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de Oliveira Formiga R, Amaral FC, Souza CF, Mendes DAGB, Wanderley CWS, Lorenzini CB, Santos AA, Antônia J, Faria LF, Natale CC, Paula NM, Silva PCS, Fonseca FR, Aires L, Heck N, Starick MR, Queiroz‐Junior CM, Santos FRS, de Souza FRO, Costa VV, Barroso SPC, Morrot A, Van Weyenbergh J, Sordi R, Alisson‐Silva F, Cunha FQ, Rocha EL, Chollet‐Martin S, Hurtado‐Nedelec MM, Martin C, Burgel P, Mansur DS, Maurici R, Macauley MS, Báfica A, Witko‐Sarsat V, Spiller F. Neuraminidase is a host-directed approach to regulate neutrophil responses in sepsis and COVID-19. Br J Pharmacol 2023; 180:1460-1481. [PMID: 36526272 PMCID: PMC9877938 DOI: 10.1111/bph.16013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Neutrophil overstimulation plays a crucial role in tissue damage during severe infections. Because pathogen-derived neuraminidase (NEU) stimulates neutrophils, we investigated whether host NEU can be targeted to regulate the neutrophil dysregulation observed in severe infections. EXPERIMENTAL APPROACH The effects of NEU inhibitors on lipopolysaccharide (LPS)-stimulated neutrophils from healthy donors or COVID-19 patients were determined by evaluating the shedding of surface sialic acids, cell activation, and reactive oxygen species (ROS) production. Re-analysis of single-cell RNA sequencing of respiratory tract samples from COVID-19 patients also was carried out. The effects of oseltamivir on sepsis and betacoronavirus-induced acute lung injury were evaluated in murine models. KEY RESULTS Oseltamivir and zanamivir constrained host NEU activity, surface sialic acid release, cell activation, and ROS production by LPS-activated human neutrophils. Mechanistically, LPS increased the interaction of NEU1 with matrix metalloproteinase 9 (MMP-9). Inhibition of MMP-9 prevented LPS-induced NEU activity and neutrophil response. In vivo, treatment with oseltamivir fine-tuned neutrophil migration and improved infection control as well as host survival in peritonitis and pneumonia sepsis. NEU1 also is highly expressed in neutrophils from COVID-19 patients, and treatment of whole-blood samples from these patients with either oseltamivir or zanamivir reduced neutrophil overactivation. Oseltamivir treatment of intranasally infected mice with the mouse hepatitis coronavirus 3 (MHV-3) decreased lung neutrophil infiltration, viral load, and tissue damage. CONCLUSION AND IMPLICATIONS These findings suggest that interplay of NEU1-MMP-9 induces neutrophil overactivation. In vivo, NEU may serve as a host-directed target to dampen neutrophil dysfunction during severe infections.
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Affiliation(s)
- Rodrigo de Oliveira Formiga
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Université de Paris, Institut Cochin, INSERM U1016, CNRSParisFrance
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Flávia C. Amaral
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Camila F. Souza
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Daniel A. G. B. Mendes
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Carlos W. S. Wanderley
- Department of Pharmacology, School of Medicine of Ribeirão PretoUniversity of São PauloRibeirão PretoBrazil
| | - Cristina B. Lorenzini
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Adara A. Santos
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Juliana Antônia
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Lucas F. Faria
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Caio C. Natale
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Nicholas M. Paula
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Priscila C. S. Silva
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Fernanda R. Fonseca
- Department of Clinical MedicineFederal University of Santa CatarinaFlorianópolisBrazil
| | - Luan Aires
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Nicoli Heck
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Márick R. Starick
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Celso M. Queiroz‐Junior
- Department of Morphology, Institute of Biological SciencesFederal University of Minas GeraisBelo HorizonteBrazil
| | - Felipe R. S. Santos
- Department of Biochemistry and Immunology, Institute of Biological SciencesFederal University of Minas GeraisBelo HorizonteBrazil
| | - Filipe R. O. de Souza
- Department of Morphology, Institute of Biological SciencesFederal University of Minas GeraisBelo HorizonteBrazil
| | - Vivian V. Costa
- Department of Morphology, Institute of Biological SciencesFederal University of Minas GeraisBelo HorizonteBrazil
| | - Shana P. C. Barroso
- Molecular Biology Laboratory, Institute of Biomedical ResearchMarcilio Dias Naval Hospital, Navy of BrazilRio de JaneiroBrazil
| | - Alexandre Morrot
- Tuberculosis Research Laboratory, Faculty of MedicineFederal University of Rio de JaneiroRio de JaneiroBrazil
- Immunoparasitology LaboratoryOswaldo Cruz Foundation (FIOCRUZ)Rio de JaneiroBrazil
| | - Johan Van Weyenbergh
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory for Clinical and Epidemiological VirologyKU LeuvenLeuvenBelgium
| | - Regina Sordi
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Frederico Alisson‐Silva
- Department of Immunology, Paulo de Goes Institute of MicrobiologyFederal University of Rio de JaneiroRio de JaneiroBrazil
| | - Fernando Q. Cunha
- Department of Pharmacology, School of Medicine of Ribeirão PretoUniversity of São PauloRibeirão PretoBrazil
| | - Edroaldo L. Rocha
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Sylvie Chollet‐Martin
- INSERM UMR 996, ‘Infammation, Microbiome and Immunosurveillance’, Faculty of PharmacyUniversité Paris‐SaclayChâtenay‐MalabryFrance
| | | | - Clémence Martin
- Université de Paris, Institut Cochin, INSERM U1016, CNRSParisFrance
- Department of PneumologyAP‐HP, Hôpital CochinParisFrance
| | - Pierre‐Régis Burgel
- Université de Paris, Institut Cochin, INSERM U1016, CNRSParisFrance
- Department of PneumologyAP‐HP, Hôpital CochinParisFrance
| | - Daniel S. Mansur
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | - Rosemeri Maurici
- Department of Clinical MedicineFederal University of Santa CatarinaFlorianópolisBrazil
| | - Matthew S. Macauley
- Department of Chemistry, Department of Medical Microbiology and ImmunologyUniversity of AlbertaEdmontonAlbertaCanada
| | - André Báfica
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
| | | | - Fernando Spiller
- Department of PharmacologyFederal University of Santa CatarinaFlorianópolisBrazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and ParasitologyFederal University of Santa CatarinaFlorianópolisBrazil
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Maurici R. What happened to non-SARS-CoV-2 respiratory diseases during the pandemic? J Bras Pneumol 2023; 49:e20230042. [PMID: 36946821 PMCID: PMC10171263 DOI: 10.36416/1806-3756/e20230042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Affiliation(s)
- Rosemeri Maurici
- . Departamento de Clínica Médica, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
- . Programa de Pós-Graduação em Ciências Médicas - UFSC - Florianópolis (SC) Brasil
- . Hospital Universitário - UFSC - Florianópolis (SC) Brasil
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Wong BDMS, Silva AMD, Maurici R, Melo Júnior JTD. Pathophysiology of reduced forced vital capacity with airflow obstruction on spirometry: performance of two mathematical models in clinical practice. J Bras Pneumol 2023; 49:e20220377. [PMID: 36888880 PMCID: PMC9970377 DOI: 10.36416/1806-3756/e20220377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Affiliation(s)
- Bruno de Moraes Santos Wong
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Andria Machado da Silva
- . Hospital Universitário Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina - HU-UFSC - Florianópolis (SC) Brasil
| | - Rosemeri Maurici
- . Faculdade de Medicina, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - José Tavares de Melo Júnior
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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Delevatti RS, Danielevicz A, Sirydakis ME, de Melo PUG, de la Rocha Freitas C, Rech CR, Guglielmo LGA, Speretta GFF, Hansen F, Fonseca FR, Starke AC, de Lucas RD, de Melo Junior JT, Maurici R, Gerage AM. Effects of physical training on functional, clinical, morphological, behavioural and psychosocial outcomes in post-COVID-19 infection: COVID-19 and REhabilitation study (CORE-study)-a study protocol for a randomised controlled clinical trial. Trials 2023; 24:39. [PMID: 36658592 PMCID: PMC9850322 DOI: 10.1186/s13063-022-07055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic remains ongoing, with a significant number of survivors who have experienced moderate to severe clinical conditions and who have suffered losses of great magnitude, especially in functional capacity, triggering limitations to daily autonomy and quality of life. Among the possibilities of intervention for disease rehabilitation, physical exercise training stands out, which can benefit several health outcomes and favours the adoption of healthier behaviours. Therefore, the aim of the study will be to analyse the effects of physical training on the functional, clinical, morphological, behavioural and psychosocial status in adults and the elderly following COVID-19 infection. METHODS A randomised controlled clinical trial is to be conducted in parallel, with the experimental group undergoing an intervention involving a multicomponent physical rehabilitation programme, carried out at the Sports Center in partnership with the Academic Hospital of the Federal University of Santa Catarina, in Florianópolis, Brazil. Participants will be adults and the elderly, of both sexes, in a post-COVID-19-infection state, who were hospitalised during the infection. The intervention will have a total duration of 24 weeks and will include a multicomponent physical training programme, which will have gradual progression in frequency, duration and intensity over time. Regarding the outcomes, before, at the 12th and after 24 weeks of intervention, functional (primary outcome = functional index of aerobic capacity), clinical, morphological, behavioural and psychosocial outcomes will be assessed. DISCUSSION This study will contribute to a greater understanding of the safety, adherence and benefits of physical training in the rehabilitation of post-COVID-19 patients. The results of this study will be disseminated through presentations at congresses, workshops, peer-reviewed publications and local and international conferences, especially with a view to proposing a post-COVID-19 rehabilitation care protocol. TRIAL REGISTRATION ReBEC, RBR-10y6jhrs . Registered on 22 February 2022. 2015.
