ABSTRACT Asbestos was largely used in Brazil. It is a mineral that induces pleural and pulmonary fibrosis, and it is a potent carcinogen. Our objective was to develop recommendations for the performance of adequate imaging tests for screening asbestos-related diseases. We searched peer-reviewed publications, national and international technical documents, and specialists’ opinions on the theme. Based on that, the major recommendations are: Individuals exposed to asbestos at the workplace for ≥ 1 year or those with a history of environmental exposure for at least 5 years, all of those with a latency period > 20 years from the date of initial exposure, should initially undego HRCT of the chest for investigation. Individuals with pleural disease and/or asbestosis should be considered for regular lung cancer monitoring. Risk calculators should be adopted for lung cancer screening, with a risk estimate of 1.5%. Brazil fibrosis carcinogen asbestosrelated related diseases peerreviewed peer reviewed publications documents specialists theme are 2 investigation andor monitoring 15 1.5% 1.5 1.

ABSTRACT Objective: Talc pleurodesis is a widely used treatment option for malignant pleural effusion (MPE). However, the optimal form of administration remains controversial. Thus, we performed a systematic review and meta-analysis to assess the effectiveness of talc slurry (TS) in comparison with thoracoscopic talc insufflation/poudrage (TTI) for MPE treatment. Methods: We searched PubMed, EMBASE, and Cochrane Library databases for studies that compared TS with TTI in patients with MPE. We used a random-effects model with a 95% CI to pool the data. Heterogeneity was assessed with I2 statistics. Results: We included eight studies involving 1,163 patients, 584 of whom (50.21%) underwent TS. Pleurodesis failure rates were similar between the procedures (OR = 1.07; 95% CI: 0.56-2.06; p = 0.83; I2 = 62%); and 68% of patients (95% CI: 0.31-1.47; p = 0.33; I2 = 58%) had postoperative complications, which were lower in patients in the TS group than in the TTI group. In a subgroup analysis considering only randomized clinical trials, the failure rate was significantly lower in the TS treatment group (OR = 0.62; 95% CI: 0.42-0.90; p = 0.01; I2 = 0%). Similarly, dyspnea was less common in the TS group (OR = 0.74; 95% CI: 0.41-1.34; p = 0.32; I2 = 55%). Adverse effects were reported in 86 patients, and no significant difference was seen between the TS and TTI groups: empyema (OR = 1.43; 95% CI: 0.36-5.64; p = 0.86; I2 = 0%), pain (OR = 1.22 (95% CI: 0.67-2.21; p = 0.51; I2 = 38%), and pneumonia (OR = 1.15; 95% CI: 0.30-4.46; p = 0.86; I2 = 27%). Conclusions: Our findings suggest that TS is an effective treatment for MPE, with no significant increase in adverse events. Results suggest equivalent efficacy and safety for both procedures. Objective . (MPE) However controversial Thus metaanalysis meta (TS insufflationpoudrage insufflation poudrage (TTI Methods PubMed EMBASE randomeffects random 95 data I statistics 1163 1 163 1,16 58 50.21% 5021 50 21 (50.21% OR 1.07 107 07 0.562.06 056206 0.56 2.06 0 56 2 06 0.56-2.06 0.83 083 83 62% 62 62%) 68 (95 0.311.47 031147 0.31 1.47 31 47 0.31-1.47 0.33 033 33 58% complications trials 0.62 062 0.420.90 042090 0.42 0.90 42 90 0.42-0.90 0.01 001 01 0%. 0% 0%) Similarly 0.74 074 74 0.411.34 041134 0.41 1.34 41 34 0.41-1.34 0.32 032 32 55%. 55 55% 55%) 8 groups 1.43 143 43 0.365.64 036564 0.36 5.64 36 5 64 0.36-5.64 0.86 086 0%, , 122 22 1.2 0.672.21 067221 0.67 2.21 67 0.67-2.21 0.51 051 51 38%, 38 38% 38%) 1.15 115 15 0.304.46 030446 0.30 4.46 30 4 46 0.30-4.46 27%. 27 27% 27%) Conclusions events (MPE 9 116 16 1,1 50.21 502 (50.21 1.0 10 562 0.562.0 05620 056 0.5 206 2.0 0.56-2.0 0.8 08 6 (9 311 0.311.4 03114 031 0.3 147 1.4 3 0.31-1.4 03 0.6 420 0.420.9 04209 042 0.4 090 0.9 0.42-0.9 0.0 00 0.7 7 411 0.411.3 04113 041 134 1.3 0.41-1.3 14 365 0.365.6 03656 036 564 5.6 0.36-5.6 12 1. 672 0.672.2 06722 067 221 2.2 0.67-2.2 05 1.1 11 304 0.304.4 03044 030 446 4.4 0.30-4.4 1, 50.2 (50.2 0.562. 0562 0. 20 2. 0.56-2. ( 0.311. 0311 0.31-1. 0.420. 0420 04 09 0.42-0. 0.411. 0411 13 0.41-1. 0.365. 0365 5. 0.36-5. 0.672. 0672 0.67-2. 0.304. 0304 44 4. 0.30-4. 50. (50. 0.562 0.56-2 0.311 0.31-1 0.420 0.42-0 0.411 0.41-1 0.365 0.36-5 0.672 0.67-2 0.304 0.30-4 (50 0.56- 0.31- 0.42- 0.41- 0.36- 0.67- 0.30- (5

