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1.
Respirar (Ciudad Autón. B. Aires) ; 16(4): 417-420, Dic.2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1580716

RESUMO

El síndrome de Kartagener es una variante de la discinesia ciliar primaria, que consiste en una enfermedad hereditaria autosómica recesiva, poco frecuente, caracterizada por la tríada de bronquiectasias, sinusitis y dextrocardia. En este existen mutaciones en los genes responsables de la síntesis de proteínas ciliares, siendo el deterioro de la motilidad ciliar el principal problema fisiopatológico. Se presenta el caso de una paciente de 14 años de edad quien consulta por tos de tres semanas de evolución sin antecedentes de importancia, a quien como hallazgo incidental se le diagnostica dextrocardia. Por alta sospecha de síndrome de Kartagener, se solicitan estudios complementarios y se realiza broncoscopia que obtiene todos los componentes para un síndrome de Kartagener completo.


Kartagener syndrome is a variant of primary ciliary dyskinesia, which consists of a ra-re, autosomal recessive inherited disease, characterized by the triad of bronchiectasis, sinusitis and dextrocardia. In this case, there are mutations in the genes responsible for ciliary protein, with the deterioration of ciliary motility being the main pathophysiological problem. The case of a 14-year-old patient with a three-week history of cough with no significant history is presented. Dextrocardia was diagnosed as an incidental finding. Due to high suspicion of Kartagener syndrome, complementary studies were requested and bronchoscopy was performed, obtaining all the components for a complete Kartagener syndrome.


Assuntos
Humanos , Feminino , Adolescente , Sinusite , Situs Inversus , Bronquiectasia , Síndrome de Kartagener/diagnóstico , Transtornos da Motilidade Ciliar/congênito , Dextrocardia , Infecções Respiratórias , Biópsia , Broncoscopia , Diagnóstico por Imagem , Técnicas de Laboratório Clínico , Tosse , Guatemala , Doenças Genéticas Inatas/diagnóstico , Infertilidade , Antibacterianos , Mutação/genética
2.
Respirar (Ciudad Autón. B. Aires) ; 16(4): 424-430, Dic.2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1580740

RESUMO

La proteinosis alveolar pulmonar (PAP) es una enfermedad que entra en el gran número de patologías pulmonares intersticiales, con una baja incidencia y prevalencia a nivel mundial. Consiste en un acúmulo de material proteináceo derivado del surfactante que se genera por diferentes causas (primaria, secundaria, congénita y no clasificada), dentro de las cuales la causa autoinmune o primaria es la más frecuente. Su tratamiento de elección es el lavado pulmonar total, con mejoría según el grado de afectación y avance de la enfermedad. En la actualidad, hay nuevas terapias y otras que están en estudio, pero en países en vías de desarrollo muchas veces no se encuentran disponibles. Presentamos el caso de una paciente femenina de 32 años de edad que se presentó en insuficiencia respiratoria tipo 1 y debutando con PAP.


Pulmonary Alveolar Proteinosis (PAP) is a disease that belongs to the large number of interstitial lung pathologies, with a low incidence and prevalence worldwide. It consists of an accumulation of proteinaceous material derived from surfactant, which is generated by different causes (primary, secondary, congenital and unclassified), within which the autoimmune or primary cause is the most frequent. Its treatment of choice is total lung lavage, with improvement depending on the degree of involvement and progression of the disease. Currently, there are new therapies and others that are being studied, but in developing countries they are often not available. We present the case of a 32-year-old female patient who presented with type 1 respiratory failure and debuting with PAP.


Assuntos
Humanos , Feminino , Adulto , Proteinose Alveolar Pulmonar/terapia , Tensoativos , Doenças Pulmonares Intersticiais/diagnóstico , Lavagem Broncoalveolar/métodos , Insuficiência Respiratória , Biópsia , Broncoscopia , Diagnóstico por Imagem , Tosse , Diagnóstico Diferencial , Dispneia , Hemoptise , Honduras
3.
Respirar (Ciudad Autón. B. Aires) ; 16(4): 411-415, Dic.2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1580768

RESUMO

La infestación por Paragonimus spp. clásicamente se da por la ingestión de crustáceos de agua dulce, crudos, poco cocidos o en forma de ceviches. Se presenta el caso de un paciente adulto que conscientemente ingería cangrejos crudos y desarrolló sintomatología pulmonar con tos y disnea, lo cual lo llevó a efectuarse estudios broncoscópicos cuyo resultado citológico del cepillado bronquial fue de adenocarcinoma pulmonar. Se le realizó biopsia pulmonar y la patología fue concluyente de la presencia de huevecillos y formas larvarias de Paragonimus spp., que es una entidad poco frecuente en Guatemala. El paciente recibió tratamiento con prazicuantel y mostró buena res-puesta clínica.


