RODRIGO ABENSUR ATHANAZIO
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
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- Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts(2017) ATHANAZIO, Rodrigo; PEREIRA, Monica Corso; GRAMBLICKA, Georgina; CAVALCANTI-LUNDGREN, Fernando; FIGUEIREDO, Mara Fernandes de; ARANCIBIA, Francisco; RACHED, Samia; ROSA, David de la; MAIZ-CARRO, Luis; GIRON, Rosa; OLVEIRA, Casilda; PRADOS, Concepcion; MARTINEZ-GARCIA, Miguel AngelBackground: The FACED score is an easy-to-use multidimensional grading system that has demonstrated an excellent prognostic value for mortality in patients with bronchiectasis. A Spanish group developed the score but no multicenter international validation has yet been published. Methods: Retrospective and multicenter study conducted in six historical cohorts of patients from Latin America including 651 patients with bronchiectasis. Clinical, microbiological, functional, and radiological variables were collected, following the same criteria used in the original FACED score study. The vital status of all patients was determined in the fifth year of follow-up. The area under ROC curve (AUC-ROC) was used to calculate the predictive power of the FACED score for all-cause and respiratory deaths and both number and severity of exacerbations. The discriminatory power to divide patients into three groups of increasing severity was also analyzed. Results: Mean (SD) age of 48.2 (16), 32.9% of males. The mean FACED score was 2.35 (1.68). During the follow up, 95 patients (14.6%) died (66% from respiratory causes). The AUC ROC to predict all-cause and respiratory mortality were 0.81 (95% CI: 0.77 to 0.85) 0.84 (95% CI: 0.80 to 0.88) respectively, and 0.82 (95% CI: 078-0.87) for at least one hospitalization per year. The division into three score groups separated bronchiectasis into distinct mortality groups (mild: 3.7%; moderate: 20.7% and severe: 48.5% mortality; p < 0.001). Conclusions: The FACED score was confirmed as an excellent predictor of all-cause and respiratory mortality and severe exacerbations, as well as having excellent discriminative capacity for different degrees of severity in various bronchiectasis populations.
- Comparação entre medidas objetivas do tabagismo e tabagismo autodeclarado em pacientes com asma ou DPOC: será que nossos pacientes dizem a verdade?(2015) STELMACH, Rafael; FERNANDES, Frederico Leon Arrabal; CARVALHO-PINTO, Regina Maria; ATHANAZIO, Rodrigo Abensur; RACHED, Samia Zahi; PRADO, Gustavo Faibischew; CUKIER, AlbertoObjective: Smoking prevalence is frequently estimated on the basis of self-reported smoking status. That can lead to an underestimation of smoking rates. The aim of this study was to evaluate the difference between self-reported smoking status and that determined through the use of objective measures of smoking at a pulmonary outpatient clinic. Methods: This was a cross-sectional study involving 144 individuals: 51 asthma patients, 53 COPD patients, 20 current smokers, and 20 never-smokers. Smoking status was determined on the basis of self-reports obtained in interviews, as well as through tests of exhaled carbon monoxide (eCO) and urinary cotinine. Results: All of the asthma patients and COPD patients declared they were not current smokers. In the COPD and asthma patients, the median urinary cotinine concentration was 167 ng/mL (range, 2-5,348 ng/mL) and 47 ng/mL (range, 5-2,735 ng/mL), respectively (p < 0.0001), whereas the median eCO level was 8 ppm (range, 0-31 ppm) and 5 ppm (range, 2-45 ppm), respectively (p < 0.05). In 40 (38%) of the patients with asthma or COPD (n = 104), there was disagreement between the self-reported smoking status and that determined on the basis of the urinary cotinine concentration, a concentration > 200 ng/mL being considered indicative of current smoking. In 48 (46%) of those 104 patients, the self-reported non-smoking status was refuted by an eCO level > 6 ppm, which is also considered indicative of current smoking. In 30 (29%) of the patients with asthma or COPD, the urinary cotinine concentration and the eCO level both belied the patient claims of not being current smokers. Conclusions: Our findings suggest that high proportions of smoking pulmonary patients with lung disease falsely declare themselves to be nonsmokers. The accurate classification of smoking status is pivotal to the treatment of lung diseases. Objective measures of smoking could be helpful in improving clinical management and counseling.
