LIM/09 - Laboratório de Pneumologia

URI Permanente desta comunidade

https://observatorio.fm.usp.br/handle/OPI/3630
O Laboratório de Pneumologia é ligado ao Departamento de Cardiopneumologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP).

Linhas de pesquisa: fisiologia respiratória; insuficiência respiratória; ventilação mecânica invasiva e não invasiva; síndrome do desconforto respiratório agudo; pneumotites intersticiais; fibrose pulmonar; vasculites pulmonares; circulação pulmonar; derrame pleural, distúrbios respiratórios e cardiocirculatórios do sono e monitorização respiratória (tomografia de impedância elétrica).

Site oficial: http://limhc.fm.usp.br/portal/lim09-laboratorio-de-pneumologia/

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article 0 Citação(ões) na Scopus
Prognostic factors associated with mortality in acute exacerbations of idiopathic pulmonary fibrosis: A systematic review and meta-analysis
(2024) PITRE, Tyler; LUPAS, Daniel; EBEIDO, Ibrahim; COLAK, Alexander; MODI, Mihir; KACHKOVSKI, George V.; MONTESI, Sydney B.; KHOR, Yet H.; KAWANO-DOURADO, Leticia; JENKINS, Gisli; FISHER, Jolene H.; SHAPERA, Shane; ROCHWERG, Bram; COUBAN, Rachel; ZERAATKAR, Dena
Background: Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) increases mortality risk, but which factors increase mortality is unknown. We aimed to perform a prognostic review of factors associated with mortality in patients with IPF. Study design: and methods: We searched MEDLINE, EMBASE, and CINAHL for studies that reported on the association between any prognostic factor and AE-IPF. We assessed risk of bias using the QUIPS tool. We conduced pairwise meta -analyses using REML heterogeneity estimator, and GRADE approach to assess the certainty of the evidence. Results: We included 35 studies in our analysis. We found that long-term supplemental oxygen at baseline (aHR 2.52 [95 % CI 1.68 to 3.80]; moderate certainty) and a diagnosis of IPF compared to non-IPF ILD (aHR 2.19 [95 % CI 1.22 to 3.92]; moderate certainty) is associated with a higher risk of death in patients with AE-IPF. A diffuse pattern on high resolution computed tomography (HRCT) compared to a non -diffuse pattern (aHR 2.61 [95 % CI 1.32 to 2.90]; moderate certainty) is associated with a higher risk of death in patients with AE-IPF. We found that using corticosteroids prior to hospital admission (aHR 2.19 [95 % CI 1.26 to 3.82]; moderate certainty) and those with increased neutrophils (by % increase) in bronchoalveolar lavage (BAL) during the exacerbation is associated with a higher risk of death (aHR 1.02 [1.01 to 1.04]; moderate certainty). Interpretation: Our results have implications for healthcare providers in making treatment decisions and prognosticating the clinical trajectory of patients, for researchers to design future interventions to improve patient trajectory, and for guideline developers in making decisions about resource allocation.
article 1 Citação(ões) na Scopus
article 0 Citação(ões) na Scopus
Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic
(2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, Geraldo
Introduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
article 0 Citação(ões) na Scopus
Bronchoscopic, laboratory and anatomopathological criteria for airway disease in patients diagnosed with granulomatosis with polyangiitis
(2023) DíAZ, C. Moreno; JACOMELLI, M.; DEMARZO, S. E.; PALOMINO, A. M.; OLIVEIRA, E. P. de; ASSUNCAO, G. L. M. de; TOLEDO, A. P. de; BARBAS, C. S. V.
