Concentraciones de 25 hidroxi vitamina D séricas y en lavado bronco-alveolar en pacientes con tuberculosis pulmonar / Levels of 25 hydroxy vitamin D of serum and broncho-alveolar lavage in patients with pulmonary tuberculosis

INTRODUCCIÓN: La alteración de la vitamina D es un factor de riesgo para enfermar de tuberculosis (TBC). OBJETIVO: Evaluar la concentración pulmonar y sérica del compuesto 25-hidroxi-vitamina D (25OHD) en pacientes con y sin TBC pulmonar. METODOLOGÍA: Estudio de dos etapas: la primera parte fue de corte transversal, retrospectiva, y la segunda prospectiva. Se incluyeron > 18 años a los que se les realizó fibrobroncoscopia por sospecha de TBC pulmonar y en quienes se confirmó la infección. Se tomaron como controles a pacientes con otro tipo de infección no TBC, y enfermedades no infecciosas para la primera etapa y controles infecciosos sin TBC en la fase prospectiva. La medición de 25OHD se realizó mediante ELFA (ensayo de fluorescencia ligado a enzima). Se empleó la prueba de Kruskal-Wallis para evaluar asociación considerando significativo un valor de p < 0,05. Los datos se procesaron con el programa SPSS versión 23. RESULTADOS: La muestra total fue de 77 pacientes (35 en la primera etapa y 42 en la segunda). Las características entre los grupos fueron homogéneas. Las concentraciones en suero (segunda fase) como en el lavado bronco-alveolar (primera y segunda fase) de 25OHD fueron más bajas en pacientes con TBC comparado con los controles e independientes de la concentración de calcio sérico (suero: 22,4 ng/mL vs 33 ng/mL, p = 0,006 y lavado bronco-alveolar: 9,7 ng/mL vs 12,2 ng/mL; p = 0,012). CONCLUSIONES: Hubo una diferencia significativa entre las concentraciones de 25OHD, tanto en suero como en lavado bronco-alveolar, en pacientes con TBC pulmonar con relación a sus controles.

BACKGROUND: Alteration of vitamin D is a risk factor for tuberculosis (TB). AIM: To evaluate the pulmonary and serum levels of 25-hydroxy vitamin D (25OHD) in patients with and without pulmonary TB. METHODS: Two-stage study: the first part was retrospective cross-sectional and the second prospective. Those > 18 years of age who underwent fiberoptic bronchoscopy for suspected pulmonary TB and in whom the infection was confirmed were included. Patients with another type of infection without TB and non-infectious diseases were taken as controls for the first stage and infectious controls without TB in the prospective phase. The measurement of 25OHD was performed by ELFA (enzyme-linked fluorescence assay). The Kruskal-Wallis test was used to evaluate association, considering a value of p < 0.05 to be significant. The data were processed with the SPSS version 23 program. RESULTS: The total sample was 77 patients (35 in the first stage and 42 in the second). The characteristics between the groups were homogeneous. Serum (second phase) and broncho-alveolar lavage (first and second phase) levels of 25OHD were lower in TB patients compared to controls and were independent of serum calcium level (serum: 22.4 ng/mL vs 33 ng/mL, p = 0.006 and broncho-alveolar lavage: 9.7 ng/mL vs 12.2 ng/mL; p = 0.012). CONCLUSIONS: There was a significant difference between the levels of 25OHD in both serum and broncho-alveolar lavage in patients with pulmonary TB in relation to their controls.

Expression and clinical significance of receptor-interacting protein kinase-3 levels in children with mycoplasma pneumoniae pneumonia and their relationship with inflammatory factors / 中国综合临床

Objective:To explore the level of expression, clinical significance of receptor-interacting protein kinase-3(RIPK3) in the bronchoalveolar alveolar lavage fluid (BALF) of mycoplasma pneumoniae pneumonia(MPP) in children and the relationship between RIPK3 and various cytokines.Methods:Using a case-control study, 30 refractory mycoplasma pneumoniae pneumonia children treated in Children′s Hospital of Xuzhou Medical University from February 2019 to February 2021 were selected as the MRPP group, 35 mycoplasma pneumoniae pneumonia children as the RPP group.Meanwhile, 20 sex- and age-matched hospitalized children with bronchial foreign body were selected as the case-control group.In all subjects, protein levels of RIPK3 and mixed lineage kinase domain-like protein(MLKL) were determined by Western Blot.Meanwhile, levels of IL-6, IL-1β and TNF-α were determined by enzyme linked immuno sorbent assay(ELISA). Compare levels of different parameters between the three groups and analyze the correlation between levels of RIPK3 and MLKL, L-6, IL-1β, TNF-α in the BALF of MPP children using Spearman rank correlation analysis.Results:There were statistically significant differences in the levels of RIPK3, MLKL, IL-6, IL-1β and TNF-α in BALF between RMPP group, MPP group and control group (all P<0.001). Pairwise comparisons also showed statistical differences, and the RMPP group was the highest, followed by MPP group, and the control group was the lowest.The level of RIPK3 in BALF of MPP children was positively correlated with MLKL, IL-6, IL-1β and TNF-α ( r=0.711, 0.676, 0.725, 0.651, P<0.001). Linear regression analysis shows: MLKL=0.432×RIPK3. Conclusion:RIPK3 may be involved in the occurrence and development of MPP in children, and is closely related to cytokines such as IL-6, IL-1β and TNF-α.

