EVELISE LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- What is the optimal large airway size reduction value to determine malacia: exploratory bronchoscopic analysis in patients in Mounier-Kuhn syndrome(2021) LIMA, Evelise; GENTA, Pedro Rodrigues; ATHANAZIO, Rodrigo Abensur; RODRIGUES, Ascedio Jose; APARECIDA, Maria; NAKAMURA, Maria Aparecida Miyuki; RACHED, Samia Zahi; COSTA, Eduardo Leite Vieira; STELMACH, Rafael
- Laryngo-tracheobronchial amyloidosis(2020) UYAGUARI, Juan Pablo; QUIZHPE, Pedro Jose; LIMA, Evelise
conferenceObject Cryobiopsy in the Diagnosis of Lung Allograft Rejection: Brazilian Case Series(2022) BELON, Carlos E. F.; OKUNO, Elissa A.; CAMPOS, Silvia V.; RODRIGUES, Ascedio J.; LIMA, Evelisse; SCORDAMAGLIO, Paulo R.; CAMARGO, Priscila C. L. B.; TEIXEIRA, Ricardo H. O. B.; CARRARO, Rafael M.; COSTA, Andre N.; PIRES, Juliana P.; REIS, Flavio P.; FERNANDES, Lucas M.; ABDALLA, Luis G.; FERNANDES, Paulo M. P.; FILHO, Mauro R.; SANTOS, Samuel L.- Improving Airways Patency and Ventilation Through Optimal Positive Pressure Identified by Noninvasive Mechanical Ventilation Titration in Mounier-Kuhn Syndrome: Protocol for an Interventional, Open-Label, Single-Arm Clinical Trial(2020) LIMA, Evelise; NAKAMURA, Maria Aparecida Miyuki; GENTA, Pedro Rodrigues; RODRIGUES, Ascedio Jose; ATHANAZIO, Rodrigo Abensur; RACHED, Samia; COSTA, Eduardo Leite Vieira; STELMACH, RafaelBackground: Mounier-Kuhn syndrome or congenital tracheobronchomegaly is a rare disease characterized by dilation of the trachea and the main bronchi within the thoracic cavity. The predominant signs and symptoms of the disease include coughing, purulent and abundant expectoration, dyspnea, snoring, wheezing, and recurrent respiratory infection. Symptoms of the disease in some patients are believed to be pathological manifestations arising due to resident tracheobronchomalacia. Although treatment options used for the management of this disease include inhaled bronchodilators, corticosteroids, and hypertonic solution, there is no consensus on the treatment. The use of continuous positive airway pressure (CPAP) has been reported as a potential therapeutic option for tracheobronchomalacia, but no prospective studies have demonstrated its efficacy in this condition. Objective: The purpose of this is to identify the presence of tracheobronchomalacia and an optimal CPAP pressure that reduces the tracheobronchial collapse in patients with Mounier-Kuhn syndrome and to analyze the repercussion in pulmonary ventilation. In parallel, we aim to evaluate the prevalence of obstructive sleep apnea/hypopnea syndrome. Methods: This interventional, open-label, single-arm clinical trial will enroll patients who are diagnosed Mounier-Kuhn syndrome. Patient evaluation will be conducted in an outpatient clinic and involve 3 visits. Visit 1 will involve the collection and registration of social demographic, clinical, and functional data. Visit 2 will entail polysomnography, bronchoscopy for the evaluation of tracheobronchomalacia, titration of the optimal pressure that reduces the degree of collapse of the airway, and electrical impedance tomography. In visit 3, patients exhibiting a reduction in collapse areas will be requested to undergo chest computed tomography during inspiration and forced expiration with and without positive pressure (titrated to determine optimal CPAP pressure). Results: This protocol is a doctorate project. The project was submitted to the institutional review board on January 24, 2017, and approval was granted on February 2, 2017 (Brazilian Research database number CAAE 64001317.4.000.0068). Patient evaluations started in April 2018. Planned recruitment is based on volunteers' availability and clinical stability, and interventions will be conducted at least once a month to finish the project at the end of 2020. A preliminary analysis of each case will be performed after each intervention, but detailed results are expected to be reported in the first quarter of 2021. Conclusions: There is no consensus on the best treatment options for managing Mounier-Kuhn syndrome. The use of positive pressure could maintain patency of the collapsed airways, functioning as a ""pneumatic stent"" to reduce the degree of airflow obstruction. This, in turn, could promote mobilization of thoracic secretion and improve pulmonary ventilation.
