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1. Immunogenicity and Safety According to Immunosuppressive Drugs and Different COVID-19 Vaccine Platforms in Immune-Mediated Disease: Data from SAFER Cohort

Author: Ketty Lysie Libardi Lira Machado, Ana Paula Neves Burian, Olindo Assis Martins-Filho, José Geraldo Mill, Lunara Baptista Ferreira, Karina Rosemarie Lallemand Tapia, Anna Carolina Simões Moulin, Isac Ribeiro Moulaz, Priscila Dias Cardoso Ribeiro, Vanessa de Oliveira Magalhães, Erika Biegelmeyer, Flávia Maria Matos Melo Campos Peixoto, Sandra Lúcia Euzébio Ribeiro, Camila Maria Paiva França Telles, Juliana Bühring, Natalia Sarzi Sartorio, Vanessa Hax, Rodrigo Poubel Vieira de Rezende, Katia Lino Baptista, Ana Karla Guedes de Melo, Vitor Alves Cruz, Rejane Maria Rodrigues de Abreu Vieira, Renata Henriques de Azevedo, Valderilio Feijó Azevedo, Marcelo de Medeiros Pinheiro, Odirlei André Monticielo, Edgard Torres Dos Reis Neto, Andréa Teixeira-Carvalho, Ricardo Machado Xavier, Emilia Inoue Sato, Viviane Angelina de Souza, Gilda Aparecida Ferreira, Gecilmara Salviato Pileggi, and Valeria Valim
Subjects: registries, COVID-19, vaccine, autoimmune disorders, humoral immunity, Medicine
Abstract: Background/Objectives: The effectiveness of COVID-19 vaccine in patients with immune-mediated inflammatory diseases (IMID) depends on the underlying disease, immunosuppression degree and the vaccine regimens. We evaluate the safety and immunogenicity of different COVID-19 vaccine schedules. Methods: The SAFER study: “Safety and effectiveness of the COVID-19 Vaccine in Rheumatic Disease”, is a Brazilian multicentric prospective observational phase IV study in the real-life. Data were analyzed after 2 or 3 doses of COVID-19 vaccines: adenoviral vectored vaccine (ChAdOx1 nCoV-19, Astrazeneca), mRNA vaccine (BNT162b2, Pfizer–BioNTech) or inactivated SARS-COV-2 vaccine (CoronaVac, Sinovac Biotech). IgG antibody against SARS-CoV-2 spike (IgG-S) receptor-binding domain level were quantified at baseline (T1) and 28 days after the first (T2), 2nd (T3) and 3rd (T4) doses by chemiluminescence (SARS-CoV-2-IgG-II Quant-assay, Abbott-Laboratories). Results: 721 patients with IMID were included in the analysis. The median titers of IgG-S (BAU/mL) increased progressively over the times: at baseline was 6.26 (5.41–7.24), T2: 73.01 (61.53–86.62), T3: 200.0 (174.36–229.41) and T4: 904.92 (800.49–1022.97). The multivariate linear regression showed that greater IgG-S titers were associated with pre-exposure to COVID-19 (p < 0.001) and BNT162b2 booster vaccine (p < 0.001). Rituximab and immunosuppressant drugs were independent factors for low titers (p = 0.002, p < 0.001, respectively). No serious adverse event was reported. Conclusions: All platforms were safe and induced an increase in IgG-S antibodies. COVID-19 pre-exposure and BNT162b2 booster regimens were predictors of higher humoral immune responses, which is relevant in immunosuppressed populations. Immunosuppressants (mainly rituximab) predicted the lowest antibodies.
Published: 2024
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2. Beliefs and attitudes about chronic pain among public health professionals: cross-sectional study

Author: Paula Torrezani Sales, Samira Tatiyama Miyamoto, and Valeria Valim
Subjects: chronic pain, health belief model, public health, Medicine
Abstract: BACKGROUND AND OBJECTIVES: The barriers of scientific knowledge and adequate training can influence the skills of health professionals in the management of chronic pain in non-specialized environments. The aim of this study was to assess the beliefs and attitudes of the Brazilian public health care system's (Sistema Único de Saúde - SUS) professionals who work in the care of patients with chronic pain in the clinical routine. METHODS: This is a cross-sectional study carried out with non-specialized pain professionals from primary and medium-complexity care, assessed by the Inventory of Attitudes towards Pain. Participants were grouped by place of work and length of training for comparison analysis using the t-test for independent samples. Effect sizes were calculated (η² generalized), and the level of statistical significance was set at p
Published: 2024
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3. THE IMPACT OF TIMELY ACCESS TO AN ASSISTED THERAPY CENTER

Author: Roberta de Almeida Pernambuco, Paula Regina Toche dos Santos, Karina Gatz Capobianco, Vanessa Hax, Luciana Paula Dardin, Ana Carolina Fragoso Motta, Maria Lúcia Lemos Lopes, Virginia Fernandes Moça Trevisani, Valeria Valim, Aiessa Zanchett Fedrigo, Samira Tatiyama Miyamoto, Juliana Markus, Aysa César Pinheiro, Érica Vieira Serrano, Giovanna Sant’Ana Petterle, Fernanda Lourenço Macagnan, Ricardo Machado Xavier, Maria Clara Cardoso Gomes Zampirolli, Alisson Aliel Vigano Pugliesi, Sandra Lúcia Euzébio Ribeiro, Simone Appenzeller, Licia Maria Henrique Mota, Eduardo Rosa, Ketty Lisie Libardi Machado, Gustavo Pafume de Sá, Nathália de Carvalho Sacilotto, Fabiola Reis de Oliveira, Leandro Augusto Tanure, and Laura Caldas
Subjects: medicine.medical_specialty, business.industry, medicine, Disease, Sjogren s, business, Dermatology
Published: 2022
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4. CCL3, CCL5, IL-15, IL-1Ra and VEGF compose a reliable algorithm to discriminate classes of adverse events following 17DD-YF primary vaccination according to cause-specific definitions

Author: Marília Lima Cruz Rocha, Eva Lídia Arcoverde Medeiros, Izabela Maurício de Rezende, Valeria Valim, Maira Alves Pereira, Matheus de Souza Gomes, Ana Carolina Campi-Azevedo, Daniel Garkauskas Ramos, Josiane Dias Gusmão, Maria Auxiliadora-Martins, Talita Émile Ribeiro Adelino, Regina Coeli Magalhães Rodrigues, Marcos Vieira Silva, Andréa Teixeira-Carvalho, Francieli Fontana Sutile Tardetti Fantinato, Alessandro Pecego Martins Romano, Laurence Rodrigues do Amaral, Rodrigo Fabiano do Carmo Said, Glauco de Carvalho Pereira, Sandra Carvalho, Eder Gatti Fernandes, Jordana Rodrigues Barbosa Fradico, Jordana Grazziela Alves Coelho-dos-Reis, Elaine Spezialli Faria, Betânia Paiva Drumond, Vanessa Peruhype-Magalhães, Janaina Fonseca Almeida, Felipe Campos de Melo Iani, José Geraldo Leite Ribeiro, Roberta Barros da Silva, and Olindo Assis Martins-Filho
Subjects: Vascular Endothelial Growth Factor A, VEGF receptors, 030231 tropical medicine, CCL3, Reference range, CCL5, BIOMARCADORES, 03 medical and health sciences, 0302 clinical medicine, Serum biomarkers, Yellow Fever, Humans, Medicine, 030212 general & internal medicine, Adverse effect, Chemokine CCL5, Interleukin-15, General Veterinary, General Immunology and Microbiology, biology, business.industry, Vaccination, Yellow Fever Vaccine, Public Health, Environmental and Occupational Health, Interleukin 1 Receptor Antagonist Protein, Infectious Diseases, Interleukin 15, biology.protein, Molecular Medicine, Differential diagnosis, business, Algorithm, Algorithms
Abstract: In the present study, a range of serum biomarkers were quantified in suspected cases of adverse events following YF immunization (YEL-AEFI) to propose a reliable laboratorial algorithm to discriminate confirmed YEL-AEFI (“A1” class) from cases with other illnesses (“C” class). Our findings demonstrated that increased levels of CXCL8, CCL2, CXCL10, IL-1β, IL-6 and TNF-α were observed in YEL-AEFI (“A1” and “C” classes) as compared to primary vaccines without YEL-AEFI [PV(day 3–28)] and reference range (RR) controls. Notably, increased levels of CCL3, CCL4, CCL2, CCL5, IL-1β, IL-15, IL-1Ra and G-CSF were found in “A1” as compared to “C” class. Venn diagrams analysis allowed the pre-selection of biomarkers for further analysis of performance indices. Data demonstrated that CCL3, CCL5, IL-15 and IL-1Ra presented high global accuracy (AUC = 1.00) to discriminate “A1” from “C”. Decision tree was proposed with a reliable algorithm to discriminate YEL-AEFI cases according to cause-specific definitions with outstanding overall accuracy (91%). CCL3, CCL5, IL-15 and IL-1Ra appears as root attributes to identify “A1” followed by VEGF as branch nodes to discriminate Wild Type YFV infection (“C(WT-YFV)”) from cases with other illnesses (“C*”). Together, these results demonstrated the applicability of serum biomarker measurements as putative parameters towards the establishment of accurate laboratorial tools for complementary differential diagnosis of YEL-AEFI cases.
Published: 2021
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5. Epidemiological profile and north-south gradient driving baseline systemic involvement of primary Sjogren's syndrome

