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https://www.readbyqxmd.com/read/28218980/microbiologic-yield-of-bronchoalveolar-lavage-specimens-from-stem-cell-transplant-recipients
#1
Kenneth K Sakata, Christine L Klassen, Kathryn B Bollin, Thomas E Grys, James L Slack, Lewis J Wesselius, Holenarasipur R Vikram
PURPOSE: Stem cell transplant (SCT) recipients commonly undergo bronchoalveolar lavage (BAL) collection as an infectious pulmonary work-up. Previous studies report the utility and overall diagnostic yield of fiberoptic bronchoscopy with BAL in this vulnerable population, though none focused purely on microbiologic yield or made comparisons with less invasive means of pathogen detection. We sought to determine and elaborate on the microbiologic yield of BAL in SCT recipients, assess a correlation between BAL studies and less invasive means of pathogen detection, and assess the utility of repeating a BAL within 30 days...
February 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28217253/miliary-tuberculosis-infection-during-hepatitis-c-treatment-with-sofosbuvir-and-ledipasvir-plus-ribavirin
#2
Maria Pilar Ballester-Ferré, Fernando Martínez, Natalia Garcia-Gimeno, Francisco Mora, Miguel A Serra
Chronic hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. In the last 5 years, treatment for HCV infection has experienced a marked development. In 2014, the use of ledipasvir/sofosbuvir with or without concomitant weight-based ribavirin was approved with a very significant increase in the sustained virological response. However, new side effects have been associated. We report the first case of an HCV infected patient treated for 12 wk with the combination of sofosbuvir/ledipasvir plus ribavirin who developed a miliary tuberculosis (TB) infection while on therapy...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28216702/evaluation-of-simple-pre-determined-length-insertion-technique-split-with-conventional-method-for-oral-fibreoptic-intubation-a-randomised-cross-over-study
#3
Elangovan Muthukumar, Lenin Babu Elakkumanan, Prasanna Udupi Bidkar, Mvs Satyaprakash, Sandeep Kumar Mishra
BACKGROUND AND AIMS: The difficulty during flexible fiber-optic bronchoscopy (FOB) guided tracheal intubation could be because of inability in visualising glottis, advancing and railroading of endotracheal tube. Several methods are available for visualising glottis, but none is ideal. Hence, this randomised controlled study was designed to evaluate the simple pre-determined length insertion technique (SPLIT) during oral FOB. METHODS: Fifty-eight patients were randomised into Group C and Group P...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216610/pulmonary-kaposi-sarcoma-with-osseous-metastases-in-an-human-immunodeficiency-virus-hiv-patient-a-remarkable-response-to-highly-active-antiretroviral-therapy
#4
Ahmed Dirweesh, Muhammad Yasir Khan, Shaikh Fawad Hamiz, Nigahus Karabulut
BACKGROUND Kaposi sarcoma (KS) is known to involve the mucocutaneous tissues and the aero-digestive tracts. In acquired immune deficiency syndrome (AIDS) patients, KS has an aggressive course and carries poor prognosis. We present a case of pulmonary KS with osseous metastases as the first presentation of human immunodeficiency virus (HIV) infection in a young male. The lesions impressively decreased in size and numbers following initiation of highly active antiretroviral therapy (HAART). CASE REPORT A 34-year-old heterosexual male presented with a one month history of cough and 15-20 pound weight loss within six months...
February 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28214275/detection-of-pneumocystis-jirovecii-by-nested-pcr-in-hiv-negative-patients-with-pulmonary-disease
#5
Cristina Rodrigues Santos, Ângela M de Assis, Edson A Luz, Luzia Lyra, Ivan F Toro, José Claudio C Seabra, Dira H Daldin, Tathiane U Marcalto, Marcos T Galasso, Ronaldo F Macedo, Angélica Z Schreiber, Francisco H Aoki
BACKGROUND: Nested PCR can be used to determine the status of Pneumocystis jirovecii infection in other lung diseases. AIMS: This study sought to detect a target DNA fragment (mitochondrial large subunit rRNA or mtL SUrRNA) of P. jirovecii in patients with lung disease who underwent bronchoscopy with collection of bronchoalveolar lavage (BAL). METHODS: The results from toluidine blue staining were compared with those obtained using molecular methods that included an "in house" DNA extraction procedure, PCR and nested PCR...
