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Abstract Psoriatic arthritis (PsA) is a chronic and systemic immune disease characterized by inflammation of peripheral and/ or axial joints and entheses in patients with psoriasis (PsO). Extra-articular and extracutaneous manifestations and numerous comorbidities can also be present. These recommendations replace the previous version published in May 2013. A systematic review of the literature retrieved 191 articles that were used to formulate 12 recommendations in response to 12 clinical questions, divided into 4 sections: diagnosis, non-pharmacological treatment, conventional drug therapy and biologic therapy. These guidelines provide evidence-based information on the clinical management for PsA patients. For each recommendation, the level of evidence (highest available), degree of strength (Oxford) and degree of expert agreement (interrater reliability) are reported.

https://doi.org/10.1186/s42358-021-00219-y

Revisiting hydroxychloroquine and chloroquine for patients with chronic immunity-mediated inflammatory rheumatic diseases
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Reis Neto, Edgard Torres dos

; Kakehasi, Adriana Maria

; Pinheiro, Marcelo de Medeiros

; Ferreira, Gilda Aparecida

; Marques, Cláudia Diniz Lopes

; Mota, Licia Maria Henrique da

; Paiva, Eduardo dos Santos

; Pileggi, Gecilmara Cristina Salviato

; Sato, Emília Inoue

; Reis, Ana Paula Monteiro Gomides

; Xavier, Ricardo Machado

; Provenza, José Roberto

Advances in Rheumatology

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2020, Volume 60 elocation 32

Abstract: En | Text: En | PDF: En

Abstract Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using antimalarials to manage patients with chronic immune-mediated inflammatory rheumatic diseases for decades. It is an appropriate time to review their immunomodulatory and anti-inflammatory mechanisms impact on disease activity and survival of systemic lupus erythematosus patient, including antiplatelet effect, metabolic and lipid benefits. We also discuss possible adverse effects, adding a practical and comprehensive approach to monitoring rheumatic patients during treatment with these drugs.

https://doi.org/10.1186/s42358-020-00134-8 2393 downloads

The Brazilian Society of Rheumatology guidelines for axial spondyloarthritis – 2019
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Resende, Gustavo Gomes

; Meirelles, Eduardo de Souza

; Marques, Cláudia Diniz Lopes

; Chiereghin, Adriano

; Lyrio, Andre Marun

; Ximenes, Antônio Carlos

; Saad, Carla Gonçalves

; Gonçalves, Célio Roberto

; Kohem, Charles Lubianca

; Schainberg, Cláudia Goldenstein

; Campanholo, Cristiano Barbosa

; Bueno Filho, Júlio Silvio de Sousa

; Pieruccetti, Lenise Brandao

; Keiserman, Mauro Waldemar

; Yazbek, Michel Alexandre

; Palominos, Penelope Esther

; Goncalves, Rafaela Silva Guimarães

; Lage, Ricardo da Cruz

; Assad, Rodrigo Luppino

; Bonfiglioli, Rubens

; Anti, Sônia Maria Alvarenga

; Carneiro, Sueli

; Oliveira, Thauana Luíza

; Azevedo, Valderílio Feijó

; Bianchi, Washington Alves

; Bernardo, Wanderley Marques

; Pinheiro, Marcelo de Medeiros

; Sampaio-Barros, Percival Degrava

Advances in Rheumatology

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2020, Volume 60 elocation 19

Abstract: En | Text: En | PDF: En

Abstract Spondyloarthritis is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. The classification axial spondyloarthritis is adopted when the spine and/or the sacroiliac joints are predominantly involved. This version of recommendations replaces the previous guidelines published in May 2013. A systematic literature review was performed, and two hundred thirty-seven studies were selected and used to formulate 29 recommendations answering 15 clinical questions, which were divided into four sections: diagnosis, non-pharmacological therapy, conventional drug therapy and biological therapy. For each recommendation the level of evidence supporting (highest available), the strength grade according to Oxford, and the degree of expert agreement (inter-rater reliability) is informed. These guidelines bring evidence-based information on clinical management of axial SpA patients, including, diagnosis, treatment, and prognosis.

