Brazilian Journal of Pulmonology

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

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The search for the author or contributors found : 10 results


Activated charcoal bronchial aspiration

Broncoaspiração de carvão ativado

Bruna Quaranta Lobão Bairral, Makoto Saito, Nelson Morrone

J Bras Pneumol.2012;38(4):533-534

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Diagnosis of tuberculosis in individuals with respiratory symptoms. Commentary on the II Guidelines of the Brazilian Society of Pulmonology and Phthisiology and the Ministry of Health

Diagnóstico da tuberculose em sintomáticos respiratórios. Comentários a respeito das II Diretrizes da Sociedade Brasileira de Pneumologia e Tisiologia e Ministério da Saúde

Nelson Morrone

J Bras Pneumol.2005;31(4):350-355

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Comparative study between technical use, immediate bronchodilation, and adverse effects of the terbutaline turbuhaler and salbutamol (albuterol) in asthmatic patients

Estudo comparativo entre a técnica de uso, efeito broncodilatador e efeitos adversos imediatos de terbutalina via "Turbuhaler" e salbutamol via aerossol em asmáticos

Luiz Fernando F. Pereira, Nelson Morrone

J Bras Pneumol.1997;23(4):167-173

Abstract PDF PT

Summary: b-agonists are considered the agents of first choice for the treatment of asthmatic symptoms and are usually available for aerosol administration. Its propellants damage the ozone layer and are often not used properly by the patients. Turbuhaler seems a better alternative since it does not present these inconveniences. In Brazil, it has been recently introduced. Purpose: Compare salbutamol aerosol (SA) to terbutaline turbuhaler (TT) in relation to technical use, bronchodilation and adverse effects in outpatients with mild-obstruction asthma (PFR ³ 60 and < 80% predicted). Material and methods: Open, parallel randomized study performed in each arm of 20 patients (SA: 200 mg and TT: 500 mg). After 30 minutes, a second dose was given if PFR was not 15% or 30 L/min greater than the initial one; a second dose was also delivered if PFR was not greater than 80%. All patients were instructed on how to use both devices. Results: Clinical improvement and increase in PFR were similar in both groups (SA 69.5 vs. TT 58.1 L/min, p > 0.05). A second dose was given to 13 patients (SA 6 and TT 7) with similar results. Errors in the usage were observed in all 20 patients of group SA vs. 11 patients in group TT (p < 0.05). Adverse effects were more frequent with TT - 9 patients - due to its unpleasant taste. Fifteen patients of group TT and with previous experience with SA considered turbuhaler easier. Conclusions: 1) administration by the patient is easier with turbuhaler than with SA; 2) bronchodilation is not different with SA 200 mg and TT 500 mg; 3) unpleasant taste was noted only in group TT (50% of the patients).

 


Keywords: Asthma. Salbutamol aerosol. Terbutaline Turbuhaler.

 


Gynecomastia: a rare adverse effect of isoniazid

Ginecomastia: um efeito colateral raro da isoniazida

Nelson Morrone, Nelson Morrone Junior, Alessandra Garcia Braz, José Antonio Freire Maia

J Bras Pneumol.2008;34(11):978-981

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We report the case of a patient who twice developed gynecomastia following tuberculosis treatment. An 18-year-old male developed painful bilateral gynecomastia after three months of treatment with the isoniazid-rifampin-pyrazinamide regimen. Partial resolution of gynecomastia was achieved at the end of treatment. The patient was retreated with the same regimen eight years later, and gynecomastia recurred after six months of treatment. Hormone levels were normal, and a mammogram revealed bilateral gynecomastia. The isoniazid was discontinued, and the gynecomastia was partially resolved by the end of treatment. Four years later, gynecomastia was not detected. We conclude that isoniazid-related gynecomastia completely resolves when the medication is discontinued. Therefore, pharmacological and surgical treatment should be avoided.

