Função pulmonar na evolução de 35 doentes com paracoccidioidomicose

Campos, Elisabete Ferreira Esteves; Catâneo, Antônio José Maria

doi:10.1590/s0036-46651986000500008

Cited by 13 publications

(12 citation statements)

References 6 publications

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“…Indeed, most of the patients were classified as having mild obstructive defects, and only one patient presented with severe obstruction. This contrasts with earlier studies in which more than 50% of the patients evaluated presented with a moderate to severe obstructive defect (38), the alveolar-arterial gradient was altered in all patients (39,40), and cor pulmonale was present in almost 25% of the cases (40). This discrepancy may be related to the more restricted access to health care facilities in Brazil at the time these studies were conducted, which delayed proper diagnosis and treatment.…”

Section: Discussioncontrasting

confidence: 92%

The lung in paracoccidioidomycosis: new insights into old problems

Costa¹,

Benard²,

Albuquerque³

et al. 2013

Clinics

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OBJECTIVES:Chronic paracoccidioidomycosis can diffusely affect the lungs. Even after antifungal therapy, patients may present with residual respiratory abnormalities due to fungus-induced lung fibrosis.METHODS:A cross-sectional analysis of 50 consecutive inactive, chronic paracoccidioidomycosis patients was performed using high resolution computed tomography, pulmonary function tests, ergospirometry, the six-minute walk test and health-related quality of life questionnaires.RESULTS:Radiological abnormalities were present in 98% of cases, the most frequent of which were architectural distortion (90%), reticulate and septal thickening (88%), centrilobular and paraseptal emphysema (84%) and parenchymal bands (74%). Patients typically presented with a mild obstructive disorder and a mild reduction in diffusion capacity with preserved exercise capacity, including VO2max and six-minute walking distance. Patient evaluation with the Saint-George Respiratory Questionnaire showed low impairment in the health-related quality of life, and the Medical Research Council questionnaire indicated a low dyspnea index. There were, however, patients with significant oxygen desaturation upon exercise that was associated with respiratory distress compared with the non-desaturated patients. The initial counterimmunoelectrophoresis of these patients was higher and lung emphysema was more prominent; however, there were no differences in the interstitial fibrotic tomographic abnormalities, tobacco exposure, functional responses, exercise capacity or quality of life.CONCLUSIONS:Inactive, chronic paracoccidioidomycosis patients show persistent and disseminated radiological abnormalities by high resolution computed tomography, short impairments in pulmonary function and low impacts on aerobic capacity and quality of life. However, there was a subset of individuals whose functional impairment was more severe. These patients present with higher initial serology and more severe emphysema, stressing the importance of adequate treatment associated with tobacco exposure cessation.

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Section: Discussioncontrasting

confidence: 92%

The lung in paracoccidioidomycosis: new insights into old problems

Costa¹,

Benard²,

Albuquerque³

et al. 2013

Clinics

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“…Esses resultados podem ter influenciado na redução de cerca de 15 cmH 2 O nas médias de PImáx medida em comparação com a prevista (Tabela 1). pulmonar da espirometria de 35 pacientes com paracoccidioidomicose, 50% deles manifestaram padrão respiratório normal, 57% do tipo obstrutivo e apenas 8% distúrbio ventilatório do tipo misto (42). Em nosso estudo, a relação VEF 1 /CVF medida alcançou média de 87,6%, enquanto que a relação prevista alcançou média de 84,4%.…”

Section: Discussionunclassified

Adaptações crônicas sobre a função pulmonar em indivíduos infectados pela leishmaniose visceral

Silva¹,

Silva²,

Pires³

et al. 2013

Fisioter. mov.

