Year 2025 - Volume 51 - Issue 2 (March/April)

Editorial

1 - COPD and bronchiectasis; more than mere enemies

Grace Oscullo1,2, Amina Bekki1,2, Miguel Ángel Martinez-García1,2

J Bras Pneumol.2025;51(2):e20250086

Original Article

2 - Early discharge, inpatient treatment, or ICU management for patients with acute pulmonary embolism: is the guidelinerecommended practice being followed?

Paula Ruiz-Talero1,2, Oscar M Muñoz-Velandia1,2, Santiago Méndez Salazar1

J Bras Pneumol.2025;51(2):20240167

3 - A polymorphism in the FAM13A gene confers protection against tuberculosis in Brazilian workers exposed to silica

Marcos César Santos de Castro1,2, Angela Santos Ferreira Nani2, Kaio Cezar Rodrigues Salum1, Lucas de Carvalho Costa1, Valéria Barbosa Moreira2, Hermano Albuquerque de Castro4, Patrícia Canto Ribeiro4, Walter Costa3, Cícero Brasileiro de Mello1,5, Fabiana Barzotto Kohlrausch5

J Bras Pneumol.2025;51(2):e20240327

4 - Impact of elexacaftor/tezacaftor/ivacaftor on the small airways in cystic fibrosis

Sofia Campos Silva1, Andreia Barroso2, Maria Cunha3, Elsa Fragoso4,5, Pilar Azevedo4,5

J Bras Pneumol.2025;51(2):e20240406

Objective: To evaluate the impact of the elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) combination on the small airways in adults with cystic fibrosis (CF), a genetic disorder that primarily affects the respiratory system, leading to progressive lung disease. In CF, the small airways play a critical role, contributing to chronic symptoms such as cough, sputum production, and dyspnea. Methods: This was a single-center, retrospective observational study of adults with CF treated with ELX/TEZ/IVA for 12 months. We compared the patients who were homozygous for the F508del mutation of the CF transmembrane conductance regulator (CFTR) gene with those who were heterozygous for that mutation, in terms of lung function outcomes (FEV1, FEF25-75%, and the RV/TLC ratio) and the extent of non-homogeneous ground-glass opacity. Among the patients within the cohort, the same parameters were evaluated separately in those who had advanced lung disease and in those who had previously undergone CFTR modulator therapy. Results: There was a significant post-treatment improvement in lung function, with a median increase of 0.42 L/s in the FEF25-75% (p < 0.001) and a 5% reduction in the mean RV/TLC ratio (p < 0.001). There was a trend toward a higher improvement the F508del homozygous patients. A significant reduction in non-homogeneous ground-glass opacity was observed in 79.5% of the patients. Among the patients with advanced lung disease, there were notable post-treatment improvements in all of the parameters assessed. Conclusions: Our results highlight the positive impact that ELX/TEZ/IVA treatment can have on small airway function in patients with CF, with potential benefits even for those with advanced lung disease. Further research is needed in order to evaluate the long-term effects of this treatment and its relationship with patient-reported outcomes.

Keywords: Cystic fibrosis/diagnostic imaging; Lung/physiopathology; Respiratory function tests; Lung/drug effects; Lung/diagnostic imaging; Cystic fibrosis/drug therapy.

5 - Characteristics of nicotine product use, perceptions of dependence, and passive exposure among first-year university students in Brazil

Matheus Milani Silva1, Sandra Silva Marques2, Ludmila Candida de Braga2, Suzana Erico Tanni4, Ilda de Godoy5, Irma de Godoy6

J Bras Pneumol.2025;51(2):e20240384

Objective: To assess nicotine product use among incoming students at public and private universities in Brazil. Methods: This was a multicenter cross-sectional study including a convenience sample of incoming university students (= 18 years of age). Current use of conventional cigarettes, electronic cigarettes, and other nicotine products, as well as indicators of dependence and knowledge of the consequences of active use of or passive exposure to nicotine products were investigated with the use of a 38-item questionnaire. Descriptive statistics were used to analyze the data. Results: A total of 863 students completed the questionnaire. Of those, most (61%) were female, and most (76.6%) identified themselves as White. In addition, most (86%) were in the 18- to 24-year age bracket, and most (88.6%) attended a public university. In the past 30 days, 20.7% reported using electronic cigarettes, 23.2% reported using conventional cigarettes, and more than 50% reported using other nicotine products. More than 80% agreed that electronic cigarettes are harmful to health and are as damaging as other types of smoking. Over half of the respondents reported using the product shortly after waking up, and, paradoxically, 81% stated that they would quit whenever they wanted. Passive exposure was reported by 21.6%, occurring at home (in 33.6%), in other indoor environments (in 41.7%), and in open environments (in 87.5%). Conclusions: Experimentation and current use of nicotine products are high among incoming students at public and private universities in Brazil. Passive exposure to nicotine products is commonplace. Advanced communication tools are needed, particularly to emphasize the dangers of nicotine dependence. Being a legal drug, nicotine is often perceived as harmless, reinforcing the misconception that it can be used without consequences.

Keywords: Cigarette smoking; Electronic nicotine delivery systems; Tobacco use disorder; Tobacco smoke pollution.

Special Article

6 - Brazilian guidelines for the pharmacological treatment of pulmonary embolism. Official document of the Brazilian Thoracic Association based on the GRADE methodology

Diretrizes brasileiras para o tratamento farmacológico do tromboembolismo pulmonar. Documento oficial da Sociedade Brasileira de Pneumologia e Tisiologia baseado na metodologia GRADE

Veronica Moreira Amado1, Caio Júlio César dos Santos Fernandes2, William Salibe-Filho2, Marcelo Basso Gazzana3, Ana Thereza Rocha4, Hugo Hyung Bok Yoo5, Wanderley Marques Bernardo6,7, Suzana Tanni5

J Bras Pneumol.2025;51(2):e20240314

Letters to the Editor

7 - Exploring perspectives on the benefits of a tuberculosis short-treatment regimen: a cross-sectional study on treatment experiences and perceptions

Fernando Pereira da Silva1, João Pedro Ramos2,3, Pedro Barbosa2,3, Mariana Vieira2,3, Raquel Duarte2,3,4

J Bras Pneumol.2025;51(2):e20250059

Images in Pulmonary Medicine

8 - Granulomatosis with polyangiitis

Roberta Wartchow Machado1, Felipe Welter Langer2, Dionatta Halle Flores Lisboa3

J Bras Pneumol.2025;51(2):e20250091

Point of View

9 - Why we should rethink military metaphors in cancer

Gustavo Faibischew Prado1,2, Thais Azzi Gonçalves3

J Bras Pneumol.2025;51(2):e20250109

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