Liana Gonçalves Macêdo

Universidade de Pernambuco

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Edmundo Pessoa Lopes

Universidade Federal de Pernambuco

Ana Lúcia Coutinho Domingues

Universidade Federal de Pernambuco

Simone Cristina Soares Brandão

Hospital das Clínicas da Universidade Federal de Pernambuco

Joyce Ferreira Gomes de Oliveira

Center for Effective Philanthropy

Lucas dos Santos Accioly

Vítor Gomes Mota

Universidade Federal de Pernambuco

Andréa Simone Siqueira de Queirós

Universidade Federal de Pernambuco

Raphaella Amanda Maria Leite Fernandes

Centro Universitário Maurício de Nassau

Sérgio Manoel Lemos de Carvalho

Maira Souto Ourem

Universidade Federal de Pernambuco

Cooperative Institutions

Universidade Federal de Pernambuco

Hospital das Clínicas da Universidade Federal de Pernambuco

Universidade de Pernambuco

Universidade de São Paulo

Hospital Geral de Bonsucesso

Sociedade Brasileira de Cardiologia

Weatherford College

The Royal Free Hospital

University College London

Institute of Rural Management Anand

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Evaluation of intrapulmonary vascular dilatation in hepatosplenic schistosomiasis patients by lung perfusion scan

Journal of Nuclear Medicine (2011)

Simone Cristina Soares Brandão Liana Gonçalves Macêdo Andrea de Queiros Ana Lúcia Coutinho Domingues Everton Rodrigues da Silva

1366 Objectives The hepatopulmonary syndrome is defined as a triad, represented by intrapulmonary vascular dilatation (IPVD) associated with an alveolar-arterial oxygen tension difference (A-aDO2) ≥ 15 mmHg or a PaO2 Methods Nine consecutive HSS patients were submitted to arterial blood gas analysis, and lung perfusion scan with 99mTc-MAA. The diagnostic of IPVD was considered when 99mTc-MAA brain uptake ≥6%. No patient had lung disease or cardiac shunt. Results The patients were mean age of 56+/-11 years and 56% were males. The mean PaO2 and A-aDO2 were 78 +/- 10 mmHg and 28 +/- 15 mmHg, respectively. The patients presented a brain uptake mean of 5.21 +/- 0.02%. Five (56%) patients had IPVD and four of them A-aDO2 ≥ 15 mmHg, possibly characterizing hepatopulmonary syndrome. Conclusions The lung perfusion scan can help to evaluate IPVD in HSS patients. Its presence was associated with elevated A-aDO2 and hepatopulmonary syndrome. This syndrome could be a marker of poor prognostic in these patients

Hepatopulmonary syndrome

Arterial oxygen tension

Arterial blood

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Occurrence of hepatopulmonary syndrome in patients with cirrhosis who are candidates for liver transplantation* Ocorrência de síndrome hepatopulmonar em pacientes cirróticos candidatos a transplante de fígado

Liana Gonçalves Macêdo Edmundo Pessoa de Almeida Maria de Fátima Pessoa Flávio Henrique Amaral Pires Véras

Objective: To determine the occurrence of hepatopulmonary syndrome (HPS) in patients with cirrhosis who are candidates for liver transplantation; to compare demographic, clinical, laboratory, and spirometric characteristics, as well as echocardiography results, arterial blood gas analysis, and severity of liver disease between the groups of patients with and without HPS; and to describe the occurrence of HPS in the subgroup of patients with cirrhosis and schistosomiasis mansoni (mixed liver disease). Methods: Between January and November of 2007, we evaluated 44 patients under treatment at the Liver Transplant Outpatient Clinic of the Federal University of Pernambuco Hospital das Clinicas, in the city of Recife, Brazil. The diagnostic criteria for HPS were intrapulmonary vascular dilatation, identified by transthoracic echocardiography, and an alveolar-arterial oxygen tension difference ≥ 15 mmHg or a PaO 2 < 80 mmHg. Results: The mean age of the patients was 52 years, and 31 patients (70%) were males. The most common cause of cirrhosis was alcohol use. Schistosomiasis was present in 28 patients (64%). Of the 44 patients, 20 (45.5%) were diagnosed with HPS. No significant differences were found between those patients and the patients without HPS in terms of any of the characteristics studied. Of the 28 patients with cirrhosis and schistosomiasis, 10 (35.7%) were diagnosed with HPS. Conclusions: In the population studied, HPS was highly prevalent and did not correlate with any of the variables analyzed.

