Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Castleman disease or angiofollicular hyperplasia as a solitary pulmonary nodule: case report

Doença de Castleman ou hiperplasia angiofolicular como nódulo pulmonar solitário: relato de caso

Guilherme Andrade Krawczun, Cristiano de Morais Garcia, Kazuhiro Ito, Olavo Franco Ferreira Filho, João Carlos Thomson

J Bras Pneumol.2007;33(2):226-228

Abstract PDF PT PDF EN Portuguese Text

Castleman disease is a rare disorder generally characterized by a mediastinal nodule, with a great variety of alternative presentations regarding age, clinical manifestations and evolution. This case report describes a 40-year-old female patient presenting with uncharacteristic chest pain for a few years. A chest X-ray revealed a hypotransparency on the right side. Computed tomography and pulmonary arteriography did not elucidate the diagnosis, which was made through surgical resection and anatomopathological examination of the nodule, which presented characteristics of angiofollicular hyperplasia, or Castleman disease. This article emphasizes the importance of adding this disease to the list of morbidities in the differential diagnosis of pulmonary solitary nodules.

 


Keywords: Giant lymph node hyperplasia; Angiography; Coin lesion, Pulmonary; Case reports [publication type].

 


Post-pneumonectomy thoracic drainage: to drain or not to drain? A retrospective study

Drenagem torácica pós-pneumonectomia: sim ou não? Estudo retrospectivo

João Carlos Thomson, Olavo Franco Ferreira Filho

J Bras Pneumol.2006;32(4):290-293

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the need for post-pneumonectomy thoracic drainage. Methods: This was a retrospective study of 46 patients having undergone pneumonectomy in the Thoracic Surgery Department of the Londrina University Hospital between January of 1998 and December of 2004. Patients were divided into two groups: those having been submitted to drainage and those not having been. The diseases involved were lung cancer, bronchiectasis and tuberculosis. Results: Drainage was used in 21 patients, whereas no drainage was used in 25. The most common postoperative complication was subcutaneous emphysema (12 cases). Hospital stays were of shorter duration among patients who were not submitted to drainage than among those who were (mean, 6.5 days vs. 10.2 days). No serious postoperative complications were observed in the group of patients not submitted to drainage. Conclusion: The findings that evolutions were more favorable and hospital stays were shorter for the patients not submitted to drainage call into question the need for routine post-pneumonectomy drainage.

 


Keywords: Drainage; Pleural cavity; Pneumonectomy; Postoperative care; Postoperative complications; Retrospective studies

 


Idiopathic tracheal stenosis. A report of four cases

Estenose idiopática de traquéia. Relato de quatro casos

Carolina Rossi, Fernanda Colombari, Alda Losi Guembarowsky, Olavo Franco Ferreira Filho, João Carlos Thomson

J Bras Pneumol.2007;33(1):101-104

Abstract PDF PT PDF EN Portuguese Text

Idiopathic tracheal stenosis is uncommon. Herein, we report four cases, all presenting a similar clinical profile: diagnosed through bronchoscopy and having a history of being treated unsuccessfully for bronchospasm. Three of the patients were treated with dilatation and an oral corticosteroid. One of those three underwent tracheoplasty. In the remaining patient, the stenosis was more extensive (2 cm, with a 70% reduction in the size of the lumen), and dilatation was not an option. Therefore, that patient underwent laryngotracheal resection. In all four patients, the evolution was favorable. Idiopathic tracheal stenosis should be contemplated in cases of 'bronchitis' that are not resolved using conventional treatments. Bronchoscopy and dilatation have provided satisfactory results. Occasionally, laryngotracheal reconstruction is necessary.

 


Keywords: Trachea/surgery; Constriction; Pathologic; Case reports [publication type].

 


Brazilian examples of programs for the control of asthma

Exemplos brasileiros de programas de controle de asma

Alcindo Cerci Neto, Olavo Franco Ferreira Filho, Tatiara Bueno

J Bras Pneumol.2008;34(2):103-106

Abstract PDF PT PDF EN Portuguese Text

The aim of this study was to determine which Brazilian programs demonstrate experience in asthma management. Data on and characteristics of those programs were obtained by electronic mail. The variables studied were related to the program itself, its patients and staff. Descriptive statistics were used in the study, which evaluated 17 programs. All programs received public funding, produced educational/training materials and had specialized physicians on staff. We concluded that the experience accumulated by all the programs can be used as one of the pillars of a national program for the control of asthma in Brazil.

 


Keywords: Programs; Asthma; Public health.

