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PubMed1991

[Surgical treatment of "minor" forms of bronchiectasis].

A total of 835 operations were conducted for bronchiectasis on 734 patients (75.9% were children and adolescents). The late-term results of operations for "minor" forms of the disease in 118 patients are discussed. The increase of the proportion of "minor" forms in the structure of bronchiectasis calls for changes of the tactics with prevalence of segmental and polysegmental lung resections. The relative number of the last named has been constantly growing in the recent 2 decades. The methods for determining the volume of the operation in bronchiectasis must be improved. All patients who underwent operation for "minor" forms of bronchiectasis must be kept under dynamic observation and more than half of them must be given regular anti-recurrence treatment for some years.

Adolescent↗

PubMedDate not supplied

[Bronchiectasis in advanced old-age. Etiopathogenetic and diagnostic considerations and medico-social implications].

A study was carried out on the etiopathogeny and socio-medical implications in 18 cases of bronchiectasis, without a typical clinical symptomatology before admission. All the patients were over the age of 60 years. The bronchographic examination was performed in all the cases. In 8 of the cases bronchiectasis was interpreted as a post-tuberculosis syndrome and in the other 10 cases bronchiectasis was attributed to pulmonary sclerosis of different origin (acute unsuppurated pneumopathy). The gradual changes in pulmonary mechanics, the organic and functional deficiences developing with age lowered the resistance of the body to viral and bacterial infection, contributing to the onset of bronchiectasis in the older group. The suppurative episodes were curred by treatment in all the cases.

Age Factors↗

PubMed1987

Humoral immunity in bronchiectasis.

Bronchiectasis occurs in patients with immunodeficiency and fungal hypersensitivity disorders. To assess the prevalence of abnormal humoral immune parameters in bronchiectasis, a retrospective study was carried out on sera from 30 patients. Studies included immunoglobulin quantitation and specific antibody to fungal species. Eleven patients were found to have immunodeficiency (nine with panhypoglobulinemia and two with selective IgM deficiency). Six patients had elevations of serum IgA and four patients had elevations of serum IgE. Six patients had elevated total antibody to Aspergillus or Candida species and six had precipitin bands to one or more fungal antigens. This study indicates that immunodeficiency is prevalent and plays a causative role in some patients with bronchiectasis. Hypersensitivity reactions to Aspergillus, Candida, and other ubiquitous environmental fungi may also play an etiopathogenic role in this disease (bronchiectasis, humoral immunity, immunodeficiency).

Adult↗

PubMed1979

Experience with bronchiectasis in Nigeria.

Between April 1975 and March 1978, 54 patients were treated for bronchiectasis at the University College Hospital, Ibadan. The sex distribution was equal and ages of the patients ranged from five to 67 years with a peak incidence of the disease in the third and fourth decades of life.One third of the patients had tuberculous bronchiectasis with destroyed left lung syndrome, another third had chronic sinusitis, while nine percent had sickle cell hemoglobinopathy. One case of Kartagener syndrome, pulmonary aspergillosis, poliomyelitis, and aspiration of a foreign body were associated with bronchiectasis.Factors influencing the clinical course and prognosis of this disease in this environment include life threatening hemoptysis, bilateral disease, associated lung abscess or empyema, malnutrition, and chronic anemia.Twenty-six patients were treated conservatively with one death, while 28 patients were treated surgically with three deaths. Twenty percent of the surgical patients developed recurrent bronchiectasis within one to 31/2 years, in lobes which were bronchographically free of disease prior to surgery. These findings suggest that bronchiectasis is a progressive disease and that elective surgery for localized disease probably does not affect its clinical and natural history in this environment.

Adolescent↗

PubMed1982

Bronchiectasis following pulmonary ammonia burn.

Long-term follow-up of the pulmonary lesions of severe exposure to ammonia in humans has seldom been documented, and development of bronchiectasis continues to be of concern. We studied a previously healthy 30-year-old woman whose lungs at time of necropsy, three years after massive exposure to ammonia fumes, had extensive cylindrical and saccular bronchiectasis. We concluded that massive exposure to ammonia can lead to bronchiectasis. It is not known, however, whether the bronchiectasis resulted from chemical injury by ammonia or from a superimposed bacterial bronchitis.

