Lidia Alice Gomes Monteiro Marin Torres | Universidade de São Paulo (original) (raw)
Papers by Lidia Alice Gomes Monteiro Marin Torres
Indian Journal of Forensic Medicine and Pathology, 2016
PLOS ONE, 2018
Chronic lung infection by Pseudomonas aeruginosa is the leading cause of morbidity and mortality ... more Chronic lung infection by Pseudomonas aeruginosa is the leading cause of morbidity and mortality in cystic fibrosis (CF) patients. This is associated with the conversion of the nonmucoid to the mucoid phenotype. However, there is little information about the occurrence of alginate-producing P. aeruginosa in CF patients outside Europe and North America. The aim of the present study was to investigate mutations in the algTmucABD operon in mucoid and non-mucoid isolates from Brazilian CF patients. Twenty-seven mucoid and 37 nonmucoid isolates from 40 CF patients chronically infected by P. aeruginosa attending a CF reference center in Brazil were evaluated by sequence analysis. Mutations in mucA were observed in 93% of the mucoid isolates and 54% of the non-mucoid isolates. Among these non-mucoid isolates, 55% were considered revertants, since they also had mutations in algT (algU). Most isolates associated with moderate alginate production presented point mutations in mucB and/or mucD. We identified 30 mutations not previously described in the operon. In conclusion, mutations in mucA were the main mechanism of conversion to mucoidy, and most of the non-mucoid isolates were revertants, but the mechanism of revertance is not fully explained by changes in algT.
Journal of Cystic Fibrosis, 2014
Objectives: Standard culture may fail to detect fungal pathogens. Reliance upon this technique al... more Objectives: Standard culture may fail to detect fungal pathogens. Reliance upon this technique alone amidst clinical decline or antifungal therapy can make clinical decision-making and disease-monitoring challenging. This pilot study aims to further evaluate the CF fungal airways burden in recognition of this unmet clinical need. Methods: 16 adult CF patients with a spectrum of fungal disease provided spontaneous sputum samples at a single timepoint to be examined by 3 different techniques: (1) Prolonged fungal cultures (Sabouraud's Dextrose Agar + chloramphenicol and Dermasel Agar incubated at 37ºC 48 h then 30ºC and interpreted at Day 7, D14, D21, D28). (2) Microbiology stain: Calcofluor White (CFW) (3) Cytology stain: Grocott's Methenamine Silver (GMS). Results: Prolonged fungal culture (>D7) yielded a positivity rate of 57% compared to 35% of samples at <D7. However CFW stain revealed fungal elements eg. hyphae, in 75% of samples. GMS stain revealed fungal findings in 73%. Of the fungal culture-negative samples, stains detected fungal elements in up to 50% (CFW 33%, GMS 50%). Conclusion: Whilst the sample size in this preliminary cohort is small, the clinical utility for additional evaluation of fungal disease by a panel of laboratory techniques available to most hospital pathology departments is highlighted. Of note, Scedosporium apiospermum and Exophiala dermatitidis, two emerging fungal pathogens required >D7 culture. GMS stain a had greater detection rate for fungal elements compared to CFW in the fungal culture-negative samples. The evaluation of these techniques in monitoring disease over time and for early detection of fungal infection forms the focus of the next stage of this study.