Author: Marie Wahren-Herlenius, Xavier Mariette, Jacques-Eric Gottenberg, Manuel Ramos-Casals, Chiara Baldini, Aike A. Kruize, Bei Xu, Virginia Fernandes Moça Trevisani, Gabriela Hernández-Molina, Jorge Sanchez-Guerrero, Pilar Brito-Zerón, Sung-Hwan Park, Sandra Gofinet Pasoto, Valeria Valim, Roberto Giacomelli, Roberta Priori, Kathy L. Sivils, Maureen Rischmueller, Wan-Fai Ng, Margit Zeher, Damien Sène, Berkan Armagan, Yasunori Suzuki, Valérie Devauchelle-Pensec, Marika Kvarnström, Soledad Retamozo, Guadalupe Fraile, Gunnel Nordmark, Sonja Praprotnik, Luca Quartuccio, Jacques Morel, Piotr Wiland, David A. Isenberg, Astrid Rasmussen, Seung-Ki Kwok, Stefano Bombardieri, Salvatore De Vita, Hendrika Bootsma, Benedikt Hofauer, Tamer A. Gheita, Thomas Mandl, Fabiola Atzeni, Xiaomei Li, Michele Bombardieri, Daniel Hammenfors, Antonina Minniti, Nihan Acar-Denizli, Roberto Gerli, Roser Solans, Levent Kilic, Eefje van der Heijden, Pulukool Sandhya, Hideki Nakamura, Raphaèle Seror, Debashish Danda, Ildikó Horváth, C. Vollenweider, Hospital Clinic (IDIBAPS), Mimar Sinan Üniversitesi, Institute of Cellular Medicine [Newcastle], Newcastle University [Newcastle], University of Debrecen [Hungary], Oklahoma Medical Research Foundation (OMRF), CHU Le Kremlin-Bicêtre (Rheumatology Department), Department of Rheumatology, Departement of Rheumatology and Immunology, Hefei (Anhui Provincial Hospital), Rheumatology Unit (Rheum Unit - PISA), University of Pisa - Università di Pisa, Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Department of Clinical Immunology and Rheumatology, Vellore (Christian Medical College & Hospital), Rheumatology Clinic, Udine (DSMB), UO Complessa Reumatologia, Rome, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico], Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Hacettepe University = Hacettepe Üniversitesi, University Medical Center [Utrecht], Division of Rheumatology, Seoul (Department of Internal Medicine), Unit of Experimental Rheumatology, Stockhom (Department of Medicine), University Medical Center, Hôpital Lariboisière, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University and Azienda Ospedaliera of Perugia, Vall d'Hebron University Hospital [Barcelona], The Queen Elizabeth Hospital, Adelaide, Department of Rheumatology, Skane University Hospital, Division of Rheumatology Kanazawa University Graduate School of Medicine, Kanazawa, Centre for Rheumatology - London, Department of Medicine, Universidade Federal do Espirito Santo, Vitoria, Wroclaw Medical University, Uppsala University, Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), University of Groningen [Groningen], Department of Immunology and Rheumatology, Nagasaki, Japan, University of L'Aquila [Italy] (UNIVAQ), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), University of Freiburg [Freiburg], Queen Mary University London, Federal University of Sao Paulo (Unifesp), University of Bergen (UiB), Rheumatology Division, Hospital das Clinicas, Sao Paulo (HCFMUSP), Rheumatology Unit, Cordoba (Institute University of Biomedical Sciences University of Cordoba (IUCBC), Rheumatology Department, Cairo, Messina and Milan Univ, Milan, Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Rheumatology, Buenos Aires, Department of Immunology [Debrecen, Hungary], Clinical Immunology & Rheumatology, Vellore, Department of Medical Area, University Hospital Santa Maria della Misericordia, Udine, Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Physics Department,Rome University 'LaSapienza' (Physics Department,Rome University 'LaSapienza'), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Department of Immunology [Mexico City], Natl Inst Pediat, Immunodeficiencies Res Unit, Mexico City, DF, Mexico, Rheumatology, Hacetttepe University Faculty of Medicine, Ankara, Laboratoire d'Immunologie [AP-HP Hôpital Kremlin-Bicêtre] (GHU Paris-Sud), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CELLEX-IDIBAPS Department of Autoimmune Diseases, Barcelona, Translational Immunology Groningen (TRIGR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Wrocław Medical University, Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Universidad de Córdoba = University of Córdoba [Córdoba], Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), and Michel, Geneviève
Subjects: Male, Systemic disease, [SDV]Life Sciences [q-bio], Disease, primary Sjogren's syndrome, Severity of Illness Index, DISEASE, Cohort Studies, geoepidemiology, 0302 clinical medicine, Epidemiology, gender, Medicine, VASCULITIS, CRITERIA, Pharmacology (medical), Registries, African american, 0303 health sciences, Hispanic or Latino, ethnicity, phenotype, primary Sjögren's syndrome, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Sjogren's Syndrome, Cohort, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Vasculitis, musculoskeletal diseases, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, education, primary Sjögren’s syndrome, DIAGNOSIS, White People, CLASSIFICATION, ethnicity, gender, geoepidemiology, phenotype, primary Sjögren’s syndrome, 03 medical and health sciences, Asian People, Rheumatology, Internal medicine, SCORE, Humans, COHORT, Rheumatology and Autoimmunity, 030304 developmental biology, 030203 arthritis & rheumatology, Reumatologi och inflammation, Information Dissemination, business.industry, MORTALITY, Racial Groups, GEOEPIDEMIOLOGY, AIR-POLLUTION, medicine.disease, Black or African American, Clinical research, Sjogren s, business
Abstract: Objective To characterize the systemic phenotype of primary Sjögren’s syndrome at diagnosis by analysing the EULAR-SS disease activity index (ESSDAI) scores. Methods The Sjögren Big Data Consortium is an international, multicentre registry based on worldwide data-sharing cooperative merging of pre-existing databases from leading centres in clinical research in Sjögren’s syndrome from the five continents. Results The cohort included 10 007 patients (9352 female, mean 53 years) with recorded ESSDAI scores available. At diagnosis, the mean total ESSDAI score was 6.1; 81.8% of patients had systemic activity (ESSDAI score ≥1). Males had a higher mean ESSDAI (8.1 vs 6.0, P 65 years, P Conclusion The systemic phenotype of primary Sjögren’s syndrome is strongly influenced by personal determinants such as age, gender, ethnicity and place of residence, which are key geoepidemiological players in driving the expression of systemic disease at diagnosis.
Published: 2020
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6. Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil

Author: Mirhelen Mendes de Abreu, Eduardo Ferreira Borba, Marcelo de Medeiros Pinheiro, Nafice Costa Araújo, Helena Lúcia Alves Pereira, Kirla Wagner Poti Gomes, Licia Maria Henrique Mota, Marcus V. G. Lacerda, Gecilmara S. Pileggi, Eduardo dos Santos Paiva, José Roberto Provenza, Camila Santana Justo Cintra Sampaio, Eloisa Bonfa, Mariana Peixoto Guimarães, Blanca Elena Rios Gomes Bica, Odirlei André Monticielo, Claudia Diniz Lopes Marques, Rafaela Cavalheiro do Espírito Santo, Thelma Larocca Skare, Ana Paula Monteiro Gomides Reis, Cleandro Pires de Albuquerque, Dante Valdetaro Bianchi, Ângela Luzia Branco Pinto Duarte, Laurindo Ferreira da Rocha Junior, Gilda Aparecida Ferreira, Vanderson Souza Sampaio, Paula Reale Fernandes, Gabriela Araújo Munhoz, Edgard Torres Reis-Neto, Evandro Mendes Klumb, Sandra Lúcia Euzébio Ribeiro, Emilia Inoue Sato, Danielle Christinne Soares Egypto de Brito, Ricardo Machado Xavier, Valeria Valim, Ana Beatriz Bacchiega, Viviane Angelina de Souza, Adriana Maria Kakehasi, and Cristina Costa Duarte Lanna
Subjects: Adult, Male, medicine.medical_specialty, Cross-sectional study, Diseases of the musculoskeletal system, Statistics, Nonparametric, Arthritis, Rheumatoid, Cohort Studies, Young Adult, Rheumatic diseases, Rheumatology, Internal medicine, Epidemiology, Humans, Medicine, Risk factor, Aged, Aged, 80 and over, Family Health, Chi-Square Distribution, Scleroderma, Systemic, business.industry, Research, COVID-19, Hydroxychloroquine, RC581-607, Middle Aged, medicine.disease, Clinical trial, Cross-Sectional Studies, Logistic Models, Sjogren's Syndrome, RC925-935, Antirheumatic Agents, Rheumatoid arthritis, Hydroxycloroquine, Female, Immunologic diseases. Allergy, business, Brazil, Cohort study, medicine.drug
Abstract: Background There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann–Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03–2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19–6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31–3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46–0.98). Conclusion Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR – 9KTWX6).
Published: 2021

