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 : 20 results


Fiberoptic bronchoscopy findings in patients diagnosed with lung cancer

Achados de fibrobroncoscopia em pacientes com diagnóstico de neoplasia pulmonar

Marcelo Fouad Rabahi, Andréia Alves Ferreira, Bruno Pereira Reciputti, Thalita de Oliveira Matos, Sebastião Alves Pinto

J Bras Pneumol.2012;38(4):445-451

Abstract PDF PT PDF EN Portuguese Text

Objective: To compile fiberoptic bronchoscopy findings in patients diagnosed with lung cancer and to correlate those with histopathological findings. Methods: This was a retrospective study involving 212 patients with a confirmed diagnosis of lung cancer by cytological evaluation of BAL specimens or by histopathological evaluation of endobronchial or transbronchial biopsy specimens. The data were collected at the Respiratory Endoscopy Section of Hospital São Salvador, located in the city of Goiânia, Brazil, between 2005 and 2010. The endoscopic findings were classified as endoscopically visible tumor, endoscopically invisible tumor, and mucosal injury, as well as being classified by the presence/type of secretion. The visible tumors were also classified according to their location in the tracheobronchial tree. Results: Endobronchial mass (64%) and mucosal infiltration (35%) were the main endoscopic findings. The histological type was determined in 199 cases, the most prevalent types being squamous carcinoma, in 78 (39%), adenocarcinoma, in 42 (21%), small cell carcinoma, in 24 (12%), and large cell carcinoma, in 2 (1%). More than 45% of the visible tumors were at the upper bronchi. Squamous carcinoma (n = 78) was most commonly visualized as an endobronchial mass (in 74%), mucosal infiltration (in 36%), luminal narrowing (in 10%), or external compression (in 6%). Conclusions: Our results show that an endobronchial mass is the most common bronchoscopic finding that is suggestive of malignancy. Proportionally, mucosal infiltration is the most common finding in small cell carcinoma. In adenocarcinoma, luminal narrowing, external compression, mucosal injury, and endobronchial secretion prevail.

 


Keywords: Lung neoplasms/diagnosis; Lung neoplasms/classification; Bronchoscopy.

 


Evaluation of the impact that the changes in tuberculosis treatment implemented in Brazil in 2009 have had on disease control in the country

Avaliação do impacto das mudanças do tratamento da tuberculose implantadas em 2009 no controle da tuberculose pulmonar no Brasil

Marcelo Fouad Rabahi, José Laerte Rodrigues da Silva Júnior, Marcus Barreto Conde

J Bras Pneumol.2017;43(6):437-444

Abstract PDF PT PDF EN Portuguese Text

Objective: To analyze the impact that the 2009 changes in tuberculosis treatment in Brazil had on the rates of cure, tuberculosis recurrence, mortality, treatment abandonment, and multidrug-resistant tuberculosis (MDR-TB). Methods: An ordinary least squares regression model was used in order to perform an interrupted time series analysis of secondary data collected from the Brazilian Tuberculosis Case Registry Database for the period between January of 2003 and December of 2014. Results: The 2009 changes in tuberculosis treatment in Brazil were found to have no association with reductions in the total number of cases (β = 2.17; 95% CI: −3.80 to 8.14; p = 0.47) and in the number of new cases (β = −0.97; 95% CI: −5.89 to 3.94; p = 0.70), as well as having no association with treatment abandonment rates (β = 0.40; 95% CI: −1.12 to 1.93; p = 0.60). The changes in tuberculosis treatment also showed a trend toward an association with decreased cure rates (β = −4.14; 95% CI: −8.63 to 0.34; p = 0.07), as well as an association with increased mortality from pulmonary tuberculosis (β = 0.77; 95% CI: 0.16 to 1.38; p = 0.01). Although there was a significant increase in MDR-TB before and after the changes (p < 0.0001), there was no association between the intervention (i.e., the changes in tuberculosis treatment) and the increase in MDR-TB cases. Conclusions: The changes in tuberculosis treatment were unable to contain the decrease in cure rates, the increase in treatment abandonment rates, and the increase in MDR-TB rates, being associated with increased mortality from pulmonary tuberculosis during the study period.

