Inflammatory mediators in BAL fluid as markers of evolving pneumonia in leukocytopenic patients.


STUDY OBJECTIVES:Pneumonia during chemotherapy-induced leukocytopenia is a major cause of overall treatment failure in patients with hematologic malignancies. To improve outcome in these high-risk patients, early diagnosis of pulmonary infiltrates and institution of adequate antimicrobial treatment are mandatory. To identify patients with evolving pneumonia, we have prospectively studied the prognostic value of cytokine and complement measurements in early BAL samples from febrile leukocytopenic patients. DESIGN:Prospective, comparative study. SETTING:Hematology/oncology section of a university hospital. PATIENTS:Twenty-one patients with leukocytopenia (WBC count < 1.000/microL) following cytoreductive chemotherapy for malignant disorders. INTERVENTION:Early BAL sampling primarily for microbiologic diagnostic purposes. MEASUREMENTS AND RESULTS:Proinflammatory cytokines and activated complement components were measured in the BAL aspirates and the results were related to the prevalence or subsequent evolution of overt pneumonia. Of the 21 patients studied, 10 patients presented with overt pneumonia at BAL sampling (group A), 5 patients developed objective signs of pneumonia 3 to 5 days after BAL (group B), and 6 patients remained free of pneumonia during follow-up (group C). In comparison with group C, patients in groups A and B both had distinctly elevated bronchoalveolar levels of tumor necrosis factor-alpha, interleukin-6, granulocyte colony-stimulating factor, C3a, and C5a. CONCLUSIONS:Cytokine and complement determinations in early BAL samples may aid in the identification of febrile leukocytopenic patients with evolving pneumonia 3 to 5 days prior to the manifestation of diagnostic clinical and radiographic signs.






Kiehl MG,Ostermann H,Thomas M,Birkfellner T,Kienast J




Has Abstract


1997-11-05 00:00:00
















  • Soluble leukocyte selectin in the analysis of pleural effusions.

    abstract:STUDY OBJECTIVES:To determine if soluble leukocyte selectin (sL-selectin) levels in serum and pleural fluid (PF) are an inflammatory marker that differentiates pleural effusion transudates from exudates. DESIGN:sL-selectin PF and serum levels were measured in consecutive patients and compared to established criteria. ...


    pub_type: 杂志文章


    authors: Horvath LL,Gallup RA,Worley BD,Merrill GA,Morris MJ

    更新日期:2001-08-01 00:00:00

  • A Longitudinal Cohort Study of Aspirin Use and Progression of Emphysema-like Lung Characteristics on CT Imaging: The MESA Lung Study.

    abstract:BACKGROUND:Platelet activation reduces pulmonary microvascular blood flow and contributes to inflammation; these factors have been implicated in the pathogenesis of COPD and emphysema. We hypothesized that regular use of aspirin, a platelet inhibitor, would be associated with a slower progression of emphysema-like lung...


    pub_type: 杂志文章,多中心研究


    authors: Aaron CP,Schwartz JE,Hoffman EA,Angelini E,Austin JHM,Cushman M,Jacobs DR Jr,Kaufman JD,Laine A,Smith LJ,Yang J,Watson KE,Tracy RP,Barr RG

    更新日期:2018-07-01 00:00:00

  • Variability in lung collagen amounts after prolonged support of acute respiratory failure.

    abstract::In order to identify correlates of fibrosis in acute respiratory failure, autopsies were performed on 16 patients who died after an episode of more than two weeks' duration, and the left lower lung lobe was obtained for biochemical measurements. The average amount of lobar collagen in one group of patients was nearly ...


    pub_type: 杂志文章


    authors: Collins JF,Smith JD,Coalson JJ,Johanson WG Jr

    更新日期:1984-05-01 00:00:00

  • Budesonide/formoterol maintenance plus reliever therapy: a new strategy in pediatric asthma.

    abstract:OBJECTIVES:A fixed combination of long-acting beta(2)-agonists (LABA) plus inhaled corticosteroids (ICS) has never been proven to reduce asthma exacerbations vs ICS alone in children. This 12-month, double-blind, randomized study in 341 children (age range, 4 to 11 years) with asthma uncontrolled on ICS investigated wh...