https://doi.org/10.1186/s42358-020-0116-2 1116 downloads

Update on the treatment of musculoskeletal manifestations in chikungunya fever: a guideline
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Brito, Carlos Alexandre Antunes de

; Marques, Cláudia Diniz Lopes

; Falcão, Melissa Barreto

; Cunha, Rivaldo Venâncio da

; Simon, Fabrice

; Valadares, Lilian David de Azevedo

; Luz, Kleber Giovanni

; Melo, Carlos Frederico Campelo de Albuquerque e

; Albuquerque Filho, Dalcy de Oliveira

; Brito, Marina Coelho Moraes de

; Duarte, Angela Luzia Branco Pinto

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20190517

Abstract: En | Text: En | PDF: En

Abstract Since the emergence of the chikungunya virus in Brazil in 2014, more than 700,000 cases have been reported throughout the country, corresponding to one-third of all cases reported in the Americas. In addition to its high attack rates, resulting in hundreds of thousands of cases, the disease has high chronicity rates with persistent joint manifestations for more than 3 months, which can spread to more than half of the patients affected in the acute phase. Pain associated with musculoskeletal manifestations, often disabling, has an effect on patients’ quality of life at different stages of the disease. Currently, the challenge faced by specialists is identifying the best therapy to be instituted for symptom relief despite the limited number of published intervention studies. In 2016, a multidisciplinary group published pharmacological treatment protocols for pain in patients with chikungunya, which was incorporated into the guidelines for clinical management of the Brazilian Ministry of Health in 2017; in that same year, a consensus was published by the Brazilian Society of Rheumatology about diagnosis and treatment. After 5 years of experience with chikungunya epidemics, in 2019, specialists involved in the protocols of the Brazilian Society of Rheumatology and Brazilian Ministry of Health prepared an update with the main objective of developing flowcharts for the therapeutic approach of musculoskeletal manifestations in adult patients to enable specialists at different levels of healthcare to spread and apply this guideline in a systematic and simplified manner.

https://doi.org/10.1590/0037-8682-0517-2019 1083 downloads

Comments on: Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage Due to Uterine Atony
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Matsubara, Shigeki

; Moleiro, Maria Lúcia

; Guedes-Martins, Luís

; Mendes, Alexandrina

; Marques, Cláudia

; Braga, Jorge

Revista Brasileira de Ginecologia e Obstetrícia

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mar 2019, Volume 41 N. 3 Pages 206 - 208

Abstract: En | Text: En | PDF: En

https://doi.org/10.1055/s-0039-1681111 342 downloads

Gestational Diabetes and Microbiota: role of probiotic intervention
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Morais, Juliana

; Cardoso, Manuela

; Branco, Jorge

; Marques, Cláudia

; Teixeira, Diana

; Faria, Ana

; Calhau, Conceição

Acta Portuguesa de Nutrição

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jun 2018, N. 13 Pages 22 - 26

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O número de mulheres com Diabetes Gestacional tem vindo a aumentar. A microbiota tem sido associada à regulação energética, função imunológica e doença metabólica, como a resistência à insulina. É essencial compreender quais as mudanças que ocorrem no microbioma do intestino, da placenta e da vagina durante a gravidez e qual o impacto que essas mudanças podem ter sobre a saúde da mãe e do feto. A suplementação com probióticos parece ser uma terapia eficaz na prevenção e tratamento da Diabetes Gestacional e do ganho de peso. Estudos demonstram que a ingestão de alimentos ricos em probióticos melhora a tolerância à glicose e a sensibilidade à insulina das grávidas. Esta revisão apresenta evidência sobre a influência que a microbiota intestinal, placentária e vaginal têm sobre a Diabetes Gestacional e qual o papel da intervenção com probióticos.