Infestation by Paragonimus spp. classically occurs through the ingestion of freshwater crustaceans, raw, undercooked or in the form of "ceviches". We present the case of an adult patient who consciously ingested raw crabs and developed pulmonary symptoms with cough and dyspnea, which leaded him to undergo bronchoscopic studies, whose cytological result of bronchial brushing was pulmonary adenocarcinoma. A lung biopsy was performed and the pathology was conclusive of the presence of eggs and larval forms of Paragonimus spp., which is a rare entity in Guatemala. Patient received treatment with praziquantel and showed a good clinical response.


Assuntos
Humanos , Masculino , Adulto , Paragonimíase/diagnóstico , Paragonimus/isolamento & purificação , Praziquantel/uso terapêutico , Crustáceos , Neoplasias Pulmonares , Biópsia , Broncoscopia , Diagnóstico por Imagem , Toracotomia , Tosse , Diagnóstico Diferencial , Dispneia , Guatemala
4.
Codas ; 36(6): e20230347, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39417433

RESUMO

PURPOSE: Chronic Cough (CC) is an emerging area of practice in speech language pathology. Behavioral treatment for managing CC has gained attention in the recent past. This study aimed to devise a comprehensive behavioural therapy program for CC by involving allied health professionals (AHPs), who are typically involved in management of CC. METHODS: A qualitative methodology was used to devise a behavioral treatment module for CC. Practice patterns of medical professionals, AHPs and yoga practitioners for CC were gathered through semi-structured interviews. A constant comparative framework was used to recruit participants until data saturation was achieved. The interview transcripts were analyzed to identify relevant components for the module. A post-interview survey was conducted to finalize the module through a consensus-based approach. RESULTS: Three themes and respective sub-themes were identified from analysis. The module was developed based on the treatment strategies followed by professionals and was labeled 'Comprehensive Cough Therapy Program (CCTP)'. This comprised four components - similar to what is available in literature - patient education, breathing exercises, laryngeal hydration, and cough control strategies. This was devised using inputs from the interviews and evidence in the literature. CONCLUSION: In line with global guidelines, this behavioral treatment module can serve as a possible management option for CC.


Assuntos
Tosse , Pesquisa Qualitativa , Humanos , Tosse/terapia , Doença Crônica , Índia , Masculino , Feminino , Pessoal Técnico de Saúde , Terapia Comportamental/métodos , Educação de Pacientes como Assunto , Yoga , Adulto , Exercícios Respiratórios , Entrevistas como Assunto , Tosse Crônica
5.
Belo Horizonte; UFMG/EEFFTO; 1; 20240000. 17 p. ilus.
Não convencional em Português | LILACS, BDENF - Enfermagem, Coleciona SUS | ID: biblio-1579684

RESUMO

O empilhamento de ar é uma técnica realizada com um "AMBU" que vai te permitir encher todo o pulmão de ar. Essa técnica é muito utilizada por pessoas que não conseguem respirar de forma adequada.


Assuntos
Humanos , Respiração Artificial/instrumentação , Insuflação , Pico do Fluxo Expiratório , Capacidade Vital , Guia de Prática Clínica , Tosse , Esclerose Lateral Amiotrófica
6.
Int J Tuberc Lung Dis ; 28(9): 446-453, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39188000

RESUMO

INTRODUCTIONClosing the TB diagnostic gap is an urgent priority, for which non-sputum-based tests are needed. We evaluated the diagnostic accuracy of Aeonose, an exhaled breath test (EBT), as a TB triage test.METHODSPatients with cough or TB risk factors admitted to a tertiary hospital in Lima, Peru, were prospectively enrolled and underwent EBT. We evaluated EBT sensitivity and specificity for diagnosing pulmonary TB using culture and Xpert as primary and secondary reference standards and conducted stratified analyses based on risk factors.RESULTSEBT sensitivity was 85% (95% CI 72.9-93.4), and specificity was 51% (95% CI 46.0-56.6) in the training cohort (n = 417). EBT sensitivity was 70% (95% CI 47.1-86.8), and specificity was 54% (95% CI 44.8-63.6) in the validation cohort (n = 139) using the culture reference standard, with higher sensitivity (78%) when using the Xpert reference standard (n = 156). Sensitivity (60%) and specificity (48%) were lower when patients with prior TB were included. In a subset of participants randomly selected for interviews, 94% (15/16) preferred EBT to sputum-based testing.CONCLUSIONSEBT had moderate sensitivity and low specificity as a TB triage test in this hospitalised cohort with cough or risk factors. Diagnostic accuracy was lower in people with prior TB..


