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PubMed1976

[Contribution on the chronic fibrinous bronchitis (author's transl)].

The present report deals with an actual case of the rare chronic fibrinous bronchitis. With references to previous publications on this subject the picture of the disease is described on the basis of an actual case. A review of the literature available and the investigation of the actual case have led to parameters of the disease mentioned, which are typical and indicative of this disease. It has been found out that chronic fibrinous bronchitis is diagnosable by clinical means. Problems concerning the therapy, prognosis and etiology are discussed.

Bronchial Diseases↗
PubMed1998

[The characteristics of the course of chronic dust-induced bronchitis in workers in granite quarries].

Our objective in this study was to go into particular features of the clinical course that chronic bronchitis runs in those men working in granite quarries. The studies made showed chronic bronchitis to have peculiar clinical manifestations leading to the development of pulmonary insufficiency and diffuse pneumosclerosis presenting with atrophic and sclerosal changes in bronchial mucosa. Investigations designed to study systemic immunity status permitted the changes in the T-system to be revealed, with indices for the B-system being in the normal range.

Adult↗
PubMed1998

[The pathogenetic mechanisms of bronchospasm in different clinical forms of chronic bronchitis].

The article is dedicated to the study of main links of pathogenesis of bronchospasm of chronic obstructive bronchitis, establishing differential and diagnostic criteria of obstructive and asthmatic bronchitis to find new approaches toward treatment of bronchospasm. A comparison has been made between clinical and laboratory findings that can be helpful in quests for an efficient treatment option of the above condition.

Asthma↗
PubMed1999

Infectious exacerbations of chronic bronchitis. ORIONE Board.

Approximately 50% of chronic bronchitis exacerbations are caused by bacteria and 25-50% by viruses. Streptococcus pneumoniae and Haemophilus influenzae are traditionally considered leading pathogens. In Italy, S. pneumoniae and H. influenzae resistance to beta-lactams is low but resistance to macrolides is more widespread. Pathogenic bacteria are isolated in the airways of most chronic bronchitis patients, impairing host respiratory defences, further predisposing towards infection and, thus, establishing a vicious circle, fuelled by damage due to cigarette smoking. The diagnosis of an exacerbation is essentially clinical. Lung function testing may show no modification, or indicate worsening airway obstruction. Blood gas analysis is performed in severe cases. The utility of culture is lessened by evidence of airway bacterial contamination in clinically stable periods. Quantitative thresholds have been identified over and above which bacterial exacerbation is considered probable. General preventative measures include the adoption of hygiene-behavioural standards. Antibiotic prophylaxis is not advisable. Prophylaxis by means of vaccination is indicated against influenza. Vaccination against S. pneumoniae is available but is seldom employed. The principal form of treatment is antibiotic therapy, but there is an ongoing debate regarding the objective criteria for its use. A recent meta-analysis showed a small but statistically significant difference in favour of antibiotic treatment. The antibiotic cost-benefit ratio is favourable in patients with severe functional impairment. Oral administration is to be preferred as more practical and less costly for equal efficacy. In selecting an antibiotic, pharmacokinetic considerations (bioavailability, tissue diffusion, half-life) must be kept in mind. Prescription should be oriented towards drugs active against the most commonly occurring pathogens. In more severe cases coverage against Gram-negative bacteria is considered. Complementary medical treatment includes bronchodilators corticosteroids, diuretics, and oxygen therapy. Chest physiotherapy may be beneficial. Ventilatory support treatment may be necessary, noninvasive ventilatory assistance being preferable early in the course of the acute episode. In a high number of cases endotracheal intubation may be avoided. Most exacerbations may be treated on an outpatient basis, but in some cases admission to hospital is indicated.

Acute Disease↗
PubMedDate not supplied

[The prevalence of respiratory symptoms, bronchial asthma and chronic bronchitis (simple and obstructive) in a representative sample of the adult rural population].

