Quimio-radioterapia sequencial no carcinoma pulmonar não de pequenas células: estudo retrospectivo de 100 doentes

ABSTRACTCombined chemotherapy and radiotherapy has shown to be the correct treatment of unresectable non-small cell lung cancer, aier many years of poor survival figures with standard radiotherapy alone. It has also been demonstrated that the benefit of chemotherapy is mainly achieved if cisplatin-based schedules are used. The authors present a retrospective study of 100 cases of stage III non-small cell lung cancer treated with a sequential approach of chemotherapy and radiotherapy and evaluate median and overall survival, local progression-free survival and distant progression-free survival.The results of our series are quite similar to those published in literature.REV PORT PNEUMOL 2003; IX (3): 215-22

Pneumonia organizativa – Experiência da consulta de um hospital central

AbstractAim: to characterise outpatients of a Portuguese central hospital diagnosed with organising pneumonia (OP) and compare results with current literature. Methods: medical processes with diagnosis of OP were retrospectively studied as to demographics, aetiology, clinical and radiological features, average time until and date of diagnosis, laboratory and histological changes, treatment and relapse. Results – thirteen patients with a mean follow-up of 171.6weeks (max 334 and min 28 weeks) were evaluated. Nine of these patients (70%) had cryptogenic OP (COP) while 30% had secondary OP (SOP), two with rheumatoid arthritis, one with dermatomyositis and another undergoing radiotherapy for breast cancer. Mean age was 55.6 (+-15.3years), 92% female, 77% were non-smokers. Average time until diagnosis was 77.2weeks (min 3 and max 432 weeks). Symptoms at presentation were tiredness (92%), cough (85%), fever (65%), shortness of breath (54%), thoracic pain (23%) and weight loss (23%). At the time of diagnosis, the mean erythrocyte sedimentation rate was 70mm (max 170mm and min 16mm). C-reactive protein level was increased in eight patients. Significant leucocytosis was absent. Chest X-ray and chest CT scan showed bilateral distribution in 12 patients (92%). Consolidation with an air bronchogram was present in 12 patients and in four (31%), consolidation was migratory. Four patients (30%) underwent transbronchial pulmonary biopsy, all uncharacteristic and eight patients surgical pulmonary biopsy, four showed histological confirmation of SOP. Corticosteroids were started in 11 patients and average treatment was 61.6weeks (16-288 weeks). 15% (2/13) had spontaneous resolution. Four patients (31%) relapsed, one of them five times. Two patients are dependent on a low dose of corticosteroids, one due to underlying disease and another due to multiple relapses. Therapy of relapse was corticosteroids alone in minimum effective dosage or associated to azathioprine or ciclosporin. Discussion and conclusion: such a high incidence in females (92%) may be explained by the limited sample of patients. In 70% of the patients diagnosis were established by clinical and radiology criteria. Mean time to diagnosis was very variable which suggests that in some cases the disease was not diagnosed and treated as another interstitial lung disease or as recurrent pneumonia. Most patients (53.8%) had a favourable clinical course after treatment with corticosteroids with a very low number of relapses (30.8%), much lower than described by other authors (60%). Only in experienced centres should the diagnosis of OP established by clinical and radiological criteria.Rev Port Pneumol 2010; XVI (3): 369-38

On the influence of the inlet slug length distribution- a slug flow simulator

A slug flow simulator was developed considering: (i) an overtaking mechanism based on air-water co-currentcontinuous experimental data [1]; (ii) expansion of the gas phase and its consequences in bubble length and velocityand (iii) several types of slug length and gas flow rate distributions, at column inlet. The simulator allows the monitoringof various flow characteristics, namely (i) the evolution of the distributions of several variables along the column; (ii) thedefinition of column zones, with different coalescence and (iii) the evaluation of the flow stability height (flow developinglength), for certain flow conditions.The simulator was used to study the influence of the inlet slug length distribution over the stabilized slug flow pattern.Four similar simulations were prepared with inlet slug lengths normally distributed around averages of 0.075, 0.1, 0.15and 0.2 m, and equal initial number of bubbles, inlet gas flow rate, and liquid flow rate. The output results showed tobe independent of the inlet distributions, indicating that the bubble overtaking mechanism has dominant influence overthe overall slug flow pattern development

