1.Bronchiectasis: still a problem.
Chinese Medical Journal 2014;127(1):157-172
OBJECTIVEThe purpose of this descriptive review was to delineate the current knowledge of bronchiectasis in terms of prevalence, burden of disease, pathophysiology, and management.
DATA SOURCESThe National Library of Medicines MEDLINE and PubMed database (2005-2013) were used to conduct a search using the keyword term "bronchiectasis". The references for articles being considered for inclusion were searched from additional sources such as conference proceedings.
STUDY SELECTIONCriteria for inclusion of articles included data outlining epidemiology, pathogenesis, diagnosis, and evidence-based guidelines for management of bronchiectasis. In assessing the quality of the articles, factors such as size of the population studied, clinical setting of the study, and whether or not the studies were prospective or retrospective were taken into consideration. Review articles were also included in our data collection. RESULTS Despite many advances in modern medicine, bronchiectasis still remains a significant public health problem in developed countries and the developing world. It carries a significant burden worldwide in terms of morbidity and mortality, as well as financially to the affected population. In addition, bronchiectasis may associate with chronic airflow obstruction, regardless of smoking status.
CONCLUSIONSBronchiectasis is a debilitating illness responsible for significant morbidity with a poor health-related quality of life. The condition has a substantial socioeconomic cost because both primary and secondary healthcare resources are frequently used and periods of sick leave are common.
Bronchiectasis ; diagnosis ; drug therapy ; epidemiology ; Humans
2.Heterogeneity of non-cystic-fibrosis bronchiectasis in multiethnic Singapore: A prospective cohort study at a tertiary pulmonology centre.
Si Ling YOUNG ; Youxin PUAN ; Si Yuan CHEW ; Salahudeen Mohamed HAJA MOHIDEEN ; Pei Yee TIEW ; Gan Liang TAN ; Mariko Siyue KOH ; Ken Cheah Hooi LEE
Annals of the Academy of Medicine, Singapore 2021;50(7):556-565
INTRODUCTION:
Non-cystic fibrosis bronchiectasis (NCFB) is a highly heterogenous disease. We describe the clinical characteristics of NCFB patients and evaluate the performance of Bronchiectasis Severity Index (BSI) in predicting mortality.
METHODS:
Patients attending the bronchiectasis clinic between August 2015 and April 2020 with radiologically proven bronchiectasis on computed tomography were recruited. Clinical characteristics, spirometry, radiology, microbiology and clinical course over a median period of 2.4 years is presented.
RESULTS:
A total of 168 patients were enrolled in this prospective cohort study. They were predominantly women (67.8%), Chinese (87.5%) and never-smokers (76.9%). Median age of diagnosis was 64 years (interquartile range 56-71) and the most common aetiology was "idiopathic" bronchiectasis (44.6%). Thirty-nine percent had normal spirometries. Compared to female patients, there were more smokers among the male patients (53.8% versus 8.5%,
CONCLUSION
The NCFB cohort in Singapore has unique characteristics with sex differences. Over half the patients had a history of haemoptysis. The BSI score is a useful predictor of mortality in our population.
Aged
;
Bronchiectasis/epidemiology*
;
Cohort Studies
;
Female
;
Fibrosis
;
Humans
;
Male
;
Middle Aged
;
Prospective Studies
;
Pulmonary Medicine
;
Severity of Illness Index
;
Singapore/epidemiology*
3.Prevalence of Depression and Anxiety in Outpatients with Chronic Airway Lung Disease.
