FABIO DE REZENDE PINNA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
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- Biopsy of the olfactory epithelium from the superior nasal septum: is it possible to obtain neurons without damaging olfaction?(2022) GARCIA, Ellen Cristine Duarte; LUZ, Lucas de Almeida; ANZOLIN, Lucas Kanieski; SILVA, Jose Lucas Barbosa da; DOTY, Richard L.; PINNA, Fabio de Rezende; VOEGELS, Richard Louis; FORNAZIERI, Marco AurelioIntroduction: Olfactory epithelium biopsy has been useful for studying diverse otorhinolaryngological and neurological diseases, including the potential to better understand the pathophysiology behind COVID-19 olfactory manifestations. However, the safety and efficacy of the technique for obtaining human olfactory epithelium are still not fully established. Objective: This study aimed to determine the safety and efficacy of harvesting olfactory epithelium cells, nerve bundles, and olfactory epithelium proper for morphological analysis from the superior nasal septum. Methods: During nasal surgery, 22 individuals without olfactory complaints underwent olfactory epithelium biopsies from the superior nasal septum. The efficacy of obtaining olfactory epithelium, verification of intact olfactory epithelium and the presence of nerve bundles in biopsies were assessed using immunofluorescence. Safety for the olfactory function was tested psychophysically using both unilateral and bilateral tests before and 1 month after the operative procedure. Results: Olfactory epithelium was found in 59.1% of the subjects. Of the samples, 50% were of the quality necessary for morphological characterization and 90.9% had nerve bundles. There was no difference in the psychophysical scores obtained in the bilateral olfactory test (University of Pennsylvania Smell Identification Test [UPSIT (R)]) between means before biopsy: 32.3 vs. postoperative: 32.5, p = 0.81. Also, no significant decrease occurred in unilateral testing (mean unilateral test scores 6 vs. 6.2, p = 0.46). None out of the 56 different odorant identification significantly diminished (p > 0.05). Conclusion: The technique depicted for olfactory epithelium biopsy is highly effective in obtaining neuronal olfactory tissue, but it has moderate efficacy in achieving samples useful for morphological analysis. Olfactory sensitivity remained intact. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Clinical, sociodemographic and environmental factors impact post-COVID-19 syndrome(2022) FERREIRA, Juliana Carvalho; MOREIRA, Tiana C. Lopes; ARAUJO, Adriana Ladeira de; IMAMURA, Marta; DAMIANO, Rodolfo F.; GARCIA, Michelle L.; SAWAMURA, Marcio V. Y.; PINNA, Fabio R.; GUEDES, Bruno F.; GONCALVES, Fabio A. Rodrigues; MANCINI, Marcio; BURDMANN, Emmanuel A.; SILVA FILHO, Demostenes Ferreira da; POLIZEL, Jefferson Lordello; BENTO, Ricardo F.; ROCHA, Vanderson; NITRINI, Ricardo; SOUZA, Heraldo Possolo de; LEVIN, Anna S.; KALLAS, Esper G.; FORLENZA, Orestes V.; BUSATTO, Geraldo F.; BATISTELLA, Linamara R.; CARVALHO, Carlos R. Ribeiro de; MAUAD, Thais; GOUVEIA, NelsonBackground Sociodemographic and environmental factors are associat-ed with incidence, severity, and mortality of COVID-19. However, little is known about the role of such factors in persisting symptoms among re-covering patients. We designed a cohort study of hospitalized COVID-19 survivors to describe persistent symptoms and identify factors associated with post-COVID-19 syndrome. Methods We included patients hospitalized between March to August 2020 who were alive six months after hospitalization. We collected indi-vidual and clinical characteristics during hospitalization and at follow-up assessed ten symptoms with standardized scales, 19 yes/no symptoms, a functional status and a quality-of-life scale and performed four clinical tests. We examined individual exposure to greenspace and air pollution and considered neighbourhood acute accent s population density and socioeconomic conditions as contextual factors in multilevel regression analysis. Results We included 749 patients with a median follow-up of 200 (IQR = 185-235) days, and 618 (83%) had at least one of the ten symptoms measured with scales. Pain (41%), fatigue (38%) and posttraumatic stress disorder (35%) were the most frequent. COVID-19 severity, comorbidities, BMI, female sex, younger age, and low socioeconomic position were associ-ated with different symptoms. Exposure to ambient air pollution was asso-ciated with higher dyspnoea and fatigue scores and lower functional status. Conclusions We identified a high frequency of persistent symptoms among COVID-19 survivors that were associated with clinical, sociodemographic, and environmental variables. These findings indicate that most patients re-covering from COVID-19 will need post-discharge care, and an additional burden to health care systems, especially in LMICs, should be expected.