Accidents↗

PubMedDate not supplied

Selective and partial IgA deficiency in an adolescent male with bronchiectasis.

Selective IgA deficiency is the most common primary immunodeficiency. Two types of selective IgA deficiency may be distinguished: the complete form, with IgA level less than 5 mg/dl, and the partial IgA deficiency, with level greater than 5 mg/dl but less than 2 standard deviations below the age-adjusted mean level; 50% of the cases belong to the partial type and half of them may be considered as transient clinical form. Patterns of this condition, are very unsteady: while some patients remain without any symptoms, others present recurrent respiratory and gastrointestinal tract infections. Though respiratory tract infections are the most frequent diseases, and in very few patients are associated bronchiectasis. A twelve-year-old patient with permanent partial IgA deficiency was treated for bronchiectasis in our pneumology and allergy pediatric center. The other serum immunoglobulins, IgG subclass, lymphocytes sub-populations, cell with expression of DR markers and proliferative response to PHA of peripheral blood lymphocytes, were normal. The alpha-1-antitrypsin, Mantoux test (negative), sweat chloride concentration and ciliated nasal epithelium were also normal. Pneumonia, bronchiectasis and meningitis are found in the complete IgA deficiency. The greater part of studies confirm that this severe, chronic and/or recurrent lower respiratory tract diseases are scarcely found in children with partial selective IgA deficiency, although our case states that it can be found. We think that in every patient with bronchiectasis the selective IgA deficiency complete or partial, has to be considered as an isolated etiologic factor.

Bronchiectasis↗

PubMed1994

[Changes in neuroendocrine cells and immunocompetent cells in bronchiectasis].

Pulmonary endocrine cells and immunocompetent cells from the lungs of 35 subjects with bronchiectasis and in 10 normal controls were investigated by using immunohistochemical technique. The morphological and immunohistochemical characteristics of bronchus associated lymphoid tissue (BALT) of the lung were also studied. The number of calcitonin and serotonin immunoreactive pulmonary endocrine cells increased significantly in bronchiectasis as compared with those from control subjects. The number of IgA, IgG and IgM positive cells and UCHL1 positive cells were higher in the bronchial lamina propria in bronchiectasis than those in controls. These changes were most marked in hyperplastic BALT areas, which suggest that neuroendocrine and immune mechanisms may be involved in the pathogenesis of bronchiectasis.

Adult↗

PubMed1994

Bacterial bronchitis and bronchiectasis in human immunodeficiency virus infection.

BACKGROUND: Bacterial pneumonia and sinusitis are important causes of morbidity in patients with human immunodeficiency virus (HIV) infection. We noted an increased incidence of bacterial bronchitis and bronchiectasis in our patients with HIV infection. METHODS: This study was conducted on persons with HIV infection at a county hospital and clinic. Bronchiectasis was diagnosed by bronchogram and computed tomography in one patient and by computed tomography alone in two others. Bacterial bronchitis was defined by a Gram's stain showing an abundance of neutrophils with a predominance of one or more bacteria and by a confirmatory sputum culture. Bronchoscopy with broncho-alveolar lavage was performed in patients with bronchitis to eliminate other causes of bronchial inflammation. RESULTS: Eighteen episodes of bacterial bronchitis in 10 patients are described. The mean CD4 lymphocyte counts for these patients was 0.061 x 10(9)/L (range, 0.001 to 0.203 x 10(9)/L). The most common pathogens in 18 episodes of bacterial bronchitis were Haemophilus influenzae and Streptococcus pneumoniae (five episodes each) and Pseudomonas aeruginosa (four episodes). Response to antibiotic therapy was usually rewarding though recurrences were frequent. Three patients with well-defined bronchiectasis who appeared to have developed, or who became symptomatic during the course of, HIV infection are described. Their mean CD4 cell count was 0.03 x 10(9)/L (range, 0.024 to 0.037 x 10(9)/L). Haemophilus influenzae, Staphylococcus aureus, Pseudomonas cepacia, and P aeruginosa were recovered from these patients; the P aeruginosa was a mucoid strain. CONCLUSIONS: Recurrent bacterial bronchitis should be added to the list of bacterial infections that occur with increased frequency with HIV infection. Repeated bacterial bronchitis may lead to bronchiectasis, which may be more common in HIV infection than generally appreciated.

