Browsing by Author "The, Stephanie"

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    Establishing a Normal Range for Induced Sputum Cell Counts in Western Canada
    (2013-01-01) Davidson, Warren J; The, Stephanie; Leigh, Richard
    BACKGROUND: Induced sputum cell counts are a noninvasive, reliable method for evaluating the presence, type and degree of airway inflammation. Whether current reference values for induced sputum cell counts are applicable in other induced-sputum laboratories, particularly those in Western Canada or at elevated altitude, is not clear.OBJECTIVES: To describe the normal range of induced sputum cell counts in healthy adults in Western Canada.METHODS: A total of 105 healthy nonsmoking adults with normal bronchial responsiveness and no history of lung disease proceeded with sputum induction. Sputum samples were fixed in formalin.RESULTS: Sixty-nine subjects were included in the final analyses. The mean ± SD and median (interquartile range) of the cell counts, respectively, were: total cell count 2.453±2.108, 2.000 (2.512); neutrophils 1.212±1.491, 0.721 (1.016); eosinophils 0.034±0.069, 0.005 (0.043); macrophages 1.050±1.213, 0.696 (1.005); lymphocytes 0.057±0.161, 0.001 (0.049); and bronchial epithelial cells 0.041±0.126, 0.000 (0.027). The respective differential cell percentages were: neutrophils 50.3±23.5, 51.9 (32); eosinophils 1.4±2.3, 0.3 (2); macrophages 43±22.8, 39.3 (32); lymphocytes 2.6±5.2, 0.4 (2.5); and bronchial epithelial cells 2.2±4.8, 0.0 (2.9). Bland-Altman analysis and intraclass correlation coefficients revealed excellent interobserver agreement for measurement of sputum cell types.DISCUSSION: The range of induced sputum cell counts performed in a laboratory in Western Canada in healthy nonsmoking adult subjects was described; cellular distributions were similar to previous studies. This was also the first description of normal values for formalin-fixed induced sputum samples.CONCLUSIONS: These results confirm that current reference values for induced sputum are generalizable across different laboratories, including those in Western Canada and those at elevated altitude, and are also generalizable to formalin-fixed samples, allowing use in the broader Canadian asthma population.
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    Identification and Validation of Nebulized Aerosol Devices for Sputum Induction
    (2014-01-01) Davidson, Warren J; Dennis, John; The, Stephanie; Litoski, Belinda; Pieron, Cora; Leigh, Richard
    BACKGROUND: Induced sputum cell counts are a noninvasive and reliable method for evaluating the presence, type and degree of airway inflammation in patients with asthma. Currently, standard nebulizer devices used for sputum induction in multiple patients are labelled as single-patient devices by the manufacturer, which conflicts with infection prevention and control requirements. As such, these devices cannot feasibly be used in a clinical sputum induction program. Therefore, there is a need to identify alternative nebulizer devices that are either disposable or labelled for multi-patient use.OBJECTIVE: To apply validated rigorous, scientific testing methods to identify and validate commercially available nebulizer devices appropriate for use in a clinical sputum induction program.METHODS: Measurement of nebulized aerosol output and size for the selected nebulizer designs followed robust International Organization for Standardization methods. Sputum induction using two of these nebulizers was successfully performed on 10 healthy adult subjects. The cytotechnologist performing sputum cell counts was blinded to the type of nebulizer used.RESULTS: The studied nebulizers had variable aerosol outputs. The AeroNeb Solo (Aerogen, Ireland), Omron NE-U17 (Omron, Japan) and EASYneb II (Flaem Nuova, Italy) systems were found to have similar measurements of aerosol size. There was no significant difference in induced sputum cell results between the AeroNeb Solo and EASYneb II devices.DISCUSSION: There is a need for rigorous, scientific evaluation of nebulizer devices for clinical applications, including sputum induction, for measurement of cell counts.CONCLUSION: The present study was the most comprehensive analysis of different nebulizer devices for sputum induction to measure cell counts, and provides a framework for appropriate evaluation of nebulizer devices for induced sputum testing.
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    The impact of diurnal variation on induced sputum cell counts in healthy adults
    (BioMed Central, 2013-03-28) Davidson, Warren J.; Wong, Lisa E; The, Stephanie; Leigh, Richard