Sputum analysis

However, conditions placing the patient at risk for fiberoptic comphca-tions are limitations for using invasive diagnostic techniques in nonventilated patients, because performance of bronchoscopy may paradoxically be more dangerous in this setting than in patients receiving mechanical ventilation. Our personal bias would be to use a policy based only on chnical evaluation and results of sputum analysis to select treatment in critically ill patients... 

Sputum collection is a simple, costless and non-invasive method compared with lung tissue and BAL sampling. It was demonstrated that sputum analysis for asbestos bodies is an insensitive method for... 

Noninvasive techniques such as induced sputum analysis have been used to document airway inflammation after allergen exposure (48,76-79). Such techniques may be easily repeated, making it possible to correlate changes with physiological parameters over time. 

Induced-sputum analysis was also able to demonstrate an increase in met-achromatic cells and eosinophils after allergen inhalation (48,76). The late response to allergens was associated with an increased concentration of tumor necrosis factor a (TNFa) and interleukin 5 (IL-5) in induced sputum in addition to an increased eosinophil count and in eosinophil cationic protein (ECP) and eosinophil peroxidase (EPO) (77). After aerosolized allergen challenge, ECP and histamine in induced-sputum supernatant were higher than at baseline (78). Tryp-tase was detectable in the sputum of many subjects. 

Aguila, C. D. P., C. G. Moura, H. Silva, A. J. D. Leitch, G. J. Moss, D. M. Wallace, S. Slemenda, S. B. Peiniazek, N. J. Wisvesvara, G. S. Ultrastructure, immunofluorescence, Western blot, and PCR analysis of eight isolates of Encephalitozoon (Septata) intestinalis established in culture from sputum and urine samples and duodenal aspirates of five patients with AIDS. J. Clin. Microbiol. 1998, 36, 1201-1208. 

An alternative system proved to be both simpler and more user friendly (Unger et al., 2004 Machtejevas et al., 2006). Thus far we have used this configuration to analyze human plasma, sputum, urine, cerebrospinal fluid, and rat plasma. For each particular analysis we set up an analytical system based on a simple but specific strategy (Figure 9.5). The analysis concept is based on an online sample preparation and a two-dimensional LC system preseparating the majority of the matrix components from the analytes that are retained on a RAM-SCX column followed by a solvent switch and transfer of the trapped peptides. The SCX elution used five salt steps created by mixing 20 mM phosphate buffer (pH 2.5) (eluent Al) and 20 mM phosphate buffer with 1.5 M sodium chloride (eluent Bl) in the following proportions 85/15 70/30 65/45 45/55 0/100 with at the constant 0.1 mL/min flow rate. Desorption of the... 

The role of oral steroid use in chronic stable COPD patients was evaluated in a meta-analysis over a decade ago. Investigators concluded that only a small fraction (10%) of COPD patients treated with steroids showed clinically significant improvement in baseline FEVi (increase of 20%) compared with those treated with placebo. While a small number of COPD patients are considered responders to oral steroids, many of these patients actually may have an asthmatic, or reversible, component to their disease. The best predictors for response to oral steroids is the presence of eosinophils on sputum examination (>3%) and a significant response on pulmonary function tests to sympathomimetics. Both the presence of eosinophils in sputum and the responsiveness to sympathomimetics suggest an asthmatic component to the disease process and thus may explain the clinical benefit seen with steroids. 

This meta-analysis concluded that antibiotics are of most benefit and should be initiated if at least two of the following three symptoms are present increased dyspnea, increased sputum volume, and increased sputum purulence. The utility of sputum Gram stain and culture is questionable because some patients have chronic bacterial colonization of the bronchial tree between exacerbations. 

With chronic, persistent pneumonia, C. immitis often can be cultured from the sputum for a period of several years. Chest radiographs usually demonstrate apical fibronodular lesions or slowly progressive cavitation. With CNS infection, analysis of the CSF generally reveals a lymphocytic pleocytosis with elevated protein and a decreased glucose concentration. Although serum usually is positive for coccidioidal CF antibodies, the coccidioidal skin test is often negative. 

Tests in this list are grouped by the following types blood, electrodiagnostic, endoscopy, fluid analysis, manometric, microscopic examination, nuclear scan, other studies, sputum, stool, ultrasound, urine, and x-ray. 

T.C. Kennedy, S.P. Proudfoot, W.A. Franklin, et al. (1996). Cytopathological analysis of sputum in patients with airflow obstruction and significant smoking histories. Cancer Res., 56, 4673-4678. 

Sputum and tissue section. However, only sputum result was demonstrated in the analysis. Detection of TB bacilli in tissue is more difficult compared to the ones in sputum, due to the complexity of tissues background. Furthermore, overstaining and understaining often occur in tissue samples [10]. These will produced images with intensity inhomogeneities and further complicate the analysis. 

The purpose of the mineralogical analysis of lung samples (lung tissue, bronchoalveolar lavage fluid, sputum) is to evaluate the particle burden retained in the lungs at the time of sampling. The measured particle levels integrate both phenomena of particle deposition and clearance. 

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