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1.
Thaís Batista de Carvalho Teresa Cristina Goulart Oliveira-Sequeira Semíramis Guimar?es 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(1):43-47
The quest for new antiparasitic alternatives has led researchers to base
their studies on insights into biology, host-parasite interactions and pathogenesis.
In this context, proteases and their inhibitors are focused, respectively, as
druggable targets and new therapy alternatives. Herein, we proposed to evaluate the
in vitro effect of the cysteine protease inhibitor E-64 on
Giardia trophozoites growth, adherence and viability.
Trophozoites (105) were exposed to E-64 at different final concentrations,
for 24, 48 and 72 h at 37 °C. In the growth and adherence assays, the number of
trophozoites was estimated microscopically in a haemocytometer, whereas cell
viability was evaluated by a dye-reduction assay using MTT. The E-64 inhibitor showed
effect on growth, adherence and viability of trophozoites, however, its better
performance was detected in the 100 µM-treated cultures. Although metronidazole was
more effective, the E-64 was shown to be able to inhibit growth, adherence and
viability rates by ≥ 50%. These results reveal that E-64 can interfere in some
crucial processes to the parasite survival and they open perspectives for future
investigations in order to confirm the real antigiardial potential of the protease
inhibitors. 相似文献
2.
Milagro Fernández-Delgado María Alexandra García-Amado Monica Contreras Renzo Nino Incani Humberto Chirinos Héctor Rojas Paula Suárez 《Revista do Instituto de Medicina Tropical de S?o Paulo》2015,57(1):21-26
The causative agent of cholera, Vibrio cholerae, can
enter into a viable but non-culturable (VBNC) state in response to unfavorable
conditions. The aim of this study was to evaluate the in situ
survival of V. cholerae in an aquatic environment of the Southern
Caribbean Sea, and its induction and resuscitation from the VBNC state. V.
cholerae non-O1, non-O139 was inoculated into diffusion chambers placed
at the Cuare Wildlife Refuge, Venezuela, and monitored for plate, total and viable
cells counts. At 119 days of exposure to the environment, the colony count was <
10 CFU/mL and a portion of the bacterial population entered the VBNC state.
Additionally, the viability decreased two orders of magnitude and morphological
changes occurred from rod to coccoid cells. Among the aquatic environmental
variables, the salinity had negative correlation with the colony counts in the dry
season. Resuscitation studies showed significant recovery of cell cultivability with
spent media addition (p < 0.05). These results suggest that
V. cholerae can persist in the VBNC state in this Caribbean
environment and revert to a cultivable form under favorable conditions. The VBNC
state might represent a critical step in cholera transmission in susceptible
areas. 相似文献
3.
Lara Stefania Netto de Oliveira LE?O-VASCONCELOS Ana Beatriz Mori LIMA Dayane de Melo COSTA Larissa Oliveira ROCHA-VILEFORT Ana Claúdia Alves de OLIVEIRA Nádia Ferreira GON?ALVES José Daniel Gon?alves VIEIRA Marinésia Aparecida PRADO-PALOS 《Revista do Instituto de Medicina Tropical de S?o Paulo》2015,57(2):121-127
The evaluation of workers as potential reservoirs and disseminators of pathogenic
bacteria has been described as a strategy for the prevention and control of
healthcare-associated infections (HAIs). The aim of this study was to evaluate the
presence of Enterobacteriaceae in the oral cavity of workers at an
oncology hospital in the Midwest region of Brazil, as well as to characterize the
phenotypic profile of the isolates. Saliva samples of 294 workers from the hospital’s
healthcare and support teams were collected. Microbiological procedures were
performed according to standard techniques. Among the participants, 55 (18.7%) were
colonized by Enterobacteriaceae in the oral cavity. A total of 64
bacteria were isolated, including potentially pathogenic species. The most prevalent
species was Enterobacter gergoviae (17.2%). The highest rates of
resistance were observed for β-lactams, and 48.4% of the isolates were considered
multiresistant. Regarding the enterobacteria isolated, the production of ESBL and KPC
was negative. Nevertheless, among the 43 isolates of the CESP group, 51.2% were
considered AmpC β-lactamase producers by induction, and 48.8% were hyper-producing
mutants. The significant prevalence of carriers of
Enterobacteriaceae and the phenotypic profile of the isolates
represents a concern, especially due to the multiresistance and production of AmpC
β-lactamases. 相似文献
4.
