As there was not any data on Chlamydia pneumoniae (TWAR) infections in Brazil so far, a prospective cohort study of adult patients hospitalized due to CAP was carried out for one year in a Brazilian university general hospital to detect the incidence of CAP by Chlamydophila pneumoniae (TWAR) for one year. During a whole year 645 consecutive patients hospitalized due to an initial presumptive diagnosis of respiratory diseases by ICD-10 (J00-J99), excluding upper respiratory diseases, were screened; 59 consecutive patients with CAP were diagnosed. They had determinations of serum antibodies to C. pneumoniae by microimmunofluorescence at the Infectious Diseases Laboratory of University of Louisville (KY, USA); 37 patients (63.8%) had seroreactivity to TWAR antigens, from which 23 (39.6%) had previous infection; 3 patients (5.2%) were diagnosed with CAP by TWAR and got cured. The incidence of TWAR CAP in our hospital by seroconversion was 5.2%. Our incidence of 5.2% is probably underestimated since TWAR culture was not available; we suggest that Real-Time PCR be used along with other diagnostic methods in future studies to detect the actual incidence of TWAR CAP. We propose that the serological criterion of IgM >1:16 alone to the diagnosis of acute infection by TWAR are discontinued due a lack of specificity.

RACIONAL: A biopsia hepática transjugular é um procedimento alternativo para pacientes que apresentam contra-indicações ao procedimento padrão (percutâneo). OBJETIVO: Comparar o índice de diagnóstico obtido por meio da biopsia hepática transjugular utilizando uma agulha automatizada trucut e uma agulha Ross modificada. MÉTODOS: Oitenta e cinco pacientes com suspeita de doenças hepáticas crônicas e apresentando contra-indicações para biopsia hepática percutânea (coagulopatia, ascite maciça, obesidade mórbida ou problemas renais crônicos) foram submetidos a 89 biopsias hepáticas transjugulares entre março de 1994 e abril de 2001 no Hospital São José, Irmandade da Santa Casa de Misercórdia de Porto Alegre, RS, Brasil. Trinta e cinco pacientes foram submetidos a 36 biopsias com uma agulha trucut automatizada, e 50 a 53 biopsias com uma agulha Ross modificada. RESULTADOS: Diagnóstico histológico foi obtido em 32/35 pacientes submetidos a biopsia hepática transjugular com a agulha trucut (91%) e em 35/50 (70%) dos com a agulha Ross modificada. Os espécimes obtidos com a agulha trucut eram significativamente maiores e menos fragmentados do que aqueles obtidos com a agulha Ross. CONCLUSÃO: A biopsia hepática transjugular com a agulha trucut automatizada apresentou maior índice de diagnóstico histológico quando comparada com a agulha Ross modificada em pacientes com suspeita de doença hepática crônica.

BACKGROUND: Transjugular liver biopsy is an alternative procedure for patients who present contraindications to standard percutaneous procedure. AIM: To compare the rate of histological diagnosis obtained on transjugular liver biopsy with an automated trucut needle and with a modified Ross needle. PATIENTS / METHOD: Eighty-five patients with suspicion of chronic liver diseases and presenting contraindications for percutaneous liver biopsy (coagulopathy, massive ascites, morbid obesity, or chronic renal problems) were submitted to 89 transjugular liver biopsies between March 1994 and April 2001 at ''Hospital São José, Irmandade da Santa Casa de Misercórdia'', Porto Alegre, RS, Brazil. Thirty-five patients underwent 36 biopsies with an automated trucut needle, and 50 patients underwent 53 biopsies with a modified Ross needle. RESULTS: Histological diagnosis was reached in 32/35 subjects submitted to transjugular liver biopsy with the trucut needle (91%) and in 35/50 (70%) submitted to biopsy with the modified Ross needle. Specimens obtained with the trucut needle were significantly larger and less fragmented than those obtained with the Ross needle. CONCLUSION: Transjugular liver biopsy with the automated trucut needle allowed a higher rate of histological diagnosis when compared to the modified Ross needle in patients with suspicion of chronic liver diseases.

A atresia brônquica é uma anomalia congênita rara que usualmente produz massa justa-hilar com hipertransparência distal à radiografia simples. A maioria dos pacientes é jovem e não apresenta sintomas. A tomografia computadorizada confirma o diagnóstico, permitindo o manejo conservador nos casos assintomáticos. Os autores relatam três casos de atresia brônquica. Um caso, de particular interesse, estava associado a volumosa broncocele em paciente do sexo feminino, de 45 anos de idade, que apresentou quadro sintomático de infecção respiratória. O diagnóstico foi estabelecido por meio dos achados da radiologia convencional, da tomografia computadorizada e da comparação com radiografias convencionais e tomografia linear prévios, que já demonstravam alterações. Realizou-se uma revisão sobre os achados clínicos e radiológicos dessa malformação.

Bronchial atresia is a rare congenital abnormality that usually shows a juxta-hilar mass with distal radiolucency on conventional x-ray films. Most patients are young and have no symptoms. Computed tomography usually confirms the diagnosis, allowing conservative management of the asymptomatic cases. The authors report three cases of bronchial obstruction. One of the patients was of particular importance and interest, a 45-year-old female patient with symptoms of respiratory infection, due to the association with a bulky bronchocele. The diagnosis was made by analyzing the findings of conventional x-ray films and computed tomography, and the comparison with previous conventional x-ray films and linear tomography, which had already demonstrated abnormalities. A literature review on the clinical and radiological findings of this pulmonary malformation is presented.