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Journal articles on the topic 'Expectorations – Analyse'
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1
Sednaoui, P., N. Janin, and J.-M. Alonso. "Nouveau milieu de transport et de conservation à-50°C des expectorations pour analyse microbiologique." Médecine et Maladies Infectieuses 25, no. 12 (December 1995): 1201–5. http://dx.doi.org/10.1016/s0399-077x(05)81360-5.
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Marcot, C., N. Khayath, and F. De Blay. "Analyse rétrospective du phénotype des patients asthmatiques suivis au CHU de Strasbourg, basée sur l’exploration de la formule leucocytaire des expectorations induites." Revue des Maladies Respiratoires Actualités 12, no. 1 (January 2020): 38. http://dx.doi.org/10.1016/j.rmra.2019.11.062.
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Marcot, C., N. Khayath, and F. De Blay. "Analyse rétrospective du phénotype des patients asthmatiques suivis au CHU de Strasbourg, basée sur l’exploration de la formule leucocytaire des expectorations induites." Revue Française d'Allergologie 60, no. 4 (June 2020): 370. http://dx.doi.org/10.1016/j.reval.2020.02.189.
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Mohd Hanafiah, Khayriyyah, Mary Garcia, and David Anderson. "An Observational Case-Control Study to Determine Human Immunodeficiency Virus and Host Factor Influence on Biomarker Distribution and Serodiagnostic Potential in Adult Pulmonary Tuberculosis." Tropical Medicine and Infectious Disease 4, no. 2 (March 31, 2019): 57. http://dx.doi.org/10.3390/tropicalmed4020057.
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Influence of host factors, including human immunodeficiency virus (HIV) co-infection, on the distribution and diagnostic potential of previously evaluated biomarkers of pulmonary tuberculosis (PTB), such as anti-antigen 60 (A60) immunoglobulin (Ig) G, anti-A60 IgA, and C-reactive protein (CRP), remain unclear. Anti-A60 IgG, anti-A60 IgA, and CRP in PTB and non-PTB patient sera (n = 404, including smear-positive/negative, culture-positive (SPCP/SNCP) and HIV+ve/−ve) were measured by enzyme-linked immunoassay and statistically analysed. In multinomial logistic regression, expectoration, chest pain, wasting, and culture count positively associated with CRP (p < 0.001), while smear count positively associated with anti-A60 IgG (p = 0.090). Expectoration and enlarged lymph nodes negatively associated with anti-A60 IgA (p = 0.018). Biomarker distribution and diagnostic potential varied significantly by symptoms and bacilli burden, and across different PTB subpopulations. CRP was correlated poorly with anti-A60 antibodies, while anti-A60 IgA and IgG were correlated in non-tuberculosis (TB) and SPCP patients (p < 0.001). When combined, anti-A60 IgG and CRP best discriminated SPCP/HIV−ve from non-TB (AUC: 0.838, 95% CI: 0.783–0.894), while anti-A60 IgA and CRP performed best in discriminating HIV+ve PTB from non-TB (AUC: 0.687, 95% CI: 0.598–0.777). Combined CRP and anti-A60 antibodies had significantly reduced accuracy in SNCP and SNCP/HIV+ve compared to SPCP/HIV−ve subpopulations. The complex relationships between host factors and biomarkers suggest their limited utility, especially in SNCP/HIV+ve subpopulations, highlighting the importance of examining host response and immune biomarkers across relevant patient subpopulations.
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Otu, Akaninyene, Philip Langridge, and David Denning. "Nebulised N-Acetylcysteine for Unresponsive Bronchial Obstruction in Allergic Brochopulmonary Aspergillosis: A Case Series and Review of the Literature." Journal of Fungi 4, no. 4 (October 15, 2018): 117. http://dx.doi.org/10.3390/jof4040117.
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Many chronic lung diseases are characterized by the hypersecretion of mucus. In these conditions, the administration of mucoactive agents is often indicated as adjuvant therapy. N-acetylcysteine (NAC) is a typical example of a mucolytic agent. A retrospective review of patients with pulmonary aspergillosis treated at the National Aspergillosis Centre in Manchester, United Kingdom, with NAC between November 2015 and November 2017 was carried out. Six Caucasians with Aspergillus lung disease received NAC to facilitate clearance of their viscid bronchial mucus secretions. One patient developed immediate bronchospasm on the first dose and could not be treated. Of the remainder, two (33%) derived benefit, with increased expectoration and reduced symptoms. Continued response was sustained over 6–7 months, without any apparent toxicity. In addition, a systematic review of the literature is provided to analyze the utility of NAC in the management of respiratory conditions which have unresponsive bronchial obstruction as a feature.
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Ackerstaff, Annemieke H., Frans J. M. Hilgers, Alfons J. M. Balm, Neil K. Aaronson, and Nico van Zandwuk. "Improvements in Respiratory and Psychosocial Functioning following Total Laryngectomy by the Use of a Heat and Moisture Exchanger." Annals of Otology, Rhinology & Laryngology 102, no. 11 (November 1993): 878–83. http://dx.doi.org/10.1177/000348949310201111.
