RODRIGO CARUSO CHATE

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/65, Hospital das Clínicas, Faculdade de Medicina

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  • article 32 Citação(ões) na Scopus
    Do Current Lung Cancer Screening Guidelines Apply for Populations With High Prevalence of Granulomatous Disease? Results From the First Brazilian Lung Cancer Screening Trial (BRELT1)
    (2016) SANTOS, Ricardo Sales dos; FRANCESCHINI, Juliana P.; CHATE, Rodrigo Caruso; GHEFTER, Mario Claudio; KAY, Fernando; TRAJANO, Andre Luiz C.; PEREIRA, Jose Rodrigues; SUCCI, Jose Ernesto; FERNANDO, Hiran C.; SAAD JUNIOR, Roberto
    Background. Low-dose computed tomography (LDCT) screening for lung cancer has been demonstrated to be effective in reducing cancer mortality. However, these studies have not been undertaken in countries where the incidence of granulomatous disease is high. The First Brazilian Lung Cancer Screening Trial (BRELT1) has completed initial accrual and is now in the follow-up phase. We present results from the initial prevalence round of screening. Methods. The inclusion criteria were the same as those for the National Lung Cancer Screening Trial (NLST). Pulmonary nodules larger than 4 mm were considered positive and required evaluation by a multidisciplinary team. Indeterminate nodules were evaluated with fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) or biopsy when indicated. Statistical analysis was performed with Fisher's exact test to compare our positive findings with those of the NLST. Results. From January 2013 to July 2014, 790 participants were enrolled. Positive LDCT scans were reported in 312 (39.4%) participants, with a total of 552 nodules larger than 4 mm. The comparison between positive findings in the NLST (7,191 of 26,722 cases) and those in the BRELT1 (312 of 790 cases) showed a significant difference (p < 0.001). The positive predictive value was lower in BRELT1 than in the NLST (3.2% versus 3.8%, respectively). Follow-up imaging was indicated in 278 of 312 (89.1%) participants; 35 procedures were performed in 25 participants. In 15 cases, benign lesions were diagnosed. Non-small-cell lung cancer (NSCLC) was diagnosed in 10 patients (prevalence of 1.3%). In 8 patients (stage IA/IB disease), treatment was by resection only, in 1 patient neoadjuvant chemotherapy was used (stage IIIA), and in 1 patient advanced disease was diagnosed (stage IV). Conclusions. Using NSLT criteria, a larger number of patients had positive scans (nodules), compared with previous lung cancer screening studies. However, the number of participants requiring surgical biopsy procedures and who were ultimately identified as having cancer was similar to other reports. This supports the role of screening in patient populations with a high incidence of granulomatous inflammation. (C) 2016 by The Society of Thoracic Surgeons
  • bookPart
    Métodos Diagnósticos por Imagem em Doenças Respiratórias
    (2016) FUNARI, Marcelo Buarque de Gusmão; FRANCISCO NETO, Miguel José; CHATE, Rodrigo Caruso
  • article 20 Citação(ões) na Scopus
    Hard metal lung disease: a case series
    (2016) MIZUTANI, Rafael Futoshi; TERRA-FILHO, Mario; LIMA, Evelise; FREITAS, Carolina Salim Goncalves; CHAFE, Rodrigo Caruso; KAIRALLA, Ronaldo Adib; CARVALHO-OLIVEIRA, Regiani; SANTOS, Ubiratan Paula
    Objetivo: Descrever aspectos relacionados ao diagnóstico e tratamento de pacientes com doença pulmonar por metal duro (DPMD) e realizar uma revisão da literatura. Métodos: Estudo retrospectivo dos prontuários médicos de pacientes atendidos no Serviço de Doenças Respiratórias Ocupacionais do Instituto do Coração, localizado na cidade de São Paulo, entre 2010 e 2013. Resultados: Entre 320 pacientes atendidos no período do estudo, 5 (1,56%) foram diagnosticados com DPMD. Todos os pacientes eram do sexo masculino, com média de idade de 42,0 ± 13,6 anos e média de tempo de exposição a metal duro de 11,4 ± 8,0 anos. Os pacientes foram submetidos a avaliação clinica, história ocupacional, TCAR de tórax, prova de função pulmonar, broncoscopia com LBA e biópsia pulmonar. Todos apresentaram distúrbio ventilatório restritivo. O achado de imagem à TCAR de tórax mais frequente foi de opacidades em vidro fosco (em 80%). Em 4 pacientes, o LBA revelou presença de células gigantes multinucleadas. Em 3, foi diagnosticada pneumonia intersticial por células gigantes na biópsia pulmonar. Houve o diagnóstico de pneumonia intersticial descamativa associada à bronquiolite celular em 1 paciente e de pneumonite de hipersensibilidade em 1. Todos foram afastados da exposição e tratados com corticoide. Houve melhora em 2 pacientes e progressão da doença em 3. Conclusões: Apesar de ser uma entidade rara, a DPMD deve ser sempre considerada em trabalhadores com risco ocupacional elevado de exposição a metais duros. A história clínica e ocupacional associada a achados em TCAR de tórax e LBA sugestivos da doença podem ser suficientes para o diagnóstico.
  • conferenceObject
    Incidence of pulmonary embolism and upper-extremity deep venous thrombosis in patients submitted to lead extraction and upgrade procedures
    (2016) ALBERTINI, C. M. M.; SILVA, K. R.; AMAYA, I. C. M.; MELO, G. R. G.; CREVELARI, E. S.; LEAL, J. M. M.; LIMA, M. F.; CHATE, R. C.; HIGA, K.; NOMURA, C.; MARTINELLI FILHO, M.; COSTA, R.