Hypersensitivity Pneumonia Research Articles

Prognostic significance of plasma cytomegalovirus (CMV) DNA load in immunocompetent patients with CMV pneumonia: A retrospective cohort study.

Cytomegalovirus (CMV) pneumonia, often presented as pneumonitis, is characterized by respiratory failure and large interstitial infiltrates visible on chest radiographs. This retrospective cohort study investigates the predictive significance of plasma CMV DNA load on the short- and long-term mortality among immunocompetent patients diagnosed with CMV pneumonia. The study included 61 immunocompetent patients suspected of having CMV pneumonia, treated with intravenous ganciclovir after positive CMV DNA results from bronchoalveolar lavage or plasma. Our multivariate Cox regression analysis identified several independent predictors of mortality. Having idiopathic pulmonary fibrosis (IPF) significantly increased the risk of in-hospital mortality (HR: 7.27, 95% CI: 1.62-32.52, p = 0.009), as did shorter durations of antiviral therapy (HR: 0.90, 95% CI: 0.84-0.97, p = 0.005) and higher CMV DNA levels (>3870 IU/mL; HR: 9.63, 95% CI: 2.32-39.98, p = 0.002). High CMV DNA levels (>5154 IU/mL) were also predictors of 30-day mortality (HR: 9.39, 95% CI: 2.20-40.01, p = 0.002). For 1-year mortality, the presence of IPF (HR: 2.96, 95% CI: 1.08-8.06, p = 0.034), hypersensitivity pneumonia (HP) (HR: 4.30, 95% CI: 1.57-11.78, p = 0.005), shorter duration of total antiviral therapy (HR: 0.95, 95% CI: 0.93-0.99, p = 0.010), and higher CMV DNA levels (>327 IU/mL) (HR: 3.36, 95% CI: 1.33-8.47, p = 0.010) were identified as independent determinants. The study reveals that IPF increases short and long-term mortality risks, while HP increases long-term mortality. Extended antiviral treatment duration results in a 10% reduction in in-hospital mortality for each additional day of treatment. Furthermore, elevated viral loads are associated with higher mortality rates, highlighting the necessity for careful monitoring.

Evaluation of progressive pulmonary fibrosis in non-idiopathic pulmonary fibrosis-interstitial lung diseases: a cross-sectional study

BackgroundProgressive pulmonary fibrosis is the symptomatic, physiological, and radiological progression of interstitial lung diseases. The aim of this study was to examine the relationship between progressive pulmonary fibrosis and demographic characteristics and to evaluate the effect on clinical outcomes and mortality.MethodsThis cross-sectional study included 221 patients diagnosed with non-idiopathic pulmonary fibrosis interstitial lung diseases who were followed in the last 5 years. Patient symptoms, clinical, radiological, and demographic data were examined. Risk factors for the development of progressive pulmonary fibrosis and the relationship with clinical outcomes and mortality were examined.ResultsOf the patients, 33.0% (n = 73) had fibrotic idiopathic nonspecific interstitial pneumonia (iNSIP), 35.7% (n = 79) had fibrotic hypersensitivity pneumonia (HP), 18.1% (n = 40) had fibrotic connective tissue disease (CTD) interstitial lung diseases (ILD), and 13.1% (n = 29) had postinfectious fibrotic ILD. The progressive pulmonary fibrosis development rates of the subtypes were 46.5% iNSIP (n = 34), 86.0% fibrotic HP (n = 68), 42.5% fibrotic CTD-ILD (n = 17), and 20.7% postinfectious ILD (n = 6). The presence of progressive pulmonary fibrosis was associated with the development of respiratory failure and mortality (odds ratio [OR]: 2.70, 95% CI: 1.04–7.05 and OR: 2.13, 95% CI: 1.23–3.69). Progressive pulmonary fibrosis development was higher in hypersensitivity pneumonia patients with farmer’s lung (OR: 5.06, 95% CI: 1.02–25.18).ConclusionProgressive pulmonary fibrosis was more prevalent in older patients. Farming was an important risk factor in the development of hypersensitivity pneumonia-progressive pulmonary fibrosis. Respiratory failure and mortality were higher in those who developed progressive pulmonary fibrosis.

