The Experts below are selected from a list of 47937 Experts worldwide ranked by ideXlab platform
Javeed Akhter - One of the best experts on this subject based on the ideXlab platform.
-
specificity and sensitivity of hemosiderin laden macrophages in routine Bronchoalveolar Lavage in children
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Zeynep N Salih, Afreen Akhter, Javeed AkhterAbstract:Abstract Context.—The presence of iron or hemosiderin in macrophages obtained in routine Bronchoalveolar Lavage is considered crucial in the diagnosis of the clinical syndrome of hemosiderosis. However, there do not appear to be any data on the sensitivity and specificity of the finding of hemosiderin-laden macrophages (HLMs) in Bronchoalveolar Lavage in children. Objective.—To review data from Bronchoalveolar Lavage studies done in children to correlate the presence of HLMs with pneumonia and hemosiderosis and to determine what proportion of HLMs has the optimal sensitivity and specificity for the diagnosis of hemosiderosis. Design.—One hundred ten Bronchoalveolar Lavage specimens obtained via flexible bronchoscopy were reviewed retrospectively. The data collected for demographics, indication for the bronchoscopy, diagnosis of pneumonia, anemia, and bronchoscopy and Bronchoalveolar Lavage findings were compared between patients diagnosed with hemosiderosis and those diagnosed with other diseases. Results...
-
specificity and sensitivity of hemosiderin laden macrophages in routine Bronchoalveolar Lavage in children
Archives of Pathology & Laboratory Medicine, 2006Co-Authors: Zeynep N Salih, Afreen Akhter, Javeed AkhterAbstract:Context The presence of iron or hemosiderin in macrophages obtained in routine Bronchoalveolar Lavage is considered crucial in the diagnosis of the clinical syndrome of hemosiderosis. However, there do not appear to be any data on the sensitivity and specificity of the finding of hemosiderin-laden macrophages (HLMs) in Bronchoalveolar Lavage in children. Objective To review data from Bronchoalveolar Lavage studies done in children to correlate the presence of HLMs with pneumonia and hemosiderosis and to determine what proportion of HLMs has the optimal sensitivity and specificity for the diagnosis of hemosiderosis. Design One hundred ten Bronchoalveolar Lavage specimens obtained via flexible bronchoscopy were reviewed retrospectively. The data collected for demographics, indication for the bronchoscopy, diagnosis of pneumonia, anemia, and bronchoscopy and Bronchoalveolar Lavage findings were compared between patients diagnosed with hemosiderosis and those diagnosed with other diseases. Results Six patients were diagnosed with hemosiderosis by clinical findings, lung biopsy, or autopsy. There were no statistical differences in pneumonia (P > .99), anemia (P > .99), or coughing (P = .08) between patients with hemosiderosis and other patients. Hemoptysis was the only symptom that was significantly different between the 2 groups (P = .04). The mean HLM index for patients with hemosiderosis was 56% +/- 16.17% and for other patients, 7.5% +/- 10.74% (P Conclusions These results confirm a strong association between HLM index and diagnosis of hemosiderosis in a pediatric population. Availability of this HLM index will result in accurate and timely diagnosis of pulmonary hemosiderosis, which may influence treatment and long-term prognosis.
Kenneth S Knox - One of the best experts on this subject based on the ideXlab platform.
-
antigen detection in Bronchoalveolar Lavage fluid for diagnosis of fungal pneumonia
Current Opinion in Pulmonary Medicine, 2011Co-Authors: Chadi A Hage, Kenneth S Knox, Thomas E Davis, L J WheatAbstract:PURPOSE OF REVIEW The purpose of this review is to describe important findings published during the past 18 months using Bronchoalveolar Lavage (BAL) for diagnosis of pulmonary mycoses. RECENT FINDINGS Clinical studies and meta-analysis have established a high sensitivity and specificity for Aspergillus galactomannan testing of BAL specimens for diagnosis of invasive aspergillosis, superior to that observed with other diagnostic methods. Similar findings have been reported in histoplasmosis and blastomycosis. SUMMARY Fungal antigen testing of BAL specimens is recommended if bronchoscopy is performed for diagnosis of pulmonary infiltrates in patient groups at risk for aspergillosis or the endemic mycoses if the diagnosis cannot be established by evaluation of sputum specimens or detection of antigen in the urine or serum.
