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Biomedical subjects

A Agustí-Vidal

Publications and source records attributed to A Agustí-Vidal.

At least 19 recordsLinked to original sources
PubMed1990

[Antibody-coated bacteria and quantitative culture in sputum samples from patients with bronchiectasis].

The results of the quantitative culture of sputum samples from patients with bronchiectasis were compared with those obtained in the same samples with the detection of antibody-coated bacteria (ACB), in the acute phase of the disease (group I), after antibiotic therapy (group II), and in the phase of clinical stability (group III). In quantitative cultures at least one potentially pathogen species was isolated, at a concentration of greater than or equal to 10(6) colony forming units/ml in the 7 sputum samples from group I, in 4 of the 5 samples from group II, and in 10 of the 11 samples from group III. The immunofluorescence technique detected ACB in all samples from group I and group II, and in 10 of the 11 from group III. The sample from group III in which ACB were not detected was the same in which potentially pathogen organisms were not detected by culture.

Acute Disease↗
PubMed1989

[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↗
PubMed1989

[Treatment of atypical pneumonia with josamycin].

In the present study the clinical efficacy and tolerance of josamycin (1 g every 12 hours) was prospectively evaluated for the empirical therapy of patients below 70 years with community acquired pneumonia of atypical presentation (AP), without respiratory failure, radiological cavitation or risk factors of pharyngeal colonization by gram-negative bacilli. During a 28-month period 168 patients adequate for the study were included. The etiological diagnosis was established in 56 cases (33.3%); in 55 by seroconversion (28 Mycoplasma pneumoniae, 22 Legionella pneumophila, 1 Chlamydia psittaci and 4 Coxiella burnetii) and in only one case by positive blood culture (Streptococcus pneumoniae). The mean duration of therapy was 9 days and that of fever 1.4 days. Five patients (3%) had mild transient gastrointestinal complaints. No patient required a change of therapy. Relapses were not observed in the 45 days of follow up. In conclusion, josamycin (1 g/12 h p.o.) is an effective and well tolerated antibiotic for the therapy of pneumonia by M. pneumoniae or L. pneumophila, and it represents a good empirical treatment of AP in patients below 70 years without risk factors of GNB infection, respiratory failure or radiological cavitation.

Adolescent↗
PubMed1989

Incidence and etiology of pneumonia acquired during mechanical ventilation.

A total of 77 consecutive patients submitted to mechanical ventilation (MV) for greater than 48 h in a respiratory ICU (RICU) were studied to investigate the incidence, etiology, and consequences of ventilator-associated pneumonia. Eighteen (23%) patients developed a bacterial pneumonia after 5.6 +/- 1.0 days (mean +/- SEM; range 2 to 17) of MV. Three additional cases were demonstrated at autopsy, raising the incidence to 27%. Overall, the mean duration of MV increased from 9.7 +/- 0.9 to 32.2 +/- 5.1 days (p less than .0001) when pneumonia developed. A longer period of hospital stay before RICU admission and the presence of chronic obstructive pulmonary disease were significant characteristics of patients with pneumonia when compared to patients without nosocomial pulmonary infection. One or more etiological agents were identified in 14 patients from the pneumonia group by means of a highly specific technique (protected brush catheter, transthoracic needle aspiration, pleural fluid, and/or blood cultures). The predominant pathogens isolated were Gram-negative bacilli (Acinetobacter sp. and Pseudomonas sp.). Half of the cases were polymicrobial. Compared to other series, our results may reflect with more accuracy the actual incidence of nosocomial pneumonia in mechanically ventilated patients, since we used highly accurate techniques along with autopsy findings which allowed us to confirm or discard the diagnosis of bacterial pneumonia.

Cross Infection↗
PubMed1989

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↗
PubMed1989

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↗
PubMed1989

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↗
PubMed1988

Arnold-Chiari malformation and paralysis of the diaphragm.

A woman aged 17 years presented with symptoms of somnolence. A bilateral diaphragmatic paralysis and an Arnold-Chiari malformation were diagnosed. Lung function tests revealed a marked restrictive defect and a blunted ventilatory response to hypercapnia and hypoxia. A sleep study also showed central apneas, an irregular pattern of breathing and marked hypoventilation.

Adolescent↗
PubMed1988

Nosocomial pneumonia. A multivariate analysis of risk and prognosis.

One hundred and twenty consecutive episodes of nosocomial pneumonia (NP) in 118 nonneutropenic adults admitted to a 1,000-bed teaching hospital were studied in order to investigate the prognosis and risk factors. The overall fatality rate was 36.6 percent. The identification of a "high-risk" microorganism (Pseudomonas aeruginosa, Enterobacteriaceae, and other Gram-negative bacilli, Streptococcus faecalis, Staphylococcus aureus, Candida sp, Aspergillus sp, and episodes of polymicrobial pneumonia), bilateral involvement on chest x-ray examination, the presence of respiratory failure, inappropriate antibiotic therapy, and age older than 60 years or an underlying condition ultimately or rapidly fatal were those factors selected by a stepforward logistic regression analysis as independently worsening the prognosis. A series of variables frequently quoted as predisposing to NP was determined to be either present or absent in the same 120 cases of NP and in an equal number of randomly selected control subjects. After adjusting for confounding, factors significantly predisposing to NP were tracheal intubation, depressed level of consciousness, underlying chronic lung disease, thoracic or upper abdominal surgery, prior episode of a large volume aspiration, and age older than 70 years. Since some of the factors influencing the risk or the prognosis of NP are amenable to medical intervention, a percentage of NP might be prevented and its prognosis can be improved.

Adult↗
PubMed1987

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↗
PubMed1987

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↗