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Topic:Respiratory Disease

Respiratory disease in horses encompasses a range of conditions affecting the respiratory system, including the upper and lower airways. These diseases can result from various etiologies such as infectious agents, environmental factors, or genetic predispositions. Common respiratory conditions in horses include equine asthma, equine influenza, and strangles. Clinical signs often associated with respiratory disease in horses include coughing, nasal discharge, and labored breathing. Diagnostic approaches may involve endoscopy, imaging, and laboratory tests to assess the function and health of the respiratory tract. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, and management of respiratory diseases in equine populations.
Multiple Gene Deletion Mutants of Equine Herpesvirus 1 Exhibit Strong Protective Efficacy Against Wild Virus Challenge in a Murine Model.
Vaccines    January 8, 2025   Volume 13, Issue 1 45 doi: 10.3390/vaccines13010045
Pradhan SS, Balena V, Bera BC, Anand T, Khetmalis R, Madhwal A, Kandasamy S, Pavulraj S, Bernela M, Mor P, Tripathi BN, Virmani N.Equine herpesvirus type 1 (EHV1) is a ubiquitous viral pathogen infecting the equine population worldwide. EHV1 infection causes respiratory illness, abortion, neonatal foal mortality, and myeloencephalopathy. The currently available modified live EHV1 vaccines have safety and efficacy limitations. The two mutant EHV1 viruses (vToH-DMV (∆IR6/gE) and vToH-QMV (∆IR6/UL43/gE/UL56)), generated by the deletion of genes responsible for virulence (gE and IR6) and immunosuppression (uL43 and uL56), have been previously characterized by our group and found to generate good immune responses. The pre...
Soft palate angle and basihyoid depth increase with tongue size and with body condition score in horses.
Equine veterinary journal    January 2, 2025   doi: 10.1111/evj.14445
Talbot AM, Shanks-Boon H, Baldwin CM, Barnes H, Maddox TW.Obesity has been associated with human obstructive sleep apnoea and canine brachycephalic obstructive airway syndrome. The effect of body condition score (BCS) on structures of the oropharynx, nasopharynx and upper airway of the horse has not been investigated. Objective: To investigate the effect of BCS on tongue measurements, soft palate angle and basihyoid depth in horses. Methods: Retrospective, analytical, cross-sectional. Methods: Computed tomographic (CT) images of the head of 58 horses were assessed. DICOM viewing software was used to measure head length, basihyoid-skin depth, soft pal...
Comparison of nasal swabs and handmade foam cubes for detecting equine herpesvirus 5 (EHV-5) by quantitative polymerase chain reaction (qPCR). Charbonnel A, Lavoie JP, Juette T, St-Sauveur VG, Denis S, Gagnon CA, Leclère M.The control of equine respiratory infections is a biosecurity challenge. Respiratory viruses are often rapidly detected using quantitative polymerase chain reaction (qPCR) on nasal swabs. In the past, some laboratories developed handmade techniques to increase the amount of nasal secretions collected, without comparing them with nasal swabs when qPCR replaced the use of viral culture. The objectives of this study were to compare nasal swabs and handmade foam cubes for i) the detection of a common equine herpesvirus (EHV-5) by qPCR, and ii) their tolerability. Forty-five polyester swabs and foa...
Could Serum Collectin-11, surfactant protein-A and D be suitable biomarkers for assessing pulmonary damage caused by Rhodococcus equi infection in foals on large farms?
Polish journal of veterinary sciences    December 30, 2024   Volume 27, Issue 3 355-362 doi: 10.24425/pjvs.2024.149367
Ekinci G, Deniz O, Tüfekci E, Timur MC, Onmaz AC, Günes V, Citil M, Keles I, Hoven RVD.Rhodococcus equi (R. equi) is a primary cause of pyogranulomatous pneumonia of foals between three weeks and five months of age. Early diagnosis of rhodococcal pneumonia has always been considered a preferable approach as it can lead to more successful treatment and better outcomes. Horse stud farms where the disease is common, neonatal foals are subjected to tests such as complete blood count and fibrinogen analysis at certain intervals. However, new biomarkers are needed in addition to blood count and fibrinogen measurement in this field for early diagnosis of diseases. Based on this need, i...
Impact of musical rhythm on blood, physiological and welfare parameters in stabled horses.
