检索结果-南通市图书馆

Journal of Forensic Science and Medicine 2024年第1期10卷 68-71页

作者： Sapna Patel Deepika Gurumurthy Smitha Rani Sheela Devi Department of Pathology JSSAHERMysoreKarnatakaIndia2Department of Forensic MedicineJSSAHERMysoreKarnatakaIndia

Pulmonary alveolar proteinosis(PAP)is an idiopathic rare diffuse pulmonary disease,first described in 1958 by Rosen et al.Its estimated prevalence is about 1 in 3.7-6.9×10^(6) with a male:female ratio of 1:1-2:1.Majority of the patient’s age ranges between 20 and 50 years.PAP on microscopy is characterized by the presence of massive insoluble,amorphous,phospholipid-rich protein deposits in the bronchial and alveolar cavities.Most patients with acquired PAP present with cough and exertional dyspnea.It has been studied that there is increased risk of superinfection in PAP with opportunistic organisms like pneumocystis and vice versa.Definitive diagnosis of Pneumocystis jirovecii pneumonia rests on the demonstration of the organism within the alveoli by special stains like Grocott Methenamine Silver stain.Molluscum contagiosum(MC)is a common superficial skin infection caused by the poxvirus.MC is characterized by painless papules commonly seen in children and immunocompromised individuals.Here,we present a 34-year-old female who had complaints of severe difficulty in breathing and was brought dead to our hospital.On external examination,she had multiple warts over chest,abdomen,and over genitalia.Internal examination was unremarkable.Specimens of kidney,lung,and skin biopsy of genital warts sent for histopathological examination revealed acute tubular necrosis,P.jirovecii with PAP,and MC respectively.

关键词： bronchoalveolar lavage molluscum contagiosum Pneumocystis jirovecii pulmonary alveolar proteinosis

Existing tests vs. novel non-invasive assays for detection of invasive aspergillosis in patients with respiratory diseases

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2022年第13期135卷 1545-1554页

作者： Wei Xiao Longyi Du Linli Cai Tiwei Miao Bing Mao Fuqiang Wen Peter Gerard Gibso Deying Gong Yan Zeng Mei Kang Xinmiao Du Junyan Qu Yan Wang Xuemei Liu Ruizhi Feng Juanjuan Fu Respiratory Group Department of Integrated Traditional Chinese and Western MedicineWest China Hospital of Sichuan UniversityChengduSichuan 610041China Divison of Pulmonary Diseases State Key Laboratory of BiotherapyWest China Hospital of Sichuan UniversityChengduSichuan 610093China West China School of Medicine Sichuan UniversityChengduSichuan 610041China Department of Respiratory and Critical Care Medicine West China Hospital of Sichuan UniversityChengduSichuan 610041China priority Research Centre for Healthy Lungs The University of NewcastleNewcastleNSW 2305Australia Priority Research Centre for Asthma and Respiratory Diseases Hunter Medical Research InstituteNewcastleNSW 2305Australia Department of Respiratory and Sleep Medicine John Hunter HospitalNewcastleNSW 2305Australia Laboratory of Anesthesia and Critical Care Medicine Translational Neuroscience CenterWest China Hospital of Sichuan UniversityChengduSichuan 610093China Department of Pneumology Pidu District of Traditional Chinese MedicineThe Third Aflated Hospital of Chengdu University of Traditional Chinese MedicineChengduSichuan 611730China Department of Laboratory Medicine West China Hospital of Sichuan UniverstyChengduSichuan 610041China Center of Infectious Disease West China Hospital of Sichuan UniversityChengduSichuan 610041China Research Core Failty West China Hospital of Sichuan UniversitChengduSichuan 610093China.

