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Results for “Bronchitis, Chronic”

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At least 55 records · Page 3Linked to original sources

PubMed1991

Double-blind comparative study of ofloxacin (Hoe 280) and trimethoprim-sulfamethoxazole in the treatment of patients with acute exacerbations of chronic bronchitis and chronic obstructive lung disease.

In a double-blind study of 137 patients with exacerbation of chronic bronchitis and chronic obstructive lung disease, the efficacy and safety of ofloxacin was compared with that of trimethoprim-sulfamethoxazole (TMP/SMX). Both groups improved. The frequency of severe adverse reactions was highest in the TMP/SMX group, and 14.9% of the patients discontinued the treatment. In the ofloxacin group 6% had to stop the treatment. The failure rate was significantly lower in the ofloxacin-treated patients, 3.2% versus 13.8% in the TMP/SMX group. Ofloxacin was found to be an effective drug with few adverse reactions.

Adolescent↗

PubMed1990

Effects of corticosteroids in "chronic bronchitis" and "chronic obstructive airway disease".

In order to improve our knowledge concerning the supposedly beneficial effects of corticosteroids in patients with "chronic bronchitis" and "chronic obstructive airway disease" (COAD), it is necessary to define our patients carefully, so that every investigator can interpret the data adequately. Up to now, no definite conclusion can be drawn as to the profitable effect of corticosteroids in COAD. A combination of data from many studies on oral and inhaled corticosteroids strongly suggests that long-term studies in large groups of patients are essential if we wish to determine a potential treatment effect. In this way, a sub-group of patients who improve on corticosteroids may be found too. In addition to objective measurements, e.g. degree of airflow obstruction and airway hyperresponsiveness (AH), subjective data and information on the patient's quality of life and exacerbations should be included for evaluation.

Adrenal Cortex Hormones↗

PubMed2003

[Pharmacoeconomic study of antibiotic therapy for exacerbations of chronic bronchitis and chronic obstructive pulmonary disease in Latin America].

Chronic obstructive pulmonary disease (COPD) and chronic bronchitis are highly prevalent diseases. Studies designed to analyze the economic impact of these diseases in Latin American countries have not previously been published. In the present study we analyzed the direct health care costs of treating patients with exacerbations of chronic bronchitis and COPD in Argentina, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela, applying the real cost of drugs and medical acts in those 7 countries to the pattern of treatment and outcomes obtained from a study carried out in primary care settings in Spain. The mean direct health care cost ranged from US $98 in Colombia to $329 in Argentina. Most of the cost was related to failure of therapy, which accounted for 52% of the total cost of exacerbation, with the lowest rate in Colombia at 28.6% and the highest in Ecuador at 59.3% The cost of antibiotic therapy represented 19% of the total cost; the rest was owing to other drugs or medical visits. Exacerbations generate significant costs for health care systems. There are considerable variations related mainly to differences between systems. Antibiotic therapy represents a small part of the overall cost. The use of more effective antibiotics, if they can reduce failure rates, may be a cost-effective strategy.

Acute Disease↗

PubMed1991

[Physiotherapy and mask treatment of chronic bronchitis and chronic obstructive lung disease].

The literature concerning traditional chest physiotherapy (postural drainage, percussion, vibration, breathing exercises), treatments with masks (CPAP, IPPB, RMT, PEP, PEEP) and general physical training in the treatment of chronic bronchitis is reviewed. The mucociliary clearance is increased after postural drainage, cough, forced expiratory manoeuvres and general physical training, but the influence of this upon the course of the disease is unknown. Chest physiotherapy in the treatment of patients admitted due to acute exacerbation of chronic bronchitis seems of no help. The use of face masks in this population has only been subject to limited investigation, but results from controlled trials do not indicate any favourable effect. In contrast general physical training seems to increase physical endurance and decrease dyspnoea. Specific rehabilitation programmes comprising psychological assistance, cessation of smoking and general physical training seem promising.