The number of women with Gestational Diabetes is increasing over the years. The microbiota has been related to energy regulation, immune function and metabolic disorders, such as insulin resistance. It is essential to understand the changes in the gut, placental and vaginal microbiota during pregnancy and the impact this may have on mother and fetus health. Supplementation with probiotics appears to be an effective strategy in the prevention and treatment of Gestational Diabetes and weight gain. Studies shown that probiotic intake improves maternal glucose tolerance and insulin sensitivity. This review intends to shed some light on the influence of gut, placental and vaginal microbiota on Gestational Diabetes and the role of probiotics intervention.

https://doi.org/10.21011/apn.2018.1304 1481 downloads

Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony
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Moleiro, Maria Lúcia

; Guedes-Martins, Luís

; Mendes, Alexandrina

; Marques, Cláudia

; Braga, Jorge

Revista Brasileira de Ginecologia e Obstetrícia

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feb 2018, Volume 40 N. 2 Pages 92 - 95

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Atualmente, a hemorragia pós-parto é a maior causa de morbimortalidadematerna em todo o mundo. Sua principal causa é a atonia uterina, pelo que têm sido instituídas e desenvolvidas medidas profiláticas, bem como tratamentos médicos e cirúrgicos para esta complicação. As suturas uterinas de compressão representam uma possibilidade terapêutica que permite a preservação do útero e, por conseguinte, do potencial fértil. Tendo isso por base, apresentamos dois casos de hemorragia pós-parto após cesariana, que foram tratados com sucesso com uma nova modificação da sutura de Pereira - suturas uterinas longitudinais e transversais foram efetuadas após falha das terapias de primeira linha. Ambas as pacientes se recuperaram, e na reavaliação pós-parto objetivou-se um útero normal com manutenção de uma irrigação adequada, sugerindo a preservação do seu potencial fértil, tal como vem sendo descrito na literatura em relação a este tipo de procedimento.

Abstract Nowadays, postpartum hemorrhage is the major cause of maternal mortality and morbidity worldwide. Uterine atony is its main cause; thus, prophylactic measures, as well as medical and surgical fast approaches, have been developed to manage it. The uterine compression sutures are a possible treatment that preserves the uterus and, consequently, the fertility potential. Bearing that in mind, we report two cases of postpartum hemorrhage after caesarean section, successfully treated with a new modification of Pereira suture - longitudinal and transverse uterine sutures were applied after no response was registered to the first-line therapies. Both women recovered, and the postpartum evaluation revealed a normal uterus with an adequate blood supply, suggesting potential fertility, as described in the literature regarding this kind of therapeutic approach.

https://doi.org/10.1055/s-0037-1613690 1474 downloads

Avaliação da modulação autonômica cardíaca no processo de enchimento da bexiga em mulheres com incontinência urinária: perspectiva da fisioterapia
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Padilha, Juliana Falcão

; Braz, Melissa Medeiros

; Seidel, Enio Júnior

; Mazo, Giovana Zarpellon

; Marques, Jefferson Luiz Brum

; Marques, Cláudia Mirian de Godoy

Fisioterapia e Pesquisa

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dec 2017, Volume 24 N. 4 Pages 363 - 370

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Comparou-se o comportamento do sistema nervoso autônomo, por meio da variabilidade da frequência cardíaca (VFC), durante as fases de enchimento vesical de mulheres com e sem incontinência urinária (IU). Aplicou-se o International Consultation on Incontinence Questionnaire - Short Form, para autodiagnóstico de IU. Para análise da VFC utilizaram-se registros de eletrocardiograma (ECG), sendo 6 registros durante o enchimento vesical. Para quantificar a VFC utilizaram-se os métodos: domínio do tempo (milissegundos); frequência (Hertz) e medidas não lineares. A estes parâmetros aplicou-se transformação logarítmica (Log). Na comparação de médias de dados normais utilizou-se teste t e para os dados não normais o teste de Mann-Whitney. Participaram 64 mulheres (64,8±6,73 anos), 33 com IU e 31 continentes. A variável logaritmo da razão dos componentes LF e HF (LogLH/HF) foi significativamente maior (p<0,05) no grupo continente em todos os momentos do enchimento vesical. A capacidade volumétrica vesical foi significativamente maior nas mulheres continentes (p=0,0015). A análise no domínio da frequência demonstrou redução da função simpática e aumento do parassimpático nas mulheres incontinentes. As mulheres continentes apresentaram melhor balanço autonômico durante todo processo de enchimento vesical, em comparação às incontinentes. A redução da função simpática, bem como o aumento da função parassimpática nas incontinentes, pôde ser reportada para uma diminuição da capacidade de relaxamento do detrusor e um aumento das contrações, ainda na fase de enchimento vesical, ambos associados à IU.