Assuntos
Testes Respiratórios , Tosse , Sensibilidade e Especificidade , Tuberculose Pulmonar , Humanos , Masculino , Feminino , Tosse/diagnóstico , Tosse/etiologia , Pessoa de Meia-Idade , Peru , Adulto , Estudos Prospectivos , Tuberculose Pulmonar/diagnóstico , Fatores de Risco , Triagem , Idoso , Hospitalização , Adulto Jovem , Escarro/microbiologia
7.
Viruses ; 16(7)2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-39066191

RESUMO

Long COVID presents with diverse symptoms after COVID-19. Different clusters of symptoms have been reported; however, their persistence beyond 2 years after COVID-19 remains unclear. In this cohort study, we prospectively evaluated individuals with previous severe COVID-19 presenting with long COVID at a two-year follow-up. We characterized the included patients and performed a cluster analysis of symptoms through multiple correspondence analysis and hierarchical clustering. A total of 199 patients with long COVID were included. The median age was 58 years (48-69), 56% were male, and the median follow-up time since the COVID-19 diagnosis was 26 months (IQR: 25, 27). Three symptom clusters were identified: Cluster 1 is characterized by fatigue, myalgia/arthralgia, a low prevalence of symptoms, and a lack of specific symptoms; Cluster 2 is defined by a high prevalence of fatigue, myalgia/arthralgia, and cardiorespiratory symptoms, including palpitations, shortness of breath, cough, and chest pain; and Cluster 3 is demonstrated a high prevalence of ageusia, anosmia, fatigue, and cardiorespiratory symptoms. Our study reinforces the concept of symptom clustering in long COVID, providing evidence that these clusters may persist beyond two years after a COVID-19 diagnosis. This highlights the chronic and debilitating nature of long COVID and the importance of developing strategies to mitigate symptoms in these patients.


Assuntos
Artralgia , COVID-19 , Fadiga , Mialgia , Síndrome de COVID-19 Pós-Aguda , Sistema de Registros , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/complicações , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , Fadiga/etiologia , Mialgia/etiologia , Mialgia/fisiopatologia , Artralgia/virologia , Artralgia/etiologia , Estudos Prospectivos , Prevalência , Análise por Conglomerados , Ageusia/epidemiologia , Ageusia/etiologia , Ageusia/virologia , Anosmia/epidemiologia , Anosmia/etiologia , Dispneia/fisiopatologia , Dispneia/virologia , Dispneia/etiologia , Seguimentos , Tosse , Fatores de Tempo , Estudos de Coortes
8.
Medicina (Kaunas) ; 60(6)2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38929561

RESUMO

Background and Objectives: Medical and public recognition of "long-COVID or post-COVID syndrome", as well as its impact on the quality of life (QoL), is required to better address the disease burden. Objectives: We aimed to describe the persistence of COVID-19 symptoms and QoL among patients at three and twelve months after their discharge from the hospital. Materials and Methods: We conducted an observational, prospective, and longitudinal analytic study from September 2021 to April 2022. To measure QoL, we used a validated version of the 36-item Short-Form Health Survey (SF-36). Results: We included 68 patients in the study. A total of 54 (79.4%) patients reported at least one persistent symptom at three months vs. 52 (76.4%) at twelve months (p = 0.804). Some persistent symptoms (myalgia, alopecia, and cough) decreased significantly at twelve months (50% vs. 30.9%, 29.4% vs. 13.2%, and 23.5% vs. 7.4%; respectively, p = 0.007); in contrast, other persistent symptoms (sleep-wake and memory disorders) were more frequent (5.9% vs. 32.4% and 4.4% vs. 20.6%; respectively, p = ≤0.001). Regarding QoL, a statistically significant improvement was observed in some scores over time, p = ≤0.037. At twelve months, dyspnea, myalgia, and depression were risk factors associated with a poor physical component summary (PCS), p = ≤0.027, whereas anxiety, depression, and fatigue were associated with a poor mental component summary (MCS), p = ≤0.015. Conclusion: As the proportion of persistent symptoms at twelve months is high, we suggest that patients must continue under long-term follow up to reclassify, diagnose, and treat new onset symptoms/diseases.


