MARCIO VALENTE YAMADA SAWAMURA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina
74 resultados
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- Methotrexate and rheumatoid arthritis associated interstitial, Lung disease(2021) JUGE, Pierre-Antoine; LEE, Joyce S.; LAU, Jessica; KAWANO-DOURADO, Leticia; SERRANO, Jorge Rojas; SEBASTIANI, Marco; KODURI, Gouri; MATTESON, Eric; BONFIGLIOLI, Karina; SAWAMURA, Marcio; KAIRALLA, Ronaldo; CAVAGNA, Lorenzo; CASSIONE, Emanuele Bozzalla; MANFREDI, Andreina; MEJIA, Mayra; RODRIGUEZ-HENRIQUEZ, Pedro; GONZALEZ-PEREZ, Montserrat I.; FALFAN-VALENCIA, Ramces; BUENDIA-ROLDAN, Ivette; PEREZ-RUBIO, Gloria; EBSTEIN, Esther; GAZAL, Steven; BORIE, Raphael; OTTAVIANI, Sebastien; KANNENGIESSER, Caroline; WALLAERT, Benoit; UZUNHAN, Yurdagul; NUNES, Hilario; VALEYRE, Dominique; SAIDENBERG-KERMANAC, Nathalie; BOISSIER, Marie-Christophe; WEMEAU-STERVINOU, Lidwine; FLIPO, Rene-Marc; MARCHAND-ADAM, Sylvain; RICHETTE, Pascal; ALLANORE, Yannick; DROMER, Claire; TRUCHETET, Marie-Elise; RICHEZ, Christophe; SCHAEVERBEKE, Thierry; LIOTE, Huguette; THABUT, Gabriel; DEANE, Kevin D.; SOLOMON, Joshua J.; DOYLE, Tracy; RYU, Jay H.; ROSAS, Ivan; HOLERS, V. Michael; BOILEAU, Catherine; DEBRAY, Marie-Pierre; PORCHER, Raphael; SCHWARTZ, David A.; VASSALLO, Robert; CRESTANI, Bruno; DIEUDE, PhilippeQuestion addressed by the study: Methotrexate (MTX) is a key anchor drug for rheumatoid arthritis (RA) management. Fibrotic interstitial lung disease (ILD) is a common complication of RA. Whether MTX exposure increases the risk of ILD in patients with RA is disputed. We aimed to evaluate the association of prior MTX use with development of RA-ILD. Methods: Through a case-control study design with discovery and international replication samples, we examined the association of MTX exposure with ILD in 410 patients with chronic fibrotic ILD associated with RA (RA-ILD) and 673 patients with RA without ILD. Estimates were pooled over the different samples using meta-analysis techniques. Results: Analysis of the discovery sample revealed an inverse relationship between MTX exposure and RA-ILD (adjusted OR 0.46, 95% CI 0.24 0.90; p=0.022), which was confirmed in the replication samples (pooled adjusted OR 0.39, 95% CI 0.19 -0.79; p=0.009). The combined estimate using both the derivation and validation samples revealed an adjusted OR of 0.43 (95% CI 0.26 0.69; p=0.0006). MTX ever-users were less frequent among patients with RA-ILD compared to those without II,D, irrespective of chest high-resolution computed tomography pattern. In patients with RA-ILD, ILD detection was significantly delayed in MTX ever-users compared to never-users (11.4 +/- 10.4 years and 4.0 +/- 7.4 years, respectively; p<0.001). Answer to the question: Our results suggest that MTX use is not associated with an increased risk of RA-ILD in patients with RA, and that ILD was detected later in MTX-treated patients.
