Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149514 (bronchitis)
 6,902 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Air pollution referable to increased ambient levels of sulfur dioxide and suspended particulates is associated with increased episodes of acute bronchitis and is also causally related to some cases of chronic bronchitis. Oxidant air pollution is associated with abnormalities of pulmonary function in children and is a major contributory factor in COP, especially bronchitis, in some areas of the United States. The relationship of nitrogen dioxide atmospheric contamination to COPD is still controversial. In our opinion, the epidemiologic studies conducted to date have been inadequate and further elucidation is indicated. Cadmium fumes and compounds have been found to be instrumental in the development of some cases of chronic bronchitis and emphysema in Sweden. This association is unproved in the United States and warrants a thorough clinical and epidemiologic evaluation.
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PMID:Air pollution and COPD. 87 96

Bronchoalveolar lavage (BAL) may have a potential role in contributing to a more precise definition of COPD disorders, but at present little is known about the cellular and biochemical changes that occur in BAL in the different stages of COPD. On the contrary, BAL features due to smoking habits, a well-known risk factor for COPD, have been widely investigated. We submitted to BAL 15 normal nonsmokers, 15 asymptomatic smokers and 11 smokers affected by chronic bronchitis. In this latter group BAL fluid recovery was significantly reduced and cellularity increased, but less prominently than in asymptomatic smokers. The CD4/CD8 ratio was significantly decreased in smokers with and without bronchitis, the CD8 percentage being positively correlated with the smoking history. NK cells were decreased in patients with chronic bronchitis. BAL neutrophils were increased in both smoker groups and a correlation was seen with smoking history and degree of airflow obstruction. Neutrophils are markedly involved in the oxidation of BAL proteins, as we could determine with the evaluation of the methionine sulphoxide/methionine ratio in BAL fluids. This finding may be relevant to better understand COPD pathogenesis and progression.
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PMID:Local immune components in chronic obstructive pulmonary disease. 157 26

Adjusted admission rates for respiratory distress (COPD, asthma, bronchitis, and pneumonia) varied up to 3.09-fold between the highest and lowest hospital market areas in 1986 for the state of Ohio. Reasons for the variability can be determined through small area analysis techniques with the help of area physicians. Substantial improvements in the availability, delivery, and cost of respiratory care would reasonably be anticipated as a result of such analysis and feedback.
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PMID:Small area analysis shows differences in utilization. 182 50

Chronic bronchitis was a disease which attracted much attention in the U.K. in the 1950's. It was classified into three forms known as simple chronic bronchitis, recurrent or mucopurulent bronchitis, and chronic obstructive bronchitis and it was thought that the disease progressed from one form to the next in accordance with their order as listed here. Later, however, it was realized that the disease did not progress according to this order and that chronic bronchitis actually included three kinds of the disease. Furthermore, in the U.K., with the prohibition of the use of coal and the reduction of air pollution and with the decline of infectious disease in child age, recurrent or mucopurulent bronchitis underwent an extreme reduction. Chronic obstructive bronchitis is known to be caused by smoking and is now called chronic bronchitis and emphysema or COPD. Simple chronic bronchitis may in fact be only a simple physical response to smoking. Now in Japan the disease called chronic bronchitis is often recognized when written on receipts for health insurance, but patients of chronic bronchitis as were seen in the U.K. in the 1950's are extremely rare. Diffuse panbronchiolitis is seen in Japan but is a disease not found in the West. Diffuse bronchiectasis and its differentiation become the point of question for this disease. With the effectiveness of erythromycin, we can expect a decline in the number of patients and an improvement in prognosis.
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PMID:[Chronic bronchitis and related disorders]. 221 80