Early diagnostic value of soluble triggering receptor expressed on myeloid cells1 in patients with ventilator associated pneumonia / 中华急诊医学杂志

Objective To evaluate the early diagnostic values of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) in patients with ventilator associated pneumonia (VAP).Methods A total of 112 clinical suspicion VAP ventilator-associated pneumonia (VAP) patients accepted from January 2008 through December 2010 were enrolled for prospective and observational study.Two independent intensivists without aware of the results of the sTREM-1 assay separately made diagnosis of VAP present or absent depending on the clinical symptoms and results of microbial culture.Patients were categorized into two groups:VAP group (n =74) and non-VAP group (n =38).The levels of sTREM-1 in broncho-alveolar lavage fluid (BALF) collected with Gibot method in unemployment of bronchoscope and in serum were measured by enzyme-linked immunosorbent assay (ELISA) on the first day of suspected diagnosis.Comparison of sTREM-1 level between BALF and serum was made by t-test and Receiver Operating Characteristic (ROC) curve.Results A total of 112 clinical suspicion VAP patients admitted from January 2008 through December 2010 were enrolled for prospective and observational study.Two independent intensivists without aware of the results of the sTREM-1 assay made diagnosis of VAP present or absent depending on the clinical symptoms and results of microbial culture.Patients were categorized into two groups:VAP group (n =74) and non-VAP group (n =38).The levels of sTREM-1 in broncho-alveolar lavage fluid (BALF) collected with Gibot method in unemployment of bronchoscope and in serum were measured by enzyme-linked immunosorbent assay (ELISA) on the first day of suspected diagnosis.Comparison of sTREM-1 level between BALF and serum was made by t-test and Receiver Operating Characteristic (ROC) curve.Conlclusions In suspected VAP patients,measurement of sTREM-1 levels in BALF and in serum could help identify VAP in early stage.

Microbiologic Analysis of Severe Childhood Pneumonia by Bronchoalveolar Lavage / 소아알레르기및호흡기학회지

PURPOSE: Pneumonia is rather common and benign disease in children but its course is various. Many clinicians used the empirical antibiotics to treat pneumonia without identification of causative organism. This study was performed to find the pathogenic organism from the fluid culture by bronchoscopy with BAL (bronchoalveolar lavage) in severe pneumonia patients. METHODS: We studied 21 cases (male 15, female 6) who were admitted with severe pneumonia in the Department of Pediatrics, Sunlin Hospital from March to October in 1999. These patients had no underlying disease such as immunologic deficiency. We took laboratory tests including CBC, CRP, ESR, PB smear, mycoplasmal antibody and blood culture at admission day. We performed bronchoscopy with BAL, and wet smear and culture of that fluid. RESULTS: Organisms were cultured in nineteen cases out of 21 cases. Seven cases of Streptococcus mitis, five of Stenotrphomonas maltophilia, five cases of Streptococcus oralis, two of Moraxella species, two of Acinetobacter junii, one of Acinetobacter spesies, one Staphylococcus hominus, one alpha-h-Streptococcus, one Klebsiella pneumoniae, one Pseudomonas aeruginosa, one Enterobacter cloacae. Two organisms were cultured in nine cases. CONCLUSION: The positive rate of BALF culture was very high (90.5%). But, further studies are necessary for the patients with severe pneumonia preceded the use of antibiotics.

Protective effect of hyperoxic solution on phosgene-induced lung injury / 解放军医学杂志

Objective To study the protective effect of a hyperoxic solution on phosgene-induced lung injury by observing the changes in W/D ratio, lung water (LW), and L/B, and MDA contents, GSH-PX activity, and protein contents in broncho-alveolar lavage fluid (BALF). Methods The rabbits were divided into normal control group, hyperoxic solution (HO) and balance salt(BS) groups.Group HO and Group BS inhaled phosgene, and hyperoxic solution was given intravenously in group HO, but BS was given in group BS. W/D, LW, L/B, and MDA contents,GSH-PX activity,protein contents in broncho-alveolar lavage fluid (BALF) were determined. Results The MDA contents, W/D, LW and L/B were increased, and GSH-PX activity was decreased significantly in Group HO and Group BS compared with control group (P

Broncho-alveolar lavage: An aid to diagnosis in immuncompromised children with pulmonary lesion.

Conventional broncho-alveolar lavage with flexible bronchoscope has proven to be an effective method for the diagnosis of pulmonary lesions, especially in immunocompromised patients. The disadvantage of flexible endoscopy is that it can not be performed safely in pediatric patients with compromised airway due to the lack of ventilating channel. We designed an alternative method for broncho-alveolar lavage by target bronchus and secure the airway at the same time. We performed brocho-alveolar lavage via that method in 15 immunocompromised paediatric patients with signs and symptoms of pneumonia from December 1995 to September 1997. The group comprised eight males and seven females with a mean age of 30.35+24.60 months. Most of the patients had positive HIV titre (86.67 percent). Causative agents were identified in 11 of 15 patients (77.33 percent) Pneumocystis carinii was found in four cases (26.7 percent) followed by fungus (four cases, 26.7 percent), Mycobacterium tuber culosis (one cases, 6.7 percent) and Respiratory syncytial virus (one cases, 6.7 percent). No complications were reported. Compared to the literature control which gave an average yield of 45-84 percent, this technique of brocho-alveolar lavage was proven to be an effective, safe diagnostic method which gave satisfactory results.