Resumen: Objetivo: Evaluar la morbimortalidad de las bronquiectasias, su interface con el mantenimiento de las tasas de ingreso hospitalario y los resultados pronósticos insatisfactorios, y el impacto negativo en la salud pública brasileña. Métodos: Las informaciones clínicas y epidemiológicas provinieron del departamento de informática del Sistema Único de Salud de Brasil - DataSus, del cual se filtraron los datos requeridos a través de la lista de morbilidades del SUS - CID10. Se buscó información sobre la hospitalización de pacientes con bronquiectasias, como sexo, edad, tiempo y costo de la hospitalización, régimen de tratamiento y número de muertes a consecuencia de la enfermedad. Resultados: Se observó que de enero de 2008 a febrero de 2020 se hospitalizaron alrededor de 24.087 pacientes con bronquiectasias. El 65% eran adultos, con una gran porción en la fase productiva. El 84% de los pacientes buscó unidades de salud en modalidad de emergencia y el 47% acudió a los servicios públicos. El promedio brasileño de estancia hospitalaria fue estimado en 8,1 días, el costo del servicio rondaba los R$ 28 millones y se registraron 698 muertes por bronquiectasias. Conclusiones: Enfermedades como las bronquiectasias están lejos del manejo adecuado que requieren las enfermedades pulmonares crónicas. A pesar de la importante evolución diagnóstica, la etiología y el tratamiento de la enfermedad siguen siendo cuestionables.

Abstract: Objective: To evaluate the morbidity and mortality of bronchiectasis, its interface with the maintenance of hospitalization rates and unsatisfactory prognostic outcomes, as well as the negative impact on Brazilian public health. Methods: The clinical and epidemiological information came from the IT department of the Brazilian Unified Health System - DataSus, from which the required data was filtered through the SUS - CID10 list of morbidities. Information was sought, in absolute numbers, regarding the hospitalization of bronchiectasis patients, such as gender, age, time and cost of hospitalization, care regime, and the number of deaths due to the disease. Results: From the variables found, it was noted that in the period from January 2008 to February 2020, around 24,087 bronchiectasis patients were hospitalized. 65% of the total number of hospitalizations due to the disease consisted of adults, with a large portion in the productive phase (between 20 and 79 years). 84% of the patients sought health units in an emergency mode and 47% used public services at the time of hospitalization. The Brazilian average length of stay in hospital was estimated at 8.1 days and the cost of the service was around R$ 28 million in the twelve years analyzed. Besides, 698 deaths due to bronchiectasis were recorded in Brazil. Conclusions: Diseases such as bronchiectasis are far from the adequate management that chronic lung diseases require. Despite the significant diagnostic evolution, the etiology and treatment of disease is still questionable, providing unsatisfactory quality of life for bronchiectasis patients.

Resumo Os produtos naturais têm sido apontados como ferramentas importantes devido ao seu vasto potencial para o desenvolvimento de compostos com atividade antimicrobiana e a possível atividade inibitória e/ou adjuvante de mecanismos de resistência. O própolis é utilizado empiricamente há muitos anos no tratamento de doenças, principalmente devido às suas atividades antioxidantes, anti-inflamatórias e antimicrobianas. Este estudo teve como objetivo avaliar a atividade antimicobacteriana in vitro do extrato etanólico de própolis isoladamente e em associação com rifampicina (RIF), amicacina (AMI) e ciprofloxacina (CIP). O extrato etanólico de própolis mostrou atividade antibacteriana frente Mycobacterium chelonae e M. kansasii e foi capaz de aumentar a atividade de AMI, RIF e CIP em associação. Por outro lado, frente a M. absecessus, M. fortuitum e M. avium, o extrato não foi ativo a 200 µg/mL e não apresentou capacidade adjuvante pronunciada quando avaliado em associação com os fármacos. Com base nesses resultados, pode-se concluir que o extrato etanólico de própolis pode ser uma alternativa no desenvolvimento de novos fármacos e pode ser utilizado complementarmente com o atual tratamento das micobacterioses.

Abstract Natural products have been touted as important tools because of their vast potential for the development of compounds with antimicrobial activity and the possible inhibitory activity and/or adjuvant resistance mechanisms. Propolis has been empirically used for many years for the treatment of diseases, mainly due to its antioxidant, anti inflammatory and antimicrobial activities. This study aimed to evaluate the in vitro antimycobacterial activity of the ethanol extract of propolis alone and in combination with rifampicin (RIF), amikacin (AMI) and ciprofloxacin (CIP). The ethanol extract of propolis showed antibacterial activity against Mycobacterium chelonae and M. kansasii and was capable of increasing AMI, RIF and CIP activity in combination. On the other hand, compared to M. absecessus, M. fortuitum and M. avium, the extract was not active at 200 µg/mL and did not show pronounced adjuvant capacity when evaluated in association with the drugs. Based on these results, it can be concluded that the ethanol extract of propolis could be an alternative in the development of new drugs and can be used complementary with the current mycobacteriosis treatment.