Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

SBPT

Publication continuous and bimonthly

SCImago Journal & Country Rank
Advanced Search

Search Results

The search for the author or contributors found : 11 results


Evaluation of the nitrate reductase assay for the rapid detection of resistance to first-line medications in Mycobacterium tuberculosis strains isolated from patients in a general hospital

Avaliação do teste de nitrato redutase para a detecção rápida de resistência aos medicamentos de primeira linha em cepas de Mycobacterium tuberculosis isoladas de pacientes em um hospital geral

Maria de Fátima Filardi Oliveira Mansur, Wânia da Silva Carvalho, Raquel Bandeira da Silva, Rodrigo Gonçalves Cata Preta, Lucas Almeida Fernandes Junior, Silvana Spíndola de Miranda

J Bras Pneumol.2012;38(2):210-213

Abstract PDF PT PDF EN Portuguese Text

We compared the nitrate reductase assay with the proportion method, which is considered the gold standard, in 57 Mycobacterium tuberculosis strains isolated from patients treated at the Federal University of Minas Gerais Hospital das Clínicas, located in the city of Belo Horizonte, Brazil. For rifampin and isoniazid, the sensitivity, specificity, and accuracy of the nitrate reductase assay were all 100%, whereas they were 100%, 88.9%, and 66.7%, respectively, for streptomycin and 98.0%, 100%, and 98.2%, respectively, for ethambutol. The mean time to results was ten days. In the study sample, the nitrate reductase assay proved highly accurate and showed excellent concordance with the gold standard.

 


Keywords: Mycobacterium tuberculosis; Microbial sensitivity tests; Tuberculosis, multidrug-resistant; Nitrate reductase.

 


Characteristics of tuberculosis in the state of Minas Gerais, Brazil: 2002-2009

Características da tuberculose no estado de Minas Gerais entre 2002 e 2009

Cláudio José Augusto, Wânia da Silva Carvalho, Alan Douglas Gonçalves, Maria das Graças Braga Ceccato, Silvana Spindola de Miranda

J Bras Pneumol.2013;39(3):357-364

Abstract PDF PT PDF EN Portuguese Text

Objective: To analyze the profile of tuberculosis cases reported between 2002 and 2009 in the state of Minas Gerais, Brazil, according to sociodemographic, clinical, and laboratory characteristics, as well as to comorbidities and mortality. Methods: This was a descriptive, epidemiological study based on data obtained from the Brazilian Case Registry Database and the Brazilian Mortality Database for the 2002-2009 period. Results: There were 47,285 reported cases of tuberculosis, corresponding to a mean incidence of 22.3/100,000 population. The individuals diagnosed with tuberculosis were predominantly in the 20- to 49-year age bracket and male (62.4% and 67.0%, respectively). Individuals with a low level of education accounted for 18.5% of the cases. New cases, cases of recurrence, and cases of retreatment accounted for 83.7%, 5.7%, 5.7%, respectively. The rates of cure and treatment noncompliance were 66.2% and 11.2%, respectively; multidrug-resistant tuberculosis was identified in 0.2% of the cases; and the mortality rate was 12.9%. The directly observed treatment, short-course (DOTS) strategy was applied in 21.8% of the cases. Sputum smear microscopy and culture were performed in only 73.9% and 12.9% of the cases, respectively. Chest X-rays were performed in 90.5% of the cases. Pulmonary tuberculosis was the predominant form (in 83.9%). Comorbidity with alcoholism, HIV infection, and diabetes mellitus were identified in 17.2%, 8.3%, and 3.8%, respectively. Conclusions: During the study period, the numbers of new cases, cases of treatment noncompliance, and deaths were high, comorbidities were common, and there was a failure to perform adequately basic tests for the diagnosis of tuberculosis. Multidisciplinary approaches, expanded use of the DOTS strategy, better knowledge of the distribution of tuberculosis, and improvements in the databases are needed in order to achieve better control of the disease in the state of Minas Gerais.

 


Keywords: Tuberculosis/epidemiology; Tuberculosis/mortality; Information systems.

