LETICIA BARBOSA KAWANO DOURADO
Projetos de Pesquisa
Unidades Organizacionais
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- 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
- 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, DenaBackground: 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.
- Heterogeneity in rheumatoid arthritis-associated interstitial lung disease: time for splitting?(2022) KAWANO-DOURADO, Leticia; BONFIGLIOLI, Karina
- 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.
- High flow nasal catheter therapy versus non-invasive positive pressure ventilation in acute respiratory failure (RENOVATE trial): protocol and statistical analysis plan(2022) MAIA, Israel S.; KAWANO-DOURADO, Leticia; ZAMPIERI, Fernando G.; DAMIANI, Lucas P.; NAKAGAWA, Renato H.; GURGEL, Rodrigo M.; NEGRELLI, Karina; GOMES, Samara P. C.; PAISANI, Denise; LIMA, Lucas M.; V, Eliana Santucci; VALEIS, Nanci; LARANJEIRA, Ligia N.; LEWIS, Roger; FITZGERALD, Mark; CARVALHO, Carlos R. R.; BROCHARD, Laurent; CAVALCANTI, Alexandre B.Background: The best way to offer non-invasive respiratory support across several aetiologies of acute respiratory failure (ARF) is presently unclear. Both high flow nasal catheter (HFNC) therapy and non-invasive positive pressure ventilation (NIPPV) may improve outcomes in critically ill patients by avoiding the need for invasive mechanical ventilation (IMV). Objective: Describe the details of the protocol and statistical analysis plan designed to test whether HFNC therapy is non inferior or even superior to NIPPV in patients with ARF due to different aetiologies. Methods: RENOVATE is a multicentre adaptive randomised controlled trial that is recruiting patients from adult emergency departments, wards and intensive care units (ICUs). It takes advantage of an adaptive Bayesian framework to assess the effectiveness of HFNC therapy versus NIPPV in four subgroups of ARF (hypoxaemic non-immunocompromised, hypoxaemic immunocompromised, chronic obstructive pulmonary disease exacerbations, and acute cardiogenic pulmonary oedema). The study will report the posterior probabilities of non-inferiority, superiority or futility for the comparison between HFNC therapy and NIPPV. The study assumes neutral priors and the final sample size is not fixed. The final sample size will be determined by a priori determined stopping rules for non-inferiority, superiority and futility for each subgroup or by reaching the maximum of 2000 patients. Outcomes: The primary endpoint is endotracheal intubation or death within 7 days. Secondary outcomes are 28-day and 90-day mortality, and ICU-free and IMV-free days in the first 28 days. Results and conclusions: RENOVATE is designed to provide evidence on whether HFNC therapy improves, compared with NIPPV, important patient-centred outcomes in different aetiologies of ARF. Here, we describe the rationale, design and status of the trial. Trial registration: ClinicalTrials.gov NCT03643939.
- 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