 


The relative frequency of hypomagnesemia in outpatients with chronic airflow limitation treated at a referral center in the north of the state of Paraná, Brazil

Freqüência relativa de hipomagnesemia em pacientes com limitação crônica do fluxo aéreo atendidos em ambulatório de referência do norte do Paraná

Alcindo Cerci Neto, Olavo Franco Ferreira Filho, Johnathan de Sousa Parreira

J Bras Pneumol.2006;32(4):294-300

Abstract PDF PT PDF EN Portuguese Text

Objective: To determine the relative frequency of hypomagnesemia among patients with chronic airflow limitation treated as outpatients at a referral center in the northern part of the state of Paraná between 2000 and 2001, as well as to determine whether hypomagnesemia correlates with hypoxia, with other electrolyte disturbances and with the severity of airflow limitation. Methods: This was a descriptive study of the relative frequency of hypomagnesemia in 72 patients with chronic airflow limitation. All of the patients were submitted to blood tests to determine serum levels of magnesium and other electrolytes, as well as to staging of the underlying disease. Results: The prevalence of hypomagnesemia was 27.8%. The mean age was 65 ± 9.9 years, and there was a predominance of males. The mean forced expiratory volume in one second was 1.31 ± 0.52 L. Most of the patients (68.1%) were found to be in the advanced stages of the disease. Hypomagnesemia was not found to correlate with other electrolyte disturbances, hypoxemia or disease stage. Conclusion: The high frequency of patients in the advanced stages is likely attributable to the fact that the outpatient facility is a referral center for the region. Further studies should be conducted in order to determine the probable causes of this high prevalence of hypomagnesemia.

 


Keywords: Magnesium/blood; Pulmonary ventilation; Pulmonary disease, chronic obstructive; Respiratory insufficiency

 


Impact of the implementation of a therapeutic guideline on the treatment of nosocomial pneumonia acquired in the intensive care unit of a university hospital

Impacto da implantação de um guia terapêutico para o tratamento de pneumonia nosocomial adquirida na unidade de terapia intensiva em hospital universitário

Joseani Coelho Pascual Garcia, Olavo Franco Ferreira Filho, Cíntia Magalhães Carvalho Grion, Claudia Maria Dantas de Maio Carrilho

J Bras Pneumol.2007;33(2):175-184

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the impact that the implementation of therapeutic guidelines has on the empirical treatment of nosocomial pneumonia. Methods: A clinical trial, using historical controls and involving current ICU patients who had acquired nosocomial pneumonia, was carried out from June of 2002 to June of 2003. All were treated according to therapeutic guidelines developed by the Commission for Nosocomial Infection Control of the institution (group with intervention). As controls, the medical charts of the patients who acquired nosocomial pneumonia between June of 2000 and June of 2001 (group without intervention) were analyzed. Mortality and mean treatment period, as well as the length of hospital and ICU stays, were determined for the patients who acquired nosocomial pneumonia. Results: Mortality associated with pneumonia was lower in the group treated according to the therapeutic guidelines (26 vs. 53.6%; p = 0.00). As for overall mortality, there was no statistically significant difference between the two periods (51 vs. 57.9%; p = 0.37). There was also no difference in the type of microorganisms isolated, treatment period, length of hospital stay or length of ICU stay. Conclusion: The implementation of therapeutic guidelines for the treatment of nosocomial pneumonia acquired in the ICU can be efficacious in decreasing mortality rates.

 


Keywords: Pneumonia/treatment; Cross infection; Intensive care units; Mortality.

 


Epidemiological profile of lung tuberculosis infection and disease among cocaine users being treated in hospitals of São Paulo, Brazil

Perfil epidemiológico da tuberculose infecção e doença entre usuários de cocaína internados em serviços hospitalares da Grande São Paulo

Olavo Franco Ferreira Filho, Marilia Dalva Turchi, Ronaldo Laranjeiras, Adauto Castelo

J Bras Pneumol.2003;29(3):125-132

Abstract



Community-acquired pneumonia in elderly patients: adherence to Brazilian guidelines for the treatment of pneumonia

Pneumonias adquiridas na comunidade em pacientes idosos: aderência ao Consenso Brasileiro sobre Pneumonias

