Objective: To evaluate cognitive learning, ability to perform and interpret lung ultrasound exams, and self-perception of learning among medical students after a short pedagogical intervention at a medical school in Brazil.
Methods: An experimental pilot study was conducted with medical students at different stages of their education (basic cycle, clinical cycle, and medical internship). The participants underwent a cognitive test before and after the intervention, a practical test, a test to recognize lung ultrasound pathologies, and a qualitative evaluation test at the end of the intervention. Statistical analysis was performed using a significance level of p < 0.05.
Results: A total of 42 students were included in the study, with a median age of 23 years and a predominance of males. The mean score of the pre-intervention cognitive test was 2.97 ± 0.87, and that of the post-intervention test was 6.57 ± 1.41, showing significant improvement (p < 0.001). The score of the practical test and that of the recognition of pathologies test also showed significant improvement after the intervention. There was no significant difference in execution time between the groups. Students in the clinical cycle had a better self-perception of learning.
Conclusions: Theoretical teaching and practical training of lung ultrasound in a short pedagogical intervention can improve cognitive performance, practical skills, and interpretation of the exam. The level of learning achievement was higher among more advanced students in medical education. Additionally, the students in the clinical cycle had a better perception of their learning.
{"title":"Lung ultrasound teaching in medical education: a pilot study at a Brazilian medical school.","authors":"Gabrielle Turnes Pereira Demetrio, Ana Cristina Burigo Grumann, Mariângela Pimentel Pincelli, Leonardo Jonck Staub","doi":"10.36416/1806-3756/e20230382","DOIUrl":"10.36416/1806-3756/e20230382","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate cognitive learning, ability to perform and interpret lung ultrasound exams, and self-perception of learning among medical students after a short pedagogical intervention at a medical school in Brazil.</p><p><strong>Methods: </strong>An experimental pilot study was conducted with medical students at different stages of their education (basic cycle, clinical cycle, and medical internship). The participants underwent a cognitive test before and after the intervention, a practical test, a test to recognize lung ultrasound pathologies, and a qualitative evaluation test at the end of the intervention. Statistical analysis was performed using a significance level of p < 0.05.</p><p><strong>Results: </strong>A total of 42 students were included in the study, with a median age of 23 years and a predominance of males. The mean score of the pre-intervention cognitive test was 2.97 ± 0.87, and that of the post-intervention test was 6.57 ± 1.41, showing significant improvement (p < 0.001). The score of the practical test and that of the recognition of pathologies test also showed significant improvement after the intervention. There was no significant difference in execution time between the groups. Students in the clinical cycle had a better self-perception of learning.</p><p><strong>Conclusions: </strong>Theoretical teaching and practical training of lung ultrasound in a short pedagogical intervention can improve cognitive performance, practical skills, and interpretation of the exam. The level of learning achievement was higher among more advanced students in medical education. Additionally, the students in the clinical cycle had a better perception of their learning.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 2","pages":"e20230382"},"PeriodicalIF":2.7,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27eCollection Date: 2024-01-01DOI: 10.36416/1806-3756/e20230261
Tarciane Aline Prata, Arnaldo Santos Leite, Valéria Maria Augusto, Daniel Cruz Bretas, Bruno Horta Andrade, Jaqueline das Graças Ferreira Oliveira, Aline Priscila Batista, George Luiz Lins Machado-Coelho, Eliane Mancuzo, Carolina Coimbra Marinho
Objective: To evaluate symptoms, lung function, and quality of life of a cohort of patients hospitalized for severe COVID-19 12 months after hospital admission.
Methods: This was a cross-sectional study. We included severe COVID-19 survivors hospitalized in one of three tertiary referral hospitals for COVID-19 in the city of Belo Horizonte, Brazil. Participants were submitted to lung function and six-minute walk tests and completed the EQ-5D-3L questionnaire.
Results: The whole sample comprised 189 COVID-19 survivors (mean age = 59.6 ± 13.4 years) who had been admitted to a ward only (n = 96; 50.8%) or to an ICU (n = 93; 49.2%). At 12 months of follow-up, 43% of patients presented with dyspnea, 27% of whom had a restrictive ventilatory disorder and 18% of whom presented with impaired DLCO. There were no significant differences in FVC, FEV1, and TLC between the survivors with or without dyspnea. However, those who still had dyspnea had significantly more impaired DLCO (14.9% vs. 22.4%; p < 0.020) and poorer quality of life.
