Base de dados : MEDLINE
Pesquisa : C08.695 [Categoria DeCS]
Referências encontradas : 465 [refinar]
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[PMID]:28592019
[Au] Autor:An DY; Zhang Y; Zhang HL
[Ti] Título:[Progres of diagnosis and treatment of congenital lung malformations].
[So] Source:Zhonghua Er Ke Za Zhi;55(6):471-474, 2017 Jun 02.
[Is] ISSN:0578-1310
[Cp] País de publicação:China
[La] Idioma:chi
[Mh] Termos MeSH primário: Pneumopatias/diagnóstico
Anormalidades do Sistema Respiratório/diagnóstico
[Mh] Termos MeSH secundário: Seres Humanos
Recém-Nascido
Pneumopatias/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1310.2017.06.017


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[PMID]:28390642
[Au] Autor:Droukas DD; Machnicki SC
[Ad] Endereço:Department of Diagnostic Radiology, Lenox Hill Hospital, New York, NY. Electronic address: ddroukas@northwell.edu.
[Ti] Título:A 28-Year-Old Woman With Branching Opacity and Chest Pain.
[So] Source:Chest;151(4):e85-e89, 2017 Apr.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 28-year-old female patient presented through her primary care physician with symptoms of atypical chest pain and chronic cough. Her pain was described as pleuritic and intermittently radiating to the right arm. Her medical history was significant for recurrent respiratory infections, gastritis, and a left ovarian cyst treated with ipsilateral salpingo-oophorectomy. She denied any history of smoking, known lung disease, or extrapulmonary infections.
[Mh] Termos MeSH primário: Brônquios/anormalidades
Anormalidades do Sistema Respiratório/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Brônquios/cirurgia
Dor no Peito/diagnóstico
Tosse/diagnóstico
Diagnóstico Diferencial
Diagnóstico por Imagem
Feminino
Seres Humanos
Anormalidades do Sistema Respiratório/patologia
Anormalidades do Sistema Respiratório/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170410
[St] Status:MEDLINE


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[PMID]:28296740
[Au] Autor:Ren H; Duan L; Zhao B; Wu X; Zhang H; Liu C
[Ad] Endereço:Department of Pediatric Surgery, Children's Hospital of Shanxi Province, Shanxi, China.
[Ti] Título:Diagnosis and treatment of communicating bronchopulmonary foregut malformation: Report of two cases and review of the literature.
[So] Source:Medicine (Baltimore);96(11):e6307, 2017 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Communicating bronchopulmonary foregut malformation (CBPFM) is a rare congenital malformation involving both the digestive and respiratory systems. To our best knowledge, most cases of CBPFM reported in the literature were in infancy or adulthood and CBPFM in infantile is even rarer with a high case-fatality rate partly due to misdiagnosis. PATIENT CONCERNS: We presented 2 cases of neonatal CBPFM. A 11-hour male newborn was admitted because of moaning for 7 hours, and a 1-day male newborn was referred to us with profuse foams, choking on breast-milk feeding and facial cyanosis. DIAGNOSES: With the assistance of upper gastrointestinal tract imaging and contrast-enhanced chest computed tomography (CT), the diagnosis was established according to the most recent diagnostic criteria. INTERVENTIONS: The case one recieved a lower left pneumonectomy and surgical repair of esophageal fistula. The case two was performed with a surgical repair of esophageal atresia and esophageal tracheal fistula firstly, and then also received a repair of communicating bronchopulmonary foregut malformation two weeks after the first operation. OUTCOMES: The case one was cured and discharged 2 weeks after admission. Unfortunately the case two died from respiratory failure. LESSONS: Pediatric surgeons should therefore be aware that type I CBPMF is rare and preoperative diagnosis is usually difficult. Maldiagnosis is uncommon because clinicians often focus their attention on esophageal atresia and neglect pulmonary abnormalities. Other than upper gastrointestinal tract radiography and CT scan, bronchoscopy should be considered in pediatric patients with esophageal atresia complicated with pulmonary abnormalities, knowing that bronchoscopy may help confirm the diagnosis and select surgical strategies.
