Epidemiologic data on idiopathic pulmonary fibrosis are relatively scarce, and its real incidence and prevalence are unknown. Recent studies suggest that mortality due to idiopathic pulmonary fibrosis is rising in developed countries. OBJECTIVE: To describe mortality caused by idiopathic pulmonary fibrosis in the State of Rio Grande do Sul (RS), Brazil, from 1970 to 2000, analyzing its trend and comparing it with that from other countries. METHOD: Prevalence study, using data from the Brazilian Institute of Geography and Statistics (IBGE), analyzing death certificates in which idiopathic pulmonary fibrosis was stated as the ultimate cause of death. RESULTS: Annual mortality rate adjusted to the population was 0.22/100,000 people in the 1970’s, 0.3/100,000 people in the 1980’s, and 0.48/100,000 people in the 1990’s. Total mortality raised 36% from 1970 to 1980, and 73% from 1980 to 1990. The mortality rate adjusted to the population raised 36% and 60% during the same periods. The rise in both total and adjusted mortality from IPF was statistically significant (p < 0.05). The mean mortality rate per 100,000 inhabitants between 1996 and 1998, however, was 0.683, corresponding to a 70% increase when compared to the previous three-year period, which was 0.4 (p = 0.0002), probably reflecting coding practices. CONCLUSION: There was a significant increase in IPF mortality in RS from 1970 to 2000, partly due to changes in coding practices. This increase is in conformity with observations in other countries, although mortality rates in RS are considerably lower
OBJETIVO: Este estudo de casos do Rio Grande do Sul, Brasil, propõe-se a traçar um perfil local da sarcoidose, descrevendo as características dos pacientes, apresentação clínica, função pulmonar, achados radiológicos, histopatológicos e exames bioquímicos de uma série de casos, por ocasião do diagnóstico. MÉTODOS: Estudo retrospectivo de 92 pacientes com sarcoidose, atendidos no Pavilhão Pereira Filho, da Santa Casa de Porto Alegre (RS), entre 1990 e 2003. O protocolo incluiu dados clínicos, bioquímicos, radiológicos, espirométricos e de biópsia. RESULTADOS: Não houve diferença de freqüência entre homens e mulheres (42% e 58%, respectivamente). A média de idade foi de 41,8 ± 14,1 anos, situando-se 87% dos pacientes entre 20 e 60 anos. Houve predomínio em caucasianos (84%). Dados sobre tabagismo mostraram que 61% dos pacientes nunca fumaram, 29% eram ex-fumantes, e 10% ainda fumavam. O diagnóstico foi feito principalmente no inverno (33%). Dentre os dados clínicos destacaram-se: 12% eram assintomáticos, 18% tinham somente sintomas torácicos, 22% somente manifestações extratorácicas, e 48% apresentaram combinação de sintomas torácicos e extratorácicos. A espirometria foi realizada em 79% dos pacientes, no momento do diagnóstico, com resultados anormais em 45% deles, com os seguintes padrões: restritivo em 23%, obstrutivo em 18%, e misto em 4% deles. A distribuição dos tipos radiológicos mostrou 30% tipo I, 48% tipo II e 22% tipo III. CONCLUSÃO: Os achados desta série mostraram-se semelhantes aos descritos na literatura, particularmente na européia.
Mounier-Kuhn syndrome, or tracheobronchomegaly, is a rare clinical entity characterized by abnormal dilation of the trachea and main bronchi. The diagnosis can usually be made by measuring the tracheal diameter. We report the case of a 40-year-old black man with refractory lower respiratory tract infection. Tracheobronchomegaly was confirmed through computed tomography.
Relata-se um caso típico de sarcoidose pediátrica com apresentação de doença granulomatosa pulmonar e acometimento sistêmico, revisando aspectos clínicos, diagnósticos e particularidades da apresentação da doença nesta faixa etária, com ênfase na freqüentemente difícil diferenciação com a tuberculose.
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