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A prospective clinical study in 61 patients was undertaken to investigate the subjective and objective influence of a heat and moisture exchanger (HME) on the respiratory and psychosocial problems following total laryngectomy. Although statistical comparisons failed to detect significant differences between the experimental and the control groups, there was a clear trend toward improvements in respiratory and psychosocial functioning in the experimental group. Analyses of differences over time within the HME user group showed significant reductions in the incidence of coughing, the mean daily frequency of sputum production, forced expectoration, and stoma cleaning. Significant improvements were also found in shortness of breath, fatigue and malaise, sleep problems, levels of anxiety and depression, and perceived voice quality. Pulmonary function tests showed significant improvements in inspiratory flow and volume values following use of the HME. This objective improvement in inspiratory pulmonary function reflects the decrease in sputum production reported by the patients.
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Luthfi, Muhammad, Aqsa Sjuhada Oki, Retno Indrawati, Muhaimin Rifai, Yoes Prijatna Dachlan, and Fathilah Abdul Razak. "CD89/CD35 Expression Ratio in Salivary Neutrophil as an Early Detection Marker for Severe Early Childhood Caries." European Journal of Dentistry 14, no. 03 (July 2020): 386–92. http://dx.doi.org/10.1055/s-0040-1713704.
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Abstract Objectives To analyze CD35/CD89 expression ratio on the surface of neutrophils as an early detection marker for S-ECC. Materials and Methods Saliva was collected from 4- to 6-year-old kindergarten students. Salivary neutrophils were obtained by instructing the subjects to rinse their mouth with 1 mL of sterile 1.5% NaCl for 30 seconds before expectorating it into a sterile glass. The expression of CFSE+CD35+ and CFSE+CD89+was measured and analyzed using flow cytometry. Results The expression of CFSE+CD89+ in the caries-free group (2.46 ± 0.39) was significantly lower than that in the S-ECC group (3.41 ± 1.11), with a p-value of 0.0001, while the expression of CFSE+CD35+ in the caries-free group was (2.35 ± 0.56) compared with (1.54 ± 0.35) (p = 0.0001) in the S-ECC group. Conclusions The expression ratio of CFSE+CD89+ and CFSE+CD35+constitutes a marker for S-ECC.
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Prevaes, Sabine M. P. J., Wouter A. A. de Steenhuijsen Piters, Karin M. de Winter-de Groot, Hettie M. Janssens, Gerdien A. Tramper-Stranders, Mei Ling J. N. Chu, Harm A. Tiddens, et al. "Concordance between upper and lower airway microbiota in infants with cystic fibrosis." European Respiratory Journal 49, no. 3 (March 2017): 1602235. http://dx.doi.org/10.1183/13993003.02235-2016.
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Nasopharyngeal and oropharyngeal samples are commonly used to direct therapy for lower respiratory tract infections in non-expectorating infants with cystic fibrosis (CF).We aimed to investigate the concordance between the bacterial community compositions of 25 sets of nasopharyngeal, oropharyngeal and bronchoalveolar lavage (BAL) samples from 17 infants with CF aged ∼5 months (n=13) and ∼12 months (n=12) using conventional culturing and 16S-rRNA sequencing.Clustering analyses demonstrated that BAL microbiota profiles were in general characterised by a mixture of oral and nasopharyngeal bacteria, including commensals like Streptococcus, Neisseria, Veillonella and Rothia spp. and potential pathogens like Staphylococcus aureus, Haemophilus influenzae and Moraxella spp. Within each individual, however, the degree of concordance differed between microbiota of both upper respiratory tract niches and the corresponding BAL.The inconsistent intra-individual concordance between microbiota of the upper and lower respiratory niches suggests that the lungs of infants with CF may have their own microbiome that seems seeded by, but is not identical to, the upper respiratory tract microbiome.
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Teixeira, Renato da Costa, Kézia Danniely da Silva Santos, Marinara do Socorro Dias da Silva, Valéria Marques Ferreira Normando, and Madacilina de Melo Teixeira. "Occurrence of respiratory symptoms in elderly persons heard by the family health strategy in Águas Lindas, Ananindeua, Pará State." Acta Scientiarum. Health Sciences 42 (April 22, 2020): e47682. http://dx.doi.org/10.4025/actascihealthsci.v42i1.47682.
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Respiratory diseases are among the five leading causes of death in Brazil, particularly among the elderly. This study identified the occurrence of respiratory symptoms in older persons. Specifically, a descriptive, observational, and quantitative study was conducted using a sample of elderly people enrolled in the Hypertension and Diabetes sessions of the Family Health Strategy program in a Brazilian city. MRC-ATS-DLD78 questionnaires were used to analyze respiratory symptoms with a sample comprised of 50 volunteers (mean age = 69.96 years). The median time living in a dwelling within a polluted sample area was 30 years, with 82% reporting spending more time per day at home or in the neighborhood. The presence of coughing was reported by 18% persons, expectoration (17%), productive cough (14%), wheezing (34%), dyspnea (12%), and respiratory diseases (26%). Physiological changes in aging associated with the effects of pollution exposure leave elderly people more vulnerable to respiratory diseases because they are predisposed to diseases, such as decreased pulmonary elasticity, elevated lung compliance, reduced oxygen diffusion capacity, reduced expiratory flow, and premature closure of airways. The occurrence of respiratory symptoms in the elderly was 30% with one symptom, two (22%), three (10%), four (6%), and five (2%).