Adult↗

PubMed1994

Improved plain film criteria for the diagnosis of bronchiectasis.

This manuscript establishes criteria that allow more accurate detection of bronchiectasis from plain films. Chest radiographs of 38 patients with proven bronchiectasis were evaluated for seven radiologic signs: bronchial dilatation, identified by visually comparing bronchial diameters in affected areas to bronchial diameters in normal areas an equal distance from the hilum; signet ring sign, with dilated, thick-walled bronchus adjacent to a smaller companion artery; bronchial wall thickening; volume loss; compensatory hyperinflation of surrounding segments or lobes; mucoid impaction of bronchi; and obvious cyst formation. The chest radiograph was abnormal in all 38 cases. Bronchial dilatation was present in 100%, signet ring sign in 79%, bronchial wall thickening in 92%, volume loss in 97%, compensatory hyperinflation in 58%, mucoid impaction in 45%, and cyst formation in 42%. By combining these signs, a very certain diagnosis of bronchiectasis was possible. Measurements of the pulmonary artery-bronchus ratio (ABR) in cases demonstrating the signet ring sign were useful in validating the signet ring sign as a good sign of bronchiectasis on plain films. Overall, the chest radiograph showed 235 (92%) of the 255 bronchiectatic lung segments identified by bronchography or high-resolution computed tomography.

Adolescent↗

PubMed1993

[Bronchiectasis with concomitant lung cancer--a report of 7 cases].

This article reports 7 cases of bronchiectasis with concomitant lung cancer, accounted for 3.6% of 194 cases of bronchiectasis admitted in the same period. The carcinoma originated from the pulmonary tissue with bronchiectasis in 5 cases, and from the superior segment of lower lobe with bronchiectasis in the basal segment in the other two cases. In 5 cases (71.4%) the tumor was smaller than 3 cm in diameter or only invaded into the submucosa, representing an early stage cancer. On the plain films of the chest only one case revealed a mass suspecting of the presence of carcinoma. Obviously it was hard to make a correct diagnosis in such a situation. In our group, correct preoperative diagnosis was made only in two cases and suspected of concomitant cancer in 3, while in the other two cases a definite diagnosis was obtained postoperatively by histopathological examination. In one of those two cases the lesion was so small that the diagnosis was made after several consecutive pathological examinations. It is emphasized that cytological examination of sputum and bronchoscopy should be performed in every patient. A CT scanning of the chest is of great help to find very small foci. Any massive lesions revealed on the film or CT scanning should be considered as a lung cancer. During operation pulmonary nodules should be also considered as possible cancers. The surgical specimen should be examined thoroughly to avoid missing of any minute cancer foci.

Adenocarcinoma↗

PubMed2026

Symptoms and treatment response to florensocatib and inhaled tobramycin in bronchiectasis: Post hoc analysis of two randomized trials.

Inhaled antibiotics and DPP-1 inhibitors improve clinical outcomes in bronchiectasis, but whether baseline symptom burden predicts differential treatment responses remains unclear. In this post hoc analysis of two multicenter randomized trials (SAVE-BE, n = 224; TORNASOL, n = 357), we evaluate the association between baseline Quality of Life-Bronchiectasis Respiratory Symptom Scale (QoL-B-RSS) and treatment effects of florensocatib and inhaled tobramycin. In SAVE-BE, florensocatib reduces exacerbation rates versus placebo (relative risk [RR], 0.47; 95% confidence interval [CI], 0.33-0.67; p < 0.0001), with RRs of 0.53 and 0.40 observed in patients with high and low symptom burdens, respectively, but no significant symptomatic improvement. In TORNASOL, tobramycin produces clinically meaningful QoL-B-RSS improvements (exceeding the 8-point cutoff in high-symptom patients) and ameliorates bronchitic symptoms, with greater benefits in those with higher baseline symptom burden. These hypothesis-generating findings suggest that baseline symptom burden may identify differential responses to anti-inflammatory versus anti-infective therapies in bronchiectasis and support its potential as a simple, practical stratification tool to guide personalized treatment.