    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Bisgaard H,Le Roux P,Bjåmer D,Dymek A,Vermeulen JH,Hultquist C

    更新日期:2006-12-01 00:00:00

  • Characteristics of airway inflammation and bronchodilator reversibility in COPD: a potential guide to treatment.

    abstract:STUDY OBJECTIVES:The management of stable patients with COPD depends on the severity of symptoms and airflow limitation. Regarding inflammation, corticosteroids are the only medications that are recommended for use, and only under restricted circumstances. Corticosteroids tend to undertreat or overtreat patients with C...


    pub_type: 杂志文章


    authors: Perng DW,Huang HY,Chen HM,Lee YC,Perng RP

    更新日期:2004-08-01 00:00:00

  • The potential for bronchoscopic lung volume reduction using bronchial prostheses: a pilot study.

    abstract:STUDY OBJECTIVES:Significant morbidity and mortality offset the benefits of lung volume reduction surgery (LVRS) for emphysema. By contributing to distal lung collapse, bronchoscopic placement of valved prostheses has the potential to noninvasively replicate the beneficial effects of LVRS. The purpose of this study was...


    pub_type: 杂志文章


    authors: Snell GI,Holsworth L,Borrill ZL,Thomson KR,Kalff V,Smith JA,Williams TJ

    更新日期:2003-09-01 00:00:00

  • O2 uptake kinetics in response to exercise. A measure of tissue anaerobiosis in heart failure.

    abstract::Oxygen uptake (VO2) reflects the rate of aerobic regeneration of high-energy phosphate compounds (primarily adenosine triphosphate [ATP]). Since lactate increase is thought to result from an inadequate rate of aerobic ATP regeneration, it might be expected that lactate increase would be associated with a delayed attai...


    pub_type: 杂志文章


    authors: Zhang YY,Wasserman K,Sietsema KE,Ben-Dov I,Barstow TJ,Mizumoto G,Sullivan CS

    更新日期:1993-03-01 00:00:00

  • Prevalence rates of asthma in developing countries and their comparison with those in Europe and North America.

    abstract::Prevalence rates for asthma in various parts of the world are different and this cannot be entirely explained by differences in methodology. Low prevalence rates are found in third world countries, particularly marked for children. The reasons for these differences are obscure but are largely environmental. Some sugge...


    pub_type: 杂志文章


    authors: Cookson JB

    更新日期:1987-06-01 00:00:00

  • Bronchial adenoma. Clinicopathologic study and results of treatment.

    abstract::Among 1,700 primary tumors of the lung, there were 53 cases of bronchial adenoma (3.1 percent); 38 (72 percent) of the 53 were typical carcinoids, and the remaining 15 were of a higher grade of malignant neoplasm. There was a slight predominance of female patients, and the age of greatest incidence was between 30 and ...


    pub_type: 杂志文章


    authors: de Lima R

    更新日期:1980-01-01 00:00:00

  • The Master Settlement Agreement and its impact on tobacco use 10 years later: lessons for physicians about health policy making.

    abstract::The issue of tobacco industry responsibility for population health problems and compensation for their treatment has been growing since the 1960s. In 1999, the state attorneys general collectively launched the largest class action lawsuit in US history and sued the tobacco industry to recover the costs of caring for s...


    pub_type: 杂志文章,评审


    authors: Jones WJ,Silvestri GA

    更新日期:2010-03-01 00:00:00

  • Effects of the Combination of Atomoxetine and Oxybutynin on OSA Endotypic Traits.

    abstract:BACKGROUND:We recently showed that administration of the combination of the noradrenergic drug atomoxetine plus the antimuscarinic oxybutynin (ato-oxy) prior to sleep greatly reduced OSA severity, likely by increasing upper airway dilator muscle activity during sleep. In patients with OSA who performed the ato-oxy tria...


    pub_type: 杂志文章


    authors: Taranto-Montemurro L,Messineo L,Azarbarzin A,Vena D,Hess LB,Calianese NA,White DP,Wellman A,Sands SA

    更新日期:2020-06-01 00:00:00

  • Safety and efficacy of two courses of OM-85 BV in the prevention of respiratory tract infections in children during 12 months.

    abstract:BACKGROUND:Acute respiratory tract infections (ARTIs) are among the main causes of morbidity and mortality in children. The bacterial extract OM-85 BV (bronchovaxom) has shown protective effect for ARTIs on children. We report a double-blind, placebo-controlled, parallel, prospective clinical trial to assess the safety...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Gutiérrez-Tarango MD,Berber A

    更新日期:2001-06-01 00:00:00

  • Effect of preoperative renin-angiotensin system blockade on hypertension following coronary surgery.

    abstract::Renin-angiotensin system activation is suspected of being involved in postcoronary surgery hypertension, but appears to be useful in maintaining blood pressure during anesthesia and cardiopulmonary bypass. To clarify these points, 19 patients were compared: ten as a control group and nine who received captopril during...


    pub_type: 杂志文章


    authors: Colson P,Grolleau D,Chaptal PA,Ribstein J,Mimran A,Roquefeuil B

    更新日期:1988-06-01 00:00:00

  • How Health-Care Organizations Implement Shared Decision-making When It Is Required for Reimbursement: The Case of Lung Cancer Screening.

