RODRIGO ABENSUR ATHANAZIO
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
13 resultados
Resultados de Busca
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- Cross-sectional, observational study to estimate the prevalence of the eosinophilic phenotype for Brazilian patients with severe asthma: the BRAEOS study(2020) ATHANAZIO, Rodrigo; STELMACH, Rafael; ANTILA, Martti; MACHADO, Adelmir; ARRUDA, Luisa Karla; NETO, Alcindo; CERPA, Faradiba; BLANCO, Daniela; LIMA, Marina; RABAHI, Marcelo; BIANCHI, Pedro; FURLAN, Luisa; MARIA, Andre Santa; LOPES, Flavia; SOUZA, Angela; PENHA, Marcio
- Symptom variability over the course of the day in patients with stable COPD in Brazil: a real-world observational study(2020) CUKIER, Alberto; GODOY, Irma de; COSTA, Claudia Henrique da; RUBIN, Adalberto Sperb; GREGORIO, Marcelo Gervilla; ALBUQUERQUE NETO, Aldo Agra de; LIMA, Marina Andrade; PEREIRA, Monica Corso; TANNI, Suzana Erico; ATHANAZIO, Rodrigo Abensur; BESSA, Elizabeth Jauhar Cardoso; WEHRMEISTER, Fernando Cesar; LOURENCO, Cristina Bassi; MENEZES, Ana Maria BaptistaObjective: To analyze symptoms at different times of day in patients with COPD. Methods: This was a multicenter, cross-sectional observational study conducted at eight centers in Brazil. We evaluated morning, daytime, and nighttime symptoms in patients with stable COPD. Results: We included 593 patients under regular treatment, of whom 309 (52.1%) were male and 92 (15.5%) were active smokers. The mean age was 67.7 years, and the mean FEV1 was 49.4% of the predicted value. In comparison with the patients who had mild or moderate symptoms, the 183 (30.8%) with severe symptoms were less physically active (p = 0.002), had greater airflow limitation (p < 0.001), had more outpatient exacerbations (p = 0.002) and more inpatient exacerbations (p = 0.043), as well as scoring worse on specific instruments. The most common morning and nighttime symptoms were dyspnea (in 45.2% and 33.1%, respectively), cough (in 37.5% and 33.3%, respectively), and wheezing (in 24.4% and 27.0%, respectively). The intensity of daytime symptoms correlated strongly with that of morning symptoms (r = 0.65, p < 0.001) and that of nighttime symptoms (r = 0.60, p < 0.001), as well as with the COPD Assessment Test score (r = 0.62; p < 0.001), although it showed only a weak correlation with FEV 1 (r = -0.205; p < 0.001). Conclusions: Dyspnea was more common in the morning than at night. Having morning or nighttime symptoms was associated with greater daytime symptom severity. Symptom intensity was strongly associated with poor quality of life and with the frequency of exacerbations, although it was weakly associated with airflow limitation.
conferenceObject Mycobacterium Parascrofulaceum in a Patient with Alpha 1 Antitrypsin Deficiency: Case Report(2020) BRIDI, G. D.; JESUS, R. M. De; SCHUBSKY, J.; LEIBEL, T.; ENDLICH, B. N.; RACHED, S. Z.; ATHANAZIO, R. A.; PINTO, R. M. De Carvalho; STELMACH, R.; CUKIER, A.- Quality of Life Questionnaire-Bronchiectasis: a study of the psychometric properties of the Brazilian Portuguese version(2020) CAMARGO, Cristiane O. de; JOSE, Anderson; LUPPO, Adriano; CAMARGO, Anderson A. de; ATHANAZIO, Rodrigo A.; RACHED, Samia Z.; QUITTNER, Alexandra L.; STELMACH, Rafael; CORSO, Simone DalObjective: To evaluate the psychometric properties of the Brazilian Portuguese version of the Quality of Life Questionnaire-Bronchiectasis. Design: Cross-sectional study. Setting: Outpatient clinic. Subjects: Clinically stable individuals with a diagnosis of bronchiectasis. Measures: The evaluations performed were spirometry, incremental shuttle walk test, Saint George's Respiratory Questionnaire, and the modified Medical Research Council dyspnea scale. The Quality of Life Questionnaire-Bronchiectasis was administered twice (seven to 14 days apart). Psychometric analyses were performed as follows: reliability, construct validity, criterion validity, and interpretability. Results: In total, 108 individuals (48 +/- 14 years, 61 women) participated in the study. Internal consistency was considered adequate (Cronbach's alpha > 0.70) for the majority of scales (from 0.58 to 0.93). Test-retest coefficients were moderate to excellent (intraclass correlation coefficients from 0.70 to 0.93). In the construct validity, 35 of 37 items correlated more strongly with their assigned scale than a competing scale. The convergent validity showed significant correlations between scales of the Quality of Life Questionnaire-Bronchiectasis with modified Medical Research Council dyspnea scale, and incremental shuttle walk test (r from 0.20 to 0.59). A low to moderate correlations was revealed between all scales of the Quality of Life Questionnaire-Bronchiectasis and the Saint George's Respiratory Questionnaire domains (r from 0.26 to 0.70). The standard error of measurement was acceptable. Ceiling effects were found for the Social Functioning and Treatment Burden scales. Conclusions: The Quality of Life Questionnaire-Bronchiectasis is a reliable, valid instrument with adequate internal consistency for the evaluation of the impact of bronchiectasis on the health-related quality of life of Brazilian adults.