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Affiliation(s)
- Rodrigo Sudatti Delevatti
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Angelica Danielevicz
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Maria Eduarda Sirydakis
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Paulo Urubatan Gama de Melo
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Cíntia de la Rocha Freitas
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Cassiano Ricardo Rech
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Luiz Guilherme Antonacci Guglielmo
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Guilherme Fleury Fina Speretta
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Fernanda Hansen
- grid.411237.20000 0001 2188 7235Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Fernanda Rodrigues Fonseca
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Ana Carolina Starke
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Ricardo Dantas de Lucas
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - José Tavares de Melo Junior
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Rosemeri Maurici
- grid.411237.20000 0001 2188 7235Health Sciences Center/NUPAIVA, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
| | - Aline Mendes Gerage
- grid.411237.20000 0001 2188 7235Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina 88040-900 Brazil
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de Oliveira Formiga R, Amaral FC, Souza CF, Mendes DAGB, Wanderley CWS, Lorenzini CB, Santos AA, Antônia J, Faria LF, Natale CC, Paula NM, Silva PCS, Fonseca FR, Aires L, Heck N, Starick MR, Queiroz-Junior CM, Santos FRS, de Souza FRO, Costa VV, Barroso SPC, Morrot A, Van Weyenbergh J, Sordi R, Alisson-Silva F, Cunha FQ, Rocha EL, Chollet-Martin S, Hurtado-Nedelec MM, Martin C, Burgel PR, Mansur DS, Maurici R, Macauley MS, Báfica A, Witko-Sarsat V, Spiller F. Neuraminidase inhibitors rewire neutrophil function in vivo in murine sepsis and ex vivo in COVID-19. bioRxiv 2022:2020.11.12.379115. [PMID: 33200130 PMCID: PMC7668734 DOI: 10.1101/2020.11.12.379115] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Neutrophil overstimulation plays a crucial role in tissue damage during severe infections. Neuraminidase (NEU)-mediated cleavage of surface sialic acid has been demonstrated to regulate leukocyte responses. Here, we report that antiviral NEU inhibitors constrain host NEU activity, surface sialic acid release, ROS production, and NETs released by microbial-activated human neutrophils. In vivo, treatment with Oseltamivir results in infection control and host survival in peritonitis and pneumonia models of sepsis. Single-cell RNA sequencing re-analysis of publicly data sets of respiratory tract samples from critical COVID-19 patients revealed an overexpression of NEU1 in infiltrated neutrophils. Moreover, Oseltamivir or Zanamivir treatment of whole blood cells from severe COVID-19 patients reduces host NEU-mediated shedding of cell surface sialic acid and neutrophil overactivation. These findings suggest that neuraminidase inhibitors can serve as host-directed interventions to dampen neutrophil dysfunction in severe infections.
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Affiliation(s)
- Rodrigo de Oliveira Formiga
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Université de Paris, Institut Cochin, INSERM U1016, CNRS, Paris, France
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Flávia C. Amaral
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Camila F. Souza
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Daniel A. G. B. Mendes
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Carlos W. S. Wanderley
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Cristina B. Lorenzini
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Adara A. Santos
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Juliana Antônia
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Lucas F. Faria
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Caio C. Natale
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Nicholas M. Paula
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Priscila C. S. Silva
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Fernanda R. Fonseca
- Department of Clinical Medicine, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Luan Aires
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Nicoli Heck
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Márick R. Starick
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Celso M. Queiroz-Junior
- Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Felipe R. S. Santos
- Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Filipe R. O. de Souza
- Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Vivian V. Costa
- Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Shana P. C. Barroso
- Molecular Biology Laboratory, Institute of Biomedical Research, Marcilio Dias Naval Hospital, Navy of Brazil, RJ, Brazil
| | - Alexandre Morrot
- Tuberculosis Research Laboratory, Faculty of Medicine, Federal University of Rio de Janeiro
- Immunoparasitology Laboratory, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Johan Van Weyenbergh
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory for Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium
| | - Regina Sordi
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Frederico Alisson-Silva
- Department of Immunology, Paulo de Goes Institute of Microbiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Fernando Q. Cunha
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Edroaldo L. Rocha
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Sylvie Chollet-Martin
- INSERM UMR 996, “Infammation, Microbiome and Immunosurveillance”, Faculty of Pharmacy, Université Paris-Saclay, Châtenay-Malabry, France
| | | | - Clémence Martin
- Université de Paris, Institut Cochin, INSERM U1016, CNRS, Paris, France
- Department of Pneumology, AP-HP, Hôpital Cochin, Paris, France
| | - Pierre-Régis Burgel
- Université de Paris, Institut Cochin, INSERM U1016, CNRS, Paris, France
- Department of Pneumology, AP-HP, Hôpital Cochin, Paris, France
| | - Daniel S. Mansur
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Rosemeri Maurici
- Department of Clinical Medicine, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Matthew S. Macauley
- Department of Chemistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - André Báfica
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | | | - Fernando Spiller
- Department of Pharmacology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
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dos Reis NF, Figueiredo FCXS, Biscaro RRM, Lunardelli EB, Maurici R. Psychometric Properties of the Barthel Index Used at Intensive Care Unit Discharge. Am J Crit Care 2022; 31:65-72. [PMID: 34972844 DOI: 10.4037/ajcc2022732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Barthel Index, originally developed and validated to assess activities of daily living in patients with neuromuscular disorders, is commonly used in research and clinical practice involving critically ill patients. OBJECTIVES To evaluate the internal consistency, reliability, measurement error, and construct validity of the Barthel Index used at intensive care unit discharge. METHODS In this observational study, 2 physiotherapists measured the physical functioning of 122 patients at intensive care unit discharge, using the Barthel Index and other measurement instruments. RESULTS The patients had a median (IQR) age of 56 (47-66) years, and 62 patients (51%) were male. The primary reason for intensive care unit admission was sepsis (28 patients [23%]), and 83 patients (68%) were receiving mechanical ventilation. The Cronbach α value indicating internal consistency was 0.81. For interrater reliability, the intraclass correlation coefficient for the total score was 0.98 (95% CI, 0.97-0.98; P < .001) and the κ statistic for the individual items was 0.54 to 0.94. The standard error of measurement was 7.22, the smallest detectable change was 20.01, and the 95% limits of agreement were -10.3 and 11.8. The Barthel Index showed moderate to high correlations with the other physical functioning measurement instruments (ρ = 0.57 to 0.88; P < .001 for all). CONCLUSION The Barthel Index is a reliable and valid instrument for assessing physical functioning at intensive care unit discharge.
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Affiliation(s)
- Nair Fritzen dos Reis
- Nair Fritzen dos Reis is a physiotherapist and doctoral student in medical sciences at Santa Catarina Federal University, Florianopolis, Brazil
| | | | - Roberta Rodolfo Mazzali Biscaro
- Roberta Rodolfo Mazzali Biscaro is a physiotherapist and doctoral student in medical sciences at Santa Catarina Federal University
| | - Elizabeth Buss Lunardelli
- Elizabeth Buss Lunardelli is a physician and a doctoral student in medical sciences at Santa Catarina Federal University
| | - Rosemeri Maurici
- Rosemeri Maurici is a physician and professor in the postgraduate program in medical sciences at Santa Catarina Federal University
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Rê AD, Fonseca FR, Queiroz AP, Reis CMD, Bahl MM, Kocks J, Molen TVD, Maurici R. Brazilian version of the Clinical COPD Questionnaire, administered by interview: reliability and validity measurement properties. ACTA ACUST UNITED AC 2021; 47:e20200371. [PMID: 34076173 PMCID: PMC8332715 DOI: 10.36416/1806-3756/e20200371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 02/06/2021] [Indexed: 11/22/2022]
Abstract
Objective: To test the reliability, validity, and interpretability of the Brazilian version of the Clinical COPD Questionnaire (CCQ) in patients with COPD. Methods: Fifty patients with COPD completed the CCQ by interview on two occasions. At the first visit, the CCQ was administered twice, by two different raters, approximately 10 min apart; the patients also underwent spirometry and were administered the COPD Assessment Test, the modified Medical Research Council scale, and Saint George’s Respiratory Questionnaire (SGRQ). At the second visit (1-2 weeks later), the CCQ was readministered. We tested the hypothesis that the CCQ total score would correlate positively with the total and domain SGRQ scores (r ≥ 0.5). Results: Of the 50 patients, 30 (60%) were male. The mean age was 66 ± 8 years, and the mean FEV1 was 44.7 ± 17.9% of the predicted value. For all CCQ items, Cronbach’s alpha coefficient (95% CI) was 0.93 (0.91-0.96). To analyze the interrater reliability and test-retest reliability of the CCQ, we calculated the two-way mixed effects model/single measure type intraclass correlation coefficient (0.97 [95% CI: 0.95-0.98] and 0.92 [95% CI: 0.86-0.95], respectively); the agreement standard error of measurement (0.65 for both); the smallest detectable change at the individual level (1.81 and 1.80, respectively) and group level (0.26 and 0.25, respectively); and the limits of agreement (−0.58 to 0.82 and −1.14 to 1.33, respectively). The CCQ total score correlated positively with all SGRQ scores (r ≥ 0.70 for all). Conclusions: The Brazilian version of the CCQ showed an indeterminate measurement error, as well as satisfactory interrater/test-retest reliability and construct validity.