The cGAS-STING pathway drives inflammation in Usual Interstitial Pneumonia, phagocytosis could prevent inflammation but is inhibited by the don’t eat me signal CD47

BackgroundUsual Interstitial Pneumonia (UIP) a fibrosing pneumonia is associated with idiopathic pulmonary fibrosis, chronic autoimmune disease (AID), or hypersensitivity pneumonia. Oxygen radicals, due to tobacco smoke, can damage DNA and might upregulate PARP1. Cytosolic DNA from dying pneumocytes activate cytosolic GMP-AMP-synthase–stimulator of interferon genes (cGAS-STING) pathway and TREX1. Prolonged inflammation induces senescence, which might be inhibited by phagocytosis, eliminating nuclear debris. We aimed to evaluate activation of cGAS-STING-TREX1 pathway in UIP, and if phagocytosis and anti-phagocytosis might counteract inflammation. Methods44 cases of UIP with IPF or AID were studied for the expression of cGAS, pSTING, TREX1 and PARP1. LAMP1 and Rab7 expression served as phagocytosis markers. CD47 protecting phagocytosis and p16 to identify senescent cells were also studied. ResultsEpithelial cells in remodeled areas and macrophages expressed cGAS-pSTING, TREX1; epithelia but not macrophages stained for PARP1. Myofibroblasts, endothelia, and bronchial/bronchiolar epithelial cells were all negative except early myofibroblastic foci expressing cGAS. Type II pneumocytes expressed cGAS and PARP1, but less pSTING. TREX1 although expressed was not activated. Macrophages and many regenerating epithelial cells expressed LAMP1 and Rab7. CD47, the ’don’t-eat-me-signal‘, was expressed by macrophages and epithelial cells including senescence cells within the remodeled areas. ConclusionsThe cGAS-STING pathway is activated in macrophages and epithelial cells within remodeled areas. LikelyTREX1 because not activated cannot sufficiently degrade DNA fragments. PARP1 activation points to smoking-induced oxygen radical release, prolonging inflammation and leading to fibrosis. By expressing CD47 epithelial cells within remodeled areas protect themselves from being eliminated by phagocytosis.

#1356 Kidney phenotype in interstitial lung disease associated with ANCA-vasculitis: European Multicentre Study

Abstract Background and Aims Interstitial lung disease (ILD) in ANCA-associated vasculitis (AAV) has the appearance of a progressive fibrotic disease on imaging and primarily affects the interstitial lung compartment and is usually associated with MPO-ANCA. Whether patients with AAV-ILD display a similar fibrotic pattern in their kidneys is unclear. Method A European multicentre retrospective study included patients with AAV-ILD. The diagnosis of ILD was confirmed by a CT chest pattern of usual interstitial pneumonia (UIP), non-specific interstitial pneumonia (NSIP), organising pneumonia or chronic hypersensitivity pneumonia. We aimed to determine if kidney involvement in AAV-ILD exhibited a more fibrotic pattern compared to AAV-related nephritis without ILD, using data from the Cambridge AAV cohort. Results 135 patients with AAV-ILD were included; 94 (70%) had also kidney involvement, in whom the mean age was 71 ± 11 years and 87% MPO-ANCA positive. The ILD diagnosis preceded AAV in 17%, 64% presented concurrently with kidney involvement, 20% with pulmonary haemorrhage. The most common lung radiological pattern was UIP (67%). At presentation, the median glomerular filtration rate (GFR) was 27 ml/min per 1.73 m2 (interquartile range 12-50), with a median albumin-to creatinine ratio 23 mg/mmol (IQR 10-97). Among 72 patients with available kidney biopsy, the most prevalent Berden class was focal in 45%, followed by mixed in 33%, crescentic in 18% and sclerotic in 4%. Although, the prevalence of Berden classes did not significantly differ between ILD-nephritis and no ILD-nephritis groups, the former group had a higher baseline GFR (p = 0.05), lower albuminuria level (p = 0.002), higher percentage of normal glomeruli (p = 0.027), lower glomerular necrosis percentage (p = 0.002) and higher interstitial fibrosis score (p = 0.049). Within five years, the ILD-nephritis group demonstrated renal recovery, as indicated by an adjusted mean delta GFR of 13.4 ml/min per 1.73 m2, without a significant difference compared to the no ILD-nephritis group. Over a median follow-up of 4.9 years (IQR 2-9), the progression to end-stage kidney disease (ESKD) was comparable between the groups. However, notably, the ILD-nephritis group experienced significantly poorer survival rates (mean 10.9 years vs 17.9 years, log-rank p < 0.001). Conclusion In AAV-ILD, kidney involvement is often characterized by fewer inflammatory and a higher prevalence of fibrotic lesions than on non-ILD-AAV. Despite initial differences in renal pathology and kidney function between these groups, both demonstrated similar risks of progressing to ESKD. Nevertheless, it's crucial to underscore the significant influence of ILD on the overall outcomes of AAV patients with kidney involvement.

