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At least 19 recordsLinked to original sources
PubMed1991

Evaluation of chronic bronchitis, chronic obstructive pulmonary disease, and ventilatory function among workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is produced as an undesirable contaminant in the manufacture of 2,4,5-trichlorophenol (TCP) and its derivatives. There is considerable concern about the health effects that may be associated with exposure to TCDD-contaminated substances. A cross-sectional medical study that included a comprehensive medical history, medical examination, and measurement of pulmonary function was conducted on workers employed more than 15 yr earlier in the manufacture of NaTCP and its derivatives at two chemical plants. The workers had substantial exposure to substances contaminated with TCDD, as evidenced by a mean serum TCDD level, lipid adjusted, of 200 ppt compared with a mean of 7 ppt in the unexposed reference group. The comparison group consisted of individuals with no occupational exposure to phenoxy herbicides who lived in the same communities as the workers. A total of 281 workers and 260 unexposed referents participated in the medical examination. Logistic and linear regression analyses, which contained categorical and continuous measures of TCDD exposure, were performed to control for important confounders, including cigarette and alcohol consumption. No difference was found between workers and referents in the risk for chronic bronchitis or COPD. Analysis of the ventilatory function data revealed no association between history of exposure to substances contaminated with TCDD and the forced expiratory volume at one second (FEV1), forced vital capacity (FVC), or the ratio of FEV1 to FVC (FEV1/FVC%).

Bronchitis↗
PubMed2000

Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease.

BACKGROUND: Individuals with chronic bronchitis or chronic obstructive pulmonary disease (COPD) may suffer recurrent exacerbations with an increase in volume and/or purulence of sputum and any therapy that reduced the number of exacerbations would be useful. There is a marked difference between countries in terms of the prescribing of mucolytics depending on whether or not they are perceived to be effective. OBJECTIVES: To assess the effects of oral mucolytics in adults with stable chronic bronchitis or COPD. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised trials that compared oral mucolytic therapy with placebo for at least two months in adults with chronic bronchitis or COPD. Studies of people with asthma and cystic fibrosis were excluded. DATA COLLECTION AND ANALYSIS: One reviewer extracted data. Study authors and drug companies were contacted for missing information. MAIN RESULTS: Twenty two trials were included. Compared with placebo, there was a significant reduction in the number of exacerbations per patient with oral mucolytics (weighted mean difference (WMD) -0.067 per month, 95% confidence interval -0.079, -0.055, p<0.001) which is a 29% reduction. The annualised rate of exacerbations in the control patients was 2.7 per year. The number of days of disability also fell on mucolytic therapy (WMD -0.56, 95% confidence interval -0.77, -0.35, p<0.001). The number of patients who remained exacerbation-free was greater in the mucolytic group thanin the placebo group (OR 2.22, 95% confidence interval 1.93, 2.54, p<0.001). There was no difference in lung function or in adverse effects reported between treatments. REVIEWER'S CONCLUSIONS: In subjects with chronic bronchitis or COPD, treatment with mucolytics was associated with a small reduction in acute exacerbations and a somewhat greater reduction in total number of days of disability.

Adult↗
PubMed2005

Development of a quantifiable symptom assessment tool for patients with chronic bronchitis: the Chronic Bronchitis Symptoms Assessment Scale.

Clinical trials that rely solely on physiologic outcomes may underestimate effects of interventions on patients' symptoms and well-being. We sought to develop and validate an instrument to reliably assess symptom severity and frequency in therapeutic trials for patients with chronic bronchitis. We performed a series of psychometric studies that determined instrument content and assessed validity and reliability. The final version of the Chronic Bronchitis Symptoms Assessment Scale (CBSAS) comprised 15 scored items (16 items total). The instrument demonstrated strong reliability with moderate to high item correlations with total scores (0.41-0.80) and an overall Cronbach's alpha of 0.91. As expected, scores were at the bottom of the range for patients without a history of previous lung disease, and no ceiling effect was seen in the most severely obstructed patients. The CBSAS demonstrated statistically significant and moderate to strong association with spirometry, (post bronchodilator, % pred FEV1, r = -0.42, % pred FVC, r = -0.50), SGRQ (total, r = 0.67) and SOBQ (r = 0.50). The Chronic Bronchitis Symptoms Assessment Scale is an easy to administer, once daily or once weekly, valid and reliable outcome measure for assessing symptom severity among patients with chronic bronchitis.

Adult↗
PubMedDate not supplied

Allergic pathogenesis in chronic bronchitis.