- Airway-Invasive Aspergillosis: Acute Tracheobronchitis(2022) FARIAS, Lucas de Padua Gomes de; SAWAMURA, Marcio Valente Yamada
- Computed tomography in hypersensitivity pneumonitis: main findings, differential diagnosis and pitfalls(2018) DIAS, Olivia Meira; BALDI, Bruno Guedes; PENNATI, Francesca; ALIVERTI, Andrea; CHATE, Rodrigo Caruso; SAWAMURA, Marcio Valente Yamada; CARVALHO, Carlos Roberto Ribeiro de; ALBUQUERQUE, Andre Luis Pereira deIntroduction: Hypersensitivity pneumonitis (HP) is a disease with variable clinical presentation in which inflammation in the lung parenchyma is caused by the inhalation of specific organic antigens or low molecular weight substances in genetically susceptible individuals. Alterations of the acute, subacute and chronic forms may eventually overlap, and the diagnosis based on temporality and presence of fibrosis (acute/inflammatory HP vs. chronic HP) seems to be more feasible and useful in clinical practice. Differential diagnosis of chronic HP with other interstitial fibrotic diseases is challenging due to the overlap of the clinical history, and the functional and imaging findings of these pathologies in the terminal stages.Areas covered: This article reviews the essential features of HP with emphasis on imaging features. Moreover, the main methodological limitations of high-resolution computed tomography (HRCT) interpretation are discussed, as well as new perspectives with volumetric quantitative CT analysis as a useful tool for retrieving detailed and accurate information from the lung parenchyma.Expert commentary: Mosaic attenuation is a prominent feature of this disease, but air trapping in chronic HP seems overestimated. Quantitative analysis has the potential to estimate the involvement of the pulmonary parenchyma more accurately and could correlate better with pulmonary function results.
conferenceObject Radiographic Fibrosis Is Associated with Accelerated Lung Function Decline in Patients with Hypersensitivity Pneumonitis(2020) KAWANO-DOURADO, L. C.; ARIMURA, F. E.; RODRIGUES, S. C.; SPONHOLZ, M.; LIMA, M. S.; BEDER, T.; STORRER, K. M.; SAWAMURA, M.; CATUNDA, L. G.; CARVALHO, A. Castro De; SANTOS, P. C. C.; BASILIO, C. C.; SANCHEZ, G. J. S.; NAKAGAWA, R. H.; MONTEIRO, J. T. C.; SANTOS, R. K.; PINHEIRO, M. F. S.; CUNHA, T. M.; JOHANNSON, K. A.; KAIRALLA, R. A.- Texture-based classification of lung disease patterns in chronic hypersensitivity pneumonitis and comparison to clinical outcomes(2021) PENNATI, F.; ALIBONI, L.; ANTONIAZZA, A.; BERETTA, D.; DIAS, O.; BALDI, B. G.; SAWAMURA, M.; CHATE, R. C.; CARVALHO, C. R. R. De; ALBUQUERQUE, A.; ALIVERTI, A.Computer-aided detection algorithms applied to CT lung imaging have the potential to objectively quantify pulmonary pathology. We aim to develop an automatic classification method based on textural features able to classify healthy and pathological patterns on CT lung images and to quantify the extent of each disease pattern in a group of patients with chronic hypersensitivity pneumonitis (cHP), in comparison to pulmonary function tests (PFTs). 27 cHP patients were scanned via high resolution CT (HRCT) at full-inspiration. Regions of interest (ROIs) were extracted and labeled as normal (NOR), ground glass opacity (GGO), reticulation (RET), consolidation (C), honeycombing (HB) and air trapping (AT). For each ROI, statistical, morphological and fractal parameters were computed. For automatic classification, we compared two classification methods (Bayesian and Support Vector Machine) and three ROI sizes. The classifier was therefore applied to the overall CT images and the extent of each class was calculated and compared to PFTs. Better classification accuracy was found for the Bayesian classifier and the 16x16 ROI size: 92.1 +/- 2.7%. The extent of GGO, HB and NOR significantly correlated with forced vital capacity (FVC) and the extent of NOR with carbon monoxide diffusing capacity (DLCO).
