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Query: UMLS:C0149514 (bronchitis)
 6,902 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of outpatient parenteral antibiotic therapy (OPAT) has enjoyed substantial success in Italy, where patients generally believe that treatment at home is better than in the hospital. Intramuscular administration, which is commonplace in Italy, facilitates OPAT, requiring minimal training and circumventing intravenous access problems. The Italian OPAT model is a general practice-based model, but a team approach is used in the presence of severe disease, such as HIV. Seven centers in Italy are participating in the International OPAT Outcomes Registry, and have enrolled about 200 patients over 8 months. Eighty patients (40%) were treated for lower respiratory tract infections (60 pneumonia, 20 bronchitis). Most pneumonia patients had concomitant disease, including chronic heart disease, HIV and cancer. The most frequently used therapy was ceftriaxone, which permits once-daily convenience due to its prolonged half-life. Antibiotics were administered intramuscularly in more than 50% of cases. Clinical outcome was excellent, and patient and physician satisfaction was high.
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PMID:Treatment of lower respiratory tract infections in Italy: the role of outpatient parenteral antibiotic therapy. 1109 87

Common variable immunodeficiency (CVI) is a primary immunodeficiency characterized by deficient antibody production. The cause of this immunodeficiency is unknown; several in vitro studies have revealed a significant number of alterations that could explain the hypogammaglobulinemia present in this syndrome. Among those described are primary B cell alterations, numerical and functional T cell abnormalities, and defects in the interaction between accessory cells. The alteration typical of CVI is the failure of B lymphocytes to differentiate from antibody-producing cells, resulting in deficient immunoglobulin secretion. Among the T cell abnormalities described are a diminished proliferative response to mitogens and antigens, alterations in the level of production of several cytokines, especially reduction in the production of IL-2, diminished antigen-specific T cells and increase basal apoptosis after stimulation. Antigen presenting cells, monocytes and dendritic cells can also present alterations and contribute to deficient antigen response. The clinical manifestations of these patients is variable; most present recurrent bacterial infections due to encapsulated bacteria, especially sinusitis, otitis, bronchitis, and pneumonias. A few patients can present mycobacterial or fungal infection and occasionally Pneumocystis carinii. Viral infection is uncommon in these patients although some suffer recurrent herpes zoster infection. Clinical features of septicemia and central nervous system infections are less frequent. The incidence of digestive tract infections in these patients is high. The most common cause of diarrhea is Giardia lamblia; Salmonella, Shigella and Campylobacter are also common pathogens. Autoimmune disease is also more prevalent in these patients than in the general population. The most frequently associated diseases are hemolytic anemia, idiopathic thrombocytopenic purpura and autoimmune neutropenia. Cancer is also frequently associated with CVI, the most common forms being lymphoproliferative syndromes, especially non-Hodgkin's lymphoma. Granulomas are a unusual manifestation in some patients with CVI; their localization varies but the most commonly affected organs are the spleen and lungs. Some authors have compared these granulomas with those characterizing sarcoidosis, especially when appearing in the lung. Diagnosis of CVI is usually by exclusion of other diseases, such as cystic fibrosis, immotile cilia syndrome or allergic processes. CVI should be suspected in all patients with recurrent bacterial infections especially those localized in the respiratory tract. Other primary immunodeficiencies which present clinical findings similar to CVI and which should be ruled out are selective IgG subclass deficiency, IgA deficiency and selective deficiency in the response to polysaccharide antigens with normal immunoglobulin levels. The serum hypogammaglobulinemia present in all patients with CVI provides the diagnostic key. The age at which clinical manifestations appear, the absence of familial antecedents and the presence of circulating B lymphocytes form the basis of the differential diagnosis between X-linked agammaglobulinemia and autosomal recessive forms. The treatment of choice of patients with CVI is treatment with human gamma-globulin. Currently, the most common route of administration is intravenous; these molecules have a half-life of approximately 21 days and a high degree of safety concerning the possible transmission of viral infections. Adverse reactions are generally few and clinically unimportant. The most frequently used doses oscillate between 200 and 400 mg/kg body weight every 2-4 weeks. Both the dose and its frequency should be personalized for each patient. Early diagnosis of patients with CVI, application of treatment with appropriate antibiotics for infections and treatment with gamma-globulins prevent long-term complications of this disease and dramatically improve the quality of life and life expectancy of these patients.
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PMID:[Common variable immunodeficiency. Review]. 1143 84