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Li, Y., Z. Jia, S. Li, Y. Huang, X. Yuan, and W. Chen. "Factors associated with long-term haemoptysis recurrence after transarterial embolisation for haemoptysis." International Journal of Tuberculosis and Lung Disease 24, no. 6 (June 1, 2020): 606–11. http://dx.doi.org/10.5588/ijtld.19.0490.
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OBJECTIVE: To assess factors associated with long-term haemoptysis recurrence after transarterial embolisation (TAE) for haemoptysis due to bronchiectasis.METHODS: Patients with haemoptysis due to bronchiectasis who underwent TAE between May 2010 and May 2019 were included in this retrospective study. Long-term haemoptysis recurrence was defined as the expectoration of >10 mL/day of fresh blood (for at least 1 day) 1 month after TAE. Univariate and multivariate analyses were performed to identify risk factors for long-term haemoptysis recurrence after TAE.RESULTS: A total of 197 patients (108 women; mean age, 61.0 ± 12.2 years) were included in the study. TAE was performed successfully in all patients. Side effects occurred in 43 (21.8%) patients, and all patients recovered uneventfully. During 37.6 ± 11.6 months of follow-up, long-term haemoptysis recurrence occurred in 41 (20.8%) patients; the mean interval between the TAE and haemoptysis recurrence was 21.4 ± 16.3 months. Long-term haemoptysis recurrence after TAE was associated with a history of haemoptysis (OR 3.483, 95% CI 1.373–8.836; P = 0.009).CONCLUSIONS: Approximately one fifth patients with bronchiectasis had long-term haemoptysis recurrence after TAE. Risk factor for long-term haemoptysis recurrence after TAE was a history of haemoptysis.
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Xi, Xiu-hong, Shui-hua Lu, and Yong-ping Mu. "Severe Novel Influenza A (H1N1) in Shanghai: Clinical Features, Therapeutic Management and Risk Factors for Mortality." Infection International 1, no. 2 (June 1, 2012): 97–102. http://dx.doi.org/10.1515/ii-2017-0015.
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Abstract Objective To analyze the clinical features, therapeutic management and risk factors for mortality of patients with severe novel A (H1N1) influenza in Shanghai, China. Methods All patients were diagnosed by influenza A (H1N1) virus mRNA detection. Chest CT scan, routine blood, hepatic function, humoral and cellular immunity, sputum smears, and sputum cultures were performed. Logistic analysis was applied to identify risk factors for mortality. Results Total of 68 patients were enrolled in this study, the primary clinical symptoms including cough (66, 97.1%), expectoration (41, 60.3%), and polypnea (41, 60.3%). Altogether, 37 (54.4%) and 11 (16.2%) patients were infected with bacterial and fungal, respectively. CT scan demonstrated that 67 (98.6%) patients had pneumonia. Oxygen therapy, oseltamivir, antibiotic and antifungal drugs were performed in 68 (100%), 66 (97.1%), 39 (57.4%), and 11 (16.2%) patients, respectively. Finally, 4 of 68 patients died. Logistic analysis demonstrated that there was a significant correlation between the percentage of neutrophils and mortality before therapy and direct bilirubin content and mortality after therapy, respectively. Conclusions Patients with severe H1N1 influenza were susceptible to bacterial and/or fungal infection. The risk factors for mortality may be associated with pre-therapeutic neutrophil percentage and post-therapeutic direct bilirubin content.
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Muñoz, Gerard, Javier de Gracia, Maria Buxó, Antonio Alvarez, and Montserrat Vendrell. "Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial." European Respiratory Journal 51, no. 1 (January 2018): 1701926. http://dx.doi.org/10.1183/13993003.01926-2017.
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Keeping airways clear of mucus by airway clearance techniques seems essential in bronchiectasis treatment, although no placebo-controlled trials or any studies lasting longer than 3 months have been conducted. We evaluate the efficacy of the ELTGOL (slow expiration with the glottis opened in the lateral posture) technique over a 1-year period in bronchiectasis patients with chronic expectoration in a randomised placebo-controlled trial.Patients were randomised to perform the ELTGOL technique (n=22) or placebo exercises (n=22) twice-daily (ClinicalTrials.gov,NCT01578681). The primary outcome was sputum volume during the first intervention and 24 h later. Secondary outcomes included sputum volume during the intervention and 24 h later at month 12, exacerbations, quality of life, sputum analyses, pulmonary function, exercise capacity, systemic inflammation, treatment adherence, and side effects.Sputum volume during intervention and 24 h later was higher in the ELTGOL group than in the placebo group both at the beginning and end of the study. Patients in the ELTGOL group had fewer exacerbations (p=0.042) and a clinically significant improvement in the St George's Respiratory Questionnaire score (p<0.001) and the Leicester Cough Questionnaire score compared with the placebo group (p<0.001).Twice-daily ELTGOL technique over 1 year in bronchiectasis patients facilitated secretion removal and was associated with fewer exacerbations, improved quality of life, and reduced cough impact.