Journal of Cystic Fibrosis, 2015
Objectives Alginate production (mucoid phenotype) of P. aeruginosa is a marker of chronic biofilm... more Objectives Alginate production (mucoid phenotype) of P. aeruginosa is a marker of chronic biofilm infection in the lungs of CF patients. Little is known about the occurrence of alginate-producing P. aeruginosa in CF patients outside Europe and North America. We therefore decided to study the occurrence of the alginate phenotype in P. aeruginosa from chronically infected CF patients in a CF center in Brazil and CF centers in Scandinavia (Ciofu et al., 2008). Methods The phenotype was classified according to Schurr et al. (1994): Type I: mucoid (M) on PIA ( Pseudomonas isolation agar) and LB agar, type II: mucoid on PIA but non-mucoid (NM) on LB, type III: non-mucoid on both, type IV: very slight but detectable mucoidy on both media after ≥4 days incubation. Results See the table. TableDistribution of different alginate phenotypesType I TypeII Type III Type IVBoth M&NM isolates from 20 Brazilian patients95%40%65%Both M&NM isolates from 83 Scandinavian patients89%17%87%6%Only NM isolates from 12 Brazilian patients92%8%Only NM isolates from 8 Scandinavian patients75%25% Conclusion Generally, the results show rather similar distributions of the Brazilian and Scandinavian isolates on the different phenotypes (Table). This probably reflects common selective environment in the lungs of CF patients in Brazil and Scandinavia, since the countries are widely separated and have completely different climate and geography, whereas the public medical systems are tax-based in all 4 countries. We are now sequencing the mucA and algT genes of the isolates which are responsible for the alginate phenotypes.
Acta Paulista de Enfermagem, 2012
Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxi... more Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxiliar profissionais de saúde e familiares a contarem para crianças menores de 5 anos sobre seu diagnóstico de Fibrose Cística. O livro traz a história de Lola, uma criança que descobre que tem Fibrose Cística e cria um monstro imaginário como representação da doença. A experiência emergida da prática profissional em um ambulatório multiprofissional de atendimento a esses pacientes, traduz a importância de conciliar teoria e prática, além da interdisciplinaridade para a construção de estratégias inovadoras e criativas no desenvolvimento do cuidado integral.
Acta Paulista de Enfermagem, 2012
Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxi... more Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxiliar profissionais de saúde e familiares a contarem para crianças menores de 5 anos sobre seu diagnóstico de Fibrose Cística. O livro traz a história de Lola, uma criança que descobre que tem Fibrose Cística e cria um monstro imaginário como representação da doença. A experiência emergida da prática profissional em um ambulatório multiprofissional de atendimento a esses pacientes, traduz a importância de conciliar teoria e prática, além da interdisciplinaridade para a construção de estratégias inovadoras e criativas no desenvolvimento do cuidado integral.
Journal of Cystic Fibrosis, 2014
To evaluate, in a longitudinal study, the profile of lipid peroxidation and antioxidant capacity ... more To evaluate, in a longitudinal study, the profile of lipid peroxidation and antioxidant capacity markers in sickle cell anaemia patients receiving different treatments and medication over different time periods. The three groups were: patients undergoing transfusion therapy and receiving iron chelator deferasirox (DFX group, n = 20); patients receiving deferasirox and hydroxyurea (DFX + HU group, n = 10), and patients receiving only folic acid (FA group, n = 15). Thiobarbituric acid-reactive substance (TBARS) assays and trolox-equivalent antioxidant capacity (TEAC) assays were evaluated during two different periods of analysis, T0 and T1 (after ~388 days). Higher FA group TBARS values were observed compared with the DFX + HU group (p = 0.016) at T0; and at T1, higher FA group TBARS values were also observed compared with both the DFX group (p = 0.003) and the DFX + HU group (p = 0.0002). No variation in TEAC values was seen between groups, at either T0 or T1. The mean values of TBAR...
Frontiers in Cellular and Infection Microbiology
Jornal Brasileiro de Pneumologia
Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology], Jan 4, 2017
Identification of nonfermenting Gram-negative bacteria (NFGNB) of cystic fibrosis patients is har... more Identification of nonfermenting Gram-negative bacteria (NFGNB) of cystic fibrosis patients is hard and misidentification could affect clinical outcome. This study aimed to propose a scheme using polymerase chain reaction to identify NFGNB. This scheme leads to reliable identification within 3 days in an economically viable manner when compared to other methods.
