LETICIA BARBOSA KAWANO DOURADO
Projetos de Pesquisa
Unidades Organizacionais
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay(2023) BRIDI, Guilherme das Posses; SAWAMURA, Marcio Valente Yamada; WANDERLEY, Mark; SOUZA, Luciana Volpon Soares; KAIRALLA, Ronaldo Adib; KAWANO-DOURADO, Leticia; BALDI, Bruno GuedesRheumatoid arthritis ( RA) is an autoimmune inflammatory and heterogeneous disease that affects several systems, especially the joints. Among the extra- articular manifestations of RA, pleuropulmonary involvement occurs frequently, with different presentations, potentially in all anatomic thoracic compartments, and may determine high morbidity and mortality. The most common pleuropulmonary manifestations in patients with RA include interstitial lung disease (ILD), pleural disease, pulmonary arterial hypertension, rheumatoid lung nodules, airway disease (bronchiectasis and bronchiolitis), and lymphadenopathy. Pulmonary hypertension and ILD are the manifestations with the greatest negative impact in prognosis. HRCT of the chest is essential in the evaluation of patients with RA with respiratory symptoms, especially those with higher risk factors for ILD, such as male gender, smoking, older age, high levels of rheumatoid factor, or positive anti-cyclic citrullinated peptide antibody results. Additionally, other etiologies that may determine tomographic pleuropulmonary manifestations in patients with RA are infections, neoplasms, and drug-induced lung disease. In these scenarios, clinical presentation is heterogeneous, varying from being asymptomatic to having progressive respiratory failure. Knowledge on the potential etiologies causing tomographic pleuropulmonary manifestations in patients with RA coupled with proper clinical reasoning is crucial to diagnose and treat these patients.
- 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
- Update in statistical analysis plan of the RENOVATE trial(2023) MAIA, I. S.; KAWANO-DOURADO, L.; DAMIANI, L. P.; FITZGERALD, M.; LEWIS, R. J.; CAVALCANTI, A. B.
- Systemic sclerosis associated interstitial lung disease: a conceptual framework for subclinical, clinical and progressive disease(2023) ROOFEH, David; BROWN, Kevin K.; KAZEROONI, Ella A.; TASHKIN, Donald; ASSASSI, Shervin; MARTINEZ, Fernando; WELLS, Athol U.; RAGHU, Ganesh; DENTON, Christopher P.; CHUNG, Lorinda; HOFFMANN-VOLD, Anna-Maria; DISTLER, Oliver; JOHANNSON, Kerri A.; ALLANORE, Yannick; MATTESON, Eric L.; KAWANO-DOURADO, Leticia; PAULING, John D.; SEIBOLD, James R.; VOLKMANN, Elizabeth R.; WALSH, Simon L. F.; V, Chester Oddis; WHITE, Eric S.; BARRATT, Shaney L.; BERNSTEIN, Elana J.; DOMSIC, Robyn T.; DELLARIPA, Paul F.; CONWAY, Richard; ROSAS, Ivan; BHATT, Nitin; HSU, Vivien; INGEGNOLI, Francesca; KAHALEH, Bashar; GARCHA, Puneet; GUPTA, Nishant; KHANNA, Surabhi; KORSTEN, Peter; LIN, Celia; MATHAI, Stephen C.; STRAND, Vibeke; DOYLE, Tracy J.; STEEN, Virginia; ZOZ, Donald F.; OVALLES-BONILLA, Juan; RODRIGUEZ-PINTO, Ignasi; SHENOY, Padmanabha D.; LEWANDOSKI, Andrew; BELLOLI, Elizabeth; LESCOAT, Alain; NAGARAJA, Vivek; YE, Wen; HUANG, Suiyuan; MAHER, Toby; KHANNA, DineshObjectives To establish a framework by which experts define disease subsets in systemic sclerosis associated interstitial lung disease (SSc-ILD). Methods A conceptual framework for subclinical, clinical and progressive ILD was provided to 83 experts, asking them to use the framework and classify actual SSc-ILD patients. Each patient profile was designed to be classified by at least four experts in terms of severity and risk of progression at baseline; progression was based on 1-year follow-up data. A consensus was reached if >= 75% of experts agreed. Experts provided information on which items were important in determining classification. Results Forty-four experts (53%) completed the survey. Consensus was achieved on the dimensions of severity (75%, 60 of 80 profiles), risk of progression (71%, 57 of 80 profiles) and progressive ILD (60%, 24 of 40 profiles). For profiles achieving consensus, most were classified as clinical ILD (92%), low risk (54%) and stable (71%). Severity and disease progression overlapped in terms of framework items that were most influential in classifying patients (forced vital capacity, extent of lung involvement on high resolution chest CT [HRCT]); risk of progression was influenced primarily by disease duration. Conclusions Using our proposed conceptual framework, international experts were able to achieve a consensus on classifying SSc-ILD patients along the dimensions of disease severity, risk of progression and progression over time. Experts rely on similar items when classifying disease severity and progression: a combination of spirometry and gas exchange and quantitative HRCT.