Yon Ju RYU ; Eun Mi CHUN ; Jin Hwa LEE ; Jung Hyun CHANG
The Korean Journal of Internal Medicine 2010;25(1):51-57
BACKGROUND/AIMS: Patients with chronic airway lung diseases often experience depression and anxiety, but little information is available regarding Koreans with these conditions. We thus assessed depression and anxiety in Korean patients with chronic airway lung diseases. METHODS: The degree of depression and anxiety in 84 outpatients with chronic obstructive pulmonary disease (COPD), 37 with asthma, 33 with bronchiectasis, and 73 healthy controls were evaluated by the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). RESULTS: The patients with COPD and bronchiectasis had higher BDI scores and were more likely than controls to experience depression ([COPD, 17; range, 0 to 42; prevalence, 55%], [bronchiectasis, 16; range, 3 to 51; prevalence, 55%], [controls, 13; range, 0 to 31; prevalence, 30%], p < 0.05). The state-anxiety scores of the patients were higher than those of the controls, but only the bronchiectasis group demonstrated a higher frequency of state-anxiety compared with the controls (39 vs. 16%, patients vs. controls, p = 0.015). Among all patients, 22% presented with concomitant depression and state-anxiety, and 25% demonstrated depression and trait-anxiety. Depression was positively correlated with both state-anxiety (r = 0.644) and trait-anxiety (r = 0.597, p < 0.0001). Irrespective of individual diagnosis, post-bronchodilator FEV1 (odds ratio [OR], 0.972; p = 0.027) and smoking history (OR, 3.894; p = 0.018) were independent risk factors for depression in patients with chronic airway lung diseases. CONCLUSIONS: Chronic airway lung diseases are associated with depression and/or anxiety, particularly in those with a higher airflow limitation and/or history of smoking.
Aged
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Aged, 80 and over
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Anxiety/*epidemiology
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Asthma/epidemiology/psychology
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Bronchiectasis/epidemiology/psychology
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Chronic Disease
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Depression/*epidemiology
;
Female
;
Humans
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Male
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Middle Aged
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Prevalence
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Pulmonary Disease, Chronic Obstructive/*epidemiology/*psychology
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Risk Factors
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Smoking/epidemiology/psychology
4.Thoracoscopic management for bronchiectasis with non-tuberculous mycobacterial infection.
Guang-suo WANG ; Zheng WANG ; Lin YANG ; Shao-lin LIN ; Jin-song WU
Chinese Medical Journal 2008;121(24):2539-2543
BACKGROUNDNon-tuberculous mycobacteria (NTM) have emerged as important opportunistic pathogens of the human being in recent years. Patients with pre-existing bronchiectasis are susceptible to NTM. However, information about its occurrence among bronchiectatic patients in Shenzhen, China is lacking and its impact on the course of bronchiectasis following surgical intervention is unknown. This preliminary study aimed to investigate the prevalence of NTM in bronchiectasis that required surgery in our center, evaluate the role of intraoperative routine screening for NTM, and summarize our initial experience in thoracoscopic management for bronchiectatic patients with NTM.
METHODSA retrospective analysis of clinical, microbiological data of our bronchiectatic patients with NTM over 5 years was made and 40 patients with bronchiectasis were studied to determine the role of intraoperative routine screening for NTM.
RESULTSThe prevalence of NTM in this population of patients with bronchiectasis in our center was 6.7% (7/105). The diagnostic yield of the 40 intraoperative specimens was 7.5% (3/40). Of the 7 patients with bronchiectasis and NTM, 3 patients developed postoperative wound infections. All were cured with chemotherapy for 8 - 12 months along with vigorous surgical debridement. Another patient had a slow growth of mycobacteria involving double lungs and the right thoracic cavity and recovered after chemotherapy for nearly 14 months and tube drainage. The affected tissue was completely resected in the remaining 3 patients with no operative mortality and postoperative morbidity, and routine intraoperative screening for NTM was initiated in these patients.
CONCLUSIONSNTM is not uncommon in bronchiectatic patients which deserves surgeons' utmost attention. Routine intraoperative screening for NTM identified otherwise unsuspected patients has shown favorable outcomes. Thoracoscopic management for bronchiectasis with NTM is technically feasible although its role remains to be defined.
Adolescent ; Adult ; Aged ; Bronchiectasis ; drug therapy ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium Infections ; drug therapy ; epidemiology ; Retrospective Studies ; Young Adult
5.Bronchiectasis Management in China, What We Can Learn from European Respiratory Society Guidelines.