Arq Cienc Saude, Dec 1, 2007
Introdução: A fibrose cística é uma doença genética letal, crônica e progressiva, que compromete ... more Introdução: A fibrose cística é uma doença genética letal, crônica e progressiva, que compromete o funcionamento de quase todos os órgãos e sistemas do organismo, sendo as complicações pulmonares as principais causas de morbidade e mortalidade. Nesse sentido, torna-se fundamental a compreensão das complicações respiratórias provocadas e das ações de reabilitação, possibilitando intervenções que reduzam o impacto dessa doença nas atividades diárias. Objetivo: Este trabalho teve por objetivo realizar uma revisão bibliográfica discutindo os principais recursos ...
Rev Bras Alergia Imunopatol, Dec 1, 1995
Diet and Exercise in Cystic Fibrosis, 2015
Jornal Brasileiro de Pneumologia, 2010
OBJETIVO: A fibrose cística (FC) é uma doença hereditária, multissistêmica e crônica, para a qual... more OBJETIVO: A fibrose cística (FC) é uma doença hereditária, multissistêmica e crônica, para a qual é importante uma abordagem multidisciplinar. O objetivo deste estudo foi mostrar a evolução de um grupo de pacientes com FC após a implantação desse tipo de atendimento. MÉTODOS: Foram analisados retrospectivamente 19 pacientes (idades entre 6 e 29 anos) em acompanhamento clínico no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, na cidade de Ribeirão Preto (SP). Os pacientes foram divididos em dois grupos: grupo 6-12 (6-12 anos) e grupo 13+ (> 12 anos). Dados referentes a índice de massa corporal (IMC), escore Z, escore de Shwachman (ES), número de exacerbações/ano, colonização crônica por Pseudomonas aeruginosa e medidas espirométricas (CVF, VEF1, VEF1% e FEF25-75%) foram obtidos. Os dados foram coletados em dois momentos (antes e após a implantação de atendimento multidisciplinar) e foram analisados com o teste dos postos sinalizados ...
Pediatric Pulmonology, 2003
The present study evaluates the relationships of pulmonary volumes and flows and the anthropometr... more The present study evaluates the relationships of pulmonary volumes and flows and the anthropometric variables of standing height, sitting height, and arm span in 100 6-10-year-old children. To be included in the study, all children were required to be healthy and above the 3rd percentile of the curve of Tanner et al. (Arch Dis Child 1966;41:454-471; Arch Dis Child 1966;41:613-635) for height and weight. Standing height, sitting height, and arm span were measured according to standard protocol. The pulmonary function measurements were: tidal volume, minute respiratory volume, respiratory rate, expiratory reserve volume, inspiratory capacity, vital capacity, residual volume (RV), functional residual capacity, total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 sec of FVC (FEV(1)), forced expiratory flow measured between 25-75% of FVC, and FEV(1)/FVC and RV/TLC ratios. Simple linear regression best expressed the correlation between pulmonary function and the anthropometric variables. Significant correlations between anthropometric and pulmonary function measurements were observed, with FVC and FEV(1) showing the highest and RV the lowest r(2) values. There was a significant positive correlation between standing height and arm span according to linear regression and Bland-Altman comparison (Bland and Altman, Lancet 1968;8:307-310). Our results suggest that when an accurate determination of standing height cannot be obtained, arm span could be used interchangeably, using the same regression equation. However, for patients with limb deformities, regression equations of pulmonary function measurements in relation to sitting height may be a better choice for estimating pulmonary function.
Journal of Pediatric Surgery, 2007
An 8-year-old girl was evaluated for a mass in the left pulmonary lobe. Her clinical history was ... more An 8-year-old girl was evaluated for a mass in the left pulmonary lobe. Her clinical history was remarkable for an intermittent dry cough since the age of 2, with recurrent episodes of purulent sputum and fever. She underwent left lower lobectomy, which was found to be a bronchioloalveolar carcinoma arising in a type 1 congenital pulmonary airway malformation at pathologic examination. No additional therapies were undertaken. Two years after resection, imaging studies showed 5 contralateral pulmonary nodules suggestive of disseminated disease with a poor outcome. A review of presentation, treatment, and outcome of this association was made.
