ANDRE NATHAN COSTA
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
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Pediatric lung transplantation: 10 years of experience(2014) CAMARGO, Priscila C. L. B.; PATO, Eduardo Z. S.; CAMPOS, Silvia V.; AFONSO JR., Jose E.; CARRARO, Rafael M.; COSTA, Andre N.; TEIXEIRA, Ricardo H. O. B.; SAMANO, Marcos N.; PEGO-FERNANDES, Paulo M.Lung transplantation is a well-established treatment for advanced lung diseases. In children, the diseases that most commonly lead to the need for a transplantation are cystic fibrosis, pulmonary hypertension, and bronchiolitis. However, the number of pediatric lung transplantations being performed is low compared with the number of transplants performed in the adult age group. The objective of this study was to demonstrate our experience with pediatric lung transplants over a 10-year period in a program initially designed for adults.
- Posterior Reversible Encephalopathy Syndrome in Lung Transplantation: 5 Case Reports(2014) ARIMURA, F. E.; CAMARGO, P. C. L. B.; COSTA, A. N.; TEIXEIRA, R. H. O. B.; CARRARO, R. M.; AFONSO JR., J. E.; CAMPOS, S. V.; SAMANO, M. N.; FERNANDES, L. M.; ABDALLA, L. G.; PEGO-FERNANDES, P. M.Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiologic entity characterized by typical neurologic symptoms with characteristic cerebral image alterations. It has been reported in solid organ transplantations, especially related to the use of calcineurin inhibitors. The incidence of PRES in lung transplantation is unknown and probably under-reported in the literature. Here we describe 5 cases of PRES after bilateral lung transplantation. One of the reported cases was the first in the literature in which the neurologic onset precluded the introduction of calcineurin inhibitor. Therefore, although calcineurin inhibitors are known to play an important role in the development of PRES in the setting of lung transplantation, other causes seems to be involved in the physiopathology of this syndrome.
- Combined pulmonary fibrosis and emphysema: an increasingly recognized condition(2014) DIAS, Olivia Meira; BALDI, Bruno Guedes; COSTA, Andre Nathan; CARVALHO, Carlos Roberto RibeiroCombined pulmonary fibrosis and emphysema (CPFE) has been increasingly recognized in the literature. Patients with CPFE are usually heavy smokers or former smokers with concomitant lower lobe fibrosis and upper lobe emphysema on chest HRCT scans. They commonly present with severe breathlessness and low DLCO, despite spirometry showing relatively preserved lung volumes. Moderate to severe pulmonary arterial hypertension is common in such patients, who are also at an increased risk of developing lung cancer. Unfortunately, there is currently no effective treatment for CPFE. In this review, we discuss the current knowledge of the pathogenesis, clinical characteristics, and prognostic factors of CPFE. Given that most of the published data on CPFE are based on retrospective analysis, more studies are needed in order to address the role of emphysema and its subtypes; the progression of fibrosis/emphysema and its correlation with inflammation; treatment options; and prognosis.
conferenceObject Evaluation Of Bronchial Anastomosis Stenosis After Lung Transplantation With Electrical Impedance Tomography: A Case Report(2014) CAMARGO, P. C. L. B. D.; AFONSO JR., J. E.; COSTA, A. N.; CARRARO, R. M.; CAMPOS, S. V.; ABDALLA, L. G.; FERNANDES, L. M.; SAMANO, M. N.; TORSANI, V.; PEGO-FERNANDES, P. M.; AMATO, M. B. D. P.- Fungal Infection by Mucorales Order in Lung Transplantation: 4 Case Reports(2014) NETO, F. M. F. D.; CAMARGO, P. C. L. B.; COSTA, A. N.; TEIXEIRA, R. H. O. B.; CARRARO, R. M.; AFONSO JR., J. E.; CAMPOS, S. V.; SAMANO, M. N.; FERNANDES, L. M.; ABDALLA, L. G.; PEGO-FERNANDES, P. M.Mucorales is a fungus that causes systemic, highly lethal infections in immunocompromised patients. The overall mortality of pulmonary mucormycosis can reach 95%. This work is a review of medical records of 200 lung transplant recipients between the years of 2003 and 2013, in order to identify the prevalence of Mucorales in the Lung Transplantation service of Heart Institute (InCor), Hospital das Clinicas da Universidade de Sao Paulo, Brazil, by culture results from bronchoalveolar lavage and necropsy findings. We report 4 cases found at this analyses: 3 in patients with cystic fibrosis and 1 in a patient with bronchiectasis due to Kartagener syndrome. There were 2 unfavorable outcomes related to the presence of Mucorales, 1 by reduction of immunosuppression, another by invasive infection. Another patient died from renal and septic complications from another etiology. One patient was diagnosed at autopsy just 5 days after lung transplantation, with the Mucor inside the pulmonary vein with a precise, well-defined involvement only of donor's segment, leading to previous colonization hypothesis. There are few case reports of Mucorales infection in lung transplantation in the literature. Surveillance for the presence of Mucor can lead to timely fungal treatment and reduce morbidity and mortality in the immunocompromised patients, especially lung transplant recipients.
