RAFAEL FUTOSHI MIZUTANI
Projetos de Pesquisa
Unidades Organizacionais
PAHC, 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
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
- Cases series on nontuberculous mycobacterial (NTM) lung disease and silicosis in Brazil(2017) RANGEL, Diana Arrais de Souza; GARCIA, Marcos Vinicius Fernandes; MIZUTANI, Rafael Futoshi; SALES, Roberta Karla Barbosa; SANTOS, Ubiratan de Paula; TERRA-FILHO, Mario
- Silicosis with acute renal injury and glomerulonephritis: a case report(2017) COCCOLIN, Fernanda; SOARES, Fernando; MIZUTANI, Rafael; DIAS, Cristiane; GARCIA, Marcos; TERRA-FILHO, Mario; SANTOS, Ubiratan; PINHEIRO, Rafaela
- Work-related asthma consequences on socioeconomic, asthma control, quality of life, and psychological status compared with non-work-related asthma: A cross-sectional study in an upper-middle-income country(2023) ROIO, Lavinia Clara; STELMACH, Rafael; MIZUTANI, Rafael F. F.; TERRA-FILHO, Mario; SANTOS, Ubiratan d. P.BackgroundWork-related asthma (WRA) is the most prevalent occupational respiratory disease, and it has negative effects on socioeconomic standing, asthma control, quality of life, and mental health status. Most of the studies on WRA consequences are from high-income countries; there is a lack of information on these effects in Latin America and in middle-income countries. MethodsThis study compared socioeconomic, asthma control, quality of life, and psychological outcomes among individuals diagnosed with WRA and non-work-related asthma (NWRA) in a middle-income country. Patients with asthma, related and not related to work, were interviewed using a structured questionnaire to assess their occupational history and socioeconomic conditions, and with questionnaires to assess asthma control (Asthma Control Test and Asthma Control Questionnaire-6), quality of life (Juniper's Asthma Quality of Life Questionnaire), and presence of anxiety and depression symptoms (Hospital Anxiety and Depression Scale). Each patient's medical record was reviewed for exams and use of medication, and comparisons were made between individuals with WRA and NWRA. ResultsThe study included 132 patients with WRA and 130 with NWRA. Individuals with WRA had worse socioeconomic outcomes, worse asthma control, more quality-of-life impairment, and a higher prevalence of anxiety and depression than individuals with NWRA. Among individuals with WRA, those who had been removed from occupational exposure had a worse socioeconomic impact. ConclusionsConsequences on socioeconomic, asthma control, quality of life, and psychological status are worse for WRA individuals when compared with NWRA.
- Biomarkers related to silicosis and pulmonary function in individuals exposed to silica(2023) LOMBARDI, Elisa M. S.; MIZUTANI, Rafael F.; TERRA-FILHO, Mario; PAULA, Santos Ubiratan deBackgroundThe identification of markers that can facilitate the early diagnosis of silicosis has remained challenging. We evaluated the association of inflammatory markers with the presence of silicosis and lung function impairment in individuals exposed to silica. Methods Individuals exposed and not exposed to silica were assessed by occupational history, clinical findings, lung function, chest imaging findings, and inflammatory markers. Results Among 297 men evaluated, 51 were unexposed controls (G1), 149 were exposed to silica without silicosis (G2), and 97 were exposed to silica with silicosis (G3). Inflammatory marker levels were higher in G3 than in G2 and G1. Platelet/lymphocyte ratio (PLR), lactate dehydrogenase (LDH), soluble tumor necrosis factor II (sTNFRII), and macrophage inflammatory protein-4 (MIP-4) were associated with silicosis, and LDH, neutrophil/lymphocyte ratio (NLR), sTNFRII, monocyte chemoattractant protein-1 (MCP-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and fibrinogen were negatively associated with lung function. Conclusion Blood inflammatory markers are associated with silicosis and impaired lung function.
- Constrictive bronchiolitis secondary to exposure to flavoring agents: a little known occupational hazard(2023) ALMEIDA, Gustavo Correa de; MIZUTANI, Rafael Futoshi; TERRA-FILHO, Mario; SANTOS, Ubiratan de Paula
- Mesothelioma in situ with regressive malignant pleural effusion and an unexpected evolution: A case report(2022) ALMEIDA, Gustavo C. de; SANTOS, Ubiratan de P.; PARENTE, Yuri de D. M.; COLARES, Philippe de F. B.; MIZUTANI, Rafael F.; BERNARDI, Fabiola del C.; TERRA, Ricardo M.; TERRA-FILHO, MarioMalignant pleural mesothelioma (MPM) is an aggressive neoplasm that originates from hyperplasia and metaplasia of the mesothelial cells that cover the pleural cavity. Previous exposure to asbestos is the main risk factor. Since MPM is often diagnosed at an advanced stage with rapid evolution and resistance to treatment, it is associated with an unfavorable outcome. Mesothelioma in situ (MIS) has been postulated as a preinvasive phase of MPM; however, its diagnostic criteria have been defined only recently. Diagnosis of MIS may represent an opportunity for early therapies with better results, but the optimal approach has not been defined thus far. Here, we report on a case of a 74-year-old man with right-sided pleural effusion and a previous history of occupational exposure to asbestos for 9 years who was diagnosed with MIS after a latency of 36 years. During follow-up, spontaneous disease regression was observed 5 months after the initial diagnosis; however, it recurred in the form of invasive epithelioid MPM. There is a paucity of literature on MIS and its evolution; however, our case provides relevant knowledge of this unusual behavior, which is important to define follow-up and therapeutic strategies for future cases.
