Jornal Brasileiro De Pneumologia最新文献

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Initial insights on vaping-associated illnesses in Colombia: evidence for action 哥伦比亚电子烟相关疾病的初步见解:采取行动的证据

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-20 DOI: 10.36416/1806-3756/e20230130

Jeadran Malagón-Rojas1, Yesith Toloza1, Alvaro J. Idrovo2, Jürg Niederbacher-Velazquez3

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Idiopathic bronchiectasis. What are we talking about? 原发性支气管扩张。我们在说什么?

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-19 DOI: 10.36416/1806-3756/e20230249

Jose Daniel Gómez-Olivas1, Grace Oscullo1, Miguel Ángel Martínez-García1,2

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Questionnaires and risk scores: how to transform research projects into practical tools 问卷调查和风险评分:如何将研究项目转化为实用工具

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-19 DOI: 10.36416/1806-3756/e20230302

Frederico Leon Arrabal Fernandes1

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Effects of air temperature on the risk of death from COPD in major microregions in Brazil: a time series study 气温对巴西主要微地区COPD死亡风险的影响:一项时间序列研究

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-10 DOI: 10.36416/1806-3756/e20220442

Igor Magaton Ribas1, João Pedro Medeiros Gomes¹, Pedro Augusto Rosa Valadares¹, Lucas Santos Jardim¹, Mário Círio Nogueira¹, Cássia de Castro Martins Ferreira2, William Cossich Marcial de Farias3, Letícia de Castro Martins Ferreira1

Objective: To evaluate the association between the risk of death from COPD and air temperature events in ten major Brazilian microregions. Methods: This was a time series analysis of daily COPD deaths and daily mean air temperatures between 1996 and 2017. Using distributed nonlinear lag models, we estimated the cumulative relative risks of COPD mortality for four temperature percentiles (representing moderate and extreme cold and heat events) in relation to a minimum mortality temperature, with a lag of 21 days, in each microregion. Results: Significant associations were found between extreme air temperature events and the risk of death from COPD in the southern and southeastern microregions in Brazil. There was an association of extreme cold and an increased mortality risk in the following microregions: 36% (95% CI, 1.12-1.65), in Porto Alegre; 27% (95% CI, 1.03-1.58), in Curitiba; and 34% (95% CI, 1.19-1.52), in São Paulo; whereas moderate cold was associated with an increased risk of 20% (95% CI, 1.01-1.41), 33% (95% CI, 1.09-1.62), and 24% (95% CI, 1.12-1.38) in the same microregions, respectively. There was an increased COPD mortality risk in the São Paulo and Rio de Janeiro microregions: 17% (95% CI, 1.05-1.31) and 12% (95% CI, 1,02-1,23), respectively, due to moderate heat, and 23% (95% CI, 1,09-1,38) and 32% (95% CI, 1,15-1,50) due to extreme heat. Conclusions: Non-optimal air temperature events were associated with an increased risk of death from COPD in tropical and subtropical areas of Brazil.

目的:评价巴西10个主要微区COPD死亡风险与气温事件的相关性。方法:这是对1996年至2017年间每日COPD死亡人数和每日平均气温的时间序列分析。使用分布式非线性滞后模型，我们估计了四个温度百分位数(代表中度和极端寒冷和炎热事件)与最低死亡温度相关的慢性阻塞性肺病死亡率的累积相对风险，滞后21天，在每个微区域。结果:在巴西南部和东南部微地区，极端气温事件与COPD死亡风险之间存在显著关联。在以下微区，极端寒冷与死亡风险增加存在关联:阿雷格里港36% (95% CI, 1.12-1.65);库里提巴27% (95% CI, 1.03-1.58);在圣保罗;34% (95% CI, 1.19-1.52);而在相同的微区，中度寒冷与风险分别增加20% (95% CI, 1.01-1.41)、33% (95% CI, 1.09-1.62)和24% (95% CI, 1.12-1.38)相关。在圣保罗和里约热内卢微区，慢性阻塞性肺病死亡风险增加:中度高温分别为17% (95% CI, 1.05-1.31)和12% (95% CI, 1,02-1,23)，极端高温分别为23% (95% CI, 1,09-1,38)和32% (95% CI, 1,15-1,50)。结论:在巴西热带和亚热带地区，非最佳气温事件与COPD死亡风险增加相关。

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The role of the pulmonary function laboratory to assist in disease management: Asthma. 肺功能实验室在疾病管理中的作用：哮喘。

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-09-18 DOI: 10.36416/1806-3756/e20230236

