Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.751
Filtrar
1.
Medicine (Baltimore) ; 100(4): e23858, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530179

RESUMO

BACKGROUND: This meta-analysis aimed to systematically estimate the prevalence of comorbid bronchiectasis in patients with asthma and to summarize its clinical impact. METHODS: Embase, PubMed, and Cochrane Library electronic databases were searched to identify relevant studies published from inception until March 2020. STUDY SELECTION: Studies were included if bronchiectasis was identified by high-resolution computed tomography. Outcomes included the prevalence of bronchiectasis and its association with demographic characteristics and indicators of asthma severity, including results of lung function tests and the number of exacerbations. RESULTS: Five observational studies with 839 patients were included. Overall, the mean prevalence of bronchiectasis in patients with asthma was 36.6% (307/839). Patients with comorbid bronchiectasis had lower forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (MD: -2.71; 95% CI: -3.72 to -1.69) and more frequent exacerbations (MD: 0.68; 95% CI: 0.03 to 1.33) than those with asthma alone, and there was no significant difference of sex, duration of asthma and serum levels of immunoglobulin(Ig)Es between asthmatic patients with or without bronchiectasis. CONCLUSION: The presence of bronchiectasis in patients with asthma was associated with greater asthma severity. There are important therapeutic implications of identifying bronchiectasis in asthmatic patients.


Assuntos
Asma/complicações , Bronquiectasia/complicações , Asma/epidemiologia , Asma/fisiopatologia , Biomarcadores/sangue , Bronquiectasia/epidemiologia , Bronquiectasia/fisiopatologia , Comorbidade , Eosinófilos/metabolismo , Volume Expiratório Forçado , Humanos , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Capacidade Vital
3.
BMC Pulm Med ; 21(1): 56, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33573635

RESUMO

BACKGROUND: The effects of comorbidities on chronic obstructive pulmonary disease (COPD) have been usually studied individually in the past. In this study, we aimed to investigate the comorbidities associated with mortality, the effect of multimorbidity on mortality and other factors associated with mortality among Korean COPD population. METHODS: The Korean National Health Insurance Service-National Sample Cohort version 2.0, collected between 2002 and 2015, was used. Among COPD patients [entire cohort (EC), N = 12,779], 44% of the participants underwent additional health examination, and they were analysed separately [health-screening cohort (HSC), N = 5624]. Fifteen comorbidities previously reported as risk factors for mortality were studied using Cox proportional hazards regression models. RESULTS: Total mortality rates were 38.6 per 1000 person-years (95% CI 37.32-40.01) and 27.4 per 1000 person-years (95% CI 25.68-29.22) in EC and HSC, respectively. The most common causes of death were disease progression, lung cancer, and pneumonia. Only some of the comorbidities had a direct impact on mortality. Multimorbidity, assessed by the number of comorbid diseases, was an independent risk factor of all-cause mortality in both cohorts and was a risk factor of respiratory mortality only in HSC. The Kaplan-Meier analysis showed significant differences in survival trajectories according to the number of comorbidities in all-cause mortality but not in respiratory mortality. Low BMI, old age and male sex were independent risk factors for both mortalities in both cohorts. CONCLUSIONS: The number of comorbidities might be an independent risk factor of COPD mortality. Multimorbidity contributes to all-cause mortality in COPD, but the effect of multimorbidity is less evident on respiratory mortality.


Assuntos
Neoplasias Pulmonares/mortalidade , Pneumonia/mortalidade , Doença Pulmonar Obstrutiva Crônica/mortalidade , Idoso , Asma/epidemiologia , Bronquiectasia/epidemiologia , Doenças Cardiovasculares/epidemiologia , Causas de Morte , Estudos de Coortes , Comorbidade , Diabetes Mellitus/epidemiologia , Neoplasias do Sistema Digestório/epidemiologia , Progressão da Doença , Dislipidemias/epidemiologia , Feminino , Refluxo Gastroesofágico/epidemiologia , Humanos , Estimativa de Kaplan-Meier , Hepatopatias/epidemiologia , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Multimorbidade , Osteoporose/epidemiologia , Modelos de Riscos Proporcionais , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Insuficiência Renal Crônica/epidemiologia , República da Coreia/epidemiologia , Fatores de Risco , Neoplasias da Glândula Tireoide/epidemiologia
5.
Diagn Interv Imaging ; 102(2): 77-84, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33419693