Scientific reports    December 28, 2024   Volume 14, Issue 1 31311 doi: 10.1038/s41598-024-82637-8
The aim of this study was to evaluate the effects of two styles of classical music, based on different tempos (BPM), on the physiological and blood parameters of horses during social isolation and restriction of movements. First experiment was carried out using nine horses of no defined breed, distributed in Control, Slow-tempo music and Moderate-tempo music .For social isolation and restriction of movement, the animals were housed daily in individual stalls for two hours and exposed to the stimuli for 60 min, and eye temperature, heart rate, and respiratory rate were assessed. The second exp...
Respiratory viruses affecting health and performance in equine athletes.
Virology    December 24, 2024   Volume 603 110372 doi: 10.1016/j.virol.2024.110372
Frippiat T, van den Wollenberg L, van Erck-Westergren E, van Maanen K, Votion DM.Some respiratory viruses can affect equine athletes, with acute respiratory clinical signs leading to a reduced ability to perform. The direct association between equine respiratory viruses and athletic performance is unclear in subclinically affected horses. This narrative review summarises the current evidence on respiratory viruses most commonly detected in performing horses, including equine herpesviruses, equine influenza virus, equine rhinitis viruses, equine arteritis virus, and equine adenovirus 1. It covers their virology, clinical manifestations, epidemiology, pathogenesis, diagnosis...
Factors affecting survival of foals with pneumonia in a referral hospital.
BMC veterinary research    December 18, 2024   Volume 20, Issue 1 562 doi: 10.1186/s12917-024-04405-0
Rossi HS, Hyytiäinen HK, Junnila JJT, Rajamäki MM, Mykkänen AK.Pneumonia is a common condition in ailing neonatal foals, and it remains an important cause of morbidity and mortality in this veterinary patient group. Factors affecting the survival of young foals with pneumonia have not been thoroughly investigated. The aim of this study was to explore the potential prognostic factors associated with survival of these foals. Fifty foals under one month of age with pneumonia were included in this retrospective clinical study. The foals were divided into groups based on survival (survived to discharge or died/euthanised during hospitalisation). Multiple clini...
How to perform a transtracheal aspirate in horses for diagnosis of lower respiratory tract disease.
Journal of the American Veterinary Medical Association    December 18, 2024   1 doi: 10.2460/javma.24.11.0697
Bishop RC, Nobrega AD, Mersich I, Wilkins PA.To describe indications for and demonstrate the technique to perform a transtracheal aspirate in horses. Transtracheal aspirate is indicated to collect samples for cytology and bacteriologic culture in cases of suspected pneumonia or other lower respiratory tract disease. Methods: 1 healthy university-owned horse was used for demonstration purposes. Images of clinical case samples from the University of Illinois Veterinary Teaching Hospital are shown. Methods: The horse is restrained and sedated with detomidine or xylazine to facilitate restraint and butorphanol to minimize coughing. The ventr...
Effect of Bio-Electro-Magnetic-Energy-Regulation (BEMER) Horse Therapy on Cardiopulmonary Function and Recovery Quality After Isoflurane Anesthesia in 100 Horses Subjected to Pars-Plana Vitrectomy: An Investigator-Blinded Clinical Study.
Animals : an open access journal from MDPI    December 18, 2024   Volume 14, Issue 24 3654 doi: 10.3390/ani14243654
Brandenberger O, Kalinovskiy A, Körner J, Genn H, Burger R, Leser S.The use of Bio-Electro-Magnetic-Energy-Regulation (BEMER) therapy during general anesthesia has not previously been reported in horses. This randomized, investigator-blinded, placebo-controlled trial evaluates equine cardiopulmonary function and recovery quality after BEMER therapy application for 15 min in 100 horses during general anesthesia using isoflurane for pars-plana vitrectomy surgery as treatment for recurrent uveitis. Visually identical blankets were used in the two groups (1:1 ratio), one with a functional BEMER module and the other with a placebo module. Arterial blood pressure, b...
Successful management of two horses with suspected pulmonary haemorrhage in recovery from general anaesthesia.