The objective of our study is to understand the clinical features of patients with acute respiratory tract infection associated with Streptococcus milleri group (SMG). Fifteen patients with SMG respiratory tract infection visited our hospital from July, 1997 through May, 2000. There were seven cases of pneumonia, two pulmonary abscess, three thoracic empyema and three acute bronchitis. The mean age of the patients was 57.8 years (range 16-87), twelve were males, and seven were smokers. The moderately to severe underlying diseases existed in thirteen patients (86.7%) and included the following: respiratory diseases (20.0%), history of the esophageal or gastric surgery (26.7%), central nerve system diseases (13.3%), alcohol intake (60.0%), hepatitis and pancreatitis (33.3%), diabetes mellitus (13.3%) and malignancy (6.7%). The species of SMG detected were as follows: S. constellatus, 8, S. anginosus, 6 and S. intermedius, 1. Anaerobic organism and other microorganisms were detected in five patients. A patient with SMG nosocominal pneumonia who previously had thoracic surgery for esophageal cancer died. Antibiotics therapy with carbapenem or combination therapy, drainage and no surgery, were successful in 14 of the 15 cases (93.3%). The number of intermediately or complete resistant strains against penicillin G, ampicillin and cefmetazole were 5 (33.3%), 8 (53.3%) and 12 (80.0%), respectively in this series. Recently, it is seemed that acute respiratory tract infections caused by SMG are increasing in the patients with moderately to severe underlying diseases, and several clinical strains of SMG are acquiring a tolerance to antibiotics.
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PMID:[A three-year review of acute respiratory tract infections caused by Streptococcus milleri group]. 1197 85

Invasive carcinoma originates from the epithelial cells lining the lumen of an organ. It is often preceded by metaplasia, dysplasia or carcinoma in situ. The purpose of this review is to suggest that this disease of the epithelium may be, in part, the result of underlying tissue-based disorganization. Human cancer is frequently associated with pre-existing tissue disease. For example, hepatocellular carcinoma usually occurs in patients with a macronodular cirrhotic liver. Most lung cancers arise among patients with chronic lung disease (bronchitis, emphysema, and chronic infection). Mechanical forces appear to play a major role in regulating normal and cancer cell growth. The loss of cell polarity by neoplastic cells, coupled to an otherwise normal growth rate is enough to explain the cancer star-shaped pattern. By changing the plane of cell division, tumor cells may escape physical constraints from surrounding cells and divide. Loss of cell polarity and the resulting cell proliferation appears to be a consequence of either tissue-based disorganization (chronic inflammation, fibrosis) or of direct carcinogenic insult. The multiple mutations frequently described in cancer may be, in part, secondary to physical stress and not primary events. Several animal and clinical trials have shown that tissue disruption (i.e. radiation-induced fibrosis or liver cirrhosis) can be successfully treated. It is possible that treatment targeted at tissue disruption would delay or reduce cancer incidence regardless of the precise biological mechanism of carcinogenesis.
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PMID:Cancer: the role of extracellular disease. 1202 30

This article focuses on the difficulty in monitoring differences in health status in South Africa, based on subsectors of the population. Morbidity data is not routinely published, except for notifiable diseases. National mortality data is available, but lack accurate recording among rural Africans. During 1984-86, in urban areas, Africans and Coloreds had higher than the expected number of deaths from each cause of death. Standardized mortality ratios (SMRs) were significantly higher for urban Africans, compared to urban Coloreds and Whites, for tuberculosis, cancer of the cervix, pneumonia and bronchitis, and abdominal hernia. Rural Coloreds, compared to urban Coloreds, had higher SMRs for tuberculosis, cancer of the cervix, hypertensive disease, and abdominal hernia. Whites in urban and rural areas had SMRS below 100 for each cause of death. Whites living in rural areas had significantly lower SMRs for pneumonia and bronchitis. The causes of death were all treatable. The findings indicate a well-known racial inequality in mortality rates and urban-rural differences by cause. Future systems of data collection on health should be stratified by socioeconomic and demographic factors.
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PMID:Some spatial variations in South African mortality. 1217 75