 


Keywords: Isoniazid/adverse effects; Gynecomastia/chemically induced; Tuberculosis.

 


Jornal Brasileiro de Pneumologia: 40 years of tradition

Jornal Brasileiro de Pneumologia: 40 anos de tradição

Nelson Morrone

J Bras Pneumol.2015;41(5):398-398

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Osteitis in a female infant after vaccination with BCG Moreau in the neonatal period

Osteíte por BCG Moreau em uma menina vacinada ao nascer

Nelson Morrone, Cláudio do Amaral Antonio, Claudio Santilli, Beatriz Tavares Costa-Carvalho, Denise Rodrigues

J Bras Pneumol.2012;38(5):674-676

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Lung disease caused by Mycobacterium kansasii

Pneumopatia causada por Mycobacterium kansasii

Nelson Morrone, Maria do Carmo Cruvinel, Nelson Morrone Junior, José Antonio dos Santos Freire, Lilia Maria Lima de Oliveira, Carla Gonçalves

J Bras Pneumol.2003;29(6):341-349

Abstract PDF PT

Background: Mycobacterium kansasii is a nontuberculous mycobacterium that can colonize the lungs and cause pulmonary infection. Objective: To report authors' study of 6 patients with pulmonary disease caused by M. kansasii infection in a series of 6 patients diagnosed over 5 years. Method: Between June 1995 and June 2000, 1,349 patients diagnosed with tuberculosis were admitted to the Ipiranga Ari Nogueira da Silva Sanitarium. M. kansasii was identified in the sputum cultures of six (0.44%) of these patients. Results: Patient ages ranged from 25 to 77 years, 5 of the 6 were male, and all presented symptomatic chronic lung disease. All patients tested negative for HIV. Chest radiographs confirmed a history of lung disease; all presented thin walled cavities and adjacent pleural thickening was seen in 2. All patients were initially treated with isoniazid-rifampin-pyrazinamide. In 2 patients, intolerance to pyrazinamide necessitated the substitution of pyrazinamide with ethambutol. Based on the culture results, pyrazinamide was also replaced by ethambutol in 2 other patients. All patients were treated for 9 months or longer, and only one patient suffered recurrence of the disease. After being considered cured of the M. kansasii infection, 1 patient died of respiratory insufficiency due to silicosis. Conclusions: Mycobacteriosis due to M. kansasii was found only rarely and may be attributable to the characteristics of our patients. Therapy with isoniazid, rifampin and pyrazinamide with eventual replacement of the latter by ethambutol was shown to be effective.

 


Keywords: Mycobacterium kansaii. Lung diseases. Respiratory insufficiency.

 


Primary bacillary resistance in multidrug-resistant tuberculosis and predictive factors associated with cure at a referral center in São Paulo, Brazil

Resistência bacilar primária em tuberculose multidrogarresistente e fatores preditivos associados à cura, em um centro de referência da cidade de São Paulo

Marcia Telma Guimarães Savioli1,a, Nelson Morrone2,b, Ilka Santoro1,c

J Bras Pneumol.2019;45(2):e20180075-e20180075

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Objective: To identify transmitted or primary resistance among cases of multidrug-resistant tuberculosis and predictive factors for cure in multidrug-resistant tuberculosis after the first treatment. Method: Descriptive study of a cohort from 2006 to 2010, in a reference unit of tuberculosis in São Paulo, Brazil. The data were obtained by the revision of medical records. Clinical criteria were used to classify transmitted and acquired resistance. Extended primary resistance was also defined, in this study, as cases initially treated with a standardized scheme, but with no therapeutic success, and the pre-treatment drug susceptibility test (DST) showed presence of resistance. Results: 156 patients with multidrug-resistant tuberculosis and their respective sputum samples were eligible for the study. Only 7% of the patients were positive for the human immunodeficiency virus (HIV). Previous treatment occurred in 95% of the sample. The cure rate after the first treatment was 54%. The median bacteriological conversion time of those who healed was one month. Bacillary resistance was considered acquired resistance in 100 (64%) and transmitted resistance in 56 (36%). By logistic regression, patients who presented primary multidrug-resistant tuberculosis (odds ratio-OR = 6,29), without comorbidity (OR = 3,37) and with higher initial weight (OR = 1.04) were associated with cure after the first treatment. Conclusion: The early detection of bacillary resistance and appropriate treatment are in favor of healing. Thus, it is crucial to know exactly the primary resistance rate avoiding the use of inadequate treatments, amplification of bacillary resistance and its transmission.