Chronic bronchitis is a disease related to numerous etiologic factors: infections, climate influence, air pollution, cigarette smoking, etc. From a pathogenetic point of view, chronic bronchitis is generally considered as the phlogistic resultant of various irritative conditions, with a characteristic neutrophil component in the phlogistic pattern. Microbic involvement has up to now been considered a very important factor, with consequent wide utilization of antibiotic agents in basic therapy. Considerations of clinical nature induced us to consider unsatisfactory such pathogenetic concepts based on neutrophil phlogosis, while the involvement of an allergic mechanism became more acceptable. In order to solve this problem, we have carried out hitological studies on postmortem material from the respiratory tract of individuals whose death was attributable to chronic bronchitis or to concurrent chronic bronchitis. Results of our study conducted up to now on 60 cases may be summarized as follows: Bronchitis with lymphomonoplasmacytoid phlogosis of immunoallergic type (60%), bronchitis with neutrophil phlogosis of irritative-infective type (20%); bronchitis with mixed allergic-neutrophil phlogosis (20%). Lymphocytes, monocytes and plasma cells are directly involved in allergic tissue reactions, both of immediate and delayed type because they release active substances such as hsitamine, bradyquinine, quinine, etc., which will their multiple pharmacodynamic actions are responsible of various anatomic and functional changes in hypersensitivity. Infiltration of the bronchial mucosa with lymphomonoplasmacytary cells in chronic bronchitis, has a pattern of mixed allergic phlogosis of immediate and delayed type. Prophylaxis and management of chronic bronchitis should therefore be set up on new bases, with the various treatments used for hyperactive pathology.

Adult↗
PubMed2000

The inflammatory response in chronic bronchitis.

Chronic bronchitis is diagnosed clinically by a chronic productive cough and is characterized by a variety of pathological changes, including bronchial gland hyperplasia, goblet cell metaplasia, and peribronchiolar fibrosis. As implied by the term ;;bronchitis,'' chronic airway inflammation is typically found in the central airways in patients with persistent cough and mucus hypersecretion. Although the exact pathogenesis of chronic bronchitis remains unclear, bacterial colonization and the resulting inflammatory response are thought to be of central importance. The generation of proinflammatory cytokines and chemotactic stimuli by the airway epithelium likely plays a central role in propagating the inflammatory response in patients with chronic bronchitis. Typically, an inflammatory mononuclear cell infiltrate is found in the airway wall, and the airway lumen is filled with neutrophils and their products. Further insights into the initiating events and underlying mechanisms that result in the clinical syndrome of chronic bronchitis will likely provide novel opportunities for therapeutic interventions.

Journal Article↗
PubMed2003

Quality of life, distress and self-esteem: a focus group study of people with chronic bronchitis.

Chronic bronchitis (a form of chronic obstructive pulmonary disease or COPD) is a common cause of morbidity and mortality resulting in around 5% of deaths in the UK. Over recent years, there has been an increased emphasis on patient-based evaluation of health and social care, which has led to a rapid growth in quality of life measures and an increase in measuring quality of life for COPD patients. However, less attention has been paid to patients' perceptions and experiences of everyday life, specifically their active engagement in the psychological, emotional and social aspects of adjustment and adaptation to living with chronic bronchitis. This study employs a series of four focus groups (N = 20) to identify key experiences of living with chronic bronchitis. The results, obtained through using both thematic and conceptual qualitative analysis, within a broadly symbolic interactionist framework, describe the subjective and sometimes contradictory ways in which the disease leads to psychological distress, dependency on medication, and disruption to social and family relationships, and has a negative impact on self-esteem. The study further argues for greater awareness of qualitative approaches to the broad view of quality of life as complementary to quality of life assessments.

Adult↗
PubMed2000

Goblet cell hyperplasia and epithelial inflammation in peripheral airways of smokers with both symptoms of chronic bronchitis and chronic airflow limitation.

To quantify the number of goblet cells and inflammatory cells in the epithelium of peripheral airways in smokers with both symptoms of chronic bronchitis and chronic airflow limitation, we examined surgical specimens obtained from 25 subjects undergoing lung resection for localized pulmonary lesions: 10 smokers with symptoms of chronic bronchitis and chronic airflow limitation, six asymptomatic smokers with normal lung function, and nine nonsmoking control subjects. Peripheral airways were examined with histochemical methods to identify goblet cells and with immunohistochemical methods to identify total leukocytes (CD45(+) cells), neutrophils, macrophages, CD4(+) and CD8(+) cells in the epithelium. When compared with nonsmokers, smokers with both symptoms of chronic bronchitis and chronic airflow limitation had an increased number of goblet cells (p < 0.01), CD45(+) cells (p < 0. 01), macrophages (p < 0.05), and CD8(+) cells (p < 0.01) in the epithelium of peripheral airways. When all the smokers were grouped together, they showed an increased number of neutrophils (p < 0.05) along with an increased number of goblet cells, CD45(+) cells, macrophages and CD8(+) cells (p < 0.05) compared with nonsmokers. In conclusion, smokers with both symptoms of chronic bronchitis and chronic airflow limitation have an increased number of goblet cells and inflammatory cells in the epithelium of peripheral airways.

Aged↗
PubMed2005

Diagnostic and therapeutic value of short-term corticosteroid therapy in exacerbation of mustard gas-induced chronic bronchitis.