ABSTRACT The behavior of the Autonomic Nervous System, through Heart Rate Variability (HRV), during the bladder filling phases of women with and without urinary incontinence (UI) was compared. The International Consultation on Incontinence Questionnaire - Short Form was applied for UI self-diagnosis. For the HRV analysis, electrocardiogram (ECG) records were used, 6 of them were recorded during bladder filling. To quantify HRV, the following methods were used: time domain (milliseconds); frequency (Hertz) and non-linear measurements. Logarithmic transformation (Log) was applied to these parameters. In the comparison of normal data means, the t-test was applied and the Mann-Whitney test was applied for the non-normal data. The participants consisted of 64 women (64.8±6.73 years), 33 with UI and 31 without. The logarithm of the LF and HF ratio (LogLH/HF) was significantly higher (p<0.05) in the continent group at all phases of the bladder filling. Bladder volumetric capacity was significantly higher in the continent women (p=0.0015). Frequency analysis demonstrated a reduction in sympathetic function and an increase in parasympathetic function in incontinent women. The continent women presented better autonomic balance, during the whole process of bladder filling compared to incontinent ones. The reduction of sympathetic function as well as the increase of the parasympathetic function in the incontinent women could be reported for a decrease of the detrusor relaxation capacity and an increase of the contractions, still in the bladder filling phase, both associated with UI.

RESUMEN Se comparó el comportamiento del sistema nervioso autónomo, a través de la variabilidad de la frecuencia cardíaca (VFC), durante las fases de llenado vesical de mujeres con y sin incontinencia urinaria (IU). Se aplicó el International Consultation on Incontinence Questionnaire - Short Form, para autodiagnóstico de IU. Para el análisis de la VFC se utilizaron registros de electrocardiograma (ECG), considerándose 6 registros durante el llenado vesical. Para cuantificar la VFC se utilizaron los métodos: dominio del tiempo (milisegundos); frecuencia (Hertz) y medidas no lineales. A estos parámetros se aplicó la transformación logarítmica (Log). En la comparación de promedios de datos normales se utilizó la prueba t y para los datos no normales la prueba de Mann-Whitney. Participaron 64 mujeres (64.8±6.73 años), 33 con IU y 31 continentes. La variable logaritmo de la razón de los componentes LF y HF (LogLH/HF) ha sido significativamente mayor (p<0.05) en el grupo continente en todos los momentos del llenado vesical. La capacidad volumétrica vesical ha sido significativamente mayor en las mujeres continentes (p=0.0015). El análisis en el dominio de la frecuencia demostró reducción de la función simpática y aumento del parasimpático en las mujeres incontinentes. Las mujeres continentes presentaron mejor balance autonómico durante todo el proceso de llenado vesical, en comparación a las incontinentes. La reducción de la función simpática, así como el aumento de la función parasimpática en las incontinentes, pudo ser reportada para una disminución de la capacidad de relajación del detrusor y un aumento de las contracciones, aún en la fase de llenado vesical, ambos asociados a la IU.

https://doi.org/10.1590/1809-2950/16196024042017 3290 downloads

A new species of Characithecium (Monogenea: Dactylogyridae) from external surface and gills of two species of Astyanax (Ostariophysi: Characidae) in southern Brazil
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Gallas, Moisés

; Calegaro-Marques, Cláudia

; Amato, Suzana B.

