Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services.

BACKGROUND: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. METHODS: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. RESULTS: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. CONCLUSIONS: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.

Rothia mucilaginosa pneumonia in an immunocompetent patient.

Rothia mucilaginosa is a gram-postive coccus that occurs as part of the normal flora of the oropharynx and upper respiratory tract. Lower respiratory tract infections caused by this organism are rare and usually occur in immunocompromised patients. This is the case of an immunocompetent 47-year-old woman with right upper lobe pneumonia in which R.mucilaginosa was isolated in sputum and bronchial aspirate. Infections caused by this agent in the last four years in our hospital were reviewed. The most common predisposing factor was COPD with bronchiectasis. R.mucilaginosa was identified as the causative agent for pneumonia in only two cases, of which one was our case and the other was a patient with lung cancer.

Neumonía por Rothia mucilaginosa en paciente inmunocompetente / Rothia mucilaginosa Pneumonia in an Immunocompetent Patient

Rothia mucilaginosa es un coco grampositivo que forma parte de la flora normal de la orofaringe y del tracto respiratorio superior. Las infecciones del tracto respiratorio inferior por este germen son infrecuentes y se presentan habitualmente en pacientes inmunocomprometidos. Presentamos una mujer de 47 a˜nos inmunocompetente con neumonía en lóbulo superior derecho en la que se aísla R. mucilaginosa en esputo y en broncoaspirado. Además se revisan las infecciones por este germen en los últimos cuatro años en nuestro hospital. En dicha revisión el factor predisponente más frecuente ha sido la EPOC con bronquiectasias, y en solo dos casos se ha identificado el germen como agente causante de neumonía, entre los que se encuentra nuestro caso y el de un paciente con una neoplasia pulmonar

Rothia mucilaginosa is a gram-postive coccus that occurs as part of the normal flora of the oropharynx and upper respiratory tract. Lower respiratory tract infections caused by this organism are rare and usually occur in immunocompromised patients. This is the case of an immunocompetent 47-year-old woman with right upper lobe pneumonia in which R. mucilaginosa was isolated in sputum and bronchial aspirate. Infections caused by this agent in the last four years in our hospital were reviewed. The most common predisposing factor was COPD with bronchiectasis. R. mucilaginosa was identified as the causative agent for pneumonia in only two cases, of which one was our case and the other was a patient with lung cancer

Hiperplasia de células neuroendocrinas y tumorletscarcinoides pulmonares en paciente con obstruccióndel flujo aéreo / Hyperplasia of pulmonary neuroendocrine cells and carcinoid tumourlets in a patient with airflow obstruction

En el presente trabajo se describe el caso de una mujerde 41 años con cuadro de tos seca y sibilancias de 3 años deevolución con una Capacidad Vital Forzada y un VEMS1disminuidos sin mejoría significativa con broncodilatadores.Se realiza TCAR ante la discordancia clínico-radiológica,que demuestra nódulos múltiples subcentimétricos queson biopsiados. El estudio anatomopatológico demuestrahiperplasia de células neuroendocrinas (HCNE) y tumorletscarcinoides múltiples, con compromiso de la luz bronquiolar.Se destaca la importancia de la valoración morfológicade la vía respiratoria y del estado funcional ante el diagnósticode HCNE/tumorlet carcinoides (AU)

A case is presented of a 41 year old woman with a 3 yearhistory of a dry cough and wheezing. Forced Vital Capacityand FEV1 are reduced using bronchodilators, but with nosignificant improvement. A CAT scan of the thorax iscarried out to investigate the discrepancy between thepatient’s symptoms and the radiological image. Multiplesmall nodules are seen, the biopsy of which revealed neuroendocrinecell hyperplasia, multiple carcinoid tumourletsand involvement of the bronchial lumen. The importance ofboth morphological and functional evaluation of the respiratorytract in the presence of neuroendocrine cell hyperplasia/carcinoid tumourlets is stressed (AU)