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Pope, C., R. Spacie, S. Reynolds, and H. Jones. "Quantifying sputum production in intensive therapy." Critical Care 18, Suppl 1 (2014): P309. http://dx.doi.org/10.1186/cc13499.
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Crichton, Megan L., Mike Lonergan, Alan F. Barker, et al. "Inhaled aztreonam improves symptoms of cough and sputum production in patients with bronchiectasis: a post hoc analysis of the AIR-BX studies." European Respiratory Journal 56, no. 1 (2020): 2000608. http://dx.doi.org/10.1183/13993003.00608-2020.
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IntroductionInhaled antibiotics may improve symptom scores, but it is not known which specific symptoms improve with therapy. Item-level analysis of questionnaire data may allow us to identify which specific symptoms respond best to treatment.MethodsPost hoc analysis of the AIR-BX1 studies and two trials of inhaled aztreonam versus placebo in bronchiectasis. Individual items from the quality of life bronchiectasis (QOL-B) respiratory symptom scale, were extracted as representing severity of nine distinct symptoms. Generalised linear models were used to evaluate changes in symptoms with treatment versus placebo from baseline to end of first on-treatment cycle and mixed models were used to evaluate changes across the full 16-week trial.ResultsAztreonam improved cough (difference 0.22, 95% CI 0.08–0.37; p=0.002), sputum production (0.30, 95% CI 0.15–0.44; p<0.0001) and sputum colour (0.29, 95% CI 0.15–0.43; p<0.0001) versus placebo equating to a 20% improvement in cough and 25% improvement in sputum production and colour. Similar results were observed for cough, sputum production and sputum purulence across the trial duration (all p<0.05). Patients with higher sputum production and sputum colour scores had a greater response on the overall QOL-B (difference 4.82, 95% CI 1.12–8.53; p=0.011 for sputum production and 5.02, 95% CI 1.19–8.86; p=0.01 for sputum colour). In contrast, treating patients who had lower levels of bronchitic symptoms resulted in shorter time to next exacerbation (hazard ratio 1.83, 95% CI 1.02–3.28; p=0.042).ConclusionBaseline bronchitic symptoms predict response to inhaled aztreonam in bronchiectasis. More sensitive tools to measure bronchitic symptoms may be useful to better identify inhaled antibiotic responders and to evaluate patient response to treatment.
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Lu, Korina Yun-Fan, Hend Alqaderi, Saadoun Bin Hasan, et al. "Sputum production and salivary microbiome in COVID-19 patients reveals oral-lung axis." PLOS ONE 19, no. 7 (2024): e0300408. http://dx.doi.org/10.1371/journal.pone.0300408.
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SARS-CoV-2, a severe respiratory disease primarily targeting the lungs, was the leading cause of death worldwide during the pandemic. Understanding the interplay between the oral microbiome and inflammatory cytokines during acute infection is crucial for elucidating host immune responses. This study aimed to explore the relationship between the oral microbiome and cytokines in COVID-19 patients, particularly those with and without sputum production. Saliva and blood samples from 50 COVID-19 patients were subjected to 16S ribosomal RNA gene sequencing for oral microbiome analysis, and 65 saliva and serum cytokines were assessed using Luminex multiplex analysis. The Mann-Whitney test was used to compare cytokine levels between individuals with and without sputum production. Logistic regression machine learning models were employed to evaluate the predictive capability of oral microbiome, salivary, and blood biomarkers for sputum production. Significant differences were observed in the membership (Jaccard dissimilarity: p = 0.016) and abundance (PhILR dissimilarity: p = 0.048; metagenomeSeq) of salivary microbial communities between patients with and without sputum production. Seven bacterial genera, including Prevotella, Streptococcus, Actinomyces, Atopobium, Filifactor, Leptotrichia, and Selenomonas, were more prevalent in patients with sputum production (p<0.05, Fisher’s exact test). Nine genera, including Prevotella, Megasphaera, Stomatobaculum, Selenomonas, Leptotrichia, Veillonella, Actinomyces, Atopobium, and Corynebacteria, were significantly more abundant in the sputum-producing group, while Lachnoanaerobaculum was more prevalent in the non-sputum-producing group (p<0.05, ANCOM-BC). Positive correlations were found between salivary IFN-gamma and Eotaxin2/CCL24 with sputum production, while negative correlations were noted with serum MCP3/CCL7, MIG/CXCL9, IL1 beta, and SCF (p<0.05, Mann-Whitney test). The machine learning model using only oral bacteria input outperformed the model that included all data: blood and saliva biomarkers, as well as clinical and demographic variables, in predicting sputum production in COVID-19 subjects. The performance metrics were as follows, comparing the model with only bacteria input versus the model with all input variables: precision (95% vs. 75%), recall (100% vs. 50%), F1-score (98% vs. 60%), and accuracy (82% vs. 66%).
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Rusi Syarri, Yani, Yayang Harigustian, and Venny Diana. "Literature Review : Implementation of Effective Cough on Sputum Production in Tuberculosis Patients." Health Media 3, no. 2 (2022): 36–43. http://dx.doi.org/10.55756/hm.v3i2.97.
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Background : Tuberculosis is an infectious disease that can attack the lungs and organs outside the lungs. One of the signs and symptoms of tuberculosis is coughing. Effective cough aims to remove sputum in the airway. Objective: To identify the implementation of effective cough therapy on sputum production in tuberculosis patients. Methods: This study used a literature review method by determining the keywords tuberculosis, effective cough and sputum production. Then an article search was carried out until 3 research articles were found to be analyzed. Result: The results of this study used 3 research articles that matched the inclusion criteria set by the authors. From the results of the analysis of the three research articles used, it is known that the three articles used effective coughing techniques in removing sputum in Tuberculosis patients. Conclusion: From the results of the literature review, it can be seen that the effective cough technique is the right technique in removing sputum
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Cammarata, Sue Killion, John Dircks, Geoffrey Grambau, and Robert Hyzy. "Elevated Right Hemidiaphragm with Yellow Sputum Production." Chest 99, no. 6 (1991): 1463–65. http://dx.doi.org/10.1378/chest.99.6.1463.
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Zheng, Shanzi, Masaru Yanai, Toshifumi Matsui, Kiyohisa Sekizawa, and Hidetada Sasaki. "Nocturnal cough in patients with sputum production." Lancet 350, no. 9081 (1997): 864–65. http://dx.doi.org/10.1016/s0140-6736(05)62033-8.
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Karinja, Miriam N., Tonya M. Esterhuizen, Sven O. Friedrich, and Andreas H. Diacon. "Sputum Volume Predicts Sputum Mycobacterial Load during the First 2 Weeks of Antituberculosis Treatment." Journal of Clinical Microbiology 53, no. 4 (2014): 1087–91. http://dx.doi.org/10.1128/jcm.02379-14.
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Disease severity in patients with pulmonary tuberculosis is associated with mycobacterial sputum load. To ascertain whether reduced sputum production during treatment is a useful clinical sign of improvement, we analyzed the mycobacterial loads of 5,552 sputum samples collected from 439 newly diagnosed sputum smear-positive tuberculosis patients who participated in six 14-day studies of antituberculosis treatment. Sputum volumes were categorized as low (<6 ml), medium (6 to 10 ml), or large (>10 ml), and mycobacterial load was measured by the time to positivity in liquid culture and the CFU counts on solid culture. The association of sputum volume with mycobacterial load was estimated with multiple linear regression models adjusted for repeated measures. The predictor variables were sputum volume category, treatment day, specific study , and the interaction of sputum volume category and treatment day. Mycobacterial load was significantly associated only with the day on treatment and sputum volume, which tended to decrease with ongoing treatment. With the volume held constant, each day on treatment decreased the log CFU by 0.082 (P< 0.001) and increased the time to positivity (TTP) by 1.04 h (P< 0.001). From low to medium and from medium to large sputum volumes, the log CFU/ml increased by 0.265 (P< 0.003) and 0.490 (P< 0.001), respectively, and the TTP decreased by 1.17 h (P< 0.001) and 1.30 h (P< 0.001), respectively, for a given day of treatment. The variability of the sputum load measurements increased with the day of treatment and lower sputum volumes. The significant association of sputum volume and mycobacterial load validates decreasing sputum production as a clinical sign of improvement during early antituberculosis treatment.
