LEA CAMPOS DE OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
61 resultados
Resultados de Busca
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- Incremental Prognostic Value of Echocardiography to Brain Natriuretic Peptide in Patients with Chagas Cardiomyopathy from Endemic Areas(2022) MAIA, Marcelo Alves; SABINO, Ester Cerdeira; OLIVEIRA, Lea Campos de; OLIVEIRA, Claudia Di Lorenzo; CARDOSO, Clareci S.; MAIA, Ana Isabel Nobre; VERSIANI, Fellipe Colares P. G.; SILVA, Jose Luiz Padilha da; FERREIRA, Ariela Mota; RIBEIRO, Antonio Luiz P.; NUNES, Maria Carmo P.
- Hospitalizations due to gastrointestinal Chagas disease: National registry(2022) BIERRENBACH, Ana Luiza; QUINTINO, Nayara Dornela; MOREIRA, Carlos Henrique Valente; DAMASCENO, Renata Fiuza; NUNES, Maria do Carmo Pereira; BALDONI, Nayara Ragi; SILVA, Lea Campos de Oliveira da; FERREIRA, Ariela Mota; CARDOSO, Clareci Silva; HAIKAL, Desiree Sant'Ana; SABINO, Ester Cerdeira; RIBEIRO, Antonio Luiz Pinho; OLIVEIRA, Claudia Di LorenzoObjectives Analyze the hospitalizations of patients admitted for Chagas disease with gastro-intestinal involvement (CD-GI) in the Brazilian Unified Health System, describe the epidemiological profile, mortality and costs. Methods This is an observational study that uses secondary data from the National Hospital Information System (SIH-SUS) for the years 2017-2019. CD-GI admissions were defined by specific ICD-10 codes that identify the main diagnosis. Results From 2017 to 2019, there were 4,407 hospitalizations for CD-GI in Brazil, considering only public hospitals and those associated with the SUS. This corresponds to an average of 1,470 hospitalizations per year, or 0.6 per 100,000 inhabitants, with significant regional variation. Hospitalizations increased with age and were slightly higher in men. More than 60% were emergencies and in 50% the procedure performed was surgical. The most used code was the one for megaesophagus followed by megacolon. In-hospital mortality was 5.8% and 17.2% went to intensive care units. The median cost was USD$ 553.15 per hospitalization, and an overall cost of USD$ 812,579.98 per year to the SUS budget. Conclusion The numbers, rates and costs presented here are possibly underestimated but they give us an idea of the overall profile of hospitalizations due to CD-GI, which are not rare and are related to significant in-hospital mortality. CD-GI is a neglected manifestation of a neglected disease.
- Risk Score for Predicting 2-Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi-Trop Cohort Study(2020) OLIVEIRA, Claudia Di Lorenzo; NUNES, Maria Carmo P.; COLOSIMO, Enrico Antonio; LIMA, Emilly Malveira de; CARDOSO, Clareci S.; FERREIRA, Ariela Mota; OLIVEIRA, Lea Campos de; MOREIRA, Carlos Henrique Valente; BIERRENBACH, Ana Luiza; HAIKAL, Desiree Sant'Ana; PEIXOTO, Sergio Viana; LIMA-COSTA, Maria Fernanda; SABINO, Ester Cerdeira; RIBEIRO, Antonio Luiz P.Background Risk stratification of Chagas disease patients in the limited-resource setting would be helpful in crafting management strategies. We developed a score to predict 2-year mortality in patients with Chagas cardiomyopathy from remote endemic areas. Methods and Results This study enrolled 1551 patients with Chagas cardiomyopathy from Minas Gerais State, Brazil, from the SaMi-Trop cohort (The Sao Paulo-Minas Gerais Tropical Medicine Research Center). Clinical evaluation, ECG, and NT-proBNP (N-terminal pro-B-type natriuretic peptide) were performed. A Cox proportional hazards model was used to develop a prediction model based on the key predictors. The end point was all-cause mortality. The patients were classified into 3 risk categories at baseline (low, <2%; intermediate, >= 2% to 10%; high, >= 10%). External validation was performed by applying the score to an independent population with Chagas disease. After 2 years of follow-up, 110 patients died, with an overall mortality rate of 3.505 deaths per 100 person-years. Based on the nomogram, the independent predictors of mortality were assigned points: age (10 points per decade), New York Heart Association functional class higher than I (15 points), heart rate >= 80 beats/min (20 points), QRS duration >= 150 ms (15 points), and abnormal NT-proBNP adjusted by age (55 points). The observed mortality rates in the low-, intermediate-, and high-risk groups were 0%, 3.6%, and 32.7%, respectively, in the derivation cohort and 3.2%, 8.7%, and 19.1%, respectively, in the validation cohort. The discrimination of the score was good in the development cohort (C statistic: 0.82), and validation cohort (C statistic: 0.71). Conclusions In a large population of patients with Chagas cardiomyopathy, a combination of risk factors accurately predicted early mortality. This helpful simple score could be used in remote areas with limited technological resources.