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Hafez, Manal R., and Omaima I. Abo-Elkheir. "Clinical, radiological, laboratory and bronchoscopic features characterizing each type of bronchogenic carcinoma." International Journal of Research in Medical Sciences 5, no. 12 (November 25, 2017): 5107. http://dx.doi.org/10.18203/2320-6012.ijrms20175428.
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Background: To analyse the clinical, radiological, laboratory, and bronchoscopic findings characterizing each type of bronchogenic carcinoma.Methods: A cross-sectional study was conducted on 123 bronchogenic carcinoma patients. They were subjected to history taking, laboratory investigations, computed tomographic scan and fiberoptic bronchoscopy.Results: The mean age of the patients was 56.9±6.7 years, 76.4% were males and 78.9% were smokers. Most of them were symptomatic, adenocarcinoma (ADC) being the highest symptomatic one. Expectoration, fingers clubbing, and fever were common in ADC and small cell lung cancer (SCLC). Dyspnea, haemoptysis, dysphonia, dysphagia, vocal cord paralysis, anorexia and weight loss were common in SCLC and squamous cell carcinoma (SCC). Deep venous thrombosis was common in ADC and SCC. Mass lesion, atelectasis, chest wall invasion and elevated hemidiaphragm were common in SCLC and SCC. Ipsilateral mediastinal lymph nodes enlargement, cavitary lesion, and apical lesion were common in SCC and ADC. Contralateral mediastinal lymph nodes enlargement was common in SCLC. Nodular lesion, consolidation and pleural effusion were common in ADC. Hypercalcemia and hyponatremia were common in SCC. Malignant pleural effusion was common in ADC. Most of the patients had bronchoscopically-visible lesions; SCLC and SCC being the highest visible types. Most of the SCC and SCLC were centrally located, while LCC and ADC were mainly peripherally located. Most of cases were diagnosed via bronchoscopy. More than half of the studied cases were inoperable at presentation, especially SCLC and SCC.Conclusions: The 4 pathological types are distinguished from each other’s by certain clinical, radiological, laboratory and bronchoscopic features.
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Panic, Dragan, Andreja Todorovic, Milica Stanojevic, and Violeta Iric Cupic. "Wells’ Score in Diagnosis of Pulmonary Embolism in Patient with Thrombocytopenia: A Case Report." Serbian Journal of Experimental and Clinical Research 20, no. 3 (September 1, 2019): 281–85. http://dx.doi.org/10.1515/sjecr-2017-0061.
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Abstract Current diagnostic workup of patients with suspected acute pulmonary embolism (PE) usually starts with the assessment of clinical pretest probability, using clinical prediction rules and plasma D-dimer measurement. Although an accurate diagnosis of acute pulmonary embolism (PE) in patients is thus of crucial importance, the diagnostic management of suspected PE is still challenging. A 60-year-old man with chest pain and expectoration of blood was admitted to the Department of Cardiology, General Hospital in Cuprija, Serbia. After physical examination and laboratory analyses, the diagnosis of Right side pleuropne monia and acute pulmonary embolism was established. Clinically, patient was hemodynamically stable, auscultative slightly weaker respiratory sound right basal, without pretibial edema. Laboratory: C-reactive protein (CRP) 132.9 mg/L, Leukocytes (Le) 18.9x109/L, Erythrocytes (Er) 3.23x1012/L, Haemoglobin (Hgb) 113 g/L, Platelets (Plt) 79x109/L, D-dimer 35.2. On the third day after admission, D-dimer was increased and platelet count was decreased (Plt up to 62x109/L). According to Wells’ rules, score was 2.5 (without symptoms on admission), a normal clinical finding with clinical manifestation of hemoptysis and chest pain, which represents the intermediate level of clinical probability of PE. After the recidive of PE, Wells’ score was 6.5. In summary, this study suggests that Wells’ score, based on a patient’s risk for pulmonary embolism, is a valuable guidance for decision-making in combination with knowledge and experience of clinicians. Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being consiered.
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Al-Swiahb, Jamil N., and Mohammed A. Motiwala. "Upper respiratory tract and otolaryngological manifestations of coronavirus disease 2019 (COVID-19): A systemic review." SAGE Open Medicine 9 (January 2021): 205031212110169. http://dx.doi.org/10.1177/20503121211016965.
