Jornal Brasileiro De Pneumologia最新文献

英文中文

Effectiveness of wearing masks during the COVID-19 outbreak in cohort and case-control studies: a systematic review and meta-analysis 队列和病例对照研究中 COVID-19 爆发期间佩戴口罩的效果：系统回顾和荟萃分析

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-11-16 DOI: 10.36416/1806-3756/e20230003

Idevaldo Floriano1, Antônio Silvinato1,2, Hélio Arthur Bacha3, Alexandre Naime Barbosa4, Suzana Tanni5, Wanderley Marques Bernardo2,6

ABSTRACT Objective: To evaluate the efficacy of wearing a mask to prevent COVID-19 infection. Methods: This was a systematic review and meta-analysis of cohort and case-control studies, considering the best level of evidence available. Electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Clinical Trials.gov) were searched to identify studies that evaluated the effectiveness of wearing masks compared with that of not wearing them during the COVID-19 pandemic. Risk of bias and quality of evidence were assessed using the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development, and Evaluation. Results: Of the 1,028 studies identified, 9 met the inclusion criteria (2 cohort studies and 7 case-control studies) and were included in the analysis. The meta-analysis using cohort studies alone showed statistically significant differences, wearing a cloth mask decreased by 21% [RD = −0.21 (95% CI, −0.34 to −0.07); I2 = 0%; p = 0,002] the risk of COVID-19 infection, but the quality of evidence was low. Regarding case-control studies, wearing a surgical mask reduced the chance of COVID-19 infection [OR = 0.51 (95% CI, 0.37-0.70); I2 = 47%; p = 0.0001], as did wearing an N95 respirator mask [OR = 0.31 (95% CI, 0.20-0.49); I2 = 0%; p = 0.00001], both with low quality of evidence. Conclusions: In this systematic review with meta-analysis, we showed the effectiveness of wearing masks in the prevention of SARS-CoV-2 infection regardless of the type of mask (disposable surgical mask, common masks, including cloth masks, or N95 respirators), although the studies evaluated presented with low quality of evidence and important biases.

摘要目的评估佩戴口罩预防 COVID-19 感染的效果。方法：这是对队列研究和病例对照研究进行的系统回顾和荟萃分析，考虑了现有的最佳证据水平。我们检索了电子数据库（MEDLINE、EMBASE、Cochrane Central Register of Controlled Trials 和 Clinical Trials.gov），以确定在 COVID-19 大流行期间评估戴口罩与不戴口罩效果的研究。使用 Cochrane 的偏倚风险工具和建议评估、制定和评价分级法对偏倚风险和证据质量进行了评估。结果：在已确定的 1,028 项研究中，有 9 项符合纳入标准（2 项队列研究和 7 项病例对照研究）并被纳入分析。仅使用队列研究进行的荟萃分析表明，戴布口罩可将 COVID-19 感染风险降低 21% [RD = -0.21 (95% CI, -0.34 to -0.07)；I2 = 0%；p = 0,002]，差异具有统计学意义，但证据质量较低。在病例对照研究中，佩戴外科口罩可降低 COVID-19 感染的几率[OR = 0.51 (95% CI, 0.37-0.70); I2 = 47%; p = 0.0001]，佩戴 N95 呼吸器口罩也可降低 COVID-19 感染的几率[OR = 0.31 (95% CI, 0.20-0.49); I2 = 0%; p = 0.00001]，这两项研究的证据质量均较低。结论在这项系统综述和荟萃分析中，我们发现，无论口罩的类型（一次性外科口罩、普通口罩（包括布制口罩）或 N95 呼吸器）如何，戴口罩在预防 SARS-CoV-2 感染方面都是有效的，尽管所评估的研究证据质量不高且存在重要偏差。

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引用次数: 0

Use of elexacaftor+tezacaftor+ivacaftor in individuals with cystic fibrosis and at least one F508del allele: a systematic review and meta-analysis 在患有囊性纤维化且至少有一个 F508del 等位基因的个体中使用 elexacaftor+tezacaftor+ivacaftor: 系统综述和荟萃分析

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-11-16 DOI: 10.36416/1806-3756/e20230187

Luiz Vicente Ribeiro Ferreira da Silva Filho1, Rodrigo Abensur Athanazio2, Carolina Rodrigues Tonon3, Juliana Carvalho Ferreira2, Suzana Erico Tanni3

