FABIOLA DEL CARLO BERNARDI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
21 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 21
conferenceObject Association Of Sarcoidosis, Monoclonal Gammopathy Of Undetermined Significance And Cardiac Amyloidosis: A Case Report(2017) AMARAL, A. F.; OLIVEIRA, M. R.; ARIMURA, F. E.; NASCIMENTO, E. C. T.; BERNARDI, F. C.; FERNANDES, F.; CARVALHO, C. R. R.; KAIRALLA, R. A.; BALDI, B. G.conferenceObject Constrictive Bronchiolitis Mimicking Pulmonary Lymphangioleiomyomatosis(2016) TOLEDO, A. P.; ENDLICH, B. N.; ARIMURA, F. E.; FREITAS, C. S.; NASCIMENTO, E. C. T.; BERNARDI, F. D. C.; DOLHNIKOFF, M.; KAIRALLA, R. A.; BALDI, B. G.; CARVALHO, C. R.- Immunopathological aspects of schistosomiasis-associated pulmonary arterial hypertension(2014) MAUAD, Thais; POZZAN, Geanette; LANCAS, Tatiana; OVERBEEK, Maria J.; SOUZA, Rogerio; JARDIM, Carlos; DOLHNIKOFF, Marisa; MELLO, George; PIRES-NETO, Ruy Camargo; BERNARDI, Fabiola del Carlo; GRUNBERG, KatrienObjectives: Pulmonary hypertension is a lethal complication of chronic hepatosplenic schistosomiasis. Little is known of the underlying (immuno-)histopathological characteristics of lung vasculopathy. Methods: We characterized vasculopathy and inflammation in lung tissue of 10 patients with Schistosomiasis-associated PH (SCH-PH) in comparison to 22 idiopathic pulmonary arterial hypertension (IPAH) patients and 10 normal controls. SCH-PH cases were younger than controls. Results: Plexiform lesions and/or angiomatoid lesions were found in 10/10 SCH-PH, and 19/22 IPAH patients (chi(2) p = 0.22). Lung granulomas with Schistosoma eggs were found in 2/10 of SCH-PH cases. PAH cases had increased peri-arterial density of CD3+ T cells, chymase+ and tryptase+ mast cells when compared to controls (p <= 0.047). SCH-PH showed increased density of CD4+ cells when compared to controls (p = 0.025), paralleled by an increased density of dendritic CD83+ cells when compared to both controls and IPAH patients (p <= 0.022). Conclusion: Both SCH-PH and IPAH feature plexogenic arteriopathy and increased periarterial T cell and mast cell density. SCH-PH and IPAH differ only with respect to the density of dendritic CD83+ cells. These findings imply ongoing antigenic stimulation in SCH-PH, yet a pattern of pulmonary vasculopathy similar to IPAH, suggestive of a final common pathway in their pathogenesis of PAH.
- The Expression of Water and Ion Channels in Diffuse Alveolar Damage Is Not Dependent on DAD Etiology(2016) PIRES-NETO, Ruy Camargo; BERNARDI, Fabiola Del Carlo; ARAUJO, Priscila Alves de; MAUAD, Thais; DOLHNIKOFF, MarisaIntroduction Aquaporins and ion channels are membrane proteins that facilitate the rapid movement of water and solutes across biological membranes. Experimental and in vitro studies reported that the function of these channels and pulmonary edema resolution are impaired in acute lung injury (ALI). Although current evidence indicates that alveolar fluid clearance is impaired in patients with ALI/diffuse alveolar damage (DAD), few human studies have addressed the alterations in pulmonary channels in this clinical condition. Additionally, it is not known whether the primary cause of DAD is a relevant variable for the channel dysfunction. Methods Autopsied lungs of 43 patients with acute respiratory failure (ARF) due to DAD of three different etiologies, non-pulmonary sepsis, H1N1 viral infection and leptospirosis, were compared to 18 normal lungs. We quantified the expression of aquaporin (AQP) 1, AQP3, AQP5, epithelial Na+ channel (ENaC) and sodium potassium ATPase (Na-K-ATPase) in the alveolar septum using immunohistochemistry and image analysis. Results The DAD group presented with increased expression of AQP3, AQP5 and Na-K-ATPase and decreased expression of ENaC compared to controls. However, there was no difference in protein expression within the DAD groups of different etiologies. Conclusion Water and ion channels are altered in patients with ARF due to DAD. The cause of DAD does not seem to influence the level of impairment of these channels.
