Objective: To characterize a population of patients with bronchiectasis, correlating clinical, radiological, and functional aspects with the severity of dyspnea. Methods: This was a cross-sectional study involving adult patients with HRCT-confirmed bronchiectasis, categorized according to the severity of dyspnea (as being mildly or severely symptomatic, on the basis of the modified Medical Research Council scale). We correlated the severity of dyspnea with clinical parameters, functional parameters (spirometry values, lung volumes, and DLCO), and CT parameters. Results: We evaluated 114 patients, 47 (41%) of whom were men. The median age (interquartile range) was 42 years (30-55 years). The most common form was idiopathic bronchiectasis. Of the 114 patients, 20 (17.5%) were colonized with Pseudomonas aeruginosa and 59 (51.8%) were under continuous treatment with macrolides. When we applied the Exacerbation in the previous year, FEV1, Age, Colonization, Extension, and Dyspnea score, the severity of dyspnea was categorized as moderate in 54 patients (47.4%), whereas it was categorized as mild in 50 (43.9%) when we applied the Bronchiectasis Severity Index. The most common lung function pattern was one of obstruction, seen in 95 patients (83.3%), and air trapping was seen in 77 patients (68.7%). The prevalence of an obstructive pattern on spirometry was higher among the patients with dyspnea that was more severe, and most functional parameters showed reasonable accuracy in discriminating between levels of dyspnea severity. Conclusions: Patients with bronchiectasis and dyspnea that was more severe had greater functional impairment. The measurement of lung volumes complemented the spirometry data. Because bronchiectasis is a complex, heterogeneous condition, a single variable does not seem to be sufficient to provide an overall characterization of the clinical condition.

Keywords: Bronchiectasis; Dyspnea; Respiratory function tests; Multidetector computed tomography; Plethysmography.

Sleep disorders

8 - Translation and cultural adaptation of the Sleep Apnea Clinical Score for use in Brazil

Tradução e adaptação cultural do questionário Sleep Apnea Clinical Score para uso no Brasil

Verônica Sobral Camara Lapas1, Anamelia Costa Faria1, Rogério Lopes Rufino1, Cláudia Henrique da Costa1

J Bras Pneumol.2020;46(5):e20190230

Objective: To determine the relationships that smoking history has with inflammatory markers, metabolic markers, body composition, muscle strength, and cardiopulmonary capacity in current smokers. Methods: This was a cross-sectional study involving 65 smokers (age range: 18-60 years). On three non-consecutive days, each participant was evaluated in terms of smoking history, pre-existing comorbidities, lung function (by spirometry), peripheral muscle strength (by dynamometry), body composition (by bioelectrical impedance analysis), levels of metabolic/inflammatory markers, and maximum cardiopulmonary capacity (by treadmill exercise test). We evaluated the relationships that smoking history has with inflammatory markers, metabolic markers, body composition, muscle strength, and cardiopulmonary capacity, using logarithmic transformation of the data and calculating Pearson's correlation coefficient and for partial correlations adjusted for age, gender, body mass index (BMI), and comorbidities. To identify the influence of smoking history on pre-existing comorbidities, we used a logistic regression model adjusted for age, BMI, and duration of smoking. Results: Smoking history correlated significantly, albeit weakly, with triglyceride level (r = 0.317; p = 0.005), monocyte count (r = 0.308; p = 0.013), and waist circumference (r = 0.299; p = 0.017). However, those correlations did not retain their significance in the adjusted analysis. In the logistic regression model, smoking more than 20 cigarettes/day correlated significantly with the presence of metabolic diseases (OR = 0.31; 95% CI: 1.009-1.701; p = 0.043). Conclusions: In this sample of smokers, smoking history correlated positively with the triglyceride level, the monocyte count, and waist circumference. The prevalence of metabolic disease was highest in those who smoked more than 20 cigarettes/day.

Keywords: Tobacco; Smoking; Triglycerides; Monocytes; Waist circumference; Body composition.

9 - Using the No-Apnea score to screen for obstructive sleep apnea in adults referred to a sleep laboratory: comparative study of the performance of the instrument by gender

Triagem de apneia obstrutiva do sono através do escore No-Apnea em indivíduos adultos encaminhados para um laboratório de sono: estudo comparativo do desempenho do instrumento relacionado ao gênero

Ricardo Luiz de Menezes Duarte1,2, Flavio José Magalhães da Silveira1, Tiago Soares de Oliveira e Sá3,4, Marcelo Fouad Rabahi5, Fernanda Carvalho de Queiroz Mello2, David Gozal6

J Bras Pneumol.2020;46(5):e20190297

Lung Diseases, Interstitial

10 - High resolution computed tomography patterns in interstitial lung disease (ILD): prevalence and prognosis