The effect of sub-lethal doses (40% and 80% of
LC50/24h) of plant derived molluscicides of singly,
binary (1:1) and tertiary (1:1:1) combinations of the Rutin,
Ellagic acid, Betulin and taraxerol with J. gossypifolia latex,
leaf and stem bark powder extracts and their active component on the
reproduction of freshwater snail Lymnaea acuminata have been
studied. It was observed that the J. gossypifolia latex, stem
bark, individual leaf and their combinations with other plant derived active
molluscicidal components caused a significant reduction in fecundity,
hatchability and survival of young snails. It is believed that sub-lethal
exposure of these molluscicides on snail reproduction is a complex process
involving more than one factor in reducing the reproductive capacity. 相似文献
5.
Elsy Nalleli Loría-Cervera Fernando José Andrade-Narváez 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(1):1-11
Leishmaniasis remains a major public health problem worldwide and is
classified as Category I by the TDR/WHO, mainly due to the absence of control. Many
experimental models like rodents, dogs and monkeys have been developed, each with
specific features, in order to characterize the immune response to
Leishmania species, but none reproduces the pathology observed in
human disease. Conflicting data may arise in part because different parasite strains
or species are being examined, different tissue targets (mice footpad, ear, or base
of tail) are being infected, and different numbers (“low” 1×102 and “high”
1×106) of metacyclic promastigotes have been inoculated. Recently, new
approaches have been proposed to provide more meaningful data regarding the host
response and pathogenesis that parallels human disease. The use of sand fly saliva
and low numbers of parasites in experimental infections has led to mimic natural
transmission and find new molecules and immune mechanisms which should be considered
when designing vaccines and control strategies. Moreover, the use of wild rodents as
experimental models has been proposed as a good alternative for studying the
host-pathogen relationships and for testing candidate vaccines. To date, using
natural reservoirs to study Leishmania infection has been
challenging because immunologic reagents for use in wild rodents are lacking. This
review discusses the principal immunological findings against
Leishmania infection in different animal models highlighting the
importance of using experimental conditions similar to natural transmission and
reservoir species as experimental models to study the immunopathology of the
disease. 相似文献
6.
7.
Muhammad Shafiq Shahid Masato Ikegami Abdul Waheed Rob W. Briddon Keiko T. Natsuaki 《Viruses》2014,6(1):189-200
Samples were collected in 2011 from tomato plants exhibiting typical tomato leaf curl disease symptoms in the vicinity of Komae, Japan. PCR mediated amplification, cloning and sequencing of all begomovirus components from two plants from different fields showed the plants to be infected by Tomato
yellow
leaf
curl
virus (TYLCV) and Ageratum
yellow
vein
virus (AYVV). Both viruses have previously been shown to be present in Japan, although this is the first identification of AYVV on mainland Japan; the virus previously having been shown to be present on the Okinawa Islands. The plant harboring AYVV was also shown to contain the betasatellite Tomato leaf curl Java betasatellite (ToLCJaB), a satellite not previously shown to be present in Japan. No betasatellite was associated with the TYLCV infected tomato plants analyzed here, consistent with earlier findings for this virus in Japan. Surprisingly both plants were also found to harbor an alphasatellite; no alphasatellites having previously been reported from Japan. The alphasatellite associated with both viruses was shown to be Sida yellow vein China alphasatellite which has previously only been identified in the Yunnan Province of China and Nepal. The results suggest that further begomoviruses, and their associated satellites, are being introduced to Japan. The significance of these findings is discussed. 相似文献
8.