Sarcomas primitivos do pulmão

RESUMO: Os sarcomas primitivos do pulmão são raros, representando 0.1 % de todas as neoplasias pulmonares malignas.No presente trabalho os autores reveem 5 casos clinicos diagnosticodos no periodo compreendido entre 1985 e 1997.A série inclui 4 doentes do sexo musculino e l do sexo femimino, com idades entre os 21 e os 73 anos. Apenas um doente era fumador.A sintomatologia mais frequente foi a toracalgia, a tosse seca. a dispneia e a expeetoração hemoptoica.O diagnóstieo hislopatológico foi feito em 3 casos através da peça operatória e cm 2 por biópsia brôm quica. Os tipos histológicos encontrados foram: 2 leiomiossarcomas, I rabdomiossarcoma, 1 careinos-sarcoma e 1 sarcoma poueo diferenciado.No que sc refere à terapêutica, todos os doentes tratados foram submetidos a cirurgia, tendo efectua-do cm 3 casos terapêutica adjuvante com quimiote-rapia ou quimioterapia+radioterapia.Após o dingnóstieo, os doentes sobreviveram entre 6 dias e 49 meses. Apesar da maioria ter sido submetida a cirurgia. apenas um doente sobreviveu para além dos 3 anos, o que está de acordu cum a agressividade destas neoplasias.REV PORT PNEUMOL 1998; IV (4): 403-412 ABSTRACT: Primary pulmonary sarcomas represent 0.1% of all primary lung neoplasms.In this work w e reviewed a consecutive serie of patients with this diagnosis, treated al our department between the period of 1985 and 1997.Four patients were males and I female, aged between 21 and 72 years old. Only one was a smoker.The most frequent symptoms were chest pain, cough, dyspnea and hemoptoic sputum.The diagnosis was obtained by surgery in 3 patients and by bronchial biopsy in 2 cases. The histologic types observed w ere 2 leiomyossareomas. 1 rabdomyossarcoma, I carcinossarcoma and I low diferentiated sarcoma.Four patients were treated with pulmonary surgery and in 3 cases plus thoracic irradiation and chemotherapy or simply chemotherapy.After the diagnosis, patients had survived between 6 days and 49 months. Although surgery, only I patient survived more than 3 years.REV PORT PNEUMOL 1998; IV (4): 403-412 : Key-words, Lung neoplasms, Pulmonary sarcomas, Palavras-chavc: Neoplasia, pulmoares, Sarcomas pulmonare

Derrame pleural recidivante e polipose gástrica: Caso clínico Relapsing pleural effusion and gastric polyposis: A case report

Os autores descrevem um caso de doença linfoproliferativa (DLP) com repercussão pleuropulmonar. Trata-se de um linfoma MALT primário do estômago com comportamento agressivo numa mulher de 86 anos internada no serviço de pneumologia do nosso hospital com derrame pleural como forma de apresentação clínica. A pesquisa de Helicobacter pylori foi negativa, situação pouco frequente. A doença apresentou-se disseminada e sem qualquer resposta às múltiplas terapêuticas instituídas, o que não é frequente. Abordam-se as formas de apresentação clínica desta patologia, aspectos diagnósticos e terapêuticos, fazendo-se uma discussão sobre as características particulares deste caso e cotejando-os com os dados existentes na literatura. Realça-se a importância de se incluir a DLP no diagnóstico diferencial dos derrames pleurais de etiologia em estudo.The authors present the case of a lymphoproliferative disorder (LPD) with pleuro-pulmonary involvement. It was a very aggressive primary gastric lymphoma of the MALT subtype, diagnosed in an 86-year-old woman admitted in Pulmonology ward at our Hospital with pleural effusion. Helicobacter pylori search was negative, what is infrequent. The disease was already disseminated at the time of the diagnosis and did not respond to various treatment modalities, what is also an uncommon finding. Clinical presentation, diagnosis and management of this disease are reviewed, pointing out its unique features and comparing the particular aspects of this case with the published literature. The authors stress that LPD is an important diagnosis to be held in mind in the case of a pleural effusion of unknown aetiology