- Immune receptors and adhesion molecules in human pulmonary leptospirosis(2012) BERNARDI, Fabiola Del Carlo; CTENAS, Bruno; SILVA, Luiz Fernando Ferraz da; NICODEMO, Antonio Carlos; SALDIVA, Paulo Hilario Nascimento; DOLHNIKOFF, Marisa; MAUAD, ThaisPulmonary involvement in leptospirosis has been increasingly reported in the last 20 years, being related to the severity and mortality of the disease. The pathogenesis of pulmonary hemorrhage in leptospirosis is not understood. Lung endothelial cells have been proposed as targets in the pathogenesis of lung involvement in leptospirosis through the activation of Toll-like receptor 2 or the complement system, which stimulates the release of cytokines that lead to the activation of adhesion molecules. The aim of this study was to investigate the involvement of immune pathways and of the intercellular and vascular cell adhesion molecules (intercellular adhesion molecule and vascular cell adhesion molecule, respectively) in the lungs of patients with pulmonary involvement of leptospirosis. We studied the lungs of 18 patients who died of leptospirosis and compared them with 2 groups of controls: normal and noninfectious hemorrhagic lungs. Using immunohistochemistry and image analysis, we quantified the expression of the C3a anaphylatoxin receptor, intercellular adhesion molecule, vascular cell adhesion molecule, and Toll-like receptor 2 in small pulmonary vessels and in the alveolar septa. There was an increased expression of intercellular adhesion molecule (P <.03) and C3a anaphylatoxin receptor (P <.008) in alveolar septa in the leptospirosis group compared with the normal and hemorrhagic controls. In the vessels of the leptospirosis group, there was an increased expression of intercellular adhesion molecule (P=.004), vascular cell adhesion molecule (P=.030), and Toll-like receptor 2 (P=.042) compared with the normal group. Vascular cell adhesion molecule expression in vessels was higher in the leptospirosis group compared with the hemorrhagic group (P=.015). Our results indicate that immune receptors and adhesion molecules participate in the phenomena leading to pulmonary hemorrhage in leptospirosis.
- Giant multilocular thymic cyst in an HIV-infected adolescent(2011) TAMAGNO, Mauro; BIBAS, Benoit Jacques; BERNARDI, Fabiola; LIAN, Yu Ching; BAMMANN, Ricardo Helbert; FERNANDEZ, Angelo; JATENE, Fabio BiscegliA girl with vertically acquired HIV infection presented with a 6-month history of dyspnea and chest pain. Computed tomography of the thorax showed a heterogenous mass measuring 13 x 9 x 17 cm located in the anterior mediastinum. Complete surgical resection was accomplished with no complications. The final diagnosis was multilocular thymic cyst, a distinct pathologic entity that is morphologically distinguishable and unrelated to congenital thymic cyst.
- Mesothelioma in situ with regressive malignant pleural effusion and an unexpected evolution: A case report(2022) ALMEIDA, Gustavo C. de; SANTOS, Ubiratan de P.; PARENTE, Yuri de D. M.; COLARES, Philippe de F. B.; MIZUTANI, Rafael F.; BERNARDI, Fabiola del C.; TERRA, Ricardo M.; TERRA-FILHO, MarioMalignant pleural mesothelioma (MPM) is an aggressive neoplasm that originates from hyperplasia and metaplasia of the mesothelial cells that cover the pleural cavity. Previous exposure to asbestos is the main risk factor. Since MPM is often diagnosed at an advanced stage with rapid evolution and resistance to treatment, it is associated with an unfavorable outcome. Mesothelioma in situ (MIS) has been postulated as a preinvasive phase of MPM; however, its diagnostic criteria have been defined only recently. Diagnosis of MIS may represent an opportunity for early therapies with better results, but the optimal approach has not been defined thus far. Here, we report on a case of a 74-year-old man with right-sided pleural effusion and a previous history of occupational exposure to asbestos for 9 years who was diagnosed with MIS after a latency of 36 years. During follow-up, spontaneous disease regression was observed 5 months after the initial diagnosis; however, it recurred in the form of invasive epithelioid MPM. There is a paucity of literature on MIS and its evolution; however, our case provides relevant knowledge of this unusual behavior, which is important to define follow-up and therapeutic strategies for future cases.