Humans↗

PubMed1998

Resolution of severe bronchiectasis after removal of long-standing retained foreign body.

Saccular bronchiectasis secondary to the presence of a long retained foreign body is considered irreversible and an indication for resection of the diseased segment or lobe. We describe a 3 1/2 year-old girl with a retained organic foreign body for 18 months, and who was treated conservatively after laser resection and extraction of the inflammatory mass from the bronchus intermedius followed by complete resolution of the bronchiectasis. We suggest that even severe bronchiectasis following prolonged retention of a foreign body may be reversible after removal of the obstruction and reestablishment of airway patency.

Bronchi↗

PubMed2000

Bronchopulmonary hygiene physical therapy for chronic obstructive pulmonary disease and bronchiectasis.

BACKGROUND: Bronchopulmonary hygiene physical therapy is a form of chest physical therapy including chest percussion and postural drainage to remove lung secretions. These are applied commonly to patients with both acute and chronic airway diseases. Despite controversies in the literature regarding its efficacy, it remains in use in a variety of clinical settings. The various forms of this therapy are labour intensive and need to be evaluated. OBJECTIVES: The objective of this review was to assess the effects of bronchial hygiene physical therapy in people with chronic obstructive pulmonary disease and bronchiectasis. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles up to July 1997. We also wrote to study authors. SELECTION CRITERIA: Randomised trials in which postural drainage, chest percussion, vibration, chest shaking, directed coughing or forced exhalation technique was compared to other drainage or breathing techniques, placebo or no treatment. DATA COLLECTION AND ANALYSIS: Two reviewers applied the inclusion and exclusion criteria on masked publications independently. They assessed the trial quality independently. Only data from the first arm of crossover trials were included. MAIN RESULTS: The seven included trials involved six comparisons and a total of 126 people. The trials were small and not generally of high quality. The results could not be combined as trials addressed different patient groups and outcomes. In most comparisons, bronchial hygiene physical therapy produced no significant effects on pulmonary function, apart from clearing sputum in chronic obstructive pulmonary disease and in bronchiectasis. REVIEWER'S CONCLUSIONS: There is not enough evidence to support or refute the use of bronchial hygiene physical therapy in people with chronic obstructive pulmonary disease and bronchiectasis.

Bronchiectasis↗

PubMed2000

Leukotriene receptor antagonists for non-cystic fibrosis bronchiectasis.

BACKGROUND: Leukotriene receptor antagonists are a new class of drug that were initially identified for use in asthma. As they have an effect on neutrophil mediated inflammation, they may be of benefit in bronchiectasis. OBJECTIVES: To determine whether leukotriene receptor antagonists have any additive benefit over and above conventional treatment for bronchiectasis (usually consisting of antibiotics and postural drainage). SEARCH STRATEGY: The Cochrane Airways Group clinical trials register derived from MEDLINE, EMBASE and hand searching of major journals was searched using the terms:Bronchiec* AND leukotrien* OR anti-leuk* OR cysteinyl, Bronchiec* AND monteluk*, Bronchiec* AND zafirluk* SELECTION CRITERIA: Only randomised, controlled trials were considered DATA COLLECTION AND ANALYSIS: The results of searches were analysed by both authors MAIN RESULTS: No randomised, controlled trials were identified REVIEWER'S CONCLUSIONS: Further research is required to establish any benefit from the use of leukotriene antagonists in bronchiectasis.

Acetates↗

PubMed2005

Xanthoma disseminatum: a child with respiratory system involvement and bronchiectasis.