ABSTRACT Objective: To evaluate the effect of treatment with the combination of three cystic fibrosis transmembrane conductance regulator (CFTR) modulators-elexacaftor+tezacaftor+ivacaftor (ETI)-on important clinical endpoints in individuals with cystic fibrosis. Methods: This was a systematic review and meta-analysis of randomized clinical trials that compared the use of ETI in individuals with CF and at least one F508del allele with that of placebo or with an active comparator such as other combinations of CFTR modulators, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and the Patients of interest, Intervention to be studied, Comparison of interventions, and Outcome of interest (PICO) methodology. We searched the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from their inception to December 26th, 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool, and the quality of evidence was based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: We retrieved 54 studies in the primary search. Of these, 6 met the inclusion criteria and were analyzed (1,127 patients; 577 and 550 in the intervention and control groups, respectively). The meta-analysis revealed that the use of ETI increased FEV1% [risk difference (RD), +10.47%; 95% CI, 6.88-14.06], reduced the number of acute pulmonary exacerbations (RD, −0.16; 95% CI, −0.28 to −0.04), and improved quality of life (RD, +14.93; 95% CI, 9.98-19.89) and BMI (RD, +1.07 kg/m2; 95% CI, 0.90-1.25). Adverse events did not differ between groups (RD, −0.03; 95% CI, −0.08 to 0.01), and none of the studies reported deaths. Conclusions: Our findings demonstrate that ETI treatment substantially improves clinically significant, patient-centered outcomes.

摘要目的评估三种囊性纤维化跨膜传导调节剂（CFTR）调节剂--lexacaftor+tezacaftor+ivacaftor（ETI）--的联合治疗对囊性纤维化患者重要临床终点的影响。研究方法这是一项系统性综述和荟萃分析，按照系统性综述和荟萃分析首选报告项目（PRISMA）建议和 "感兴趣的患者"、"待研究的干预措施"、"干预措施的比较 "和 "感兴趣的结果"（PICO）方法，比较了在患有囊性纤维化且至少有一个 F508del 等位基因的患者中使用 ETI 与安慰剂或活性比较物（如其他 CFTR 调节剂组合）的随机临床试验。我们检索了以下数据库：MEDLINE、EMBASE、Cochrane Central Register of Controlled Trials、ClinicalTrials.gov（从开始到 2022 年 12 月 26 日）。偏倚风险采用 Cochrane 偏倚风险工具进行评估，证据质量采用建议评估、发展和评价分级法（GRADE）。结果我们在主要搜索中检索到 54 项研究。其中，6 项符合纳入标准并进行了分析（1,127 名患者；干预组和对照组分别为 577 人和 550 人）。荟萃分析表明，使用 ETI 可提高 FEV1% [风险差异 (RD)，+10.47%；95% CI，6.88-14.06]，减少急性肺部恶化次数（RD，-0.16；95% CI，-0.28--0.04），改善生活质量（RD，+14.93；95% CI，9.98-19.89）和 BMI（RD，+1.07 kg/m2；95% CI，0.90-1.25）。不良事件在不同组间没有差异（RD，-0.03；95% CI，-0.08 至 0.01），没有一项研究报告死亡病例。结论：我们的研究结果表明，ETI 治疗可显著改善以患者为中心的临床效果。

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引用次数: 0

Radon exposure: a major cause of lung cancer in nonsmokers 氡暴露:非吸烟者患肺癌的主要原因

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-11-14 DOI: 10.36416/1806-3756/e20230210

Marilyn Urrutia-Pereira1, José Miguel Chatkin2, Herberto José Chong-Neto3, Dirceu Solé4

Exposure to radon can impact human health. This is a nonsystematic review of articles written in English, Spanish, French, or Portuguese published in the last decade (2013-2023), using databases such as PubMed, Google Scholar, EMBASE, and SciELO. Search terms selected were radon, human health, respiratory diseases, children, and adults. After analyzing the titles and abstracts, the researchers initially identified 47 studies, which were subsequently reduced to 40 after excluding reviews, dissertations, theses, and case-control studies. The studies have shown that enclosed environments such as residences and workplaces have higher levels of radon than those outdoors. Moreover, radon is one of the leading causes of lung cancer, especially in nonsmokers. An association between exposure to radon and development of other lung diseases, such as asthma and COPD, was also observed. It is crucial to increase public awareness and implement governmental control measures to reduce radon exposure. It is essential to quantify radon levels in all types of buildings and train professionals to conduct such measurements according to proven efficacy standards. Health care professionals should also be informed about this threat and receive adequate training to deal with the effects of radon on human health.