    abstract:BACKGROUND:The Centers for Medicare and Medicaid Services stipulate shared decision-making (SDM) counseling as a prerequisite to lung cancer screening (LCS) reimbursement, despite well-known challenges implementing SDM in practice. RESEARCH QUESTION:How have health-care organizations implemented SDM for LCS? STUDY DE...


    pub_type: 杂志文章


    authors: Alishahi Tabriz A,Neslund-Dudas C,Turner K,Rivera MP,Reuland DS,Elston Lafata J

    更新日期:2021-01-01 00:00:00

  • CPR and postarrest care: overview, documentation, and databases.

    abstract::It is estimated that 350,000 people suffer a cardiac arrest each year in the United States, with one-half occurring out-of-hospital and the other half in-hospital. Overall survival is < 10% and has not changed significantly for decades. CPR is the umbrella term for attempts to restore organized cardiac contractility a...


    pub_type: 杂志文章,评审


    authors: Gaieski DF,Abella BS,Goyal M

    更新日期:2012-04-01 00:00:00

  • A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria.

    abstract:BACKGROUND:In chronic obstructive pulmonary disease, both smaller and larger airways are affected. FEV1 mainly reflects large airways obstruction, while the later fraction of forced exhalation reflects reduction in terminal expiratory flow. In this study, the objective was to evaluate the relationship between spirometr...


    pub_type: 杂志文章


    authors: Dilektasli AG,Porszasz J,Casaburi R,Stringer WW,Bhatt SP,Pak Y,Rossiter HB,Washko G,Castaldi PJ,Estepar RSJ,Hansen JE,COPDGene investigators.

    更新日期:2016-11-01 00:00:00

  • The Neurokinin-1 Receptor Antagonist Orvepitant Is a Novel Antitussive Therapy for Chronic Refractory Cough: Results From a Phase 2 Pilot Study (VOLCANO-1).

    abstract:BACKGROUND:Substance P and the neurokinin-1 (NK-1) receptor are implicated in chronic refractory cough pathophysiology. We assessed the efficacy and safety of orvepitant, a brain-penetrant NK-1 antagonist, in an open-label study in CRC patients with chronic refractory cough. METHODS:Thirteen patients with daytime coug...


    pub_type: 杂志文章,随机对照试验


    authors: Smith J,Allman D,Badri H,Miller R,Morris J,Satia I,Wood A,K Trower M

    更新日期:2020-01-01 00:00:00

  • The effect of glucagon on the pulmonary transvascular fluid filtration rate.

    abstract::Administration of glucagon has been shown to decrease pulmonary vascular resistance, but its primary site of action is undetermined. Whether this is on the arterial or venous side of the capillary would be reflected in the microvascular hydrostatic pressure. We used the pulmonary flow of lymph, a sensitive index of th...


    pub_type: 杂志文章


    authors: Demling RH,Manohar M,Will J

    更新日期:1978-08-01 00:00:00

  • Work disability among adults with asthma.

    abstract:OBJECTIVE:To estimate the incidence of work disability among adults with asthma and to evaluate a clinically based illness severity score as a predictor of such disability. DESIGN:Baseline and follow-up telephone interviews and medical record review. SETTING:University-based outpatient pulmonary specialty practice. ...


    pub_type: 杂志文章


    authors: Blanc PD,Jones M,Besson C,Katz P,Yelin E

    更新日期:1993-11-01 00:00:00

  • The role of computer games in measuring spirometry in healthy and "asthmatic" preschool children.

    abstract:STUDY OBJECTIVES:To explore the role of respiratory interactive computer games in teaching spirometry to preschool children, and to examine whether the spirometry data achieved are compatible with acceptable criteria for adults and with published data for healthy preschool children, and whether spirometry at this age c...


    pub_type: 杂志文章


    authors: Vilozni D,Barak A,Efrati O,Augarten A,Springer C,Yahav Y,Bentur L

    更新日期:2005-09-01 00:00:00

  • Miliary PCP in AIDS.

    abstract::The most frequent radiographic presentation of (PCP) is bilateral interstitial or alveolar infiltrates. Atypical features include lobar distribution, pleural effusions, hilar adenopathy, cyst formation and spontaneous pneumothorax. A diffuse miliary pattern has not been described previously for PCP. A 30-year-old male...


    pub_type: 杂志文章


    authors: Wasser LS,Brown E,Talavera W

    更新日期:1989-09-01 00:00:00

  • Characterization of the clonidine receptor site.

    abstract::At the cardiac sympathetic nerve terminal the alpha 2-adrenoceptor is presynaptic and appears to be located at an extrasynaptic site. This is suggested by (1) absence of evidence of autoinhibitory feedback at physiologic stimulus levels up to about 50 percent of the maximum chronotropic response in the isolated guinea...