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To detect, analyze, and discuss the different ear nose throat manifestations, those were reported in coronavirus disease-positive patients in the published and reviewed literature. Coronavirus disease has been reported to present with several symptoms. Common symptoms include new onset of fever, cough, fatigue, and myalgia. Other symptoms like sputum production, dyspnea, rhinorrhea, anosmia, nasal stuffiness, headache, and sore throat are less frequently reported, but the clinical presentation is highly variable among individuals. We review the otolaryngologic manifestations of coronavirus disease reported in the published literature to assess its importance in the early diagnosis of coronavirus disease. We searched PubMed database, MEDLINE, Web of Science, LILACS, SciELO, and Cochrane Library to find out relevant articles, using the following keywords: COVID-19, clinical features, characteristics, symptoms, clinical, manifestations, throat, cough, rhinorrhea, COVID-19 anosmia, headache, nasal, coronavirus, and coronavirus otolaryngologic. Article selection was based on their relevance to the research question. Totally, 14 articles and 2971 patients were recruited for our study. A wide variety of upper and lower airway manifestations were reported. Fever (34%–96.5%), cough (17.9%–83%), myalgia or fatigue (10%–31%), expectoration (20%–32.7%), dyspnea (7.6%–7.5%), rhinorrhea (1%–6.8%), sore throat (4%–61%), nasal congestion (3%–4.8%), and headache (3%–16.2%) were the most common symptoms reported. Our findings confirm that coronavirus disease infection presents with a wide spectrum of clinical presentation. The ear nose throat manifestations for coronavirus disease are not uncommon, but more attention should also be paid to patients with otolaryngologic symptoms which can appear early, as this could encourage an earlier diagnosis and treatment, which limits spread of the disease.
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Schepers, Raf J. F., Jonathan M. Oyler, Robert E. Joseph, Edward J. Cone, Eric T. Moolchan, and Marilyn A. Huestis. "Methamphetamine and Amphetamine Pharmacokinetics in Oral Fluid and Plasma after Controlled Oral Methamphetamine Administration to Human Volunteers." Clinical Chemistry 49, no. 1 (January 1, 2003): 121–32. http://dx.doi.org/10.1373/49.1.121.
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Abstract Background: Methamphetamine (METH) and amphetamine (AMP) concentrations in 200 plasma and 590 oral fluid specimens were used to evaluate METH pharmacokinetics and pharmacodynamics after oral administration of sustained-release METH. Methods: Eight participants received four oral 10-mg S-(+)-METH hydrochloride sustained-release tablets within 7 days. Three weeks later, five participants received four oral 20-mg doses. Blood samples were collected for up to 24 h and oral fluid for up to 72 h after drug administration. Results: After the first oral dose, initial plasma METH detection was within 0.25–2 h; cmax was 14.5–33.8 μg/L (10 mg) and 26.2–44.3 μg/L (20 mg) within 2–12 h. In oral fluid, METH was detected as early as 0.08–2 h; cmax was 24.7–312.2 μg/L (10 mg) and 75.3–321.7 μg/L (20 mg) and occurred at 2–12 h. The median oral fluid-plasma METH concentration ratio was 2.0 across 24 h and was highly variable. Neutral cotton swab collection yielded significantly higher METH and AMP concentrations than citric acid candy-stimulated expectoration. Mean (SD) areas under the curve for AMP were 21% ± 25% and 24% ± 11% of those observed for METH in plasma and oral fluid, respectively. After a single low or high dose, plasma METH was >2.5 μg/L for up to 24 h in 9 of 12 individuals (mean, 7.3 ± 5.5 μg/L at 24 h); in oral fluid the detection window was at least 24 h (mean, 18.8 ± 18.0 μg/L at 24 h). The plasma and oral fluid 24-h METH detection rates were 54% and 60%, respectively. After four administrations, METH was measurable for 36–72 h (mean, 58.3 ± 14.5 h). Conclusions: Perceived advantages of oral fluid for verifying METH exposure compared with urine include simpler specimen collection and reduced potential for adulteration, but urine offers higher analyte concentrations and a greater window of detection.
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Avdeeva, Marina G., G. V. Shubina, A. A. Ganzha, and E. V. Zhuravleva. "COMMUNITY-ACQUIRED PNEUMONIA IN INFECTIOUS HOSPITAL PATIENTS: THE DEVELOPMENT OF RESISTANCE TO ANTIMICROBIALS." Epidemiology and Infectious Diseases (Russian Journal) 23, no. 3 (June 15, 2018): 108–13. http://dx.doi.org/10.18821/1560-9529-2018-23-3-108-113.
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The aim of the work was to study the structure, level and dynamics of resistance to antimicrobial drugs of the most common types of microorganisms in patients with community-acquired pneumonia (CAP) in the Krasnodar Territory, on the example of patients treated in a regional specialized infectious hospital for the period 2015-2017. Materials and methods. The results of bacteriological tests of expectoration, including 523 positive strains of microorganisms, are analyzed. The analysis does not include strains with hospital multidrug resistance. A bacterioscopy with Gram stain and sputum seeding on plate-like artificial nutrient media were carried out. Identification of the pathogen was performed by mass spectrometry using MALDI-TOF technology (Microflex LT, Bruker, Germany), phenotypically identified resistance mechanisms were confirmed on the automatic analyzer Vitek II Compact (BioMérieux, France). The sensitivity to antimicrobials was determined by the disc-diffusion method in the Müller-Hinton medium, using the disks by Bio-Rad, France. The antibioticogram was analyzed on the apparatus “Adagio” (Bio-Rad, France). Results. In the etiologic structure of community-acquired pneumonia, Streptoccocus pneumonia prevails in patients hospitalized in an infectious hospital in the Krasnodar Territory, which is determined in 73.56% of confirmed cases, which is twice as high as an average in Russia. Staphylococcus aureus was determined in 9.04% of casesd, with fluctuations in different years from 3.8% to 12.1%. Klebsiella pneumoniae was found in 4.61%, with variations from 1.7% to 9.3%. Pseudomonas aeruginosa was registered in 4.6%, altered from 1.3% to 7.8%. Other microorganisms were represented with Enterobacteriaceae family, 8.2% of the cases. The resistance of wild strains of microorganisms isolated at CAP to a number of antimicrobial agents has been established. A number of negative trends were noted: the emergence of pneumococcal strains resistant to beta-lactam antimicrobial drugs (benzylpenicillin MIC < 2μg); an increase in the resistance of pneumococci to macrolides, tetracyclines, sulfonamides. There is a high percentage of Staphylococcus aureus (80%) producing penicillinase, and an increase in their resistance to macrolides. A high level of Pseudomonas aeruginosa resistance to 3-rd and 4-th generation cephalosporins is noted. Conclusion. The obtained data determine the need for further monitoring of regional resistance of microorganisms, which will allow both adequate start therapy and the possibility of its timely correction. In the practical work of a doctor, it is important not only to be guided by local data on the resistance of microorganisms to antimicrobial drugs, but also to analyze the possible causes of its occurrence with the establishment of individual risk factors.
