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Helena Teresinha Mocelin - One of the best experts on this subject based on the ideXlab platform.
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Health-related quality of life in patients with Bronchiolitis Obliterans,
Jornal de Pediatria, 2018Co-Authors: Edgar Enrique Sarria, Eduardo Mundstock, Denise Greff Machado, Helena Teresinha Mocelin, Gilberto Bueno Fischer, Silvana P. Furlan, Ivan Carlos Ferreira Antonello, Ricardo Stein, Rita MattielloAbstract:Abstract Objective To evaluate the overall health-related quality of life in patients with Bronchiolitis Obliterans. Methods Participants with a diagnosis of post-infectious Bronchiolitis Obliterans, who were being followed-up at two specialized outpatient clinics of Pediatric Pulmonology in Porto Alegre, Brazil, and controls aged between 8 and 17 years, of both genders, were included in the study. Controls were paired by gender, age, and socioeconomic level in relation to the group of participants with post-infectious Bronchiolitis Obliterans. The version of the Pediatric Quality of Life Inventory (PedsQ) tool validated for Brazil was applied for the assessment of Health-related Quality of Life, through an interview. The comparison of the Health-related Quality of Life means between the groups was performed using Student's t-test for independent samples and the chi-squared test, for categorical variables. Results 34 patients diagnosed with post-infectious Bronchiolitis Obliterans and 34 controls participated in the study. The mean age of the children included in the study was 11.2 ± 2.5 years, and 49 (72%) of them were males. The groups showed no significant differences in relation to these variables. The quality of life score was significantly and clinically lower in the post-infectious Bronchiolitis Obliterans group when compared with controls in the health (72.36 ± 15.6, 81.06 ± 16.4, p = 0.031) and school domains (62.34 ± 20.7, 72.94 ± 21.3, p = 0.043), as well as in the total score (69.53 ± 14.9, 78.02 ± 14.8, p = 0.024), respectively. Conclusion Patients with post-infectious Bronchiolitis Obliterans presented lower health-related quality of life scores when compared with healthy individuals in the total score and in the health and school domains.
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Post-infectious Bronchiolitis Obliterans in children.
Jornal de pediatria, 2011Co-Authors: Natália Da Silva Champs, Gilberto Bueno Fischer, Laura Maria De Lima Belizário Facury Lasmar, Paulo Augusto Moreira Camargos, Christophe Marguet, Helena Teresinha MocelinAbstract:OBJECTIVE To review publications about the main features of post-infectious Bronchiolitis Obliterans and its history, etiology, epidemiology, risk factors, pathogenesis, histological findings, clinical presentation, complementary tests, diagnostic criteria, differential diagnosis, treatment and prognosis. SOURCES Non-systematic review of MEDLINE and LILACS databases and selection of 66 most relevant studies. SUMMARY OF THE FINDINGS In the post-infectious Bronchiolitis Obliterans there is an insult to respiratory epithelial cells, and its clinical severity is associated with the degree of lesion and inflammation. Diagnosis is made according to clinical signs and symptoms, by exclusion of main differential diagnoses and with the aid of complementary tests. High resolution CT, particularly images obtained during inspiration and expiration, provide information for the evaluation of the small airways. Pulmonary function tests show fixed airway obstructions and marked decrease of FEF25-75%. Treatment has not been definitely established, and corticoids have been administered as pulse therapy or by inhalation of high doses of steroids. However, data about its efficacy are scarce in the literature. Long-term prognosis is variable, and there might be either clinical improvement or deterioration into respiratory insufficiency and death. CONCLUSION Post-infectious Bronchiolitis Obliterans is a disease with a high morbidity rate; it should be treated by a multidisciplinary team, and patients should be followed up for a long period of time.
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Post infectious Bronchiolitis Obliterans in children.