ABSTRACT Objective: Although EBUS-TBNA combined with EUS-FNA or EUS-B-FNA stands as the primary approach for mediastinal staging in lung cancer, guidelines recommend mediastinoscopy confirmation if a lymph node identified on chest CT or showing increased PET scan uptake yields negativity on these techniques. This study aimed to assess the staging precision of EBUS/EUS. Methods: We conducted a retrospective study comparing the clinical staging of non-small cell lung cancer patients undergoing EBUS/EUS with their post-surgery pathological staging. We analyzed the influence of histology, location, tumor size, and the time lapse between EBUS and surgery. Patients with N0/N1 staging on EBUS/EUS, undergoing surgery, and with at least one station approached in both procedures were selected. Post-surgery, patients were categorized into N0/N1 and N2 groups. Results: Among the included patients (n = 47), pathological upstaging to N2 occurred in 6 (12.8%). Of these, 4 (66.7%) had a single N2 station, and 2 (33.3%) had multiple N2 stations. The adenopathy most frequently associated with upstaging was station 7. None of the analyzed variables demonstrated a statistically significant difference in the occurrence of upstaging. PET scan indicated increased uptake in only one of these adenopathies, and only one was visualized on chest CT. Conclusions: Upstaging proved independent of the studied variables, and only 2 patients with negative EBUS/EUS would warrant referral for mediastinoscopy. Exploring other noninvasive methods with even greater sensitivity for detecting micrometastatic lymph node disease is crucial. Objective EBUSTBNA TBNA EUSFNA EUS FNA EUSBFNA B techniques EBUSEUS Methods nonsmall non small postsurgery post surgery histology location size N0N1 NN N0 N1 N N0/N selected Postsurgery, Postsurgery Post Post-surgery groups Results n 47, 47 , 47) 12.8%. 128 12.8% . 12 8 (12.8%) 66.7% 667 66 7 (66.7% 33.3% 333 33 3 (33.3% stations adenopathies Conclusions crucial N0N 12.8 1 (12.8% 66.7 (66.7 33.3 (33.3 12. (12.8 66. (66. 33. (33. (12. (66 (33 (12 (6 (3 (1 (

ABSTRACT Objective: In order to study the scenario of respiratory infections in pediatrics after the emergence of SARS-CoV-2 in Brazil, this study aimed to compare characteristics of children admitted for SARS or upper airway infection caused by either RSV or SARS-CoV-2. Methods: This was a cross-sectional study involving children up to 48 months of age admitted to a tertiary pediatric hospital with a diagnosis of SARS or upper airway infection between April of 2020 and April of 2021. Respiratory secretion samples were collected 2-5 days after hospitalization, and antigen/PCR tests for viral etiologies were performed. In this analysis, patients with laboratorial diagnosis of SARS-CoV-2 and/or RSV were selected, and their clinical and epidemiological characteristics were compared using logistic regression. Results: Our sample initially comprised 369 participants. SARS-CoV-2 and RSV infections were confirmed in 55 (15%) and 59 children (16%), respectively. Mean age was 12 months (0-48 months), and 47 were female. The following characteristics were significantly more frequent in patients with RSV when compared with those with COVID-19: younger age (OR = 0.94; 95% CI: 0.90-0.98); lower frequency of fever (OR = 0.18; 95% CI: 0.05-0.66); and more frequent upper airway symptoms: cough (OR = 7.36; 95% CI: 1.04-52.25); and tachypnea (OR = 6.06; 95% CI: 1.31-28.0). Conclusions: Children with RSV-related SARS were younger, had lower frequency of fever at admission, but had a higher frequency of signs of upper airway infection and lower systemic inflammation when compared with children hospitalized for COVID-19 during the first year of the pandemic. Objective SARSCoV2 SARSCoV CoV 2 SARS-CoV- Brazil SARSCoV2. 2. Methods crosssectional cross sectional 4 202 2021 25 5 2- hospitalization antigenPCR antigen PCR performed analysis andor selected regression Results 36 participants 15% 15 (15% 16%, 16 16% , (16%) respectively 1 048 0 (0-4 months, months) female COVID19 COVID 19 OR 0.94 094 94 95 CI 0.900.98 090098 0.90 0.98 90 98 0.90-0.98) 0.18 018 18 0.050.66 005066 0.05 0.66 05 66 0.05-0.66) symptoms 7.36 736 7 1.0452.25 1045225 1.04 52.25 04 52 1.04-52.25) 6.06 606 6 06 1.3128.0. 131280 1.31 28.0 . 31 28 1.31-28.0) Conclusions RSVrelated related admission COVID-1 pandemic SARS-CoV 20 3 (15 (16% (0- COVID1 0.9 09 9 900 0.900.9 09009 090 098 0.90-0.98 0.1 01 050 0.050.6 00506 005 0.0 066 0.6 0.05-0.66 7.3 73 0452 1.0452.2 104522 104 1.0 5225 52.2 1.04-52.25 6.0 60 3128 1.3128.0 13128 131 1.3 280 28. 1.31-28.0 COVID- (1 (16 (0 0. 0.900. 0900 0.90-0.9 0.050. 0050 00 0.05-0.6 7. 045 1.0452. 10452 10 1. 522 52. 1.04-52.2 6. 312 1.3128. 1312 13 1.31-28. ( 0.900 0.90-0. 0.050 0.05-0. 1.0452 1045 1.04-52. 1.3128 1.31-28 0.90-0 0.05-0 1.045 1.04-52 1.312 1.31-2 0.90- 0.05- 1.04-5 1.31- 1.04-