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  1. Article ; Online: The Added Value of Bronchoalveolar Lavage for Pulmonary Tuberculosis Diagnosis in High-Risk Hospitalized Patients with Negative Sputum Samples.

    Freund, Ophir / Hadad, Yitzhac / Lagziel, Tomer / Friedman Regev, Inbal / Kleinhendler, Eyal / Unterman, Avraham / Bar-Shai, Amir / Perluk, Tal Moshe

    Advances in respiratory medicine

    2023  Volume 92, Issue 1, Page(s) 15–24

    Abstract: Hospitalized patients with a high suspicion of pulmonary tuberculosis (HS-PTB) are isolated until a definite diagnosis can be determined. If doubt remains after negative sputum samples, bronchoscopy with bronchoalveolar lavage (BAL) is often sought. ... ...

    Abstract Hospitalized patients with a high suspicion of pulmonary tuberculosis (HS-PTB) are isolated until a definite diagnosis can be determined. If doubt remains after negative sputum samples, bronchoscopy with bronchoalveolar lavage (BAL) is often sought. Still, evidence of the added value of BAL in this patient population is scarce. To address this issue, we included consecutive HS-PTB patients with negative sputum samples who underwent BAL between 2017 and 2018. Chest X-rays (CXR) and CT scans were evaluated by a chest radiologist blind to the final diagnosis. Independent predictors for PTB were assessed by multivariate regression, using all positive PTB patients between 2017 and 2019 (by sputum or BAL) as a control group (
    MeSH term(s) Humans ; Female ; Adult ; Middle Aged ; Male ; Mycobacterium tuberculosis ; Sputum ; Bronchoalveolar Lavage Fluid ; Sensitivity and Specificity ; Tuberculosis, Pulmonary/diagnostic imaging ; Bronchoalveolar Lavage ; Dimercaprol
    Chemical Substances Dimercaprol (0CPP32S55X)
    Language English
    Publishing date 2023-12-21
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2893877-X
    ISSN 2543-6031 ; 2451-4934
    ISSN (online) 2543-6031
    ISSN 2451-4934
    DOI 10.3390/arm92010003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Real-Life Diagnostic Performance of the Hypersensitivity Pneumonitis Guidelines: A Multicenter Cohort Study.

    Freund, Ophir / Hadad, Yitzhac / Shalmon, Tamar / Wand, Ori / Schneer, Sonia / Perluk, Tal Moshe / Kleinhendler, Eyal / Hershko, Tzlil / Tiran, Boaz / Aviram, Galit / Gershman, Evgeni / Adir, Yochai / Shitrit, David / Bar-Shai, Amir / Unterman, Avraham

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 14

    Abstract: Hypersensitivity pneumonitis (HP) is a heterogeneous interstitial lung disease (ILD) that may be difficult to confidently diagnose. Recently, the 2020 ATS/JRS/ALAT HP diagnostic guidelines were published, yet data validating their performance in real- ... ...

    Abstract Hypersensitivity pneumonitis (HP) is a heterogeneous interstitial lung disease (ILD) that may be difficult to confidently diagnose. Recently, the 2020 ATS/JRS/ALAT HP diagnostic guidelines were published, yet data validating their performance in real-life settings are scarce. We aimed to assess the diagnostic performance of the HP guidelines compared to the gold-standard multidisciplinary discussion (MDD). For this purpose, we included consecutive ILD patients that underwent diagnostic bronchoscopy between 2017 and 2020 in three large medical centers. Four diagnostic factors (antigen exposure history, chest computed tomography pattern, bronchoalveolar lavage lymphocyte count, and histology results) were used to assign guidelines-based HP diagnostic confidence levels for each patient. A sensitivity analysis was performed, with MDD diagnosis as the reference standard. Overall, 213 ILD patients were included, 45 (21%) with an MDD diagnosis of HP. The guidelines' moderate (≥70%) confidence threshold produced optimal performance with 73% sensitivity for HP, 89% specificity, and a J-index of 0.62. The area under the receiver operating characteristic curve (AUC) for a correct guidelines-based diagnosis was 0.86. The guidelines had better performance for non-fibrotic than fibrotic HP (AUC 0.92 vs. 0.82). All diagnostic factors, except bronchoalveolar lavage lymphocyte count, were independent predictors for MDD diagnosis of HP in a multivariate analysis. In conclusion, the HP guidelines exhibited a good diagnostic performance compared to MDD diagnosis in real-life setting.
    Language English
    Publishing date 2023-07-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13142335
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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