Case Report: Allergic bronchopulmonary aspergillosis in a 21-year-old female patient with no prior asthma

Hypersensitivity brought on by Aspergillus causes a lung illness known as allergic bronchopulmonary aspergillosis (ABPA). ABPA is a common fungal disease that affects individuals with uncontrolled asthma, cystic fibrosis, and immunocompromised patients. Aspergillus mould species are highly prevalent in the environment, especially in organic waste. There are more than a hundred different species of Aspergillus throughout the world, but the most common offenders are Aspergillus fumigatus, Aspergillus niger, Aspergillus flavus, and Aspergillus clavatus. Several Aspergillus species, most notably Aspergillus fumigatus, are responsible for human diseases. Depending on the amount and virulence of inhaled Aspergillus and the host’s genetic vulnerability and immunity, Aspergillus can produce allergic or allergic (Aspergillus-mediated allergies and asthma, hypersensitivity pneumonia, and ABPA pulmonary disorders. Because of its unique appearance, particularly when there is no medical history of asthma, it may be challenging to diagnose in some circumstances. Although side effects from treating ABPA are regularly described, cumulative medication toxicity caused by several compounds is uncommon. It’s essential to make a wise decision among the several compounds that are available and efficient against ABPA. We document a case of ABPA in a female patient who had no prior history of asthma. She had complained about having trouble breathing. The presence of specific IgE antibodies against Aspergillus fumigatus & an elevated eosinophil count were used to make the diagnosis of ABPA.

Unusual radiological manifestation of hypersensitivity pneumonia

Hypersensitivity pneumonia is suspected in a suggestive clinical context and in the presence of specific exposure to an allergen. It can be characterized on chest CT by diffuse interstitial involvement. However, the diagnosis is not always so simple. We report a case of hypersensitivity pneumonia with scan pattern of organizing pneumonia.

Variation in information needs of patients with interstitial lung disease and their family caregivers according to long-term oxygen therapy: a descriptive study

BackgroundThe information needs of patients and their families regarding interstitial lung disease (ILD) have yet to be studied in detail, and few reports have examined the differences in information needs according to patient status. This study aimed to determine whether there are differences in information needs between outpatients with ILD and their family caregivers and whether these differences depend on long-term oxygen therapy use.MethodsPatients with fibrotic ILDs and their families who visited Kyoto University Hospital between February 2020 and March 2022 were recruited for this descriptive study. Fibrotic ILDs included idiopathic pulmonary fibrosis (IPF), other idiopathic interstitial pneumonias (IIPs) than IPF, connective tissue disease-associated ILD (CTD-ILD), and fibrotic hypersensitivity pneumonia. Data were obtained from electronic patient records and questionnaires. Descriptive data analyses were performed.ResultsSixty-five patients and their family caregivers were analyzed. Twenty-seven (41.5%) patients had IIPs (IPF 9 and other IIPs 18), 34 (52.3%) had CTD-ILD, and 4 (6.2%) had fibrotic hypersensitivity pneumonia. The most common relationship between the patient and their family was a spouse (67.7%), with 80% living together. The primary information needs among patients and their family caregivers were common up to the third rank but differed from the rest. Patients were interested in “when and where to contact health care providers” and “end-of-life care and advanced directives,” while family caregivers were interested in “diet and nutrition” and “care and support at home.” Patients with long-term oxygen therapy had higher needs for “end-of-life care and advanced directives” and “how to manage breathlessness, cough, and fatigue,” while the needs for “drugs for ILD” and “acute exacerbation of ILD” were relatively low. Family caregivers were interested in “diet and nutrition” in the long-term oxygen therapy group and “acute exacerbation of ILD” in the no long-term oxygen therapy group.ConclusionsThis study found that the information needs of patients and their family caregivers were not the same and that the aspect of information needs differed by long-term oxygen therapy status. Healthcare providers should consider the position of the recipient of information, the appropriate time based on the patient’s condition, and the necessary information.

