Poor Concordance between Sequential Transbronchial Lung Cryobiopsy and Surgical Lung Biopsy in the Diagnosis of Diffuse Interstitial Lung Diseases.

Rationale: The diagnostic concordance between transbronchial lung cryobiopsy (TBLC)-versus surgical lung biopsy (SLB) as the current gold standard-in interstitial lung disease (ILD) cases requiring histology remains controversial. Objectives: To assess diagnostic concordance between TBLC and SLB sequentially performed in the same patients, the diagnostic yield of both techniques, and subsequent changes in multidisciplinary assessment (MDA) decisions. Methods: A two-center prospective study included patients with ILD with a nondefinite usual interstitial pneumonia pattern (on high-resolution computed tomography scan) confirmed at a first MDA. Patients underwent TBLC immediately followed by video-assisted thoracoscopy for SLB at the same anatomical locations. After open reading of both sample types by local pathologists and final diagnosis at a second MDA (MDA2), anonymized TBLC and SLB slides were blindly assessed by an external expert pathologist (T.V.C.). Kappa-concordance coefficients and percentage agreement were computed for: TBLC versus SLB, MDA2 versus TBLC, MDA2 versus SLB, and blinded pathology versus routine pathology. Measurements and Main Results: Twenty-one patients were included. The median TBLC biopsy size (longest axis) was 7 mm (interquartile range, 5-8 mm). SLB biopsy sizes averaged 46.1 ± 13.8 mm. Concordance coefficients and percentage agreement were: TBLC versus SLB: κ = 0.22 (95% confidence interval [CI], 0.01-0.44), percentage agreement = 38% (95% CI, 18-62%); MDA2 versus TBLC: κ = 0.31 (95% CI, 0.06-0.56), percentage agreement = 48% (95% CI, 26-70)%; MDA2 versus SLB: κ = 0.51 (95% CI, 0.27-0.75), percentage agreement = 62% (95% CI, 38-82%); two pneumothoraces (9.5%) were recorded during TBLC. TBLC would have led to a different treatment if SLB was not performed in 11 of 21 (52%) of cases. Conclusions: Pathological results from TBLC and SLB were poorly concordant in the assessment of ILD. SLBs were more frequently concordant with the final diagnosis retained at MDA.

Profiling the biological effects of wastewater samples via bioluminescent bacterial biosensors combined with estrogenic assays.

Various water samples were successfully evaluated using a panel of different recombinant bioluminescent bacteria and estrogenic activity analysis. The bioluminescent bacteria strains induced by oxidative (superoxide radical or hydroxyl radical), protein damage, cell membrane damage, or cellular toxicity were used. Estrogenic activities were examined by using the yeast strain BY4741, which carries the ß-galactosidase reporter gene under the control of the estrogen-responsive element (ERE). A total of 14 samples from three wastewater treatment plants, one textile factory, and seawater locations in Tunisia were analyzed. A wide range of bio-responses were described. Site/sample heterogeneity was prevalent, in combination with generally high relative bioluminescence scores for oxidative stress (OH•). Estrogenic activity was detected at all sites and was particularly elevated at certain sites. Our perspectives include the future exploration of the variation detected in relation to treatment plant operations and environmental impacts. In conclusion, this new multi-experimental method can be used for rapid bio-response profile monitoring and the evaluation of environmental samples spanning a wide range of domains. This study confirms that bio-reactive wastewater treatment plant (WWTP) effluents are discharged into seawater, where they may impact coastal populations.