CLEYDE MYRIAM AVERSA NAKAIE
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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- Subclinical pulmonary abnormalities in childhood-onset systemic lupus erythematosus patients(2016) VEIGA, C. S.; COUTINHO, D. S.; NAKAIE, C. M. A.; CAMPOS, L. M. A.; SUZUKI, L.; CUNHA, M. T.; LEONE, C.; SILVA, C. A.; RODRIGUES, J. C.Objective The aims of this study were to analyze the pulmonary function of childhood-onset systemic lupus erythematosus (cSLE) patients and to identify possible correlations between the high-resolution computed chest tomography (HRCT) score, disease activity, disease cumulative damage, and the participants' quality of life. Methods Forty cSLE patients, median age: 14.1 years (range: 7.4-17.9), underwent spirometry and plethysmography. Carbon monoxide diffusing capacity (DLCO), HRCT, disease activity, disease cumulative damage, and quality of life were assessed. Results Pulmonary abnormalities were evident in 19/40 (47.5%) cSLE patients according to spirometry/DLCO. Forced expired volume in one second (FEV1%) was the parameter most affected (30%). The HRCT showed some abnormality in 22/30 patients (73%), which were minimal in 43%. Signs of airway affects were found in 50%. Twelve patients were hospitalized due to cSLE-related pulmonary complications before the study began (median discharge: 2.1 years earlier). Total lung capacity (TLC%), vital capacity (VC%), forced vital capacity (FVC%), and FEV1% were significantly lower in the group with hospitalization compared to the group without hospitalization (p=0.0025, p=0.0022, p=0.0032, and p=0.0004, respectively). Of note, DLCO was positively correlated with disease duration (r=+0.4; p=0.01). The HRCT-score was negatively correlated with FEV1/VC (r=-0.63; p=0.0002), FEV1 (r=-0.54; p=0.018), FEF25%-75% (r=-0.67; p<0.0001), and HRCT-score was positively correlated with resistance (r=+0.49; p=0.0056). Conclusions Almost half of patients with cSLE had subclinical pulmonary abnormalities, especially airway abnormalities. The cSLE-related pulmonary complications seem to determine long-term functional damage.
- PULMONARY ABNORMALITIES IN CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS(2015) VEIGA, C. S. da; COUTINHO, D. S.; NAKAIE, C. M. A.; CAMPOS, L. M. A.; SUZUKI, L.; LEONE, C.; SILVA, C. A.; RODRIGUES, J. C.
bookPart Bronquiectasias(2019) NAKAIE, Cleyde Myriam AversabookPart Introdução(2019) RODRIGUES, Joaquim Carlos; ADDE, Fabíola Villac; SILVA FILHO, Luiz Vicente Ribeiro Ferreira da; NAKAIE, Cleyde Myriam AversaconferenceObject The Impact of Neonatal Screening on the Pulmonary Function of School-aged Children with Cystic Fibrosis(2023) MUNOZ, T. A. Soria; AMORAS, A. Da Silva; SARUHASHI, R. Porto Avary de Campos; SILVA, R. Galdino Da; GOMES, I. M. Forti; PEREIRA, C. M. Lourinho; ARANHA NETTO, N.; TANAKA, S. Onoda Tomikawa; NAKAIE, C. M. Aversa; RODRIGUES, J. C.; V, L. Ribeiro Ferreira Silva FilhoconferenceObject Chest Computed Tomography for Infants and Preschoolers with Cystic Fibrosis: When to Indicate and What are the Therapeutic Implications?(2023) AMORAS, A. Da Silva; MUNOZ, T. A. Soria; SILVA, R. Galdino Da; CAMPOS, R. Porto Avary de; GOMES, I. M. Forti; PEREIRA, C. M. Lourinho; ARANHA NETTO, N.; TANAKA, S. Onoda Tomikawa; NAKAIE, C. M. Versa; RODRIGUES, J. C.; SILVA FILHO, L. V. Ribeiro Ferreira Da- Effectiveness of a multistep Pseudomonas aeruginosa eradication treatment protocol in children with cystic fibrosis in Brazil(2020) RIQUENA, Barbara; SILVA FILHO, Luiz Vicente Ribeiro Ferreira da; NAKAIE, Cleyde Myriam Aversa; ALMEIDA, Marina Buarque de; RODRIGUES, Joaquim Carlos; ADDE, Fabiola VillacObjective: Although various strategies have been proposed for eradicating Pseudomonas aeruginosa in patients with cystic fibrosis (CF), only a few employ multistep treatment in children colonized by that pathogen for the first time. The aim of this study was to describe the effectiveness of a three-phase eradication protocol, initiated