Deve-se extrapolar o tratamento de bronquiectasias em pacientes com fibrose cística para aqueles com bronquiectasias de outras etiologias?

Athanazio, Rodrigo Abensur; Rached, Samia Zahi; Rohde, Ciro; Pinto, Rodrigo Ambar; Fernandes, Frederico Leon Arrabal; Stelmach, Rafaël

doi:10.1590/s1806-37132010000400006

Cited by 16 publications

(13 citation statements)

References 23 publications

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“…The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) recently outlined several research priorities for improving the management of bronchiectasis [14, 15], including greater understanding of its classification and prognosis. Since there is a tendency to manage bronchiectasis based on approaches used for chronic obstructive pulmonary disease (COPD) and cystic fibrosis [16, 17], FEV 1 has traditionally been used to define the severity of bronchiectasis. However, other key variables besides FEV 1 , such as age, quality of life, airway chronic colonization and lung volumes [18–21], have proved useful in this respect by showing a correlation with mortality in bronchiectasis.…”

Section: Discussionmentioning

confidence: 99%

Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts

Athanazio

Pereira

Gramblicka³

et al. 2017

BMC Pulm Med

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BackgroundThe FACED score is an easy-to-use multidimensional grading system that has demonstrated an excellent prognostic value for mortality in patients with bronchiectasis. A Spanish group developed the score but no multicenter international validation has yet been published.MethodsRetrospective and multicenter study conducted in six historical cohorts of patients from Latin America including 651 patients with bronchiectasis. Clinical, microbiological, functional, and radiological variables were collected, following the same criteria used in the original FACED score study. The vital status of all patients was determined in the fifth year of follow-up. The area under ROC curve (AUC-ROC) was used to calculate the predictive power of the FACED score for all-cause and respiratory deaths and both number and severity of exacerbations. The discriminatory power to divide patients into three groups of increasing severity was also analyzed.ResultsMean (SD) age of 48.2 (16), 32.9% of males. The mean FACED score was 2.35 (1.68). During the follow up, 95 patients (14.6%) died (66% from respiratory causes). The AUC ROC to predict all-cause and respiratory mortality were 0.81 (95% CI: 0.77 to 0.85) 0.84 (95% CI: 0.80 to 0.88) respectively, and 0.82 (95% CI: 078–0.87) for at least one hospitalization per year. The division into three score groups separated bronchiectasis into distinct mortality groups (mild: 3.7%; moderate: 20.7% and severe: 48.5% mortality; p < 0.001).ConclusionsThe FACED score was confirmed as an excellent predictor of all-cause and respiratory mortality and severe exacerbations, as well as having excellent discriminative capacity for different degrees of severity in various bronchiectasis populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-017-0417-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts

Athanazio

Pereira

Gramblicka³

et al. 2017

BMC Pulm Med

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“…[6] Adult patients with CF bronchiectasis are more likely to be colonised with P. aeruginosa than adults with non-CF bronchiectasis. [7] An increasing number of studies have described the organisms colonising the airways in paediatric non-CF bronchiectasis. [8] The bacteria most commonly found to be colonising the airways of HIVuninfected children with non-CF bronchiectasis are H. influenzae, S. pneumoniae, Moraxella catarrhalis and S. aureus.…”

Section: Researchmentioning

confidence: 99%

Bacteria isolated from the airways of paediatric patients with bronchiectasis according to HIV status

2017

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Background. Knowledge of which bacteria are found in the airways of paediatric patients with bronchiectasis unrelated to cystic fibrosis (CF) is important in defining empirical antibiotic guidelines for the treatment of acute infective exacerbations. Objective. To describe the bacteria isolated from the airways of children with non-CF bronchiectasis according to their HIV status. Methods. Records of children with non-CF bronchiectasis who attended the paediatric pulmonology clinic at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, from April 2011 to March 2013, or were admitted to the hospital during that period, were reviewed. Data collected included patient demographics, HIV status, and characteristics of the airway samples and types of bacteria isolated. Results. There were 66 patients with non-CF bronchiectasis over the 2-year study period. The median age was 9.1 years (interquartile range 7.2 -12.1). The majority of patients (78.8%) were HIV-infected. A total of 134 samples was collected (median 1.5 per patient, range 1 -7), of which 81.3% were expectorated or induced sputum samples. Most bacteria were Gram negatives (72.1%). Haemophilus influenzae was the most common bacterium identified (36.0%), followed by Streptococcus pneumoniae (12.6%), Moraxella catarrhalis (11.1%) and Staphylococcus aureus (10.6%). There were no differences between HIV-infected and uninfected patients in prevalence or type of pathogens isolated. Conclusion. Bacterial isolates from the airways of children with non-CF bronchiectasis were similar to those in other paediatric populations and were not affected by HIV status.

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“…British guidelines were recently published (90); however, there are few data on the therapeutic recommendations for bronchiectasis due to a lack of well-conducted randomized clinical trials. Many measures are still being extrapolated from studies of cystic fibrosis, but physicians must be aware of the differences between the various diseases that may be similar to bronchiectasis (91). …”

Section: Introductionmentioning

confidence: 99%

Airway disease: similarities and differences between asthma, COPD and bronchiectasis

Athanazio¹

2012

Clinics

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Airway diseases are highly prevalent worldwide; however, the prevalence of these diseases is underestimated. Although these diseases present several common characteristics, they have different clinical outcomes. The differentiation between asthma, chronic obstructive pulmonary disease and bronchiectasis in the early stage of disease is extremely important for the adoption of appropriate therapeutic measures. However, because of the high prevalence of these diseases and the common pathophysiological pathways, some patients with different diseases may present with similar symptoms. The objective of this review is to highlight the similarities and differences between these diseases in terms of the risk factors, pathophysiology, symptoms, diagnosis and treatment.

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Deve-se extrapolar o tratamento de bronquiectasias em pacientes com fibrose cística para aqueles com bronquiectasias de outras etiologias?

Cited by 16 publications

References 23 publications

Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts

Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts

Bacteria isolated from the airways of paediatric patients with bronchiectasis according to HIV status

Airway disease: similarities and differences between asthma, COPD and bronchiectasis

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