Bronchitis↗

PubMed2000

Airway inflammation in nonobstructive and obstructive chronic bronchitis with chronic haemophilus influenzae airway infection. Comparison with noninfected patients with chronic obstructive pulmonary disease.

Nonencapsulated Haemophilus influenzae often causes chronic infections of the lower respiratory tract in both nonobstructive and obstructive chronic bronchitis. We assessed airway inflammation in clinically stable, chronically H. influenzae-infected patients with nonobstructive (CB-HI, n = 10) and in patients with obstructive chronic bronchitis (COPD-HI, n = 10) by analyses of the sol phase of spontaneously expectorated sputum (SSP). As compared with the CB-HI group, the COPD-HI group had significantly higher (p < 0.05) levels of myeloperoxidase (MPO) and tumor necrosis factor (TNF)-alpha in their SSP, whereas the degree of plasma protein leakage (SSP-to-serum ratio of plasma proteins) and the levels of interleukin (IL)-8, secretory IgA, and lactoferrin were similar in the two groups. These findings point to differences in pathophysiology in CB-HI and COPD-HI. The high level of TNF-alpha in the SSP of COPD-HI patients is in accord with the proposed role of TNF-alpha in the development of airway obstruction in COPD patients. In apparent contradiction, low levels of TNF-alpha were found in the SSP of noninfected but otherwise similar COPD patients (n = 9). This finding, however, does not exclude an exaggerated TNF-alpha response to infection or another stimulus in the airways of COPD patients. The SSP levels of MPO and IL-8, and the degree of plasma protein leakage in the COPD-HI group, were retrospectively compared with and found significantly higher than those of noninfected COPD patients, suggesting a more marked inflammatory response in COPD-HI. Whether this reflects a direct cause-and-effect relationship should be addressed in a future long-term prospective study involving repeated measurements in the same patients.

Bronchitis↗

PubMed2005

Health-related QOL in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease: a review of the literature.

There is a lack of emphasis on health-related QOL (HR-QOL) changes associated with acute exacerbation of chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD). The aim of this review is to examine the use of HR-QOL instruments to evaluate acute exacerbation of CB or COPD, so as to form recommendations for future research.A literature search of papers published between 1966 and July 2003 identified more than 300 articles that used acute exacerbation of CB or COPD as the search term. However, only 21 of these studies employed HR-QOL measures as predictors of outcome or in the assessment of the impact, evolution or treatment of acute exacerbations of COPD or CB. A variety of HR-QOL measures were used, both generic and disease specific. The disease-specific St George's Respiratory Questionnaire (SGRQ), devised for patients with stable CB and with a recall period of 1-12 months, was the most widely used measure, with the Chronic Respiratory disease Questionnaire (CRQ) and the Baseline and Transitional Dyspnoea Index (BDI, TDI) being the only other disease-specific measures used. Most measures, both generic and disease specific, performed adequately when used during acute exacerbation of CB or COPD and indicated poor HR-QOL during acute exacerbation, which improved on resolution of the exacerbation. Relationships were evident between HR-QOL during an acute exacerbation and various outcomes, including post-exacerbation functional status, hospital re- admission for acute exacerbation or COPD, and mortality. There is a need for studies of treatments for acute exacerbation of CB or COPD to include an appropriate HR-QOL instrument to aid in the stratification of patients so as to target the right treatment to the right patient group. While a new instrument could be developed to measure HR-QOL during acute exacerbation of CB or COPD, currently available disease-specific measures such as the CRQ and the SGRQ appear to be acceptable to patients during acute exacerbation. However, the recall period of the SGRQ symptoms component should be shortened to make it more appropriate for use during acute exacerbation.

Animals↗

PubMed2005

Variables associated with recovery from acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease.

