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A Xaubet

Publications and source records attributed to A Xaubet.

At least 91 records · Page 5Linked to original sources

[Significance of the presence of mastocytes in bronchoalveolar lavage in the diagnostic evaluation of diffuse interstitial lung diseases].

The cell preparations of 199 bronchoalveolar lavages (BAL) were reviewed to evaluate the meaning of the presence of mastocytes for the diagnosis of diffuse interstitial lung diseases. The study population consisted of 41 control individuals, 10 with extrinsic allergic alveolitis (EAA), 55 with sarcoidosis 38 with asbestosis, 25 with pulmonary fibrosis associated to collagen diseases, 18 with idiopathic pulmonary fibrosis and 12 with carcinomatous lymphangitis. Mastocytes were predominantly found in patients with EAA (8 of 10 cases) and in some cases of sarcoidosis and idiopathic pulmonary fibrosis. The rate of mastocytes in the patients with EAA was significantly higher than in the other groups (p less than 0.001). The presence of mastocytes in the BAL is particularly suggestive of EAA; rates higher than 3% are only found in this condition.

Alveolitis, Extrinsic Allergic↗

Bronchoalveolar lavage cell analysis in patients with human immunodeficiency virus related diseases.

The value of differential cell counts in bronchoalveolar lavage fluid in patients who were serologically positive for the human immunodeficiency virus (HIV) was studied in 30 patients with classified into four groups according to the severity of illness: (1) seven subjects with the AIDS related complex without clinical or radiological evidence of pulmonary infection; (2) eight patients with the AIDS related complex and pulmonary tuberculosis; (3) eight patients with AIDS and Pneumocystis carinii pneumonia; and (4) seven patients with AIDS, Pneumocystis carinii pneumonia, and severe respiratory failure. All four groups had a similar percentage of lymphocytes, significantly higher than that of a control group of 15 healthy volunteers. A significant increase in the percentage of neutrophils was observed in groups 2, 3, and 4. The lavage fluid differential cell count does not therefore appear to help in the differential diagnosis of pulmonary infections in HIV positive patients. The abnormal percentage of lymphocytes observed in some patients with the AIDS related complex without clinical evidence of pulmonary infection suggests that lung injury may exist before clinical or radiological abnormalities develop. This might be related to an immunological mechanism or might be caused by an undetected subclinical infection.

AIDS-Related Complex↗

Demonstration of surface antigens on bronchoalveolar lavage cells using the immunoalkaline phosphatase method.

The immunoalkaline phosphatase procedure is described as a method for labelling bronchoalveolar lavage cellular specimens with monoclonal antibodies. This method has several advantages over conventional immunofluorescent techniques: it can be performed on cytocentrifuge preparations stored for long periods before staining; cell morphology can be observed in detail in positive and negative cells; the staining is permanent and stable, and, the reaction can be evaluated with a light microscope. Normal values for lymphocyte subpopulations in smokers and nonsmokers are also reported.

Adult↗

Bronchoalveolar lavage analysis with anti-T6 monoclonal antibody in the evaluation of diffuse lung diseases.

To evaluate the usefulness of anti-T6 monoclonal antibody cell analysis in the assessment of diffuse lung disease, 77 bronchoalveolar lavages (BAL) were performed on 70 subjects: 18 normal smokers, 14 normal nonsmokers, 30 patients with chronic interstitial lung diseases (15 sarcoidosis, 12 idiopathic or associated pulmonary fibrosis, 3 histiocytosis X) and 8 patients with diffuse lung neoplastic disorders. The percentage of T6-positive cells was significantly higher in normal smokers than in normal nonsmokers (p less than 0.05). Positive T6 cells were absent or less than 1% in normal subjects, in patients with interstitial lung diseases and in patients with diffuse lung cancer, except in a case of desquamative interstitial pneumonitis, who had 2% of reacting cells. In contrast, such cells were always 3% or higher in the 6 BAL performed in histiocytosis X patients (p less than 0.05).

Adult↗

Diagnostic value of quantitative cultures of bronchoalveolar lavage and telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia.

