Utilities Index (HUI). The following additional measurements were taken after each AECB: AECB-symptom days and willingness to pay to avoid the AECB. Economic evaluations were performed from the societal viewpoint and the viewpoint of a major third-party payer. Cost-effectiveness analysis was based on cost per AECB-symptom day averted; cost-utility analysis (CUA) was based on cost per quality-adjusted life-year (QALY) gained using the HUI as the basis for calculating QALYs. Cost-benefit analysis was based on the willingness-to-pay (WTP) data. SETTING: This was a study of outpatients enrolled from 46 family physicians and 2 respirologists in Ontario (29 sites) and Québec (19 sites), Canada, between November 1993 and June 1994. PATIENTS AND PARTICIPANTS: 240 adult male and female patients aged > or = 18 years with chronic bronchitis. MAIN OUTCOME MEASURES AND RESULTS: WTP data did not pass scope tests for reasonableness. Ciprofloxacin was more costly and provided better outcomes compared with usual antibacterial care. The base-case results are as follows (1994/1995 values): the incremental annual cost was 578 Canadian dollars ($Can) from the societal viewpoint and $Can840 for the third-party payer; the cost-effectiveness ratio per AECB-symptom day averted was $Can209 from the societal viewpoint and $Can304 for the third-party payer; the cost-utility ratio per QALY gained was $Can18,600 from the societal viewpoint and $Can27,000 for the third-party payer. According to Laupacis criteria, these CUA results are strong evidence in favour of adoption from the societal viewpoint and moderate evidence in favour from the viewpoint of the third-party payer. A subgroup analysis suggests that ciprofloxacin may be particularly cost effective, even 'win-win', in patients with more severe disease. CONCLUSIONS: The sensitivity analyses indicate that the results are relatively robust. Nevertheless, the statistical uncertainty in the results is sufficient that the findings cannot be accepted unequivocally. A further study with a larger sample size would be useful to confirm (or deny) the findings of this study.

Adult↗
PubMed2007

Determining factors in the prescription of moxifloxacin in exacerbations of chronic bronchitis in the primary-care setting.

OBJECTIVE: To describe the characteristics of patients and exacerbations that may determine the choice of an antibacterial in exacerbations of chronic bronchitis (ECB). METHODS: This was a multicentre, observational study in ECB. A group of 225 primary-care practitioners were randomly selected to include 1007 patients. A logistic regression model was used to identify the characteristics of the physicians, patients and exacerbations associated with the choice of an antibacterial. RESULTS: The mean age of the patients was 67.6 years (+/- SD 11) and 72.1% were male. In 91.4% of patients, the exacerbation was type I or II according to Anthonisen's classification. Most exacerbations (68.2%) were treated with moxifloxacin while only 31.8% were treated with other antibacterials. The more experienced practitioners (those with the longest professional careers and those who had higher numbers of patient-visits for chronic bronchitis) prescribed moxifloxacin more frequently (per each year of experience: OR 1.05; 95% CI 1.02, 1.07; per each additional patient-visit per week: OR 1.02; 95% CI 1.003, 1.04). The probability of receiving moxifloxacin increased with the severity of baseline dyspnoea (OR 1.94; 95% CI 1.27, 2.96) and decreased in smokers (OR 0.54; 95% CI 0.36, 0.81) and in patients receiving oral corticosteroids (OR 0.61; 95% CI 0.41, 0.90). CONCLUSIONS: Prescription of moxifloxacin in primary care is significantly associated with more years of physician practice and with a higher severity of disease. The use of oral corticosteroids in exacerbations is commonly associated with other antibacterials (non-quinolones), either to improve antibacterial efficacy or because of doubtful bacterial aetiology, thus the preference for a narrow-spectrum antibacterial combined with an anti-inflammatory drug.

Adrenal Cortex Hormones↗
PubMed1995

Budgerigar breeders' hypersensitivity pneumonitis presenting as chronic bronchitis with purulent sputum.

