Brazilian Journal of Pulmonology

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

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Year 2002 - Volume 28  - Number 6  (November/December)






Editorial

1 - O sonho dos mil gatos

Geraldo Lorenzi-Filho

J Bras Pneumol.2002;28(6):305-306

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2 - A pesquisa experimental na pneumologia brasileira

Carlos Roberto Ribeiro Carvalho

J Bras Pneumol.2002;28(6):307-308

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Original Article

3 - Study on the effect of amiodarone on the body weight and on lung morphologic and cytopathologic parameters of male and female Wistar, Wistar-Kyoto, and SHR rats

Estudo do efeito da amiodarona sobre o peso corpóreo e sobre determinantes morfológicos e citopatológicos do pulmão em ratos machos e fêmeas das linhagens Wistar, Wistar-Kyoto e SHR

Thais Thomaz Queluz, Maria Helena de Castro e Silva, Silméia Garcia Zanatti, Frederico Sobral de Oliveira, Rodrigo Bazan, Júlio Defaveri

J Bras Pneumol.2002;28(6):309-316

Abstract PDF PT Portuguese Text

Introduction: Most of the experimental studies on amiodarone-induced pulmonary toxicity have been performed in male Fischer-344 rats. Objective: To investigate the effect of amiodarone on body weight and on lung morphological and cytopathologic parameters in both genders of other rat strains. Methods: Groups of male and female Wistar, Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats received, 175 mg/kg/day of amiodarone suspended in saline by gavage for four weeks. Controls received saline alone. Body weight gain, total cellularity, and differential of the bronchoalveolar lavage (BAL) and lung histopathology were studied. Results: Mortality due to amiodarone was observed in treated WKY rats, mostly in males. Treated male and female SHR animals had less body weight gain among all strains studied. Male Wistar and SHR treated rats presented more body weight gain than females of the respective strains. BAL of treated SHR rats were hemorrhagic. BAL cellularity was higher in treated males (WKY > Wistar > SHR). In WKY males and females, however, the differential count showed a lesser percent of macrophages and higher of neutrophils than in the other strains. BAL macrophages of treated Wistar rats presented phospholipidosis, whereas most macrophages of treated SHR rats were normal. In lung anatomicopathologic examination, no difference was found related to gender and no pneumonitis was observed. In Wistar rats, the examination was characterized by a marked quantity of intra-alveolar "foamy" macrophages, numerous intraparenchymal abscesses were found in WKY rats, and alveolar hemorrhage was present in SHR rats. Conclusions: 1) amiodarone induces more foamy macrophages in Wistar rats than in the WKY and SHR strains, although they do not develop pneumonitis in the model used; 2) amiodarone has greater effect on lung morphological and cytopathologic parameters of male rats.

 


4 - Clinical and radiographic spectrum of organizing pneumonia: retrospective analysis of 38 cases

O espectro clínico e radiológico da pneumonia em organização: análise retrospectiva de 38 casos

Fabrício Piccoli Fortuna, Cristiano Perin, Juliano de Bortoli, Geraldo Resin Geyer, Nelson da Silva Porto, Adalberto Sperb Rubin

J Bras Pneumol.2002;28(6):317-323

Abstract PDF PT Portuguese Text

Organizing pneumonia, whether or not accompanied by bronchiolitis obliterans, is a specific anatomicopathological condition of the lungs that can present in a variety of clinical and radiographic ways. It can be either idiopathic or secondary to a number of diseases, including infection and drugs. Objectives: To describe the clinical manifestations, radiographic and spirometric data seen in patients with organizing pneumonia. Methods: Retrospective analysis of patients with a diagnosis of organizing pneumonia. Results: 38 patients were included in the analysis. Fourteen also had clinical conditions related to organizing pneumonia, and they presented more frequently with diffuse pulmonary infiltrates (three of four cases) and associated bronchiolitis obliterans (57% vs. 20%, p = 0,05). Of the 13 patients with bronchiolitis obliterans, only one was asymptomatic and two had localized lesions (15%). Of the eight asymptomatic patients with localized lesions, no one had associated bronchiolitis obliterans, and the radiographic appearance often resembled bronchial carcinoma. Spirometry was generally of little value to diagnosis, probably because of the high prevalence of smoking in the sample. Conclusion: The clinical and radiographic presentation of organizing pneumonia is variable. Factors that suggest the absence of coexisting bronchiolitis obliterans are the absence of symptoms and localized radiographic lesions, and this form of the disease has to be more often differentiated from bronchial carcinoma in clinical practice.

 


5 - Study of correlation between functional respiratory tests and the six minute walk test in patients with chronic obstructive pulmonary disease

Estudo de correlação entre provas funcionais respiratórias e o teste de caminhada de seis minutos em pacientes portadores de doença pulmonar obstrutiva crônica

Sérgio Leite Rodrigues, Carlos Alberto de Assis Viegas

J Bras Pneumol.2002;28(6):324-328

Abstract PDF PT Portuguese Text

Introduction: Spirometry and analysis of blood gases data have been extensively used to assess ventilatory limitation and prognosis of COPD patients. However, functional physical tests, such as the six-minute walk test (6wt) have been used for the dynamic assessment of COPD patients. Objective: To determine correlations between respiratory function test data and the six-minute walk test in COPD patients. Patients and methods: 45 patients were submitted to clinical history survey and complete physical examination performed by the medical staff of the Pneumology Department of the Brasilia University Hospital, followed by spirometry, analysis of arterial blood gases, maximal respiratory pressures data, and the six-minute walk test. Results: Concerning the spirometric, analysis of blood gases and maximal respiratory pressures data, statistically significant positive correlations (p < 0.05) between FEV1, PaO2, SpO2, MEP and the six-minute walk test were obtained. Conclusions: For the studied group, the six minute walk test has significant correlation with FEV1, PaO2, SpO2 and MEP, and can be used as an alternative functional assessment of COPD patients.