- Lung cancer biopsy: Can diagnosis be changed after immunohistochemistry when the H&E-Based morphology corresponds to a specific tumor subtype?(2018) BERNARDI, Fabiola Del Carlo; BERNARDI, Marcela Del Carlo; TAKAGAKI, Teresa; SIQUEIRA, Sheila Aparecida Coelho; DOLHNIKOFF, MarisaOBJECTIVES: Advancements in non-small cell lung cancer treatment based on targeted therapies have made the differentiation between adenocarcinoma and squamous cell carcinoma increasingly important. Pathologists are challenged to make the correct diagnosis in small specimens. We studied the accuracy of an immunohistochemical panel in subclassifying non-small cell lung cancer in routine small biopsies and compared the results with the diagnosis from resected lung specimens, autopsy samples or biopsied/resected metastases. METHODS: In total, 340 lung cancer biopsies were investigated for the expression of CK5, TTF1, p63 and surfactant. RESULTS: We characterized 166 adenocarcinomas and 124 squamous cell carcinomas. Overall, 85% of cases displayed binary staining (TTF1 positive/p63 negative, and vice versa). The diagnoses of ten cases with a morphology that indicated a specific tumor subtype were changed after immunohistochemistry (IHC). A second specimen was available for 71 patients, and the first diagnosis at biopsy was confirmed in 95% of these cases. Most non-small cell lung cancer cases present a binary immunohistochemical profile in small biopsies, contributing to good diagnostic accuracy with routine markers. In a small proportion of cases, the diagnosis can be changed after IHC even when the morphological aspects indicate one specific tumor subtype. CONCLUSIONS: We recommend that routine small biopsies of lung cancer without classic morphology should be subjected to a minimum immunohistochemical panel to differentiate adenocarcinoma from squamous cell carcinoma.
- Differential elemental distribution of retained particles along the respiratory tract(2011) SAIEG, Mauro A.; CURY, Patricia M.; GODLESKI, John J.; STEARNS, Rebecca; DUARTE, Luis G. P.; D'AGOSTINO, Liz; KAHN, Henrique; PINTO, Emilia M.; MAUAD, Thais; SALDIVA, Paulo H. N.; BERNARDI, Fabiola D. C.Objective: To compare the elemental profile of particles retained along the bronchial tree and lymph nodes by combining laser capture microdissection (LCM) and elemental composition analysis through energy dispersive x-ray (EDX) and scanning electron microscopy (SEM). Material and methods: Twenty-four right lung middle lobes from autopsied cases were obtained from two cities with different pollution backgrounds. Lung samples were collected from three distinct sites within the lung at the time of autopsy: peribronchial tissue, peripheral parenchyma and hilar lymph nodes. Areas of potentially increased particle deposition were microdissected using LCM and analyzed for elemental composition through EDX """"allied"""" with SEM. Results: Elemental analyses of the particles retained along the bronchial tree showed two groups of distribution: peribronchiolar or lymph node deposition. The elemental profile of peribronchial areas were significantly different between the two cities and were better discriminators of past air pollution exposure. Conclusion: Our data suggest that particle uptake varies along the bronchial tree and human lung tissue retains particles indicative of regional air pollution background.
- Pulmonary arterial involvement leading to alveolar hemorrhage in lymphangioleiomyomatosis(2011) BALDI, Bruno Guedes; PIMENTA, Suzana Pinheiro; KAWASSAKI, Alexandre de Melo; BERNARDI, Fabiola Del Carlo; DOLHNIKOFF, Marisa; CARVALHO, Carlos Roberto Ribeiro
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