Clinical, spirometric, serological differences and outcomes in patients with allergic bronchopulmonary aspergillosis (ABPA) based on the classification by Kumar et al with and without the presence high attenuation mucus (HAM).

<p>Values are expressed as mean (SD) or median (IQR) unless otherwise stated; ABPA-S - serologic ABPA; ABPA-CB - ABPA with central bronchiectasis; ABPA-CB-ORF - ABPA with CB and other radiologic findings;</p>a<p>ABPA-CB-ORF value significant compared to ABPA-s;</p>b<p>ABPA-CB-ORF value significant compared to ABPA-CB;</p>c<p>ABPA-CB value significant compared to ABPA-s;</p>d<p>ABPA-CB value significant compared to ABPA-CB-ORF;</p><p>The <i>A fumigatus</i> specific IgE levels and eosinophil counts, but not the total IgE levels are different between the groups (columns 1 to 3). On post hoc analysis, the <i>A fumigatus</i> specific IgE levels are higher in ABPA-CB (column 2) compared to ABPA-S (column 1) and the eosinophil counts are higher in ABPA-CB (column 2) in comparison to the other two groups (columns 1 and 3). Once HAM is excluded (columns 5 and 6), only the eosinophil counts remain significant in ABPA-CB (column 5) compared to ABPA-S (column 1) and ABPA-CB-ORF (column 6).</p

Baseline characteristics including spirometry, serological and HRCT findings (n = 234).

<p>Baseline characteristics including spirometry, serological and HRCT findings (n = 234).</p

Presence of central bronchiectasis in two different patients with allergic bronchopulmonary aspergillosis.

<p>The presence of classic signet ring appearance of dilated bronchi is easily appreciable (arrows). The bronchiectasis is located predominantly in the inner half of the lung fields.</p

Clinical, spirometric, serological differences and outcomes in patients with allergic bronchopulmonary aspergillosis (ABPA) based on the classification by Greenberger et al with and without the presence of high attenuation mucus (HAM) and other radiologic findings (ORF).

<p>Values are expressed as mean (SD) or median (IQR) unless otherwise stated; ABPA-S - serologic ABPA; ABPA-CB - ABPA with central bronchiectasis.</p><p>The <i>A fumigatus</i> specific IgE levels and eosinophil counts were higher in ABPA-CB compared to ABPA-S. The serological severity varies once patients with HAM and ORF are excluded. On removal of HAM (column 4), only the eosinophil counts retain significance, whereas on removal of ORF (column 6), both <i>A fumigatus</i> specific IgE levels and eosinophil counts remain significant.</p

Clinical, spirometric, serological differences and outcomes in patients with allergic bronchopulmonary aspergillosis (ABPA) based on the proposed staging on the basis of high attenuation mucus (HAM) with and without the presence of other radiologic findings (ORF).

<p>Values are expressed as mean (SD) or median (IQR) unless otherwise stated; ABPA-S - serologic ABPA; ABPA-CB - ABPA with central bronchiectasis;</p>a<p>ABPA-CB-HAM value significant compared to ABPA-s;</p>b<p>ABPA-CB-HAM value significant compared to ABPA-CB;</p>c<p>ABPA-CB value significant compared to ABPA-s;</p>d<p>ABPA-CB value significant compared to ABPA-HAM.</p

High-resolution computed tomographic images of patients with allergic bronchopulmonary aspergillosis demonstrating the presence of high-attenuation mucus.

<p>(A) Mediastinal window showing the presence of hyperattenuated mucus within dilated bronchi. The mucus is denser than the paraspinal skeletal muscle (asterisk) (B) Lung window shows that hyperdense mucus can occasionally be appreciated even with the parenchymal sections (circle); (C) CT Hounsfield values of mucus in dilated bronchi: mucus in the left lung is hyperdense with higher CT attenuation values compared to mucoid impaction in the right lung; (d) Hyperattenuated (bold arrow) and normal attenuation mucus (thin arrow) in the same mediastinal window.</p

Effects of HRCT findings (HAM, number of bronchiectatic segments and ORF) on occurrence of frequent relapses - multivariate logistic regression model.

<p>Effects of HRCT findings (HAM, number of bronchiectatic segments and ORF) on occurrence of frequent relapses - multivariate logistic regression model.</p

Rosenberg-Patterson criteria for the diagnosis of allergic bronchopulmonary aspergillosis [3], [4].

<p>The presence of six out eight major criteria makes the diagnosis almost certain.</p

Other radiological features (ORF) that are encountered in patients with allergic bronchopulmonary aspergillosis:

<p>(A) parenchymal fibrosis involving the right lower lobe; (B) parenchymal and pleural fibrosis; (C) aspergilloma within a bronchiectatic cavity; (D) large cavity with air fluid level; (E) multiple bulla with central bronchiectasis; (F) left sided pneumothorax- numerous bronchiectatic cavities can be appreciated in the collapsed lung.</p

Transcriptome analysis of mycobacteria in sputum samples of pulmonary tuberculosis patients

<div><p>Pulmonary tuberculosis, the disease caused by <i>Mycobacterium tuberculosis</i>, still retains a top rank among the deadliest communicable diseases. Sputum expectorated during the disease continues to be a primary diagnostic specimen and also serves as a reservoir of bacteria. The expression pattern of mycobacteria in sputum will lead to an insight into bacterial adaptation at the most highly transmissible stage of infection and can also help in identifying newer diagnostic as well as drug targets. Thus, in the present study, a whole genome microarray of <i>Mycobacterium tuberculosis</i> was used to elucidate the transcriptional profile of mycobacteria in the sputum samples of smear positive pulmonary tuberculosis patients. Overall, the mycobacteria in sputum appeared to be in a low energy and low replicative state as compared to <i>in vitro</i> grown log phase <i>M</i>. <i>tb</i> with downregulation of genes involved in ATP synthesis, aerobic respiration and translational machinery. Simultaneously, downregulation was also seen in the genes involved in secretion machinery of mycobacteria along with the downregulation of genes involved in the synthesis of phthiocerol dimycocerosate and phenol glycolipids. In contrast, the majority of the genes which showed an upregulation in sputum mycobacteria were of unknown function. Further identification of these genes may provide new insights into the mycobacterial behavior during this phase of infection and may help in deciphering candidates for development of better diagnostic and drug candidates.</p></div