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Avdeeva, Marina G., G. V. Shubina, A. A. Ganzha, and E. V. Zhuravleva. "COMMUNITY-ACQUIRED PNEUMONIA IN INFECTIOUS HOSPITAL PATIENTS: THE DEVELOPMENT OF RESISTANCE TO ANTIMICROBIALS." Epidemiology and Infectious Diseases (Russian Journal) 23, no. 3 (June 15, 2018): 108–13. http://dx.doi.org/10.18821/1560-9529-2019-23-3-108-113.
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The aim of the work was to study the structure, level and dynamics of resistance to antimicrobial drugs of the most common types of microorganisms in patients with community-acquired pneumonia (CAP) in the Krasnodar Territory, on the example of patients treated in a regional specialized infectious hospital for the period 2015-2017. Materials and methods. The results of bacteriological tests of expectoration, including 523 positive strains of microorganisms, are analyzed. The analysis does not include strains with hospital multidrug resistance. A bacterioscopy with Gram stain and sputum seeding on plate-like artificial nutrient media were carried out. Identification of the pathogen was performed by mass spectrometry using MALDI-TOF technology (Microflex LT, Bruker, Germany), phenotypically identified resistance mechanisms were confirmed on the automatic analyzer Vitek II Compact (BioMérieux, France). The sensitivity to antimicrobials was determined by the disc-diffusion method in the Müller-Hinton medium, using the disks by Bio-Rad, France. The antibioticogram was analyzed on the apparatus “Adagio” (Bio-Rad, France). Results. In the etiologic structure of community-acquired pneumonia, Streptoccocus pneumonia prevails in patients hospitalized in an infectious hospital in the Krasnodar Territory, which is determined in 73.56% of confirmed cases, which is twice as high as an average in Russia. Staphylococcus aureus was determined in 9.04% of casesd, with fluctuations in different years from 3.8% to 12.1%. Klebsiella pneumoniae was found in 4.61%, with variations from 1.7% to 9.3%. Pseudomonas aeruginosa was registered in 4.6%, altered from 1.3% to 7.8%. Other microorganisms were represented with Enterobacteriaceae family, 8.2% of the cases. The resistance of wild strains of microorganisms isolated at CAP to a number of antimicrobial agents has been established. A number of negative trends were noted: the emergence of pneumococcal strains resistant to beta-lactam antimicrobial drugs (benzylpenicillin MIC < 2μg); an increase in the resistance of pneumococci to macrolides, tetracyclines, sulfonamides. There is a high percentage of Staphylococcus aureus (80%) producing penicillinase, and an increase in their resistance to macrolides. A high level of Pseudomonas aeruginosa resistance to 3-rd and 4-th generation cephalosporins is noted. Conclusion. The obtained data determine the need for further monitoring of regional resistance of microorganisms, which will allow both adequate start therapy and the possibility of its timely correction. In the practical work of a doctor, it is important not only to be guided by local data on the resistance of microorganisms to antimicrobial drugs, but also to analyze the possible causes of its occurrence with the establishment of individual risk factors.
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Lima, Evelise, Maria Aparecida Miyuki Nakamura, Pedro Rodrigues Genta, Ascedio José Rodrigues, Rodrigo Abensur Athanazio, Samia Rached, Eduardo Leite Vieira Costa, and Rafael Stelmach. "Improving Airways Patency and Ventilation Through Optimal Positive Pressure Identified by Noninvasive Mechanical Ventilation Titration in Mounier-Kuhn Syndrome: Protocol for an Interventional, Open-Label, Single-Arm Clinical Trial." JMIR Research Protocols 9, no. 8 (August 14, 2020): e14786. http://dx.doi.org/10.2196/14786.