conferenceObject Whole exome sequencing of Chagas disease cardiomyopathy families reveals accumulation of rare variants in mitochondrial and inflammation-associated genes(2019) CUNHA-NETO, E.; MARQUET, S.; FRADE, A. Farage; FERREIRA, A. Mota; OUARHACHE, M.; IANNI, B.; FERREIRA, L. Rodrigues Pinto; RIGAUD, V. Oliveira-Carvalho; ALMEIDA, R. Ribeiro; CANDIDO, D.; TORRES, M.; GALLARDO, F.; FERNANDES, R.; MADY, C.; BUCK, P.; CARDOSO, C.; SANTOS-JUNIOR, O. R.; OLIVEIRA, L. C.; OLIVEIRA, C. D. L.; NUNES, M. do Carmo; ABEL, L.; KALIL, J.; RIBEIRO, A. L. P.; SABINO, E. C.; CHEVILLARD, C.- Lack of evidence of seronegative infection in an endemic area of Chagas disease(2019) OLIVEIRA, Lea Campos de; LEE, Tzong-Hae; FERREIRA, Ariela Mota; BIERRENBACH, Ana Luiza; SOUZA-BASQUEIRA, Marcela de; OLIVEIRA, Claudia Di Lorenzo; CARDOSO, Clareci Silva; MOREIRA, Carlos Henrique Valente; OIKAWA, Marcio K.; RIBEIRO, Antonio Luiz P.; BUSCH, Michael P.; SABINO, Ester CerdeiraThe diagnosis of Chagas disease is based on the detection of Trypanosoma cruzi (T. cruzi)-specific antibodies. Nonetheless, there is concern about the sensitivity of current serological assays due to reports of T. cruzi PCR positivity among seronegative individuals. The aim of this study was to evaluate if T. cruzi seronegative infections occur in endemic areas. We recruited 2,157 individuals that were identified as having Chagas disease in a public health system database of an endemic region in Brazil. All participants were interviewed and 2,091 had a sample collected for serological and PCR testing. From these, 149 (7.1%) had negative serological results. PCR was positive in 610 samples (31.4%) of the 1,942 seropositive samples but in none of the 149 samples from seronegative participants. True T. cruzi seronegative infections seem to be rare (95% CI 0-3.7) and should not be a concern for blood supply, which relies on antibody screening.
- Risk Score for Predicting 2-Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi-Trop Cohort Study (vol 9, e014176, 2020)(2021) OLIVEIRA, Claudia Di Lorenzo; NUNES, Maria Carmo P.; COLOSIMO, Enrico Antonio; LIMA, Emilly Malveira de; CARDOSO, Clareci S.; FERREIRA, Ariela Mota; OLIVEIRA, Lea Campos de; MOREIRA, Carlos Henrique Valente; BIERRENBACH, Ana Luiza; HAIKAL, Desiree Sant'Ana; PEIXOTO, Sergio Viana; LIMA-COSTA, Maria Fernanda; SABINO, Ester Cerdeira; RIBEIRO, Antonio Luiz P.
- Association between typical electrocardiographic abnormalities and NT-proBNP elevation in a large cohort of patients with Chagas disease from endemic area(2018) BRITO, Bruno Oliveira de Figueiredo; PINTO-FILHO, Marcelo Martins; CARDOSO, Clareci Silva; OLIVEIRA, Claudia Di Lorenzo; FERREIRA, Ariela Mota; OLIVEIRA, Lea Campos de; GOMES, Paulo; NUNES, Maria do Carmo Pereira; SABINO, Ester Cerdeira; RIBEIRO, Antonio Luiz PinhoChagas cardiomyopathy is the most harmful complication of Chagas disease. The electrocardiogram is a well studied exam and has been considered an important tool for detection and evaluation of Chagas cardiomyopathy since the first years of its description. Many of its abnormalities have been described as associated with a worse prognosis. Serum BNP levels were described as inversely related to the left ventricular ejection fraction and as an independent predictor of death. It was not reported how electrocardiographic alterations correlate to NT-proBNP and its analog. The present study aims to describe the baseline electrocardiograms of a large cohort of patients with Chagas disease from endemic area and to establish an association between the number of electrocardiogram alterations and high levels of NT-ProBNP in Chagas disease patients. This study selected 1959 Chagas disease patients in 21 municipalities within a limited region in the northern part of the State of Minas Gerais (Brazil), 1084 of them had Chagas cardiomyopathy. NT-proBNP levels were suggestive of heart failure in 11.7% of this population. One or more electrocardiographic alterations have an Odds Ratio of 9.12 (CI 95% 5.62-14.80) to have NT-proBNP elevation. Considering the association between the number of 1, 2, and 3 or more alterations in electrocardiogram and NT-proBNP elevation, the ORs were 7.11 (CI 95% 4.33-11.67); 16.04 (CI 95% 9.27-27.77) and 47.82 (CI 95% 17.98-127.20), respectively. The presence and the number of typical electrocardiographic alterations of Chagas disease are independently associated with the severity of the cardiomyopathy. (C) 2018 Published by Elsevier Inc.