A representative sample of an adult population living in a rural area (1001 adult subjects aged 18 and above) was submitted to the ECHRS standardised questionnaire (administrated by interview) and performed lung function tests (ventilatory). The most frequent respiratory symptoms were chronic cough (especially in males and smokers) and intermittent dyspnoea (in females more prevalent than in males). All symptoms showed a higher frequency after 50 years. Obstructive ventilatory impairment was found in 12.29% of the subjects, more frequently in males, ex-smokers and above 50 years of age. The prevalence of asthma bronchiale was 4.09%; the subjects over 40 years of age, the non-smokers and the females showed higher figures. Chronic simple bronchitis was found in 5.69% of examined subjects, especially in males and smokers. The prevalence of chronic obstructive bronchitis was as high as 2.29%, more prevalent in males, smokers, over 40 years. The prevalence rates found in this study are higher than those observed in a rural population living in an unpolluted area: this fact may be ascribed to the noxious effect of the air pollution due to the chemical industrial plants situated in the vicinity of the studied population.

Adolescent↗
PubMedDate not supplied

[Means for correcting the microecological disorders of the intestines in children with recurrent bronchitis].

The majority of children (63%) with recurrent bronchitis present with disturbances in microbial biocenosis. A combined treatment of patients with recurrent bronchitis involving enoant (dark grapes peel extract), biphicol, the myrter tincture, special diet make for the intestinal microbial biocenosis to return to normal. The most efficient correction option for dysbacteriosis was found to be enoant.

Bronchitis↗
PubMed1999

[Clinical contribution of the newer fluoroquinolones in acute bacterial exacerbation of chronic bronchitis].

Acute exacerbations occur frequently in patients with chronic bronchitis and the majority of these patients benefit from antimicrobial therapy. The ideal antimicrobial agent for the management of acute exacerbations of chronic bronchitis (AECB) should have good activity against the common bacterial pathogens associated with these exacerbations (non-typable Haemophilus influenzae, Moraxella catarrhalis and pneumococci); it should be resistant to bacterial betalactamases; penetrate well into pulmonary tissues and secretions; kill bacteria without inducing excessive airway inflammation; be easy to take (given once or twice a day) in order to ensure high patient compliance, and be cost-effective. Fluoroquinolone antibiotics have demonstrated efficacy in the treatment of AECB, but because of the limited activity of certain older agents in this class when administered in standard doses against Streptococcus pneumoniae, they have not be extensively used for this indication. Newer agents including levofloxacin, grepafloxacin, sparfloxacin and trovafloxacin have excellent activity against both Gram positive and Gram negative pathogens likely to be involved in AECB. These agents can be administered once daily, making patient compliance and a successful therapeutic outcome more likely. The new quinolones offer promising alternatives for antimicrobial therapy in outpatients with AECB, particularly those with underlying co-morbidity and severe obstruction.

Acute Disease↗
PubMedDate not supplied

[The prevention and treatment of a Candida-mycosis type of dysbacteriosis in chronic bronchitis in older patients].

Changes were studied in the clinical picture and microecological setting of the large intestine in elderly and old patients with chronic bronchitis (n = 17) against the background of antibacterial therapy that leads to the development of dysbacteriosis, including that with increased content of Candida. Shown in elderly and old patients with chronic bronchitis is efficacy of the outlined treatment option for the prophylaxis of candidiasis type dysbacteriosis (diphlucan, linaex, decamevite, nitroxoline).

Aged↗
PubMed1999

[The use of pharmacological tests for the diagnosis of the nature of bronchial obstruction in coal miners with premorbid stage of chronic dust-related bronchitis].

Bronchospasm in premorbid chronic dust bronchitis in coal miners is caused mostly by dystonic effects of sympathetic and parasympathetic nervous system, and minimally by hypersecretion and swelling of respiratory tract mucosa. Pathogenetic features of obstruction in premorbid chronic dust bronchitis are lower sympathetic tone (major feature) and higher parasympathetic tone (minor one). Those items should be considered in therapeutic and prophylactic tactics.

Adult↗
PubMed1999

[Multicenter, controlled, double-blind study of the efficacy and tolerance of Vectrine (erdostein) versus placebo in the treatment of stabilized chronic bronchitis with hypersecretion].