RESUMO

PURPOSE: The purpose of this study was to identify clinical and chest computed tomography (CT) features associated with a severe form of coronavirus disease 2019 (COVID-19) and to propose a quick and easy to use model to identify patients at risk of a severe form. MATERIALS AND METHODS: A total of 158 patients with biologically confirmed COVID-19 who underwent a chest CT after the onset of the symptoms were included. There were 84 men and 74 women with a mean age of 68±14 (SD) years (range: 24-96years). There were 100 non-severe and 58 severe cases. Their clinical data were recorded and the first chest CT examination was reviewed using a computerized standardized report. Univariate and multivariate analyses were performed in order to identify the risk factors associated with disease severity. Two models were built: one was based only on qualitative CT features and the other one included a semi-quantitative total CT score to replace the variable representing the extent of the disease. Areas under the ROC curves (AUC) of the two models were compared with DeLong's method. RESULTS: Central involvement of lung parenchyma (P<0.001), area of consolidation (P<0.008), air bronchogram sign (P<0.001), bronchiectasis (P<0.001), traction bronchiectasis (P<0.011), pleural effusion (P<0.026), large involvement of either one of the upper lobes or of the middle lobe (P<0.001) and total CT score≥15 (P<0.001) were more often observed in the severe group than in the non-severe group. No significant differences were found between the qualitative model (large involvement of either upper lobes or middle lobe [odd ratio (OR)=2.473], central involvement [OR=2.760], pleural effusion [OR=2.699]) and the semi-quantitative model (total CT score≥15 [OR=3.342], central involvement [OR=2.344], pleural effusion [OR=2.754]) with AUC of 0.722 (95% CI: 0.638-0.806) vs. 0.739 (95% CI: 0.656-0.823), respectively (P=0.209). CONCLUSION: We have developed a new qualitative chest CT-based multivariate model that provides independent risk factors associated with severe form of COVID-19.


Assuntos
/diagnóstico por imagem , Simulação por Computador , Pulmão/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Bronquiectasia/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença
6.
Arch. argent. pediatr ; 118(6): S164-S182, dic 2020. tab, ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1146240

RESUMO

Las bronquiectasias se encuentran dentro del espectro de enfermedad pulmonar crónica caracterizada por la dilatación bronquial progresiva y, a menudo, irreversible, causada por cambios estructurales en la pared bronquial e inflamación crónica de las vías respiratorias. El síntoma cardinal es la tos crónica persistente húmeda y productiva, que debe alertar para realizar una intervención oportuna e interrumpir el ciclo de inflamación, infección y daño de la vía aérea. Un diagnóstico precoz a través de la tomografía axial computarizada de alta resolución de tórax y el monitoreo clínico facilitan la implementación de un tratamiento intensivo que reduce y minimiza el daño de la vía aérea. Si bien las acciones terapéuticas actuales para el manejo de bronquiectasias son efectivas, existen pocos estudios clínicos aleatorizados en pediatría. El objetivo del documento es proporcionar una actualización sobre el diagnóstico, seguimiento y tratamiento de las bronquiectasias no relacionadas con fibrosis quística en niños


Bronchiectasis is within the spectrum of chronic lung disease characterized by progressive and often irreversible bronchial dilation caused by structural changes in the bronchial wall and chronic inflammation of the airways. The cardinal symptom is persistent moist and productive chronic cough that should alert to timely intervention and interrupt the cycle of inflammation, infection, and airway damage. Early diagnosis through high-resolution computed tomography of the chest and clinical monitoring facilitate the implementation of intensive treatment that reduces and minimizes damage to the airway. Although current therapeutic actions for the management of bronchiectasis are effective, there are few randomized clinical trials in pediatrics. The objective of the document is to provide an update on the diagnosis, monitoring and treatment of bronchiectasis not related to cystic fibrosis in children


Assuntos
Humanos , Masculino , Feminino , Criança , Bronquiectasia/diagnóstico , Sinais e Sintomas , Bronquiectasia/complicações , Bronquiectasia/etiologia , Bronquiectasia/terapia , Bronquiectasia/epidemiologia , Assistência ao Convalescente
7.
Isr Med Assoc J ; 22(12): 794-799, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33381955

RESUMO

BACKGROUND: For most passengers, even those with respiratory disease, air travel is safe and comfortable. Some travelers may experience hypoxia at sea level but may not need supplemental oxygen during air travel in a hypobaric hypoxic environment. For some individuals compensatory pulmonary mechanisms may be inadequate, causing profound hypoxia. In addition, venous thromboembolism/pulmonary emboli may occur, especially during long haul flights. With adequate screening, patients at risk can be identified, therapeutic solutions can be proposed for the flight, and most can travel can continue safely with supplemental oxygen and other preventive measures.


