BRUNO GUEDES BALDI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, 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
22 resultados
Resultados de Busca
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- Computed tomography in hypersensitivity pneumonitis: main findings, differential diagnosis and pitfalls(2018) DIAS, Olivia Meira; BALDI, Bruno Guedes; PENNATI, Francesca; ALIVERTI, Andrea; CHATE, Rodrigo Caruso; SAWAMURA, Marcio Valente Yamada; CARVALHO, Carlos Roberto Ribeiro de; ALBUQUERQUE, Andre Luis Pereira deIntroduction: Hypersensitivity pneumonitis (HP) is a disease with variable clinical presentation in which inflammation in the lung parenchyma is caused by the inhalation of specific organic antigens or low molecular weight substances in genetically susceptible individuals. Alterations of the acute, subacute and chronic forms may eventually overlap, and the diagnosis based on temporality and presence of fibrosis (acute/inflammatory HP vs. chronic HP) seems to be more feasible and useful in clinical practice. Differential diagnosis of chronic HP with other interstitial fibrotic diseases is challenging due to the overlap of the clinical history, and the functional and imaging findings of these pathologies in the terminal stages.Areas covered: This article reviews the essential features of HP with emphasis on imaging features. Moreover, the main methodological limitations of high-resolution computed tomography (HRCT) interpretation are discussed, as well as new perspectives with volumetric quantitative CT analysis as a useful tool for retrieving detailed and accurate information from the lung parenchyma.Expert commentary: Mosaic attenuation is a prominent feature of this disease, but air trapping in chronic HP seems overestimated. Quantitative analysis has the potential to estimate the involvement of the pulmonary parenchyma more accurately and could correlate better with pulmonary function results.
- Texture-based classification of lung disease patterns in chronic hypersensitivity pneumonitis and comparison to clinical outcomes(2021) PENNATI, F.; ALIBONI, L.; ANTONIAZZA, A.; BERETTA, D.; DIAS, O.; BALDI, B. G.; SAWAMURA, M.; CHATE, R. C.; CARVALHO, C. R. R. De; ALBUQUERQUE, A.; ALIVERTI, A.Computer-aided detection algorithms applied to CT lung imaging have the potential to objectively quantify pulmonary pathology. We aim to develop an automatic classification method based on textural features able to classify healthy and pathological patterns on CT lung images and to quantify the extent of each disease pattern in a group of patients with chronic hypersensitivity pneumonitis (cHP), in comparison to pulmonary function tests (PFTs). 27 cHP patients were scanned via high resolution CT (HRCT) at full-inspiration. Regions of interest (ROIs) were extracted and labeled as normal (NOR), ground glass opacity (GGO), reticulation (RET), consolidation (C), honeycombing (HB) and air trapping (AT). For each ROI, statistical, morphological and fractal parameters were computed. For automatic classification, we compared two classification methods (Bayesian and Support Vector Machine) and three ROI sizes. The classifier was therefore applied to the overall CT images and the extent of each class was calculated and compared to PFTs. Better classification accuracy was found for the Bayesian classifier and the 16x16 ROI size: 92.1 +/- 2.7%. The extent of GGO, HB and NOR significantly correlated with forced vital capacity (FVC) and the extent of NOR with carbon monoxide diffusing capacity (DLCO).