- Implementing the severe community-acquired pneumonia guidelines in low- and middle-income countries(2023) SALLUH, Jorge; KAWANO-DOURADO, Leticia
- Linking Adiposity to Interstitial Lung Disease: The Role of the Dysfunctional Adipocyte and Inflammation(2023) MACKLIN, Michael; THOMPSON, Chelsea; KAWANO-DOURADO, Leticia; VENTURA, Iazsmin Bauer; WESCHENFELDER, Camila; TROSTCHANSKY, Andres; MARCADENTI, Aline; TIGHE, Robert M.Adipose tissue has functions beyond its principal functions in energy storage, including endocrine and immune functions. When faced with a surplus of energy, the functions of adipose tissue expand by mechanisms that can be both adaptive and detrimental. These detrimental adipose tissue functions can alter normal hormonal signaling and promote local and systemic inflammation with wide-ranging consequences. Although the mechanisms by which adipose tissue triggers metabolic dysfunction and local inflammation have been well described, little is known about the relationship between adiposity and the pathogenesis of chronic lung conditions, such as interstitial lung disease (ILD). In this review, we detail the conditions and mechanisms by which adipose tissue becomes dysfunctional and relate this dysfunction to inflammatory changes observed in various forms of ILD. Finally, we review the existing basic and clinical science literature linking adiposity to ILD, highlighting the need for additional research on the mechanisms of adipocyte-mediated inflammation in ILD and its clinical implications.
- Lessons Learned from a Global Perspective of Coronavirus Disease-2019(2023) KAUL, Viren; CHAHAL, Japjot; SCHRARSTZHAUPT, Isaac N.; GEDULD, Heike; SHEN, Yinzhong; CECCONI, Maurizio H.; SIQUEIRA, Andre M.; MARKOSKI, Melissa M.; KAWANO-DOURADO, Leticia
- Systemic corticosteroids in fibrotic lung disease: a systematic review and meta-analysis(2023) PITRE, Tyler; KAWANO-DOURADO, Leticia; V, George Kachkovski; LEUNG, Darren; LEUNG, Gareth; DESAI, Kairavi; ZHAI, Chunjuan; ADAMS, Wendy; FUNKE-CHAMBOUR, Manuela; KREUTER, Michael; STEWART, Iain; RYERSON, Christopher J.; JENKINS, Gisli; ZERAATKAR, DenaObjectivesWe aimed to assess the available evidence for corticosteroids in fibrotic interstitial lung disease (fILD) to inform the randomised embedded multifactorial adaptive platform ILD.DesignSystematic review and meta-analysis.Data sourcesWe searched Embase, Medline, Cochrane CENTRAL and Web of Science databases from inception to April 17 2023.Eligibility criteriaWe included studies that compared corticosteroids with standard care, placebo or no treatment in adult patients with fILD.Data extraction and synthesisWe report on the change in forced vital capacity (FVC) and mortality. We used random-effects meta-analysis to estimate relative risk (RR) for dichotomous outcomes, and mean difference (MD) and standardised MDs for continuous outcomes, with 95% CIs.ResultsOf the 13 229 unique citations identified, we included 10 observational studies comprising 1639 patients. Corticosteroids had an uncertain effect on mortality compared with no treatment (RR 1.03 (95% CI 0.85 to 1.25); very low certainty evidence). The effect of corticosteroids on the rate of decline in FVC (% predicted) was uncertain when compared with no treatment (MD 4.29% (95% CI -8.26% to 16.83%); very low certainty evidence). However, corticosteroids might reduce the rate of decline in FVC in patients with non-idiopathic pulmonary fibrosis (IPF) fILD (MD 10.89% (95% CI 5.25% to 16.53%); low certainty evidence), while an uncertain effect was observed in patients with IPF (MD -3.80% (95% CI -8.94% to 1.34%); very low certainty evidence).ConclusionsThe current evidence on the efficacy and safety of corticosteroids in fILD is limited and of low certainty. Randomised trials are needed to address this significant research gap.