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Afrianus Afrianus, Diah Pujiastuti, and Margaretha Rina Anjarwati. "EFEKTIVITAS KOMBINASI FISIOTERAPI DADA DAN SUCTION TERHADAP PENURUNAN PRODUKSI SPUTUM PADA PASIEN GAGAL NAFAS DI RUANG ICU RUMAH SAKIT SWASTA 2024: CASE REPORT." ASSYIFA : Jurnal Ilmu Kesehatan 2, no. 1 (2024): 141–45. http://dx.doi.org/10.62085/ajk.v2i1.56.
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Respiratory failure is a failure in the gas exchange function between oxygen and carbon dioxide which can cause decreased consciousness. One of the complications of decreased consciousness that is often encountered is sputum retention. The intervention carried out was chest physiotherapy combined with suction. Based on a preliminary study, it was found that 24 (80%) experienced respiratory failure. To reduce sputum production in patients with respiratory failure with chest physiotherapy intervention combined with suction in the ICU of a private hospital. The research method used in this research is a case report by conducting intervention observations and also airway clearance research with 1 respondent. After chest physiotherapy combined with suction, the results showed an increase in oxygen saturation from 88% to 99% and sputum production decreased from ± 10 cc to ± 7 cc. After chest physiotherapy combined with suction for 3 days, significant results were obtained, namely an increase in oxygen saturation and also a decrease in sputum production. ICU nurses are expected to be able to apply chest physiotherapy combined with suction to reduce sputum production in patients with respiratory failure in the ICU by paying attention to vital signs. Intervention is carried out once a day.
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Akpinar-Elci, Muge, Kimberly J. Stemple, Paul L. Enright, et al. "Induced Sputum Evaluation in Microwave Popcorn Production Workers." Chest 128, no. 2 (2005): 991–97. http://dx.doi.org/10.1378/chest.128.2.991.
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Martin, Clémence, and Pierre-Régis Burgel. "Do Cough and Sputum Production Predict COPD Exacerbations?" Chest 156, no. 4 (2019): 641–42. http://dx.doi.org/10.1016/j.chest.2019.06.023.
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Dreyer, Y., A. Rossouw, H. Schoeman, et al. "An observational study on factors influencing antibiotic use in chronic obstructive pulmonary disease at Universitas Academic Hospital, Bloemfontein." South African Family Practice 57, no. 4 (2015): 4. http://dx.doi.org/10.4102/safp.v57i4.4159.
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Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are often precipitated by excessive airway inflammation caused by viral or bacterial infections. Current guidelines suggest prescribing antibiotics to patients with AECOPD and purulent sputum production, but this may lead to unnecessary or inappropriate antibiotic use. The aim of this study was to identify clinical and laboratory variables influencing antibiotic prescriptions of clinicians managing patients hospitalised for AECOPD.Methods: An observational study was conducted among patients hospitalised with AECOPD. Antibiotic prescriptions were compared with sputum appearance, white blood cell count, C-reactive protein (CRP) levels and sputum cultures. Treatment outcomes were assessed on days 3 and 5 after admission.Results: Thirteen patients were included in the study, from July to October 2013, at Universitas Academic Hospital, Bloemfontein. Antibiotics were prescribed in seven out of eight patients with an elevated CRP level. None of the patients with reported sputum purulence received antibiotics. White blood cell count and sputum cultures did not seem to influence antibiotic prescription habits.Conclusions: Clinicians managing patients with AECOPD do not follow guidelines that suggest prescribing antibiotics to patients presenting with purulent sputum production. Further studies on whether biomarkers such as CRP may be more acceptable as a deciding factor on which to base antibiotic prescriptions are required.
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Venkatesan, P., K. Sole, C. Tang, J. T. Macfarlane, and R. G. Finch. "Oropharyngeal production of pneumococcal capsular antigen and the potential for contamination of expectorated sputum samples in pneumococcal pneumonia." Epidemiology and Infection 110, no. 3 (1993): 621–31. http://dx.doi.org/10.1017/s0950268800051049.
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SUMMARYThe presence of pneumococcal capsular antigen (PCA) in the oropharynx was sought in subjects without respiratory tract infection. Saliva specimens from 239 subjects were analysed by counter-current immunoelectrophoresis using ‘Omni-serum’. 15.5% gave positive reactions but only 24% of positive samples were typable and therefore due to pneumococcal or pneumococcal-like antigens. Given that oropharyngeal production of antigens occurs we investigated whether PCA in expectorated sputum arose from oropharyngeal contamination. Sixteen patients with pneumococcal pneumonia, and with sputum positive for PCA, were investigated in detail. On the basis of serotyping and concentration the PCA in sputum was thought to arise from the lower respiratory tract in all cases. This was confirmed by a simple, novel approach involving the comparison of concentrations in concomitant samples of saliva and sputum. Thus while oropharyngeal production of antigens poses a potential diagnostic problem the latter approach can be used to exclude contamination.
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Hamzaoui, A., M. Ben Brahim, A. Zhioua, Kh Ayed, and K. Hamzaoui. "Inflammatory response in induced sputum mononuclear cells from patients with acute exacerbation of asthma." Mediators of Inflammation 9, no. 3-4 (2000): 147–53. http://dx.doi.org/10.1080/09629350020002886.
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Examination of sputum provides a direct method to investigate airway inflam mation non-invasively in particular Th1 (IL-2, IFN–γ) and Th2 (IL–4, IL–10) cytokine production.IL–2, IL–4, IL–10 and IFN–γ cytokine were studied in induced sputum mononuclear cells of asthmatic patients.Sputum induction was performed on 10 patients and 10 normal controls. Basal and mitogen-stimulated cytokine production was determined in induced sputum T-cell culture. Supernatants were collected and assayed not only with specific ELISA but also with polymerase chain reaction (PCR) techniques.Data showed a significantly higher production of IL–10 by both the ELISA and the RT-PCR techniques in asthmatic patients compared with sputum mononuclear cells from healthy controls. IL–4 production was detected at a low level using the ELISA method in asthmatic patients. The RT-PCR analysis detected a significantly IL–4-mRNA expression in all asthmatic patients, compared with controls. Results of IL–10 and IL–4 mRNA expression were reproducible. We did not find any alteration in the expression of the type 1 derived cytokines (IL–2 and IFN–γ) in asthmatic patients or in healthy controls.Our study showed a tendency of induced sputum mononuclear cells to express a Th2-like cytokine pattern in acute exacerbation of asthmatic patients, where IL–10 and IL–4 are synthesized in larger amounts. The combination of sputum induction as a non-invasive tool to explore the lung and the identification of disease-associated cytokine expression and of specific cytokine mRNA should help elucidate mechanisms of the immunologically mediated inflammatory responses in asthma.
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Oktaviani, Vivin, and Setiyo Adi Nugroho. "STUDI LITERATUR: PENGARUH FISIOTERAPI DADA PADA PASIEN PNEUMONIA." Jurnal Keperawatan Profesional 10, no. 1 (2022): 56–71. http://dx.doi.org/10.33650/jkp.v10i1.3405.
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Patients suffering from respiratory system disorders often experience excess mucus production, which makes breathing difficult because sputum usually accumulates until it becomes thick and difficult to expel. Chest physiotherapy can be applied to remove sputum for a more effective airway. The purpose of this study of literature review is to evaluate the effect of chest physiotherapy on pneumonia patients. Database searches included ScienceDirect, Pubmed, Google Scholar with keywords chest physiotherapy and pneumonia. The criteria for selected articles are 2017-2021, with full text and in English and Indonesian. This study of literature used 18 articles that met the inclusion criteria. Chest physiotherapy can facilitate sputum production, improve respiratory rate and provide an airway. This technique can be applied to increase the effectiveness of the airway.
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Cohen, Yehuda Z., and Wendy Stead. "ExophialaPneumonia Presenting with a Cough Productive of Black Sputum." Case Reports in Infectious Diseases 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/821049.
