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

Lower respiratory tract infections (LRIs) during early childhood can lead to bronchial hyperreactivity or recurrent obstructive bronchitis. The role of LRIs in the pathogenesis of allergic diseases such as allergic rhinoconjunctivitis, atopic eczema, and bronchial asthma is less clear. The aim of this retrospective study was to determine the incidence of subsequent wheezing and atopy, and the known risk factors for allergic sensitization in 74 children hospitalized for acute LRIs of various etiologies from January 1994 through December 1994. Results showed that there are no differences in outcomes between patients with respiratory syncytial virus LRI, Chlamydia pneumoniae LRI, and LRIs caused by other agents. Although lower respiratory tract illnesses, especially those caused by respiratory syncytial virus during infancy, were associated with an increased risk of subsequent wheezing during early childhood, wheezing tended to disappear with increasing age in many children. This study also found recurrent episodes of wheezing during the first 5 years of life, and symptoms suggestive of allergic rhinoconjunctivitis were the only factors predictive of subsequent diagnosis of asthma for children who had LRIs during early childhood. In conclusion, this study suggests that prevention of recurrent wheezing LRIs and good control of allergic rhinoconjunctivitis is critical for preventing subsequent development of bronchial asthma.
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PMID:Risk factors of wheeze and allergy after lower respiratory tract infections during early childhood. 1182 5

This case presented the scenario of a patient who had severe bronchospasm from an unknown etiology. Further, she had difficulty speaking and denied any past medical history, which made a diagnosis more difficult. Prehospital providers were challenged with determining the differential diagnosis for bronchospasm and hypoxemia. Was the patient experiencing an anaphylactic reaction, acute asthmatic attack or something else? The key here, once again, is conducting a thorough assessment and patient history. Remember, all that wheezes is not asthma; therefore, providers in this case had to determine if the patient was suffering something such as anaphylaxis, asthma, bronchitis, pneumonia or even congestive heart failure (CHF). Typically, anaphylaxis and asthma affect ventilation, not oxygenation, so until the late stages of anaphylaxis or asthma, the patient will have difficulty moving air, but will be oxygenating OK. We understand that many respiratory conditions can cause wheezing, but CHF? Yes: As left ventricular function diminishes and leads to increased pulmonary pressure, serum begins to leak out of the pulmonary vessels and into the interstitial space. As the interstitial pressure increases, it causes narrowing of the bronchioles, and air traveling through the narrowed bronchioles causes the wheezing sound. Fluid may also be leaking out of the pulmonary capillaries and occupying space in the alveolar sacs. When the interstitial pressure is high and the bronchioles continue to narrow, providers may initially hear only the wheezing and not the crackles from the smaller airways. In these conditions, oxygen is not exchanged adequately into the blood, and the patient becomes hypoxemic. Good assessment and patient history will guide the EMS provider to the cause of bronchospasm. For example, does the patient have a history of asthma? If yes, asthma is likely to be the cause. Does the patient have any rash, hives or swelling? If yes, anaphylaxis is likely the cause. Is the patient elderly, and does he/she show pedal edema, JVD, hypoxemia and/or distended neck veins? If yes, CHF may be the cause. [table: see text] There are questions regarding the use of bronchodilators in patients suffering CHF. If a CHF patient is wheezing (bronchospasm), then a beta-2 selective breathing treatment may be appropriate, along with nitrates and diuretics. Oxygenation is the critical problem in CHF, and hypoxemia will continue to worsen cardiac function. Remember, both bronchoconstriction and alveolar sacs filling with fluid will impair oxygenation of the RBCs and ultimately the vital organs. Focused prehospital management of CHF is aggressive in restoring oxygenation. For example, many agencies are now using oxygen, nitrates, ACE inhibitors and CPAP. By better understanding the pathophysiology of respiratory emergencies and their differential diagnosis, we will improve patient outcomes.
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PMID:Breathless. 1196 14

Despite the important contribution of traffic sources to urban air quality, relatively few studies have evaluated the effects of traffic-related air pollution on health, such as its influence on the development of asthma and other childhood respiratory diseases. We examined the relationship between traffic-related air pollution and the development of asthmatic/allergic symptoms and respiratory infections in a birth cohort (n approximately 4,000) study in The Netherlands. A validated model was used to assign outdoor concentrations of traffic-related air pollutants (nitrogen dioxide, particulate matter less than 2.5 micro m in aerodynamic diameter, and "soot") at the home of each subject of the cohort. Questionnaire-derived data on wheezing, dry nighttime cough, ear, nose, and throat infections, skin rash, and physician-diagnosed asthma, bronchitis, influenza, and eczema at 2 years of age were analyzed in relation to air pollutants. Adjusted odds ratios for wheezing, physician-diagnosed asthma, ear/nose/throat infections, and flu/serious colds indicated positive associations with air pollutants, some of which reached borderline statistical significance. No associations were observed for the other health outcomes analyzed. Sensitivity analyses generally supported these results and suggested somewhat stronger associations with traffic, for asthma that was diagnosed before 1 year of age. These findings are subject to confirmation at older ages, when asthma can be more readily diagnosed.
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PMID:Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children. 1237 53