Assuntos
COVID-19 , Alta do Paciente , Qualidade de Vida , Humanos , COVID-19/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Longitudinais , Idoso , SARS-CoV-2 , Síndrome de COVID-19 Pós-Aguda , Adulto , Mialgia , Fatores de Tempo , Tosse/psicologia , Alopecia/psicologia
9.
Respirar (Ciudad Autón. B. Aires) ; 16(2): 177-182, Junio 2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1556164

RESUMO

La bronquitis plástica es una enfermedad infrecuente y poco estudiada. Se caracteriza por la obstrucción parcial o total de la vía aérea inferior por moldes o yesos gomosos y firmes, compuestos por múltiples sustancias como fibrina, mucina y otros, que se acumulan en la luz bronquial. En la actualidad, no hay un consenso de la fisiopatología real. Puede presentarse con síntomas leves como tos, sibilancias y disnea, hasta eventos fatales de insuficiencia respiratoria. Se clasifican en tipo I (inflamatorios) y tipo II (acelulares). La presencia de la bronquitis plástica es una complicación de varias enfermedades y está relacionada con procedimientos correctivos de cardiopatías congénitas (procedimiento de Fontan). El diagnóstico se hace a través de la identificación de los yesos bronquiales, ya sea cuando el paciente los expectora o por broncoscopía. Se han utilizado múltiples terapias que solo tienen evidencias anecdóticas. En los últimos años se han observado buenos resultados con el uso de heparinas, así como el alteplasa nebulizado e instilado por broncoscopia.


Plastic bronchitis is a rare and little-studied disease. It is characterized by partial or total obstruction of the lower airway by rubbery and firm molds or plasters, made up of multiple substances that accumulate in the bronchial lumen. Currently, there is no consensus on real pathophysiology. It can present itself with mild symptoms such as cough, wheezing and dyspnea, to fatal events of respiratory failure. They are classified into type I (inflammatory) and type II (acellular). The presence of plastic bronchitis is a complication of several diseases and in corrective procedures for congenital heart disease (Fontan procedure). Diagnosis is made by identifying bronchial casts, either by the patient expectorating them or by bronchoscopy. Multiple therapies have been used that only have anecdotal evidence. In recent years, good results have been observed with the use of heparins and tPA nebulized and instilled by bronchoscop.


Assuntos
Humanos , Feminino , Adulto , Bronquite/diagnóstico , Broncoscopia , Técnica de Fontan , Pneumonia , Insuficiência Respiratória , Choque Séptico , Fibrina , Traqueostomia , Sons Respiratórios , Tosse , Obstrução das Vias Respiratórias/diagnóstico , Dispneia
10.
Respirar (Ciudad Autón. B. Aires) ; 16(2): 183-192, Junio 2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1556174

RESUMO

Se presenta a un paciente con liposarcoma mediastinal gigante con dolor torácico, disnea, cuyos estudios por imágenes revelaban la presencia de una gran tumoración de 42 cm en su diámetro mayor que abarcaba todo el mediastino, comprometía ambas cavidades torácicas, rechazaba los pulmones, corazón y grandes vasos. La biopsia con aguja cortante bajo guía ecográfica fue informada como liposarcoma. El paciente tuvo resección completa del tumor mediante la incisión Clamshell. En el post operatorio inmediato, presentó shock circulatorio más disfunción multiorgánica (DOMS): plaquetopenia, insuficiencia renal aguda con necesidad de soporte dialítico, injuria hepática. El soporte y monitoreo especializado en la Unidad de Cuidados Intensivos (UCI) permitió mejoría clínica y buena evolución. Salió de alta en buenas condiciones.


We present a patient with giant mediastinal liposarcoma with chest pain, dyspnea, whose imaging studies revealed the presence of a large tumor measuring 42 cm in its greatest diameter that covered the entire mediastinum, involved both thoracic cavities, rejected the lungs, heart and big glasses. The sharp needle biopsy under ultrasound guidance was reported as liposarcoma. The patient had complete resection of the tumor through the Clamshell incision. In the immediate postoperative period, he presented circulatory shock plus multiple organ dysfunction (DOMS): plateletopenia, acute renal failure with the need for dialytic support, liver injury. Specialized support and monitoring in the Intensive Care Unit (ICU) allowed clinical improvement and good evolution. He was discharged in good condition.


