ROBERTA KARLA BARBOSA DE SALES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
15 resultados
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conferenceObject Brazilian Analysis of Lent Score: Predicting the Survival Rate of Malignant Pleural Effusion(2023) COLARES, P. F.; RIVAS, J. Delgado; BELON, C. E. F.; ACENCIO, M. M. P.; SALES, R. K.; TEIXEIRA, L. R.conferenceObject Production Of Inflammatory Mediators And Induction Of Apoptosis In Pleural Mesothelial Cells, Lung And Breast Cancer Cells Exposed To Talc Particles(2016) ACENCIO, M. M. P.; TEIXEIRA, L. R.; ALVARENGA, V. A.; SILVA, C. S. R.; SALES, R. K. B.; MARCHI, E.- Role of markers C-Reactive Protein, Procalcitonin and TREM-1 in diagnosis of infection pleural effusion(2018) ALVARENGA, Vanessa; ACENCIO, Milena; SALES, Roberta; SILVA, Aline; SILVA, Jucara; SILVA, Carlos; TEIXEIRA, Lisete Ribeiro; MARCHI, Evaldo
- Pleural tuberculosis: is radiological evidence of pulmonary-associated disease related to the exacerbation of the inflammatory response?(2012) ANTONANGELO, Leila; VARGAS, Francisco S.; PUKA, Juliana; SEISCENTO, Marcia; ACENCIO, Milena M. P.; TEIXEIRA, Lisete R.; TERRA, Ricardo M.; SALES, Roberta K. B.OBJECTIVE: Pleural tuberculosis is the most frequently occurring form of extra pulmonary disease in adults. In up to 40% of cases, the lung parenchyma is concomitantly involved, which can have an epidemiological impact. This study aims to evaluate the pleural and systemic inflammatory response of patients with pleural or pleuropulmonary tuberculosis. METHODS: A prospective study of 39 patients with confirmed pleural tuberculosis. After thoracentesis, a high resolution chest tomography was performed to evaluate the pulmonary involvement. Of the 39 patients, 20 exhibited only pleural effusion, and high resolution chest tomography revealed active associated-pulmonary disease in 19 patients. The total protein, lactic dehydrogenase, adenosine deaminase, vascular endothelial growth factor, interleukin-8, tumor necrosis factor-alpha, and transforming growth factor-beta(1) levels were quantified in the patient serum and pleural fluid. RESULTS: All of the effusions were exudates with high levels of adenosine deaminase. The levels of vascular endothelial growth factor and transforming growth factor-beta(1) were increased in the blood and pleural fluid of all of the patients with pleural tuberculosis, with no differences between the two forms of tuberculosis. The tumor necrosis factor-alpha levels were significantly higher in the pleural fluid of the patients with the pleuropulmonary form of tuberculosis. The interleukin-8 levels were high in the pleural fluid of all of the patients, without any differences between the forms of tuberculosis. CONCLUSION: Tumor necrosis factor-alpha was the single cytokine that significantly increased in the pleural fluid of the patients with pulmonary involvement. However, an overlap in the results does not permit us to suggest that cytokine is a biological marker of concomitant parenchymal involvement. Although high resolution chest tomography can be useful in identifying these patients, the investigation of fast acid bacilli and cultures for M. tuberculosis in the sputum is recommended for all patients who are diagnosed with pleural tuberculosis.