Background: Although existing mycological tests (bronchoalveolar lavage [BAL] galactomannan [GM], serum GM, serum (1,3)-β-D-glucan [BDG], and fungal culture) are widely used for diagnosing invasive pulmonary aspergillosis (IPA) in non-hematological patients with respiratory diseases, their clinical utility in this large population is actually unclear. We aimed to resolve this clinical uncertainty by evaluating the diagnostic accuracy and utility of existing tests and explore the efficacy of novel sputum-basedAspergillus assays.Methods: Existing tests were assessed in a prospective and consecutive cohort of patients with respiratory diseases in West China Hospital between 2016 and 2019 while novel sputum assays (especially sputum GM andAspergillus-specific lateral-flow device [LFD]) in a case-controlled subcohort. IPA was defined according to the modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity and specificity were computed for each test and receiver operating characteristic (ROC) curve analysis was performed.Results: The entire cohort included 3530 admissions (proven/probable IPA=66, no IPA=3464) and the subcohort included 127 admissions (proven/probable IPA=38, no IPA=89). Sensitivity of BAL GM (≥1.0 optical density index [ODI]: 86% [24/28]) was substantially higher than that of serum GM (≥0.5 ODI: 38% [39/102]) (χ^(2)=19.83,P<0.001), serum BDG (≥70 pg/mL: 33% [31/95]) (χ^(2)=24.65,P<0.001), and fungal culture (33% [84/253]) (χ^(2)=29.38,P<0.001). Specificity varied between BAL GM (≥1.0 ODI: 94% [377/402]), serum GM (≥0.5 ODI: 95% [2130/2248]), BDG (89% [1878/2106]), and culture (98% [4936/5055]). Sputum GM (≥2.0 ODI) had similar sensitivity (84% [32/38]) (Fisher’s exactP=1.000) to and slightly lower specificity (87% [77/89]) (χ^(2)=5.52,P=0.019) than BAL GM (≥1.0 ODI). Area under the ROC curve values were comparable between sputum GM (0.883 [0.812-0.953]) and BAL GM (0.901 [0.824-0.977]) (P=0.734). Sputum LFD had similar specificity (91% [81/89]) (χ^(

关键词： Invasive pulmonary aspergillosis Sputum bronchoalveolar lavage Galactomannan Lateral-flow device

Characteristics of Proinflammatory Cytokines and Chemokines in Airways of Asthmatics： Relationships with Disease Severity and Infiltration of Inflammatory Cells

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2017年第17期130卷 2033-2040页

作者： Ting Yang Yan Li Zhe Lyu Kewu Huang Chris J Corrigan Sun Ying Wei Wang Chen Wang National Clinical Research Center for Respiratory Diseases Center for Respiratory Diseases China-Japan Friendship Hospital Capital Medical University Beijing 100029 China Department of Immunology School of Basic Medical Sciences Capital Medical University Beijing 100069 China Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University and Beijing Institute of Respiratory Medicine Beijing 100020 China MRC and Asthma UK Centre in Allergic Mechanisms of Asthma Division of Asthma Allergy and Lung Biology King&#39 s College London London UK

Background：Increased proinflammatory cytokines and chemokines might contribute to infiltration of inflammatory cells and remodeling in airways of asthma.Although these molecules may be associated with asthma,there is lack of systemic evidence showing which and how important these events are in the disease.We aimed to analyze the concentrations of these molecules in the airways and relationships with disease severity and with airway infiltration of inflammatory cells in a large cohort of asthmatics （n =70,including 37 mild and 33 moderate/severe asthmatics） compared with controls （n =30）.Methods：Meso scale discovery system and commercial ELISA kits were used to measure the concentrations ofproinflammatory cytokines interleukin （IL）-1 β;tumor necrosis factor-alpha （TNF-α）;IL-6;and IL-17 and CC and CXC chemokines CCL2,CCL4,CCL 11,CCL 13,CCL17,CCL22,and CCL26 and CXCL8,CXCL9,CXCL10,and CXCL1 1 in bronchoalveolar lavage fluid of asthmatics and controls.Results：The concentrations ofIL-1,TNF-α,IL-6,CXCL8 and CXCL 10,and CCL4,CCL 11,CCL 17,and CCL22 were significantly elevated in asthmatics compared with controls （P 〈 0.05）.The concentrations of TNF-α and CXCL8,but not others,were negatively correlated with severity of disease （lung function forced expiratory volume in 1 s）（TNF-α vs.total：r =-0.359,P =0.002 vs.moderate/severe：r =-0.541,P =0.001;CXCL8 vs.total：r =-0.327,P =0.006 vs.moderate/severe：r =-0.625,P =0.0001,respectively）.In addition,concentrations of these two molecules were also correlated with the absolute numbers of infiltrating eosinophils and neutrophils in asthmatic airways.Conclusions：Increased concentrations of TNF-α and CXCL8 are associated with pathogenesis of asthma.Targeting these molecules might provide an alternative therapeutic for this disease.