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Exophialaspecies are black, yeast-like molds that can cause subcutaneous cysts as well as disseminated disease. Isolated pneumonia due toExophialaspecies is extremely uncommon. We report a case of isolatedExophialapneumonia in a patient with bronchiectasis who presented with worsening dyspnea and a cough productive of black sputum. The production of black sputum, known as melanoptysis, is an uncommon physical finding with a limited differential diagnosis. To our knowledge, this is the first reported case ofExophialapneumonia presenting with a cough productive of black sputum.
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Milad A. Mezher, Wa,ad M. Ra,oof, and Khalil I. Bandar. "Isolation and Identification of Candida spp. In immunocomparomised patients and Detection some virulence factors." Tikrit Journal of Pure Science 20, no. 2 (2023): 54–60. http://dx.doi.org/10.25130/tjps.v20i2.1159.
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One hundred thirty patients undergoing chemotherapy for different types of cancer attending Tikrit Teaching Hospital from January 2013 to Augusto 2013 were enrolled in this study. Their age were range between “11-83 years old”. 68 blood samples and 62 sputum samples were collected in this study.
 Candida spp. Infection was 14(20.5%) isolates from patients blood and 5(8.1%) isolates from patients sputum, were infections more in blood C.albicans 8(57.8%) , C.glabrata 3(21.4%) C.krusei 2(14.3%) and C.parasillosis while isolates from sputum were 3(60%) of C.albicans and C.glabrata 2(40%). The isolated were identified according morphological , Cultural and biochemical characteristic.
 Fungal isolates in present study produced various virulence factors hemolysin and protease production were produced in C.albicans 8(72.8), 11(100%) respectively, while C.glabrata hemolysin production were 4(80%) and (40%) of protease production , while C.parasillosis isolate were produced protease and hemolysin. C.krusei were produce only hemolysin 1(50%).
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Profita, Mirella, Angelo Sala, Loredana Riccobono, et al. "15(S)-HETE modulates LTB4 production and neutrophil chemotaxis in chronic bronchitis." American Journal of Physiology-Cell Physiology 279, no. 4 (2000): C1249—C1258. http://dx.doi.org/10.1152/ajpcell.2000.279.4.c1249.
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We evaluated the levels of 15(S)-hydroxyeicosatetraenoic acid [15(S)-HETE] and the expression of 15-lipoxygenase (15-LO) mRNA in induced sputum obtained from 10 control and 15 chronic bronchitis subjects. 15(S)-HETE was evaluated by reverse phase high-performance liquid chromatography separation followed by specific RIA. 15-LO mRNA expression was determined by primed in situ labeling. The levels of both soluble and cell-associated 15(S)-HETE resulted significantly higher in chronic bronchitis than in control subjects. The percentage of cells expressing 15-LO mRNA was significantly higher in chronic bronchitis than in control subjects ( P < 0.01). Double staining for specific cell type markers and 15-LO mRNA showed macrophages and neutrophils positive for 15-LO, whereas similar staining of peripheral blood neutrophils did not show evidence for 15-LO expression, suggesting that expression of 15-LO in neutrophils takes place on migration into the airways. Because 15(S)-HETE inversely correlated with the percentage of neutrophils in sputum of chronic bronchitis subjects, we studied the effect of 15(S)-HETE on leukotriene B4 (LTB4) production in vitro and evaluated the concentration of LTB4 in induced sputum and the contribution of LTB4 to the chemotactic activity of induced sputum samples ex vivo. The results obtained indicate that macrophages and neutrophils present within the airways of chronic bronchitis subjects express 15-LO mRNA; increased basal levels of 15(S)-HETE may contribute to modulate, through the inhibition of 5-lipoxygenase metabolites production, neutrophil infiltration and airway inflammation associated with chronic bronchitis.
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Munro, N. C., D. C. Currie, N. D. Garbett, and P. J. Cole. "Chest pain in chronic sputum production: a neglected symptom." Respiratory Medicine 83, no. 4 (1989): 339–41. http://dx.doi.org/10.1016/s0954-6111(89)80209-4.
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Smyrnios, Nicholas A., Richard S. Irwin, and Frederick J. Curley. "Chronic Cough with a History of Excessive Sputum Production." Chest 108, no. 4 (1995): 991–97. http://dx.doi.org/10.1378/chest.108.4.991.
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Senya, Benjamin Kwame, Nketiah Bernard Anim, Bright Segu Kobena Domson, and Patrick Adu. "Prevalence of Asymptomatic Mycobacterium tuberculosis Infection in Charcoal Producers: A Cross-Sectional Study in Kaase, Ghana." Journal of Pathogens 2018 (August 2, 2018): 1–4. http://dx.doi.org/10.1155/2018/9094803.
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Background. Charcoal production is a significant economic activity in Ghana. However, there is scarcity of data on the risk of acquiring Mycobacterium tuberculosis infection among charcoal producers in Ghana, even though persistent smoke exposure is a known predisposition factor. Methods. This cross-sectional study recruited 40 charcoal producers: 6 males and 34 females. Two sets of early morning sputum samples were collected from each participant and examined for the presence of acid-fast bacilli (AFB) using fluorescent microscopy. Structured questionnaires were used to retrieve demographic data from each participant. Data were analyzed using SPSS version 21 and presented as frequencies and proportions. Categorical variables were compared using Chi-square test. Significant difference was identified as p<0.05 at 95% confidence interval. Results. Overall, 2/40 (5%) of the participants demonstrated AFB in their sputum. All participants with AFB positive sputum were females and had 6–10 years of experience in charcoal production. Whereas coughing was the most self-reported symptom by the charcoal producers, none complained of blood in sputum. Also, only 9/40 (22.5%) had knowledge about the Mycobacterium tuberculosis-infection risk associated with charcoal production. Moreover, 62.5% (25/40) of participants had no formal education. Conclusion. Education on personal protection equipment must be a public health priority in these charcoal producers in Ghana as sawdust and smoke exposure may predispose charcoal producers to acquisition of tuberculosis.
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Taylor, EL, TJ Marrie, MJ Fine, et al. "Observations from a Multicentre Study on the Use of the Sputum Specimen in Patients Hospitalized with Community-Acquired Pneumonia." Canadian Journal of Infectious Diseases 10, no. 1 (1999): 39–46. http://dx.doi.org/10.1155/1999/414595.
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OBJECTIVE: To describe the use of sputum Gram stain and culture in patients with community-acquired pneumonia (CAP) and to determine the factors that are associated with obtaining sputum for culture.TYPE OF STUDY: Prospective observational cohort study of patients hospitalized for treatment of CAP at four medical institutions in three geographic locations.MAIN MEASUREMENTS: Results of Gram stain and culture of sputum; comparison of patients who had sputum processed for culture within 24 h of admission with those who did not have such a specimen processed during the first week of hospitalization; and the results of investigator assignment of etiology of pneumonia according to predefined criteria.RESULTS: Four hundred and seventy-eight of 1339 (36%) patients had a sputum specimen processed for culture within 24 h of admission. Patients who had a sputum specimen processed within 24 h of admission were more likely to be hospitalized at the Boston site (odds ratio [OR] 20.6) or Pittsburgh sites (3.4) and to have current sputum production, chronic obstructive lung disease and moderate or large amount of sputum. Female sex (0.4), neutropenia (0.05), and do not resuscitate status (0.36) were important predictors of failure to have a sputum processed for culture. The rate ofStreptococcus pneumoniaeisolation was highest in Boston, 53 of 269 (19.3 %) patients (P<0.001) compared with the other sites;Moraxella catarrhaliswas isolated only at the Boston site. Sputum culture results served as the basis for the assignment of an etiological diagnosis of the pneumonia by investigators in 67% of 397 patients. CONCLUSIONS: Sputum is not processed for culture in the majority of patients with CAP. The factors that determine whether sputum is processed for culture within 24 h of admission are site of care and a variety of patient factors. Common respiratory pathogens when present in sputum culture tend to be used to assign an etiological diagnosis. A positive sputum culture result appears not to result in a more favourable outcome.
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Van der Vliet, Albert, Mai N. Nguyen, Mark K. Shigenaga, Jason P. Eiserich, Gregory P. Marelich, and Carroll E. Cross. "Myeloperoxidase and protein oxidation in cystic fibrosis." American Journal of Physiology-Lung Cellular and Molecular Physiology 279, no. 3 (2000): L537—L546. http://dx.doi.org/10.1152/ajplung.2000.279.3.l537.