Brazilian Journal of Medical and Biological Research, 2006
Fitness improvement was used to compare morning with afternoon exercise periods for asthmatic chi... more Fitness improvement was used to compare morning with afternoon exercise periods for asthmatic children. Children with persistent moderate asthma (according to GINA criteria), 8 to 11 years old, were divided into 3 groups: morning training group (N = 23), afternoon training group (N = 23), and non-training group (N = 23). The program was based on twice a week 90-min sessions for 4 months. We measured the 9-min running distance, resting heart rate and abdominal muscle strength (sit-up number) before and after the training. All children took budesonide, 400 µg/day, and an on demand inhaled ßagonist. The distance covered in 9 min increased (mean ± SEM) from 1344 ± 30 m by 248 ± 30 m for the morning group, from 1327 ± 30 m by 162 ± 20 m for the afternoon group, and from 1310 ± 20 m by 2 ± 20 m for the control group (P < 0.05 for the comparison of morning and afternoon groups with the control group by ANOVA and P > 0.05 for morning with afternoon comparison). The reduction of resting heart rate from 83 ± 1, 85 ± 2 and 86 ± 1 bpm was 5.1 ± 0.8 bpm in the morning group, 4.4 ± 0.8 bpm in the afternoon group, and-0.2 ± 0.7 bpm in the control group (P > 0.05 for morning with afternoon comparison and P < 0.05 versus control). The number of situps in the morning, afternoon and control groups increased from 22.0 ± 1.7, 24.3 ± 1.4 and 23 ± 1.1 sit-ups by 9.8 ± 0.9, 7.7 ± 1.4, and 1.9 ± 0.7 sit-ups, respectively (P > 0.05 for morning with afternoon comparison and P < 0.05 versus control). No statistically significant differences were detected between the morning and afternoon groups in terms of physical training of asthmatic children.
Indian Journal of Forensic Medicine and Pathology, 2016
PLOS ONE, 2018
Chronic lung infection by Pseudomonas aeruginosa is the leading cause of morbidity and mortality ... more Chronic lung infection by Pseudomonas aeruginosa is the leading cause of morbidity and mortality in cystic fibrosis (CF) patients. This is associated with the conversion of the nonmucoid to the mucoid phenotype. However, there is little information about the occurrence of alginate-producing P. aeruginosa in CF patients outside Europe and North America. The aim of the present study was to investigate mutations in the algTmucABD operon in mucoid and non-mucoid isolates from Brazilian CF patients. Twenty-seven mucoid and 37 nonmucoid isolates from 40 CF patients chronically infected by P. aeruginosa attending a CF reference center in Brazil were evaluated by sequence analysis. Mutations in mucA were observed in 93% of the mucoid isolates and 54% of the non-mucoid isolates. Among these non-mucoid isolates, 55% were considered revertants, since they also had mutations in algT (algU). Most isolates associated with moderate alginate production presented point mutations in mucB and/or mucD. We identified 30 mutations not previously described in the operon. In conclusion, mutations in mucA were the main mechanism of conversion to mucoidy, and most of the non-mucoid isolates were revertants, but the mechanism of revertance is not fully explained by changes in algT.
