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J R Vieira

Publications and source records attributed to J R Vieira.

5 recordsLinked to original sources

[Benign pleural effusion caused by asbestos exposure].

The Authors present the first case described among us of benign pleural effusion of an asbestotic origin. They stress the importance of thoracoscopy (pleuroscopy) in the diagnosis of this situation. Attention is drawn to the fact that asbestotic lesions and asbestotic bodies have been found in the lung and, in particular, in the parietal pleura as well. They emphasize the fact that exposure to asbestos was not realized by the patient, which made the clarification of the situation more difficult. It was a CT scan that showed the signs suggestive of exposure to asbestos which raised the diagnostic suspicion. They conclude that every patient with a pleural effusion must be thoroughly questioned about exposure to asbestos. Even if the exposure is accepted, they consider that one should proceed to a pleuro-pulmonar biopsy by thoracoscopy. This biopsy allows demonstration of the characteristic histopathological lesions and rule out other etiologies, namely malignancy and tuberculosis. They suggest that these patients must be highly motivated to stop any smoking and kept under periodic surveillance.

Adult↗

[Chronic obstructive pulmonary disease].

Chronic obstructive pulmonary disease (COPD) includes two entities, Chronic Bronchitis (C.B.) and Emphysema (E.), assembled by their common physiopathological feature, a progressive expiratory airflow obstruction. The presence of hyperreactivity is common and partial reversibility may be observed. The coexistence of CB and E. is largely the most prevalent. Cigarette smoking is the main risk factor per se or associated with other urban or occupational air pollutants. Therefore epidemiological COPD rats follow the prevalence of smoking habits in the population. The main goal of the strategy against the disease are preventive decisions and measures, as far as smoking is concerned. FEV1 values lower than 75% of FVC and a decline of FEV1 higher than 30 ml/year indicate a high risk of COPD among smokers. The assessment of FEV1 is important for monitoring and guiding treatment and is valid for grading the severity of COPD. Once the disease is confirmed the therapeutic skills are the following: to reduce the symptoms; to prevent and treat the exacerbations; to attenuate the functional impairment, both short and long term; to achieve better performance in daily activities and quality of life; to avoid and minimise the adverse effects of medication. The increase in life expectancy and the reduction of mortality are tangible goals related to a global and multidisciplinary approach. They mainly depend on smoking cessation, reducing the bronchial obstruction, and correcting chronic hypoxemia.

Clinical Protocols↗