ROSANA CAMARA AGONDI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
LIM/19 - Laboratório de Histocompatibilidade e Imunidade Celular, Hospital das Clínicas, Faculdade de Medicina

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  • article 5 Citação(ões) na Scopus
    Spirometric values in elderly asthmatic patients are not influenced by obesity
    (2012) AGONDI, R. C.; BISACCIONI, C.; AUN, M. V.; RIBEIRO, M. R.; KALIL, J.; GIAVINA-BIANCHI, P.
    Background Studies have suggested that asthma in obese individuals differs from the classic asthma phenotype, presenting as a disease that is more difficult to control. Objective The objective of the present study was to determine whether obesity, age or a combination of the two are associated with worse spirometry parameters in patients with asthma. Methods This was an observational cross-sectional study involving patients over 18 years of age who had been diagnosed with asthma (allergic or nonallergic). We evaluated the results of their spirometric tests. The patients were classified in accordance with two criteria: body mass index (BMI) and age. Based on their BMIs, the patients were divided into three groups: normal weight, overweight and obese. Patients were also separated into two categories by age: 18-59 years of age; and >= 60 years of age. Results We evaluated 451 patients with asthma and their spirometry tests. In the present study, the pulmonary function parameters were negatively correlated with BMI and age (P < 0.05). We found that there was a statistically significant correlation between spirometric values and BMI among patients 18-59 years of age (P < 0.001), however, among patients over 60, we did not observe this negative association. Conclusions and Clinical Relevance The spirometric values decreased significantly in proportion to the increase of BMI and age in patients with asthma, especially among young adults. There was no negative correlation between BMI and FEV1 in the group >= 60 years of age, suggesting that perhaps the time of disease is a major factor in the loss of lung function than weight gain in the elderly.
  • article 0 Citação(ões) na Scopus
    Hypersensitivity to dipyrone in aspirin-exacerbated respiratory disease patients is associated with urticaria
    (2020) AGONDI, Rosana Camara; DIAS, Gabriella Melo Fontes Silva; ASSIS, Joao Paulo de; PACHECO, Rosilane; KALIL, Jorge; GIAVINA-BIANCHI, Pedro
    Objective: To phenotype patients with aspirin-exacerbated respiratory disease (AERD) according to the presence of atopy, urticaria and level of peripheral eosinophils. Methods: This study included adult asthmatic patients with AERD followed up at a tertiary hospital. They were classified according to atopy and/or urticaria, assessing clinical and laboratorial differences among the groups in order to identify possible aggravating factors of the disease. Results: We included 73 patients, 78.1% being female with a mean age of 54.0 years. Severe asthma was observed in 68.5% and respiratory exacerbation with dipyrone in 67.1% of these patients. They had median total serum IgE of 191.6 IU/mL, mean peripheral eosinophils of 718.5 cells/mm(3), and 50.7% were atopic. Urticaria was observed in 32.9% of them, and exacerbations were more often triggered by dipyrone (p = .016). Atopic patients were younger than nonatopic patients (p = .023), and had, on average, higher total serum IgE levels (p = .022). We observed a good correlation between asthma severity and peripheral eosinophils count (r(2) = 026; p = .021). Conclusions: In this study, severe asthma was highly prevalent in AERD patients. Likewise, urticaria was quite prevalent and its presence was associated with dipyrone induced hypersensitivity reaction. Atopy was found in half of the patients, with no association with asthma severity. Patients with higher levels of peripheral eosinophils had more severe asthma. Dypirone hypersensitivity may be a marker for concomitant respiratory and cutaneous hypersensitivity reactions.