 


Keywords: Tuberculosis, pulmonary/epidemiology; Tuberculosis, pulmonary/drug therapy; Tuberculosis, pulmonary/mortality; Interrupted time series analysis; Drug resistance, multiple; Drug compounding.

 


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

Abstract PDF PT PDF EN Portuguese Text

Resumo

Objetivo: Descrever as taxas de cura, falência e abandono do tratamento da tuberculose com o esquema básico preconizado pelo Ministério da Saúde (tratamento com rifampicina, isoniazida, pirazinamida e etambutol por dois meses seguido de isoniazida e rifampicina por quatro meses) utilizando comprimidos em dose fixa combinada em regime autoadministrado e descrever os eventos adversos e seus possíveis impactos nos desfechos do tratamento. Métodos: Estudo descritivo utilizando dados coletados prospectivamente dos prontuários médicos de pacientes com tuberculose (idade ≥ 18 anos) tratados com o esquema básico em duas unidades básicas de saúde da região metropolitana de Goiânia, GO. Resultados: A amostra foi composta por 40 pacientes com tuberculose. A taxa de cura foi de 67,5%, a taxa de abandono foi de 17,5%, e não ocorreram casos de falência. Nessa amostra, 19 pacientes (47%) relataram reações adversas aos medicamentos. Essas foram leves e moderadas, respectivamente, em 87% e 13% dos casos. Em nenhum caso houve necessidade de mudança do esquema ou suspensão do tratamento. Conclusões: A taxa de cura do esquema básico com o uso de comprimidos em dose fixa combinada sob regime autoadministrado foi semelhante às taxas históricas do esquema anterior. A taxa de abandono, na amostra estudada, foi muito acima da taxa preconizada como adequada (até 5%).

 


Palavras-chave: Tuberculose; Resultado de tratamento; Combinação de medicamentos.

 


Multidisciplinary education with a focus on COPD in primary health care

Educação multiprofissional com foco na DPOC na atenção primária à saúde

Erikson Custódio Alcântara1,2,a, Krislainy de Sousa Corrêa2,3,b, José Roberto Jardim4,c, Marcelo Fouad Rabahi5,d

J Bras Pneumol.2019;45(6):e20180230-e20180230

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the use of video lessons on the topic of COPD as a training tool for a multidisciplinary team working in the primary health care sector. Methods: This was a quasi-experimental study involving a multidisciplinary team working at a primary health care clinic. The level of knowledge about COPD was measured by applying a specific, 16-item questionnaire - before, immediately after, and three months after the video lessons. In a set of six structured video lessons, the training focused on the prevention, case-finding, treatment, and monitoring of cases of COPD. The data were analyzed with the Friedman test, the Kruskal-Wallis test, Tukey's post hoc test, Dunnett's test, and the Bonferroni test. Results: There was a significant difference between the periods before and immediately after the training in terms of the scores on 15 of the 16 items on the questionnaire regarding the level of knowledge about COPD. The median total score of the participants increased significantly, from 60 points before the training to 77 points immediately thereafter and 3 months thereafter (p < 0.001 for both). Before the training, 23 (63.9%) and 13 (36.1%) of the members of the multidisciplinary team presented strong and very strong levels of agreement, respectively, among the 16 questionnaire items. After the training, 100% of the individuals presented a very strong degree of agreement. Conclusions: Multidisciplinary education through video lessons increased the knowledge of COPD on the part of a primary health care team, and the knowledge acquired was retained for at least three months after the intervention.

 


Keywords: Instructional films and videos; Pulmonary disease, chronic obstructive; Inservice training; Primary health care; Education, medical.

 


Effect of seasonality on the occurrence of respiratory symptoms in a Brazilian city with a tropical climate

Efeito da sazonalidade climática na ocorrência de sintomas respiratórios em uma cidade de clima tropical

José Laerte Rodrigues da Silva Júnior, Thiago Fintelman Padilha, Jordana Eduardo Rezende, Eliane Consuelo Alves Rabelo, Anna Carolina Galvão Ferreira, Marcelo Fouad Rabahi