接触氡会影响人体健康。这是对过去十年(2013-2023)以英语、西班牙语、法语或葡萄牙语发表的文章的非系统综述，使用PubMed、Google Scholar、EMBASE和SciELO等数据库。选定的搜索词是氡、人类健康、呼吸系统疾病、儿童和成人。在分析了标题和摘要后，研究人员最初确定了47项研究，随后在排除综述、论文、论文和病例对照研究后减少到40项。研究表明，住宅和工作场所等封闭环境的氡含量高于室外环境。此外，氡是导致肺癌的主要原因之一，尤其是在不吸烟者中。还观察到暴露于氡与哮喘和慢性阻塞性肺病等其他肺部疾病的发生之间存在关联。提高公众意识和实施政府控制措施以减少氡暴露是至关重要的。必须量化所有类型建筑物中的氡水平，并培训专业人员根据已证实的功效标准进行此类测量。卫生保健专业人员也应了解这一威胁，并接受适当的培训，以处理氡对人体健康的影响。

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引用次数: 0

COVID-19: clinical factors associated with functional capacity of hospitalized patients at admission and discharge COVID-19:与住院患者入院和出院时功能能力相关的临床因素

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-11-14 DOI: 10.36416/1806-3756/e20230121

Raiany Franca Guimarães1, Marcela Cangussu Barbalho-Moulim1, Veronica Lourenço Wittmer1, Lais Mello Serafim1, Elizângela Kuster1, Jenaine Rosa Godinho Emiliano2, Juliana Baroni Cordeiro2, Michele Coutinho Maia da Silva2, Rozy Tozetti Lima2, Juliana Zangirolami-Raimundo3, Rodrigo Daminello Raimundo3, Luiz Carlos Abreu1, Flavia Marini Paro1

引用次数: 0

Not everything is disease progression—increased fluorodeoxyglucose uptake secondary to diaphragmatic paralysis 并非所有症状都是疾病进展——继发于膈肌麻痹的氟脱氧葡萄糖摄取增加

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-11-10 DOI: 10.36416/1806-3756/e20230324

Felipe Marques da Costa1, Augusto Kreling Medeiros2, Marcos Aurélio Fonseca Magalhães Filho3

引用次数: 0

Management and prognosis of malignant pleural effusions managed with indwelling pleural catheters 胸腔留置导尿管治疗恶性胸腔积液的处理及预后

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-11-10 DOI: 10.36416/1806-3756/e20230225

M Martins1, M Serino1, F Viana-Machado1, H Novais-Bastos1,2

引用次数: 0

Mobile health applications designed for self-management of chronic pulmonary diseases in children and adolescents: a systematic mapping review. 为儿童和青少年慢性肺病自我管理而设计的移动健康应用程序：一项系统绘图综述。

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-30 eCollection Date: 2023-01-01 DOI: 10.36416/1806-3756/e20230201

Vaia Sapouna, Pavlos Kitixis, Elpiniki Petrou, Theano Michailidou, Panagiotis Dalamarinis, Eleni Kortianou

Objective: Mobile health (mHealth) applications are scarce for children and adolescents with chronic pulmonary diseases (CPDs). This study aimed to map and describe the contents of the mHealth apps available for use in children and adolescents with CPDs.

Methods: We performed a systematic mapping review of published scientific literature in PubMed, Scopus, and Cochrane Library by February of 2023, using relevant keywords. Inclusion criteria were as follows: children aged < 18 years with CPDs; and studies published in English on mHealth apps.

Results: A total number of 353 studies were found, 9 of which met the inclusion criteria. These studies described seven mHealth apps for Android and iOS, designed either for asthma (n = 5) or for cystic fibrosis (n = 2). Five content areas were identified: education/information; pharmacological treatment; emergency; support; and non-pharmacological treatment. The studies (4, 2, and 3, respectively) showed consistent findings using qualitative, quantitative, and mixed methodologies.