 


Incidence of TB diagnosed in the emergency room of a teaching hospital in southeastern Brazil

Incidência de TB diagnosticada no pronto-atendimento de um hospital escola na região sudeste do Brasil

Silvana Spíndola de Miranda, Ana Rita de Paiva Toledo, Simone Rodrigues Ribeiro, Izabela Magalhães Campos, Petra Maria de Oliveira Duarte Sthur, Afrânio Lineu Kritski

J Bras Pneumol.2009;35(2):174-178

Abstract PDF PT PDF EN Portuguese Text

In this study, we analyzed the number of TB cases in an emergency room (ER) and the susceptibility profile of Mycobacterium tuberculosis strains. Patients were selected from among those treated at the Hospital das Clínicas, in the city of Belo Horizonte, Brazil. Between 2002 and 2005, 240 TB patients were identified. Of those, 117 patients (48.7%) were diagnosed in the ER, 72 (61.5%) presenting positive sputum smear microscopy. Drug susceptibility testing was carried out in 90 strains, of which 80 (89%) were sensitive, 9 (10%) were resistant, and 1 (1%) was multidrug resistant. The incidence of positive smear sputum microscopy and resistant TB strains was high, which calls for the immediate adoption of TB control measures in the ER.

 


Keywords: Tuberculosis; Disease transmission, infectious; Drug resistance.

 


Lymphadenitis caused by infection with an isoniazid- and rifampin-resistant strain of Mycobacterium bovis BCG in an infant with IFN-γ/IL-12 pathway defect

Linfadenite por Mycobacterium bovis BCG resistente a isoniazida e rifampicina em lactente com defeito no eixo IFN-γ/IL-12

Lilian Martins Oliveira Diniz, Tiago Guimarães, Maria das Graças Rodrigues de Oliveira, Jorge Andrade Pinto, Silvana Spindola de Miranda

J Bras Pneumol.2014;40(2):-

Abstract PDF PT PDF EN Portuguese Text

We report a rare case in a female infant (age, 3.5 months) with primary immunodeficiency (IFN-γ/IL-12 pathway defect) who presented with suppurative lymphadenitis after Mycobacterium bovis BCG vaccination. The strain of M. bovis BCG identified was found to be resistant to isoniazid and rifampin. The patient was treated with a special pharmacological regimen involving isoniazid (in a limited, strategic manner), ethambutol, streptomycin, and IFN-γ, after which there was complete resolution of the lesions.

 


Keywords: BCG vaccine; Interferon-gamma; Tuberculosis, multidrug-resistant.

 


Profile and follow-up of patients with Mycobacterium sp. at the Hospital das Clínicas da Universidade Federal de Minas Gerais

Perfil e seguimento dos pacientes portadores de Mycobacterium sp. do Hospital das Clínicas da Universidade Federal de Minas Gerais

Giselle Carvalho Froes, Rosane Luiza Coutinho, Marcelo Nardy de Ávila, Leandra Rocha Cançado, Silvana Spíndola de Miranda

J Bras Pneumol.2003;29(6):365-370

Abstract PDF PT

Background: Surveys of patients diagnosed with mycobacteriosis, taken at the Laboratory of Mycobacteriology of the Hospital das Clínicas da Universidade Federal de Minas Gerais, have shown that lack of information concerning diagnosis prevented 42% from initiating treatment. Objective: To evaluate the profile of patients with mycobacterial infection attending the Hospital das Clínicas da Universidade Federal de Minas Gerais. To describe the follow up of those patients and compare it to the guidelines made by the National Program for the Control of Tuberculosis. Methods: The files of patients diagnosed with mycobacterium infection during 2002 were selected from the archives of the Laboratory of Mycobacteriology of the Hospital das Clínicas da Universidade Federal de Minas Gerais. An active search for these patients was carried out and follow-up exams were then performed. Results: Of the 66 patients selected, 62 (94%) were positive for Mycobacterium tuberculosis and 4 (6%) had nontuberculous mycobacteriosis. Another 4 (6%) had been transferred to other institutions. Of the remaining 58, 37 (63%) had been cured, 1 (2%) had refused treatment, 9 (16%) were not found and 11 (19%) had died. Of the 11 deaths, 7 (64%) had tested positive for HIV. Conclusion: Patients failed to receive treatment not due to lack of diagnosis, but to inadequate structure, low awareness levels of all parties, and lack of tuberculosis control organization at the hospital level. Due to the high number of HIV-positive patients, the number of patients cured was lower than that required by the National Health Ministry. Deaths were attributed to HIV infection and lack of knowledge about the disease. In order to identify and address the problems associated with clinical laboratory practice, laboratory professionals must work in concert with their clinical counterparts when carrying out operational research on tuberculosis.

