Jornal Brasileiro De Pneumologia最新文献

{"title":"Early discharge, inpatient treatment, or ICU management for patients with acute pulmonary embolism: is the guideline-recommended practice being followed?","authors":"Paula Ruiz-Talero, Oscar M Muñoz-Velandia, Santiago Méndez Salazar","doi":"10.36416/1806-3756/e20240167","DOIUrl":"10.36416/1806-3756/e20240167","url":null,"abstract":"<p><strong>Objective: </strong>To describe the rates of adherence to the 2019 European Society of Cardiology guideline recommendations on the setting of care for patients with acute pulmonary embolism (PE) of varying severity.</p><p><strong>Methods: </strong>This was a retrospective cohort study of PE patients treated in a referral hospital in Colombia between 2019 and 2022.</p><p><strong>Results: </strong>We analyzed 506 patients with acute PE (median age, 67 years). Of those, 58% were women, and 33% had a history of cancer. In-hospital mortality was 9.2%, and 30-day mortality was 17.9%. Of the total of patients, 8.3% were classified as low-risk patients, 77.6% were classified as intermediate-low-risk patients, 11.2% were classified as intermediate-high-risk patients, and 2.7% were classified as high-risk patients. Of the total of low-risk patients, 9.5% were discharged early in accordance with the guideline recommendations. Of the total of intermediate-high-risk patients, 43.8% were treated in the general ward instead of being transferred to the ICU for monitoring. Of the total of high-risk patients, 92.8% were treated in the ICU. No cancer patients were discharged early.</p><p><strong>Conclusions: </strong>These results suggest that clinical practice guideline recommendations regarding the setting of care for patients with acute PE are not being followed. This is particularly true for low-risk PE patients who may be candidates for early discharge. Further studies are needed to investigate the reasons why low-risk patients are not being discharged early.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20240167"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional studies: understanding applications, methodological issues, and valuable insights.","authors":"Ricardo G Figueiredo, Cecilia M Patino, Juliana C Ferreira","doi":"10.36416/1806-3756/e20250047","DOIUrl":"10.36416/1806-3756/e20250047","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20250047"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic contribution of GeneXpert Ultra in pediatric pulmonary tuberculosis.","authors":"Claudia Stella Pereira Battaglia, Ana Alice Amaral Ibiapina Parente, Ronir Raggio Luiz, Rafaela Baroni Aurilio, Michely Alexandrino de Souza Pinheiro, Maria de Fátima Bazhuni Pombo Sant'Anna, Clemax Couto Sant'Anna","doi":"10.36416/1806-3756/e20240241","DOIUrl":"10.36416/1806-3756/e20240241","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the contribution of Ultra to the diagnosis of pediatric pulmonary tuberculosis (PTB).</p><p><strong>Methods: </strong>We analyzed prospective data from children and adolescents with presumed PTB whose specimens were tested with Ultra between January 2020 and December 2022. Diagnosis was based on clinical-radiological criteria, clinical response after a two-month treatment period, and microbiological analysis. Ultra was considered positive with a result of 'Detected' and 'Traces' in children under 10 years and in HIV-infected individuals. Fisher's exact test was used for group comparisons, and McNemar's test was used to compare Ultra results with the diagnostic presumption. The study was approved by the Ethics Committee (CAAE No. 02173518.2.0000.5264).</p><p><strong>Results: </strong>A total of 41 patients were included, of whom 63% (26/41) were diagnosed with PTB. Among these, 9/26 (34%) had positive results only through Ultra, with negative AFB and culture. The sensitivity and specificity of Ultra were 50% (13/26) and 100% (15/15), respectively. The PPV was 100% (13/13), and the NPV was 54% (15/28). Of these 28 (68%) patients with negative Ultra results, 13 (46%) were diagnosed with PTB, mostly by MoH-SS. Considering culture as the reference, the PPV and NPV were 67% and 100%, respectively.</p><p><strong>Conclusions: </strong>Ultra significantly contributed to the diagnosis of pediatric PTB, proving to be a promising tool for paucibacillary forms of the disease. However, it should not be used alone. Integrating laboratory tests with clinical evaluation is essential to improving diagnostic accuracy and the management of pediatric TB.