Padrões de tomografia computadorizada de alta resolução na doença pulmonar intersticial (DPI): prevalência e prognóstico

Renata Fragomeni Almeida1 , Guilherme Watte2,3 , Edson Marchiori4 , Stephan Altmayer2,3 , Gabriel Sartori Pacini2, Marcelo Cardoso Barros2,3 , Aldo Paza Junior5 , Adalberto Sperb Rubin1 , Moacyr Christopher Garces Gamarra Salem1 , Bruno Hochhegger2,3

J Bras Pneumol.2020;46(5):e20190153

COVID-19

11 - Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data

Gravidade do comprometimento pulmonar em radiografias de tórax de pacientes infectados por SARS-coronavirus-2 como possível ferramenta para prever a evolução clínica: análise retrospectiva observacional da relação entre dados radiológicos, clínicos e laboratoriais

Elisa Baratella1, Paola Crivelli2, Cristina Marrocchio3, Alessandro Marco Bozzato3, Andrea De Vito4, Giordano Madeddu4, Laura Saderi5, Marco Confalonieri6, Luigi Tenaglia7, Maria Assunta Cova1

J Bras Pneumol.2020;46(5):e20200226

Smoking

12 - Smoking history: relationships with inflammatory markers, metabolic markers, body composition, muscle strength, and cardiopulmonary capacity in current smokers

Relação da carga tabágica com marcadores inflamatórios, marcadores metabólicos, composição corporal, força muscular e capacidade cardiorrespiratória em tabagistas

Tamara dos Santos Gouveia1, Iara Buriola Trevisan1, Caroline Pereira Santos1, Bruna Spolador de Alencar Silva1, Ercy Mara Cipulo Ramos1, Mahara Proença2, Dionei Ramos1

J Bras Pneumol.2020;46(5):e20180353

Keywords: Tobacco; Smoking; Triglycerides; Monocytes; Waist circumference; Body composition.

Critical Care

13 - Impact of a respiratory ICU rotation on resident knowledge and confidence in managing mechanical ventilation

Impacto de um estágio em UTI respiratória no conhecimento e confiança no manejo da ventilação mecânica entre residentes

Fátima Kiyoko Hayashi1, Pedro Paulo Marino Rodrigues Ayres1, Anna Miethke Morais1, Mayson Laércio de Araújo Sousa1, Carmen Sílvia Valente Barbas1, Eduardo Leite Vieira Costa1, Pedro Caruso1, Juliana Carvalho Ferreira1

J Bras Pneumol.2020;46(5):e20190108

Review Article

14 - Social determinants of health and catastrophic costs associated with the diagnosis and treatment of tuberculosis

Determinantes sociais da saúde e custos catastróficos associados ao diagnóstico e tratamento da tuberculose

Adriana da Silva Rezende Moreira1, Afrânio Lineu Kritski1, Anna Cristina Calçada Carvalho2

J Bras Pneumol.2020;46(5):e20200015

15 - Are smoking, environmental pollution, and weather conditions risk factors for COVID-19?

Tabagismo, poluição ambiental e condições climáticas são fatores de risco para COVID-19?

José Miguel Chatkin1, Irma Godoy2

J Bras Pneumol.2020;46(5):e20200183

Letters to the Editor

16 - Tuberculosis in elderly patients in the city of Cali, Colombia: a hospital-based cohort study

Tuberculose em pacientes idosos na cidade de Cali, na Colômbia: um estudo de coorte de base hospitalar

Jose Fernando García-Goez1,2, Juan Diego Vélez1,2, Barbara Lucía Mora3, Luis Gabriel Parra-Lara2,3, Jessica Pino-Escobar3, Joan Artur Caylà4, Jose M. Miro5

J Bras Pneumol.2020;46(5):e20200072

17 - Triple-matched defects on ventilation/perfusion scintigraphy and computed tomography: the importance of the reticular reversed halo sign

Concordância tripla de alterações na cintilografia de ventilação/perfusão e tomografia computadorizada: a importância do sinal do halo invertido reticular

Bruno Lima Moreira1, Pablo Rydz Pinheiro Santana1,2, Antônio Carlos Portugal Gomes1, Edson Marchiori3

J Bras Pneumol.2020;46(5):e20190416

18 - COVID-19 morbidity and mortality in 2020: the case of the city of Rio de Janeiro

Morbidade e mortalidade por COVID-19 em 2020: o caso da cidade do Rio de Janeiro

Nádia Cristina Pinheiro Rodrigues1,2, Mônica Kramer de Noronha Andrade1, Denise Leite Maia Monteiro3, Valéria Teresa Saraiva Lino1, Inês do Nascimento Reis1, Vera Cecília Frossard1, Gisele O'Dwyer1

J Bras Pneumol.2020;46(5):e20200341