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Affiliation(s)
- Alexânia de Rê
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Fernanda Rodrigues Fonseca
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Ana Paula Queiroz
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Cardine Martins Dos Reis
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Marina Mônica Bahl
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Janwillem Kocks
- . General Practitioners Research Institute, Groningen, The Netherlands.,. University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands.,. Observational and Pragmatic Research Institute, Singapore
| | - Thys van der Molen
- . Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rosemeri Maurici
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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8
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Queiroz APA, Fonseca FR, Rê AD, Maurici R. Clinical, laboratory, and functional characteristics of asthma-COPD overlap in patients with a primary diagnosis of COPD. ACTA ACUST UNITED AC 2020; 47:e20200033. [PMID: 33174971 PMCID: PMC7889314 DOI: 10.36416/1806-3756/e20200033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the frequency of asthma-COPD overlap (ACO) in patients with COPD and to compare, from a clinical, laboratory, and functional point of view, patients with and without ACO, according to different diagnostic criteria. METHODS The participants underwent evaluation by a pulmonologist, together with spirometry and blood tests. All of the patients were instructed to record their PEF twice a day. The diagnosis of ACO was based on the Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (PLATINO, Latin American Project for the Investigation of Obstructive Lung Disease) criteria, the American Thoracic Society (ATS) Roundtable criteria, and the Spanish criteria. We investigated patient histories of exacerbations and hospitalizations, after which we applied the COPD Assessment Test and the modified Medical Research Council scale, to classify risk and symptoms in accordance with the GOLD criteria. RESULTS Of the 51 COPD patients, 14 (27.5%), 8 (12.2%), and 18 (40.0) were diagnosed with ACO on the basis of the PLATINO, ATS Roundtable, and Spanish criteria, respectively. The values for pre-bronchodilator FVC, post-bronchodilator FVC, and pre-bronchodilator FEV1 were significantly lower among the patients with ACO than among those with COPD only (1.9 ± 0.4 L vs. 2.4 ± 0.7 L, 2.1 ± 0.5 L vs. 2.5 ± 0.8 L, and 1.0 ± 0.3 L vs. 1.3 ± 0.5 L, respectively). When the Spanish criteria were applied, IgE levels were significantly higher among the patients with ACO than among those with COPD only (363.7 ± 525.9 kU/L vs. 58.2 ± 81.6 kU/L). A history of asthma was more common among the patients with ACO (p < 0.001 for all criteria). CONCLUSIONS In our sample, patients with ACO were more likely to report previous episodes of asthma and had worse lung function than did those with COPD only. The ATS Roundtable criteria appear to be the most judicious, although concordance was greatest between the PLATINO and the Spanish criteria.
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Affiliation(s)
- Ana Paula Adriano Queiroz
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Fernanda Rodrigues Fonseca
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Alexânia de Rê
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Rosemeri Maurici
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.,. Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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Souza ECCD, Pizzichini MMM, Dias M, Cunha MJ, Matte DL, Karloh M, Maurici R, Pizzichini E. Body mass index, asthma, and respiratory symptoms: a population-based study. ACTA ACUST UNITED AC 2019; 46:e20190006. [PMID: 31859815 PMCID: PMC7462679 DOI: 10.1590/1806-3713/e20190006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/01/2019] [Indexed: 11/29/2022]
Abstract
Objective: To estimate the prevalence of respiratory symptoms and asthma, according to body mass index (BMI), as well as to evaluate factors associated with physician-diagnosed asthma, in individuals ≥ 40 years of age. Methods: This was a population-based cross-sectional study conducted in Florianópolis, Brazil, with probability sampling. Data were collected during home visits. Demographic data were collected, as were reports of physician-diagnosed asthma, respiratory symptoms, medications in use, and comorbidities. Anthropometric measurements were taken. Individuals also underwent spirometry before and after bronchodilator administration. Individuals were categorized as being of normal weight (BMI < 25 kg/m2), overweight (25 kg/m2 ≥ BMI < 30 kg/m2), or obese (BMI ≥ 30 kg/m2). Results: A total of 1,026 individuals were evaluated, 274 (26.7%) were of normal weight, 436 (42.5%) were overweight, and 316 (30.8%) were obese. The prevalence of physician-diagnosed asthma was 11.0%. The prevalence of obesity was higher in women (p = 0.03), as it was in respondents with ≤ 4 years of schooling (p < 0.001) or a family income of 3-10 times the national minimum wage. Physician-diagnosed asthma was more common among obese individuals than among those who were overweight and those of normal weight (16.1%, 9.9%, and 8.0%, respectively; p = 0.04), as were dyspnea (35.5%, 22.5%, and 17.9%, respectively; p < 0.001) and wheezing in the last year (25.6%, 11.9%, and 14.6%, respectively; p < 0.001). These results were independent of patient smoking status. In addition, obese individuals were three times more likely to report physician-diagnosed asthma than were those of normal weight (p = 0.005). Conclusions: A report of physician-diagnosed asthma showed a significant association with being ≥ 40 years of age and with having a BMI ≥ 30 kg/m2. Being obese tripled the chance of physician-diagnosed asthma.
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Affiliation(s)
- Elaine Cristina Caon de Souza
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - Marcia Margaret Menezes Pizzichini
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - Mirella Dias
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - Maíra Junkes Cunha
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - Darlan Lauricio Matte
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - Manuela Karloh
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - Rosemeri Maurici
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
| | - Emilio Pizzichini
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas - NUPAIVA - Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.,. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil
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10
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Fonseca FR, Biscaro RRM, de Rê A, Junkes-Cunha M, dos Reis CM, Bahl MM, Yohannes AM, Maurici R. The Brazilian Portuguese-language version of the Manchester Respiratory Activities of Daily Living questionnaire: construct validity, reliability, and measurement error. J Bras Pneumol 2019; 46:e20180397. [PMID: 31851219 PMCID: PMC7462675 DOI: 10.1590/1806-3713/e20180397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/31/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To test the construct validity, reliability, and measurement error of the Brazilian Portuguese-language version of the Manchester Respiratory Activities of Daily Living (MRADL) questionnaire in patients with COPD. METHODS We evaluated 50 patients with COPD, among whom 30 were men, the mean age was 64 ± 8 years, and the median FEV1 as a percentage of the predicted value (FEV1%predicted) was 38.4% (interquartile range, 29.1-57.4%). Pulmonary function and limitations in activities of daily living (ADLs) were assessed by spirometry and by face-to-face application of the MRADL, respectively. For the construct validity analysis, we tested the hypothesis that the total MRADL score would show moderate correlations with spirometric parameters. We analyzed inter-rater reliability, test-retest reliability, inter-rater measurement error, and test-retest measurement error. RESULTS The total MRADL score showed moderate correlations with the FEV1/FVC ratio, FEV1 in liters, FEV1%predicted, and FVC%predicted, all of the correlations being statistically significant (r = 0.34, r = 0.31, r = 0.42, and r = 0.38, respectively; p < 0.05 for all). For the reliability and measurement error of the total MRADL score, we obtained the following inter-rater and test-retest values, respectively: two-way mixed-effects model intraclass correlation coefficient for single measures, 0.92 (95% CI: 0.87-0.96) and 0.89 (95% CI: 0.81-0.93); agreement standard error of measurement, 1.03 and 0.97; smallest detectable change at the individual level, 2.86 and 2.69; smallest detectable change at the group level, 0.40 and 0.38; and limits of agreement, -2.24 to 1.96 and -2.65 to 2.69. CONCLUSIONS In patients with COPD in Brazil, this version of the MRADL shows satisfactory construct validity, satisfactory inter-rater/test-retest reliability, and indeterminate inter-rater/test-retest measurement error.
