Miguel Ângelo Uflacker Lutz de Castro1, Laura Menestrino Prestes1, Gabriela de Azevedo Bastian de Souza1, Maria Paula de Carli Hanel1, Leonardo Araújo Pinto1,2, Débora Carla Chong e Silva3,4

J Bras Pneumol.2025;51(2):e20250137

Original Article

Asthma

9 - Level of agreement between two asthma control questionnaires in children and adolescents

Cláudio Luiz Castro Gomes de Amorim1,2, Karina Couto Furlanetto2,3, Thaila Corsi2,3, Fabio Pitta1,2

J Bras Pneumol.2025;51(2):e20240407

Cystic Fibrosis

10 - Impact of elexacaftor/tezacaftor/ivacaftor on the small airways in cystic fibrosis

Sofia Campos Silva1, Andreia Barroso2, Maria Cunha3, Elsa Fragoso4,5, Pilar Azevedo4,5

J Bras Pneumol.2025;51(2):e20240406

Objective: To evaluate the impact of the elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) combination on the small airways in adults with cystic fibrosis (CF), a genetic disorder that primarily affects the respiratory system, leading to progressive lung disease. In CF, the small airways play a critical role, contributing to chronic symptoms such as cough, sputum production, and dyspnea. Methods: This was a single-center, retrospective observational study of adults with CF treated with ELX/TEZ/IVA for 12 months. We compared the patients who were homozygous for the F508del mutation of the CF transmembrane conductance regulator (CFTR) gene with those who were heterozygous for that mutation, in terms of lung function outcomes (FEV1, FEF25-75%, and the RV/TLC ratio) and the extent of non-homogeneous ground-glass opacity. Among the patients within the cohort, the same parameters were evaluated separately in those who had advanced lung disease and in those who had previously undergone CFTR modulator therapy. Results: There was a significant post-treatment improvement in lung function, with a median increase of 0.42 L/s in the FEF25-75% (p < 0.001) and a 5% reduction in the mean RV/TLC ratio (p < 0.001). There was a trend toward a higher improvement the F508del homozygous patients. A significant reduction in non-homogeneous ground-glass opacity was observed in 79.5% of the patients. Among the patients with advanced lung disease, there were notable post-treatment improvements in all of the parameters assessed. Conclusions: Our results highlight the positive impact that ELX/TEZ/IVA treatment can have on small airway function in patients with CF, with potential benefits even for those with advanced lung disease. Further research is needed in order to evaluate the long-term effects of this treatment and its relationship with patient-reported outcomes.

Keywords: Cystic fibrosis/diagnostic imaging; Lung/physiopathology; Respiratory function tests; Lung/drug effects; Lung/diagnostic imaging; Cystic fibrosis/drug therapy.

11 - Depression and anxiety in adolescents with cystic fibrosis in Brazil: prevalence, stability over time, and relationship with treatment adherence

Tatiana Rozov1, Marcos Tadeu Nolasco da Silva2, Maria Ângela Gonçalves Oliveira Ribeiro2, Neiva Damaceno3, Maria Angelica Pinheiro Santos Santana4, Paulo Jose Cauduro Marostica5, Roberta de Cássia Nunes Cruz Melotti6, Valeria de Carvalho Martins7, Carlos Antônio Riedi8, Edna Lucia Santos de Souza9, Norberto Ludwig Neto10, Rodrigo Abensur Athanazio1, Francyelly Wisnievski Yamamoto11, Lusmaia Damaceno Camargo Costa12, Sonia Mayumi Chiba13, Izabela Sad14, José Dirceu Ribeiro2, Alexandra L. Quittner15, Brazilian Anxiety, Depression and Adherence Study Group (BADAS)1

J Bras Pneumol.2025;51(2):e20240416

Objective: Depression and anxiety have been documented in people with cystic fibrosis (CF), jeopardizing treatment adherence. To date, no studies have assessed the prevalence of psychosocial issues in adolescents with CF in Brazil. We sought to assess the prevalence of depression and anxiety in adolescents with CF in Brazil, as well as the impact of depression and anxiety on treatment adherence. Methods: This was a multicenter, prospective, observational, longitudinal study conducted between 2017 and 2019 at 14 CF referral centers in Brazil. We used standardized tools such as the nine-item Patient Health Questionnaire (for depression), the seven-item Generalized Anxiety Disorder scale (for anxiety), and the eight-item Morisky Medication Adherence Scale (for treatment adherence) in order to collect data on 218 CF patients at two different time points. Results: The prevalence of depression was 19.1% at time point 1 and 15.4% at time point 2. The prevalence of anxiety was 19.1% at time point 1 and 18.0% at time point 2. Depression and anxiety were significantly higher in female patients and lower in those who underwent home physiotherapy or had psychological support. Significant correlations were found between depression and anxiety at both time points, the associations being strongest at time point 1 (r = 0.68; p < 0.001). Most (66.7%) of the study participants reported low adherence to treatment, and the remainder reported either average adherence (in 28%) or high adherence (in 5.3%). Depression and anxiety showed inverse correlations with treatment adherence. Conclusions: The prevalence of depression and anxiety in adolescents with CF in Brazil appears to be similar to that reported in other countries, being higher in females and lower in those undergoing home physiotherapy or receiving psychological care. Depression and anxiety appear to correlate with lower treatment adherence. Treating psychosocial issues may effectively improve rates of treatment adherence in adolescents with CF.