Journal of Cystic Fibrosis, 2014
Objectives: Standard culture may fail to detect fungal pathogens. Reliance upon this technique al... more Objectives: Standard culture may fail to detect fungal pathogens. Reliance upon this technique alone amidst clinical decline or antifungal therapy can make clinical decision-making and disease-monitoring challenging. This pilot study aims to further evaluate the CF fungal airways burden in recognition of this unmet clinical need. Methods: 16 adult CF patients with a spectrum of fungal disease provided spontaneous sputum samples at a single timepoint to be examined by 3 different techniques: (1) Prolonged fungal cultures (Sabouraud's Dextrose Agar + chloramphenicol and Dermasel Agar incubated at 37ºC 48 h then 30ºC and interpreted at Day 7, D14, D21, D28). (2) Microbiology stain: Calcofluor White (CFW) (3) Cytology stain: Grocott's Methenamine Silver (GMS). Results: Prolonged fungal culture (>D7) yielded a positivity rate of 57% compared to 35% of samples at <D7. However CFW stain revealed fungal elements eg. hyphae, in 75% of samples. GMS stain revealed fungal findings in 73%. Of the fungal culture-negative samples, stains detected fungal elements in up to 50% (CFW 33%, GMS 50%). Conclusion: Whilst the sample size in this preliminary cohort is small, the clinical utility for additional evaluation of fungal disease by a panel of laboratory techniques available to most hospital pathology departments is highlighted. Of note, Scedosporium apiospermum and Exophiala dermatitidis, two emerging fungal pathogens required >D7 culture. GMS stain a had greater detection rate for fungal elements compared to CFW in the fungal culture-negative samples. The evaluation of these techniques in monitoring disease over time and for early detection of fungal infection forms the focus of the next stage of this study.
Journal of Cystic Fibrosis, 2015
Objectives Alginate production (mucoid phenotype) of P. aeruginosa is a marker of chronic biofilm... more Objectives Alginate production (mucoid phenotype) of P. aeruginosa is a marker of chronic biofilm infection in the lungs of CF patients. Little is known about the occurrence of alginate-producing P. aeruginosa in CF patients outside Europe and North America. We therefore decided to study the occurrence of the alginate phenotype in P. aeruginosa from chronically infected CF patients in a CF center in Brazil and CF centers in Scandinavia (Ciofu et al., 2008). Methods The phenotype was classified according to Schurr et al. (1994): Type I: mucoid (M) on PIA ( Pseudomonas isolation agar) and LB agar, type II: mucoid on PIA but non-mucoid (NM) on LB, type III: non-mucoid on both, type IV: very slight but detectable mucoidy on both media after ≥4 days incubation. Results See the table. TableDistribution of different alginate phenotypesType I TypeII Type III Type IVBoth M&NM isolates from 20 Brazilian patients95%40%65%Both M&NM isolates from 83 Scandinavian patients89%17%87%6%Only NM isolates from 12 Brazilian patients92%8%Only NM isolates from 8 Scandinavian patients75%25% Conclusion Generally, the results show rather similar distributions of the Brazilian and Scandinavian isolates on the different phenotypes (Table). This probably reflects common selective environment in the lungs of CF patients in Brazil and Scandinavia, since the countries are widely separated and have completely different climate and geography, whereas the public medical systems are tax-based in all 4 countries. We are now sequencing the mucA and algT genes of the isolates which are responsible for the alginate phenotypes.
Acta Paulista de Enfermagem, 2012
Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxi... more Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxiliar profissionais de saúde e familiares a contarem para crianças menores de 5 anos sobre seu diagnóstico de Fibrose Cística. O livro traz a história de Lola, uma criança que descobre que tem Fibrose Cística e cria um monstro imaginário como representação da doença. A experiência emergida da prática profissional em um ambulatório multiprofissional de atendimento a esses pacientes, traduz a importância de conciliar teoria e prática, além da interdisciplinaridade para a construção de estratégias inovadoras e criativas no desenvolvimento do cuidado integral.
Acta Paulista de Enfermagem, 2012
Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxi... more Este trabalho descreve a experiência da construção de um livro de história com o objetivo de auxiliar profissionais de saúde e familiares a contarem para crianças menores de 5 anos sobre seu diagnóstico de Fibrose Cística. O livro traz a história de Lola, uma criança que descobre que tem Fibrose Cística e cria um monstro imaginário como representação da doença. A experiência emergida da prática profissional em um ambulatório multiprofissional de atendimento a esses pacientes, traduz a importância de conciliar teoria e prática, além da interdisciplinaridade para a construção de estratégias inovadoras e criativas no desenvolvimento do cuidado integral.