 


Keywords: Tuberculosis/diagnosis. Mycobacterium infections/complications.

 


Functional profile of patients with tuberculosis sequelae in a university hospital

Perfil funcional de pacientes portadores de seqüela de tuberculose de um hospital universitário

Lucia Maria Macedo Ramos, Nara Sulmonett, Cid Sergio Ferreira, Juliana Fulgêncio Henriques, Silvana Spíndola de Miranda

J Bras Pneumol.2006;32(1):43-47

Abstract PDF PT PDF EN Portuguese Text

Objective: To describe data related to the pulmonary function of patients with sequelae of pulmonary tuberculosis, pleural tuberculosis or both. Methods: In the outpatient clinic of a university hospital, 218 patients were evaluated. Of those 218, 56 had sequelae of tuberculosis (pulmonary, pleural or both), and 162 had other types of tuberculosis. All patients were evaluated in the pulmonary function laboratory between February 2000 and July 2004, and 43 were found to be eligible for inclusion in the study. Patients with a history of asthma, chronic pulmonary obstructive disease, cardiac insufficiency, collagen diseases, silicosis or thoracic surgery, as well as those for whom spirometry yielded unacceptable results or was not performed, were excluded. The lung fields were divided into six zones, and radiographic results were classified by degree: I (involvement of only one zone with no cavitation); II (involvement of two or three zones or of one zone with cavitation); or III (extensive involvement of three or more zones with or without cavitation). Results: The final study sample comprised 50 patients, 44 (88%) of whom had pulmonary tuberculosis. The most prevalent form (17/50; 34%) was mixed ventilatory disturbance. Severe disturbances were more significant in degree III radiographs (p = 0.0002) and normal pulmonary function was predominant among patients presenting degree I and II radiographs (p = 0.002). Conclusion: The early discovery and treatment of tuberculosis contribute to reduce the number of cases, as well as the incidence of tuberculosis sequelae, thereby improving the quality of life of tuberculosis patients. Further studies, involving longitudinal, sequential analysis and larger samples of patients with tuberculosis sequelae, should be conducted in referral centers in Brazil.

 


Keywords: Tuberculosis, pulmonary/diagnosis; Tuberculosis, pleural/diagnosis; Respiratory function tests; Spirometry;

 


Prevalence of latent Mycobacterium tuberculosis infection in prisoners

Prevalência da infecção latente por Mycobacterium tuberculosis em pessoas privadas de liberdade

Pedro Daibert de Navarro1,2, Isabela Neves de Almeida1, Afrânio Lineu Kritski3, Maria das Graças Ceccato4, Mônica Maria Delgado Maciel1, Wânia da Silva Carvalho4, Silvana Spindola de Miranda5

J Bras Pneumol.2016;42(5):348-355

Abstract PDF PT PDF EN Portuguese Text

Objective: To determine the prevalence of and the factors associated with latent Mycobacterium tuberculosis infection (LTBI) in prisoners in the state of Minas Gerais, Brazil. Methods: This was a cross-sectional cohort study conducted in two prisons in Minas Gerais. Tuberculin skin tests were performed in the individuals who agreed to participate in the study. Results: A total of 1,120 individuals were selected for inclusion in this study. The prevalence of LTBI was 25.2%. In the multivariate analysis, LTBI was associated with self-reported contact with active tuberculosis patients within prisons (adjusted OR = 1.51; 95% CI: 1.05-2.18) and use of inhaled drugs (adjusted OR = 1.48; 95% CI: 1.03-2.13). Respiratory symptoms were identified in 131 (11.7%) of the participants. Serological testing for HIV was performed in 940 (83.9%) of the participants, and the result was positive in 5 (0.5%). Two cases of active tuberculosis were identified during the study period. Conclusions: Within the prisons under study, the prevalence of LTBI was high. In addition, LTBI was associated with self-reported contact with active tuberculosis patients and with the use of inhaled drugs. Our findings demonstrate that it is necessary to improve the conditions in prisons, as well as to introduce strategies, such as chest X-ray screening, in order to detect tuberculosis cases and, consequently, reduce M. tuberculosis infection within the prison system.

