Maria Fernanda Gonçalves Meirelles Fernandes1, Gabriela de Azevedo Bastian de Souza1, Júlia Giffoni Krey1, Leonardo Araújo Pinto1,2, Maria de Fátima B. Pombo Sant’Anna3, Clemax Couto Sant’Anna3

J Bras Pneumol.2025;51(1):e20250045

Original Article

COVID-19

8 - Evaluation of the IMPROVE-DD score in COVID-19 patients submitted to venous thromboembolism investigation at a hospital in Brazil

Ronney Argolo Ferreira1, Lian Zanatta1, Juliane Bispo de Oliveira1, Janaina Ibele Carvalho Gomes1, Luiz Ritt2,3, Ana Thereza Cavalcanti Rocha1,2,3

J Bras Pneumol.2025;51(1):e20240042

9 - Machine learning algorithms applied to the diagnosis of COVID-19 based on epidemiological, clinical, and laboratory data

Silvia Elaine Cardozo Macedo1, Marina de Borba Oliveira Freire1, Oscar Schmitt Kremer2, Ricardo Bica Noal1, Fabiano Sandrini Moraes2, Mauro André Barbosa Cunha2

J Bras Pneumol.2025;51(1):e20240385

Interstitial Lung Disease

10 - Timed “up and go” to identify physically inactive individuals with interstitial lung disease

Camile Ludovico Zamboti1,2, Larissa Dragonetti Bertin1,3, Gabriela Garcia Krinski1,3, Humberto Silva1, Heloise Angélico Pimpão1,3,4, Emanuel Gois Junior1,4, Fabio Pitta1, Carlos Augusto Camillo1,2,3

J Bras Pneumol.2025;51(1):e20240248

Pulmonary hypertension

11 - Relationships that perceived barriers to physical activity have with functional capacity and quality of life in patients with pulmonary hypertension

Layse Nakazato Guedes de Lima1, Vitoria Veronez1, Paulo Roberto Araújo Mendes1, Tatiana Alves Kiyota1, Marcos Mello Moreira1,2, Monica Corso Pereira1

J Bras Pneumol.2025;51(1):e20240195

Objective: Barriers to physical activity can affect the functional capacity and quality of life of patients with pulmonary hypertension (PH). This study aimed to identify the main barriers to physical activity in patients with PH and to examine whether those barriers are related to functional capacity, echocardiographic variables, or quality of life. Methods: This was a cross-sectional observational study involving 70 patients. Participants scored seven potential barriers to their activities, with a score = 5 indicating a significant barrier. Participants completed the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Manchester Respiratory Activity of Daily Living questionnaire, as well as the six-minute walk test. Correlation analysis, univariate analysis and multiple logistic regression were performed. Results: As a perceived barrier to physical activity, 'lack of will' or 'lack of energy' was cited by 67% of the patients. The 'lack of will' barrier was found to correlate with all SF-36 domains except bodily pain. We also identified a correlation between the SF-36 vitality domain and the barriers 'lack of energy', 'lack of will' and 'lack of structure'. The logistic regression analysis indicated that the vitality domain correlated significantly with the barriers 'social influence', 'lack of energy', 'lack of will', and 'lack of structure'. For each unit decrease in the vitality score, there was a 10% increase in the probability of citing the barrier 'lack of will'. No significant correlations were identified between any of the perceived barriers and echocardiographic parameters. Conclusions: The perceived barrier most commonly reported was 'lack of will/energy', which correlated with almost all SF-36 domains, especially vitality. The 'lack of will' barrier also correlated with functional capacity.

Keywords: Pulmonary arterial hypertension; Exercise; Motivation; Quality of life; Surveys and questionnaires; Walk test.