José Alberto Neder, Danilo Cortozi Berton, Denis E O'Donnell

Asthma is a heterogeneous, chronic airway inflammatory disease in which pulmonary function tests (PFTs) might provide valuable information for diagnosis, assessment of clinical control

引用次数: 0

Effect of vaccination on COVID-19 hospitalizations and mortality. 接种疫苗对新冠肺炎住院和死亡率的影响。

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-09-18 DOI: 10.36416/1806-3756/e20230254

Fábio Fernandes Dantas Filho, Karen Gomes D'Ávila, Denise Rossato Silva

1. Hospital de Clínicas de Porto Alegre, Porto Alegre (RS) Brasil. 2. Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul – UFRGS – Porto Alegre (RS) Brasil. 3. Faculdade de Medicina, Universidade do Vale do Rio dos Sinos – Unisinos – São Leopoldo (RS) Brasil. 4. Faculdade de Medicina, Universidade Federal do Rio Grande do Sul –UFRGS – Porto Alegre (RS) Brasil. COVID-19, caused by SARS-CoV-2, has spread worldwide since December of 2019, causing significant morbidity and mortality. As of July 26, 2023, a total of 768,560,727 cases of COVID-19 had been confirmed worldwide, including 6,952,522 deaths. In Brazil, from January 3, 2020 to July 26, 2023, there were 37,704,598 confirmed COVID-19 cases and 704,488 COVID-19 deaths reported to the WHO.(1)

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Dealing with confounding in observational studies. 处理观察性研究中的混淆。

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-09-18 DOI: 10.36416/1806-3756/e20230281

Cristiane Fumo-Dos-Santos, Juliana Carvalho Ferreira

it is a cause of the outcome, and it is not in the causal pathway between the main exposure and the outcome of interest. In B, obesity is a confounder in the relation between asthma and lung function since obesity may worsen asthma and may cause a reduction in lung function. Adjusting for obesity is advised in this scenario. In C, the model represents a mediation effect —obstructive sleep apnea may lead to cardiovascular disease (direct effect), but obstructive sleep apnea may also lead to high blood pressure, which causes cardiovascular disease (indirect effect). In this case, adjusting for high blood pressure is not appropriate

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Factors associated with pulmonary infection in kidney and kidney-pancreas transplant recipients: a case-control study. 肾和肾胰腺移植受者肺部感染的相关因素：一项病例对照研究。

IF 2.9 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-09-15 eCollection Date: 2023-01-01 DOI: 10.36416/1806-3756/e20220419

Leonardo Meira de Faria, Vandack Nobre, Letícia Ribeiro de Oliveira Guardão, Camila Magalhães Souza, Amanda Damasceno de Souza, Deborah Dos Reis Estrella, Bruno Porto Pessoa, Ricardo Amorim Corrêa

Objective: To evaluate the etiology of and factors associated with pulmonary infection in kidney and kidney-pancreas transplant recipients.

Methods: This was a single-center case-control study conducted between December of 2017 and March of 2020 at a referral center for kidney transplantation in the city of Belo Horizonte, Brazil. The case:control ratio was 1:1.8. Cases included kidney or kidney-pancreas transplant recipients hospitalized with pulmonary infection. Controls included kidney or kidney-pancreas transplant recipients without pulmonary infection and matched to cases for sex, age group, and donor type (living or deceased).

Results: A total of 197 patients were included in the study. Of those, 70 were cases and 127 were controls. The mean age was 55 years (for cases) and 53 years (for controls), with a predominance of males. Corticosteroid use, bronchiectasis, and being overweight were associated with pulmonary infection risk in the multivariate logistic regression model. The most common etiologic agent of infection was cytomegalovirus (in 14.3% of the cases), followed by Mycobacterium tuberculosis (in 10%), Histoplasma capsulatum (in 7.1%), and Pseudomonas aeruginosa (in 7.1%).

Conclusions: Corticosteroid use, bronchiectasis, and being overweight appear to be risk factors for pulmonary infection in kidney/kidney-pancreas transplant recipients, endemic mycoses being prevalent in this population. Appropriate planning and follow-up play an important role in identifying kidney and kidney-pancreas transplant recipients at risk of pulmonary infection.