Conclusions: After one year, survivors of severe COVID-19 in a middle-income country still present with high symptom burden, restrictive ventilatory changes, and loss of quality of life. Ongoing follow-up is needed to characterize long COVID-19 and identify strategies to mitigate its consequences.
{"title":"Lung function and quality of life one year after severe COVID-19 in Brazil.","authors":"Tarciane Aline Prata, Arnaldo Santos Leite, Valéria Maria Augusto, Daniel Cruz Bretas, Bruno Horta Andrade, Jaqueline das Graças Ferreira Oliveira, Aline Priscila Batista, George Luiz Lins Machado-Coelho, Eliane Mancuzo, Carolina Coimbra Marinho","doi":"10.36416/1806-3756/e20230261","DOIUrl":"10.36416/1806-3756/e20230261","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate symptoms, lung function, and quality of life of a cohort of patients hospitalized for severe COVID-19 12 months after hospital admission.</p><p><strong>Methods: </strong>This was a cross-sectional study. We included severe COVID-19 survivors hospitalized in one of three tertiary referral hospitals for COVID-19 in the city of Belo Horizonte, Brazil. Participants were submitted to lung function and six-minute walk tests and completed the EQ-5D-3L questionnaire.</p><p><strong>Results: </strong>The whole sample comprised 189 COVID-19 survivors (mean age = 59.6 ± 13.4 years) who had been admitted to a ward only (n = 96; 50.8%) or to an ICU (n = 93; 49.2%). At 12 months of follow-up, 43% of patients presented with dyspnea, 27% of whom had a restrictive ventilatory disorder and 18% of whom presented with impaired DLCO. There were no significant differences in FVC, FEV1, and TLC between the survivors with or without dyspnea. However, those who still had dyspnea had significantly more impaired DLCO (14.9% vs. 22.4%; p < 0.020) and poorer quality of life.</p><p><strong>Conclusions: </strong>After one year, survivors of severe COVID-19 in a middle-income country still present with high symptom burden, restrictive ventilatory changes, and loss of quality of life. Ongoing follow-up is needed to characterize long COVID-19 and identify strategies to mitigate its consequences.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 2","pages":"e20230261"},"PeriodicalIF":2.7,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27DOI: 10.36416/1806-3756/e20230405
Giovana De Marchi Castelli, Frederico Friederich, Anasthácia Ferreira Wiemann, Giovana Dos Santos, Paulo Márcio Pitrez
{"title":"Clinical remission after biologic therapy discontinuation in pediatric patients with severe asthma: a case series from a tertiary center.","authors":"Giovana De Marchi Castelli, Frederico Friederich, Anasthácia Ferreira Wiemann, Giovana Dos Santos, Paulo Márcio Pitrez","doi":"10.36416/1806-3756/e20230405","DOIUrl":"10.36416/1806-3756/e20230405","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 2","pages":"e20230405"},"PeriodicalIF":2.7,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27eCollection Date: 2024-01-01DOI: 10.36416/1806-3756/e20230364
David Halen Araújo Pinheiro, João Victor Hermógenes de Souza, Alberto Fernando Oliveira Justo, Regina Maria Carvalho-Pinto, Fabiano Francisco de Lima, Celso R F Carvalho
Objective: To analyze the number of hospitalizations, the length of hospital stay, and mortality due to asthma, as well as the costs to the Unified Health Care System in Brazil between 2008 and 2021.
Methods: This was a cross-sectional epidemiological study using data from the Information Technology Department of the Brazilian Unified Health Care System. Proportional hospitalization and death rates were estimated per 100,000 population by age, microregion, and year.