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Cystic fibrosis (CF) is associated with chronic pulmonary inflammation and progressive lung dysfunction, possibly associated with the formation of neutrophil myeloperoxidase (MPO)-derived oxidants. Expectorated sputum specimens from adult CF patients were analyzed for MPO characteristic protein modifications and found to contain large amounts of active MPO as well as high levels of protein-associated 3-chlorotyrosine and 3,3′-dityrosine, products that result from MPO activity, compared with expectorated sputum from non-CF subjects. Sputum levels of nitrite (NO2−) and nitrate (NO3−), indicating local production of nitric oxide (NO·), were not elevated but in fact were slightly reduced in CF. However, there was a slight increase in protein-associated 3-nitrotyrosine in CF sputum compared with controls, reflecting the formation of reactive nitrogen intermediates, possibly through MPO-catalyzed oxidation of NO2−. CF sputum MPO was found to contribute to oxidant-mediated cytotoxicity toward cultured tracheobronchial epithelial cells; however, peroxidase-dependent protein oxidation occurred primarily within sputum proteins, suggesting scavenging of MPO-derived oxidants by CF mucus and perhaps formation of secondary cytotoxic products within CF sputum. Our findings demonstrate the formation of MPO-derived oxidizing and possibly nitrating species within the respiratory tract of subjects with CF, which collectively may contribute to bronchial injury and respiratory failure in CF.
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Fantone, Kayla M., Joanna B. Goldberg, Arlene A. Stecenko, and Balázs Rada. "Sputum from People with Cystic Fibrosis Reduces the Killing of Methicillin-Resistant Staphylococcus aureus by Neutrophils and Diminishes Phagosomal Production of Reactive Oxygen Species." Pathogens 12, no. 9 (2023): 1148. http://dx.doi.org/10.3390/pathogens12091148.
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Cystic fibrosis (CF) airway disease is characterized by chronic polymicrobial infections and an infiltration of neutrophils (PMNs). Staphylococcus aureus has been the most prevalent respiratory pathogen in CF. In particular, methicillin-resistant S. aureus (MRSA) represents a huge clinical burden in CF due to its association with lung disease and increased resistance to antibiotics. In CF, PMNs are unable to kill and clear MRSA. The reason for this remains largely unknown. Our study found that CF PMNs are as equally capable of killing MRSA as healthy PMNs. We show that the CF sputum, however, significantly impairs the ability of human PMNs to kill CF MRSA isolates. In the absence of CF sputum, PMNs kill MRSA via intracellular mechanisms mediated by phagocytosis, rather than extracellular mechanisms via NET formation. CF sputum does not affect the phagocytosis of MRSA via healthy or CF PMNs. Our results demonstrate that CF sputum exposure impairs phagosomal levels of reactive oxygen species (ROS) in MRSA-phagocytosing PMNs. While phagosomal co-localizations of MRSA with primary granule markers, myeloperoxidase and cathepsin D, were significantly reduced upon CF sputum exposure, that of a third azurophilic granule marker, neutrophil elastase, remained unaffected. This suggests that CF sputum does not compromise the fusion of primary granules with phagosomes but diminishes phagosomal ROS levels via another, likely more specific, mechanism. Overall, we identified the airway environment as an important factor that restricts neutrophils’ oxidative microbicidal activities in CF against MRSA. These results deliver new details of the complex host–pathogen interactions present in the CF lung.
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Balode, Līga, Gunta Strazda, Normunds Jurka, et al. "Lipoxygenase-Derived Arachidonic Acid Metabolites in Chronic Obstructive Pulmonary Disease." Medicina 48, no. 6 (2011): 43. http://dx.doi.org/10.3390/medicina48060043.
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Background and Objective. Chronic obstructive pulmonary disease (COPD) is characterized by a persistence of inflammation in large and small airways. We hypothesized that this could be caused by the inability of an inflammatory process to resolve. In the resolution of inflammation, a switching of arachidonic acid metabolism from the production of proinflammatory leukotriene B4 (LtB4) to the synthesis of anti-inflammatory lipoxins plays an important role. The aim of our study was to determine the content of lipoxin A4 (LXA4) and LtB4 in induced sputum of patients with exacerbated COPD and to compare it to healthy controls, as well as to analyze the relationship between proinflammatory and anti-inflammatory mediators and an inflammatory cell spectrum in induced sputum. Material and Methods. Induced sputum from 17 COPD patients and 7 healthy controls were analyzed for LXA4 and LtB4 content and inflammatory cell spectrum. Results. COPD patients had a significantly lower sputum LXA4 concentration and LtB4/LXA4 ratio compared with healthy controls. A significant negative correlation was found between the LXA4 concentration and the relative neutrophil count and between the LtB4/LXA4 ratio and the relative macrophage count. Conclusions. COPD patients during the late phase of exacerbation had a suppressed production of LXA4 and an elevated LtB4/LXA4 ratio in induced sputum demonstrating a proinflammatory imbalance. The correction of a balance between proinflammatory and anti-inflammatory eicosanoids by the administration of stable analogues of lipoxins could improve the treatment of chronic obstructive pulmonary disease in the future.
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Wagner, Mitchell J., Monette Dimitrov, Grace Y. Lam, Winnie Leung, Gregory J. Tyrrell, and Dilini Vethanayagam. "Microbiology sampling in non-cystic fibrosis bronchiectasis cases from northern Alberta." PLOS ONE 18, no. 7 (2023): e0288704. http://dx.doi.org/10.1371/journal.pone.0288704.
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Non-cystic fibrosis bronchiectasis (NCFB) is a chronic respiratory disease resulting in chronic cough, thick sputum, and lower airway microbial colonization, akin to patients with cystic fibrosis (CF). NCFB is a common, yet under recognized entity which inflicts significant morbidity and mortality particularly to older individuals, with a rising prevalence in the developed world. Given that sputum cultures are a non-invasive method to characterize the lower airway microbiota in NCFB patients, for which pathogenic organisms are associated with worsened outcomes, we sought to characterize the microbiological pattern and clinical outcomes associated with sputum culture in a cohort of NCFB patients from Western Canada. A total of 20 subjects were prospectively recruited from various bronchiectasis clinics across the Greater Edmonton area. A retrospective chart review and a symptoms questionnaire was performed, gathering information not limited to symptoms, comorbidities, exacerbations, hospitalizations, sputum production, and sputum culture results over the prior 5 years. Subjects reported frequent hospitalization alongside a significant burden of symptoms. A large majority of sputum cultures grew pathogenic organisms such as Haemophilus influenzae and Pseudomonas aeruginosa. We also note the considerable waste and inefficiency associated with sputum cultures, outlining areas for which this important diagnostic modality can be improved. Accurate characterization of the airway microbiota alongside efficient delivery of health services are key to ensuring the proper treatment of individuals with NCFB, given their high disease burden and frequent hospitalization.
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Marks, John H., Karyl L. Hare, Robert A. Saunders, and Douglas N. Homnick. "Pulmonary Function and Sputum Production in Patients With Cystic Fibrosis." Chest 125, no. 4 (2004): 1507–11. http://dx.doi.org/10.1378/chest.125.4.1507.
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Worlitzsch, D., T. Bensel, M. Borneff-Lipp, and G. Döring. "86* Lactate production and Pseudomonas aeruginosa metabolism in CF sputum." Journal of Cystic Fibrosis 6 (June 2007): S21. http://dx.doi.org/10.1016/s1569-1993(07)60076-9.
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Cullinan, P. "Aetiological factors in persistent sputum production: a case-control study." Journal of Epidemiology & Community Health 47, no. 1 (1993): 27–31. http://dx.doi.org/10.1136/jech.47.1.27.
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Bista, Bidesh, Niraj Karmacharya, Ram Hari Ghimire, et al. "Diagnostic Yield of Bronchoscopic Alveolar Lavage Gene Xpert MTB/Rif in Smear Negative Clinico-Radiologically Suspected Case of Pulmonary Tuberculosis." Journal of Nobel Medical College 11, no. 1 (2022): 38–42. http://dx.doi.org/10.3126/jonmc.v11i1.45735.