The aim of this part of the FinEsS-studies was to assess whether differences existed in prevalence of asthma, chronic bronchitis, and respiratory symptoms between three Baltic capitals, and to examine risk factor profiles for respiratory conditions. In 1996, a postal survey was performed in these cities with a response rate of 72% in Stockholm, 76% in Helsinki, and 68% in Tallinn. The prevalence of physician-diagnosed asthma was 76% in Stockholm, 6.2% in Helsinki, and 2.3% in Tallinn, while respiratory symptoms were most common in Tallinn. The prevalence of physician-diagnosed chronic bronchitis was 10.6% in Tallinn, 3.4% in Helsinki, and 3.0% in Stockholm. Risk factor analyses revealed a significantly increased risk for those living in Tallinn compared to that of Stockholm for wheezing conditions, OR 1.56-1.69, longstanding cough, OR 1.92 (1.74-2.13), attacks of shortness of breath during the previous 12 months, OR 1.35 (1.20-1.52), and chronic productive cough, OR 1.49 (1.28-1.74). Subjects having symptoms common in asthma were more likely to have physician-diagnosed asthma in Stockholm and Helsinki than in Tallinn, while subjects having bronchitis symptoms had more often physician-diagnosed chronic bronchitis in Tallinn. Prevalence of respiratory symptoms was higher in Tallinn than in Stockholm and Helsinki, while physician-diagnosed asthma was more common in Stockholm and Helsinki. The prevalence of physician-diagnosed chronic bronchitis was three times as high in Tallinn as in Helsinki or Stockholm. Our results also suggest large differences in diagnostic practices between the three countries, while the differences between the capitals in true prevalence of disease may be small.
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PMID:Prevalence and risk factors for asthma and chronic bronchitis in the capitals Helsinki, Stockholm, and Tallinn. 1241 74

A cross-sectional descriptive study to determine the economic burden in management of acute lower respiratory infection from the patient's perspective was conducted at Takhli District Hospital from March 2000 to February 2001. Information obtained from interviewing caretakers of 165 children with LRI and data collected from medical records revealed the cost per case ranged from 140 to 6,471 baht with an average total cost per case of 1248 baht. The main determinants of the average total cost per case included the diagnosis of diseases, type of patient (outpatient or inpatient), wheezing association and respiratory syncytial virus positivity. Children with severe pneumonia accounted for the highest in the average total cost per case (2,348 baht) while those with bronchitis accounted for the lowest (924 baht). The average total cost per case of inpatients was 3.5 times higher than that of outpatients. Health policy efforts to improve the effectiveness of care in an ambulatory setting may reduce the financial cost of the illness.
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PMID:Economic burden in management of acute lower respiratory infection, patients' perspective: a case study of Takhli District Hospital. 1254 1

Exposure to particulate matter (PM) may exacerbate preexisting respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), bronchitis, and pneumonia. However, few experimental studies have addressed the effects of PM on lower respiratory tract (LRT) viral infection. Respiratory syncytial virus (RSV) is a major etiological agent for LRT infections in infants, the elderly, and the immunocompromised and may lead to chronic wheezing and the development of asthma in children. In this study, we examined the effects of carbon black (CB) on RSV-induced pulmonary inflammation, chemokine and cytokine expression, and airway hyperresponsiveness in a mouse model of RSV. Female BALB/c mice were instilled via the trachea (i.t.) with 1 x 106 plaque forming units (pfu) RSV or with uninfected culture media. On day 3 of infection, mice were i.t. instilled with either 40 micro g ultrafine CB particles or with saline. End points were examined on days 4, 5, 7, and 14 of RSV infection. Viral titer and clearance in the lung were unaffected by CB exposure. Neutrophil numbers were elevated on days 4 and 7, and lymphocyte numbers were higher on days 4 and 14 of infection in CB-exposed, RSV-infected mice. CB exposure also enhanced RSV-induced airway hyperresponsiveness to methacholine, bronchoalveolar lavage (BAL) total protein, and virus-associated chemokines monocyte chemoattractant protein (MCP-1), macrophage inflammatory protein (MIP-1 alpha), and regulated upon activation, normal T cell expressed and secreted (RANTES). MIP-1 alpha mRNA expression was increased in the alveolar epithelium, where ultrafine particles deposit in the lung. These data demonstrate a synergistic effect of ultrafine CB particles on RSV infection, and suggest a potential mechanism for increased respiratory infections in human populations after PM exposure.
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PMID:Ultrafine carbon black particles enhance respiratory syncytial virus-induced airway reactivity, pulmonary inflammation, and chemokine expression. 1265 33

