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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↗
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↗
PubMed1989

The prevention of severe lower respiratory infections in chronic bronchitis.

Chronic bronchitis remains as a serious medical problem for many adults and a smaller proportion of children in the United States. The frequency of severe lower respiratory infections in patients with chronic bronchitis is quite variable. The infectious agents most likely responsible for severe lower respiratory disease include pneumococci, nontypable Haemophilus influenza, Mycoplasma pneumoniae, and Branhamella catarrhalis among the bacteria, and influenza A and B viruses, with parainfluenza and adenoviruses less common. Prophylactic antibiotics, particularly tetracycline and derivatives, were the only drugs suggesting efficacy in controlled trials for decreasing exacerbation, but many studies failed to show efficacy. Killed influenza vaccines should be used annually in any patient with chronic bronchitis. Pneumococcal vaccine has had questionable benefit for bronchitics but should nevertheless be considered for use because of its low cost and proven safety. The antiviral drug amantadine may be useful in bronchitics unable to take influenza vaccines.

Adult↗
PubMed1991

Risk factors for chronic bronchitis and chronic obstructive lung disease.

Among the risk factors for chronic bronchitis and chronic obstructive lung disease, only smoking and alpha 1-antitrypsin deficiency effects have been well demonstrated. Other factors, as air pollution, occupational exposure and childhood lung diseases may have an influence, but on a lower scale. The prevention of chronic bronchitis and chronic obstructive lung disease remains mainly based on antismoking programs.

Air Pollution↗
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↗
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↗
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↗
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↗
PubMed1990

Airway pathology of functional significance in chronic bronchitis and chronic obstructive airway disease.

The three major hypothesis for reduction in the calibre of the peripheral airways in chronic obstructive lung disease are 1) a loss of elastic recoil in the alveolar supporting structure, 2) destruction of the alveolar attachments to the outer wall of the small airways, and 3) a chronic inflammatory process in the wall and lumen of the peripheral airways. This presentation is based on the analysis of an ongoing study where lung function has been measured a few days prior to lung resection. The data collected to date support the third hypothesis and are of interest in developing strategies to treat patients with COAD because they suggest that therapy should be directed at preventing the inflammatory process in the peripheral airways rather than the prevention of lung destruction by emphysema.

Bronchitis↗
PubMed1977

Some psychological concomitants of chronic bronchitis.

Thirty chronic bronchitic patients with severe airways obstruction were individually matched with non-bronchitic controls from the general population. The 2 groups were compared using the Zung Self-Rating Depression Scale (SDS) and the General Health Questionnaire (GHQ) to assess non-psychotic psychiatric disturbance, the Eysenck Personality Inventory (EPI) to assess personality traits, and the Marlowe-Crowne (M-C) scale plus the L (Lie) scale of the EPI to assess social-desirability response set. Chronic bronchitic patients were both more psychiatrically disturbed and more neurotic in personality than were their matched controls; but there were no differences between the 2 groups on the personality trait of extraversion or on measure of social desirability response set. The results are discussed in the context of both chronic bronchitis specifically and chronic illness in general, and future investigations are proposed.

Adult↗
PubMed1991

History of the treatment of chronic bronchitis.

Although chronic bronchitis was first named and described in 1808, the disease has been known since earliest time, and numerous drugs have been utilized in its therapy. The basic historic theories of human function have readily been applied to bronchitis; thus in Greek medicine, the disease was appreciated as one of excess phlegm. Early remedies included garlic, pepper, cinnamon, and turpentine, whereas later therapies of choice emphasized coffee, ipecac, and potassium nitrate. Most of the favored bronchodilator drugs of today are derived from the traditional folk remedies, ephedrine, atropine, and theophylline. The most interesting historical drugs, however, are those that have given rise to modern mucokinetic agents such as bromhexine and iodides.

Bronchitis↗
PubMed1979

[Antibiotics therapy in chronic bronchitis].

In chronic bronchitis antibiotic therapy is no causative therapy, because infection rarely is the beginning but the complication of an already existing airway disease. While sputum cultures are very limited in their value, blind chemotherapy of bacterial infections by substances like tetracycline, ampicilline, azidocilline or cotrimoxazole is allowed. In cases of additional obstruction a combination with corticosteroids sometimes may be useful.

Anti-Bacterial Agents↗
PubMed1978

Criteria for evaluating mucus functions and their disorders in chronic bronchitis.

In chronic bronchitis, disorders of the physical and chemical properties of mucus may contribute to bronchial obstruction. The abnormalities are analysed in sputum collected by physiotherapy. Measurements of the rheological properties (apparent viscosity and strain recovery), content analysis of secretory immunoglobulin A (S-IgA) and of serum albumin, and determination of the transport velocity of sputum on the ciliated frog palate provide reliable indices of the functional capacity of bronchial mucosa. The effectiveness of mucociliary clearance and coughing is analysed in patients by measuring the rate of removal of radioactive particles deposited on proximal airways. Different types of pathological secretions may be observed. In subjects with occasional cough and sputum, the secretions are characterized by a high content of S-IgA and serum albumin, and a high viscosity and low elasticity, reflecting their high degree of cross-linking. In chronic bronchitics, the S-IgA content and viscoelastic properties of sputum decrease as the illness progresses. During infection, purulent sputum exhibits high viscosity and low strain recovery. Such modifications of the rheological properties of mucus may impair mucociliary clearance. The role of the elastic component is predominant. Sputum, characterized by very low strain recovery (SR less than 4 units) or conversely by very high strain recovery (SR greater than 15 units), is transported at a low rate by mucociliary clearance. A marked hyperviscosity (no greater than 200 poises (120 N s m-2)) also appears as a limiting factor of the mucociliary clearance.

Animals↗