7. Juvenile Sjogren's Syndrome

Author: Vibke Lilleby, Malin V. Jonsson, Daniel Hammenfors, Esther Mossel, Johan G. Brun, Juan Carlos Nieto-González, Rosa Maria Rodrigues Pereira, Sandra Gofinet Pasoto, Valeria Valim, Hendrika Bootsma, Clovis A. Silva, Blanca Elena Rios Gomes Bica, Aline Coelho, Akaluck Thatayatikom, Haukeland University Hospital, University of Bergen (UiB), Projet NECESSITY (PN), Hôpitaux Universitaires Paris Sud [AP-HP] (HUPS)-Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Federal University of Espírito Santo, Universidade do Estado do Rio de Janeiro [Rio de Janeiro] (UERJ), Universidade de São Paulo = University of São Paulo (USP), Oslo University Hospital [Oslo], Hospital General Universitario 'Gregorio Marañón' [Madrid], University Medical Center Groningen [Groningen] (UMCG), University of Florida [Gainesville] (UF), Supported by the University of Bergen (Strategic Programme for International Research and Education) and the European Union (projects NECESSITY [H2020-JTI-IMI2/806975] and HarmonicSS [H2020-SC1-2016-RTD/731944]). Dr. Hammenfors’ work was supported by Helse Vest Regional Health Authority., European Project: 806975,NECESSITY, European Project: 731944 ,HarmonicSS, and Translational Immunology Groningen (TRIGR)
Subjects: Male, medicine.medical_specialty, Saliva, Adolescent, [SDV]Life Sciences [q-bio], FEATURES, CHILDHOOD, CHILDREN, AMERICAN-COLLEGE, DIAGNOSIS, Gastroenterology, Severity of Illness Index, Pediatrics, Salivary Glands, 03 medical and health sciences, 0302 clinical medicine, RENAL INVOLVEMENT, AGE, Rheumatology, Major Salivary Gland, Internal medicine, Severity of illness, medicine, Rheumatoid factor, Humans, CLASSIFICATION CRITERIA, Child, Ultrasonography, 030203 arthritis & rheumatology, UTILITY, Salivary gland, business.industry, Infant, medicine.disease, 3. Good health, medicine.anatomical_structure, Cross-Sectional Studies, Sjogren's Syndrome, Child, Preschool, Female, Original Article, business, CONSENSUS, Rheumatism, Parotitis
Abstract: International audience; Objective. Juvenile Sjögren's syndrome (SS) is a rare, poorly defined, and possibly underdiagnosed condition affecting children and adolescents. The aim of this study was to characterize symptoms and clinical findings of juvenile SS and to explore the clinical application of major salivary gland ultrasonography (SGUS) in patients with juvenile SS. Methods. A cross-sectional multicenter study recruited patients with disease onset until age 18 years (n = 67). Disease characteristics were recorded, and unstimulated whole sialometry and SGUS examination of the parotid and submandibular salivary glands were performed. Results. The female:male ratio was 58:9. The mean age at first symptom was 10.2 years and 12.1 years at diagnosis. Ocular and oral symptoms were noted in 42 of 67 patients (63%) and 53 of 66 patients (80%), respectively. The American-European Consensus Group or American College of Rheumatology/European League Against Rheumatism classification criteria for primary SS were fulfilled by 42 of 67 patients (63%). Pathologic SGUS findings were observed in 41 of 67 patients (61%); 26 of 41 SGUS+ patients (63%) fulfilled primary SS criteria. Salivary gland enlargements/parotitis were noted in 37 of 58 patients and were nonsignificantly associated with SGUS+ status (P = 0.066). The mean levels of saliva were 5.6 ml/15 minutes in SGUS-patients compared to 3.3 ml/15 minutes in the SGUS+ patients (P = 0.049). A total of 36 of 41 SGUS+ patients (88%) were anti-Ro/La+ compared to 14 of 26 SGUS-patients (54%) (P = 0.001). In addition, 24 of 39 SGUS+ patients (62%) were positive for rheumatoid factor (RF), whereas only 5 of 25 SGUS-patients (20%) were RF+ (P = 0.001). Conclusion. Juvenile SS is characterized by a large spectrum of clinical symptoms and findings. Several glandular and extraglandular parameters such as hyposalivation, swollen salivary glands, and autoantibodies are associated with pathologic SGUS findings.
Published: 2020
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8. Managing fatigue in patients with primary Sjögren’s syndrome: challenges and solutions

Author: Wan-Fai Ng, Samira Tatiyama Miyamoto, Dennis Lendrem, Valeria Valim, and Katie Hackett
Subjects: 030203 arthritis & rheumatology, medicine.medical_specialty, business.industry, Psychological intervention, law.invention, stomatognathic diseases, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Randomized controlled trial, law, SAFER, Medicine, Aerobic exercise, Rituximab, In patient, 030212 general & internal medicine, Sjogren s, business, Intensive care medicine, medicine.drug
Abstract: Primary Sjogren's syndrome (pSS) patients identify fatigue as their most important symptom and the one most difficult to cope with, but there are still many challenges and few solutions to manage this debilitating symptom. Promising pharmacological treatments, such as rituximab, have failed in more stringent tests including randomized controlled trials (RCTs) and meta-analysis. While non-pharmacological interventions may be safer, less costly, and address other common comorbidities, to date only aerobic exercise seems to be effective at reducing fatigue in pSS. All interventions, pharmacological or not, need to be tested in high-quality RCTs. The aim of this review is to provide an overview of fatigue management in pSS and discuss potential opportunities for future research.
Published: 2019
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9. Parotid gland swelling in primary Sjögren's syndrome: activity and other sialadenosis causes

Author: Bianca Barbosa Rosa, Antonio Catalán-Pellet, Anastasia Secco, Marcos Vázquez, Katherine Daniela Vargas, Fernanda Lourenço Macagnani, Alejandra Hernández-Delgado, Elías Rojas, Valeria Valim, Fabiola Reis de Olveira, and Gabriela Hernández-Molina
Subjects: Adult, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Physical examination, medicine.disease, Logistic regression, Gastroenterology, Severity of Illness Index, Serology, Cohort Studies, Basal (phylogenetics), Sjogren's Syndrome, Rheumatology, Internal medicine, Diabetes mellitus, Cohort, medicine, Humans, Parotid Gland, Pharmacology (medical), Prospective Studies, Prospective cohort study, business, Body mass index
Abstract: Objective To assess the prevalence of parotid gland swelling (PGS) and its association with features of SS and other causes of sialadenosis in a Latin-American cohort of primary SS. Methods We included 668 patients from Argentina, Brazil, Mexico and Paraguay. We retrospectively registered demographics, disease duration, oral/ocular symptoms, serology and scored the basal ESSDAI. We defined PGS as a recurrent or persistent increase of volume of any parotid glands during adulthood (self-reported and/or physical examination). We registered the presence of diabetes mellitus, dyslipidaemia, body mass index and alcohol consumption. We used logistic regression analysis reporting odds ratio (OR) and 95% CI. Results PGS was present in 242 patients (36.2%): 78 previous to SS diagnosis, 86 concomitantly, 73 during follow-up and five unknown. At the multivariate analysis, PGS was associated with RF (OR 2.47, 95% CI: 1.1, 6.5, P = 0.0001), basal articular ESSDAI domain (OR 1.63, 95% CI: 1.01, 2.6, P = 0.04) and alcohol consumption (OR 2.42, 95% CI: 1.41, 4-15). Patients with PGS during the follow-up had a higher prevalence of alcohol consumption (45.3%) compared with the remaining PGS cases (26.8%; OR 2.41 95% CI: 1.2, 4.7), or patients without parotid gland swelling (15.6%; OR 3.8 95% CI: 1.7, 8.2) in all the adjusted models. Conclusion PGS generally precedes or presents concomitantly with SS diagnosis, and is related to RF and articular activity. Alcohol consumption is an additional factor in PGS, especially during follow-up. The meaning of this last finding as well as its prognostic implications remains to be elucidated and deserves further evaluation in prospective studies.
Published: 2021

10. Serum biomarker profile orchestrating the seroconversion status of patients with autoimmune diseases upon planned primary 17DD Yellow fever vaccination

Author: Vanessa Peruhype-Magalhães, Licia Maria Henrique da Mota, Valquiria Garcia Dinis, Ana Paula Espíndula Gianordoli, Gisela Freitas Trindade, Francieli Fontana Sutile Tardetti Fantinato, Ana Carolina Campi-Azevedo, Andréa Teixeira-Carvalho, Lídia Balarini da Silva, Ana Paula Neves Burian, Érica Vieira Serrano, Ruben Horst Duque, Maria da Penha Gomes Gouvea, Olindo Assis Martins-Filho, Sávio Carvalho Deotti, Priscila Costa Martins Rocha, Ismael Artur da Costa-Rocha, Maria de Fatima Bissoli, Emily Hime Miranda, Gecilmara Salviato Pileggi, Sonia Alves Gouvea, Maria Bernadete Renoldi de Oliveira Gavi, Lauro Ferreira da Silva Pinto-Neto, Valeria Valim, Sheila Maria Barbosa de Lima, Ketty Lysie Libardi Lira Machado, Samira Tatiyama Miyamoto, Thays Zanon Casagrande, and Rafaela Villa Real Barbosa
Subjects: Male, Autoimmunity, Antibodies, Viral, 0302 clinical medicine, Immunogenicity, Vaccine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, 80 and over, Vaccines, Multidisciplinary, Vaccination, Yellow Fever Vaccine, Middle Aged, Healthy Volunteers, Titer, Seroconversion, Rheumatoid arthritis, Medicine, Biomarker (medicine), Cytokines, Female, Chemokines, Yellow fever virus, Adult, Adolescent, Science, Immunology, Viremia, Vaccines, Attenuated, Article, Autoimmune Diseases, 03 medical and health sciences, Young Adult, Plaque reduction neutralization test, Yellow Fever, medicine, Humans, Aged, 030203 arthritis & rheumatology, business.industry, medicine.disease, Antibodies, Neutralizing, Case-Control Studies, business, Biomarkers
Abstract: The present study aimed to investigate whether the serum biomarkers of immune response orchestrate the seroconversion status in patients with autoimmune diseases (AID) upon planned primary 17DD-YF vaccination. For this purpose a total of 161 individuals were enrolled in a prospective study, including patients with Rheumatoid Arthritis (RA = 38), Spondyloarthritis (SpA = 51), Systemic Lupus Erythematosus (SLE = 21) and Sjögren’s Syndrome (SS = 30) along with a group of healthy controls (HC = 21). Analysis of plaque reduction neutralization test (PRNT) titers and seropositivity rates along with the 17DD-YF viremia and serum biomarkers were carried out at distinct time points (D0/D3–4/D5–6/D7/D14–28). The results demonstrated an overall lower PRNT titer and seropositivity rate (170 vs. 448; 77 vs. 95%) in AID as compared to HC, especially in SpA and SLE subgroups. No significant differences were observed in the viremia levels amongst groups. In general, a more prominent serum biomarker response was observed in AID as compared to HC, throughout the timeline kinetics. Remarkably, AID/PRNT(−) exhibited higher levels of several biomarkers at baseline as compared to AID/PRNT+. Moreover, while AID/PRNT(+) exhibited earlier increase in serum biomarkers at D3–4/D5–6, the AID/PRNT(−) displayed higher response at later time points (D7/D14–D28). Of note, a synchronic increase of IFN-γ at the peak of viremia (D5–6) was observed in HC and AID/PRNT(+) groups, whereas a later asynchronous IFN-γ response was reported for AID/PRNT(−) at D7. The biomarker profile tends to deflate at post-vaccination timeline, highlighting a putative immunomodulatory effect of live attenuated 17DD-YF vaccine in AID/PRNT(+), but not in AID/PRNT(−). Altogether these data suggested that inflammatory status prior vaccination, low IFN-γ at viremia peak and the occurrence of asynchronous biomarker storm after 17DD-YF vaccination may orchestrate the lack of neutralizing antibody response γ.
Published: 2021

