Variables associated with changes in spirometry in patients with obstructive lung diseases

Kanner, Richard E.; Renzetti, Attilio D.; Klauber, Melville R.; Smith, Charles B.; Golden, Carole A.

doi:10.1016/0002-9343(79)90072-x

Cited by 82 publications

(38 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results would be consistent with such an adverse effect, even if a direct comparison is difficult, as our bronchitis cohort was made up of nonsmoking people under 60 years of age with regular cough or phlegm, probably including only a few participants with clinically manifest COPD. This additional adverse effect of environmental tobacco smoke on participants with a history of symptoms may be highly relevant to the pathophysiological development of lung disease, as frequent lower-respiratory-tract illnesses among COPD patients have been associated with an increased rate of decline of FVC (forced vital capacity) and FEV 1 (22). Moreover, the participants defined as nonsymptomatic and nonhyperreactive at the cross-sectional examination showed a tendency to report symptoms of cough and phlegm more frequently when exposed to environmental tobacco smoke, a finding in agreement with the higher prevalence of chronic symptoms among the participants exposed to environmental tobacco smoke in the cross-sectional study (11).…”

Section: Discussionmentioning

confidence: 99%

Passive smoking exposure among adults and the dynamics of respiratory symptoms in a prospective multicenter cohort study

Jayet¹,

Schindler²,

Schwartz³

et al. 2005

Scand J Work Environ Health

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Passive smoking exposure among adults and the dynamics of respiratory symptoms in a prospective multicenter cohort study

Jayet¹,

Schindler²,

Schwartz³

et al. 2005

Scand J Work Environ Health

View full text Add to dashboard Cite

“…In particular, elastase can cause epithelial detachment [22] and damage to host mucociliary clearance [23]. Although there is no clear evidence that exacerbations of COPD are associated with a long-term decline in lung function [24,25], it should be emphasized that the commonly applied definition of an exacerbation [8] does not require the inclusion of factors indicative of bacterial infection with neutrophil influx 16 and accompanying elastase release. It remains possible that more closely defined episodes, such as those reported in this study, contribute to airways disease and hence long-term morbidity.…”

Section: Discussionmentioning

confidence: 99%

Bronchial inflammation in acute bacterial exacerbations of chronic bronchitis: the role of leukotriene B4

Crooks¹,

Bayley²,

Hill³

et al. 2000

Eur Respir J

201

148

View full text Add to dashboard Cite

Neutrophils recruited to the airways in chronic obstructive pulmonary disease (COPD) are thought to mediate tissue destruction. Neutrophil recruitment is increased during bacterial exacerbations. The inflammatory process was studied in patients with an acute exacerbation of COPD in order to ascertain the role of leukotriene B 4 (LTB 4 ).The sputum of eight subjects with a bacterial exacerbation of COPD was analysed for neutrophil products (myeloperoxidase, elastase) and chemoattractants (interleukin-8 (IL-8) and LTB 4 ). The contribution of LTB 4 to the chemotactic activity of the sputum sol phase was determined using the LTB 4 receptor antagonist LY293111. The concentrations of the serum acute phase proteins a 1 -proteinase inhibitor, a 1 -antichymotrypsin and C-reactive protein were measured. All patients received appropriate broad-spectrum antibiotic treatment for 7±14 days.Initially, the sputum myeloperoxidase activity was high, indicating neutrophil influx; this was associated with high levels of IL-8 and LTB 4 . All these concentrations fell with treatment (p<0.01). The chemotactic activity of the sputum was raised on presentation and fell with treatment (p<0.01). LTB 4 contributed~30% of the total chemotactic activity on presentation; this diminished with therapy. All acute phase proteins were raised on presentation and fell with therapy (p<0.01).These findings suggest that leukotriene B 4 contributes to neutrophil influx into the airway in chronic obstructive pulmonary disease and may influence disease progresgression. Eur Respir J 2000; 15: 274±280.

show abstract

“…The role of exacerbations in causing permanent alteration or in accelerating long-term decline in pulmonary function is unclear [64]. Three prospective studies showed no correlation between exacerbation and long-term loss of pulmonary function [65±67], whereas another one did [68]. It may be argued that exacerbations may lead to frequent hospitalizations, and these are likely to have a major impact on healthcare for two reasons.…”

Section: Discussionmentioning

confidence: 99%

The effect of oral N-acetylcysteine in chronic bronchitis: a quantitative systematic review

Stey¹,

Steurer²,

Bachmann³

et al. 2000

Eur Respir J

248

127

View full text Add to dashboard Cite

The role of N-acetylcysteine (NAC) in the treatment of chronic bronchitis is unclear. Since a number of studies have been published on this topic, a systematic review of published studies seems justified.A systematic search (Medline, Embase, Cochrane Library, bibliographies, no language restriction) for published randomized trials comparing oral NAC with placebo in patients with chronic bronchitis was performed. Dichotomous data on prevention of exacerbation, improvement of symptoms and adverse effects were extracted from original reports. The relative benefit and number-needed-to-treat were calculated for both individual trials and combined data.Thirty-nine trials were retrieved; eleven (2,011 analysed patients), published 1976± 1994, were regarded as relevant and valid according to preset criteria. In nine studies, 351 of 723 (48.5%) patients receiving NAC had no exacerbation compared with 229 of 733 (31.2%) patients receiving placebo (relative benefit 1.56 (95% confidence interval (CI) 1.37±1.77), number-needed-to-treat 5.8 (95% CI 4.5±8.1). There was no evidence of any effect of study period (12±24 weeks) or cumulative dose of NAC on efficacy. In five trials, 286 of 466 (61.4%) patients receiving NAC reported improvement of their symptoms compared with 160 of 462 (34.6%) patients receiving placebo (relative benefit 1.78 (95% CI 1.54±2.05), number-needed-to-treat 3.7 (95% CI 3.0±4.9)). With NAC, 68 of 666 (10.2%) patients reported gastrointestinal adverse effects compared with 73 of 671 (10.9%) taking placebo. With NAC, 79 of 1,207 (6.5%) patients withdrew from the study due to adverse effects, compared with 87 of 1,234 (7.1%) receiving placebo.In conclusion, with treatment periods of~12±24 weeks, oral N-acetylcysteine reduces the risk of exacerbations and improves symptoms in patients with chronic bronchitis compared with placebo, without increasing the risk of adverse effects. Whether this benefit is sufficient to justify the routine and long-term use of Nacetylcysteine in all patients with chronic bronchitis should be addressed in further studies and cost-effectiveness analyses. Eur Respir J 2000; 16: 253±262.

show abstract

Variables associated with changes in spirometry in patients with obstructive lung diseases

Cited by 82 publications

References 10 publications

Passive smoking exposure among adults and the dynamics of respiratory symptoms in a prospective multicenter cohort study

Passive smoking exposure among adults and the dynamics of respiratory symptoms in a prospective multicenter cohort study

Bronchial inflammation in acute bacterial exacerbations of chronic bronchitis: the role of leukotriene B4

The effect of oral N-acetylcysteine in chronic bronchitis: a quantitative systematic review

Contact Info

Product

Resources

About