Course Of Bronchiectasis Research Articles

Bilateral staged anatomic lung resection for bronchiectasis and infected polycystic disease complicated by bleeding: viability with 3 hypertrophied segments maintained

Bilateral lung resections are performed for various pathologies: pulmonary emphysema, parasitic diseases, metastatic lesions, and bronchiectasis. In clinical practice, sequential or staged interventions are more common. Surgical treatment of bronchiectasis is currently carried out only in cases with complications of localized forms and, as a rule, consists of resection of the affected part of the lung. The percentage of such patients is not large and amounts to about 5%. Taking into account the chronic course of bronchiectasis and certain successes of the conservative treatment, indications for resection operations may arise at different periods of the patient’s life. Sometimes, up to several decades can pass between the surgeries. Aim. To demonstrate a rare clinical case of staged lung resection for bronchiectasis in a patient who had 4 lung lobes removed with an interval of 52 years. Results. History of the disease was described. Indications for staged surgical interventions were identified. The main characteristics of the health status after the surgeries were described. Conclusion. The presented case illustrates the place and role of surgical methods in the treatment of bronchiectasis, as well as the compensatory capabilities of the lung tissue in the case of staged resection interventions.

Bronchiectasis Exacerbations: Definitions, Causes, and Acute Management.

Pulmonary exacerbations (PExs) are events in the course of bronchiectasis which are defined as an increase in disease symptoms lasting a period of a few days. It is established that the tendency toward having PEx is stable throughout the course of the disease. Certain conditions were found to be associated with an increased risk of developing a PEx. Among these are chronic airway infection with Pseudomonas aeruginosa or Aspergillus species, concomitant airway diseases (asthma, chronic obstructive pulmonary disease, and chronic rhinosinusitis), genetic factors such as primary ciliary dyskinesia, and nutritional factors. The immediate events underlying the onset of a PEx are less clearly determined. Although acute changes in bacterial airway composition have been the paradigm for decades, recent microbiome-focused research has not uniformly established such acute changes at the onset of PEx. Other acute changes such as air pollution, viral infection, and changes in bacterial metabolic activity have also been implicated as causes of a PEx. Despite these gaps in our knowledge of the biology of PEx, antimicrobial therapy directed against the identified pathogens in sputum is currently the recommended therapeutic strategy. Various long-term therapies, including antimicrobial and anti-inflammatory strategies, have been proven effective in reducing the frequency of PEx, leading to a recommendation for the use of these strategies in people with frequent PEx.

KMBARC registry: protocol for a multicentre observational cohort study on non-cystic fibrosis bronchiectasis in Korea

IntroductionDespite the significant disease burden of bronchiectasis in Korea, no large-scale, representative prospective cohort studies have been conducted to evaluate the clinical characteristics of Korean patients with bronchiectasis, indicating an...

A fast and fatal course of bronchiectasis: an unusual rare expression of chronic graft versus host disease. A case report.

Introduction. We report a case of a patient with acute myeloid leukaemia whose treatment with bone marrow transplantation (BMT) was followed by chronic graft versus host disease (GVHD) with lung involvement and bronchiectasis. This report illustrates an unusual course of a fast progression of the bronchiectasis due to BMT.Case description. A 33-year-old female was diagnosed with acute myeloid leukaemia. An allogeneic BMT was performed. One month after the transplantation, acute GVHD with skin involvement occurred. Treatment with prednisolone and mycophenolate mofetil (MMF) has been started. Nine months later, the patient was examined by a pulmonologist due to progressive dyspnoea. A pulmonary computed tomography (CT) scan showed normal parenchyma of the lungs and no changes to the bronchi. A CT scan performed 7 months later revealed bronchiectasis for the first time. No clinical response was associated with the treatment and the patient’s respiratory status progressively deteriorated. During the final hospitalization, a CT scan performed 1 year later revealed huge cystic bronchiectasis in both lungs. Despite the prophylaxis and treatment of GVHD and aggressive antimicrobial therapy, the patient died one year after the diagnosis of bronchiectasis.Conclusions. This case demonstrates that a fast and fatal course of bronchiectasis, that occurs after BMT, should always be considered as a possible manifestation of chronic graft versus host disease (cGVHD) following allogeneic BMT.

