ROSANA CAMARA AGONDI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
LIM/19 - Laboratório de Histocompatibilidade e Imunidade Celular, Hospital das Clínicas, Faculdade de Medicina
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
LIM/19 - Laboratório de Histocompatibilidade e Imunidade Celular, Hospital das Clínicas, Faculdade de Medicina
14 resultados
Resultados de Busca
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- Vocal cord dysfunction diagnosis may be improved by a screening check list(2016) PINTO, Lucia Helena Eduardo; AUN, Marcelo Vivolo; CUKIER-BLAJ, Sabrina; STELMACH, Rafael; CUKIER, Alberto; KALIL, Jorge; AGONDI, Rosana Camara; GIAVINA-BIANCHI, PedroBackground: Many patients with vocal cord dysfunction (VCD), with or without asthma, receive inappropriate treatment because they are misdiagnosed as having difficult-to-control asthma alone. We developed a clinical screening check list designed to aid the diagnosis of VCD. Methods: A prospective observational study involving 80 patients aged >= 8 years, diagnosed with severe asthma. After anamnesis and physical examination, physicians completed a check list with 6 questions to identify VCD, for which the answer ""yes"" counted one point. Then patients underwent spirometry and laryngoscopy. On the basis of the laryngoscopic findings, we created three patient groups: VCD (vocal cord adduction during inspiration, n = 14); unconfirmed VCD (inconclusive findings, n = 29); and control (normal findings, n = 37). We attempted to determine whether any of those groups were associated with the responses to individual questions or sets of questions on the check list. Results: The proportion of affirmative answers to the question ""Does pulmonary auscultation reveal wheezing, predominantly in the cervical region, and/or stridor?"" was significantly higher for the VCD group than for the other two groups (P = 0.006), notably in elderly patients. The variable ""4 or more affirmative answers"" was more common in VCD and unconfirmed VCD groups in comparison to controls (P = 0.022). Conclusions: A finding of wheezing or stridor on auscultation of the cervical region is suggestive of vocal cord dysfunction, especially in elderly patients, and such dysfunction can be confirmed through laryngoscopy. Our VCD screening check list proved to be useful in the screening of VCD among patients with severe asthma.
- Identifying the Characteristics of Responders and Nonresponders in a Behavioral Intervention to Increase Physical Activity Among Patients With Moderate to Severe Asthma: Protocol for a Prospective Pragmatic Study(2023) LIMA, Fabiano Francisco de; LUNARDI, Adriana Claudia; PINHEIRO, David Halen Araujo; CARVALHO-PINTO, Regina Maria; STELMACH, Rafael; GIAVINA-BIANCHI, Pedro; AGONDI, Rosana Camara; CARVALHO, Celso R. F.Background: Previous research has suggested that most adults improve their asthma control after a short-term behavioral intervention program to increase physical activity in daily life (PADL). However, the characteristics of individuals who respond and do not respond to this intervention and the medium-term response remain unknown.Objective: This study aims to (1) identify the characteristics of adult responders and nonresponders with asthma to a behavioral intervention to increase physical activity and (2) evaluate the functional and clinical benefits in the medium term.Methods: This prospective pragmatic study will include adults with moderate to severe asthma who enroll in a behavioral intervention. All individuals will receive an educational program and an 8-week intervention to increase PADL (1 time/wk; up to 90 min/session). The educational program will be conducted in a class setting through group discussions and video presentations. Behavioral interventions will be based on the transtheoretical model using counseling, incentives, and individual feedback aiming to increase participation in physical activity. Motivational interviewing and guidelines for overcoming barriers will be used to stimulate individuals to reach their goals. Pre-and postintervention assessments will include the following: PADL (triaxial accelerometry), body composition (octopolar bioimpedance), barriers to PADL (questionnaire), clinical asthma control (Asthma Control Questionnaire), quality of life (Asthma Quality of Life Questionnaire), anxiety and depression levels (Hospital Anxiety and Depression Scale), and exacerbations. ""Responders"" to the intervention will be defined as those who demonstrate an increase in the number of daily steps (& GE;2500). Results: In December 2021, the clinical trial registration was approved. Recruitment and data collection for the trial is ongoing, and the results of this study are likely to be published in late 2024. Conclusions: The intervention will likely promote different effects according to the clinical characteristics of the individuals, including asthma control, age, anxiety and depression levels, obesity, and several comorbidities. Identifying individuals who respond or do not respond to behavioral interventions to increase PADL will help clinicians prescribe specific interventions to adults with asthma.Trial Registration: ClinicalTrials.gov NCT05159076; https://clinicaltrials.gov/ct2/show/NCT05159076International Registered Report Identifier (IRRID): DERR1-10.2196/49032