    pub_type: 杂志文章


    authors: Korner PI,Angus JA,Lew MJ,Heinzow BG

    更新日期:1983-02-01 00:00:00

  • Allograft colonization and infections with pseudomonas in cystic fibrosis lung transplant recipients.

    abstract:OBJECTIVE:To assess the incidence of pseudomonal infection, colonization, and inflammation in the allograft of lung transplant recipients with cystic fibrosis (CF) as compared with recipients with other end-stage lung disease. DESIGN:Retrospective review. SETTING:University medical center transplant service. PATIENT...


    pub_type: 杂志文章


    authors: Nunley DR,Grgurich W,Iacono AT,Yousem S,Ohori NP,Keenan RJ,Dauber JH

    更新日期:1998-05-01 00:00:00

  • Diagnosis of pneumothorax by ultrasound immediately after ultrasonically guided aspiration biopsy.

    abstract::We report two cases of pneumothorax detected by echographic examination immediately after ultrasonically guided aspiration biopsy and confirmed by chest x-ray film. The pneumothorax was characterized by the disappearance of the lung tumor. In the real-time image, the respiratory excursions of the visceral pleura also ...


    pub_type: 杂志文章


    authors: Targhetta R,Bourgeois JM,Chavagneux R,Balmes P

    更新日期:1992-03-01 00:00:00

  • Esophageal pressure measurements in cardiopulmonary exercise testing.

    abstract:STUDY OBJECTIVES:We sought to determine the adaptability and effectiveness of a new esophageal balloon technique to measure changes in esophageal pressure (Pes) as a reflection of pleural pressure with progressive incremental exercise testing in normal subjects. DESIGN:An 8F (0.9 cm) esophageal balloon catheter (Smart...


    pub_type: 杂志文章


    authors: Thomas AM,Turner RE,Tenholder MF

    更新日期:1997-09-01 00:00:00

  • Echocardiographic diagnosis of intraventricular clot.

    abstract::The literature contains many reports of the echocardiographic findings in left atrial myxoma and clot; however, descriptions of left ventricular thrombus or tumor are rare. We discuss here the echocardiographic findings in a patient with a large apical left ventricular thrombus which was confirmed both angiographicall...


    pub_type: 杂志文章


    authors: DeJoseph RL,Shiroff RA,Levenson LW,Martin CE,Zelis RF

    更新日期:1977-03-01 00:00:00

  • Lipid mediator dysregulation in primary pulmonary hypertension.

    abstract::The characteristic arteriopathy of primary pulmonary hypertension (PPH) with attendant endothelial dysfunction provides an opportunity for enhanced cellular activation in the lung. Data from many laboratories support the concept of altered eicosanoid metabolism in PPH. Rigorously quantitative measurements of the excre...


    pub_type: 杂志文章,评审


    authors: Christman BW

    更新日期:1998-09-01 00:00:00

  • A Randomized Trial of Initiation of Chronic Noninvasive Mechanical Ventilation at Home vs In-Hospital in Patients With Neuromuscular Disease and Thoracic Cage Disorder: The Dutch Homerun Trial.

    abstract:BACKGROUND:There is an increasing demand for home mechanical ventilation (HMV) in patients with chronic respiratory insufficiency. At present, noninvasive ventilation is exclusively initiated in a clinical setting at all four centers for HMV in the Netherlands. In addition to its high societal costs and patient discomf...


    pub_type: 杂志文章


    authors: van den Biggelaar RJM,Hazenberg A,Cobben NAM,Gaytant MA,Vermeulen KM,Wijkstra PJ

    更新日期:2020-12-01 00:00:00

  • Hypercapnic ventilatory response in patients with and without obstructive sleep apnea: do age, gender, obesity, and daytime PaCO(2) matter?

    abstract:STUDY OBJECTIVE:To evaluate the relationship between obstructive sleep apnea (OSA) and ventilatory responsiveness to carbon dioxide in both men and women. DESIGN:An analysis of 219 patients referred to an university-based sleep center between 1989 to 1994 was conducted (104 with OSA and 115 without OSA; 43 women and 1...


    pub_type: 杂志文章


    authors: Sin DD,Jones RL,Man GC

    更新日期:2000-02-01 00:00:00

  • Closure of a tracheoesophageal fistula by bronchoscopic application of fibrin glue and decontamination of the oral cavity.

    abstract::A tracheoesophageal fistula was successfully closed with a fibrin adhesive applied by means of a fiberoptic bronchoscope, instead of by esophagoscopy. To facilitate closure of the fistula, the technique was combined with decontamination of the oral cavity, to avoid bacterial contamination. The procedure is proposed as...


    pub_type: 杂志文章


    authors: Antonelli M,Cicconetti F,Vivino G,Gasparetto A

    更新日期:1991-08-01 00:00:00