Results: The number of hospitalizations and deaths due to asthma decreased from 2008 to 2021 (205,392 vs. 55,009 and 822 vs. 327, respectively). In addition, a between-sex difference was observed in asthma-related hospitalizations in 2008, and more men were hospitalized in 2021 (51.8%). Asthma mortality rates were similar for both sexes (50.0% each) in 2008, and a slight increase was observed in women's deaths in 2021 (52.9%). Even so, approximately one death/day and more than 55,000 hospitalizations were observed yearly, with a mean length of hospital stay of three days. Additionally, the Southeast region allocated more financial resources to asthma-related hospitalizations.
Conclusions: Our results showed that the number of deaths and hospitalizations due to asthma substantially declined during the study period.
{"title":"Asthma in the Brazilian Unified Health Care System: an epidemiological analysis from 2008 to 2021.","authors":"David Halen Araújo Pinheiro, João Victor Hermógenes de Souza, Alberto Fernando Oliveira Justo, Regina Maria Carvalho-Pinto, Fabiano Francisco de Lima, Celso R F Carvalho","doi":"10.36416/1806-3756/e20230364","DOIUrl":"10.36416/1806-3756/e20230364","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the number of hospitalizations, the length of hospital stay, and mortality due to asthma, as well as the costs to the Unified Health Care System in Brazil between 2008 and 2021.</p><p><strong>Methods: </strong>This was a cross-sectional epidemiological study using data from the Information Technology Department of the Brazilian Unified Health Care System. Proportional hospitalization and death rates were estimated per 100,000 population by age, microregion, and year.</p><p><strong>Results: </strong>The number of hospitalizations and deaths due to asthma decreased from 2008 to 2021 (205,392 vs. 55,009 and 822 vs. 327, respectively). In addition, a between-sex difference was observed in asthma-related hospitalizations in 2008, and more men were hospitalized in 2021 (51.8%). Asthma mortality rates were similar for both sexes (50.0% each) in 2008, and a slight increase was observed in women's deaths in 2021 (52.9%). Even so, approximately one death/day and more than 55,000 hospitalizations were observed yearly, with a mean length of hospital stay of three days. Additionally, the Southeast region allocated more financial resources to asthma-related hospitalizations.</p><p><strong>Conclusions: </strong>Our results showed that the number of deaths and hospitalizations due to asthma substantially declined during the study period.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 2","pages":"e20230364"},"PeriodicalIF":2.7,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To identify how pediatric surgeons manage children with pneumonia and parapneumonic pleural effusion in Brazil.
Methods: An online cross-sectional survey with 27 questions was applied to pediatric surgeons in Brazil through the Brazilian Association of Pediatric Surgery. The questionnaire had questions about type of treatment, exams, hospital structure, and epidemiological data.
Results: A total of 131 respondents completed the questionnaire. The mean age of respondents was 44 ± 11 years, and more than half (51%) had been practicing pediatric surgery for more than 10 years. The majority of respondents (33.6%) reported performing chest drainage and fibrinolysis when facing a case of fibrinopurulent parapneumonic pleural effusion. A preference for video-assisted thoracic surgery instead of chest drainage plus fibrinolysis was noted only in the Northeast region.
Conclusions: Chest drainage plus fibrinolysis was the treatment adopted by most of the respondents in this Brazilian sample. There was a preference for large drains; in contrast, smaller drains were preferred by those who perform chest drainage plus fibrinolysis. Respondents would rather change treatment when facing treatment failure or in critically ill children.
