[Mortality from respiratory diseases in the provinces of Apulia Region (Southern Italy) from 1933 to 2010]. / La mortalità per patologie respiratorie nelle province pugliesi dal 1933 al 2010.

OBIETTIVI: valutare l'andamento temporale della mortalità per patologie respiratorie nelle province pugliesi utilizzando dati omogenei per fonte e metodologia di calcolo. DISEGNO: analisi ecologica storica degli andamenti temporali di mortalità per tumori e patologie dell'apparato respiratorio nelle province pugliesi, in Puglia e nelle ripartizioni geografiche italiane dal 1933 al 2010. SETTING E PARTECIPANTI: i dati di mortalità e le popolazioni residenti sono di fonte Istat. Sono state esaminate tutte le cause di decesso, il tumore della laringe, il tumore del polmone, l'insieme dei tumori respiratori, la bronchite, la polmonite e la broncopolmonite considerate congiuntamente, e l'insieme delle patologie respiratorie. Le analisi sono disaggregate per sesso dal 1969. PRINCIPALI MISURE DI OUTCOME: rapporti standardizzati di mortalità (SMR%) in riferimento all'Italia, con intervalli di confidenza al 95%, e tassi di mortalità standardizzati col metodo diretto (TSD ) in riferimento alla popolazione standard europea. RISULTATI: dal 1933 al 2010, i TSD per tumori respiratori e per bronchiti diminuiscono in tutte le aree analizzate. Tuttavia, nelle province di Taranto, Brindisi e Lecce, l'SMR% per tumori respiratori, inferiore al riferimento nazionale fino agli anni Sessanta, si allinea (a Brindisi) e supera (a Lecce e Taranto) il riferimento negli anni successivi. Nelle province di Foggia e Bari il numero dei decessi per tumore del polmone è costantemente inferiore all'atteso. CONCLUSIONI: la ricostruzione storica e l'analisi dei trend temporali di mortalità dal 1933 al 2010 mostrano alcune criticità sanitarie in periodi specifici. L'elaborazione dei dati di mortalità per un arco temporale di circa 80 anni ha messo in evidenza la maggiore rilevanza di queste criticità con l'avvio dello sviluppo industriale.

[200 years of bronchitis--from 1808 to 2008]. / 200 Jahre Bronchitis--1808 bis 2008.

Because of the still growing importance of airway diseases, it should be worthwhile to remember Charles Badham's coining of the term bronchitis 200 years ago--in 1808. In the two editions of his book he reviewed historical names and concepts of tracheobronchial affections according to humoralism mainly under the topic of catarrh. Using his new term "bronchitis" he classified three forms (Br. acuta, asthenica and chronica). Analyses of clinical symptoms, case histories and therapeutic aspects form the central chapters of his work, always in relation to former ideas and authors. According to modern authors his characterization of chronic bronchitis conforms best with today's definitions, whereas the first two forms remain unclear even today. Early German medical reviews and comments uniformly concur with both editions of his book (1808 and 1814). Finally we present some important dates of his life and work.

[Sinobronchitis--historical aspect]. / Zespól zatokowo-oskrzelowy w aspekcie historycznym.

There is evidence that a link exists between the upper and lower respiratory tracts. During the last fifty years many clinical observations has lead to a new pathogenic view of rhinosinusitis and asthma defined as Sinobronchial Syndrome. The inflammatory process in the nose and bronchi explains some of the complex interactions among different clinical diseases, such as rhinosinusitis, asthma, bronchial hyperresponsiveness and viral infections.

[The relationship between asthma and chronic obstructive and restrictive pulmonary diseases; lessons from the past century]. / De relatie tussen astma en chronisch obstructieve en restrictieve longziekten; lessen uit de afgelopen eeuw.

The so-called 'Dutch hypothesis' (Fletcher) which describes chronic obstructive (restrictive) pulmonary disease (CO(R)PD) as a consequence of complicated childhood asthma (from 1900-1960) is well-founded. It can explain many aspects of the ever changing pattern of asthma and COPD in the Western world. Severe respiratory disease in children during the first part of the 20th century was primarily the result of respiratory complications of measles and whooping cough, and caused a high mortality in children below the age of two years. Gradually more children survived and a picture of the complications was formed: chronic bronchitis and bronchiectasis. In 1939 it was suggested that this happened mainly in children with asthmatic predisposition and this pattern was documented in detail in the post World War II period. After 1970 the complications virtually disappeared as a result of vaccination and improved therapy. Consequently, bronchiectasis and cor pulmonale became rare and CO(R)PD became COPD, the old-age form of asthma. There has also been a marked increase in asthma after childhood over the past 30 years. The double role of obstruction-provoking and anti-obstructive (and asthma-masking) infections plays an important role in this respect. The old picture from the fifties in the Western world still prevails in developing countries. Prevention of this 'old COPD' must consist of vaccination against measles and whooping cough (and possibly also against respiratory syncytial virus), and treatment of asthma.

History of the treatment of chronic bronchitis.

Although chronic bronchitis was first named and described in 1808, the disease has been known since earliest time, and numerous drugs have been utilized in its therapy. The basic historic theories of human function have readily been applied to bronchitis; thus in Greek medicine, the disease was appreciated as one of excess phlegm. Early remedies included garlic, pepper, cinnamon, and turpentine, whereas later therapies of choice emphasized coffee, ipecac, and potassium nitrate. Most of the favored bronchodilator drugs of today are derived from the traditional folk remedies, ephedrine, atropine, and theophylline. The most interesting historical drugs, however, are those that have given rise to modern mucokinetic agents such as bromhexine and iodides.

Immunity to avian infectious bronchitis.

Avian infectious bronchitis is recognized clinically as a respiratory disease in its only natural host,the chicken, but the virus is disseminated throughout other systems by a viraemia with localization especially in the kidney and oviduct. The sensitivity or instability of the antigenic and immunogenic properties of the virus under laboratory stress or natural influences complicates the selection of seed virus for vaccines. Modified or attenuated active virus vaccines induce greater protection against subsequent infection than do inactive virus vaccines. Maternal antibody is effective in providing passive immunity for about two weeks after the chick is hatched. Immunoglobulins induced by primary infection or by vaccination are IgG effective for neutralization of virus by circulating antibody, and presumably secretory IgA in the respiratory tract, with the latter being more effective as evidenced by protection of the trachea against reinfection. The level of humoral antibody is not necessarily correlative with immunity based on chicken protection tests against challenge with virulent virus. A true carrier status apparently does not result from primary infection but it has been suggested that the chicken may possibly become an immune carrier.

Some social and forensic aspects of exhumation and reinterment of industrial revolution remains.

The aetiological aspects of exhumed remains from two burial sites were examined using 1839 and 1879 as years of comparison. We tried to discover whether the sample of recovered remains was representative of those buried. The state of the remains varied according to the type of soil and coffin material in which they were buried. At the earlier date most deaths were caused by infectious lesions rather than degenerative ones and 76% of those who died were below employable age-whereas in 1879 the commonest causes of death were tuberculosis ("phthisis") and bronchitis, and 42% died before they could be employed. The registration of deaths were recorded more accurately at the later date, and it was easier to build up a picture of the age, sex, and occupation of the people who died.