ADRIANA SATIE GONCALVES KONO MAGRI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • article 22 Citação(ões) na Scopus
    First report of a clinical isolate of Candida haemulonii in Brazil
    (2012) ALMEIDA JR., Joao Nobrega de; MOTTA, Adriana Lopes; ROSSI, Flavia; ABDALA, Edson; PIERROTTI, Ligia Camera; KONO, Adriana Satie Goncalves; DIZ, Maria Del Pilar Estevez; BENARD, Gil; NEGRO, Gilda Maria Barbaro Del
  • article 249 Citação(ões) na Scopus
    Brazilian guidelines for the clinical management of paracoccidioidomycosis
    (2017) SHIKANAI-YASUDA, Maria Aparecida; MENDES, Rinaldo Poncio; COLOMBO, Arnaldo Lopes; QUEIROZ-TELLES, Flavio de; KONO, Adriana Satie Goncalves; PANIAGO, Anamaria M. M.; NATHAN, Andre; VALLE, Antonio Carlos Francisconi do; BAGAGLI, Eduardo; BENARD, Gil; FERREIRA, Marcelo Simao; TEIXEIRA, Marcus de Melo; SILVA-VERGARA, Mario Leon; PEREIRA, Ricardo Mendes; CAVALCANTE, Ricardo de Souza; HAHN, Rosane; DURLACHER, Rui Rafael; KHOURY, Zarifa; CAMARGO, Zoilo Pires de; MORETTI, Maria Luiza; MARTINEZ, Roberto
    Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America that is associated with rural environments and agricultural activities. However, the incidence and prevalence of paracoccidiodomycosis is underestimated because of the lack of compulsory notification. If paracoccidiodomycosis is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. While the Paracoccidioides brasiliensis (P. brasiliensis) complex has been known to be the causal agent of paracoccidiodomycosis, a new species, Paracoccidioides lutzii (P. lutzii), has been reported in Rondonia, where the disease has reached epidemic levels, and in the Central West and Para. Accurate diagnoses and availability of antigens that are reactive with the patients' sera remain significant challenges. Therefore, the present guidelines aims to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. This consensus summarizes etiological, ecoepidemiological, molecular epidemiological, and immunopathological data, with emphasis on clinical, microbiological, and serological diagnosis and management of clinical forms and sequelae, as well as in patients with comorbidities and immunosuppression. The consensus also includes discussion of outpatient treatments, severe disease forms, disease prevalence among special populations and resource-poor settings, a brief review of prevention and control measures, current challenges and recommendations.
  • article 29 Citação(ões) na Scopus
    The lung in paracoccidioidomycosis: new insights into old problems
    (2013) COSTA, Andre Nathan; BENARD, Gil; ALBUQUERQUE, Andre Luis Pereira; FUJITA, Carmem Lucia; MAGRI, Adriana Satie Kono; SALGE, Joao Marcos; SHIKANAI-YASUDA, Maria Aparecida; CARVALHO, Carlos Roberto Ribeiro
    OBJECTIVES: Chronic paracoccidioidomycosis can diffusely affect the lungs. Even after antifungal therapy, patients may present with residual respiratory abnormalities due to fungus-induced lung fibrosis. METHODS: A cross-sectional analysis of 50 consecutive inactive, chronic paracoccidioidomycosis patients was performed using high resolution computed tomography, pulmonary function tests, ergospirometry, the six-minute walk test and health-related quality of life questionnaires. RESULTS: Radiological abnormalities were present in 98% of cases, the most frequent of which were architectural distortion (90%), reticulate and septal thickening (88%), centrilobular and paraseptal emphysema (84%) and parenchymal bands (74%). Patients typically presented with a mild obstructive disorder and a mild reduction in diffusion capacity with preserved exercise capacity, including VO(2)max and six-minute walking distance. Patient evaluation with the Saint-George Respiratory Questionnaire showed low impairment in the health-related quality of life, and the Medical Research Council questionnaire indicated a low dyspnea index. There were, however, patients with significant oxygen desaturation upon exercise that was associated with respiratory distress compared with the non-desaturated patients. The initial counterimmunoelectrophoresis of these patients was higher and lung emphysema was more prominent; however, there were no differences in the interstitial fibrotic tomographic abnormalities, tobacco exposure, functional responses, exercise capacity or quality of life. CONCLUSIONS: Inactive, chronic paracoccidioidomycosis patients show persistent and disseminated radiological abnormalities by high resolution computed tomography, short impairments in pulmonary function and low impacts on aerobic capacity and quality of life. However, there was a subset of individuals whose functional impairment was more severe. These patients present with higher initial serology and more severe emphysema, stressing the importance of adequate treatment associated with tobacco exposure cessation.
  • article 40 Citação(ões) na Scopus
    Brazilian guidelines for the clinical management of paracoccidioidomycosis
    (2018) SHIKANAI-YASUDA, Maria Aparecida; MENDES, Rinaldo Poncio; COLOMBO, Arnaldo Lopes; TELLES, Flavio de Queiroz; KONO, Adriana; PANIAGO, Anamaria Mello Miranda; NATHAN, Andre; VALLE, Antonio Carlos Francisconi do; BAGAGLI, Eduardo; BENARD, Gil; FERREIRA, Marcelo Simao; TEIXEIRA, Marcus de Melo; VERGARA, Mario Leon Silva; PEREIRA, Ricardo Mendes; CAVALCANTE, Ricardo de Souza; HAHN, Rosane; DURLACHER, Rui Rafael; KHOURY, Zarifa; CAMARGO, Zoilo Pires de; MORETTI, Maria Luiza; MARTINEZ, Roberto
    Paracoccidioidomycosis is a systemic fungal disease associated with agricultural activities. Its incidence and prevalence are underestimated because of the lack of reporting in several Brazilian states. If paracoccidiodomycosis is not diagnosed and treated early and adequately, endemic fungal infection may result in serious sequelae. In addition to the Paracoccidioides brasiliensis (P. brasiliensis) complex, the appearance of a new species, Paracoccidioides lutzii (P. lutzii), in Rondonia state, where the disease has reached epidemic levels, and in the country's Midwest region and Para state, are challenges to diagnosis and to the urgent availability of antigens that are reactive with patients' sera. These guidelines aim to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. The guidelines provide data on etiology, epidemiology, immunopathogenesis, diagnosis, treatment and sequelae, with emphasis on diagnosis and treatment, as well as current recommendations and challenges in this field of knowledge.