[Mh] Termos MeSH primário: Anormalidades Múltiplas/diagnóstico por imagem
Anormalidades Múltiplas/cirurgia
[Mh] Termos MeSH secundário: Obstrução das Vias Respiratórias
Anormalidades do Sistema Digestório/diagnóstico por imagem
Anormalidades do Sistema Digestório/cirurgia
Endoscopia do Sistema Digestório
Atresia Esofágica/cirurgia
Seres Humanos
Recém-Nascido
Masculino
Anormalidades do Sistema Respiratório/diagnóstico por imagem
Anormalidades do Sistema Respiratório/cirurgia
Fístula do Sistema Respiratório/diagnóstico por imagem
Fístula do Sistema Respiratório/cirurgia
Tomografia Computadorizada por Raios X
Traqueia/diagnóstico por imagem
Traqueia/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170403
[Lr] Data última revisão:
170403
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006307


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[PMID]:28202768
[Au] Autor:Delestrain C; Khen-Dunlop N; Hadchouel A; Cros P; Ducoin H; Fayon M; Gibertini I; Labbé A; Labouret G; Lebras MN; Lezmi G; Madhi F; Thouvenin G; Thumerelle C; Delacourt C
[Ad] Endereço:Pneumologie Pédiatrique.
[Ti] Título:Respiratory Morbidity in Infants Born With a Congenital Lung Malformation.
[So] Source:Pediatrics;139(3), 2017 Mar.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: The actual frequency of respiratory symptoms related to congenital pulmonary malformations (CPMs) remains undetermined. The goal of this study was to prospectively evaluate the respiratory symptoms occurring in infants with prenatally diagnosed CPMs, identify factors associated with the occurrence of these symptoms, and evaluate their resolution after surgery. METHODS: Infectious and noninfectious respiratory symptoms were prospectively collected in a French multicenter cohort of children with CPMs. RESULTS: Eighty-five children were followed up to the mean age of 2.1 ± 0.4 years. Six children (7%) underwent surgery during the first 28 days of life. Of the 79 remaining children, 33 (42%) had respiratory symptoms during infancy before any surgery. Wheezing was the dominant symptom (24 of 79 [30%]), and only 1 infant had documented infection of the cystic lobe. Symptoms were more frequent in children with noncystic CPMs, prenatally ( = .01) or postnatally ( < .03), and with postnatally hyperlucent CPMs ( < .01). Sixty-six children underwent surgery during the follow-up period, and 40% of them displayed symptoms after the intervention. Six children had documented pneumonia during the postoperative period. At the end of the follow-up, pectus excavatum was observed in 10 children, significantly associated with thoracotomy ( < .02) or with surgery before the age of 6 months ( < .002). CONCLUSIONS: CPMs are frequently associated with wheezing episodes. Surgery had no significant impact on these symptoms but was associated with a paradoxical increase in pulmonary infections, as well as an increased risk of pectus excavatum after thoracotomy.
[Mh] Termos MeSH primário: Enfisema Pulmonar/congênito
Anormalidades do Sistema Respiratório/epidemiologia
[Mh] Termos MeSH secundário: Osso e Ossos/anormalidades
Pré-Escolar
Estudos de Coortes
Feminino
Seguimentos
França/epidemiologia
Tórax em Funil/epidemiologia
Seres Humanos
Lactente
Recém-Nascido
Pneumonia/epidemiologia
Poli-Hidrâmnios/epidemiologia
Gravidez
Nascimento Prematuro
Enfisema Pulmonar/epidemiologia
Enfisema Pulmonar/cirurgia
Sons Respiratórios/etiologia
Anormalidades do Sistema Respiratório/cirurgia
Toracotomia/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE


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[PMID]:28040760
[Au] Autor:Lee S; Kim DH; Lee SK
[Ad] Endereço:Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea.