Revista mexicana de biodiversidad

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sep 2016, Volume 87 N. 3 Pages 903 - 907

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: A new species of Characithecium, a genus of monogenean parasites of Neotropical characids, is described from specimens collected on the body surface and gills of Astyanax aff. fasciatus and Astyanax jacuhiensis from Lake Guaíba, State of Rio Grande do Sul, Brazil. The new species is similar to Characithecium costaricensis, but differs by having the haptor separated from the body by a long peduncle, and by having an accessory piece composed of 2 subunits in the male copulatory complex - 1 ventral pincer-shaped at the distal end, and 1 dorsal with an expanded rod-shaped proximal end and the distal end containing 3 elongated projections-, and the dorsal bar usually presenting a small median elevation in the anterior margin. This study increases the number of species of Characitecium to 7 and expands our knowledge on the diversity of monogenean parasites of characids.

Resumen: Una especie nueva de Characithecium, género que comprende especies de parásitos monogenéticos de carácidos neotropicales, se describe a partir de especímenes colectados de la superficie corporal y las branquias de los peces Astyanax aff. fasciatus y Astyanax jacuhiensis en el lago Guaíba, estado de Rio Grande do Sul, Brasil. Esta especie nueva es similar a Characithecium costaricensis pero se diferencia por tener el haptor separado del cuerpo por un pedúnculo largo y por presentar una estructura accesoria compuesta por 2 subunidades en el complejo copulador masculino -una ventral con forma de pinza en el extremo posterior y otra dorsal con forma de barra en el extremo anterior y posterior, la cual tiene 3 prolongaciones alargadas-. Además, la barra dorsal usualmente presenta una pequeña elevación media en el margen anterior. Este estudio aumenta el número de especies de Characitecium a 7 y mejora nuestro conocimiento sobre la diversidad de parásitos monogenéticos en carácidos.

https://doi.org/10.1016/j.rmb.2016.06.011 489 downloads

10.

Supplemental observations on the morphology of Procamallanus (Spirocamallanus) hilarii (Nematoda: Camallanidae) parasitizing two species of Astyanax (Characiformes: Characidae) and ecological analyses
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Gallas, Moisés

; Calegaro-Marques, Cláudia

; Bencke-Amato, Suzana

Revista mexicana de biodiversidad

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2015, Volume 86 N. 3 Pages 590 - 596

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Procamallanus (Spirocamallanus) hilarii parasitizes several fish species but only few studies on morphology and ecology have been published. In this study we describe the morphology of P. (S.) hilarii parasitizing Astyanax aff. fasciatus and Astyanax jacuhiensis , and compare ecological parameters of their populations. Seventy A. aff. fasciatus and 60 A. jacuhiensis individuals were captured in Lake Guaiba, Rio Grande do Sul State, Brazil, between March 2012 and December 2013. The specimens of P. (S.) hilarii presented an oval oral opening with 6 cuticular elevations and 2 groups of papillae (one internal and one external) in the anterior region of the body. Males have 8 pairs of sessile caudal papillae (4 pre-cloacal and 4 post-cloacal), spicules with distal bifurcation and lack caudal alae. The prevalence of P. (S.) hilarii was higher in A. aff. fasciatus (69%) than in A. jacuhiensis (18%), whereas there was no difference in mean intensity (respectively, 2 and 5) and mean abundance (respectively, 1.6 and 0.9) of infection between the 2 host species. We suggest that the consumption of copepods, intermediate hosts of P. (S.) hilarii , may explain this difference.