 


Keywords: Prisons; Tuberculin test; Latent tuberculosis, HIV.

 


Prevalence of latent Mycobacterium tuberculosis infection in renal transplant recipients

Prevalência da infecção latente por Mycobacterium tuberculosis em transplantados renais

Mônica Maria Moreira Delgado Maciel1,2,a, Maria das Graças Ceccato3,b, Wânia da Silva Carvalho3,c, Pedro Daibert de Navarro1,d, Kátia de Paula Farah1,e, Silvana Spindola de Miranda1,f

J Bras Pneumol.2018;44(6):461-467

Abstract PDF PT PDF EN Portuguese Text

Objective: To estimate the prevalence of latent Mycobacterium tuberculosis infection (LTBI) in renal transplant recipients and to assess sociodemographic, behavioral, and clinical associations with positive tuberculin skin test (TST) results. Methods: This was a cross-sectional study of patients aged ≥ 18 years who underwent renal transplantation at the Renal Transplant Center of the Federal University of Minas Gerais Hospital das Clínicas, located in the city of Belo Horizonte, Brazil. We included renal transplant recipients who underwent the TST between January 2011 and July 2013. If the result of the first TST was negative, a second TST was administered. Bivariate and multivariate analyses using logistic regression were used to determine factors associated with positive TST results. Results: The sample included 216 patients. The prevalence of LTBI was 18.5%. In the multivariate analysis, history of contact with a tuberculosis case and preserved graft function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2) were associated with positive TST results. TST induration increased by 5.8% from the first to the second test, which was considered significant (p = 0.012). Conclusions: The prevalence of LTBI was low in this sample of renal transplant recipients. The TST should be administered if renal graft function is preserved. A second TST should be administered if the first TST is negative.

 


Keywords: Tuberculosis; Tuberculin test; Immunocompromised host.

 


Prevalence of latent tuberculosis infection and risk of infection in patients with chronic kidney disease undergoing hemodialysis in a referral center in Brazil

Prevalência de infecção latente por Mycobacterium tuberculosis e risco de infecção em pacientes com insuficiência renal crônica em hemodiálise em um centro de referência no Brasil

Jane Corrêa Fonseca, Waleska Teixeira Caiaffa, Mery Natali Silva Abreu, Katia de Paula Farah, Wânia da Silva Carvalho, Silvana Spindola de Miranda

J Bras Pneumol.2013;39(2):214-220

Abstract PDF PT PDF EN Portuguese Text

Objective: To determine the prevalence of latent tuberculosis infection (LTBI) and the risk of infection in patients with chronic kidney disease treated at a hemodialysis center. Methods: We included 307 patients with chronic kidney disease undergoing hemodialysis at the Mineiro Institute of Nephrology, located in the city of Belo Horizonte, Brazil. All of the patients were submitted to tuberculin skin tests (TSTs). We investigated the booster effect and TST conversion. If the initial TST (TST1) was negative, a second TST (TST2) was performed 1-3 weeks later in order to investigate the booster effect. If TST2 was also negative, a third TST (TST3) was performed one year after TST2 in order to determine whether there was TST conversion. Results: When we adopted a cut-off induration of 5 mm, the prevalence of LTBI was 22.2% on TST1, increasing by 11.2% on TST2. When we adopted a cut-off induration of 10 mm, the prevalence of LTBI was 28.5% on TST1, increasing by 9.4% on TST2. The prevalence of LTBI increased significantly from TST1 to TST2 (booster effect), as well as from TST2 to TST3 (p < 0.01 for both). In our sample, the mean annual risk of infection was 1.19%. Conclusions: In the population studied, the prevalence of LTBI was high, and the mean annual risk of infection was similar to that reported for the general population of Brazil, which suggests recent infection.