Assuntos
Humanos , Masculino , Adulto , Toracotomia , Lipossarcoma/cirurgia , Neoplasias do Mediastino/diagnóstico , Choque , Dor no Peito , Tomografia , Tosse , Cuidados Críticos , Tratamento Farmacológico , Dispneia , Biópsia Guiada por Imagem , Insuficiência de Múltiplos Órgãos/cirurgia
11.
Neumol. pediátr. (En línea) ; 19(2): 49-58, jun. 2024. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1566990

RESUMO

La atrofia muscular espinal (AME) 5q es una de las enfermedades neuromusculares de mayor incidencia en la infancia. Sin embargo, la prevalencia de AME tipo 1, su forma más severa de presentación, es menor debido a muertes prematuras evitables antes de los dos años por insuficiencia ventilatoria subtratada. La irrupción de nuevos tratamientos modificadores de la enfermedad pueden cambiar dramáticamente este pronóstico y es una oportunidad para actualizar el manejo respiratorio, a través de cuidados estandarizados básicos, preferentemente no invasivos, abordando la debilidad de los músculos respiratorios, la insuficiencia tusígena y ventilatoria, con un enfoque preventivo. La siguiente revisión literaria entrega estrategias para evitar la intubación y la traqueostomía usando soporte ventilatorio no invasivo (SVN), reclutamiento de volumen pulmonar (RVP) y facilitación de la tos. Se analizan en detalle los protocolos de extubación en niños con AME tipo 1.


Spinal muscular atrophy (SMA) 5q is one of the neuromuscular diseases with the highest incidence in childhood. Nevertheless, the prevalence of its most severe form SMA1 is lower due to premature preventable deaths before two years of age related to ventilatory insufficiency undertreated. The emergence of new disease-modifying treatments can dramatically change this prognosis and is an opportunity to update respiratory management, through basic standardized care, mostly non-invasive, addressing respiratory muscles pump weakness, cough and ventilatory insufficiency with a preventive approach. This literature review provides consensus recommendations for strategies to avoid intubation and tracheostomy using noninvasive ventilatory support (NVS), lung volume recruitment (LVR), and cough facilitation. Extubation protocols in children with SMA type 1 are analyzed in detail.


Assuntos
Humanos , Criança , Atrofia Muscular Espinal/terapia , Insuficiência Respiratória/prevenção & controle , Unidades de Terapia Intensiva Pediátrica , Desmame do Respirador , Tosse , Extubação , Ventilação não Invasiva , Medidas de Volume Pulmonar
12.
Neumol. pediátr. (En línea) ; 19(2): 39-40, jun. 2024.
Artigo em Espanhol | LILACS | ID: biblio-1566976

Assuntos
Humanos , Criança , Tosse
13.
BMC Pulm Med ; 24(1): 218, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38698348

RESUMO

BACKGROUND: Utilizing clinical tests, such as objective cough measurement, can assist in predicting the success of the weaning process in critically ill patients. METHODS: A multicenter observational analytical study was conducted within a prospective cohort of patients recruited to participate in COBRE-US. We assessed the capability of objective cough measurement to predict the success of the spontaneous breathing trial (SBT) and extubation. Intra- and inter-observer reproducibility of the cough test and was evaluated using the intraclass correlation coefficient (ICC) and Cohen's weighted kappa. We used receiver operating characteristic curves (ROC-curve) to evaluate the predictive ability of objective cough measurement. RESULTS: We recruited 367 subjects who were receiving invasive mechanical ventilation. A total of 451 objective cough measurements and 456 SBTs were conducted. A significant association was found between objective cough measurement and successful SBT (OR: 1.68; 95% CI 1.48-1.90; p = 0.001). The predictive capability of the objective cough test for SBT success had a ROC-curve of 0.58 (95% CI: 0.56-0.61). Objective cough measurement to predict successful extubation had a ROC-curve of 0.61 (95% CI: 0.56-0.66). The intraobserver reproducibility exhibited an ICC of 0.94 (95% CI: 0.89-0.96; p < 0.001), while the interobserver reproducibility demonstrated an ICC of 0.72 (95% CI: 0.51-0.85; p < 0.001). The intraobserver agreement, assessed using Cohen's weighted kappa was 0.94 (95% CI: 0.93-0.99; p < 0.001), whereas the interobserver agreement was 0.84 (95% CI: 0.67 - 0.10; p < 0.001). CONCLUSIONS: The objective measurement of cough using the method employed in our study demonstrates nearly perfect intra-observer reproducibility and agreement. However, its ability to predict success or failure in the weaning process is limited.