- Mechanisms of Exercise Limitation and Prevalence of Pulmonary Hypertension in Pulmonary Langerhans Cell Histiocytosis(2020) HEIDEN, Glaucia Itamaro; SOBRAL, Juliana Barbosa; FREITAS, Carolina Salim Goncalves; ALBUQUERQUE, Andre Luis Pereira de; SALGE, Joao Marcos; KAIRALLA, Ronaldo Adib; FERNANDES, Caio Julio Cesar dos Santos; CARVALHO, Carlos Roberto Ribeiro; SOUZA, Rogerio; BALDI, Bruno GuedesBACKGROUND: Pulmonary Langerhans cell histiocytosis (PLCH) determines reduced exercise capacity. The speculated mechanisms of exercise impairment in PLCH are ventilatory and cardiocirculatory limitations, including pulmonary hypertension (PH). RESEARCH QUESTION: What are the mechanisms of exercise limitation, the exercise capacity , and the prevalence of dynamic hyperinflation (DH) and PH in PLCH? STUDY DESIGN AND METHODS: In a cross-sectional study, patients with PLCH underwent an incremental treadmill cardiopulmonary exercise test with an evaluation of DH, pulmonary function tests, and transthoracic echocardiography. Those patients with lung diffusing capacity for carbon monoxide (D-LCO) < 40% predicted and/or transthoracic echocardiogram with tricuspid regurgitation velocity > 2.5 m/s and/or with indirect PH signs underwent right heart catheterization. RESULTS: Thirty-five patients were included (68% women; mean age, 47 +/- 11 years). Ventilatory and cardiocirculatory limitations, impairment suggestive of PH, and impaired gas exchange occurred in 88%, 67%, 29%, and 88% of patients, respectively. The limitation was multifactorial in 71%, exercise capacity was reduced in 71%, and DH occurred in 68% of patients. FEV1 and D-LCO were 64 +/- 22% predicted and 56 +/- 21% predicted. Reduction in D-LCO, an obstructive pattern, and air trapping occurred in 80%, 77%, and 37% of patients. FEV1 and D-LCO were good predictors of exercise capacity. The prevalence of PH was 41%, predominantly with a precapillary pattern, and mean pulmonary artery pressure correlated best with FEV1 and tricuspid regurgitation velocity. INTERPRETATION: PH is frequent and exercise impairment is common and multifactorial in PLCH. The most prevalent mechanisms are ventilatory, cardiocirculatory, and suggestive of PH limitations.
- Hiperinsuflação dinâmica no esforço: ainda muito a ser esclarecido(2012) ALBUQUERQUE, Andre Luis Pereira de; BALDI, Bruno Guedes
- Metabolomic spittle analysis of post COVID-19 patients(2022) MACHADO, L.; PRUDENTE, R.; FRANCO, E.; GATTO, M.; MOTA, G.; PAGAN, L.; BRIZOLA, L.; SANTOS, M. Dos; CUNHA, T.; SABINO-SILVA, R.; FILHO, L.; MARTINS, M.; SANTOS, P.; MAIA, L.; ALBUQUERQUE, A.; MACHADO, E.; BALDI, B.; TANNI, S.
- A textural approach for quantitative CT in chronic hypersensitivity pneumonitis (cHP)(2019) PENNATI, Francesca; DIAS, Olivia; ANTONIAZZA, Alessio; BERETTA, Davide; ALIBONI, Lorenzo; BALDI, Bruno Guedes; SAWAMURA, Marcio; CHATE, Rodrigo Caruso; CARVALHO, Carlos Roberto Ribeiro De; ALBUQUERQUE, Andre; ALIVERTI, Andrea
- Exercise in patients with pulmonary Langerhans cell histiocytosis: performance and mechanisms of limitation(2017) HEIDEN, Glaucia Itamaro; FREITAS, Carolina; SOBRAL, Juliana Barbosa; KAIRALLA, Ronaldo; CARVALHO, Carlos Roberto; SALGE, Joao Marcos; ALBUQUERQUE, Andre Luis; SOUZA, Rogerio; BALDI, Bruno
- Post-COVID-19 tomographic abnormalities(2022) SAWAMURA, M. V. Y.; VERRASTRO, C. G. Y.; FERREIRA, E. V. M.; ALBUQUERQUE, A. L. P. de; RIBEIRO, S. M.; V, R. Auad; SPERANDIO, P. C. de Abreu; SOUZA, V. C.; LIMA, M. L.; PRUDENTE, R. A.; FRANCO, E. T.; FRANCO, A. C.; BALDI, B. G.; TANNI, S. E.BACKGROUND: The prevalence of persistent respiratory symptoms tends to be low in patients with a longer recovery time after COVID-19. However, some patients may present persistent pulmonary abnormalities. OBJECTIVE: To evaluate the prevalence of tomographic abnormalities 90 days after symptom onset in patients with COVID-19 and compare two chest high-resolution computed tomography (HRCT) analysis techniques. METHODS: A multicentre study of patients hospitalised with COVID-19 having oxygen saturation <93% on room air at hospital admission were evaluated using pulmonary function and HRCT scans 90 days after symptom onset. The images were evaluated by two thoracic radiologists, and were assessed using software that automatically quantified the extent of pulmonary abnormalities. RESULTS: Of the 91 patients included, 81% had at least one pulmonary lobe with abnormalities 90 days after discharge (84% were identified using the automated algorithm). Ground-glass opacities (76%) and parenchymal bands (65%) were the predominant abnormalities. Both chest HRCT technical assessments presented high sensitivity (95.9%) and positive predictive value (92%), with a statistically significant correlation at baseline (R = 0.80) and after 90 days (R = 0.36). CONCLUSION: The prevalence of pulmonary abnormalities on chest HRCT 90 days after symptom onset due to COVID-19 was high; both technical assessments can be used to analyse the images.
