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Lower airway bronchoscopic interpretation
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
Kimberley R. Kaspy, Sara M. Zak
If obtaining a bronchoalveolar lavage for infectious etiologies, reasonable attempts at delaying antibiotic administration should be made, as cultures may quickly become sterilized. There are times when this is not possible, and cytology can still be useful to provide information regarding possible causes. Interpretation of bronchoalveolar lavage is discussed further in Chapter 7.
Gene Therapy and Small Molecules Used in the Treatment of Cystic Fibrosis
Published in Yashwant Pathak, Gene Delivery, 2022
Manish P. Patel, Uma G. Daryai, Mansi N. Athalye, Praful D. Bharadia, Jayvadan Patel
The bronchoalveolar lavage procedure is basically done to collect a sample from the lungs for diagnostic purpose. The results of diagnosis shows a high percentage of neutrophils (≥50% in patients with cystic fibrosis as compared with normal subjects having 3%); the presence of large numbers of neutrophils in lavage fluid, even in the absence of pathogens, is strong evidence of cystic fibrosis (Stern, 1997).
HIV and Its Complications and Needlestick Injuries
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Diagnosis may need to be clinical if histochemical tests (e.g. silver/immunofluorescent techniques from bronchoalveolar lavage [BAL]) are unavailable. Do not delay treatment in suspected cases. Spontaneous pneumothorax should raise suspicion for PCP.
Medical thoracoscopy in the diagnosis of pleural disease: a guide for the clinician
Published in Expert Review of Respiratory Medicine, 2020
Faisal Shaikh, Robert J. Lentz, David Feller-Kopman, Fabien Maldonado
Despite the intimate association of the pleura with the pulmonary parenchyma, TB pleuritis often occurs in isolation of parenchymal disease and is considered to be an extrapulmonary form of TB. The traditional diagnostic methods of sputum induction and bronchoalveolar lavage are therefore unreliable. In fact, sputum culture in patients with pleural TB and normal chest radiograph has been shown to yield a diagnosis in only 55% of cases in one series [71], however the number is likely closer to 4–11% [72–74]. Where TB prevalence is high, the positive predictive value of a lymphocytic predominant exudate and elevated pleural adenosine deaminase is as high as 98% [75]. However, the data for European and Western patient cohorts are less convincing. Pleural fluid microscopy has a less than 10% diagnostic yield and the sensitivity of liquid culture media is positive in less than one third of cases [73,76–78]. In several meta-analyses, pleural adenosine deaminase, interferon gamma, and nucleic acid amplification have been shown to have respectable specificity for the diagnosis of TB pleuritis although, importantly, sensitivity (ability to rule out TB) is variable [79,80].
Molecular links between COPD and lung cancer: new targets for drug discovery?
Published in Expert Opinion on Therapeutic Targets, 2019
Gaetano Caramori, Paolo Ruggeri, Sharon Mumby, Antonio Ieni, Federica Lo Bello, Vrushali Chaminka, Chantal Donovan, Filippo Andò, Francesco Nucera, Irene Coppolino, Giovanni Tuccari, Philip M. Hansbro, Ian M. Adcock
Clearly, the assessment of human tissues comparing samples from lung cancer and COPD patients with age- and sex-matched controls provides critical information on disease features. Diseased tissues include lungs resected during lung transplantation and control lungs not suitable for transplant [15]. Sputum, bronchoalveolar lavage (BAL) and bronchoscopy samples can be collected. Specific cell types such as macrophages, neutrophils, fibroblasts, and bronchoepithelial cells can be specifically isolated and assessed [16,17]. Bronchoepithelial cells can also be cultured at the air-liquid interface and grown into differentiated airway epithelium maintaining their disease phenotype [18,19]. Blood samples can also be assessed, but the data do not always correlate with observations in the lung [20,21].
Repeated pulmonary exposures to zinc ions enhance inflammatory responses to subsequent metal exposures
Published in Experimental Lung Research, 2018
Christa Watson-Wright, Priscila Queiroz, Sylvia Rodrigues, Thomas C. Donaghey, Joseph D. Brain, Ramon M. Molina
We seek to determine what distinguishes sensitization versus adaptation due to metal exposures via the respiratory tract. The aim of this study is to develop an animal model to investigate multiple-chemical sensitivity. For this purpose, we compared two groups of animals: one that was repeatedly exposed to ZnCl2 for 4 weeks and another group that was not. We also exposed animals to a challenge dose of CeCl3 to study the possibility of cross reactivity between zinc and cerium ions. The inflammatory response was assessed through the analysis of bronchoalveolar lavage fluid. Inflammatory cytokines and biomarkers of injury such as lactate dehydrogenase (LDH), myeloperoxidase (MPO), albumin and hemoglobin were determined. Levels of total and reduced glutathione were evaluated to examine the role of oxidative stress in chemical sensitivity.