OBJECTIVE: To identify risk factors for late recovery and failure after ambulatory treatment of exacerbations of chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD). METHODS: Observational, non-randomised study of risk factors carried out in 2001 and 2002 in Primary Care practices. Patients aged 40 or older diagnosed with an exacerbation of CB or COPD of probable bacterial etiology were included in the study and followed up for 10 days. Patients were treated with amoxicillin plus clavulanic acid (co-amoxiclav) 500-125 mg tds for 10 days, clarithromycin 500 mg bd for 10 days or moxifloxacin 400 mg od for 5 days. RESULTS: Two hundred and fifty-two general practitioners participated, registering 1147 valid patients. The rate of failure at day 10 was 15.1% without significant differences among the antibiotic treatments. Median time to recovery was 5 days. Factors significantly associated with late recovery (>5 days) on multivariate analysis were: use of long-term oxygen (OR=1.96; 95%CI=1.35-2.85); use of short-acting beta-2 agonists (OR=1.51; 1.17-1.92). The use of moxifloxacin had a "protective" effect against late recovery compared to co-amoxiclav (OR=0.34; 0.26-0.45) and clarithromycin (OR=0.41; 0.31-2.85). Factors associated with therapeutic failure were: previous hospitalisation (OR=1.61; 1.08-2.42); and 2 or more exacerbations the previous year (OR=1.51; 1.04-2.17); criteria of CB had a protective effect against failure (OR=0.53; 0.35-0.79). CONCLUSIONS: There are readily identifiable risk factors for ambulatory treatment failure of exacerbations of CB and COPD. In addition, long-term oxygen therapy and short-acting beta-2 agonists are associated with late recovery, and the use of moxifloxacin compared with co-amoxiclav and clarithromycin is associated with faster recovery of symptoms.

Acute Disease↗

PubMed1990

[Physical therapy and mask treatment of chronic bronchitis and chronic obstructive lung disease (COPD)].

The literature concerning traditional chest physiotherapy (postural drainage, percussion, vibration, breathing exercises), treatments with masks (CPAP, IPPB, RMT, PEP, PEEP) and general physical training in the treatment of chronic bronchitis is reviewed. The mucociliary clearance is increased after postural drainage, cough, forced expiratory manoeuvres and general physical training, but the influence of this upon the course of the disease is unknown. Chest physiotherapy in the treatment of patients admitted on account of acute exacerbation of chronic bronchitis does not appear to help. The use of face masks in this population has only been subject to limited investigation, but results from controlled trials do not indicate any favourable effect. In contrast, general physical training seems to increase physical endurance and decrease dyspnoea. Specific rehabilitation programmes comprising psychological assistance, cessation of smoking and general physical training seem promising.

Bronchitis↗

PubMed1993

Eosinophilic and neutrophilic inflammation in asthma, chronic bronchitis, and chronic obstructive pulmonary disease.

BACKGROUND: Eosinophils but not neutrophils may play a role in the airway inflammation of asthma. In chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD), neutrophils are present in the airways. To differentiate among the pathology of asthma, CB, and COPD eosinophils and neutrophils were studied in peripheral blood, bronchial biopsy specimens, and bronchoalveolar lavage fluid (BALF). METHODS: We studied nine nonsmoking healthy subjects, 20 nonsmoking patients with asthma, 10 nonatopic smoking patients with CB (forced expiratory volume in 1 second: 98.4% +/- 11.3%) and 17 patients with COPD (forced expiratory volume in 1 second: 51.2% +/- 14.3%). Eosinophils were characterized by their enumeration in biopsy specimens (EG2 monoclonal antibody), peripheral blood, and BALF and by measurement of eosinophil cationic protein in BALF. Neutrophils were characterized by their enumeration in biopsy specimens (anti-elastase monoclonal antibody) and BALF and by measurement of neutrophil-specific myeloperoxidase in BALF. RESULTS: In patients with asthma we found degranulated eosinophils in biopsy specimens and significantly increased eosinophil cationic protein levels in BALF. In patients with CB or COPD, eosinophil numbers in biopsy specimens were not significantly different from those of patients with asthma, but cells were not degranulated and eosinophil cationic protein levels in BALF were similar to those of normal subjects. In patients with CB or COPD neutrophils were not increased in the mucosa, but neutrophil numbers and myeloperoxidase levels in BALF were significantly increased. CONCLUSION: The percentages of neutrophils in BALF were greater in patients with COPD than in those with CB, suggesting a role in the chronic airflow limitation.