Paediatric Respiratory Reviews, 2010Co-Authors: Gilberto Bueno Fischer, Helena Teresinha Mocelin, Rita Mattiello, Edgar E. Sarria, Jose A. Castro-rodriguezAbstract:Bronchiolitis Obliterans (BO) is an infrequent chronic and obstructive lung disease secondary to an insult to the terminal airway and its surroundings. In children, the most common presentation is the post-infectious variant, closely related to a severe viral infection in the first three years of life. However, the increase in the number of lung and bone-marrow transplants has also been followed by an increase in post-transplant BO. Post-transplant BO is progressive while post-infectious BO does not seem to be, but both forms share some common pathways that result in a characteristic histopathology of bronchiolar obliteration. This review covers up-to-date evidence on epidemiology, diagnosis, treatment and prognosis of post-infectious Bronchiolitis Obliterans, including areas of controversy that need to be addressed in future studies.
Gilberto Bueno Fischer - One of the best experts on this subject based on the ideXlab platform.
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Health-related quality of life in patients with Bronchiolitis Obliterans,
Jornal de Pediatria, 2018Co-Authors: Edgar Enrique Sarria, Eduardo Mundstock, Denise Greff Machado, Helena Teresinha Mocelin, Gilberto Bueno Fischer, Silvana P. Furlan, Ivan Carlos Ferreira Antonello, Ricardo Stein, Rita MattielloAbstract:Abstract Objective To evaluate the overall health-related quality of life in patients with Bronchiolitis Obliterans. Methods Participants with a diagnosis of post-infectious Bronchiolitis Obliterans, who were being followed-up at two specialized outpatient clinics of Pediatric Pulmonology in Porto Alegre, Brazil, and controls aged between 8 and 17 years, of both genders, were included in the study. Controls were paired by gender, age, and socioeconomic level in relation to the group of participants with post-infectious Bronchiolitis Obliterans. The version of the Pediatric Quality of Life Inventory (PedsQ) tool validated for Brazil was applied for the assessment of Health-related Quality of Life, through an interview. The comparison of the Health-related Quality of Life means between the groups was performed using Student's t-test for independent samples and the chi-squared test, for categorical variables. Results 34 patients diagnosed with post-infectious Bronchiolitis Obliterans and 34 controls participated in the study. The mean age of the children included in the study was 11.2 ± 2.5 years, and 49 (72%) of them were males. The groups showed no significant differences in relation to these variables. The quality of life score was significantly and clinically lower in the post-infectious Bronchiolitis Obliterans group when compared with controls in the health (72.36 ± 15.6, 81.06 ± 16.4, p = 0.031) and school domains (62.34 ± 20.7, 72.94 ± 21.3, p = 0.043), as well as in the total score (69.53 ± 14.9, 78.02 ± 14.8, p = 0.024), respectively. Conclusion Patients with post-infectious Bronchiolitis Obliterans presented lower health-related quality of life scores when compared with healthy individuals in the total score and in the health and school domains.
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Post-infectious Bronchiolitis Obliterans in children.
Jornal de pediatria, 2011Co-Authors: Natália Da Silva Champs, Gilberto Bueno Fischer, Laura Maria De Lima Belizário Facury Lasmar, Paulo Augusto Moreira Camargos, Christophe Marguet, Helena Teresinha MocelinAbstract:OBJECTIVE To review publications about the main features of post-infectious Bronchiolitis Obliterans and its history, etiology, epidemiology, risk factors, pathogenesis, histological findings, clinical presentation, complementary tests, diagnostic criteria, differential diagnosis, treatment and prognosis. SOURCES Non-systematic review of MEDLINE and LILACS databases and selection of 66 most relevant studies. SUMMARY OF THE FINDINGS In the post-infectious Bronchiolitis Obliterans there is an insult to respiratory epithelial cells, and its clinical severity is associated with the degree of lesion and inflammation. Diagnosis is made according to clinical signs and symptoms, by exclusion of main differential diagnoses and with the aid of complementary tests. High resolution CT, particularly images obtained during inspiration and expiration, provide information for the evaluation of the small airways. Pulmonary function tests show fixed airway obstructions and marked decrease of FEF25-75%. Treatment has not been definitely established, and corticoids have been administered as pulse therapy or by inhalation of high doses of steroids. However, data about its efficacy are scarce in the literature. Long-term prognosis is variable, and there might be either clinical improvement or deterioration into respiratory insufficiency and death. CONCLUSION Post-infectious Bronchiolitis Obliterans is a disease with a high morbidity rate; it should be treated by a multidisciplinary team, and patients should be followed up for a long period of time.