J Bras Pneumol.2011;37(6):759-767

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the effect that seasonality has on the occurrence of respiratory symptoms in a Brazilian city with a tropical climate. Methods: This was a cross-sectional study, in which data related to subjects who sought outpatient treatment at a primary health care clinic in the city of Goiânia, Brazil, were correlated with daily meteorological data. Over a one-year period, all the patients who met the inclusion criteria were interviewed on 44 distinct, randomly selected days (11 days per season). We used ANOVA in order to compare the means of the dependent variables by season. Correlations were drawn between each dependent variable and each meteorological variable. The effects of the meteorological variables were analyzed with an AutoRegressive Moving Average with eXogenous input (ARMAX) model. Results: Of the 3,354 participants, 494 (14.6%) had respiratory symptoms. Although temperature variation alone had no effect on the number of individuals with respiratory symptoms, the low levels of humidity during winter resulted in a statistically significant difference among the seasons (p < 0.01). The mean minimum relative humidity on the three days prior to the interviews correlated negatively with the number of subjects with respiratory symptoms (p = 0.04). An ARMAX model including the same variable showed a statistically significant coefficient (p < 0.0001). Conclusions: In this sample, the number of subjects with respiratory symptoms increased significantly when the relative humidity dropped, and this increase could be predicted using meteorological data.

 


Keywords: Seasons; Tropical climate/adverse effects; Signs and symptoms, respiratory; Logistic models.

 


Eliminating tuberculosis in Latin America: making it the point

Eliminação da tuberculose na América Latina: considerações

Raquel Duarte1,2,3,a, Denise Rossato Silva4,b, Adrian Rendon5,c, Tatiana Galvẫo Alves6,d, Marcelo Fouad Rabahi7,e, Rosella Centis8,f, Afrânio Kritski9,g, Giovanni Battista Migliori8,h

J Bras Pneumol.2018;44(2):73-76

PDF PT PDF EN Portuguese Text



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

Abstract PDF PT PDF EN Portuguese Text

Tuberculosis continues to be a major public health problem. Although efforts to control the epidemic have reduced mortality and incidence, there are several predisposing factors that should be modified in order to reduce the burden of the disease. This review article will address some of the risk factors associated with tuberculosis infection and active tuberculosis, including diabetes, smoking, alcohol use, and the use of other drugs, all of which can also contribute to poor tuberculosis treatment results. Tuberculosis can also lead to complications in the course and management of other diseases, such as diabetes. It is therefore important to identify these comorbidities in tuberculosis patients in order to ensure adequate management of both conditions.

 


Keywords: Tuberculosis/epidemiology; Tuberculosis/prevention & control; Diabetes mellitus/prevention & control; Smoking/adverse effects; Alcohol drinking/adverse effects; Street drugs/adverse effects.

 


Usual interstitial pneumonia: typical, possible, and

Pneumonia intersticial usual: padrões típico, possível e inconsistente

Pedro Paulo Teixeira e Silva Torres1, Marcelo Fouad Rabahi2, Maria Auxiliadora Carmo Moreira2, Gustavo de Souza Portes Meirelles3, Edson Marchiori4

J Bras Pneumol.2017;43(5):393-398

Abstract PDF PT PDF EN Portuguese Text

Idiopathic pulmonary fibrosis is a severe and progressive chronic fibrosing interstitial lung disease, a definitive diagnosis being established by specific combinations of clinical, radiological, and pathological findings. According to current international guidelines, HRCT plays a key role in establishing a diagnosis of usual interstitial pneumonia (UIP). Current guidelines describe three UIP patterns based on HRCT findings: a typical UIP pattern; a pattern designated "possible UIP"; and a pattern designated "inconsistent with UIP", each pattern having important diagnostic implications. A typical UIP pattern on HRCT is highly accurate for the presence of histopathological UIP, being currently considered to be diagnostic of UIP. The remaining patterns require further diagnostic investigation. Other known causes of a UIP pattern include drug-induced interstitial lung disease, chronic hypersensitivity pneumonitis, occupational diseases (e.g., asbestosis), and connective tissue diseases, all of which should be included in the clinical differential diagnosis. Given the importance of CT studies in establishing a diagnosis and the possibility of interobserver variability, the objective of this pictorial essay was to illustrate all three UIP patterns on HRCT.

 


Keywords: Tomography, X-ray computed; Lung diseases, interstitial; Pulmonary fibrosis.