- Post-acute sequelae of SARS-CoV-2 infection: relationship of central nervous system manifestations with physical disability and systemic inflammation(2022) BUSATTO, Geraldo F.; ARAUJO, Adriana Ladeira de; CASTALDELLI-MAIA, Joao Mauricio; DAMIANO, Rodolfo Furlan; IMAMURA, Marta; GUEDES, Bruno F.; PINNA, Fabio de Rezende; SAWAMURA, Marcio Valente Yamada; MANCINI, Marcio C.; SILVA, Katia R. da; GARCIA, Michelle L.; SUMITA, Nairo; BRUNONI, Andre Russowsky; DUARTE, Alberto J. da Silva; BURDMANN, Emmanuel A.; KALLAS, Esper G.; CERRI, Giovanni G.; NITRINI, Ricardo; BENTO, Ricardo F.; ROCHA, Vanderson Geraldo; SOUZA, Heraldo Possolo de; MIGUEL, Euripedes C.; CARVALHO, Carlos R. R. de; FORLENZA, Orestes V.; BATISTELLA, Linamara RizzoBackground Despite the multitude of clinical manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC), studies applying statistical methods to directly investigate patterns of symptom co-occurrence and their biological correlates are scarce. Methods We assessed 30 symptoms pertaining to different organ systems in 749 adults (age = 55 +/- 14 years; 47% female) during in-person visits conducted at 6-11 months after hospitalization due to coronavirus disease 2019 (COVID-19), including six psychiatric and cognitive manifestations. Symptom co-occurrence was initially investigated using exploratory factor analysis (EFA), and latent variable modeling was then conducted using Item Response Theory (IRT). We investigated associations of latent variable severity with objective indices of persistent physical disability, pulmonary and kidney dysfunction, and C-reactive protein and D-dimer blood levels, measured at the same follow-up assessment. Results The EFA extracted one factor, explaining 64.8% of variance; loadings were positive for all symptoms, and above 0.35 for 16 of them. The latent trait generated using IRT placed fatigue, psychiatric, and cognitive manifestations as the most discriminative symptoms (coefficients > 1.5, p < 0.001). Latent trait severity was associated with decreased body weight and poorer physical performance (coefficients > 0.240; p <= 0.003), and elevated blood levels of C-reactive protein (coefficient = 0.378; 95% CI 0.215-0.541; p < 0.001) and D-dimer (coefficient = 0.412; 95% CI 0.123-0.702; p = 0.005). Results were similar after excluding subjects with pro-inflammatory comorbidities. Conclusions Different symptoms that persist for several months after moderate or severe COVID-19 may unite within one latent trait of PASC. This trait is dominated by fatigue and psychiatric symptoms, and is associated with objective signs of physical disability and persistent systemic inflammation.
- Post-acute sequelae of SARS-CoV-2 infection: relationship of central nervous system manifestations with physical disability and systemic inflammation (May, 10.1017/S0033291722001374, 2020)(2022) BUSATTO, Geraldo F.; ARAUJO, Adriana Ladeira de; CASTALDELLI-MAIA, Joao Mauricio; DAMIANO, Rodolfo Furlan; IMAMURA, Marta; GUEDES, Bruno F.; PINNA, Fabio de Rezende; SAWAMURA, Marcio Valente Yamada; MANCINI, Marcio C.; SILVA, Katia R. da; GARCIA, Michelle L.; SUMITA, Nairo; BRUNONI, Andre Russowsky; DUARTE, Alberto J. da Silva; BURDMANN, Emmanuel A.; KALLAS, Esper G.; CERRI, Giovanni G.; NITRINI, Ricardo; BENTO, Ricardo F.; ROCHA, Vanderson Geraldo; SOUZA, Heraldo Possolo de; MIGUEL, Euripedes C.; CARVALHO, Carlos R. R. de; FORLENZA, Orestes V.; BATISTELLA, Linamara Rizzo
- Adaptation of the Pediatric Smell Wheel (TM) to evaluate olfactory function in Brazilian children(2022) FORNAZIERI, Marco A.; EBARA, Lucas K.; ARAUJO, Rafael Goulart de; LIMA, Joao Vitor Fernandes; FAVARETO, Felipe B.; PINNA, Fabio R.; VOEGELS, Richard L.; DOTY, Richard L.Objective: Olfaction influences nutrition, safety, and the cognitive development of children. Presently there are few olfactory tests for children, and normative reference values are generally lacking. In this study, we validate the Pediatric Smell Wheel (TM) (PSW) to evaluate olfactory function in Brazilian children. Methods: We modified and validated the PSW, a test developed in the United States, for administration in Brazil, and established normative data for Brazilian children. The validation process consisted of five phases. First, we identified odorants familiar to Brazilian children. Second, we established the test-retest reliability of the Brazilian PSW test that employed these odorants. Third, we compared the test scores of healthy children to those microsmic from adenoid hypertrophy. Fourth, we examined the test's ability to detect improvement in olfactory function before and after adenoidectomy. Finally, we determined a normative 10th percentile cut point for defining microsmia in a sample of 169 healthy Brazilian children between 5 and 12 years of age. Results: Eleven odors were identified for inclusion in the test. The test-retest reliability wasmodest (r = 0.54, p < 0.001), although likely attenuated based on the inclusion of only datafrom children with normal function. The test clearly differentiated the olfactory function ofchildren with adenoid hypertrophy from that of healthy children and demonstrated the returnof function after adenoidectomy. An overall score <7 was found useful in defining hyposmia, although additional age-related cut-points were also defined. Conclusion: A Brazilian version of the PSW was developed and validated and found to be efficacious in detecting smell dysfunction in children ranging in age from 5 to 12 years. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.