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
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conferenceObject Peribronchiolar Metaplasia Associated to Interstitial Lung Disease: A Case Report(2022) SANTOS, G. D.; BRIDI, G. D.; SAAVEDRA, N. L. M.; VASCONCELOS, A.; SILVA, N. F.; ALMEIDA, G. C.; NASCIMENTO, E. C. T.; ARIMURA, F. E.; AMARAL, A. F.; BALDI, B. G.; KAIRALLA, R. A.- 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.
- Pulmonary Hypertension in Interstitial Lung Disease(2022) BALDI, Bruno Guedes; SOUZA, Rogerio
- Something not so new for lymphangioleiomyomatosis: is VEGF-D a glass half empty or half full?(2022) AMARAL, Alexandre Franco; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno Guedes
- 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.
- COVID-19 in Lymphangioleiomyomatosis An International Study of Outcomes and Impact of Mechanistic Target of Rapamycin Inhibition(2022) BALDI, Bruno Guedes; RADZIKOWSKA, Elzbieta; COTTIN, Vincent; DILLING, Daniel F.; ATAYA, Ali; CARVALHO, Carlos Roberto Ribeiro; HARARI, Sergio; KOSLOW, Matthew; GRUTTERS, Jan C.; INOUE, Yoshikazu; GUPTA, Nishant; JOHNSON, Simon R.
- Repercussions of the COVID-19 pandemic for science and for the management of the Jornal Brasileiro de Pneumologia(2022) BALDI, Bruno Guedes; PIZZICHIN, Marcia Margaret Menezes
- Quantitative CT Analysis in Chronic Hypersensitivity Pneumonitis: A Convolutional Neural Network Approach(2022) ALIBONI, Lorenzo; DIAS, Olivia Meira; PENNATI, Francesca; BALDI, Bruno Guedes; SAWAMURA, Marcio Valente Yamada; CHATE, Rodrigo Caruso; CARVALHO, Carlos Roberto Ribeiro; ALBUQUERQUE, Andre Luis Pereira de; ALIVERTI, AndreaRationale and Objectives: Chronic hypersensitivity pneumonitis (cHP) is a heterogeneous condition, where both small airway involvement and fibrosis may simultaneously occur. Computer-aided analysis of CT lung imaging is increasingly used to improve tissue characterization in interstitial lung diseases (ILD), quantifying disease extension, and progression. We aimed to quantify via a convolutional neural network (CNN) method the extent of different pathological classes in cHP, and to determine their correlation to pulmonary function tests (PFTs) and mosaic attenuation pattern. Materials and Methods: The extension of six textural features, including consolidation (C), ground glass opacity (GGO), fibrosis (F), low attenuation areas (LAA), reticulation (R) and healthy regions (H), was quantified in 27 cHP patients (age: 56 +/- 11.5 years, forced vital capacity [FVC]% = 57 +/- 17) acquired at full-inspiration via HRCT. Each class extent was correlated to PFTs and to mosaic attenuation pattern. Results: H showed a positive correlation with FVC%, FEV1% (forced expiratory volume), total lung capacity%, and diffusion of carbon monoxide (DLCO)% (r = 0.74, r = 0.78, r = 0.73, and r = 0.60, respectively, p < 0.001). GGO, R and C negatively correlated with FVC% and FEV1% with the highest correlations found for R (r = -0.44, and r = -0.46 respectively, p < 0.05); F negatively correlated with DLCO% (r = -0.42, p < 0.05). Patients with mosaic attenuation pattern had significantly more H (p = 0.04) and lower R (p = 0.02) and C (p = 0.0009) areas, and more preserved lung function indices (higher FVC%; p = 0.04 and DLCO%; p = 0.05), but did not show more air trapping in lung function tests. Conclusion: CNN quantification of pathological tissue extent in cHP improves its characterization and shows correlation with PFTs. LAA can be overestimated by visual, qualitative CT assessment and mosaic attenuation pattern areas in cHP represents patchy ILD rather than small-airways disease.
bookPart Tabagismo - situações em que o pediatra pode ajudar(2022) LOTUFO, João Paulo Becker; FERNANDES, Frederico Leon Arrabal; BALDI, Bruno Guedes- A Convolutional Neural Network Approach to Quantify Lung Disease Progression in Patients with Fibrotic Hypersensitivity Pneumonitis (HP)(2022) ALIBONI, Lorenzo; DIAS, Olivia Meira; BALDI, Bruno Guedes; SAWAMURA, Marcio Valente Yamada; CHATE, Rodrigo Caruso; CARVALHO, Carlos Roberto Ribeiro; ALBUQUERQUE, Andre Luis Pereira de; ALIVERTI, Andrea; PENNATI, FrancescaRationale and Objectives To evaluate associations between longitudinal changes of quantitative CT parameters and spirometry in patients with fibrotic hypersensitivity pneumonitis (HP). Materials and Methods Serial CT images and spirometric data were retrospectively collected in a group of 25 fibrotic HP patients. Quantitative CT analysis included histogram parameters (median, interquartile range, skewness, and kurtosis) and a pretrained convolutional neural network (CNN)-based textural analysis, aimed at quantifying the extent of consolidation (C), fibrosis (F), ground-glass opacity (GGO), low attenuation areas (LAA) and healthy tissue (H). Results At baseline, Ric was 61(44-70) %pred. The median follow-up period was 1.4(0.8-3.2) years, with 3(2-4) visits per patient. Over the study, 8 patients (32%) showed a FVC decline of more than 5%, a significant worsening of all histogram parameters (p <= 0.015) and an increased extent of fibrosis via CNN (p=0.038). On histogram analysis, decreased skewness and kurtosis were the parameters most strongly associated with worsened FVC (respectively, r2=0.63 and r2=0.54, p<0.001). On CNN classification, increased extent of fibrosis and consolidation were the measures most strongly correlated with FVC decline (r2=0.54 and r2=0.44, p<0.001). Conclusion CT histogram and CNN measurements provide sensitive measures of functional changes in fibrotic HP patients over time. Increased fibrosis was associated with FVC decline, providing index of disease progression. CNN may help improve fibrotic HP follow-up, providing a sensitive tool for progressive interstitial changes, which can potentially contribute to clinical decisions for individualizing disease management.