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Background: Early diagnosis of pulmonary tuberculosis is difficult but dreaded complications like cavitations, abscess, disseminations and fibrosis of lung parenchyma can be avoided. Sputum microscopy is still the most available test for diagnosis of pulmonary tuberculosis but sustainable number of active cases remains undiagnosed via this method alone. In strong clinico-radiological pulmonary tuberculosis patients who are sputum scarce or sputum microscopy and sputum Xpert MTB/Rif negative broncho-alveolar lavage may provide superior sample for Gene Xpert MTB/Rif in diagnosis of Pulmonary Tuberculosis.
 Materials and Methods: Over 2 years period, patients with strong clinico-radiological suspicion of pulmonary tuberculosis who had sputum microscopy and sputum Xpert MTB/Rif negative were included in the study. Fibro-optic bronchoscopy was done for BAL Xpert MTB/Rif test. Base line demographic, clinical and radiological data were systematically analysedby SPSS software version 17.
 Results: 64 patients were included in the study with mean age 41 ± 10.52 years. The most common symptoms were cough, sputum production and weight loss with frequency of 58 (90.6%), 31 (48.4%) and 21 (32.11%) patients respectively. The most common CT scan findings were consolidation, cavitation and tree in bud pattern. BAL Xpert MTB/Rif was positive in 11 (17.18%) patients. According to the CT findings BAL Xpert MTB/Rif was most commonly present in patients presenting with cavitary lung disease.
 Conclusion: Eleven patients had BAL gene Xpert/Rif positive out of 64 patients who were sputum scarce or had both microscopy and sputum gene Xpert/Rif negative. Bronchoscopy BAL Xpert/Rif could provide an additional diagnostic test in these groups of patients.
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Ade, Grysha Viofananda Agung Kharisma, Fahruddin Kurdi, Risha Putri Mahardika, Faizatul Ulya, Gevin Yensya, and Nadya Rahmania Naristiti. "THE INNOVATION OF THE MINI TUBERCULOSISI SPUTUM EXAMINATION PROGRAM (MPIS-TB): A PILOT STUDY AT THE BANJARSENGON COMMUNITY HEALTH CENTER, JEMBER REGENCY." Nursing Current: Jurnal Keperawatan 10, no. 1 (2022): 41. http://dx.doi.org/10.19166/nc.v10i1.4835.
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In the era of the Covid-19 pandemic, the fear and anxiety of families of TB-positive patients increased, making it difficult for the sputum investigation program. Not coughing with phlegm, fear of being diagnosed with Covid-19, and feeling physically healthy are obstacles to the screening process. The aim of the study was to compare the sputum pots between the control and intervention groups in the innovation of the Mini TB Sputum Examination Program (MPIS-TB) in the Banjarsengon Community Health Center, Jember Regency. Quasy experimental with post test on 2 group design was using. This pilot study on 13 participants (6 different families) became group control ad intervention. Quickcheck Covid-19 East Java Provincial Health Office and SRQ-29 are used as a tool to approach the community to understand the differences in the diagnosis of TB and Covid-19. Effective cough therapy, chest physiotherapy, and simple inhalation for 3 consecutive days were also given to all participants to facilitate sputum production and release stimulation. The study results were 15,38% sputum pots were identified to return to the health center for laboratory analysis, 53,84% sputum pots returned intact (sealed sterile), and 30,76% sputum pots returned without sterile seals. The lack of return of sputum pots in 11 participants (84.6%) was due to several factors, namely not coughing with phlegm, fear of being diagnosed with Covid-19, and not feeling TB symptoms. The implementation of the MPIS-TB Program Innovation was successful with a sputum return ratio in the intervention and control groups of 40%: 0% so that in the future this program could be considered to be applied to the TB public health center program.
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Mishra, Prashant. "ENDOBRONCHIAL TUBERCULOSIS: A CASE BASED APPROACH." International Journal of Advanced Research 11, no. 08 (2023): 697–711. http://dx.doi.org/10.21474/ijar01/17440.
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Endobronchial tuberculosis is defined as tuberculous infection of the tracheobronchial tree. Although clinical features differ between various types and stages of endobronchial tuberculosis, common symptoms are cough, hemoptysis, sputum production, wheezing, chest pain, fever and dyspnea. Although endobronchial lesions usually result in sputum positivity for acid fast bacilli (AFB), a false negative sputum or absence of radiological lesions may result in delayed diagnosis. On the other hand, sputum positivity with presence of signs on chest radiology may lead to consideration of parenchymal TB as the primary diagnosis and the coexistence of endobronchial lesions may be missed until sequelae of the latter ensue. Bronchoscopy is essential for confirmation of endobronchial TB. This write up aims to summarize various clinico-radiological manifestations of endobronchial tuberculosis which were encountered in 45 years of clinical practice and will help respiratory clinicians in future for early and prompt diagnosis and management of the same.
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Donald, P. R., F. A. Sirgel, A. Venter, et al. "A review of the determination of the early bactericidal activity of various antituberculosis agents." Suid-Afrikaanse Tydskrif vir Natuurwetenskap en Tegnologie 22, no. 2/3 (2003): 79–88. http://dx.doi.org/10.4102/satnt.v22i2/3.215.
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The early bactericidal activity (EBA) of an antituberculosis agent is the daily decline in log10 colony forming units of M tuberculosis per ml of sputum during the first two days of treatment with the agent. It reflects the capacity of an agent to kill the actively metabolising organisms in tuberculosis lung cavities. It offers a relatively cheap means to evaluate the antituberculosis activity of an agent in a small group of patients within a matter of months. This article summarizes the authors’ experience in seven published EBA studies and identifies sources of variation in the procedure. The patients who participated in these studies had a mean age of 33 years, a mean weight of 50 kg and there was extensive or massive involvement of the lungs in 55% of patients. The highest EBA values (0,50-0,66) were found in groups of patients receiving isoniazid and the lowest values (0,05 and 0,09 respectively), in patients receiving the aminoglycosides amikacin and paromomycin in a dose of 15 mg/kg body weight. The variation in EBA in 248 patients was 0,0312 and the variation ascribable to the process of sputum production and collection was 0,0233. This implies that the different aspects of sputum production and collection involved in obtaining a representative sputum sample are responsible for most of the variation in EBA results. The selection of patients for inclusion in EBA studies and their ability to co-operate in producing a representative sputum specimen are of critical importance in the successful completion of EBA studies.
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Surendra, Kumar, and Kumar Agrawal Sunil. "To study the Broncho alveolar Lavage fluid analysis for AFB Smear Examination for MTB in clinically suspected case of Pulmonary Tuberculosis having no sputum production." International Journal of Pharmaceutical and Clinical Research 15, no. 12 (2023): 1859–62. https://doi.org/10.5281/zenodo.11208472.
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<strong>Background:</strong> Sputum smear test is the quickest way of detecting acid fast bacteria, but a very large sample is required for accurate sensitivity and so this test has a reason for low sensitivity. The Sputum smear test stands as an accurate prognosis for pulmonary tuberculosis also called PTB. Although sputum staining is the appropriate detection for PTB, more than 45-50% of the smears results as negative. The main aim of this study is to analyze the Broncho alveolar lavage fluid in sputum smear negative patients with strong suspicion of pulmonary tuberculosis clinically and radiologically in X- Ray chest. <strong>Materials and Methods:</strong> The design of the study was prospective cross-sectional study. A total of 145 patients were selected for this study. Participants who underwent a negative sputum smear and were suspected of pulmonary tuberculosis were included. All the participants encountered fiberoptic bronchoscopy and broncho alveolar lavage, and then the samples of broncho alveolar lavage were stained separately. <strong>Results:</strong> Among the 145 patients, 87 were male and the remaining 58 were females. The average age of the patients in this study was 52.5 ± 19.2 years. In the total 145 samples, 55 were positive for acid-fast bacteria. <strong>Conclusion:</strong> Broncho alveolar lavage associated with fiberoptic bronchoscopy is an accurate and convenient method of detecting pulmonary tuberculosis with decreased risk factors.