A 49-year-old woman complained of cough and a purulent sputum (about 40 ml/day). She kept budgerigars for a period of 30 years, she first noticed a productive cough 10 years previously. Her chest roentgenogram revealed a diffuse reticulonodular pattern. She was diagnosed as having a chronic type of budgerigar breeder's lung associated with chronic bronchitis. Peptostreptococcus anaerobius was cultured from her sputum, bronchoalveolar lavage fluid, as well as from droppings of her budgerigar. This is the second case of hypersensitivity pneumonitis presenting as chronic bronchitis with much sputum in Japan.

Animals↗
PubMedDate not supplied

[Mucoregulators in acute bronchitis syndromes: focus on use by general practitioners and data from the literature].

Antibiotics have long been used in the initial treatment of acute bronchitis (AB) and acute exacerbations of chronic bronchitis (AECB). However, their lack of value in AB has been clearly demonstrated and antibiotic therapy is justified in only a few cases of AECB. In parallel, although the value of mucoregulators in these diseases is still debated, their prescription remains important in general practice. In this context, our aim was to determine the prescribing behaviour of general practitioners (GPs) with regard to these drugs, as well as the beliefs of GPs concerning the place of mucoregulators in the treatment of AB in children and adult smokers, as well as in patients with non-obstructive AECB. A survey was carried out in 370 GPs, who were presented with three standardised and computerised medical cases: (i) rhinopharyngitis + AB in a child; (ii) AB in an adult smoker without a previous medical history; and (iii) a patient with non-obstructive AECB. The results showed that mucoregulators are frequently prescribed by GPs for children and adults with AB, or in AECB. This high prescribing rate is due to the belief of the GPs that these drugs are effective and well tolerated, which is confirmed by the literature. Their use avoids the frequent and unjustified prescription of antibiotics in situations where they are not recommended but where the patients request drug therapy.

Acute Disease↗
PubMed1993

Wrong-way swallowing as a possible cause of bronchitis in patients with gastroesophageal reflux disease.

A new theory was tested that swallowing the wrong way is the cause of the strong correlation between bronchial symptoms and gastroesophageal reflux disease (GERD). One hundred and nineteen patients who were operated on for hiatal hernia and GERD were compared with 89 patients treated with the proton pump inhibitor omeprazole concerning bronchial symptoms before and after treatment. Both groups had a frequency of cough of 34% before treatment. Omeprazole did not give any significant relief of cough, whereas patients who were operated on with fundoplication and crural repair showed a highly significant reduction of cough and bronchitis. It is believed that the distal anchoring of the longitudinal esophageal muscle by surgery improves esophageal transit and restores the delicate coordination in the swallowing centre between deglutition, the opening of the upper esophageal sphincter, and the epiglottic closure of the laryngeal entrance. It is concluded that the main reason for chronic bronchitis in patients with GERD is intermittent aspiration due to partial mis-swallowing.

Bronchitis↗
PubMed1988

Transition from normal to hypersecretory bronchial mucus in a canine model of bronchitis: changes in yield and composition.

Density-gradient analysis was used to follow the transition from normal to hypersecretory bronchial mucus in a model of bronchitis induced in dogs by chronic exposure to SO2 gas. Aspirates of saline bronchial lavage were obtained by fiberoptic bronchoscopy from dogs before, during a 6- to 9-month exposure period to SO2 gas, and during a recovery period of similar duration. Prior to SO2 exposure, aspirates from all animals had a low yield of nondialyzable macromolecules (15 +/- 6 mg/aspirate) and similar composition. Specifically, epithelial glycoprotein of typical buoyant density was not detected; rather a glycoconjugate of higher buoyant density with features of both proteoglycan and glycoprotein was identified. Neutral lipids were predominant with lesser amounts of phospholipids; no glycolipids were detected. During the SO2 exposure period, aspirates from five of the eight dogs contained components similar in buoyant density to human bronchitic glycoprotein. Glycoprotein isolated from the canine aspirates was similar to glycoprotein isolated from human chronic bronchitic sputum, having the same carbohydrate composition and range of oligosaccharide size. Further, during and after SO2 exposure some aspirates contained appreciable amounts of glycolipids. These data demonstrate substantial similarities in composition between normal human and canine mucus and in mucus isolated from dogs with chronic airway inflammation induced by repeated irritant exposure and from human patients with chronic bronchitis.