Assuntos
Extubação , Tosse , Curva ROC , Desmame do Respirador , Humanos , Masculino , Feminino , Desmame do Respirador/métodos , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Estudos Prospectivos , Idoso , Valor Preditivo dos Testes , Respiração Artificial/métodos , Estado Terminal , Adulto
14.
Chem Biodivers ; 21(8): e202400072, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38780224

RESUMO

The traditional use of the M. charantia L. plant to treat coughs, fever and expectoration is widely practiced in different cultures, but its effectiveness and safety still require scientific investigation. This study sought to perform a chemical analysis and evaluate the antitussive, expectorant and antipyretic effects of the ethanolic extract of M. charantia leaves (EEMc) in rats and mice. The EEMc was subjected to chemical analysis by HPLC-DAD, revealing the presence of the flavonoids astragalin and isoquercetin. Acute oral toxicity in mice did not result in deaths, although changes in liver weight and stool consistency were observed. EEMc demonstrated an antitussive effect at doses of 100 and 300 mg/kg in mice subjected to cough induction by citric acid nebulization. Furthermore, it showed expectorant activity at a dose of 300 mg/kg, assessed based on the elimination of the phenol red marker in bronchoalveolar lavage. In the evaluation of antipyretic activity in rats, fever induced by Saccharomyces cerevisiae was reduced at all doses tested during the first hour after treatment. This innovative study identified the presence of astragalin and isoquercetin in EEMc and indicated that the extract has antitussive, expectorant and antipyretic properties. Therefore, EEMc presents itself as a promising option in herbal medicine for the treatment of respiratory symptoms and fever.


Assuntos
Antipiréticos , Antitussígenos , Etanol , Expectorantes , Momordica charantia , Extratos Vegetais , Folhas de Planta , Animais , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Extratos Vegetais/isolamento & purificação , Camundongos , Antitussígenos/farmacologia , Antitussígenos/química , Antitussígenos/isolamento & purificação , Folhas de Planta/química , Ratos , Etanol/química , Antipiréticos/farmacologia , Antipiréticos/química , Antipiréticos/isolamento & purificação , Masculino , Momordica charantia/química , Expectorantes/farmacologia , Expectorantes/isolamento & purificação , Expectorantes/química , Tosse/tratamento farmacológico , Ratos Wistar , Relação Dose-Resposta a Droga , Saccharomyces cerevisiae/efeitos dos fármacos , Febre/tratamento farmacológico
15.
Braz J Otorhinolaryngol ; 90(4): 101424, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38581960

RESUMO

OBJECTIVES: The purpose of this study is to investigate the lung function in Chronic Rhinosinusitis (CRS) patients with Chronic Cough (CC). METHODS: A total of 1413 CC patients were retrospectively screened and 109 CRS patients with CC were enrolled. Lung function, Lund-Mackay Computed Tomography (CT) score, smoking status, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples, and Sino-Nasal Outcome Test were examined. Normal control subjects are also recruited. RESULTS: The Forced Expiratory Volume in 1 second (FEV1.0), Percent Predicted FEV1.0, and FEV1.0/Forced Vital Capacity (FVC) ratio in the patients were significantly low as compared with the control subjects. The FEV1.0/FVC ratio was negatively correlated with the Lund-Mackay CT scores of the patients with a high CT score. CONCLUSIONS: The CRS patients with CC should be investigated with lung function. In addition, the multidisciplinary evaluation including a pulmonologist is needed to manage the CRS patients with CC. LEVEL OF EVIDENCE: Level 4.


Assuntos
Tosse , Rinite , Sinusite , Tomografia Computadorizada por Raios X , Humanos , Sinusite/fisiopatologia , Sinusite/complicações , Masculino , Doença Crônica , Rinite/fisiopatologia , Rinite/complicações , Feminino , Tosse/fisiopatologia , Tosse/etiologia , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Estudos de Casos e Controles , Testes de Função Respiratória , Volume Expiratório Forçado/fisiologia , Capacidade Vital/fisiologia , Idoso , Pulmão/fisiopatologia , Pulmão/diagnóstico por imagem , Adulto Jovem , Imunoglobulina E/sangue , Rinossinusite , Tosse Crônica
16.
BMC Gastroenterol ; 24(1): 127, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575859