The recent understanding of the key role of adhesion molecules in the pathogenesis of chest allergy in parasitic infections may provide a pharmacological target for the associated asthmatic symptoms. Circulating levels of the endothelial cell adhesion molecules (CAMs): sICAM-1, sVCAM-1 and sE-selectin in sera of 18 allergic asthmatic patients. 16 fascioliasis cases (acute & chronic), 24 fascioliasis cases with allergic chest manifestations and 10 apparently healthy control subjects were estimated by ELISA method. Also, IL-4 serum level was evaluated in all groups. Chest allergy in association with fascioliasis included mainly bronchial asthma, beside eosinophilic bronchitis, persistent wheezing and chronic cough. The study provided evidence that adhesion molecules expression is up regulated in acute and chronic fascioliasis cases with allergic chest manifestations. sVCAM-1 seemed to be an early indicator of asthma development in human fascioliasis. IL-4 cytokine was suggested to be responsible for the increased expression especially in the chronic phase of the disease, yet the role of other cytokines cannot be excluded.
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PMID:Role of endothelial cell adhesion molecules in the development of allergy in human fascioliasis. 1273 9

There is convincing evidence that several distinct wheezing syndromes exist in childhood. The purpose of this research was to assess the potential of using healthcare utilization profiles to identify wheezing syndromes in children which are distinct from asthma. Using population-based healthcare administrative data, a cohort of children, aged 5-15 years, with bronchitis diagnoses from time of birth to 1995, but no physician diagnoses of asthma, was followed over the period January 1996-March 1998. In this follow-up period, 13% had subsequent healthcare utilization for asthma, 23% had continued healthcare utilization for bronchitis, and 64% had no further healthcare utilization. The likelihood of bronchitis vs. asthma outcomes was determined for a variety of asthma risk factors. In a cohort of 11,043 children with initial healthcare contact for bronchitis but not asthma, two potentially distinct entities of bronchitis emerged from our data: 1) transient bronchitis, similar to transient wheezing of early childhood, which was associated with winter-only healthcare utilization and absence of allergy, and 2) recurrent bronchitis which differed from asthma on the basis of winter-only healthcare utilization, prematurity at birth, absence of allergy, and low socioeconomic status. Healthcare administrative records can be used to describe the natural history of wheezing in children and to identify markers which may discriminate asthma from other syndromes.
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PMID:Childhood wheezing syndromes and healthcare data. 1283 92

Chronic and recurrent respiratory tract disorders are a frequent problem in general practice. The purpose of the study was to investigate the role of hypersensitivity to house dust mites in respiratory tract diseases in general practice patients. We tried to assess the influence of determined risk factors exposure on development of respiratory tract allergy. Patients from family practitioners surgeries with chronic or recurrent respiratory tract symptoms who had no diagnosis of allergy were recruited to the study (n = 89). All patients responded to a questionnaire focused on history of symptoms, atopic conditions in family and exposure to determined environmental factors like dwelling conditions, obstetrician history, diet in the first year of life. All patients underwent skin prick test with common inhalant allergens. Families of the patients were asked to participate in the study. Families who agreed to take part also responded to the questionnaire and underwent skin tests. In patients and their families blood samples were taken to determine total IgE and specific IgE antibodies to mites allergens. Dust samples were collected by vacuuming of patients' bedroom carpets and mattresses to determine house dust mites allergens concentration. Data on 30 complete patients family sets of their brotherhood, mother and father were collected. Total and specific serum IgE antibodies were determined by disc enzyme-immunoassay (Analco). Mites allergens concentration in dust was measured by simple Acarex strip test (Nexter). The results of the assays (positive skin tests and/or elevated levels of specific IgE) showed allergy to house dust mites in 24 of 89 study patients from general practitioners surgeries (27%). The prevalence of chronic rhinitis, recurrent bronchitis, chronic or recurrent cough, wheezing, dyspnoea was higher in allergic than in nonallergic subjects. Patients with the diagnosis of allergy to house dust mites had usually worse dwelling conditions. Especially the influence of dampness in flats on several respiratory symptoms was observed. Subjects who had been found to be allergic were more frequently exposed to higher concentrations of house dust mites allergens in bedroom carpets and in mattresses. In allergic children early introducing of sensitizing components into the diet in infancy related to shorter breast feeding was observed.
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PMID:Allergy to house dust mites in primary health care subjects with chronic or recurrent inflammatory states of respiratory system. 1289 69

Foregut cysts frequently cause symptoms in the first three decades of life. The symptoms consist of dyspnea, wheezing, cough and sputum, dysphagia, stridor, and those associated with right heart strain. Symptoms and the radiological appearance of the uncomplicated cyst mimic mediastinal tumour and mediastinal obstruction. The symptoms and radiological appearance of the ruptured infected cyst simulate those of lung abscess, diaphragmatic hernia, ruptured hydatid cyst, cavitated peripheral carcinoma and pulmonary tuberculosis. In this series the differentiation from other cysts was made thus: with intralobar sequestration, a systemic arterial blood supply was demonstrated; with hydatid cyst, there was a positive intradermal skin test and (radiologically) following rupture, the appearance of a pericystic pneumatocele followed by the water-lily sign was diagnostic; with emphysematous cysts, the signs of associated bronchitis were present; in the presence of pseudocysts, there was a previous history of lung abscess, staphylococcal infection or tuberculosis. Cysts should be removed when first diagnosed.
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PMID:Foregut cysts. 1397 21


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