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  1. Article ; Online: Chest X-ray and chest CT findings in patients diagnosed with pulmonary tuberculosis following solid organ transplantation: a systematic review.

    Giacomelli, Irai Luis / Schuhmacher Neto, Roberto / Marchiori, Edson / Pereira, Marisa / Hochhegger, Bruno

    Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia

    2018  Volume 44, Issue 2, Page(s) 161–166

    Abstract: The objective of this systematic review was to select articles including chest X-ray or chest CT findings in patients who developed pulmonary tuberculosis following solid organ transplantation (lung, kidney, or liver). The following search terms were ... ...

    Abstract The objective of this systematic review was to select articles including chest X-ray or chest CT findings in patients who developed pulmonary tuberculosis following solid organ transplantation (lung, kidney, or liver). The following search terms were used: "tuberculosis"; "transplants"; "transplantation"; "mycobacterium"; and "lung". The databases used in this review were PubMed and the Brazilian Biblioteca Virtual em Saúde (Virtual Health Library). We selected articles in English, Portuguese, or Spanish, regardless of the year of publication, that met the selection criteria in their title, abstract, or body of text. Articles with no data on chest CT or chest X-ray findings were excluded, as were those not related to solid organ transplantation or pulmonary tuberculosis. We selected 29 articles involving a collective total of 219 patients. The largest samples were in studies conducted in Brazil and South Korea (78 and 35 patients, respectively). The imaging findings were subdivided into five common patterns. The imaging findings varied depending on the transplanted organ in these patients. In liver and lung transplant recipients, the most common pattern was the classic one for pulmonary tuberculosis (cavitation and "tree-in-bud" nodules), which is similar to the findings for pulmonary tuberculosis in the general population. The proportion of cases showing a miliary pattern and lymph node enlargement, which is most similar to the pattern seen in patients coinfected with tuberculosis and HIV, was highest among the kidney transplant recipients. Further studies evaluating clinical data, such as immunosuppression regimens, are needed in order to improve understanding of the distribution of these imaging patterns in this population.
    MeSH term(s) Humans ; Immunocompetence ; Incidental Findings ; Kidney Transplantation/adverse effects ; Liver Transplantation/adverse effects ; Lung Transplantation/adverse effects ; Radiography, Thoracic/methods ; Tomography, X-Ray Computed/methods ; Tuberculosis, Pulmonary/diagnostic imaging ; Tuberculosis, Pulmonary/etiology
    Language English
    Publishing date 2018-05-23
    Publishing country Brazil
    Document type Journal Article ; Systematic Review
    ZDB-ID 2223157-2
    ISSN 1806-3756 ; 1806-3713
    ISSN (online) 1806-3756
    ISSN 1806-3713
    DOI 10.1590/s1806-37562017000000459
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Multiple cavitary lung lesions on CT: imaging findings to differentiate between malignant and benign etiologies.

    Giacomelli, Irai Luis / Barros, Marcelo / Pacini, Gabriel Sartori / Altmayer, Stephan / Zanon, Matheus / Dias, Adriano Basso / Nin, Carlos Schüler / Rodrigues, Roger Pirath / Marchiori, Edson / Watte, Guilherme / Hochhegger, Bruno

    Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia

    2019  Volume 46, Issue 2, Page(s) e20190024

    Abstract: Objective: To determine the CT findings of multiple cavitary lung lesions that allow the differentiation between benign and malignant etiologies.: Methods: We reviewed CT scans, including patients with two or more cavitary lung lesions. We evaluated ... ...

    Abstract Objective: To determine the CT findings of multiple cavitary lung lesions that allow the differentiation between benign and malignant etiologies.
    Methods: We reviewed CT scans, including patients with two or more cavitary lung lesions. We evaluated the number of cavitary lesions, their location, cavity wall thickness, and additional findings, correlating the variables with the diagnosis of a benign or malignant lesion.
    Results: We reviewed the chest CT scans of 102 patients, 58 (56.9%) of whom were male. The average age was 50.5 ± 18.0 years. Benign and malignant lesions were diagnosed in 74 (72.6%) and 28 (27.4%) of the patients, respectively. On the CT scans, the mean number of cavities was 3, the mean wall thickness of the largest lesions was 6.0 mm, and the mean diameter of the largest lesions was 27.0 mm. The lesions were predominantly in the upper lobes, especially on the right (in 43.1%). In our comparison of the variables studied, a diagnosis of malignancy was not found to correlate significantly with the wall thickness of the largest cavity, lymph node enlargement, emphysema, consolidation, bronchiectasis, or bronchial obstruction. The presence of centrilobular nodules correlated significantly with the absence of malignant disease (p < 0.05). In contrast, a greater number of cavities correlated significantly with malignancy (p < 0.026).
    Conclusions: A larger number of cavitary lung lesions and the absence of centrilobular nodules may be characteristic of a malignant etiology. However, on the basis of our evaluation of the lesions in our sample, we cannot state that wall thickness is a good indicator of a benign or malignant etiology.
    MeSH term(s) Adult ; Aged ; Cross-Sectional Studies ; Diagnosis, Differential ; Female ; Humans ; Immune Tolerance ; Lung Diseases/diagnostic imaging ; Lung Diseases/etiology ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/etiology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed/methods ; Tuberculosis/diagnostic imaging ; Tuberculosis/etiology
    Language Portuguese
    Publishing date 2019-12-20
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2223157-2
    ISSN 1806-3756 ; 1806-3713
    ISSN (online) 1806-3756
    ISSN 1806-3713
    DOI 10.36416/1806-3756/e20190024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: High-resolution computed tomography findings of pulmonary tuberculosis in lung transplant recipients.