11. Hydroxychloroquine Impairs Primary Humoral Response after Yellow Fever Vaccination in Primary Sjögren’s Syndrome

Author: Gisela Freitas Trindade, Ana Paula Espíndula Gianordoli, Érica Vieira Serrano, Laura Gonçalves Aguiar, Andréa Teixeira-Carvalho, Ketty Lysie Libardi Lira Machado, Licia Maria Henrique Mota, Ismael Artur da Costa-Rocha, Priscila Costa Martins Rocha, Valeria Valim, Samira Tatiyama Miyamoto, Thays Zanon Casagrande, Sheila Maria Barbosa de Lima, Olindo Assis Martins-Filho, Vanessa Peruhype-Magalhães, Maria de Fatima Bissoli, Ana Carolina Campi-Azevedo, Adriana de Souza Azevedo Soares, Sávio Carvalho Deotti, and Larissa Carvalho Caser
Subjects: business.industry, Yellow fever vaccination, Immunology, medicine, Hydroxychloroquine, Sjogren s, business, medicine.drug
Abstract: , , , , , , , , , , , , , , , , ,
Published: 2021
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12. BRAZILIAN VERSION OF THE 'PRIMARY SJÖGREN SYNDROME - QUALITY OF LIFE QUESTIONNAIRE (PSS-QOL)

Author: Bianca Domingos Noronha, Ana Paula Truhlar Pedrini, Érica Vieira Serrano, Valeria Valim, Maria Bernadete Renoldi de Oliveira Gavi, Letícia Fonseca Favarato, Ana Paula Espíndula Gianordoli, Pedro Henrique Alves dos Santos, Samira Tatiyama Miyamoto, Luiza Vallory Alochio, and Weider Andrade Tomé
Subjects: Pediatrics, medicine.medical_specialty, Quality of life, business.industry, medicine, business, Primary Sjögren Syndrome
Published: 2021
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13. PERSISTENT LYMPHADENOPATHY IN LUPUS PATIENT ASSOCIATED WITH CASTLEMAN'S DISEASE: A CASE REPORT

Author: Lídia Balarini da Silva, Filipe Faé, Valeria Valim, Weider Andrade Tomé, Érica Vieira Serrano, Mariana de Oliveira Macabú, Gustavo Pinto de Oliveira Gomes, Luiza Vallory Alochio, Ketty Lysie Libardi Lira Machado, Débora Marques Veghini, Ruben Horst Duque, Bárbara Ferraço Dalmaso, Maria Carmen Lopes Ferreira Silva Santos, Raiza Cansian Tuão, Paula dos Santos Athayde, Pietra Zava Lorencini, João Peçanha Schuwartz, and Ana Paula Espíndula Gianordoli
Subjects: medicine.medical_specialty, Systemic lupus erythematosus, business.industry, medicine, Disease, medicine.disease, business, Dermatology
Published: 2021
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14. EPIDEMIOLOGICAL, CLINICAL AND LABORATORY ANALYSIS OF PATIENTS WITH TAKAYASU ARTERITIS AT HOSPITAL UNIVERSITÁRIO CASSIANO ANTÔNIO DE MORAES

Author: Raíza Cansian Tuã, Ruben Horst Duque, Luiza Vallory Alochio, Samira Tatiyama Miyamoto, Valquiria Garcia Dinis, Letícia Fonseca Favarato, Weider Andrade Tomé, Ketty Lysie Libardi Lira Machado, Bárbara Ferraço Dalmaso, and Valeria Valim
Subjects: medicine.medical_specialty, business.industry, Takayasu arteritis, Epidemiology, medicine, business, Dermatology
Published: 2021
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15. CHRONIC USE OF HYDROXYCHLOROQUINE DID NOT PROTECT AGAINST COVID-19 IN A LARGE COHORT OF PATIENTS WITH RHEUMATIC DISEASES IN BRAZIL

Author: Gilda Aparecida Ferreira, Ângela Luzia Branco Pinto Duarte, Licia Maria Henrique Mota, Vanderson Souza Sampaio, Marcelo de Medeiros Pinheiro, Paula Reale Fernandes, Ana Paula Monteiro Gomides Reis, Ricardo Machado Xavier, José Roberto Provenza, Mirhelen Mendes de Abreu, Emília Inoue Sato, Mariana Peixoto Guimarães, Blanca Elena Rios Gomes Bica, Danielle Christinne Soares Egypto de Brito, Viviane Angelina de Souza, Kirla Wagner Poti Gomes, Gabriela Araújo Munhoz, Ana Beatriz Santos Bacchiega, Marcus Lacerda, Cleandro Pires de Albuquerque, Claudia Diniz Lopes Marques, Rafaela Cavalheiro do Espírito Santo, Eduardo Ferreira Borba, Helena Lúcia Alves Pereira, Sandra Lúcia Euzébio Ribeiro, Laurindo Ferreira da Rocha Junior, Valeria Valim, Nafice Costa Araújo, Evandro Mendes Klumb, Edgard Torres Reis-Neto, Gecilmara Salviato Pileggi, Eloisa Bonfa, Dante Valdetaro Bianchi, Eduardo dos Santos Paiva, Adriana Maria Kakehasi, Cristina Costa Duarte Lanna, Odirlei André Monticielo, Thelma Skare, and Camila Santana Justo Cintra Sampaio
Subjects: Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Medicine, Hydroxychloroquine, business, medicine.drug, Large cohort
Published: 2021
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16. HIGH PREVALENCE OF CANCER AMONG PRIMARY SJÖGREN’S SYNDROME: DATA FROM BRAZILIAN SJÖGREN’S SYNDROME REGISTRY (RE-BRASS)

Author: Fabiola Reis de Oliveira, Rafael Coradin, Paula Regina Toche dos Santos, Maria Clara Cardoso Gomes Zampirolli, Fernanda Lourenço Macagnani, Aysa César Pinheiro, Ketty Lisie Libardi Machado, Laura Caldas, Barbara Seabra Carneiro, Gustavo Pafume de Sá, Giovanna Sant’Ana Petterle, Bianca Barbosa Rosa, Juliana Markus, Valeria Valim, Vanessa Hax, Virginia Fernandes Moça Trevisani, Roberta de Almeida Pernambuco, Ricardo Machado Xavier, Alisson Aliel Vigano Pugliesi, Leandro Augusto Tanure, Samira Tatiyama Miyamoto, Raíssa Dudienas Domingues Pereira, Ana Carolina Pereira Nunes Pinto, Nathália de Carvalho Sacilotto, Camila Avila Megda Cabianca, Thais Ferreira Costa, Karina Gatz Capobianco, Maria Lúcia Lemos Lopes, and Aiessa Zanchett Fedrigo
Subjects: medicine.medical_specialty, High prevalence, business.industry, medicine, Cancer, Sjogren s, medicine.disease, business, Dermatology
Published: 2021
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17. Purple after Adalimumab: a case report

Author: Valquiria Garcia Dinis, Anna Carolina Simões Moulin, Érica Vieira Serrano, Laura Gonçalves Aguiar, João Peçanha Schwartz, Bárbara Ferraço Dalmaso, Elisabeth Lima Marques de Aguiar, Gustavo Pinto de Oliveira Gomes, Luiza Vallory Alochio, Luiza Correa Rodrigues Dalpiero, Ruben Horst Duque, Hellen Carvalho Ribeiro, João Victor Cornachini, Matheus Pereira Rosi, Raiza Cansian Tuão, Estephania Pignaton Naseri, Laís Pizzol Pasti, Bárbara Oliveira Souza, Weider Andrade Tomé, Heitor Filipe Surlo, Tiago Barcelos da Silva, Débora Marques Veghini, Bárbara Petronetto Fafá Fardin, Mariana de Oliveira Macabú, Paula dos Santos Athayde, Valeria Valim, Guilherme Vallin Garcia, Luiza Lorenzoni Grillo, Ketty Lysie Libardi Lira Machado, and Fernanda Sales Soares de Oliveira
Subjects: medicine.medical_specialty, business.industry, Adalimumab, Medicine, business, Dermatology, medicine.drug
Published: 2021
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18. SEVERE ADVERSE EVENT POST YELLOW FEVER VACCINE IN A PATIENT WITH ANTI-IFN TYPE I AUTOANTIBODIES: A CASE REPORT

Author: Valeria Valim, Estephania Pignaton Naseri, Gustavo Pinto de Oliveira Gomes, Alexandra Mendes Tonaco Flores Pinto, Bárbara Ferraço Dalmaso, Raiza Cansian Tuão, Débora Marques Veghini, Ketty Lysie Libardi Lira Machado, Lídia Balarini da Silva, Pietra Zava Lorencini, Luiza Lorenzoni Grillo, Kaicki Teófilo da Silva, and Anna Carolina Simões Moulin
Subjects: business.industry, Immunology, Autoantibody, Medicine, Yellow fever vaccine, business, Adverse effect, medicine.drug
Published: 2021
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19. LEUKOCYTOCLASTIC VASCULITIS AND THROMBOSIS IN PRIMARY SJÖGREN SYNDROME AFTER COVID-19: A CASE REPORT

Author: Gustavo Pinto de Oliveira Gomes, Gabriel Sobral Smith Vieira, Mariana de Oliveira Macabú, Ruben Horst Duque, Ketty Lysie Libardi Lira Machado, Raiza Cansian Tuão, Bárbara Ferraço Dalmaso, Lídia Balarini da Silva, Paula dos Santos Athayde, Valeria Valim, Débora Marques Veghini, Marina Deorce de Lima, Arthur Prando de Barros, Érica Vieira Serrano, Ana Paula Espíndula Gianordoli, and Estephania Pignaton Naseri
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Leukocytoclastic vasculitis, medicine, medicine.disease, business, Dermatology, Thrombosis, Primary Sjögren Syndrome
Published: 2021
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20. Understanding fatigue in Sjögren’s Syndrome: Outcome measures, biomarkers and possible interventions

