Brazilian Journal of Pulmonology

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

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Year 2000 - Volume 26  - Number 1  (January/February)






Editorial

1 - O "bug" do ano 2000: foi melhor prevenir do que remediar

Thais Helena A. Thomaz Queluz

J Bras Pneumol.2000;26(1):1-2

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Original Article

2 - Surgical treatment of necrotizing pneumonia: analysis of four cases

Tratamento cirúrgico de pneumonia necrosante: análise de quatro casos

Fernando Luiz Westphal, Luiz Carlos de Lima, Cyntia Almeida Ferreira, Maria Auxiliadora de Carvalho

J Bras Pneumol.2000;26(1):1-4

Abstract PDF PT Portuguese Text

Necrotizing pneumonia is a serious complication of lobar pneumonia. Four children aged between ten months and three years were admitted with acute bacteremic pneumonia and developed sepsis, pleural effusion, and respiratory distress despite adequate antibiotic treatment and chest tube drainage. Decortication and pulmonary resection were performed in all of them. The observed complications were bronchopleural fistula and one death. The emergency pulmonary resection is indicated when pulmonary necrosis is associated to sepsis and massive bronchopleural fistula. In such circumstances, morbidity and mortality are higher than in other conditions.

 


Keywords: staphylococcal pneumonia; thoracotomy; lung, surgery

 

3 - Community-acquired pneumonia in outpatients: epidemiological, clinical and radiographic features between atypical and non-atypical pneumonia

Pneumonia adquirida na comunidade em pacientes tratados ambulatorialmente: aspectos epidemiológicos, clínicos e radiológicos das pneumonias atípicas e não atípicas

Rosali Teixeira Rocha, Anna Cristina Vital, Clystenes Odyr Santos Silva, Carlos Alberto de Castro Pereira, Jorge Nakatani

J Bras Pneumol.2000;26(1):5-14

Abstract PDF PT Portuguese Text

Aim: To evaluated the etiologic percentage of the atypical pneumoniae in outpatients and to identify the epidemiologic, clinical and radiographic features that permit to distinguish between atypical and non-atypical pneumonia. Methods: All patients underwent clinical and radiographic evaluation. Serum and sputum samples were obtained to serological tests including Legionella sp, Chlamydia sp, M. pneumoniae, Influenza A and Influenza B virus, and Gram stain, respectively. These procedures were performed on the first and 21 days after inclusion. Three independent observers reviewed chest X-rays. Results: During 22 months, 129 patients were evaluated. The final population under study comprised 69 patients (46 men - 23 women) with a mean age of 37 years. The etiologic diagnosis was defined in 34 (50%) of the patients. Etiologic agents included Chlamydia sp, 11 (16%) isolated cases; M. pneumoniae 7 (10%) cases. Influenza A was the third more frequent agent in 4 (6%) patients, and Legionella sp in 4 (6%). Mixed infections were observed with association of Chlamydia sp and M. pneumoniae in 5 (7.3%) cases, Chlamydia sp and Influenza B one (1.5%) case, and another of M. pneumoniae and Influenza A. The atypical pneumonia and non-atypical pneumonia groups were compared to respiratory symptoms and signs. There were no differences between them. The three independent observers' radiographic evaluation showed disagreement among them as to the type of pneumonia. Radiographic diagnoses of individual observers were compared to the clinical diagnoses, and no significant association was obtained for any observer. Conclusion: Pneumonia caused by "atypical" agents occurs in 50% of the outpatients with community acquired pneumonia. It is not possible to distinguish atypical pneumonia from non-atypical pneumonia. The clinical and radiographic presentations are similar in both groups.