February 14, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28212154/optical-coherence-tomography-and-confocal-laser-endomicroscopy-in-pulmonary-diseases
#6
Lizzy Wijmans, Julia N S d'Hooghe, Peter I Bonta, Jouke T Annema
PURPOSE OF REVIEW: Current imaging techniques (X-ray, computed tomography scan, ultrasound) have limitations in the identification and quantification of pulmonary diseases, in particular, on highly detailed level. The purpose of this review is to provide an overview of the current knowledge of innovative light- and laser-based imaging techniques that might fill this gap. RECENT FINDINGS: Optical coherence tomography (OCT) and confocal laser endomicroscopy (CLE) are high-resolution imaging techniques, which, combined with bronchoscopy, provide 'near histology' detailed imaging of the airway wall, lung parenchyma, mediastinal lymph nodes, and pulmonary vasculature...
February 16, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28210572/endobronchial-solitary-fibrous-tumor
#7
Cristiano Claudino Oliveira, Marcelo Padovani Toledo de Moraes, Thomas Colby, Gilmar Felisberto Oliveira, Erica Nishida Hasimoto, Daniele Cristina Cataneo, Antônio José Maria Cataneo, Julio De Faveri
Solitary fibrous tumor (SFT) is a mesenchymal neoplasm that appears primarily in the pleura and rarely in intrapulmonary or endobronchial topography. The authors report the case of a 47-year-old woman who presented obstructive respiratory symptoms for 4 years. The chest computed tomography and bronchoscopy showed an obstructive polypoid lesion located between the trachea and the left main bronchus associated with distal atelectasis of the left lung. A resection of the lesion was performed and, macroscopically, the mass was oval, encapsulated, and firm, measuring 2...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28206930/using-electromagnetic-navigation-bronchoscopy-and-dye-injection-to-aid-in-video-assisted-lung-resection
#8
Jordan Brown, Thomas J Lee, Theresa Joiner, William Wrightson
Small (2 cm) peripheral lung lesions and ground glass opacities remain a difficult subset of lung lesions for the diagnosis and management of lung cancer. Surgical biopsy is more difficult for these lesions because intraoperative localization has to be made without the aid of direct visualization or manual palpation. Electromagnetic navigation bronchoscopy can be used in the operating room to identify a small peripheral lesion and marked using an injection of methylene blue, which can be seen on the visceral pleura of the lung...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28203440/tracheobronchial-tuberculosis-a-clinical-review
#9
REVIEW
Wen Ting Siow, Pyng Lee
Endobronchial tuberculosis (EBTB) is defined as tuberculous infection of the tracheobronchial tree. The exact pathogenesis is unclear, and it has a heterogenous clinical course. Its diagnosis requires the clinician to have a high index of suspicion based on clinical symptoms and radiological features. Computed tomography and bronchoscopy are useful tools in its evaluation. The goal of treatment is in the eradication of tuberculous bacilli with appropriate anti-tuberculous therapy. Use of corticosteroids is controversial for the prevention of tracheobronchial stenosis...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203438/current-concepts-in-severe-adult-tracheobronchomalacia-evaluation-and-treatment
#10
REVIEW
Daniel H Buitrago, Jennifer L Wilson, Mihir Parikh, Adnan Majid, Sidhu P Gangadharan
There is increasing recognition of tracheobronchomalacia (TBM) in patients with respiratory complaints, though its true incidence in the adult population remains unknown. Most of these patients have an acquired form of severe diffuse TBM of unclear etiology. The mainstays of diagnosis are dynamic (inspiratory and expiratory) airway computed tomography (CT) scan and dynamic flexible bronchoscopy with forced expiratory maneuvers. While the prevailing definition of TBM is 50% reduction in cross-sectional area, a high proportion of healthy volunteers meet this threshold, thus this threshold fails to identify patients that might benefit from intervention...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203437/update-on-the-diagnosis-and-treatment-of-tracheal-and-bronchial-injury
