Management of acute bronchitis in healthy adults

Anti-microbial Effects In Vitro and In Vivo of Alstonia scholaris

Alstonia scholaris could be used as a traditional medicinal plant in China for the treatment of acute respiratory, which might be caused by respiratory tract infections. The investigation tested the anti-infective effects of total alkaloids extract (TA) from leaves of A. scholaris, and as a result, TA inhibited herpes simplex virus type 1 (HSV-1), respiratory syncytial virus (RSV) and influenza A virus (H1N1) in vitro respectively. In addition, the survival days of mice were prolonged, and the lung weights and mortality of mice were decreased significantly, after oral administrated TA in H1N1 and beta-hemolytic streptococcus infectious models in vivo respectively. The finding supported partly the traditional usage of A. scholaris in the treatment of respiratory infections.

[Update on respiratory infections in the emergency department]

Las infecciones respiratorias agudas (IRA) constituyen uno de los motivos de consulta más frecuentes en los Servicios de Urgencias (SU) y se encuentran entre las primeras causas de morbimortalidad en los países en vías de desarrollo, según la Organización Mundial de la Salud (OMS). De manera general, se pueden definir como un deterioro clínico agudo caracterizado por la presencia de tos, expectoración, disnea, fiebre, cambios en las características del esputo y alteraciones radiológicas; todas estas mani- festaciones pueden comprometer de manera significativa la salud de los pacientes. Realizar un buen diagnóstico y tratamiento de las IRA es primordial en la práctica diaria, tanto en Atención Primaria como a nivel hospitalario, para evitar complicaciones y mortalidad relacionadas con estas enfermedades. En esta actualización, hablaremos de las infecciones respiratorias más frecuentes en el SU, la bronquitis aguda, las agudizaciones de la EPOC o bronquiectasias y las neumonías.

Acute primary Chlamydophila pneumoniae bronchitis and bronchial hyperresponsiveness in young nonasthmatic Thai military recruits

BACKGROUND

A correlation between chronic Chlamydophila pneumoniae infection and chronic airway diseases has been suggested by several studies, but direct evidence to support the link between acute Cpneumoniae infection and new-onset asthma is insufficient.

OBJECTIVES

To determine the association between C. pneumoniae infection and subsequent bronchial hyperresponsiveness (BHR) and hence asthma.

METHODS

We studied 110 Thai military conscripts during an epidemic of Cpneumoniae infection in Thailand, from November 1, 1998, through February 28, 1999. The diagnosis was based on a standardized microimmunofluorescence technique. Spirometry and methacholine challenge tests (MCTs) were conducted. This cohort study excluded all conscripts with preexisting positive MCTs.

RESULTS

Ninety-three percent of the conscripts presented with an acute cough of a mean duration of 15.2 days. The pattern of serologic response revealed that 83% had acute primary infections and 10% had acute reinfections. Mean forced expiratory volume in 1 second was 99.5%, with an improvement of 1.8% after bronchodilator administration. Only 3.6% revealed small airways disease (forced expiratory flow between 25% and 75% of <65%) on spirometry. Methacholine challenge tests failed to demonstrate BHR in all conscripts, and none had developed a new-onset wheeze (physician-diagnosed asthma) at up to 2 years of follow-up.

CONCLUSIONS

This study demonstrates that cough in patients with acute primary Cpneumoniae infection is not associated with BHR among previously healthy adults. The pathogenetic mechanism by which organisms cause coughing and wheezing in acute bronchitis seems to be different among causative respiratory pathogens.