- Diagnosis and treatment of systemic mastocytosis in Brazil: Recommendations of a multidisciplinary expert panel(2022) VELLOSO, Elvira D. Rodrigues Pereira; PADULLA, Georgia A.; CERQUEIRA, Ana Maria Mosca de; SOUSA, Adriana Martins de; SANDES, Alex Freire; TRAINA, Fabiola; SEGURO, Fernanda Salles; NOGUEIRA, Frederico Lisboa; PEREIRA, Grazielly de Fathima; BOECHAT, jose Laerte; PAGNANO, Katia Borgia Barbosa; MARCHI, Luan Lima; ENSINA, Luis Felipe; GIAVINA-BIANCHI, Mara; AUN, Marcelo Vivolo; AGONDI, Rosana Camara; SANTOS, Fabio Pires de Souza; GIAVINA-BIANCHI, PedroIntroduction: Systemic Mastocytosis comprises a group of neoplastic diseases character-ized by clonal expansion and infiltration of mast cells into several organs. The diagnosis and treatment of this disease may be challenging for non-specialists. Objective: Make suggestions or recommendations in Systemic Mastocytosis based in a panel of Brazil-ian specialists.Method and results: An online expert panel with 18 multidisciplinary specialists was con-vened to propose recommendations on the diagnosis and treatment of Systemic Mastocy-tosis in Brazil. Recommendations were based on discussions of topics and multiple-choice questions and were graded using the Oxford Centre for Evidence-Based Medicine 2011 Lev-els of Evidence Chart. Conclusion: Twenty-two recommendations or suggestions were proposed based on a litera-ture review and graded according to the findings.(c) 2022 Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular.
- Can patients with common variable immunodeficiency have allergic rhinitis?(2013) AGONDI, Rosana C.; BARROS, Myrthes T.; KOKRON, Cristina M.; COHON, Andrea; OLIVEIRA, Ana K. B.; KALIL, Jorge; GIAVINA-BIANCHI, PedroBackground: Rhinosinusitis is highly prevalent in patients with common variable immunodeficiency (CVID), and probably allergic rhinitis (AR) may be masked by a history of repeated respiratory infections. The diagnosis of AR is based on the patient's symptoms and detection of specific immunoglobulin E (IgE) to aeroallergens. This study was designed to identify rhinitis of probable allergic cause in patients with CVID. Methods: This study included 72 adult CVID patients. The patients were divided into three groups according to their history: suggestive of AR, nonallergic rhinitis, and without rhinitis. They were tested for total and specific IgE (in vivo and in vitro). Results: The patients' mean age was 38.2 years. A history of chronic rhinitis was observed in 59 (81.9%) of the cases, 31 of which (43%) had a history suggestive of AR. Patients with a history of rhinitis (whether allergic or nonallergic) presented an earlier onset of symptoms and diagnosis of CVID. Total IgE was undetectable in 86.1% of patients. AR was confirmed by detection of specific IgE to aeroallergens in only 5.6% of the patients. Conclusion: In CVID patients, chronic rhinitis may be allergic, because many have personal and family histories suggestive of atopy. However, in this study, allergy was confirmed by specific IgE detection in only 5.6% of cases. CVID patients with a history suggestive of AR commonly present negative results on traditional testing, so additional experiments may be necessary. One suggestion for the investigation of AR in CVID patients would be nasal provocation with the most prevalent allergens.
- Worsening of asthma control after COVID-19(2022) AGONDI, Rosana Camara; MENECHINO, Natalia; MARINHO, Ana Karolina Barreto Berselli; KALIL, Jorge; GIAVINA-BIANCHI, PedroBackgroundSARS-CoV-2 enters lung cells via angiotensin-converting enzyme 2 (ACE2) receptor. Several studies suggest that interleukin-13, an important cytokine involved in T2 inflammation, reduces ACE2 expression, and therefore, asthma would not be a significant risk factor for the development of severe COVID-19. However, several asthma-related risk factors should be valued during the concurrent occurrence of asthma and COVID-19. The purpose of this study was to compare the evolution of asthma in patients who had COVID-19 with those who did not have the disease. MethodsThis was an observational and retrospective study involving asthmatic patients followed up at a tertiary center. Patients were assessed for severity of asthma, atopy, comorbidities, and COVID-19. Worsening of asthma was considered when, during the period of Sept 2020 to Oct 2021, patients referred an increasing of asthma symptoms and a need to increment their maintenance therapy. ResultsThis study included 208 asthmatic patients, the mean age was 52.75 years, 79.81% were atopic asthmatics, and 59 (28.37%) had laboratory-confirmed coronavirus disease. Of all patients infected with the SARS-CoV-2, eleven (18.64%) needed hospitalization and required oxygen supply with an O2 mask. Comparing the worsening of asthma between patients who had COVID-19 and those who had not the disease, there was a statistically significant difference, 33.90 vs. 11.41%, respectively (p < 0.001). There was no statistical significance regarding asthma comorbidities. ConclusionThis study assessed a group of asthmatic patients that had COVID-19, and that although the respiratory symptoms related to COVID-19 were mild to moderate, a subgroup of these asthmatic patients evolved with a chronic worsening of their asthma requiring an increment in asthma medication to control the disease.
