RODRIGO CARUSO CHATE
Índice h a partir de 2011
7
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/65, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Swyer-James-MacLeod Syndrome: The Hyperlucent Lung(2020) FARIAS, Lucas De Padua Gomes De; FONSECA, Eduardo Kaiser Ururahy Nunes; CHATE, Rodrigo Caruso; SAWAMURA, Marcio Valente Yamada
- Long-term respiratory follow-up of ICU hospitalized COVID-19 patients: Prospective cohort study(2023) CARVALHO, Carlos Roberto Ribeiro; LAMAS, Celina Almeida; CHATE, Rodrigo Caruso; SALGE, Joao Marcos; SAWAMURA, Marcio Valente Yamada; ALBUQUERQUE, Andre L. P. de; JR, Carlos Toufen; LIMA, Daniel Mario; GARCIA, Michelle Louvaes; SCUDELLER, Paula Gobi; NOMURA, Cesar Higa; GUTIERREZ, Marco Antonio; BALDI, Bruno GuedesBackgroundCoronavirus disease (COVID-19) survivors exhibit multisystemic alterations after hospitalization. Little is known about long-term imaging and pulmonary function of hospitalized patients intensive care unit (ICU) who survive COVID-19. We aimed to investigate long-term consequences of COVID-19 on the respiratory system of patients discharged from hospital ICU and identify risk factors associated with chest computed tomography (CT) lesion severity. MethodsA prospective cohort study of COVID-19 patients admitted to a tertiary hospital ICU in Brazil (March-August/2020), and followed-up six-twelve months after hospital admission. Initial assessment included: modified Medical Research Council dyspnea scale, SpO(2) evaluation, forced vital capacity, and chest X-Ray. Patients with alterations in at least one of these examinations were eligible for CT and pulmonary function tests (PFTs) approximately 16 months after hospital admission. Primary outcome: CT lesion severity (fibrotic-like or non-fibrotic-like). Baseline clinical variables were used to build a machine learning model (ML) to predict the severity of CT lesion. ResultsIn total, 326 patients (72%) were eligible for CT and PFTs. COVID-19 CT lesions were identified in 81.8% of patients, and half of them showed mild restrictive lung impairment and impaired lung diffusion capacity. Patients with COVID-19 CT findings were stratified into two categories of lesion severity: non-fibrotic-like (50.8%-ground-glass opacities/reticulations) and fibrotic-like (49.2%-traction bronchiectasis/architectural distortion). No association between CT feature severity and altered lung diffusion or functional restrictive/obstructive patterns was found. The ML detected that male sex, ICU and invasive mechanic ventilation (IMV) period, tracheostomy and vasoactive drug need during hospitalization were predictors of CT lesion severity(sensitivity,0.78 +/- 0.02;specificity,0.79 +/- 0.01;F1-score,0.78 +/- 0.02;positive predictive rate,0.78 +/- 0.02; accuracy,0.78 +/- 0.02; and area under the curve,0.83 +/- 0.01). ConclusionICU hospitalization due to COVID-19 led to respiratory system alterations six-twelve months after hospital admission. Male sex and critical disease acute phase, characterized by a longer ICU and IMV period, and need for tracheostomy and vasoactive drugs, were risk factors for severe CT lesions six-twelve months after hospital admission.
- Macroscopic Fat Embolism after Cosmetic Surgery(2022) FONSECA, Eduardo Kaiser Ururahy Nunes; CHATE, Rodrigo Caruso
- A Convolutional Neural Network Approach to Quantify Lung Disease Progression in Patients with Fibrotic Hypersensitivity Pneumonitis (HP)(2022) ALIBONI, Lorenzo; DIAS, Olivia Meira; BALDI, Bruno Guedes; SAWAMURA, Marcio Valente Yamada; CHATE, Rodrigo Caruso; CARVALHO, Carlos Roberto Ribeiro; ALBUQUERQUE, Andre Luis Pereira de; ALIVERTI, Andrea; PENNATI, FrancescaRationale and Objectives To evaluate associations between longitudinal changes of quantitative CT parameters and spirometry in patients with fibrotic hypersensitivity pneumonitis (HP). Materials and Methods Serial CT images and spirometric data were retrospectively collected in a group of 25 fibrotic HP patients. Quantitative CT analysis included histogram parameters (median, interquartile range, skewness, and kurtosis) and a pretrained convolutional neural network (CNN)-based textural analysis, aimed at quantifying the extent of consolidation (C), fibrosis (F), ground-glass opacity (GGO), low attenuation areas (LAA) and healthy tissue (H). Results At baseline, Ric was 61(44-70) %pred. The median follow-up period was 1.4(0.8-3.2) years, with 3(2-4) visits per patient. Over the study, 8 patients (32%) showed a FVC decline of more than 5%, a significant worsening of all histogram parameters (p <= 0.015) and an increased extent of fibrosis via CNN (p=0.038). On histogram analysis, decreased skewness and kurtosis were the parameters most strongly associated with worsened FVC (respectively, r2=0.63 and r2=0.54, p<0.001). On CNN classification, increased extent of fibrosis and consolidation were the measures most strongly correlated with FVC decline (r2=0.54 and r2=0.44, p<0.001). Conclusion CT histogram and CNN measurements provide sensitive measures of functional changes in fibrotic HP patients over time. Increased fibrosis was associated with FVC decline, providing index of disease progression. CNN may help improve fibrotic HP follow-up, providing a sensitive tool for progressive interstitial changes, which can potentially contribute to clinical decisions for individualizing disease management.