Assuntos
Aeronaves , Doenças Respiratórias/etiologia , Astenia/etiologia , Bronquiectasia/etiologia , Humanos , Doença Pulmonar Obstrutiva Crônica/etiologia , Viagem
8.
Monaldi Arch Chest Dis ; 90(4)2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33169599

RESUMO

The pandemic of COVID-19 has emerged as a serious health crisis globally and India too has been extensively affected with 604,641 active cases reported, till date. The present study focuses on the demographic, clinical and laboratory profile of such patients from a tertiary level non-COVID respiratory care hospital. This is a retrospective observational study. Seventy-seven sick patients fulfilling COVID suspect criteria were admitted to the isolation area. Their RT-PCR test was done from the designated laboratory and 35 of them  were confirmed to be COVID-19 patients. The detailed demographic, clinical and laboratory profile of these COVID-19 patients was studied. The mean age was 46±17 years with male predominance (57%). Majority  of the cases (83%) were symptomatic. The most common symptom was cough (66%) followed by breathlessness and fever. Nineteen (54.3%) patients had one or the other co-morbidity and 16 (45.7%) had chronic lung diseases as one of the comorbidities. Nearly half of the patients (51%) required supplementary oxygen on presentation. Two patients were put on invasive mechanical ventilation while 4 patients required non-invasive ventilation before being shifted to the COVID hospital. Hence, it can be concluded that COVID-19 in patients of chronic respiratory diseases  manifests with higher prevalence of symptoms and also higher severity of disease. Further, the  symptomatology of COVID-19 closely mimics the acute exacerbation of chronic lung diseases, so cautious screening and testing should be done, especially at the pulmonary department.


Assuntos
Infecções por Coronavirus/fisiopatologia , Diabetes Mellitus/epidemiologia , Hospitais Especializados , Hipertensão/epidemiologia , Hipóxia/fisiopatologia , Pneumopatias/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumologia , Centros de Atenção Terciária , Adulto , Asma/epidemiologia , Betacoronavirus , Bronquiectasia/epidemiologia , Doença Crônica , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Tosse/fisiopatologia , Dispneia/fisiopatologia , Feminino , Febre/fisiopatologia , Humanos , Índia/epidemiologia , Doenças Pulmonares Intersticiais/epidemiologia , Masculino , Pessoa de Meia-Idade , Ventilação não Invasiva , Oxigenoterapia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Respiração Artificial , Estudos Retrospectivos
9.
Wiad Lek ; 73(8): 1717-1722, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055340

RESUMO

OBJECTIVE: The aim: This study aims to determine specific predictive factors of bronchiectasis exacerbations. PATIENTS AND METHODS: Materials and methods: 47 patients with bronchiectasis were prospectively recruited into the study in Dnipro, Ukraine. Following the number of exacerbations during the previous year, they were divided into two groups: frequent exacerbators - ≥ 3 cases per year (n = 24) and non-frequent exacerbators - < 3 cases per year (n = 23). Demographic and anthropometric data, medical history, smoking status, shortness of breath by Modified Medical Research Council Dyspnea Scale, sputum culture, respiratory function by computed spirometry, disease severity by Bronchiectasis Severity index and FACED scales were evaluated in both groups. RESULTS: Results: The factors found to be independently associated with frequent exacerbations were: overweight, airway obstruction, longer duration of the disease, more severe dyspnea, greater number of involved pulmonary lobes and presence of one or more comorbid conditions. Non-influencing factors were: underweight, age, sex, smoking status and, unexpectedly, presence of Pseudomonas aeruginosa or other pathogens in sputum culture. CONCLUSION: Conclusions: Particular attention is required for patients with bronchiectasis who have overweight, airway obstruction, longer duration of the disease, more severe dyspnea, the greater number of involved pulmonary lobes and presence of one or more comorbid conditions in order to correct modifiable risk factors of future exacerbations.