 


6 - Profile of 300 workers exposed to silica seen in an university outpatient clinic

Perfil de 300 trabalhadores expostos à sílica atendidos ambulatorialmente em Belo Horizonte

Ana Paula Scalia Carneiro, Luciano de Oliveira Campos, Marcelo Fonseca Coutinho Fernandes Gomes, Ada Ávila Assunção

J Bras Pneumol.2002;28(6):329-334

Abstract PDF PT Portuguese Text

Introduction: Silicosis is the most prevalent pneumoconiosis in Brazil, with most of the registered cases occurring in the State of Minas Gerais. Although it is a preventable disease, silicosis is still epidemic in some areas. Objective: To describe the profile of workers seen at the Clinics Hospital of the Federal University of Minas Gerais. Patients and methods: 300 medical records of silica-exposed workers in different occupations, seen between 1989-2000, were reviewed. Clinical and occupational information, radiographic and spirometric data were analyzed. Statistical methods included univariate analyses with chi-square and t tests. Results and conclusion: The mean age of the exposed patients was 51 years, with mean exposure duration of 15.6 years. 126/300 (42%) were radiologically classified as cases of silicosis. Increasing grades of profusion were associated with lower spirometric indices and more frequent associations with tuberculosis and chronic airflow limitation. Most of the workers were regularly registered employees and the main occupational activity was mining, accounting for the exposure of 197 (66%) workers. Non-registered workers presented more severe radiological grades of silicosis, suggesting, possibly, worse conditions of silica exposure in this group of workers.

 


Case Report

7 - Bronchiolitis obliterans in nodular form

Bronquiolite obliterante na forma nodular

Paulo de Almeida, Murilo J.B. Guimarães, Mario Gesteira Costa, Vital Lyra, Isabella Coimbra, Luiz Adriano de Albuquerque Oliveira

J Bras Pneumol.2002;28(6):335-338

Abstract PDF PT Portuguese Text

A 54 year old female patient, public servant, ex-smoker, after two weeks of a common cold complained of cough with yellow sputum, nasal obstruction and facial pain. A chest X-ray showed a solitary nodular lesion in the upper left lobe. The patient was submitted to a left thoracotomy, which established the diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP).

 


8 - Bronchogenic cyst with videothoracoscopic approach

Cisto broncogênico com abordagem videotoracoscópica

Nelson Perelman Rosenberg, Celso Schuler, Fernando Delgiovo, José Augusto Ferreira Bittencourt

J Bras Pneumol.2002;28(6):339-341

Abstract PDF PT Portuguese Text

Bronchogenic cysts are the most common cause of mediastinal cystic mass and surgical resection is the treatment of choice. The authors report a case of bronchogenic cyst with successful treatment by video-assisted thoracic surgery (VATS). They emphasize the benefits of VATS in the management of this pathology and compare this technique to conventional thoracotomy.

 


9 - Mucoepidermoid carcinoma

Carcinoma mucoepidermóide

Cristiano Feijó Andrade, Spencer Marcantônio Camargo, Paulo Francisco Guerreiro Cardoso, José Carlos Felicetti

J Bras Pneumol.2002;28(6):342-344

Abstract PDF PT Portuguese Text

Mucoepidermoid carcinoma is an uncommon neoplasm of the tracheobronchial tree, of unknown etiology. Its preferred endobronchial location often results in respiratory symptoms such as obstruction of the airways and lung diseases of slow recovery. They usually are slow growing tumors although they may present an aggressive behavior with local invasion and lymph node metastases depending on their histopathologic characteristics. The mainstay therapy is complete surgical resection either by means of lobectomy or by lung sparing procedures such as bronchotomy and bronchoplasty. Prognosis depends upon the degree of cellular differentiation of the tumors. The authors report a case of this rare neoplasia and describe the clinical and radiographic characteristics, and the surgical treatment.

 


Review Article

10 - Radiotherapy in lung cancer

Radioterapia no câncer de pulmão

Heloisa de Andrade Carvalho

J Bras Pneumol.2002;28(6):345-350

Abstract PDF PT Portuguese Text

A review of the role of radiotherapy in lung cancer is presented, with the most recent innovations. Indications for postoperative irradiation and chemo-radiotherapy in non-small cell lung cancer are discussed. Recommendations are made for prophylactic cranium irradiation and perspectives of thoracic radiotherapy for small cell lung cancer. Recent techniques and results of the "Brazilian Consensus on Lung Cancer - Radiotherapy" are also presented.

 


Upgrading

11 - Liquid ventilation: literature review

Ventilação líquida: revisão da literatura

Cristiano Feijó Andrade, Elaine Aparecida Felix Fortis, Paulo Francisco Guerreiro Cardoso

J Bras Pneumol.2002;28(6):351-361

Abstract PDF PT Portuguese Text

New methods of ventilation are being studied in different settings of pulmonary insufficiency in which the ultimate goal is to improve gas exchange and to minimize aggression to the lung parenchyma. The use of liquid perfluorocarbons administered directly in the airways has been ostensibly studied in pulmonary lesion models and in some clinical essays with good results relating to gas exchange, ventilatory mechanics, and anti-inflammatory properties. PFCs are substances with low surface tension, high density, they are not soluble in water, and allow for high diffusion of oxygen and carbonic gas. They act by recruiting collapsed alveoli, improving the gas exchange, protecting pulmonary architecture, and they wash out alveoli debris. This review article focuses on the different liquid ventilation strategies with perfluorocarbons, and provides information on the state of the art of liquid ventilation.

 


 


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