- Endoscopic aspects and associated factors in paradoxical vocal fold movement(2022) ESPINDULA, Bianca Fidelix; LIMA, Evelise; RODRIGUES, Ascedio Jose; CUKIER, AlbertoIntroduction: Paradoxical vocal fold movement (PVFM) is a respiratory disorder related to inadequate movement of vocal folds during inspiration or expiration. Its epidemiology and pathogenesis are unknown. The present study describes the standardization of the examination performed in our service and the main endoscopic changes found, evaluating the prevalence of PVFM in patients with suggestive symptoms and describing the association of PVFM with asthma and other diseases. Materials and methods: Retrospective observational study of a series of cases over a 13-year period - adult patients referred for outpatient bronchoscopy due to suspected PVFM. Results: We analyzed 1131 laryngoscopies performed on patients referred for suspicion of PVFM from May 2006 to June 2019. Of these, 368 cases were excluded from the study. A total of 255 patients (33%) had a confirmed diagnosis of PVFM, 224 women (88%). The most frequent comorbidities found were asthma (62%), rhinitis (45%), gastro-oesophageal reflux disease (45%), obesity (24%), and psychiatric disorders (19%). Among the endoscopic findings concomitant with the diagnosis of PVDM, we highlight posterior laryngitis (71%), diseases of the nasal septum (18%), nasal polyps (7%). Discussion: Female sex is more affected. There are several associations with other diseases, the main one being asthma, followed by rhinitis and psychiatric disorders. Obesity appears as a comorbidity in 24% of patients, as does sleep apnoea in 13%. Posterior laryngitis was the most common endoscopic finding. PVFM is an underdiagnosed disease, little known as it is a rare entity that still needs prospective studies. Exam standardization is important.
- 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 PaulaObjetivo: 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.
- Intracavitary pulmonary aspergilloma: endoscopic aspects(2015) LIMA, Evelise; NAGY, Andre Louis Lobo; ATHANAZIO, Rodrigo Abensur
- Flexible bronchoscopy: the first-choice method of removing foreign bodies from the airways of children(2022) LIMA, Evelise; ESPINDOLA, Bianca Fidelix; MORAIS, Isadora Oliveira; SCORDAMAGLIO, Paulo Rogerio; RODRIGUES, Ascedio Jose
conferenceObject Hard metal lung disease - Role of bronchoalveolar lavage in the diagnosis(2014) MIZUTANI, Rafael Futoshi; GONCALVES, Carolina Salim; LIMA, Evelise; LEAO, Beatriz Dalcolmo de Almeida; LOMBARDI, Elisa Maria Siqueira; TERRA-FILHO, Mario; SANTOS, Ubiratan de Paula- Flexible broncoscopy in patients in supportive therapy with oxygenation by extracorporeal membrane(2022) REDIVO, Camila Franca; LIMA, Evelise; FERREIRA, Anaregia de Pontes; SCORDAMAGLIO, Paulo Rogerio; CAMPOS, Silvia Vidal; HO, Yeh-Li; RODRIGUES, Ascedio JoseObjective: To report the experience of performing bronchoscopy in patients who underwent supportive therapy with extracorporeal membrane oxygenation in whom the bronchoscopy was performed. Methods: This was a review of medical records of patients diagnosed with extracorporeal membrane oxygenation and who required diagnostic or therapeutic bronchoscopy. Records included were related to patients admitted to the intensive care unit of Hospital das Clinicas of Faculdade de Medicina of Universidade de Sao Paulo, between 2014 and 2020. Results: During the study, 16 bronchoscopies were performed in 8 patients admitted to the intensive care unit and who underwent supportive therapy with extracorporeal membrane oxygenation. The mean age of patients was 28.37 years. Four patients were women (50%). A total of 5 (31.25%) therapeutic bronchoscopies and 11 (68.75%) diagnostics were performed. In 5 of patients, material was collected: 4 samples of bronchoalveolar lavage, three collections of transbronchial biopsies, and 1 of endobronchial biopsies. No patient had radiological worsening or hemodynamic complications. One patient (6.25%) had transient desaturation. There was moderate bleeding after transbronchial biopsy in 1 (6.25%) procedure, which was resolved endoscopically. Conclusion: Patients undergoing extracorporeal membrane oxygenation can safely perform diagnostic or therapeutic bronchoscopy provided that they have a detailed indication. Procedures were performed by a specialized bronchoscopy team in intensive care environment and with the assistance of a qualified multidisciplinary team in membrane oxygenation therapy extracorporeal.