[Ti] Título:Efficacy of segmental resection in patients with prenatally diagnosed congenital lung malformations.
[So] Source:Interact Cardiovasc Thorac Surg;24(3):425-429, 2017 03 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: Lung segmental resection is a better treatment option than lobectomy for patients with prenatally diagnosed congenital lung malformations (CLMs). However, data are lacking on the effects of this procedure in prenatally diagnosed CLM patients. In this study, we explored whether parenchyma-saving resection was feasible in patients with this condition. Methods: A retrospective analysis was performed on 27 patients prenatally diagnosed with CLM, who subsequently underwent surgery between March 2011 and September 2015. Lobectomies and segmental resections were performed in 7 and 20 patients, respectively, based on the extent of cystic lesion invasion. Results: The operative time significantly differed between the two groups (lobectomy group, 92.9 ± 32.0 min; segmental resection group, 126.5 ± 37.5 min). However, the duration of chest tube drainage and the length of hospital stay did not significantly differ between the groups. Chest computed tomography (CT) was performed during follow-up on all but 3 patients. We encountered 2 cases of remnant lesions, and one instance of a small emphysematous lesion around the surgical site was noted in either group. Conclusions: Lung-sparing surgery is relatively safe with few complications. In this study, the incidence of remnant lung lesions (a drawback of segmentectomy) was low. Thus, segmental resection affords results similar to those of lobectomy in patients with prenatally diagnosed CLM. Furthermore, segmental resection can preserve lung volume, thereby maintaining later pulmonary function. Therefore, elective segmental resection performed after precise identification of the lesions' locations may be highly beneficial for CLM patients.
[Mh] Termos MeSH primário: Pulmão/anormalidades
Pneumonectomia/métodos
Anormalidades do Sistema Respiratório/cirurgia
Ultrassonografia Pré-Natal/métodos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Lactente
Recém-Nascido
Pulmão/diagnóstico por imagem
Pulmão/cirurgia
Masculino
Gravidez
Anormalidades do Sistema Respiratório/diagnóstico
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170102
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw408


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[PMID]:27859296
[Au] Autor:DeMarcantonio MA; Hart CK; Yang CJ; Tabangin M; Rutter MJ; Bryant R; Manning PB; de Alarcón A
[Ad] Endereço:Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
[Ti] Título:Slide tracheoplasty outcomes in children with congenital pulmonary malformations.
[So] Source:Laryngoscope;127(6):1283-1287, 2017 Jun.
[Is] ISSN:1531-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES/HYPOTHESIS: Evaluate and compare surgical outcomes of slide tracheoplasty for the treatment of congenital tracheal stenosis in children with and without pulmonary malformations. STUDY DESIGN: Retrospective chart review at a tertiary care pediatric medical center. METHODS: We identified patients with tracheal stenosis who underwent slide tracheoplasty from 2001 to 2014, and a subset of these patients who were diagnosed with congenital pulmonary malformations. Hospital course and preoperative and postoperative complications were recorded. RESULTS: One hundred thirty patients (18 with pulmonary malformations, 112 with normal pulmonary anatomy) were included. Pulmonary malformations included unilateral pulmonary agenesis (61%) and hypoplasia (39%). Children with pulmonary malformations had a greater median age compared to their normal lung anatomy counterparts. Preoperatively, patients with pulmonary malformations more frequently required preoperative mechanical ventilation (55.6% vs. 21.3%, P = .007), extracorporeal membrane oxygenation (ECMO) (11% vs. 0.9%, P = .05), and tracheostomy (22.2% vs. 3.6%, P = .01). Postoperatively, patients with pulmonary malformations more frequently required mechanical ventilation >48 hours (78% vs. 37%, P =.005) and ECMO use (11% vs. 0.9%, P = .05). Pulmonary malformation patients and children with normal anatomy did not differ in terms of postoperative tracheostomy (16.7% vs. 4.4%, P > .05), dehiscence (6% vs. 0%, P > .05%), restenosis (11% vs. 6%, P > .05) or postoperative figure 8 deformity (6% vs. 3%, P > .05). Mortality, however, was significantly increased (22.2% vs. 3.6%, P = .01) in children with pulmonary malformations. CONCLUSIONS: Although slide tracheoplasty can be successfully performed in patients with abnormal pulmonary anatomy, surgeons and families should anticipate a more difficult postoperative course, with possible associated prolonged mechanical ventilation, ECMO use, and higher mortality than in children with tracheal stenosis alone. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1283-1287, 2017.