Journal of Cystic Fibrosis, 2014
To evaluate, in a longitudinal study, the profile of lipid peroxidation and antioxidant capacity ... more To evaluate, in a longitudinal study, the profile of lipid peroxidation and antioxidant capacity markers in sickle cell anaemia patients receiving different treatments and medication over different time periods. The three groups were: patients undergoing transfusion therapy and receiving iron chelator deferasirox (DFX group, n = 20); patients receiving deferasirox and hydroxyurea (DFX + HU group, n = 10), and patients receiving only folic acid (FA group, n = 15). Thiobarbituric acid-reactive substance (TBARS) assays and trolox-equivalent antioxidant capacity (TEAC) assays were evaluated during two different periods of analysis, T0 and T1 (after ~388 days). Higher FA group TBARS values were observed compared with the DFX + HU group (p = 0.016) at T0; and at T1, higher FA group TBARS values were also observed compared with both the DFX group (p = 0.003) and the DFX + HU group (p = 0.0002). No variation in TEAC values was seen between groups, at either T0 or T1. The mean values of TBAR...
Frontiers in Cellular and Infection Microbiology
Jornal Brasileiro de Pneumologia
Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology], Jan 4, 2017
Identification of nonfermenting Gram-negative bacteria (NFGNB) of cystic fibrosis patients is har... more Identification of nonfermenting Gram-negative bacteria (NFGNB) of cystic fibrosis patients is hard and misidentification could affect clinical outcome. This study aimed to propose a scheme using polymerase chain reaction to identify NFGNB. This scheme leads to reliable identification within 3 days in an economically viable manner when compared to other methods.
Arq Cienc Saude, Dec 1, 2007
Introdução: A fibrose cística é uma doença genética letal, crônica e progressiva, que compromete ... more Introdução: A fibrose cística é uma doença genética letal, crônica e progressiva, que compromete o funcionamento de quase todos os órgãos e sistemas do organismo, sendo as complicações pulmonares as principais causas de morbidade e mortalidade. Nesse sentido, torna-se fundamental a compreensão das complicações respiratórias provocadas e das ações de reabilitação, possibilitando intervenções que reduzam o impacto dessa doença nas atividades diárias. Objetivo: Este trabalho teve por objetivo realizar uma revisão bibliográfica discutindo os principais recursos ...
Rev Bras Alergia Imunopatol, Dec 1, 1995
Diet and Exercise in Cystic Fibrosis, 2015
Jornal Brasileiro de Pneumologia, 2010
OBJETIVO: A fibrose cística (FC) é uma doença hereditária, multissistêmica e crônica, para a qual... more OBJETIVO: A fibrose cística (FC) é uma doença hereditária, multissistêmica e crônica, para a qual é importante uma abordagem multidisciplinar. O objetivo deste estudo foi mostrar a evolução de um grupo de pacientes com FC após a implantação desse tipo de atendimento. MÉTODOS: Foram analisados retrospectivamente 19 pacientes (idades entre 6 e 29 anos) em acompanhamento clínico no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, na cidade de Ribeirão Preto (SP). Os pacientes foram divididos em dois grupos: grupo 6-12 (6-12 anos) e grupo 13+ (> 12 anos). Dados referentes a índice de massa corporal (IMC), escore Z, escore de Shwachman (ES), número de exacerbações/ano, colonização crônica por Pseudomonas aeruginosa e medidas espirométricas (CVF, VEF1, VEF1% e FEF25-75%) foram obtidos. Os dados foram coletados em dois momentos (antes e após a implantação de atendimento multidisciplinar) e foram analisados com o teste dos postos sinalizados ...