Author: Elisabeth Mæland, Samira T. Miyamoto, Daniel Hammenfors, Valeria Valim, and Malin V. Jonsson
Subjects: Oncology, medicine.medical_specialty, biomarker (BM), Mini Review, Immunology, Psychological intervention, Disease, Severity of Illness Index, Pharmacological treatment, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Internal medicine, medicine, Humans, Immunology and Allergy, intervention, 030203 arthritis & rheumatology, Autoimmune disease, outcome measure, business.industry, Outcome measures, RC581-607, medicine.disease, Neuromodulation (medicine), cytokines, stomatognathic diseases, Sjogren's Syndrome, Sjögren’s sydrome, Quality of Life, fatigue, Sjogren s, Immunologic diseases. Allergy, business, Biomarkers, 030217 neurology & neurosurgery
Abstract: Sjögren’s syndrome (SS) is an autoimmune disease affecting the salivary and lacrimal glands. Symptoms range from dryness to severe extra-glandular disease involving manifestations in the skin, lungs, nervous system, and kidney. Fatigue occurs in 70% of patients, characterizing primary SS (pSS) and significantly impacting the patient’s quality of life. There are some generic and specific instruments used to measure fatigue in SS. The mechanisms involved with fatigue in SS are still poorly understood, but it appears fatigue signaling pathways are more associated with cell protection and defense than with pro-inflammatory pathways. There are no established pharmacological treatment options for fatigue in pSS. So far, exercise and neuromodulation techniques have shown positive effects on fatigue in pSS. This study briefly reviews fatigue in pSS, with special attention to outcome measures, biomarkers, and possible treatment options.
Published: 2021

21. COVID-19 INFECTION IN A PATIENT WITH LUPUS PROGRESSING TO VERTEBRAL ARTERY DISSECTION AND ISCHEMIC STROKE

Author: Ketty Lysie Libardi Lira Machado, Raiza Cansian Tuão, Gustavo Pinto de Oliveira Gomes, Bárbara Ferraço Dalmaso, Leonardo Luiz Avanza, Estephania Pignaton Naseri, Valeria Valim, Débora Marques Veghini, Luiza Vallory Alochio, Paula dos Santos Athayde, Luiza Correa Rodrigues Dalpiero, Lídia Balarini da Silva, Érica Vieira Serrano, Weider Andrade Tomé, Ruben Horst Duque, Filipe Faé, Pietra Zava Lorencini, Ana Paula Espíndula Gianordoli, and João Peçanha Schuwartz
Subjects: medicine.medical_specialty, Systemic lupus erythematosus, Coronavirus disease 2019 (COVID-19), business.industry, Vertebral artery dissection, Internal medicine, Ischemic stroke, medicine, Cardiology, medicine.disease, business
Published: 2021
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22. A RARE OVERLAP OF JUVENILE IDIOPATHIC ARTHRITIS AND SARCOIDOSIS: CASE REPORT

Author: Valquiria Garcia Dinis, Érica Vieira Serrano, Bárbara Ferraço Dalmaso, Ruben Horst Duque, Weider Andrade Tomé, Raiza Cansian Tuão, Valeria Valim, and Luiza Vallory Alochio
Subjects: medicine.medical_specialty, business.industry, Medicine, Arthritis, Juvenile, Sarcoidosis, business, medicine.disease, Dermatology
Published: 2021
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23. PREVALENCE OF RADIOGRAPHIC ABNORMALITIES OF TEMPOROMANDIBULAR JOINTS BY MAGNETIC RESONANCE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Author: Érica Vieira Serrano, Livia Guidoni, Valeria Valim, Maria Bernadete Renoldi de Oliveira Gavi, Samira Tatiyama Miyamoto, Ana Maria Tamelini, Ruben Horst Duque, Marcos Rosa Júnior, and Maria Helena Monteiro de Barros Miotto
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Radiography, Rheumatoid arthritis, medicine, Magnetic resonance imaging, In patient, Radiology, business, medicine.disease
Published: 2021
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24. HIGH BASDAI SCORES DID NOT REDUCE IMMUNE RESPONSE TO PLANNED YELLOW FEVER PRIMARY VACCINATION IN SPONDYLOARTHRITIS

Author: João Gabriel Fragoso Dias, Ruben Horst Duque, Ana Paula Espíndula Gianordoli, Gisela Freitas Trindade, Elizandra Polito, Lídia Balarini da Silva, Priscila Costa Martins Rocha, Ana Carolina Campi-Azevedo, Maria Bernadete Renoldi de Oliveira Gavi, Érica Vieira Serrano, Arthur Dalmaso Pinto, Valquiria Garcia Dinis, Ketty Lysie Libardi Lira Machado, Sonia Alves Gouvea, Leticia Resende Brandao, Ismael Artur da Costa-Rocha, Samira Tatiyama Miyamoto, Thays Zanon Casagrande, Emily Hime Miranda, Vanessa Peruhype-Magalhães, Andréa Teixeira-Carvalho, Lauro Ferreira da Silva Pinto-Neto, Valeria Valim, Sheila Maria Barbosa de Lima, and Olindo Assis Martins-Filho
Subjects: medicine.medical_specialty, Immune system, business.industry, Internal medicine, Primary vaccination, Yellow fever, medicine, business, medicine.disease, BASDAI
Published: 2021
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25. ADVERSE EVENTS POST FIRST COVID-19 VACCINATION IN PATIENTS WITH AUTOIMMUNE DISEASES AND HEALTHY CONTROLS: FIRST DATA FROM SAFER STUDY

Author: Gabriel Smith Sobral Vieira, Laís Pizzol Pasti, Valeria Valim, Emília Inoue Sato, Bárbara Ferraço Dalmaso, Marcelo Medeiros Pinheiro, Filipe Faé, Andréa Teixeira-Carvalho, Anna Carolina Simões Moulin, Olindo Assis Martins-Filho, Bárbara Oliveira Souza, Heitor Filipe Surlo, Valderílio Feijó Azevedo, Odirlei André Monticielo, Ricardo Machado Xavier, Ana Karla Guedes de Melo, Raiza Casian Tuão, Rebeca Silva Moreira da Fraga, Edgard Torres dos Reis Neto, Laura Gonçalves Aguiar, Vitor Alves Cruz, Marina Deorce de Lima, Luiza Lorenzoni Grillo, Adriana Maria Kakehasi, Rejane Maria Rodrigues de Abreu Vieira, Rodrigo Poubel Vieira de Rezende, Gecilmara Salviato Pileggi, Sandra Lúcia Euzébio Ribeiro, Danielle Cristina Filgueira Alves Batista, Ana Paula Neves Burian, Ketty Lysie Libardi Lira Machado, Arthur Prando de Barros, Thaisa de Moraes Ribeiro Espirito Santo, Isac Ribeiro Moula, Ciro Martins Gomes, Gilda Aparecida Ferreira, and Viviane Angelina de Souza
Subjects: Vaccination, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Internal medicine, SAFER, Medicine, In patient, business, Adverse effect
Published: 2021
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26. DIAGNOSIS OF DERMATOMYOSITIS TWO MONTHS AFTER COVID-19 INFECTION

Author: Ruben Horst Duque, Ana Paula Espíndula Gianordoli, Bárbara Petronetto Fafá, Ketty Lysie Libardi Lira Machado, Érica Vieira Serrano, Luiza Vallory Alochio, Bárbara Ferraço Dalmaso, Lídia Balarini da Silva, Isac Ribeiro Moulaz, Débora Marques Veghini, Luiza Correa Rodrigues Dalpiero, Valeria Valim, Weider Andrade Tomé, Estephania Pignaton Naseri, Gustavo Pinto de Oliveira Gomes, Raiza Cansian Tuão, Paula dos Santos Athayde, and Mariana de Oliveira Macabú
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, medicine, Dermatomyositis, medicine.disease, business, Dermatology
Published: 2021
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27. FREQUENCY OF FLU-LIKE SYMPTOMS AND THE CONCERNS ON THE COVID-19 PANDEMIC IN GRADUATE MEDICAL STUDENTS FROM ALL BRAZILIAN REGIONS - A REAL LIFE STUDY

Author: João Vitor Ziroldo Lopes, Helena Lúcia Alves Pereira, Viviane Angelina de Souza, Sandra Lúcia Euzébio Ribeiro, Kirla Wagner Poti Gomes, Lilian David de Azevedo Valadares, Egypt Brito, Maycoln Leôni Martins Teodoro, José Roberto Provenza, Edgard Torres Reis-Neto, Ana Karla Guedes, Marcelo de Medeiros Pinheiro, Mirhelen Mendes de Abreu, Gabriela Araújo Munhoz, Emília Inoue Sato, Henrique de Ataíde Mariz, Ângela Luzia Branco Pinto Duarte, Valeria Valim, Ana Beatriz Santos Bacchiega, Nafice Costa Araújo, Licia Maria Henrique Mota, Ana Paula Monteiro Gomides, Claudia Diniz Lopes Marques, Adriana Maria Kakehasi, Danielle Christinne Soares, Gecilmara Salviato Pileggi, Débora Cerqueira Calderaro, Bárbara Stadler Kalow, Thelma Skare, Cleandro Pires de Albuquerque, Samuel Elias Basualto Dias, Paula Reale Fernandes, Aline Rizzo Borges, Gilda Aparecida Ferreira, Evandro Mendes Klumb, Eduardo dos Santos Paiva, and Blanca Elena Rios Gomes Bica
Subjects: Flu-like symptoms, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Family medicine, Pandemic, medicine, Life study, business
Published: 2021
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28. EVALUATION OF THE EFFECTIVENESS AND SAFETY OF REMSIMA (INFLIXIMAB BIOSSIMILAR) IN COMPARISON WITH THE REMICADE, IN PATIENTS WITH TAKAYASU'S ARTERITIS