[Mh] Termos MeSH primário: Complicações Pós-Operatórias/etiologia
Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos
Anormalidades do Sistema Respiratório/cirurgia
Traqueia/cirurgia
Estenose Traqueal/cirurgia
[Mh] Termos MeSH secundário: Pré-Escolar
Oxigenação por Membrana Extracorpórea
Feminino
Seres Humanos
Lactente
Masculino
Complicações Pós-Operatórias/mortalidade
Procedimentos Cirúrgicos Reconstrutivos/métodos
Respiração Artificial
Estudos Retrospectivos
Traqueia/anormalidades
Estenose Traqueal/congênito
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161119
[St] Status:MEDLINE
[do] DOI:10.1002/lary.26404


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[PMID]:27383520
[Au] Autor:Fijalkowska M; Antoszewski B
[Ad] Endereço:Department of Plastic, Reconstructive and Aesthetic Surgery, Second Chair of Surgery Medical University of Lodz, University Hospital No. 1, Kopcinskiego Street 22, 90-153, Lodz, Poland. fijalkowska.m@wp.pl.
[Ti] Título:Classification of congenital nasal deformities: a proposal to amend the existing classification.
[So] Source:Eur Arch Otorhinolaryngol;274(3):1231-1235, 2017 Mar.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Congenital nasal anomalies are rare malformations with a broad spectrum of defects. The only existing classification strictly relating to nasal anomalies was presented by Losee et al. (Plast Reconstr Surg 113(2):676-689, 2004). The aim of this paper is to propose some suggestions, based on our current knowledge and experience gained by treating our patients in the clinic, in creating a specification of patients with congenital nasal anomalies. All patients with congenital nose defects treated in our health center were selected for this study. The research was retrospective and included years from 1995 to 2015. Nasal anomaly associated with cleft lip and palate was excluded. Patients were classified into four categories of congenital nasal anomalies, according to Losee et al. CLASSIFICATION: In the period of 20 years, 191 patients with congenital nasal anomalies were treated in our health center. Type 1 defects were found in 124 patients, type 2 in 15, type 3 in 32 and type 4 in 20 patients. The nasal defect accompanying craniofacial syndrome is the most common type of nose malformation. The nose cleft is not always a part of craniofacial clefts; isolated forms of such malformations can occur. Vascular anomalies, due to different etiology, categorization and treatment, should not be recognized as nasal malformation.
[Mh] Termos MeSH primário: Anormalidades Craniofaciais
Doenças Nasais/congênito
Nariz/anormalidades
Anormalidades do Sistema Respiratório
[Mh] Termos MeSH secundário: Anormalidades Craniofaciais/classificação
Anormalidades Craniofaciais/diagnóstico
Seres Humanos
Anormalidades do Sistema Respiratório/classificação
Anormalidades do Sistema Respiratório/diagnóstico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160708
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-016-4195-y


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[PMID]:27752149
[Au] Autor:Kyncl M; Koci M; Ptackova L; Hornofova L; Ondrej F; Snajdauf J; Pychova M
[Ad] Endereço:Department of Radiology, 2nd Faculty of Medicine, Charles University in Prague and Faculty Hospital Motol, Prague, Czech Republic.