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20240241"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on medical education in Brazil.","authors":"Clystenes Soares Silva, José Roberto Jardim","doi":"10.36416/1806-3756/e20250033","DOIUrl":"10.36416/1806-3756/e20250033","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20250033"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The laboratory of lung function in the follow-up of lung transplant recipients.","authors":"José Alberto Neder, Denis E O'Donnell, Danilo C Berton","doi":"10.36416/1806-3756/e20250015","DOIUrl":"10.36416/1806-3756/e20250015","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20250015"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary talcosis due to aspiration.","authors":"Edson Marchiori, Bruno Hochhegger, Gláucia Zanetti","doi":"10.36416/1806-3756/e20240401","DOIUrl":"10.36416/1806-3756/e20240401","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20240401"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships that perceived barriers to physical activity have with functional capacity and quality of life in patients with pulmonary hypertension.","authors":"Layse Nakazato Guedes de Lima, Vitoria Veronez, Paulo Roberto Araújo Mendes, Tatiana Alves Kiyota, Marcos Mello Moreira, Monica Corso Pereira","doi":"10.36416/1806-3756/e20240195","DOIUrl":"10.36416/1806-3756/e20240195","url":null,"abstract":"<p><strong>Objective: </strong>Barriers to physical activity can affect the functional capacity and quality of life of patients with pulmonary hypertension (PH). This study aimed to identify the main barriers to physical activity in patients with PH and to examine whether those barriers are related to functional capacity, echocardiographic variables, or quality of life.</p><p><strong>Methods: </strong>This was a cross-sectional observational study involving 70 patients. Participants scored seven potential barriers to their activities, with a score ≥ 5 indicating a significant barrier. Participants completed the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Manchester Respiratory Activity of Daily Living questionnaire, as well as the six-minute walk test. Correlation analysis, univariate analysis and multiple logistic regression were performed.</p><p><strong>Results: </strong>As a perceived barrier to physical activity, 'lack of will' or 'lack of energy' was cited by 67% of the patients. The 'lack of will' barrier was found to correlate with all SF-36 domains except bodily pain. We also identified a correlation between the SF-36 vitality domain and the barriers 'lack of energy', 'lack of will' and 'lack of structure'. The logistic regression analysis indicated that the vitality domain correlated significantly with the barriers 'social influence', 'lack of energy', 'lack of will', and 'lack of structure'. For each unit decrease in the vitality score, there was a 10% increase in the probability of citing the barrier 'lack of will'. No significant correlations were identified between any of the perceived barriers and echocardiographic parameters.</p><p><strong>Conclusions: </strong>The perceived barrier most commonly reported was 'lack of will/energy', which correlated with almost all SF-36 domains, especially vitality. The 'lack of will' barrier also correlated with functional capacity.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20240195"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timed \"up and go\" to identify physically inactive individuals with interstitial lung disease.","authors":"Camile Ludovico Zamboti, Larissa Dragonetti Bertin, Gabriela Garcia Krinski, Humberto Silva, Heloise Angélico Pimpão, Emanuel Gois Junior, Fabio Pitta, Carlos Augusto Camillo","doi":"10.36416/1806-3756/e20240248","DOIUrl":"10.36416/1806-3756/e20240248","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between the timed \"up and go\" (TUG) test and physical activity in daily life (PADL) in patients with interstitial lung disease (ILD) and propose a cutoff point to identify physically inactive individuals.