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

A good deal of ambiguity exists surrounding the term chronic obstructive pulmonary disease. Although much information has been uncovered concerning cellular epithelial mechanisms, the inflammatory response, and airflow obstruction, considerable research still needs to be conducted to offer better diagnostic categorization and definition of the role of occupational and environmental agents in the development of obstructive lung disease. This article will review these ambiguities of definition, as well as difficulties in estimating disease prevalence. The pathology of occupational bronchitis as well as occupational etiologic factors, including coal dust, will be reviewed. The significance of airways obstruction as a prognostic factor for future morbidity and its relevance for prevention are discussed.
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PMID:Occupational chronic bronchitis: does it mean anything? 797 63

Seven cases of single lung transplantation are reported. The recipients were all below 60 years of age and severely disabled with end-stage lung disease. Transplantation was performed according to ABO blood group compatibility and negative lymphocytotoxic cross-match between donor and recipient irrespective of HLA mismatch. Recipients' diagnoses were sarcoidosis (3), alfa-1 antitrypsin deficiency (3), and idiopathic emphysema (1). Mean recipient age was 48 +/- 2.4 years (range 45-52). Donor age was 29.7 +/- 5.6 years (range 16-49). The immunosuppressive regimen included cyclosporin A, azathioprine, steroids and rabbit antithymocyte globulin. Excellent graft function was achieved. Six patients survived the postoperative period and are alive 4-18 months posttransplant. One patient died after the operation due to pneumonia with respiratory distress syndrome. Graft function was also monitored by transbronchial biopsy, and 57 biopsy procedures were performed without fatal complications. Acute cellular rejection was seen in 16 biopsy specimens from 5 recipients (grade 1 and 2 rejection in 14, grade 3 rejection in 2). Neither severe rejection with septal necrosis (grade 4) nor obliterative bronchiolitis was seen. The rejection rate was 0.03 episodes per patient/month. In contrast to other reports, episodes of cellular rejection occurred throughout the observation period, and were not mainly limited to the first 4 months posttransplant. Graft vascular occlusive disease or chronic vascular rejection was found in 6 biopsy specimens from one recipient. Five patients experienced 7 episodes of cytomegalovirus infection. The cytomegalovirus infection rate was 0.01 episodes per patient/month. The incidence of infection was significantly lower compared to previous studies of rejection in other lung graft combinations. Both infections and rejection episodes may contribute to the development of obliterative bronchiolitis. Almost one third of the specimens (30%) showed lymphocytic bronchitis without perivascular inflammation. The absence of perivascular infiltrates and exclusion of infectious agents leaves in question the aetiology of this inflammation. The lymphocytic bronchitis could be ischaemic, related to aspiration, or represent recurrent sarcoidosis, or, in fact, express bronchial rejection. All biopsy specimens regarded as rejection with cellular infiltrates in the lung parenchyma also showed a lymphocytic bronchitis. The impact of HLA mismatch on cellular and vascular rejection is unclear. Transbronchial biopsy is a reasonably safe and reliable method in the diagnosis of rejection and infection in single lung transplantation.
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PMID:Single lung transplantation. Morphological surveillance by transbronchial biopsy. 839 61

Five patients in a pediatric population were identified with idiopathic follicular bronchitis (IFB) by open lung biopsy and their case records were reviewed. All were tachypneic and had a chronic cough by 6 weeks of age. The physical examination was characterized by diffuse fine crackles in four patients and by coarse rhonchi in one. The chest radiographs in all demonstrated a diffuse interstitial pattern. None had a collagen vascular or an autoimmune disease demonstrable. Response to corticosteroid therapy was minimal. Associated or coincidental esophageal reflux was treated surgically in two. No viral or bacterial agents were isolated in the sputum or the biopsy specimens. Patients have been followed up for 2 to 15 years; the conditions of all patients improved at about 2 to 4 years of age. The older patients have residual mild obstructive lung disease. To our knowledge, this is the first reported series of IFB in the pediatric population.
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PMID:Follicular bronchitis in the pediatric population. 840 88