Up-regulation by overexpression of c-MET in fibroblastic foci of usual interstitial pneumonia.

Usual interstitial pneumonia (UIP) is the radiologic and histologic hallmark of idiopathic pulmonary fibrosis (IPF) and the commonest histologic pattern of other progressive fibrosing interstitial lung diseases (e.g., fibrotic hypersensitivity pneumonia). Analogous to lung cancer, activation of epithelial-to-mesenchymal transition (EMT) is one of the main molecular pathways recently identified by transcriptomic studies in IPF. Fibroblastic foci (FF) are considered the active/trigger component of UIP pattern. The proto-oncogene C-MET is a key gene among molecules promoting EMT against which several inhibitors are currently available or promising in ongoing studies on lung cancer. Twenty surgical cases of diffuse fibrosing interstitial lung diseases (fILD) with UIP pattern and FF-rich (17 IPF and 3 patients with fibrotic hypersensitivity pneumonia, fHP) were retrospectively selected. FF were manually microdissected and analysed for c-MET gene alterations (FISH amplification and gene hot-spot mutations Sanger sequencing) and tested with a c-MET companion diagnostic antibody (clone SP44 metmab) by immunohistochemistry. FF are characterized by upregulation of c-MET as shown by overexpression of the protein in 80% of cases, while no gene amplification by FISH or mutations were detected. C-MET upregulation of FF was observed either in IPF and fHP, with a tropism for the epithelial cell component only. Upregulation of c-MET in FF of ILD with UIP pattern further confirms the key role of the proto-oncogene c-MET in its pathogenesis, possibly representing an interesting and easily-detectable molecular target for selective therapy using specific inhibitors in future clinical trials, similar to lung cancer. It is reasonable to speculate that molecular alterations in FF can also be detected in FF by transbronchial cryobiopsy.

Alveolitis as a result of dust chlorine exposure

Hypersensitivity pneumonia of the lung, also called "extrinsic allergic alveolitis" or "hypersensitivity pneumonitis", is a condition in which the lung tissue becomes inflamed for reasons other than microbial causes. There may be many different reasons. Among the most common reasons were bird feeding, agricultural works and air conditioners. There are acute, subacute or chronic (slowly progressing) forms. Acute and subacute forms may recur, while the chronic form progresses and causes permanent and irreversible damage such as fibrosis and emphysema. Bird proteins, mammalian proteins, fungi, bacterial proteins and small molecular weight chemicals are generally blamed for the formation of the disease. Sometimes the causative agent may not be identified. In this case, we aimed to present a patient who applied to our clinic due to complaints of sudden respiratory distress, rapid fatigue and cough as a result of dust chlorine exposure, and was diagnosed with alveolitis, hospitalized and followed up.

Imaging of hypersensitivity pneumonia in clinical practice guidelines

Imaging of hypersensitivity pneumonia in clinical practice guidelines

A case of occupational hypersensitivity pneumonia in a welder

A 35-year-old male patient with a history of pigeon feeding was reported to have hypersensitivity pneumonia on thorax high-resolution computed tomography, which was taken after complaints of shortness of breath, fever, and weight loss. Firstly, hypersensitivity pneumonia due to pigeon feeding was considered a diagnosis. The patient's contact with the pigeon was cut off. His clinic improved with oral corticosteroid therapy. His symptoms recurred after oral corticosteroid therapy was discontinued. In the professional anamnesis taken, it was learned that he had been doing welding work for 14 years and his complaints increased on the days he worked. After other causes were excluded with the differential diagnosis, the case was diagnosed with hypersensitivity pneumonia due to metal dust contact. The rarity of occupational hypersensitivity pneumonia cases in welding workers makes it important to report individual cases and exposures. Occupational history can be skipped in hypersensitivity pneumonia patients, as it is often thought to be caused by contact with organic factors such as pigeon breeding. The importance of work history anamnesis is highlighted in the diagnosis of rare diseases such as occupational hypersensitivity pneumonia.