Ning WANG ; Jie-Ming QU ; Jin-Fu XU
Chinese Medical Journal 2018;131(16):1891-1893
Anti-Bacterial Agents
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therapeutic use
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Bronchiectasis
;
drug therapy
;
epidemiology
;
etiology
;
microbiology
;
China
;
Ciliary Motility Disorders
;
drug therapy
;
epidemiology
;
etiology
;
microbiology
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Connective Tissue
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metabolism
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Humans
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Immunoglobulins
;
metabolism
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Pseudomonas aeruginosa
;
drug effects
;
pathogenicity
6.Polymorphism of angiotensin I converting enzyme (ACE) gene according to the severity of asthma in Korean adult asthmatics.
Journal of Asthma, Allergy and Clinical Immunology 2000;20(3):509-516
BACKGROUND AND OBJECTIVE: Many chemical mediators such as histamine, prostaglandins, leukotrienes, bradykinin, angiotensisn II (A II), and even angiotensin converting enzyme (ACE) affect the pathophysiology of asthma. ACE exists in the epithelium, endothelium, neuroepithelium, plasma, and especially in high concentrations in human lung tissue. ACE converts A I to A II, which is highly vasoconstrictive, bronchoconstrictive, inflammatory substance, and can also inactivate bradykinin. ACE polymorphism determines the level of ACE such as DD, higher concentration of ACE, but II, lowest concentration of that, so in DD type, the level of A II increase, but that of bradykinin decrease. From that point we can speculate polymorphism of ACE gene anyhow affects asthma, so we carried out this study for evaluating relationships between the ACE genotype distribution and genesis and severity of asthma in Korean adult asthmatics. MATERIALS AND METHODS: The study population consisted of 150 asthmatics, 57 patients of non asthmatic lung diseases including lung cancer (n=10), pulmonary tuberculosis (n=27), empyema (n=3), pneumonia (n=11), bronchiectasis (n=5) and lung abscess (n=1) and 100 normal healthy subjects without hypertension, cardiovascular disease, diabetes mellitus and nephropathy which may bias the result. Bronchial asthmatics were classified into 3 groups according to the criteria of the NAPE. PCR (polymerase chain reaction) for ACE genotypes was performed. PCR products were electrophoresed in 1% agarose gels, and then DNA pattern was directly visualized under ethidium bromide staining. RESULTS: The frequency for II, ID, and DD genotypes were 46 (46%), 38 (38%), 16 (16%) in control group, 59 (39.6%), 74 (49.5%), 17 (10.9%) in asthma group and 28 (49.1%), 24 (42.1%), 5 (8.8%) in non-bronchial lung disease group, respectively. There was no signi- ficant difference in frequency of ACE genotype distribution among the 3 groups (p > 0.05). The frequency for II, ID, and DD genotypes in the 3 groups of asthmatics were 17 (34%), 27 (54%), 6 (12%) in mild subset, 13 (26%), 30 (60%), 7 (14%) in moderate subset, and 11 (22%), 33 (66%), 6 (12%) in severe subset. Even though there was also no significant difference among the 3 severity subsets in the asthma group, the frequency of non-DD subsets such as II and ID was higher in moderate and severe asthmatics. CONCLUSION: The results suggest that ACE gene polymorphism dose not affect the genesis but can progress asthma in Korean adult asthmatics. However, further mass studies on asthmatics will be needed to clarify the effect of ACE polymorphism on the severity of Korean adult asthmatics.
Adult*
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Angiotensin I*
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Angiotensins*
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Asthma*
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Bias (Epidemiology)
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Bradykinin
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Bronchiectasis
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Cardiovascular Diseases
;
Diabetes Mellitus
;
DNA
;
Empyema
;
Endothelium
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Epithelium
;
Ethidium
;
Gels
;
Genotype
;
Histamine
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Humans
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Hypertension
;
Leukotrienes
;
Lung
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Lung Abscess
;
Lung Diseases
;
Lung Neoplasms
;
Peptidyl-Dipeptidase A*
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Plasma
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Pneumonia
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Polymerase Chain Reaction
;
Prostaglandins
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Sepharose
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Tuberculosis, Pulmonary