Special attention has emerged towards biomass smoke-induced chronic obstructive pulmonary disease (COPD), providing new knowledge for prevention and therapeutic approach of non-smoker COPD patients. However, the understanding of biomass smoke COPD is still limited and somewhat controversial. The aim of the present study was to compare COPD exclusively caused by tobacco smoking with COPD exclusively caused by environmental or occupational exposures. For this cross-sectional study, COPD patients were recruited from outpatient clinics and formed two groups: non-smoker COPD group (n=16) with exposure to biomass smoke who did not smoke cigarette and tobacco smoker COPD group (n=15) with people who did not report biomass smoke exposure. Subjects underwent pulmonary function tests, thoracic high-resolution computed tomography, 6-min walk test, and sputum induction. The non-smoker COPD group had biomass smoke exposure of 133.3±86 hour-years. The tobacco COPD group smoked 48.5±27.4 pack-years. Women were 62.5 and 66.7%, respectively, of non-smokers and smokers. The non-smoker COPD group showed higher prevalence of dyspnea, lower arterial oxygen tension (PaO
2
), and lower arterial oxygen saturation (SaO
2
%) with similar spirometry results, lung volumes, and diffusion capacity. Regarding inflammatory biomarkers, differences were detected in sputum number of lymphomononuclear cells and in sputum concentrations of interleukin (IL)-6 and IL-8 with higher values in the smoker group. Emphysema was more prevalent in the tobacco smoker group, which also showed higher relative bronchial wall thickness and lower lung density by quantitative analysis. Biomass smoke induced more hypoxemia compared to tobacco in COPD patients with similar severity.
Pulmonary complications from autoimmune diseases are rare in the pediatric age group, but with significant morbidity, compromising the patients’ quality of life in adulthood. The objective of this study was to evaluate the presence of interstitial lung disease in pediatric rheumatologic patients with connective tissue diseases, who were submitted to investigation through lung ultrasound during outpatient follow-up. The medical records of 40 patients were reviewed from April 2014 to December 2021. The patients evaluated were those who had already undergone lung ultrasound and presented changes suggestive of interstitial lung disease and were submitted to complementary investigation with chest high-resolution computed tomography and pulmonary function tests. The sample consisted of 20 patients, 70% of whom were female. The average age was 14 years. Half of the patients with connective tissue diseases showed changes suggesting pulmonary fibrosis on lung ultrasound and underwent further investigation with chest high-resolution computed tomography and pulmonary function test. In this group, 40% had tomography with abnormal patterns in the lung parenchyma, suggestive of interstitial lung disease, predominantly with normal spirometry. Older age and longer duration of disease were statistically significant in the analysis between the group with both altered imaging tests and the 20 patients underwent lung ultrasound (p= 0.008 and p= 0.006, respectively). Lung ultrasound can be a valuable screening tool for the early detection of interstitial lung changes in pediatric collagenosis. Larger prospective and longitudinal studies are needed in the pediatric age group, so that its specificity for interstitial syndrome can be determined.
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