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S Gompertz

Publications and source records attributed to S Gompertz.

7 recordsLinked to original sources
PubMed2001

Relationship between airway inflammation and the frequency of exacerbations in patients with smoking related COPD.

BACKGROUND: Patients with more frequent exacerbations of chronic obstructive pulmonary disease (COPD) may have increased bronchial inflammation. Airway inflammation was measured in patients who had been thoroughly investigated with full pulmonary function testing, thoracic HRCT scanning, and sputum microbiology to examine further the relationship between exacerbation frequency and bronchial inflammation. METHODS: Airway inflammation (spontaneous sputum sol phase myeloperoxidase (MPO), elastase, leukotriene (LT)B(4), interleukin (IL)-8, secretory leukoprotenase inhibitor (SLPI), protein leakage) and serum levels of C reactive protein (CRP) were compared in 40 patients with stable, smoking related COPD, divided into those with frequent (> or =3/year) or infrequent (< or =2/year) exacerbations according to the number of primary care consultations during the preceding year. The comparisons were repeated after excluding eight otherwise clinically indistinguishable patients who had tubular bronchiectasis on the HRCT scan. RESULTS: Patients with frequent (n=12) and infrequent (n=28) exacerbations were indistinguishable in terms of their clinical, pulmonary function, and sputum characteristics, CRP concentrations, and all of their bronchial inflammatory parameters (p>0.05). The patients without evidence of tubular bronchiectasis (n=32) were equally well matched but the sputum concentrations of SLPI were significantly lower in the frequent exacerbators (n=8) in this subset analysis (p<0.05). CONCLUSIONS: There are several clinical features that directly influence bronchial inflammation in COPD. When these were carefully controlled for, patients with more frequent reported exacerbations had lower sputum concentrations of SLPI. This important antiproteinase is also known to possess antibacterial and antiviral activity. Further studies are required into the nature of recurrent exacerbations and, in particular, the regulation and role of SLPI in affected individuals.

Aged↗
PubMed2001

Changes in bronchial inflammation during acute exacerbations of chronic bronchitis.

There are little data describing noncellular changes in bronchial inflammation during exacerbations of chronic bronchitis. The relationship between sputum colour and airway inflammation at presentation has been assessed during an exacerbation in patients with chronic bronchitis and a primary care diagnosis of chronic obstructive pulmonary disease. Sputum myeloperoxidase, neutrophil elastase, leukotriene B4 (LTB4), interleukin-8 (IL-8), sol:serum albumin ratio and serum C-reactive protein were measured in patients presenting with an exacerbation and mucoid (n = 27) or purulent sputum (n = 42). Mucoid exacerbations were associated with little bronchial or systemic inflammation at presentation, and sputum bacteriology was similar to that obtained in the stable state. Purulent exacerbations were associated with marked bronchial and systemic inflammation (p < 0.025 for all features) and positive sputum cultures (90%). Resolution was related to a significant reduction in LTB4 (p < 0.01), but no change in IL-8, suggesting that LTB4 may be more important in neutrophil recruitment in these mild, purulent exacerbations. In the stable state, IL-8 remained higher in patients who had experienced a purulent exacerbation (2p < 0.02). The presented results indicate that exacerbations of chronic bronchitis, defined by sputum colour, differ in the degree of bronchial and systemic inflammation. Purulent exacerbations are related to bacterial infection, and are associated with increased neutrophilic inflammation and increased leukotriene B4 concentrations.

Acute Disease↗
PubMed2000

Inflammation--role of the neutrophil and the eosinophil.

Neutrophils are regularly identified in the airway secretions of patients with smoking-related chronic bronchitis and in those with chronic obstructive pulmonary disease. The migration and activation of these cells plays a role that is central to the secondary bronchial defences against potential bacterial pathogens. Where these processes persist or are excessive, potent mediators derived from the neutrophil may cause a perpetuation of bronchial inflammation and result in bronchial epithelial damage and impairment of endobronchial defences. Recent evidence has suggested that the eosinophil may also be present in the airways of some patients with chronic bronchitis, although its role in bronchial inflammation is not yet clear. In this article we have reviewed the evidence relating to the roles of both the neutrophil and of the eosinophil in the airway inflammation of chronic bronchitis.

Bronchitis↗
PubMed1990

Needle-stick injuries in medical students.

A standard questionnaire was used to assess the experience of needle-stick injury in 151 undergraduate medical students, during the previous 10 months. Eighty-two injuries were reported in the 95 questionnaires which were returned. Fifty-one of these took place during venepuncture; of these 26 whilst resheathing a needle. Seventy-two per cent of students resheathed used hypodermic needles, but their rate of injury did not differ significantly from the rate in those who did not resheath. The remaining 31 injuries occurred during surgical procedures. There was a significantly lower rate of injury in those who had earlier been advised to have hepatitis B immunization.

Acquired Immunodeficiency Syndrome↗