MARIO TERRA FILHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina - Líder
6 resultados
Resultados de Busca
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- Burnt sugarcane harvesting is associated with acute renal dysfunction(2015) SANTOS, Ubiratan Paula; ZANETTA, Dirce Maria T.; TERRA-FILHO, Mario; BURDMANN, Emmanuel A.Sugarcane harvesting has been associated with an epidemic of chronic kidney disease in Central America mainly affecting previously healthy young workers. Repeated episodes of acute kidney dysfunction are hypothesized to be one of the possible mechanisms for this phenomenon. Therefore, this exploratory study aimed to assess the acute effects of burnt sugarcane harvesting on renal function among 28 healthy non-African Brazilian workers. Urine and blood samples were collected at the beginning and at the end of the harvesting season and before and at the end of a harvesting workday. All individuals decreased their estimated glomerular filtration rate by similar to 20% at the end of the daily shift, and 18.5% presented with serum creatinine increases consistent with acute kidney injury. Those changes were associated with increased serum creatine phosphokinase (a known marker for exertional rhabdomyolysis) and oxidative stress-associated malondialdehyde levels, increased peripheral blood white cell counts, decreased urinary and serum sodium, decreased calculated fractional sodium excretion, and increased urine density. Thus, burnt sugarcane harvesting caused acute renal dysfunction in previously healthy workers. This was associated with a combination of dehydration, systemic inflammation, oxidative stress, and rhabdomyolysis.
- Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography(2015) TERRA-FILHO, Mario; BAGATIN, Ericson; NERY, Luiz Eduardo; NAPOLIS, Lara Maris; NEDER, Jose Alberto; MEIRELLES, Gustavo de Souza Portes; SILVA, C. Isabela; MULLER, Nestor L.Background Chest radiography (CXR) is inferior to Thin-section computed tomography in the detection of asbestos related interstitial and pleural abnormalities. It remains unclear, however, whether these limitations are large enough to impair CXR's ability in detecting the expected reduction in the frequency of these asbestos-related abnormalities (ARA) as exposure decreases. Methods Clinical evaluation, CXR, Thin-section CT and spirometry were obtained in 1418 miners and millers who were exposed to progressively lower airborne concentrations of asbestos. They were separated into four groups according to the type, period and measurements of exposure and/or procedures for controlling exposure: Group I (1940-1966/tremolite and chrysotile, without measurements of exposure and procedures for controlling exposure); Group II (1967-1976/chrysotile only, without measurements of exposure and procedures for controlling exposure); Group III (1977-1980/chrysotile only, initiated measurements of exposure and procedures for controlling exposure) and Group IV (after 1981/chrysotile only, implemented measurements of exposure and a comprehensive procedures for controlling exposure). Results In all groups, CXR suggested more frequently interstitial abnormalities and less frequently pleural plaques than observed on Thin-section CT (p < 0.050). The odds for asbestosis in groups of decreasing exposure diminished to greater extent at Thin-section CT than on CXR. Lung function was reduced in subjects who had pleural plaques evident only on Thin-section CT (p < 0.050). In a longitudinal evaluation of 301 subjects without interstitial and pleural abnormalities on CXR and Thin-section CT in a previous evaluation, only Thin-section CT indicated that these ARA reduced as exposure decreased. Conclusions CXR compared to Thin-section CT was associated with false-positives for interstitial abnormalities and false-negatives for pleural plaques, regardless of the intensity of asbestos exposure. Also, CXR led to a substantial misinformation of the effects of the progressively lower asbestos concentrations in the occurrence of asbestos-related diseases in miners and millers.
