Navegando por Palavras-chave "Rheumatic diseases"
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- ItemSomente MetadadadosAssociation between demyelinating disease and autoimmune rheumatic disease in a pediatric population(Elsevier Science Inc, 2017) Amorim, Ana Luiza M. [UNIFESP]; Cabral, Nadia C. [UNIFESP]; Osaku, Fabiane M. [UNIFESP]; Len, Claudio A. [UNIFESP]; Oliveira, Enedina M. L. [UNIFESP]; Terreri, Maria Teresa [UNIFESP]Introduction: Multiple sclerosis (MS) and neuromyelitis optica (NMO) are demyelinating diseases of the central nervous system. Autoimmunity in patients with demyelinating disease and in their families has been broadly investigated and discussed. Recent studies show a higher incidence of rheumatic autoimmune diseases among adult patients with MS or NMO and their families, but there are no studies in the pediatric population. Objective: To evaluate an association of MS and NMO with autoimmune rheumatic diseases in pediatric patients. Method: 22 patients younger than 21 years old with MS or NMO diagnosed before the age of 18 years were evaluated regarding epidemiological data, clinical presentation, association with autoimmune diseases, family history of autoimmune diseases, laboratory findings, imaging studies and presence of auto-antibodies. Results: Among the patients studied, there was a prevalence of females (68.1%). The mean age of symptoms onset was 8 years and 9 months and the mean current age was 16 years and 4 months. Two patients (9%) had a history of associated autoimmune rheumatic disease: one case of juvenile dermatomyositis in a patient with NMO and another of systemic lupus erythematosus in a patient with MS. Three patients (13%) had a family history of autoimmunity in first-degree relatives. ANA was found positive in 80% of patients with NMO and 52% of patients with MS. About 15% of ANA-positive patients were diagnosed with rheumatologic autoimmune disieses. Conclusion: Among patients with demyelinating diseases diagnosed in childhood included in this study there was a high frequency of ANA positivity but a lower association with rheumatologic autoimmune diseases than that observed in studies conducted in adults. (C) 2016 Elsevier Editora Ltda.
- ItemAcesso aberto (Open Access)Comparative study of ophthalmological and serological manifestations and the therapeutic response of patients with isolated scleritis and scleritis associated with systemic diseases(Conselho Brasileiro de Oftalmologia, 2011-12-01) Sousa, Jacqueline Martins de [UNIFESP]; Trevisani, Virgínia Fernandes Moça [UNIFESP]; Modolo, Rodrigo Pilon [UNIFESP]; Gabriel, Luís Alexandre Rassi [UNIFESP]; Vieira, Luis Antonio [UNIFESP]; Freitas, Denise de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo AmaroINTRODUCTION: Scleritis is a rare, progressive and serious disease, the signs of which are inflammation and edema of episcleral and scleral tissues and is greatly associated with systemic rheumatoid diseases. PURPOSE: To perform a prospective and comparative study between ophthalmologic manifestations, serologic findings and therapeutic response of patients with isolated scleritis and scleritis associated with systemic rheumatoid disease. METHODS: Thirty-two outpatients with non-infectious scleritis were studied, from March 2006 to March 2008. The treatment was corticoid eye drops associated with anti-inflammatory agents, followed by systemic corticoids and immunosuppressive drugs if necessary, was considered successful after six months without scleritis recurrence. RESULTS: Fourteen of 32 patients had scleritis associated with systemic rheumatoid disease, of which nine had rheumatoid arthritis, two systemic lupus erythematosus, one Crohn's disease, one Behçet's disease and one gout. There were no difference in relation to involvement and ocular complications, there was predominance of nodular anterior scleritis and scleral thinning was the most frequent complication. The scleritis associated with systemic rheumatoid disease group had 64.3% of autoantibodies, versus 27.8% among those with isolated scleritis and this difference was statistically significant. In the isolated scleritis group 16.7% used anti-inflammatory, 33.3% corticosteroids, 27.8% corticosteroids with one immunosuppressive drug, 5.5% two immunosuppressive drugs, 16.7% corticosteroids with two immunosuppressive drugs and 33.3% pulse of immunosuppressive drugs, there was remission in 88.9%. In the scleritis associated with systemic rheumatoid disease group 7.1% used anti-inflammatory, 7.1% corticosteroids, 50% corticosteroids with one immunosuppressive drug, 7.1% two immunosuppressive drugs and 22.2% pulse of immunosuppressive drugs, 100% had treatment success. CONCLUSION: Prevalence of unilateral nodular scleritis was noted in both groups and higher rates of all the parameters tested were noted in the scleritis associated with systemic rheumatoid disease group. There were no differences between the groups with respect to the use of immunosuppressive drugs and therapeutic response, which was fully satisfactory in the scleritis associated with systemic rheumatoid disease group and satisfactory in the isolated scleritis group.