Veterinary anaesthesia and analgesia    December 16, 2024   doi: 10.1016/j.vaa.2024.11.002
Hordle T, Ranninger E, Bettschart-Wolfensberger R.A 24 year old warmblood mare (case 1) and a 12 year old Holsteiner gelding (case 2) were anaesthetized for bursoscopy and phacoemulsification, respectively. Both were premedicated with intramuscular acepromazine (30 μg kg-1). The horses were sedated with intravenous (IV) medetomidine (7-9 μg kg-1 to effect), before anaesthetic induction with ketamine-diazepam. Anaesthesia was maintained with isoflurane in a mixture of oxygen and medical air, alongside a medetomidine constant rate infusion at 3.5 μg kg-1 hour-1. In recovery, 3 and 5 μg kg-1 of medetomidine were administered IV to cases 1 an...
Pilot study characterizing a single pooled preparation of equine platelet lysate for nebulization in the horse.
Frontiers in veterinary science    December 12, 2024   Volume 11 1488942 doi: 10.3389/fvets.2024.1488942
Egli P, Boone L, Huber L, Higgins C, Gaonkar PP, Arrington J, Naskou MC, Peroni J, Gordon J, Lascola KM.Platelet lysate (PL) demonstrates antimicrobial and anti-inflammatory properties offering potential for treatment of bacterial pneumonia in horses. It remains unknown whether nebulization is suitable for PL administration in horses. This pilot study characterized particle size and flow rate of pooled equine PL (single preparation) nebulized using an equine-specific nebulizer (Flexivent®). Unassigned: Protein composition and antimicrobial activity were compared before and after nebulization. Protein composition was evaluated according to growth factor, antimicrobial peptide and cytokine concen...
Immunodeficiencies in Foals.
The Veterinary clinics of North America. Equine practice    December 9, 2024   Volume 40, Issue 2S e1-e19 doi: 10.1016/j.cveq.2024.11.006
Magdesian KG.Knowledge of immunodeficiencies is crucial to neonatal medicine, in that they predispose to sepsis in the newborn and neonatal foal, as well as recurrent infections in older foals. The most common immunodeficiency in newborn and neonatal foals is failure of passive transfer, which is an example of an acquired immunodeficiency. Congenital or developmental immunodeficiencies may be transient or permanent, and can either affect the cell-mediated or humoral arms of immunity, and in some cases both. Affected foals often have chronic or recurrent respiratory or gastrointestinal infections, often wit...
Traumatic Hemothorax With Rib Fixation in a Professional Jockey Following a Horse Stomping Incident.
Cureus    December 8, 2024   Volume 16, Issue 12 e75349 doi: 10.7759/cureus.75349
Cervantes-Sevilla JR, Ramírez-Cervera M, Guzman-Ruvalcaba MJ.Traumatic hemothorax is a serious condition requiring immediate intervention. We present a case of a 48-year-old male professional jockey who suffered traumatic hemothorax, bilateral pulmonary contusions, and multiple rib fractures after being stomped by a horse. Management included intercostal drainage placement, costal fixation from the 5th to the 10th rib, and intensive care unit admission. Postoperative complications included, acute kidney injury, rhabdomyolysis, and severe acute respiratory distress syndrome. This case highlights the importance of a multidisciplinary approach in managing ...
Transport-related respiratory pathogens in horses travelling long distances: A prospective study on arrival at the slaughterhouse.
Research in veterinary science    December 7, 2024   Volume 183 105498 doi: 10.1016/j.rvsc.2024.105498
Padalino B, Pellegrini F, Felici M, Zappaterra M, Catella C, Cordisco M, Lorusso E, Cirone F, Pratelli A.Respiratory disorders (RDs) are a common transport-related welfare consequence in horses. This prospective study described the journeys of horses transported to two slaughterhouses in Italy, documented the prevalence of potentially RD-related pathogens, and identified possible predisposing factors. Data were recorded from arrival until 48 h after arrival and included the collection of Deep Nasopharyngeal Swabs (DNS), journey details and welfare assessment of horses (n = 155). PCR was used to quantify the presence of influenza A virus, reovirus, equine herpesvirus type 1 and 4, adenovirus, r...
Clinical efficacy of inhaled corticosteroids in equine asthma: A meta-analysis and number needed to treat.