Chronic bronchitis is the most frequent late respiratory disease among Iranians exposed to mustard gas during the Iraq-Iran war. The aim of this study was to investigate efficacy of oral and intravenous corticosteroid therapy in improving lung function in mustard gas induced chronic bronchitis patients. 65 mustard gas-exposed chronic bronchitis patients, who were not responsive to standard treatments in exacerbation occasions, were randomly divided into two groups: an intravenous group (39 patients) receiving 500 mg intravenous methylprednisolone daily, and an oral group (26 patients) receiving 1 mg/kg oral prednisolone daily. Corticosteroid was tapered over the study period in both groups. Spirometery was performed on admission and on day 8 of therapy for assessment of effectiveness of therapy. There was significant improvement in spirometery indexes of both groups in approximately half of the patients over the study period. Furthermore, there was no difference between the pulse corticosteroid versus oral corticosteroid therapy in these patients. Since short-term corticosteroid therapy has a significant effect on lung function of almost fifty percent of patients with mustard gas-induced chronic bronchitis in exacerbation occasions, we suggest a short-term bolus steroid treatment to triage the patients into responders and non-responders for subsequent treatment.

Administration, Oral↗
PubMed2001

[Hereditary polymorphism features in patients with silicosis associated with chronic bronchitis].

Chronic bronchitis frequently accompanies silicosis in metallurgy workers. Association of the two diseases significantly lowers life quality and disables the patients. Prophylactic measures for the diseases are elimination of the etiologic factors and detection of genetic markers for propensity and insusceptibility to silicosis and chronic bronchitis. Phenotypes of Lewis a-b- system, of Hp2-1 haptoglobin and of group-specific component Gc2-2 could be risk factors for chronic bronchitis in silicosis patients. Those of Lewis a-b+ system, of Hp2-2 haptoglobin and group-specific component Gc1-2 are resistant to chronic bronchitis on silicosis background.

Adult↗
PubMed2004

[Changes of plasma adrenomedullin level during the process from chronic bronchitis to chronic cor-pulmonale].

OBJECTIVE: To investigate the relationship between the plasma adrenomedullin (ADM) levels and the extent of chronic cor-pulmonale and its underlying diseases, and explore the role of ADM in these diseases. METHODS: Totally 26 patients with chronic bronchitis, chronic bronchitis accompanied with obstructive pneumonectasia or chronic cor-pulmonale were included respectively as clinical test group T1, T2 and T3; 26 normal people and 14 patients with pneumonia were chosen as control groups (group C1 and C2). Plasma concentration of ADM in every selected individual had been measured with specific radioimmunoassay. RESULTS: Levels of plasma ADM in T3 were significantly higher than those in T2, and T2 than T1, C1 and C2 (P < 0.05), but there were no obvious difference between T1 and C1, between T1 and C2 (P > 0.05). CONCLUSIONS: Plasma ADM levels can reflect the severity of the above series of diseases.

Adrenomedullin↗
PubMed2000

The safety and efficacy of short course (5-day) moxifloxacin vs. azithromycin in the treatment of patients with acute exacerbation of chronic bronchitis.

Chronic bronchitis is common among adults and infectious exacerbations contribute considerably to morbidity and mortality. We aimed to compare the safety and efficacy of moxifloxacin to azithromycin for the treatment of patients with acute exacerbations of chronic bronchitis (AECB) of suspected bacterial origin. Between October 1998 and April 1999, 567 patients with AECB were enrolled at 37 centers across the United States and Canada of which 280 (49%) had acute bacterial exacerbation of chronic bronchitis (i.e. pretherapy pathogen). Patients were randomized to either oral moxifloxacin 400 mg administered once daily for 5 days or azithromycin for 5 days (500 mg qd x 1, then 250 mg qd x 4). For the purpose of study blinding, all patients received encapsulated tablets. The main outcome measure was clinical response at the test-of-cure visit (14-21 days post-therapy). Secondary measures included bacteriologic response and a time-course of bacteriological eradication (one center only). Three patient populations were analysed for efficacy: clinically-valid, microbiologically-valid (i.e. those with a pretherapy pathogen), and intent-to-treat (i.e. received at least one dose of study drug). For the efficacy-valid group, clinical response at the test-of-cure visit was 88% for patients in each treatment group. In 237 microbiologically-valid patients, corresponding clinical resolution rates were 88% for 5-day moxifloxacin vs. 86% for 5-day azithromycin. Bacteriological eradication rates at the end of therapy were 95% for 5-day moxifloxacin and 94% for the azithromycin group. Corresponding eradication rates at the test-of-cure visit were 89% and 86%, respectively. Of note, eradication rates at test-of-cure for Haem. philos influenzae and H. parainfluenzae for moxifloxacin were 97% and 88% compared to 83% and 62% respectively for azithromycin. Among 567 intent-to-treat patients (283 moxifloxacin and 284 azithromycin), drug-related events were reported for 22% and 17%, respectively. Diarrhea and nausea were the most common drug-related events reported in each treatment group. Moxifloxacin 400 mg once daily for 5 days was found to be clinically and bacteriologically equivalent to 5-day azithromycin for the treatment of AECB of proven bacterial etiology. Given its excellent in-vitro activity, especially against antibiotic-resistant respiratory pathogens, and its acceptable safety profile, moxifloxacin should be considered an effective alternative therapy for patients with AECB of suspected bacterial origin.

Acute Disease↗