- ItemSomente MetadadadosImportance of Adherence in the Outcome of Juvenile Idiopathic Arthritis(Springer, 2014-04-01) Len, Claudio Arnaldo [UNIFESP]; Miotto e Silva, Vanessa B. [UNIFESP]; Terreri, Maria Teresa R. A. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Medical treatment of juvenile idiopathic arthritis (JIA) has advanced in the last decade, and improved prognosis is a reality in daily clinical practice. Despite this improvement in the quality of treatment, the outcome can still be compromised by modifiable factors, including delayed referral to a specialist, delayed drug treatment, poor adherence to treatment, and early interruption of drug treatment. in this review we discuss the most relevant aspects related to adherence to treatment in JIA, with emphasis on: factors that affect adherence to treatment; effect of poor adherence to treatment on JIA prognosis; when to suspect and how to assess poor adherence to treatment; and strategies to promote adherence to treatment, with an emphasis on information-reinforcement education. Besides presenting the findings of other authors, we also try to report our experience of this subject, which is still a challenge for health professionals.
- ItemAcesso aberto (Open Access)Inadequação do consumo alimentar de crianças e adolescentes com artrite idiopática juvenil e lúpus eritematoso sistêmico(Sociedade Brasileira de Pediatria, 2009-12-01) Caetano, Michelle Caetano [UNIFESP]; Ortiz, Thaís Tobaruela [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Silva, Simone Guerra Lopes [UNIFESP]; Souza, Fabíola Isabel Suano [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: To evaluate the dietary intake of children and adolescents with juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) using a 24-hour diet recall and relating it to the patients clinical and anthropometric characteristics and to the drugs used in their treatment. METHODS: By means of a cross-sectional study, we assessed the 24-hour diet recalls of outpatients. Their nutritional status was classified according to the CDC (2000). The computer program NutWin UNIFESP-EPM was used for food intake calculation. The Recommended Dietary Allowances and the Brazilian food pyramid were used for quantitative and qualitative analysis. RESULTS: Median age was 12 years for JIA patients and 16.5 years for JSLE patients. Among the JIA patients, 37.5% had active disease, and among the JSLE patients, 68.2% showed Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Malnutrition was found in 8.3 and 4.5% of the JIA and JSLE patients, respectively, and obesity was present in 16.7 and 18.2%. For JIA patients, the excessive intake of energy, protein, and lipids was 12.5, 75, and 31.3%, respectively. For JSLE patients, the excessive intake of energy, protein, and lipids was 13.6, 86.4, and 36.4%, respectively. Low intake of iron, zinc, and vitamin A was found in 29.2 and 50, 87.5 and 86.4, and 87.5 and 95.2% of the JIA and JSLE patients, respectively. There was not a significant association between intake, disease activity, and nutritional status. CONCLUSION: Patients with rheumatic diseases have inadequate dietary intake. There is excessive intake of lipids and proteins and low intake of micronutrients.
- ItemAcesso aberto (Open Access)Pain-related diseases and sleep disorders(Associação Brasileira de Divulgação Científica, 2012-09-01) Roizenblatt, Marina [UNIFESP]; Rosa Neto, Nilton Salles; Tufik, Sergio [UNIFESP]; Roizenblatt, Suely [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Nove de Julho Centro de Dor e Neurocirurgia FuncionalPain and sleep share mutual relations under the influence of cognitive and neuroendocrine changes. Sleep is an important homeostatic feature and, when impaired, contributes to the development or worsening of pain-related diseases. The aim of the present review is to provide a panoramic view for the generalist physician on sleep disorders that occur in pain-related diseases within the field of Internal Medicine, such as rheumatic diseases, acute coronary syndrome, digestive diseases, cancer, and headache.
- ItemSomente MetadadadosReatividade de anticorpos para glicoesfingolipidios em doenças do sistema nervoso, reumáticas, e na infecção pelo HIV(Universidade Federal de São Paulo (UNIFESP), 1996) Zeballos, Roberto Sebastian [UNIFESP]
- ItemAcesso aberto (Open Access)Uveítes anteriores associadas a doenças sistêmicas(Conselho Brasileiro de Oftalmologia, 2003-01-01) Dimantas, Maria Angélica Pavão; Lowder, Careen; Muccioli, Cristina [UNIFESP]; Cleveland Clinic Foundation Setor de Uveítes; Universidade Federal de São Paulo (UNIFESP)Anterior uveitis describes a disease predominantly limited to the anterior segment of the eye. Conjunctival hyperemia, anterior chamber cell and flare, keratic precipitates, and iris abnormalities including posterior synechiae characterize the inflammation. This article discusses clinical aspects of the systemic diseases that cause anterior uveitis with review of the literature.