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Affiliation(s)
- Fernanda Rodrigues Fonseca
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | | | - Alexânia de Rê
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Maíra Junkes-Cunha
- . Departamento de Fisioterapia, Centro de Ciências da Saúde, Universidade do Estado de Santa Catarina, Florianópolis (SC) Brasil
| | - Cardine Martins dos Reis
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Marina Mônica Bahl
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | | | - Rosemeri Maurici
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Núcleo de Pesquisa em Asma e Inflamação das Vias Aéreas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
- . Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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11
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Staub LJ, Biscaro RRM, Maurici R. Emergence of Alveolar Consolidations in Serial Lung Ultrasound and Diagnosis of Ventilator-Associated Pneumonia. J Intensive Care Med 2019; 36:304-312. [PMID: 31818178 DOI: 10.1177/0885066619894279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Lung ultrasound (LUS) has been reported as a promising diagnostic tool for ventilator-associated pneumonia (VAP), but patients with previous lung parenchyma commitment have been not studied. PURPOSE To evaluate whether the emergence of sonographic consolidations, rather than their presence, can improve the VAP diagnosis in a sample including patients with previous lung parenchyma diseases. METHODS Patients who completed 48 hours of mechanical ventilation were prospectively studied with daily LUS examinations. We checked the emergence of different consolidation types on the eve and on the day of a clinical suspicion of VAP. We elaborated an algorithm considering, sequentially, the emergence of (1) subpleural consolidations in anterior lung regions on the eve of suspicion; (2) lobar/sublobar consolidation in anterior lung regions on the day of suspicion; (3) lobar/sublobar consolidation with dynamic air bronchograms on the day of suspicion; and (4) any other lobar/sublobar consolidation on the day of suspicion in association with a positive Gram smear of endotracheal aspirate. RESULTS Of the 188 included patients, 60 were suspected and 33 confirmed VAP. The presence of sonographic consolidations at the clinical suspicion had no diagnostic value for VAP. The emergence of subpleural consolidations in anterior lung regions on the eve of suspicion had specificity of 95% (95% confidence interval [CI], 79%-99%). The emergence of lobar/sublobar consolidations in anterior lung regions on the day of suspicion had specificity of 100% (95% CI, 87%-100%). The emergence of lobar/sublobar consolidations with dynamic air bronchograms on the day of suspicion had specificity of 96% (95% CI, 81%-99%). Finally, the proposed algorithm had sensitivity of 63% (95% CI, 46%-77%) and specificity of 85% (95% CI, 67%-94%) for VAP. CONCLUSIONS The presence of sonographic consolidations was not accurate for VAP when patients with previous lung parenchyma commitment were included. However, serial LUS examinations detected the emergence of specific signs of VAP.
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Affiliation(s)
- Leonardo Jönck Staub
- Department of Clinical Medicine, 28117Federal University of Santa Catarina, Florianópolis, Brazil.,Division of Clinical Medicine, University Hospital of 28117Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Rosemeri Maurici
- Department of Clinical Medicine, 28117Federal University of Santa Catarina, Florianópolis, Brazil.,Graduate Program in Clinical Sciences, 28117Federal University of Santa Catarina, Florianópolis, Brazil
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Melo JT, Tunstall T, Pizzichini MMM, Maurici R, Rocha CC, Dal-Pizzol F, Gonçalves J, Hansel TT, Thwaites RS, Pizzichini E. IL-5 Levels in Nasosorption and Sputosorption Correlate with Sputum Eosinophilia in Allergic Asthma. Am J Respir Crit Care Med 2019; 199:240-243. [PMID: 30335470 DOI: 10.1164/rccm.201807-1279le] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jose T Melo
- 1 Universidade Federal de Santa Catarina Florianópolis, Brazil and
| | | | | | - Rosemeri Maurici
- 1 Universidade Federal de Santa Catarina Florianópolis, Brazil and
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13
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Pereira MC, Athanazio RA, Dalcin PDTR, Figueiredo MRFD, Gomes M, Freitas CGD, Ludgren F, Paschoal IA, Rached SZ, Maurici R. Brazilian consensus on non-cystic fibrosis bronchiectasis. ACTA ACUST UNITED AC 2019; 45:e20190122. [PMID: 31411280 PMCID: PMC6733718 DOI: 10.1590/1806-3713/e20190122] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/16/2019] [Indexed: 12/16/2022]
Abstract
Bronchiectasis is a condition that has been increasingly diagnosed by chest HRCT. In the literature, bronchiectasis is divided into bronchiectasis secondary to cystic fibrosis and bronchiectasis not associated with cystic fibrosis, which is termed non-cystic fibrosis bronchiectasis. Many causes can lead to the development of bronchiectasis, and patients usually have chronic airway symptoms, recurrent infections, and CT abnormalities consistent with the condition. The first international guideline on the diagnosis and treatment of non-cystic fibrosis bronchiectasis was published in 2010. In Brazil, this is the first review document aimed at systematizing the knowledge that has been accumulated on the subject to date. Because there is insufficient evidence on which to base recommendations for various treatment topics, here the decision was made to prepare an expert consensus document. The Brazilian Thoracic Association Committee on Respiratory Infections summoned 10 pulmonologists with expertise in bronchiectasis in Brazil to conduct a critical assessment of the available scientific evidence and international guidelines, as well as to identify aspects that are relevant to the understanding of the heterogeneity of bronchiectasis and to its diagnostic and therapeutic management. Five broad topics were established (pathophysiology, diagnosis, monitoring of stable patients, treatment of stable patients, and management of exacerbations). After this subdivision, the topics were distributed among the authors, who conducted a nonsystematic review of the literature, giving priority to major publications in the specific areas, including original articles, review articles, and systematic reviews. The authors reviewed and commented on all topics, producing a single final document that was approved by consensus.
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Affiliation(s)
- Mônica Corso Pereira
- . Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil
| | - Rodrigo Abensur Athanazio
- . Divisão de Pneumologia, Instituto do Coração - InCor - Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Paulo de Tarso Roth Dalcin
- . Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS) Brasil.,. Serviço de Pneumologia, Hospital de Clínicas de Porto Alegre, Porto Alegre (RS) Brasil
| | | | - Mauro Gomes
- . Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo (SP) Brasil.,. Equipe de Pneumologia, Hospital Samaritano, São Paulo (SP) Brasil
| | | | | | - Ilma Aparecida Paschoal
- . Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil
| | - Samia Zahi Rached
- . Divisão de Pneumologia, Instituto do Coração - InCor - Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rosemeri Maurici
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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Vuolo F, Abreu SC, Michels M, Xisto DG, Blanco NG, Hallak JE, Zuardi AW, Crippa JA, Reis C, Bahl M, Pizzichinni E, Maurici R, Pizzichinni MMM, Rocco PRM, Dal-Pizzol F. Cannabidiol reduces airway inflammation and fibrosis in experimental allergic asthma. Eur J Pharmacol 2018; 843:251-259. [PMID: 30481497 DOI: 10.1016/j.ejphar.2018.11.029] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/16/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Abstract
Asthma is characterized by chronic lung inflammation and airway hyperresponsiveness. Asthma remains a major public health problem and, at present, there are no effective interventions capable of reversing airway remodelling. Cannabidiol (CBD) is known to exert immunomodulatory effects through the activation of cannabinoid-1 and - 2 (CB1 and CB2) receptors located in the central nervous system and immune cells, respectively. However, as the role of CBD on airway remodelling and the mechanisms of CB1 and CB2 aren't fully elucidated, this study was designed to evaluate the effects of cannabidiol in this scenario. Allergic asthma was induced in Balb/c mice exposed to ovalbumin, and respiratory mechanics, collagen fibre content in airway and alveolar septa, cytokine levels, and CB1 and CB2 expression were determined. Moreover, expressions of CB1 and CB2 in induced sputum of asthmatic individuals and their correlation with airway inflammation and lung function were also evaluated. CBD treatment, regardless of dosage, decreased airway hyperresponsiveness, whereas static lung elastance only reduced with high dose. These outcomes were accompanied by decreases in collagen fibre content in both airway and alveolar septa and the expression of markers associated with inflammation in the bronchoalveolar lavage fluid and lung homogenate. There was a significant and inverse correlation between CB1 levels and lung function in asthmatic patients. CBD treatment decreased the inflammatory and remodelling processes in the model of allergic asthma. The mechanisms of action appear to be mediated by CB1/CB2 signalling, but these receptors may act differently on lung inflammation and remodelling.
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Affiliation(s)
- Francieli Vuolo
- Laboratory of Experimental Pathophysiology, Extreme University South of Santa Catarina, Criciúma, Brazil
| | - Soraia C Abreu
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Monique Michels
- Laboratory of Experimental Pathophysiology, Extreme University South of Santa Catarina, Criciúma, Brazil
| | - Débora G Xisto
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália G Blanco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jaime Ec Hallak
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Antonio W Zuardi
- Department of Pneumology, Asthma Research Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Cardine Reis
- Department of Pneumology, Asthma Research Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Marina Bahl
- Department of Pneumology, Asthma Research Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Emílio Pizzichinni
- Department of Pneumology, Asthma Research Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rosemeri Maurici
- Department of Pneumology, Asthma Research Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Marcia M M Pizzichinni
- Department of Pneumology, Asthma Research Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patricia R M Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe Dal-Pizzol
- Laboratory of Experimental Pathophysiology, Extreme University South of Santa Catarina, Criciúma, Brazil; Department of Pneumology, Asthma Research Centre, Federal University of Santa Catarina, Florianópolis, Brazil.