目的：探讨肾胰腺移植受者肺部感染的病因及相关因素。方法：这是一项单中心病例对照研究，于2017年12月至2020年3月在巴西贝洛奥里藏特市的肾移植转诊中心进行。病例与对照组的比例为1:1.8。病例包括因肺部感染住院的肾或肾胰腺移植受者。对照组包括没有肺部感染的肾或肾胰腺移植受者，并根据性别、年龄组和供体类型（活的或死的）与病例相匹配。结果：共有197名患者被纳入研究。其中70例为病例，127例为对照组。平均年龄为55岁（病例）和53岁（对照组），其中男性占多数。在多变量逻辑回归模型中，皮质类固醇的使用、支气管扩张和超重与肺部感染风险相关。感染最常见的病原体是巨细胞病毒（14.3%的病例），其次是结核分枝杆菌（10%）、荚膜组织浆体（7.1%）和铜绿假单胞菌（7.1%，地方性真菌病在该人群中流行。适当的计划和随访在识别有肺部感染风险的肾和肾胰腺移植受者方面发挥着重要作用。

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引用次数: 0

"Post-tuberculosis financial disease"-we need to face it to eliminate tuberculosis. “后结核病金融病”——我们需要面对它来消灭结核病。

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-09-15 DOI: 10.36416/1806-3756/e20230253

Ana Paula Santos, Fernanda Carvalho de Queiroz Mello

1. Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ) Brasil. 2. Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil. In the study by Loureiro et al.,(1) published in this issue of the Jornal Brasileiro de Pneumologia, the authors studied the economic burden on the household during the follow-up of patients after tuberculosis diagnosis and treatment in five Brazilian capitals. They concluded that “participants incurred economic losses in the pre-diagnosis period and severe loss of income in the post-diagnosis period,”, which resulted in unemployment and social sequelae caused by tuberculosis.

引用次数: 0

Predictors of prolonged ventilator weaning and mortality in critically ill patients with COVID-19. 新冠肺炎危重患者长期停用呼吸机和死亡率的预测因素。

IF 2.9 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-09-15 eCollection Date: 2023-01-01 DOI: 10.36416/1806-3756/e20230131

Marcella M Musumeci, Bruno Valle Pinheiro, Luciana Dias Chiavegato, Danielle Silva Almeida Phillip, Flavia R Machado, Fabrício Freires, Osvaldo Shigueomi Beppu, Jaquelina Sonoe Ota Arakaki, Roberta Pulcheri Ramos

Objective: To identify factors associated with prolonged weaning and mortality in critically ill COVID-19 patients admitted to ICUs and under invasive mechanical ventilation.

Methods: Between March of 2020 and July of 2021, we retrospectively recorded clinical and ventilatory characteristics of critically ill COVID-19 patients from the day of intubation to the outcome. We classified the patients regarding the weaning period in accordance with established criteria. A logistic regression analysis was performed to identify variables associated with prolonged weaning and mortality.

Results: The study involved 303 patients, 100 of whom (33.0%) had a prolonged weaning period. Most of the patients were male (69.6%), 136 (44.8%) had more than 50% of pulmonary involvement on chest CT, and 93 (30.6%) had severe ARDS. Within the prolonged weaning group, 62% died within 60 days. Multivariate analysis revealed that lung involvement greater than 50% on CT and delay from intubation to the first separation attempt from mechanical ventilation were significantly associated with prolonged weaning, whereas age and prolonged weaning were significantly associated with mortality.

Conclusions: Prolonged weaning can be used as a milestone in predicting mortality in critically ill COVID-19 patients. Lung involvement greater than 50% on CT and delay from intubation to the first separation attempt from mechanical ventilation were identified as significant predictors of prolonged weaning. These results might provide valuable information for healthcare professionals when making clinical decisions regarding the management of critically ill COVID-19 patients who are on mechanical ventilation.

目的：确定入住ICU并接受有创机械通气的危重新冠肺炎患者断奶时间延长和死亡率的相关因素。方法：在2020年3月至2021年7月期间，我们回顾性记录了危重新冠肺炎患者从插管当天到结果的临床和通气特征。我们根据既定标准对患者的断奶期进行了分类。进行逻辑回归分析，以确定与断奶时间延长和死亡率相关的变量。结果：该研究涉及303名患者，其中100人（33.0%）断奶期延长。大多数患者是男性（69.6%），136例（44.8%）在胸部CT上肺部受累超过50%，93例（30.6%）患有严重ARDS。在长期断奶组中，62%在60天内死亡。多因素分析显示，CT显示肺部受累超过50%，从插管到第一次尝试脱离机械通气的延迟与断奶时间延长显著相关，而年龄和断奶时间延长与死亡率显著相关。结论：延长断奶时间可作为预测危重新冠肺炎患者死亡率的里程碑。CT检查中肺部受累超过50%以及从插管到首次尝试机械通气分离的延迟被确定为延长断奶的重要预测因素。这些结果可能会为医疗保健专业人员在做出有关机械通气重症新冠肺炎患者管理的临床决策时提供有价值的信息。

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