Pulmonary pharmacology & therapeutics    December 5, 2024   Volume 88 102342 doi: 10.1016/j.pupt.2024.102342
Equine asthma, a prevalent chronic inflammatory condition affecting the equine population, significantly compromises the performance and quality of life in affected horses. Inhaled corticosteroids (ICS) are often the first-line pharmacological intervention due to their potent anti-inflammatory properties. This meta-analysis investigates the clinical efficacy of ICS in treating equine asthma, emphasizing the number needed to treat (NNT) and the likelihood of achieving a clinical response. A comprehensive literature search identified relevant studies comparing ICS with placebo (PCB) controlled t...
Equine Asthma Diagnostics: Review of Influencing Factors and Difficulties in Diagnosing Subclinical Disease.
Animals : an open access journal from MDPI    December 4, 2024   Volume 14, Issue 23 3504 doi: 10.3390/ani14233504
Lendl L, Barton AK.This literature review focuses on diagnostics of equine asthma (EA), possible influencing factors on diagnostic techniques and latest developments in diagnosing horses during EA remission or with subclinical disease. Routine EA diagnostics include a clinical examination of the respiratory system with percussion and auscultation including a rebreathing examination, and clinical pathology including white blood cells and arterial blood gas analysis. Subsequent diagnostics include bronchoscopy to evaluate the amount and viscosity of respiratory secretion, bronchoalveolar lavage, and the cytology o...
A clinical and hematologic approach to basophilia in dogs, cats, and horses.
Veterinary clinical pathology    December 1, 2024   Volume 54, Issue 1 24-34 doi: 10.1111/vcp.13404
Mau A, Keller SM, Kol A.Basophils are the rarest blood leukocyte in most healthy domestic mammals and the clinical significance of basophilia is poorly understood. Objective: To empirically determine magnitude thresholds for basophilia, identify its hematologic correlates, and identify associations between breeds, specific diseases, disease categories, organ systems, and basophilia in dogs, cats, and horses. Methods: CBCs and clinical information from dogs, cats, and horses were collected from the University of California-Davis School of Veterinary Medicine between 2000 and 2020. Relationships between basophil concen...
Phenotypic, Biochemical and Molecular Characterization of Streptococcus equi Isolates in Northern India.
Indian journal of microbiology    November 26, 2024   Volume 65, Issue 2 1292-1298 doi: 10.1007/s12088-024-01420-5
Chhabra D, Nagra J, Manuja A, Singha HS, Vaid RK, Goutam U, Kumar B. poses a significant threat to equine health globally. The bacteria causes strangles, a respiratory disease characterized by enlarged, abscessed lymph nodes, leading to airway obstruction. The bacterium, a Gram-positive, chain-forming, Lancefield group C β-hemolytic , is closely related to and distinction between these species is challenging. The present study focused on characterization of isolates from horses in northern India, aiming at elucidation of their sugar fermentation patterns. Nasal and nasopharyngeal swabs collected from different geographical regions of northern India, yieldin...
Fenestration of the maxillary septal bulla using different surgical approaches and endoscopy systems in horses: An ex vivo study.
Journal of equine veterinary science    November 23, 2024   Volume 144 105229 doi: 10.1016/j.jevs.2024.105229
de Lima AE, Mendes RP, Piñeros DDV, Alibrando BB, de Zoppa ALV, da Silva LCLC, de Freitas SH, Corrêa RR.Sinusitis is common in horses. Sinoscopy is used for visualization of sinus cavities and can be used for diagnostic and therapeutic purposes. In this surgical procedure, a larger chamber is created and communication with other sinus compartments facilitated. To compare the applicability of different surgical approaches and rigid endoscopy systems for sinus inspection and fenestration of the maxillary septal bulla, and to examine the impact of different lens angles on the effectiveness of the procedure. Six chemically preserved cadaveric equine heads were used. Frontal and caudal maxillary port...
Anesthesia for non-obstetric surgery during late term pregnancy in mares.
PloS one    November 22, 2024   Volume 19, Issue 11 e0313563 doi: 10.1371/journal.pone.0313563
Brito PHS, Ferreira MA, Rusch E, Arantes JA, Carregaro AB, Valadão CAA, Ghantous GF, Dória RGS.Submitting late-term pregnant mares to anesthesia for non-obstetric surgery raises concerns about the survival of the mother and fetus. This study aimed to evaluate and describe transient maternal and fetal hemodynamic changes during general inhalation anesthesia in mares during the last month of gestation. Nine adult mares in the last month of gestation were subjected to general inhalation anesthesia and dorsal recumbency for 90 minutes. Trans-anesthetic vital parameters, arterial hemogasometry, cardiac output, pulmonary arterial pressure, central venous pressure, and fetal heart rates were a...
