RONALDO ADIB KAIRALLA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Exercise in patients with lymphangioleiomyomatosis: Performance and the prevalence of dynamic hyperinflation(2012) ALBUQUERQUE, Andre; BALDI, Bruno; PIMENTA, Suzana; SALGE, Joao Marcos; KAIRALLA, Ronaldo; CARVALHO, Carlos- Highlights of the Brazilian Thoracic Association Guidelines for Interstitial Lung Diseases(2012) BALDI, Bruno Guedes; PEREIRA, Carlos Alberto de Castro; RUBIN, Adalberto Sperb; SANTANA, Alfredo Nicodemos da Cruz; COSTA, Andre Nathan; CARVALHO, Carlos Roberto Ribeiro; ALGRANTI, Eduardo; CAPITANI, Eduardo Mello de; BETHLEM, Eduardo Pamplona; COLETTA, Ester Nei Aparecida Martins; ARAKAKI, Jaquelina Sonoe Ota; MARTINEZ, Jose Antonio Baddini; CARVALHO, Jozelio Freire de; STEIDLE, Leila John Marques; ROCHA, Marcelo Jorge Jaco; LIMA, Mariana Silva; SOARES, Maria Raquel; CARAMORI, Marlova Luzzi; AIDE, Miguel Abidon; FERREIRA, Rimarcs Gomes; KAIRALLA, Ronaldo Adib; OLIVEIRA, Rudolf Krawczenko Feitoza de; JEZLER, Sergio; RODRIGUES, Silvia Carla Sousa; PIMENTA, Suzana PinheiroInterstitial lung diseases (ILDs) are heterogeneous disorders, involving a large number of conditions, the approach to which continues to pose an enormous challenge for pulmonologists. The 2012 Brazilian Thoracic Association ILD Guidelines were established in order to provide Brazilian pulmonologists with an instrument that can facilitate the management of patients with ILDs, standardizing the criteria used for the diagnosis of different conditions and offering guidance on the best treatment in various situations. The objective of this article was to briefly describe the highlights of those guidelines.
conferenceObject Prevalence of pulmonary hypertension among outpatients with sarcoidosis: An echocardiographic and pulmonary catheterization study(2012) MEDEIROS-NETO, Agostinho Hermes; RODRIGUES, Fabiola Gomes; TSUTSUI, Jean Mike; SOUZA, Rogerio; CARVALHO, Carlos Roberto Ribeiro; KAIRALLA, Ronaldo AdibconferenceObject Sarcoidosis in Sao Paulo, Brazil: Clinical, tomographic and lung functions data from 72 patients(2012) MEDEIROS-NETO, Agostinho Hermes; RODRIGUES, Fabiola Gomes; CARVALHO, Carlos Roberto Ribeiro; KAIRALLA, Ronaldo Adib- Tunnel excavation triggering pulmonary sarcoidosis(2012) KAWANO-DOURADO, L. B.; CARVALHO, C. R. R.; SANTOS, U. P.; CANZIAN, M.; COLETTA, E. N. A.; PEREIRA, C. A. C.; KAIRALLA, R. A.Context A definite cause of sarcoidosis has not been identified, however past research suggests that environmental factors may be triggers of the granulomatous response in genetically susceptible individuals. Case Presentation A 22-year-old male non-smoker, presented with progressive exertional dyspnea and cough of 3 months duration. One year before, when he started working in tunnel excavation, he had a normal chest radiograph. Chest imaging revealed bilateral nodules and masses of peribronchovascular distribution plus mediastinal lymphadenomegaly. Histologic lymph node analysis revealed non-caseating confluent granulomas. Sarcoidosis was diagnosed. The patient was treated with corticosteroids and advised to change jobs. Complete remission of the disease was achieved and persisted for at least one year without steroid treatment. Discussion Sarcoidosis is believed to have environmental triggers. The timing of the onset of sarcoidosis in this patient following intensive exposure to tunnel dust suggests an environmental contribution. The recognition that sarcoidosis may have occupational triggers have medical, employment, and legal implications. Am. J. Ind. Med. 55: 390-394, 2012. (C) 2011 Wiley Periodicals, Inc.