Exacerbations of bronchiectasis in adults

Exacerbations are significant events in the course of bronchiectasis. Exacerbations are associated with accelerated lung function decline and deterioration in quality of life (QoL). Prevention of exacerbations is therefore one of the key objectives of management of bronchiectasis. A few treatments have been proven to reduce the risk of exacerbations, but these include the treatment of underlying causes of bronchiectasis and the use of prophylactic antibiotic therapies (macrolides and inhaled antibiotics). Nonantibiotic therapies, such as airway clearance and pulmonary rehabilitation, also play an important role in the prevention of exacerbations. Acute exacerbations are treated with antibiotics directed against the known bronchiectasis pathogens and guided by previous sputum culture results. This emphasizes the importance of screening sputum cultures in stable patients. Assessment of severity is used to determine whether patients should be treated at home or in hospital. Supportive therapy for exacerbations should include airway clearance alongside oxygen, hydration, and treatment of bronchospasm as required. Bronchiectasis is a rapidly developing field and new therapies, both for the prevention of exacerbations and the treatment of acute exacerbations, are currently being developed.

Predicting mortality in bronchiectasis using bronchiectasis severity index and FACED scores: a 19-year cohort study.

The clinical course of bronchiectasis is unpredictable, posing a challenge both in clinical practice and in research. Two mortality prediction scores, the bronchiectasis severity index (BSI) and FACED scores, have recently been developed. The aim of this study was to assess the ability of these scores to predict long-term mortality and to compare the two scores.The study was a single-centre retrospective cohort analysis consisting of 91 subjects originally recruited in 1994. BSI and FACED scores were calculated at the time of enrolment and long-term mortality ascertained. Data was available for 74 patients with a median of 18.8 years of follow-up.Both scoring systems had similar predictive power for 5-year mortality (area under receiver operator characteristic curve (AUC) 0.79 for BSI and 0.8 for FACED). Both scores were able to predict 15-year mortality with the FACED score showing slightly superior predictive power (AUC 0.82 versus 0.69, p=0.0495).This study provides further validation of the FACED and BSI scores for the prediction of mortality in bronchiectasis and demonstrates their utility over a longer period than originally described. Whilst both scores had excellent predictive power, the FACED score was superior for 15-year mortality.

Thoracoscopic management for bronchiectasis with non-tuberculous mycobacterial infection

Non-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. A 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. The 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. NTM 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.

Patients with Cartilage-Hair Hypoplasia Have an Increased Risk for Bronchiectasis

To assess the prevalence, predictors, and course of bronchiectasis in patients with cartilage-hair hypoplasia. Patients who had undergone high-resolution computed tomography of the lungs or bronchography were included in the study. Hospital records were coorelated for clinical features, respiratory symptoms, and laboratory variables. Imaging studies were correlated for changes suggestive of bronchiectasis and findings correlated with clinical and immunological measurements. The study included 15 patients (5 male; median height Z-score, -7.7) aged from 2 to 39 years (median, 10 years). Cell-mediated immunity was impaired in 79% of the subjects, and humoral immunity was impaired in 71% of the subjects. 8 patients (52%) had bronchiectasis, diagnosed by means of high-resolution computed tomography (n = 6) or bronchography (n = 2). The findings ranged from localized mild dilatation of the airways to severe bronchiectasis with saccular airway dilatation. Bronchiectasis progressed during follow-up in 2 patients. Patients with bronchiectasis tended to have more severe growth failure and more often had defective humoral immunity than the general cartilage-hair hypoplasia population. Patients with cartilage-hair hypoplasia are at risk of the development of bronchiectasis.