Investigation of symptoms and lung functions in tea packaging factory employees

Inhalation of organic powders may lead to various diseases such as asthma-like syndrome and hypersensitivity pneumonia. The study aim to evaluate respiratory health effects by respiratory function measurements, respiratory survey, ambient dust concentration, and toxic gas in workers of a tea packaging factory. 69 employees from different departments of the tea packaging factory were included. A group of 53 office workers of a separate establishment was included as a control. Sputum production in the morning was significantly higher in the tea packaging workers (p=0.013). Among the respiratory function values, only FEV1/FVC was lower in this group than in the control group. There was a significant decrease in FEF75% value among smokers in the study group compared to non-smokers. Respiratory effects observed in some food processing industry workers are also seen in the tea packaging industry. Effective dust control will positively affect the health of the workers. More studies are needed to better identify potential risks.

Correlation between high-resolution computed tomography appearance and histopathological features in the diagnosis of interstitial lung diseases. A real-life study.

According to current guidelines, a surgical biopsy is rarely required when a high-confidence radiologic interstitial lung disease (ILD) diagnosis is made on thin-section high-resolution computed tomography (HRCT). Nevertheless, disowning HRCT scans diagnosed by biopsy are more common than presumed. Our study aimed to describe the concordance rate between HRCT scans and pathological diagnoses of ILDs obtained by surgical biopsy. The current guideline suggests the use of surgical lung biopsy (SLB) in patients with newly detected ILD of unknown cause. Patients who underwent mini-invasive surgical biopsies for interstitial lung diseases from January 2018 to August 2022 were analyzed. The HRCT scans were reviewed by an observer blinded to the patient's clinical information. The concordance between histological and HRCT-scan were assessed. Data from 104 patients with uncertain low confidence diagnosis of interstitial lung diseases at HRCT were analyzed. Most of the patients are male (65; 62.5%). The more frequent HRCT pattern were: alternative diagnoses (46; 44.23%), UIP probable (42; 40.38%), UIP indeterminate (7; 6.73%), and non-specific interstitial pneumonia (NSIP) (9, 8.65%). The more common histological diagnosis was UIP definite (30; 28.84%), hypersensitivity pneumonia [HP](19; 18.44%), NSIP (15; 14.42%), sarcoidosis (10; 9.60%). In 7 (20%) cases, the final pathological finding denies HRCT-scans diagnoses; indeed, a moderate agreement was observed between HRCT-scan findings and the definitive histological diagnosis (kappa index: 0.428). HRCT-scan has limitations if the objective is to define interstitial lung diseases accurately. Consequently, pathological assessment should be taken into account in order to provide more accurate tailored treatment strategies because the risk is to wait from 12 to 24 months to ascertain if the ILD will be treatable as progressive pulmonary fibrosis (PPF). Undeniably true, video-assisted surgical lung biopsy (VASLB) with endotracheal intubation and mechanical ventilation is associated with a risk of mortality and morbidity that is far from nil. Nevertheless, in recent years a VASLB approach performed in awake subjects under loco-regional anesthesia (awake-VASLB) has been suggested as an effective method to obtain a highly confident diagnosis in patients with diffuse pathologies of the lung parenchyma.

Evaluation of cases with hypersensitivity pneumonia: 10year analysis.

The aim of this study was to examine the clinical features of hypersensitivity pneumonia (HP) cases, diagnostic methods, and related conditions in our hospital, which is a reference clinic in Turkey for chest disease. The population of this retrospective cross-sectional study consists of all hypersensitivity pneumonia patients followed in a tertiary hospital between 2010 and 2019. The data of 78 patients were included in the analysis. Data were grouped by source of exposure (occupational, environmental, and cryptogenic) by examining the files of the patients. Occupational risk factors were detected in 29 (37.2%) of the cases, environmental risk factors were found in 24 (30.8%) cases, neither occupational nor environmental risk factors were detected in 25 (32%) cases, and they were evaluated as cryptogenic. The time from the onset of symptoms to diagnosis was 15.8 ± 26.6months. The time from the onset of symptoms to diagnosis was found to be longer in the group with occupational risk factors compared with the other groups and was statistically significant (0.044). HP is a immune-mediated interstitial lung disease induced by repeated exposure to environmental and occupational antigens. Etiological agent can be detected in HP patients by detailed questioning of occupational and environmental exposure that may be associated with the onset of symptoms in cases with suspected HP.

