Category: Cystic Fibrosis

Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum: Summary

Microbiology results suggested SI may be a useful tool in the multicentered research setting. Aliquots of induced sputum appear to provide a representative sample as quantitative bacterial cultures only varied by approximately a half-log count over time. In standard induced-sputum sample processing, di-thiothreitol has to be added to the sputum sample to homogenize it. However, the addition of dithiothre-itol decreases microbiological counts after 2 h….

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Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum: Asthmatic subjects

SI was relatively well tolerated by all subjects, However, two subjects had a > 15% fall in FEVj with this procedure even when premedicated with albuterol, However, the adverse effects associated with the sedation and the procedure of bronchoscopy with BAL on pulmonary function and oxygenation in patients with CF is not well reported but would appear greater than those of SI. Throat irritation was…

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Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum: Sample Size Calculations

The null hypothesis for these tests was that sampling times, taken together, had no effect on the outcome of interest. A test for linear time trend was also performed for each outcome measure by fitting a regression in which time was modeled as a continuous variable. Finally, the mean change calculated as the 20-min value minus the 4-min value with 95% confidence intervals (CIs) was…

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Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum: Quantitative Culture

Samples were run in triplicate and compared to a standard curve. In order to ensure that dithiothreitol did not degrade IL-8, we added 100 ng and 500 ng IL-8 for 90 min to each sample from three patients (ie, total of 15 samples) and generated standard curves. Dithiothreitol did not degrade IL-8. Urea concentration was measured at the clinical laboratory of the University of Washington…

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Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum: SI

Using a modification of the protocol described by Fahy et al, modified by the Cystic Fibrosis Foundation Therapeutics Development Network, subjects inhaled nebulized sterile hypertonic saline (3%) solution for 20 min from an Ultra-Neb 99 ultrasonic nebulizer (DeVilbiss; Somerset, PA). This nebulizer generates particles of a mean mass median diameter of 4.5 μm and has an output of 2.4 mL/min. After expelling saliva, subjects were…

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Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum: Materials and Methods

We have previously shown that SI may provide a more representative airway sample than BAL in patients with CF. When SI is compared with BAL and expectorated sputum (ES), SI had a lower percentage of squamous cells than ES, all three techniques had a similar nonsquamous cell differential count, quantitative microbiology correlated best between ES and SI, and cytokine measurements by all three techniques were…

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Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum

Hypertonic saline has recently been used as a form of airway clearance in patients with cystic fibrosis (CF),-2 and as a means to obtain a lower airway sample for clinical use from patients who are unable to expectorate spontaneously. However, in high concentration (10%), hypertonic saline solution has been shown to cause bronchospasm in some patients with CF. Although sputum induction (SI) has been recognized…

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