Tuberculosis and other mycobacterioses

12 - Diagnostic contribution of GeneXpert Ultra in pediatric pulmonary tuberculosis

Claudia Stella Pereira Battaglia1, Ana Alice Amaral Ibiapina Parente1,2, Ronir Raggio Luiz2, Rafaela Baroni Aurilio1, Michely Alexandrino de Souza Pinheiro1, Maria de Fátima Bazhuni Pombo Sant’Anna2, Clemax Couto Sant’Anna2

J Bras Pneumol.2025;51(1):e20240241

Special Article

13 - Brazilian Thoracic Association recommendations for the management of lymphangioleiomyomatosis

Recomendações da Sociedade Brasileira de Pneumologia e Tisiologia para a abordagem da linfangioleiomiomatose

Bruno Guedes Baldi1, Paulo Henrique Ramos Feitosa2, Adalberto Sperb Rubin3, Alexandre Franco Amaral1, Carolina Salim Gonçalves Freitas4, Cláudia Henrique da Costa5a, Eliane Viana Mancuzo6a, Ellen Caroline Toledo do Nascimento7a, Mariana Sponholz Araujo8a, Marcelo Jorge Jacó Rocha9, Martina Rodrigues de Oliveira1, Tatiana Senna Galvão10, Pedro Paulo Teixeira e Silva Torres11, Carlos Roberto Ribeiro Carvalho1

J Bras Pneumol.2025;51(1):e20240378

Narrative Review

14 - Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies

Orientações práticas de ventilação mecânica baseadas em evidências: sugestões de duas sociedades médicas brasileiras

Juliana Carvalho Ferreira1, Arthur Oswaldo de Abreu Vianna2, Bruno Valle Pinheiro3, Israel Silva Maia4,5, Sérgio Vasconcellos Baldisserotto6, Alexandre Marini Isola7, on behalf of Associação de Medicina Intensiva Brasileira, Sociedade Brasileira de Pneumologia e Tisiologia and the Mechanical Ventilation Practical Suggestions and Considerations Working Group

J Bras Pneumol.2025;51(1):e20240255

Mechanical ventilation can be a life-saving intervention, but its implementation requires a multidisciplinary approach, with an understanding of its indications and contraindications due to the potential for complications. The management of mechanical ventilation should be part of the curricula during clinical training; however, trainees and practicing professionals frequently report low confidence in managing mechanical ventilation, often seeking additional sources of knowledge. Review articles, consensus statements and clinical practice guidelines have become important sources of guidance in mechanical ventilation, and although clinical practice guidelines offer rigorously developed recommendations, they take a long time to develop and can address only a limited number of clinical questions. The Associação de Medicina Intensiva Brasileira and the Sociedade Brasileira de Pneumologia e Tisiologia sponsored the development of a joint statement addressing all aspects of mechanical ventilation, which was divided into 38 topics. Seventy-five experts from all regions of Brazil worked in pairs to perform scoping reviews, searching for publications on their specific topic of mechanical ventilation in the last 20 years in the highest impact factor journals in the areas of intensive care, pulmonology, and anesthesiology. Each pair produced suggestions and considerations on their topics, which were presented to the entire group in a plenary session for modification when necessary and approval. The result was a comprehensive document encompassing all aspects of mechanical ventilation to provide guidance at the bedside. In this article, we report the methodology used to produce the document and highlight the most important suggestions and considerations of the document, which has been made available to the public in Portuguese.

Keywords: Respiration, artificial; Practice guidelines as topic; Noninvasive ventilation; Ventilator weaning; Intensive care units

Systematic Reviews and Meta-analyses

15 - Bedaquiline and linezolid regimens for multidrug-resistant tuberculosis: a systematic review and meta-analysis

Mahdis Cheraghi1, Mehrnaz Amiri1, Sahar Andarzgoo2, Fatemeh Zarei3, Zahra Sadat Seghatoleslami4, Rosella Centis5, Dina Visca5, Lia D’Ambrosio6, Emanuele Pontali7, Mohammad Javad Nasiri1, Giovanni Battista Migliori5