    Giacomelli, Irai Luis / Schuhmacher Neto, Roberto / Nin, Carlos Schuller / Cassano, Priscilla de Souza / Pereira, Marisa / Moreira, José da Silva / Nascimento, Douglas Zaione / Hochhegger, Bruno

    Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia

    2018  Volume 43, Issue 4, Page(s) 270–273

    Abstract: Objective: Respiratory infections constitute a major cause of morbidity and mortality in solid organ transplant recipients. The incidence of pulmonary tuberculosis is high among such patients. On imaging, tuberculosis has various presentations. Greater ... ...

    Abstract Objective: Respiratory infections constitute a major cause of morbidity and mortality in solid organ transplant recipients. The incidence of pulmonary tuberculosis is high among such patients. On imaging, tuberculosis has various presentations. Greater understanding of those presentations could reduce the impact of the disease by facilitating early diagnosis. Therefore, we attempted to describe the HRCT patterns of pulmonary tuberculosis in lung transplant recipients.
    Methods: From two hospitals in southern Brazil, we collected the following data on lung transplant recipients who developed pulmonary tuberculosis: gender; age; symptoms; the lung disease that led to transplantation; HRCT pattern; distribution of findings; time from transplantation to pulmonary tuberculosis; and mortality rate. The HRCT findings were classified as miliary nodules; cavitation and centrilobular nodules with a tree-in-bud pattern; ground-glass attenuation with consolidation; mediastinal lymph node enlargement; or pleural effusion.
    Results: We evaluated 402 lung transplant recipients, 19 of whom developed pulmonary tuberculosis after transplantation. Among those 19 patients, the most common HRCT patterns were ground-glass attenuation with consolidation (in 42%); cavitation and centrilobular nodules with a tree-in-bud pattern (in 31.5%); and mediastinal lymph node enlargement (in 15.7%). Among the patients with cavitation and centrilobular nodules with a tree-in-bud pattern, the distribution was within the upper lobes in 66.6%. No pleural effusion was observed. Despite treatment, one-year mortality was 47.3%.
    Conclusions: The predominant HRCT pattern was ground-glass attenuation with consolidation, followed by cavitation and centrilobular nodules with a tree-in-bud pattern. These findings are similar to those reported for immunocompetent patients with pulmonary tuberculosis and considerably different from those reported for AIDS patients with the same disease.
    MeSH term(s) Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Lung Transplantation/adverse effects ; Male ; Middle Aged ; Tomography, X-Ray Computed/methods ; Transplant Recipients/statistics & numerical data ; Tuberculosis, Pulmonary/diagnostic imaging ; Tuberculosis, Pulmonary/etiology ; Young Adult
    Language Portuguese
    Publishing date 2018-01-24
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2223157-2
    ISSN 1806-3756 ; 1806-3713
    ISSN (online) 1806-3756
    ISSN 1806-3713
    DOI 10.1590/S1806-37562016000000306
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Hospitalized patients with COPD

    Irai Luis Giacomelli / Leila John Marques Steidle / Frederico Fernandes Moreira / Igor Varela Meyer / Ricardo Goetten Souza / Mariângela Pimentel Pincelli

    Jornal Brasileiro de Pneumologia, Vol 40, Iss 3, Pp 229-

    analysis of prior treatment

    2014  Volume 237

    Abstract: Objective: Although COPD is a prevalent disease, it is undertreated, and there are no available data regarding previous treatment of COPD in Brazil. This study aimed to determine the appropriateness of maintenance treatment in COPD patients prior to ... ...