- Accelerated silicosis: A report of three patients(2015) COSTA, Felipe Marques da; OLIVEIRA, Ellen Pierre de; ALGRANTI, Eduardo; MENDONCA, Elizabete Medina Coeli; PAIVA, Antonio Fernando Lins de; CHATE, Rodrigo Caruso; TERRA FILHO, Mario; SANTOS, Ubiratan de Paula
- An approach to using heart rate monitoring to estimate the ventilation and load of air pollution exposure(2015) COZZA, Izabela Campos; ZANETTA, Dirce Maria Trevisan; FERNANDES, Frederico Leon Arrabal; ROCHA, Francisco Marcelo Monteiro da; ANDRE, Paulo Afonso de; GARCIA, Maria Lucia Bueno; PACELI, Renato Batista; PRADO, Gustavo Faibischew; TERRA-FILHO, Mario; SALDIVA, Paulo Hilario do Nascimento; SANTOS, Ubiratan de PaulaBackground: The effects of air pollution on health are associated with the amount of pollutants inhaled which depends on the environmental concentration and the inhaled air volume. It has not been clear whether statistical models of the relationship between heart rate and ventilation obtained using laboratory cardiopulmonary exercise test (CPET) can be applied to an external group to estimate ventilation. Objectives: To develop and evaluate a model to estimate respiratory ventilation based on heart rate for inhaled load of pollutant assessment in field studies. Methods: Sixty non-smoking men; 43 public street workers (public street group) and 17 employees of the Forest Institute (park group) performed a maximum cardiopulmonary exercise test (CPET). Regression equation models were constructed with the heart rate and natural logarithmic of minute ventilation data obtained on CPET. Ten individuals were chosen randomly (public street group) and were used for external validation of the models (test group). All subjects also underwent heart rate register, and particulate matter (PM2.5) monitoring for a 24-hour period. Results: For the public street group, the median difference between estimated and observed data was 0.5 (CI 95% -0.2 to 1.4) l/min and for the park group was 0.2 (CI 95% -0.2 to 1.2) l/min. In the test group, estimated values were smaller than the ones observed in the CPET, with a median difference of -2.4 (CI 95% -4.2 to -1.8) l/min. The mixed model estimated values suggest that this model is suitable for situations in which heart rate is around 120-140 bpm. Conclusion: The mixed effect model is suitable for ventilation estimate, with good accuracy when applied to homogeneous groups, suggesting that, in this case, the model could be used in field studies to estimate ventilation. A small but significant difference in the median of external validation estimates was observed, suggesting that the applicability of the model to external groups needs further evaluation.
- Chemical exposure triggering connective tissue disease with lung involvement(2015) DIDIER-NETO, Fernando Moacyr Fragoso; LEAO, Beatriz Dalcolmo de Almeida; COSTA, Andre Nathan; PRADO, Gustavo Faibischew; TERRA-FILHO, Mario; SANTOS, Ubiratan de Paula
- Aging of the Lungs in Asymptomatic Lifelong Nonsmokers: Findings on HRCT(2015) WINTER, Daniel H.; MANZINI, Marcos; SALGE, Joao Marcos; BUSSE, Alexandre; JALUUL, Omar; FILHO, Wilson Jacob; MATHIAS, Wilson; TERRA-FILHO, MarioTo report lung parenchymal findings on high-resolution computed tomography (HRCT) in a population of asymptomatic, never-smoker urban dwellers aged 65 years and older. After institutional approval, asymptomatic older patients from the Geriatrics Outpatient Clinic aged 65 years and older (older group) and healthy volunteers aged 30-50 years (younger group) were invited to participate in the study. Asymptomatic, never-smoker subjects considered free of relevant disease after spirometry and echocardiography underwent chest HRCT. Three researchers reviewed every scan, noting the absence/presence and distribution of pre-specified parenchymal findings. Statistical comparisons between groups were performed using appropriate tests with the aid of software. Forty-seven older and 24 younger subjects were included in this analysis. A higher proportion of women and a longer history of urban dwelling were present in the older group. Parenchymal findings were more prevalent in the older group (78.7 vs. 25 % in the younger group; p < 0.001). Parenchymal bands (59.6 vs. 25 %; p = 0.007), ground-glass opacities (25.5 vs. 0 %; p = 0.006), and septal lines (21.3 vs. 0 %; p = 0.013) were more prevalent in the elderly. When only subjects aged 75 years and older were considered as the older group, micronodules, reticular opacities, cysts, and bronchiectases (19.1 vs. 0 % for all comparisons; p = 0.04) were also more frequently found among the elderly. Parenchymal bands, ground-glass opacities, septal lines, bronchiectasis, micronodules, reticular opacities, and lung cysts were more prevalent among the elderly.