Avaliação da incidência e evolução das manifestações de doenças nasais em pacientes portadores de fibrose cística
Carregando...
Data
2018-04-27
Autores
Campos, Camila Sá de Melo
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
CAMPOS, C. S. M. 2018. Avaliação da incidência e evolução das manifestações das doenças nasais em pacientes portadores de fibrose cística. 2018. Dissertação (Mestrado) – Faculdade de Medicina de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, 2018. Introdução: A fibrose cística é uma doença originada da mutação do gene responsável pela codificação da proteína CFTR. A ausência ou defeito dessa proteína leva a um transporte irregular de sal e água em células mucosas respiratórias e de glândulas exócrinas podendo resultar em diversas manifestações clínicas. As alterações otorrinolaringológicas frequentes são rinossinusite crônica e polipose nasal. Objetivo: Avaliar a incidência e a evolução de doenças nasais em pacientes portadores de fibrose cística com exame videonasolaringoscópico documentado em prontuário do período de agosto de 2015 a agosto de 2017. Casuística e Métodos: Realizou-se a coleta de dados de 65 pacientes acompanhados no ambulatório de fibrose cística do Hospital das Clínicas de Botucatu. Foram incluídos os pacientes que possuíam exames videonasolaringoscópicos realizados durante o período de acompanhamento e que concordaram em participar do estudo. Realizou-se um estudo de coorte com avaliação dos dados epidemiológicos, presença de comorbidades, achados nos exames videonasolaringoscópicos, positivação de cultura de orofaringe e resposta ao tratamento clínico. Resultados: Foram analisados 51 pacientes. A mutação delta F508 esteve presente em 20 pacientes. As comorbidades avaliadas foram: bronquiectasias (n= 39), pneumonia (n= 29), íleo meconial ao nascimento (n=9), hepatopatia (n= 22) e insuficiência pancreática (n= 32). Nos exames videonasolaringoscópicos encontramos: 19 pacientes com pólipos nasais (37,2%), destes, treze tiveram resposta positiva com o tratamento com corticoide tópico nasal. Doze pacientes possuiam hipertrofia adenoideana (23,5%), oito pacientes tinham secreção purulenta em cavidades nasais (15,7%), 40 pacientes possuíam alteração na mucosa nasal. O microorganismo mais frequente nas culturas de orofaringe foi a Pseudomonas aeruginosa (72,5%). Não encontramos relação entre a presença de pólipos nasais e complicações pulmonares; entre a positivação da cultura de orofaringe para Pseudomonas aeruginosa e presença de pólipos nasais; e entre as complicações pulmonares e a positivação de cultura de orofaringe para Pseudomonas aeruginosa. Conclusão: A incidência de polipose nasal observada neste estudo foi de 37,2%. O exame videonasolaringoscópico permite a detecção precoce da polipose nasal nesta população.
CAMPOS, C.S.M. 2018. Evaluation of the incidence and evolution of the manifestations of nasal diseases in patients with cystic fibrosis. 2018. Thesis (Master) – Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, 2018. Introduction: Cystic fibrosis is a disease originated from the mutation of the gene responsible for the coding of the CFTR protein. The absence or defect of this protein leads to an irregular transport of salt and water in respiratory mucous cells and exocrine glands, resulting in several clinical manifestations. Frequent otorhinolaryngological changes are chronic rhinosinusitis and nasal polyps. Objective: To evaluate the incidence and evolution of nasal diseases in patients with cystic fibrosis with a videonasolaryngoscopic exam documented in medical records from August 2015 to August 2017. Casuistry and Methods: Data were collected from 65 patients followed in the cystic fibrosis outpatient clinic Botucatu Medical School. Patients who had videonasolaryngoscopic examinations performed during the follow-up period and who agreed to participate in the study were included. A cohort study was conducted with epidemiological data, presence of comorbidities, findings in videonasolaryngoscopic examinations, oropharyngeal culture positivity and response to clinical treatment. Results: Fifty-one patients were analyzed. The delta F508 mutation was present in 20 patients. The comorbidities evaluated were: bronchiectasis (n = 39), pneumonia (n = 29), meconium ileus at birth (n = 9), liver disease (n = 22) and pancreatic insufficiency (N=32) . In the videonasolaringoscopic exams we found: 19 patients with nasal polyps (37.2%), of whom thirteen had a positive response to nasal topical corticosteroid treatment. Twelve patients had adenoid hypertrophy (23.5%), eight patients had purulent secretion in nasal cavities (15.7%), and 40 patients had alterations in the nasal mucosa. The most frequent microorganism in oropharynx cultures was Pseudomonas aeruginosa (72.5%). We did not find a relation between the presence of nasal polyps and pulmonary complications; between the positivity of the oropharynx culture for Pseudomonas aeruginosa and the presence of nasal polyps; and between pulmonary complications and the positivity of oropharynx culture for Pseudomonas aeruginosa.Conclusion: The incidence of nasal polyposis observed in this study was 37.2%. The videonasolaringoscopic examination allows the early detection of nasal polyposis in this population.
CAMPOS, C.S.M. 2018. Evaluation of the incidence and evolution of the manifestations of nasal diseases in patients with cystic fibrosis. 2018. Thesis (Master) – Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, 2018. Introduction: Cystic fibrosis is a disease originated from the mutation of the gene responsible for the coding of the CFTR protein. The absence or defect of this protein leads to an irregular transport of salt and water in respiratory mucous cells and exocrine glands, resulting in several clinical manifestations. Frequent otorhinolaryngological changes are chronic rhinosinusitis and nasal polyps. Objective: To evaluate the incidence and evolution of nasal diseases in patients with cystic fibrosis with a videonasolaryngoscopic exam documented in medical records from August 2015 to August 2017. Casuistry and Methods: Data were collected from 65 patients followed in the cystic fibrosis outpatient clinic Botucatu Medical School. Patients who had videonasolaryngoscopic examinations performed during the follow-up period and who agreed to participate in the study were included. A cohort study was conducted with epidemiological data, presence of comorbidities, findings in videonasolaryngoscopic examinations, oropharyngeal culture positivity and response to clinical treatment. Results: Fifty-one patients were analyzed. The delta F508 mutation was present in 20 patients. The comorbidities evaluated were: bronchiectasis (n = 39), pneumonia (n = 29), meconium ileus at birth (n = 9), liver disease (n = 22) and pancreatic insufficiency (N=32) . In the videonasolaringoscopic exams we found: 19 patients with nasal polyps (37.2%), of whom thirteen had a positive response to nasal topical corticosteroid treatment. Twelve patients had adenoid hypertrophy (23.5%), eight patients had purulent secretion in nasal cavities (15.7%), and 40 patients had alterations in the nasal mucosa. The most frequent microorganism in oropharynx cultures was Pseudomonas aeruginosa (72.5%). We did not find a relation between the presence of nasal polyps and pulmonary complications; between the positivity of the oropharynx culture for Pseudomonas aeruginosa and the presence of nasal polyps; and between pulmonary complications and the positivity of oropharynx culture for Pseudomonas aeruginosa.Conclusion: The incidence of nasal polyposis observed in this study was 37.2%. The videonasolaringoscopic examination allows the early detection of nasal polyposis in this population.
Descrição
Palavras-chave
Fibrose cística, Obstrução nasal, Sinusite, Cystic fibrosis, Nasal obstruction, Sinusitis