J Bras Pneumol.2025;51(1):e20240391

Objective: Multidrug-resistant tuberculosis (MDR-TB) remains a global public health challenge, complicating treatment strategies and requiring advanced therapeutic approaches. The persistence of MDR-TB has led to a demand for regimens that are more effective in improving treatment outcomes and controlling transmission. This systematic review and meta-analysis sought to examine the efficacy of linezolid (LZD) and bedaquiline (BDQ) in MDR-TB treatment regimens, evaluating their roles in enhancing therapeutic success and informing optimized management of MDR-TB. Methods: A comprehensive search was conducted across MEDLINE (PubMed), EMBASE, the Cochrane Central Register of Controlled Trials, Scopus, and Web of Science for randomized controlled trials assessing the efficacy of LZD and BDQ in MDR-TB patients up to September 14, 2024. We analyzed treatment outcomes, reporting favorable outcomes (cured and treatment completed) and unfavorable outcomes (death, treatment failure, and loss to follow-up) with a 95% confidence interval. Results: Our analysis included 11 trials, with a total of 1,999 participants. The findings indicate that BDQ+LZD-containing regimens yield significantly higher favorable treatment outcomes (84.5%; 95% CI, 79.8%-88.2%) and lower unfavorable outcomes (15.4%; 95% CI, 11.6%-20.2%). In contrast, regimens lacking either LZD or BDQ show lower efficacy, with favorable outcomes at 66.8% (95% CI, 59.5%-73.4%) and unfavorable outcomes at 33.0% (95% CI, 25.6%-41.4%). Conclusions: MDR-TB treatment regimens including BDQ and LZD lead to significantly better patient outcomes. The combined bactericidal and protein synthesis-inhibiting effects of BDQ and LZD create a powerful therapeutic synergy. Adding pretomanid further enhances this effectiveness, highlighting its value in complex cases. Future research should focus on optimizing these regimens for safety and efficacy and explore adjunctive therapies to improve MDR-TB outcomes even further.

Keywords: Linezolid; Tuberculosis; Tuberculosis, multidrug-resistant; Treatment outcome; Systematic review.

Letters to the Editor

16 - Incidence rate, clinical profile, and outcomes of COVID-19 in adults with noncystic fibrosis bronchiectasis

Cristiane Christ Camargo1, Fernanda de Miranda Schmitz2, Letícia Bauer Jacobsen1, Bruna Ziegler1,3, Paulo de Tarso Roth Dalcin1,2

J Bras Pneumol.2025;51(1):e20240258

17 - The hidden dangers of electronic cigarettes: e-cigarette, or vaping, product–use associated lung injury requiring extracorporeal membrane oxygenation

Anna Maria Garcia Cardoso1, Wanessa Nayane Alves Rabelo1, Stephan Adamour Soder1, Fabíola Adélia Perin1, Spencer Marcantonio Camargo1

J Bras Pneumol.2025;51(1):e20240163

18 - The thirty-second sit-to-stand test as a predictor of postoperative complications of lung resection: a real-world study

Inês Fernandes Pedro1, Diana Organista1a, Teresa Seguro2, Mariana Maia Silva3, Fátima Rodrigues1,4

J Bras Pneumol.2025;51(1):e20240342

19 - Severity of COPD in comparison with acute myocardial infarction: evidence of in-hospital mortality in Brazil

Marcelo Fouad Rabahi1,2, Guylherme Saraiva2, Frederico Leon Arrabal Fernandes3, Klaus Rabe4

J Bras Pneumol.2025;51(1):e20240289

Images in Pulmonary Medicine

20 - Life-threatening pulmonary embolism seen as hyperdense clots on unenhanced CT

Ana Paula Zanardo1,2, Rafael Domingos Grando1,2, Rafael Ramos Rambo1,2

J Bras Pneumol.2025;51(1):e20240311

21 - A Right extrapleural hematoma due to thoracic trauma. The extrapleural fat sign

Raquel García-Latorre1, Luis Gorospe1, Abel González-Huete1

J Bras Pneumol.2025;51(1):e20250027

Previous Issue

Year 2025 - Volume 51 - Issue 1 (January/February)

PDF

Editorial

1 - What’s new in the 2025 GOLD report

2 - Reflections on medical education in Brazil

3 - Evidence, implementation, and challenges in mechanical ventilation

Continuing Education: Imaging

4 - Pulmonary talcosis due to aspiration

Continuing Education : Scientific Methodology

5 - Cross-sectional studies: understanding applications, methodological issues, and valuable insights

Continuing Education: Respiratory Physiology

6 - The laboratory of lung function in the follow-up of lung transplant recipients

Continuing Education: Pediatric Pulmonology

7 - Diagnosis and management of tuberculosis in children