Conclusions: This mapping review provided a guided selection of the most appropriate mHealth apps for use in children and adolescents with CPDs based on the needs of each target population. However, these mHealth apps have limited capabilities to reinforce disease self-management and provide information related to treatment compliance.

目的：移动健康（mHealth）在患有慢性肺病（CPD）的儿童和青少年中的应用很少。本研究旨在绘制和描述可用于CPD儿童和青少年的mHealth应用程序的内容。方法：我们使用相关关键词，对截至2023年2月在PubMed、Scopus和Cochrane图书馆发表的科学文献进行了系统的制图审查。纳入标准如下：18岁以下CPD儿童；以及在mHealth应用程序上以英语发表的研究。结果：共发现353项研究，其中9项符合纳入标准。这些研究描述了七款适用于Android和iOS的mHealth应用程序，它们要么是为哮喘（n=5）设计的，要么是为囊性纤维化（n=2）设计的。确定了五个内容领域：教育/信息；药物治疗；突发事件支持以及非药物治疗。研究（分别为4、2和3）使用定性、定量和混合方法显示出一致的结果。结论：本次绘图审查根据每个目标人群的需求，提供了最适合CPD儿童和青少年使用的mHealth应用程序的指导选择。然而，这些mHealth应用程序在加强疾病自我管理和提供与治疗依从性相关的信息方面的能力有限。

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引用次数: 0

Pulmonary hypertension. 肺动脉高压。

IF 2.7 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-30 DOI: 10.36416/1806-3756/e20230275

Edson Marchiori, Bruno Hochhegger, Gláucia Zanetti

引用次数: 0

Sleep parameters in patients with chronic hypersensitivity pneumonitis: a case-control study. 慢性超敏性肺炎患者的睡眠参数:一项病例对照研究

IF 2.9 4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-30 eCollection Date: 2023-01-01 DOI: 10.36416/1806-3756/e20230036

Rafaela Boaventura Martins, Lia Rita Azeredo Bittencourt, André Bezerra Botelho, Ana Carolina Lima Resende, Paula Silva Gomes, Sergio Tufik, Simone Lobo Krupok Matias, Maria Raquel Soares, Carlos Alberto de Castro Pereira

Objective: To compare patients with chronic hypersensitivity pneumonitis (cHP) and controls with normal spirometry in terms of their sleep characteristics, as well as to establish the prevalence of obstructive sleep apnea (OSA) and nocturnal hypoxemia. Secondary objectives were to identify factors associated with OSA and nocturnal hypoxemia; to correlate nocturnal hypoxemia with the apnea-hypopnea index (AHI) and lung function, as well as with resting SpO2, awake SpO2, and SpO2 during exercise; and to evaluate the discriminatory power of sleep questionnaires to predict OSA.

Methods: A total of 40 patients with cHP (cases) were matched for sex, age, and BMI with 80 controls, the ratio of controls to cases therefore being = 2:1. The STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index, the Berlin questionnaire and the Neck circumference, obesity, Snoring, Age, and Sex (NoSAS) score were applied to all cases, and both groups underwent full-night polysomnography.

Results: The patients with cHP had longer sleep latency, lower sleep efficiency, a lower AHI, a lower respiratory disturbance index, fewer central apneas, fewer mixed apneas, and fewer hypopneas than did the controls. The patients with cHP had significantly lower nocturnal SpO2 values, the percentage of total sleep time spent below an SpO2 of 90% being higher than in controls (median = 4.2; IQR, 0.4-32.1 vs. median = 1.0; IQR, 0.1-5.8; p = 0.01). There were no significant differences between cases with and without OSA regarding the STOP-Bang questionnaire, NoSAS, and ESS scores.

Conclusions: The prevalence of OSA in cHP patients (cases) was high, although not higher than that in controls with normal spirometry. In addition, cases had more hypoxemia during sleep than did controls. Our results suggest that sleep questionnaires do not have sufficient discriminatory power to identify OSA in cHP patients.

