Desnutrição em doentes internados no Serviço de Pneumonologia do CHVNG/E

[resumo][abstract

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Pneumonia lipóide exógena â Caso clínico

Resumo: A pneumonia lipóide exógena (PLE) é uma patologia pouco frequente que resulta da aspiração ou inalação de hidrocarbonetos exógenos. A forma aguda pode observar-se em casos de aspiração acidental de material lipídico descrita tradicionalmente em cuspidores-de-fogo.Os autores apresentam o caso clínico de uma PLE aguda de um paciente de 19 anos, cuspidor de fogo, que recorreu ao Serviço de Urgência após inalação de petróleo.Tecem-se ainda breves considerações sobre os aspectos clínico-imagiológicos mais relevantes desta situação.Rev Port Pneumol 2005; XI (6): 567-572 Abstract: Exogenous lipoid pneumonia (ELP) is an infrequent pathology that results from the aspiration or inhalation of exogenous hydrocarbon. The acute form may be seen in cases of accidental aspiration of fatlike material traditionally described in fire-eaters.The authors present the case report of an acute ELP in a 19 year-old patient, fire-eater, admitted at the Emergency Room after inhalation of petroleum.By conclusion, some brief considerations on clinical-imagiological aspects of this situation are discussed.Rev Port Pneumol 2005; XI (6): 567-572 Palavras-chave: Aspiração, hidrocarbonetos, broncofibroscopia, oil-red, Key-words: Aspiration, hydrocarbon, bronchoscopy, âoil red

Unmasking the hidden threat: COPD awareness and knowledge in Portugal

© 2023 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC- ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)The burden of Chronic Obstructive Pulmonary Disease (COPD) is recognised worldwide, constituting a major public health problem due to significant morbidity and mortality. Portugal is not an exception to the impact of the COPD burden. The most recent data for the Portuguese population indicates that COPD is the fifth cause of death, with an estimated prevalence of 14.2% for individuals > 40 years old, as shown in a study conducted in the region of Lisbon. The GOLD report5 indicates that COPD is preventable and treatable. Detection, early diagnosis, and modifiable risk factors, such as tobacco use, can be determinants for the disease path. In this context, epidemiological studies of COPD are a crucial element for the prevention, diagnosis, and implementation of health policies to reduce the burden of the disease. In addition, knowledge about COPD among the general population is described in different studies reporting low levels of knowledge with a negative impact on early diagnosis and treatment success.6,7 In Portugal, COPD epidemiological studies are scarce and the knowledge of the disease among the general population and public awareness is very limited.info:eu-repo/semantics/publishedVersio

Malformações arteriovenosas pulmonares: Associação a telangiectasia hemorrágica hereditária Casos clínicos e rastreio familiar Pulmonary arteriovenous malformations: Association with hereditary hemorrhagic telangiectasia. Clinical cases and family screening

As malformações arteriovenosas pulmonares são raras e mais de metade dos casos surgem em associação a telangiectasia hemorrágica hereditária. Faz-se uma revisão teórica sobre a apresentação clínica, abordagem diagnóstica, terapêutica e prognóstico destas malformações vasculares. Estão associadas a morbilidade e mortalidade consideráveis, pelo que se preconiza o seu tratamento, assim como o rastreio dos familiares directos quando se identificam malformações arteriovenosas pulmonares num doente com telangiectasia hemorrágica hereditária. Ainda não existem estudos prospectivos que estabeleçam o melhor plano de estudo do doente e seus familiares. Descrevem-se dois casos clínicos de malformações arteriovenosas pulmonares no contexto familiar de telangiectasia hemorrágica hereditária. A identificação das doentes implicou o rastreio familiar que permitiu detectar malformações arteriovenosas pulmonares em dois familiares e excluir o envolvimento pulmonar em quatro familiares com a doença.Pulmonary arteriovenous malformations are a rare disorder associated to hereditary hemorrhagic telangiectasia in over 50% of the cases. Clinical presentation, diagnostic work-up, therapeutic options and prognosis are reviewed by the authors. Pulmonary arteriovenous malformations are known to have considerable morbidity and mortality, their treatmentbeing advisable as well as their screening among family members, especially if the index case is diagnosed with both pulmonary arteriovenous malformations and hereditary hemorrhagic telangiectasia. To this moment prospective studies establishing the best diagnostic work-up for the patients and their families are lacking. The authors report two pulmonary arteriovenous malformations cases in a family with hereditary hemorrhagic telangiectasia. Patient’s diagnosis led to family screening which resulted in the identification of pulmonary arteriovenous malformations in two family members and pulmonary disease exclusion in four patients previously known to have hereditary hemorrhagic telangiectasia

Raoultella ornithinolytica in MALT-type non-Hodgkin Lymphoma

Raoultella ornithinolytica is a bacterium that belongs to the Enterobacteriaceae family. The most frequently reported infections are gastrointestinal and hepatobiliary. Urinary tract infections are very rarely reported and bloodstream infections are usually reported without an identified source. This bacterium is responsible for an increasing number of infections, especially in immunocompromised patients. The authors describe the first case ever reported of an immunocompromised patient due to non-Hodgkin lymphoma MALT type and corticotherapy, who developed urinary tract infection and subsequently bacteriemia due to this pathogen