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Barril S, Sebastián L, Cotta G, Crespo A, Mateus E, Torrejón M, Ramos-Barbón D, Plaza V. Utility of Induced Sputum in Routine Clinical Practice. Arch Bronconeumol 2015; 52:250-5. [PMID: 26651625 DOI: 10.1016/j.arbres.2015.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the general and specific utility in diagnosis and/or treatment of induced sputum (IS) inflammatory cell counts in routine clinical practice. METHODS Retrospective study of 171 patients referred for clinical sputum induction over a 1-year period in the pulmonology department of a referral hospital. Independent observers established whether the information provided by IS inflammatory cell count was useful for making diagnostic and therapeutic decisions. RESULTS The most frequent reasons for determination of IS inflammatory cell count were: asthma 103 (59.20%); uncontrolled asthma 34 (19.54%); chronic cough 19 (10.9%), and gastroesophageal reflux 15 (8.6%). In 115 patients (67.3%) it was generally useful for diagnosis and/or treatment; in 98 patients (57.3%) it provided diagnostic information and in 85 patients (49.7%) it assisted in therapeutic decision-making. In asthma, uncontrolled asthma, chronic cough and gastroesophageal reflux, the results were useful in 71.8%, 67.6%, 47.4% and 60%, respectively. CONCLUSION The information provided by IS inflammatory cell count is extremely useful in clinical practice, especially in asthma and chronic cough. These results may justify the inclusion of the IS technique in pulmonology departments and asthma units of referral centers.
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Affiliation(s)
- Silvia Barril
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Laura Sebastián
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Gianluca Cotta
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Astrid Crespo
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Eder Mateus
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Montserrat Torrejón
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - David Ramos-Barbón
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Vicente Plaza
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
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Pacheco A, de Diego A, Domingo C, Lamas A, Gutierrez R, Naberan K, Garrigues V, López Vime R. Tos crónica. Arch Bronconeumol 2015; 51:579-89. [DOI: 10.1016/j.arbres.2015.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 03/21/2015] [Accepted: 03/23/2015] [Indexed: 12/16/2022]
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Cepeda S, Martínez Moragón E, Ponce S. Tos ferina del adulto: una enfermedad emergente en la consulta del neumólogo. Arch Bronconeumol 2015; 51:472-3. [DOI: 10.1016/j.arbres.2014.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 10/25/2014] [Accepted: 10/28/2014] [Indexed: 10/24/2022]
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Pacheco A, Faro V, Cobeta I, Royuela A. Chronic Cough With Limited Response to Treatment and Incidence of Gastroesophageal Reflux. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.arbr.2012.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Tos crónica de escasa respuesta al tratamiento e incidencia de reflujo gastroesofágico. Arch Bronconeumol 2012; 48:197-201. [DOI: 10.1016/j.arbres.2012.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 02/01/2012] [Accepted: 02/01/2012] [Indexed: 01/10/2023]
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Pacheco-Galván A, Hart SP, Morice AH. Relationship between gastro-oesophageal reflux and airway diseases: the airway reflux paradigm. Arch Bronconeumol 2011; 47:195-203. [PMID: 21459504 DOI: 10.1016/j.arbres.2011.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 02/02/2011] [Accepted: 02/04/2011] [Indexed: 12/21/2022]
Abstract
Our understanding of the relationship between gastro-oesophageal reflux and respiratory disease has recently undergone important changes. The previous paradigm of airway reflux as synonymous with the classic gastro-oesophageal reflux disease (GORD) causing heartburn has been overturned. Numerous epidemiological studies have shown a highly significant association of the acid, liquid, and gaseous reflux of GORD with conditions such as laryngeal diseases, chronic rhinosinusitis, treatment resistant asthma, COPD and even idiopathic pulmonary fibrosis. However, it has become clear from studies on cough hypersensitivity syndrome that much reflux of importance in the airways has been missed, since it is either non- or weakly acid and gaseous in composition. The evidence for such a relationship relies on the clinical history pointing to symptom associations with known precipitants of reflux. The tools for the diagnosis of extra-oesophageal reflux, in contrast to the oesophageal reflux of GORD, lack sensitivity and reproducibility. Unfortunately, methodology for detecting such reflux is only just becoming available and much additional work is required to properly delineate its role.
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Affiliation(s)
- Adalberto Pacheco-Galván
- Servicio de Neumología, Unidad de Asma y Tos de Difícil Manejo, Hospital Ramón y Cajal, Madrid, Spain.
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Tos crónica: a propósito de un caso. Semergen 2010. [DOI: 10.1016/j.semerg.2009.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sáez-Jiménez R, Ochoa-Prieto J, Aparicio-García S. Paciente joven con tos crónica y alteración espirométrica severa. Semergen 2008. [DOI: 10.1016/s1138-3593(08)71845-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Seguí Díaz M, Linares Pou L, Ausín Olivera A. El asma bronquial desde el médico de familia (II). Semergen 2005. [DOI: 10.1016/s1138-3593(05)72877-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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