-
plasmalyte as a cause of false positive results for aspergillus galactomannan in Bronchoalveolar Lavage fluid
Journal of Clinical Microbiology, 2007Co-Authors: Chadi A Hage, John M Reynolds, Michelle Durkin, Joseph L Wheat, Kenneth S KnoxAbstract:The detection of galactomannan (GM) in the serum of immunocompromised patients is widely used for the early diagnosis of invasive aspergillosis ([6][1]). The test may also be useful when applied to Bronchoalveolar Lavage (BAL) fluid specimens for clinical diagnosis ([5][2]), though not FDA approved
-
lymphocytic alveolitis Bronchoalveolar Lavage viral load and outcome in human immunodeficiency virus infection
American Journal of Respiratory and Critical Care Medicine, 1999Co-Authors: Homer L Twigg, Kenneth S Knox, Diaa M Soliman, Richard B Day, Rodney J Anderson, David S Wilkes, Carol T SchnizleinbickAbstract:Lymphocytic alveolitis portends a poor prognosis in human immunodeficiency virus (HIV)-infected subjects. Because alveolar lymphocytes consist predominantly of HIV-specific CD8+ cytotoxic T lymphocytes (CTL), they could represent an appropriate immune response to infected cells in the lung, and be a surrogate marker for a high pulmonary viral burden. We assessed long-term outcome in a cohort of asymptomatic HIV-infected subjects who underwent bronchoscopy between 1990 and 1993 and had Bronchoalveolar Lavage fluid (BALF) available for determination of viral load by reverse transcription–polymerase chain reaction. The ability to detect HIV in BALF increased with disease progression. Lymphocytic alveolitis, although present at all stages of HIV infection, was most pronounced in patients with middle stage disease. The HIV viral load as measured by Bronchoalveolar Lavage correlated with the percentage of alveolar lymphocytes in patients with peripheral blood CD4+ cell counts above 200/ μ l. Including patients ...
Shahid Husain - One of the best experts on this subject based on the ideXlab platform.
-
a strategy for prevention of fungal infections in lung transplantation role of Bronchoalveolar Lavage fluid galactomannan and fungal culture
Journal of Heart and Lung Transplantation, 2018Co-Authors: Shahid Husain, Archana Bhaskaran, Coleman Rotstein, Alyajahan Bhimji, R Pavan, Deepali Kumar, Atul Humar, Shaf Keshavjee, L G SingerAbstract:Background The optimal strategy for prevention of invasive fungal infections in lung transplant recipients remains undetermined. We studied strategies based on Bronchoalveolar Lavage fungal culture and galactomannan for prevention of invasive aspergillosis in lung transplant recipients. Methods Consecutive lung transplant recipients were evaluated during the period January 2010 to September 2014. Rates of invasive aspergillosis and all-cause mortality were recorded at 1 year. Criteria established by the International Society for Heart and Lung Transplantation were used to define invasive fungal infections . Multivariate Cox regression analyses were performed to assess the outcomes of mortality and invasive aspergillosis. Results A total of 519 lung transplant recipients with 3,077 bronchoscopies were included in our study. The cumulative incidence of fungal infections was 14% (75 of 519). Of these patients, 10.6% (54 of 519) developed Aspergillus -related clinical syndromes. Using multivariate analysis , pre-emptive therapy was associated with significantly lower rates of invasive aspergillosis at 1 year post-transplantation compared with no pre-emptive therapy (hazard ratio [HR] 0.23, 95% confidence interval [CI] 0.09 to 0.58). Pre-emptive therapy and invasive aspergillosis had similar mortality rates compared with no invasive aspergillosis, or negative culture and galactomannan at 1 year (HR 0.54, 95% CI 0.23 to 1.28; and HR 0.99, 95% CI 0.44 to 2.25, respectively). During follow-up, 50% (259 of 519) of patients were negative for galactomannan and Aspergillus culture in Bronchoalveolar Lavage, and did not receive anti-fungal treatment . Only 2 patients developed invasive aspergillosis in this cohort. Conclusions Our study suggests that use of Bronchoalveolar Lavage culture and a galactomannan-directed pre-emptive approach significantly decreased the risk of invasive aspergillosis, allowing a 50% reduction in anti-fungal exposure compared with a universal prophylaxis approach, without affecting mortality at 1 year.