  • article 21 Citação(ões) na Scopus
    Vocal cord dysfunction diagnosis may be improved by a screening check list
    (2016) PINTO, Lucia Helena Eduardo; AUN, Marcelo Vivolo; CUKIER-BLAJ, Sabrina; STELMACH, Rafael; CUKIER, Alberto; KALIL, Jorge; AGONDI, Rosana Camara; GIAVINA-BIANCHI, Pedro
    Background: Many patients with vocal cord dysfunction (VCD), with or without asthma, receive inappropriate treatment because they are misdiagnosed as having difficult-to-control asthma alone. We developed a clinical screening check list designed to aid the diagnosis of VCD. Methods: A prospective observational study involving 80 patients aged >= 8 years, diagnosed with severe asthma. After anamnesis and physical examination, physicians completed a check list with 6 questions to identify VCD, for which the answer ""yes"" counted one point. Then patients underwent spirometry and laryngoscopy. On the basis of the laryngoscopic findings, we created three patient groups: VCD (vocal cord adduction during inspiration, n = 14); unconfirmed VCD (inconclusive findings, n = 29); and control (normal findings, n = 37). We attempted to determine whether any of those groups were associated with the responses to individual questions or sets of questions on the check list. Results: The proportion of affirmative answers to the question ""Does pulmonary auscultation reveal wheezing, predominantly in the cervical region, and/or stridor?"" was significantly higher for the VCD group than for the other two groups (P = 0.006), notably in elderly patients. The variable ""4 or more affirmative answers"" was more common in VCD and unconfirmed VCD groups in comparison to controls (P = 0.022). Conclusions: A finding of wheezing or stridor on auscultation of the cervical region is suggestive of vocal cord dysfunction, especially in elderly patients, and such dysfunction can be confirmed through laryngoscopy. Our VCD screening check list proved to be useful in the screening of VCD among patients with severe asthma.
  • article 1 Citação(ões) na Scopus
    Identifying the Characteristics of Responders and Nonresponders in a Behavioral Intervention to Increase Physical Activity Among Patients With Moderate to Severe Asthma: Protocol for a Prospective Pragmatic Study
    (2023) LIMA, Fabiano Francisco de; LUNARDI, Adriana Claudia; PINHEIRO, David Halen Araujo; CARVALHO-PINTO, Regina Maria; STELMACH, Rafael; GIAVINA-BIANCHI, Pedro; AGONDI, Rosana Camara; CARVALHO, Celso R. F.
    Background: Previous research has suggested that most adults improve their asthma control after a short-term behavioral intervention program to increase physical activity in daily life (PADL). However, the characteristics of individuals who respond and do not respond to this intervention and the medium-term response remain unknown.Objective: This study aims to (1) identify the characteristics of adult responders and nonresponders with asthma to a behavioral intervention to increase physical activity and (2) evaluate the functional and clinical benefits in the medium term.Methods: This prospective pragmatic study will include adults with moderate to severe asthma who enroll in a behavioral intervention. All individuals will receive an educational program and an 8-week intervention to increase PADL (1 time/wk; up to 90 min/session). The educational program will be conducted in a class setting through group discussions and video presentations. Behavioral interventions will be based on the transtheoretical model using counseling, incentives, and individual feedback aiming to increase participation in physical activity. Motivational interviewing and guidelines for overcoming barriers will be used to stimulate individuals to reach their goals. Pre-and postintervention assessments will include the following: PADL (triaxial accelerometry), body composition (octopolar bioimpedance), barriers to PADL (questionnaire), clinical asthma control (Asthma Control Questionnaire), quality of life (Asthma Quality of Life Questionnaire), anxiety and depression levels (Hospital Anxiety and Depression Scale), and exacerbations. ""Responders"" to the intervention will be defined as those who demonstrate an increase in the number of daily steps (& GE;2500). Results: In December 2021, the clinical trial registration was approved. Recruitment and data collection for the trial is ongoing, and the results of this study are likely to be published in late 2024. Conclusions: The intervention will likely promote different effects according to the clinical characteristics of the individuals, including asthma control, age, anxiety and depression levels, obesity, and several comorbidities. Identifying individuals who respond or do not respond to behavioral interventions to increase PADL will help clinicians prescribe specific interventions to adults with asthma.Trial Registration: ClinicalTrials.gov NCT05159076; https://clinicaltrials.gov/ct2/show/NCT05159076International Registered Report Identifier (IRRID): DERR1-10.2196/49032
  • article 1 Citação(ões) na Scopus
    Diagnosis and treatment of systemic mastocytosis in Brazil: Recommendations of a multidisciplinary expert panel
    (2022) VELLOSO, Elvira D. Rodrigues Pereira; PADULLA, Georgia A.; CERQUEIRA, Ana Maria Mosca de; SOUSA, Adriana Martins de; SANDES, Alex Freire; TRAINA, Fabiola; SEGURO, Fernanda Salles; NOGUEIRA, Frederico Lisboa; PEREIRA, Grazielly de Fathima; BOECHAT, jose Laerte; PAGNANO, Katia Borgia Barbosa; MARCHI, Luan Lima; ENSINA, Luis Felipe; GIAVINA-BIANCHI, Mara; AUN, Marcelo Vivolo; AGONDI, Rosana Camara; SANTOS, Fabio Pires de Souza; GIAVINA-BIANCHI, Pedro
    Introduction: Systemic Mastocytosis comprises a group of neoplastic diseases character-ized by clonal expansion and infiltration of mast cells into several organs. The diagnosis and treatment of this disease may be challenging for non-specialists. Objective: Make suggestions or recommendations in Systemic Mastocytosis based in a panel of Brazil-ian specialists.Method and results: An online expert panel with 18 multidisciplinary specialists was con-vened to propose recommendations on the diagnosis and treatment of Systemic Mastocy-tosis in Brazil. Recommendations were based on discussions of topics and multiple-choice questions and were graded using the Oxford Centre for Evidence-Based Medicine 2011 Lev-els of Evidence Chart. Conclusion: Twenty-two recommendations or suggestions were proposed based on a litera-ture review and graded according to the findings.(c) 2022 Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular.
