FREDERICO LEON ARRABAL FERNANDES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
68 resultados
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Agora exibindo 1 - 10 de 68
- Th17/Treg-Related Intracellular Signaling in Patients with Chronic Obstructive Pulmonary Disease: Comparison between Local and Systemic Responses(2021) LOURENCO, Juliana D.; TEODORO, Walcy R.; BARBEIRO, Denise F.; VELOSA, Ana Paula P.; SILVA, Larissa E. F.; KOHLER, Julia B.; MOREIRA, Alyne R.; V, Marcelo Aun; SILVA, Isadora C. da; FERNANDES, Frederico L. A.; NEGRI, Elnara M.; GROSS, Jefferson L.; TIBERIO, Iolanda F. L. C.; ITO, Juliana T.; LOPES, Fernanda D. T. Q. S.Th17/Treg imbalance plays a pivotal role in COPD development and progression. We aimed to assess Th17/Treg-related intracellular signaling at different COPD stages in local and systemic responses. Lung tissue and/or peripheral blood samples were collected and divided into non-obstructed (NOS), COPD stages I and II, and COPD stages III and IV groups. Gene expression of STAT3 and -5, ROR gamma t, Foxp3, interleukin (IL)-6, -17, -10, and TGF-beta was assessed by RT-qPCR. IL-6, -17, -10, and TGF-beta levels were determined by ELISA. We observed increased STAT3, ROR gamma t, Foxp3, IL-6, and TGF-beta gene expression and IL-6 levels in the lungs of COPD I and II patients compared to those of NOS patients. Regarding the systemic response, we observed increased STAT3, ROR gamma t, IL-6, and TGF-beta gene expression in the COPD III and IV group and increased IL-6 levels in the COPD I and II group. STAT5 was increased in COPD III and IV patients, although there was a decrease in Foxp3 expression and IL-10 levels in the COPD I and II and COPD III and IV groups, respectively. We demonstrated that an increase in Th17 intracellular signaling in the lungs precedes this increase in the systemic response, whereas Treg intracellular signaling varies between the compartments analyzed in different COPD stages.
- Comparação entre medidas objetivas do tabagismo e tabagismo autodeclarado em pacientes com asma ou DPOC: será que nossos pacientes dizem a verdade?(2015) STELMACH, Rafael; FERNANDES, Frederico Leon Arrabal; CARVALHO-PINTO, Regina Maria; ATHANAZIO, Rodrigo Abensur; RACHED, Samia Zahi; PRADO, Gustavo Faibischew; CUKIER, AlbertoObjective: Smoking prevalence is frequently estimated on the basis of self-reported smoking status. That can lead to an underestimation of smoking rates. The aim of this study was to evaluate the difference between self-reported smoking status and that determined through the use of objective measures of smoking at a pulmonary outpatient clinic. Methods: This was a cross-sectional study involving 144 individuals: 51 asthma patients, 53 COPD patients, 20 current smokers, and 20 never-smokers. Smoking status was determined on the basis of self-reports obtained in interviews, as well as through tests of exhaled carbon monoxide (eCO) and urinary cotinine. Results: All of the asthma patients and COPD patients declared they were not current smokers. In the COPD and asthma patients, the median urinary cotinine concentration was 167 ng/mL (range, 2-5,348 ng/mL) and 47 ng/mL (range, 5-2,735 ng/mL), respectively (p < 0.0001), whereas the median eCO level was 8 ppm (range, 0-31 ppm) and 5 ppm (range, 2-45 ppm), respectively (p < 0.05). In 40 (38%) of the patients with asthma or COPD (n = 104), there was disagreement between the self-reported smoking status and that determined on the basis of the urinary cotinine concentration, a concentration > 200 ng/mL being considered indicative of current smoking. In 48 (46%) of those 104 patients, the self-reported non-smoking status was refuted by an eCO level > 6 ppm, which is also considered indicative of current smoking. In 30 (29%) of the patients with asthma or COPD, the urinary cotinine concentration and the eCO level both belied the patient claims of not being current smokers. Conclusions: Our findings suggest that high proportions of smoking pulmonary patients with lung disease falsely declare themselves to be nonsmokers. The accurate classification of smoking status is pivotal to the treatment of lung diseases. Objective measures of smoking could be helpful in improving clinical management and counseling.