Assuntos
Bronquiectasia , Adulto , Bronquiectasia/epidemiologia , Progressão da Doença , Humanos , Índice de Gravidade de Doença , Espirometria , Ucrânia
10.
Rev. esp. patol. torac ; 32(3): 248-250, oct. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-ET2-7558

RESUMO

Se describe el caso de una paciente joven con amiloidosis secundaria (AA) a bronquiectasias no tuberculosas y no filiadas hasta el momento del diagnóstico, como causante de enfermedad inflamatoria crónica, responsable de la producción mantenida de SAA (proteína sérica amiloide), y depósito amiloide A en los diferentes tejidos. Se discute la rareza del caso, más habitual en el contexto de otras enfermedades inflamatorias, pero como en el pasado, aún potencialmente presente en nuestros días


The case of a young patient with amyloidosis (AA) secondary to nontuberculous bronchiectasis, which was undetermined at the time of diagnosis, is described as a cause of chronic inflammatory disease, responsible for the maintained production of SAA (serum AA protein) and amyloid A deposit in different tissues. The case is argued to be rare, being more common in the context of other inflammatory diseases, but, like in the past, potentially still present today


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Amiloidose/etiologia , Bronquiectasia/complicações , Amiloidose/patologia , Proteína Amiloide A Sérica/análise , Diagnóstico Diferencial , Tomografia Computadorizada por Raios X , Broncoscopia/métodos , Tórax/diagnóstico por imagem , Tórax/patologia
12.
BMC Pulm Med ; 20(1): 244, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928157

RESUMO

BACKGROUND: Since the beginning of SARS-CoV-2 outbreak in China, severe acute respiratory syndrome has been widely descripted. Hemoptysis has rarely been observed in SARS-CoV-2 infection. We report here a case of severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection and managed in a referral center. CASE PRESENTATION: A 58-year-old man was admitted to our intensive care unit for severe hemoptysis with history of post-tuberculosis bronchiectasis. At ICU admission the patient had fever and severe acute respiratory failure requiring high flow oxygen therapy. Respiratory tract sampling was positive for SARS-CoV-2. Multi-detector computed tomography angiography pointed out localized bronchiectasis on the left lower lobe and enlarged left bronchial and phrenic arteries; bronchial arteriography with distal embolization was performed with favorable outcome and no bleeding recurrence. CONCLUSIONS: To our knowledge, this is the first case of acute exacerbation of bronchiectasis related to SARS-CoV-2 infection and complicated by severe hemoptysis. Whether the virus may play a role in the dysregulation of airway haemostasis, and contribute to episodes of hemoptysis in patients with chronic pulmonary diseases and predisposing factors might be investigated.


Assuntos
Bronquiectasia/complicações , Infecções por Coronavirus/complicações , Hemoptise/etiologia , Pneumonia Viral/complicações , Tuberculose Pulmonar/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Índice de Gravidade de Doença
13.
Monaldi Arch Chest Dis ; 90(4)2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32945644

RESUMO

The coronavirus disease 2019 (COVID-19) is a recent pandemic that affected more than 5 million people worldwide. Chest high resolution computed tomography (HRCT) is an essential tool in diagnosis and management of the disease. Pulmonary parenchymal opacity is a typical sign of the disease, but not the only one. Pneumothorax, pneumomediastinum, bronchiectasis and cysts are probably underrated complications of COVID-19 that can worsen prognosis, in terms of prolonged hospitalization and need of oxygen therapy. In our single center case series, we outline four different manifestations of pneumothorax, pneumomediastinum and cysts in hospitalized patients with COVID-19 pneumonia.


Assuntos
Bronquiectasia/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Cistos/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Enfisema Mediastínico/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Adulto , Betacoronavirus , Bronquiectasia/etiologia , Infecções por Coronavirus/complicações , Cistos/etiologia , Humanos , Itália , Pneumopatias/diagnóstico por imagem , Pneumopatias/etiologia , Masculino , Enfisema Mediastínico/etiologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumotórax/etiologia , Enfisema Subcutâneo/diagnóstico por imagem , Enfisema Subcutâneo/etiologia , Tomografia Computadorizada por Raios X
14.
PLoS One ; 15(9): e0239459, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946530

