Year 2000 - Volume 26 - Issue 2 (March/April)

Editorial

1 - AIDS e tuberculose: novo problema, velho problema

Margareth Pretti Dalcolmo

J Bras Pneumol.2000;26(2):3-4

Original Article

2 - Impact of multiple biopsies in two different sites of the pleural surface for the diagnosis of tuberculosis

Impacto de múltiplas biópsias em dois pontos distintos da superfície pleural no diagnóstico de tuberculose

Marcelo Chalhoub, Ronald Fidelis, Ana Paula Barreto, Eduardo Ramos, Manoel Barral-Netto, Aryon Almeida Barbosa Jr.

J Bras Pneumol.2000;26(2):55-60

For diagnostic purposes of pleural tuberculosis, three pleural fragments are routinely obtained from a single site by needle biopsy. The objective of this study is to compare the diagnostic yield of the routine procedure with two different approaches: harvesting five fragments on a single site (A), and collection of fragments at an additional site (B); from the same cutaneous orifice, the needle was partially removed up to the subcutaneous tissue and redirected at a 45o angle. The authors performed a prospective study in 115 patients submitted to pleural biopsy. The first three pleural fragments were placed in a vial (VA1-3), the 5 subsequent fragments obtained at the same site were placed in a second vial (VA4-8), and the five fragments from the second site were placed in a third vial (VB1-5). Analysis of fragments from VA1-3 revealed granuloma in 72/92 tuberculosis cases (78.3%), whereas in fragments VA5-8 and VB1-5, granuloma was observed in 74/92 cases (80.5%). In 6/92 patients the diagnosis at VA1-3 was non-specific pleuritis, but granuloma was found in VA4-8, resulting in a diagnosis increment of 8.3% (adding six to the 72 patients). In 7/92 patients (7.6%) the histopathological examination at site A led to a non-specific result but granuloma was found at site B, leading to a diagnostic increment of 9.0% (7 to 78 patients). Histological concordance of two examinations by the same pathologist had a kappa index of 0.62 (0.54 to 0.7) whereas concordance between two different pathologists had a kappa index of 0.64 (0.56 to 0.72). The performance of multiple biopsies at two different sites at the pleural surface led to an additional diagnosis of 13 patients, i.e., an increase of 18% (13 to 72) relative to the routine procedure. Considering the low cost increase of obtaining the fragments, adoption of this method is recommended in routine pleural tuberculosis diagnosis.

Keywords: Tuberculosis, pleural tuberculosis, biopsy, diagnosis.

3 - Pulmonary idiopathic fibrosis: clinical findings and survival in 132 histologically-proven patients

Fibrose pulmonar idiopática: características clínicas e sobrevida em 132 pacientes com comprovação histológica

Adalberto Sperb Rubin, José da Silva Moreira, Nelson da Silva Porto, Klaus Loureiro Irion, Rafael Franco Moreira, Bruno Scheidt

J Bras Pneumol.2000;26(2):61-68

5 - Functional respiratory changes in laparoscopic cholecystectomy

Alterações funcionais respiratórias na colecistectomia por via laparoscópica

Luciana Dias Chiavegato, José Roberto Jardim, Sonia Maria Faresin, Yara Juliano

J Bras Pneumol.2000;26(2):69-76

Objective: The aim of this study was to measure the changes in lung volume, pulmonary ventilation, maximum respiratory muscle strength, and the incidence of pulmonary complications in patients undergoing elective laparoscopic cholecystectomy. Type of study: Prospective study. Material and methods: Twenty patients (7 men and 13 women) with mean age of 42.7 years with normal respiratory function were studied. All patients in the preoperative period answered a long questionnaire, had a physical examination done, and had their lung volumes, respiratory muscle strength, diaphragmatic index and pulse oximetry determined. All measurements were repeated on the 1st, 2nd, 3rd and 6th postoperative days. Results: Patients showed a significant decrease (p < 0.05) on the first postoperative day: 26% ± 13% in tidal volume; 20% ± 14% in minute volume; 36% ± 17% in vital capacity; 47% ± 17% in maximum inspiratory pressure, 39% ± 27% in the maximum expiratory pressure and 36% ± 25% in diaphragmatic index. Tidal volume, minute volume and maximum expiratory pressure returned to their basal values on the third postoperative day; vital capacity, maximum inspiratory pressure and diaphragmatic index returned to their basal values between the 4th and 6th postoperative days. Among the 20 patients pulmonary complication was observed in just one patient (lobar atelectasis); there was a full recovery by the third postoperative day with the use of chest physical therapy techniques. Conclusion: The authors conclude that patients undergoing a laparoscopic cholecystectomy show a significant decrease in lung volume and in respiratory muscle strength on the first postoperative day. But, when these measurements are compared to the literature, return to their basal values is faster (between the 4th and 6th postoperative days) than with conventional surgery.

Keywords: Laparoscopic surgery, preoperative and postoperative care and respiratory muscle strength.

Upgrading

6 - Pesquisa bibliográfica em ciências biomédicas

Enilze de Souza Nogueira Volpato

J Bras Pneumol.2000;26(2):77-80

Review Article

7 - Respiratory health hazards in agricultural activities

Agravos respiratórios decorrentes da atividade agrícola

Carlos A.A. Viegas

J Bras Pneumol.2000;26(2):83-90

8 - Bronchial remodeling in asthma

Remodelamento brônquico na asma

Thais Mauad, Alessandra Sandrini Lopes de Souza, Paulo Hilário Nascimento Saldiva, Marisa Dolhnikoff4

J Bras Pneumol.2000;26(2):91-98

Case Report

9 - Intrabronchial leiomyoma: report of a case with seven years of tumor evolution

Leiomioma intrabrônquico: relato de um caso com sete anos de evolução

Paulo José Lorenzoni, Maria Ilizabeti Donatti, Paulo de Tarso Muller, Eliana Setti A. Aguiar, Pedro Nango Dobashi

J Bras Pneumol.2000;26(2):99-102

10 - Pulmonary and pleural paragonimiasis: report of two cases

Paragonimíase pulmonar e pleural: relato de dois casos

Teresa de Jesus Jhayya S., Miguel Angel Coloma S., Mónica Pérez V., Danilo Montaño E.

J Bras Pneumol.2000;26(2):103-106

Letters to the Editor

11 - O Brasil no "bonde da história da asma"

Márcia Alcântara Holanda

J Bras Pneumol.2000;26(2):19-21

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