- The global impact of the COVID-19 pandemic on the management and course of chronic urticaria(2021) KOCATURK, Emek; SALMAN, Andac; CHERREZ-OJEDA, Ivan; CRIADO, Paulo Ricardo; PETER, Jonny; COMERT-OZER, Elif; ABUZAKOUK, Mohamed; AGONDI, Rosana Camara; AL-AHMAD, Mona; ALTRICHTER, Sabine; ARNAOUT, Rand; ARRUDA, Luisa Karla; ASERO, Riccardo; BAUER, Andrea; BEN-SHOSHAN, Moshe; BERNSTEIN, Jonathan A.; BIZJAK, Mojca; BOCCON-GIBOD, Isabelle; BONNEKOH, Hanna; BOUILLET, Laurence; BRZOZA, Zenon; BUSSE, Paula; CAMPOS, Regis A.; CARNE, Emily; CONLON, Niall; CRIADO, Roberta F.; LIMA, Eduardo M. de Souza; DEMIR, Semra; DISSEMOND, Joachim; GUNAYDIN, Sibel Dogan; DOROFEEVA, Irina; ENSINA, Luis Felipe; ERTAS, Ragip; FERRUCCI, Silvia Mariel; FIGUERAS-NART, Ignasi; FOMINA, Daria; FRANKEN, Sylvie M.; FUKUNAGA, Atsushi; GIMENEZ-ARNAU, Ana M.; GODSE, Kiran; GONCALO, Margarida; GOTUA, Maia; GRATTAN, Clive; GUILLET, Carole; INOMATA, Naoko; JAKOB, Thilo; KARAKAYA, Gul; KASPERSKA-ZAJAC, Alicja; KATELARIS, Constance H.; KOSNIK, Mitja; KRASOWSKA, Dorota; KULTHANAN, Kanokvalai; KUMARAN, M. Sendhil; LANG, Claudia; LARCO-SOUSA, Jose Ignacio; LAZARIDOU, Elisavet; LESLIE, Tabi Anika; LIPPERT, Undine; LLOSA, Oscar Calderon; MAKRIS, Michael; MARSLAND, Alexander; V, Iris Medina; MESHKOVA, Raisa; PALITOT, Esther Bastos; PARISI, Claudio A. S.; PICKERT, Julia; RAMON, German D.; RODRIGUEZ-GONZALEZ, Monica; ROSARIO, Nelson; RUDENKO, Michael; RUTKOWSKI, Krzysztof; SANCHEZ, Jorge; SCHLIEMANN, Sibylle; SEKEREL, Bulent Enis; SERPA, Faradiba S.; SERRA-BALDRICH, Esther; SONG, Zhiqiang; SORIA, Angele; STAEVSKA, Maria; STAUBACH, Petra; TAGKA, Anna; TAKAHAGI, Shunsuke; THOMSEN, Simon Francis; TREUDLER, Regina; VADASZ, Zahava; VALLE, Solange Oliveira Rodrigues; DOORN, Martijn B. A. Van; VESTERGAARD, Christian; WAGNER, Nicola; WANG, Dahu; WANG, Liangchun; WEDI, Bettina; XEPAPADAKI, Paraskevi; YUCEL, Esra; ZALEWSKA-JANOWSKA, Anna; ZHAO, Zuotao; ZUBERBIER, Torsten; MAURER, MarcusIntroduction The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. Materials and Methods Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. Conclusions The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.
- Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial(2021) FELIX, Soraia Nogueira; AGONDI, Rosana Camara; AUN, Marcelo Vivolo; OLIVO, Clarice Rosa; ALMEIDA, Francine Maria de; AMORIM, Thais Santos; CEZARIO, Julia Caroline; GIAVINA-BIANCHI, Pedro; TIBERIO, Iolanda de Fatima Lopes Calvo; MARTINS, Milton de Arruda de; ROMANHOLO, Beatriz Mangueira SaraivaThis study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 min applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 before and after bronchodilator and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in both groups. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.