Keywords: Cystic fibrosis; Anxiety; Depression; Treatment adherence and compliance; Adolescent.

12 - Early discharge, inpatient treatment, or ICU management for patients with acute pulmonary embolism: is the guidelinerecommended practice being followed?

Paula Ruiz-Talero1,2, Oscar M Muñoz-Velandia1,2, Santiago Méndez Salazar1

J Bras Pneumol.2025;51(2):20240167

Smoking

13 - Characteristics of nicotine product use, perceptions of dependence, and passive exposure among first-year university students in Brazil

Matheus Milani Silva1, Sandra Silva Marques2, Ludmila Candida de Braga2, Suzana Erico Tanni4, Ilda de Godoy5, Irma de Godoy6

J Bras Pneumol.2025;51(2):e20240384

Objective: To assess nicotine product use among incoming students at public and private universities in Brazil. Methods: This was a multicenter cross-sectional study including a convenience sample of incoming university students (= 18 years of age). Current use of conventional cigarettes, electronic cigarettes, and other nicotine products, as well as indicators of dependence and knowledge of the consequences of active use of or passive exposure to nicotine products were investigated with the use of a 38-item questionnaire. Descriptive statistics were used to analyze the data. Results: A total of 863 students completed the questionnaire. Of those, most (61%) were female, and most (76.6%) identified themselves as White. In addition, most (86%) were in the 18- to 24-year age bracket, and most (88.6%) attended a public university. In the past 30 days, 20.7% reported using electronic cigarettes, 23.2% reported using conventional cigarettes, and more than 50% reported using other nicotine products. More than 80% agreed that electronic cigarettes are harmful to health and are as damaging as other types of smoking. Over half of the respondents reported using the product shortly after waking up, and, paradoxically, 81% stated that they would quit whenever they wanted. Passive exposure was reported by 21.6%, occurring at home (in 33.6%), in other indoor environments (in 41.7%), and in open environments (in 87.5%). Conclusions: Experimentation and current use of nicotine products are high among incoming students at public and private universities in Brazil. Passive exposure to nicotine products is commonplace. Advanced communication tools are needed, particularly to emphasize the dangers of nicotine dependence. Being a legal drug, nicotine is often perceived as harmless, reinforcing the misconception that it can be used without consequences.

Keywords: Cigarette smoking; Electronic nicotine delivery systems; Tobacco use disorder; Tobacco smoke pollution.

Tuberculosis and other mycobacterioses

14 - A polymorphism in the FAM13A gene confers protection against tuberculosis in Brazilian workers exposed to silica

Marcos César Santos de Castro1,2, Angela Santos Ferreira Nani2, Kaio Cezar Rodrigues Salum1, Lucas de Carvalho Costa1, Valéria Barbosa Moreira2, Hermano Albuquerque de Castro4, Patrícia Canto Ribeiro4, Walter Costa3, Cícero Brasileiro de Mello1,5, Fabiana Barzotto Kohlrausch5

J Bras Pneumol.2025;51(2):e20240327

15 - Knowledge of, Attitude towards, and Preventive Behavior towards Tuberculosis questionnaire: translation and cross-cultural adaptation for use in Brazil

Rosana Maria Barreto Colichi1, Sebastião Pires Ferreira Filho2, Renata Camargo Alves3, Silvana Andrea Molina Lima1, Hélio Rubens de Carvalho Nunes1

J Bras Pneumol.2025;51(2):e20240426

Special Article

16 - Brazilian guidelines for the pharmacological treatment of pulmonary embolism. Official document of the Brazilian Thoracic Association based on the GRADE methodology

Diretrizes brasileiras para o tratamento farmacológico do tromboembolismo pulmonar. Documento oficial da Sociedade Brasileira de Pneumologia e Tisiologia baseado na metodologia GRADE

Veronica Moreira Amado1, Caio Júlio César dos Santos Fernandes2, William Salibe-Filho2, Marcelo Basso Gazzana3, Ana Thereza Rocha4, Hugo Hyung Bok Yoo5, Wanderley Marques Bernardo6,7, Suzana Tanni5

J Bras Pneumol.2025;51(2):e20240314

Letters to the Editor

17 - Exploring perspectives on the benefits of a tuberculosis short-treatment regimen: a cross-sectional study on treatment experiences and perceptions

Fernando Pereira da Silva1, João Pedro Ramos2,3, Pedro Barbosa2,3, Mariana Vieira2,3, Raquel Duarte2,3,4

J Bras Pneumol.2025;51(2):e20250059

Images in Pulmonary Medicine

18 - Granulomatosis with polyangiitis

Roberta Wartchow Machado1, Felipe Welter Langer2, Dionatta Halle Flores Lisboa3

J Bras Pneumol.2025;51(2):e20250091

Previous Issue

Year 2025 - Volume 51 - Issue 2 (March/April)

Editorial

1 - COPD and bronchiectasis; more than mere enemies

2 - Comprehensive care in cystic fibrosis: mental health assessments

3 - The pitfalls of evaluating asthma control in children and adolescents

Point of View

4 - Why we should rethink military metaphors in cancer

Continuing Education: Imaging

5 - Centrilobular nodules with central calcifications

Continuing Education : Scientific Methodology

6 - Beyond the average: why data spread matters in clinical studies

Continuing Education: Respiratory Physiology

7 - The lung function laboratory to assist in the management of chronic kidney disease

Continuing Education: Pediatric Pulmonology

8 - An overview of electronic cigarette use and consequences among adolescents.