Xanthoma disseminatum (XD) is a rare normolipemic mucocutaneous xanthomatosis due to the proliferation of non-x histiocytes. Occasional involvement of the upper respiratory system has been reported, but lower respiratory tract involvement is very rare. Here, we present a child with severe involvement of the upper and lower respiratory tract by XD and bronchiectasis in the lower lobes of both lungs. The patient was an 8-year-old boy who was admitted to our hospital because of red-brown papules which developed on the skin and progressive dyspnea. He was diagnosed as having XD by skin biopsy. Physical examination revealed disseminated, numerous yellow-reddish brown papular xanthomas on the forehead and eyelids, around the neck and axillary area, and in the oral cavity and pharynx. He had respiratory distress and clubbing of the fingers. Chest x-rays showed hyperaeration and segmental atelectasis. High-resolution CT of the thorax revealed diffuse thickening of the whole tracheal and bronchial wall, and bronchiectasis in the lower lobes. Flexible fiberoptic bronchoscopy revealed numerous xanthomatous lesions in the nasal cavity, nasopharynx, oropharynx, subglottic area, trachea, bifurcation, both main bronchi, and smaller bronchi. To the best of our knowledge, this is the first report of a child with typical lesions of XD with severe involvement of the lower respiratory tract and bronchiectasis.

Bronchiectasis↗

PubMed1996

Interobserver variation in the diagnosis of bronchiectasis on high-resolution computed tomography.

The purpose of our study was to determine interobserver variation in the analysis of high-resolution computed tomography (HRCT) in the lungs of patients with clinically suspected bronchiectasis. HRCT scans of 88 patients were analysed independently by three radiologists with variable experience in thoracic radiology using a subjective scoring system to record bronchi as normal, mildly abnormal or severely abnormal. The presence, severity and distribution of bronchial dilatation and bronchial wall thickening were recorded. Kappa values were calculated for assessment of interobserver agreement. Agreement between the three readers was good for the detection of bronchiectasis (kappa 0.78) and assessment of its severity (0.68), detection of bronchial wall thickening (0.64) and moderately good for the assessment of its severity (0.58) on a per-patient basis. When individual lobes were analysed, agreement was moderately good for the detection of abnormal bronchi (0.59). Agreement on the extent of abnormal bronchi using five categories was only fair (0.39), but was good when differences of one category were ignored (0.63). Interobserver variation with HRCT in suspected bronchiectasis appears satisfactory for comparative studies.

Adolescent↗

PubMed1992

Bronchiectasis in children with lymphocytic interstitial pneumonia and acquired immune deficiency syndrome. Plain film and CT observations.

In a review of 77 HIV positive children seen between 1981 and 1990, 32 were diagnosed as having lymphocytic interstitial pneumonitis). Four of the LIP group developed bronchiectasis, a finding not previously reported. The precise factors leading to the bronchiectasis are unclear. All patients had chronically consolidated lung with volume loss. A history of recurrent bacterial superinfection was not noted in any of the cases. With more cases of HIV positive children living longer, bronchiectasis, long known to occur in primary immunologic disorders, will probably be more frequently noted.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Analysis of factors associated with bronchial hyperreactivity to methacholine in bronchiectasis.

Nonspecific bronchial hyperreactivity (BHR) has been reported to occur in patients with bronchiectasis. To evaluate this further, we studied 77 patients with stable bronchiectasis (noncystic fibrosis) with special reference to the prevalence of BHR to methacholine (MCh), and its relation to lung function, sputum characteristics, concommitant asthma, and atopy. The concentration of MCh required to produce a fall of 20% in forced expiratory volume in 1 s (FEV1), PC20, was determined by Wright's nebulization tidal breathing method. BHR defined by a PC20 greater than or equal to 8 mg/ml was found in 21 of 47 (45%) subjects who underwent bronchial challenge. Presence of BHR was positively associated with low baseline spirometric values, diagnosis of asthma, long duration of disease, and elevated total IgE on univariant analysis, and was significantly related to FEV1/forced vital capacity (FVC) ratio and asthma on multiple regression analysis. Ten of the 21 hyperreactive subjects did not have clinical asthma, whereas all 11 of 22 subjects with clinical asthma who underwent bronchial challenge were hyperreactive. Among those with BHR, there was a positive correlation between PC20 and baseline FEV1. When patients were further classified into asthmatic and nonasthmatic subjects, a positive correlation between PC20 and FEV1 was seen only in those without asthma. Frequency of infective episodes and inflammatory score of sputum assessed by average daily volume, purulence, and leukocyte count did not differ significantly in the groups with and without BHR. These results suggest that BHR in patients with bronchiectasis is associated with coexistent asthma and worse spriometric values, and not with the severity of bronchial sepsis.

Adult↗