Pediatric Pulmonology, 2003
The present study evaluates the relationships of pulmonary volumes and flows and the anthropometr... more The present study evaluates the relationships of pulmonary volumes and flows and the anthropometric variables of standing height, sitting height, and arm span in 100 6-10-year-old children. To be included in the study, all children were required to be healthy and above the 3rd percentile of the curve of Tanner et al. (Arch Dis Child 1966;41:454-471; Arch Dis Child 1966;41:613-635) for height and weight. Standing height, sitting height, and arm span were measured according to standard protocol. The pulmonary function measurements were: tidal volume, minute respiratory volume, respiratory rate, expiratory reserve volume, inspiratory capacity, vital capacity, residual volume (RV), functional residual capacity, total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 sec of FVC (FEV(1)), forced expiratory flow measured between 25-75% of FVC, and FEV(1)/FVC and RV/TLC ratios. Simple linear regression best expressed the correlation between pulmonary function and the anthropometric variables. Significant correlations between anthropometric and pulmonary function measurements were observed, with FVC and FEV(1) showing the highest and RV the lowest r(2) values. There was a significant positive correlation between standing height and arm span according to linear regression and Bland-Altman comparison (Bland and Altman, Lancet 1968;8:307-310). Our results suggest that when an accurate determination of standing height cannot be obtained, arm span could be used interchangeably, using the same regression equation. However, for patients with limb deformities, regression equations of pulmonary function measurements in relation to sitting height may be a better choice for estimating pulmonary function.
Journal of Pediatric Surgery, 2007
An 8-year-old girl was evaluated for a mass in the left pulmonary lobe. Her clinical history was ... more An 8-year-old girl was evaluated for a mass in the left pulmonary lobe. Her clinical history was remarkable for an intermittent dry cough since the age of 2, with recurrent episodes of purulent sputum and fever. She underwent left lower lobectomy, which was found to be a bronchioloalveolar carcinoma arising in a type 1 congenital pulmonary airway malformation at pathologic examination. No additional therapies were undertaken. Two years after resection, imaging studies showed 5 contralateral pulmonary nodules suggestive of disseminated disease with a poor outcome. A review of presentation, treatment, and outcome of this association was made.
Brazilian Journal of Medical and Biological Research, 2006
Fitness improvement was used to compare morning with afternoon exercise periods for asthmatic chi... more Fitness improvement was used to compare morning with afternoon exercise periods for asthmatic children. Children with persistent moderate asthma (according to GINA criteria), 8 to 11 years old, were divided into 3 groups: morning training group (N = 23), afternoon training group (N = 23), and non-training group (N = 23). The program was based on twice a week 90-min sessions for 4 months. We measured the 9-min running distance, resting heart rate and abdominal muscle strength (sit-up number) before and after the training. All children took budesonide, 400 µg/day, and an on demand inhaled ßagonist. The distance covered in 9 min increased (mean ± SEM) from 1344 ± 30 m by 248 ± 30 m for the morning group, from 1327 ± 30 m by 162 ± 20 m for the afternoon group, and from 1310 ± 20 m by 2 ± 20 m for the control group (P < 0.05 for the comparison of morning and afternoon groups with the control group by ANOVA and P > 0.05 for morning with afternoon comparison). The reduction of resting heart rate from 83 ± 1, 85 ± 2 and 86 ± 1 bpm was 5.1 ± 0.8 bpm in the morning group, 4.4 ± 0.8 bpm in the afternoon group, and-0.2 ± 0.7 bpm in the control group (P > 0.05 for morning with afternoon comparison and P < 0.05 versus control). The number of situps in the morning, afternoon and control groups increased from 22.0 ± 1.7, 24.3 ± 1.4 and 23 ± 1.1 sit-ups by 9.8 ± 0.9, 7.7 ± 1.4, and 1.9 ± 0.7 sit-ups, respectively (P > 0.05 for morning with afternoon comparison and P < 0.05 versus control). No statistically significant differences were detected between the morning and afternoon groups in terms of physical training of asthmatic children.