Author: Weider Andrade Tomé, Bárbara Ferraço Dalmaso, Thaís Segato Garcia, Letícia Fonseca Favarato, Ketty Lysie Libardi Lira Machado, Luiza Vallory Alochio, Valquiria Garcia Dinis, Ruben Horst Duque, Raiza Cansian Tuão, Bárbara Petronetto Fafá Fardin, Priscila Costa Martins Rocha, Thaís Chaves Belisário, and Valeria Valim
Subjects: medicine.medical_specialty, business.industry, Takayasu's arteritis, medicine, In patient, medicine.disease, business, Dermatology, Infliximab, medicine.drug
Published: 2021
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29. PRIMARY SJÖGREN'S SYNDROME PATIENTS WITH BETTER LEVELS OF PHYSICAL ACTIVITY PRESENT LESS FATIGUE AND BETTER QUALITY OF LIFE

Author: Jessica Carvalho da Mota, Pedro Henrique Alves dos Santos, Luiza Vallory Alochio, Lara Betini Altoé, Letícia Fonseca Favarato, Ana Paula Truhlar Pedrini, Ana Paula Espíndula Gianordoli, Samira Tatiyama Miyamoto, Weider Andrade Tomé, Érica Vieira Serrano, Bianca Domingos Noronha, Nicole Reis Souza da Silva, and Valeria Valim
Subjects: Pediatrics, medicine.medical_specialty, Quality of life (healthcare), business.industry, Physical activity, Medicine, Sjogren s, business
Published: 2021
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30. Health Resources and Direct Costs in patients with rheumatoid arthritis under biological therapy: Data from Brazilian National Public Health System (Sistema Único de Saúde – SUS)

Author: Poliane Sampaio Buffon, Valeria Valim, Bruna Costa da Mata Moura, Ketty Lysie Libardi Lira Machado, and Mirhelen Mendes de Abreu
Subjects: medicine.medical_specialty, Indirect costs, business.industry, Family medicine, Public health, Rheumatoid arthritis, medicine, In patient, business, medicine.disease
Published: 2021
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31. TAKAYASU’S ARTERITIS ASSOCIATED TO MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS: A CASE REPORT

Author: Valeria Valim, Beatriz Paoli Thompson, Débora Marques Veghini, Anna Carolina Simões Moulin, Gustavo Pinto de Oliveira Gomes, Ketty Lysie Libardi Lira Machado, Bárbara Ferraço Dalmaso, Bárbara Oliveira Souza, Karen Evelin Monlevade Lança, Ruben Horst Duque, Raiza Cansian Tuão, Gabriel Smith Sobral Vieira, and Luiza Lorenzoni Grillo
Subjects: medicine.medical_specialty, business.industry, Takayasu's arteritis, Membranoproliferative glomerulonephritis, Medicine, business, medicine.disease, Dermatology
Published: 2021
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32. LUPUS LIKE SYNDROME FOLLOWING PARVOVIRUS B19 INFECTION

Author: Lídia Balarini da Silva, Tiago Barcelos da Silva, Ana Paula Espíndula Gianordoli, Luiza Vallory Alochio, João Victor Cornachini, Hellen Carvalho Ribeiro, Valeria Valim, Laís Pizzol Pasti, João Peçanha Schwartz, Bárbara Ferraço Dalmaso, Luiza Correa Rodrigues Dalpiero, Gustavo Pinto de Oliveira Gomes, Weider Andrade Tomé, Ketty Lysie Libardi Lira Machado, Bárbara Oliveira Souza, Heitor Filipe Surlo, Érica Vieira Serrano, Laura Gonçalves Aguiar, Fernanda Sales Soares de Oliveira, Matheus Pereira Rosi, Anna Carolina Simões Moulin, Mariana de Oliveira Macabú, Débora Marques Veghini, Raiza Cansian Tuão, Luiz Lorenzoni Grillo, Guilherme Vallin Garcia, Paula dos Santos Athayde, and Bárbara Petronetto Fafá Fardin
Subjects: biology, Parvovirus, business.industry, Medicine, biology.organism_classification, business, Lupus-like syndrome, Virology
Published: 2021
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33. MULTIBACILAR LEPROSY MIMICKING SYSTEMIC LUPUS ERYTHEMATOSUS

Author: Ketty Lysie Libardi Lira Machado, Laís Pizzol Pasti, Fernanda Sales Soares de Oliveira, Gustavo Pinto de Oliveira Gomes, Tiago Barcelos da Silva, Valeria Valim, Érica Vieira Serrano, Laura Gonçalves Aguiar, João Victor Cornachini, Guilherme Vallin Garcia, Raiza Cansian Tuão, Hellen Carvalho Ribeiro, Paula dos Santos Athayde, João Peçanha Schwartz, Bárbara Ferraço Dalmaso, Lídia Balarini da Silva, Bárbara Oliveira Souza, Heitor Filipe Surlo, Matheus Pereira Rosi, Anna Carolina Simões Moulin, Luiza Vallory Alochio, Luiza Correa Rodrigues Dalpiero, Weider Andrade Tomé, Débora Marques Veghini, Ana Paula Espíndula Gianordoli, Mariana de Oliveira Macabú, and Luiza Lorenzoni Grillo
Subjects: medicine.medical_specialty, business.industry, Medicine, Leprosy, business, medicine.disease, Dermatology
Published: 2021
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34. HOSPITALIZATION AND MORTALITY RATE RELATED TO COVID-19 IN PATIENTS WITH RHEUMATIC DISEASES ON CHRONIC USE OF HYDROXYCHLOROQUINE: 16-WEEK PRELIMINARY DATA FROM THE MARIO PINOTTI STUDY

Author: José Roberto Provenza, Eduardo Ferreira Borba, Ana Karla Guedes, Marcus Lacerda, Ângela Luzia Branco Pinto Duarte, Claudia Diniz Lopes Marques, Dante Valdetaro Bianchi, Vanderson Souza Sampaio, Viviane Angelina de Souza, Gilda Aparecida Ferreira, Evandro Mendes Klumb, Kirla Wagner Poti Gomes, Valeria Valim, Thelma Skare, Ana Paula Monteiro Gomides Reis, Marcelo Medeiros Pinheiro, Adriana Maria Kakehasi, Eduardo dos Santos Paiva, Mirhelen Mendes de Abreu, Emília Inoue Sato, Odirlei André Monticielo, Danielle Christinne Soares Egypto de Brito, Nafice Costa Araújo, Gabriela Gimenez Faustino, Mariana Peixoto Guimarães, Ricardo Machado Xavier, Camila Santana Justo Cintra Sampaio, Blanca Elena Rios Gomes Bica, Paula Reale Fernandes, Gabriela Araújo Munhoz, Licia Maria Henrique Mota, Cleandro Pires de Albuquerque, Gecilmara Salviato Pillegi, Ana Beatriz Santos Bacchiega, Laurindo Ferreira da Rocha Junior, Edgard Torres Reis-Neto, Rafaela Cavalheiro do Espírito Santo, Helena Lúcia Alves Pereira, Sandra Lúcia Euzébio Ribeiro, and Eloisa Bonfa
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Internal medicine, Mortality rate, Medicine, Hydroxychloroquine, In patient, business, medicine.drug
Published: 2021
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35. OBSTRUCTIVE HYDROCEPHALUS DUE TO AQUEDUCTAL STENOSIS IN AN ELDERLY MAN WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE REPORT

Author: Ketty Lysie Libardi Lira Machado, Ruben Horst Duque, Ana Paula Espíndula Gianordoli, Luiza Correa Rodrigues Dalpiero, Rodrigo Leite Marinho, Érica Vieira Serrano, Bárbara Ferraço Dalmaso, Isac Ribeiro Moulaz, Gustavo Pinto de Oliveira Gomes, Débora Marques Veghini, Lídia Balarini da Silva, Raiza Cansian Tuão, Marcos Rosa Júnior, Paula dos Santos Athayde, Valeria Valim, Luiza Vallory Alochio, Weider Andrade Tomé, and Mariana de Oliveira Macabú
Subjects: medicine.medical_specialty, business.industry, Aqueductal stenosis, Internal medicine, Cardiology, medicine, Obstructive hydrocephalus, business, medicine.disease
Published: 2021
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36. Health-related quality of life and costs in Sjögren’s syndrome

Author: Valeria Valim, Benjamin A Fisher, and Samira Tatiyama Miyamoto
Subjects: 030203 arthritis & rheumatology, medicine.medical_specialty, SF-36, business.industry, Disease, Systemic scleroderma, medicine.disease, humanities, law.invention, 03 medical and health sciences, 0302 clinical medicine, Sexual dysfunction, Rheumatology, Randomized controlled trial, Quality of life, law, EQ-5D, Internal medicine, Sicca syndrome, Medicine, Pharmacology (medical), 030212 general & internal medicine, medicine.symptom, business
Abstract: Health-related quality of life (HRQoL) has an increasing role in medical decision-making. This review of the literature aims to provide an overview on HRQoL, costs, and work disability in SS, a disease characterized by focal lymphocytic infiltration of exocrine glands with no therapeutics of proven immunomodulatory potential. HRQoL is markedly reduced in SS in multiple studies across many countries when compared with HRQoL in healthy controls. The reduction in HRQoL is similar to that observed in other chronic diseases such as RA, SLE, FM and, interestingly, non-SS sicca syndrome. Impaired HRQoL in SS has been found to be associated with fatigue, pain/articular involvement, ocular and oral involvement, pruritus, sexual dysfunction, impaired sleep, pulmonary manifestations, psychological dysfunction and impaired physical function. Until now, no therapeutic has been shown to improve HRQoL in an adequately powered double-blind, placebo-controlled randomized controlled trial. Although primary SS does not, in general, impair life expectancy and is often inappropriately considered a benign ‘nuisanvce’ disease for those patients without systemic manifestations, the associated costs and work disability are striking. This, together with the significant reduction in HRQoL, strongly argues for the development of new therapeutic approaches to manage this neglected disease.
Published: 2019
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37. Incidence of Infectious Adverse Events in Patients With Rheumatoid Arthritis and Spondyloarthritis on Biologic Drugs—Data From the Brazilian Registry for Biologics Monitoring

