The Role of Bordetella Infections in Patients with Acute Exacerbation of Chronic Bronchitis

Abstract : Background: : Acute exacerbations of chronic bronchitis (AECB) are associated with a variety of viral and bacterial infectious agents, some of which are potentially preventable by immunization. Bordetella pertussis, which causes whooping cough, has not been studied in this context. We aimed to assess the role of Bordetella infections in patients with AECB. Patients and Methods: : Patients with AECB, who presented to participating private practices in Basel, Switzerland, between October 2000 and June 2002, were evaluated by a standardized questionnaire, nasopharyngeal swabs for culture (Bordetella spp.), and PCR (Bordetella spp. and selected other respiratory pathogens) and paired blood samples for serologic diagnosis of Bordetella infection. Results: : A total of 26 patients (34-86 years of age) were recruited. All culture and PCR samples were negative. Serology revealed Bordetella infection in eight (31%) patients. Duration of cough was shorter in patients with Bordetella infection compared to those without Bordetella infection (mean 15 days vs 41 days, p = 0.04). Cough ≥ 21 days duration was present in three (43%) of seven patients with evidence of Bordetella infection compared to 17 (94%) of 18 controls (p = 0.012). Progression to convalescence from initial to follow-up visit after 4-6 weeks was comparable between both groups. Conclusion: : Bordetella infections appear to play a significant role in AECB and preventive measurements such as immunization with acellular pertussis vaccines should be considered. Extended investigations are necessary to confirm our preliminary and provocative finding

Hilbert Lattice Equations

There are five known classes of lattice equations that hold in every infinite dimensional Hilbert space underlying quantum systems: generalised orthoarguesian, Mayet's E_A, Godowski, Mayet-Godowski, and Mayet's E equations. We obtain a result which opens a possibility that the first two classes coincide. We devise new algorithms to generate Mayet-Godowski equations that allow us to prove that the fourth class properly includes the third. An open problem related to the last class is answered. Finally, we show some new results on the Godowski lattices characterising the third class of equations.Comment: 24 pages, 3 figure

Division Algebras and Quantum Theory

Quantum theory may be formulated using Hilbert spaces over any of the three associative normed division algebras: the real numbers, the complex numbers and the quaternions. Indeed, these three choices appear naturally in a number of axiomatic approaches. However, there are internal problems with real or quaternionic quantum theory. Here we argue that these problems can be resolved if we treat real, complex and quaternionic quantum theory as part of a unified structure. Dyson called this structure the "three-fold way". It is perhaps easiest to see it in the study of irreducible unitary representations of groups on complex Hilbert spaces. These representations come in three kinds: those that are not isomorphic to their own dual (the truly "complex" representations), those that are self-dual thanks to a symmetric bilinear pairing (which are "real", in that they are the complexifications of representations on real Hilbert spaces), and those that are self-dual thanks to an antisymmetric bilinear pairing (which are "quaternionic", in that they are the underlying complex representations of representations on quaternionic Hilbert spaces). This three-fold classification sheds light on the physics of time reversal symmetry, and it already plays an important role in particle physics. More generally, Hilbert spaces of any one of the three kinds - real, complex and quaternionic - can be seen as Hilbert spaces of the other kinds, equipped with extra structure.Comment: 30 pages, 3 encapsulated Postscript figure

Modulation of airway inflammation to prevent exacerbations of COPD

Exacerbations of chronic obstructive pulmonary disease (COPD) are periods in the chronic course of this disease with symptoms of intensified inflammation, induced in part by infections but also by noninfectious irritating mechanisms. Although these exacerbations seem to be linked to accelerated long-term disease progression and impaired quality of life, there are only limited preventive measures available, apart from smoking cessation. This article compares the effectiveness of different pharmacological treatments for the prevention of COPD exacerbations, including the oral bacterial lysate OM-85. Given the differences in the mechanism of action of the treatments discussed, this opens some hope for additive or potentiating effects with combined treatments, which will have to be studied in future controlled trials

The role of Bordetella infections in patients with acute exacerbation of chronic bronchitis

Background: Acute exacerbations of chronic bronchitis (AECB) are associated with a variety of viral and bacterial infectious agents, some of which are potentially preventable by immunization. Bordetella pertussis, which causes whooping cough, has not been studied in this context. We aimed to assess the role of Bordetella infections in patients with AECB. Patients and Methods: Patients with AECB, who presented to participating private practices in Basel, Switzerland, between October 2000 and June 2002, were evaluated by a standardized questionnaire, nasopharyngeal swabs for culture (Bordetella spp.), and PCR (Bordetella spp. and selected other respiratory pathogens) and paired blood samples for serologic diagnosis of Bordetella infection. Results: A total of 26 patients (34-86 years of age) were recruited. ALL culture and PCR samples were negative. Serology revealed Bordetella infection in eight (31 patients with Bordetella infection compared to those without Bordetello infection (mean 15 days vs 41 days, p = 0.04). Cough greater than or equal to 21 days duration was present in three (43 with evidence of Bordetello infection compared to 17 (94 controls (p = 0.012). Progression to convalescence from initial to follow-up visit after 4-6 weeks was comparable between both groups. Conclusion: Bordetella infections appear to play a significant rote in AECB and preventive measurements such as immunization with acellular pertussis vaccines should be considered. Extended investigations are necessary to confirm our preliminary and provocative findings

Insufficient control of asthma: increase the dose of inhaled steroids or add long-acting beta 2-agonists?

Internationally accepted treatment guidelines for bronchial asthma have established the early introduction of inhaled corticosteroids as a disease-modifying treatment, in addition to bronchodilator treatment as needed. In a small group of patients this approach does not lead to sufficient control of asthma. It is a matter of debate whether in this situation the dose of inhaled steroids should be increased or the bronchodilator treatment intensified by the introduction of long-acting beta 2-agonists. Advantages and limitations of both treatment strategies are discussed in the light of recent data. Guidelines for the use of long-acting beta 2-agonists are proposed