Brazilian Journal of Pulmonology

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

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Year 2004 - Volume 30  - Number 1  (January/February)






Editorial

1 - Jornal Brasileiro de Pneumologia

Carlos Alberto de Castro Pereira

J Bras Pneumol.2004;30(1):1

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Upgrading

2 - O JP de cara nova

Geraldo Lorenzi-Filho

J Bras Pneumol.2004;30(1):1

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Original Article

3 - Long-term survival in lung cancer after surgical treatment: is gender a prognostic factor?

Sobrevida de longo prazo em carcinoma brônquico após tratamento cirúrgico: sexo é fator prognóstico?

Carolina Mariante de Abreu, José Miguel Chatkin, Carlos Cezar Fritscher, Mário Bernardes Wagner, José A. L. Figueiredo Pinto

J Bras Pneumol.2004;30(1):2-8

Abstract PDF PT Portuguese Text

BACKGROUND: In agreement with other reported studies, wehad previously found a possible association between gender and prognosis in stage I non-small cell lung cancer (NSCLC), showing a higher survival rate among females. OBJECTIVES: The purpose of this study was to further clarify the role of gender as a possible prognostic factor in NSCLC. METHOD: In a retrospective cohort study, we examined the survival of 163 NSCLC patients who underwent curative surgical treatment at the Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Hospital between 1990 and 1997. Data was analyzed using Kaplan-Meier plots. Additionally, we used the Mann-Whitney test for comparing group survival rates and the Cox regression model to adjust for potential confounding factors. RESULTS: Were included 124 (76.07%) males and 39 (23.93%) females, whose median survival was of 32.3 and 60.6 months, respectively. The 5-year survival was 38.0% for men and 55.4% for women (P=0.030). Considering only stage I patients, survival rates were 44.4% and 81.8% for men and women, respectively (P=0.009). Effect of gender continued after adjustment for several factors (age, hemoglobin, histology, tumor size, type of surgery and postoperative complications). CONCLUSION: This study confirms our previous findings that women live longer after NSCLC surgery when compared to men. This result is only observed at an early stage and persists after adjustment of several factorsP

 


Keywords: Carcinoma, bronchogenic [surgery]; Carcinoma, bronchogenic [epidemiolgy]; Prognosis; Sex distribution; Disease - free survival.

 

4 - Cystic fibrosis in adults clinical and spirometric aspects

Fibrose cística em adultos: aspectos clínicos e espirométricos

Antônio Carlos M. Lemos; Eliana Matos; Rosana Franco; Pablo Santana; Maria Angélica Santana

J Bras Pneumol.2004;30(1):9-13

Abstract PDF PT Portuguese Text

INTRODUCTION: Cystic Fibrosis is usually diagnosed in childhood. In Brazil, few studies have approached CF diagnosed in adulthood. OBJECTIVE:The aim of this study was to describe demographic and clinical characteristics and spirometric data of patients with CF diagnosed in adulthood (over 16 years of age) in Bahia, Brazil. METHODS: Twenty-eight patients with cystic fibrosis diagnosed in adulthood were evaluated at the Reference Center of Cystic Fibrosis of the state of Bahia. Variables of interest were age, gender, race, body mass index (BMI), sputum culture, presence of sinusitis and bronchiectasis, spirometric tests with the best values performed for forced expiratory volume in the first second (FEV1), forced vital capacity (FVC) and response to bronchodilators. RESULTS: Mean age of diagnosis was 31.1 ± 12.4 years. Of the patients, 53.4% were black and mulatto and the mean BMI was 18.7 ± 3.0 kg/m2. P aeruginosa was present in 12 (43%) of the total patients. The mean percentages ± SD of FVC and FEV1 were 58.9 ± 21.6% and 44.1 ± 23%, respectively. In the group of patients with presence of P. aeruginosa in sputum cultures, mean of the spirometry parameters were lower than those of the P. aeruginosa-free group. However, this difference achieved a statistically significant difference (p = 0.0007) only in FVC . CONCLUSIONS: In agreement with many authors, this study strengthen the point of view that CF must be investigated in patients with recurrent infections, sinusitis and bronchiectasis even in adulthood. Values of the percentages of FVC and FEV1 in relation to those foreseen were lower in patients bearers of P. aeruginosa thereby showing a higher deterioration of the pulmonary function.

