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
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
conferenceObject Evaluation Of The Functional Impact Of The Use Of Doxycycline For Three Years In Patients With Lymphangioleiomyomatosis(2014) BALDI, B. G.; PIMENTA, S. P.; ARAUJO, M. S.; FREITAS, C. S. G.; KAIRALLA, R. A.; CARVALHO, C. R. R.conferenceObject Rapamycin As Treatment Of Lymphangioleiomyomatosis: Favorable Response In Different Clinical Manifestations(2014) FREITAS, C. S. G.; ARAUJO, M. S.; BALDI, B. G.; KAIRALLA, R. A.; CARVALHO, C. R. R.article 25 Citação(ões) na Scopus CLINICAL COURSE AND CHARACTERISATION OF LYMPHANGIOLEIOMYOMATOSIS IN A BRAZILIAN REFERENCE CENTRE(2014) BALDI, B. Guedes; SALIM, C.; FREITAS, G.; ARAUJO, M. Sponholz; DIAS, O. Meira; PEREIRA, D. A. Silva; PIMENTA, S. Pinheiro; KAIRALLA, R. A.; CARVALHO, C. R. RibeiroBackground and objective: Lymphangioleiomyomatosis (LAM) is a rare disease that promotes pulmonary cystic destruction and impairs pulmonary function. We aim to describe features and clinical course of LAM patients from Brazil. Methods: We described the clinical and functional features, performance in six minute walk test (6MWT), management details, survival and clinical course of 84 LAM patients followed in a Brazilian reference centre. Results: All subjects were women, the average age at onset of symptoms was 38 years, and the average at diagnosis was 42 years. The major symptoms during the course of the disease were dyspnoea and pneumothorax. The patients experienced impaired quality of life, with worse scores in the physical and emotional domains. The most common abnormalities in pulmonary function tests were an obstructive pattern and reduced diffusion capacity, whereas a quarter of the patients had normal spirometric results. In the 6MWT, although patients had preserved exercise capacity, more than half of the patients had significant desaturation. Hormonal blockage and doxycycline were the most common treatment modalities employed in our patients. The survival probability from diagnosis was 90% at 5 years, whereas the mean annual rate of decline in FEV1 was 60 +/- 78 mL. Conclusions: Clinical and functional features of the LAM patients from our centre are similar to those from other countries. Our sample showed preserved exercise capacity, with desaturation in the 6MWT, and impaired quality of life. Survival was similar, whereas the annual rate of decline of FEV1 was slightly lower than in recent studies.- Use of sirolimus in the treatment of lymphangioleiomyomatosis: favorable responses in patients with different extrapulmonary manifestations(2015) FREITAS, Carolina Salim Gonçalves; BALDI, Bruno Guedes; ARAÚJO, Mariana Sponholz; HEIDEN, Glaucia Itamaro; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto RibeiroOBJECTIVE: Lymphangioleiomyomatosis (LAM) is a rare disease that is currently considered a low-grade neoplasm with metastatic potential and variable progression. Mammalian target of rapamycin (mTOR) inhibitors, such as sirolimus and everolimus, have recently become a treatment option for LAM patients, especially those with extrapulmonary manifestations. The objective of the present study was to describe a case series of four patients with LAM in Brazil who showed significant improvement, particularly in their extrapulmonary manifestations, after treatment with sirolimus (at 1-4 mg/day). METHODS: We describe four cases of LAM patients with different extrapulmonary manifestations who were treated with sirolimus. RESULTS: After treatment with sirolimus for 12 months, one patient presented resolution of severe chylothorax; one had a significant reduction in renal angiomyolipoma volume; and one showed significant regression of retroperitoneal lymphangioleiomyomas and abdominal lymph node enlargement. After treatment with sirolimus for 6 months, the remaining patient had a significant reduction in the volume of a massive retroperitoneal lymphangioleiomyoma. CONCLUSIONS: Our findings confirm that mTOR inhibitors are beneficial for patients with LAM, especially those with extrapulmonary manifestations, such as renal angiomyolipoma, lymphangioleiomyomas, and chylous effusions. However, certain aspects, such as the optimal dose, duration of treatment, and long-term adverse effects, have yet to be sufficiently clarified for mTOR inhibitors to be incorporated into LAM management protocols.