[Ti] Título:Congenital bronchopulmonary malformation: CT histopathological correlation.
[So] Source:Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub;160(4):533-537, 2016 Dec.
[Is] ISSN:1213-8118
[Cp] País de publicação:Czech Republic
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study evaluated the accuracy of postnatal computed tomography (CT) imaging in the identification of congenital bronchopulmonary malformation (BPM) in comparison with histopathological analysis. METHODS: CT scans of prenatally diagnosed BPMs from 24 patients with available histology were analysed retrospectively. The CT images were reviewed blinded to histological findings by two radiologists. Specific diagnosis was assigned based on predetermined criteria. The accuracy of CT was evaluated. RESULTS: The agreement rate in CT diagnosis between two radiologists was 100%. In 75% the lesions were located in the lower lobes. An overlap of 71% in CT and histopathological diagnoses was reached. The least matching diagnosis was type 2 CPAM. CONCLUSION: Contrast enhanced chest CT is very accurate in characterizing the BPM spectrum and provides important information on lesion type and structure.
[Mh] Termos MeSH primário: Pulmão/anormalidades
Tomografia Computadorizada por Raios X/normas
[Mh] Termos MeSH secundário: Pré-Escolar
Meios de Contraste
Feminino
Seres Humanos
Lactente
Pulmão/diagnóstico por imagem
Masculino
Anormalidades do Sistema Respiratório/diagnóstico por imagem
Anormalidades do Sistema Respiratório/patologia
Sensibilidade e Especificidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161019
[St] Status:MEDLINE
[do] DOI:10.5507/bp.2016.051


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Castro, Hermano Albuquerque
PubMed Central Texto completo
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[PMID]:27612198
[Au] Autor:de Sá PM; Castro HA; Lopes AJ; Melo PL
[Ad] Endereço:Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering and BioVasc Research Laboratory, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
[Ti] Título:Early Diagnosis of Respiratory Abnormalities in Asbestos-Exposed Workers by the Forced Oscillation Technique.
[So] Source:PLoS One;11(9):e0161981, 2016.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The current reference test for the detection of respiratory abnormalities in asbestos-exposed workers is spirometry. However, spirometry has several shortcomings that greatly affect the efficacy of current asbestos control programs. The forced oscillation technique (FOT) represents the current state-of-the-art technique in the assessment of lung function. This method provides a detailed analysis of respiratory resistance and reactance at different oscillatory frequencies during tidal breathing. Here, we evaluate the FOT as an alternative method to standard spirometry for the early detection and quantification of respiratory abnormalities in asbestos-exposed workers. METHODOLOGY/PRINCIPAL FINDINGS: Seventy-two subjects were analyzed. The control group was composed of 33 subjects with a normal spirometric exam who had no history of smoking or pulmonary disease. Thirty-nine subjects exposed to asbestos were also studied, including 32 volunteers in radiological category 0/0 and 7 volunteers with radiological categories of 0/1 or 1/1. FOT data were interpreted using classical parameters as well as integer (InOr) and fractional-order (FrOr) modeling. The diagnostic accuracy was evaluated by investigating the area under the receiver operating characteristic curve (AUC). Exposed workers presented increased obstruction (resistance p<0.001) and a reduced compliance (p<0.001), with a predominance of obstructive changes. The FOT parameter changes were correlated with the standard pulmonary function analysis methods (R = -0.52, p<0.001). Early respiratory abnormalities were identified with a high diagnostic accuracy (AUC = 0.987) using parameters obtained from the FrOr modeling. This accuracy was significantly better than those obtained with classical (p<0.001) and InOr (p<0.001) model parameters. CONCLUSIONS: The FOT improved our knowledge about the biomechanical abnormalities in workers exposed to asbestos. Additionally, a high diagnostic accuracy in the diagnosis of early respiratory abnormalities in asbestos-exposed workers was obtained. This makes the FOT particularly useful as a screening tool in the context of asbestos control and elimination. Moreover, it can facilitate epidemiological research and the longitudinal follow-up of asbestos exposure and asbestos-related diseases.