 


Lipoid pneumonia secondary to long-term use of evening primrose oil

Pneumonia lipoide secundária ao uso prolongado de óleo de prímula

Marcelo Fouad Rabahi, Andreia Alves Ferreira, João Gabriel Piccirilli Madeira, Paulo Menzel Galvao, Sebastião Alves Pinto

J Bras Pneumol.2010;36(5):657-661

Abstract PDF PT PDF EN Portuguese Text

Lipoid pneumonia is an underdiagnosed disease that is caused by the aspiration of lipid particles into the lungs. Although most of the reported cases have been associated with the use of mineral oil as a laxative, other lipid substances can also cause the disease. We report the case of a 50-year-old female patient with a complaint of productive cough who was initially diagnosed with bronchial hyperresponsiveness and gastroesophageal reflux disease (GERD). The patient was treated for GERD. Because the productive cough persisted, the patient underwent chest CT, fiberoptic bronchoscopy, and open lung biopsy. She was diagnosed with lipoid pneumonia. The patient was questioned regarding the use of lipid substances, and she reported the chronic use of evening primrose oil. After the discontinuation of the substance and the maintenance of GERD treatment, her condition improved.

 


Keywords: Pneumonia, lipid; Cough; Plant oils.

 


Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables

Prevalência e variáveis preditivas de distúrbios respiratórios do sono em pacientes com DPOC e hipoxemia leve

José Laerte Rodrigues Silva Júnior1,4, Marcus Barreto Conde2,3, Krislainy de Sousa Corrêa4, Helena Rabahi4, Arthur Alves Rocha5, Marcelo Fouad Rabahi1,4

J Bras Pneumol.2017;43(3):176-182

Abstract PDF PT PDF EN Portuguese Text

Objective: To infer the prevalence and variables predictive of isolated nocturnal hypoxemia and obstructive sleep apnea (OSA) in patients with COPD and mild hypoxemia. Methods: This was a cross-sectional study involving clinically stable COPD outpatients with mild hypoxemia (oxygen saturation = 90-94%) at a clinical center specializing in respiratory diseases, located in the city of Goiânia, Brazil. The patients underwent clinical evaluation, spirometry, polysomnography, echocardiography, arterial blood gas analysis, six-minute walk test assessment, and chest X-ray. Results: The sample included 64 patients with COPD and mild hypoxemia; 39 (61%) were diagnosed with sleep-disordered breathing (OSA, in 14; and isolated nocturnal hypoxemia, in 25). Correlation analysis showed that PaO2 correlated moderately with mean sleep oxygen saturation (r = 0.45; p = 0.0002), mean rapid eye movement (REM) sleep oxygen saturation (r = 0.43; p = 0.001), and mean non-REM sleep oxygen saturation (r = 0.42; p = 0.001). A cut-off point of PaO2 ≤ 70 mmHg in the arterial blood gas analysis was significantly associated with sleep-disordered breathing (OR = 4.59; 95% CI: 1.54-13.67; p = 0.01). The model showed that, for identifying sleep-disordered breathing, the cut-off point had a specificity of 73.9% (95% CI: 51.6-89.8%), a sensitivity of 63.4% (95% CI: 46.9-77.9%), a positive predictive value of 81.3% (95% CI: 67.7-90.0%), and a negative predictive value of 53.1% (95% CI: 41.4-64.4%), with an area under the ROC curve of 0.69 (95% CI: 0.57-0.80), correctly classifying the observations in 67.2% of the cases. Conclusions: In our sample of patients with COPD and mild hypoxemia, the prevalence of sleep-disordered breathing was high (61%), suggesting that such patients would benefit from sleep studies.

 


Keywords: Pulmonary disease, chronic obstructive/complications; Sleep wake disorders/epidemiology; Anoxia/etiology.

 


Lung pseudotumor as the initial presentation of Wegener's granulomatosis

Pseudotumor pulmonar como apresentação inicial de granulomatose de Wegener

Marcelo Fouad Rabahi, Ludmila Bertti Coelho, Eliza de Oliveira Borges, Marcella Stival Lemes, Weniskley Mendes de Castro, Siderley de Souza Carneiro

J Bras Pneumol.2009;35(4):392-395

Abstract PDF PT PDF EN Portuguese Text

Wegener's granulomatosis is a multisystemic inflammatory illness of unknown etiology, characterized by vasculitis of small and medium caliber vessels. The most common clinical manifestations involve the upper respiratory tract, lungs and kidneys. Common alterations in imaging studies include pulmonary opacities and bilateral multiple nodules, cavitations occurring in 50% of the cases. Treatment includes corticosteroids and immunosuppressants. We describe an atypical case of a 61-year-old man initially investigated due to suspicion of a unilateral lung tumor, which proved to be, in fact, a case of Wegener's granulomatosis.