Procamallanus (Spirocamallanus) hilarii (P. (S.) hilarii) parasita varias especies de peces, pero son escasos los estudios publicados sobre su morfología y ecología. En este estudio describimos la morfología de P. (S.) hilarii que parasitan las mojarras Astyanax aff. fasciatus y A. jacuhiensis y comparamos diferentes parámetros ecológicos de sus poblaciones. Entre marzo de 2012 y diciembre de 2013, capturamos 70 individuos de Astyanax (A.) aff. fasciatus y 60 de A. jacuhiensis en el Lago Guaiba, estado de Rio Grande do Sul, Brazil. Los ejemplares de P. (S.) hilarii presentaron una abertura oral de forma oval con 6 elevaciones cuticulares y 2 grupos de papilas (una interna y otra externa) en la región anterior del cuerpo. Los machos presentaron 8 pares de papilas caudales sésiles (4 precloaca y 4 poscloaca), espículas con bifurcación distal y ausencia de ala caudal. La prevalencia de P. (S.) hilarii fue mayor en A. aff. fasciatus (69%) que en A. jacuhiensis (18%). Sin embargo, no existieron diferencias en la intensidad promedio (2 y 5 respectivamente) y la abundancia promedio (1.6 y 0.9 respectivamente) de infección entre las 2 especies hospederas. Sugerimos que el consumo de copépodos, hospederos intermediarios de P. (S.) hilarii , podría explicar esta diferencia.

https://doi.org/10.1016/j.rmb.2015.07.005 1070 downloads

11.

Perfil epidemiológico da espondiloartrite de início juvenil comparada com a espondiloartrite de início na vida adulta em uma grande coorte brasileira
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Duarte, Angela P

; Marques, Cláudia DL

; Bortoluzzo, Adriana B

; Gonçalves, Célio R

; Silva, José Antonio Braga da

; Ximenes, Antonio Carlos

; Bértolo, Manoel B

; Ribeiro, Sandra Lúcia E

; Keiserman, Mauro

; Skare, Thelma L

; Carneiro, Sueli

; Menin, Rita

; Azevedo, Valderilio F

; Vieira, Walber P

; Albuquerque, Elisa N

; Bianchi, Washington A

; Bonfiglioli, Rubens

; Campanholo, Cristiano

; Carvalho, Hellen MS

; Costa, Izaias P

; Kohem, Charles L

; Leite, Nocy

; Lima, Sonia AL

; Meirelles, Eduardo S

; Pereira, Ivânio A

; Pinheiro, Marcelo M

; Polito, Elizandra

; Resende, Gustavo G

; Rocha, Francisco Airton C

; Santiago, Mittermayer B

; Sauma, Maria de Fátima LC

; Valim, Valéria

; Barros, Percival D Sampaio

Revista Brasileira de Reumatologia

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dec 2014, Volume 54 N. 6 Pages 424 - 430

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivo Analisar as características clínicas e epidemiológicas das espondiloartrites (EpA) de início juvenil (< 16 anos) e compará-las com um grupo de pacientes com EspA de início na vida adulta (≥ 16 anos). Pacientes e métodos Coorte prospectiva, observacional e multicêntrica com 1.424 pacientes com diagnóstico de EspA de acordo com o European Spondyloarthropathy Study Group (ESSG) submetidos a um protocolo comum de investigação e recrutados em 29 centros de referência participantes do Registro Brasileiro de Espondiloartrites (RBE). Os pacientes foram divididos em dois grupos: idade no início<16 anos (grupo EspAiJ) e idade no início ≥ 16 anos. Resultados Entre os 1.424 pacientes, 235 manifestaram o início da doença antes dos 16 anos (16,5%). As variáveis clínicas e epidemiológicas associadas com a EspAiJ foram: gênero masculino (p<0,001), artrite em membro inferior (p=0,001), entesite (p=0,008), uveíte anterior (p=0,041) e HLA-B27 positivo (p=0,017), em associação com escores mais baixos de atividade da doença (Bath Ankylosing Spondylitis Disease Activity Index – BASDAI; p=0,007) e de capacidade funcional (Bath Ankylosing Spondylitis Functional Index – BASFI; p=0,036). A psoríase cutânea (p<0,001), a doença inflamatória intestinal (p=0,023), a dactilite (p=0,024) e o envolvimento ungueal (p=0,004) foram mais frequentes em pacientes com EspA de início na vida adulta. Conclusões Nessa grande coorte brasileira, os pacientes com EspAiJ se caracterizavam predominantemente pelo gênero masculino, envolvimento periférico (artrite e entesite), HLA-B27 positivo e escores de doença mais baixos.