We compared the diagnostic value of quantitative cultures of bronchoalveolar lavage (BAL) and telescoping plugged catheter (TPC) samples in 34 nonimmunocompromised, mechanically ventilated (MV) patients with suspected bacterial pneumonia. A control group of seven "noninfected" MV patients was also studied. In 92% of patients with bacterial pneumonia (32 of 34), simple endotracheal aspiration samples recovered one or more microorganisms. Both BAL and TPC samples cultured colony-forming units (cfu) greater than or equal to 10(3)/ml of one or more microorganisms in 56% (19 of 34) of patients. TPC and BAL culture results agreed on 88.5% (54 of 61) of the recovered microorganisms. Sterile TPC and BAL cultures agreed on 80% (4 of 5) of the cases. Microorganisms cultured from blood samples were also cultured from BAL and TPC specimens. Culture results from the two techniques completely disagreed in only one case (3%). In the control group, one TPC and two BAL cultures yielded microorganisms in cfu greater than or equal to 10(3)/ml. Specificities of BAL and TPC were 71 and 86%, respectively, whereas specificity of endotracheal aspiration was only 14%. Both the bacterial index obtained by TPC and BAL, as well as the quantitative cultures, correlated moderately well (r = 0.78 and 0.72, respectively, p less than 0.001 for both correlations). BAL and TPC results caused changes of antibiotic treatment in 11 of 23 survivors. Neither BAL nor TPC caused complications. Our results demonstrate that BAL and TPC diagnose bacterial pneumonia in MV patients with similar accuracy. Culture results from both techniques showed excellent qualitative and reasonable quantitative agreement.

Adult↗

Pulmonary infiltrates in immunocompromised patients. Diagnostic value of telescoping plugged catheter and bronchoalveolar lavage.

The usefulness of telescoping plugged catheter (TPC) together with bronchoalveolar lavage (BAL) in the same bronchoscopic act in the diagnosis of pulmonary infiltrates was studied in 113 fiberoptic bronchoscopic examinations performed on 96 immunocompromised patients. The TPC cultures detected pulmonary bacterial infections in 25 (22 percent) cases but showed a high frequency of false positive results (12 microorganisms, 27 percent). Bronchoalveolar lavage had an overall diagnostic yield of 49 percent (53 of 113 cases). Combining TPC and BAL diagnostic values, 78 of 113 pulmonary infiltrates (69 percent) were diagnosed. The results obtained by both techniques allowed us to modify the treatment in 35 (31 percent) cases. Combined, TPC and BAL show a good diagnostic yield in immunocompromised patients with pulmonary infiltrates. Both techniques should be performed as the first approach in the evaluation of these patients, and be done in the same bronchoscopic procedure.

Bacteria↗

Y-body study in bone marrow precursors, peripheral blood cells and alveolar macrophages for demonstration of haemopoietic engraftment in allogeneic bone marrow transplantation.

The value of Y-body study for assessment of haemopoietic engraftment was analyzed in 50 consecutive patients submitted to allogeneic bone marrow transplantation (BMT) (sex-matched in 28 cases, sex-mismatched in 22). The study was performed weekly on bone marrow and peripheral blood smears in all cases, and alveolar macrophages were also studied in 15 patients in whom bronchoalveolar lavage was carried out because of concurrent respiratory disturbances. The analysis was performed blindly by 2 independent observers. In both sex-matched and sex-mismatched cases there was an absolute concordance between recipient and donor Y-body results, as well as with the simultaneous cytogenetic study. The engraftment of erythroid and granulopoietic lines was documented at day +14 in all cases of sex-mismatched BMT, whereas megakaryocyte and lymphocyte take was demonstrated at d +21. On the other hand, the results from alveolar macrophages were in accordance with those obtained in the simultaneous study of bone marrow precursors after BMT. The above results indicate that Y-body analysis is a simple and useful tool for the demonstration of bone marrow take in sex-mismatched BMT.

Blood Cells↗

Different patterns of gas exchange response to exercise in asbestosis and idiopathic pulmonary fibrosis.