 


Keywords: Wegener's Granulomatosis; Vasculitis; Diagnosis, differential; Lung neoplasms.

 


Recommendations for the pharmacological treatment of COPD: questions and answers

Recomendações para o tratamento farmacológico da DPOC: perguntas e respostas

Frederico Leon Arrabal Fernandes1, Alberto Cukier1, Aquiles Assunção Camelier2,3, Carlos Cezar Fritscher4, Cláudia Henrique da Costa5, Eanes Delgado Barros Pereira6, Irma Godoy7, José Eduardo Delfini Cançado8, José Gustavo Romaldini8, Jose Miguel Chatkin4, José Roberto Jardim9, Marcelo Fouad Rabahi10, Maria Cecília Nieves Maiorano de Nucci11, Maria da Penha Uchoa Sales12, Maria Vera Cruz de Oliveira Castellano13, Miguel Abidon Aidé14, Paulo José Zimermann Teixeira15,16, Renato Maciel17, Ricardo de Amorim Corrêa18, Roberto Stirbulov8, Rodrigo Abensur Athanazio1, Rodrigo Russo19, Suzana Tanni Minamoto7, Fernando Luiz Cavalcanti Lundgren20

J Bras Pneumol.2017;43(4):290-301

Abstract PDF PT PDF EN Portuguese Text

The treatment of COPD has become increasingly effective. Measures that range from behavioral changes, reduction in exposure to risk factors, education about the disease and its course, rehabilitation, oxygen therapy, management of comorbidities, and surgical and pharmacological treatments to end-of-life care allow health professionals to provide a personalized and effective therapy. The pharmacological treatment of COPD is one of the cornerstones of COPD management, and there have been many advances in this area in recent years. Given the greater availability of drugs and therapeutic combinations, it has become increasingly challenging to know the indications for, limitations of, and potential risks and benefits of each treatment modality. In order to critically evaluate recent evidence and systematize the major questions regarding the pharmacological treatment of COPD, 24 specialists from all over Brazil gathered to develop the present recommendations. A visual guide was developed for the classification and treatment of COPD, both of which were adapted to fit the situation in Brazil. Ten questions were selected on the basis of their relevance in clinical practice. They address the classification, definitions, treatment, and evidence available for each drug or drug combination. Each question was answered by two specialists, and then the answers were consolidated in two phases: review and consensus by all participants. The questions answered are practical questions and help select from among the many options the best treatment for each patient and his/her peculiarities.

 


Keywords: Pulmonary disease, chronic obstructive/drug therapy; pulmonary disease, chronic obstructive/prevention & control; pulmonary disease, chronic obstructive/therapy.

 


Authors' reply

Resposta dos autores

Maria Conceição de Castro Antonelli Monteiro de Queiroz, Maria Auxiliadora Carmo Moreira,Marcelo Fouad Rabahi

J Bras Pneumol.2013;39(2):256-256

PDF PT PDF EN Portuguese Text



Authors' reply

Resposta dos autores

Marcelo Fouad Rabahi1,a, José Laerte Rodrigues da Silva Júnior2,3,b, Marcus Barreto Conde4,5,c

J Bras Pneumol.2018;44(3):251-252

PDF PT PDF EN Portuguese Text



Underdiagnosis of COPD at primary health care clinics in the city of Aparecida de Goiânia, Brazil

Subdiagnóstico de DPOC na atenção primária em Aparecida de Goiânia, Goiás

Maria Conceição de Castro Antonelli Monteiro de Queiroz, Maria Auxiliadora Carmo Moreira, Marcelo Fouad Rabahi