Objective To analyze the clinical and epidemiologic characteristics of juvenile-onset spondyloarthritis (SpA) (< 16 years) and compare them with a group of adult-onset (≥ 16 years) SpA patients. Patients and methods Prospective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE – Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset<16 years (JOSpA group) and age at onset ≥ 16 years (AOSpA group). Results Among the 1,424 patients, 235 presented disease onset before 16 years (16.5%). The clinical and epidemiologic variables associated with JOSpA were male gender (p<0.001), lower limb arthritis (p=0.001), enthesitis (p=0.008), anterior uveitis (p=0.041) and positive HLA-B27 (p=0.017), associated with lower scores of disease activity (Bath Ankylosing Spondylitis Disease Activity Index – BASDAI; p=0.007) and functionality (Bath Ankylosing Spondylitis Functional Index – BASFI; p=0.036). Cutaneous psoriasis (p<0.001), inflammatory bowel disease (p=0.023), dactylitis (p=0.024) and nail involvement (p=0.004) were more frequent in patients with adult-onset SpA. Conclusions Patients with JOSpA in this large Brazilian cohort were characterized predominantly by male gender, peripheral involvement (arthritis and enthesitis), positive HLA-B27 and lower disease scores.

https://doi.org/10.1016/j.rbr.2014.06.005 3636 downloads

12.

Parasite sharing between humans and nonhuman primates and the hidden dangers to primate conservation
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Bicca-Marques, Júlio César

; Calegaro-Marques, Cláudia

Zoologia (Curitiba)

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aug 2014, Volume 31 N. 4 Pages 313 - 315

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/S1984-46702014000400001 2031 downloads

13.

Peroxisome proliferator-activated receptor agonists (PPARs): a promising prospect in the treatment of psoriasis and psoriatic arthritis
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Lima, Emerson de Andrade

; Lima, Mariana Modesto Dantas de Andrade

; Marques, Cláudia Diniz Lopes

; Duarte, Angela Luzia Branco Pinto

; Pita, Ivan da Rocha

; Pita, Maira Galdino da Rocha

Anais Brasileiros de Dermatologia

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dec 2013, Volume 88 N. 6 Pages 1029 - 1035

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A psoríase é uma doença poligênica, inflamatória, progressiva e recorrente, caracterizada por um ciclo evolutivo acelerado dos queratinócitos, associado à ativação imune desordenada e a alterações sistêmicas correlacionadas, sendo a artrite psoriásica o comprometimento articular inflamatório crônico que pode ocorrer em pacientes com a doença cutânea. Na inflamação autoimune, uma rede interativa entre células e citocinas suporta o início e a perpetuação da doença. A fisiopatologia da psoríase e da artrite psoriásica compreende uma disfunção das células do sistema imune e da rede de citocinas, levando à inflamação de pele, enteses e articulações. Estudos recentes têm demonstrado um papel importante da inflamação sistêmica no desenvolvimento da aterosclerose. Corroborando esses achados, pacientes portadores de psoríase grave apresentam marcada incidência de artrite psoriásica, doença cardiovascular, hipertensão arterial sistêmica, dislipidemia, obesidade e diabetes mellitus, evidenciando um risco aumentado para infarto agudo do miocárdio e sugerindo que a doença não se restringe à pele. Os receptores nucleares são fatores de transcrição ligante-dependente cuja ativação afeta genes controladores de processos vitais. Entre eles, destacam-se os receptores ativados pelo proliferador de peroxissoma, responsáveis por estabelecer a relação entre os lipídios, doenças metabólicas e imunidade inata. Na pele, os receptores ativados pelo proliferador de peroxissoma têm ação importante na homeostase dos ceratinócitos, exibindo uma função pró-diferenciação, antiproliferativa e imunomoduladora, sugerindo um papel relevante em doenças como a psoríase. Os agonistas dos receptores ativados pelo proliferador de peroxissoma representam uma relevante fonte de investigação no tratamento de doenças da pele. No entanto, estudos clínicos são necessários para definirmos o potencial de resposta dessas drogas em pacientes com psoríase e artrite psoriásica.