    Abstract Objective: Although COPD is a prevalent disease, it is undertreated, and there are no available data regarding previous treatment of COPD in Brazil. This study aimed to determine the appropriateness of maintenance treatment in COPD patients prior to their hospitalization and to identify variables associated with inappropriate treatment. Methods: This was an observational, cross-sectional, analytical study involving 50 inpatients with COPD at two hospitals in the city of Florianópolis, Brazil. The patients completed a questionnaire on parameters related to the maintenance treatment of COPD. Non-pharmacological management and pharmacological treatment were assessed based on the recommendations made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2011 and by the Brazilian National Ministry of Health in the chronic respiratory diseases section of its Caderno de Atenção Básica (CAB, Primary Care Guidebook). Results: In most of the patients, the COPD was classified as being severe or very severe. Regarding non-pharmacological management, 33% of the patients were smokers, only 32% had been advised to receive the flu vaccine, 28% had received pneumococcal vaccine, and only 6.5% of the patients in the B, C, and D categories received pulmonary rehabilitation. Regarding GOLD and CAB recommendations, pharmacological treatment was inappropriate in 50% and 74% of the patients, respectively. Based on GOLD recommendations, 38% were undertreated. A low level of education, low income, not receiving oxygen therapy, and not receiving the flu vaccine were associated with inappropriate treatment. Conclusions: The application of various non-pharmacological management recommendations was unsatisfactory. Regarding the GOLD recommendations, the high rate of inappropriate maintenance treatment was mainly due to undertreatment. In Brazil, even in severe COPD cases, optimizing treatment to achieve greater benefits continues to be a challenge.
    Keywords Doença pulmonar obstrutiva crônica/terapia ; Doença pulmonar obstrutiva crônica/prevenção & controle ; Protocolos clínicos ; Diseases of the respiratory system ; RC705-779 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 610
    Language Portuguese
    Publishing date 2014-06-01T00:00:00Z
    Publisher Sociedade Brasileira de Pneumologia e Tisiologia
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Hospitalized patients with COPD: analysis of prior treatment.

    Giacomelli, Irai Luis / Steidle, Leila John Marques / Moreira, Frederico Fernandes / Meyer, Igor Varela / Souza, Ricardo Goetten / Pincelli, Mariângela Pimentel

    Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia

    2014  Volume 40, Issue 3, Page(s) 229–237

    Abstract: Objective: Although COPD is a prevalent disease, it is undertreated, and there are no available data regarding previous treatment of COPD in Brazil. This study aimed to determine the appropriateness of maintenance treatment in COPD patients prior to ... ...

    Abstract Objective: Although COPD is a prevalent disease, it is undertreated, and there are no available data regarding previous treatment of COPD in Brazil. This study aimed to determine the appropriateness of maintenance treatment in COPD patients prior to their hospitalization and to identify variables associated with inappropriate treatment.
    Methods: This was an observational, cross-sectional, analytical study involving 50 inpatients with COPD at two hospitals in the city of Florianópolis, Brazil. The patients completed a questionnaire on parameters related to the maintenance treatment of COPD. Non-pharmacological management and pharmacological treatment were assessed based on the recommendations made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2011 and by the Brazilian National Ministry of Health in the chronic respiratory diseases section of its Caderno de Atenção Básica (CAB, Primary Care Guidebook).
    Results: In most of the patients, the COPD was classified as being severe or very severe. Regarding non-pharmacological management, 33% of the patients were smokers, only 32% had been advised to receive the flu vaccine, 28% had received pneumococcal vaccine, and only 6.5% of the patients in the B, C, and D categories received pulmonary rehabilitation. Regarding GOLD and CAB recommendations, pharmacological treatment was inappropriate in 50% and 74% of the patients, respectively. Based on GOLD recommendations, 38% were undertreated. A low level of education, low income, not receiving oxygen therapy, and not receiving the flu vaccine were associated with inappropriate treatment.
    Conclusions: The application of various non-pharmacological management recommendations was unsatisfactory. Regarding the GOLD recommendations, the high rate of inappropriate maintenance treatment was mainly due to undertreatment. In Brazil, even in severe COPD cases, optimizing treatment to achieve greater benefits continues to be a challenge.
    MeSH term(s) Aged ; Brazil ; Clinical Protocols ; Cross-Sectional Studies ; Female ; Hospitalization ; Humans ; Male ; Middle Aged ; Practice Patterns, Physicians' ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/therapy ; Socioeconomic Factors ; Spirometry ; Surveys and Questionnaires
    Language Portuguese
    Publishing date 2014-07-16
    Publishing country Brazil
    Document type Journal Article ; Observational Study
    ZDB-ID 2223157-2
    ISSN 1806-3756 ; 1806-3713
    ISSN (online) 1806-3756
    ISSN 1806-3713
    DOI 10.1590/s1806-37132014000300005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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