Introduction: patients with granulomatosis with polyangiitis (GPA) may present upper airway (UA) and lower airway (LA) involvement. Objectives: we describe the endoscopic manifestations of the airways, histological findings from biopsied tissue and antineutrophilic cytoplasm antibody (ANCA) in a group of patients with GPA. Methods: retrospective study of medical records of patients with GPA undergoing bronchoscopy between 2012 and 2019. Airway findings, results of biopsies performed and ANCA results were analyzed. Results: 40 patients were included, with a mean age of 46.92±17.61 years and predominantly female (67.5%). Airway involvement was observed in 90% (n=36). The C-ANCA was reactive in 63.9%, P-ANCA in 25%, doubly reactive ANCA in 8.33% and non-reactive in 20%. The findings in upper airway (UA) were: chronic sinusitis (41.7%), destruction of the nasal septum (16.7%); and in lower airway (LA) were: tracheobronchial stenosis (38.9%) and tracheobronchitis (25%). The pathological findings most common of bronchoscopic biopsies were: polymorphonuclear inflammatory process (61.9%) and geographic necrosis (47.6%). Conclusion: the airway is involved in up to 90% of patients with GPA. Non-reactive ANCA does not rule out this possibility. Chronic sinusitis and tracheobronchial fibrostenotic processes were the most common endoscopic findings. Vasculitis in biopsies was found in a minority of cases.
article 0 Citação(ões) na Scopus
Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study
(2023) SILVA, E. C. G. E.; SCHMITT, A. C. B.; GODOY, C. G. de; OLIVEIRA, D. B. de; TANAKA, C.; TOUFEN, C. Jr.; CARVALHO, C. R. R. de; CARVALHO, C. R. F.; FU, C.; HILL, K. D.; POMPEU, J. E.
(1) Background: Some older people hospitalized with COVID-19 have experienced reduced ambulation capacity. However, the prevalence of the impairment of ambulation capacity still needs to be established. Objective: To estimate the prevalence of, and identify the risk factors associated with, the impairment of ambulation capacity at the point of hospital discharge for older people with COVID-19. (2) Methods: A retrospective cohort study. Included are those with an age > 60 years, of either sex, hospitalized due to COVID-19. Clinical data was collected from patients’ medical records. Ambulation capacity prior to COVID-19 infection was assessed through the patients’ reports from their relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data for 429 older people hospitalized with COVID-19 were randomly collected from the medical records. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were a hospital stay longer than 20 days (Odds Ratio (OR): 3.5) and dependent ambulation capacity prior to COVID-19 (Odds Ratio (OR): 11.3). (4) Conclusion: More than half of the older people who survived following hospitalization due to COVID-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection and a longer hospital stay were risks factors for reduced ambulation capacity.
article 2 Citação(ões) na Scopus
Pronation Reveals a Heterogeneous Response of Global and Regional Respiratory Mechanics in Patients With Acute Hypoxemic Respiratory Failure
(2023) MORAIS, C. C. A.; ALCALA, G.; SANTIAGO, R. R. De Santis; VALSECCHI, C.; DIAZ, E.; WANDERLEY, H.; FAKHR, B. S.; FENZA, R. Di; GIANNI, S.; FOOTE, S.; CHANG, M. G.; BITTNER, E. A.; CARROLL, R. W.; COSTA, E. L. V.; AMATO, M. B. P.; BERRA, L.
OBJECTIVES: Experimental models suggest that prone position and positive end-expiratory pressure (PEEP) homogenize ventral-dorsal ventilation distribution and regional respiratory compliance. However, this response still needs confirmation on humans. Therefore, this study aimed to assess the changes in global and regional respiratory mechanics in supine and prone positions over a range of PEEP levels in acute respiratory distress syndrome (ARDS) patients. DESIGN: A prospective cohort study. PATIENTS: Twenty-two intubated patients with ARDS caused by COVID-19 pneumonia. INTERVENTIONS: Electrical impedance tomography and esophageal manometry were applied during PEEP titrations from 20 cm H2O to 6 cm H2O in supine and prone positions. MEASUREMENTS: Global respiratory system compliance (Crs), chest