Case report: The treatment of a chronic parotid cutaneous fistula by the injection of a solution of lipiodol with cyanoacrylate

Cystic fibrosis is an autosomal recessive disorder, and the product of the gene results in an epithelial cell membrane chloride channel defect [2]. The abnormally low water content of mucus leads to blockage of bronchioles and bronchi resulting in infection and inflammation which progresses to bronchiectasis. The clinical course of bronchiectasis is interspersed with episodic acute exacerbations of pulmonary infection leading to peribronchial fibrosis and progressive loss of pulmonary function and respiratory failure. To treat this, double lung transplantation has been successful in cystic fibrosis patients with end stage lung disease [3]. On high resolution CT scans, cystic fibrosis is manifest as bronchiectasis and a mosaic pattern of lung attenuation which reflects small airways disease and air trapping. Expiratory high resolution CT scans accentuate the mosaic pattern of lung attenuation caused by air trapping [4,5], indeed, the expiratory high resolution CT scan is necessary to help to differentiate among different causes of a mosaic pattern of lung attenuation [4]. Air trapping is accentuated by expiration because the areas of decreased attenuation on the CT scan remain unchanged in volume and attenuation, whereas the uninvolved lung shows a homogenous increase in attenuation [5,6]. MinIP images accentuate the differences in lung attenuation due to the inherent high-contrast resolution. As expiration accentuates air trapping, expiratory MinlP images are potentially very useful to demonstrate the mosaic pattern of lung attenuation caused by small airways disease. Air trapping has been demonstrated following forced expiration of subjects with normal pulmonary function [7,8]. Up to 25% of the cross-sectional area of one section of lung has been shown to demonstrate air-trapping in normal subjects [7], in our patient approximately 70% and 60% of the cross-sectional area of the

Allergic bronchopulmonary aspergillosis: A comparative evaluation of computed tomography with plain chest radiography

Computed tomography (CT) was done in 15 consecutive patients with allergic bronchopulmonary aspergillosis (ABPA). When compared with chest X-ray, CT was found to be superior in the diagnosis of bronchiectasis in patients with ABPA. Of the 90 lobes studied, CT detected bronchiectasis in 57 lobes and plain chest X-ray in 44 lobes. In addition to central bronchiectasis, peripheral bronchiectasis was diagnosed with CT in 18 of the 57 lobes. Follow-up CT was done in two patients after treatment for detection of progression or regression of bronchiectatic lesions. One patient showed radiological as well as clinical improvement, while the other patient presented with a recurrence of symptoms 4 months after stopping treatment. Computed tomography showed radiological progression of bronchiectasis and the patient was successfully treated with corticosteroids (thus preventing further bronchial damage). It is concluded from this study that CT is superior to plain chest X-ray in the diagnosis of bronchiectasis in patients with ABPA. Being non-invasive, it is also helpful in monitoring the course of bronchiectasis in these patients.

Purpura hyperglobulinemica: Report of a case complicated in the course of bronchiectasis

Purpura hyperglobulinemica: Report of a case complicated in the course of bronchiectasis

The fate of children with bronchiectasis.