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Nwe, Aung Aung, Nimit Kosura, Chatchai Phimphasak, et al. "Variation of sputum expectoration within day in bronchiectasis: Preliminary observational descriptive study." Journal of Associated Medical Sciences 58, no. 2 (2025): 297–304. https://doi.org/10.12982/jams.2025.064.
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Background: Effective prescription of physical therapy airway clearance (ACT) is crucial for bronchiectasis patients, yet the optimal timing and frequency remain undefined. Understanding sputum expectoration patterns may determine the most suitable times for patients to undergo ACT. Objective: This study aimed to investigate the daily sputum expectoration patterns in patients with bronchiectasis. Materials and methods: Sputum was collected from ten bronchiectasis patients at home over three days, during morning (6 to 9 am), daytime (9 am to 6 pm), and evening (6 to 9 pm) periods. Collected sputum was centrifuged to remove saliva, weighed, and then converted to grams per hour for analysis. Results: A total of 90 sputum containers were collected over three days from 10 patients. Most patients (N=8) expectorated a median (IQR) of 14.34 (7.96, 23.67) gm, showing a higher trend in the morning (2.07 (1.16, 4.03) gm/hr), followed by evening (1.18 (1.86, 1.92) g/hr) with the least during daytime (0.41 (0.32, 0.82) gm/hr). A minority of patients (N=2) with massive sputum production (72 and 63.98 for participant 1 and participant 2 respectively) exhibited the highest rate of expectoration during daytime (5.71 /hr), followed by the evening (3.83 /hr) and morning (1.69 /hr) on average over three days. Conclusion: Most bronchiectasis patients exhibited higher rates of sputum expectoration in the morning and evening. Therefore, it is recommended to administer physical therapy for airway clearance twice daily, in the morning and evening, to prevent accumulation and enhance clearance.
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Calhoun, Kara M., Emily Armantrout, Katie Poch, et al. "Prospective Analysis of urINe LAM to Eliminate NTM Sputum Screening (PAINLESS) study: Rationale and trial design for testing urine lipoarabinomannan as a marker of NTM lung infection in cystic fibrosis." PLOS ONE 20, no. 3 (2025): e0309191. https://doi.org/10.1371/journal.pone.0309191.
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Background Routine screening for nontuberculous mycobacterial (NTM) lung disease is dependent on sputum cultures. This is particularly challenging in the cystic fibrosis (CF) population due to reduced sputum production and low culture sensitivity. Biomarkers of infection that do not rely on sputum may lead to earlier diagnosis, but validation trials require a unique prospective design. Purpose The rationale of this trial is to investigate the utility of urine lipoarabinomannan (LAM) as a test to identify people with CF with a new positive NTM culture. We hypothesize that urine LAM is a sensitive, non-invasive screening test with a high negative predictive value to identify individuals with a relatively low risk of having positive NTM sputum culture. Study design This is a prospective, single-center, non-randomized observational study in adults with CF, 3 years of negative NTM cultures, and no known history of NTM positive cultures. Patients are followed for two year-long observational periods with the primary endpoint being a positive NTM sputum culture within a year of a positive urine LAM result and a secondary endpoint of a positive NTM sputum culture within 3 years of a positive urine LAM result. Study implementation includes remote consent and sample collection to accommodate changes from the COVID-19 pandemic. Conclusions This report describes the study design of an observational study aimed at using a urine biomarker to assist in the diagnosis of NTM lung infection in pwCF. If successful, urine LAM could be used as an adjunct to traditional sputum cultures for routine NTM screening, and replace cultures in low-risk individuals unable to produce sputum.
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Hancox, Robert J., Hayden H. Shin, Andrew R. Gray, Richie Poulton, and Malcolm R. Sears. "Effects of quitting cannabis on respiratory symptoms." European Respiratory Journal 46, no. 1 (2015): 80–87. http://dx.doi.org/10.1183/09031936.00228914.
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Smoking cannabis is associated with symptoms of bronchitis. Little is known about the persistence of symptoms after stopping cannabis use. We assessed associations between changes in cannabis use and respiratory symptoms in a population-based cohort of 1037 young adults.Participants were asked about cannabis and tobacco use at ages 18, 21, 26, 32 and 38 years. Symptoms of morning cough, sputum production, wheeze, dyspnoea on exertion and asthma diagnoses were ascertained at the same ages. Frequent cannabis use was defined as ≥52 occasions over the previous year. Associations between frequent cannabis use and respiratory symptoms were analysed using generalised estimating equations with adjustments for tobacco smoking, asthma, sex and age.Frequent cannabis use was associated with morning cough (OR 1.97, p<0.001), sputum production (OR 2.31, p<0.001) and wheeze (OR 1.55, p<0.001). Reducing or quitting cannabis use was associated with reductions in the prevalence of cough, sputum and wheeze to levels similar to nonusers.Frequent cannabis use is associated with symptoms of bronchitis in young adults. Reducing cannabis use often leads to a resolution of these symptoms.
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Lubis, Nita Andriani. "The Effect of Complementary Vitamin D on Sputum Conversion in Pulmonary TB Patients." Indonesian Journal of Medicine 2, no. 3 (2018): 169–74. https://doi.org/10.26911/theijmed.v2i3.64.
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Background: Pulmonary TB is one of the most important health problems in Indonesia. The number of pulmonary TB patients ranked second after India. Vitamin D has a complex effect in the immune system. One of the effects of vitamin D is to stimulate the production of Cathelicidin which increases macrophage phagocytosis. This study aimed to analyze the effect of complementary vitamin D on sputum conversion in pulmonary tuberculosis patients.Subjects and Method: This study was a randomized controlled trial conducted at several health centers in Deli Serdang, North Sumatera, from November 2015 to June 2016. A total sample of 80 patients with positive acid-resistant bacilli (BTA) was selected for this study by consecutive sampling. The sample was allocated randomly into two groups: (1) TB drug group + 2.5 mg vitamin D; (2) TB drug group + placebo. The dependent variable was sputum conversion. The independent variable was complementary vitamin D. Pre and post vitamin D levels were examined by ELISA technique. Sputum conversion was examined by TB laboratory worker at the health center where patients received TB drug treatment. Difference in percent of sputum conversion between the two groups was tested by chi-square test. Difference in mean of sputum conversion time between the two groups was tested by t-test.Results: The mean serum vitamin D level in the intervention group (62.05±22.08) was higher than the control group (28.56±7.48) after the intervention, and it was statistically significant (p<0.001). After 56 days, all subjects in the vitamin D group experienced sputum conversion (100%) with a median sputum conversion time of 28 days, whereas 90% of subjects in the placebo group experienced sputum conversion with a median sputum conversion time of 48 days (p= 0.002).Conclusion: Adding vitamin D to anti-TB drug treatment effectively improves and accelerates sputum conversion of patients with tuberculosis acid-fast bacilli smear positive.Keywords: Vitamin D, sputum conversion, pulmonary tuberculosisCorrespondence: Nita Andriani Lubis. Department of Health Analysis, School of Health Polytechnics Medan, North Sumatera. Jl. William Iskandar Pasar V Barat No. 6 Medan 20137, North Sumatera, Indonesia. Email: taufik.abay.mumtaz@gmail.com.Indonesian Journal of Medicine (2017), 2(3): 169-174https://doi.org/10.26911/theijmed.2017.02.03.04
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Lubis, Nita Andriani. "The Effect of Complementary Vitamin D on Sputum Conversion in Pulmonary TB Patients." Indonesian Journal of Medicine 2, no. 3 (2018): 169–74. https://doi.org/10.26911/theijmed.2017.2.3.64.