  • article 1 Citação(ões) na Scopus
    Asthma studies should be phenotype specific
    (2013) GIAVINA-BIANCHI, Pedro; AGONDI, Rosana Camara; KALIL, Jorge
  • article 17 Citação(ões) na Scopus
    Can patients with common variable immunodeficiency have allergic rhinitis?
    (2013) AGONDI, Rosana C.; BARROS, Myrthes T.; KOKRON, Cristina M.; COHON, Andrea; OLIVEIRA, Ana K. B.; KALIL, Jorge; GIAVINA-BIANCHI, Pedro
    Background: Rhinosinusitis is highly prevalent in patients with common variable immunodeficiency (CVID), and probably allergic rhinitis (AR) may be masked by a history of repeated respiratory infections. The diagnosis of AR is based on the patient's symptoms and detection of specific immunoglobulin E (IgE) to aeroallergens. This study was designed to identify rhinitis of probable allergic cause in patients with CVID. Methods: This study included 72 adult CVID patients. The patients were divided into three groups according to their history: suggestive of AR, nonallergic rhinitis, and without rhinitis. They were tested for total and specific IgE (in vivo and in vitro). Results: The patients' mean age was 38.2 years. A history of chronic rhinitis was observed in 59 (81.9%) of the cases, 31 of which (43%) had a history suggestive of AR. Patients with a history of rhinitis (whether allergic or nonallergic) presented an earlier onset of symptoms and diagnosis of CVID. Total IgE was undetectable in 86.1% of patients. AR was confirmed by detection of specific IgE to aeroallergens in only 5.6% of the patients. Conclusion: In CVID patients, chronic rhinitis may be allergic, because many have personal and family histories suggestive of atopy. However, in this study, allergy was confirmed by specific IgE detection in only 5.6% of cases. CVID patients with a history suggestive of AR commonly present negative results on traditional testing, so additional experiments may be necessary. One suggestion for the investigation of AR in CVID patients would be nasal provocation with the most prevalent allergens.
  • article 1 Citação(ões) na Scopus
    Multiple comorbidities in patients with long-lasting chronic spontaneous urticaria
    (2023) AGONDI, Rosana Camara; ARGOLO, Paula Natassya; MOUSINHO-FERNANDES, Mariana; GEHLEN, Bruna; KALIL, Jorge; MOTTA, Antonio Abilio
  • article 9 Citação(ões) na Scopus
    Worsening of asthma control after COVID-19
    (2022) AGONDI, Rosana Camara; MENECHINO, Natalia; MARINHO, Ana Karolina Barreto Berselli; KALIL, Jorge; GIAVINA-BIANCHI, Pedro
    BackgroundSARS-CoV-2 enters lung cells via angiotensin-converting enzyme 2 (ACE2) receptor. Several studies suggest that interleukin-13, an important cytokine involved in T2 inflammation, reduces ACE2 expression, and therefore, asthma would not be a significant risk factor for the development of severe COVID-19. However, several asthma-related risk factors should be valued during the concurrent occurrence of asthma and COVID-19. The purpose of this study was to compare the evolution of asthma in patients who had COVID-19 with those who did not have the disease. MethodsThis was an observational and retrospective study involving asthmatic patients followed up at a tertiary center. Patients were assessed for severity of asthma, atopy, comorbidities, and COVID-19. Worsening of asthma was considered when, during the period of Sept 2020 to Oct 2021, patients referred an increasing of asthma symptoms and a need to increment their maintenance therapy. ResultsThis study included 208 asthmatic patients, the mean age was 52.75 years, 79.81% were atopic asthmatics, and 59 (28.37%) had laboratory-confirmed coronavirus disease. Of all patients infected with the SARS-CoV-2, eleven (18.64%) needed hospitalization and required oxygen supply with an O2 mask. Comparing the worsening of asthma between patients who had COVID-19 and those who had not the disease, there was a statistically significant difference, 33.90 vs. 11.41%, respectively (p < 0.001). There was no statistical significance regarding asthma comorbidities. ConclusionThis study assessed a group of asthmatic patients that had COVID-19, and that although the respiratory symptoms related to COVID-19 were mild to moderate, a subgroup of these asthmatic patients evolved with a chronic worsening of their asthma requiring an increment in asthma medication to control the disease.