 


Keywords: pneumonia; etiology; diagnosis; epidemiology

 

4 - Venous thromboembolism prophylaxis in an intensive care unit

Profilaxia para tromboembolia venosa em uma unidade de tratamento intensivo

Sérgio Saldanha Menna Barreto, Paula Mallman da Silva, Carlo Sasso Faccin, Alexandro de Lucena Theil, Alice Hoefel Nunes, Cleovaldo T. S. Pinheiro

J Bras Pneumol.2000;26(1):

Abstract PDF PT Portuguese Text

Objectives: To identify the degree of risk and the practice of prophylaxis to venous thromboembolism (VTE) in an intensive care unit (ICU). Methods: The subjects were patients admitted to the ICU between December 1997 and February 1998. Patients were excluded if they were in anticoagulant therapy or presented contra-indication to heparin. Determination of risk factors and classification of the degree of risk for VTE were done according to international consensus. The ICU medical staff did not know about the study. Results: The authors evaluated one hundred and eighty patients with a mean age of 58 years (±16.5). Risk factors more frequently found were: age ³ 40 years (85.0%), surgery (47.8%), thoracic or abdominal infection (22.8%). Two or more risk factors were present in 146 (81%) cases. In the evaluation of VTE risk, 142 (79%) patients were classified as moderate/high risk. Prophylactic measures were prescribed to 102 patients (57%), and heparin was used in 60% of moderate/high risk cases. There was a significant association between risk level and the number of risk factors with the use of prophylaxis (p < 0.05). Conclusion: VTE risk factors were frequent in the sample analyzed. However, 40% of patients considered moderate/high risk did not receive pharmacological prophylaxis for VTE.

 


Keywords: thromboembolism, prevention & control

 

5 - Sequelae of foreign body aspiration in the respiratory tract of children

Aspiração de corpo estranho na árvore traqueobrônquica em crianças: avaliação de seqüelas através de exame cintilográfico

João Antônio Bonfadini Lima, Gilberto Bueno Fischer, José Carlos Felicetti, José Antônio Flores, Christina N. Penna, Eduardo Ludwig

J Bras Pneumol.2000;26(1):20-24

Abstract PDF PT Portuguese Text

Objective: The aim of this study was to detect late sequelae of foreign body aspiration in the respiratory tract of children. Methods: This study included children admitted from 1987 to 1999 to Hospital da Criança Santo Antônio, of Porto Alegre, with clinical symptoms of foreign body aspiration to the respiratory tract confirmed by chest X-ray and bronchoscopy. Thirty days after the extraction of the foreign body a perfusion lung scan with technetium was performed. Results: 77% of the foreign bodies were organic materials. In 65% of children the aspiration event occurred at least 7 days before referral. The main location of foreign body was in the right lower lobe bronchus. Perfusion lung scans were performed in 24 patients. In 67% of them reduction in lung perfusion was detected. A chance of sequelae was 3.8 times greater in those patients who had the foreign body removed after 7 days from the aspiration event. Conclusion: This study showed that children that have had foreign body aspiration may have perfusion sequelae in their lungs even after removal of the foreign body. These sequelae were more frequent if the removal was delayed in 7 days of aspiration. Pediatricians must keep this in mind at the follow-up of children that have had foreign body aspiration.

 


Keywords: foreign bodies; aspiration; bronchi; prognosis

 

6 - M. tuberculosis resistance profile in HIV/AIDS patients in a reference hospital

Perfil de resistência de "M. tuberculosis" isolados de pacientes portadores do HIV/AIDS atendidos em um hospital de referência

Cid Gomes, Darcita Buerger Rovaris, João Laus Severino, Mônica Ferreira Gruner

J Bras Pneumol.2000;26(1):25-29

Abstract PDF PT Portuguese Text

This study was performed in 117 patients infected by HIV, admitted to a reference hospital, in a period of one year (from 10/1/95 to 9/30/1996). All patients were 15 years old or more and had their sputum collected for AFB research, by clinical indication. All the 117 collected samples were submitted to bacilloscopic examination and 116 to culture (due to contamination in one sample) and also drug susceptibility test in all the 39 isolated strains. The strains were evaluated by PNB and TCH tests, and sent to a reference laboratory to typify the specimens. The bacilloscopic examination was positive in 34.2% (40/117) of the samples. From the 39 isolated strains, three did not belong to the M. tuberculosis complex (M. avium intracellulare in two, and one not identified strain). The resistance rate attributed separately to the M. tuberculosis was 13.90% (5/36). Resistance was not found that could be attributed to a single drug and the combination responsible for the highest resistance rate was that of rifampicin and isoniazid. The primary and secondary resistance was 20% (4/20) and 9.1% (1/10), respectively. Among social-demographic and clinical aspects, drug resistance was just significantly associated to a larger number of previous hospitalization (p < 0.03). These data suggest an intrahospital possible transmission of MDR (multi drug resistant) strains, among patients infected by HIV.