-
aspergillus galactomannan antigen in the Bronchoalveolar Lavage fluid for the diagnosis of invasive aspergillosis in lung transplant recipients
Transplantation, 2007Co-Authors: Shahid Husain, Michelle Durkin, David L Paterson, Sean M Studer, M Crespo, Joseph M Pilewski, Joseph Wheat, Bruce E Johnson, Lisa Mclaughlin, Christopher BentsenAbstract:Background. The clinical utility of Platelia Aspergillus enzyme immunoassay (EIA) for galactomannan (GM) antigen detection in Bronchoalveolar Lavage (BAL) for the diagnosis of invasive aspergillosis (IA) in lung transplant recipients is not known.
Zeynep N Salih - One of the best experts on this subject based on the ideXlab platform.
-
specificity and sensitivity of hemosiderin laden macrophages in routine Bronchoalveolar Lavage in children
Archives of Pathology & Laboratory Medicine, 2009Co-Authors: Zeynep N Salih, Afreen Akhter, Javeed AkhterAbstract:Abstract Context.—The presence of iron or hemosiderin in macrophages obtained in routine Bronchoalveolar Lavage is considered crucial in the diagnosis of the clinical syndrome of hemosiderosis. However, there do not appear to be any data on the sensitivity and specificity of the finding of hemosiderin-laden macrophages (HLMs) in Bronchoalveolar Lavage in children. Objective.—To review data from Bronchoalveolar Lavage studies done in children to correlate the presence of HLMs with pneumonia and hemosiderosis and to determine what proportion of HLMs has the optimal sensitivity and specificity for the diagnosis of hemosiderosis. Design.—One hundred ten Bronchoalveolar Lavage specimens obtained via flexible bronchoscopy were reviewed retrospectively. The data collected for demographics, indication for the bronchoscopy, diagnosis of pneumonia, anemia, and bronchoscopy and Bronchoalveolar Lavage findings were compared between patients diagnosed with hemosiderosis and those diagnosed with other diseases. Results...
-
specificity and sensitivity of hemosiderin laden macrophages in routine Bronchoalveolar Lavage in children
Archives of Pathology & Laboratory Medicine, 2006Co-Authors: Zeynep N Salih, Afreen Akhter, Javeed AkhterAbstract:Context The presence of iron or hemosiderin in macrophages obtained in routine Bronchoalveolar Lavage is considered crucial in the diagnosis of the clinical syndrome of hemosiderosis. However, there do not appear to be any data on the sensitivity and specificity of the finding of hemosiderin-laden macrophages (HLMs) in Bronchoalveolar Lavage in children. Objective To review data from Bronchoalveolar Lavage studies done in children to correlate the presence of HLMs with pneumonia and hemosiderosis and to determine what proportion of HLMs has the optimal sensitivity and specificity for the diagnosis of hemosiderosis. Design One hundred ten Bronchoalveolar Lavage specimens obtained via flexible bronchoscopy were reviewed retrospectively. The data collected for demographics, indication for the bronchoscopy, diagnosis of pneumonia, anemia, and bronchoscopy and Bronchoalveolar Lavage findings were compared between patients diagnosed with hemosiderosis and those diagnosed with other diseases. Results Six patients were diagnosed with hemosiderosis by clinical findings, lung biopsy, or autopsy. There were no statistical differences in pneumonia (P > .99), anemia (P > .99), or coughing (P = .08) between patients with hemosiderosis and other patients. Hemoptysis was the only symptom that was significantly different between the 2 groups (P = .04). The mean HLM index for patients with hemosiderosis was 56% +/- 16.17% and for other patients, 7.5% +/- 10.74% (P Conclusions These results confirm a strong association between HLM index and diagnosis of hemosiderosis in a pediatric population. Availability of this HLM index will result in accurate and timely diagnosis of pulmonary hemosiderosis, which may influence treatment and long-term prognosis.