- United airway disease: current perspectives(2016) GIAVINA-BIANCHI, Pedro; AUN, Marcelo Vivolo; TAKEJIMA, Priscila; KALIL, Jorge; AGONDI, Rosana CamaraUpper and lower airways are considered a unified morphological and functional unit, and the connection existing between them has been observed for many years, both in health and in disease. There is strong epidemiologic, pathophysiologic, and clinical evidence supporting an integrated view of rhinitis and asthma: united airway disease in the present review. The term ""united airway disease"" is opportune, because rhinitis and asthma are chronic inflammatory diseases of the upper and lower airways, which can be induced by allergic or nonallergic reproducible mechanisms, and present several phenotypes. Management of rhinitis and asthma must be jointly carried out, leading to better control of both diseases, and the lessons of the Allergic Rhinitis and Its Impact on Asthma initiative cannot be forgotten.
- Clinical features of hereditary angioedema and warning signs (H4AE) for its identification(2022) GIAVINA-BIANCHI, Pedro; AUN, Marcelo Vivolo; GARCIA, Juliana Foes Bianchini; GOMES, Lais Souza; RIBERIRO, Ana Julia; TAKEJIMA, Priscila; AGONDI, Rosana Camara; KALIL, Jorge; MOTTA, Antonio AbilioObjectives: The study describes a case series of hereditary angioedema with C1 Inhibitor Deficiency (C1INH-HAE) in order to corroborate six clinical warning signs ""HAAAAE (H4AE)"" to enable early identification of this disease. Methods: The authors analyzed the C1INH-HAE cohort to analyze the clinical aspects of the present study's patients and corroborate the six clinical warning signs of the Hereditary Angioedema Brazilian Guidelines. Data regarding demographics, the onset of disease, time to diagnosis, frequency of attacks per year, organs involved, triggers, crisis duration and their outcomes, and disease treatment were collected. Then the authors developed an acronym, H4AE, to help healthcare professionals remember the warning signs. Results: The authors included 98 patients in the study, with a mean age of 38.1 years, 67.3% being female, and 75.3% with a family history of HAE. HAE diagnosis was delayed, on average, 13.7 years after its initial manifestation. Exploratory laparotomy was reported by 26.9%, and orotracheal intubation by 21.3% of the present study's patients; 61.3% and 30.3% of them were admitted at least once in the hospital and in the intensive care unit, respectively. The authors constructed an acronym ""H4AE"" with the six warning signs of HAE: Hereditary, recurrent Angioedema, Abdominal pain, Absence of urticaria, Absence of response to antihistamines, Estrogen association. Conclusion: C1INH-HAE is still underdiagnosed and associated with high morbidity. The study showed clinical features of this disease, corroborating the warning signs, which may be useful in raising awareness and improving the diagnosis of C1INH-HAE. The authors suggest the acronym ""H4AE"" to remind the warning signs.
- Episodic angioedema with eosinophilia (Gleich's syndrome) associated with urticarial vasculitis: a coincidence or a novel clinical entity?(2021) BASSO, J. R.; BIZINOTO, L. G. Z.; LIMONE, G. A.; ENOKIHARA, M. M. S. S.; ESPIRITO-SANTO FILHO, K. do; FONSECA, A. R.; AGONDI, R. C.; GOIS, A. F. T. de; CUNHA, L. L.Episodic angioedema with eosinophilia (EAE) is a rare condition characterized by recurrent attacks of angioedema and urticaria accompanied by a marked elevation of peripheral eosinophil count. We report the case of a young female patient diagnosed with EAE associated with urticarial vasculitis. A 40-year-old female patient was admitted to our institution due to recurrent episodes of cheek and eyelid angioedema in the previous year. Episodes of facial angioedema lasted for two months with spontaneous remission afterwards. In addition, she presented pruritic and painful skin eruptions of erythematous circles, which persisted for longer than 24 h, that were palpable, somewhat purplish, and more pronounced on the face, arms, and trunk. Laboratory investigation showed a sustained elevation of white cell counts with marked eosinophilia. Serum IgM, IgE, and IgA were normal; IgG was slightly elevated. C1-esterase inhibitor and tryptase test were normal. Reverse transcriptase-polymerase chain reaction was performed for detection of FIP1L1-PDGFRA and BCR-ABL rearrangements. None of these alterations were found. Skin biopsies were suggestive of urticarial vasculitis. The patient was submitted to esophagogastroduodenoscopy, which showed mild chronic gastritis, with no eosinophilic infiltration. Cardiac dimensions and function were normal. Abdominal ultrasound and total body CT-scan failed to show lymphadenopathy, organomegaly, and tumors. We report the first case of association between episodic angioedema with eosinophilia and urticarial vasculitis. It is possible that both conditions share a physiopathological mechanism, suggesting that it is not just a chance association.