Author: Julio C. B. Moraes, Ivanio Alves Pereira, Hellen M.S. Carvalho, David C. Titton, Izaias Pereira da Costa, Geraldo da Rocha Castelar Pinheiro, José Roberto Silva Miranda, Maria F L Cunha, Rogério de Melo Costa Pinto, Paulo Louzada-Junior, Roberto Acayaba de Toledo, Manoel Barros Bertolo, Claiton Viegas Brenol, Roberto Ranza, Washington A. Bianchi, B. Stadler, José Caetano Macieira, Miguel Ángel Descalzo, Mariana Cecconi, Ângela Luzia Branco Pinto Duarte, Marlene Freire, Valeria Valim, Vander Fernandes, Ieda Maria Magalhães Laurindo, and Gláucio Ricardo Werner de Castro
Subjects: rheumatoid arthritis, Drug, medicine.medical_specialty, medicine.drug_class, media_common.quotation_subject, Arthritis, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, Spondylarthritis, medicine, Humans, 030212 general & internal medicine, Adverse effect, media_common, 030203 arthritis & rheumatology, Biological Products, Tumor Necrosis Factor-alpha, business.industry, Incidence, Incidence (epidemiology), registries, Original Articles, spondyloarthritis, medicine.disease, Confidence interval, Antirheumatic Agents, Rheumatoid arthritis, adverse drug events, Corticosteroid, business, Brazil
Abstract: BACKGROUND The safety profile of biologic drugs might present substantial regional differences. Since 2009, the Brazilian Society of Rheumatology has maintained BIOBADABRASIL (Brazilian Registry for Biologic Drugs), a registry for monitoring of biologic therapies in rheumatic diseases. OBJECTIVES The aim of this study was to verify the incidence rate (IR) of serious infections in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients on biologic drugs. METHODS BIOBADABRASIL prospectively included patients with rheumatic diseases who started the first biologic drug or a synthetic disease-modifying antirheumatic drug as a parallel control group. This study focuses on serious infectious adverse events (SIAEs) in RA and SpA patients on biologic drugs compared with controls, from January 2009 to June 2015. Time of exposure was set from initiation of the drug to the date of last administration or censorship. Serious infectious adverse events IR was calculated per 1000 patient/years with 95% confidence interval (CI). RESULTS A total of 1698 patients (RA, 1121; SpA, 577) were included, 7119 patient/years. Serious infectious adverse events were more common among patients on tumor necrosis factor inhibitors (TNFi's) than controls (adjusted IR ratio, 2.96 [95% CI, 2.01-4.36]; p < 0.001). Subsequent TNFi was associated with a higher SIAEs incidence when compared with first TNFI (adjusted IR ratio, 1.55 [95% CI, 1.15-2.08]; p = 0.004). Serious infectious adverse events were associated with age and corticosteroids intake. Serious infectious adverse events were more frequent in the respiratory tract in all subgroups. CONCLUSIONS In BIOBADABRASIL, biologic drugs, especially the subsequent TNFi, were associated with a higher risk of serious infections compared with synthetic DMARDs. Corticosteroid intake and age represented risk factors for SIAEs. Constant monitoring is required to follow the safety profile of drugs in the clinical setting of rheumatic conditions in Brazil.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Published: 2018
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38. Pulmonary paracoccidioidomycosis: a case report of reactivation in a patient receiving biological therapy

Author: Pâmela Mazzini Hombre, Aloísio Falqueto, Paulo Mendes Peçanha, Lúcia Carla Polaco Covre, and Valeria Valim
Subjects: 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Pulmonary paracoccidioidomycosis, lcsh:RC955-962, Spondyloarthropathy, medicine.medical_treatment, 030106 microbiology, 030231 tropical medicine, 03 medical and health sciences, 0302 clinical medicine, Biopsy, Medicine, medicine.diagnostic_test, business.industry, Paracoccidioidomycosis, Sulfamethoxazole, Immunosuppression, medicine.disease, Dermatology, Trimethoprim, Infliximab, Infectious Diseases, Parasitology, business, medicine.drug
Abstract: Paracoccidioidomycosis is an endemic disease in Latin America that is rarely associated with immunosuppression and biological therapy. Herein, we report for the first time a case of pulmonary paracoccidioidomycosis reactivation after infliximab treatment. A 47-year-old man from Brazil received infliximab to treat psoriatic spondyloarthropathy and presented with cough, dyspnea, weight loss, and fever. Chest computed tomography revealed a pulmonary nodule and biopsy confirmed paracoccidioidomycosis. Treatment with sulfamethoxazole and trimethoprim was initiated for fungal infection and infliximab was reintroduced two months later. Considering his clinical improvement and favorable radiologic evolution, antifungal therapy was discontinued after 29 months.
Published: 2018
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39. Safety of the Methotrexate–leflunomide Combination in Rheumatoid Arthritis: Results of a Multicentric, Registry-based, Cohort Study (BiobadaBrasil)

Author: José Caetano Macieira, André Luiz Shinji Hayata, Ana Cristina de Medeiros Ribeiro, Paulo Roberto Louzada, Reginaldo Botelho Teodoro, Vander Fernandes, Hellen M.S. Carvalho, Manoel Barros Bertolo, Ângela Luzia Branco Pinto Duarte, Marcelo de Medeiros Pinheiro, Roberto Ranza, Adriana Maria Kakehasi, Bárbara Stadler Kahlow, Ivânio Alves Pereira, Aline Ranzolin, Markus Bredemeier, Cristiano Michelini Lupo, Maria de Fátima Lobato da Cunha Sauma, Laurindo Ferreira da Rocha, Letícia Guimarães da Silveira, David C. Titton, Gláucio Ricardo Werner de Castro, Ieda Maria Magalhães Laurindo, Morgana Ohira Gazzeta, Valeria Valim, Inês Guimarães da Silveira, S. Studart, Geraldo da Rocha Castelar Pinheiro, and José Roberto Silva Miranda
Subjects: Oncology, medicine.medical_specialty, Immunology, Arthritis, Rheumatoid, Cohort Studies, Rheumatology, Sulfasalazine, Internal medicine, Medicine, Humans, Immunology and Allergy, Registries, Adverse effect, Leflunomide, business.industry, Proportional hazards model, Incidence (epidemiology), Isoxazoles, medicine.disease, Methotrexate, Rheumatoid arthritis, Drug Therapy, Combination, business, medicine.drug, Cohort study
Abstract: Objective.To evaluate the safety of the methotrexate (MTX)–leflunomide (LEF) combination in rheumatoid arthritis (RA), comparing it with other therapeutic schemes involving conventional synthetic (cs-) and biologic (b-) disease-modifying antirheumatic drugs (DMARDs) or Janus kinase inhibitors (JAKi).Methods.Patients with RA starting a treatment course with a csDMARD (without previous use of bDMARD or JAKi) or their first bDMARD/JAKi were followed up in a registry-based, multicentric cohort study in Brazil (BiobadaBrasil). The primary outcome was the incidence of serious adverse events (SAEs); secondary outcomes included serious infections. Multivariate Cox proportional hazards models and propensity score matching analysis (PSMA) were used for statistical comparisons.Results.In total, 1671 patients (5349 patient-years [PY]) were enrolled; 452 patients (1537 PY) received MTX + LEF. The overall incidence of SAEs was 5.6 per 100 PY. The hazard of SAEs for MTX + LEF was not higher than for MTX or LEF (adjusted HR [aHR] 1.00, 95% CI 0.76–1.31, P = 0.98). MTX + LEF presented a lower hazard of SAEs (aHR 0.56, 95% CI 0.36–0.88, P = 0.01) and infectious SAEs (aHR 0.48, 95% CI 0.25–0.94, P = 0.03) than bDMARDs/JAKi with MTX or LEF. MTX + LEF presented lower hazard of SAEs than MTX + sulfasalazine (SSZ; aHR 0.33, 95% CI 0.16–0.65, P = 0.002). Analysis using PSMA confirmed the results obtained with traditional multivariate Cox analysis.Conclusion.In our study, MTX + LEF presented a relatively good overall safety profile in comparison to MTX + SSZ and schemes involving advanced therapies in RA.
Published: 2022
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40. POS1252 COVID-19 IN PATIENTS WITH RHEUMATIC DISEASES ON CHRONIC USE OF HYDROXYCHLOROQUINE IN A LARGE BRAZILIAN COHORT – A 24-WEEK PROSPECTIVE STUDY