Chronic Hypersensitivity Pneumonia. What the Clinical Radiologist Participating in a Multidisciplinary Meet Needs to Know

Chronic hypersensitivity pneumonia (CHP) is a diffuse interstitial lung disease, brought about by an inflammatory response to various known and unknown antigens. It affects the small airways, its surrounding parenchyma and interstitium. It can manifest either as a fibrosing or non-fibrosing diffuse lung disease. The fibrotic pattern is irreversible, hence if not recognized early, it embarks on a downhill course. The pattern and anatomical distribution of fibrosis shows some differences from other fibrosing disorders. Features resembling sarcoidosis, fibrosing NSIP or UIP may be seen towards the end stage, making distinction difficult. Clinical evaluation and perusal of previous records helps suggest the diagnosis and assess its progress. In this review article, an attempt will be made to understand the disease in order to enable the radiologist add value in a multidisciplinary discussion (MDD).

Features of transbronchial lung cryobiopsy-diagnosed fibrotic hypersensitivity pneumonitis.

Hypersensitivity pneumonitis (HP) is a common type among all the interstitial lung diseases, and transbronchial lung cryobiopsy is an alternative diagnostic technique for interstitial lung diseases. In this study, we describe the clinical and pathological features of fibrotic hypersensitivity pneumonitis diagnosed with transbronchial lung cryobiopsy (TBLC). A total of 46 diffused parenchyma lung disease (DPLD) patients received TBLC were included in this study. Medical records including medical history spirometry examinations, 6-min walk test (6MWT) results, high resolution computed tomographic (HRCT) scans, BAL, and histopathology were collected. Results of HRCT and histopathology were compared and classified, especially. Sixteen patients were diagnosed with fibrotic HP, the mean age of whomwas 56.3 ± 12.1 years, and 62.5% of them were male. Three of the 16 patients had been misdiagnosed as tuberculosis and received antituberculosis medications, five patients had been diagnosed as unclassifiable pulmonary fibrosis, and five patients had been diagnosed as idiopathic pulmonary fibrosis (IPF). Thirteen (81.3%) patients had a normal lymphocyte count in BAL. The pathological features of usual interstitial pneumonia (UIP) were detected in 11 (68.8%) of the cases, poor defined granulomatous was detected in nine (56.3%) of the cases, and bronchiolocentric fibrosis was detected in two (12.5%) of the 16 cases. Fibrotic hypersensitivity pneumonitis should be included in differential diagnosis of pulmonary fibrosis. Pathological characteristics of fibrotic hypersensitivity pneumonitis could be demonstrated from cryobiopsy lung tissue. TBLC is recommended as an alternative diagnostic technique, which may improve the specificity of hypersensitivity pneumonia detection, and UIP is the most frequent pathological finding.

B Lymphocytes Balance Th1/Th2 to Participate in Fibrotic Hypersensitivity Pneumonia Induced by Pigeon Shedding

Introduction: We investigated the molecular mechanism by which B lymphocytes regulate Th1/Th2 imbalance to participate in the pulmonary fibrosis in hypersensitivity pneumonia induced by pigeon shedding in rats. Methods: CD19+ rats and CD19− rats were used to construct animal models of fibrotic hypersensitivity pneumonia. DAPT was used to inhibit the Notch signaling pathway. The pathological changes were assessed with HE and Masson staining. Protein level was detected with Western blot. Th1/Th2 ratio was analyzed with flow cytometry. Cytokine levels were measured with ELISA. Results: The pathological changes of pulmonary fibrosis were not obvious in the CD19− rats and after DAPT treatment. Notch signaling pathway proteins, including Notch1, Notch2, Jag1, Jag2, DLL1, and DLL4, in lung tissues of model rats were all significantly upregulated than those in control rats. However, these proteins in CD19− rats were lower in CD19+ rats, suggesting that B cells play a key role in inducing pneumonia. Besides, the Th1/Th2 ratio in the BALF of model rats decreased, which was further reversed by DAPT. However, we found that in CD19− rats, the regulation of the Th1/Th2 ratio by the Notch signaling pathway was lost. Conclusion: Deleting B lymphocytes or blocking the Notch pathway both reversed the Th1/Th2 imbalance in fibrotic hypersensitivity pneumonia and inhibited pulmonary fibrosis.