bookPart Tromboembolia pulmonar aguda(2015) FERNANDES, Frederico Leon Arrabal; TRINDADE, Alexandre Moreto; SOUSA, Thiago Lins Fagundes de; ALMEIDA, Guilherme Eler deconferenceObject Heart rate and ventilation in a group of burned sugar cane cutters (Brazil): Estimative of particulate matter (PM2,5) exposure load(2012) COZZA, Izabela; NAMBU, Danilo; FERNANDES, Frederico; BUSSACOS, Marcos; PACELI, Renato; PRADO, Gustavo; TERRA-FILHO, Mario; SANTOS, Ubiratan- Identification of functional phenotypes in people with COPD: influence of postural balance, physical activity, sedentary behaviour and quadriceps muscle strength(2019) XAVIER, Rafaella; CAPORALI, Ana Carolina; LOPES, Aline; OLIVEIRA, Cristino; FERNANDES, Frederico; STELMACH, Rafael; PINTO, Regina Carvalho; CUKIER, Alberto; CARVALHO, Celso
- Recommendations for the pharmacological treatment of COPD: questions and answers(2017) FERNANDES, Frederico Leon Arrabal; CUKIER, Alberto; CAMELIER, Aquiles Assuncao; FRITSCHER, Carlos Cezar; COSTA, Claudia Henrique da; PEREIRA, Eanes Delgado Barros; GODOY, Irma; CANCADO, Jose Eduardo Delfini; ROMALDINI, Jose Gustavo; CHATKIN, Jose Miguel; JARDIM, Jose Roberto; RABAHI, Marcelo Fouad; NUCCI, Maria Cecilia Nieves Maiorano de; SALES, Maria da Penha Uchoa; CASTELLANO, Maria Vera Cruz de Oliveira; AIDE, Miguel Abidon; TEIXEIRA, Paulo Jose Zimermann; MACIEL, Renato; CORREA, Ricardo de Amorim; STIRBULOV, Roberto; ATHANAZIO, Rodrigo Abensur; RUSSO, Rodrigo; MINAMOTO, Suzana Tanni; LUNDGREN, Fernando Luiz CavalcantiO tratamento da DPOC vem se tornando cada vez mais eficaz. Medidas que envolvem desde mudanças comportamentais, redução de exposições a fatores de risco, educação sobre a doença e seu curso, reabilitação, oxigenoterapia, manejo de comorbidades, tratamentos cirúrgicos e farmacológicos até os cuidados de fim de vida permitem ao profissional oferecer uma terapêutica personalizada e efetiva. O tratamento farmacológico da DPOC constitui um dos principais pilares desse manejo, e muitos avanços têm sido atingidos na área nos últimos anos. Com a maior disponibilidade de medicações e combinações terapêuticas fica cada vez mais desafiador conhecer as indicações, limitações, potenciais riscos e benefícios de cada tratamento. Com o intuito de avaliar criticamente a evidência recente e sistematizar as principais dúvidas referentes ao tratamento farmacológico da DPOC, foram reunidos 24 especialistas de todo o Brasil para elaborar a presente recomendação. Foi elaborado um guia visual para a classificação e tratamento adaptados à nossa realidade. Dez perguntas foram selecionadas pela relevância na prática clínica. Abordam a classificação, definições, tratamento e evidências disponíveis para cada medicação ou combinação. Cada pergunta foi respondida por dois especialistas e depois consolidadas em duas fases: revisão e consenso entre todos os participantes. As questões respondidas são dúvidas práticas e ajudam a selecionar qual o melhor tratamento, entre as muitas opções, para cada paciente com suas particularidades.
- The patient profile of individuals with Alpha-1 antitrypsine gene mutations at a referral center in Brazil(2018) FELISBINO, Manuela Brisot; FERNANDES, Frederico Leon Arrabal; NUCCI, Maria Cecilia Nieves Maiorano de; PINTO, Regina Maria de Carvalho; PIZZICHINI, Emilio; CUKIER, Alberto
conferenceObject Incremental shuttle walking test: A reproducible and valid measure of exercise tolerance in adult subjects with non-cystic fibrosis bronchiectasis (nCF-BCt)(2013) CAMARGO, Anderson Alves de; RACHED, Samia Zahi; ATHANAZIO, Rodrigo Abensur; AMARAL, Tatiane Soares; LANZA, Fernanda de Cordoba; SELMAN, Jessyca Pachi Rodrigues; CUKIER, Alberto; FERNANDES, Frederico Leon Arrabal; CARVALHO, Celso Ricardo Fernandes; STELMACH, Rafael; CORSO, Simone Dal- The Mini-Balance Evaluation System Test Can Predict Falls in Clinically Stable Outpatients With COPD A 12-MO PROSPECTIVE COHORT STUDY(2019) PEREIRA, Ana Carolina A. C.; XAVIER, Rafaella F.; LOPES, Aline C.; SILVA, Cibele C. B. M. da; OLIVEIRA, Cristino C.; FERNANDES, Frederico L. A.; STELMACH, Rafael; CARVALHO, Celso R. F.Purpose: This study evaluated the accuracy of the Mini-Balance Evaluation System Test (Mini-BESTest) for predicting falls in patients with chronic obstructive pulmonary disease (COPD) and investigated whether postural balance is a risk factor for falls. Methods: Postural balance was evaluated by the Mini-BESTest at baseline, and the incidence of falls over a 12-mo period was prospectively measured by a self-reported falls diary and confirmed by telephone calls. A discriminative power analysis was performed using receiver operating characteristic (ROC) curve and logistic regression analysis. Results: Sixty-seven outpatients with COPD (mean age SD = 67 +/- 9.3 yr) were included. Twenty-five patients (37.3%) experienced 1 fall, and 28.2% of the falls resulted in injuries. The Mini-BESTest predicted falls in patients with COPD at the 6- and 12-mo follow-ups with a cut-off score of 22.5 (area under the curve = 0.85 and 0.87) with good sensitivity and specificity (85.7% and 66.7%; 84% and 73.8%, respectively). Higher scores on the Mini-BESTest were associated with a lower risk of falls at 12 mo (OR = 0.50; 95% CI, 0.36-0.70; P < .001). Conclusions: Postural balance assessed by the Mini-BESTest is a good predictor of falls in patients with COPD. Our results imply that impaired balance contributes to the risk of falling and that balance training and fall prevention programs may be required for this population.
conferenceObject Non Concordance Between Sputum and Pulmonary Explant Fragments Culture in Patients with Cystic Fibrosis After Lung Transplantation(2018) ATHANAZIO, R. A.; RACHED, S. Z.; STELMACH, R.; CUKIER, A.; CARVALHO-PINTO, R. M.; COSTA, A. N.; FERNANDES, F. L.; SAMANO, M. N.; TEIXEIRA, R. H.; CAMPOS, S. V.