The Role of Viral Pathogens in Horse Respiratory Diseases: A Cytological and Molecular Approach Using Next-Generation Sequencing.
Animals : an open access journal from MDPI    November 21, 2024   Volume 14, Issue 23 doi: 10.3390/ani14233347
Mazzei M, Sorvillo B, Sgorbini M, Bindi F, Perelli A, Laus F.(1) Background: Respiratory problems may be associated with pathogens among which viruses may play an important role in causing or promoting clinical signs. However, traditional diagnostic methods for equine infectious diseases, such as PCR, are limited to known pathogens and often miss rare or novel viruses. Metagenomic next-generation sequencing is a transformative method that allows the sequencing of all genomes present in a sample. Recent studies have used next-generation sequences to identify viral sequences in horses with unexplained respiratory symptoms, revealing potential links betwee...
The Role of Viral Pathogens in Horse Respiratory Diseases: A Cytological and Molecular Approach Using Next-Generation Sequencing.
Animals : an open access journal from MDPI    November 21, 2024   Volume 14, Issue 23 doi: 10.3390/ani14233347
Mazzei M, Sorvillo B, Sgorbini M, Bindi F, Perelli A, Laus F.(1) Background: Respiratory problems may be associated with pathogens among which viruses may play an important role in causing or promoting clinical signs. However, traditional diagnostic methods for equine infectious diseases, such as PCR, are limited to known pathogens and often miss rare or novel viruses. Metagenomic next-generation sequencing is a transformative method that allows the sequencing of all genomes present in a sample. Recent studies have used next-generation sequences to identify viral sequences in horses with unexplained respiratory symptoms, revealing potential links betwee...
Comparative analysis of racing performance following surgical correction of epiglottic entrapment in standardbreds and thoroughbreds.
Frontiers in veterinary science    November 19, 2024   Volume 11 1479144 doi: 10.3389/fvets.2024.1479144
Norton AM, Rosanowski SM, O'Brien T.Epiglottic entrapment (EE) is a common cause of poor performance in racing standardbreds (STBs) and thoroughbreds (TBs). There is limited information published on the condition in STB racehorses and limited information on factors associated with return to racing available for either breed. Unassigned: This study investigated and compared the pre surgical findings, post-surgical complications and racing performance in STBs and TBs undergoing surgery for correction of EE. Associations between signalment and pre-surgical findings, and the presence of complications and racing post-surgery were com...
Serum Vitamin D Level Is Unchanged in Equine Asthma.
Animals : an open access journal from MDPI    November 18, 2024   Volume 14, Issue 22 doi: 10.3390/ani14223310
Mainguy-Seers S, Holcombe SJ, Lavoie JP.Vitamin D deficiency is associated with asthma development and severity of symptoms in humans, but whether the same occurs in horses is unknown. We aimed to determine whether the serum vitamin D levels differ in horses with asthma compared to control animals and, secondarily, to explore clinical, respiratory, and environmental parameters associated with its concentration in equids in a retrospective cross-sectional study. The total serum vitamin D (25(OH)D) was measured by radioimmunoassay in 45 serum samples from the Equine Respiratory Tissue Biobank (15 control animals, 14 horses with mild o...
Protective Role of Cepharanthine Against Equid Herpesvirus Type 8 Through AMPK and Nrf2/HO-1 Pathway Activation.
Viruses    November 12, 2024   Volume 16, Issue 11 doi: 10.3390/v16111765
Li S, Li L, Sun Y, Khan MZ, Yu Y, Ruan L, Chen L, Zhao J, Jia J, Li Y, Wang C, Wang T.Equid herpesvirus type 8 (EqHV-8) is known to cause respiratory disease and miscarriage in horses and donkeys, which is a major problem for the equine farming industry. However, there are currently limited vaccines or drugs available to effectively treat EqHV-8 infection. Therefore, it is crucial to develop new antiviral approaches to prevent potential pandemics caused by EqHV-8. This study evaluates the antiviral and antioxidant effects of cepharanthine against EqHV-8 by employing both in vitro assays and in vivo mouse models to assess its therapeutic efficacy. To assess the effectiveness of ...