Adult↗

PubMed1990

Inflammatory indices for chronic bronchitis and chronic obstructive airway disease. Cell populations in bronchial and bronchoalveolar lavage.

The development of chronic bronchitis (CB) and chronic obstructive airway disease (COAD) seems to be related to inflammatory changes of airway structure. However, the cause and the exact location and type of these changes resulting in altered airway function are not known. Mucosal inflammation is characterized by the recruitment of granulocytes, macrophages and lymphocytes as well as by the shedding of epithelial cells. The present chapter discusses the usefulness of bronchial lavage (BL; 50 ml of lavage volume) directly followed by bronchoalveolar lavage (BAL; 200 ml), for the characterization and quantification of inflammation in proximal and peripheral airways, respectively. On the basis of results from the literature and a pilot study on CB patients with or without coexisting COAD, the following conclusions may be drawn: There is a profound difference in lavage cell composition and numbers between non-smokers and smokers. However, within the group of smokers there are few additional changes in cell numbers and composition when concomitant airway disease is present. The obstruction of the COAD patients is correlated to a reduced recovery of BL and BAL fluid. Furthermore, these patients seem to have a reduced number of most cell types in their BL. This diminitution is not just related to the reduced fluid recovery. The BL cells have a lower viability and BL macrophages have a reduced phagocytic capacity when compared with matching BAL cells. The viability of cells was lowest in BL from the COAD group. These findings may suggest that COAD entails a reduced transport of macrophages to the small airways and/or an enhanced turnover of these cells in the bronchi. Functional studies of lavage cells may supply additional, and perhaps more specific, information on the mechanisms involved in the inflammatory process.

Bronchi↗

PubMed1976

Follow-up evaluation of a prevalence study for chronic bronchitis and chronic airway obstruction.

Follow-up of the prevalence study of respiratory symptoms and chronic airway obstruction was performed after a 6- to 7-year interval. One hundred fifteen of 117 subjects (98%) originally labeled "abnormal" (chronic bronchitis or asthma by history, or ratio of 1-sec forced expiratory volume to forced vital capacity less than 60 per cent), and 111 of a random sample of 116 subjects (96%) originally labeled "normal" were traced. Nineteen patients were dead, 14 "abnormal" subjects, and 5 "normal" subjects (P less than 0.01). Eighty-eight of the originally labeled "abnormal" subjects and 91 of the random "normal" sample could be retested by spirometry. Subjects with lower initial ratios of 1-sec forced expiratory volume to forced vital capacity tended to lose more 1-sec forced expiratory volume and forced vital capacity. Early identification of respiratory symptoms and spirometric abnormalities may identify persons at increased risk of death who could benefit from appropriate therapy.

Adult↗

PubMed2001

Safety and effectiveness of lomefloxacin in patients with acute exacerbation of chronic bronchitis (AECB) chronically treated with oral theophyllines.

Lomefloxacin is a difluorinated quinolone with excellent activity against a wide range of pathogens including those responsible for acute exacerbations of chronic bronchitis (AECB). This open, cross-sectional, multicenter study has evaluated the efficacy and safety of a once-daily dosage of 400 mg lomefloxacin in patients with AECB chronically treated with theophylline. 137 patients (96 males, 41 females; mean age 66.1+/-11.2 yrs) were enrolled and 133 completed the study. 81% suffered from moderate AECB, 16% severe AECB. The clinical success rate was very high (95%), as well as the microbiological (93%). Side effects were scarce and were significant only in 3 patients, with 2 dropouts. All patients were using theophylline derivatives twice daily and continued without any variation in dosage during the lomefloxacin treatment. Theophylline plasma levels determined in 103 patients at baseline, during and at the end of the lomefloxacin treatment did not significantly change. We conclude that orally administered lomefloxacin at standard recommended dosage is well tolerated and effective in elderly patients with AECB. No dose adjustment is required even when it is co-administered with methylxanthines.

Acute Disease↗

PubMed1986