Jornal Brasileiro De Pneumologia最新文献

{"title":"Depression and anxiety in adolescents with cystic fibrosis in Brazil: prevalence, stability over time, and relationship with treatment adherence.","authors":"Tatiana Rozov, Marcos Tadeu Nolasco da Silva, Maria Ângela Gonçalves Oliveira Ribeiro, Neiva Damaceno, Maria Angelica Pinheiro Santos Santana, Paulo Jose Cauduro Marostica, Roberta de Cássia Nunes Cruz Melotti, Valeria de Carvalho Martins, Carlos Antônio Riedi, Edna Lucia Santos de Souza, Norberto Ludwig Neto, Rodrigo Abensur Athanazio, Francyelly Wisnievski Yamamoto, Lusmaia Damaceno Camargo Costa, Sonia Mayumi Chiba, Izabela Sad, José Dirceu Ribeiro, Alexandra L Quittner","doi":"10.36416/1806-3756/e20240416","DOIUrl":"10.36416/1806-3756/e20240416","url":null,"abstract":"<p><strong>Objective: </strong>Depression and anxiety have been documented in people with cystic fibrosis (CF), jeopardizing treatment adherence. To date, no studies have assessed the prevalence of psychosocial issues in adolescents with CF in Brazil. We sought to assess the prevalence of depression and anxiety in adolescents with CF in Brazil, as well as the impact of depression and anxiety on treatment adherence.</p><p><strong>Methods: </strong>This was a multicenter, prospective, observational, longitudinal study conducted between 2017 and 2019 at 14 CF referral centers in Brazil. We used standardized tools such as the nine-item Patient Health Questionnaire (for depression), the seven-item Generalized Anxiety Disorder scale (for anxiety), and the eight-item Morisky Medication Adherence Scale (for treatment adherence) in order to collect data on 218 CF patients at two different time points.</p><p><strong>Results: </strong>The prevalence of depression was 19.1% at time point 1 and 15.4% at time point 2. The prevalence of anxiety was 19.1% at time point 1 and 18.0% at time point 2. Depression and anxiety were significantly higher in female patients and lower in those who underwent home physiotherapy or had psychological support. Significant correlations were found between depression and anxiety at both time points, the associations being strongest at time point 1 (r = 0.68; p < 0.001). Most (66.7%) of the study participants reported low adherence to treatment, and the remainder reported either average adherence (in 28%) or high adherence (in 5.3%). Depression and anxiety showed inverse correlations with treatment adherence.</p><p><strong>Conclusions: </strong>The prevalence of depression and anxiety in adolescents with CF in Brazil appears to be similar to that reported in other countries, being higher in females and lower in those undergoing home physiotherapy or receiving psychological care. Depression and anxiety appear to correlate with lower treatment adherence. Treating psychosocial issues may effectively improve rates of treatment adherence in adolescents with CF.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20240416"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COPD and bronchiectasis; more than mere enemies.","authors":"Grace Oscullo, Amina Bekki, Miguel Ángel Martinez-García","doi":"10.36416/1806-3756/e20250086","DOIUrl":"https://doi.org/10.36416/1806-3756/e20250086","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20250086"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge of, Attitude towards, and Preventive Behavior towards Tuberculosis questionnaire: translation and cross-cultural adaptation for use in Brazil.","authors":"Rosana Maria Barreto Colichi, Sebastião Pires Ferreira Filho, Renata Camargo Alves, Silvana Andrea Molina Lima, Hélio Rubens de Carvalho Nunes","doi":"10.36416/1806-3756/e20240426","DOIUrl":"https://doi.org/10.36416/1806-3756/e20240426","url":null,"abstract":"<p><strong>Objective: </strong>To translate the Knowledge of, Attitude towards, and Preventive Behavior towards Tuberculosis questionnaire into Brazilian Portuguese and adapt it for use in Brazil.</p><p><strong>Methods: </strong>This methodological study followed internationally recommended guidelines for translation and cross-cultural adaptation. After permission was obtained from the original authors, the process of translation and cross-cultural adaptation began, including translation into Brazilian Portuguese by bilingual translators, synthesis of the translations, back-translation for similarity analysis, revision, and preparation of the final version. A pretest was conducted on 68 medical students.</p><p><strong>Results: </strong>Most of the questionnaire items showed strong content similarity, with minor semantic differences. The content validity index for the questionnaire was 0.882, and Cronbach's alpha coefficients were 0.682, 0.809, and 0.613 for knowledge of tuberculosis, attitudes toward tuberculosis, and preventive behavior toward tuberculosis, respectively. Cronbach's alpha and omega coefficients were a = 0.717, w1 = 0.673, w2 = 0.673, and w3 = 0.520.</p><p><strong>Conclusions: </strong>The process of translation and cross-cultural adaptation of the Knowledge of, Attitude towards, and Preventive Behavior towards Tuberculosis questionnaire was successful, making the Brazilian Portuguese version of the questionnaire reliable for reproducibility. It can be used in order to collect tuberculosis-related data and support changes in health education curricula.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20240426"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why we should rethink military metaphors in cancer.","authors":"Gustavo Faibischew Prado, Thais Azzi Gonçalves","doi":"10.36416/1806-3756/e20250109","DOIUrl":"https://doi.org/10.36416/1806-3756/e20250109","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20250109"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centrilobular nodules with central calcifications.","authors":"Edson Marchiori, Bruno Hochhegger, Gláucia Zanetti","doi":"10.36416/1806-3756/e20250021","DOIUrl":"https://doi.org/10.36416/1806-3756/e20250021","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20250021"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive care in cystic fibrosis: mental health assessments.","authors":"Paulo Camargos","doi":"10.36416/1806-3756/e20250143","DOIUrl":"https://doi.org/10.36416/1806-3756/e20250143","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20250143"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of elexacaftor/tezacaftor/ivacaftor on the small airways in cystic fibrosis.","authors":"Sofia Campos Silva, Andreia Barroso, Maria Cunha, Elsa Fragoso, Pilar Azevedo","doi":"10.36416/1806-3756/e20240406","DOIUrl":"10.36416/1806-3756/e20240406","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"51 2","pages":"e20240406"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}