RONALDO ADIB KAIRALLA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
40 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 40
- Idiopathic pulmonary fibrosis: current diagnosis and treatment(2023) AMARAL, Alexandre Franco; COLARES, Philippe De Figueiredo Braga; KAIRALLA, Ronaldo AdibIdiopathic pulmonary fibrosis (IPF) is a devastating chronic lung disease without a clear recognizable cause. IPF has been at the forefront of new diagnostic algorithms and treatment developments that led to a shift in patients' care in the past decade, indeed influencing the management of fibrotic interstitial lung diseases other than IPF itself. Clinical presentation, pathophysiology, and diagnostic criteria are briefly addressed in this review article. Additionally, evidence regarding the use of antifibrotics beyond the settings of clinical trials, impact of comorbidities, and therapeutic approaches other than pharmacological treatments are discussed in further detail.
- Eosinophilic pneumonia: remember topical drugs as possible etiology(2018) DIAS, Olivia Meira; NASCIMENTO, Ellen Caroline Toledo do; CHATE, Rodrigo Caruso; KAIRALLA, Ronaldo Adib; BALDI, Bruno Guedes
article 37 Citação(ões) na Scopus Doxycycline use in patients with lymphangioleiomyomatosis: safety and efficacy in metalloproteinase blockade(2011) PIMENTA, Suzana Pinheiro; BALDI, Bruno Guedes; ACENCIO, Milena Marques Pagliarelli; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto RibeiroObjective: Lymphangioleiomyomatosis (LAM) is characterized by lung cysts, whose development is associated with matrix metalloproteinase (MMP) hyperactivity, principally that of MMP-2 and MMP-9. Our objective was to compare LAM patients and controls in terms of the levels of these MMPs, as well as to determine the safety and efficacy of treatment with doxycycline, a potent MMP inhibitor. Methods: Prospective clinical study involving female LAM patients who received doxycycline (100 mg/day) for six months. Urine and blood samples were collected for the quantification of MMP-2 and MMP-9 before and after the treatment period. Samples from 10 healthy women were also collected. Results: Of the 41 LAM patients who started the treatment, 34 completed the protocol. Serum and urinary MMP-9 levels were significantly lower in the controls than in the LAM patients (p < 0.0001). Comparing pre- and post-treatment values, we found that the median level of MMP-9 in serum decreased from 919 ng/mL to 871 ng/mL (p = 0.05), whereas that of MMP-9 in urine decreased from 11,558 pg/mL to 7,315 pg/mL (p = 0.10). After treatment, the median level of MMP-2 in serum was significantly lower (p = 0.04) and urinary MMP-2 levels were undetectable. Nausea, diarrhea, and epigastric pain were the most prevalent adverse affects and were often self-limiting. There was only one case in which the patient discontinued the treatment because of side effects. Conclusions: We have demonstrated, for the first time, a decrease in serum and urine levels of MMPs in LAM patients treated with doxycycline, which proved to be a safe medication, with mild and well-tolerated side effects.