关键词： Asthma bronchoalveolar lavage Chemokine Proinflammatory Cytokines

Diagnostic Value of Nasopharyngeal Aspirates in Children with Lower Respiratory Tract Infections

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2017年第6期130卷 647-651页

作者： Ai-Zhen Lu Peng Shi Li-Bo Wang Li-Ling Qian Xiao-Bo Zhang Department of Respiratory Children's Hospital of Fudan University Shanghai 201102 China Department of Information Management Children's Hospital of Fudan University Shanghai 201102 China Center for Evidenced-based Medicine Fudan University Shanghai 200032 China

Background： The accuracy of nasopharyngeal aspirate （NPA） specimens in detecting lower respiratory pathogens remains controversial. The objective of this study was to evaluate the diagnostic accuracy of aspirates （NPAs） specimen in lower respiratory tract infections （LRTIs） in children. Methods： The prospective study was designed to collect the data of paired NPAs and bronchoalveolar lavage fluids from children with acute LRTIs from January 2013 to December 2015. All specimens were subjected to pathogen detection： bacterial detection by culture, Mvcoplasma pneumoniae （Mp） detection by polymerase chain reaction assay and virus （influenza A and B viruses, parainfluenza virus [PIV] Types 1 and 3, respiratory syncytial virus, and adenovirus） detection by immunofluorescence assay. The diagnostic accuracy analysis of NPAs was stratified by age ≤3 years （n = 194） and 〉3 years （n = 294）. Results： We collected paired specimens from 488 children. The positive rate of pathogen was 61.6%. For Streptococcus pneumoniae, NPA culture had the specificity of 89.9% and negative predictive value of 100% in age ≤3 years, the specificity of 97.2% and negative predictive value of 98.9% in age 〉3 years. For Mp, the positive predictive values of NPA was 77.4% in children ≤3 years, and 89.1% in children 〉3 years. For PIV III, NPA specimen had the specificity of 99.8% and negative predictive value of 96.5% in children ≤3 years. For adenovirus, NPA had the specificity of 97.8% and negative predictive value of 98.4% in age ≤3 years, the specificity of 98.9% and negative predictive value of 99.3% in age 〉3 years. Conclusions： NPAs are less invasive diagnostic respiratory specimens, a negative NPA result is helpful in ＂rule out＂ lower airway infection; however, a positive result does not reliably ＂rule in＂ the presence of pathogens.

关键词： bronchoalveolar lavage Diagnostic Accuracy Lower Respiratory Tract Infection Nasopharyngeal Aspirate

Pulmonary alveolar proteinosis complicated with tuberculosis:A case report

在线全文

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2021年第17期9卷 4400-4407页

作者： Hao Bai Zi-Rui Meng Bin-Wu Ying Xue-Rong Chen Department of Laboratory Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Respiratory and Critical Care Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Pulmonary alveolar proteinosis(PAP)is a rare lung disease characterized by the accumulation of phospholipoproteinaceous material in the alveoli.Cases of PAP complicated with tuberculosis are much more complex and have rarely been well recorded.CASE SUMMARY We describe a 21-year-old Han Chinese patient with suspicious lung infection associated with mild restrictive ventilatory dysfunction and diffusion reduction.High resolution computed tomography revealed a“crazy-paving”appearance and multiple pulmonary miliary nodules around the bronchi.bronchoalveolar lavage demonstrated a small amount of periodic acid-Schiff positive proteinaceous materials.A serological test for the presence of a Mycobacterium tuberculosis antibody and an interferon-gamma release assay were both positive.The patient received a standard course of first-line anti-tuberculosis treatment after diagnostic bronchoalveolar lavage.To date,clinical remission has been achieved and maintained for five years.CONCLUSION In summary,the diagnosis of PAP complicated with tuberculosis was supported by a combination of clinical manifestations,imaging,pulmonary function,laboratory examinations,bronchoalveolar lavage,etc.This case highlighted that diagnostic bronchoalveolar lavage in combination with anti-tuberculosis treatment is a safe and effective option for mild PAP patients with tuberculosis.