- Transient Lymphadenopathy Secondary to Nephrotic Syndrome(2012) DIAS, Olivia Meira; COSTA, Andre Nathan; CARVALHO, Carlos Roberto Ribeiro; KAIRALLA, Ronaldo AdibMediastinal lymphadenomegaly secondary to hypervolemia is an underdiagnosed tomographic finding. Herein we describe, in a patient with normal cardiac function, findings of pulmonary congestion associated to lymph node enlargement. The nephrotic syndrome causing hypoalbuminemia, low plasma colloid osmotic pressure and augmented transcapillary fluid leakage was the probable cause of the radiological findings.
article 10 Citação(ões) na Scopus Lymphatic fluctuation in the parenchymal remodeling stage of acute interstitial pneumonia, organizing pneumonia, nonspecific interstitial pneumonia and idiopathic pulmonary fibrosis(2012) PARRA, E. R.; ARAUJO, C. A. L.; LOMBARDI, J. G.; AB'SABER, A. M.; CARVALHO, C. R. R.; KAIRALLA, R. A.; CAPELOZZI, V. L.Because the superficial lymphatics in the lungs are distributed in the subpleural, interlobular and peribroncovascular interstitium, lymphatic impairment may occur in the lungs of patients with idiopathic interstitial pneumonias (IIPs) and increase their severity. We investigated the distribution of lymphatics in different remodeling stages of IIPs by immunohistochemistry using the D2-40 antibody. Pulmonary tissue was obtained from 69 patients with acute interstitial pneumonia/diffuse alveolar damage (AIP/DAD, N = 24), cryptogenic organizing pneumonia/organizing pneumonia (COP/OP, N = 6), nonspecific interstitial pneumonia (NSIP/NSIP, N = 20), and idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP, N = 19). D2-40+ lymphatic in the lesions was quantitatively determined and associated with remodeling stage score. We observed an increase in the D2-40+ percent from DAD (6.66 +/- 1.11) to UIP (23.45 +/- 5.24, P = 0.008) with the advanced process of remodeling stage of the lesions. Kaplan-Meier survival curves showed a better survival for patients with higher lymphatic D2-40+ expression than 9.3%. Lymphatic impairment occurs in the lungs of IIPs and its severity increases according to remodeling stage. The results suggest that disruption of the superficial lymphatics may impair alveolar clearance, delay organ repair and cause severe disease progress mainly in patients with AIP/DAD. Therefore, lymphatic distribution may serve as a surrogate marker for the identification of patients at greatest risk for death due to IIPs.conferenceObject Characterization of 76 patients with lymphangioleiomyomatosis from a Brazilian reference center(2012) FREITAS, Carolina; ARAUJO, Mariana; BALDI, Bruno; PIMENTA, Suzana; KAIRALLA, Ronaldo; CARVALHO, Carlos Roberto- It's Not Asthma(2012) KAWASSAKI, Alexandre Melo; KAWANO-DOURADO, Leticia; KAIRALLA, Ronaido A.
- Exercise Performance and Dynamic Hyperinflation in Lymphangioleiomyomatosis(2012) BALDI, Bruno G.; ALBUQUERQUE, Andre L. P.; PIMENTA, Suzana P.; SALGE, Joao M.; KAIRALLA, Ronaldo A.; CARVALHO, Carlos R. R.Rationale: Lymphangioleiomyomatosis (LAM) is characterized by exercise performance impairment. Although airflow limitation is common, no previous studies have evaluated the prevalence and impact of dynamic hyperinflation (DH) in LAM. Objectives: To investigate the dynamic responses during maximal exercise and the prevalence, predictors, and repercussions of DH in LAM. Methods: Forty-two patients with LAM performed symptom-limited incremental cycle exercise and pulmonary functions tests (PFTs) and were compared with 10 age-matched healthy women. Dyspnea intensity, inspiratory capacity, oxygen saturation, and cardiac, metabolic, and respiratory variables were assessed during exercise. Patients with LAM also performed a 6-minute walk test (6MWT). Measurements and Main Results: Patients with LAM had higher baseline dyspnea, poorer quality of life, obstructive pattern, air trapping, and reduced diffusing capacity of carbon monoxide in PFTs. Although they had the same level of regular physical activity, their maximal exercise performance was reduced and was associated with ventilatory limitation, greater desaturation, and dyspnea. The prevalence of DH was high in LAM (55%), even in patients with mild spirometric abnormalities, and was correlated with airflow obstruction, air trapping, and diffusing capacity of carbon monoxide. Compared with the non-DH subgroup, the patients who developed DH had a ventilatory limitation contributing to exercise cessation on cycling and higher desaturation and dyspnea intensity during the 6MWT. Conclusions: Ventilatory limitation and gas exchange impairment are important causes of exercise limitation in LAM. DH is frequent in LAM, even in patients with mild spirometric abnormalities. DH was associated with the severity of disease, higher dyspnea, and lower oxygen saturation. In the 6MWT, desaturation and dyspnea were greater in patients with DH.