Acute exacerbations of chronic bronchitis

Not every patient with bronchitis needs to be treated with an antibiotic. When treatment is indicated, however, the regimen should be selected carefully. A simple four-part disease classification scheme serves as a practical aid for initial assessment of the patient and as a guideline for choosing therapy.     

Plastic bronchitis

We report a case of plastic bronchitis occurring in a 58 year-old man free from underlying pulmonary disease. Relief of symptoms was observed under steroid therapy (1 mg/kg), but relapse occurred as treatment being tapered. Such evolution is in accordance with recent published data.     

Plastic bronchitis

Plastic bronchitis is generally associated with some type of pulmonary disease and improves either spontaneously or with medical therapy. We present a case of plastic bronchitis with no known cause. The patients' symptoms were not responsive to medical therapy but were relieved after right middle lobectomy.     

Epidemiology of chronic bronchitis

In this short paper, the definition of chronic bronchitis, as it is now widely accepted by epidemiologists, is given and a comparison is made with the disease as usually referred to by general practitioners. Risk factors which are related to the development of the disease are then briefly discussed and the importance of internal parameters is underlined. At last, the methodological difficulties which arise in the assessment of the relationship between air pollution and respiratory symptoms are emphasized.     

Chronic bronchitis: primary care management

Chronic bronchitis is a clinical diagnosis characterized by a cough productive of sputum for over three months' duration during two consecutive years and the presence of airflow obstruction. Pulmonary function testing aids in the diagnosis of chronic bronchitis by documenting the extent of reversibility of airflow obstruction. A better understanding of the role of inflammatory mediators in chronic bronchitis has led to greater emphasis on management of airway inflammation and relief of bronchospasm. Inhaled ipratropium bromide and sympathomimetic agents are the current mainstays of management. While theophylline has long been an important therapy, its use is limited by a narrow therapeutic range and interaction with other agents. Oral steroid therapy should be reserved for use in patients with demonstrated improvement in airflow not achievable with inhaled agents. Antibiotics play a role in acute exacerbations but have been shown to lead to only modest airflow improvement. Strengthening of the respiratory muscles, smoking cessation, supplemental oxygen, hydration and nutritional support also play key roles in long-term management of chronic bronchitis.     

Chronic bronchitis. Key points in evaluation

Thorough history taking is essential in evaluation of chronic bronchitis. Patients often reveal key symptoms that help define the disorder and provide information about contributing factors, such as cigarette smoking, that can be eliminated. Useful baseline data can be collected through pulmonary function studies, electrocardiogram, chest radiographs, complete blood cell count, and measurement of electrolyte levels.     

多药物治疗慢性支气管炎疗效辨析

目的:针对慢性支气管炎的病因、病期和反复发作的特点,采取防治结合的综合措施.方法:在急性发作期和慢性迁延期应以控制感染和祛痰、镇咳为主.伴发喘息时,应予解痉平喘的治疗.对临床缓解期宜加强锻炼,增强体质,提高机体抵抗力,预防复发为主.应宣传、教育病人自觉戒烟,避免和减少各种诱发因素.结果:治疗慢性支气管炎,中医、西医各有策略,具体根据患者体征和医院条件施治选用.     

Long-term atrovent treatment of chronic obstructive bronchitis

AIM: The study of effects of long-term ipratropium bromide on the course of chronic obstructive bronchitis. MATERIALS AND METHODS: A 3-month atrovent monotherapy (3-6 doses daily) was performed in 19 patients with verified chronic obstructive bronchitis of moderate severity. Monitoring consisted of symptoms registration, pickflowmetry (two times a day), external respiration measurements. RESULTS: Atropen produced a positive trend in all the clinical symptoms, course of viral infections, exercise tolerance, bronchial permeability, respiratory capacity. The highest atrovent efficacy was recorded in patients with chronic bronchitis of smokers and chronic bronchitis in tracheobronchial diskinesia. No side effects were observed. CONCLUSION: Basic atrovent monotherapy modifies the course of chronic obstructive bronchitis and can be recommended for secondary prophylaxis of this disease.