The clinical efficacy of vectrine (erdosteine) was evaluated in the treatment of chronic bronchitis patients with hypersecretion during a controlled clinical trial having included 170 patients. For inclusion, the bronchitis patients had to be in a stable status (no exacerbation since at least three months). The patients received, in double-blind protocol, vectrine, one capsule b.i.d. or placebo, one similar capsule b.i.d. during a period treatment of 21 days. The results of the main evaluation criteria, the global index of efficacy (frequency of the cough + severity of the cough + difficulty in breathing + dyspnea) but also on the intensity and frequency of the cough were statistically significant in favor of vectrine. The safety of the treatment was excellent.

Administration, Oral↗
PubMed1999

A prospective study of infections with atypical pneumonia organisms in acute exacerbations of chronic bronchitis.

The objective of this paper was to study the incidence of 6 atypical pneumonia pathogens or atypical organisms in local patients admitted for acute exacerbation of chronic bronchitis. This is a prospective observational study. Over a period of 3 years (1995 to 1997), 90 patients admitted to a large general hospital in Singapore for acute exacerbation of chronic bronchitis were tested for the following infections: Legionella, Mycoplasma, Chlamydia, influenza A, influenza B and parainfluenza viruses, using paired serological examination. The antibiotic prescribing pattern by the attending physicians in these cases were also examined. Positive serologies were found in 31 patients (34%), of whom 26 patients (28%) had viral infections. The most common organism was influenza A with 18 positive serologies (20%). Five patients were tested positive for Legionella. There was no evidence of acute infections by Mycoplasma pneumoniae or chlamydia using serological tests.

Acute Disease↗
PubMed2000

[Use of antibiotics in chronic bronchitis].

Whether it is advisable to use tarivide, a wide-spectrum acting antibiotic, in 193 patients aged 23 to 50 years who had chronic catarrhal bronchitis. The experimental group included 43 and 57 patients with chronic nonobstructive and obstructive bronchitis, respectively. For comparison, a matched group receiving penicillin comprised 40 and 53 patients, respectively. Tarivide eliminated most strains of pathogens and improves cellular immunity. Cure and improvement were achieved in 147 (77%) and 13 (12%) patients, respectively. The favourable pharmacokinetics of tarivide, its easy-to-use regimen make it the drug of choice for oral treatment.

Administration, Oral↗
PubMed2000

[Effectiveness of treatment in patients with pulmonary tuberculosis and chronic bronchitis by exposure on vertebro-osteo-sternal joints].

A hundred and twenty six patients with infiltrative destructive pulmonary tuberculosis were examined. In 62 patients of them, the vertebroosteosternal joints were exposed as part of multimodality treatment in order to arrest an exacerbation of chronic bronchitis. A control group included 64 patients. The exposure of vertebroosteosternal joints was found to enhance the efficiency of treatment for chronic bronchitis in patients with pulmonary tuberculosis. This treatment promotes lower inflammatory intensity, diminished antigenemia and anti-protein antibody production. To arrest lesions in the bronchial tree with the proposed package of methods also favours a higher efficiency of treatment of a tuberculous process.

Adult↗
PubMed2000

[Dynamic surface tension of blood in chronic dust bronchitis in coal mines workers].

Chronic dust bronchitis in miners is associated with increase in dynamic surface tension of blood at short (t = 0.01 s) and medium (t = 1 s) surface lifetimes with lower declination angle of interphase tensiograms curve. Surface tension disorders were similar to those in experimental dust bronchitis. There are correlations between surface tension parameters and the workers' underground length of service, some mining geologic conditions and serum level of proteous and lipid surfactants.

Adult↗
PubMed2000

A comparison of a five-day regimen of cefdinir with a seven-day regimen of loracarbef for the treatment of acute exacerbations of chronic bronchitis.