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Arnold FW, Lopardo G, Wiemken TL, Kelley R, Peyrani P, Mattingly WA, Feldman C, Gnoni M, Maurici R, Ramirez JA. Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia. Respir Med 2018; 140:115-121. [PMID: 29957272 DOI: 10.1016/j.rmed.2018.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 05/23/2018] [Accepted: 05/28/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Community-acquired pneumonia (CAP) has a potential complication of bacteremia. The objective of this study was to define the clinical outcomes of patients with CAP and bacteremia treated with and without a macrolide. MATERIALS AND METHODS Secondary analysis of the Community-Acquired Pneumonia Organization database of hospitalized patients with CAP. Patients with a positive blood culture were categorized based on the presence or absence of a macrolide in their initial antimicrobial regimen, and severity of their CAP. Outcomes included in-hospital all-cause mortality, 30-day mortality, length of stay, and time to clinical stability. RESULTS Among 549 patients with CAP and bacteremia, 247 (45%) were treated with a macrolide and 302 (55%) were not. The primary pathogen was Streptococcus pneumoniae (74%). Poisson regression with robust error variance models were used to compare the adjusted effects of each study group on the outcomes. The unadjusted 30-day mortality was 18.4% in the macrolide group, and 29.6% in the non-macrolide group (adjusted relative risk (aRR)0.81; 95% confidence interval (CI)0.50-1.33; P = 0.41). Unadjusted in-hospital all-cause mortality was 7.3% in the macrolide group, and 18.9% in the non-macrolide group (aRR 0.54, 95% CI 0.30-0.98; P = 0.043). Length of stay and time to clinical stability were not significantly different. CONCLUSIONS In-hospital mortality, but not 30-day mortality, was significantly better in the macrolide group. Our data support the use of a macrolide in hospitalized patients with CAP and bacteraemia.
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Affiliation(s)
- Forest W Arnold
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, United States.
| | - Gustavo Lopardo
- Hospital Professor Bernardo Houssay, Buenos Aires, Argentina.
| | - Timothy L Wiemken
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, United States.
| | - Robert Kelley
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, United States.
| | - Paula Peyrani
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, United States.
| | - William A Mattingly
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, United States.
| | - Charles Feldman
- Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Martin Gnoni
- Good Samaritan Hospital, Cincinnati, OH, United States.
| | - Rosemeri Maurici
- University Hospital, Federal University of Santa Catarina, Santa Catarina, Brazil.
| | - Julio A Ramirez
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, United States.
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Scheffer MC, Prim RI, Wildner LM, Medeiros TF, Maurici R, Kupek E, Bazzo ML. Performance of centralized versus decentralized tuberculosis treatment services in Southern Brazil, 2006-2015. BMC Public Health 2018; 18:554. [PMID: 29699537 PMCID: PMC5922025 DOI: 10.1186/s12889-018-5468-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 04/17/2018] [Indexed: 11/16/2022] Open
Abstract
Background Tuberculosis (TB) control programs face the challenges of decreasing incidence, mortality rates, and drug resistance while increasing treatment adherence. The Brazilian TB control program recommended the decentralization of patient care as a strategy for combating the disease. This study evaluated the performance of this policy in an area with high default rates, comparing epidemiological and operational indicators between two similar municipalities. Methods This study analyzed epidemiological and operational indicators on new cases of pulmonary tuberculosis reported in the Brazilian Notifiable Diseases Information System between 2006 and 2015. In addition, to characterize differences between the populations of the two studied municipalities, a prospective cohort study was conducted between 2014 and 2015, in which patients with new cases of culture-confirmed pulmonary tuberculosis were interviewed and monitored until the disease outcome. A descriptive analysis, the chi-square test, and a Poisson regression model were employed to compare TB treatment outcomes and health care indicators between the municipalities. Results Two thousand three hundred nine cases were evaluated, of which 207 patients were interviewed. Over the 2006–2015 period, TB incidence per 100,000 population in the municipality with decentralized care was significantly higher (39%, 95% CI 27–49%) in comparison to that of the municipality with centralized care. TB treatment default rate (45%, 95% CI 12–90%) was also higher in the municipality with decentralized care. During the two-year follow-up, significant differences were found between patients in centralized care and those in decentralized care regarding treatment success (84.5 vs. 66.1%), treatment default (10.7 vs. 25.8%), illicit drug use (27.7 vs. 45.9%), and homelessness (3.6 vs. 12.9%). The operational indicators revealed that the proportion of control smear tests, medical imaging, and HIV tests were all significantly higher in the centralized care. However, a significantly higher proportion of patients started treatment in the early stages of the disease in the municipality with decentralized care. Conclusions These data showed a low success rate in TB treatment in both municipalities. Decentralization of TB care, alone, did not improve the main epidemiological and operational indicators related to disease control when compared to centralized care. Full implementation of strategies already recommended is needed to improve TB treatment success rates.
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Affiliation(s)
- Mara Cristina Scheffer
- Departamento de Análises Clínicas for Programa de Pós-Graduação em Farmácia da, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Rodrigo Ivan Prim
- Departamento de Análises Clínicas for Programa de Pós-Graduação em Farmácia da, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Leticia Muraro Wildner
- Departamento de Análises Clínicas for Programa de Pós-Graduação em Farmácia da, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Taiane Freitas Medeiros
- Departamento de Análises Clínicas for Programa de Pós-Graduação em Farmácia da, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Rosemeri Maurici
- Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Maria Luiza Bazzo
- Departamento de Análises Clínicas for Programa de Pós-Graduação em Farmácia da, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil. .,Laboratório de Biologia Molecular, Sorologia e Micobactérias, Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Campos Universitário- Trindade, Florianopolis, SC, 88040-900, Brazil.
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Staub LJ, Mazzali Biscaro RR, Velho GV, Reis C, Maurici R. A 59-Year-Old Man With ARDS Receiving “Protective” Ventilation. Chest 2018; 153:e67-e70. [DOI: 10.1016/j.chest.2017.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/11/2017] [Accepted: 10/31/2017] [Indexed: 10/17/2022] Open
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Staub LJ, Biscaro RRM, Kaszubowski E, Maurici R. Chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax: A systematic review and meta-analysis. Injury 2018; 49:457-466. [PMID: 29433802 DOI: 10.1016/j.injury.2018.01.033] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 01/25/2018] [Accepted: 01/29/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the accuracy of the chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax in adults. STUDY DESIGN Systematic review and meta-analysis. METHODS PubMed, EMBASE, Scopus, Web of Science and LILACS (up to 2016) were systematically searched for prospective studies on the diagnostic accuracy of ultrasonography for pneumothorax and haemothorax in adult trauma patients. The references of other systematic reviews and the included studies were checked for further articles. The characteristics and results of the studies were extracted using a standardised form, and their methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Primary analysis was performed considering each hemithorax as an independent unit, while secondary analysis considered each patient. The global diagnostic accuracy of the chest ultrasonography was estimated using the Rutter-Gatsonis hierarchical summary ROC method. Moreover, Reitsma's bivariate model was used to estimate the sensitivity, specificity, positive likelihood ratio (LR + ) and negative likelihood ratio (LR-) of each sonographic sign. This review was previously registered (PROSPERO CRD42016048085). RESULTS Nineteen studies were included in the review, 17 assessing pneumothorax and 5 assessing haemothorax. The reference standard was always chest tomography, alone or in parallel with chest radiography and observation of the chest tube. The overall methodological quality of the studies was low. The diagnostic accuracy of chest ultrasonography had an area under the curve (AUC) of 0.979 for pneumothorax (Fig). The absence of lung sliding and comet-tail artefacts was the most reported sonographic sign of pneumothorax, with a sensitivity of 0.81 (95% confidence interval [95%CI], 0.71-0.88), specificity of 0.98 (95%CI, 0.97-0.99), LR+ of 67.9 (95%CI, 26.3-148) and LR- of 0.18 (95%CI, 0.11-0.29). An echo-poor or anechoic area in the pleural space was the only sonographic sign for haemothorax, with a sensitivity of 0.60 (95%CI, 0.31-0.86), specificity of 0.98 (95%CI, 0.94-0.99), LR+ of 37.5 (95%CI, 5.26-207.5), LR- of 0.40 (95%CI, 0.17-0.72) and AUC of 0.953. CONCLUSION Notwithstanding the limitations of the included studies, this systematic review and meta-analysis suggested that chest ultrasonography is an accurate tool for the diagnostic assessment of traumatic pneumothorax and haemothorax in adults.
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Affiliation(s)
- Leonardo Jönck Staub
- Emergency Department, University Hospital, Federal University of Santa Catarina, 88036-800, Rua Professora Maria Flora Pausewang, Bairro Trindade, Florianópolis, Santa Catarina, Brazil; Intensive Care Unit, Nereu Ramos Hospital, Florianópolis, Santa Catarina, Brazil.
| | | | - Erikson Kaszubowski
- Department of Psychology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Rosemeri Maurici
- Department of Clinical Medicine, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil; Graduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Kock KDS, Maurici R. Respiratory mechanics, ventilator-associated pneumonia and outcomes in intensive care unit. World J Crit Care Med 2018; 7:24-30. [PMID: 29430405 PMCID: PMC5797973 DOI: 10.5492/wjccm.v7.i1.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/05/2017] [Accepted: 12/04/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the predictive capability of respiratory mechanics for the development of ventilator-associated pneumonia (VAP) and mortality in the intensive care unit (ICU) of a hospital in southern Brazil.
METHODS A cohort study was conducted between, involving a sample of 120 individuals. Static measurements of compliance and resistance of the respiratory system in pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) modes in the 1st and 5th days of hospitalization were performed to monitor respiratory mechanics. The severity of the patients’ illness was quantified by the Acute Physiology and Chronic Health Evaluation II (APACHE II). The diagnosis of VAP was made based on clinical, radiological and laboratory parameters.