 


Keywords: Tuberculosis; Renal insufficiency, chronic; Tuberculin test.

 


Tuberculous uveitis at a referral center in southeastern Brazil

Uveíte por tuberculose em um centro de referência no Sudeste do Brasil

Wesley Ribeiro Campos, Juliana Fulgêncio Henriques, Afrânio Lineu Kritski, André Curi, Rosita Tomishi Pimentel, Silvana Spindola de Miranda

J Bras Pneumol.2008;34(2):98-102

Abstract PDF PT PDF EN Portuguese Text

Objective: To describe the occurrence of tuberculous uveitis (TBU) at a referral center in the state of Minas Gerais, Brazil. Methods: A total of 16 consecutive patients (≥15 years of age) who underwent diagnostic evaluation of uveitis between January of 2001 and July of 2004 at the Minas Gerais State Referral Center were selected for study. Demographic and clinical data, as well as data related to screening for toxoplasmosis, syphilis, and rheumatologic diseases, together with the results of tuberculin skin testing and HIV testing, were collected. Results: Of the16 patients evaluated, 11 (69%) were found to have TBU. A history of contact with pulmonary tuberculosis was reported by 8 (72%) of the 11 patients with TBU and by 1 (20%) of the 5 with non-TBU. Although the odds ratio for this association was 10.67 (95% CI: 0.59-398.66), the p value was borderline significant (p = 0.078). There was no difference between the patients with TBU and those with non-TBU in terms of the status of ocular inflammation or the tuberculin skin testing results. All of the patients were HIV negative and were monitored for two years. Conclusion: In this study, a history of contact with pulmonary tuberculosis proved to be useful in diagnosing TBU.

 


Keywords: Tuberculosis; Uveitis; Diagnosis; Brazil.

 


Spirometry reference values for Black adults in Brazil

Valores de referência para espirometria forçada em adultos negros no Brasil

Tarciane Aline Prata1,a, Eliane Mancuzo2,3,b, Carlos Alberto de Castro Pereira4,c,Silvana Spíndola de Miranda2,d, Larissa Voss Sadigursky5,e, Camila Hirotsu6,f, Sérgio Tufik6,g

J Bras Pneumol.2018;44(6):449-455

Abstract PDF PT PDF EN Portuguese Text

Objective: To derive reference equations for spirometry in healthy Black adult never smokers in Brazil, comparing them with those published in 2007 for White adults in the country. Methods: The examinations followed the standards recommended by the Brazilian Thoracic Association, and the spirometers employed met the technical requirements set forth in the guidelines of the American Thoracic Society/European Respiratory Society. The lower limits were defined as the 5th percentile of the residuals. Results: Reference equations and limits were derived from a sample of 120 men and 124 women, inhabitants of eight Brazilian cities, all of whom were evaluated with a flow spirometer. The predicted values for FVC, FEV1 , FEV1 /FVC ratio, and PEF were better described by linear equations, whereas the flows were better described by logarithmic equations. The FEV1 and FVC reference values derived for Black adults were significantly lower than were those previously derived for White adults, regardless of gender. Conclusions: The fact that the predicted spirometry values derived for the population of Black adults in Brazil were lower than those previously derived for White adults in the country justifies the use of an equation specific to the former population.

 


Keywords: Spirometry; Reference values; African continental ancestry group.

 


 

 


The Brazilian Journal of Pulmonology is indexed in:

Latindex Lilacs SciELO PubMed ISI Scopus Copernicus pmc

Support

CNPq, Capes, Ministério da Educação, Ministério da Ciência e Tecnologia, Governo Federal, Brasil, País Rico é País sem Pobreza
Secretariat of the Brazilian Journal of Pulmonology
SCS Quadra 01, Bloco K, Salas 203/204 Ed. Denasa. CEP: 70.398-900 - Brasília - DF
Fone/fax: 0800 61 6218/ (55) (61) 3245 1030/ (55) (61) 3245 6218
E-mails: jbp@jbp.org.br
jpneumo@jornaldepneumologia.com.br

Copyright 2019 - Brazilian Thoracic Association

Logo GN1