ABSTRACT
Comparison of the mean results of routine pulmonary function studies of 17 patients with diffuse pulmonary paracoccidioidomycosis (PM) and manifestations of chronic obstructive pulmonary disease (COPD) to those of 17 matched patients with pure COPD showed no significant differences. These findings were interpreted as fresh evidence suggesting that expiratory obstruction in PM may be secondary to underlying COPD. Other evidence to that effect is discussed.
Subject(s)
Lung Diseases, Fungal/physiopathology , Paracoccidioidomycosis/physiopathology , Female , Forced Expiratory Volume , Humans , Lung/physiopathology , Lung Diseases, Obstructive/physiopathology , Male , Smoking , Vital CapacitySubject(s)
Lung Diseases, Fungal/physiopathology , Lung/physiopathology , Paracoccidioidomycosis/physiopathology , Respiratory Function Tests , Adult , Aged , Antifungal Agents/therapeutic use , Humans , Lung Diseases, Fungal/drug therapy , Lung Diseases, Obstructive/physiopathology , Male , Middle Aged , Paracoccidioidomycosis/drug therapyABSTRACT
Vinte doentes com lesoes pulmonares, difusas causadas pelo Paracoccidioides brasiliensis foram submetidos a provas de funcao pulmonar basicas antes e depois do inicio de tratamento especifico. Apos 1 ou 2 meses de tratamento, a capacidade vital ou a capacidade vital forcada haviam aumentado em mais de 10% em 7 de 19 doentes (36,8%), e a diferenca para o grupo todo foi significativa (P < 0,05). Apos 4 a 10 meses, 5 de 6 doentes apresentaram aumentos superiores a 10% nesse parametro. A evolucao do volume expiratorio forcado em 1 segundo, ou de sua relacao com a capacidade vital, e a da pressao parcial do oxigenio no sangue foi variavel. Estes resultados evidenciam que as provas de funcao pulmonar nao representam meio adequado para o controle do tratamento dessa condicao morbita. Por outro lado, sugerem que os infiltrados pulmonares causados pelo P.brasiliensis tem pouca influencia sobre o componente obstrutivo, que e frequentemente o principal elemento do disturbio funcional na forma pulmonar difusa da paracoccidioidose, mas parece ser causado pela doenca pulmonar obstrutiva cronica frequentemente subjacente
Subject(s)
Adult , Middle Aged , Humans , Male , Lung Diseases, Fungal , Paracoccidioidomycosis , Respiratory Function TestsABSTRACT
Nine patients with sickle cell disease and without concomitant cardiopulmonary illness or acute problems were studied with lung function tests. Besides arterial hemoglobin unsaturation, found in all cases so studied, a slight decrease in PaO2 was also present. The pulmonary gas transfer defect was studied and found to be due mostly to increased right to left shunting, although uneven ventilation/perfusion relationships seem to have been a factor in a few cases. Our data clearly show that the diffusion was not implicated in the gas transfer defect. The clinical implications of this little studied and less mentioned respiratory defect are discussed. Since the defect may enhance the risk of sickling crises, it should be measured in each individual patient, for appropriate prophylactic measures. After accidents, pre and post-operatively and during acute respiratory illness, the defect should be again reevaluated. In all probability many patients will be discovered who represent a respiratory risk, and may require special immunizations, prophylactic antibiotics, professional relocation and, during emergencies, intensive respiratory care.