RESULTS The significant associations found for the development of VAP were APACHE II scores above the average (P = 0.016), duration of MV (P = 0.001) and ICU length of stay above the average (P = 0.003), male gender (P = 0.004), and worsening of respiratory resistance in PCV mode (P = 0.010). Age above the average (P < 0.001), low level of oxygenation on day 1 (P = 0.003) and day 5 (P = 0.004) and low lung compliance during VCV on day 1 (P = 0.032) were associated with death as the outcome.
CONCLUSION The worsening of airway resistance in PCV mode indicated the possibility of early diagnosis of VAP. Low lung compliance during VCV and low oxygenation index were death-related prognostic indicators.
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Affiliation(s)
- Kelser de Souza Kock
- Department of Physiotherapy, University of South of Santa Catarina, Tubarão, SC 88704-001, Brazil
| | - Rosemeri Maurici
- Graduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, SC 88700-000, Brazil
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20
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Staub LJ, Biscaro RRM, Maurici R. Accuracy and Applications of Lung Ultrasound to Diagnose Ventilator-Associated Pneumonia: A Systematic Review. J Intensive Care Med 2017; 33:447-455. [PMID: 29084483 DOI: 10.1177/0885066617737756] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lung ultrasound (LUS) is an accurate tool to diagnose community-acquired pneumonia. However, it is not yet an established tool to diagnose ventilator-associated pneumonia (VAP). PURPOSE To assess the evidence about LUS in the diagnosis of VAP, we conducted a systematic review of the literature. METHODS We searched PubMed, Embase, Scopus, Web of Science, and LILACS. Two researchers independently selected the studies that met the inclusion criteria. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the studies. In a qualitative synthesis, 3 questions guided the review: Q1. What are the sonographic signs of VAP? Q2. How can LUS be combined with others tests or signs of VAP? Q3. What is the role of LUS in VAP screening? MAIN RESULTS Three studies (n = 377 patients) with different designs were included. In terms of Q1, the 3 studies assessed the accuracy of sonographic consolidations. In patients suspected for VAP, lobar or hemilobar consolidation alone was not sufficient to diagnose VAP but seems useful to exclude it. The most useful signs were small subpleural consolidations (sensitivity: 81%; specificity: 41%) and dynamic air bronchograms (sensitivity: 44%; specificity: 81%). Two studies were assessed for Q2, when the 2 signs above were included in a clinical score (Ventilator-associated Pneumonia Lung Ultrasound Score associated with quantitative culture of endotracheal aspirate-VPLUS-EAquant), the accuracy was amplified (sensitivity: 48% and specificity: 97% for score ≥4; sensitivity: 78% and specificity: 77% for score ≥3 points). Finally, regarding Q3, no studies have assessed the use of LUS in screening of VAP. CONCLUSION Small subpleural consolidations and dynamic air bronchograms were the most useful sonographic signs to diagnose VAP in suspected patients. Clinical scores including LUS had better diagnosis accuracy than LUS alone. There are no data on LUS for VAP screening.
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Affiliation(s)
- Leonardo Jönck Staub
- 1 Emergency Department of University Hospital, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil.,2 Intensive Care Unit of Nereu Ramos Hospital, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Rosemeri Maurici
- 4 Department of Clinical Medicine, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil.,5 Graduate Program in Medical Sciences, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Melo Júnior JTD, Maurici R, Tavares MGDS, Pizzichini MMM, Pizzichini E. The Quebec Sleep Questionnaire on quality of life in patients with obstructive sleep apnea: translation into Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol 2017; 43:331-336. [PMID: 28767769 PMCID: PMC5790660 DOI: 10.1590/s1806-37562016000000160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 02/26/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To translate the Quebec Sleep Questionnaire (QSQ), a specific instrument for the assessment of quality of life in patients with sleep obstructive apnea, into Portuguese and to create a version that is cross-culturally adapted for use in Brazil. Methods: The Portuguese-language version was developed according to a rigorous methodology, which included the following steps: preparation; translation from English into Portuguese in three versions; reconciliation to a single version; back-translation of that version into English; comparison and harmonization of the back-translation with the original version; review of the Portuguese-language version; cognitive debriefing; text review; and arrival at the final version. Results: The Portuguese-language version of the QSQ for use in Brazil had a clarity score, as measured by cognitive debriefing, ranging from 0.81 to 0.99, demonstrating the consistency of translation and cross-cultural adaptation processes. Conclusions: The process of translating the QSQ into Portuguese and creating a version that is cross-culturally adapted for use in Brazil produced a valid instrument to assess the quality of life in patients with obstructive sleep apnea.
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Affiliation(s)
| | - Rosemeri Maurici
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
| | | | | | - Emilio Pizzichini
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
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22
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Kock K, Tavares EG, Traebert JL, Maurici R. Calculation of reproducibility rates (R0) by simplification of SIR model applied to Influenza A epidemic (H1N1) in Brazil occurred in 2009. Rev Epidemiol Control Infect 2017. [DOI: 10.17058/reci.v7i2.7685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Justificativa e objetivo:A pandemia de influenza A (H1N1) de 2009 atingiu mais de 200 países com graus variados de morbimortalidade, fomentando diversas pesquisas na área, com objetivo de auxiliar futuras estratégias epidemiológicas. A utilização de modelos matemáticos de infecções pode propiciar melhor compreensão deste fenômeno e fornecer subsídios para intervenções em saúde pública. O presente estudo teve como objetivos descrever a taxa de reprodutividade (R0) através da simplificação de modelo matemático epidemiológico, estimar o valor de R0 na pandemia de influenza de 2009 no Brasil e nos estados brasileiros e comparar R0 com a população infectada. Método: Trata-se de um estudo ecológico, utilizando um banco de dados público com notificações de influenza pandêmica ocorrida no Brasil em 2009. Foi proposta uma análise simplificada do modelo compartimental: Suscetível (I), Infectado (I), Recuperado (R), para comparação da taxa de reprodutividade (R0) viral nos estados brasileiros. Também foi correlacionado o valor de R0 com o percentual de infectados. Resultados: Em 12 estados e no Brasil como um todo foi configurado um surto epidêmico, e em cinco estados além do Distrito Federal ocorreu mais de um surto epidêmico. A correlação entre R0 e o percentual de infectados apresentou-se forte e positiva (r = 0,74), demonstrado que uma maior taxa reprodutiva está associada a maior contágio viral.Conclusão: a simplificação matemática realizada neste estudo demonstra outra maneira de identificar epidemias, sendo uma ferramenta básica e de pouca complexidade nas implementações computacionais.
DESCRITORES: Epidemiologia. Epidemia. Simulação por Computador. Influenza humana. Doenças Transmissíveis.
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Cavallazzi R, Maurici R, Ramirez JA. Tuberculosis is always a possibility (even in the intensive care unit). Rev Bras Ter Intensiva 2017; 28:97-9. [PMID: 27410402 PMCID: PMC4943044 DOI: 10.5935/0103-507x.20160021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 02/23/2016] [Indexed: 11/20/2022] Open
Affiliation(s)
- Rodrigo Cavallazzi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville, Louisville, KY, USA
| | - Rosemeri Maurici
- Programa de Pós-graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Julio A Ramirez
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
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Seidel W, Bins-Ely J, Ongaratto Barazzetti D, Della Giustina R, Walter GP, Ferri TA, Maurici R, Narciso-Schiavon JL. Breast reconstruction after mastectomy for breast cancer: comparative analysis of early and delayed reconstruction. MINERVA CHIR 2017; 72:188-199. [PMID: 28198179 DOI: 10.23736/s0026-4733.17.07314-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Early reconstruction after mastectomy for breast cancer with definitive implants has been widely used, especially with the evolution of conservative surgical breast cancer treatments. We aimed to identify different characteristics associated with plastic surgery, based on immediate or delayed reconstruction time and evaluate quality of life in patients undergoing mastectomy for cancer. METHODS This is a cross-sectional analytical study that evaluated adult patients undergoing mastectomy for breast cancer and breast reconstruction in Plastic Surgery Service at a tertiary hospital. RESULTS Between March 2011 and November 2015, 58 patients who underwent mastectomy were included, with a mean age of 51.6±10.6 years and 98.3% of them being women. Eighty percent of the patients underwent a radical mastectomy and 20% underwent segmentectomies. Immediate and delayed surgical reconstructions occurred in 22.4% and 77.6% of the cases, respectively, including immediate reconstruction with the local flap trade (15.5%), immediate reconstruction with prosthesis (6.9%), transverse rectus abdominis myocutaneous (TRAM) flap (6.9%), delayed reconstruction with local flap (8.6%), expander and prosthesis (35.7%), and reconstruction with latissimus dorsi flap and prosthesis (22.4%). When comparing subjects undergoing reconstructive surgery based on timing of reconstruction, it was observed that patients undergoing delayed breast reconstruction surgery presented a higher proportion of radical mastectomy (90.7% vs. 41.7%; P=0.001) and the need for two or more surgical interventions (64.1% vs. 20.0%; P=0.029). There was no difference in the quality of life according to reconstruction time. CONCLUSIONS The characteristics associated with postmastectomy reconstruction timing are related to preoperative factors such as the procedure employed and the number of interventions performed and have no influence on complications or the quality of life.