关键词： Pulmonary alveolar proteinosis Pulmonary tuberculosis bronchoalveolar lavage Case report

Magnusiomyces capitatus in Immune-Competent Patients with Pulmonary Haemorrhage and Systemic Lupus Erythematosus

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Case Reports in Clinical Medicine 2023年第10期12卷 408-417页

作者： Waleed Amasaib Ahmed Angham Ahmed Almakki Abeer Ahmed Bashinim Abdelgaffar A. Mohamed Amna Al Kalkami Mohannad AbuRageila Department of Medicine Security Forces Hospital Makkah Saudi Arabia Department of Laboratory and Blood Bank Security Forces Hospital Makkah Saudi Arabia Department of Critical Care Security Forces Hospital Makkah Saudi Arabia

Invasive fungal infections have grown significantly over the last two decades, owing to an increase in immunocompromised hosts and geriatric patients. When the host’s defenses are compromised, such infections are associated with severe morbidity and mortality. Here, a rare case of fungal infection in a 61-year-old immunocompetent male patient from Saudi Arabia was reported, who suffered from pulmonary hemorrhage and Systemic Lupus Erythematous. bronchoalveolar lavage was used as a diagnostic tool to identify the fungus reported in the case. The pathogenic fungal specie identified as Magnusiomyces capitatus, in macroscopic and microscopic morphological characteristics of the colonies. Based on clinical evidence, liposomal amphotericin formulation was recommended for initial therapy against fungal infection. Also, liposomal amphotericin B induced mycological eradication up to 70 percent in patients with proven Magnusiomyces capitatus infection. In addition to addressing suspected Systemic lupus erythematosus, the patient’s health has improved with no evidence of pulmonary bleeding and hemoptysis.

关键词： Magnusiomyces capitatus Fungal Infection bronchoalveolar lavage Pulmonary Haemorrhage SLE (Systemic Lupus Erythematosus) Amphotericin A Case Report

Application of fiberoptic bronchscopy in patients with acute exacerbations of chronic obstructive pulmonary disease during sequential weaning of invasive-noninvasive mechanical ventilation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Emergency Medicine 2012年第1期3卷 29-34页

作者： Rong-rong Song Yan-ping Qiu Yong-ju Chen Yong Ji Department of Intensive Care Unit Tongzhou People's HospitalNantong

BACKGROUND:Early withdrawal of invasive mechanical ventilation(IMV) followed by noninvasive MV(NIMV) is a new strategy for changing modes of treatment in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD) with acute respiratory failure(ARF).Using pulmonary infection control window(PIC window) as the switch point for transferring from invasive to noninvasive MV,the time for early extubation can be more accurately judged,and therapy efficacy can be improved.This study aimed to prospectively investigate the clinical effectiveness of fiberoptic bronchscopy(FOB) in patients with AECOPD during sequential weaning of invasive-noninvasive MV.METHODS:Since July 2006 to January 2011,106 AECOPD patients with ARF were treated with comprehensive medication and IMV after hospitalization.Patients were randomly divided into two groups according to whether fiberoptic bronchoscope is used(group A,n=54) or not(group B,n=52) during sequential weaning from invasive to noninvasive MV.In group A,for sputum suction and bronchoalveolar lavage(BAL),a fiberoptic bronchoscope was put into the airway from the outside of an endotracheal tube,which was accompanied with uninterrupted use of a ventilator.After achieving PIC window,patients of both groups changed to NIMV mode,and weaned from ventilation.The following listed indices were used to compare between the groups after treatment:1) the occurrence time of PIC,the duration of MV,the length of ICU stay,the success rate of weaning from MV for the first time,the rate of reventilatJon and the occurrence rate of ventilator-associated pneumonia(VAP);2) the convenience and safety of FOB manipulation.The results were compared using Student's f test and the Chi-square test.RESULTS:The occurrence time of PIC was(5.01 ±1.49) d,(5.87±1.87) d in groups A and B,respectively(P<0.05);the duration of MV was(6.98±1.84) d,(8.69±2.41) d in groups A and B,respectively(P<0.01);the length of ICU stay was(9.25±1.84) d,(11.10±2.63) d in groups A and B,respectively(P<0.01);the success