- Brazilian recommendations of mechanical ventilation 2013. Part 1(2014) CAVALCANTI, Alexandre Biasi; ISOLA, Alexandre Marini; GAMA, Ana Maria Casati; DUARTE, Antonio Carlos Magalhaes; VIANNA, Arthur; SERPA NETO, Ary; FARIAS, Augusto Manoel de Carvalho; BRAVIM, Bruno de Arruda; PINHEIRO, Bruno do Valle; MAZZA, Bruno Franco; CARVALHO, Carlos Roberto Ribeiro de; TOUFEN JUNIOR, Carlos; BARBAS, Carmen Silvia Valente; DAVID, Cid Marcos Nascimento; TANIGUCHI, Corine; MAZZA, Debora Dutra da Silveira; DRAGOSAVAC, Desanka; TOLEDO, Diogo Oliveira; COSTA, Eduardo Leite; CASER, Eliana Bemardete; SILVA, Eliezer; AMORIM, Fabio Ferreira; SADDY, Felipe; GALAS, Filomena Regina Barbosa Gomes; SILVA, Gisele Sampaio; MATOS, Gustavo Faissol Janot de; EMMERICH, Joao Claudio; VALIATTI, Jorge Luis dos Sanots; TELES, Jose Mario Vleira; VICTORINO, Josue Almeida; FERREIRA, Juliana Carvalho; PRODOMO, Luciana Passuello do Vale; HAJAR, Ludhmila Abrahao; MARTINS, Luiz Claudio; MALBOUISSON, Luiz Marcelo Sa; VARGAS, Mara Ambrosina de Oliveira; HOLANDA, Marcelo Alcantara; AMATO, Marcelo Brito Passos; PARK, Marcelo; JACOMELLI, Marcia; REIS, Marco Antonio Soares; TAVARES, Marcos; DAMASCENO, Marta Cristina Paulette; DAMASCENO, Moyzes Pinto Coelho Duarte; ASSUNCAO, Murillo Santucci Cesar; YOUSSEF, Nazah Cherif Mohamad; MESSEDER, Octavio; TEIXEIRA, Paulo Jose Zimmermann; CARUSO, Pedro; DUARTE, Pericles Almeida Delfino; EID, Raquel Caserta; RODRIGUES, Ricardo Goulart; JESUS, Rodrigo Francisco de; KAIRALLA, Ronald Adib; JUSTINO, Sandra; NEMER, Sergio Nogueira; ROMERO, Simone Barbosa; AMADO, Veronica MoreiraPerspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associacao de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in Sao Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document.
- Brazilian recommendations of mechanical ventilation 2013. Part 2(2014) CAVALCANTI, Alexandre Biasi; ISOLA, Alexandre Marini; GAMA, Ana Maria Casati; DUARTE, Antonio Carlos Magalhaes; VIANNA, Arthur; SERPA NETO, Ary; FARIAS, Augusto Manoel de Carvalho; BRAVIM, Bruno de Arruda; PINHEIRO, Bruno do Valle; MAZZA, Bruno Franco; CARVALHO, Carlos Roberto Ribeiro de; TOUFEN JUNIOR, Carlos; BARBAS, Carmen Silvia Valente; DAVID, Cid Marcos Nascimento; TANIGUCHI, Corine; MAZZA, Debora Dutra da Silveira; DRAGOSAVAC, Desanka; TOLEDO, Diogo Oliveira; COSTA, Eduardo Leite; CASER, Eliana Bernardete; SILVA, Eliezer; AMORIM, Fabio Ferreira; SADDY, Felipe; GALAS, Filomena Regina Barbosa Gomes; SILVA, Gisele Sampaio; MATOS, Gustavo Faissol Janot de; EMMERICH, Joao Claudio; VALIATTI, Jorge Luis dos Sanots; TELES, Jose Mario Meira; VICTORINO, Josue Almeida; FERREIRA, Juliana Carvalho; PRODOMO, Luciana Passuello do Vale; HAJJAR, Ludhmila Abrahao; MARTINS, Luiz Claudio; MALBOUISSON, Luiz Marcelo Sa; VARGAS, Mara Ambrosina de Oliveira; HOLANDA, Marcelo Alcantara; AMATO, Marcelo Brito Passos; PARK, Marcelo; JACOMELLI, Marcia; REIS, Marco Antonio Soares; TAVARES, Marcos; DAMASCENO, Marta Cristina Paulette; DAMASCENO, Moyzes Pinto Coelho Duarte; ASSUNCAO, Murillo Santucci Cesar; YOUSSEF, Nazah Cherif Mohamad; MESSEDER, Octavio; TEIXEIRA, Paulo Jose Zimmermann; CARUSO, Pedro; DUARTE, Pericles Almeida Delfino; EID, Raquel Caserta; RODRIGUES, Ricardo Goulart; JESUS, Rodrigo Francisco de; KAIRALLA, Ronaldo Adib; JUSTINO, Sandra; NEMER, Sergio Nogueira; ROMERO, Simone Barbosa; AMADO, Veronica MoreiraPerspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associacao de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in Sao Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document.