- Preanalytical conditions can interfere with M-tuberculosis detection by PCR in respiratory samples(2018) CARNEVALE, Gabriela Gaspar; VARGAS, Francisco Suso; CAIAFFA-FILHO, Helio Hehl; ACENCIO, Milena Marques Pagliarelli; MARCAL, Lia Junqueira; SALES, Roberta Karla Barbosa; TEIXEIRA, Lisete Ribeiro; ANTONANGELO, LeilaOBJECTIVES: Tuberculosis is one of the most prevalent infections in humans. Although culture is the reference for diagnosis, its sensitivity is compromised, especially in paucibacillary samples. Because polymerase chain reaction (PCR) amplifies mycobacterial DNA, it is more sensitive than culture for the diagnosis of Mycobacterium tuberculosis (Mtb). However, its performance can be affected by intrinsic sample inhibitors and by the extraction/detection techniques used. METHODS: We evaluated the influence of preanalytical conditions on Mtb detection in samples of sputum (SPU), bronchoalveolar lavage (BAL), and pleural fluid (PF) using combinations of extraction/detection methods. Respiratory samples were prepared to contain different concentrations of red blood cells and nucleated cells to which increasing amounts of Mtb colonies were inoculated and submitted to PCR. RESULTS: Up to 10(2) CFU/ml of Mtb were detected in the SPU in all methods, except for the Roche extraction/detection method, regardless of the preanalytical sample condition. In BAL samples, medium and high concentrations of cells and high concentrations of red blood cells contributed to a lower Mtb detection, regardless of the extraction method used. In PF, red blood cells were the variable that most interfered with Mtb detection, with better recovery (10(2) CFU/ml) observed with the Qiagen/Nanogen combination. CONCLUSION: The choice of Mtb extraction and detection method is of fundamental importance for PCR analytical sensitivity, especially when paucibacillary samples and/or samples containing potential PCR inhibitors are analyzed.
- Profile of Metalloproteinases and Their Association with Inflammatory Markers in Pleural Effusions(2016) TEIXEIRA, Lisete Ribeiro; DIAS, Murilo B.; SALES, Roberta K. B.; ANTONANGELO, Leila; ALVARENGA, Vanessa A.; PUKA, Juliana; MARCHI, Evaldo; ACENCIO, Milena Marques PagliarelliMatrix metalloproteinases (MMPs) are responsible for the breakdown of the extracellular matrix and play an important role in the inflammatory processes of pleural exudates. The imbalance between MMPs and their inhibitors (TIMPs) is present in various pathological processes. To evaluate the profile of MMPs and TIMPs in pleural effusions of different etiologies correlated with inflammatory markers. The patients with pleural effusion due to tuberculosis (TB), cancer (CA) or transudate were prospectively evaluated. Pleural fluid was submitted to cytological, biochemical, cytokines, MMP, and TIMP analysis. Statistical analysis was performed using ANOVA and Spearman's correlation, and p < 0.05 was considered significant. One hundred and fourteen patients were enrolled, 80 exudates (41 TB and 39 CA) and 34 transudates. The levels of MMP-8 and MMP-9 were higher in exudates compared to transudates. The level of MMP-8 was significantly higher in TB than in CA. TIMP-1 levels were higher in exudates. IL-6, VEGF, and TGF-beta(1) showed differences between exudates and transudates. However, IL-6 level was higher in TB than in CA. We found a significant correlation between MMPs and TIMPs with inflammation markers. MMP-1 was correlated with LDH levels. MMP-8 was correlated with LDH, total cell count, neutrophils, and ADA as well as MMP-1 levels. MMP-9 was correlated with IL-6, TGF-beta(1), and VEGF. TIMP-1 was correlated with MMP-9 and IL-6. MMPs and TIMPs are expressed in pleural fluid of different etiologies and correlate with inflammatory mediators. MMPs may be useful in determining the cause of fluid, but more studies are needed to determine the spectrum of diseases associated with the various isoforms of MMPS and TIMPs.