RESUMO

This study aimed to evaluate the visualization of peripheral bronchioles in normal lungs via quarter-detector computed tomography (QDCT). Visualization of bronchioles within 10 mm from the pleura is considered a sign of bronchiectasis. However, it is not known peripheral bronchioles how close to the pleura in normal lungs can be tracked using QDCT. This study included 228 parts in 76 lungs from 38 consecutive patients who underwent QDCT. Reconstruction was performed with different thicknesses, increments, and matrix sizes: 0.5-mm thickness and increment with 512 and 1024 matrixes (Group5 and Group10, respectively) and 0.25-mm thickness and increment with 1024 matrix (Group10Thin). The distance between the most peripheral bronchiole visible and the pleura was determined in the three groups. The distance between the peripheral bronchial duct ends and the nearest pleural surface were significantly shorter in the order of Group10Thin, Group10, and Group5, and the mean distances from the pleura in Group10Thin and Group10 were shorter than 10 mm. These findings suggest the visualization of peripheral bronchioles in QDCT was better with a 1024 axial matrix than with a 512 matrix, and with a 0.25-mm slice thickness/increment than with a 0.5-mm slice thickness/increment. Our study also indicates bronchioles within 10 mm of the pleura do not necessarily indicate pathology.


Assuntos
Bronquíolos/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Bronquiectasia/diagnóstico por imagem , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pleura/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/estatística & dados numéricos
15.
Medicine (Baltimore) ; 99(39): e22475, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991486

RESUMO

RATIONALE: Although bronchiectasis is conventionally considered a chronic pulmonary disease of adulthood, knowledge of pediatric bronchiectasis not related to cystic fibrosis started to emerge. Limited information in this field is available and the management is based on expert opinion. PATIENT CONCERNS: An 8-year-old girl admitted for 7 days history of wet cough, purulent fetid sputum, shortness of breath and low-grade fever. The wet cough has presented for the past 4 years, during which she had frequent hospitalization for recurrent lower respiratory tract infections. DIAGNOSIS: Chest high-resolution computerized tomography revealed diffuse bronchial dilations accompanied by inflammation in the bilateral lung fields. Microbiologic investigation for bronchoalveolar lavage fluid was positive for Pseudomonas aeruginosa. INTERVENTIONS: With a working diagnosis of bronchiectasis with secondary pulmonary infection, sensitive cefoperazone-sulbactam was administrated for 14 days with gradual improvement of clinical symptoms. Bronchoscopy washing substantially soothed the symptoms, reducing the cough and sputum volumes. OUTCOMES: The child was discharged after 14 days, and treated on long-term prophylactic antibiotic use (amoxicillin-clavulanic acid, 20 mg/kg/d, ≥ 4 weeks). LESSONS: Although bronchiectasisis are condition in childhood, the diagnosis is suspected in children with persistent wet or productive cough, and should be confirmed by a chest high-resolution computerized tomography scan. Antibiotics and airway clearance techniques represent the milestones of bronchiectasis management although there are only a few guidelines in children.


Assuntos
Bronquiectasia/complicações , Infecções por Pseudomonas/complicações , Pseudomonas aeruginosa/isolamento & purificação , Antibacterianos/administração & dosagem , Bronquiectasia/microbiologia , Criança , Feminino , Humanos , Infecções por Pseudomonas/tratamento farmacológico
18.
Br J Radiol ; 93(1115): 20200409, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32783627

RESUMO

OBJECTIVE: To investigate the clinical and radiological features of immune checkpoint inhibitor-related pneumonitis (ICI-P), a rare but serious pulmonary complication of cancer immunotherapy and to evaluate key differences between lung cancer (LC) and non-LC patients. METHODS: 247 patients (LC, n = 151) treated with ICI for malignancies were retrospectively screened in a single institute. The number of patients, history of other immune-related adverse events (irAE), the onset, serum KL-6 levels, and chest CT features (types of pneumonitis, symmetry, laterality, location) were recorded for the ICI-P population and compared for LC and non-LC groups. RESULTS: ICI-P was identified in 26 patients in total (LC, n = 19; non-LC, n = 7). The incidence of other irAE was significantly higher in ICI-P group (63%) compared with patients without ICI-P (34%) (p = 0.0056). An earlier onset of ICI-P was recorded in LC (78 days) compared to non-LC patients (186 days) (p = 0.0034). Serum KL-6 was significantly elevated only in the non-LC group when ICI-P was noticed (p = 0.029). Major CT findings of ICI-P, irrespective of primary disease, were organizing pneumonia pattern and ground glass opacities. LC patients commonly exhibited consolidation and traction bronchiectasis and were prone to asymmetrical shadows (p < 0.001). Non-LC patients were more likely to exhibit symmetrical infiltrations. A small fraction of both groups experienced relapse or moving patterns of ICI-P. CONCLUSION: ICI-P patients more often experienced other irAE prior to the development of ICI-P. The characteristics of ICI-P can differ in terms of the onset, KL-6 reliability, and chest CT findings between LC and non-LC patients. ADVANCES IN KNOWLEDGE: In ICI-P patients, a history of other irAE can be more frequently observed. Differences in disease onset and radiological patterns between LC and non-LC patients might be helpful to make a diagnosis of ICI-P; however, longitudinal observation of chest CT scans is advised to observe the pneumonitis activity irrespective of cancer types.


Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Neoplasias/terapia , Pneumonia/induzido quimicamente , Pneumonia/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Bronquiectasia/diagnóstico por imagem , Antígeno CTLA-4/antagonistas & inibidores , Pneumonia em Organização Criptogênica/induzido quimicamente , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Feminino , Humanos , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Nivolumabe/efeitos adversos , Nivolumabe/uso terapêutico , Polissacarídeos Bacterianos/sangue , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Pneumonite por Radiação/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
19.
Radiologe ; 60(9): 802-812, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32816050

RESUMO

CLINICAL ISSUE: Patients with cystic fibrosis (CF) require regular follow-up examinations, usually from birth onwards, using imaging techniques. METHODS: The conventional chest x­ray examination is the only technique recommended by the guidelines at this age. The examination can be performed at every age and is well standardized. The radiation dose to the patient is small and does not require any sedation. RADIOLOGICAL FINDINGS AND CLASSIFICATION: The typical structural changes of the bronchi and the lung parenchyma can be depicted. Typical findings are air-trapping, bronchiectasis, peribronchial cuffing, bronchial wall thickening, mucus plugging, nodular opacities, atelectasis and/or consolidations and hilar lymphadenopathy. Different scoring systems have been developed to allow for a relatively easy but reproducible assessment of the severity of the disease. The most important ones for daily clinical practice are the Chrispin-Norman score, Brasfield score, and the Wisconsin score. All of them show a good correlation with pulmonary function parameters and the clinical picture of the patients. PRACTICAL RECOMMENDATIONS: It is recommended to take an annual X­ray for patients with CF, and in addition in individual cases with clinical deterioration. Computed tomography (CT) can be performed if relevant information for treatment is expected to gained.


Assuntos
Bronquiectasia , Fibrose Cística , Atelectasia Pulmonar , Radiografia Torácica , Bronquiectasia/diagnóstico por imagem , Fibrose Cística/diagnóstico por imagem , Humanos , Pulmão/diagnóstico por imagem , Atelectasia Pulmonar/diagnóstico por imagem
20.
Rev Assoc Med Bras (1992) ; 66(5): 659-665, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32638954

RESUMO

OBJECTIVES To evaluate the efficacy of mucosal bacterial vaccines (MBV) in reducing the number of exacerbations in patients with chronic respiratory disease. METHODS A prospective cohort study of patients followed at the Pneumology Unit of the University and Hospital Centre of Coimbra, with frequent infectious exacerbations (3 or more) despite the best therapeutic strategies employed. MBV was used as additional therapy. The number of exacerbations 1 year before therapy and 1 year after it were analyzed. RESULTS A sample of 11 individuals, 45.5% male, mean age 62.5 years. Eight patients had non-cystic fibrosis bronchiectasis, 2 COPD (1 on long-term oxygen therapy), and 1 patient with Mounier Kuhn's syndrome. Three patients were on azithromycin, 1 on inhaled colistin, and 2 on inhaled tobramycin. Out of the 11 patients, one presented complication (fever), which led to a suspension of therapy (excluded from results). Of the 10 patients who completed treatment, 5 had bacterial colonization and were submitted to a custom vaccine. The remaining 6 completed the standard composition. The average of infectious exacerbations in the previous year was 4.3 (0.7 with hospitalization). In the year after therapy, the mean number was 1.5 (0.5 with hospitalization). CONCLUSION The results obtained in this study favor the use of bacterial immunostimulation to reduce the frequency of RRIs in patients with chronic respiratory disease.


Assuntos
Antibacterianos , Bronquiectasia , Azitromicina , Vacinas Bacterianas , Colistina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA