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au:Santana, Alfredo Nicodemos Cruz

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Prevalence and associated factors of experimentation with and current use of water pipes and electronic cigarettes among medical students: a multicentric study in Brazil
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Martins, Stella Regina

; Araújo, Alberto José de

; Wehrmeister, Fernando C

; Freitas, Beatriz Martins

; Basso, Rafaela Giunti

; Santana, Alfredo Nicodemos Cruz

; Santos, Ubiratan de Paula

Jornal Brasileiro de Pneumologia

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2023, Volume 49 N. 1 elocation e20210467

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To evaluate the prevalence of and factors associated with experimentation with and current use of water pipes and e-cigarettes among medical students. Methods: This was a cross-sectional multicentric study involving a convenience sample of students from medical schools in most Brazilian geographic regions. Information about experimentation with and current use of conventional cigarettes, water pipes, and e-cigarettes; beliefs and attitudes toward tobacco products; religiosity; and demographics were collected by means of an online structured questionnaire. We used descriptive statistics and logistic regression to analyze the association of those factors. Results: Our sample comprised 700 individuals from four Brazilian regions. Prevalence of experimentation with and current use of cigarettes, water pipes, and e-cigarettes were, respectively, 39.1% and 7.9%; 42.6% and 11.4%; and 13.1% and 2.3%. Water pipe experimentation was higher among those who had a sibling (adjusted OR = 2.64; 95% CI, 1.24-5.61) or friends (adjusted OR = 2.33; 95% CI, 1.63-3.31) who smoke. The same occurred regarding e-cigarette experimentation: siblings (adjusted OR = 2.76; 95% CI, 1.17-6.50) and friends (adjusted OR = 2.47; 95% CI, 1:45-4.22). Curiosity and scent/taste were the major reasons for water pipe use and e-cigarette experimentation. Although 93% of the responders learned about health damages of smoking during medical school classes, 51.4% reported having experimented with at least one of these tobacco products. Most responders who reported feeling the presence of God/the Holy Spirit in their lives were never experimenters of water pipes (59.2%) or e-cigarettes (55.3%). Conclusions: There is a high prevalence of experimentation with tobacco products among medical students whose siblings or friends smoke, despite their knowledge about smoking harms.

RESUMO Objetivo: Avaliar a prevalência de experimentação e uso atual de narguilé e cigarros eletrônicos e os fatores associados entre estudantes de medicina. Métodos: Estudo transversal multicêntrico com uma amostra de conveniência de estudantes de faculdades de medicina da maioria das regiões geográficas brasileiras. Informações sobre experimentação e uso atual de cigarros convencionais, narguilé e cigarros eletrônicos; crenças e atitudes em relação aos produtos do tabaco; religiosidade; e dados demográficos foram coletados por meio de um questionário on-line estruturado. Utilizou-se estatística descritiva e regressão logística para analisar a associação desses fatores. Resultados: Nossa amostra foi composta por 700 indivíduos de quatro regiões brasileiras. As prevalências de experimentação e uso atual de cigarros, narguilé e cigarros eletrônicos foram, respectivamente, de 39,1% e 7,9%; 42,6% e 11,4%; e 13,1% e 2,3%. A experimentação de narguilé foi maior entre aqueles que tinham irmãos (OR ajustada = 2,64; IC95%: 1,24-5,61) ou amigos (OR ajustada = 2,33; IC95%: 1,63-3,31) fumantes. O mesmo ocorreu em relação à experimentação de cigarros eletrônicos: irmãos (OR ajustada = 2,76; IC95%: 1,17-6,50) e amigos (OR ajustada = 2,47; IC95%: 1,45-4,22). Curiosidade e aroma/sabor foram os principais motivos para o uso de narguilé e a experimentação de cigarros eletrônicos. Embora 93% dos respondentes tenham aprendido sobre os danos do tabagismo à saúde nas aulas da faculdade de medicina, 51,4% relataram já ter experimentado pelo menos um desses produtos do tabaco. A maioria dos respondentes que relataram sentir a presença de Deus/Espírito Santo em suas vidas nunca experimentou narguilé (59,2%) ou cigarros eletrônicos (55,3%). Conclusões: Há uma alta prevalência de experimentação de produtos do tabaco entre estudantes de medicina cujos irmãos ou amigos fumam, apesar de terem conhecimento sobre os malefícios do tabagismo.

https://doi.org/10.36416/1806-3756/e20210467

Challenges in the management of patients with pulmonary embolism in Brazil
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Amado, Veronica Moreira

; Santana, Alfredo Nicodemos Cruz

Jornal Brasileiro de Pneumologia

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2022, Volume 48 N. 3 elocation e20220187

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36416/1806-3756/e20220187

The role of Clinical-Functional Vulnerability Index-20 to detect quality of life in older adults assisted in primary care
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Sena, Levi Bezerra

; Batista, Larissa Paixão

; Fernandes, Flávia Fonseca

; Santana, Alfredo Nicodemos Cruz

Revista da Associação Médica Brasileira

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jan 2021, Volume 67 N. 1 Pages 83 - 87

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: To determine the cutoff point of the Clinical-Functional Vulnerability Index-20 to detect poor quality of life in the elderly in Primary Health Care. METHODS: This cross-sectional study was carried out in Primary Health Care units of Ceilândia (DF, Brasil) between September 2019 and January 2020. Four hundred and fifty-eight individuals were included in the study and answered the Clinical-Functional Vulnerability Index-20 (IVCF-20) and the World Health Organization Quality of Life – WHOQOL-BREF (validated to access quality of life) instruments. Based on the WHOQOL-BREF answers, three subgroups were created: poor, good and undetermined quality of life. The receiver operating characteristic curve (using Youden index) showed the IVCF-20 cutoff point to detect poor quality of life (in individuals with good quality of life as the Control Group), and therefore diagnostic tests were performed. RESULTS: The IVCF-20 cutoff point to detect poor quality of life was ≥11. The area under the receiver operating characteristic curve was 0.97 (95%CI 0.95–0.98). The IVCF-20 diagnostic tests showed good sensitivity (88.1%) and specificity (84.9%). CONCLUSIONS: The IVCF-20 ≥11 detected poor quality of life adequately in the elderly in Primary Health Care. These data suggest that elderly individuals with IVCF ≥11 should attend appointments more often in Primary Health Care or geriatrics collaborative care, considering the impact that quality of life can have on the elderly population’s mortality.

https://doi.org/10.1590/1806-9282.67.01.20200387 230 downloads

The role of VES-13 to identify limited life expectancy in older adults in primary healthcare settings
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Assis, Danilo Lopes

; Chagas, Virgínia Oliveira

; Saulo, Helton

; Suemoto, Claudia Kimie

; Santana, Alfredo Nicodemos Cruz

Revista da Escola de Enfermagem da USP

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2021, Volume 55 elocation e03743

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo Investigar o potencial do instrumento Vulnerable Elders Survey para identificar idosos com expectativa de vida limitada, em ambientes de atenção primária à saúde. Método Estudo transversal realizado em todas as (nove) unidades de saúde de Jataí, Goiás (Brasil), no período de julho a dezembro de 2018. Obteve-se uma amostra de 407 idosos, considerando uma população ≥ 60 anos. Os participantes responderam a um questionário sobre características sociodemográficas e clínicas, incluindo o Vulnerable Elders Survey e o índice de Suemoto. Testamos a associação entre a expectativa de vida limitada e o Vulnerable Elders Survey usando análise de regressão logística múltipla. Resultados A idade média foi de 68,9 ± 6,6 anos, e 58,0% dos participantes eram mulheres. A pontuação média do Vulnerable Elders Survey foi de 2,0 ± 2,2, a pontuação média do índice de Suemoto foi de 31,5 ± 21,1%, e 17,2% dos participantes tinham expectativa de vida limitada. O Vulnerable Elders Survey foi associado a uma expectativa de vida limitada (OR = 1,57; p = < 0,0001). Conclusão O instrumento Vulnerable Elders Survey foi capaz de identificar idosos com expectativa de vida limitada em ambientes de atenção primária à saúde, além de poder auxiliar na detecção de idosos que não se beneficiariam com a triagem e o controle estrito de doenças crônicas.

ABSTRACT Objective To investigate the potential role of the Vulnerable Elders Survey to identify older adults with limited life expectancy in primary healthcare settings. Method This cross-sectional study was performed in all (nine) healthcare units in Jatai, Goiás (Brazil) from July to December 2018. A sample size of 407 older adults was obtained considering an older population (≥ 60 years old). Participants answered a questionnaire about sociodemographic and clinical characteristics, including the Vulnerable Elders Survey and the Suemoto index. We tested the association between limited life expectancy and the Vulnerable Elders Survey using multiple logistic regression analysis. Results The mean age was 68.9 ± 6.6 yo, and 58.0% were women. The mean score of the Vulnerable Elders Survey was 2.0 ± 2.2, the mean score of Suemoto index was 31.5 ± 21.1%, and 17.2% had limited life expectancy. The Vulnerable Elders Survey was associated with limited life expectancy (OR = 1.57; p = < 0.0001). Conclusion The Vulnerable Elders Survey was able to identify older adults with limited life expectancy in primary healthcare settings and can play a role in detecting older adults who would not benefit from screening and strict control of chronic diseases.

RESUMEN Objetivo Investigar el potencial del instrumento Vulnerable Elders Survey para identificar adultos mayores con esperanza de vida limitada en centros de atención primaria. Método Se trata de un estudio transversal realizado en todas las (nueve) unidades sanitarias de Jataí, Goiás (Brasil) de julio a diciembre de 2018. Se consideró una población de ≥ 60 años, de la cual se obtuvo una muestra de 407 adultos mayores. Los participantes respondieron un cuestionario sobre características sociodemográficas y clínicas, incluyendo el Vulnerable Elders Survey y el índice de Suemoto. Se comprobó la asociación entre la esperanza de vida limitada y el Vulnerable Elders Survey, mediante el análisis de regresión logística múltiple. Resultados La edad promedio era de 68,9 ± 6,6 años y el 58,0% de los participantes pertenecía al sexo femenino. La puntuación media del Vulnerable Elders Survey resultó en 2,0 ± 2,2; la puntuación media del índice de Suemoto, 31,5 ± 21,1% y el 17,2% de los participantes tenía una esperanza de vida limitada. El Vulnerable Elders Survey estaba asociado a una esperanza de vida limitada (OR = 1,57; p = < 0,0001). Conclusión El instrumento Vulnerable Elders Survey ha sido capaz de identificar a los adultos mayores con una esperanza de vida limitada en los centros de atención primaria, además de ayudar en la detección de aquellos adultos mayores que no se beneficiarían con el triaje y el control estricto de las enfermedades crónicas.

https://doi.org/10.1590/s1980-220x2020003603743 314 downloads

Association of health vulnerability with adverse outcomes in older people with COVID-19: a prospective cohort study
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Assis, Fábio Cavalcante de

; Silva, Michelle Cristina-Oliveira da

; Geber-Júnior, João Carlos

; Roschel, Hamilton

; Peçanha, Tiago

; Drager, Luciano Ferreira

; Santana, Alfredo Nicodemos Cruz

Clinics

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2021, Volume 76 elocation e3369

Abstract: En | Text: En | PDF: En

OBJECTIVES: Health vulnerability is associated with a higher risk of mortality and functional decline in older people in the community. However, few studies have evaluated the role of the Vulnerable Elders Survey (VES-13) in predicting clinical outcomes of hospitalized patients. In the present study, we tested the ability of the VES-13 to predict mortality and the need for invasive mechanical ventilation in older people hospitalized with coronavirus disease 2019 (COVID-19). METHODS: This prospective cohort included 91 participants aged ≥60 years who were confirmed to have COVID-19. VES-13 was applied, and the demographic, clinical, and laboratory variables were collected within 72h of hospitalization. A Poisson generalized linear regression model with robust variance was used to estimate the relative risk of death and invasive mechanical ventilation. RESULTS: Of the total number of patients, 19 (21%) died and 15 (16%) required invasive mechanical ventilation. Regarding health vulnerability, 54 (59.4%) participants were classified as non-vulnerable, 30 (33%) as vulnerable, and 7 (7.6%) as extremely vulnerable. Patients classified as extremely vulnerable and male sex were strongly and independently associated with a higher relative risk of in-hospital mortality (p<0.05) and need for invasive mechanical ventilation (p<0.05). CONCLUSION: Elderly patients classified as extremely vulnerable had more unfavorable outcomes after hospitalization for COVID-19. These data highlight the importance of identifying health vulnerabilities in this population.

https://doi.org/10.6061/clinics/2021/e3369

Interstitial lung diseases: the role of HRCT in in the era of antifibrotic therapy
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Santana, Alfredo Nicodemos Cruz

; Soares, Flavia de Souza Nunes

Jornal Brasileiro de Pneumologia

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2020, Volume 46 N. 5 elocation e20200457

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36416/1806-3756/e20200457 375 downloads

Functional health literacy in hypertensive elders at primary health care
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Costa, Victor Roberto Santos

; Costa, Polyana D’arc Rezende

; Nakano, Eduardo Yoshio

; Apolinário, Daniel

; Santana, Alfredo Nicodemos Cruz

Revista Brasileira de Enfermagem

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2019, Volume 72 Suppl. 2 Pages 266 - 273

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

ABSTRACT Objective: to assess the relationship between inadequate functional health literacy and inadequate blood pressure control in older people with hypertension in Primary Health Care. Method: a cross-sectional study with sample calculated at 392. SAHLPA-18 tool was used for functional health literacy; blood pressure was measured; sociodemographic and clinical data were collected. Hierarchical logistic regression was used. Results: (high) inadequate blood pressure and (low) functional inadequate health literacy were present in 41.6% and 54.6% of the people, respectively. Factors associated with inadequate blood pressure were: inadequate functional health literacy, black-brown skin color, overweight-obesity, hypertension diagnosis time, non-adherence to exercise/diet, drug treatment. Schooling had no association with inadequate blood pressure Conclusion: hypertensive elderly people with inadequate health literacy were more likely to have inadequate blood pressure. Thus, health professionals need to value functional health literacy as a possible component to control blood pressure.

RESUMEN Objetivo: evaluar la relación entre alfabetismo funcional en salud inadecuada y control inadecuado de la presión arterial en personas ancianas hipertensas em la Atención Primaria de Salud. Método: estudio transversal com muestra calculada en 392. Se utilizó instrumento SAHLPA-18 para alfabetismo funcional en salud; a la presión arterial; recogidos datos sociodemográficos y clínicos. Se utilizo La regresión logística jerárquica. Resultados: La presión arterial inadecuada (alta) y el alfabetismo funcional en salud inadecuada (bajo) estaban presentes en el 41,6% y el 54,6% de las personas, respectivamente. Los factores asociados com la presión arterial inadecuada fueron: alfabetismo funcional en salud inadecuada, color parda-negra, sobrepeso-obesidad, tiempo de diagnóstico de la hipertensión, no adhesión a ejercicio/dieta, no adhesión al tratamiento medicamentoso. El nivel de escolaridad no tuvo asociación con la presión arterial inadecuada. Conclusión: las personas mayores hipertensas con alfabetismo funcional em salud inadecuada presentaron más posibilidades de tener presión arterial inadecuada. Así, los profesionales de La salud necesitan valorizar el alfabetismo funcional en salud como posible componente para controlar la presión arterial.

RESUMO Objetivo: avaliar a relação entre alfabetismo funcional em saúde inadequado e controle inadequado da pressão arterial em pessoas idosas hipertensas na Atenção Primária. Método: estudo transversal com amostra calculada em 392. Foi usado instrumento SAHLPA-18 para alfabetismo funcional em saúde; aferida a pressão arterial; coletados dados sociodemográficos e clínicos. Utilizou-se regressão logística hierárquica. Resultados: pressão arterial inadequada(alta) e alfabetismo funcional em saúde inadequado(baixo) estavam presentes em 41,6% e 54,6% das pessoas, respectivamente. Fatores associados com pressão arterial inadequada foram: alfabetismo funcional em saúde inadequado, cor parda-negra, sobrepeso-obesidade, tempo de diagnóstico da hipertensão, não adesão a exercício/dieta, não adesão a tratamento medicamentoso. O nível de escolaridade não teve associação com pressão arterial inadequada. Conclusão: pessoas idosas hipertensas com alfabetismo funcional em saúde inadequado apresentaram mais chance de ter pressão arterial inadequada. Assim, profissionais de saúde precisam valorizar o alfabetismo funcional em saúde como possível componente para controlar a pressão arterial.

https://doi.org/10.1590/0034-7167-2018-0897 74 downloads

Functional health literacy in hypertensive elders at primary health care
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Costa, Victor Roberto Santos

; Costa, Polyana D’arc Rezende

; Nakano, Eduardo Yoshio

; Apolinário, Daniel

; Santana, Alfredo Nicodemos Cruz

Revista Brasileira de Enfermagem

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2019, Volume 72 Suppl. 2 Pages 266 - 273

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/0034-7167-2018-0897 1801 downloads

VES-13 and WHOQOL-bref cutoff points to detect quality of life in older adults in primary health care
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Silva, Samira Monteiro

; Santana, Alfredo Nicodemos Cruz

; Silva, Nayhane Nayara Barbosa da

; Novaes, Maria Rita Carvalho Garbi

Revista de Saúde Pública

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2019, Volume 53 elocation 26

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE: To determine Vulnerable Elders Survey (VES-13) and WHOQOL-bref cutoff points to detect poor quality of life (QoL) in older individuals. METHODS: This is a cross-sectional study, performed in all primary health care units in Samambaia, DF, Brazil. The data were collected from August 2016 to May 2017. The sample size of 466 older individuals treated in primary health care was obtained considering a 5% margin of error, 95% confidence level, 50% prevalence, and 20% possible losses, in a population of 13,259 older individuals. The subjects answered the VES-13 and WHOQOL-bref questionnaires. They were divided into 3 subgroups: poorQoL (older individuals with self-reported very poor or poor QoL AND very dissatisfied or dissatisfied with their health), goodQoL (very good or good QoL AND very satisfied or satisfied with Health) and indeterminateQoL (NOT belonging to poorQoL or goodQoL subgroups). A receiver-operating characteristic (ROC) curve was performed with poorQoL (case) versus goodQoL (control) to determine the cutoff score in VES-13 and WHOQOL-bref. A diagnostic test using these cutoffs was carried out in all older individuals (n = 466). RESULTS: The VES-13 and WHOQOL-bref cutoff points to detect poorQoL were ≥ 2 and < 60, respectively. The area under ROC curve of VES-13 and WHOQOL-bref was 0.741 (CI95% 0.659-0.823; p < 0.001) and 0.934 (CI95% 0.881-0.987; p < 0.001), respectively. In diagnostic tests, VES-13 showed 84% sensitivity and 98.2% negative predictive value, and WHOQOL-bref, 88% sensitivity and 99% negative predictive value. CONCLUSIONS: VES-13 score ≥ 2 and WHOQOL-bref score < 60 adequately detected poorQoL in patients treated in primary health care. Our data suggest that older individuals with these scores require special treatment such as geriatrics collaborative care to improve this scenario, considering QoL impact on mortality.

https://doi.org/10.11606/s1518-8787.2019053000802 1637 downloads

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VES-13 and WHOQOL-bref cutoff points to detect quality of life in older adults in primary health care
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Silva, Samira Monteiro

; Santana, Alfredo Nicodemos Cruz

; Silva, Nayhane Nayara Barbosa da

; Novaes, Maria Rita Carvalho Garbi

Revista de Saúde Pública

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2019, Volume 53 elocation 26

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2019053000802

11.

Noninvasive positive airway pressure: from critically ill patients to physical exercise in outpatients
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Silva, Vinicius Zacarias Maldaner da

; Santana, Alfredo Nicodemos Cruz

Jornal Brasileiro de Pneumologia

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dec 2017, Volume 43 N. 6 Pages 405 - 406

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/s1806-37562017000060001 1612 downloads

12.

A murine model of elastase- and cigarette smoke-induced emphysema: is it an opportunity to understand CT emphysema in humans?
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Santana, Alfredo Nicodemos Cruz

Jornal Brasileiro de Pneumologia

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apr 2017, Volume 43 N. 2 Pages 83 - 84

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/s1806-37562017000200002 970 downloads

13.

CHYLOTHORAX IN PARACOCCIDIOIDOMYCOSIS
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FERNANDES, Flávia Fonseca

; ALVES, Victor Oliveira

; SÁNCHEZ, Tarquino Erastides Gavilanes

; PAULA, Wagner Diniz de

; SANTANA, Alfredo Nicodemos Cruz

Revista do Instituto de Medicina Tropical de São Paulo

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2016, Volume 58 elocation 57

Abstract: En | Text: En | PDF: En

SUMMARY A previously healthy, 52-year-old woman presented with a nine months history of low fever and weight loss (> 30 kg). Physical examination disclosed generalized lymphadenopathy, skin lesions, abdominal distension, mild tachypnea and a left breast mass. Laboratory tests showed anemia; (prerenal) kidney injury, low serum albumin level; and negative serology for HIV and viral hepatitis. Computed tomography (neck/chest/abdomen) showed generalized lymph node enlargement, splenomegaly, pleural effusion and ascites. We performed thoracocentesis and paracentesis, and the findings were consistent with chylothorax and chylous ascites (with no neoplastic cells). Biopsies of the breast mass, skin and lymph nodes were performed and all of them showed large round yeast cells with multiple narrow-based budding daughter cells, characteristic of Paracoccidioides brasiliensis. Consequently, paracoccidioidomycosis was diagnosed, and liposomal amphotericin B was prescribed, as well as a high protein and low fat diet (supplemented with medium chain triglycerides). Even so, her clinical status worsened, requiring renal replacement therapy. She evolved with pneumonia, septic shock and respiratory failure and subsequently died. To our knowledge, this is the first description of a case with chylothorax and breast mass due to paracoccidioidomycosis. Additionally, we discuss: 1- the importance of the inclusion of this mycosis in the differential diagnosis of chylothorax and breast mass (breast cancer), especially in endemic areas; and 2- the possible mechanism involved in the development of chylous effusions.

https://doi.org/10.1590/S1678-9946201658057 1144 downloads

14.

Destaques das diretrizes de doenças pulmonares intersticiais da Sociedade Brasileira de Pneumologia e Tisiologia
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Baldi, Bruno Guedes

; Pereira, Carlos Alberto de Castro

; Rubin, Adalberto Sperb

; Santana, Alfredo Nicodemos da Cruz

; Costa, André Nathan

; Carvalho, Carlos Roberto Ribeiro

; Algranti, Eduardo

; Capitani, Eduardo Mello de

; Bethlem, Eduardo Pamplona

; Coletta, Ester Nei Aparecida Martins

; Arakaki, Jaquelina Sonoe Ota

; Martinez, José Antônio Baddini

; Carvalho, Jozélio Freire de

; Steidle, Leila John Marques

; Rocha, Marcelo Jorge Jacó

; Lima, Mariana Silva

; Soares, Maria Raquel

; Caramori, Marlova Luzzi

; Aidé, Miguel Abidon

; Ferreira, Rimarcs Gomes

; Kairalla, Ronaldo Adib

; Oliveira, Rudolf Krawczenko Feitoza de

; Jezler, Sérgio

; Rodrigues, Sílvia Carla Sousa

; Pimenta, Suzana Pinheiro

Jornal Brasileiro de Pneumologia

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jun 2012, Volume 38 N. 3 Pages 282 - 291

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

As doenças pulmonares intersticiais (DPIs) são afecções heterogêneas, envolvendo um elevado número de condições, cuja abordagem ainda é um grande desafio para o pneumologista. As Diretrizes de DPIs da Sociedade Brasileira de Pneumologia e Tisiologia, publicadas em 2012, foram estabelecidas com o intuito de fornecer aos pneumologistas brasileiros um instrumento que possa facilitar a abordagem dos pacientes com DPIs, padronizando-se os critérios utilizados para a definição diagnóstica das diferentes condições, além de orientar sobre o melhor tratamento nas diferentes situações. Esse artigo teve como objetivo descrever resumidamente os principais destaques dessas diretrizes.

Interstitial lung diseases (ILDs) are heterogeneous disorders, involving a large number of conditions, the approach to which continues to pose an enormous challenge for pulmonologists. The 2012 Brazilian Thoracic Association ILD Guidelines were established in order to provide Brazilian pulmonologists with an instrument that can facilitate the management of patients with ILDs, standardizing the criteria used for the diagnosis of different conditions and offering guidance on the best treatment in various situations. The objective of this article was to briefly describe the highlights of those guidelines.

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15.

Atualização do tratamento das vasculites associadas a anticorpo anticitoplasma de neutrófilos
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Santana, Alfredo Nicodemos Cruz

; Woronik, Viktoria

; Halpern, Ari Stiel Radu

; Barbas, Carmen S V

Jornal Brasileiro de Pneumologia

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dec 2011, Volume 37 N. 6 Pages 809 - 816

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

As vasculites antineutrophil cytoplasmic antibody (ANCA, anticorpo anticitoplasma de neutrófilos) associadas (VAAs) são caracterizadas por uma inflamação sistêmica das artérias de pequeno e médio calibre (especialmente no trato respiratório superior e inferior, e nos rins). As VAAs compreendem a granulomatose de Wegener (agora chamada de granulomatose com poliangeíte), poliangeíte microscópica, VAA limitada ao rim e a síndrome de Churg-Strauss. Neste artigo, discutiremos as fases de tratamento dessas vasculites, como fase de indução (com ciclofosfamida ou rituximab) e fase de manutenção (com azatioprina, metotrexato ou rituximab). Além disso, discutiremos como manusear os casos refratários à ciclofosfamida.

In its various forms, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is characterized by a systemic inflammation of the small and medium-sized arteries (especially in the upper and lower respiratory tracts, as well as in the kidneys). The forms of AAV comprise Wegener's granulomatosis (now called granulomatosis with polyangiitis), microscopic polyangiitis, renal AAV, and Churg-Strauss syndrome. In this paper, we discuss the phases of AAV treatment, including the induction phase (with cyclophosphamide or rituximab) and the maintenance phase (with azathioprine, methotrexate, or rituximab). We also discuss how to handle patients who are refractory to cyclophosphamide.

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