- Sensitivity of Antigen, Serology, and Microbiology Assays for Diagnosis of the Subtypes of Chronic Pulmonary Aspergillosis at a Teaching Hospital in Sao Paulo, Brazil(2023) OLIVEIRA, Vitor Falcao de; VIANA, Joshua Araujo; SAWAMURA, Marcio Valente Yamada; MAGRI, Adriana Satie Goncalves Kono; COSTA, Andre Nathan; ABDALA, Edson; MARIANI, Alessandro Wasum; BENARD, Gil; MAGRI, Marcello Mihailenko ChavesChronic pulmonary aspergillosis (CPA) is divided into five subtypes. The diagnosis of CPA is complicated due to poor sensitivity of the laboratory tests. Diagnostic performance of different antigen, serological, and microbiologi-cal methods in subtypes of CPA is unknown. The purpose of this study was to evaluate the diagnostic performance in different subtypes of CPA. A total of 91 participants with CPA were included, and the study was performed at Hospital das Clinicas of University of Sao Paulo. Bronchoalveolar lavage galactomannan (73%, 11/15), serology by immunodiffu-sion test (81%, 61/75), and histology (78%, 39/50) had the best sensitivity. The counterimmunoelectrophoresis (CIE) titers had a significant statistical difference between the CPA subtypes (P < 0.001), in which the forms chronic fibrosing pulmonary aspergillosis (CFPA) and subacute invasive aspergillosis (SAIA) had higher titers: 1/64 (interquartile range [IQR]: 1/32-1/256) and 1/64 (1/32-1/128).C-reactive protein generally presented lower values (median 15 mg/L, IQR: 6-33), with higher values in SAIA and lower values for Aspergillus nodule. Overall, we found a low diagnostic sensitivity of current tests. Regarding the CPA subtypes, we did not find great differences in the performance of the tests, but it is observed that the inflammatory markers and CIE titers tend to be higher in forms of the more extensive lung parenchyma involvement, such as SAIA and CFPA.
- Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal(2021) HOCHHEGGER, Bruno; MARCHIORI, Edson; RODRIGUES, Rosana; MANCANO, Alexandre; JASINOWODOLINSKI, Dany; CHATE, Rodrigo Caruso; JR, Arthur Soares Souza; SILVA, Alexandre Marchini; SAWAMURA, Marcio; FURNARI, Marcelo; ARAUJO-NETO, Cesar; ESCUISSATO, Dante; PINETTI, Rogerio; NOBRE, Luiz Felipe; WARSZAWIAK, Danny; SZARF, Gilberto; TELLES, Gustavo Borges da Silva; MEIRELLES, Gustavo; SANTANA, Pablo Rydz; ANTUNES, Viviane; CAPOBIANCO, Julia; MISSRIE, Israel; SOUZA, Luciana Volpon Soares; SANTOS, Marcel Koeningan; IRION, Klaus; DUARTE, Isabel; SANTOS, Rosana; PINTO, Erique; PENHA, DianaEffective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.
- The role of the radiologist in the assessment of thoracic changes after radiotherapy(2021) ANDO, Sabrina de Mello; FONSECA, Eduardo Kaiser Ururahy Nunes; FRASSEI, Julliana dos Santos; FARIAS, Lucas de Pádua Gomes de; NEVES, Yuri Costa Sarno; CHATE, Rodrigo Caruso; SAWAMURA, Márcio Valente YamadaAbstract Radiotherapy plays a central role in the palliative and curative treatment of neoplasms of the chest wall or intrathoracic structures. However, despite technical advances, radiotherapy can alter previously normal organs and tissues, those alterations presenting as various types of imaging findings. Post-radiation alterations must be promptly recognized by radiologists, in order to avoid confusion between complications of radiotherapy and the recurrence of a tumor. This pictorial essay aims to illustrate different thoracic changes after radiotherapy.
- Erasmus Syndrome(2022) FILHO, Mauricio Ricardo Moreira da Silva; GARCIA, Juliana Rocha; FONSECA, Eduardo Kaiser Ururahy Nunes; SAWAMURA, Marcio Valente Yamada
bookPart Coordenação do programa de residência médica(2019) GOMES, Regina Lúcia Elia; SAWAMURA, Márcio Valente Yamada