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Affiliation(s)
- William Seidel
- Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil - .,Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil -
| | - Jorge Bins-Ely
- Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Daniel Ongaratto Barazzetti
- Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Renata Della Giustina
- Gastroenterology and Hepatology Unit, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Gustavo P Walter
- Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil.,Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Thiago A Ferri
- Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil.,Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rosemeri Maurici
- Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Janaína L Narciso-Schiavon
- Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.,Gastroenterology and Hepatology Unit, Federal University of Santa Catarina, Florianópolis, Brazil
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Maurici R, Morello Gearhart A, Virissimo Maciel V, Arnold F, Fernandez F, Persaud AK, Furmanek S, Wiemken T, Ramirez J, Cavallazzi R. The presence of COPD does not influence clinical outcomes in hospitalized patients with community-acquired pneumonia. JRI 2017. [DOI: 10.18297/jri/vol1/iss3/8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Junkes-Cunha M, Mayer AF, Reis C, Yohannes AM, Maurici R. The Manchester Respiratory Activities of Daily Living questionnaire for use in COPD patients: translation into Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol 2016; 42:15-21. [PMID: 26982036 PMCID: PMC4805382 DOI: 10.1590/s1806-37562016000000029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 11/18/2015] [Indexed: 11/21/2022] Open
Abstract
Objective : To translate The Manchester Respiratory Activities of Daily Living (MRADL) questionnaire into Portuguese and to create a version of the MRADL that is cross-culturally adapted for use in Brazil. Methods : The English-language version of the MRADL was translated into Portuguese by two health care researchers who were fluent in English. A consensus version was obtained by other two researchers and a pulmonologist. That version was back-translated into English by another translator who was a native speaker of English and fluent in Portuguese. The cognitive debriefing process consisted in having 10 COPD patients complete the translated questionnaire in order to test its understandability, clarity, and acceptability in the target population. On the basis of the results, the final Portuguese-language version of the MRADL was produced and approved by the committee and one of the authors of the original questionnaire. Results : The author of the MRADL questioned only a few items in the translated version, and some changes were made to the mobility and personal hygiene domains. Cultural differences regarding the domestic activities domain were found, in particular regarding the item "Do you have the ability to do a full clothes wash and hang them out to dry?", due to socioeconomic and climatic issues. The item "Do you take care of your garden?" was questioned by the participants who lived in apartments, being modified to "Do you take care of your garden or plants in your apartment?" Conclusions : The final Portuguese-language version of the MRADL adapted for use in Brazil was found to be easy to understand and easily applied.
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Affiliation(s)
| | | | - Cardine Reis
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Abebaw M Yohannes
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Rosemeri Maurici
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
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Kock KDS, Rosa BCD, Martignago N, Reis C, Maurici R. Comparison of respiratory mechanics measurements in the volume cycled ventilation (VCV) and pressure controlled ventilation (PCV). Fisioter mov 2016. [DOI: 10.1590/0103-5150.029.002.ao02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Monitoring respiratory mechanics may provide important information for the intensivist, assisting in the early detection of pulmonary function changes of patients hospitalized in ICU. Objective: To compare measurements of respiratory mechanics in VCV and PCV modes, and correlate them with age and oxygenation index. Materials and methods: Cross-sectional study conducted in the adult ICU of the Hospital Nossa Senhora da Conceição, in Tubarão - SC. A hundred and twenty individuals were selected between March and August 2013. The respiratory mechanics measurements were evaluated using compliance and resistance static measures of the respiratory system in PCV and VCV modes between the 1st and 5th day of hospitalization. Simultaneously, the oxygenation index PaO2/FiO2 was collected. Results: The obtained results were: compliance (VCV) = 40.9 ± 12.8 mL/cmH2O, compliance (PCV) = 35.0 ± 10.0 mL/cmH2O, resistance (VCV) = 13.2 ± 4.9 cmH2O/L/s, resistance (PCV) = 27.3 ± 16.2 cmH2O/L/s and PaO2/FiO2 = 236.0 ± 97.6 mmHg. There was statistical difference (p < 0.001) between the compliance and resistance measures in VCV and PCV modes. The correlations between the oxygenation index and compliance in VCV and PCV modes and resistance in VCV and PCV modes were, respectively, r = 0.381 (p < 0.001), r = 0.398 (p < 0.001), r = -0.188 (p = 0.040), r = -0.343 (p < 0.001). Conclusion: Despite the differences between the respiratory mechanics measurements the monitoring using VCV and PCV modes seems to show complementary aspects.
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Karloh M, Fleig Mayer A, Maurici R, Pizzichini MMM, Jones PW, Pizzichini E. The COPD Assessment Test: What Do We Know So Far?: A Systematic Review and Meta-Analysis About Clinical Outcomes Prediction and Classification of Patients Into GOLD Stages. Chest 2016; 149:413-425. [PMID: 26513112 DOI: 10.1378/chest.15-1752] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/09/2015] [Accepted: 10/01/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The COPD Assessment Test (CAT) was developed as a simple instrument to assess health status in patients with COPD. This study aimed to systematically review the determinants of the CAT score, its ability to predict clinical outcomes, and the agreement between CAT (≥ 10) and the modified Medical Research Council scale (mMRC ≥ 2) to categorize patients into the new Global Initiative for Chronic Obstructive Lung Disease classification system. METHODS From January 1, 2009, to June 30, 2015, databases were searched for studies using CAT in adults with COPD and in general populations aiming to detect COPD. Two investigators independently screened, selected, and extracted data by using a standardized form. Where appropriate, the results were combined in a random effects meta-analysis. RESULTS Of 453 studies, 17 were included, and eight were used in the meta-analysis. The models to predict the CAT score were able to explain < 50% of its variance. CAT scores can indicate risk of exacerbation, depression, acute deterioration in health status, and mortality. All studies found a different proportion of patients in each Global Initiative for Chronic Obstructive Lung Disease category using CAT ≥ 10 or mMRC ≥ 2. On average, the distribution was 13% different according to the instrument used. The κ agreement between CAT and mMRC ranged from 0.13 to 0.77. CONCLUSIONS CAT may be used as a complementary tool in a patient's clinical assessment to predict COPD exacerbation, health status deterioration, depression, and mortality. The interpretation of this meta-analysis does not support the use of the recommended cutoff points of ≥10 for CAT and ≥2 for mMRC as equivalents for the purpose of assessing patient symptoms.
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Affiliation(s)
- Manuela Karloh
- Asthma and Airway Inflammation Research Center-NUPAIVA and Post Graduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, Brazil; Center of Assistance, Education and Research in Pulmonary Rehabilitation, Santa Catarina State University, Florianópolis, Brazil
| | - Anamaria Fleig Mayer
- Center of Assistance, Education and Research in Pulmonary Rehabilitation, Santa Catarina State University, Florianópolis, Brazil
| | - Rosemeri Maurici
- Asthma and Airway Inflammation Research Center-NUPAIVA and Post Graduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Marcia M M Pizzichini
- Asthma and Airway Inflammation Research Center-NUPAIVA and Post Graduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Paul W Jones
- Division of Clinical Science, St. George's University of London, London, UK
| | - Emilio Pizzichini
- Asthma and Airway Inflammation Research Center-NUPAIVA and Post Graduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.
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Nogueira CL, Prim RI, Senna SG, Rovaris DB, Maurici R, Rossetti ML, Couvin D, Rastogi N, Bazzo ML. First insight into the molecular epidemiology of Mycobacterium tuberculosis in Santa Catarina, southern Brazil. Tuberculosis (Edinb) 2016; 97:57-64. [PMID: 26980497 DOI: 10.1016/j.tube.2015.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/14/2015] [Accepted: 12/20/2015] [Indexed: 12/01/2022]
Abstract
Molecular epidemiology of Mycobacterium tuberculosis is useful for understanding disease transmission dynamics, and to establish strategic measures for TB control and prevention. The aim of this study was to analyze clinical, epidemiological and molecular characteristics of MTBC clinical isolates from Santa Catarina state, southern Brazil. During one-year period, 406 clinical isolates of MTBC were collected from Central Laboratory of Public Health and typed by spoligotyping. Demographic and clinical data were collected from the Brazilian National Mandatory Disease Reporting System. The majority of cases occurred in highest population densities regions and about 50% had some condition associated with TB. Among all isolates, 5.7% were MDR, which showed association with drug addiction. LAM was the most predominant lineage with 47.5%, followed by the T superfamily with 25.9% and Haarlem with 12.3%. The MST showed two major groups: the first was formed mainly by the LAM lineage and the second was mainly formed by the T and Haarlem lineages. Others lineages were distributed in peripheral positions. This study provides the first insight into the population structure of M. tuberculosis in SC State. Spoligotyping and other genotyping analyses are important to establish strategic measures for TB control and prevention.