conferenceObject Venous Thromboembolism: A Retrospective Analysis Of 87 Lung Transplant Patients(2014) DIDIER-NETO, F. M. F.; CAMARGO, P. C. L. B.; COSTA, A. N.; TEIXEIRA, R. H. O. B.; CARRARO, R. M.; AFONSO, J. E.; CAMPOS, S. V.; SAMANO, M. N.; FERNANDES, L. M.; ABDALLA, L. G.; PEGO-FERNANDES, P. M.conferenceObject Retrospective Cohort Of Neurosarcoidosis Patients From A Reference Center In Brazil: The Underestimation Of A Relevant Feature(2014) FELISBINO, M. B.; PEREIRA, D. A. S.; COSTA, A. N.; ARAUJO, M. S.; KAWASSAKI, A. M.; FREITAS, C. S.; KAWANO-DOURADO, L.; DIAS, O. M.; BALDI, B. G.; KAIRALLA, R. A.- Environmental exposure in inflammatory myositis(2014) COSTA, A. N.; KAWANO-DOURADO, L.; SHINJO, S. K.; CARVALHO, C. R. R.; KAIRALLA, R. A.
- Doença pulmonar intersticial aguda induzida por adalimumabe em paciente com artrite reumatoide(2014) DIAS, Olivia Meira; PEREIRA, Daniel Antunes Silva; BALDI, Bruno Guedes; COSTA, Andre Nathan; ATHANAZIO, Rodrigo Abensur; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto RibeiroThe use of immunobiological agents for the treatment of autoimmune diseases is increasing in medical practice. Anti-TNF therapies have been increasingly used in refractory autoimmune diseases, especially rheumatoid arthritis, with promising results. However, the use of such therapies has been associated with an increased risk of developing other autoimmune diseases. In addition, the use of anti-TNF agents can cause pulmonary complications, such as reactivation of mycobacterial and fungal infections, as well as sarcoidosis and other interstitial lung diseases (ILDs). There is evidence of an association between ILD and the use of anti-TNF agents, etanercept and infliximab in particular. Adalimumab is the newest drug in this class, and some authors have suggested that its use might induce or exacerbate preexisting ILDs. in this study, we report the first case of acute ILD secondary to the use of adalimumab in Brazil, in a patient with rheumatoid arthritis and without a history of ILD.
- Epipericardial fat necrosis: an underdiagnosed condition(2014) GIASSI, K. de S.; COSTA, A. N.; BACHION, G. H.; APANAVICIUS, A.; FILHO, J. R. P.; KAIRALLA, R. A.; LYNCH, D. A.Objective: Epipericardial fat necrosis (EFN) is an uncommon benign and self-limited condition that leads patients to the emergency department (ED) owing to the onset of acute pleuritic chest pain. The aim of this study was to describe the cases of this disease in our institution and to illustrate the associated clinical and radiological findings. Methods: We reviewed 3604 chest scans referred by the ED from November 2011 to July 2013. Patients diagnosed with epipericardial necrosis had their medical records and original tomography reports analysed. Results: Chest pain was the primary complaint in 426 patients; 11 of them had definitive EFN findings characterized by a round soft-tissue attenuation lesion with a varying degree of strands. All patients presented with pleuritic chest pain on the same side as the lesion. Pericardial thickening, pleural effusion and mild atelectasis were the associated tomography findings. Cardiac enzyme and D-dimer tests performed during the episode were normal in all cases. 27% of the cases only were correctly diagnosed with EFN at the time of presentation. Conclusion: EFN is a benign inflammatory condition frequently overlooked in the ED by physicians and radiologists but is an important factor in the differential diagnosis of patients with acute chest pain. Advances in knowledge: The article adds clinically and radiologically useful information about the condition and displays the importance of making the correct diagnosis to avoid unnecessary examinations.