Sheila Jorge Adad Renata Margarida Etchebehere Alessandro Adad Jammal 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(6):529-532
This study aimed to determine the existence of blood vessels within
ganglia of the myenteric plexus of the human esophagus and colon. At necropsy,
15 stillborns, newborns and children up to two years of age, with no
gastrointestinal disorders, were examined. Rings of the esophagus and colon were
analyzed and then fixed in formalin and processed for paraffin. Histological
sections were stained by hematoxylin-eosin, Giemsa and immunohistochemistry for
the characterization of endothelial cells, using antibodies for anti-factor VIII
and CD31. Blood vessels were identified within the ganglia of the myenteric
plexus of the esophagus, and no blood vessels were found in any ganglia of the
colon. It was concluded that the ganglia of the myenteric plexus of the
esophagus are vascularized, while the ganglia of the colon are avascular.
Vascularization within the esophageal ganglia could facilitate the entrance of
infectious agents, as well as the development of inflammatory responses
(ganglionitis) and denervation, as found in Chagas disease and
idiopathic achalasia. This could explain the higher frequency of megaesophagus
compared with megacolon. 相似文献
9.
Yusuke Tomoi Mitsuyoshi Takahara Yoshimitsu Soga Masahiko Fujihara Osamu Iida Daizo Kawasaki Amane Kozuki Kenji Ando 《Journal of atherosclerosis and thrombosis》2021,28(11):1153
Aim: Originally developed for predicting the risk of stroke in patients with atrial fibrillation (AF), the CHA 2 DS 2 -VASc score also has the potential to predict the risk of other cardiovascular disease. This study aimed to investigate the prognostic value of the CHA 2 DS 2 -VASc score in patients with peripheral artery disease (PAD) requiring Femoral popliteal (FP) endovascular therapy (EVT). Methods: This multicenter, retrospective study analyzed the clinical database of 2190 patients who underwent FP EVT for symptomatic PAD (Rutherford categories 2–4) between January 2010 and December 2018. We calculated the CHA 2 DS 2 -VASc score and then investigated the association between the score, as well as AF, and their prognosis. Outcome measures were major adverse cardiovascular events (MACEs) and major adverse limb events (MALEs). Results: During a median follow-up of 3.0 years (interquartile range, 1.5–5.0 years), 532 MACEs and 562 MALEs occurred. The CHA 2 DS 2 -VASc score and AF were independently associated with an increased risk of MACEs; their adjusted hazard ratios [95% confidence intervals] were 1.28 [1.20–1.36] ( P <0.001) per 1-point increase and 1.49 [1.06–2.09] ( P =0.022), respectively. The CHA 2 DS 2 -VASc score was almost linearly associated with MACEs, without any clear threshold point. On the other hand, these variables were not associated with MALEs risk ( P =0.32 and 0.48). Conclusion: The CHA 2 DS 2 -VASc score and AF were independently associated with the increased risk of MACEs but not of MALEs in patients with symptomatic PAD who underwent FP EVT. The score might be useful in stratifying the MACEs risk in this type of patients. 相似文献
10.
Maria Teresa Nascimento Silva José Valfrido Santana Gérson Bragagnoli Alexandre Magno da Nóbrega Marinho Elizabeth Malague?o 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(5):451-454
There is a clear need to perform epidemiological studies to find the
true prevalence of Entamoeba histolytica around the world. The
evaluation of this prevalence has been hindered by the existence of two
different species which are morphologically identical, but genetically
different, namely E. histolytica, which causes amebiasis, and
E. dispar, which is non-pathogenic. In Brazil, the
E. dispar has been detected in communities in the
Southeastern (SE) and Northeastern (NE) regions with poor
sanitation. However, individuals infected with E. histolytica
have been identified in other regions. There is an absence of reports on the
prevalence of these parasites in the state of Paraíba, which also has areas
with poor sanitary conditions where a high prevalence of the E.
histolytica/E. dispar complex has been detected in children
from urban slums. The present study evaluated the prevalence of E.
histolytica and E. dispar in 1,195 asymptomatic
children between two and 10 years of age, living in a sprawling urban slum in
Campina Grande, in the state of Paraíba, in Northeastern Brazil. These
children were examined and their feces samples were analyzed microscopically. A
total of 553 children tested positive for the E. histolytica/E.
dispar complex, and 456 of the positive samples were tested with
the E. histolytica II® ELISA kit. All 456 samples were
negative for the presence of the adhesin E. histolytica
specific antigen. The evidence suggests that in this community E.
histolytica is absent and E. dispar is the
dominant species. 相似文献
11.