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Background Mounier-Kuhn syndrome or congenital tracheobronchomegaly is a rare disease characterized by dilation of the trachea and the main bronchi within the thoracic cavity. The predominant signs and symptoms of the disease include coughing, purulent and abundant expectoration, dyspnea, snoring, wheezing, and recurrent respiratory infection. Symptoms of the disease in some patients are believed to be pathological manifestations arising due to resident tracheobronchomalacia. Although treatment options used for the management of this disease include inhaled bronchodilators, corticosteroids, and hypertonic solution, there is no consensus on the treatment. The use of continuous positive airway pressure (CPAP) has been reported as a potential therapeutic option for tracheobronchomalacia, but no prospective studies have demonstrated its efficacy in this condition. Objective The purpose of this is to identify the presence of tracheobronchomalacia and an optimal CPAP pressure that reduces the tracheobronchial collapse in patients with Mounier-Kuhn syndrome and to analyze the repercussion in pulmonary ventilation. In parallel, we aim to evaluate the prevalence of obstructive sleep apnea/hypopnea syndrome. Methods This interventional, open-label, single-arm clinical trial will enroll patients who are diagnosed Mounier-Kuhn syndrome. Patient evaluation will be conducted in an outpatient clinic and involve 3 visits. Visit 1 will involve the collection and registration of social demographic, clinical, and functional data. Visit 2 will entail polysomnography, bronchoscopy for the evaluation of tracheobronchomalacia, titration of the optimal pressure that reduces the degree of collapse of the airway, and electrical impedance tomography. In visit 3, patients exhibiting a reduction in collapse areas will be requested to undergo chest computed tomography during inspiration and forced expiration with and without positive pressure (titrated to determine optimal CPAP pressure). Results This protocol is a doctorate project. The project was submitted to the institutional review board on January 24, 2017, and approval was granted on February 2, 2017 (Brazilian Research database number CAAE 64001317.4.000.0068). Patient evaluations started in April 2018. Planned recruitment is based on volunteers’ availability and clinical stability, and interventions will be conducted at least once a month to finish the project at the end of 2020. A preliminary analysis of each case will be performed after each intervention, but detailed results are expected to be reported in the first quarter of 2021. Conclusions There is no consensus on the best treatment options for managing Mounier-Kuhn syndrome. The use of positive pressure could maintain patency of the collapsed airways, functioning as a “pneumatic stent” to reduce the degree of airflow obstruction. This, in turn, could promote mobilization of thoracic secretion and improve pulmonary ventilation. Trial Registration ClinicalTrails.gov NCT03101059; https://clinicaltrials.gov/ct2/show/NCT03101059. International Registered Report Identifier (IRRID) DERR1-10.2196/14786
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Bartoli, M. L., E. Bacci, S. Cianchetti, F. L. Dente, A. Di Franco, B. Vagaggini, M. De Santis, E. Masino, and P. L. Paggiaro. "Some factors influencing quality of spontaneous or induced sputum for inflammatory cell analysis." Monaldi Archives for Chest Disease 67, no. 2 (February 3, 2016). http://dx.doi.org/10.4081/monaldi.2007.493.
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predict the quality of the sputum samples obtained in a large group of asthmatic subjects. Methods. We compared the presence of sputum productive cough in the days preceding the test, easiness in expectoration during the test, and sputum macroscopic aspect (presence of visible plugs) with the quality of slides obtained from sputum processing. We also monitored changes in the quality in patients who repeated sputum collection several times, comparing those whose first sample was adequate with those whose first sample was inadequate. We analysed 547 sputum samples obtained from 238 asthmatic patients. Sputum was processed using the whole sample method. Results. Patients with productive cough in the days preceding the test and easy expectoration during the test produced a higher percentage of adequate samples than those without productive cough (86% vs 76%, p=0.01) and with difficulty in expectoration (85% vs 63%, p=0.0001). “Good” macroscopic samples were associated with better quality of slides (91% vs 38%, p=0.0001). Patients with inadequate first sample (n=40) had a higher percentage of inadequate samples (55%) in the subsequent tests than patients (n=115) with adequate first sample (8%). Conclusions. Patients with increased airway secretions in the days preceding the test, easy expectoration and “good” macroscopic aspect of the sputum are more likely to produce sputum sample adequate for inflammatory cell analysis. If the first sputum sample is adequate, subsequent samples are very likely to be adequate as well. If the first sputum sample is inadequate, the quality of subsequent samples cannot be predicted, since there are similar probabilities of having adequate or inadequate samples.
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Zhang, Jingwen, Jumin Liu, Zhihao Zhang, and Beizong Tian. "Solitary Fibrous Tumors of the Chest: An Analysis of Fifty Patients." Frontiers in Oncology 11 (July 1, 2021). http://dx.doi.org/10.3389/fonc.2021.697156.
