Article

Update on non-cystic fibrosis bronchiectasis. Curr Opin Pulm Med

Royal Brompton Hospital, Sydney Street, London, UK.
Current opinion in pulmonary medicine (Impact Factor: 2.96). 12/2008; 14(6):595-9. DOI: 10.1097/MCP.0b013e328312ed8c
Source: PubMed

ABSTRACT There is growing awareness in both adult and paediatric respiratory clinics regarding the importance of non-cystic fibrosis bronchiectasis. There has been debate regarding the requirement for investigations to establish an underlying cause of bronchiectasis. Furthermore, there has been growing interest in establishing the role of bacteria in disease progression.
Post-infection is no longer the most common cause of bronchiectasis in developed countries in children or adults and the importance of identifying immunodeficiency has been underlined. Nontuberculous mycobacteria are recognized as both causing and complicating non-cystic fibrosis bronchiectasis. It has been suggested that infection with Pseudomonas aeruginosa may confer a worse prognosis compared with other pathogens but recent publications produce conflicting views. There is increasing recognition that patients with non-cystic fibrosis bronchiectasis do not necessarily respond to cystic fibrosis treatment regimens in the same way as patients with cystic fibrosis regimens.
Non-cystic fibrosis bronchiectasis can be approached in a systematic fashion to establish the underlying cause and develop treatment strategies.

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    • "Eventually, the inflammation can lead to bronchiectasis characterized by permanent dilation of the airway and thickening of the bronchial wall. Because of these changes, areas like this can function as a seedbed for future infections (Bilton, 2008; Ilowite et al., 2008; Javidan-Nejad & Bhalla, 2009; King, 2009; Goeminne & Dupont, 2010). "
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    ABSTRACT: Mucociliary clearance has long been known to be a significant innate defence mechanism against inhaled microbes and irritants. Important knowledge has been gathered regarding the anatomy and physiology of this system, and in recent years, extensive studies of the pathophysiology related to lung diseases characterized by defective mucus clearance have resulted in a variety of therapies, which might be able to enhance clearance from the lungs. In addition, ways to study in vivo mucociliary clearance in humans have been developed. This can be used as a means to assess the effect of different pharmacological interventions on clearance rate, to study the importance of defective mucus clearance in different lung diseases or as a diagnostic tool in the work-up of patients with recurrent airway diseases. The aim of this review is to provide an overview of the anatomy, physiology, pathophysiology, and clinical aspects of mucociliary clearance and to present a clinically applicable test that can be used for in vivo assessment of mucociliary clearance in patients. In addition, the reader will be presented with a protocol for this test, which has been validated and used as a diagnostic routine tool in the work-up of patients suspected for primary ciliary dyskinesia at Rigshospitalet, Denmark for over a decade.
    Clinical Physiology and Functional Imaging 09/2013; 34. DOI:10.1111/cpf.12085 · 1.33 Impact Factor
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    • "P. aeruginosa is the most-frequently isolated Gram-negative bacterium in nosocomial infections and causes acute blood, lung, intra-abdominal space, urogenital tract and wound/burn infections (Gaynes and Edwards, 2005; Jones, 2010; Fujitani et al., 2011). Chronic conditions are also associated with P. aeruginosa infection, including cystic fibrosis (CF), chronic obstructive pulmonary disease, acquired immunodeficiency syndrome , non-CF brochiectasis and situations requiring use of in-dwelling catheters (Murray et al., 2007; Bilton, 2008; Huang et al., 2010). Antimicrobials are the mainstay of current therapy for P. aeruginosa infections; however, new anti-Pseudomonal approaches are needed because: (i) infections are often unresponsive; (ii) pan-drug-resistant P. aeruginosa strains have been isolated; and (iii) biofilms formed by P. aeruginosa are highly drug-resistant (Giamarellou and Kanellakopoulou, 2008; Page and Heim, 2009; Ho et al., 2010). "
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    • "Also incidence of chronic expectoration or daily dyspnea or periods with prescribed antibiotics is increased in COPD patients with bronchiectasis with significant difference than the COPD patients without bronchiectasis so there variables are characteristic of bronchiectasis [11] [36] [37]. According to our results, there is a wide range of possibilities from the patients with severe COPD, with bacterial colonization or at least on hospital admission in the previous year, who would have a high probability of presenting bronchiectasis , to the patients with moderate COPD. "
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