#11
REVIEW
Zhengwei Zhao, Tianyi Zhang, Xunliang Yin, Jinbo Zhao, Xiaofei Li, Yongan Zhou
Tracheal and bronchial injury, including iatrogenic injury and traumatic injury, the former usually occurred in the operation, intubation or bronchoscopy. The latter was occurred in a variety of blunt trauma, often combined with a variety of complex injuries. The therapeutic approach can be differentiated, surgical or conservative, no criteria has been universally accepted. Successful treatment of tracheobronchial injuries requires early diagnostic evaluation. This article aims to review the indications and therapeutic options for tracheal and bronchial injuries...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203410/relationship-between-radiologic-patterns-pulmonary-function-values-and-bronchoalveolar-lavage-fluid-cells-in-newly-diagnosed-sarcoidosis
#12
Regina Aleksonienė, Ingrida Zeleckienė, Mindaugas Matačiūnas, Roma Puronaitė, Laimutė Jurgauskienė, Radvilė Malickaitė, Edita Strumilienė, Vygantas Gruslys, Rolandas Zablockis, Edvardas Danila
BACKGROUND: The aim of the present study was to identify specious radiologic and/or physiologic prognostic marker(s), which lead to optimize of the patient follow-up frequency. METHODS: Eighty consecutive patients with newly diagnosed pulmonary sarcoidosis. Patients underwent chest radiography, high-resolution computed tomography (HRCT) examination, pulmonary function tests (PFT), bronchoscopy with bronchoalveolar lavage (BAL) and lung biopsy, and bronchoalveolar lavage fluid (BALF) cell examination...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203403/clinic-application-of-tissue-engineered-bronchus-for-lung-cancer-treatment
#13
Qiang Tan, Ruijun Liu, Xiaoke Chen, Jingxiang Wu, Yinggen Pan, Shun Lu, Walter Weder, Qingquan Luo
BACKGROUND: Delayed revascularization process and substitute infection remain to be key challenges in tissue engineered (TE) airway reconstruction. We propose an "in-vivo bioreactor" design, defined as an implanted TE substitutes perfused with an intra-scaffold medium flow created by an extracorporeal portable pump system for in situ organ regeneration. The perfusate keeps pre-seeded cells alive before revascularization. Meanwhile the antibiotic inside the perfusate controls topical infection...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28202865/repeated-diffuse-alveolar-hemorrhage-in-a-patient-with-hemophilia-b
#14
Hajime Kasai, Jiro Terada, Hiromasa Hoshi, Takashi Urushibara, Fumiaki Kato, Rintaro Nishimura, Koichiro Tatsumi
Diffuse alveolar hemorrhage (DAH) is a life-threatening complication that occurs in association with various diseases including coagulation disorders. In rare cases, it is caused by hemophilia. A 48-year-old man was admitted to our hospital for a third time due to DAH. Although the cause of DAH could not be identified by bronchoscopy or laboratory tests, a good response to corticosteroids suggested idiopathic DAH with pulmonary capillaritis. The patient was diagnosed with hemophilia B based on the results of a detailed inquiry, a mildly prolonged activated partial thromboplastin time, and low factor IX activity...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28198987/the-content-of-mucin-muc-2-3-and-4-antigens-in-the-bronchial-mucosa-membrane-of-chronic-obstructive-pulmonary-disease-patients-during-acute-exacerbation-initial-report
#15
Svetlana Kovalenko, Andrey Dorofieiev
INTRODUCTION: Changes in mucin production and dyscrinia are common features of inflammation in chronic obstructive pulmonary disease (COPD). Immunohistochemical assessment of MUC-2, MUC-3, MUC-4 expression in the integumentary epithelium, goblet cells, the epithelium of mucous glands and stroma fusiform cells of the bronchial mucosa of COPD patients during an infectious and noninfectious exacerbation was performed. MATERIAL AND METHODS: 30 patients with stage III COPD were enrolled to the study...
