scholarly journals Increased mRNA expression of key cytokines among suspected cases of Pneumocystis jirovecii infection

2020 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokines mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytic study undertaken in Aseer region, Saudi Arabia. A 100 suspected PCP cases and a 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by the immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to control. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrates, patchy infiltrates, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with the weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed with cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4 and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4 and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negatives cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Increased mRNA Expression of Key Cytokines Among Suspected Cases of Pneumocystis Jirovecii Infection

2020 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokines mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytic study undertaken in Aseer region, Saudi Arabia. A 100 suspected PCP cases and a 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by the immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to control. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrates, patchy infiltrates, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with the weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed with cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4 and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4 and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negatives cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Increased mRNA expression of key cytokines among suspected cases of Pneumocystis jirovecii infection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokine mRNA expression among suspected P. jirovecii infection. Methods This was a cross-sectional analytical study undertaken in Aseer region, Saudi Arabia. One hundred suspected PCP cases and 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to controls. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrate, patchy infiltrate, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p< 0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p< 0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed in cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4, and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4, and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negative cases. Conclusion Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Increased mRNA expression of key cytokines among suspected cases of Pneumocystis jirovecii infection

2021 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokine mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytical study undertaken in Aseer region, Saudi Arabia. 100 suspected PCP cases and 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to controls. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrate, patchy infiltrate, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed in cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4, and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4, and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negative cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

Pulmonary Tuberculosis

2016 ◽  
Author(s):  
Bhakti Hansoti
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Blood Test ◽  
Clinical Specimen ◽  
X Ray ◽  
Retrosternal Pain ◽  
Night Sweats ◽  
Chest X Ray ◽  
Latent Tb ◽  
Latent Tb Infection

Mycobacterium tuberculosis (TB) is most commonly known for its manifestations in the lungs; symptoms include fever and chest pain (retrosternal pain and/or dull intracapsular pain). In the reactivation stage of TB, typical symptoms may include cough, weight loss, fatigue, fever, night sweats, chest pain, dyspnea, and/or hemoptysis. Symptoms may remain undiagnosed for several years. Poverty, HIV, and drug resistance are major contributors to the resurging global TB epidemic. Two kinds of tests are used to detect TB: the tuberculin skin test or a TB blood test. These tests only tell you if a person has been infected with the bacteria. The do not differentiate between latent TB infection and active TB. This distinction clinically suspected when the clinical picture of active TB matches with initial investigations (such as acid-fast bacilli stains, chest x-ray, or CT) and is definitively confirmed by the growth of M. tuberculosis in a clinical specimen.

scholarly journals Differences and similarities between the symptoms and clinical signs in patients with pulmonary tuberculosis and pneumonia

2019 ◽  
Vol 76 (2) ◽  
pp. 192-201
Author(s):  
Sonja Smiljic ◽  
Blagica Radovic ◽  
Aleksandra Ilic ◽  
Goran Trajkovic ◽  
Sladjana Savic ◽  
...  
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Clinical Signs ◽  
Developed Countries ◽  
X Ray ◽  
Increased Risk ◽  
Night Sweats ◽  
Chest X Ray

Background/Aim. Tuberculosis in the second decade of the 21st century is an infectious disease with the highest mortality rate. In addition, in developed countries, pneumonia is the major couse of morbidity and mortality in adults. The aim of our study was to point out the differences and similarities between symptoms, laboratory parameters and clinical indicators in patients with pulmonary tuberculosis (PTB) and patients with pneumonia in the general population and in people belonging to the high risk groups for developing tuberculosis. Methods. This prospective study included patients with PTB (n = 70) and pneumonia (n = 75) treated at the Pulmonology Department of Clinical Hospital Center in Kosovska Mitrovica. Results. PTB was more frequent in men, 30?39 years of age (OR; 6:08), mainly from rural areas (p = 0.001), and with lower levels of education (p = 0.031). Pneumonia was more frequent in women older than 60 years of age (p = 0.0012). Night sweats (p = 0.001) and weight loss (p = 0.062) were significantly more frequent in patients with PTB, while chest pain (p = 0.001) and high temperature (p = 0.036) were more common in patients with pneumonia. X-ray changes in patients with PTB were located in the upper fields (p = 0.001), or appeared to be bilateral (p = 0.004). The strongest predictor associated with an increased risk of night sweats was diagnosed PTB (OR = 30.0). The chest pain was a predictor of pneumonia, unilateral changes (OR = 4.65) in the lower lung fields (OR = 0.08). Conclusion. Night sweats, weight loss and chest X-ray abnormalities in upper fields were significant indicators of PTB. Chest pain, fever and chest X-ray abnormalities in lower fields were significant indicators of pneumonia.