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Post infectious Bronchiolitis Obliterans in children.
Paediatric Respiratory Reviews, 2010Co-Authors: Gilberto Bueno Fischer, Helena Teresinha Mocelin, Rita Mattiello, Edgar E. Sarria, Jose A. Castro-rodriguezAbstract:Bronchiolitis Obliterans (BO) is an infrequent chronic and obstructive lung disease secondary to an insult to the terminal airway and its surroundings. In children, the most common presentation is the post-infectious variant, closely related to a severe viral infection in the first three years of life. However, the increase in the number of lung and bone-marrow transplants has also been followed by an increase in post-transplant BO. Post-transplant BO is progressive while post-infectious BO does not seem to be, but both forms share some common pathways that result in a characteristic histopathology of bronchiolar obliteration. This review covers up-to-date evidence on epidemiology, diagnosis, treatment and prognosis of post-infectious Bronchiolitis Obliterans, including areas of controversy that need to be addressed in future studies.
Rita Mattiello - One of the best experts on this subject based on the ideXlab platform.
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Health-related quality of life in patients with Bronchiolitis Obliterans,
Jornal de Pediatria, 2018Co-Authors: Edgar Enrique Sarria, Eduardo Mundstock, Denise Greff Machado, Helena Teresinha Mocelin, Gilberto Bueno Fischer, Silvana P. Furlan, Ivan Carlos Ferreira Antonello, Ricardo Stein, Rita MattielloAbstract:Abstract Objective To evaluate the overall health-related quality of life in patients with Bronchiolitis Obliterans. Methods Participants with a diagnosis of post-infectious Bronchiolitis Obliterans, who were being followed-up at two specialized outpatient clinics of Pediatric Pulmonology in Porto Alegre, Brazil, and controls aged between 8 and 17 years, of both genders, were included in the study. Controls were paired by gender, age, and socioeconomic level in relation to the group of participants with post-infectious Bronchiolitis Obliterans. The version of the Pediatric Quality of Life Inventory (PedsQ) tool validated for Brazil was applied for the assessment of Health-related Quality of Life, through an interview. The comparison of the Health-related Quality of Life means between the groups was performed using Student's t-test for independent samples and the chi-squared test, for categorical variables. Results 34 patients diagnosed with post-infectious Bronchiolitis Obliterans and 34 controls participated in the study. The mean age of the children included in the study was 11.2 ± 2.5 years, and 49 (72%) of them were males. The groups showed no significant differences in relation to these variables. The quality of life score was significantly and clinically lower in the post-infectious Bronchiolitis Obliterans group when compared with controls in the health (72.36 ± 15.6, 81.06 ± 16.4, p = 0.031) and school domains (62.34 ± 20.7, 72.94 ± 21.3, p = 0.043), as well as in the total score (69.53 ± 14.9, 78.02 ± 14.8, p = 0.024), respectively. Conclusion Patients with post-infectious Bronchiolitis Obliterans presented lower health-related quality of life scores when compared with healthy individuals in the total score and in the health and school domains.
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Post infectious Bronchiolitis Obliterans in children.
