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  1. Artikel ; 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  Band 92, Heft 1, Seite(n) 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-Begriff(e) Humans ; Female ; Adult ; Middle Aged ; Male ; Mycobacterium tuberculosis ; Sputum ; Bronchoalveolar Lavage Fluid ; Sensitivity and Specificity ; Tuberculosis, Pulmonary/diagnostic imaging ; Bronchoalveolar Lavage ; Dimercaprol
    Chemische Substanzen Dimercaprol (0CPP32S55X)
    Sprache Englisch
    Erscheinungsdatum 2023-12-21
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2893877-X
    ISSN 2543-6031 ; 2451-4934
    ISSN (online) 2543-6031
    ISSN 2451-4934
    DOI 10.3390/arm92010003
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Routine in-hospital interventions during acute exacerbation of COPD are associated with improved 30-day care.

    Freund, Ophir / Elhadad, Levi / Tiran, Boaz / Melloul, Ariel / Kleinhendler, Eyal / Perluk, Tal Moshe / Gershman, Evgeni / Unterman, Avraham / Elis, Avishay / Bar-Shai, Amir

    Heart & lung : the journal of critical care

    2024  Band 67, Seite(n) 114–120

    Abstract: Background: Implementing standard of care therapy for chronic obstructive pulmonary disease (COPD) has barriers. Hospitalization with an acute exacerbation of COPD (AECOPD) is a major adverse event that could also be an opportunity to improve patients' ... ...

    Abstract Background: Implementing standard of care therapy for chronic obstructive pulmonary disease (COPD) has barriers. Hospitalization with an acute exacerbation of COPD (AECOPD) is a major adverse event that could also be an opportunity to improve patients' long-term care.
    Objectives: To evaluate which in-hospital interventions during AECOPD are associated with improved 30-day care.
    Methods: This was a prospective study that included patients from 10 medical centers across Israel, hospitalized with AECOPD between 2017 and 2019. Patients were approached during hospitalization in internal medicine departments. A semi-structured follow-up call was performed 30 days after discharge, and six COPD areas of care were assessed. Multivariate analyses were used to analyze predictors for each area of care.
    Results: 234 patients were included (mean age 69 years and 34% females). A lower 30-day readmission rate was independently associated with smoking cessation and prescription of renin-angiotensin blockers. Initiating or continuing long acting bronchodilators (LABD) during admission was an independent predictor for their 30-day use. Among patients with prior LABD treatment, only 38% continued at 30-days if it was not prescribed during admission (OR 4, 95% CI 1.98-8.08, p<0.01). In-hospital daily respiratory physiotherapy was an independent predictor for smoking cessation (AOR 5.1, 95% CI 1.1-23, p=0.04), while smoking cessation recommendation was not (p=0.28). Initiating a smoking cessation program (5%) or pulmonary rehabilitation (1%) after discharge was performed only by patients with a written referral.
    Conclusion: Routine procedures during hospitalization for AECOPD could impact patients' long-term care in areas with proven effects on disease outcomes.
    Sprache Englisch
    Erscheinungsdatum 2024-05-14
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 193129-5
    ISSN 1527-3288 ; 0147-9563
    ISSN (online) 1527-3288
    ISSN 0147-9563
    DOI 10.1016/j.hrtlng.2024.05.001
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel: 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  Band 13, Heft 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.
    Sprache Englisch
    Erscheinungsdatum 2023-07-11
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13142335
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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