scholarly journals Sputum smear positivity grade and chest X-ray findings in tuberculosis: A cross-sectional study

2021 ◽  
Author(s):  
R. Behzadmehr ◽  
E. Nejadkehkha
Keyword(s):  
Cross Sectional Study ◽  
Health Concern ◽  
Sputum Smear ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
X Ray ◽  
High Prevalence ◽  
Chest X Ray

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively.  In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.

scholarly journals Chest CT as a Complement to RT-PCR to Confirm and Follow-up COVID-19 Patients

Medicinus ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Aziza Ghanie Icksan ◽  
Muhammad Hafiz ◽  
Annisa Dian Harlivasari
Keyword(s):  
Chest Ct ◽  
Rt Pcr ◽  
High Resolution Computed Tomography ◽  
X Ray ◽  
First Case ◽  
Chest X Ray ◽  
Polymerase Chain

<p><strong>Background : </strong>The first case of COVID-19 in Indonesia was recorded in March 2020. Limitation of reverse-transcription polymerase chain reaction (RT-PCR) has put chest CT as an essential complementary tool in the diagnosis and follow up treatment for COVID-19. Literatures strongly suggested that High-Resolution Computed Tomography (HRCT) is essential in diagnosing typical symptoms of COVID-19 at the early phase of disease due to its superior sensitivity  (97%) compared to chest x-ray (CXR).</p><p>The two cases presented in this case study showed the crucial role of chest CT with HRCT to establish the working diagnosis and follow up COVID-19 patients as a complement to RT-PCR, currently deemed a gold standard.<strong></strong></p>

scholarly journals Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Joanitah Nalunjogi ◽  
Frank Mugabe ◽  
Irene Najjingo ◽  
Pastan Lusiba ◽  
Francis Olweny ◽  
...  
Keyword(s):  
Screening Tool ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Case Detection ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Number Needed To Screen ◽  
Screening Algorithm ◽  
Chest X Ray

The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.

Comparison of granulomatosis with polyangiitis clinical features in patients depending of involvement or absence of kidney involvement

2021 ◽  
Vol 17 ◽  
Author(s):  
Mateusz Puchala ◽  
Andrzej Rydzewski ◽  
Ilona Kowalik ◽  
Małgorzata Wisłowska
Keyword(s):  
Clinical Features ◽  
Crescentic Glomerulonephritis ◽  
Immunosuppressive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Small Vessels ◽  
Kidney Involvement ◽  
Chest X Ray ◽  
The Mean

Background: GPA is a necrotizing inflammation of the small vessels with granulomas. Kidney involvement deteriorated its prognosis. Objective: Comparison of GPA patients with kidney (KI) and without kidney involvement (nKI). Material and methods: We conducted a cross-sectional study of 50 consecutive adult GPA patients, 25 KI from Nephrology and 25 nKI from Rheumatology Department of Central Clinical Hospital Ministry of Interior in Warsaw. We analyzed clinical features, organ involvement, laboratory, serological, imaging, histopathological data, BVAS, treatment. Results: The mean age of KI patients was statistically older then nKI (67.3±9.5 vs 55.1±15.9, p=0.002). Generalized, severe, resistance disease was observed respectively in 92% vs 44%, p<0.001. The number of red blood cells (3.47 vs 4.41T/l, p<0.001), hemoglobin (10.0 vs 12.9g/dl, p<0.001) was lower in KI, higher mean serum creatinine (3.95 vs. 0.89mg/dl, p<0.001), lower GFR (20.1 vs. 79.3, p<0.001), higher CRP (median: 43.4 vs 2.0mg/l, p<0.001), BVAS (16.6±4.4 vs 10.1±6.2, p<0.001), c-ANCA (median: 119.0 vs 15.2CU, p=0.017). Nodules in 28% KI, in 4% nKI (p=0.048) in chest X-ray, infiltration in 43.5% KI, in 15% nKI (p=0.042) in HRCT were observed. Skin granulomas were found in 61.5% nKI vs 18.2% KI, (p=0.047). Renal biopsy revealed in KI patients focal segmental glomerulonephritis in 11.8%, crescentic glomerulonephritis in 17.6%, pauci-immune crescentic glomerulonephritis in 70.6%. Conclusions: In patients with KI more frequently we found generalized, severe, resistant GPA, higher BVAS in comparison in patients without KI. The results of laboratory parameters, were worse in patients with KI. Aggressive immunosuppressive treatment is often used in KI group.

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