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Background: Pulmonary TB is one of the most important health problems in Indonesia. The number of pulmonary TB patients ranked second after India. Vitamin D has a complex effect in the immune system. One of the effects of vitamin D is to stimulate the production of Cathelicidin which increases macrophage phagocytosis. This study aimed to analyze the effect of complementary vitamin D on sputum conversion in pulmonary tuberculosis patients.Subjects and Method: This study was a randomized controlled trial conducted at several health centers in Deli Serdang, North Sumatera, from November 2015 to June 2016. A total sample of 80 patients with positive acid-resistant bacilli (BTA) was selected for this study by consecutive sampling. The sample was allocated randomly into two groups: (1) TB drug group + 2.5 mg vitamin D; (2) TB drug group + placebo. The dependent variable was sputum conversion. The independent variable was complementary vitamin D. Pre and post vitamin D levels were examined by ELISA technique. Sputum conversion was examined by TB laboratory worker at the health center where patients received TB drug treatment. Difference in percent of sputum conversion between the two groups was tested by chi-square test. Difference in mean of sputum conversion time between the two groups was tested by t-test.Results: The mean serum vitamin D level in the intervention group (62.05±22.08) was higher than the control group (28.56±7.48) after the intervention, and it was statistically significant (p<0.001). After 56 days, all subjects in the vitamin D group experienced sputum conversion (100%) with a median sputum conversion time of 28 days, whereas 90% of subjects in the placebo group experienced sputum conversion with a median sputum conversion time of 48 days (p= 0.002).Conclusion: Adding vitamin D to anti-TB drug treatment effectively improves and accelerates sputum conversion of patients with tuberculosis acid-fast bacilli smear positive.Keywords: Vitamin D, sputum conversion, pulmonary tuberculosisCorrespondence: Nita Andriani Lubis. Department of Health Analysis, School of Health Polytechnics Medan, North Sumatera. Jl. William Iskandar Pasar V Barat No. 6 Medan 20137, North Sumatera, Indonesia. Email: taufik.abay.mumtaz@gmail.com.Indonesian Journal of Medicine (2017), 2(3): 169-174https://doi.org/10.26911/theijmed.2017.02.03.04
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GABAZZA, Esteban C., Osamu TAGUCHI, Shigenori TAMAKI, et al. "Role of nitric oxide in airway remodelling." Clinical Science 98, no. 3 (2000): 291–94. http://dx.doi.org/10.1042/cs0980291.
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Airway remodelling, which is manifested by thickening of bronchial wall, is an important causative factor of bronchial hyper-responsiveness in asthma. The pathophysiological mechanism of airway remodelling is not clear. In the present study we evaluated the relationship between nitric oxide (NO) generation and airway wall thickening in patients with chronic asthma. As a marker of NO production, the levels of nitrite/nitrate were measured in induced sputum, and bronchial wall thickening was measured by high-resolution computed tomography. Sputum concentrations of nitrite/nitrate were significantly increased in asthmatic patients compared with controls. The ratio of airway wall thickness to lumen diameter was significantly correlated with the sputum concentration of nitrite/nitrate. Although statistical correlation does not prove causation, this finding suggests that NO may play a key role in the pathogenesis of airway remodelling.
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Quaedvlieg, V., M. Henket, J. Sele, and R. Louis. "Cytokine production from sputum cells in eosinophilic versus non-eosinophilic asthmatics." Clinical and Experimental Immunology 143, no. 1 (2006): 161–66. http://dx.doi.org/10.1111/j.1365-2249.2005.02968.x.
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Burgel, Pierre-Régis. "Chronic cough and sputum production: a clinical COPD phenotype?: Table 1–." European Respiratory Journal 40, no. 1 (2012): 4–6. http://dx.doi.org/10.1183/09031936.00022412.
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Shim, Chang, Malcolm King, and M. Henry Williams. "Lack of Effect of Hydration on Sputum Production in Chronic Bronchitis." Chest 92, no. 4 (1987): 679–82. http://dx.doi.org/10.1378/chest.92.4.679.
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Thurston, S. J., G. C. Donaldson, T. D. McHugh, and J. A. Wedzicha. "S17 Impact of COPD severity and sputum production on antibiotic resistance." Thorax 66, Suppl 4 (2011): A11. http://dx.doi.org/10.1136/thoraxjnl-2011-201054b.17.
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Djaharuddin, Irawaty, Harun Iskandar, and Nur Ahmad Tabri. "Relationship of Interleukin (IL-10) Level to Sputum Conversion and Influence Factors in Drug-Resistant Tuberculosis." International Journal of Research and Review 11, no. 12 (2024): 188–93. https://doi.org/10.52403/ijrr.20241222.
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Introduction: Pulmonary tuberculosis (TB) is an infection causative agent of Mycobacterium tuberculosis. Indonesia is in fifth place with drug-resistant tuberculosis. The achievement of TB management is surprisingly dependent on the analysis, suitable remedy, and comparing its remedy. Many TB patients who are present process similarly anti-tuberculosis remedies have issued sputum elimination for acid-resistant bacillus smear examination so that the healing display is not optimal. Objective: The study analyzes the relationship between interleukin 10 (IL-10) level and sputum conversion and influence factors in drug-resistant tuberculosis. Methods: A total of 45 resistance tuberculosis mycobacterium with inclusion criteria are 18-65 years old, shorter regimen, acid-fast bacilli sputum conversion, and serum IL-10 levels were recorded in the medical record—the research analytic observational with a retrospective cohort design. Results: Interleukin 10 levels show that the higher the anti-inflammatory response, the faster the sputum conversion occurs. It can be a marker of the weakened immune response of Th1 to MTB infection. Based on the AFB sputum conversion, other studies supported that the increase of IL-10 levels in serum could be used as a prognostic marker of the therapeutic success of TB. Cut off point IL-10 level in this study was 5,83 pg/ml with 94,29% sensitivity and 100% specificity in predicting conversion time. Conclusion: The higher IL-10 production in TBRO indicates suppression of immune response. Comorbid factors of diabetes mellitus and initial bacterial load affect the sputum conversion influence of TBRO patients. Keywords: Interleukin 10, influence factor, TBRO, conversion
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Khaling Rai, Mamita, Krishna Gurung, and Devraj Joshi. "Distribution Factors of Candida species in Respiratory Tract of Elderly Population of Kathmandu." Journal of Health and Allied Sciences 5, no. 1 (2019): 5–8. http://dx.doi.org/10.37107/jhas.25.
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Though normal flora of upper respiratory tract, Candida species are a significant clinical problem for a variety of immune compromised patients worldwide. Impaired salivary gland function, drugs, dentures, high carbohydrate diet, age, smoking, diabetes mellitus, Cushing’s syndrome, malignancies, and immunosuppressive conditions are the associated risk factors for the Candidiasis. The study was designed with the objectives of describing the distribution pattern of Candida species and some molds in the elderly and non elderly population randomly sampled from the three Oldage Care Centers. A total of 304 samples each of sputum and throat swabs were collected from the study objects having age 20-80 years. The specimens were cultured on Sabouraud’s Dextrose Agar (SDA). Candida isolates were identified on the basis of Gram stain, germ tube test, production of chlamydospore, sugar fermentation and assimilation test. The mold isolates were identified by cultural and microscopic characteristics. Out of total 304 samples of each sputum and throat swabs 16.45% and 5.3% samples respectively were growth positive for fungal culture. Among elderly population, 32.87% (47/143) of sputum and 9.8% (14/143) throat swabs showed culture positivity. In case of non elderly population however only 1.9% (3/161) sputum and 1.24% (2/161) throat swab samples were culture positive. In total, 56 Candida isolates (41 from sputum and 14 from throat swabs) were obtained. Significantly higher number of isolates was obtained from elderly population (38 from sputum and 12 from throat swabs) than non elderly population. Among three antimycotic drugs used, the Candida isolates were highly susceptible against Ketoconazole and resistant towards Fluconazole. Candida distribution was significantly associated with the age, respiratory tract problem and smoking habits of the study population. Elderly population having age above 50 years are in the high risk of drug resistant Candida infection.
 Key Words: Candida, elderly population, sputum, throat swab, antimycotic susceptibility
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Manar, G. Alhussine, A. Mohammed Hanan, A. Khudhair Al-Ameri Yas, and A. Al-Fahham Ali. "Evaluation Of Some Aspergillus Mycotoxins In Patients With Bronchitis In Al-Najaf City." INTERNATIONAL JOURNAL OF HEALTH & MEDICAL RESEARCH 03, no. 07 (2024): 458–63. https://doi.org/10.5281/zenodo.12783671.
