Sérgio Grava1,2, Francisco Antonio Dias Lopes3, Rodrigo Silva Cavallazzi4, Melyssa Fernanda Norman Negri Grassi5, Terezinha Inez Estivalet Svidzinski1,2,5

J Bras Pneumol.2016;42(5):392-394

Original Article

Quality of Communication Questionnaire para pacientes com DPOC em cuidados paliativos: tradução e adaptação cultural para uso no Brasil

Flávia Del Castanhel1, Suely Grosseman2

J Bras Pneumol.2017;43(5):357-362

A study of community-acquired pneumonia inpatients in a period of a year

Estudo de casos hospitalizados por pneumonia comunitária no período de um ano

Ricardo de Amorim Corrêa, Regina Magalhães Lopes, Luciana Macedo Guedes de Oliveira, Frederico Thadeu Assis Figueiredo Campos, Marco Antônio Soares Reis, Manoel Otávio da Costa Rocha

J Bras Pneumol.2001;27(5):243-248

Introduction: Besides the improvement we have had in the diagnostic methods, the causative agent in around 50% of the cases of community-acquired pneumonia (CAP) remains unknown, even in inpatients. Despite that, adequate empirical therapy results in low mortality in the majority of the cases. Goals: To describe the epidemiology, the clinical presentation, the utility of diagnostic tests, the duration of hospital stay, the morbidity and mortality rates of 42 consecutive inpatients with CAP. Methods: The inclusion criteria were the presence of a recent pulmonar infiltrate in the CXR and two items out of fever (38ºC), productive cough and leukocytosis (> 10,000/mm3), in the presence of a compatible clinical syndrome. The subsidiary tests were performed as required on individual basis. Results: Forty-two patients, aged 64.7 ± 16.8 years, 27 (64.3%) male, were studied. Twenty-seven (64%) had subjacent illness. Seventeen (40.5%) were on antimicrobial therapy on admission. There were eight cases (19%) of severe pneumonia; the patients aged > 60 or £ 60 years were similar concerning the severity of presentation (p = 0.57) and had similar hospital stay (p = 0.25). The mean global hospital stay was 14.3 ± 7.6 days. Definite etiologic diagnosis were done in three patients: Legionella sp (2), S. aureus (1). In thirty-one cases (73.8%) the antimicrobial therapy wasn't modified; when it happened (11 patients, 26.2%), the main reason was the bad outcome in six cases (54.5%); in five (45.5%), the microbiological result prompted the change in therapy. Blood samples were drawn in 16 cases (38%), being positive in only one (6.3%). There were nine adequate sputum samples for analysis (9/22, 41%). There was only one death (2.4%), due to severe pneumonia in a patient with a neoplastic disease. Conclusion: The etiologic diagnosis in CAP is reached in a minority of cases, even in inpatients. At least partly, this is probably due to the previous use of antimicrobial drugs. Adequate empirical therapy results in low mortality. Diagnostic tests can be performed on individual basis.

Keywords: Pneumonia. Community acquired infections. Epidemiology. Therapeutics.

Letters to the Editor

Usual interstitial pneumonia: a pattern or a disease? A reflection upon the topic

Pneumonia intersticial usual: um padrão ou uma doença? Reflexão sobre o assunto

Leticia Kawano-Dourado, Ronaldo Adib Kairalla

J Bras Pneumol.2013;39(1):111-112

Original Article

Systemic sclerosis-associated interstitial pneumonia: evaluation of pulmonary function over a five-year period

Pneumonia intersticial associada à esclerose sistêmica: avaliação da função pulmonar no período de cinco anos

Agnaldo José Lopes, Domenico Capone, Roberto Mogami, Sara Lucia Silveira de Menezes, Fernando Silva Guimarães, Roger Abramino Levy

J Bras Pneumol.2011;37(2):144-151

Implementation of community-acquired pneumonia guidelines at a public hospital in Brazil

Implementação de uma diretriz para pneumonia adquirida na comunidade em um hospital público no Brasil

Lucieni Oliveira Conterno, Fábio Ynoe de Moraes, Carlos Rodrigues da Silva Filho

J Bras Pneumol.2011;37(2):152-159

Case Report

Interstitial pneumonia in a patient undergoing treatment with leflunomide: drug-induced toxicity?

Pneumonite intersticial em paciente sob tratamento com leflunomide: toxicidade da droga?

Jonatas Reichert, Adriane Reichert, Luci Iolanda Bendhack, Lucia de Noronha, Dante Escuissato, Acir Rachid Filho

J Bras Pneumol.2003;29(6):395-400

Original Article

Prevalence of ventilator-associated pneumonia in a university hospital and prognosis for the patients affected

Prevalência e prognóstico dos pacientes com pneumonia associada à ventilação mecânica em um hospital universitário

Márcio Martins de Queiroz Guimarães, José Rodolfo Rocco

J Bras Pneumol.2006;32(4):339-346

Objective: To determine the prevalence of ventilator-associated pneumonia in an intensive care unit, as well as to identify related factors and characterize patient evolution. Methods: This study evaluated 278 patients on mechanical ventilation for more than 24 hours in a university hospital. Results: Ventilator-associated pneumonia developed in 38.1% of the patients, translating to 35.7 cases/1000 ventilator-days: 45.3% were caused by gram-negative agents (Pseudomonas aeruginosa accounting for 22%); and multidrug resistant organisms were identified in 43.4%. In the ventilator-associated pneumonia group, time on mechanical ventilation, time to mechanical ventilation weaning, hospital stays and intensive care unit stays were all longer (p < 0.001). In addition, atelectasis, acute respiratory distress syndrome, pneumothorax, sinusitis, tracheobronchitis and infection with multidrug resistant organisms were more common in the ventilator-associated pneumonia group (p < 0.05). Mortality rates in the intensive care unit were comparable to those observed in the hospital infirmary. Associations between ventilator-associated pneumonia and various factors are expressed as odds ratios and 95% confidence intervals: acute sinusitis (38.8; 3.4-441); > 10 days on mechanical ventilation (7.7; 4.1-14.2); immunosuppression (4.3; 1.3-14.3); acute respiratory distress syndrome (3.5; 1.4-9.0); atelectasis (3.0; 1.2-7.3); cardiac arrest (0.18; 0.05-0.66); and upper gastrointestinal tract bleeding (0.07; 0.009-0.62). The variables found to be associated with in-hospital death were as follows: chronic renal failure (26.1; 1.9-350.7); previous intensive care unit admission (15.6; 1.6-152.0); simplified acute physiologic score II > 50 (11.9; 3.4-42.0); and age > 55 years (4.4; 1.6-12.3). Conclusion: Ventilator-associated pneumonia increased the time on mechanical ventilation and the number of complications, as well as the length of intensive care unit and hospital stays, but did not affect mortality rates.

Keywords: Bacterial pneumonia; Hospital infection; Intensive care units; Prognosis; Prospective studies; Intensive care medicine

Impact of bacteremia in a cohort of patients with pneumococcal pneumonia

Impacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócica

Ileana Palma, Ricardo Mosquera, Carmen Demier, Carlos Vay, Angela Famiglietti, Carlos Luna

J Bras Pneumol.2012;38(4):422-430

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