关键词： Acute exacerbations of chronic obstructive pulmonary disease Acute respiratory failure Mechanical ventilation Sequential weaning of invasive-noninvasive ventilation Fiberoptic bronchscopy bronchoalveolar lavage Pulmonary infection control window Side effect Success rate

Role of bronchoscopy in critically ill patients managed in intermediate care units - indications and complications: A narrative review

在线全文

学校读者我要写书评

暂无评论

World Journal of Critical Care Medicine 2021年第6期10卷 334-344页

作者： Vincenzo G Menditto Federico Mei Benedetta Fabrizzi Martina Bonifazi Department of Emergency Medicine Azienda Ospedaliero-Universitaria Ospedali Riuniti di AnconaAncona 60126Italy Respiratory Diseases Unit Azienda Ospedaliero-Universitaria Ospedali Riuniti di AnconaAncona 60126Italy Cystic Fibrosis Regional Reference Center Azienda Ospedaliero-Universitaria Ospedali Riuniti di AnconaAncona 60126Italy Department of Biomedical Sciences and Public Health Marche Polytechnic UniversityAncona 60126Italy

Flexible bronchoscopy(FB)has become a standard of care for the triad of inspection,sampling,and treatment in critical care patients.It is an invaluable tool for diagnostic and therapeutic purposes in critically ill patients in intensive care unit(ICU).Less is known about its role outside the ICU,particularly in the intermediate care unit(IMCU),a specialized environment,where an intermediate grade of intensive care and monitoring between standard care unit and ICU is provided.In the IMCU,the leading indications for a diagnostic work-up are:To visualize airway system/obstructions,perform investigations to detect respiratory infections,and identify potential sources of hemoptysis.The main procedures for therapeutic purposes are secretion aspiration,mucus plug removal to solve atelectasis(total or lobar),and blood aspiration during hemoptysis.The decision to perform FB might depend on the balance between potential benefits and risks due to frailty of critically ill patients.Serious adverse events related to FB are relatively uncommon,but they may be due to lack of expertise or appropriate precautions.Finally,nowadays,during dramatic recent coronavirus disease 2019(COVID-19)pandemic,the exact role of FB in COVID-19 patients admitted to IMCU has yet to be clearly defined.Hence,we provide a concise review on the role of FB in an IMCU setting,focusing on its indications,technical aspects and complications.

关键词： Flexible bronchoscopy Critically ill bronchoalveolar lavage Indication Complication COVID-19

Secondary Bacterial Organizing Pneumonia in a Patient Recovered from COVID-19 Disease: A Case Report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Case Reports in Clinical Medicine 2021年第2期10卷 46-51页

作者： Alaa Al Zaki Reem Al Argan Abir Al Said Fears Al Kuwaiti Department of Internal Medicine College of Medicine Imam Abdulrahman Bin Faisal University King Fahd Hospital of the Universi-ty Dammam KSA

COVID-19 disease is a global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) that mainly presents with pneumonia, but has variable multi-systemic manifestations. Concomitant bacterial infections associated with the acute stage of COVID-19 disease have been rarely reported in the literature. However, to our knowledge, post viral organizing pneumonia (OP) secondary to bacterial infection after recovery from SARS-CoV2 infection has not been noted before. We report a 27-year-old male patient with Type 1 Diabetes Mellitus who presented with fever post recovery from COVID-19 disease for seven weeks and was found to have OP secondary to Klebsiella pneumoniae. Furthermore, the bronchoalveolar lavage was positive for SARS-CoV2 by RT-PCR despite multiple negative nasopharyngeal RT-PCR. The patient was successfully treated with antibiotics only. Therefore, we conclude that early recognition of OP secondary to bacterial infection in patients with COVID-19 disease and prompt antibiotic treatment could avoid the use of a prolonged course of steroids.

关键词： COVID-19 Disease Organizing Pneumonia Secondary Bacterial Infection bronchoalveolar lavage Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2)