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This research aimed to establish whether the Aspergillus species identified from bronchitis patients were mycotoxigenic or non-mycotoxigenic fungi in sputum and serum samples. A total sample of 170 subjects with ages ranging from 15 to 72 years— were obtained from Al-Najaf Province (Al-Sadr Medical City) between December 2023 and April 2024, divided into patient (n=176) and healthy groups (n=34). The Aspergillus genera isolated were cultured on coconut agar medium and screened under UV light (360 nm); each sputum and serum sample was also tested using the ELISA technique. All Aspergillus strains exhibited blue fluorescence on Coconut Cream Agar (CCA) media under UV light, confirming positivity. The study identified production of aflatoxins B1 and ochratoxins-A in sputum and serum samples among both patients with bronchitis and control groups. The results showed a significant difference in patient groups by samples (P≤ 0.05) while the healthy groups showed a non-significant (P>0.05) difference. Most Aspergillus spp. Isolated from bronchitis patients were found to produce aflatoxin B1 and ochratoxin-A on coconut agar medium— mycotoxins extracts included sputum (about 68.4% for aflatoxins-B1 and 41.7% for serum samples) and sputum (about 77.6% for ochratoxin-A and 91.7% for serum samples) taken from bronchitis patients, which were identified using ELISA technique.
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Sarina, Diva Dewi, and Susanti Widiastuti. "Analisis Asuhan Keperawatan melalui Intervensi Clapping dan Postural Drainage dengan Masalah Bersihan Jalan Napas Tidak Efektif dengan Diagnosa Bronchopneumonia." Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) 6, no. 3 (2023): 1101–9. http://dx.doi.org/10.33024/jkpm.v6i3.8793.
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ABSTRAK Clapping/perkusi dada merupakan tindakan keperawatan yang dapat dilakukan untuk membantu mengeluarkan sekret dan meningkatkan efisiensi pernafasan dan membantu membersihkan jalan nafas. Dalam hal ini, clapping adalah salah satu teknik dari serangkaian fisioterapi dada yang dapat dilakukan pada pasien dengan bronchopneumonia. Menganalisis Asuhan Keperawatan melalui intervensi clapping dan postural drainage dengan masalah bersihan jalan napas tidak efektif dengan diagnosa bronchopneumonia pada An. D dan An. R di Rumah Sakit Umum Universitas Kristen Indonesia Jakarta Timur. Tindakan keperawatan yang diberikan kepada klien An. D dan An. R dilakukan mulai tanggal 15 November 2022 sampai dengan 18 November 2022. Implementasi yang diberikan pada diagnosa keperawatan bersihan jalan napas tidak efektif dilakukan dengan pemberian intervensi clapping dan postural drainage dengan tujuan untuk membersihkan jalan napas anak. Hasil evaluasi keperawatan pada masalah keperawatan utama bersihan jalan napas berdasarkan catatan perkembangan menunjukkan bahwa, setelah dilakukannya intervensi clapping dan postural drainage selama 3 hari pertemuan pada An. D dan An. R diperoleh data pada hari ke tiga tindakan keperawatan yaitu kedua klien mengalami penurunan produksi sputum. pemberian intervensi clapping dan postural drainage terbukti mampu menurunkan produksi sputum dengan masalah keperawatan bersihan jalan napas tidak efektif dimana pada hari ke tiga pada An. D dan An. R sama mengalami penurunan produksi sputum. Diharapkan keluarga dapat mengaplikasikan perawatan clapping dan postural drainage pada anak yang mengalami masalah bersihan jalan napas tidak efektif dengan tujuan untuk membersihkan jalan napas anak dari hipersekresi sputum Kata Kunci: Clapping, Postural Drainage, Bersihan Jalan Napas Tidak Efektif ABSTRACT Chest clapping/percussion is a nursing action that can be done to help remove secretions and increase respiratory efficiency and help clear the airway. In this case, clapping is one technique from a series of chest physiotherapy that can be performed on patients with bronchopneumonia. Analyzing nursing care through clapping and postural drainage interventions with airway clearance problems was not effective with the diagnosis of bronchopneumonia in patient D and R at the Indonesian Christian University General Hospital, East Jakarta. Nursing actions given to client An. D and An. The R was carried out from 15 November 2022 to 18 November 2022. The implementation given to the nursing diagnosis of ineffective airway clearance was carried out by providing clapping and postural drainage interventions with the aim of clearing the child's airway.The results of the nursing evaluation on the main nursing problem of airway clearance based on progress notes showed that, after carrying out clapping and postural drainage interventions for 3 days meeting at An. D and An. R obtained data on the third day of nursing action, namely that both clients experienced a decrease in sputum production. Administration of clapping and postural drainage interventions proved to be able to reduce sputum production with ineffective airway clearance nursing problems where on the third day in An. D and An. R also experienced a decrease in sputum production. It is hoped that families can apply clapping and postural drainage treatments to children who experience ineffective airway clearance problems with the aim of clearing the child's airway from sputum hypersecretion. Keywords: Clapping, Postural Drainage, Ineffective Airway Clearance
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Maisetta, Giuseppantonio, Lucia Grassi, Semih Esin, et al. "Targeting Pseudomonas aeruginosa in the Sputum of Primary Ciliary Dyskinesia Patients with a Combinatorial Strategy Having Antibacterial and Anti-Virulence Potential." International Journal of Molecular Sciences 21, no. 1 (2019): 69. http://dx.doi.org/10.3390/ijms21010069.
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In primary ciliary dyskinesia (PCD) patients, Pseudomonas aeruginosa is a major opportunistic pathogen, frequently involved in chronic infections of the lower airways. Infections by this bacterial species correlates with a worsening clinical prognosis and recalcitrance to currently available therapeutics. The antimicrobial peptide, lin-SB056-1, in combination with the cation chelator ethylenediaminetetraacetic acid (EDTA), was previously demonstrated to be bactericidal against P. aeruginosa in an artificial sputum medium. The purpose of this study was to validate the anti-P. aeruginosa activity of such a combination in PCD sputum and to evaluate the in vitro anti-virulence effects of EDTA. In combination with EDTA, lin-SB056-1 was able to significantly reduce the load of endogenous P. aeruginosa ex vivo in the sputum of PCD patients. In addition, EDTA markedly reduced the production of relevant bacterial virulence factors (e.g., pyocyanin, proteases, LasA) in vitro by two representative mucoid strains of P. aeruginosa isolated from the sputum of PCD patients. These results indicate that the lin-SB056-1/EDTA combination may exert a dual antimicrobial and anti-virulence action against P. aeruginosa, suggesting a therapeutic potential against chronic airway infections sustained by this bacterium.
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Calzetta, Luigino, Beatrice Ludovica Ritondo, Maria Cristina Zappa, et al. "The impact of long-acting muscarinic antagonists on mucus hypersecretion and cough in chronic obstructive pulmonary disease: a systematic review." European Respiratory Review 31, no. 164 (2022): 210196. http://dx.doi.org/10.1183/16000617.0196-2021.
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Patients suffering from chronic obstructive pulmonary disease (COPD) clinically manifest airway mucus hypersecretion as sputum expectoration and cough. Evidence accumulated in the past decade has shown that the cholinergic system not only regulates airway smooth muscle contraction but also the activity of inflammatory and airway epithelial cells, including goblet cells, and submucosal gland activity. Long-acting muscarinic antagonists (LAMAs) with the most favourable M3/M2 muscarinic acetylcholine (ACh) receptors residency properties are not only excellent bronchodilators but potentially also mucus-modifying agents, able to positively impact on mucus hypersecretion and cough. The aim of this systematic review was to investigate the impact of LAMAs on mucus hypersecretion and cough in COPD patients. The evidence confirmed that LAMAs, mainly tiotropium and aclidinium, improved sputum production and cough in moderate to severe COPD. Thus, LAMAs not only antagonise the ACh-induced bronchoconstriction of the airways but also appear to limit the production of mucus secreted in response to ACh by airway goblet cells and/or submucosal glands. Further clinical studies are necessary to evaluate the impact of LAMAs exclusively on sputum symptoms and cough as primary end-points and to investigate whether LAMAs have a modulatory action on the rheological properties of mucus.
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Zanella, Delphine, Monique Henket, Florence Schleich, et al. "Comparison of the effect of chemically and biologically induced inflammation on the volatile metabolite production of lung epithelial cells by GC×GC-TOFMS." Analyst 145, no. 15 (2020): 5148–57. http://dx.doi.org/10.1039/d0an00720j.
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