- Nephrobronchial fistula: a diagnostic challenge in a patient with IgG4-related disease(2023) PLENS, Glauco Cabral Marinho; BRIDI, Guilherme das Posses; NASCIMENTO, Ellen Caroline Toledo do; CHATE, Rodrigo Caruso; BALDI, Bruno Guedes; ARIMURA, Fabio Eiji; KAIRALLA, Ronaldo Adib
- Clinical, tomographic and functional comparison of sporadic and tuberous sclerosis complex-associated forms of lymphangioleiomyomatosis: a retrospective cohort study(2024) OLIVEIRA, Martina Rodrigues; WANDERLEY, Mark; FREITAS, Carolina Salim Goncalves; KAIRALLA, Ronaldo Adib; CHATE, Rodrigo Caruso; AMARAL, Alexandre Franco; ARIMURA, Fabio Eiji; SAMORANO, Luciana Paula; WATANABE, Elieser Hitoshi; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno GuedesBackground Lymphangioleiomyomatosis (LAM) is a rare disease that can occur sporadically (S-LAM) or associated with the tuberous sclerosis complex (TSC-LAM). The natural history of LAM is not completely understood, including whether there is a difference between the clinical courses of the two forms. This study aimed to compare the clinical, functional and tomographic features between S-LAM and TSC-LAM, and evaluate the annual rates of change in lung function. Methods This retrospective cohort study included patients with LAM followed up between 1994 and 2019. Clinical, functional and imaging variables were evaluated, and the lung cysts were automatically quantified. Quality of life and predictors of lung function impairment were accessed, and the annual rate of lung function decline was compared between S-LAM and TSC-LAM. Results Of the 107 patients included, 77 had S-LAM and 30 had TSC-LAM. Although patients with TSCLAM had a higher prevalence of renal angiomyolipomas and neurological and dermatological manifestations, pulmonary function tests were similar. Patients with S-LAM had a greater rate of forced expiratory volume in 1 s decline and a higher extent of cysts. Pneumothorax, desaturation in the 6-minute walking test and a higher extent of lung cysts were predictors of functional impairment. A greater impact on vitality and emotional health was observed in the TSC-LAM. Conclusion Greater functional decline and a higher cystic extension were found in patients with S-LAM. Our study provides a broad clinical, functional and tomographic characterisation of patients with LAM, adding valuable information to the existing evidence to better understand the two forms of the disease.
- Post-COVID-19 respiratory sequelae two years after hospitalization: an ambidirectional study(2024) CARVALHO, Carlos Roberto Ribeiro; LAMAS, Celina de Almeida; LUNA, Luis Augusto Visani de; CHATE, Rodrigo Caruso; SALGE, Joao Marcos; SAWAMURA, Marcio Valente Yamada; TOUFEN, Carlos; GARCIA, Michelle Louvaes; SCUDELLER, Paula Gobi; NOMURA, Cesar Higa; GUTIERREZ, Marco Antonio; BALDI, Bruno GuedesBackground COVID-19 lung sequelae can impact the course of patient lives. We investigated the evolution of pulmonary abnormalities in post-COVID-19 patients 18-24 months after hospital discharge. Methods A cohort of COVID-19 patients admitted to the Hospital das Cl & iacute;nicas da Faculdade de Medicina da USP in S & atilde;o Paulo, Brazil, between March and August of 2020, were followed-up 6-12 months after hospital discharge. A subset of patients with pulmonary involvement and chest computed tomography (CT) scans were eligible to participate in this second follow-up (18-24 months). Data was analyzed in an ambidirectional manner, including retrospective data from the hospitalization, and from the first follow-up (6-12 months after discharge), and compared with the prospective data collected in this new follow-up. Findings From 348 patients eligible, 237 (68%) participated in this follow-up. Among participants, 139 (58%) patients presented ground-glass opacities and reticulations, and 80 (33%) presented fibrotic-like lesions (traction bronchiectasis and architectural distortion). Five (2%) patients improved compared to the 6-12-month assessment, but 20 (25%) of 80 presented worsening of lung abnormalities. For those with relevant assessments on both occasions, comparing the CT findings between this follow-up with the previous assessment, there was an increase in patients with architectural distortion (43 [21%] of 204 vs 57 [28%] of 204, p = 0.0093), as well as in traction bronchiectasis (55 [27%] of 204 vs 69 [34%] of 204, p = 0.0043). Patients presented a persistent functional impairment with demonstrated restrictive pattern in both follow-ups (87 [42%] of 207 vs 91 [44%] of 207, p = 0.76), as well as for the reduced diffusion capacity (88 [42%] of 208 vs 87 [42%] of 208, p = 1.0). Length of hospitalization (OR 1.04 [1.01-1.07], p = 0.0040), invasive mechanical ventilation (OR 3.11 [1.3-7.5] p = 0.011), patient's age (OR 1.03 [1.01-1.06] p = 0.0074 were consistent predictors for development of fibrotic-like lung lesions in post-COVID-19 patients. Interpretation Post-COVID-19 lung sequelae can persist and progress after hospital discharge, suggesting airways involvement and formation of new fibrotic-like lesions, mainly in patients who were in intensive care unit (ICU). Funding S & atilde;o Paulo Research Foundation (22/01769-5) and Instituto Todos pela Sa & uacute;de (C1721).