OLIVIA MEIRA DIAS
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
14 resultados
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- Colagenose pulmão dominante em pacientes com doença pulmonar intersticial: prevalência, estabilidade funcional e manifestações extratorácicas comuns(2015) PEREIRA, Daniel Antunes Silva; DIAS, Olivia Meira; ALMEIDA, Guilherme Eler de; ARAUJO, Mariana Sponholz; KAWANO-DOURADO, Leticia Barbosa; BALDI, Bruno Guedes; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto RibeiroObjective: To describe the characteristics of a cohort of patients with lung-dominant connective tissue disease (LD-CTD). Methods: This was a retrospective study of patients with interstitial lung disease (ILD), positive antinuclear antibody (ANA) results (>= 1/320), with or without specific autoantibodies, and at least one clinical feature suggestive of connective tissue disease (CO). Results: Of the 1,998 patients screened, 52 initially met the criteria for a diagnosis of LD-CTD: 37% were male; the mean age at diagnosis was 56 years; and the median follow-up period was 48 months. During follow-up, 8 patients met the criteria for a definitive diagnosis of a CTD. The remaining 44 patients comprised the LD-CTD group, in which the most prevalent extrathoracic features were arthralgia, gastroesophageal reflux disease, and Raynaud's phenomenon. The most prevalent autoantibodies in this group were ANA (89%) and anti-SSA (anti-Ro, 27%). The mean baseline and final FVC was 69.5% and 74.0% of the predicted values, respectively (p > 0.05). Nonspecific interstitial pneumonia and usual interstitial pneumonia patterns were found in 45% and 9% of HRCT scans, respectively; 36% of the scans were unclassifiable. A similar prevalence was noted in histological samples. Diffuse esophageal dilatation was identified in 52% of HRCT scans. Nailfold capillaroscopy was performed in 22 patients; 17 showed a scleroderma pattern. Conclusions: In our LD-CTD group, there was predominance of females and the patients showed mild spirometric abnormalities at diagnosis, with differing underlying ILD patterns that were mostly unclassifiable on HRCT and by histology. We found functional stability on follow-up. Esophageal dilatation on HRCT and scleroderma pattern on nailfold capillaroscopy were frequent findings and might come to serve as diagnostic criteria.
- Doenças pulmonares císticas difusas: diagnóstico diferencial(2017) BALDI, Bruno Guedes; CARVALHO, Carlos Roberto Ribeiro; DIAS, Olivia Meira; MARCHIORI, Edson; HOCHHEGGER, BrunoAs doenças pulmonares císticas difusas se caracterizam pela presença de cistos envolvendo mais de um lobo pulmonar, que se originam por diversos mecanismos, incluindo dilatação dos espaços aéreos distais por obstrução, necrose das paredes das vias aéreas e destruição do parênquima. Essas doenças apresentam evolução variável. A TCAR é fundamental na avaliação dessas doenças uma vez que permite uma melhor caracterização dos cistos pulmonares, incluindo sua distribuição, tamanho, extensão e regularidade das paredes, assim como a determinação de outras lesões pulmonares e extrapulmonares associadas. Frequentemente a TCAR é suficiente para a definição etiológica dos cistos pulmonares difusos, associada a achados clínicos e laboratoriais, sem a necessidade de realização de biópsia pulmonar. O diagnóstico diferencial das doenças pulmonares císticas difusas é extenso, incluindo etiologias neoplásicas, inflamatórias e infecciosas, sendo as mais frequentes determinantes desse padrão tomográfico a histiocitose pulmonar de células de Langerhans, a linfangioleiomiomatose, a pneumonia intersticial linfocitária e a bronquiolite folicular. Novas etiologias foram incluídas como potenciais determinantes desse padrão.
- Idiopathic pulmonary fibrosis can be a transient diagnosis(2016) OLIVEIRA, Martina Rodrigues de; PEREIRA, Daniel Antunes Silva; DIAS, Olivia Meira; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno Guedes
- Immunoglobulin G4-related systemic sclerosing disease in a patient with sclerosing cholangitis, inflammatory pseudotumors of the lung and multiple radiological patterns: a case report(2011) DIAS, Olivia Meira; KAWASSAKI, Alexandre de Melo; HAGA, Hironori; CUKIER, Alberto; CARVALHO, Carlos Roberto Ribeiro
- Combined pulmonary fibrosis and emphysema: an increasingly recognized condition(2014) DIAS, Olivia Meira; BALDI, Bruno Guedes; COSTA, Andre Nathan; CARVALHO, Carlos Roberto RibeiroCombined pulmonary fibrosis and emphysema (CPFE) has been increasingly recognized in the literature. Patients with CPFE are usually heavy smokers or former smokers with concomitant lower lobe fibrosis and upper lobe emphysema on chest HRCT scans. They commonly present with severe breathlessness and low DLCO, despite spirometry showing relatively preserved lung volumes. Moderate to severe pulmonary arterial hypertension is common in such patients, who are also at an increased risk of developing lung cancer. Unfortunately, there is currently no effective treatment for CPFE. In this review, we discuss the current knowledge of the pathogenesis, clinical characteristics, and prognostic factors of CPFE. Given that most of the published data on CPFE are based on retrospective analysis, more studies are needed in order to address the role of emphysema and its subtypes; the progression of fibrosis/emphysema and its correlation with inflammation; treatment options; and prognosis.