{"title":"Management of pediatric pleural empyema: a national survey of pediatric surgeons in Brazil.","authors":"Felippe Flausino, Luiza Maes Manara, Bruna Baioni Sandre, Gilson Nagel Sawaya, Rosemeri Maurici","doi":"10.36416/1806-3756/e20230318","DOIUrl":"10.36416/1806-3756/e20230318","url":null,"abstract":"<p><strong>Objective: </strong>To identify how pediatric surgeons manage children with pneumonia and parapneumonic pleural effusion in Brazil.</p><p><strong>Methods: </strong>An online cross-sectional survey with 27 questions was applied to pediatric surgeons in Brazil through the Brazilian Association of Pediatric Surgery. The questionnaire had questions about type of treatment, exams, hospital structure, and epidemiological data.</p><p><strong>Results: </strong>A total of 131 respondents completed the questionnaire. The mean age of respondents was 44 ± 11 years, and more than half (51%) had been practicing pediatric surgery for more than 10 years. The majority of respondents (33.6%) reported performing chest drainage and fibrinolysis when facing a case of fibrinopurulent parapneumonic pleural effusion. A preference for video-assisted thoracic surgery instead of chest drainage plus fibrinolysis was noted only in the Northeast region.</p><p><strong>Conclusions: </strong>Chest drainage plus fibrinolysis was the treatment adopted by most of the respondents in this Brazilian sample. There was a preference for large drains; in contrast, smaller drains were preferred by those who perform chest drainage plus fibrinolysis. Respondents would rather change treatment when facing treatment failure or in critically ill children.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 2","pages":"e20230318"},"PeriodicalIF":2.7,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.36416/1806-3756/e20230373
Silvia Onoda Tomikawa, Joaquim Carlos Rodrigues, Cleyde Miryam Aversa Nakaie, Luiz Vicente Ribeiro Ferreira da Silva Filho
{"title":"Methylprednisolone intravenous pulse therapy for pediatric patients with post-infectious bronchiolitis obliterans: an update.","authors":"Silvia Onoda Tomikawa, Joaquim Carlos Rodrigues, Cleyde Miryam Aversa Nakaie, Luiz Vicente Ribeiro Ferreira da Silva Filho","doi":"10.36416/1806-3756/e20230373","DOIUrl":"10.36416/1806-3756/e20230373","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 2","pages":"e20230373"},"PeriodicalIF":2.7,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-25DOI: 10.36416/1806-3756/e20240051
Laissa Harumi Furukawa, Laura de Castro E Garcia, Marina Puerari Pieta, Miguel Ângelo de Castro, Leonardo Araújo Pinto, Paulo M Pitrez
{"title":"Diagnosis and treatment of asthma in childhood: an overview of guidelines.","authors":"Laissa Harumi Furukawa, Laura de Castro E Garcia, Marina Puerari Pieta, Miguel Ângelo de Castro, Leonardo Araújo Pinto, Paulo M Pitrez","doi":"10.36416/1806-3756/e20240051","DOIUrl":"10.36416/1806-3756/e20240051","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 1","pages":"e20240051"},"PeriodicalIF":2.9,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-22eCollection Date: 2024-01-01DOI: 10.36416/1806-3756/e20230290
Fabiola Luciane Barth, Deborah Salle Levy, Marisa Gasparin, Cláudia Schweiger, Denise Manica, Camila Dalbosco Gadenz, Paulo José Cauduro Maróstica
Objective: To evaluate the combined impact of videofluoroscopic swallow study (VFSS) and therapeutic feeding and swallowing interventions on clinical outcomes in children with oropharyngeal dysphagia (OPD).
Methods: This was an uncontrolled longitudinal analytical study in which OPD patients were evaluated before and after VFSS. Children ≤ 24 months of age diagnosed with OPD in a clinical setting and undergoing VFSS for investigation and management of OPD were included in the study. The study participants received therapeutic feeding and swallowing interventions after having undergone VFSS, being followed at an outpatient clinic for pediatric dysphagia in order to monitor feeding and swallowing difficulties. Respiratory and feeding outcomes were compared before and after VFSS.
Results: Penetration/aspiration events were observed in 61% of the VFSSs (n = 72), and therapeutic feeding and swallowing interventions were recommended for 97% of the study participants. After the VFSS, there was a reduction in the odds of receiving antibiotic therapy (OR = 0.007) and in the duration of antibiotic therapy (p = 0.014), as well as in the odds of being admitted to hospital (p = 0.024) and in the length of hospital stay (p = 0.025). A combination of oral and enteral feeding became more common than oral or enteral feeding alone (p = 0.002).
Conclusions: A high proportion of participants exhibited penetration/aspiration on VFSS. Therapeutic feeding and swallowing interventions following a VFSS appear to be associated with reduced respiratory morbidity in this population.