 


Keywords: mycobacterium tuberculosis; tuberculosis, pulmonary; drug resistance; acquired immunodeficiency syndrome

 

Upgrading

7 - Redação de trabalho científico

Álvaro Oscar Campana

J Bras Pneumol.2000;26(1):30-35

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Review Article

8 - Exhaled nitric oxide for the diagnosis and monitoring of respiratory diseases

Óxido nítrico exalado no diagnóstico e acompanhamento das doenças respiratórias

José Miguel Chatkin, Per Djupesland, Wei Qian, James Haight, Noe Zamel

J Bras Pneumol.2000;26(1):36-43

Abstract PDF PT Portuguese Text

This paper reviews in brief the role of nitric oxide in the respiratory physiology and in the pathology of some pulmonary diseases. The potential diagnostic and monitoring uses in several clinical situations are also discussed.

 


Keywords: respiratory tract diseases; lung diseases, obstructive; asthma; smoking; cystic fibrosis; bronchiectasis lung; lung transplantation

 

9 - Acquired immunodeficiency syndrome and the lung

A síndrome da imunodeficiência adquirida e o pulmão

Rosemeri Maurici da Silva

J Bras Pneumol.2000;26(1):44-48

Abstract PDF PT Portuguese Text

The greatest causes of morbidity and mortality in patients infected with human immunodeficiency virus are opportunistic infections and neoplastic diseases. Most of them are lung diseases. Its correct diagnosis and proper treatment improve the quality of life as well as the survival in this group of patients.

 


Keywords: lung disease; acquired immunodeficiency syndrome; bronchoscopy

 

Case Report

10 - Granular cell tumor of the trachea: case report

Tumor de células granulares da traquéia

Jefferson Luiz Gross, Riad Naim Younes, Fabio José Haddad, Clóvis Antonio Lopes Pinto

J Bras Pneumol.2000;26(1):49-51

Abstract PDF PT Portuguese Text

Granular cell tumors are uncommon neoplasm arising from Schwann cell. They are uncommon in the respiratory tract and there are only 32 cases described with primary tracheal involvement. A case is described of a 28 year-old woman with granular cell tumor located primarily in the trachea. The tumor was treated surgically with good result.

 


Keywords: granular cell tumor; trachea

 

In Memoriam

11 - Saudação a Mario Rigatto

Carlos Antônio Mascia Gottschall

J Bras Pneumol.2000;26(1):1-3

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Case Report

11 - Bronchiolitis obliterans with organizing pneumonia and aspergilloma in patient with T cell leukemia-lymphoma

Bronquiolite obliterante com pneumonia em organização e aspergiloma em paciente com linfoma-leucemia de células T

Teresa S. Jhayya, Domingo B. Perez, Celia Mallart Llarges, Rimarcs G. Ferreira

J Bras Pneumol.2000;26(1):52-54

Abstract PDF PT Portuguese Text

There are few reports in the medical literature about association between bronchiolitis obliterans with organizing pneumonia (BOOP) and aspergilloma. This report shows the presence of both BOOP and pulmonary aspergilloma in a patient with adult T cell leukemia-lymphoma. It is suggested that these findings represent a random association rather than the expression of a nosologic unity.

 


Keywords: bronchiolitis obliterans; aspergillosis; T cell lymphoma; pneumonia

 

Letters to the Editor

12 - A história da descoberta da circulação pulmonar

Rubens Bedrikow, Valdir Golin

J Bras Pneumol.2000;26(1):11-

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