- Clinical usefulness of B-type natriuretic peptide in the diagnosis of pleural effusions due to heart failure(2011) MARINHO, Felipe C. A.; VARGAS, Francisco S.; FABRI JR., Jose; ACENCIO, Milena M. P.; GENOFRE, Eduardo H.; ANTONANGELO, Leila; SALES, Roberta K. B.; TEIXEIRA, Lisete R.Background and objective: Light's criteria are frequently used to evaluate the exudative or transudative nature of pleural effusions. However, misclassification resulting from the use of Light's criteria has been reported, especially in the setting of diuretic use in patients with heart failure (HF). The objective of this study was to evaluate the utility of B-type natriuretic peptide (BNP) measurements as a diagnostic tool for determining the cardiac aetiology of pleural effusions. Methods: Patients with pleural effusions attributable to HF (n = 34), hepatic hydrothorax (n = 10), pleural effusions due to cancer (n = 21) and pleural effusions due to tuberculosis (n = 12) were studied. Diagnostic thoracentesis was performed for all 77 patients. Receiver operating characteristic (ROC) curves were constructed to determine the diagnostic accuracy of plasma BNP and pleural fluid BNP for the prediction of HF. Results: The areas under the ROC curves were 0.987 (95% CI 0.93-0.998) for plasma BNP and 0.949 (95% CI 0.874-0.986) for pleural fluid BNP, for distinguishing between patients with pleural effusions caused by HF (n = 34) and those with pleural effusions attributable to other causes (n = 43). The cut-off concentrations with the highest diagnostic accuracy for the diagnosis of HF as the cause of pleural effusion were 132 pg/mL for plasma BNP (sensitivity 97.1%, specificity 97.4%) and 127 pg/mL for pleural fluid BNP (sensitivity 97.1%, specificity 87.8%). Conclusions: In patients with pleural effusions of suspected cardiac origin, measurements of BNP in plasma and pleural fluid may be useful for the diagnosis of HF as the underlying cause.
conferenceObject Overexpression of inhibitor of DNA-binding proteins and angiogenic markers have higher impact on survival of non small cell lung cancer patients(2012) SALES, Roberta; TUMA, Thayla; ACENCIO, Milena; TERRA, Ricardo; PARRA, Edwin; CAPELOZZI, Vera; ANTONANGELO, LeilaconferenceObject Do pre-analytical or analytical factors influence the performance of real time PCR tests in the diagnosis of tuberculosis?(2013) ANTONANGELO, Leila; CARNEVALE, Gabriela; MARCAL, Lia; SALES, Roberta; ACENCIO, Milena; VARGAS, Francisco- Pleural fluid tumour markers in malignant pleural effusion with inconclusive cytologic results(2015) ANTONANGELO, L.; SALES, R. K.; CORA, A. P.; ACENCIO, M. M. P.; TEIXEIRA, L. R.; VARGAS, F. S.Background The presence of tumour cells in pleural fluid or tissue defines an effusion as malignant. Cytology analysis of the pleural fluid has about 60% diagnostic sensitivity. Several tests have been proposed to improve diagnosis-among them, the concentrations of tumour markers in pleural fluid. We evaluated whether the concentrations of tumour markers in pleural fluid could improve the diagnosis of malignant pleural effusion (MPE) when cytology is doubtful. Methods Lymphocytic pleural fluids secondary to tuberculosis or malignancy from 156 outpatients were submitted for cytology and tumour marker quantification [carcinoembryonic antigen (CEA), cancer antigen 15-3 (CA15-3), carbohydrate antigen 19-9 (CA19-9), cancer antigen 72-4 (CA72-4), cancer antigen 125 (CA125), and CYFRA 21-1). One-way analysis of variance, the Student t-test or Mann-Whitney test, and receiver operating characteristic curves were used in the statistical analysis. Results Concentrations of the tumour markers CEA, CA15-3, CA125, and CYFRA 21-1 were higher in MPES than they were in the benign effusions (p < 0.001), regardless of cytology results. The markers CA19-9 and CA72-4 did not discriminate malignant from benign effusions. When comparing the concentrations of tumour markers in MPES having positive, suspicious, or negative cytology with concentrations in benign effusions, we observed higher levels of CEA, CA15-3, CYFRA 21-1, and CA125 in malignant effusions with positive cytology (p = 0.003, p = 0.001, p = 0.002, and p = 0.001 respectively). In pleural fluid, only CA125 was higher in MPES with suspicious or negative cytology (p = 0.001) than in benign effusions. Conclusions Given high specificity and a sensitivity of about 60%, the concentrations of tumour markers in pleural effusions could be evaluated in cases of inconclusive cytology in patients with a high pre-test chance of malignancy or a history of cancer.