To compare the efficacy and safety of five-day cefdinir treatment with seven-day loracarbef treatment in patients with acute exacerbations of chronic bronchitis, 586 patients were enrolled in a multicentre, randomised, double-blind trial. Patients received either five days of treatment with cefdinir (n = 291) at 300 mg twice daily or seven days of treatment with loracarbef (n = 295) at 400 mg twice daily. Microbiological assessments were done on sputum specimens obtained at admission and at the two post-therapy visits, if available. The clinical cure rates were 86% (138/160) and 85% (141/166) for the evaluable patients treated with cefdinir and loracarbef, respectively. Respiratory tract pathogens were isolated from 457 (78%) of 586 admission sputum specimens, with the predominant pathogens being Haemophilus parainfluenzae, H. influenzae, Moraxella catarrhalis and Staphylococcus aureus. The microbiological eradication rates at the test-of-cure visit were 88% (193/219 pathogens) and 90% (227/251 pathogens) for the evaluable patients treated with cefdinir and loracarbef, respectively. Adverse event rates while on treatment were 30% and 21% for cefdinir- and loracarbef-treated patients, respectively. These results indicate that a five-day regimen of cefdinir is effective and safe for the treatment of patients with acute exacerbations of chronic bronchitis.

Adolescent↗
PubMed2000

[Usefulness of the IUATLD respiratory symptoms questionnaire for the differential diagnosis of bronchial asthma and chronic bronchitis].

Our objective was to determine the diagnostic value of the questionnaire devised by the International Union against Tuberculosis and Lung Disease (IUATLD) for distinguishing between bronchial asthma and chronic bronchitis. We therefore compared clinical diagnoses established independently by two pneumologists for 211 patients to the patients' responses to the IUATLD questionnaire. The questions were analyzed for their ability to discriminate using the responses as independent variables and the diagnosis as the dependent variable. The individual predictive capacity of each question and the discriminating functions that identified the best clusters of questions were calculated using bayesian analysis. Finally, we compared IUATLD results to tests that assessed lung function (spirometry), obstruction variability (bronchodilator test, peak flow, bronchial challenge test), atopy (prick test, serum IgE), and clinical and biological markers (eosinophilia). The questionnaire correctly diagnosed 91% of the patients and a cluster of five questions registered a sensitivity of 85.6%, specificity of 91.4%, a positive predictive value of 93.1% and a negative predictive value of 82.2%, thus proving superior to the other tests. These results, along with the ease of administering the questionnaire allows us to consider the IUATLD instrument to be a good tool for the differential diagnosis of bronchial asthma and chronic bronchitis.

Adolescent↗
PubMedDate not supplied

[The local immunity status of patients with chronic dust-induced bronchitis].

The ratio of cells in the bronchoalveolar washing was studied as was the functional state of phagocytizing cells, with assessment thereof having been done in the pathogenesis of chronic bronchitis in those workers exposed to quartz-containing dust. The conducted studies showed the endopulmonary cytogram to be characterized by a high degree alveolar neutrophilia (28.2 +/- 1.3) in chronic bronchitis. Disturbances in local immunity were also evidenced by the dysfunction of alveolar macrophages (decline in adhesiveness and absorptivity against the background of apparent activation of intracellular oxygen-dependent metabolism), and by the decrease of the level of secretory immunoglobuline A.

Antibody Formation↗
PubMed2000

[Spectrum of pneumotropic pathogens in pediatric patients with acute bronchitis and pneumonia].

One hundred eighty nine children with acute bronchopulmonary infectious pathological processes were examined bacteriologically and serologically for typical pneumotropic pathogens, 47 of them being as well examined for atypical organisms. Microbial associations mainly with Mycoplasma and Pneumocystis and to a lesser extent with Chlamydia were isolated from the majority of the children. Reactivation of the cytomegalovirus infection was observed in 25 per cent of the children. Pneumonia and bronchitis due to Mycoplasma pneumoniae either as a monoagent or in associations were mainly stated in children over 7 years of age. No significant changes between the indices of the infection due to a definite organism and the active progression of the infectious process of the same etiology were revealed, though in the cases of chlamydiosis the changes reached almost 10 per cent. In cases of acute bronchitis and pneumonia the chlamydial or cytomegalovirus infection could be assumed to be of the persisting nature, mainly acute in cases of pneumococcal infection, mixed in cases of hemophilic or pneumocystic infection, primary contamination with a tendency to prolonged in cases of mycoplasmic infection. The findings of the examination and the clinical and anamnestic data showed that the clinical picture of acute pneumonia had specific features associated with the supposed etiological agents, still it could change under the action of associations of pneumotropic pathogens.

Acute Disease↗