 


Keywords: Multidrug-resistant tuberculosis; Drug resistance; Treatment outcome.

 


Renal sarcoidosis

Sarcoidose renal

Maria Enedina Claudino de Aquino, Roberta Karla Barbosa de Sales, José Antônio Freire dos Santos, Ana Lidia Régis, Nelson Morrone

J Bras Pneumol.2001;27(3):163-166

Abstract PDF PT

In a 62-year-old white woman, submitted to preoperative evaluation for facectomy, urinary alterations were detected. The diagnosis established included left-sided kidney stones and homolateral exclusion. At pre-nephrectomy, interstitial widespread lung disease and thoracic adenopathy were evidenced and their investigation was postponed to after surgery. In the removed kidney, non cascous epithelioid granulomas were found. Later, transbronchial biopsy disclosed this same aspect. The patient was treated with methylprednisolone and presented slight pulmonary improvement, though no amelioration in renal function occurred. Final diagnosis was sarcoidosis with lung, thoraco-lymphatic and renal involvement.

 


Keywords: Sarcoidosis. Kidney failure. Pulmonary sarcoidosis.

 


Tuberculosis: directly-observed treatment x autoadministered treatment. Outpatient experience in a philanthropic health center and review of the literature

Tuberculose: tratamento supervisionado "vs." tratamento auto-administrado. Experiência ambulatorial em instituição filantrópica e revisão da literatura

Nelson Morrone, Maria do Socorro Sandes Solha, Maria do Carmo Cruvinel, Nelson Morrone Jr., José Antonio dos Santos Freire, Zelita Lelis de Moraes Barbosa

J Bras Pneumol.1999;25(4):198-206

Abstract PDF PT

Setting: Philanthropic health center specialized in lung diseases, including tuberculosis. Background: Directly-observed treatment (DOT) is the chief measure to insure improvement in cure levels and to reduce acquired resistance. This unit adopted DOT in the past, but financial difficulties prevent its maintenance. Objectives: Compare abandon levels in DOT and auto-administered treatment (AT) and identify predictive factors associated to abandonment. Type of study: Retrospective; patients observed in different years and selected at random. Material and methods: 1,226 patients were selected (613 patients in DOT and 613 in AT). Abandonment was compared in DOT and TA; in each group, abandonment was compared to sex, age, alcoholism, previous treatment, direction of symptoms, sputum and extension of the disease. Main results: Patients in DOT and in AT differ in some aspects. In AT, males, older age, positive sputum and more extensive disease were detected, previous treatment predominantly DOT. No difference was detected in relation to duration of symptoms, race, alcoholism and call up. Abandon was more frequent in AT (5.0% vs. 17.0%), p < 0.01, OR 3.90, CI 95% (2.50-5.88); one abandom in AT may be prevented by treating 8.4 patients in DOT. In AT, abandonment was related to male, black race, previous treatment, duration of symptoms, alcoholism and to age; duration of symptoms in DOT. Conclusion and proposal: 1) As abandonment is more common in AT, it is necessary to begin DOT immediately in structured units. 2) Cooperation with company medical facilities, community leaders and pharmacist will make it easier DOT adoption. 3) Punitive measures must be adopted for uncooperative patients.

 


Keywords: Tuberculosis. Abandonment. Directly-observed treatment (DOT).

 


 

 


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