- 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.
- Highlights of the Brazilian Thoracic Association Guidelines for Interstitial Lung Diseases(2012) BALDI, Bruno Guedes; PEREIRA, Carlos Alberto de Castro; RUBIN, Adalberto Sperb; SANTANA, Alfredo Nicodemos da Cruz; COSTA, Andre Nathan; CARVALHO, Carlos Roberto Ribeiro; ALGRANTI, Eduardo; CAPITANI, Eduardo Mello de; BETHLEM, Eduardo Pamplona; COLETTA, Ester Nei Aparecida Martins; ARAKAKI, Jaquelina Sonoe Ota; MARTINEZ, Jose Antonio Baddini; CARVALHO, Jozelio Freire de; STEIDLE, Leila John Marques; ROCHA, Marcelo Jorge Jaco; LIMA, Mariana Silva; SOARES, Maria Raquel; CARAMORI, Marlova Luzzi; AIDE, Miguel Abidon; FERREIRA, Rimarcs Gomes; KAIRALLA, Ronaldo Adib; OLIVEIRA, Rudolf Krawczenko Feitoza de; JEZLER, Sergio; RODRIGUES, Silvia Carla Sousa; PIMENTA, Suzana PinheiroInterstitial lung diseases (ILDs) are heterogeneous disorders, involving a large number of conditions, the approach to which continues to pose an enormous challenge for pulmonologists. The 2012 Brazilian Thoracic Association ILD Guidelines were established in order to provide Brazilian pulmonologists with an instrument that can facilitate the management of patients with ILDs, standardizing the criteria used for the diagnosis of different conditions and offering guidance on the best treatment in various situations. The objective of this article was to briefly describe the highlights of those guidelines.
- Uso de tiotrópio e função pulmonar em portadores de bronquiolite constritiva(2014) KAWASSAKI, Alexandre Melo; KAWANO-DOURADO, Leticia; KAIRALLA, Ronaldo Adib
- Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay(2023) BRIDI, Guilherme das Posses; SAWAMURA, Marcio Valente Yamada; WANDERLEY, Mark; SOUZA, Luciana Volpon Soares; KAIRALLA, Ronaldo Adib; KAWANO-DOURADO, Leticia; BALDI, Bruno GuedesRheumatoid arthritis ( RA) is an autoimmune inflammatory and heterogeneous disease that affects several systems, especially the joints. Among the extra- articular manifestations of RA, pleuropulmonary involvement occurs frequently, with different presentations, potentially in all anatomic thoracic compartments, and may determine high morbidity and mortality. The most common pleuropulmonary manifestations in patients with RA include interstitial lung disease (ILD), pleural disease, pulmonary arterial hypertension, rheumatoid lung nodules, airway disease (bronchiectasis and bronchiolitis), and lymphadenopathy. Pulmonary hypertension and ILD are the manifestations with the greatest negative impact in prognosis. HRCT of the chest is essential in the evaluation of patients with RA with respiratory symptoms, especially those with higher risk factors for ILD, such as male gender, smoking, older age, high levels of rheumatoid factor, or positive anti-cyclic citrullinated peptide antibody results. Additionally, other etiologies that may determine tomographic pleuropulmonary manifestations in patients with RA are infections, neoplasms, and drug-induced lung disease. In these scenarios, clinical presentation is heterogeneous, varying from being asymptomatic to having progressive respiratory failure. Knowledge on the potential etiologies causing tomographic pleuropulmonary manifestations in patients with RA coupled with proper clinical reasoning is crucial to diagnose and treat these patients.
- 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