[Mh] Termos MeSH primário: Asbestos
Testes de Função Respiratória
Anormalidades do Sistema Respiratório/induzido quimicamente
Anormalidades do Sistema Respiratório/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Resistência das Vias Respiratórias/fisiologia
Diagnóstico Precoce
Feminino
Seres Humanos
Masculino
Meia-Idade
Modelos Teóricos
Pletismografia
Curva ROC
Mecânica Respiratória
Sistema Respiratório/fisiopatologia
Anormalidades do Sistema Respiratório/fisiopatologia
Espirometria
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
1332-21-4 (Asbestos)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160910
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0161981


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[PMID]:27568177
[Au] Autor:Gu W; Jiang W; Zhang X; Chen Z; Yan Y; Huang L; Wang M; Shao X; Wang S; Ji W
[Ad] Endereço:Department of Respiration, Children's Hospital of Soochow University, Suzhou, 215003, China.
[Ti] Título:Refractory wheezing in Chinese children under 3 years of age: bronchial inflammation and airway malformation.
[So] Source:BMC Pediatr;16(1):145, 2016 Aug 27.
[Is] ISSN:1471-2431
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Wheezing is a common symptom in early childhood. However, refractory wheezing is difficult to treat, and it may thus account for extensive use of medical resources. It is therefore important to improve our understanding of the pathophysiology of refractory childhood wheezing. METHODS: In this descriptive study, we studied 156 children with refractory wheezing using fiberoptic bronchoscopy and bronchoalveolar lavage (BAL), and compared the results with a control group of 46 children with various pulmonary diseases but no wheezing. Etiology and cell classification were analyzed for each BAL sample. RESULTS: Overall, 21.8 % of children with refractory wheezing had airway malformations including tracheomalacia, airway stenosis, and tracheal bronchus. The incidence of airway malformations increased to 31 % in infants under 12 months of age. A significant increase in neutrophil ratio and decrease in macrophage ratio were observed in BAL from children with refractory wheezing compared with controls. Pathogen infection led to a higher ratio of neutrophils in the wheezing group compared with controls. However, there were no significant differences in neutrophil ratios among children with various pathogen infections. Furthermore, children with refractory wheezing had a high rate of Mycoplasma pneumoniae infection. CONCLUSIONS: Airway malformations might play an important role in children under 3 years of age with refractory wheezing, especially in infants under 12 months of age. Neutrophil-mediated airway inflammation was characteristic of refractory wheezing in children under 3 years of age. In addition, infections such as M. pneumoniae may aggravate airway inflammation and affect refractory wheezing.
[Mh] Termos MeSH primário: Obstrução das Vias Respiratórias/complicações
Bronquite/complicações
Sons Respiratórios/etiologia
Anormalidades do Sistema Respiratório/complicações
Traqueomalácia/complicações
[Mh] Termos MeSH secundário: Obstrução das Vias Respiratórias/diagnóstico por imagem
Biomarcadores/metabolismo
Bronquite/diagnóstico
Bronquite/imunologia
Lavagem Broncoalveolar
Líquido da Lavagem Broncoalveolar/imunologia
Broncoscopia
Estudos de Casos e Controles
Pré-Escolar
Feminino
Seres Humanos
Lactente
Macrófagos/metabolismo
Masculino
Neutrófilos/metabolismo
Sons Respiratórios/diagnóstico
Sons Respiratórios/fisiopatologia
Anormalidades do Sistema Respiratório/diagnóstico por imagem
Estudos Retrospectivos
Fatores de Risco
Traqueomalácia/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160829
[St] Status:MEDLINE
[do] DOI:10.1186/s12887-016-0680-0



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