Animals↗
PubMed1988

Asthma and wheezy bronchitis in adolescents: biosocial correlates.

This study examined the epidemiological aspects of asthma and wheezy bronchitis at 16 years of age in children of a large British National cohort previously studied at the time of birth and when they were 7 and 11. It confirmed, for age 16, the steady decline in numbers of children suffering from asthma or wheezy bronchitis previously seen between ages 7 and 11. Significantly more boys than girls continued to report having these ailments. At age 16, children with asthma were more likely than those without to suffer from such allergy-related conditions as eczema and to come from homes where the principal wage-earner has a nonmanual job and where both mother and child smoke.

Absenteeism↗
PubMed1992

Amoxicillin in treatment of acute uncomplicated exacerbations of chronic bronchitis. A double-blind, placebo-controlled multicentre study in general practice.

The aim of the study was to evaluate whether a broad-spectrum penicillin, amoxicillin, was superior to placebo in resolving symptoms of acute exacerbations of chronic bronchitis in patients from general practice. 131 general practitioners included 278 patients over a period of 30 months. The patients were randomly assigned to treatment with amoxicillin 750 mg b.i.d. or corresponding placebo for 7 days. Patients with pneumonia, a temperature above 38.5 degrees C or heart rate over 100 were excluded for safety reasons. The main effect parameter--the doctors' overall evaluation of the treatment--did not demonstrate any statistically significant difference between amoxicillin or placebo, 63% versus 64% of the patients. Resolution of symptoms was obtained by 19% (25/132) of the patients in the amoxicillin group compared with 10% (13/136) of the patients in the placebo group, P = 0.03. The present findings do not favour routine use of antibiotics in an attempt to improve the course of acute exacerbations as defined in this study in patients with chronic bronchitis.

Acute Disease↗
PubMed1995

Acute bronchitis: course of symptoms and restrictions in patients' daily activities.

OBJECTIVE: To obtain information on the course of complaints and restrictions in daily activities of patients with acute bronchitis. DESIGN: Prospective study. SETTING: General practice. SUBJECTS: Otherwise healthy persons over 16, who visited their GP with an acute cough with purulent sputum and/or auscultatory abnormalities. MAIN OUTCOME MEASUREMENTS: Recordings by patients on reasons for encounter, symptoms and restrictions in daily activities at entry, and one and two weeks after entry. RESULTS: 99 Patients were included, of whom 79 were suitable for further analysis. Discomfort caused by coughing and concern in the patient and his/her social environment were the main reasons why patients visited their general practitioner. Counting from the onset of the disease it took three to four weeks before most patients were well and able to perform all their usual daily activities again. CONCLUSION: In most cases acute bronchitis has considerable impact on patients' well-being and daily activities for some weeks.

Activities of Daily Living↗
PubMed1984

Effects of subtype variations in the Holland strain of infectious bronchitis virus when applied as a vaccine.

Massachusetts-type infectious bronchitis viruses (IBV) designated H120, from three sources, have been evaluated as vaccines. Significant subtype variations were observed with the different vaccines based upon challenge virus infection and typical IB lesions induced where homologous and heterologous serotypes were used. In numerous cases, there was little agreement between challenge virus recovery from the respiratory tract and the presence or absence and severity of IB lesions. The study indicates that histopathological observations provide a sensitive, reliable indicator of the immune response to IB vaccination and augment the use of challenge virus isolation attempts. The data suggest that the use of the latter criterion alone was insufficient in evaluating IB immunity. The study also demonstrated that IB vaccine strains, although labeled similarly, varied in their immunogenic properties. Manipulation of infectious bronchitis virus (IBV) and other factors should be considered when obtaining and employing vaccine strains from different sources. Complete characterization of IBV vaccine strains used commercially should be stressed together with an appropriate labeling of each.