José Roberto de Almeida, Olavo Franco Ferreira Filho

J Bras Pneumol.2004;30(3):229-236

Abstract PDF PT

Background: Pneumonia is a common disease with a high mortality rate, being the sixth leading cause of death among elderly people in the USA and the fifth among those in Brazil. Initial treatment of pneumonia is usually empirical since the ethiological agent is identified in only approximately 50% of cases. Therefore, several scientific societies have defined some guidelines for initial antimicrobial therapies. Objectives: This study evaluated adherence to the guidelines set forth by the Consenso Brasileiro sobre Pneumonias (Brazilian Consensus on Pneumonia) for treatment of community-acquired pneumonia in hospitalized elderly patients. Method: Fifty-four patients, aged 60 or over, hospitalized at Londrina University Hospital with community-acquired pneumonia between 2 August 1999 and 2 August 2000 were evaluated. Whether their treatment adhered or did not adhere to guidelines, the patients were compared in terms of 30-day mortality, average time for clinical stabilization, average length of hospital stay, cost of treatment and severity score. Results: The average age was 74.1, and 61.1% of the patients were treated in accordance with the Brazilian guidelines for treatment of community-acquired pneumonia. There were no differences in length of hospital stays, cost of treatment, time to clinical stability and severity score between the two groups (adherent and non-adherent). However, there was a difference in mortality. The rate of mortality was higher in patients with pneumonia severity index (PSI) scores of IV or V who were treated according to the guidelines than in those with the same score whose treatment was non-adherent (p = 0.04). In general, PSI score was related to mortality. The mortality rate among patients with scores of II and III was 9.5%, compared with 30.3% in patients with scores of IV and V. Conclusion: Adherence to the Brazilian guidelines for treatment of community-acquired pneumonia in elderly patients was satisfactory, and there was no difference in results between both groups, except for the higher mortality rate found for patients with higher PSI scores who were treated according to the guidelines. A positive correlation was found between PSI score and mortality.

 


Keywords: Pneumonia. Health Planning Guidelines. Community-Acquired Infections. Health Services for the Aged.

 


Prevalence of symptoms of asthma, rhinitis and atopic eczema among students between 6 and 7 years of age in the city of Londrina, Brazil

Prevalência de sintomas de asma, rinite e eczema atópico em escolares de 6 e 7 anos na cidade de Londrina (PR)

Luci Keiko Kuromoto de Castro, Alcindo Cerci Neto, Olavo Franco Ferreira Filho

J Bras Pneumol.2010;36(3):-

Abstract PDF PT PDF EN Portuguese Text

Objective: To determine the prevalence of symptoms of asthma, rhinitis and atopic eczema among students between 6 and 7 years of age in the city of Londrina, Brazil. Methods: A population-based study using the International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaire (asthma, rhinitis and atopic eczema modules), validated for use in Brazil, in public school students between 6 and 7 years of age. Results: Of the 3,963 questionnaires retrieved, 3,600 (90.8%) were appropriately completed and were used in the analysis. The prevalence of symptoms of asthma, rhinitis and atopic eczema in the last 12 months was 22.0%, 27.3% and 9.6%, respectively. The prevalence of physician-diagnosed asthma, rhinitis and atopic eczema was 10.4%, 23.4% and 11.4%, respectively. The prevalence of rhinoconjunctivitis and flexural eczema was 13.6% and 6.6%, respectively. Although symptoms of asthma and rhinitis were more common in males than in females, no gender difference was found regarding atopic eczema symptoms. Conclusions: The prevalence of symptoms of asthma, rhinitis and atopic eczema in our sample was within the range found at the facilities that participated in phases I and III of the ISAAC in Brazil. The low prevalence of physician-diagnosed asthma suggests that asthma continues to be underdiagnosed.

 


Keywords: Public health; Epidemiology; Asthma.

 


Reduction in the number of asthma-related hospital admissions after the implementation of a multidisciplinary asthma control program in the city of Londrina, Brazil

Redução do número de internações hospitalares por asma após a implantação de programa multiprofissional de controle da asma na cidade de Londrina

Alcindo Cerci Neto, Olavo Franco Ferreira Filho, Tatiara Bueno, Maria Amélia Talhari

J Bras Pneumol.2008;34(9):639-645

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the relationship between the reduction in the number of asthma-related hospital admissions and the changes occurring after the intervention performed in the health care system of the city of Londrina, Brazil. Methods: In 2003, an intervention was performed in the local health care system (Family Health Clinics). The steps adopted were as follows: development of a protocol based on the III Brazilian Consensus on Asthma Management; access to free inhaled corticosteroids for patients; training of health professionals; and implementation of educational measures, especially for the community. The authorizations for hospital admissions of patients diagnosed with asthma alone between 2002 and 2005 in the city of Londrina were analyzed. Results: The mean age was 14.3 ± 0.5 years, without gender predominance. The number of hospital admissions fell more markedly in 2005 than in the previous years studied. This decline was more pronounced at the Family Health Clinics where professional training occurred earlier. The post-intervention (2004-2005) rate of asthma-related hospital admissions (120/100,000 inhabitants) was significantly lower than the pre-intervention (2002-2003) rate (178/100,000 inhabitants; p < 0.01). Conclusions: The admission curve showed a tendency toward a reduction after 2003, and, aside from the intervention performed, no other factors that would explain the results obtained were identified. The rate at which the number of hospital admissions decreased was in direct proportion to the length of time elapsed since the intervention (greater decreases over time). We conclude that the intervention performed in the local health care system was responsible for the data presented.

 


Keywords: Asthma; Hospitalization; Public health.

 


 

 


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CNPq, Capes, Ministério da Educação, Ministério da Ciência e Tecnologia, Governo Federal, Brasil, País Rico é País sem Pobreza
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