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Affiliation(s)
- Christiane Lourenço Nogueira
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Rodrigo Ivan Prim
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Simone Gonçalves Senna
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Darcita Büerger Rovaris
- Laboratório Central Do Estado de Santa Catarina - LACEN/SC, Florianópolis, Santa Catarina, Brazil.
| | - Rosemeri Maurici
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Maria Lúcia Rossetti
- Fundação Estadual de Produção e Pesquisa em Saúde Do Rio Grande Do Sul - FEEPS/RS, Porto Alegre, Rio Grande Do Sul, Brazil.
| | - David Couvin
- WHO Supranational TB Reference Laboratory, Institut Pasteur de la Guadeloupe, Abymes, Guadeloupe, France.
| | - Nalin Rastogi
- WHO Supranational TB Reference Laboratory, Institut Pasteur de la Guadeloupe, Abymes, Guadeloupe, France.
| | - Maria Luiza Bazzo
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
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Wilmer FAP, Maurici R, Nazário CAK, Nazário KCK, Pássaro PFA, Piazza HE, Bertoldi RA, Pizzichini E, Pizzichini MMM. Temporal trends in the prevalence of asthma and rhinoconjunctivitis in adolescents. Rev Saude Publica 2015; 49:S0034-89102015000100272. [PMID: 26786471 PMCID: PMC4716651 DOI: 10.1590/s0034-8910.2015049005558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 04/24/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To analyze the temporal trend of asthma and rhinoconjunctivitis prevalences as well as their symptoms in adolescents. METHODS Two cross-sectional studies were conducted using the same methodology and questionnaire as was used for adolescents aged 12 to 14 years in the Brazilian city of Florianopolis, SC, Southern Brazil. Based on the international protocol of the International Study of Asthma and Allergies in Childhood (ISAAC) study, adolescents were evaluated in 2001 and 3,150 in 2012. The schools included in this study were the same as in the 2001 study. These schools were randomly selected after stratification by network (public and private) and geographic location. The total average percentage variation was estimated for the prevalence of asthma and rhinoconjunctivitis and their symptoms. RESULTS The prevalence of reported asthma was 10.9% in 2001 and 14.8% in 2012, with an average variation of 2.8% in the period. The highest average variation in the period was observed among female adolescents (4.1%). In parallel a significant increase occurred in reported physician-diagnosed asthma, 7.3% in 2001 and 11,1% in 2012, with an annual variation of 4.5%. The largest increases in reported physician-diagnosed asthma were seen in female (5.9%) and male (4.5%) public school pupils. In addition, a significant increase in reported rhinoconjunctivitis occurred, with the average variation in the period being 5.2%. Reports of severe asthma symptoms remained unchanged during the period, while the annual variation for reported current wheezing (-1.3%) and wheezing during exercise (-1.2%) decreased. CONCLUSIONS The results showed a significant increase in the annual average variation for asthma and rhinoconjunctivitis prevalence during the 2001 to 2012 period.
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Affiliation(s)
| | - Rosemeri Maurici
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | | | | | | | - Helena Elisa Piazza
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade do Sul de Santa Catarina, Palhoça, SC, Brasil
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Kock KDS, Hobus LC, Guadagnin F, Maurici R, Machado MDO. APACHE II COMO INDICADOR DE PAVM. Rev Epidemiol Control Infect 2015. [DOI: 10.17058/reci.v5i1.4828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sakae TM, Maurici R, Trevisol DJ, Pizzichini MMM, Pizzichini E. Effects of prednisone on eosinophilic bronchitis in asthma: a systematic review and meta-analysis. J Bras Pneumol 2015; 40:552-63. [PMID: 25410844 PMCID: PMC4263337 DOI: 10.1590/s1806-37132014000500012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 06/27/2014] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE: To evaluate the effect size of oral corticosteroid treatment on eosinophilic
bronchitis in asthma, through systematic review and meta-analysis. METHODS: We systematically reviewed articles in the Medline, Cochrane Controlled Trials
Register, EMBASE, and LILACS databases. We selected studies meeting the following
criteria: comparing at least two groups or time points (prednisone vs. control,
prednisone vs. another drug, or pre- vs. post-treatment with prednisone); and
evaluating parameters before and after prednisone use, including values for sputum
eosinophils, sputum eosinophil cationic protein (ECP), and sputum IL-5-with or
without values for post-bronchodilator FEV1-with corresponding 95% CIs
or with sufficient data for calculation. The independent variables were the use,
dose, and duration of prednisone treatment. The outcomes evaluated were sputum
eosinophils, IL-5, and ECP, as well as post-bronchodilator FEV1. RESULTS: The pooled analysis of the pre- vs. post-treatment data revealed a significant
mean reduction in sputum eosinophils (↓8.18%; 95% CI: 7.69-8.67; p < 0.001),
sputum IL-5 (↓83.64 pg/mL; 95% CI: 52.45-114.83; p < 0.001), and sputum ECP
(↓267.60 µg/L; 95% CI: 244.57-290.63; p < 0.0001), as well as a significant
mean increase in post-bronchodilator FEV1 (↑8.09%; 95% CI: 5.35-10.83;
p < 0.001). CONCLUSIONS: In patients with moderate-to-severe eosinophilic bronchitis, treatment with
prednisone caused a significant reduction in sputum eosinophil counts, as well as
in the sputum levels of IL-5 and ECP. This reduction in the inflammatory response
was accompanied by a significant increase in post-bronchodilator FEV1.
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Della Justina LB, Luiz MC, Maurici R, Schuelter-Trevisol F. Prevalence and factors associated with lipodystrophy in AIDS patients. Rev Soc Bras Med Trop 2014; 47:30-7. [DOI: 10.1590/0037-8682-0240-2013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 01/28/2014] [Indexed: 12/13/2022] Open
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Kuehlkamp VM, Schneider IJC, Biudes MF, Galato D, Silva JD, Maurici R, Traebert J, Schuelter-Trevisol F. Factors associated with hepatitis C seropositivity in people living with HIV. Rev Panam Salud Publica 2014; 35:53-59. [PMID: 24626448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 01/12/2014] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To identify risk factors associated with hepatitis C virus (HCV) seropositivity in human immunodeficiency virus (HIV)-infected patients. METHODS A paired case-control study adjusted by age and gender was conducted. It included adults coinfected with HIV and HCV (cases) and HIV mono-infected subjects (controls) using non-probability sampling. Data were collected through interviews and review of medical records. The chi-square test was used for comparing categorical variables and the Student's t-test or Wilcoxon (Mann-Whitney U) test for continuous variables. Confidence intervals (95%) were estimated along with crude and adjusted odds ratios using conditional logistic regression. RESULTS A total of 165 patients were surveyed, including 55 cases and 110 controls. The mean age was 43.6 ± 8.4 years, ranging from 19 to 64 years; 70.9% were male. Independent risk factors for HIV/HCV coinfection were education (up to eight years of schooling); age at first intercourse < 15 years; having undergone tattooing; blood transfusion; and use of injecting drugs. CONCLUSIONS Low level of education, early age at first sexual intercourse, tattooing, blood transfusions, and sharing needles and other drug injection equipment were factors that increased the risk of HIV/HCV coinfection. The results from this research can be compared with similar data from other regions to help direct preventive and educational efforts targeting people living with HIV.
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Affiliation(s)
| | | | - Marcela F Biudes
- Universidade do Sul de Santa Catarina, Tubarão, Santa Catarina, Brazil,
| | - Dayani Galato
- Universidade do Sul de Santa Catarina, Tubarão, Santa Catarina, Brazil,
| | - Jane da Silva
- Universidade do Sul de Santa Catarina, Tubarão, Santa Catarina, Brazil,
| | - Rosemeri Maurici
- Universidade do Sul de Santa Catarina, Tubarão, Santa Catarina, Brazil,
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Satta G, Canepari P, Maurici R, Pompei R, Marcialis MA. Shifting of the penicillin binding proteins that are the target for inhibition by beta-lactams as a likely mechanism of resistance to antibiotics during therapy. Chemioterapia 1985; 4:113-5. [PMID: 3986940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The penicillin binding proteins (PBPs) that in Streptococcus faecium are the targets for inhibitory activity of beta-lactam antibiotics were analyzed both in cells growing at their fastest and at reduced rates. It was found that while under the former conditions the PBPs showed the highest affinity for penicillin, under the latter the target is shifted to PBP (PBP5) that has a very low affinity for penicillin and other beta-lactams. The possibility that conditions met by Enterococci in human infections cause a shifting of the penicillin target and the possible role of such shifting in resistance to beta-lactams during therapy are discussed.
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Satta G, Canepari P, Maurici R, Marcialis MA. Interactions between lateral wall elongation and septum formation during cell cycle in Klebsiella pneumoniae. Ann Inst Pasteur Microbiol (1985) 1985; 136A:85-9. [PMID: 3890694 DOI: 10.1016/s0769-2609(85)80027-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In this study, we evaluated the effect of three different beta-lactams on peptidoglycan synthesis and cell division of synchronously growing rods of the pH conditional morphology mutant MirM7 and its parental strain MirA12. We have found that mecillinam, when added at varying times to synchronous MirM7 rods during the first 30 min of the cell cycle, inhibits peptidoglycan synthesis but has no effect when added afterwards while cells form septa and divide. Addition to the above cells of piperacillin for 30 min from the very beginning of the cell cycle did not cause any delay in cell division. On the contrary, when this antibiotic was added to synchronous cells for 15 min, starting 35 min after the beginning of the cell cycle, cell division occurred with an approximate 15-min delay. Addition of cefaloridine to synchronous cells at varying times during the cell cycle invariably caused a delay in cell division equal to the time during which the antibiotic was maintained in the culture. These findings are interpreted as supporting a previous hypothesis for shape regulation in bacterial rods and are discussed in terms of the interaction between lateral wall elongation and septum formation during the cell cycle.
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