Background And Objective: Sarcoidosis can manifest with atypical findings on chest computed tomography (CT). Cysts are a rare manifestation of lung sarcoidosis. The aim of the study was to describe a series of patients with cystic sarcoidosis and their clinical-radiological characteristics and progression.
View Article and Find Full Text PDFIdiopathic pulmonary fibrosis (IPF), the most lethal form of interstitial pneumonia of unknown cause, is associated with a specific radiological and histopathological pattern (the so-called "usual interstitial pneumonia" pattern) and has a median survival estimated to be between 3 and 5 years after diagnosis. However, evidence shows that IPF has different clinical phenotypes, which are characterized by a variable disease course over time. At present, the natural history of IPF is unpredictable for individual patients, although some genetic factors and circulating biomarkers have been associated with different prognoses.
View Article and Find Full Text PDFAm J Respir Crit Care Med
May 2019
Lung volume reduction (LVR) procedures for emphysematous patients were firstly introduced in the second half of the twentieth century. Over time, from the first invasive surgical procedures, new less invasive techniques have been conceived. In regards to the surgical approach, the adoption of VATS and the execution, in selected centers, of a non-resectional approach, with folding of less functional lung tissue, reduced mortality and adverse events risks.
View Article and Find Full Text PDFChronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease.
View Article and Find Full Text PDFDuring the past decades, a growing interest has been raised in evaluating nontuberculous mycobacteria (NTM) in patients with noncystic fibrosis bronchiectasis (NCFBE). This paper reviews several aspects of the correlations between NTM and NCFBE, including pathogenesis, radiological features, diagnosis, and management. Bronchiectasis and NTM lung disease are connected, but which one comes first is still an unresolved question.
View Article and Find Full Text PDFBackground: Diffuse alveolar haemorrhage (DAH) has been rarely reported in association with pulmonary infections.
Case Presentation: We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. Chest imaging showed bilateral ground glass opacities.
Background: Interferon-gamma (IFN-gamma) release assays (IGRAs) were designed to detect latent tuberculosis infection (LTBI). However, discrepancies were found between the tuberculin skin test (TST) and IGRAs results that cannot be attributed to prior Bacille Calmètte Guerin vaccinations. The aim of this study was to evaluate tools for improving LTBI diagnosis by analyzing the IFN-gamma response to RD1 proteins in prolonged (long-term response) whole blood tests in those subjects resulting negative to assays such as QuantiFERON-TB Gold In tube (QFT-IT).
View Article and Find Full Text PDFDespite advances in diagnosis and treatment, Mycobacterium tuberculosis causes active disease in about 8 million people worldwide annually. The study of the interplay between the host and the pathogen at the site of infection in human TB may contribute to elucidate the pathogenesis of the disease. In this work, using macroarray technology and real-time PCR, we analyzed the modulation of 847 genes encoding immune-inflammatory mediators in BALF samples of patients affected by active pulmonary TB (PTB) and control patients affected by non-TB diseases.
View Article and Find Full Text PDFNocardiosis is a rare and potentially life-threatening infection caused by several species of the Nocardia genus. Most cases occur in immunocompromised patients, and a delay in establishing the diagnosis is common due to the non-specific clinical presentations and the difficulty in cultivating Nocardia. Although the majority of pulmonary nocardiosis cases are caused by Nocardia asteroides, cases of human infection due to N.
View Article and Find Full Text PDFInt J Tuberc Lung Dis
February 2006
Setting: Division of respiratory medicine in a specialised infectious disease hospital in Rome, Italy.
Objective: Retrospective evaluation of tuberculosis (TB) care associated costs in an integrated in- and out-patient management programme.
Design: Review of the medical records of 92 human immunodeficiency virus negative TB cases admitted between September 2000 and May 2003.
Innate and adaptive immunity plays a critical role in the defence of the lung and other mucosal surfaces exposed to micro-organisms. Anti-microbial peptides and proteins, cytokines and chemokines are important immune weapons as they build up the protective front for the respiratory tract. The notion that susceptibility to infectious diseases may be inherited is widely accepted and, as it is the failure to activate adaptive immunity that may allow infection to become established and progress toward invasion and dissemination, the recognition of specific gene defects affecting the ability of the immune system to overcome invading pathogens may shed light upon those mechanisms of immune regulation that are playing the most critical roles.
View Article and Find Full Text PDFNonsyncytium inducing, macrophage tropic HIV strains predominate in the course of active tuberculosis (TB). The present study assesses the expression of CCR5 in CD4+ T-lymphocytes from blood and bronchoalveolar lavage (BAL) of TB patients, non-TB lung disease controls and healthy controls. Memory (CD45RO+), recently activated (CD69+), proliferating (Ki67+) CCR5+ or CCR3+ CD4+ T-lymphocytes were determined by multiparametric flow cytometry analysis.
View Article and Find Full Text PDFWe report a case of late-onset pulmonary fibrosis involving the upper lobes that occurred in a young man treated with bleomycin for mediastinal germ-cell carcinoma. The parenchymal lesions became clinically apparent about two years after chemotherapy had been completed, with a slowly progressive course and sparing the lower lung fields during follow-up. Other possible diagnoses could be excluded on the basis of the patient's clinical history, laboratory tests and pathological findings.
View Article and Find Full Text PDFBackground: The aim of the study was to evaluate the reliability of bronchoalveolar lavage in the routine clinical assessment of patients with sarcoidosis.
Study Design: retrospective analysis.
Setting: 2 Divisions of Respiratory Medicine, both in the context of a public general hospital (Ospedale Morelli, Sondalo, Italy and Ospedale Civile, Piacenza, Italy).
Background: Eosinophils and T lymphocytes represent constant features in the airways of subjects with exacerbated chronic bronchitis. Eotaxin is the most potent and selective eosinophil chemoattractant which can also attracts lymphocytes. The aim of the study was to evaluate the expression of eotaxin and its receptor, CCR3, in bronchial airways during exacerbation of chronic bronchitis.
View Article and Find Full Text PDFSarcoidosis Vasc Diffuse Lung Dis
March 1999
We report a case of sarcoidosis, occurred in a patient with chronic lymphocytic leukemia (CLL) shortly following the completion of initial chemotherapy, who relapsed shortly after a second course. Since bronchoalveolar lavage (BAL) demonstrated a predominance of CD4+ lymphocytes, it largely excluded spread of the malignant disorder to the lung, and strongly suggested that sarcoidosis was the cause of the pulmonary infiltrates. This diagnosis was confirmed by the finding of non-caseating granuloma on transbronchial lung biopsy.
View Article and Find Full Text PDFWe present a case of diffuse alveolar damage (DAD) that occurred in a male aged 68 yrs treated with gemcitabine, a novel antineoplastic agent, that was given for hepatic relapse of a previously resected non-small cell lung cancer. The patient developed acute respiratory failure after the sixth drug dose, and died 4 days after admission. Autopsy revealed a pattern of DAD.
View Article and Find Full Text PDFThe objective of the study was to compare the safety and efficacy of cefepime and ceftazidime in the treatment of community acquired lower respiratory tract infections of moderate intensity. Eighty-six patients were randomized at a 2:1 ratio to receive respectively cefepime 1 g b.i.
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