Weidong Song - One of the best experts on this subject based on the ideXlab platform.
-
diagnostic value of galactomannan in Bronchoalveolar Lavage fluid for chronic respiratory disease with pulmonary aspergillosis
Journal of Clinical Microbiology, 2020Co-Authors: Guangbin Lai, Chao Zeng, Weidong SongAbstract:ABSTRACT The objective of this study was to explore the diagnostic value of the Bronchoalveolar Lavage fluid galactomannan (BALF GM) test for chronic respiratory disease with pulmonary aspergillosis and to establish the optimal cutoff value. Samples from a total of 309 chronic respiratory disease patients seen at the respiratory medicine department of Peking University Shenzhen Hospital from September 2016 to September 2019 were analyzed. According to the diagnostic criteria, we divided the patients into a case group (n = 79, comprising 25 proven cases and 54 probable cases) and a control group (n = 230). Bronchoalveolar Lavage fluid was collected, and the BALF GM test results were analyzed. A nonparametric rank sum test showed that the mean rank of the case group was 255.30, which was higher than that of the control group (120.55). The Z-value was −11.567 (P = 0.000), indicating that the general distributions of BALF GM differed between the two groups. A BALF GM cutoff value of 0.88 showed the highest diagnostic efficacy for pulmonary aspergillosis. The sensitivity, specificity, positive predictive value, and negative predictive value were 77.2%, 93%, 79.2%, and 92.2%, respectively. As the cutoff value increased, the specificity and sensitivity of the BALF GM test increased and decreased, respectively. The BALF GM test can be used confirm the diagnosis of patients with pulmonary aspergillosis and chronic respiratory disease. The optimum BALF GM cutoff value is 0.88.
-
diagnostic value of galactomannan in Bronchoalveolar Lavage fluid for chronic respiratory disease with pulmonary aspergillosis
bioRxiv, 2019Co-Authors: Guangbin Lai, Chao Zeng, Weidong SongAbstract:ABSTRACT Objective To explore the diagnostic value of the Bronchoalveolar Lavage fluid galactomannan (BALF GM) test for chronic respiratory disease with pulmonary aspergillosis, and establish the optimal cut-off value. Methods A total of 180 chronic respiratory disease patients seen at the Respiratory Medicine Department of Peking University Shenzhen Hospital from September 2017 to September 2018 were analyzed. According to the diagnostic criteria, we divided the patients into the case group (n = 70, comprising 5, 20, and 45 proven, probable, and possible cases, respectively) and the control group (n = 110). Bronchoalveolar Lavage fluid was collected, and the BALF GM test results were analyzed. Results A non-parametric rank-sum test showed that the mean rank of the case group was 140.80, which was higher than that of the control group (58.49). The Z-value was 10.335 (P = 0.000), indicating that the general distribution of BALF GM differed between the two groups. A BALF GM cut-off value of 0.485 showed the highest diagnostic efficacy for pulmonary aspergillosis. The sensitivity, specificity, positive predictive value, and negative predictive value were 92.9%, 100%, 92.8%, and 100%, respectively. As the cut-off value increased, the specificity and sensitivity of the BALF GM test increased and decreased, respectively. Conclusions The BALF GM test can be used confirm the diagnosis of patients with pulmonary aspergillosis and chronic respiratory disease. The optimum BALF GM cut-off value was 0.485. Antifungal therapy is important for treating pulmonary aspergillus infection in patients with chronic respiratory disease.