</p><p><strong>Methods: </strong>Participants performed the TUG test at a usual pace (TUGusual) and at a fast pace (TUGfast). Exercise capacity was assessed by the six-minute walk test, lung function was assessed by whole-body plethysmography, quadriceps strength was assessed by maximal voluntary isometric contraction, and PADL was assessed by an activity monitor worn for six consecutive days. PADL variables included number of steps/day, time spent/day in activities of different intensities, and time spent/day in different postures. A ROC curve was plotted to identify physically inactive individuals on the basis of daily steps (5,000 steps/day) and moderate to vigorous physical activity (MVPA; 30 min/day).</p><p><strong>Results: </strong>Fifty-three ILD patients (26 women, with a mean age of 60 ± 11 years) were included in the study. TUGusual and TUGfast correlated moderately with the number of steps/day and time spent/day in light physical activity and MVPA (-0.60 < r < -0.41; p < 0.05 for all). ROC curves for TUGusual showed that the cutoffs of ≥ 9.25 s and ≥ 7.9 s can identify physically inactive individuals on the basis of 5,000 steps/day (AUC: 0.73; sensitivity, 76%; specificity, 70%) and 30 min/day of MVPA (AUC: 0.85; sensitivity, 90%; specificity, 75%). Participants who performed worse on TUGusual (i.e., ≥ 9.25 s) showed lower peripheral muscle strength, exercise capacity, and PADL.</p><p><strong>Conclusions: </strong>Performance on TUGusual and TUGfast correlates moderately with PADL in patients with ILD. A TUGusual performance ≥ 9.25 s appears to be able to identify physically inactive individuals in this population.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20240248"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the IMPROVE-DD score in COVID-19 patients submitted to venous thromboembolism investigation at a hospital in Brazil.","authors":"Ronney Argolo Ferreira, Lian Zanatta, Juliane Bispo de Oliveira, Janaina Ibele Carvalho Gomes, Luiz Ritt, Ana Thereza Cavalcanti Rocha","doi":"10.36416/1806-3756/e20240042","DOIUrl":"10.36416/1806-3756/e20240042","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the incidence of venous thromboembolism (VTE) in hospitalized patients with COVID-19 who underwent diagnostic tests for suspected VTE, and to correlate the IMPROVE-DD score with the incidence of VTE in this cohort.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients with COVID-19 and suspected VTE, admitted between March 2020 and September 2021 at a private hospital in Salvador (BA), Brazil, who underwent lower or upper limb venous Doppler ultrasound or chest angiotomography. Descriptive analyses and comparisons using the chi-square test were performed to identify factors potentially associated with the risk of VTE.</p><p><strong>Results: </strong>A total of 517 patients were included, with an in-hospital VTE incidence of 18.6% (96 events). Risk factors significantly associated with VTE included obesity, ICU admission, central venous catheter use, longer hospital stays, greater lung tomographic involvement/severity, the need for mechanical ventilation, D-dimer levels at least twice the upper limit of normal (2xULN), and the IMPROVE-DD score. The mean IMPROVE-DD score among patients with VTE was 4.7 (±3) versus 3.3 (±2.4) in those without VTE (p < 0.0001). D-dimer 2xULN was sensitive in identifying 94% of the 96 patients with VTE (p < 0.0001). The in-hospital mortality rate was 14.1%, with higher rates observed in patients with VTE (24%) compared to those without VTE (11.9%) (p = 0.003).</p><p><strong>Conclusions: </strong>The incidence of VTE in hospitalized COVID-19 patients was high and correlated with increased mortality. The IMPROVE-DD score effectively identified patients at risk for in-hospital VTE, suggesting it could help to identify a high-risk subgroup that may benefit from extended thromboprophylaxis.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20240042"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of tuberculosis in children.","authors":"Maria Fernanda Gonçalves Meirelles Fernandes, Gabriela de Azevedo Bastian de Souza, Júlia Giffoni Krey, Leonardo Araújo Pinto, Maria de Fátima B Pombo Sant'Anna, Clemax Couto Sant'Anna","doi":"10.36416/1806-3756/e20250045","DOIUrl":"10.36416/1806-3756/e20250045","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 1","pages":"e20250045"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}