 


Keywords: Cystic fibrosis/diagnosis. Adult. Spirometry/methods.

 

5 - Influence of ascites in the pulmonary function of patients with portal hypertension

Influência da ascite na avaliação da função pulmonar em portadores de hipertensão portal

Angela Maria Stiefano Nitrini; Roberto Stirbulov; Ernani Geraldo Rolim

J Bras Pneumol.2004;30(1):14-19

Abstract PDF PT Portuguese Text

BACKGROUND: Oxygen deficiency in patients with portal hypertension may be secondary to changes in respiratory mechanics due to ascites. OBJECTIVES: Evaluate pulmonary function in patients with portal hypertension before and after reduction of the ascites. METHOD: Fifteen patients with portal hypertension and ascites were submitted to pulmonary function tests, comprising spirometry and arterial blood gas determination, before and after reduction of ascites. The analyzed parameters were: forced vital capacity (FVC); forced expiratory volume in one second (FEV1); forced expiratory flow between 25% - 75% of forced vital capacity (FEF 25-75%); expiratory reserve volume (ERV); FEV1/FVC; arterial oxygen pressure (PaO2); arterial carbon-dioxide pressure (PaCO2) and arterial oxygen saturation (SaO2). RESULTS: There was remarkable improvement in pulmonary volumes after decrease of ascites by treatment with diuretics associated or not to paracentesis. CONCLUSION: We concluded, that in patients with portal hypertension and ascites, there is a decrease of pulmonary volumes compared to predicted values, with significant improvement decrease of ascites. Similarly, an increase of the arterial oxygen pressure and of the arterial oxygen saturation was perceived.

 


Keywords: Ascites/therapy. Hypertension, portal. Respiratory function tests.

 

6 - Post-infectious bronchiolitis obliterans: clinical aspects and complementary tests of 48 children

Bronquiolite obliterante pós-infecciosa: aspectos clínicos e exames complementares de 48 crianças

Rosaly Vieira dos Santos; Nelson A. Rosário; Carlos Antônio Ried

J Bras Pneumol.2004;30(1):20-25

Abstract PDF PT Portuguese Text

BACKGROUND: The clinical evaluation of patients with post-infectious bronchiolitis obliterans (BO) is variable. OBJECTIVE: Substantiate the clinical characteristics, the evolution and the complementary tests of 48 patients with post-infectious bronchiolitis obliterans (BO). METHOD: Observational and retrospective study. Diagnosis of BO was based upon clinical criteria, CT scan findings and exclusion of other diseases. History prior to diagnosis and complementary tests were evaluated as well as initial and final values of oxygen saturation. RESULTS: Mean age of patients at the acute stage of the infectious disease was of 9.6. Thirty two of the patients were male. All were hospitalized during the acute stage, 14 of them (29%) in the ICU. Four patients died two years after onset of acute bronchiolitis. During evolution, all required emergency care due to exacerbation of the pulmonary condition and 24 (50%) were hospitalized, 2 of them in the ICU. The majority continued presenting cough, wheezing, crackles and hyperinflation, however to a lesser degree. Mean of initial arterial saturation was of 89% and final of 92%. The most common infectious agents in sputum samples were H. influenzae, S. pneumoniae and M. catarrhalis. Increased serum IgM and IgC were found in 9 and 7 patients, respectively. The most frequent findings at thorax CT scan were mosaic perfusion, bronchiectasis, atelectasis and bronchial wall thickening. CONCLUSION: Post infectious BO is a chronic and severe disease with persistent symptoms that in general affect infants. Positive serum cultures and increased serum immunoglobulins are suggestive of chronic infectious inflammatory condition.

 


Keywords: Bronchiolitis obliterans. Obstructive lung diseases.

 

 


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