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ResumoIntrodução: Apesar de escassas, as principais alterações cardiopulmonares verificadas durante a infecção com Leishmaniose Visceral (LV) se referem a alterações histológicas e imunológicas e poucos relatos de repercussões funcionais. Objetivo: Verificar e analisar a existência de adaptações crônicas na função pulmonar de indivíduos assintomáticos previamente infectados pela LV. Materiais e métodos: Trata-se de um estudo do tipo transversal descritivo, para o qual foram selecionados todos os indivíduos que contraíram LV em Parnaíba (Piauí, Brasil) entre 2007 e 2010 de acordo com informações do Setor de Epidemiologia do município. De um total de 20 indivíduos com confirmação parasitológica de LV, foram avaliados nove com idades entre 18 e 62 anos entre setembro e outubro de 2011. Excluíram-se indivíduos que não apresentaram diagnóstico parasitológico de LV, doenças ou sintomas cardiorrespiratórios recentes, usuários crônicos de drogas ilícitas e gestantes. Foram realizadas medidas antropométricas e testes de espirometria e de manovacuometria conforme Fisioter Mov. 2013 abr/jun;26(2):403-11 da Silva AO, Silva SB, Pires CBR, Gonçalves LSL, Coertjens PC, Coertjens M. 404 especificações da American Thoracic Society / European Respiratory Society (ATS/ERS). Para comparação das médias dos valores medidos e preditos foi realizado Teste t Student para dados dependentes. O nível de significância adotado foi p < 0,05. Resultados: A Capacidade Vital Forçada (CVF) (3,8 ± 0,9 vs. 4,2 ± 0,8 L) e o Volume Expiratório Forçado no primeiro segundo (VEF 1 ) (3,3 ± 0,7 vs. 3,5 ± 0,7 L) foram estatisticamente menores do que os valores medidos (p < 0,01). A relação VEF 1 /CVF (87,6 vs. 84,4%) foi maior nos valores medidos (p = 0,08). Conclusão: Apesar de o número de indivíduos avaliados ser pequeno, os dados indicam que a infecção por LV parece desenvolver adaptações crônicas sobre o sistema respiratório, resultando em volumes pulmonares significativamente diminuídos e uma tendência a padrões respiratórios restritivos. [P] Palavras-chave: Leishmaniose Visceral. Sistema respiratório. Testes de função pulmonar. [B] Abstract Introduction: Although scarce, the main changes observed during cardiopulmonary infection with Visceral Leishmaniasis (VL) refer to histological and immunological and few reports of functional repercussions. Objective: To verify and analyze the existence of chronic adaptations in pulmonary function in individuals who have been infected by VL. Materials and methods: It is a descriptive cross-sectional study, which evaluated nine people aged between 18 and 62 years. Anthropometric measurements and spirometry and manometer tests were performed according to the specifications of the American Thoracic Society / European Respiratory Society (ATS/ERS). For comparison of the measured and predicted values was performed Student t test for dependent data. The level of significance was p < 0.05. Results: The Forced Vital Capacity (FVC) (3,8 ± 0,9 ± 0,8 vs. 4,2 l) and Forced expiratory volume in first second (FEV 1 ) (3...

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“…Table 1 summarises the studies conducted by Brazilian investigators, whereas Table 2 displays those done by investigators from other South American countries. It can be seen from the tables [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51], as well as from some other studies that specifically focused on the performance of serological techniques [11,12,22,25,[52][53][54][55][56], that antibody titres dropped with therapy but less frequently became negative when therapy was stopped or patients were considered clinically and mycologically cured, or both. In many reports, the fall in the antibody titres persisted even after withdrawal of the anti-fungal therapy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of tests for antibody response in the follow-up of patients with acute and chronic forms of paracoccidioidomycosis

Negro¹,

Pereira²,

Andrade

et al. 2000

Journal of Medical Microbiology

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Several serological tests have been used successfully in the diagnosis of paracoccidioidomycosis (PCM). In contrast, data about the use of these tests in the follow-up of PCM patients have been heterogeneous. In this study, serum samples from 43 PCM patients with different clinical forms were analysed by counter-immuno-electrophoresis (CIE), complement fixation (CF) and ELISA before treatment. With CIE and ELISA, the chronic unifocal form showed significantly lower antibody levels compared with chronic multifocal and acute forms. Acute form patients had significantly higher titres than patients with multifocal disease by CIE but not by ELISA. No significant differences were observed with CF. Twenty-seven of these patients were followed-up for 2 years and showed a decline in antibody levels by all three tests, paralleling clinical improvement. However, only patients with unifocal disease cleared their antibodies after 1 year of treatment as analysed by CF and ELISA and after 2 years by CIE, suggesting that these patients may need shorter courses of therapy. Patients with the other clinical form of the disease needed > or =2 years of therapy to clear their antibodies. Sera from a further five patients who presented with a relapse were analysed. At the time of relapse all showed increases in antibody levels by CIE and ELISA, but only three showed increases by CF tests. Therefore, CIE and ELISA demonstrated a better clinical correlation than CF, probably reflecting the fungal burden of PCM patients more accurately.

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Função pulmonar na evolução de 35 doentes com paracoccidioidomicose

Cited by 13 publications

References 6 publications

The lung in paracoccidioidomycosis: new insights into old problems

The lung in paracoccidioidomycosis: new insights into old problems

Adaptações crônicas sobre a função pulmonar em indivíduos infectados pela leishmaniose visceral

Evaluation of tests for antibody response in the follow-up of patients with acute and chronic forms of paracoccidioidomycosis

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