Original Article

The impact of the stratification by degree of clinical severity and abandonment risk of tuberculosis treatment

O impacto da estratificação por grau de risco clínico e de abandono do tratamento da tuberculose

Pedro Daibert de Navarro1,2, João Paulo Amaral Haddad3, Juliana Veiga Costa Rabelo1, Claudia Hermínia de Lima e Silva4, Isabela Neves de Almeida2,5, Wânia da Silva Carvalho6, Silvana Spíndola de Miranda2

J Bras Pneumol.2021;47(4):e20210018

Validation of the Pulmonary Embolism Severity Index for risk stratification after acute pulmonary embolism in a cohort of patients in Brazil

Validação do Pulmonary Embolism Severity Index para a estratificação de risco após tromboembolia pulmonar aguda em uma coorte no Brasil

Leonardo de Araujo Soriano1,a, Talita Tavares Castro1,b, Kelvin Vilalva1,c, Marcos de Carvalho Borges1,d, Antonio Pazin-Filho1,e, Carlos Henrique Miranda1,f

J Bras Pneumol.2019;45(1):e20170251

Objective: To validate the Pulmonary Embolism Severity Index (PESI), which was developed for risk stratification after acute pulmonary embolism (PE), for use in Brazil. Methods: This was a single-center retrospective study involving patients admitted to the emergency department with acute PE. The original and simplified versions of the PESI were calculated using hospital admission data from medical records. The outcome measure was the overall 30-day mortality rate. Results: We included 123 patients. The mean age was 57 ± 17 years, and there was a predominance of females, who accounted for 60% of the cohort. There were 28 deaths, translating to an overall 30-day mortality rate of 23%. In the cluster analysis by risk class, overall 30-day mortality was 2.40% for classes I-II, compared with 20.00% for classes III-IV-V (relative risk [RR] = 5.9; 95% CI: 1.88-18.51; p = 0.0002). When we calculated overall 30-day mortality using the simplified version (0 points vs. ≥ 1 point), we found it to be 3.25% for 0 points and 19.51% for ≥ 1 point (RR = 2.38; 95% CI: 0.89-6.38; p = 0.06). Using the original version, a survival analysis showed that risk classes I and II presented similar Kaplan-Meier curves (p = 0.59), as did risk classes III, IV, and V (p = 0.25). However, the curve of the clusters based on the original version, showed significantly higher mortality in the III-IV-V classes than in the I-II classes (RR = 7.63; 95% CI: 2.29-25.21; p = 0.0001). The cluster analysis based on the original version showed a greater area under the ROC curve than did the analysis based on the simplified version (0.70; 95% CI: 0.62-0.77 vs. 0.60; 95% CI: 0.51-0.67; p = 0.05). Conclusions: The PESI adequately predicted the prognosis after acute PE in this sample of the population of Brazil. The cluster analysis based on the original version is the most appropriate analysis in this setting.

Keywords: Pulmonary embolism; Severity of illness index; Risk assessment.

Estimated rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four‑drug fixed-dose combination regimen at a tertiary health care facility in the city of Rio de Janeiro, Brazil

Estimativas das taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com esquema de dose fixa combinada de quatro drogas em uma unidade de saúde terciária na cidade do Rio de Janeiro

Vangie Dias da Silva1, Fernanda Carvalho de Queiroz Mello2, Sonia Catarina de Abreu Figueiredo2

J Bras Pneumol.2017;43(2):113-120

Staphylococcal superantigen-specific IgE antibodies: degree of sensitization and association with severity of asthma

Anticorpos IgE específicos para superantígenos estafilocócicos: grau de sensibilização e associação com a gravidade da asma

José Elabras Filho1,2, Fernanda Carvalho de Queiroz Mello2, Omar Lupi1,3, Blanca Elena Rios Gomes Bica1, José Angelo de Souza Papi1, Alfeu Tavares França1

J Bras Pneumol.2016;42(5):356-361

Correlation between the severity of critically ill patients and clinical predictors of bronchial aspiration

Correlação entre a gravidade de pacientes críticos e preditores clínicos de risco para a broncoaspiração

Gisele Chagas de Medeiros1, Fernanda Chiarion Sassi2, Lucas Santos Zambom3, Claudia Regina Furquim de Andrade2

J Bras Pneumol.2016;42(2):114-120

Adverse effects of the new tuberculosis treatment regimen recommended by the Brazilian Ministry of Health

Efeitos adversos causados pelo novo esquema de tratamento da tuberculose preconizado pelo Ministério da Saúde do Brasil

Ethel Leonor Noia Maciel, Letícia Molino Guidoni, Juliana Lopes Favero, David Jamil Hadad, Lucilia Pereira Molino, John L. Jonhson, Reynaldo Dietze

J Bras Pneumol.2010;36(2):232-238

Review Article

The resurgence of tuberculosis and the impact of the study of pulmonary immunopathogenesis

O ressurgimento da tuberculose e o impacto do estudo da imunopatogenia pulmonar

José Roberto Lapa e SilvaI, Neio BoéchatII

J Bras Pneumol.2004;30(4):478-484

Original Article

Descriptive study of the implementation and impact of the directly observed treatment, short-course strategy in the São José do Rio Preto municipal tuberculosis control program (1998-2003)

Estudo descritivo sobre a implantação da estratégia de tratamento de curta duração diretamente observado no controle da tuberculose em São José do Rio Preto e seus impactos (1998-2003)

Cláudia Eli Gazetta, Silvia Helena Fiqueiredo Vendramini, Antônio Ruffino-Netto, Maria Rita de Cássia Oliveira, Tereza Cristina Scatena Villa

J Bras Pneumol.2007;33(2):192-198

Characterization of the severity of dyspnea in patients with bronchiectasis: correlation with clinical, functional, and tomographic aspects

Caracterização da gravidade de dispneia em pacientes com bronquiectasias: correlação com aspectos clínicos, funcionais e tomográficos

Maria Cecília Nieves Maiorano de Nucci1, Frederico Leon Arrabal Fernandes1, João Marcos Salge1, Rafael Stelmach1, Alberto Cukier1, Rodrigo Athanazio1

J Bras Pneumol.2020;46(5):e20190162

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.

