Brazilian Journal of Pulmonology

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

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Year 1997 - Volume 23  - Number 4  (July/August)






Original Article

1 - Comparative study between technical use, immediate bronchodilation, and adverse effects of the terbutaline turbuhaler and salbutamol (albuterol) in asthmatic patients

Estudo comparativo entre a técnica de uso, efeito broncodilatador e efeitos adversos imediatos de terbutalina via "Turbuhaler" e salbutamol via aerossol em asmáticos

Luiz Fernando F. Pereira, Nelson Morrone

J Bras Pneumol.1997;23(4):167-173

Abstract PDF PT Portuguese Text

Summary: b-agonists are considered the agents of first choice for the treatment of asthmatic symptoms and are usually available for aerosol administration. Its propellants damage the ozone layer and are often not used properly by the patients. Turbuhaler seems a better alternative since it does not present these inconveniences. In Brazil, it has been recently introduced. Purpose: Compare salbutamol aerosol (SA) to terbutaline turbuhaler (TT) in relation to technical use, bronchodilation and adverse effects in outpatients with mild-obstruction asthma (PFR ³ 60 and < 80% predicted). Material and methods: Open, parallel randomized study performed in each arm of 20 patients (SA: 200 mg and TT: 500 mg). After 30 minutes, a second dose was given if PFR was not 15% or 30 L/min greater than the initial one; a second dose was also delivered if PFR was not greater than 80%. All patients were instructed on how to use both devices. Results: Clinical improvement and increase in PFR were similar in both groups (SA 69.5 vs. TT 58.1 L/min, p > 0.05). A second dose was given to 13 patients (SA 6 and TT 7) with similar results. Errors in the usage were observed in all 20 patients of group SA vs. 11 patients in group TT (p < 0.05). Adverse effects were more frequent with TT - 9 patients - due to its unpleasant taste. Fifteen patients of group TT and with previous experience with SA considered turbuhaler easier. Conclusions: 1) administration by the patient is easier with turbuhaler than with SA; 2) bronchodilation is not different with SA 200 mg and TT 500 mg; 3) unpleasant taste was noted only in group TT (50% of the patients).

 


Keywords: Asthma. Salbutamol aerosol. Terbutaline Turbuhaler.

 

2 - Evaluation of ampicillin-quinolone association in hospital treatment of severe community-acquired pneumonia

Avaliação da associação de quinolona e ampicilina no tratamento hospitalar de pneumonias graves adquiridas na comunidade

Dinália Maria Ribeiro, Marísia de Almeida Ritti, Cátia Esmeralda do Carmo, Bruno do Valle Pinheiro, Jorge Baldi, Júlio César Abreu de Oliveira

J Bras Pneumol.1997;23(4):174-178

Abstract PDF PT Portuguese Text

Objective: Evaluate the efficacy of the ampicillin-quinolone association in the treatment of severe community-acquired pneumonia. Design: Open, prospective study carried out at the Emergency room of the Hospital Universitário da Universidade Federal de Juiz de Fora. Patients and methods: From March 1994 to September 1995, the authors studied 23 patients with fever and with at least three of the following symptoms: cough, purulent sputum, pleuritic thoracic pain, leukocytosis or leukopenia, and a chest radiological examination showing infiltrations compatible with pneumonia diagnosis. The patient diagnosis would be severe pneumonia if he met the criteria of severe sepsis as established by the American College of Chest Physicians and by the Society of Critical Care Medicine. Results: 23 patients were studied. One was excluded after having a pulmonary tuberculosis diagnosis; 21 patients were considered cured and one died. Adverse drug effects occurred in one patient who presented a mild pharmacodermia. Conclusion: Ampicillin-quinolone is efficient in the treatment of severe community-acquired pneumonia.

 


3 - Prevalence of respiratory symptoms and spirometric evaluation in marble workers

Prevalência de sintomas respiratórios e avaliação espirométrica em trabalhadores de marmorarias

Ayrdes Benedita Duarte dos Anjos Pivetta, Clóvis Botelho

J Bras Pneumol.1997;23(4):179-188

Abstract PDF PT Portuguese Text

The prevalence of respiratory symptoms in populations at risk or in populations not at risk is an indirect indicator of acute and chronic respiratory diseases, with a high grade of confidence from an epidemiological point of view. In order to contribute to this, the authors carried out a prevalence study among workers with occupational exposure to silica dust in a marble plant. The authors selected workers who worked with hard granite stone, slate and marble. Workers were submitted to a standardized questionnaire and 84 people were studied. All were male, mean age was (± SD) 26.2 (± 7.4 years), and had had short time of exposure to dust (52 workers worked less than 5 years in the marble industry). Thirty-four were smokers (10.0 (± 2.3) pack years), 9 former smokers, and 41 non-smokers. Twenty-four had cough, 30 sputum, 1 dyspnea grade III, 5 wheezing. Thirty-eight presented at least one of the studied respiratory symptoms and 9 presented chronic bronchitis. The lung function evaluated in 82 workers through spirometry was normal in 78 of the cases and an obstructive pattern was detected in 4 of them. A significant statistical association between chronic bronchitis and exposure time to stone dust was found (OR = 5.37; 95% CI = 1.01-28.74). However, that association was lost after other factors, such as cigarette smoking and age, were evaluated (OR = 1.21; 95% CI = 0.12-11.93). The association between smoking and bronchitis (OR = 14.18; 95% CI = 1.80-111.62) remained marginally significant even after controlling exposure time to stone dust and age (OR = 6.34; 95% CI = 0.76-52.94). Results suggest that among the marble industry workers studied, the prevalence of chronic bronchitis is more strongly associated to smoking to with exposure time to stone dust.