Thirty patients of chronic obstructive pulmonary disease (COPD; all smokers) and an equal number of controls (15 smokers) were studied. The COPD patients were further divided into group A (predominantly emphysema) and group B (predominantly bronchitis) of 15 patients each. Serum and sputum IgG, IgA and IgM and serum C3 and C4 were estimated. IgG, IgA, IgM and C3 and C4 were similar in smoker and non-smoker controls. Mean (+/- SD) serum IgG (IU/ml) was significantly higher in COPD patients (207.78 +/- 62.73) than in control (177.25 +/- 43.5; P less than 0.05), serum IgA (IU/ml) was also significantly higher in COPD (205.04 +/- 46.56) than in control (108.21 +/- 33.3; P less than 0.01). IgM was similar in the 2 groups. Sputum IgA (IU/ml) was higher in COPD (4.68 +/- 3.51) than in control (2.25 +/- 1.03; P less than 0.05). IgG and IgM were similar in the 2 groups. Both serum C3 (IU) and C4 (IU) were lower in COPD patients (C3 = 95.9 +/- 33.11, C4 = 113.6 +/- 62.4) than in control (C3 = 167.3 +/- 25.42, C4 = 205 +/- 76.5; P less than 0.05). Serum IgA in type B COPD (212.25 +/- 50.06) was higher than in type A (197.52 +/- 43.3; P less than 0.05) IgG and IgM were similar in these 2 groups. In COPD patients, immunoglobulins were either normal or higher indicating that deficiency of immunoglobulin is not a predisposing factor in development of COPD. Similar immunoglobulin values in smoker and nonsmoker controls indicated that smoking was not the cause of rise of immunoglobulins in COPD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alterations in immunoglobulin & complement levels in chronic obstructive pulmonary disease. 222 68

The fifth leading cause of death in the United States, chronic obstructive respiratory conditions, cannot be cured but can be considerably ameliorated by appropriate management. Many patients with COPD have a combination of chronic bronchitis, asthma, and emphysema. While the damage due to emphysema is permanent, many of the pathophysiologic changes of asthma and bronchitis can be reversed to some extent, and such reversal should be a goal of therapy. Smoking cessation will help the patient more than any other medical treatment. Bronchodilator therapy is best given by inhalation from a metered dose inhaler and on a maintenance basis. Be sure to check inhaler technique. An anticholinergic agent, eg, ipratropium bromide, is probably most effective, but many patients prefer a beta 2-selective adrenergic agent. Xanthines are currently third choice but are very useful to cover nocturnal dyspnea. Corticosteroids are usually only used in acute exacerbations and then only for short courses. If prolonged use is required, however, the inhalation route minimizes side effects to which these patients are particularly prone. Antibiotics are also usually only used in exacerbations, but one can be liberal with them. Use the less expensive broad-spectrum options for ten days. Some clinicians believe that hydration is an effective expectorant. Mucolytic therapy is extensively used outside the United States. The appropriate role of mucolytic therapy in the treatment of bronchitis remains to be more fully explored. Low-flow oxygen is only used in the prevention or treatment of cor pulmonale when the PaO2 is persistently at or below 55, or with a rising hematocrit and right-sided cardiac changes. If used, oxygen is helpful only when given long term for at least 18 h per day, not on a prn basis. Cardiac glycosides are probably of little benefit, but diuretics have an important role in treatment of fluid retention. Pulmonary vasodilator therapy is still experimental, as is almitrine. Prophylaxis with pneumococcal vaccine and annual influenza vaccine is rational but has not been proven to be of value. Exercise and activity should be encouraged for all except those with frank congestive heart failure. The role of "breathing exercises" is currently being reevaluated. Surgery has almost no place in the management of COPD. Anesthesia often results in postoperative complications in this disease. Avoid all sedatives and tranquilizers.
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PMID:Chronic obstructive pulmonary disease. Current concepts and therapeutic approaches. 240 8

Total aerosol deposition in the lung was measured in 100 subjects with various lung conditions. The subjects consisted of 40 normals (N), 15 asymptomatic smokers (S), 10 smokers with small airway disease (SAD), 20 with chronic simple bronchitis (SB), and 15 with chronic obstructive bronchitis (COPD), and a relationship of total aerosol deposition to degree of lung abnormality was investigated. The subjects were categorized by medical history and a battery of pulmonary function tests, including spirometry, body plethysmography, and single and multiple N2 washout measurements. Subjects repeatedly breathed a monodisperse test aerosol (1.0 micron diam) from a collapsible rebreathing bag (0.5 liter volume) at a rate of 30 breaths/min, while inhaled and exhaled aerosol concentrations were continuously monitored by a laser aerosol photometer in situ and recorded on a strip-chart recorder. The number of rebreathing breaths resulting in 90% aerosol loss from the bag (N90) was determined, and percent predicted N90 values were then determined from the results of computer simulation and used as a deposition index. The percent predicted N90 values were 99.7 +/- 14, 86.5 +/- 15, 66.9 +/- 17, 51 +/- 12, and 30.9 +/- 9, respectively, for N, S, SAD, SB, and COPD. All of these values were significantly different from each other (P less than 0.05). There was no difference between male and female but percent predicted N90 values were slightly higher in young than in old normals. Percent predicted N90 values showed a strong linear correlation with spirometric measurements of forced expiratory volume in 1 s and maximum midexpiratory flow rate. However, many of the SAD and SB with normal spirometry showed abnormal N90. These results suggest that total lung aerosol deposition is a sensitive index of lung abnormality and may be of potential use for nonspecific general patient screening.
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PMID:Measurement of total lung aerosol deposition as an index of lung abnormality. 337 87

