Combination of Endobronchial Ultrasound and Modern Cytological Diagnosis in Patients With Intrathoracic Lesions

Objective: To evaluate the effectiveness of endobronchial (EBUS) and endoscopic ultrasound (EUS) in cytomorphological verification of a malignant process using the transbronchial needle aspiration (TBNA) of the lymph nodes and mediastinal organs.Materials and methods: In 2017–2019 we analyzed the cytological samples (standard and cell block) of 172 patients (115 males and 57 females) with an average age of 61 years (25–82 years) in the clinical diagnostic laboratory of Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation). Of them 111 were used for immunocytochemical analysis. The majority of the studies (77) were performed in patients with lung cancer in order to identify the stage of the disease. We used combined bronchoscopy under general anesthesia in the operating room with high-frequency ventilation and a rapid on-site evaluation (ROSE).Results: We found the lymph node and mediastinal invasion in 140 (81%) patients who underwent EBUS-EUS TBNA. The non-diagnostic results were obtained in 32 (19%) patients. The combination of EUS and EBUS with TBNA showed the highest effectiveness in the mentioned clinical cases. The sensitivity, specificity, and accuracy of the cytologic analysis during EBUS and EUS with TBNA and no ROSE were 89%, 100%, and 90%, respectively. ROSE reduced the rate of non-diagnostic results and increased the sensitivity (96%), specificity (100%), and accuracy (97%) of the cytologic evaluation.Conclusions: According to the obtained results, we recommend using EBUS-EUS TBNA modalities for morphological verification of the mediastinal lymph nodes as a routine invasive diagnosis component of the preoperative evaluation in patients with lung cancer

Pathogenetic Effects of Bacteria of the Genus <i>Desulfovibrio</i>. Experimental Study. Part One: Iron Metabolism

The aim of the work was to study specific systemic effect of sulfate-reducing bacteria of the genus Desulfovibrio on organism systems through creating an experimental model of intragastric bacterial invasion against the background of dysbiotic conditions of rodent gastrointestinal tract. Materials and methods. The experimental study was conducted on Wistar rats. Intestinal dysbiosis was modeled with the help of antibiotics, amoxicillin and metronidazole. Typical strain Desulfovibrio desulfuricans subsp. desulfuricans VKM B-1799T was used as an infectious agent. Results and discussion. As a result of the experiment performed, during the period of acute infection (on day 15 of the experiment), a direct correlation between the concentration of the injected D. desulfuricans VKM B-1799T bacteria suspension and the serum iron level was observed: the higher the infectious agent dose, the lower the serum iron concentration. During the phase of remote effects (day 38 of the experiment), the inverse correlation between the concentrations of D. desulfuricans VKM B-1799T in the intestines of rodents was revealed: when the concentration of the infecting agent increased from 103 CFU/g and higher, the iron level decreased from 43.5 μmol/l to 38.5 μmol/l. When comparing the level of transferrin and unsaturated iron binding capacity (UIBC), an increase in those parameters was observed in all groups of rats both during the period of acute infection and the period of long-term effects, and the percentage of transferrin iron saturation decreased, indicating the occurrence of iron deficiency against the background of exposure to the infectious agent. Intestinal dysbiosis promotes colonization by opportunistic flora, including Desulfovibrio sp. Changes in the iron metabolism markers in experimental animals against the background of D. desulfuricans VKM B-1799T infestation above 103 CFU/g and the ability of this microorganism to bind iron into an unavailable form suggest that the bacteria Desulfovibrio sp. are one of the key etiological factors of iron deficiency anemia