Topic
Expectorate
About: Expectorate is a research topic. Over the lifetime, 35 publications have been published within this topic receiving 614 citations.
Papers
TL;DR: Use of 3 induced sputum samples was more sensitive than use of 3 gastric washings for diagnosis of tuberculosis in patients who could not expectorate spontaneously, allowing for faster diagnosis, faster initiation of treatment, and shorter hospital stay.
Abstract: BACKGROUND: Many adults with pulmonary tuberculosis are unable to expectorate. Gastric washing, sputum induction using nebulized hypertonic saline, and bronchoscopy with bronchoalveolar lavage have all been used to obtain specimens for diagnosis, but to our knowledge, the timing and volume of induced sputum have not been well studied, and these 3 methods have not been compared. METHODS: The study recruited consecutive adult inpatients with chest radiography findings suggestive of tuberculosis who were unable to expectorate. Subjects provided 3 induced sputum samples for culture on day 1 and additional samples on days 2 and 3. In addition, gastric washing specimens were collected on days 1, 2, and 3. A proportion of subjects with negative smear results underwent bronchoalveolar lavage. RESULTS: The study recruited 140 subjects. Among 107 subjects who provided 3 gastric washing specimens and at least 3 induced sputum specimens, 43% had cultures positive for Mycobacterium tuberculosis. Use of 3 induced sputum samples detected more cases than did use of 3 gastric washings (39% vs. 30%; P=.03). Among 79 subjects with culture results for all 5 induced sputum specimens, there was no difference in yield between samples obtained by induced sputum induction performed in a single day or that performed over 3 days (34% vs. 37%; P=.63). There was no association between sputum volume and positive culture results. No additional cases were diagnosed in the 21 patients who underwent bronchoscopy. CONCLUSIONS: Use of 3 induced sputum samples was more sensitive than use of 3 gastric washings for diagnosis of tuberculosis in patients who could not expectorate spontaneously. Use of bronchoscopy with bronchoalveolar lavage did not increase diagnostic sensitivity. Samples could be collected in 1 day, allowing for faster diagnosis, faster initiation of treatment, and shorter hospital stay.
115 citations
Journal Article•
TL;DR: SI produced a positive smear result in 29% of patients with suspected TB who had previously been smear-negative or unable to expectorate, and proved an aid to clinical decision making.
Abstract: Objectives . To assess the value of sputum induction (SI) as a diagnostic tool for patients with suspected pulmonary tuberculosis (PTB) who are unable to expectorate or who have a negative sputum smear, Design , Study of an inpatient cohort undergoing SL Setting , Mseleni Hospital, a rural district hospital in northern KwaZulu-Natal. Subjects . All adult patients with suspected TB seen at the hospital over a 4-month period, Outcome measures , (i) Successful SI; (ii) sputum acid-fast smear result; (iii) change of admission diagnosis as a result of the induction procedure; and (iv) number of patients discharged with a diagnosis other than TB who represented within 4 months with TB, Results , A total of 51 patients (31 female) underwent SI; of these 36 (71 %) were able to produce a sputum sample, Fifteen (42%) of those were acid-fast smear-positive (29% of all patients included), The admission diagnosis was changed in 16 (44%) of the patients who were able to give an induced sputum sample as opposed to 4 (27%) who had been unable to expectorate despite an induction attempt (P = 038). Three (125%) of the 24 patients with a discharge diagnosis other than TB (17 pneumonia, 3 old TB, 2 carcinoma of the lung, 1 bronchiectasis) turned out to have TB within the follow-up period; 2 of those had extrapulmonary TB Conclusion , SI produced a positive smear result in 29% of patients with suspected TB who had previously been smear-negative or unable to expectorate. The method proved an aid to clinical decision making.
41 citations
TL;DR: The authors believe that for optimal visualization of esophageal varices the following is the procedure of choice and the intelligent use of these factors should result in a saving of both fluoroscopic time and film, and give the radiologist a safe optimal diagnostic yield.
Abstract: Twelve patients with known esophageal varices and willingness to cooperate were included in the study. Medications administered were placebo, 2 mg of glucagon, and 30 mg of propantheline bromide. All medications were given double-blind and crossover. On the basis of this study the authors believe that for optimal visualization of esophageal varices the following is the procedure of choice: (1) the patient should remain horizontal (this is best done in the left lateral position for comfort and ease of expectoration) for ten minutes after swallowing high density barium; (2) the patient should "clear his throat" frequently and expectorate all saliva (barium sticks to the pharynx and makes the patient want to swallow and "clearing his throat" by forced expiration helps the patient to expectorate this coating and prevents swallowing); (3) filming should be done in expiration in the supine (left posterior oblique to table top) position; and (4) in equivocal cases the examination can be repeated with an antichol...
26 citations
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TL;DR: Burning and paresthesias of the oral mucosa, particularly of the tongue, are common symptoms and may at times precede the onset of recognized salivary deficiency.
Abstract: AS DERMATOLOGISTS we are frequently concerned with complaints referable to the mouth and with changes in the oral mucous membranes. Deficiency or absence of saliva may result in changes in the oral mucosa with which we should all be familiar. When the quantity of saliva secreted is moderately reduced the mucous membranes may appear normal. The salivary deficiency may be evident only in that the saliva is always mucoid, sticky, weblike, bubbly and frothy rather than thin and watery. It may be adherent and ball up and be difficult to expectorate without the moistening of the mouth with water. Burning and paresthesias of the oral mucosa, particularly of the tongue, are common symptoms and may at times precede the onset of recognized salivary deficiency. Pronounced deficiency or complete absence of saliva leads to stickiness, dryness, soreness, burning and pain of the mucous membranes and to redness, atrophy,
22 citations
TL;DR: The positive results produced by the expectorate samples from the exposed smokers suggest a synergistic relationship between exposure to air pollution of the working atmosphere and smoking.
Abstract: Methanol extracts of hydrolyzed expectorate samples from workers in a Soderberg potroom were evaluated by the Salmonella reversion assay. The expectorates from exposed workers--mostly from smokers, but also to a certain extent from nonsmokers--were mutagenic; however, the control samples from both smokers and nonsmokers were not. The positive results produced by the expectorate samples from the exposed smokers suggest a synergistic relationship between exposure to air pollution of the working atmosphere and smoking.
22 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 1 |
| 2018 | 1 |
| 2017 | 3 |
| 2015 | 1 |
| 2013 | 3 |
| 2010 | 1 |