2017: Adv Respir Med
https://www.readbyqxmd.com/read/28197883/central-airway-pathology-clinic-features-ct-findings-with-pathologic-and-virtual-endoscopy-correlation
#16
REVIEW
Daniel Barnes, José Gutiérrez Chacoff, Mariana Benegas, Rosario J Perea, Teresa M de Caralt, José Ramirez, Ivan Vollmer, Marcelo Sanchez
OBJECTIVES: To describe the imaging features of the central airway pathology, correlating the findings with those in pathology and virtual endoscopy. To propose a schematic and practical approach to reach diagnoses, placing strong emphasis on multidetector computed tomography (MDCT) findings. METHODS: We reviewed our thoracic pathology database and the central airway pathology-related literature. Best cases were selected to illustrate the main features of each disease...
February 15, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28197412/bronchoscopic-diagnosis-and-treatment-of-primary-tracheobronchial-amyloidosis-a-retrospective-analysis-from-china
#17
Xiaoxiao Lu, Bixiu He, Ge Wang, Baimei He, Lijing Wang, Qiong Chen
Objective. To assess the value of bronchoscopy in the diagnosis and treatment of primary tracheobronchial amyloidosis (TBA), in order to reduce misdiagnosis rates and improve prognosis. Methods. Clinical data of 107 patients with TBA reported from 1981 to 2015 in China were retrospectively analyzed for clinical features, bronchoscopic manifestations, pathologies, treatments, and outcomes. Results. 105 of 107 TBA patients were pathologically confirmed by bronchoscopy. Main bronchoscopic manifestations of TBA were single or multiple nodules and masses within tracheobronchial lumens; local or diffuse luminal stenosis and obstruction; luminal wall thickening and rigidity; rough or uneven inner luminal walls; congestion and edema of mucosa, which was friable and prone to bleeding upon touch; and so forth...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28196961/bacterial-topography-of-the-healthy-human-lower-respiratory-tract
#18
Robert P Dickson, John R Erb-Downward, Christine M Freeman, Lisa McCloskey, Nicole R Falkowski, Gary B Huffnagle, Jeffrey L Curtis
Although culture-independent techniques have refuted lung sterility in health, controversy about contamination during bronchoscope passage through the upper respiratory tract (URT) has impeded research progress. We sought to establish whether bronchoscopic sampling accurately reflects the lung microbiome in health and to distinguish between two proposed routes of authentic microbial immigration, (i) dispersion along contiguous respiratory mucosa and (ii) subclinical microaspiration. During bronchoscopy of eight adult volunteers without lung disease, we performed seven protected specimen brushings (PSB) and bilateral bronchoalveolar lavages (BALs) per subject...
February 14, 2017: MBio
https://www.readbyqxmd.com/read/28195963/mediastinitis-following-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#19
Aruna Jahoor, Shekhar Ghamande, Shirley Jones, Carl Boethel, Heath D White
Mediastinitis is a rare complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Recent reports of infectious complications following EBUS-TBNA involved oropharyngeal bacteria. Here, we report 2 unusual cases of post-EBUS-TBNA mediastinitis involving Streptococcus pneumoniae and Pseudomonas aeruginosa, which were likely the result of direct inoculation of the organisms at the time of transbronchial needle aspiration. The first case was successfully treated with computed tomography-guided drainage and antibiotics, whereas the second case had >50% distal tracheal obstruction and near total occlusion of the left main stem bronchus, requiring rigid bronchoscopy, stent placement, debulking, and antibiotics...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28195962/ebus-stat-subscore-analysis-to-predict-the-efficacy-and-assess-the-validity-of-virtual-reality-simulation-for-ebus-tbna-training-among-experienced-bronchoscopists
#20
Simone Scarlata, Patrizio Palermo, Piero Candoli, Ariela Tofani, Tommasangelo Petitti, Lorenzo Corbetta
BACKGROUND: Linear endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) represents a pivotal innovation in interventional pulmonology; determining the best approach to guarantee systematic and efficient training is expected to become a main issue in the forthcoming years. Virtual reality simulators have been proposed as potential EBUS-TBNA training instruments, to avoid unskilled beginners practicing directly in real-life settings. A validated and perfected simulation program could be used before allowing beginners to practice on patients...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
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