Hepatopulmonary syndrome

Liver disease

Outpatient clinic

Chronic liver disease

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Ocorrência de síndrome hepatopulmonar em pacientes cirróticos candidatos a transplante de fígado

Jornal Brasileiro de Pneumologia (2010)

Liana Gonçalves Macêdo Edmundo Pessoa Lopes Maria de Fátima Pessoa Militão de Albuquerque Brivaldo Markman Filho Flávio Henrique Amaral Pires Véras

To determine the occurrence of hepatopulmonary syndrome (HPS) in patients with cirrhosis who are candidates for liver transplantation; to compare demographic, clinical, laboratory, and spirometric characteristics, as well as echocardiography results, arterial blood gas analysis, and severity of liver disease between the groups of patients with and without HPS; and to describe the occurrence of HPS in the subgroup of patients with cirrhosis and schistosomiasis mansoni (mixed liver disease).Between January and November of 2007, we evaluated 44 patients under treatment at the Liver Transplant Outpatient Clinic of the Federal University of Pernambuco Hospital das Clínicas, in the city of Recife, Brazil. The diagnostic criteria for HPS were intrapulmonary vascular dilatation, identified by transthoracic echocardiography, and an alveolar-arterial oxygen tension difference >or= 15 mmHg or a PaO2 < 80 mmHg.The mean age of the patients was 52 years, and 31 patients (70%) were male. The most common cause of cirrhosis was alcohol use. Schistosomiasis was present in 28 patients (64%). Of the 44 patients, 20 (45.5%) were diagnosed with HPS. No significant differences were found between those patients and the patients without HPS in terms of any of the characteristics studied. Of the 28 patients with cirrhosis and schistosomiasis, 10 (35.7%) were diagnosed with HPS.In the population studied, HPS was highly prevalent and did not correlate with any of the variables analyzed.

10.1590/s1806-37132010000400007

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Comparison of Doppler Echocardiographic Findings in Patients with Chronic Liver Disease with and without Intrapulmonary Shunt

Cardiology and Angiology An International Journal (2015)

Vítor Gomes Mota Brivaldo Markman Filho Liana Gonçalves Macêdo Mônica de Moraes Chaves Becker Edmundo Pessoa Lopes

Chronic liver disease

10.9734/ca/2015/20427

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Intrapulmonary Vascular Dilatation Evaluated by 99mTc-MAA Scintigraphy and Its Association with Portal Hypertension in Schistosomiasis

PLoS neglected tropical diseases (2014)

Andréa Simone Siqueira de Queirós Simone Cristina Soares Brandão Ana Lúcia Coutinho Domingues Liana Gonçalves Macêdo Maira Souto Ourem

Background Portal hypertension is responsible for various complications in patients with schistosomiasis, among them intrapulmonary vascular dilations (IPVD). In cirrhotic patients the presence of IPVD is a sign of poor prognosis, but in patients with hepatosplenic schistosomiasis (HSS) there are no studies assessing the significance of this change. The aim of this study was to evaluate the occurrence of IPVD through 99mTc-MAA scintigraphy in patients with HSS and its relationship with clinical, laboratory, endoscopic and ultrasound parameters. Methods Cross-sectional study evaluating 51 patients with HSS. Patients were diagnosed with IPVD when the brain uptake of 99mTc-MAA was higher than 6%. Subsequently, they were divided according to presence (G1) or absence (G2) of IPVD and variables were compared between groups. Results Overall, 51 patients with mean age of 56±12 years were assessed. IPVD was observed in 31 patients (60%). There was no statistically significant differences between groups when clinical, laboratory and endoscopic parameters were compared. Regarding ultrasound parameters, the splenic vein diameter was smaller in G1 (0.9±0.3 cm) compared to G2 (1.2±0.4 cm), p = 0.029. Conclusion In patients with HSS, the occurrence of IPVD by 99mTc-MAA scintigraphy was high and was associated with lower splenic vein diameter, which can be a mechanism of vascular protection against portal hypertension. However, more studies are needed to determine the clinical significance of the early diagnosis and natural evolution of IPVD in this population.

10.1371/journal.pntd.0002881

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Evaluation of normality and reproducibility parameters of scintigraphy with 99mTc-MAA in the diagnosis of intrapulmonary vascular dilatations

Annals of Nuclear Medicine (2014)

Andréa Simone Siqueira de Queirós Simone Cristina Soares Brandão Liana Gonçalves Macêdo Maira Souto Ourem Vítor Gomes Mota

10.1007/s12149-014-0915-9

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Perfil bacteriológico das infecções do trato respiratório inferior em pacientes internados na enfermaria de pneumologia em Hospital Terciário de Referência em doenças pulmonares no Estado de Pernambuco

Sérgio Manoel Lemos de Carvalho Joyce Ferreira Gomes de Oliveira Liana Gonçalves Macêdo Lucas dos Santos Accioly Raphaella Amanda Maria Leite Fernandes

Introduction: respiratory tract infection is responsible for high morbidity and mortality, and lead to frequent use ofantibiotics. It is important to know the bacteriological profile according to the evaluated base location and condition of the patient,since, on many occasions, the treatment of these infections is initiated empirically. Objective: It is to identify the bacteriological profileof sputum cultures and bronchoalveolar lavage and verify the underlying lung disease of hospitalized patients in pulmonology ward.Methods: The study consisted of a retrospective series of cases, where the cultures of sputum and / or bronchoalveolar lavage fluid of 70patients were analyzed. Results: The most prevalent pathogens in sputum cultures were Pseudomonas sp. and Klebsiella sp.,respectively, in 17 (24%) and 15 (21%) patients. There was no predominance of any pathogen in the cultures of bronchoalveolar lavage.Bronchiectasis was the most prevalent pulmonary disease with pulmonary tuberculosis after-effects, there was a significantrelationship between their presence and the infection by Pseudomonas sp. (P <0.05). Conclusion: The finding of Pseudomonas sp. asthe most common bacteria, particularly in patients with bronchiectasis by pulmonary tuberculosis after-effects, as well as the finding ofKlebsiella sp. as the second most common pathogen, although not associated with any underlying lung disease, may assist in the choiceof empirical therapy of patients admitted to the pulmonology ward of the Hospital.