Karin Kirchgatter Rosa Maria Tubaki Rosely dos Santos Malafronte Isabel Cristina Alves Giselle Fernandes Maciel de Castro Lima Lilian de Oliveira Guimar?es Robson de Almeida Zampaulo Gerhard Wunderlich 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(5):403-409
Anopheles (Kerteszia) cruzii has been
implicated as the primary vector of human and simian malarias out of the
Brazilian Amazon and specifically in the Atlantic Forest regions. The presence
of asymptomatic human cases, parasite-positive wild monkeys and the similarity
between the parasites infecting them support the discussion whether these
infections can be considered as a zoonosis. Although many aspects of the biology
of An. cruzii have already been addressed, studies conducted
during outbreaks of malaria transmission, aiming at the analysis of blood
feeding and infectivity, are missing in the Atlantic Forest. This study was
conducted in the location of Palestina, Juquitiba, where annually the majority
of autochthonous human cases are notified in the Atlantic Forest of the state of
São Paulo. Peridomiciliary sites were selected for collection of mosquitoes
in a perimeter of up to 100 m around the residences of human malaria cases. The
mosquitoes were analyzed with the purpose of molecular identification of
blood-meal sources and to examine the prevalence of Plasmodium.
A total of 13,441 females of An. (Ker.) cruzii were
collected. The minimum infection rate was calculated at 0.03% and
0.01%, respectively, for P. vivax and P.
malariae and only human blood was detected in the blood-fed
mosquitoes analyzed. This data reinforce the hypothesis that asymptomatic human
carriers are the main source of anopheline infection in the peridomiciliary
area, making the probability of zoonotic transmission less likely to happen. 相似文献
12.
Pedro Gon?alo Ferreira Susana Costa Nuno Dias António Jorge Ferreira Fátima Franco 《Jornal brasileiro de pneumologia》2014,40(3):313-318
Venlafaxine is a serotonin-norepinephrine reuptake inhibitor used as an
antidepressant. Interindividual variability and herb-drug interactions can lead to
drug-induced toxicity. We report the case of a 35-year-old female patient diagnosed
with synchronous pneumonitis and acute cardiomyopathy attributed to venlafaxine. The
patient sought medical attention due to dyspnea and dry cough that started three
months after initiating treatment with venlafaxine for depression. The patient was
concomitantly taking Centella asiatica and Fucus
vesiculosus as phytotherapeutic agents. Chest CT angiography and chest
X-ray revealed parenchymal lung disease (diffuse micronodules and focal ground-glass
opacities) and simultaneous dilated cardiomyopathy. Ecocardiography revealed a left
ventricular ejection fraction (LVEF) of 21%. A thorough investigation was carried
out, including BAL, imaging studies, autoimmune testing, right heart catheterization,
and myocardial biopsy. After excluding other etiologies and applying the Naranjo
Adverse Drug Reaction Probability Scale, a diagnosis of synchronous
pneumonitis/cardiomyopathy associated with venlafaxine was assumed. The herbal
supplements taken by the patient have a known potential to inhibit cytochrome P450
enzyme complex, which is responsible for the metabolization of venlafaxine. After
venlafaxine discontinuation, there was rapid improvement, with regression of the
radiological abnormalities and normalization of the LVEF. This was an important case
of drug-induced cardiopulmonary toxicity. The circumstantial intake of inhibitors of
the CYP2D6 isoenzyme and the presence of a CYP2D6 slow metabolism phenotype might
have resulted in the toxic accumulation of venlafaxine and the subsequent clinical
manifestations. Here, we also discuss why macrophage-dominant phospholipidosis was
the most likely mechanism of toxicity in this case. 相似文献
13.
