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Biomedical subjects

Jeffrey S Klein

Publications and source records attributed to Jeffrey S Klein.

6 recordsLinked to original sources
PubMed2005

Computed tomography correlates with pulmonary exacerbations in children with cystic fibrosis.

RATIONALE: High-resolution computed tomography (HRCT) has been suggested as a potential outcome surrogate for cystic fibrosis (CF) lung disease. An important attribute of a valid outcome surrogate is that the surrogate reflects true clinical outcomes. OBJECTIVES: We performed this study to validate HRCT, a proposed surrogate outcome measure for CF lung disease, against a true clinical outcome, the number of respiratory tract exacerbations occurring in 2 yr, and to assess the correlation of CT scores and pulmonary function tests (PFTs) with this clinical outcome. METHODS: CTs and PFTs were performed on 6- to 10-yr-old children at the beginning and end of a 2-yr study during which the number of exacerbations were recorded. Spearman correlations and Poisson models were used to assess the correlation of the number of exacerbations with baseline values and changes in PFTs and CT scores. MEASUREMENTS AND MAIN RESULTS: Nine of 61 subjects had a total of 22 respiratory tract exacerbations. At baseline, PFTs and four CT scores showed significant correlation with number of exacerbations, but no variable by itself predicted exacerbations with high accuracy. For change over the 2-yr period, three CT scores showed significant correlation with exacerbations, whereas no PFTs showed significant correlation. CONCLUSION: This is the first study showing correlation between CT and a true clinical outcome. Change in CT scores correlates moderately well with the number of exacerbation. Poor correlation between change in FEV1 and exacerbations suggests that HRCT may be a more appropriate outcome surrogate for longitudinal studies of young children.

Anti-Bacterial Agents↗
PubMed2004

High-resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests.

OBJECTIVE: To assess pulmonary abnormalities detected by high-resolution computed tomography (HRCT) in young children with cystic fibrosis (CF) and mild to moderate lung disease. STUDY DESIGN: High-resolution computed tomography was performed in 60 children, 6 to 10 years old, with mild to moderate lung disease (forced expiratory volume in 1 minute [FEV(1)], 52-137; mean, 102; SD, 15% predicted). HRCTs were scored by using a system that evaluates each lobe for severity and extent of CF lung disease. Findings of CF lung disease were tabulated in all subjects and in a subgroup with normal pulmonary function tests. HRCT scores were correlated with FEV(1), forced vital capacity (FVC), and forced expiratory flow between 25% and 75% of expired vital capacity (FEF(25-75)) in 57 patients. RESULTS: Bronchiectasis was present in 35% of subjects, mucous plugging in 15%, and air trapping in 63%. No abnormality was detected in 25%. In 37 subjects with FEV(1), FVC, and FEF(25-75) >85% predicted, bronchiectasis was present in 30%. In 17% of these subjects, bronchiectasis was seen in > or =4 lobes. Correlations between HRCT scores and FEV(1) were significant and showed fair to moderate correlation (r=0.36-0.46). CONCLUSIONS: High-resolution computed tomography demonstrated a broad range of pulmonary abnormalities in young patients with CF with mild to moderate lung disease. In this study, abnormalities, including bronchiectasis, were common in young children with CF and normal pulmonary function tests.

Bronchiectasis↗
PubMed2004

Granulomatous chest disease following intravesical bacillus Calmette-Guerin immunotherapy.

Bacillus Calmette-Guerin (BCG) is well accepted as an intravesicular method of treatment of bladder cancer. Although well tolerated in the majority of patients, adverse local and systemic adverse effects of this therapy have been described. In particular, lung disease complicating intravesicular use of BCG has been reported, producing 5 recognized forms of chest disease: 1) allergic interstitial lung disease, 2) miliary infection, 3) empyema, 4) diffuse alveolar damage, and 5) localized consolidative or cavitary lung disease. We report an asymptomatic form of pulmonary disease complicating intravesical BCG therapy, that of pulmonary granulomas with mediastinal and hilar lymph node enlargement.

Aged↗
PubMed2002

The solitary pulmonary nodule.

The radiologic evaluation of the solitary pulmonary nodule (SPN) is a common diagnostic dilemma. Although available clinical data and findings on conventional radiographs are important components in determining the imaging approach to the SPN, evaluation with CT often is necessary for detailed evaluation. This article reviews the radiologist's approach to the evaluation of the SPN, with a particular focus on the role of thin-section CT for morphologic and density analysis. The relative use of contrast-enhanced CT and nuclear medicine, particularly positron emission tomography, in detecting nodule enhancement is discussed. If the use of low-dose helical CT for screening for early lung cancer in the form of a SPN becomes widespread practice, it is likely that radiologists will encounter an increasing number of smaller SPNs in the near future.

Adult↗