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  • 1
    Online Resource
    Online Resource
    Síndrome hemofagocítica devido a sarcoidose pulmonar
    FapUNIFESP (SciELO) ; 2012
    In:  Jornal Brasileiro de Pneumologia Vol. 38, No. 5 ( 2012-10), p. 666-671
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 38, No. 5 ( 2012-10), p. 666-671
    Abstract: Although hemophagocytic syndrome is a rare clinical condition, it is associated with high mortality and the number of cases described in the literature has progressively increased. The diagnosis of hemophagocytic syndrome is made on the basis of a finding of hemophagocytosis. Sarcoidosis is a highly prevalent disease whose course and prognosis might correlate with the initial clinical presentation and the extent of the disease. We report the case of a patient with long-standing sarcoidosis who presented with intermittent fever and fatigue. The diagnosis of hemophagocytic syndrome was made by bone marrow aspiration, and specific treatment was ineffective. This is the third case of sarcoidosis-related hemophagocytic syndrome reported in the literature and the first reported in Latin America. All three cases had unfavorable outcomes.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132012000500017
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2012
    detail.hit.zdb_id: 2223157-2
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  • 2
    Online Resource
    Online Resource
    Recommendations for the pharmacological treatment of COPD: questions and answers
    FapUNIFESP (SciELO) ; 2017
    In:  Jornal Brasileiro de Pneumologia Vol. 43, No. 4 ( 2017-08), p. 290-301
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 43, No. 4 ( 2017-08), p. 290-301
    Abstract: RESUMO O tratamento da DPOC vem se tornando cada vez mais eficaz. Medidas que envolvem desde mudanças comportamentais, redução de exposições a fatores de risco, educação sobre a doença e seu curso, reabilitação, oxigenoterapia, manejo de comorbidades, tratamentos cirúrgicos e farmacológicos até os cuidados de fim de vida permitem ao profissional oferecer uma terapêutica personalizada e efetiva. O tratamento farmacológico da DPOC constitui um dos principais pilares desse manejo, e muitos avanços têm sido atingidos na área nos últimos anos. Com a maior disponibilidade de medicações e combinações terapêuticas fica cada vez mais desafiador conhecer as indicações, limitações, potenciais riscos e benefícios de cada tratamento. Com o intuito de avaliar criticamente a evidência recente e sistematizar as principais dúvidas referentes ao tratamento farmacológico da DPOC, foram reunidos 24 especialistas de todo o Brasil para elaborar a presente recomendação. Foi elaborado um guia visual para a classificação e tratamento adaptados à nossa realidade. Dez perguntas foram selecionadas pela relevância na prática clínica. Abordam a classificação, definições, tratamento e evidências disponíveis para cada medicação ou combinação. Cada pergunta foi respondida por dois especialistas e depois consolidadas em duas fases: revisão e consenso entre todos os participantes. As questões respondidas são dúvidas práticas e ajudam a selecionar qual o melhor tratamento, entre as muitas opções, para cada paciente com suas particularidades.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/s1806-37562017000000153
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2017
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  • 3
    Online Resource
    Online Resource
    Twenty-four Months Longitudinal Study of Acute Exacerbations in a Cohort of Chronic Obstructive Pulmonary Disease Patients
    Maxwell Scientific Publication Corp. ; 2013
    In:  Asian Journal of Medical Sciences Vol. 5, No. 6 ( 2013-12-25), p. 117-123
    Details
    In: Asian Journal of Medical Sciences, Maxwell Scientific Publication Corp., Vol. 5, No. 6 ( 2013-12-25), p. 117-123
    Type of Medium: Online Resource
    ISSN: 2040-8765 , 2040-8773
    URL: Article
    DOI: 10.19026/ajms.5.5346
    Language: Unknown
    Publisher: Maxwell Scientific Publication Corp.