J Bras Pneumol.2012;38(6):692-699

Abstract PDF PT PDF EN Portuguese Text

Objective: To estimate the prevalence of undiagnosed COPD among individuals with risk factors for the disease treated at primary health care clinics (PHCCs) in the city of Aparecida de Goiânia, Brazil. Methods: Inclusion criteria were being ≥ 40 years of age, having a > 20 pack-year history of smoking or a > 80 hour-year history of exposure to biomass smoke, and seeking medical attention at one of the selected PHCCs. All subjects included in the study underwent spirometry for the diagnosis of COPD. Results: We successfully evaluated 200 individuals, mostly males. The mean age was 65.9 ± 10.5 years. The diagnosis of COPD was confirmed in 63 individuals, only 18 of whom had been previously diagnosed with COPD (underdiagnosis rate, 71.4%). There were no significant differences between the subgroups with and without a previous diagnosis of COPD in relation to demographics and risk factors. However, there were significant differences between these subgroups for the presence of expectoration, wheezing, and dyspnea (p = 0.047; p = 0.005; and p = 0.047, respectively). The FEV1 and FEV1/FVC ratio, expressed as percentages of the predicted values, were significantly lower in the subjects with a previous diagnosis of COPD, which was predominantly mild or moderate in both subgroups. Conclusions: The rate of underdiagnosis of COPD was high at the PHCCs studied. One third of the patients with risk factors for COPD met the clinical and functional criteria for the disease. It seems that spirometry is underutilized at such facilities.

 


Keywords: Pulmonary disease, chronic obstructive/diagnosis; Primary health care; Spirometry.

 


STOP-Bang questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil

Tradução e adaptação transcultural do questionário STOP-Bang para a língua portuguesa falada no Brasil

Lorena Barbosa de Moraes Fonseca, Erika Aparecida Silveira, Nathalia Meireles Lima, Marcelo Fouad Rabahi

J Bras Pneumol.2016;42(4):266-272

Abstract PDF PT PDF EN Portuguese Text

Objective: To translate and perform a cross-cultural adaptation of the Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender (STOP-Bang) questionnaire so that it can be used as a screening tool for the diagnosis of obstructive sleep apnea in Brazil. Methods: Based on the principles of good practice for the translation and cross-cultural adaptation of such instruments, the protocol included the following steps: acquisition of authorization from the lead author of the original questionnaire; translation of the instrument to Brazilian Portuguese, carried out by two translators; reconciliation; back-translation to English, carried out by two English teachers who are fluent in Portuguese; review of the back-translation; harmonization; review and approval of the questionnaire by the original author; cognitive debriefing involving 14 patients who completed the questionnaire; analysis of the results; and review and preparation of the final version of the instrument approved by the review committee. Results: The final version of the STOP-Bang questionnaire for use in Brazil showed a clarity score > 9 (on a scale of 1-10) for all of the questions. The Cronbach's alpha coefficient was 0.62, demonstrating the internal consistency of the instrument. The means and standard deviations of the age, body mass index, and neck circumference of the patients studied were 46.8 ± 11.2 years, 43.7 ± 8.5 kg/m2, and 41.3 ± 3.6 cm, respectively. Conclusions: The STOP-Bang questionnaire proved to be understandable, clear, and applicable. The original instrument and the translated version, cross-culturally adapted for use in Brazil, were consistently equivalent. Therefore, it can become a widely used screening tool for patients with suspected obstructive sleep apnea.

 


Keywords: Sleep apnea, obstructive; Questionnaires; Translations.

 


Tuberculosis treatment

Tratamento da tuberculose

Marcelo Fouad Rabahi1,2, José Laerte Rodrigues da Silva Júnior2, Anna Carolina Galvão Ferreira1,3, Daniela Graner Schuwartz Tannus-Silva1, Marcus Barreto Conde4,5

J Bras Pneumol.2018;44(4):340-340

PDF PT PDF EN Portuguese Text



Tuberculosis treatment

Tratamento da tuberculose

Marcelo Fouad Rabahi1,2, José Laerte Rodrigues da Silva Júnior2, Anna Carolina Galvão Ferreira1,3, Daniela Graner Schuwartz Tannus-Silva1, Marcus Barreto Conde4,5

J Bras Pneumol.2017;43(6):472-486

Abstract PDF PT PDF EN Portuguese Text

Tuberculosis treatment remains a challenge due to the need to consider, when approaching it, the context of individual and collective health. In addition, social and economic issues have been shown to be variables that need to be considered when it comes to treatment effectiveness. We conducted a critical review of the national and international literature on the treatment of tuberculosis in recent years with the aims of presenting health care workers with recommendations based on the situation in Brazil and better informing decision-making regarding tuberculosis patients so as to minimize morbidity and interrupt disease transmission.