Article1 April 1956THE FATE OF CHILDREN WITH BRONCHIECTASISCHRISTOPHER STRANG, M.D., M.R.C.P.CHRISTOPHER STRANG, M.D., M.R.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-44-4-630 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough much has been written in recent years on the subject of bronchiectasis, few studies have dealt specifically with the disease in childhood. Many authors observe how frequently the manifestations of this condition appear in early life, but in the main they consider the prognosis and treatment of the disease in adults. Hence much uncertainty still exists about the fate of children who develop bronchiectasis, and the results of surgical and medical treatment are not widely appreciated.This paper records the results of a follow-up study carried out during the year 1950 on a group of children with bronchiectasis. These...Bibliography1. Alexander J: Roles of medicine and surgery in the management of bronchiectasis, Ann. Int. Med. 21: 565, 1944. LinkGoogle Scholar2. Anspach WE: Bronchiectasis, collapsed lung and the triangular basal shadow in the roentgenogram, and their relationship, Am. J. Roentgenol. 41: 173, 1939. Google Scholar3. ChurchillBelsey EDR: Segmental pneumonectomy in bronchiectasis, Ann. Surg. 109: 481, 1939. CrossrefMedlineGoogle Scholar4. CooksonMason HAGA: Bronchiectasis: a fatal disease, Edinburgh M. J. 45: 844, 1938. MedlineGoogle Scholar5. DiamondVan Loon SEL: Bronchiectasis in childhood, J. A. M. A. 118: 771, 1942. CrossrefGoogle Scholar6. Engel S: The child's lung, 1947, Edward Arnold & Co., London. Google Scholar7. FindlayGraham LS: Prognosis in bronchiectasis, Arch. Dis. Childhood 6: 1, 1931. CrossrefMedlineGoogle Scholar8. Ford FJ: The course of bronchiectasis in children, Glasgow M. J. 29: 19, 1948. MedlineGoogle Scholar9. LisaRosenblatt JRMR: Bronchiectasis, 1943, Oxford University Press, New York. Google Scholar10. Ogilvie AG: The natural history of bronchiectasis. A clinical, roentgenologic and pathologic study, Arch. Int. Med. 68: 395, 1941. CrossrefGoogle Scholar11. PerryKing KMDS: Bronchiectasis. A study of prognosis based on a follow-up of 400 patients, Am. Rev. Tuberc. 41: 531, 1940. Google Scholar12. Riggins HM: Bronchiectasis. Morbidity and mortality of medically treated patients, Am. J. Surg. 54: 50, 1941. CrossrefGoogle Scholar13. RolesTodd FCGS: Bronchiectasis. Diagnosis and prognosis in relation to treatment, Brit. M. J. 2: 639, 1933. CrossrefMedlineGoogle Scholar14. Strieder JW: Surgical aspects of bronchiectasis, New England J. Med. 238: 109, 1948. CrossrefMedlineGoogle Scholar15. WisslerHotz HM: Zur Prognose der Bronchiectasen in Kindersalter, Helvet. paediat. acta 3: 475, 1948. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Newcastle upon Tyne,*Received for publication May 16, 1955.From the Department of Thoracic Surgery, Shotley Bridge Hospital, Newcastle upon Tyne, England. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Epidemiology of Chronic Suppurative Lung Disease and Bronchiectasis in Children and AdolescentsPediatric bronchiectasis: No longer an orphan diseaseDiagnostic étiologique des bronchectasiesDo New Zealand children with non-cystic fibrosis bronchiectasis show disease progression?Characterisation of the onset and presenting clinical features of adult bronchiectasisTreatment of paediatric non-cystic fibrosis bronchiectasisRetrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationshipsPaediatric bronchiectasis in the twenty-first century: Experience of a tertiary children's hospital in New ZealandAn Investigation into Causative Factors in Patients with BronchiectasisA comparison of spirometric variables in cystic fibrosis and bronchiectasis over 4 yearsThe chest radiograph in whooping coughBronchiectasis in ChildhoodThe changing spectrum of pulmonary operations in infants and childrenPresent outlook in bronchiectasis: clinical and social study and review of factors influencing prognosis.Bronchiektasie: KlinikAsthma, allergy and bronchial hyper-reactivity to histamine in patients with bronchiectasisThe Radiological Follow-Up of Aboriginal Children with Bronchiectasis Treated Surgically or MedicallyVentilatory mechanics in patients with bronchiectasis starting in childhoodBronchiolitis obliterans, bronchiectasis, and other sequelae of adenovirus type 21 infection in young childrenErkrankungen der Lunge im Säuglings- und KleinkindesalterReversible Bronchial Dilatation* *From the Departments of Medicine, Veterans Administration Hospital, and the University of Oregon School of Medicine.Bronchiectasis: A Long-term Follow-up of Medical and Surgical Cases from ChildhoodA maintenance trial of combined steroid and antibiotic treatment in a series of asthmatics with chronic bronchitisBronchiektasen beim KindBronchiectasis in Children A Follow-up Study of Surgical Treatment in Seventeen Cases 1 April 1956Volume 44, Issue 4Page: 630-656KeywordsAsthmaBronchiectasisChildrenPneumoniaThoracic surgeryUpper respiratory tract infections ePublished: 1 December 2008 Issue Published: 1 April 1956 PDF downloadLoading ...