    Publication Date: 2013
    detail.hit.zdb_id: 2546018-3
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  • 4
    Online Resource
    Online Resource
    Update on diagnosis and treatment of idiopathic pulmonary fibrosis
    FapUNIFESP (SciELO) ; 2015
    In:  Jornal Brasileiro de Pneumologia Vol. 41, No. 5 ( 2015-10), p. 454-466
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 41, No. 5 ( 2015-10), p. 454-466
    Abstract: A fibrose pulmonar idiopática é um tipo de pneumonia intersticial crônica fibrosante, de causa desconhecida, associada à piora funcional respiratória progressiva e taxas elevadas de mortalidade. Em anos recentes, o interesse e os conhecimentos sobre essa moléstia têm aumentado substancialmente. O presente artigo de revisão aborda de maneira ampla aspectos relacionados ao diagnóstico e tratamento da doença. Nele são listados os critérios atuais para o diagnóstico e são discutidos as diferentes abordagens terapêuticas agora disponíveis, o tratamento sintomático, a ação de novas drogas eficazes em reduzir o ritmo de deterioração funcional pulmonar e as indicações para transplante pulmonar.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132015000000152
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2015
    detail.hit.zdb_id: 2223157-2
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  • 5
    Online Resource
    Online Resource
    Avaliação quantitativa das fibras elásticas na doença pulmonar obstrutiva crônica
    FapUNIFESP (SciELO) ; 2007
    In:  Jornal Brasileiro de Pneumologia Vol. 33, No. 5 ( 2007-10), p. 502-509
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 33, No. 5 ( 2007-10), p. 502-509
    Abstract: OBJECTIVE: To quantify elastic fibers (EFs) and smooth muscle (SM) cells, as well as CD4+ and CD8+ T lymphocytes, in stable chronic obstructive pulmonary disease (COPD). METHODS: Surgical specimens were obtained from 15 COPD patients, 18 smokers without airflow limitation, and 14 nonsmokers. Histological and immunohistochemical methods were employed in order to quantify EFs, SM cells, CD4+ T cells, and CD8+ T cells. RESULTS: There was no significant difference in EF numbers among the three groups (p 〉 0.05). The number of EFs per unit area of lung tissue (mm²) and the percentage of EFs in the lung tissue were similar among the three groups. The numbers of SM cells were found to be higher in the COPD patients than in the smokers (p = 0.003) or in the nonsmokers (p = 0.009). There was a tendency toward an increase in CD8+ T-cell counts in the COPD patients. In specimens collected from the COPD patients, CD4+ T-cell counts were lower than in those collected from the smokers (p = 0.015) or from the nonsmokers (p = 0.003). There was a weak correlation between CD4+ T-cell count and the ratio of forced expiratory volume in one second to forced vital capacity (r² = 0.003). CONCLUSIONS: The EF counts were similar among the three groups. Hypertrophy/hyperplasia of airway wall SM cells was found in the COPD patients and in the smokers, indicating that airway remodeling occurs in smokers. The CD4/CD8 ratio was lower in the COPD patients.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132007000500004
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2007
    detail.hit.zdb_id: 2223157-2
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  • 6
    Online Resource
    Online Resource
    Perfil celular do escarro induzido e sangue periférico na doença pulmonar obstrutiva crônica
    FapUNIFESP (SciELO) ; 2007
    In:  Jornal Brasileiro de Pneumologia Vol. 33, No. 5 ( 2007-10), p. 510-518
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 33, No. 5 ( 2007-10), p. 510-518
    Abstract: OBJECTIVE: To determine cell profiles, as well as to identify CD4+ and CD8+ lymphocyte subgroups, in induced sputum (IS) and peripheral venous blood (PVB) of patients with chronic obstructive pulmonary disease (COPD). METHODS: Total cell counts and counts of individual cell types, including CD4+ and CD8+ T lymphocytes, were determined in the IS and PVB of 85 subjects (38 with COPD without exacerbation, 29 smokers without obstruction and 18 nonsmokers). Mann-Whitney and Spearman non-parametric tests were used in the statistical analysis, and values of p 〈 0.05 were considered statistically significant. RESULTS: Comparing the IS of subjects with COPD to that of nonsmokers, neutrophil, eosinophil and CD8+ T