Air pollution in all its forms, including sulfur dioxide, ozone, fine particles, carbon monoxide and nitrogen oxides, has resulted in human deaths and diseases worldwide. This article reports on the human suffering caused by air pollution in terms of mortality and morbidity. Based on interviews with scientists, health experts and victims, it is noted that the cities of Thailand, Mexico, Japan, Poland, the Czech Republic, Romania, and the US have the highest levels of air pollution. In these areas people suffer from respiratory illnesses such as pharyngitis, sinusitis, laryngitis, tonsillitis, bronchitis, asthma, flu, and loss of lung function. A most alarming finding indicates that residents of Los Angeles exposed to ozone pollution have double the risk of cancer compared to residents of cleaner cities. Aggravating this situation is the fact that governments often opt to sacrifice human health and lives when forced to choose between protecting the public and shielding industry from pollution regulations.
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PMID:Poisons in the air. 1232 55

"It is often observed that mortality projections are more pessimistic when disaggregated by cause of death. This article explores the generality and strength of this relationship under a variety of forecasting models. First, a simple measure of the pessimism inherent in cause-based mortality forecasts is derived. Second, it is shown that the pessimism of cause-based forecasts can be approximated using only data on the distribution of deaths by cause in two pervious time periods. Third, using Japanese mortality data during 1951-1990, the analysis demonstrates that the pessimism of cause-based forecasts can be attributed mainly to observed trends in mortality due to cancer and heart disease, with smaller contribution due to trends in stroke (women only), pneumonia/bronchitis, accidents, and suicide. The last point requires the important qualification, however, that observed trends in cancer and heart disease may be severely biased due to changes in diagnostic practice." (SUMMARY IN FRE)
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PMID:Are mortality projections always more pessimistic when disaggregated by cause of death? 1234 29

As fibre-optic bronchoscopy and CT thorax become more widely used, patients with haemoptysis who had normal CXR and sputum results are more commonly offered both CT and bronchoscopy to exclude lung cancer. Doctors who are under possible litigation pressure arising from missed diagnoses of lung cancer are often exhaustive in their investigations, even when the haemoptysis has been transient. The present study aims to investigate the number of cancer patients who can be detected with the two investigations, and compare recent similar study results with archive results. We found that despite the use of more efficient investigation tools, the yield is paradoxically much lower and, hence, less cost-effective than that of previous studies. The likely reason is that doctors tend to over-investigate, even for short-term, minimal blood-streaked sputum, which is common among simple bronchitis. In order to be more cost-effective, these investigations should be used more selectively and for high risk patients such as those with prolonged haemoptysis and those who are heavy smokers.
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PMID:Cost-effectiveness of CT thorax and bronchoscopy in haemoptysis with normal CXR for exclusion of lung cancer. 1245 8

Agricultural work is associated with high rates of injury, disability, and illness. Agricultural workers are at increased risk for a variety of illnesses including respiratory disorders, dermatologic conditions, and cancer. The recognition of ODTS led to increased understanding of acute illness in farmers and grain workers. Previously, many cases of acute illness were probably erroneously called farmer's lung. The same agents that are responsible for ODTS are responsible for the high prevalence of bronchitis in certain agricultural workers. The recent description of the innate immune system is very exciting because it will lead to increased understanding of the pathogenesis of organic dust induced disorders.
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PMID:Agricultural lung disease. 1251 66

The endobronchial brachytherapy procedure involves the insertion of an afterloading catheter into bronchus in close proximity to an endoluminal lesion, and to perform limited irradiation sparing as much as possible normal health tissues. The catheter is inserted during a classical flexible bronchoscopy. Three types of indications have been discussed: (i) palliative treatment of lung carcinoma, with or without laser desobstruction: an improvement in respiratory symptoms was observed in 60 to 80% of the cases; (ii) curative treatment for localised endobronchial carcinomas, in previously irradiated patients, or in case of contraindication of surgery or external beam irradiation; local control rate range from 60 to 70% at 2 years; (iii) combination of external irradiation and brachytherapy in the first line treatment of lung cancers. Two randomised trials did not show any improvement in survival for this approach; however, they have included advanced diseases. In the opposite, this association seems very effective for early stage lung carcinomas. Two major complications were regularly reported, haemoptysis and radiation bronchitis. Predictive factors for these toxicities are actually better known: haemoptysis could be due to a progressive disease more often than to brachytherapy itself; technical factors (dose, volume, fractionation), however, could explain a number of radiation bronchitis, and their incidence could decrease in the future.
Cancer Radiother 2003 Feb
PMID:[Endobronchial brachytherapy: technique and indications]. 1264 15


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