The Accuracy 0f CT Chest in Determining Between Ground Glass Opacities And Those Caused by Covid-19 And Other Medications

Introduction: Diagnostic ct scanning of the chest is currently being investigated for its ability to distinguish between ground glass opacities (GGO) caused by coronavirus 2019 (COVID-19) and GGO produced by other causes. Place and Duration: From January 2022 until June 2022, I will work as a Radiologist at Qazi Hussain Ahmad Hospital in Nowshera. Methods: This study was cross sectional study carried out at the Qazi Hussain Ahmad Hospital, Nowshera for a period of six months. The overall sample size in the current study was100 non-contrast chest CTs. Eexperienced radiologists analyzed the CT images of the chest after redacting any personal information. laboratory results and the patient's medical history were noted. Results: The participants comprised 46 people with COVID19 and 100 without COVID19 who also had ground glass opacities on chest CT. There was no statistically significant difference in age between the groups (p-value = 0.212). Out of the non-COVID-19 GGO cases, three patients have hypersensitivity pneumonia in 3, eosinophilic pneumonia in 3, interstitial pneumonia in 7, pulmonary pneumonia in 3, pulmonary fibrosis in 7, drug-induced lung damage in 7, pulmonary alveolar hemorrhage in 3, and pulmonary emphysema in 11. Practical implication: This study will provide physician with the data to compare the likelihood that COVID-19 causes ground glass opacities on a chest CT scan versus the likelihood that they are caused by other probable causes Conclusion: Moreover, the specificity of chest CT in differentiating COVID-19 from viral pneumonia is only intermediate, and the specificity of chest CT in distinguishing COVID-19 from other reasons of ground glass opacities is poor. Keywords: CT Chest, Determining, Ground-Glass Opacities, Covid-19, Medications

Retracted: P495 Contamination of wind instruments: A potential threat to musicians

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PMResearch shows that wind instruments are often contaminated with various bacteria and mould, creating a potential threat to musicians. These microorganisms are partially transferred from the players to the instrument during playing. Since the moist and dark inner surface of the instruments create the perfect environment for the microorganisms, they can easily nestle and grow. Then, they are retransferred back to the players as they inhale during playing. Current literature reports many cases of Hypersensitivity Pneumonia caused by contaminated instruments.ObjectiveThe objective of the current research is to explore the amount and variety of microorganisms inside brasswind instruments as well as testing antibacterial properties of different materials used in instrument production.MethodIn this three-part study, first of all, with a face-to-face survey, information such as instrument cleaning habits, cleaning products, and methods they use and etc. are collected from the subjects. Then, with samples taken from two-three different parts of the subjects' instruments, the amount and types of microorganisms are detected. Lastly, three instruments made of three different materials (gold, silver, brass) are tested for differences in the growth rate of the pathogens, and their advantage/disadvantages for health purposes are evaluated.ResultsWhen obtained metagenomic data are analyzed, it is found that the tested instruments were highly contaminated with various bacteria, many of which are opportunistic pathogens, and mould. Furthermore, the tests done on instruments made of different materials reveal that silver instruments have antibacterial characteristics. On the other hand, gold and brass instruments do not have antibacterial characteristics.ConclusionTo conclude, the brass instruments harbor a vast amount of microorganisms and need to be regularly cleaned with an effective hygiene protocol by the players. Also, due to its antibacterial properties, the use of silver plating in brass instruments would be preferable for health purposes.

Pictorial guide for variants of Covid-19: CT imaging and interpretation.

Typical radiologic images of Covid-19 pneumonia consists in a wide spectrum of chest manifestations, which range from peripheral predominant ground-glass opacities to an organizing pneumonia pattern, with additional features including crazy-paving, consolidations, fibrotic streaks and linear opacities. With variants imaging profile of Covid-19 evolves, producing relatively atypical/indeterminate CT pattern of pulmonary involvement, which overlap with imaging features of a variety of other respiratory diseases, including infections, drug reaction and hypersensitivity pneumonia. Our knowledge of these radiological findings is incomplete and there is a need to strengthen the recognition of the many faces of Covid-19 pneumonia.