 


Keywords: Tuberculosis/drug therapy; Tuberculosis/prevention & control; Tuberculosis/surgery; Tuberculosis/classification.

 


Tuberculosis in rheumatoid arthritis patients: the difficulty in making the diagnosis of latent infection

Tuberculose em pacientes com artrite reumatoide: a dificuldade no diagnóstico da forma latente

Daniela Graner Schuwartz Tannus Silva, Bruna Daniella de Souza Silva, Ana Paula Junqueira-Kipnis, Marcelo Fouad Rabahi

J Bras Pneumol.2010;36(2):243-251

Abstract PDF PT PDF EN Portuguese Text

Since the beginning of the use of anti-TNF in the treatment of rheumatoid arthritis and other inflammatory diseases, cases of pulmonary tuberculosis and extrapulmonary tuberculosis have been reported in patients receiving such treatment. In most cases, the disease develops by the time the patient has received the sixth infusion. Every patient should be evaluated for latent tuberculosis infection prior to the use of a TNF inhibitor. However, the diagnosis of latent tuberculosis infection is a challenge. The tuberculin test, which was the only test available to detect latent tuberculosis infection for nearly a century, presents a number of limitations. Tests based on the detection of the in-vitro production of IFN-γ by mononuclear cells activated by specific antigens appear to be more accurate and have been studied in patients with rheumatoid arthritis.

 


Keywords: Tuberculosis, pulmonary; Arthritis, rheumatoid; Tumor necrosis factor-alpha; Infection.

 


Validation of the STOP-Bang questionnaire as a means of screening for obstructive sleep apnea in adults in Brazil

Validação do questionário STOP-Bang para a identificação de apneia obstrutiva do sono em adultos no Brasil

Ricardo Luiz de Menezes Duarte, Lorena Barbosa de Moraes Fonseca, Flavio José Magalhães-da-Silveira, Erika Aparecida da Silveira, Marcelo Fouad Rabahi

J Bras Pneumol.2017;43(6):456-463

Abstract PDF PT PDF EN Portuguese Text

Objective: To validate the Portuguese-language version of the STOP-Bang (acronym for Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender) questionnaire, culturally adapted for use in Brazil, as a means of screening for obstructive sleep apnea (OSA) in adults. Methods: In this validation study, we enrolled patients ≥ 18 years of age, recruited between May of 2015 and August of 2016. All patients completed the STOP-Bang questionnaire and underwent overnight polysomnography. To evaluate the performance of the questionnaire, we used contingency tables and areas under the (receiver operating characteristic) curve (AUCs). Results: We included 456 patients. The mean age was 43.7 ± 12.5 years, and 291 (63.8%) of the patients were male. On the basis of the apnea-hypopnea index (AHI), we categorized OSA as mild/moderate/severe (any OSA; AHI ≥ 5 events/h), moderate/severe (AHI ≥ 15 events/h), or severe (AHI ≥ 30 events/h). The overall prevalence of OSA was 78.3%, compared with 52.0%, and 28.5% for moderate/severe and severe OSA, respectively. The most common score on the STOP-Bang questionnaire was 4 points (n = 106), followed by 3 points (n = 85) and 5 points (n = 82). An increase in the score was paralleled by a reduction in sensitivity with a corresponding increase in specificity for all AHI cut-off points. The AUCs obtained for the identification of any, moderate/severe, and severe OSA were: 0.743, 0.731, and 0.779, respectively. For any OSA, the score on the questionnaire (cut-off, ≥ 3 points) presented sensitivity, specificity, and accuracy of 83.5%, 45.5%, and 75.2%, respectively. Conclusions: The STOP-Bang questionnaire performed adequately for OSA screening, indicating that it could be used as an effective screening tool for the disorder.

 


Keywords: Sleep apnea, obstructive/diagnosis; Polysomnography; Diagnostic techniques and procedures; Surveys and questionnaires.

 


 

 


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