lymphocyte counts were higher (respectively p = 0.005, p 〈 0.05 and p 〈 0.05), whereas the percentage of macrophages was lower (p = 0.003). There were weak linear correlations (r² 〈 0.1) between each cell type in IS and forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio. Eosinophil and CD8+ T lymphocyte counts were also higher in PVB (p = 0.04 and p = 0.02). CONCLUSIONS: In patients with stable COPD, CD8+ T lymphocyte counts were higher in PVB, whereas total leukocyte counts were similar to those of the other two groups analyzed, suggesting systemic inflammatory involvement. The CD8+ T lymphocyte count in blood can be a useful marker of systemic inflammation and can help identify smokers who already present a COPD inflammatory pattern.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132007000500005
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2007
    detail.hit.zdb_id: 2223157-2
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  • 7
    Online Resource
    Online Resource
    Características epidemiológicas de pacientes com sarcoidose na cidade do Rio de Janeiro
    FapUNIFESP (SciELO) ; 2011
    In:  Jornal Brasileiro de Pneumologia Vol. 37, No. 4 ( 2011-08), p. 438-445
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 37, No. 4 ( 2011-08), p. 438-445
    Abstract: OBJECTIVE: To analyze the epidemiological characteristics of sarcoidosis patients in the city of Rio de Janeiro, Brazil. METHODS: A descriptive, case-control study involving 100 sarcoidosis patients under outpatient treatment between 2008 and 2010 at the Pedro Ernesto University Hospital, located in the city of Rio de Janeiro, Brazil. The diagnosis of sarcoidosis was based on clinical, radiological, biochemical, and histopathological criteria. RESULTS: There was a predominance of females in the 35-40 year age bracket (range, 7-69 years), who accounted for 65% of the sample, although there was a second peak at approximately 55 years of age. The most common symptom was dyspnea (in 47%), and the most common radiological findings were pulmonary and lymph node involvement (stage II; in 43%), followed by stage III (in 20%), stage I (in 19%), stage 0 (in 15%), and stage IV (in 3%). No pleural effusion or digital clubbing was observed at diagnosis. The tuberculin skin test was negative in 94 patients. Spirometric findings at diagnosis were normal in 61 patients; indicative of obstructive lung disease in 21; and indicative of restrictive lung disease in 18. The most common biopsy sites were the lungs (principally by bronchoscopy) and the skin, the diagnosis being confirmed by biopsy in 56% and 29% of the cases, respectively. Treatment with prednisone was initiated in 75% of the patients and maintained for more than 2 years in 19.7%. CONCLUSIONS: This study corroborates the findings of previous studies regarding the epidemiological characteristics of sarcoidosis patients.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132011000400005
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2011
    detail.hit.zdb_id: 2223157-2
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  • 8
    Online Resource
    Online Resource
    Análise de 39 casos de pneumonia intersticial crônica idiopática
    FapUNIFESP (SciELO) ; 2006
    In:  Jornal Brasileiro de Pneumologia Vol. 32, No. 6 ( 2006-12), p. 505-509
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 32, No. 6 ( 2006-12), p. 505-509
    Abstract: OBJECTIVE: To make a retrospective analysis of lung biopsy samples obtained from patients diagnosed with chronic idiopathic interstitial pneumonia, as defined in the American Thoracic Society/European Respiratory Society classification system made public in 2000. METHODS: Samples from 252 open-lung biopsies of patients with interstitial lung disease, all performed between 1977 and 1999, were reviewed, and 39 cases of idiopathic interstitial lung disease were selected and re-evaluated by two pathologists in accordance with the American Thoracic Society/European Respiratory Society classification system. RESULTS: Among those 39 cases, the diagnoses were maintained in 28 (71.8%). A new pathologic entity, nonspecific interstitial pneumonia, was included in the reclassification, and overlapping patterns were observed in 6 cases. Of the 28 cases in which the diagnosis of chronic idiopathic interstitial pneumonia remained unchanged, idiopathic pulmonary fibrosis was accompanied by cryptogenic organizing pneumonia in 4, cryptogenic organizing pneumonia was accompanied by nonspecific interstitial pneumonia in 1, and desquamative interstitial pneumonia was accompanied by nonspecific interstitial pneumonia in 1. All cases of idiopathic pulmonary fibrosis were confirmed, although 3 of those were found to be accompanied by cryptogenic organizing pneumonia. Virtually all prior diagnoses were maintained in the review of the biopsy samples (p 〉 0,05). CONCLUSION: The American Thoracic Society/European Respiratory Society system of classifying interstitial lung disease is a useful tool for pathologists who deal with lung biopsies.