after the first isolation of P. aeruginosa, in children with CF in Brazil. Methods: This was a retrospective real-life study in which we reviewed the medical records of pediatric CF patients in whom the eradication protocol was applied between June of 2004 and December of 2012. The three-phase protocol was guided by positive cultures for P. aeruginosa in airway secretions, and the treatment consisted of inhaled colistimethate and oral ciprofloxacin. Success rates were assessed after each phase, as well as cumulatively. Results: During the study period, 47 episodes of P. aeruginosa colonization, in 29 patients, were eligible for eradication. Among the 29 patients, the median age was 2.7 years, 17 (59%) were male, and 19 (65%) had at least one F508del allele. All 29 patients completed the first phase of the protocol, whereas only 12 and 6 completed the second and third phases, respectively. Success rates for eradication in the three treatment phases were 58.6% (95% CI: 40.7-74.5), 50.0% (95% CI: 25.4-74.6), and 66.7% (95% CI: 30.0-90.3), respectively. The cumulative success rate was 93.1% (95% CI: 78.0-98.1). Treatment failure in all three phases occurred in only 2 patients. Conclusions: In this sample of patients, the multistep eradication protocol was effective and had a high success rate.
- Long-term home oxygen therapy in children and adolescents: analysis of clinical use and costs of a home care program(2011) MUNHOZ, Andrea S.; ADDE, Fabiola V.; NAKAIE, Cleyde M. A.; DORIA FILHO, Ulysses; SILVA FILHO, Luiz V. R. F.; RODRIGUES, Joaquim C.Objectives: To describe the clinical and laboratory characteristics of patients on long-term home oxygen therapy followed up by the home care program of Hospital das Clinicas, School of Medicine, Universidade de Sao Paulo, during a period of 8 years, and to compare groups with and without secondary pulmonary hypertension. To estimate the cost of the program using oxygen concentrators versus oxygen cylinders provided by the hospital. Methods: A descriptive, retrospective cohort study of patients on long-term home oxygen therapy followed up from 2002 to 2009 at the Unit of Pulmonology, Children's Institute, Hospital das Clinicas, School of Medicine, Universidade de Sao Paulo. Results: We studied 165 patients, of whom 53% were male, with the following medians: age at the beginning of oxygen therapy - 3.6 years; duration of oxygen therapy - 7 years; and survival time after beginning of oxygen therapy - 3.4 years. The main diagnoses were: cystic fibrosis (22%), bronchopulmonary dysplasia (19%), and bronchiolitis obliterans (15%). Of the 33 patients who underwent spirometry, 70% had severe obstructive lung disease. Echocardiogram was performed in 134 patients; 51% of them had secondary pulmonary hypertension. There was a statistically significant association between pulmonary hypertension and need of higher oxygen flows (chi-square, p = 0.011), and pulmonary hypertension and longer duration of oxygen therapy (Logrank, p = 0.0001). There was no statistically significant difference between survival time after the beginning of oxygen therapy and pulmonary hypertension. The average monthly costs of the program were: US$ 7,392.93 for concentrators and US$ 16,630.92 for cylinders. Conclusions: Long-term home oxygen therapy was used to treat different chronic diseases, predominantly in infants and preschool children. There was a high frequency of pulmonary hypertension associated with longer periods of oxygen use and greater oxygen flow, without association with survival rate. The use of concentrators instead of cylinders may reduce costs significantly.
conferenceObject EARLY PSEUDOMONAS AERUGINOSA COLONIZATION IN CYSTIC FIBROSIS: LONG TERM RESULTS OF AN ERADICATION PROTOCOL(2016) ADDE, Fabiola Villac; RIQUENA, Barbara; SILVA FILHO, Luiz Vicente R. F.; NAKAIE, Cleyde M. A.; ALMEIDA, Marina B.; RODRIGUES, Joaquim C.bookPart Abscesso pulmonar em crianças(2019) RODRIGUES, Joaquim Carlos; NAKAIE, Cleyde Myriam Aversa