{"title":"Clinical outcomes before and after videofluoroscopic swallow study in children 24 months of age or younger.","authors":"Fabiola Luciane Barth, Deborah Salle Levy, Marisa Gasparin, Cláudia Schweiger, Denise Manica, Camila Dalbosco Gadenz, Paulo José Cauduro Maróstica","doi":"10.36416/1806-3756/e20230290","DOIUrl":"10.36416/1806-3756/e20230290","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the combined impact of videofluoroscopic swallow study (VFSS) and therapeutic feeding and swallowing interventions on clinical outcomes in children with oropharyngeal dysphagia (OPD).</p><p><strong>Methods: </strong>This was an uncontrolled longitudinal analytical study in which OPD patients were evaluated before and after VFSS. Children ≤ 24 months of age diagnosed with OPD in a clinical setting and undergoing VFSS for investigation and management of OPD were included in the study. The study participants received therapeutic feeding and swallowing interventions after having undergone VFSS, being followed at an outpatient clinic for pediatric dysphagia in order to monitor feeding and swallowing difficulties. Respiratory and feeding outcomes were compared before and after VFSS.</p><p><strong>Results: </strong>Penetration/aspiration events were observed in 61% of the VFSSs (n = 72), and therapeutic feeding and swallowing interventions were recommended for 97% of the study participants. After the VFSS, there was a reduction in the odds of receiving antibiotic therapy (OR = 0.007) and in the duration of antibiotic therapy (p = 0.014), as well as in the odds of being admitted to hospital (p = 0.024) and in the length of hospital stay (p = 0.025). A combination of oral and enteral feeding became more common than oral or enteral feeding alone (p = 0.002).</p><p><strong>Conclusions: </strong>A high proportion of participants exhibited penetration/aspiration on VFSS. Therapeutic feeding and swallowing interventions following a VFSS appear to be associated with reduced respiratory morbidity in this population.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 1","pages":"e20230290"},"PeriodicalIF":2.9,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-22eCollection Date: 2024-01-01DOI: 10.36416/1806-3756/e20230233
Luiz Fernando Ferreira Pereira, Ricardo Sales Dos Santos, Daniel Oliveira Bonomi, Juliana Franceschini, Ilka Lopes Santoro, André Miotto, Thiago Lins Fagundes de Sousa, Rodrigo Caruso Chate, Bruno Hochhegger, Artur Gomes Neto, Airton Schneider, César Augusto de Araújo Neto, Dante Luiz Escuissato, Gustavo Faibischew Prado, Luciana Costa-Silva, Mauro Musa Zamboni, Mario Claudio Ghefter, Paulo César Rodrigues Pinto Corrêa, Pedro Paulo Teixeira E Silva Torres, Ricardo Kalaf Mussi, Valdair Francisco Muglia, Irma de Godoy, Wanderley Marques Bernardo
Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.
{"title":"Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging.","authors":"Luiz Fernando Ferreira Pereira, Ricardo Sales Dos Santos, Daniel Oliveira Bonomi, Juliana Franceschini, Ilka Lopes Santoro, André Miotto, Thiago Lins Fagundes de Sousa, Rodrigo Caruso Chate, Bruno Hochhegger, Artur Gomes Neto, Airton Schneider, César Augusto de Araújo Neto, Dante Luiz Escuissato, Gustavo Faibischew Prado, Luciana Costa-Silva, Mauro Musa Zamboni, Mario Claudio Ghefter, Paulo César Rodrigues Pinto Corrêa, Pedro Paulo Teixeira E Silva Torres, Ricardo Kalaf Mussi, Valdair Francisco Muglia, Irma de Godoy, Wanderley Marques Bernardo","doi":"10.36416/1806-3756/e20230233","DOIUrl":"10.36416/1806-3756/e20230233","url":null,"abstract":"<p><p>Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.</p>","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 1","pages":"e20230233"},"PeriodicalIF":2.9,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-22DOI: 10.36416/1806-3756/e20240052
Diego Caruso, Juliana C Ferreira
{"title":"Randomized controlled trials: advantages and pitfalls when studying causality.","authors":"Diego Caruso, Juliana C Ferreira","doi":"10.36416/1806-3756/e20240052","DOIUrl":"10.36416/1806-3756/e20240052","url":null,"abstract":"","PeriodicalId":14845,"journal":{"name":"Jornal Brasileiro De Pneumologia","volume":"50 1","pages":"e20240052"},"PeriodicalIF":2.9,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}