 


4 - Response to thymectomy in patients with myasthenia gravis

Resultado da timectomia em doentes com miastenia gravis

Roberto Saad Jr., Cristina Cordeiro Arranz, Vicente Dorgan Neto, Jaqueline Arantes Giannini, Márcio Botter

J Bras Pneumol.1997;23(4):189-192

Abstract PDF PT Portuguese Text

The aim of this study was to analyze the results of 17 patients with myasthenia gravis who, from 1985 to 1994, were submitted to thymectomy at the Medical School of Santa Casa de São Paulo. Nine patients (52.9%) were female and the mean age was approximately 30.3 years. The most usual symptoms were ptoses, weakness, and diplopia. Other symptoms included: dyspnea, dysphonia, thoracic pain and loss of weight. The average development period of the disease was 17.5 months (between 3 and 96 months). The diagnostic methods use were chest X-ray, response to edrophonium chloride (Tensilon), electrophysiologic study and thoracic CT. All patients were submitted to thymectomy through medium sternotomy. Patients were followed up from one month to ten years. Only one patient did not return to the clinic. Twelve patients (75%) achieved good results. The others four patients presented little or no response after thymectomy.

 


Keywords: Thymectomy. Myasthenia gravis.

 

Case Report

5 - Current approach to advanced non-small cell lung cancer: review

Abordagem atual no tratamento da neoplasia de pulmão não-pequenas células avançada: revisão

Mauro Zukin, Rogério Lilenbaum

J Bras Pneumol.1997;23(4):193-196

Abstract PDF PT Portuguese Text

Several advances have been made in the treatment of advanced non-small cell lung cancer in the last few years. Combined therapies using chemotherapy have improved survival of patients with locally advanced disease (stage III) when compared to either radiation or surgery. New chemotherapeutic agents, used alone or combined, have also made a strong impact with metastatic disease (stage IV). Ongoing randomized trials will certainly define new treatment standards and hopefully improve the outcome of patients with non-small cell lung cancer.

 


Keywords: Locally advanced. Non-small cell lung cancer.

 

Review Article

6 - Padrões histológicos dos processos infiltrativos difusos em colagenoses

Ester Nei Aparecida Martins Coletta

J Bras Pneumol.1997;23(4):197-207

PDF PT


Case Report

7 - Pulmonary aneurysm regression in Behçet's disease

Regressão de aneurisma pulmonar na doença de Behçet

Walder G. Pereira de Barros, Nelson Morone Jr., Roseli R. Brito, José A. Baddini Martinez

J Bras Pneumol.1997;23(4):208-210

Abstract PDF PT Portuguese Text

The authors present a case of a patient with Behçet's disease who complained about sudden dyspnea while performing light physical exercises, about non-productive cough, weakness, and frontal headache; he also presented significant weight loss in the last month while being treated for an alleged tuberculosis. After going through an episode of massive hemophthisis, his clinical history and physical examination were reevaluated and his new diagnosis was concluded to be Behçet's disease. Thus, the authors started treatment by giving immunosuppressive drugs and corticosteroids and, as a consequence, regression of the aneurysm was noted. In this article the authors discuss the clinical, radiological, histopathologic and therapeutic features of this syndrome.

 


Keywords: Behçet's disease. Pulmonary arterial aneurysms.

 

8 - Pulmonary nocardiosis: presentation of a clinical case with poor evolution

Nocardiose pulmonar: apresentação de caso clínico com evolução desfavorável

Lilia Azzi Collet R. Camargo, Edmir Fêlix da Silva Junior, Miltom S. Lapchik, Celso Di Loreto

J Bras Pneumol.1997;23(4):211-214

Abstract PDF PT Portuguese Text

The authors present a 62-year-old male patient who had pulmonary nocardiosis with poor evolution. He also presented mental confusion, septic shock and a significant leukocytosis. Poor evolution happened even when sulfamethoxazole + trimethoprim replaced by ceftriaxone + clindamycin as an antibiotic therapy were used. Diagnostic methods, epidemiology and therapy of this infection are discussed and revised. The authors emphasize the importance of an early diagnosis, isolation in culture, and antibiogram examination of Nocardia ssp samples for therapeutic adapting.

 


Keywords: Pneumonia. Nocardia.

 

9 - Paciente jovem com derrame pleural e insuficiência respiratória

Rosali T. Rocha, Januário M. Souza, Sergio A. Oliveira, Edson Norbert Genta

J Bras Pneumol.1997;23(4):215-219

PDF PT


 


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