Adalberto Alves Pereira Filho Clícia Rosane Costa Fran?a Dorlam's da Silva Oliveira Renato Juvino de Arag?o Mendes José de Ribamar Santos Gon?alves Ivone Garros Rosa 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(6):505-510
The action of extracts from the stem, leaves, and fruit of
Jatropha gossypiifolia on Biomphalaria
glabrata was studied by analyzing survival, feeding capacity and
oviposition ability. The extracts were obtained by macerating the plant parts in
92% ethanol, which were then evaporated until a dry residue was obtained
and phytochemically studied. The molluscicidal activity on B.
glabrata was investigated using the procedures recommended by WHO
(1965). The amount of food ingested and oviposition were measured
during each experiment. The extract of leaves from J.
gossypiifolia was shown to be a strong molluscicidal agent, causing
100% mortality of B. glabrata, even in the lowest
concentration tested, of 25 ppm. Regarding the fruit extract, there was
variation in the mortality, depending on the concentration used (100, 75,
50 and 25 ppm). The snails that were in contact with the fruit extract had
significant reduction in feeding and number of embryos in comparison to the
control. The stem extract did not present molluscicidal activity nor had any
influence on the feeding and oviposition abilities of B.
glabrata, in the concentrations tested. In conclusion, the extracts
of leaves and fruits of J. gossypiifolia investigated in this
work show molluscicidal effect and may be sources of useful compounds for the
schistosomiasis control. 相似文献
14.
Kjell Nikus Yochai Birnbaum Markku Eskola Samuel Sclarovsky Zhan Zhong-qun Olle Pahlm 《Current Cardiology Reviews》2014,10(3):229-236
The electrocardiogram (ECG) findings in acute coronary syndrome should always be interpreted in the context of the clinical findings and symptoms of the patient, when these data are available. It is important to acknowledge the dynamic nature of ECG changes in acute coronary syndrome. The ECG pattern changes over time and may be different if recorded when the patient is symptomatic or after symptoms have resolved. Temporal changes are most striking in cases of ST-elevation myocardial infarction. With the emerging concept of acute reperfusion therapy, the concept ST-elevation/non-ST elevation has replaced the traditional division into Q-wave/non-Q wave in the classification of acute coronary syndrome in the acute phase.
Keypoints:
In acute coronary syndrome, in addition to the traditional electrocardiographic risk markers, such as ST depression, the 12-lead ECG contains additional, important diagnostic and prognostic information. Clinical guidelines need to acknowledge certain high-risk ECG patterns to improve patient care. 相似文献15.
Luiz Henrique Conde Sangenis Sebasti?o Roberto de Almeida Lima Cíntia Xavier de Mello Daniela Trindade Cardoso Jurema Nunes Mello Maria Cristina Carvalho do Espírito Santo Walter Tavares 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(3):271-274
Visceral Leishmaniasis has been showing remarkable epidemiological changes
in recent decades, with marked expansion and an emergence of cases in urban areas of
the North, Southeast and Midwest regions of Brazil. The Kala-azar cases reported
here, despite being very characteristic, presented a great difficulty of diagnosis,
because the disease is not endemic in Volta Redonda. The child underwent two
hospitalizations in different hospitals, but got the correct diagnosis only after 11
months of symptom onset. In this report we discuss the main differential diagnoses
and call attention to the suspected symptoms of visceral leishmaniasis in patients
with prolonged fever, hepatosplenomegaly and pancytopenia, even in areas not
traditionally endemic for the disease. 相似文献
16.
Verónica Casmo Gerito Augusto Rassul Nala Acácio Sabonete Filipe Anibal Carvalho-Costa 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(3):219-224
This study aims to assess the association between schistosomiasis and
hookworm infection with hemoglobin levels of schoolchildren in northern Mozambique.