- Characterization of the severity of dyspnea in patients with bronchiectasis: correlation with clinical, functional, and tomographic aspects(2020) NUCCI, Maria Cecilia Nieves Maiorano de; FERNANDES, Frederico Leon Arrabal; SALGE, Joao Marcos; STELMACH, Rafael; CUKIER, Alberto; ATHANAZIO, RodrigoObjective: To characterize a population of patients with bronchiectasis, correlating clinical, radiological, and functional aspects with the severity of dyspnea. Methods: This was a cross-sectional study involving adult patients with HRCT-confirmed bronchiectasis, categorized according to the severity of dyspnea (as being mildly or severely symptomatic, on the basis of the modified Medical Research Council scale). We correlated the severity of dyspnea with clinical parameters, functional parameters (spirometry values, lung volumes, and DLCO), and CT parameters. Results: We evaluated 114 patients, 47 (41%) of whom were men. The median age (interquartile range) was 42 years (30-55 years). The most common form was idiopathic bronchiectasis. Of the 114 patients, 20 (17.5%) were colonized with Pseudomonas aeruginosa and 59 (51.8%) were under continuous treatment with macrolides. When we applied the Exacerbation in the previous year, FEV1, Age, Colonization, Extension, and Dyspnea score, the severity of dyspnea was categorized as moderate in 54 patients (47.4%), whereas it was categorized as mild in 50 (43.9%) when we applied the Bronchiectasis Severity Index. The most common lung function pattern was one of obstruction, seen in 95 patients (83.3%), and air trapping was seen in 77 patients (68.7%). The prevalence of an obstructive pattern on spirometry was higher among the patients with dyspnea that was more severe, and most functional parameters showed reasonable accuracy in discriminating between levels of dyspnea severity. Conclusions: Patients with bronchiectasis and dyspnea that was more severe had greater functional impairment. The measurement of lung volumes complemented the spirometry data. Because bronchiectasis is a complex, heterogeneous condition, a single variable does not seem to be sufficient to provide an overall characterization of the clinical condition.
- The effect of bronchodilators in the exercise capacity and thoracoabdominal mechanics of subjects with bronchiectasis: a randomized crossover, double-blinded, placebo-controlled trial(2020) SILVA, Cibele C. B. Marques Da; QUEIROZ, Douglas Silva; ATHANAZIO, Rodrigo A.; CORSO, Simone L.; RACHED, Samia; LUNARDI, Adriana C.; VITORASSO, Renato; MORIYA, Henrique T.; FONSECA, Alfredo; CARVALHO, Celso R. F.
- Early COVID-19 infection after lung transplantation in a patient with cystic fibrosis(2020) ATHANAZIO, Rodrigo Abensur; COSTA, Andre Nathan; CARRARO, Rafael Medeiros; GONZALEZ, Diego; RACHED, Samia Zahi; SAMANO, Marcos Naoyuki; TEIXEIRA, Ricardo Henrique de Oliveira Braga; CAMPOS, Silvia Vidal
- Small airway evolution of a Brazilian severe asthmatic cohort (BRASASP): 10 years follow up(2020) SANTOS JUNIOR, Nilton Goncalves Dos; LIMA, Renato Miranda; ATHANAZIO, Rodrigo Abensur; PINTO, Regina Maria De Carvalho; SALGE, Joao Marcos; RABE, Klaus; CUKIER, Alberto; STELMACH, Rafael
- 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.
- Physiological Responses During Field Walking Tests in Adults with Bronchiectasis(2020) CORSO, Simone Dal; BOLDORINI, Jacqueline C.; CAMARGO, Anderson A. de; JOSE, Anderson; RACHED, Samia Z.; ATHANAZIO, Rodrigo A.; STELMACH, Rafael; HOLLAND, Anne E.BACKGROUND: Field walking tests are commonly used in patients with chronic pulmonary diseases for assessment of functional capacity. However, the physiological demands and magnitude of desaturation on 6-min walk test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT) have not been investigated in patients with bronchiectasis. The objective of this study was to compare the physiological responses and the magnitude of desaturation of subjects with bronchiectasis when performing the 6MWT, ISWT, and ESWT. METHODS: Thirty-two subjects underwent the 6MWT, ISWT, and ESWT on 3 different days. Pulmonary gas exchange, heart rate, and S-pO2 were measured in all tests. RESULTS: There were no differences in the peak rate of oxygen uptake, ventilation, dyspnea, and leg fatigue between the tests. Equivalent cardiac demand (ie, heart rate at peak) was observed with the 6MWT (137 +/- 21 beats/min) and the ESWT (142 +/- 21 beats/min), but this was lower in the ISWT (135 +/- 19 beats/min) compared to ESWT (P < .05). Most subjects achieved a vigorous exercise intensity (heart rate of 70-90% of predicted) in all tests. There was no difference in desaturation among the tests (6MWT: -6.8 +/- 6.6%, ISWT: -6.1 +/- 6.0%, and ESWT: -7.0 +/- 5.4%). CONCLUSIONS: The 6MWT, ISWT, and ESWT induced similar physiological responses at the peak of exercise, eliciting a vigorous exercise intensity. The magnitude of desaturation was similar across tests. This means these tests can be used interchangeably for evaluation of exercise-induced desaturation.