- Persistent interstitial lung abnormalities in post- COVID-19 patients: a case series(2021) LAGO, Vanessa Carvalho; PRUDENTE, Robson Aparecido; LUZIA, Dayane Araujo; FRANCO, Estefania Thome; CEZARE, Talita Jacon; PERALTA, Amanda; FERREIRA, Eloara Vieira M.; ALBUQUERQUE, Andre Luis Pereira; OKOSHI, Marina Politi; BALDI, Bruno Guedes; TANNI, Suzana EricoA new concept of multisystem disease has emerged as a long-term condition following mild-severe COVID-19 infection. The main symptoms of this affection are breathlessness, chest pain, and fatigue. We present here the clinical case of four COVID-19 patients during hospitalization and 60 days after hospital discharge. Physiological impairment of all patients was assessed by spirometry, dyspnea score, arterial blood gas, and 6-minute walk test 60 days after hospital discharge, and computed tomographic scan 90 days after discharge. All patients had fatigue, which was not related to hypoxemia or impaired spirometry values, and interstitial lung alterations, which occurred in both mechanically ventilated and non-mechanically ventilated patients. In conclusion, identifying the prevalence and patterns of permanent lung damage is paramount in preventing and treating COVID-19-induced fibrotic lung disease. Additionally, and based on our preliminary results, it will be also relevant to establish long-term outpatient programs for these individuals.
- Pulmonary fibrosis secondary to COVID-19: a narrative review(2021) TANNI, Suzana Erico; FABRO, Alexandre Todorovic; ALBUQUERQUE, Andre de; FERREIRA, Eloara Vieira Machado; VERRASTRO, Carlos Gustavo Yuji; SAWAMURA, Marcio Valente Yamada; RIBEIRO, Sergio Marrone; BALDI, Bruno GuedesIntroduction: Coronavirus disease 2019 (COVID-19) is still increasing worldwide, and as a result, the number of patients with pulmonary fibrosis secondary to COVID-19 will expand over time. Risk factors, histopathological characterization, pathophysiology, prevalence, and management of post-COVID-19 pulmonary fibrosis are poorly understood, and few studies have addressed these issues.Areas covered:This article reviews the current evidence regarding post-COVID-19 pulmonary fibrosis, with an emphasis on the potential risk factors, histopathology, pathophysiology, functional and tomographic features, and potential therapeutic modalities. A search on the issue was performed in the MEDLINE, Embase, and SciELO databases and the Cochrane library between 1 December 2019, and 25 January 2021. Studies were reviewed and relevant topics were incorporated into this narrative review. Expert opinion: Pulmonary sequelae may occur secondary to COVID-19, which needs to be included as a potential etiology in the current differential diagnosis of pulmonary fibrosis. Therefore, serial clinical, tomographic, and functional screening for pulmonary fibrosis is recommended after COVID-19, mainly in patients with pulmonary involvement in the acute phase of the disease. Further studies are necessary to determine the risk factors, markers, pathophysiology, and appropriate management of post-COVID-19 pulmonary fibrosis.
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