Comparison Between Tracheal Wash and Bronchoalveolar Lavage Cytology for the Assessment of Exercise-Induced Pulmonary Hemorrhage (EIPH) in Racehorses.
Animals : an open access journal from MDPI    November 12, 2024   Volume 14, Issue 22 3243 doi: 10.3390/ani14223243
Bozzola C, Sala G, Schinardi L, Stancari G, Stucchi L, Ferrucci F, Zucca E.Exercise-Induced Pulmonary Hemorrhage (EIPH) is a common pulmonary disease among racehorses, diagnosed by the detection of blood in the trachea after strenuous exercise or the presence of hemosiderophages in the bronchoalveolar lavage fluid (BALF). Although the latter is considered the most sensitive method to diagnose EIPH, it is perceived as a less practical and more invasive procedure compared to tracheal wash (TW) collection among racehorse trainers. The present retrospective study aimed to verify the agreement between Tracheal wash and BALF cytology in assessing EIPH in racehorses. For th...
Pharmacokinetics of Salbutamol in Thoroughbred Horses After a Single Intravenous or Inhaled Administration.
Journal of veterinary pharmacology and therapeutics    November 11, 2024   doi: 10.1111/jvp.13491
Nomura M, Kuroda T, Ohta M, Kusano K, Minamijima Y, Nagata S.Salbutamol is a short-acting and selective beta-2 adrenergic agonist. Inhaled (IH) administration of salbutamol is widely used to control lower respiratory tract disease in horses. Here, we estimated the pharmacokinetic parameters of salbutamol after a single intravenous (IV) or IH administration in six horses, and we statistically analysed the detection times with various dosing regimens. Plasma and urine concentrations of salbutamol were measured by liquid chromatography-tandem mass spectrometry, and data were modelled by using a nonlinear mixed effect model followed by Monte Carlo simulatio...
Oxygen consumption, locomotory-respiratory coupling and exercise-induced pulmonary hemorrhage in horses during the Paso Fino gait.
Journal of veterinary internal medicine    October 31, 2024   Volume 38, Issue 6 3337-3345 doi: 10.1111/jvim.17226
Massie S, Léguillette R, Bayly W, Sides R, Zuluaga-Cabrera AM.Workload associated with the high frequency Colombian Paso Fino gait has not been evaluated. Objective: To determine the oxygen consumption (V̇O), heart rate (HR), stride frequency: breathing ratio, and hematology associated with the Paso Fino gait, including whether exercise-induced pulmonary hemorrhage (EIPH) occurs. Methods: Eleven Paso Fino horses. Methods: Prospective cohort study. Horses performed a standardized Paso Fino gait test across a wooden sounding board, simulating competition. V̇O and ventilatory parameters (tidal volume [V]; peak inspiratory and expiratory airflows [PkV̇, P...
A wearable real-time particulate monitor demonstrates that soaking hay reduces dust exposure.
Equine veterinary journal    October 27, 2024   doi: 10.1111/evj.14425
Ivester KM, Ni JQ, Couetil LL, Peters TM, Tatum M, Willems L, Park JH.Affordable particulate matter (PM) monitors suitable for use on horses will facilitate the evaluation of PM mitigation methods and improve the management of equine asthma. Objective: Calibrate a real-time wearable PM monitor (Black Beauty [BB]) and compare the PM exposures of horses fed dry or soaked hay. Methods: Laboratory calibration; complete cross-over feed trial. Methods: Side-by-side sampling with BB monitors and tapered element oscillating microbalances (TEOMs) was performed under varying concentrations of PM from alfalfa hay. Linear regression was used to derive a calibration formula ...
Exposure to respirable silica contributes to lower airway inflammation in asthmatic horses.
Journal of veterinary internal medicine    October 17, 2024   doi: 10.1111/jvim.17160
Respirable mineral particles can induce lower airway inflammation, but the role they play in asthma of horses is unknown. Objective: Respirable mineral particles, particularly respirable silica, are an overlooked determinant of chronic lung inflammation (asthma) in horses. Methods: Twenty-three horses from an equine hospital population: 11 moderately affected (MEA), 7 severely asthmatic (SEA), and 5 control horses free from respiratory clinical signs. Methods: Prospective observational study. The quantity and quality of mineral particles found in bronchoalveolar lavage fluid (BALF) were charac...