conferenceObject RELATIONSHIP OF GALECTIN-3 BIOMARKER FOR CLINICAL OUTCOMES IN A CHAGAS DISEASE COHORT FROM A BRAZILIAN ENDEMIC REGION(2021) MOREIRA, Carlos H.; FERNANDES, Fabio F.; OLIVEIRA, Lea C. De; BIERRENBACH, Ana L.; CARDOSO, Clareci; LORENZO, Claudia Di; FERREIRA, Ariela M.; VIEIRA, Thallyta M.; DAMASCENO, Renata F.; HAIKAL, Desiree S.; QUINTINO, Nayara D.; NUNES, Maria do Carmo; RIBERIO, Antonio Luiz; SABINO, Ester C.- TGFB1 and IL8 gene polymorphisms and susceptibility to visceral leishmaniasis(2011) FRADE, Amanda Farage; OLIVEIRA, Lea Campos de; COSTA, Dorcas Lamounier; COSTA, Carlos Henrique Nery; AQUINO, Dorlene; WEYENBERGH, Johan Van; BARRAL-NETTO, Manoel; BARRAL, Aldina; KALIL, Jorge; GOLDBERG, Anna CarlaVisceral leishmaniasis (VL) or Kala-azar is a serious protozoan infectious disease caused by an obligate intracellular parasite. Cytokines have a major role in determining progression and severity of clinical manifestations in VL. We investigated polymorphisms in the TGFB1 and IL8 genes, which are cytokines known to have a role in onset and severity of the disease. Polymorphisms at TGFB1 -509 C/T and +869 T/C, and IL8 -251 A/T were analyzed by a PCR-RFLP technique, in 198 patients with VL, 98 individuals with asymptomatic infection positive for a delayed-type hypersensitivity test (DTH+) and in 101 individuals with no evidence of infection (DTH-). The presence of the T allele in position -509 of the TGFB1 gene conferred a two-fold risk to develop infection both when including those with clinical symptoms (DTH+ and VL, grouped) or when considering DTH+ only, respectively p = 0.007, OR = 1.9 [1.19-3.02] and p = 0.012, OR = 2.01 [1.17-3.79], when compared with DTH- individuals. In addition, occurrence of hemorrhage was associated with TGFB1 -509 T allele. We suggest that the -509 T allele of the TGFB1 gene, a cytokine with a biologically relevant role in the natural history of the disease, may contribute to overall susceptibility to infection by Leishmania and to severity of the clinical disease.
- ELISA Saliva for Trypanosoma cruzi Antibody Detection: An Alternative for Serological Surveys in Endemic Regions(2020) OLIVEIRA, Lea Campos de; PEREIRA, Natalia Bueno; MOREIRA, Carlos Henrique Valente; BIERRENBACH, Ana Luiza; SALLES, Flavia Cristina; SOUZA-BASQUEIRA, Marcela de; MANULI, Erika Regina; FERREIRA, Ariela Mota; OLIVEIRA, Claudia Di Lorenzo; CARDOSO, Clareci Silva; RIBEIRO, Antonio Luiz P.; SABINO, Ester CerdeiraChagas is a neglected disease endemic in Latin America. Vector transmission control had been aggressively performed. Recent entomological surveillance in Brazil has revealed natural infection rates ranging from 0.40% to 0.52%. Although serological surveys are complex to develop, they are important for disease control. In this study, we validated the use of saliva in ELISA commercial kits with a cohort of 100 patients with Chagas disease followed at Hospital das Clinicas in Sao Paulo, Brazil, and 50 healthy controls. Five ELISA kits for detecting antibodies against Trypanosome cruzi were tested. The best discrimination between Chagas patients and controls was observed with the Wiener kit, which yielded a sensitivity of 97% and a specificity of 100%. Our findings reveal that the use of saliva may be an alternative to large-scale screening surveys in detecting T. cruzi antibodies; it is a noninvasive sample collection method potentially key to large-scale screening in children.