To analyse the pattern of pulmonary gas exchange during maximal exercise (Emax) in asbestosis, we compared nine subjects with this disease (1 female/8 male), aged 54 +/- 11 yrs (mean +/- SD), to nine patients (1 female/8 male) with idiopathic pulmonary fibrosis (IPF) of a similar age, height, weight and smoking history, both at rest and during Emax. No differences were observed in dynamic and static lung volumes between the groups. However, patients with IPF had a lower DLCOsb and KCO (p less than 0.005 and 0.05, respectively). At rest, both groups showed mild arterial hypoxaemia (76 +/- 11, asbestosis, vs 77 +/- 11 mmHg, IPF), widened AaPO2 (32 +/- 14 vs 31 +/- 13 mmHg) and slight increases in VD/VT (47 +/- 12 vs 46 +/- 11%), respectively. During Emax, PaO2 fell to 51 +/- 7 mmHg in patients with IPF whereas those with asbestosis had PaO2 of 73 +/- 21 mmHg (p less than 0.05). Conversely, those with asbestosis were able to reduce VD/VT (from 47 +/- 12 to 39 +/- 10%, p = 0.01) as opposed to those with IPF (from 46 +/- 11 to 47 +/- 13%). Furthermore, DLCOsb and AaPO2 during Emax were highly correlated only in IPF (r: -0.84, p less than 0.01). Despite the finding that both diseases represent a diffuse pulmonary fibrosis with a similar degree of resting ventilatory impairment, the pattern of gas exchange during exercise is different in each. These differences may be related to the underlying morphology of each process, which probably includes more airway disease and less pulmonary vascular involvement and/or a different degree of interstitial fibrotic change in asbestosis.

Asbestosis↗

Radiographic bilateral cavitary lesions in lipoid pneumonia.

We report a case of lipoid pneumonia with pulmonary bilateral cavitated lesions. The diagnosis was based on the finding of abundant lipid-laden alveolar macrophages in bronchoalveolar lavage and the presence of histologic changes indicative of lipoid pneumonia in transbronchial lung biopsy.

Adult↗

Multinuclear giant cells in bronchoalveolar lavage in interstitial lung diseases.

The presence of multinuclear giant cells (MGC) is a pathological feature of interstitial lung diseases produced either by some organic and inorganic dust or by granulomatous disorders. In order to assess the diagnostic significance of the presence of MGC in bronchoalveolar lavage (BAL), the percent of MGC in the BAL of 52 subjects exposed to asbestos (26 with asbestosis) as well as from 79 with several interstitial lung diseases (idiopathic pulmonary fibrosis, pulmonary fibrosis associated with collagen vascular disorders, hypersensitivity pneumonitis and sarcoidosis) was compared with that of a control group of 14 subjects with no evidence of diffuse pulmonary disease. The results of this study suggest that MGC are present in the BAL of subjects with no pulmonary disease, and the quantification of these cells does not aid in the diagnostic evaluation of interstitial lung diseases.

Alveolitis, Extrinsic Allergic↗

Bronchoalveolar lavage cellular analysis and gallium lung scan in the assessment of patients with amiodarone-induced pneumonitis.

Seven patients suffering from amiodarone-induced pneumonitis were followed after diagnosis over a period of 16 +/- 6 months. All of them showed clinical, radiographic and functional manifestations of interstitial lung disease. Bronchoalveolar lavage was performed on 6 of them and disclosed lymphocytosis in 2 cases (associated to eosinophilia in 1 of them), neutrophilia in 1 and normal differential count in 2. In 1 case there were abundant hemosiderin-laden macrophages. In addition, all patients evidenced an increased 67Ga lung scan uptake. After discontinuation of amiodarone therapy (with or without corticosteroid therapy), 67Ga lung uptake normalized in 3 cases, but remained increased in 3. Bronchoalveolar lavage was repeated only in 2 cases, showing disappearance of lymphocytosis in one and abundant hemosiderin-laden macrophages in the other. Our results suggest that (1) hemosiderin-laden macrophages can be found in bronchoalveolar lavage in patients with amiodarone-induced pneumonitis, probably related to subclinical chronic left-sided heart failure; (2) 67Ga lung scan appears to be a sensitive marker of amiodarone pneumonitis, although it can remain abnormal after pulmonary clinical, radiographic and functional normalization.

Adult↗

Generalized amyloidosis: a rare complication of cystic fibrosis.

A new case of cystic fibrosis complicated with secondary amyloidosis is reported. We reviewed ten cases described up to now in the literature, emphasizing the rarity of this association. The usefulness of serum trypsin concentration as an index of exocrine pancreatic function and the accuracy and simplicity of the abdominal fat biopsy in the histologic diagnosis of amyloidosis were evaluated.

Adult↗