Animals↗
PubMed1989

Acupuncture induced immunoregulatory influence on the clinical state of patients suffering from chronic spastic bronchitis and undergoing long-term treatment with corticosteroids.

36 patients suffering from chronic spastic bronchitis were treated with acupuncture. The patient group consisted of 13 men and 23 women varying in age from 26 to 64 years, with an average age of 42.2 years. The therapy consisted of two or three months of acupuncture treatment in alternation with an equal period (2 or 3 months) of recess during which no treatment was administered. Before acupuncture, patients had taken corticosteroids either orally and/or intramuscularly for a period of 2 to 24 years. For those taking corticosteroids orally the daily dosages ranged from 10 to 40 mg Encorton (Polfa, Poland). The patients took intramuscular injections of 40 to 60 mg Kenalog (Squibb) every three or four weeks. Acupuncture sessions were twice a week. All the patients had 42 acupuncture sessions. Before the treatment all the patients, and 30 healthy volunteers, made leukocytes migration tests [(in vivo, using the Rebuck method (1) as modified by Southam (2)]. It was found that patients suffering from chronic spastic bronchitis have leukocytes migration defect. This defect increases in patients who have taken corticosteroids. We have also found that after 42 acupuncture sessions the amount of leukocytes in the tissue pool comes close to the value found in healthy persons during leukocyte migration, [(tested in vivo, using the Rebuck method as modified by Southam (2)].

Acupuncture Therapy↗
PubMed1984

Bronchitis in relation to work.

The term bronchitis means different things to different people. Work-related bronchitis might include acute irritation or allergic syndromes or chronic cough and airway obstruction. The investigation of such episodes varies according to the suspected problem--acute symptoms are investigated in the individual and followed up if necessary epidemiologically, while chronic disease requires an epidemiologic approach. Examples of investigations on soldering, polyvinyl chloride manufacturing, and coal mining are quoted.

Bronchitis↗
PubMed1979

Trimethoprim/sulphamethoxazole and doxycycline in acute exacerbations of chronic bronchitis in general practice: a comparative study.

Fifty-six patients with acute exacerbation of chronic bronchitis were given one week's treatment either with a combination of trimethoprim and sulphamethoxazole (TMP/SMX) or with doxycycline, in a single blind trial. The study found no significant difference in response to the two treatments, and confirmed that both TMP/SMX and doxycycline are effective and well tolerated agents, which are suitable for the management of acute or chronic bronchitis.

Adult↗
PubMed1982

Antibiotic therapy of acute exacerbations of chronic bronchitis. A controlled study using tetracycline.

We conducted a double-blind, randomized, placebo-controlled trial in 40 patients to evaluate the need for antibiotics in acute exacerbations of chronic bronchitis. All patients were sufficiently ill to require hospitalization although none needed ventilatory support; the presence of pneumonia was excluded. Treatment consisted of bronchodilators, corticosteroids, and either tetracycline, 500 mg, or placebo by mouth every 6 hours for 1 week. Arterial blood gases, spirometric tests, bacteriologic evaluation of sputum, and patient and physician evaluation of the severity of illness were assessed at the beginning and end of the study. All patients improved both symptomatically and by objective measures of lung function. At the end of the study period there were no differences between those patients receiving tetracycline and those receiving placebo. We conclude that antibiotic therapy is not needed in moderately ill patients with exacerbations of chronic bronchitis.