  • article 54 Citação(ões) na Scopus
    The global impact of the COVID-19 pandemic on the management and course of chronic urticaria
    (2021) KOCATURK, Emek; SALMAN, Andac; CHERREZ-OJEDA, Ivan; CRIADO, Paulo Ricardo; PETER, Jonny; COMERT-OZER, Elif; ABUZAKOUK, Mohamed; AGONDI, Rosana Camara; AL-AHMAD, Mona; ALTRICHTER, Sabine; ARNAOUT, Rand; ARRUDA, Luisa Karla; ASERO, Riccardo; BAUER, Andrea; BEN-SHOSHAN, Moshe; BERNSTEIN, Jonathan A.; BIZJAK, Mojca; BOCCON-GIBOD, Isabelle; BONNEKOH, Hanna; BOUILLET, Laurence; BRZOZA, Zenon; BUSSE, Paula; CAMPOS, Regis A.; CARNE, Emily; CONLON, Niall; CRIADO, Roberta F.; LIMA, Eduardo M. de Souza; DEMIR, Semra; DISSEMOND, Joachim; GUNAYDIN, Sibel Dogan; DOROFEEVA, Irina; ENSINA, Luis Felipe; ERTAS, Ragip; FERRUCCI, Silvia Mariel; FIGUERAS-NART, Ignasi; FOMINA, Daria; FRANKEN, Sylvie M.; FUKUNAGA, Atsushi; GIMENEZ-ARNAU, Ana M.; GODSE, Kiran; GONCALO, Margarida; GOTUA, Maia; GRATTAN, Clive; GUILLET, Carole; INOMATA, Naoko; JAKOB, Thilo; KARAKAYA, Gul; KASPERSKA-ZAJAC, Alicja; KATELARIS, Constance H.; KOSNIK, Mitja; KRASOWSKA, Dorota; KULTHANAN, Kanokvalai; KUMARAN, M. Sendhil; LANG, Claudia; LARCO-SOUSA, Jose Ignacio; LAZARIDOU, Elisavet; LESLIE, Tabi Anika; LIPPERT, Undine; LLOSA, Oscar Calderon; MAKRIS, Michael; MARSLAND, Alexander; V, Iris Medina; MESHKOVA, Raisa; PALITOT, Esther Bastos; PARISI, Claudio A. S.; PICKERT, Julia; RAMON, German D.; RODRIGUEZ-GONZALEZ, Monica; ROSARIO, Nelson; RUDENKO, Michael; RUTKOWSKI, Krzysztof; SANCHEZ, Jorge; SCHLIEMANN, Sibylle; SEKEREL, Bulent Enis; SERPA, Faradiba S.; SERRA-BALDRICH, Esther; SONG, Zhiqiang; SORIA, Angele; STAEVSKA, Maria; STAUBACH, Petra; TAGKA, Anna; TAKAHAGI, Shunsuke; THOMSEN, Simon Francis; TREUDLER, Regina; VADASZ, Zahava; VALLE, Solange Oliveira Rodrigues; DOORN, Martijn B. A. Van; VESTERGAARD, Christian; WAGNER, Nicola; WANG, Dahu; WANG, Liangchun; WEDI, Bettina; XEPAPADAKI, Paraskevi; YUCEL, Esra; ZALEWSKA-JANOWSKA, Anna; ZHAO, Zuotao; ZUBERBIER, Torsten; MAURER, Marcus
    Introduction The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. Materials and Methods Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. Conclusions The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.