Clinical treatment outcomes of tuberculosis treated with the basic regimen recommended by the Brazilian National Ministry of Health using fixed-dose combination tablets in the greater metropolitan area of Goiânia, Brazil

Desfechos clínicos do tratamento de tuberculose utilizando o esquema básico recomendado pelo Ministério da Saúde do Brasil com comprimidos em dose fixa combinada na região metropolitana de Goiânia

Anna Carolina Galvão Ferreira, José Laerte Rodrigues da Silva Júnior, Marcus Barreto Conde, Marcelo Fouad Rabahi

J Bras Pneumol.2013;39(1):76-83

Ventilator-associated pneumonia: epidemiology and impact on the clinical evolution of ICU patients

Pneumonia associada à ventilação mecânica: epidemiologia e impacto na evolução clínica de pacientes em uma unidade de terapia intensiva

Pedro Mendes de Azambuja Rodrigues, Edgard do Carmo Neto, Luiz Rodrigo de Carneiro Santos, Marcos Freitas Knibel

J Bras Pneumol.2009;35(11):1084-1091

Letters to the Editor

Tuberculosis in Brazil: the impact of the COVID-19 pandemic

Tuberculose no Brasil: o impacto da pandemia de COVID-19

Célia Márcia Fernandes Maia1, Daniella R. Barbosa Martelli2, Denise Maria Mendes L. da Silveira2, Eduardo Araújo Oliveira3,4, Hercílio Martelli Júnior1,2

J Bras Pneumol.2022;48(2):e20220082

Original Article

Correlation between inflammatory mediators in the nasopharyngeal secretion and in the serum of children with lower respiratory tract infection caused by respiratory syncytial virus and disease severity

Correlação entre mediadores inflamatórios na secreção nasofaríngea e no soro de crianças com infecção do trato respiratório inferior por vírus sincicial respiratórioe a gravidade da doença

Renata Amato Vieira, Edna Maria de Albuquerque Diniz,Maria Esther Jurfest Rivero Ceccon

J Bras Pneumol.2010;36(1):59-66

Upgrading

Suitability of Health Science key words for indexing master's degree theses and dissertations in the area of respiratory diseases

Adequação dos descritores em Ciências da Saúde para a indexação de dissertações acadêmicas, na área de doenças respiratórias

J Bras Pneumol.1999;25(6):

Review Article

Analysis of the ventilatory mechanics by forced oscillations technique: main concepts and clinical applications

Avaliação de mecânica ventilatória por oscilações forçadas: fundamentos e aplicações clínicas

Pedro Lopes de Melo, Marcelo Martins Werneck, Antonio Giannella-Neto

J Bras Pneumol.2000;26(4):194-206

Original Article

Brazilian version of the Clinical COPD Questionnaire, administered by interview: reliability and validity measurement properties

Versão brasileira do Clinical COPD Questionnaire, aplicado por meio de entrevista: propriedades de medida de confiabilidade e validade

Alexânia de Rê1,2, Fernanda Rodrigues Fonseca1,2, Ana Paula Queiroz1,2, Cardine Martins dos Reis1, Marina Mônica Bahl1, Janwillem Kocks3,4,5, Thys van der Molen6, Rosemeri Maurici1,2,7,8

J Bras Pneumol.2021;47(3):e20200371

Pulmonary tuberculosis treatment regimen recommended by the Brazilian National Ministry of Health: predictors of treatment noncompliance in the city of Porto Alegre, Brazil

Fatores preditores para o abandono do tratamento da tuberculose pulmonar preconizado pelo Ministério da Saúde do Brasil na cidade de Porto Alegre (RS)

Simone Teresinha Aloise Campani, José da Silva Moreira, Carlos Nunes Tietbohel

J Bras Pneumol.2011;37(6):776-782

Review Article

Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs

Fatores de risco para tuberculose: diabetes, tabagismo, álcool e uso de outras drogas

Denise Rossato Silva1,a, Marcela Muñoz-Torrico2,b, Raquel Duarte3,4,c, Tatiana Galvão5,d, Eduardo Henrique Bonini6,7,e, Flávio Ferlin Arbex6,f, Marcos Abdo Arbex6,g, Valéria Maria Augusto8,h, Marcelo Fouad Rabahi9,i, Fernanda Carvalho de Queiroz Mello10,j

J Bras Pneumol.2018;44(2):145-152

Letters to the Editor

Impact of telehealth during the COVID-19 pandemic on clinical and nutritional conditions of adolescents with cystic fibrosis

Lavínia Mayara da Silva Reis1, Aline Antunes de Cerqueira Pinheiro1, Maurício Antônio da Silva Júnior1, Christine Pereira Gonçalves1, Nelbe Nesi Santana1

J Bras Pneumol.2024;50(2):e20230397

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