SYLVIA COSTA LIMA FARHAT
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Point-Of-Care Ultrasound for Lung Assessment in Patients With Severe Scoliosis and Chest Deformities: An Emergency Department Case Series(2020) GIORNO, Eliana Paes de Castro; PRETO-ZAMPERLINI, Marcela; WEERDENBURG, Kirstin; FERRAZ, Isabel de Siqueira; LEITE, Marcia Marques; FARHAT, Sylvia Costa Lima; SCHVARTSMAN, Claudio
- Point-of-care lung ultrasound imaging in pediatric COVID-19(2020) GIORNO, Eliana P. C.; PAULIS, Milena De; SAMESHIMA, Yoshino T.; WEERDENBURG, Kirstin; SAVOIA, Paulo; NANBU, Danilo Y.; COUTO, Thomaz B.; SA, Fernanda V. M.; FARHAT, Sylvia C. L.; CARVALHO, Werther B.; PRETO-ZAMPERLINI, Marcela; SCHVARTSMAN, ClaudioBackground: There has been limited data regarding the usefulness of lung ultrasound (US) in children with COVID-19. Objective: To describe lung US imaging findings and aeration score of 34 children with COVID-19. Methods: This study included 0-16-year-old patients with confirmed COVID-19, who were admitted between April 19 and June 18, 2020 in two hospitals in the city of Sao Paulo, Brazil. Lung US was performed as part of the routine evaluation by a skilled Pediatric Emergency physician. Clinical and laboratory data were collected and severity classifications were done according to an available clinical definition. The lung US findings were described for each lung field and a validated ultrasound lung aeration score was calculated. Data obtained was correlated with clinical information and other imaging modalities available for each case. Results: Thirty-four confirmed COVID-19 patients had a lung US performed during this period. Eighteen (18/34) had abnormalities on the lung US, but eight of them (8/18) had a normal chest radiograph. Ultrasound lung aeration score medians for severe/critical, moderate, and mild disease were 17.5 (2-30), 4 (range 0-14), 0 (range 0-15), respectively (p=0.001). Twelve patients (12/34) also had a chest computed tomography (CT) performed; both the findings and topography of lung compromise on the CT were consistent with the information obtained by lung US. Conclusion: Point-of-care lung US may have a key role in assessing lung injury in children with COVID-19.
- Point-of-care lung ultrasound is more reliable than chest X-ray for ruling out acute chest syndrome in sickle cell pediatric patients: A prospective study(2022) PRETO-ZAMPERLINI, Marcela; GIORNO, Eliana P. C.; GHOSN, Danielle S. N. Bou; SA, Fernanda V. M.; SUZUKI, Adriana S.; SUZUKI, Lisa; FARHAT, Sylvia C.; WEERDENBURG, Kirstin; SCHVARTSMAN, ClaudioBackground Acute chest syndrome (ACS) is a leading cause of morbidity and mortality in sickle cell patients, and it is often challenging to establish its diagnosis. Procedure This was a prospective observational study conducted in a pediatric emergency (PEM) department. We aimed to investigate the performance characteristics of point-of-care lung ultrasound (LUS) for diagnosing ACS in sickle cell children. LUS by trained PEM physicians was performed and interpreted as either positive or negative for consolidation. LUS results were compared to chest X-ray (CXR) and discharge diagnosis as reference standards. Results Four PEM physicians performed the LUS studies in 79 suspected ACS cases. The median age was 8 years (range 1-17 years). Fourteen cases (18%) received a diagnosis of ACS based on CXR and 21 (26.5%) had ACS discharge diagnosis. Comparing to CXR interpretation as the reference standard, LUS had a sensitivity of 100% (95% CI: 77%-100%), specificity of 68% (95% CI: 56%-79%), positive predictive value of 40% (95% CI: 24%-56%), and negative predictive value of 100% (95% CI: 92%-100%). Overall LUS accuracy was 73.42% (95% CI: 62%-83%). Using discharge diagnosis as the endpoint for both CXR and LUS, LUS had significantly higher sensitivity (100% vs. 62%, p = .0047) and lower specificity (76% vs.100%, p = .0002). LUS also had lower positive (60% vs.100%, p < .0001) and higher negative (100% vs.77%, p = .0025) predictive values. The overall accuracy was similar for both tests (82% vs. 88%, p = .2593). Conclusion The high negative predictive value, with narrow CIs, makes LUS an excellent ruling-out tool for ACS.