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BackgroundA solitary fibrous tumor of the chest (SFTC) is a subtype of solitary fibrous tumor (SFT) with a low incidence rate. The purpose of this study is to analyze the diagnosis and treatment of SFTC and the difference between benign and malignant solitary fibrous tumor of the pleura (SFTP) to improve the understanding of this rare disease.MethodsA retrospective analysis of fifty patients with SFTC (33 cases in the pleura and 17 in the lung) was performed. Clinical and imaging characteristics, pathological features, and treatment follow-up outcomes were analyzed.ResultsThe common symptoms of the 50 patients included a cough, expectoration, chest tightness, fever, and chest pain. Space occupying lesions were found via plain computed tomography (CT) and enhanced CT was used for enhancement of the tumors. It was also found that 18 cases had necrosis, and 5 cases had calcification. The histopathology results showed that frequent nuclear division, obvious morphological variation, necrosis, and the high expression of Ki-67 cells are markers of malignant SFTC. There were significant differences in age, chest tightness, necrotic foci in CT, and expression of Ki-67 between the benign and malignant SFTP cases. All the patients who received treatment were given an excellent prognosis.ConclusionA combination of enhanced CT, histopathology, and immunohistochemistry can be used for the accurate diagnosis of SFTC. Advanced age, chest tightness, necrotic foci in CT, and a high Ki-67 index were more likely to be malignant SFTP. Operation and radiofrequency ablation can provide favorable outcomes for both benign and malignant SFTC.
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Xu, Ye, Min Zheng, Qingkui Guo, Ning Wang, and Rui Wang. "Clinical Features and Survival Outcome of Early-Stage Primary Pulmonary MALT Lymphoma After Surgical Treatment." Frontiers in Surgery 8 (August 4, 2021). http://dx.doi.org/10.3389/fsurg.2021.713748.
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Background: We aimed to study the clinical features and survival outcomes of patients with early-stage primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma who underwent surgery.Methods: This is a retrospective, single-center study including 32 patients with early-stage primary pulmonary MALT lymphoma. Univariate and multivariate Cox analyses were performed to select independent prognostic factors. The overall survival (OS) was analyzed by the Kaplan-Meier method and was compared with the log-rank test.Results: Among the 32 patients included, there were 16 men (50.0%) and 16 women (50.0%). The average age was 59.2 years old. Ten patients had non-specific clinical symptoms including cough, expectoration, and chest pain, and four patients had B symptoms. CT images are not specific and can be shown as peripheral, central, solid, and ground glass but more peripheral (93.8%) and solid (75.0%). In prognostic analysis, univariate analysis showed that tumor stage and size were associated with relapse-free survival (RFS) and OS [hazard ratio (HR) = 1.105, 95% CI: 1.021–1.197, P = 0.011; HR = 1.211, 95% CI: 1.158–1.968, P = 0.003, respectively]. It seems to indicate that higher stage and larger size indicate a worse prognosis, but we could not find statistically significant predictors in multivariate analysis. Sublobectomy was performed in 21 (65.6) cases, lobectomy was performed in the other 11 (34.4) cases, both of them can achieve good prognosis (5-year RFS and OS are both 100%), and there is no significant difference between them.Conclusions: The clinical manifestation of early-stage primary pulmonary MALT lymphoma is not significantly specific, and surgical resection is an effective treatment.
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Lu, Junnan, Lisa A. Carmody, Kristopher Opron, Richard H. Simon, Linda M. Kalikin, Lindsay J. Caverly, and John J. LiPuma. "Parallel Analysis of Cystic Fibrosis Sputum and Saliva Reveals Overlapping Communities and an Opportunity for Sample Decontamination." mSystems 5, no. 4 (July 7, 2020). http://dx.doi.org/10.1128/msystems.00296-20.
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ABSTRACT Culture-independent studies of the cystic fibrosis (CF) airway microbiome typically rely on expectorated sputum to assess the microbial makeup of lower airways. These studies have revealed rich bacterial communities. There is often considerable overlap between taxa observed in sputum and those observed in saliva, raising questions about the reliability of expectorated sputum as a sample representing lower airway microbiota. These concerns prompted us to compare pairs of sputum and saliva samples from 10 persons with CF. Using 16S rRNA gene sequencing and droplet digital PCR (ddPCR), we analyzed 37 pairs of sputum and saliva samples, each collected from the same person on the same day. We developed an in silico postsequencing decontamination procedure to remove from sputum the fraction of DNA reads estimated to have been contributed by saliva during expectoration. We demonstrate that while there was often sizeable overlap in community membership between sample types, expectorated sputum typically contains a higher bacterial load and a less diverse community compared to saliva. The differences in diversity between sputum and saliva were more pronounced in advanced disease stage, owing to increased relative abundance of the dominant taxa in sputum. Our effort to model saliva contamination of sputum in silico revealed generally minor effects on community structure after removal of contaminating reads. Despite considerable overlap in taxa observed between expectorated sputum and saliva samples, the impact of saliva contamination on measures of lower airway bacterial community composition in CF using expectorated sputum appears to be minimal. IMPORTANCE Cystic fibrosis is an inherited disease characterized by chronic respiratory tract infection and progressive lung disease. Studies of cystic fibrosis lung microbiology often rely on expectorated sputum to reflect the microbiota present in the lower airways. Passage of sputum through the oropharynx during collection, however, contributes microbes present in saliva to the sample, which could confound interpretation of results. Using culture-independent DNA sequencing-based analyses, we characterized the bacterial communities in pairs of expectorated sputum and saliva samples to generate a model for “decontaminating” sputum in silico. Our results demonstrate that salivary contamination of expectorated sputum does not have a large effect on most sputum samples and that observations of high bacterial diversity likely accurately reflect taxa present in cystic fibrosis lower airways.