We studied the acute effect of a single, oral dose of 200 mg almitrine and of placebo on arterial blood gas tensions, ventilation, gas exchange and pulmonary mechanics in 28 patients with chronic obstructive bronchitis and emphysema (COPD), 20 patients with bronchial asthma and 10 patients with interstitial lung disease. Almitrine significantly increased PaO2 in COPD, had a borderline effect in bronchial asthma and no effect in lung fibrosis. In all groups of patients almitrine significantly increased minute ventilation and decreased arterial carbon dioxide tension (PaCO2). Placebo had no effect on arterial oxygen tension (PaO2) and PaCO2 in any of the groups. Therefore, despite similar effects on ventilation, the improvement of arterial PO2 by almitrine depends on the underlying disease.
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PMID:The acute effect of a single oral dose of 200 mg almitrine on gas exchange in patients with chronic obstructive bronchitis and emphysema, bronchial asthma and lung fibrosis. 369 32

The paper deals with a bronchial asthma case whose anamnesis and clinical data plead rather for a chronic obstructive bronchitis (COPD). The diagnosis is elucidated through the pulmonary function tests performed both before and after a treatment which suppresses the inflammation and oedema of the mucous membrane with hypercrinia and discrinia, thus allowing the hyperreactivity of bronchial smooth muscles to become evident. Taking into account that more than 50% of the asthmatic persons have not a correct perception of the airway obstruction, treatment effect evaluation on the basis of clinical data only may lead to an early treatment stepping which can favour the development of a chronic inflammation and a "basic" obstructive syndrome resulting in a pulmonary insufficiency later on. Pulmonary function tests are therefore useful in monitoring the treatment whose efficacy is proved by the achievement of normal pulmonary function (or at least as close to normal as possible) and not only by the suppression of clinical symptoms.
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PMID:[Clear diagnosis in an atypical case of bronchial asthma and treatment monitoring using pulmonary function tests]. 795 Apr 54

To assess awareness and understanding of obstructive airway diseases by primary-care physicians, the authors surveyed a randomly selected population of 75 primary care practitioners. During one-on-one interviews, physicians were presented with a standardized case scenario and a subsequent series of open-ended questions concerning asthma and COPD. Each respondent was presented in randomized fashion with one of two versions of a case description of a hypothetical 52-year-old male smoker with a recent upper respiratory tract infection and persistent productive cough. The only difference between case descriptions was that one included explicit reference to an earlier tentative diagnosis of chronic bronchitis (CB version); the other description made no specific mention of this diagnostic term (NCB version). Chest radiographs were requested by 80 percent of physicians and sputum cultures by 50 percent, these percentages not differing significantly between CB and NCB groups. Spirometry was requested less often than either of the foregoing tests (21 percent). The CB group requested spirometry significantly more often than the NCB group (38 percent vs 5 percent, p < 0.05). The most frequently mentioned primary diagnosis was bronchitis/pneumonia (33 percent), followed by bronchitis (28 percent) and chronic bronchitis (16 percent), all of which were similar in both groups. However, the diagnostic term "COPD" was the primary diagnosis in 16 percent of the CB group, compared with 8 percent in the NCB group (p > 0.05). Oral antibiotics were the most frequently chosen first-line drug therapy (63 percent). In subsequent questions concerning the management of obstructive airway diseases, primary practitioners distinguished COPD from asthma conceptually, but their prescribed therapy for the two disorders was less distinct. beta 2-agonists were selected most frequently and similarly as initial therapy for both disorders (53 percent). Minor differences between first-line therapeutic choices included nonsignificant trends toward the more frequent mention of anticholinergic bronchodilators for COPD than for asthma (10 percent vs 0 percent) and the more frequent selection of inhaled corticosteroids for asthma (12 percent vs 5 percent). The authors conclude that to the extent that questionnaire responses reflect actual practice, primary care practitioners (1) have a low index of suspicion for obstructive airway disease, (2) markedly underutilized spirometry as a screening tool, (3) consider beta 2-agonists first-line therapy for COPD and asthma, and (4) despite considering COPD and asthma different disease processes, choose similar medications for each disorder.
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PMID:Physician perceptions and management of COPD. 832 79


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