wall compliance, regional lung compliance, ventilation distribution in supine and prone positions. MAIN RESULTS: Compared with supine position, the maximum level of Crs changed after prone position in 59% of ARDS patients (n = 13), of which the Crs decreased in 32% (n = 7) and increased in 27% (n = 6). To reach maximum Crs after pronation, PEEP was changed in 45% of the patients by at least 4 cm H2O. After pronation, the ventilation and compliance of the dorsal region did not consistently change in the entire sample of patients, increasing specifically in a subgroup of patients who showed a positive change in Crs when transitioning from supine to prone position. These combined changes in ventilation and compliance suggest dorsal recruitment postpronation. In addition, the subgroup with increased Crs postpronation demonstrated the most pronounced difference between dorsal and ventral ventilation distribution from supine to prone position (p = 0.01), indicating heterogeneous ventilation distribution in prone position. CONCLUSIONS: Prone position modifies global respiratory compliance in most patients with ARDS. Only a subgroup of patients with a positive change in Crs postpronation presented a consistent improvement in dorsal ventilation and compliance. These data suggest that the response to pronation on global and regional mechanics can vary among ARDS patients, with some patients presenting more dorsal lung recruitment than others.
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Late Breaking Abstract - Artificial intelligence-based dec---sion support for HRCT stratification in fibrotic lung disease; an international study of 116 observers from 37 countries.
(2023) CALANDRIELLO, Lucio; MACKINTOSH, John; FELDER, Federico; AGRAWAL, Aditya; ALAMOUDI, Omer; ALBERTI, Laura; AQUARO, Giuseppe; ARENAS-JIMENEZ, Juan; AU-YONG, Iain; AVDEEV, Sergey; BALBI, Maurizio; BALDI, Bruno; BAN, Andrea Yu-Lin; BELACONI, Ionela-Nicoleta; BENDSTRUP, Elisabeth; BENNETT, David; BLUM, Hans-Christian; BARIGA, Nicola Boscolo; BOZOVIC, Gracijela; BROQI, Marsel; BRUZZI, John; BUENDIA-ROLDAN, Ivette; CALARAS, Diana; CAMPAINHA, Sergio; CARBONE, Roberto G.; CARVALHO, Andre; CERESER, Lorenzo; CHAI, Gin Tsen; CHAUDHARY, Sachin; CHAUDHURI, Nazia; CHEONG, Patrick Alain Chui Wan; COOPER, Wendy; CUTAIA, Giuseppe; D'ABRONZO, Rosa; KRUIF, Martijn D. De; DELGADO-GARCIA, Diemen; DHOORIA, Sahajal; DIAZ-CASTANON, Jesus J.; EIGER, Glenn; ELLIS, Samantha; ESTRADA-Y-MARTIN, Rosa; FANG, Yingying
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A BEAT-PCD consensus statement: a core outcome set for pulmonary disease interventions in primary ciliary dyskinesia
(2023) KOS, Renate; GOUTAKI, Myrofora; KOBBERNAGEL, Helene E.; RUBBO, Bruna; SHOEMARK, Amelia; ALIBERTI, Stefano; ALTENBURG, Josje; ANAGNOSTOPOULOU, Pinelopi; ATHANAZIO, Rodrigo A.; BEYDON, Nicole; DELL, Sharon D.; EMIRALIOGLU, Nagehan; FERKOL, Thomas W.; LOEBINGER, Micael R.; LORENT, Natalie; MAITRE, Bernarnd; MARTHIN, June K.; MORGAN, Lucy C.; NIELSEN, Kim G.; RINGHAUSEN, Felix C.; SHTEINBERG, Michal; TIDDENS, Harm A. W. M.; ZEE, Anke H. Maitland-Van Der; CHALMERS, James D.; LUCAS, Jane S. A.; HAARMAN, Eric G.
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Optimization of differential ultracentrifugation for the purification of small extracellular vesicles from human biological fluids
(2023) SILVA, Romuel; SOUZA, Jennyffer; PRIGOL, Anne; KAWANO-DOURADO, Leticia; LATINI, Alexandra
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High-intensity interval training (HIIT) versus constant-load exercise (CLE) on the short-acute beta agonist (SABA) consumption and peak-expiratory flow (PEF) in subjects with moderate to severe asthma
(2023) SILVA, Ronaldo Aparecido Da; FERNANDES, Thiago; STELMACH, Rafael; CUKIER, Alberto; CARVALHO-PINTO, Regina Maria; CARVALHO, Celso R. F.