- Environmental air pollution: respiratory effects(2021) SANTOS, Ubiratan de Paula; ARBEX, Marcos Abdo; BRAGA, Alfesio Luis Ferreira; MIZUTANI, Rafael Futoshi; CANCADO, Jose Eduardo Delfini; TERRA-FILHO, Mario; CHATKIN, Jose MiguelEnvironmental air pollution is a major risk factor for morbidity and mortality worldwide. Environmental air pollution has a direct impact on human health, being responsible for an increase in the incidence of and number of deaths due to cardiopulmonary, neoplastic, and metabolic diseases; it also contributes to global warming and the consequent climate change associated with extreme events and environmental imbalances. In this review, we present articles that show the impact that exposure to different sources and types of air pollutants has on the respiratory system; we present the acute effects-such as increases in symptoms and in the number of emergency room visits, hospitalizations, and deaths-and the chronic effects-such as increases in the incidence of asthma, COPD, and lung cancer, as well as a rapid decline in lung function. The effects of air pollution in more susceptible populations and the effects associated with physical exercise in polluted environments are also presented and discussed. Finally, we present the major studies on the subject conducted in Brazil. Health care and disease prevention services should be aware of this important risk factor in order to counsel more susceptible individuals about protective measures that can facilitate their treatment, as well as promoting the adoption of environmental measures that contribute to the reduction of such emissions.
- Telemedicine as a tool in the smoking cessation clinic-154 cases in 2 years in the largest city in Latin America.(2023) NERY, Telma Cassia Santos; MARTINS, Stella R.; FREITAS, Jefferson Benedito Pires; ROIO, Lavinia Clara Del; ALMEIDA, Gustavo Correa De; MIZUTANI, Rafael Futoshi; CARVALHO, Carlos Roberto Ribeiro
- Work-related asthma(2021) ROIO, Lavinia Clara Del; MIZUTANI, Rafael Futoshi; PINTO, Regina Carvalho; TERRA-FILHO, Mario; SANTOS, Ubiratan PaulaWork-related asthma (WRA) is highly prevalent in the adult population. WRA includes occupational asthma (OA), which is asthma caused by workplace exposures, and work-exacerbated asthma (WEA), also known as work-aggravated asthma, which is preexisting or concurrent asthma worsened by workplace conditions. In adults, the estimated prevalence of OA is 16.0%, whereas that of WEA is 21.5%. An increasing number of chemicals used in industrial production, households, and services are associated with the incidence of adult-onset asthma attributable to exposure to chemicals. This review article summarizes the different types of WRA and describes diagnostic procedures, treatment, prevention, and approaches to patient management. It is not always easy to distinguish between OA and WEA. It is important to establish a diagnosis (of sensitizer-/irritant-induced OA or WEA) in order to prevent worsening of symptoms, as well as to prevent other workers from being exposed, by providing early treatment and counseling on social security and work-related issues.
- Hard metal lung disease: a case series(2016) MIZUTANI, Rafael Futoshi; TERRA-FILHO, Mario; LIMA, Evelise; FREITAS, Carolina Salim Goncalves; CHAFE, Rodrigo Caruso; KAIRALLA, Ronaldo Adib; CARVALHO-OLIVEIRA, Regiani; SANTOS, Ubiratan PaulaObjetivo: Descrever aspectos relacionados ao diagnóstico e tratamento de pacientes com doença pulmonar por metal duro (DPMD) e realizar uma revisão da literatura. Métodos: Estudo retrospectivo dos prontuários médicos de pacientes atendidos no Serviço de Doenças Respiratórias Ocupacionais do Instituto do Coração, localizado na cidade de São Paulo, entre 2010 e 2013. Resultados: Entre 320 pacientes atendidos no período do estudo, 5 (1,56%) foram diagnosticados com DPMD. Todos os pacientes eram do sexo masculino, com média de idade de 42,0 ± 13,6 anos e média de tempo de exposição a metal duro de 11,4 ± 8,0 anos. Os pacientes foram submetidos a avaliação clinica, história ocupacional, TCAR de tórax, prova de função pulmonar, broncoscopia com LBA e biópsia pulmonar. Todos apresentaram distúrbio ventilatório restritivo. O achado de imagem à TCAR de tórax mais frequente foi de opacidades em vidro fosco (em 80%). Em 4 pacientes, o LBA revelou presença de células gigantes multinucleadas. Em 3, foi diagnosticada pneumonia intersticial por células gigantes na biópsia pulmonar. Houve o diagnóstico de pneumonia intersticial descamativa associada à bronquiolite celular em 1 paciente e de pneumonite de hipersensibilidade em 1. Todos foram afastados da exposição e tratados com corticoide. Houve melhora em 2 pacientes e progressão da doença em 3. Conclusões: Apesar de ser uma entidade rara, a DPMD deve ser sempre considerada em trabalhadores com risco ocupacional elevado de exposição a metais duros. A história clínica e ocupacional associada a achados em TCAR de tórax e LBA sugestivos da doença podem ser suficientes para o diagnóstico.