RENATA APARECIDA DE ALMEIDA MONTEIRO
Projetos de Pesquisa
Unidades Organizacionais
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Lung ECM composition, its influence factors and transcriptomics in the lungs of severe COVID-19.(2023) COSTA, Natalia de Souza Xavier; RIBEIRO JUNIOR, Gabriel; NASCIMENTO, Ellen Toledo Do; BRITO, Jose Mara De; MONTEIRO, Jhonatas Sirino; SETUBAL, Joao Carlos; PINHO, Joao Renato Rebello; PEREIRA, Roberta Verciano; MONTEIRO, Renata Aparecida De Almeida; DUARTE NETO, Amaro Nunes; SALDIVA, Paulo Hilario Nascimento; SILVA, Luiz Fernando Ferraz Da; DOLHNIKOFF, Marisa; MAUAD, Thais
- Dynamics and Heterogeneity of the Lung Immunopathology in Severe COVID-19(2022) ERJEFALT, J.; COSTA, N. De Souza Xavier; JONSSON, J.; COZZOLINO, O.; DANTAS, K.; CLAUSSON, C.; SIDDHURAJ, P.; LINDO, C.; LOMBARDI, S. Ferreira Spina; MENDRONI JUNIOR, A.; ANTONANGELO, L.; FARIA, C. Silverio; DUARTE NETO, A. Nunes; MONTEIRO, R. De Almeida; PINHO, J. Rebello; GOMES-GOUVEA, M. Soares; PEREIRA, R. Verciano; MONTEIRO, J. Sirino; SETUBAL, J.; OLIVEIRA, E. Pierre De; THEODORO FILHO, J.; SANDEN, C.; ORENGO, J.; SLEEMAN, M.; SILVA, L. Ferraz Da; SALDIVA, P. Nascimento; DOLHNIKOFF, M.; MAUAD, T.
- Differentially expressed genes in Diffuse Alveolar Damage (DAD) patterns of COVID-19.(2022) COSTA, N. de Souza Xavier; MONTEIRO, J. Sirino; ERJEFALT, J.; JONSSON, J.; COZZOLINO, O.; DANTAS, K.; CLAUSSON, C.; SIDDHURAJ, P.; LINDO, C.; LOMBARDI, S. Ferreira Spina; MENDRONI JUNIOR, A.; ANTONANGELO, L.; FARIA, C. Silverio; DUARTE NETO, A. Nunes; MONTEIRO, R. Almeida; PINHO, J. R. Rebello; GOMES-GOUVEA, M. Soares; PEREIRA, R. Verciano; OLIVEIRA, E. Pierre De; THEODORO FILHO, J.; SANDEN, C.; ORENGO, J.; SLEEMAN, M.; SILVA, L. F. Ferraz Da; SALDIVA, P. Nascimento; DOLHNIKOFF, M.; MAUAD, T.; SETUBAL, J. C.
- Postmortem chest computed tomography in COVID-19: A minimally invasive autopsy method(2024) SAVOIA, Paulo; SAWAMURA, Marcio Valente Yamada; MONTEIRO, Renata Aparecida de Almeida; DUARTE-NETO, Amaro Nunes; MARTIN, Maria da Graca Morais; DOLHNIKOFF, Marisa; MAUAD, Thais; SALDIVA, Paulo Hilario Nascimento; LEITE, Claudia da Costa; SILVA, Luiz Fernando Ferraz da; CARDOSO, Ellison FernandoObjectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology and pathology to evaluate postmortem CT lung findings and their correlation with histopathology. Methods: Twenty-nine patients with fatal COVID-19 underwent postmortem chest CT, and multiple lung tissue samples were collected. The chest CT scans were analyzed and quantified according to lung involvement in five categories: normal, ground-glass opacities, crazy-paving, small consolidations, and large or lobar consolidations. The lung tissue samples were examined and quantified in three categories: normal lung, exudative diffuse alveolar damage (DAD), and fibroproliferative DAD. A linear index was used to estimate the global severity of involvement by CT and histopathological analysis. Results: There was a positive correlation between patient mean CT and histopathological severity score indexesPearson correlation coefficient (R) = 0.66 (p = 0.0078). When analyzing the mean lung involvement percentage of each finding, positive correlations were found between the normal lung percentage between postmortem CT and histopathology (R=0.65, p = 0.0082), as well as between ground -glass opacities in postmortem CT and normal lungs in histopathology (R=0.65, p = 0.0086), but negative correlations were observed between groundglass opacities extension and exudative diffuse alveolar damage in histological slides (R=-0.68, p = 0.005). Additionally, it was found is a trend toward a decrease in the percentage of normal lung tissue on the histological slides as the percentage of consolidations in postmortem CT scans increased (R =-0.51, p = 0.055). The analysis of the other correlations between the percentage of each finding did not show any significant correlation or correlation trends (p >= 0.10). Conclusions: A minimally invasive autopsy is valid. As the severity of involvement is increased in CT, more advanced disease is seen on histopathology. However, we cannot state that one specific radiological category represents a specific pathological correspondent. Ground -glass opacities, in the postmortem stage, must be interpreted with caution, as expiratory lungs may overestimate disease.