Psoriasis is a polygenic, inflammatory and progressive disease, characterized by an abnormal differentiation and hyperproliferation of keratinocytes, associated with impaired immunologic activation and systemic disorders, while psoriatic arthritis is a chronic inflammatory articular disease. Pathophysiology of psoriasis comprises a dysfunction of the immune system cells with an interactive network between cells and cytokines supporting the initiation and perpetuation of disease and leading to inflammation of skin, enthesis and joints. Recent studies have shown an important role of systemic inflammation in the development of atherosclerosis. Corroborating these findings, patients with severe Psoriasis have marked incidence of psoriatic arthritis, cardiovascular diseases, hypertension, dyslipidemia, obesity and diabetes mellitus, showing an increased risk for acute myocardial infarction, which suggests that the condition is not restricted to the skin. Nuclear receptors are ligand-dependent transcription factors, whose activation affects genes that control vital processes. Among them the peroxisome proliferator-activated receptor is responsible for establishing the relationship between lipids, metabolic diseases and innate immunity. In the skin, peroxisome proliferator-activated receptors have an important effect in keratinocyte homeostasis, suggesting a role in diseases such as psoriasis. The peroxisome proliferator-activated receptors agonists represent a relevant source of research in the treatment of skin conditions, however more clinical studies are needed to define the potential response of these drugs in patients with psoriasis and psoriatic arthritis.

https://doi.org/10.1590/abd1806-4841.20132653 4438 downloads

14.

Are the risks of conservation introduction worth taking?
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Bicca-Marques, Júlio César

; Calegaro-Marques, Cláudia

Zoologia (Curitiba)

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oct 2012, Volume 29 N. 5 Pages 395 - 396

Abstract: En | Text: En | PDF: En

1267 downloads

15.

Investigação de infecção tuberculosa latente em pacientes com psoríase candidatos ao uso de drogas imunobiológicas
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Lima, Emerson Vasconcelos de Andrade

; Lima, Mariana de Andrade

; Duarte, Ângela

; Marques, Cláudia

; Benard, Gil

; Lorena, Virgínia

; Gomes, Yara

Anais Brasileiros de Dermatologia

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aug 2011, Volume 86 N. 4 Pages 716 - 724

Abstract: Pt | Text: Pt | PDF: Pt

O uso dos inibidores do fator de necrose tumoral no tratamento de pacientes com psoríase vem sendo relacionado a uma maior incidência de tuberculose, particularmente, nas suas formas extrapulmonar e disseminada. Apesar de sua indiscutível eficácia, essas drogas elevam o risco da reativação de infecção tuberculosa latente (ITBL), tornando obrigatório o diagnóstico da referida condição antes da sua administração. A investigação da infecção tuberculosa latente pelo teste cutâneo da tuberculina é falha, dada sua baixa especificidade, além de apresentar resultados duvidosos em pacientes com psoríase. Ensaios baseados na detecção da produção de interferon-gama in vitro por células monoclonais periféricas, estimuladas por antígenos específicos (Esat-6 e CFP-10), parecem oferecer maior acurácia quando comparados ao teste de Mantoux na identificação de infecção tuberculosa latente. Essa ferramenta diagnóstica tem oferecido maior especificidade, já que não apresenta correlação com medidas indiretas de exposição ao M. tuberculosis, como a vacinação por BCG, e com infecções por outras micobactérias

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