Paediatric Respiratory Reviews, 2010Co-Authors: Gilberto Bueno Fischer, Helena Teresinha Mocelin, Rita Mattiello, Edgar E. Sarria, Jose A. Castro-rodriguezAbstract:Bronchiolitis Obliterans (BO) is an infrequent chronic and obstructive lung disease secondary to an insult to the terminal airway and its surroundings. In children, the most common presentation is the post-infectious variant, closely related to a severe viral infection in the first three years of life. However, the increase in the number of lung and bone-marrow transplants has also been followed by an increase in post-transplant BO. Post-transplant BO is progressive while post-infectious BO does not seem to be, but both forms share some common pathways that result in a characteristic histopathology of bronchiolar obliteration. This review covers up-to-date evidence on epidemiology, diagnosis, treatment and prognosis of post-infectious Bronchiolitis Obliterans, including areas of controversy that need to be addressed in future studies.
Romain Kessler - One of the best experts on this subject based on the ideXlab platform.
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Blood CD9+ B Cell, a biomarker of Bronchiolitis Obliterans syndrome after lung transplantation
American Journal of Transplantation, 2019Co-Authors: Carole Brosseau, Richard Danger, Maxim Durand, Eugénie Durand, Aurore Foureau, Philippe Lacoste, Adrien Tissot, Antoine Roux, Martine Reynaud-gaubert, Romain KesslerAbstract:Bronchiolitis Obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of Bronchiolitis Obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with Bronchiolitis Obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a Bronchiolitis Obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of Bronchiolitis Obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of Bronchiolitis Obliterans syndrome-free survival.
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Blood CD 9 + B Cell, a biomarker of Bronchiolitis Obliterans syndrome after lung transplantation
American Journal of Transplantation, 2019Co-Authors: Carole Brosseau, Richard Danger, Eugénie Durand, Aurore Foureau, Philippe Lacoste, Adrien Tissot, Antoine Roux, Durand Maxim, Martine Reynaud‐gaubert, Romain KesslerAbstract:Bronchiolitis Obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of Bronchiolitis Obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with Bronchiolitis Obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24(hi)CD38(hi) transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a Bronchiolitis Obliterans syndrome. These CD24(hi)CD38(hi) transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9(+) B cell frequency below 6.6% displayed significantly higher incidence of Bronchiolitis Obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24(hi)CD38(hi) transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of Bronchiolitis Obliterans syndrome-free survival.
A. Qanash - One of the best experts on this subject based on the ideXlab platform.
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Bronchiolitis Obliterans After Cefuroxime-Induced Stevens-Johnson Syndrome.
American Journal of Case Reports, 2019Co-Authors: Mohammed Shabrawishi, A. QanashAbstract:BACKGROUND Bronchiolitis Obliterans is the term used to describe a clinical syndrome of irreversible airflow obstruction. Among the etiologies linked to this entity is the rarely reported association with Stevens-Johnson syndrome, which has had a poor outcome in most of the previously published cases. The optimum management of Bronchiolitis Obliterans as a complication of Stevens-Johnson syndrome is not well defined. CASE REPORT A 41-year-old woman developed significant shortness of breath 3 months after recovering from Stevens-Johnson syndrome precipitated by a second-generation cephalosporin. She was found to have severe irreversible airway obstruction on physiology studies, and computed tomography scans of the inspiratory and expiratory phases of respiration showed air trapping that was more prominent on expiratory films. The patient was diagnosed with Bronchiolitis Obliterans, for which bronchodilators and long-term macrolide therapy were administered. Although she did not recover completely, her follow-up physiology studies showed that the Bronchiolitis Obliterans was stable. CONCLUSIONS Bronchiolitis Obliterans secondary to Stevens-Johnson syndrome is a rare entity that is progressive and can lead to functional impairment. Identifying the disease at an early stage might stabilize or slow its progression. Herein, we describe a case of Bronchiolitis Obliterans as a complication of Stevens-Johnson syndrome and review the literature to raise awareness of this condition, highlight its course, and discuss the available treatments.