Industrialization of farming, animal raising, and forestry has added chemical and mechanical hazards that need to be recognized and prevented. Lung disease among farmworkers can result from a wide variety of hazardous exposures, which include organic dusts, allergens, chemicals, toxic gases, and infectious agents. In addition to nonspecific symptoms of mucous membrane irritation, farmworkers can experience occupational asthma or bronchitis, organic dust toxic syndrome, hypersensitivity pneumonitis, silo filler's disease (toxic hemorrhagic pulmonary edema), and neuromuscular respiratory failure. At risk are farmworkers and those involved in the processing, stocking, transportation, handling, and inspection of unprocessed agricultural, animal, and forestry products; veterinarians; gardeners; game, river, and forest keepers; persons involved in building, supplying, or servicing farm operations; and residents of rural communities. Worker education on the risks of environmental exposures, adherence to safety regulations, and increased knowledge of the cause and prevention of environmental diseases will reduce their prevalence and their adverse human and animal health and socioeconomic effects.
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PMID:Lung (agricultural/rural). 863 35

Use of methotrexate to treat rheumatoid arthritis is associated with pulmonary adverse effects in 3% to 5% of cases. In addition to immunoallergic lung disease, bronchitis and pneumonia due to pyogenic organisms, opportunistic lower respiratory tract infections have been reported, including, to our knowledge, 18 cases of Pneumocystis carinii pneumonia. We report two new cases of P. carinii pneumonia in methotrexate-treated rheumatoid arthritis patients. One case occurred in a 62-year-old woman with a nine-year history of seropositive rheumatoid arthritis treated for the last seven months with methotrexate, 15 mg per week, and prednisone, 10 mg/d. The other patient was a 58-year-old woman who had been diagnosed with rheumatoid arthritis 18 months earlier and had been receiving 15 mg per week of methotrexate for eight months in combination with 12.5 mg of prednisone per day. Both patients had negative tests for the human immunodeficiency virus. Symptoms consisted of fever, cough and dyspnea, with interstitial infiltrates on chest films, hypoxia, and lymphopenia (700 and 600/mm3, respectively). The diagnosis was confirmed by bronchoalveolar lavage. Both patients recovered under treatment with trimethoprim-sulfamethoxazole. An analysis of the 20 cases of P. carinii pneumonia reported to date in methotrexate-treated rheumatoid arthritis patients demonstrated a number of characteristics: the rheumatoid arthritis was of recent onset in some cases (a few months in one patient); lymphopenia was present in two thirds of cases; one-third of patients were not receiving corticosteroid therapy; the dosage and duration of methotrexate therapy varied widely, from 5 to 30 mg per week and two to 48 months; and four patients died.
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PMID:Pneumocystis carinii pneumonia in rheumatoid arthritis patients treated with methotrexate. A report of two cases. 881 57

On the basis of development of the immunosuppressive drugs such as cyclosporine since 1981, many successful cases have been reported on clinical lung and heart-lung transplantations. A principal disease for a single lung transplantation is pulmonary fibrosis. Obstructive lung disease and bilateral pulmonary sepsis such as cystic fibrosis and bronchiectasis are now considered to be done double lung transplantation. On the other hand, heart-lung transplantations have been performed not only on primary pulmonary hypertension and Eisenmenger's syndrome but also on restrictive and/or obstructive lung disease. Today's subjects on lung and heart-lung transplantations are as follows 1) The establishment of preservation method of transplant organs. 2) Development of an appropriate technique of monitoring for the rejected lungs. 3) Assessment and improvement of bronchial anastomotic healing. 4) Investigation of the causal factors on reimplantation response and obliterative bronchitis. Long-term survivals have been reported in both lung and heart-lung transplantation. Therefore, many attempts have been increasingly made in order to obtain the heart beating cadaver donors in Japan. But experimental study on the unsolved problems of transplantation should be continuously carried out for successful clinical lung and heart-lung transplantation.
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PMID:[Present status of lung transplantation and heart-lung transplantation]. 930 6

We prospectively assessed the frequency of pulmonary complications and the natural course of lung function after bone marrow transplantation (BMT), as well as the effect of several risk factors in a homogeneous group of 39 children who underwent allogeneic or autologous BMT for haematological malignancies between 1992 and 1995. Four patients developed pneumonia within the first 3 months and three 3-6 months after BMT. A considerable percentage of acute bronchitis was recorded throughout the follow-up. Three patients died after the 6 month visit because of pneumonia (two patients) and pulmonary aspergillosis (one patient). No patients had obstructive lung disease syndrome. At 3 months after BMT, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and transfer factor of the lung for carbon monoxide (TL,CO) significantly decreased, but FEV1/FVC ratio and maximal expiratory flow at 25% of FVC remained unchanged, suggesting a restrictive defect with diffusion impairment. At 18 months, there was a progressive recovery in lung function, although only 11 patients had normalized. Seropositivity for cytomegalovirus had a significant effect on lung function whereas graft-versus-host disease also had an effect, although it was not statistically significant. Baseline respiratory function, type of transplant, type of conditioning regimen and respiratory infections did not significantly affect the outcome of BMT. The high frequency of severe lung function abnormalities found in this study, suggests a careful functional monitoring in all subjects undergoing bone marrow transplantation, even in the absence of respiratory symptoms.
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PMID:Pulmonary complications and respiratory function changes after bone marrow transplantation in children. 938 57