RESUMO

BACKGROUND/AIM: London Protocol (LP) and Classification allied to high-resolution manometry (HRM) technological evolution has updated and enhanced the diagnostic armamentarium in anorectal disorders. This study aims to evaluate LP reproducibility under water-perfused HRM, provide normal data and new parameters based on 3D and healthy comparison studies under perfusional HRM. METHODS: Fifty healthy (25 F) underwent water-perfused 36 channel HRM based on LP at resting, squeeze, cough, push, and rectal sensory. Additional 3D manometric parameters were: pressure-volume (PV) 104mmHg2.cm (resting, short and long squeeze, cough); highest and lowest pressure asymmetry (resting, short squeeze, and cough). Complementary parameters (CP) were: resting (mean pressure, functional anal canal length); short squeeze (mean and maximum absolute squeeze pressure), endurance (fatigue rate, fatigue rate index, capacity to sustain); cough (anorectal gradient pressure); push (rectum-anal gradient pressure, anal canal relaxation percent); recto-anal inhibitory reflex (anal canal relaxation percent). RESULTS: No difference to genders: resting (LP, CP, and 3D); short squeeze (highest pressure asymmetry); endurance (CP); cough (CP, highest and lowest pressure asymmetry); push (gradient pressure); rectal sensory. Higher pressure in men: short squeeze (maximum incremental, absolute, and mean pressure, PV, lowest pressure asymmetry); long squeeze (PV); cough (anal canal and rectum maximum pressure, anal canal PV); push (anal canal and rectum maximum pressure). Anal canal relaxation was higher in women (push). CONCLUSIONS: LP reproducibility is feasible under water-perfused HRM, and comparative studies could bring similarity to dataset expansion. Novel 3D parameters need further studies with healthy and larger data to be validated and for disease comparisons. KEY POINTS: • London Protocol and Classification allied with the technological evolution of HRM (software and probes) has refined the diagnostic armamentarium in anorectal disorders. • Novel 3D and deepening the analysis of manometric parameters before the London Classification as a contributory diagnostic tool. • Comparison of healthy volunteers according to the London Protocol under a perfusional high-resolution system could establish equivalence points.


Assuntos
Incontinência Fecal , Doenças Retais , Humanos , Feminino , Masculino , Pressão , Reprodutibilidade dos Testes , Londres , Doenças Retais/diagnóstico , Manometria/métodos , Reto , Canal Anal , Tosse
17.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 85-92, Marzo 2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1551285

RESUMO

El sarcoma folicular de células dendríticas (SFCD) es una neoplasia maligna rara derivada de las células dendríticas foliculares. Ha sido clasificado, dadas sus características inmunohistoquímicas, como parte del grupo de los sarcomas, donde representa un porcentaje menor al 1%. Actualmente, existen menos de 1.000 reportes en la literatura a nivel mundial, lo cual plantea una dificultad no sólo diagnóstica, siendo confundido frecuentemente con neoplasias de tipo linfoide; sino también terapéutica al no existir un claro consenso sobre su manejo definitivo. Esta revisión de caso clínico describe el primer caso reportado de SFCD en Costa Rica.


Follicular dendritic cell sarcoma (SFCD) is a rare malignant neoplasm derived from follicular dendritic cells, which has been classified, given its immunohistochemical characteristics, as part of the group of sarcomas, where it represents less than 1%. Currently, there are less than 1000 reports in the literature worldwide, which generates a difficulty not only in diagnosis, being frequently confused with lymphoid type neoplasms; but also, as therapeutic as there is no clear consensus on its definitive management. This clinical case review describes the first reported case of SFCD in Costa Rica.


Assuntos
Humanos , Feminino , Adulto , Asma/diagnóstico , Tosse/diagnóstico , Sarcoma de Células Dendríticas Foliculares/diagnóstico , Neoplasias do Mediastino/diagnóstico , Obesidade/diagnóstico , Biópsia , Relatos de Casos , Diagnóstico por Imagem , Imuno-Histoquímica , Toracotomia , Costa Rica
18.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 79-83, Marzo 2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1551228

RESUMO

Se presenta el caso de un niño de 3 años con diagnóstico de asma, rinitis alérgica, características craneofaciales dismórficas e infecciones respiratorias altas y bajas recurrentes, manejado como asma desde un inicio. Como parte del estudio de comorbilidades, se decide realizar una prueba del sudor que sale en rango intermedio y más tarde se encuentra una mutación, donde se obtiene un resultado positivo para una copia que se asocia a fibrosis quística. Se revisará el caso, así como el diagnóstico, clínica y tratamiento del síndrome metabólico relacionado con el regulador de conductancia transmembrana de fibrosis quística (CRMS).