Pulmonology

Sputum culture

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Síndrome hepatopulmonar em pacientes com hipertensão portal e varizes esofágicas por esquistossomose mansônica e doença hepática crônica mista

Liana Gonçalves Macêdo

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Determinação da eficiência do VEF6 como substituto da CVF na triagem diagnóstica da doença pulmonar obstrutiva crônica através da comparação entre as relações VEF1/CVF e VEF1/VEF6

Jornal Brasileiro de Pneumologia (2007)

Fernando Luiz Cavalcanti Lundgren Marília Montenegro Cabral Danielle Cristina Silva Clímaco Liana Gonçalves Macêdo Marta de Andrade Lima Coelho

OBJETIVO: Determinar a eficácia do uso do volume expiratório forçado nos primeiros seis segundos (VEF6) como substituto da capacidade vital forçada (CVF) na triagem diagnóstica da doença pulmonar obstrutiva crônica (DPOC) através da comparação entre as medidas da relação VEF1/CVF e as medidas da relação VEF1/VEF6. MÉTODOS: No ano de 2003, durante o Dia Mundial da DPOC, realizamos uma campanha de triagem diagnóstica da DPOC. Os participantes da campanha respondiam ao questionário clínico do projeto Global Initiative for -Obstructive Lung Disease e aqueles que apresentavam pelo menos três respostas positivas submetiam-se a espirometria. RESULTADOS: Um total de 134 indivíduos respondeu positivamente a três questões e realizou espirometria. Destes, 59 foram excluídos: 45 por serem não fumantes e 14 pelo fato de seus exames não obedecerem aos critérios da American Thoracic Society para espirometria de qualidade. O número de resultados abaixo de 70% foi similar para VEF1/CVF e para VEF1/VEF6. A sensibilidade de VEF1/VEF6 para o diagnóstico de obstrução de vias aéreas definida por VEF1/CVF abaixo de 70% foi de 92% e a especificidade foi de 99%. O valor preditivo positivo foi de 100% e o valor preditivo negativo foi de 98%. O teste de correlação de Kendall mostrou r = 0,99 (p < 0,0001). O teste t para amostras pareadas mostrou correlação negativa: t = -5,93 (p < 0,0001). CONCLUSÃO: A relação VEF1/VEF6 se mostrou eficaz para uso na triagem diagnóstica da DPOC. Existe uma forte relação entre VEF1/CVF e VEF1/VEF6.

Vital capacity

10.1590/s1806-37132007000200008

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Anais da Faculdade de Medicina de Olinda (2019)

Sérgio Manoel Lemos de Carvalho Joyce Ferreira Gomes de Oliveira Liana Gonçalves Macêdo Lucas dos Santos Accioly Raphaella Amanda Maria Leite Fernandes

Introdução: A infecção do trato respiratório é responsável por elevada morbimortalidade, além de levar ao uso frequente de antibióticos. É importante o conhecimento do perfil bacteriológico de acordo com o local avaliado e a doença de base do paciente, uma vez que, em muitas ocasiões, o tratamento dessas infecções é iniciado empiricamente. Objetivo: Identificar o perfil bacteriológico das culturas de escarro e dos lavados broncoalveolares e verificar a doença pulmonar de base dos pacientes internados na enfermaria de Pneumologia de um Hospital Terciário referência em doenças pulmonares do estado de Pernambuco. Métodos: O estudo consistiu de uma série de casos retrospectiva, onde foram analisadas as culturas de escarro e/ou do lavado broncoalveolar de 70 pacientes. Resultados: Os patógenos mais prevalentes nas culturas de escarro foram a Pseudomonas sp. e a Klebsiella sp., presentes, respectivamente, em 17 (24%) e 15 (21%) pacientes. Não houve predomínio de qualquer patógeno nas culturas dos lavados broncoalveolares. A doença pulmonar de base mais prevalente foi a bronquiectasia por sequela de tuberculose pulmonar, havendo relação significativa entre a sua presença e a infecção por Pseudomonas sp. (P < 0,05). Conclusão: O encontro de Pseudomonas sp. como a bactéria mais prevalente, principalmente em pacientes que apresentam bronquiectasia por sequela de tuberculose pulmonar, assim como o achado de Klebsiella sp. como o segundo patógeno mais frequente, ainda que não associado a alguma doença pulmonar de base, poderão auxiliar na escolha da terapia empírica de pacientes internados na enfermaria de Pneumologia de um Hospital Terciário de Referência em doenças pulmonares.

10.56102/afmo.2019.108

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