Pulmonary & Respiratory Medicine

ISSN: 2161-105X

Open Access

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      Research Pages: 1 - 5

      Systemic Inflammatory Markers in Stable Chronic Obstructive Pulmonary Disease

      Marina Bahl*, Júlia Salvan da Rosa, Tânia Silvia Fröde, and Rosemeri Maurici

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      Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous lung disease featured by persistent respiratory symptoms, as well as by significantly increased inflammatory response capable of causing progressive and persistent obstruction of the airways. Investigating the incidence of systemic inflammatory mediators in stable COPD patients and their association with smoking habit, comorbidities, BMI, spirometry classification, as well as with COPD symptoms and risk of exacerbations and/or COPD-associated hospitalizations. Methods: Cytokine levels were measured through flow cytometry, whereas the levels of enzymes, such as myeloperoxidase and adenosine deaminase, as well as of nitric oxide metabolites, were measured through colorimetric methods applied to patients’ peripheral blood serum. Patients were mostly men, smokers, with comorbidities and presented mean age of 65.8 years. Significant association of IL-17A, TNF-α, IFN-γ and IL4 levels with active smokers was observed, as well as significantly increased IL-10 levels in former smokers. TNF-α levels have shown significant association with BMI, with higher IL-2 levels in obese patients than in overweight patients, as well as with higher IL-17A levels in obese patients than in those with normal BMI. The group of patients without comorbidities recorded significant increase in IL-2, IL-4, IL-10, TNF-α and IFN-γ - with emphasis on IL-2 and IL-4 - in comparison to the group with comorbidities. However, no association among inflammatory markers, lung function, COPD symptoms and risk of exacerbations/COPD-associated hospitalizations was observed. Conclusion: The current study has evidenced incidence of systemic inflammation in patients with stable COPD and its association with smoking habit, comorbidities and high BMI.

      Research Article Pages: 1 - 5

      A Study of 99 Broncho-Alveolar Lavages in Lower Respiratory Tract Infections Patients

      Ankit Kumar*, Laxmi Devi, Yogendra Narayan Verma, Shubham Chandra, Shivanki Agarwal and Parul Sharma

      DOI: 10.37421/2161-105X. 2023.13.655

      Introduction: LRTIs are a common cause of death in both children and adults worldwide. It has significant burden on healthcare resources. These infections can be caused by a variety of microorganisms, including bacteria, viruses, fungi, and parasites. The diagnosis of LRTIs can be challenging, as the symptoms can be nonspecific and the underlying cause can be multifactorial. Bronchoscopy allows the identification and management of LRTIs by allowing for the collection of lower respiratory tract specimens for microbiological evaluation. Bronchoscopy can provide valuable information about the diagnosis and management of LRTIs, as it can provide valuable information about the underlying pathology and the causative organism. The aim of this study is to investigate 99 broncho-alveolar lavages in LRTI patients, with a focus on broncho-alveolar lavage acid fast bacilli smear and gram stain culture sensitivity.

      Methods: This study retrospectively analysed the bronchoscopy findings and microbiological profile of 99 patients with suspected LRTIs who underwent bronchoscopy at our institution.

      Results: Out of the 99 patients included in the study, 59 underwent AFB smear evaluation for mycobacterium tuberculosis. Out of 59 patients, 40 patients tested negative for tuberculosis, while 19 patients were positive.

      Out of 99 patients, 39 had no organisms grow in their BAL fluid culture, indicating that their pneumonia may have been caused by non-infectious factors such as aspiration or other non-infectious causes. However, 43 patients had positive cultures, with Klebsiella and Pseudomonas being the most common bacterial species identified. Fungal culture evaluation was performed in 17 patients, and only one patient was positive for aspergillus. Biopsy specimens were collected in 16 patients, with squamous cell carcinoma being the most common finding. This suggests that some cases of pneumonia may be caused by underlying malignancies, which may have been missed by other diagnostic methods.

      Conclusion: In conclusion, the results of this study indicate that bronchoscopy is a valuable diagnostic tool for evaluating lower respiratory tract infections. The study also highlights the prevalence of tuberculosis and bacterial species. Furthermore, the study suggests that some cases of pneumonia may be caused by non-infectious factors such as aspiration, as well as underlying malignancies such as squamous cell carcinoma and adenocarcinoma. These findings highlight the importance of a comprehensive diagnostic approach to identify the underlying cause of pneumonia and guide appropriate treatment.

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