Year 1998 - Volume 24 - Issue 5 (September/October)

Original Article

1 - Influence of gastroesophageal reflux levels in the treatment of patients with chronic cough

Influência dos níveis de refluxo gastroesofágico (RGE) na escolha do tratamento de pacientes com tosse crônica

Otávio Leite Gastal, Bruno Carlos Palombini, Tom Ryan DeMeester, Carmen Palombini Gastal, Marta Mascarenhas Corrêa da Silva, Silvia Macedo

J Bras Pneumol.1998;24(5):277-282

2 - Chronic dyspnea with unexplained cause: evaluation of an investigation protocol with 90 patients

Dispnéia crônica de causa indeterminada: avaliação de um protocolo de investigação em 90 pacientes

Sílvia Helena Bersácola, Carlos Alberto de Castro Pereira, Rita de Cássia Cruz da Silva, Ricardo M. Ladeira

J Bras Pneumol.1998;24(5):283-297

Chronic dyspnea has a wide range of causes. The aim of the authors was to evaluate a diagnostic approach applied to patients with unexplained chronic (> 30 days) dyspnea, or when multiple causes were present. Methods: An algorithm for the work-up was applied: 1) complete history and physical examination; 2) bronchoprovocation test (BPT) and serial measurements of echocardiography; 3) cardiopulmonary exercise testing (CPET) and doppler echocardiography; 4) special tests: FRCT, V/Q scan, DCO, lung volumes, MIP, and others, as indicated. Results: Ninety patients were included, mean age of 51 ± 16 yr. Hyperventilation symptoms were present in 48, but associated with BHR or asthma in 19. Obstructive defect was present in 24 (asthma, 11; COPD, 8). Reduced FVC with normal FEV1/FVC was found in 10; explanations were asthma in 4, heart disease in 4. BPT was performed in 71 and was verified to be normal in 20; PEF variation was evaluated in 71, and was abnormal in 28, isolated in 16, and in 7 with asthma as final diagnosis. Echocardiography was performed in 44, and showed diastolic dysfunction in 11 out of 16 patients with final diagnosis of heart disease. CPET showed cardiovascular limitation in 19, hyperventilation in 19, and ventilatory defect in 12. CPET was decisive in 33 (38%), specially for heart diseases and to exclude causes suspected by clinical data. Respiratory disease was the explanation for dyspnea in 51 (59%): asthma (31), BHR (8), COPD (8), interstitial lung disease (4); other causes found were: heart disease (16), primary hyperventilation syndrome (8), obesity (5), neuromuscular disease (6), psychogenic dyspnea (2), and others (7). Multiple causes were found in 13 patients. Eight patients had non-recognizable etiology. Conclusion: An algorithm approach to chronic dyspnea resulted in diagnosis of 91% of the cases; spirometry, tests for BHR including PEF measurements, echocardiography, and CPET are essential for the investigation.

Keywords: Chronic dyspnea. Exercise test. Spirometry. Respiratory function tests. Bronchoprovocation tests. Peak expiratory flow. Echocardiography. Chest X-ray. Heart failure, congestive.

3 - Classification of risk and prophylaxis for venous thromboembolism in university hospital patients

Estratificação de risco e profilaxia para tromboembolia venosa em pacientes internados em hospital geral universitário

Sérgio Saldanha Menna Barreto, Carlo Sasso Faccin, Paula Mallman da Silva, Larissa Pretto Centeno, Marcelo Basso Gazzana

J Bras Pneumol.1998;24(5):299-302

4 - Pulmonary and mediastinal malformations with respiratory symptoms

Malformações pulmonares e mediastinais com repercussões respiratórias

Carlos A. Riedi, Nelson A. Rosário Filho, Isabelle V. Trevisan, José E. Carreiro, Dante L. Escuissato

J Bras Pneumol.1998;24(5):303-310

Review Article

5 - Complicações cardiovasculares da síndrome da apnéia do sono obstrutiva

Lia Rita Azeredo Bittencourt, Odair Marson, Luiz E. Nery, Sérgio Tufik

J Bras Pneumol.1998;24(5):311-316

6 - Manifestações pulmonares causadas pelo uso do "crack"

Maria do Rosário da Silva Ramos Costa, Rosemary Farias Alves, Marciel Dourado Franca

J Bras Pneumol.1998;24(5):317-321

Case Report

7 - Bronchiolitis obliterans with organizing pneumonia (BOOP)

Bronquiolite obliterante com pneumonia em organização (BOOP) aguda

José Eduardo Delfini Cançado, Carlos Alberto de Castro Pereira, Ester N.A.M. Coletta

J Bras Pneumol.1998;24(5):331-334

8 - Cystic adenomatoid malformation of the lung: report on four cases

Malformação congênita adenomatóide cística do pulmão: relato de quatro casos

Gisele A. Nai1, Carlos Zelandi Filho, Rosa M. Viero, Julio Defaveri

J Bras Pneumol.1998;24(5):335-338

9 - Human pulmonary adiaspiromycosis: a new case diagnosed by transbronchial biopsy

Novo caso de adiaspiromicose humana diagnosticado por biópsia transbrônquica

Terezinha do Socorro M. Lima, Mário A.P. Moraes, Hebe Quezado Magalhães, Norma Suely G. Athayde

J Bras Pneumol.1998;24(5):339-341

10 - Derrame pleural com elevado teor de amilase

Célia Mallart Llarges, Jaqueline Maria Lima, Luís Felipe F. da Silva, Carlos Eduardo P. Barreto

J Bras Pneumol.1998;24(5):342-344

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