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132006000600006
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2006
    detail.hit.zdb_id: 2223157-2
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  • 9
    Online Resource
    Online Resource
    A utilidade da TC de tórax no diagnóstico do sequestro pulmonar
    FapUNIFESP (SciELO) ; 2010
    In:  Jornal Brasileiro de Pneumologia Vol. 36, No. 2 ( 2010-04), p. 260-264
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 36, No. 2 ( 2010-04), p. 260-264
    Abstract: Pulmonary sequestration is a rare congenital anomaly, characterized by nonfunctional embryonic pulmonary tissue. Pulmonary sequestration accounts for 0.15-6.40% of all congenital pulmonary malformations. This anomaly, which is classified as intralobar or extralobar, involves the lung parenchyma and its vascularization. We report the case of a 56-year-old male presenting with hemoptysis. A chest X-ray showed an area of opacity behind the cardiac silhouette in the base of the left hemithorax. Chest CT scans with intravenous contrast revealed pulmonary sequestration. The patient underwent surgery, in which the anomalous tissue was successful resected. The postoperative evolution was favorable, and the patient was discharged to outpatient treatment.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132010000200016
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2010
    detail.hit.zdb_id: 2223157-2
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  • 10
    Online Resource
    Online Resource
    Evaluation of von Willebrand factor in COPD patients
    FapUNIFESP (SciELO) ; 2014
    In:  Jornal Brasileiro de Pneumologia Vol. 40, No. 4 ( 2014-08), p. 373-379
    Details
    In: Jornal Brasileiro de Pneumologia, FapUNIFESP (SciELO), Vol. 40, No. 4 ( 2014-08), p. 373-379
    Abstract: OBJETIVO: Comparar os níveis séricos absolutos e a atividade sérica em percentual do fator de von Willebrand (FvW) em pacientes com DPOC clinicamente estáveis, tabagistas sem obstrução das vias aéreas e em indivíduos saudáveis que nunca fumaram. MÉTODOS: Foram incluídos no estudo 57 indivíduos, em três grupos: DPOC (n = 36), tabagista (n = 12) e controle (n = 9). Todos os participantes realizaram radiografia do tórax, espirometria e exame de sangue durante a fase de seleção. Os níveis séricos absolutos e a atividade sérica em percentual do FvW foram obtidos por turbidimetria e ELISA, respectivamente. A escala Medical Research Council modificada foi utilizada para classificar pacientes como sintomáticos ou assintomáticos/pouco sintomáticos no grupo DPOC (ponto de corte = 2). RESULTADOS: Os níveis absolutos do FvW no grupo controle foram significativamente menores que os nos grupos tabagista e DPOC: 989 ± 436 pg/mL vs. 2.220 ± 746 pg/mL (p 〈 0,001) e 1.865 ± 592 pg/mL (p 〈 0,01). Os valores em percentual de atividade do FvW no grupo DPOC foram significativamente maiores que no grupo tabagista (136,7 ± 46,0% vs. 92,8 ± 34,0%; p 〈 0,05), assim como foram significativamente maiores no subgrupo DPOC sintomático que no subgrupo DPOC assintomático/pouco sintomático (154 ± 48% vs. 119 ± 8%; p 〈 0,05). Houve uma correlação negativa entre o VEF1 (% do previsto) e os níveis em percentual de atividade do FvW nos três grupos (r2 = −0,13; p = 0,009). CONCLUSÕES: Nossos resultados sugerem que aumentos nos níveis de FvW e de sua atividade contribuem para a manutenção da inflamação sistêmica e o aumento do risco cardiovascular em pacientes com DPOC.
    Type of Medium: Online Resource
    ISSN: 1806-3713
    URL: Article
    DOI: 10.1590/S1806-37132014000400004
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2014
    detail.hit.zdb_id: 2223157-2
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