Through a cross-sectional survey, 1,015 children from five to 12 years old in the
provinces of Nampula, Cabo Delgado and Niassa were studied. Hookworm infection and
urinary schistosomiasis were diagnosed, through Ritchie and filtration methods, with
a prevalence of 31.3% and 59.1%, respectively. Hemoglobin levels were obtained with a
portable photometer (Hemocue®). The average hemoglobin concentration was
10.8 ± 1.42 g/dL, and 62.1% of the children presented levels below 11.5 g/dL, of
which 11.8% of the total number of children had hemoglobin levels below 9 g/dL. A
multiple linear regression analysis demonstrated negative interactions between
hemoglobin levels and ancylostomiasis, this being restricted to the province of Cabo
Delgado (β = -0.55; p < 0.001) where an independent interaction
between hemoglobin levels and urinary schistosomiasis was also observed (β = -0.35;
p = 0.016). The logistical regression model indicated that
hookworm infection represents a predictor of mild (OR = 1.87; 95% CI = 1.17-3.00) and
moderate/severe anemia (OR = 2.71; 95% CI = 1.50 - 4.89). We concluded that, in the
province of Cabo Delgado, hookworm and Schistosoma haematobium
infections negatively influence hemoglobin levels in schoolchildren. Periodical
deworming should be considered in the region. Health education and improvements in
sanitary infrastructure could achieve long-term and sustainable reductions in
soil-transmitted helminthiases and schistosomiasis prevalence rates. 相似文献
17.
Anwar Hasan Siddiqui Nazia Tauheed Aquil Ahmad Zehra Mohsin 《Jornal brasileiro de pneumologia》2014,40(3):244-249
Objective:
Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy.Methods:
Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation.Results:
All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function.Conclusions:
Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy. 相似文献18.
Tatiana Forte Lopes Marcia Moreira Holcman Gerson Laurindo Barbosa Maria de Fatima Domingos Rosa Maria Oliveira Veiga Barreiros 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(5):369-374
Aedes aegypti is an important vector in Brazil being
the main vector of the dengue-fever. This paper employs survival curves to
describe the time in days from larvae to adult forms of Aedes
aegypti raised, individually and collectively, and compares it
during winter and spring when positioned inside and outside a laboratory. The
study was conducted in São Vicente, a coastal city in Southeastern Brazil.
The lowest water temperature in winter and in spring was 20 °C and the
highest was 26 °C in spring. Higher and more stable temperatures were
measured in the intra compared to the peri in both seasons. Consequently, larvae
positioned in the intra resulted in the lowest median time to develop in the
individual and collective experiment (nine and ten days,
respectively). At least 25% of the larvae positioned in the intra in
the individual experiment in the spring took only seven days to reach adulthood.
Sex ratios and the median time development by sex did not show significant
differences. These results indicate that efforts to control Aedes
aegypti must be continuous and directed mainly to prevent the
intra-domiciliary sites that can be infested in a week in order to reduce the
human-vector contact. 相似文献
19.
Olívia Meira Dias Bruno Guedes Baldi André Nathan Costa Carlos Roberto Ribeiro Carvalho 《Jornal brasileiro de pneumologia》2014,40(3):304-312
Combined pulmonary fibrosis and emphysema (CPFE) has been increasingly recognized in
the literature. Patients with CPFE are usually heavy smokers or former smokers with
concomitant lower lobe fibrosis and upper lobe emphysema on chest HRCT scans. They
commonly present with severe breathlessness and low DLCO, despite spirometry showing
relatively preserved lung volumes. Moderate to severe pulmonary arterial hypertension
is common in such patients, who are also at an increased risk of developing lung
cancer. Unfortunately, there is currently no effective treatment for CPFE. In this
review, we discuss the current knowledge of the pathogenesis, clinical
characteristics, and prognostic factors of CPFE. Given that most of the published
data on CPFE are based on retrospective analysis, more studies are needed in order to
address the role of emphysema and its subtypes; the progression of fibrosis/emphysema
and its correlation with inflammation; treatment options; and prognosis. 相似文献
20.
Germano Manuel Pires Elena Folgosa Ndlovu Nquobile Sheba Gitta Nureisha Cadir 《Jornal brasileiro de pneumologia》2014,40(2):142-147