article 0 Citação(ões) na Scopus Right lung exclusion in massive pulmonary thromboembolism(2015) ATHANAZIO, Rodrigo Abensur; RACHED, Samia Zahi- 2018 recommendations for the management of community acquired pneumonia(2019) CORREA, Ricardo de Amorim; COSTA, Andre Nathan; LUNDGREN, Fernando; MICHELIN, Lessandra; FIGUEIREDO, Mara Rubia; HOLANDA, Marcelo; GOMES, Mauro; TEIXEIRA, Paulo Jose Zimermann; MARTINS, Ricardo; SILVA, Rodney; ATHANAZIO, Rodrigo Abensur; SILVA, Rosemeri Maurici da; PEREIRA, Monica Corso
- Use of elexacaftor plus tezacaftor plus ivacaftor in individuals with cystic fibrosis and at least one F508del allele: a systematic review and meta-analysis(2023) SILVA FILHO, Luiz Vicente Ribeiro Ferreira da; ATHANAZIO, Rodrigo Abensur; TONON, Carolina Rodrigues; FERREIRA, Juliana Carvalho; TANNI, Suzana EricoObjective: To evaluate the effect of treatment with the combination of three cystic fibrosis transmembrane conductance regulator (CFTR) modulators-elexacaftor+tezac aftor+ivacaftor (ETI)-on important clinical endpoints in individuals with cystic fibrosis. Methods: This was a systematic review and meta-analysis of randomized clinical trials that compared the use of ETI in individuals with CF and at least one F508del allele with that of placebo or with an active comparator such as other combinations of CFTR modulators, following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) recommendations and the Patients of interest, Intervention to be studied, Comparison of interventions, and Outcome of interest (PICO) methodology. We searched the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from their inception to December 26th, 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool, and the quality of evidence was based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: We retrieved 54 studies in the primary search. Of these, 6 met the inclusion criteria and were analyzed (1,127 patients; 577 and 550 in the intervention and control groups, respectively). The meta-analysis revealed that the use of ETI increased FEV 1% [risk difference (RD), +10.47%; 95% CI, 6.88-14.06], reduced the number of acute pulmonary exacerbations (RD, -0.16; 95% CI, -0.28 to -0.04), and improved quality of life (RD, +14.93; 95% CI, 9.98-19.89) and BMI (RD, +1.07 kg/m(2); 95% CI, 0.90-1.25). Adverse events did not differ between groups (RD, -0.03; 95% CI, -0.08 to 0.01), and none of the studies reported deaths. Conclusions: Our findings demonstrate that ETI treatment substantially improves clinically significant, patientcentered outcomes.
- What is the optimal large airway size reduction value to determine malacia: exploratory bronchoscopic analysis in patients in Mounier-Kuhn syndrome(2021) LIMA, Evelise; GENTA, Pedro Rodrigues; ATHANAZIO, Rodrigo Abensur; RODRIGUES, Ascedio Jose; APARECIDA, Maria; NAKAMURA, Maria Aparecida Miyuki; RACHED, Samia Zahi; COSTA, Eduardo Leite Vieira; STELMACH, Rafael
- 2018 recommendations for the management of community acquired pneumonia(2018) CORREA, Ricardo de Amorim; COSTA, Andre Nathan; LUNDGREN, Fernando; MICHELIM, Lessandra; FIGUEIREDO, Mara Rubia; HOLANDA, Marcelo; GOMES, Mauro; TEIXEIRA, Paulo Jose Zimermann; MARTINS, Ricardo; SILVA, Rodney; ATHANAZIO, Rodrigo Abensur; SILVA, Rosemeri Maurici da; PEREIRA, Monica Corso
- The annual prognostic ability of FACED and E-FACED scores to predict mortality in patients with bronchiectasis(2018) CARRILLO, David de la Rosa; ATHANAZIO, Rodrigo; MORENO, Rosa Maria Giron; CARRO, Luis Maiz; OLVEIRA, Casilda; GRACIA, Javier de; VENDRELL, Montserrat; SANCHEZ, Concepcion Prados; GRAMBLICKA, Georgina; PEREIRA, Monica Corso; LUNDGREN, Fernando; FIGUEIREDO, Mara Fernandes De; ARANCIBIA, Francisco; RACHED, Samia; MARTINEZ-GARCIA, Miguel-Angel
- A study of the psychometric properties of the Brazilian-Portuguese version of Bronchiectasis Health Questionnaire(2023) LUPPO, A.; CAMARGO, C. O. de; BIRRING, S. S.; LUNARDI, A. C.; RACHED, S. Z.; ATHANAZIO, R. A.; STELMACH, R.; CORSO, S. D.Introduction and objective: The Bronchiectasis Health Questionnaire (BHQ) is a simple, repeatable, and self-reporting health status questionnaire for bronchiectasis. This study aims to cross-culturally adapt the BHQ into Brazilian Portuguese and evaluate its measurement properties.Methods: The participants answered the Saint George's Respiratory Questionnaire (SGRQ) and the modified Medical Research Council (mMRC) scale for dyspnea. The Brazilian-Portuguese version of the Bronchiectasis Health Questionnaire (BHQ-Brazil) was used at baseline (test) and after 14 days (retest). The psychometric analyses included internal consistency, test-retest reliability, and construct validity: factorial validity, convergent validity, and discriminative validity, agreement, and ceiling and floor effects. Results: The BHQ-Brazil demonstrated adequate internal consistency (Cronbach's alpha = 0.92) and substantial reliability (intraclass correlation coefficient = 0.86; 95%CI: 0.79--0.90). The exploratory factorial analysis was considered suitable. All items presented a factorial load >0.40. The convergent validity of the BHQ-Brazil with mMRC was moderate (r = -0.53, p < 0.001), while concurrent validity with the SGRQ was strong (symptoms: r = -0.72, activities: r = -0.60, impact: r = -0.60, total score: r = -0.75, all p < 0.001). The standard error of measurement was 4.81 points. The discriminative validity demonstrated that individuals with more pulmonary exacerbations, colonization by Pseudomonas aeruginosa, worst dyspnea, and a higher number of affected lung lobes presented the lowest quality of life. No floor or ceiling effects were observed.Conclusion: The BHQ-Brazil presents adequate measurement properties to evaluate the impact of bronchiectasis on health-related quality of life, and can be used in clinical and research settings.(c) 2020 Sociedade Portuguesa de Pneumologia.
- In-person and online application of the Bronchiectasis Health Questionnaire: are they interchangeable?(2022) LUPPO, Adriano; RACHED, Samia Z.; ATHANAZIO, Rodrigo A.; STELMACH, Rafael; CORSO, Simone Dal