We present the case of a 3-year-old boy with a diagnosis of asthma, allergic rhinitis, dysmorphic craniofacial characteristics and recurrent upper and lower respiratory infections, managed as asthma from the beginning. As part of the study of comorbidi-ties, it was decided to carry out a sweat test that came out in the intermediate range and later one mutation was found, where a positive result was obtained for a copy that is associated with cystic fibrosis. The case will be reviewed, as well as the diagnosis, symptoms and treatment of the metabolic syndrome related to the cystic fibrosis trans-membrane conductance regulator (CRMS).


Assuntos
Humanos , Masculino , Pré-Escolar , Asma/diagnóstico , Sons Respiratórios/diagnóstico , Tosse/diagnóstico , Fibrose Cística/diagnóstico , Síndrome Metabólica/diagnóstico , Rinite Alérgica/diagnóstico , Infecções Respiratórias , Radiografia Torácica , Comorbidade , Triagem Neonatal , Regulador de Condutância Transmembrana em Fibrose Cística/genética
19.
BMC Infect Dis ; 24(1): 193, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38350887

RESUMO

BACKGROUND: Omicron has become the dominant variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since first reported in November 2021. From the initially detected Wuhan lineage, sublineages BA.2, BA.4, BA.5, BQ, XAG, and XBB have emerged over time and are dominant in many countries. Therefore, the aim is to evaluate which variants are circulating and the clinical characteristics of inpatients infected with the Omicron variant. METHODS: This retrospective cohort study selected hospitalized patients admitted with respiratory symptoms to a hospital in the state of Rio Grande do Sul, Brazil, between June and July 2022. SARS-CoV-2 results were analyzed together with clinical outcomes and vaccination status. A viral genome library was prepared and forwarded to the Illumina MiSeq Platform for sequencing. RESULTS: In total, 37 genomes were sequenced. Concerning the Omicron sublineages, our study detected: BA.1 (21 K), BA.2 (21 L), BA.4 (22A), BA.5 (22B), BA.2.12.1 (22C), BQ.1 (22E), XBB (22F), and XAG recombinant. Omicron BA.5 (30%), BA.2 (19%), and BQ.1 (19%) were the most frequent sublineages, respectively. In total, 38% of patients present hypertension, and the most common symptoms were coughing (62%). Analyzing the COVID-19 vaccination, 30% of patients were fully vaccinated, 49% had a partial vaccination status, and 21% were unvaccinated (no dose). CONCLUSIONS: BA.5 was the most prevalent sublineage in our study and surpassed the predominance of BA.2, as reported by the national genomic surveillance program. BQ.1 was diagnosed earlier in this study than it was officially reported in the state. Current data have demonstrated that the Omicron variant causes less severe infections, with the high rate of transmissibility and mutational landscape causing the rapid emergence of new sublineages.


Assuntos
Vacinas contra COVID-19 , Pacientes Internados , Humanos , Brasil/epidemiologia , Estudos Retrospectivos , Tosse
20.
Mol Biol Rep ; 51(1): 180, 2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38252233

RESUMO

BACKGROUND: The renin-angiotensin system is potentially involved in the pathogen-host interaction in the disease caused by SARS-CoV-2, since the angiotensin-converting enzyme (ACE) 2 serves as a receptor for the virus. The impact of the pandemic in specific regions and ethnic groups highlights the importance of investigating genetic factors that disrupt the balance of the system in response to SARS-CoV-2 infection, especially in genes with ethnic frequency variations. Therefore, this study aimed to evaluate the influence of the ACE I/D polymorphism on the incidence and severity of COVID-19 in a sample of the Brazilian population. METHODS AND RESULTS: 70 severe cases and 355 mild cases patients were evaluated. DNA extraction was performed using a QIAamp DNA Blood Mini kit. Genotyping of ACE I/D polymorphism was performed. Clinical outcomes were obtained from the patients' records. We found an association between the ACE I/D polymorphism and the incidence or severity of COVID-19 in male participants. Moreover, we observed a relationship between severity and increasing age and body weight and a higher frequency of II genotype individuals among those who had a cough as their symptoms in mild patients. No differences were observed in leukocyte count or other parameters related to the inflammatory response in severe patients. CONCLUSIONS: Our data showed the influence of the ACE I/D polymorphism on severity of COVID-19 in males, as well as on the occurrence of cough in patients with mild symptoms, with a higher incidence in those carrying the I allele.


Assuntos
COVID-19 , Peptidil Dipeptidase A , Humanos , Masculino , Brasil/epidemiologia , Tosse , COVID-19/genética , Peptidil Dipeptidase A/genética , Fatores de Risco , SARS-CoV-2
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