目的：比较慢性超敏性肺炎（cHP）患者和正常肺活量测定的对照组的睡眠特征，并确定阻塞性睡眠呼吸暂停（OSA）和夜间低氧血症的患病率。次要目的是确定OSA和夜间低氧血症的相关因素；将夜间低氧血症与呼吸暂停低通气指数（AHI）和肺功能以及运动期间的静息SpO2、清醒SpO2和SpO2相关；并评估睡眠问卷预测OSA的辨别力。方法：共有40例cHP患者（例）在性别、年龄和BMI方面与80名对照组相匹配，因此对照组与病例的比例为2:1。所有病例均采用STOP-Bang问卷、Epworth睡眠量表（ESS）、匹兹堡睡眠质量指数、柏林问卷和颈围、肥胖、打鼾、年龄和性别（NoSAS）评分，两组均进行了通宵多导睡眠图检查。结果：与对照组相比，cHP患者的睡眠潜伏期更长，睡眠效率更低，AHI更低，呼吸紊乱指数更低，中心性呼吸暂停次数更少，混合性呼吸暂停更少，低通气次数更少。cHP患者的夜间SpO2值明显较低，SpO2低于90%的总睡眠时间百分比高于对照组（中位数=4.2；IQR，0.4-32.1 vs.中位数=1.0；IQR为0.1-5.8；p=0.01）。OSA患者和非OSA患者在STOP Bang问卷、NoSAS和ESS评分方面没有显著差异。结论：慢性阻塞性睡眠呼吸暂停综合征患者OSA的患病率较高，但并不高于肺活量正常的对照组。此外，病例在睡眠中出现的低氧血症比对照组多。我们的研究结果表明，睡眠问卷没有足够的辨别力来识别cHP患者的OSA。

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引用次数: 0

Changes in lung function in adolescents with substance use disorders: an exploratory study 青少年物质使用障碍患者肺功能的改变:一项探索性研究

4区医学 Q2 RESPIRATORY SYSTEM

Jornal Brasileiro De Pneumologia

Pub Date : 2023-10-30 DOI: 10.36416/1806-3756/e20230274

Daniela Benvenutti Kaiber1, João Henrique Chrusciel1, Maiara Martins1, Bernardo Mattos1, Miguel Gomes1, Luis Eduardo Wearick-Silva2, Márcio Vinícius Fagundes Donadio3,4, Frederico Friedrich1,5, Marcus Herbert Jones1,5, Thiago Wendt Viola1

Objective: To compare lung function between adolescents with and without substance use disorder (SUD). Methods: This was an observational, cross-sectional exploratory study. The sample consisted of 16 adolescents with SUD and 24 age-matched healthy controls. The adolescents in the clinical group were recruited from a psychiatric inpatient unit for detoxification and rehabilitation; their primary diagnosis was SUD related to marijuana, cocaine, or polysubstance use. Questionnaires and pulmonary function tests were applied for clinical evaluation. Results: We found that FVC, FEV1, and their percentages of the predicted values were significantly lower in the adolescents with SUD than in those without. Those differences remained significant after adjustment for BMI and the effects of high levels of physical activity. The largest effect size (Cohen's d = 1.82) was found for FVC as a percentage of the predicted value (FVC%), which was, on average, 17.95% lower in the SUD group. In addition, the years of regular use of smoked substances (tobacco, marijuana, and crack cocaine) correlated negatively with the FVC%. Conclusions: This exploratory study is innovative in that it demonstrates the early consequences of smoked substance use for the lung health of adolescents with SUD.

目的:比较青少年物质使用障碍(SUD)患者与非患者肺功能的差异。方法:这是一项观察性、横断面探索性研究。样本包括16名患有SUD的青少年和24名年龄匹配的健康对照。临床组的青少年来自精神科住院单位进行戒毒和康复;他们的初步诊断是与大麻、可卡因或多种物质使用有关的SUD。采用问卷调查和肺功能试验进行临床评价。结果:我们发现患有SUD的青少年FVC、FEV1及其预测值的百分比明显低于未患有SUD的青少年。在调整BMI和高水平体育活动的影响后，这些差异仍然显著。最大的效应量(Cohen’s d = 1.82)是FVC占预测值(FVC%)的百分比，在SUD组中平均低17.95%。此外，经常使用吸烟物质(烟草、大麻和快克可卡因)的年数与FVC%呈负相关。结论:这项探索性研究的创新之处在于它证明了吸烟物质使用对患有SUD的青少年肺部健康的早期后果。

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