conferenceObject Evaluation and correlations of the extension of pulmonary cysts in lymphangioleiomyomatosis(2013) ARAUJO, Mariana Sponholz; FREITAS, Carolina Salim Goncalves; BALDI, Bruno Guedes; TELES, Gustavo Borges da Silva; PIMENTA, Suzana Pinheiro; PEREIRA, Daniel Antunes Silva; DIAS, Olivia Meira; COSTA, Andre Nathan; KAWANO-DOURADO, Leticia; KAWASSAKI, Alexandre; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto Ribeiro- Pulmonary rehabilitation in lymphangioleiomyomatosis: a controlled clinical trial(2016) ARAUJO, Mariana S.; BALDI, Bruno G.; FREITAS, Carolina S. G.; ALBUQUERQUE, Andre L. P.; SILVA, Cibele C. B. Marques da; KAIRALLA, Ronaldo A.; CARVALHO, Celso R. F.; CARVALHO, Carlos R. R.Lymphangioleiomyomatosis (LAM) is a cystic lung disease frequently associated with reduced exercise capacity. The aim of this study was to assess safety and efficacy of pulmonary rehabilitation in LAM. This controlled clinical trial included 40 patients with LAM and a low physical activity level. The pulmonary rehabilitation programme comprised 24 aerobic and muscle strength training sessions and education. The primary outcome was exercise capacity (endurance time during a constant work rate exercise test). Secondary outcomes included health-related quality of life (St George's Respiratory Questionnaire (SGRQ)), 6-min walking distance (6MWD), dyspnoea, peak oxygen consumption (V'O-2), daily physical activity (pedometer), symptoms of anxiety and depression, lung function and peripheral muscle strength (one-repetition maximum). The baseline characteristics were well balanced between the groups. The pulmonary rehabilitation group exhibited improvements in the following outcomes versus controls: endurance time (median (interquartile range) 169 (2-303) s versus -33 (-129-39) s; p=0.001), SGRQ (median (interquartile range) -8 (-16-2) versus 2 (-4-5); p=0.002) and 6MWD (median (interquartile range) 59 (13-81) m versus 20 (-12-30) m; p=0.002). Dyspnoea, peak V'O-2, daily physical activity and muscle strength also improved significantly. No serious adverse events were observed. Pulmonary rehabilitation is a safe intervention and improves exercise capacity, dyspnoea, daily physical activity, quality of life and muscle strength in LAM.
conferenceObject Characterization of 76 patients with lymphangioleiomyomatosis from a Brazilian reference center(2012) FREITAS, Carolina; ARAUJO, Mariana; BALDI, Bruno; PIMENTA, Suzana; KAIRALLA, Ronaldo; CARVALHO, Carlos RobertoconferenceObject Interstitial Lung Disease As A Marker Of Systemic Autoimmunity: Repeated Autoantibody Measure Can Uncover An Occult Connective Tissue Disease(2014) PEREIRA, D. A. S.; BALDI, B. G.; KAWASSAKI, A. M.; KAWANO-DOURADO, L.; DIAS, O. M.; FREITAS, C. S. G.; ARAUJO, M. S.; KAIRALLA, R. A.; CARVALHO, C. R. R.- Evaluation of the impact of a pulmonary rehabilitation program on exercise capacity in LAM(2015) ARAUJO, Mariana Sponholz; BALDI, Bruno Guedes; ALBUQUERQUE, Andre Luis Pereira de; FREITAS, Carolina Salim Goncalves; KAIRALLA, Ronaldo Adib; CARVALHO, Celso Ricardo Fernandes de; CARVALHO, Carlos Roberto Ribeiro de
conferenceObject Retrospective Cohort Of Neurosarcoidosis Patients From A Reference Center In Brazil: The Underestimation Of A Relevant Feature(2014) FELISBINO, M. B.; PEREIRA, D. A. S.; COSTA, A. N.; ARAUJO, M. S.; KAWASSAKI, A. M.; FREITAS, C. S.; KAWANO-DOURADO, L.; DIAS, O. M.; BALDI, B. G.; KAIRALLA, R. A.