Bronchiectasis: a case-based approach to investigation and management

Contarini, Martina; Finch, Simon; Chalmers, James D.

doi:10.1183/16000617.0016-2018

Cited by 31 publications

(16 citation statements)

References 76 publications

(91 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering the extreme heterogeneity of non‐CF bronchiectasis, with its wide range of etiologies, various clinical and microbiological, functional and radiological features, information on patient's characteristics and social determinants is crucial in order to provide a personalized treatment approach . In other words, recognizing different phenotypes of non‐CF bronchiectasis could help to decide whether chronic macrolide should be considered.…”

Section: The Role Of Macrolides In Non‐cf Bronchiectasismentioning

confidence: 99%

A review of non‐cystic fibrosis bronchiectasis in children with a focus on the role of long‐term treatment with macrolides

Boustany¹,

Gachelin²,

Colomban³

et al. 2019

Pediatric Pulmonology

View full text Add to dashboard Cite

Bronchiectasis is a rare chronic airway disease arising from several respiratory and systemic diseases. The grade of evidence for specific treatment of childhood bronchiectasis unrelated to cystic fibrosis (CF) is low with very few randomized controlled trials. Treatment has been based mainly on evidence from studies in adults with non-cystic fibrosis bronchiectasis and patients with cystic fibrosis. Recently, longterm treatment with macrolides has been proposed. These molecules offer the advantage of anti-inflammatory and immunomodulatory properties in addition to their antibacterial properties. A total of three randomized double-blind placebo-controlled trials conducted in adults showed that macrolides taken for 6-12 months led to a significant reduction in exacerbation rates. Only one long-term, randomized doubleblind placebo-controlled trial was conducted in the pediatric population. It showed that azithromycin administered weekly for up to 24 months reduced pulmonary exacerbations. Further randomized controlled studies are needed to determine the optimal dose and duration of treatment with macrolides. The clinical profile of children who would benefit from this treatment also needs to be determined. K E Y W O R D S macrolides, non-cystic-fibrosis bronchiectasis, pulmonary exacerbations

show abstract

Section: The Role Of Macrolides In Non‐cf Bronchiectasismentioning

confidence: 99%

A review of non‐cystic fibrosis bronchiectasis in children with a focus on the role of long‐term treatment with macrolides

Boustany¹,

Gachelin²,

Colomban³

et al. 2019

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…Bronchiectasis is a chronic and progressive lung disease associated with cough, sputum and respiratory infection [1]. It is a highly heterogeneous disease of varied aetiology, coexisting conditions and overlap syndromes [2][3][4]. Chronic airway infection with pathogenic bacteria is common [5].…”

Section: Introductionmentioning

confidence: 99%

Measuring airway clearance outcomes in bronchiectasis: a review

et al. 2020

View full text Add to dashboard Cite

While airway clearance techniques (ACTs) are recommended for individuals with bronchiectasis, many trials have demonstrated inconsistent benefits or failed to reach their primary outcome. This review determined the most common clinical and patient-reported outcome measures used to evaluate the efficacy of ACTs in bronchiectasis. A literature search of five databases using relevant keywords and filtering for studies published in English, up until the end of August 2019, was completed. Studies included randomised controlled trials, using crossover or any other trial design, and abstracts. Studies were included where the control was placebo, no intervention, standard care, usual care or an active comparator. Adults with bronchiectasis not related to cystic fibrosis were included. Extracted data comprised study authors, design, duration, intervention, outcome measures and results. The search identified 27 published studies and one abstract. The most common clinical outcome measures were sputum volume (n=23), lung function (n=17) and pulse oximetry (n=9). The most common patient-reported outcomes were health-related quality of life (measured with St George's Respiratory Questionnaire, n=4), cough-related quality of life (measured with Leicester Cough Questionnaire, n=4) and dyspnoea (measured with Borg/modified Borg scale, n=8). Sputum volume, lung function, dyspnoea and health- and cough-related quality of life appear to be the most common clinical and patient-reported measures of airway clearance treatment efficacy.

show abstract

“…This is in line with the histopathological picture, where chronic bleeding is a common observation in clinical settings such as bronchiectasis, lobar pneumonia, and pulmonary abscess. [ 32 33 ]…”

Section: Discussionmentioning

confidence: 99%

Hematoidin crystals in sputum smears: Cytopathology and clinical associations

2020

View full text Add to dashboard Cite

BACKGROUND: There has been limited correlation of hematoidin crystals (HC) in sputum with clinical and diagnostic characteristics, partly because they are difficult to recognize. The aim of this study was, therefore, to assess these relationships in a consecutive cohort of sputum samples from patients submitted to a cytology laboratory. METHODS: Adequate sputum samples from 489 individuals were enrolled in this study. These were fixed in ethanol, stained by the Papanicolaou method and examined microscopically. The normality of the distribution of the continuous variable (age in years) was examined using the Shapiro–Wilk normality test. As the data were not normally distributed, Kendall rank correlation was used to correlate age with the presence of HC. The Pearson's Chi-square test was used to determine if the proportion of cases with the presence of HC was different among the categorical data variables. A univariate binary logistic regression was used to determine the variables most strongly associated with HC presence. The results include odds ratios, 95% confidence intervals, Wald χ 2 statistics, and corresponding P values, with statistical significance assumed at P ≤ 0.05. Analyses were performed using IBM SPSS Statistics 22. RESULTS: The presence of HC in sputum was associated with increasing age ( P < 0.01), current smoking ( P < 0.001), chronic occupational exposure to dust ( P = 0.001), and hemoptysis ( P < 0.001). These crystals were most prevalent in patients with a diagnosis of carcinoma (93.9%), bronchiectasis (48%), silicosis (16.0%), and chronic obstructive pulmonary disease (0.8%). Crystals were not found in patients with acute bronchitis, asthma, or lung infections, including viral and bacterial pneumonia. CONCLUSIONS: There are clear associations linked to the finding of HC in sputum that may be helpful in pointing to a specific diagnosis, such as the possibility of underlying carcinoma.

show abstract

Bronchiectasis: a case-based approach to investigation and management

Cited by 31 publications

References 76 publications

A review of non‐cystic fibrosis bronchiectasis in children with a focus on the role of long‐term treatment with macrolides

A review of non‐cystic fibrosis bronchiectasis in children with a focus on the role of long‐term treatment with macrolides

Measuring airway clearance outcomes in bronchiectasis: a review

Hematoidin crystals in sputum smears: Cytopathology and clinical associations

Contact Info

Product

Resources

About