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- Transient Lymphadenopathy Secondary to Nephrotic Syndrome(2012) DIAS, Olivia Meira; COSTA, Andre Nathan; CARVALHO, Carlos Roberto Ribeiro; KAIRALLA, Ronaldo AdibMediastinal lymphadenomegaly secondary to hypervolemia is an underdiagnosed tomographic finding. Herein we describe, in a patient with normal cardiac function, findings of pulmonary congestion associated to lymph node enlargement. The nephrotic syndrome causing hypoalbuminemia, low plasma colloid osmotic pressure and augmented transcapillary fluid leakage was the probable cause of the radiological findings.
- Mechanisms of exercise limitation in patients with chronic hypersensitivity pneumonitis(2018) DIAS, Olivia Meira; BALDI, Bruno Guedes; FERREIRA, Jeferson George; CARDENAS, Leticia Zumpano; PENNATI, Francesca; SALITO, Caterina; CARVALHO, Carlos Roberto Ribeiro; ALIVERTI, Andrea; ALBUQUERQUE, Andre Luis Pereira deSmall airway and interstitial pulmonary involvements are prominent in chronic hypersensitivity pneumonitis (cHP). However, their roles on exercise limitation and the relationship with functional lung tests have not been studied in detail. Our aim was to evaluate exercise performance and its determinants in cHP. We evaluated maximal cardiopulmonary exercise testing performance in 28 cHP patients (forced vital capacity 57 +/- 17% pred) and 18 healthy controls during cycling. Patients had reduced exercise performance with lower peak oxygen production (16.6 (12.3-19.98) mL.kg(-1).min(-1) versus 25.1 (16.9-32.0), p=0.003), diminished breathing reserve (% maximal voluntary ventilation) (12 (6.4-34.8)% versus 41 (32.7-50.8)%, p<0.001) and hyperventilation (minute ventilation/carbon dioxide production slope 37 +/- 5 versus 31 +/- 4, p<0.001). All patients presented oxygen desaturation and augmented Borg dyspnoea scores (8 (5-10) versus 4 (1-7), p=0.004). The prevalence of dynamic hyperinflation was found in only 18% of patients. When comparing cHP patients with normal and low peak oxygen production (<84% pred, lower limit of normal), the latter exhibited a higher minute ventilation/carbon dioxide production slope (39 +/- 5.0 versus 34 +/- 3.6, p=0.004), lower tidal volume (0.84 (0.78-0.90) L versus 1.15 (0.97-1.67) L, p=0.002), and poorer physical functioning score on the Short form-36 health survey. Receiver operating characteristic curve analysis showed that reduced lung volumes (forced vital capacity %, total lung capacity % and diffusing capacity of the lung for carbon dioxide %) were high predictors of poor exercise capacity. Reduced exercise capacity was prevalent in patients because of ventilatory limitation and not due to dynamic hyperinflation. Reduced lung volumes were reliable predictors of lower performance during exercise.
- Natural history of incidental sporadic and tuberous sclerosis complex associated lymphangioleiomyomatosis(2020) MARCO, Fabiano Di; TERRANEO, Silvia; DIAS, Olivia Meira; IMERI, Gianluca; CENTANNI, Stefano; RINALDO, Rocco Francesco; GIULIANI, Lisa; LESMA, Elena; PALUMBO, Giuseppina; WANDERLEY, Mark; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno GuedesLymphangioleiomyiomatosis (LAM) is a rare disease affecting women in childbearing age. A sporadic form (SLAM) affecting previously healthy women, and a form associated with Tuberous Sclerosis Complex (TSC-LAM) are described. Some data suggested that TSC-LAM could be a milder disease compared to S-LAM. To investigate whether the different disease behavior is real or due to overdiagnosis of screened TSC women, we compared the natural history of S-LAM and TSC-LAM in patients with incidental diagnosis. Clinical, and functional data from 52 patients (23 with S-LAM and 29 with TSC-LAM) were analysed. At diagnosis functional impairment was mild without differences between groups [FEV1 % pred was 97% (88-105) and 94% (82-106) in TSC-LAM and S-LAM, respectively, p = 0.125]. Patients with S-LAM had less renal angiomyolipoma, and lower VEGF-D serum levels than TSC-LAM. There was no difference in the baseline extent of pulmonary cysts on CT scan and no difference in yearly rate of functional decline between TSC-LAM, and S-LAM patients [e.g. yearly rate of decline of FEV1 % pred was 0.51 (1.59 2.24) and 0.90 (1.92 -0.42) in TSC-LAM and S-LAM, respectively, p = 0.265]. In conclusion, the natural history of TSC-LAM and S-LAM, when a potential selection bias due to screening in the latter group is balanced, is similar. Our study suggests that the prevalence of S-LAM can be significantly underestimated due to a tendency to diagnosis more frequently patients with more severe impairment, without identifying several ones with asymptomatic disease.
- Natural history of incidental sporadic or tuberous sclerosis complex associated lymphangioleiomyomatosis(2019) MARCO, Fabiano Di; TERRANEO, Silvia; DIAS, Olivia Olivia Meira; IMERI, Gianluca; CENTANNI, Stefano; GIULIANI, Lisa; LESMA, Elena; PALUMBO, Giuseppina; WANDERLEY, Mark; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno Guedes