- What else in times of COVID-19? The role of minimally invasive autopsy for the differential diagnosis of acute respiratory failure in a case of kala-azar(2023) GEBER-JUNIOR, Joao Carlos; MONTEIRO, Renata Aparecida de Almeida; ROCHA, Joao Wilson Pedro da; DUARTE, Edson Luiz Tarsia; NICODEMO, Elizabete; MUNHOZ, Olavo; PAIVA, Edison Ferreira de; MAUAD, Thais; SILVA, Luiz Fernando Ferraz da; SALDIVA, Paulo Hilario Nascimento; DOLHNIKOFF, Marisa; DUARTE-NETO, Amaro NunesVisceral leishmaniasis (VL) is a chronic vector-borne zoonotic disease caused by trypanosomatids, considered endemic in 98 countries, mainly associated with poverty. About 50,000-90,000 cases of VL occur annually worldwide, and Brazil has the second largest number of cases in the world. The clinical picture of VL is fever, hepatosplenomegaly, and pancytopenia, progressing to death in 90% of cases due to secondary infections and multi-organ failure, if left untreated. We describe the case of a 25-year-old female who lived in the metropolitan area of Sao Paulo, who had recently taken touristic trips to several rural areas in Southeastern Brazil and was diagnosed post-mortem. During the hospitalization in a hospital reference for the treatment of COVID-19, the patient developed acute respiratory failure, with chest radiographic changes, and died due to refractory shock. The ultrasound-guided minimally invasive autopsy diagnosed VL (macrophages containing amastigote forms of Leishmania in the spleen, liver and bone marrow), as well as pneumonia and bloodstream infection by gram-negative bacilli.
- COVID-19 induces more pronounced extracellular matrix deposition than other causes of ARDS(2023) COSTA, Natalia de Souza Xavier; RIBEIRO JUNIOR, Gabriel; NASCIMENTO, Ellen Caroline Toledo do; BRITO, Jose Mara de; ANTONANGELO, Leila; FARIA, Caroline Silverio; MONTEIRO, Jhonatas Sirino; SETUBAL, Joao Carlos; PINHO, Joao Renato Rebello; PEREIRA, Roberta Verciano; SEELAENDER, Marilia; CASTRO, Gabriela Salim de; LIMA, Joanna D. C. C.; MONTEIRO, Renata Aparecida de Almeida; DUARTE-NETO, Amaro Nunes; SALDIVA, Paulo Hilario Nascimento; SILVA, Luiz Fernando Ferraz da; DOLHNIKOFF, Marisa; MAUAD, ThaisBackgroundLung fibrosis is a major concern in severe COVID-19 patients undergoing mechanical ventilation (MV). Lung fibrosis frequency in post-COVID syndrome is highly variable and even if the risk is proportionally small, many patients could be affected. However, there is still no data on lung extracellular matrix (ECM) composition in severe COVID-19 and whether it is different from other aetiologies of ARDS.MethodsWe have quantified different ECM elements and TGF-beta expression in lung tissue of 28 fatal COVID-19 cases and compared to 27 patients that died of other causes of ARDS, divided according to MV duration (up to six days or seven days or more). In COVID-19 cases, ECM elements were correlated with lung transcriptomics and cytokines profile.ResultsWe observed that COVID-19 cases presented significant increased deposition of collagen, fibronectin, versican, and TGF-beta, and decreased decorin density when compared to non-COVID-19 cases of similar MV duration. TGF-beta was precociously increased in COVID-19 patients with MV duration up to six days. Lung collagen was higher in women with COVID-19, with a transition of upregulated genes related to fibrillogenesis to collagen production and ECM disassembly along the MV course.ConclusionsFatal COVID-19 is associated with an early TGF-beta expression lung environment after the MV onset, followed by a disordered ECM assembly. This uncontrolled process resulted in a prominent collagen deposition when compared to other causes of ARDS. Our data provides pathological substrates to better understand the high prevalence of pulmonary abnormalities in patients surviving COVID-19.
- Correlation between lung inflammatory cells, viral load and cytokines in fatal COVID-19(2022) COSTA, N. de Souza Xavier; ERJEFALT, J.; JONSSON, J.; COZZOLINO, O.; DANTAS, K.; CLAUSSON, C.; SIDDHURAJ, P.; LINDO, C.; LOMBARDI, S. Ferreira Spina; MENDRONI JUNIOR, A.; ANTONANGELO, L.; FARIA, C. Silverio; DUARTE NETO, A. Nunes; MONTEIRO, R. Almeida; PINHO, J. R. Rebello; GOMES-GOUVEA, M. Soares; PEREIRA, R. Verciano; MONTEIRO, J. Sirino; SETUBAL, J. C.; OLIVEIRA, E. Pierre De; THEODORO FILHO, J.; SANDEN, C.; ORENGO, J.; SLEEMAN, M.; SILVA, L. F. Ferraz Da; SALDIVA, P. Nascimento; DOLHNIKOFF, M.; MAUAD, T.
- Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy(2024) GIUGNI, Fernando R.; DUARTE-NETO, Amaro N.; SILVA, Luiz Fernando F. da; MONTEIRO, Renata A. A.; MAUAD, Thais; SALDIVA, Paulo H. N.; DOLHNIKOFF, MarisaIntroduction COVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19. Methods This study included autopsied patients, aged 6 months to 83 years, with confirmed COVID-19 in 2020-2021. We collected tissue samples from deceased patients using a minimally invasive autopsy protocol and assessed pathological data following a systematic approach. Results Eighty-six patients were included, with a median age of 55 years (IQR 32.3-66.0). We showed that age was significantly lower in patients with acute heart ischemia (p = 0.004), myocarditis (p = 0.03) and lung angiomatosis (p < 0.001), and significantly higher in patients with exudative diffuse alveolar damage (p = 0.02), proliferative diffuse alveolar damage (p < 0.001), lung squamous metaplasia (p = 0.003) and lung viral atypia (p = 0.03), compared to patients without those findings. We stratified patients by their age and showed that cardiovascular findings were more prevalent in children and young adults. We performed principal component analysis and cluster of pathological variables, and showed that cardiovascular variables clustered and covariated together, and separated from pulmonary variables. Conclusion We showed that age modulates pathological outcomes in fatal COVID-19. Younger age is associated with cardiovascular abnormalities and older age with pulmonary findings.