Abstract Background Expired breath condensate (EBC) has never been used to explore the level of oxidative stress in idiopathic pulmonary fibrosis (IPF). Therefore, the aim of this study was to measure the levels of H 2 O 2 and 8‐isoprostane, as biomarkers of oxidative stress, in the EBC of patients with IPF. Materials and methods We investigated 16 patients with IPF and 15 healthy subjects as the control group. The levels of H 2 O 2 and 8‐isoprostane were measured in the EBC of all subjects and were compared between the IPF and control groups. In patients with IPF, H 2 O 2 and 8‐isoprostane were further correlated with pulmonary function tests (PFTs), the resting pO 2 and the differential cell count from the bronchoalveolar lavage fluid (BALF). Results The mean (95%CI) concentration of H 2 O 2 was increased in the patients with IPF compared with the normal subjects (0·36, 0·24–0·47 µM vs. 0·16, 0·10–0·23 µM, P = 0·003) . The mean (95%CI) concentration of 8‐isoprostane was also increased in the patients with IPF compared with the controls (74, 38–110 pg mL −1 vs. 33, 28–39 pg mL −1 , P = 0·02). In the patients with IPF, the diffusing capacity of the lung for carbon monoxide was negatively correlated with the levels of H 2 O 2 in EBC ( P = 0·03, r = −0·58). No other correlation was found between the oxidative stress markers in the EBC and PFT values, pO 2 or BALF cell count. Conclusions Our data suggest that H 2 O 2 and 8‐isoprostane are increased in the EBC of patients with IPF. H 2 O 2 may be correlated with the severity of the disease in IPF.
Congenital bronchial atresia is a rare anomaly, which usually occurs in adulthood as an incidental finding on routine chest radiograph.The purpose of the study was to retrospectively evaluate the cases that were diagnosed in our hospital, from January 1995 to March 2003, to estimate the prevalence of this disorder and to determine the diagnostic studies of choice, according to the existing literature. Since the main portion of the male population of our country is referred to our hospital for screening soon after their enrollment in the army, epidemiological data can be easily estimated for many congenital anomalies occuring in adulthood, such as bronchial atresia.We found seven patients with Congenital Bronchial Atresia and the prevalence of this disorder was estimated at 1.2 cases per 100,000 in males. The chosen diagnostic procedure is computed tomography of the chest with high-resolution scans. Bronchoscopy would only exclude serious alternative diagnosis and prevent unnecessary surgical interventions.Congenital bronchial atresia is a rare anomaly, with a mild clinical course. The diagnosis is made radiologically, the HRCT of the chest being the procedure of choice. Bronchoscopy should be performed to exclude any endobronchial lesion due to a different disease entity and to prevent unnecessary surgical intervention in an otherwise asymptomatic individual.
We report a rare case of a 59 year-old female, who was admitted to the hospital because of a recurrent right-sided pleural effusion. The initial work-up was non-diagnostic. The diagnosis was finally confirmed following medical thoracoscopy, where an osteophyte of a rib was found to protrude sharply into the thoracic cavity. Chronic inflammatory changes of the pleura suggested mechanical irritation due to long lasting friction between this bony structure and the underlying lung. This is the first report where an osteophyte seems to be implicated in pleural pathology. A brief review of the available data from the literature is presented to further support our results.
In patients receiving anti-tumor necrosis factor (TNF) therapy, a probable exacerbation of latent tuberculosis (TB) is a major adverse event. The impairment of granuloma differentiation is considered a characteristic feature of TB in these patients. In this report we present three patients with rheumatic disease who developed TB under infliximab treatment. All of them had typical granulomas on the biopsy specimens, indicating that the expected impairment of granuloma formation is not always the case. The notion of granuloma-free TB in patients receiving anti-TNF therapy could shift a clinician's path away from performing a biopsy, thus delaying the establishment of a correct diagnosis.