Long-term health effects of moderate ambient air pollution are rarely investigated. In Switzerland, no large-scale study has addressed this issue so far. Important results of the Swiss Study on Air Pollution and Lung Disease in Adults (SAPALDIA) are presented. During the period 1991-1993, SAPALDIA investigated a random population sample (18-60 years) in eight Swiss areas with different environmental characteristics (Aarau, Basel, Davos, Geneva, Lugano, Montana, Payerne, Wald). In total, 9651 adults (60%) participated in the cross-sectional investigation (part 1, 1991), consisting of the following standardized procedures: questionnaire (interview), forced expiratory lung function test, bronchial challenge with methacholine, atopy assessment (Phadiatop, unspecific total IgE), allergy skin tests, and endexpiratory CO-measurements. Subjects with a history of respiratory symptoms, increased bronchial reactivity, reduced lung function (FEV1/FVC < 80% predicted) and 150 healthy never-smokers were included in the subsequent diary study (part 2; n = 3281, 1992/93). Peak flow (morning and evening), symptoms, medication, personal activity and visits to the doctor were monitored. Across regions, annual mean values ranged from 9 to 52 mg/m3 (NO2) and 10 to 33 mg/m3 (PM10) respectively. Air pollution had effects on prevalence of dyspnea (+41% per 10 mg/m3 increment of the annual mean PM10, 95% CI 20-65%), on symptoms of chronic bronchitis (+31%, 10-55%), on FVC (-3.1%; -3.7 to -2.6%), and FEV1 (-1.1%; -1.7% to -0.5%), on the incidence of respiratory symptoms and the length of symptomfree intervals (11% change per 10 mg/m3 PM10), but not on the prevalence of asthma. Environmental tobacco smoke (ETS) showed impact on wheezing (OR 1.94; 1.39-2.70), asthma (1.39; 1.04-1.86), bronchitis (1.60; 1.24-2.08) and chronic bronchitis (1.50; 1.11-2.02). Health effects of moderate air pollution were confirmed in Switzerland. Although for the individual the relative risks are small, the public health impact may be considerable. An ongoing follow-up will investigate the mortality profile of the SAPALDIA cohort.
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PMID:[Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA)]. 952 21

Pasteurella multocida has been implicated as the cause of a variety of respiratory conditions (eg, bronchitis, pneumonia, lung abscess, empyema), but hemoptysis has been noted only in conjunction with other lung conditions. We report a case in which hemoptysis was the sole manifestation of Pasteurella infection. The patient was a middle-aged man with severe obstructive lung disease and exposure to cats. Diagnosis was made by bronchoscopy and high-dose penicillin was required for resolution.
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PMID:Hemoptysis as the sole presentation of Pasteurella multocida infection. 959 62

Metered-dose inhalation therapy is the method of choice for a number of respiratory conditions including asthma and bronchitis. Correct use of the metered-dose inhaler (MDI) has been the subject of much research. Devices have been developed to assist with training in their proper use and to enhance the effectiveness of MDI therapy. However, all lack patient pulmonary state assessment. We have approached the development of an improved portable MDI device by focusing on the total system elements that contribute to a smart inhalation therapy device. Components of such a system should include assessment of the patient's therapeutic state, tracking of drug usage, and also include physician-modified alarm thresholds. Therapeutic state is best assessed with end-expiratory CO2 measurements augmented by inspiratory and expiratory flow efforts. Drug usage monitoring needs to include the time history of drug administration. Physician-modified alarms should allow configuration of the smart inhaler to account for patient condition so that appropriate alarm limits can be established; for example, raising the CO2 alarm threshold for patients with chronic lung disease.
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PMID:Improving portable inhalation therapy through real-time assessment of patient pulmonary state. 973 11


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