Acute Disease↗
PubMed1998

[Optimizing of antibiotics policy in the Netherlands. III. SWAB guidelines for antimicrobial therapy in adults hospitalized with bronchitis. Foundation Antibiotics Policy Work Group].

The Stichting Werkgroep Antibioticabeleid (SWAB, Foundation Antibiotics Policy Team) has issued guidelines for empirical antimicrobial therapy of adult patients with bronchitis in hospital. Acute bronchitis is rarely caused by bacteria: therefore antibiotic treatment is not indicated in most cases. In an exacerbation of asthma or chronic obstructive pulmonary disease (COPD), the primary treatment aims at combating the inflammatory reaction and the bronchospasm. In case of increasing dyspnoea, (increase of) sputum production and (increase of) purulence of the sputum, antibiotic treatment may lead to shortening of the symptoms and sickness duration. Doxycycline is to be preferred because of its spectrum, easy dosage and favourable price. If the patient has not had antibiotics earlier, amoxicillin also is a good choice. Macrolide antibiotics are no preparations of first choice because large-scale use readily leads to resistance.

Adult↗
PubMed1998

Chest physiotherapy does not exacerbate gastroesophageal reflux in patients with chronic bronchitis and bronchiectasis.

BACKGROUND: Chest physiotherapy is beneficial to patients with mucus hypersecretion. However, it is not risk-free. Chest physiotherapy may affect gastrointestinal motility and the competence of the gastroesophageal sphincter during the procedure. Our study was aimed to investigate whether gastroesophageal reflux is exacerbated or induced by chest physiotherapy. MATERIALS AND METHODS: Thirty-two adult patients with chronic bronchitis or bronchiectasis received chest physiotherapy. An esophageal pH meter was placed 5 cm above the gastroesophageal junction and monitored the reflux episodes from 8 AM on the first day to 12 noon on the second day. Physiotherapy was performed with the patient in three different positions on the second day for one hour. RESULTS: Thirteen patients were found to have gastroesophageal reflux disease. For the study group as a whole, neither the frequency nor the duration of having a pH < 4 during the physiotherapy was significantly different from the mean hourly frequency and mean hourly duration recorded on the first day or from those values recorded at a corresponding time on the first day. As for the patients with gastroesophageal reflux disease, the frequency and total duration of gastroesophageal reflux during physiotherapy were not significantly different from the mean hourly frequency and the mean hourly duration or from the values recorded at the corresponding time on the first day. There was no significant difference in the gastroesophageal reflux frequency or the duration in different body positions. CONCLUSION: Chest physiotherapy including postural drainage, percussion and forced expiration techniques in different positions did not induce or increase the incidence of gastroesophageal reflux in patients with chronic bronchitis and bronchiectasis.

Adult↗
PubMedDate not supplied

[A method for studying social security records in epidemiology. Use in a study on the prognosis of chronic bronchitis (author's transl)].

A method is presented to study, in an epidemiological research, the social security records. This study is based upon records of workers affiliated to the french social security general system. To obtain data which may be compared, it was necessary to take the legislation as a basis; this legislation gives the data which must be in the records. A study of laws and rules has been done to find out these data in the medical record and in the administrative one. A questionnaire is presented. This basic questionnaire should be modified according to the precise objectives of each study and to the characteristics of the population sample. To illustrate this method, some results of a study of chronic bronchitis risk factors are presented in the second part. These results concern 950 men, born in France, aged 30 to 59 in 1960 an still alive in 1972. The study of the long reductions of the ability to work, happened from 1960 to 1971, confirm the disabling character of the group "chronic bronchitis, asthma, emphysema, respiratory insufficiency" which follows immediately cardiovascular and rheumatic diseases. The total number of beneficiaries of the social security is already very important and the whole population will be soon concerned. The use of the social security records as data source could give very interesting informations about morbidity. So, it is possible to study representative samples of the general population or of some particular groups, which has up to now, been done only in a slight extent.

Adult↗