Author: E I Sato, P. Realle, Vanderson Souza Sampaio, G. Salviato Pileggi, Ana Paula Monteiro Gomides, Eduardo Ferreira Borba, M. Peixoto Gu e Silva de Souza, Marcus V. G. Lacerda, Evandro Mendes Klumb, N. Araújo, Cleandro Pires de Albuquerque, V. De Souza, A. Maria Kakehasi, Angela Luzia Branco Pinto Duarte, C. D. L. Marques, T. Laroca Skare, B. Bica, Odirlei André Monticielo, M. Pinheiro, Mirhelen Mendes de Abreu, Dante Valdetaro Bianchi, Ana Beatriz Santos Bacchiega, Heldher Xavier da Silva Pereira, Cristina Costa Duarte Lanna, Gabriela Araújo Munhoz, Licia Maria Henrique Mota, Valeria Valim, Cláudio L. S. Sampaio, R. Cavalheiro Do Espírito Santo, S. Ribeiro, Danielle Christinne Soares Egypto de Brito, Gustavo Portela Ferreira, Eduardo Paiva, Eloisa Bonfa, E.T. Reis Neto, Laurindo Ferreira da Rocha, José Roberto Provenza, Ricardo Machado Xavier, and K. Wagner Poti Gomes
Subjects: medicine.medical_specialty, business.industry, Mortality rate, Immunology, Hydroxychloroquine, medicine.disease, General Biochemistry, Genetics and Molecular Biology, Rheumatology, Rheumatoid arthritis, Intensive care, Internal medicine, Epidemiology, Cohort, medicine, Immunology and Allergy, Prospective cohort study, business, Survival analysis, medicine.drug
Abstract: Background:The role of chronic use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients during the SARS-CoV-2 pandemic is still subject of discussion.Objectives:To compare the occurrence of COVID-19 and its outcomes between RD patients on HCQ use with individuals from the same household not taking the drug during community viral transmission in an observational prospective multicenter study in Brazil.Methods:Participants were enrolled and monitored through 24-week (From March 29th to Sep 30th, 2020) regularly scheduled phone calls performed by trained medical professionals. Epidemiological and demographic data, as well as RD disease activity status and current treatment data, specific information about COVID-19, hospitalization, need for intensive care, and death was recorded in both groups and stored in the Research Electronic Data Capture (REDCap) database. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. The statistical analysis was performed using IBM-SPSS v.20.0 software. Group comparisons were made using the Man-Whitney, Chi-Square and Fisher Exact Test, as well as multivariate regression models adjusted to confounders. Survival curves were performed using Kaplan-Meier analysis.Results:A total of 10,427 participants mean age (SD) of 44.04 (14.98) years were enrolled, including 6004 (57.6%) rheumatic disease patients, of whom 70.8% had systemic lupus erythematosus (SLE), 6.7% rheumatoid arthritis (RA), 4% primary Sjögren’s syndrome (pSS), 1.8% mixed connective tissue disease (DMTC), 1% systemic sclerosis (SSc) and others (15.9), including overlap syndromes. In total, 1,132 (10.8%) participants fulfilled criteria for COVID-19, being 6.7% RD patients and 4.1% controls (p=0.002). A recent influenza vaccination had a protective role (p=65 years (OR=0.20; 95%CI 0.11-0.34) was negatively associated. Regarding RD, the risk factors associated with COVID-19 diagnosys were SLE (OR= 2.37; 95%CI 1.92-293), SSc (OR=2.25; 95%CI 1.05-4.83) and rituximab use (OR=1.92; 95%CI 1.13-3.26). In addition, age >=65 years (OR=5.47; 95%CI 1.7-19.4) and heart disease (OR=2.60; 95%CI 1.06-6.38) were associated with hospitalization. Seven female RD patients died, six with SLE and one with pSS, and the presence of two or more comorbidities were associated with higher mortality rate.Conclusion:Chronic HCQ use did not prevent COVID-19 in RD compared to their household cohabitants. Health care profession, presence of comorbidities LES, SSc and rituximab were identified as main risk factors for COVID-19 and aging and heart disease as higher risk for hospitalization. Our data suggest these outcomes could be considered to manage them in clinical practice.Table 1.Frequency and severity of COVID-19 in patients with rheumatic diseases on chronic use of hydroxychloroquine compared to their household controlsCOVID-19 outcomesTotal(%)GroupsPPatients(%)Controls (%)DiagnosisNo9256 (89.1)5300 (88.3)3956 (90.2)0.002Yes1132 (10.9)704 (11.7)428 (9.8)SeverityMild1059 (93.6)662 (94.0)397 (92.8)0.391Moderate52 (4.6)32 (4.5)20 (4.7)Severe21 (1.9)10 (1.4)11 (2.6)HCQ: hydroxychloroquine.Moderate and severe COVID-19 included the need for any of the following: hospitalization, intensive care, mechanical ventilation or death.Acknowledgements:To the Brazilian Society of Rheumatology for technical support and rapid nationwide mobilization.To all the 395 interviewers (medical students and physicians) who collaborated in the study and the participantsTo CNPq (Number 403442/2020-6)Disclosure of Interests:None declared
Published: 2021
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41. Isolated atrophy of the abductor digiti quinti in patients with rheumatoid arthritis

Author: Rafael Burgomeister Lourenço, Ronaldo Garcia Rondina, Ricardo Andrade Fernandes de Mello, Elton Francisco Pavan Batista, Valeria Valim, Stéphano Santos Belisario, and Ruben Horst Duque
Subjects: Adult, Male, medicine.medical_specialty, Population, Arthritis, 030218 nuclear medicine & medical imaging, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Atrophy, medicine, Humans, Radiology, Nuclear Medicine and imaging, Muscle, Skeletal, education, Aged, Denervation, 030222 orthopedics, education.field_of_study, medicine.diagnostic_test, Foot, business.industry, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Surgery, body regions, Rheumatoid arthritis, Orthopedic surgery, Population study, Female, Radiology, business
Abstract: We aim to discuss the association of isolated atrophy of the abductor digiti quinti muscle in patients with rheumatoid arthritis as well as review the anatomy and imaging findings of this condition on MRI. A consecutive series of 55 patients diagnosed with rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria were recruited. MRI of the clinically dominant feet was performed using a 1.5-T scanner. The study population was predominantly female (94.5%), and the age range was 31–79 years (mean 57.5 ± 11). A total of 55 ankles were examined by MRI, and 20 patients (36.3%), all females, showed abductor digiti quinti denervation signs. Seven patients demonstrated severe fatty atrophy of the abductor digiti quinti, corresponding to Goutallier grade 4, 2 patients showed moderate fatty atrophy (Goutallier grade 3), and the remaining 11 patients showed less than 50% fatty atrophy, corresponding to a Goutallier grade 2. Substantial agreement was found for both intra- and interobserver agreement regarding the Goutallier grading system. Prevalence of signs of abductor digiti quinti denervation on MRI was high in the studied population, suggesting that rheumatoid arthritis may be associated with inferior calcaneal nerve compression.
Published: 2017
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42. Correction to: V Brazilian consensus guidelines for detection of anti-cell autoantibodies on hep-2 cells

Author: Carlos David Araújo Bichara, Fabiano de Almeida Brito, Cristóvão Luis Pitangueira Mangueira, Natasha Slhessarenko, Lisiane Maria Ericoni dos Anjos, Fernanda Bull Flumian, Antonio Carlos Ximenes, Glaucielen Gomes da Silva, Wilson de Melo Cruvinel, Suzane Pretti Figueiredo Neves, Carlos Alberto von Mühlen, Wilton Silva dos Santos, Eloisa Bonfa, Cleonice Bueno, Sandra Gofinet Pasoto, Valeria Valim, Paulo Luiz Carvalho Francescantonio, Alessandra Dellavance, Jozelia Rêgo, and Luis Eduardo Coelho Andrade
Subjects: lcsh:Immunologic diseases. Allergy, lcsh:Diseases of the musculoskeletal system, medicine.anatomical_structure, Rheumatology, business.industry, Cell, Immunology, medicine, Autoantibody, Mistake, lcsh:RC925-935, lcsh:RC581-607, business
Abstract: After publication of the original article [1], we were notified that there is a mistake in Fig. 2.
Published: 2020

43. Recommendations from the Brazilian society of rheumatology for the diagnosis of Sjögren’s syndrome (Part I): glandular manifestations (systematic review)

Author: Maria Carmen Lopes Ferreira Silva Santos, Sonia Cristina de Magalhães Souza Fialho, Sandra Gofinet Pasoto, Valeria Valim, Tatiana Nayara Libório, Aysa César Pinheiro, Marilena Leal Mesquita Silvestre Fernandes, Leandro Paulo De Almeida Reis Tanure, Sandra Lúcia Euzébio Ribeiro, Laura Caldas Dos Santos, Danielle Christinne Soares Egypto de Brito, Maria Lúcia Lemos Lopes, Tania Fidelix, Juliana D Agostino Gennari, Samira Tatiyama Miyamoto, Jaqueline Martins de Sousa, Ana Carolina Pereira Nunes Pinto, Vinicius Tassoni Civile, Fabiola Reis de Oliveira, Simone Appenzeller, and Virginia Fernandes Moça Trevisani
Subjects: 0301 basic medicine, lcsh:Diseases of the musculoskeletal system, Delphi Technique, Lacrimal apparatus diseases, Dentists, Disease, Salivary Glands, 0302 clinical medicine, Diagnosis, Societies, Medical, Ultrasonography, Ophthalmologists, medicine.diagnostic_test, Magnetic Resonance Imaging, Sjogren's Syndrome, Systematic review, Sjogren's syndrome, Dry Eye Syndromes, Salivation, Brazil, lcsh:Immunologic diseases. Allergy, Practice guideline, medicine.medical_specialty, Consensus, Urinalysis, Specific knowledge, Delayed diagnosis, Xerostomia, 03 medical and health sciences, Rheumatology, Internal medicine, Xerophthalmia, medicine, Humans, 030203 arthritis & rheumatology, business.industry, Salivary gland diseases, medicine.disease, Dermatology, Pathologists, stomatognathic diseases, 030104 developmental biology, Positron-Emission Tomography, Sjogren’s syndrome, Syphilis, Rheumatologists, lcsh:RC925-935, Sjogren s, lcsh:RC581-607, business
Abstract: Background Primary Sjögren’s syndrome (pSS) is a systemic immune-mediated disease whose main characteristic is exocrine gland inflammation and, subsequent reduction in tear and saliva production. A delayed diagnosis is common due to the nonspecific clinical manifestations of disease. The aim of the present study was to develop recommendations for the diagnosis of glandular manifestations of pSS based on evidence and expert opinion. Main body of the abstract We conducted a systematic literature review to retrieve the best evidence available on the accuracy of diagnostic tests for pSS. We also held two in-person meetings with experts (rheumatologists, pathologists, ophthalmologists and dentists) to establish their level of agreement using the Delphi method. Ultimately, we generated 18 recommendations that aim to facilitate the diagnosis of the glandular manifestations of pSS. Conclusion The diagnosis of glandular manifestations of pSS is complex and multidisciplinary. It requires specific knowledge in the field of ophthalmology, immunology, pathology and imaging, making it compulsory for the rheumatologist to work with professionals from these different areas in order to improve accuracy and early diagnosis. Glandular dysfunction tests, ANA, RF, Anti-Ro, protein electrophoresis, urinalysis, blood count, C-Reactive protein, complement, testing for syphilis and viruses (HCV, HIV) and SGUS should be investigated when dryness or systemic manifestation are present. Minor salivary gland biopsy is recommended for all anti-Ro negative or incomplete criteria cases.
Published: 2019
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44. Chronic Inflammatory Arthropathy Preceding Acute Systemic Manifestations of Sarcoidosis: A Possible Overlap of Idiopathic Juvenile Arthritis and Sarcoidosis

Author: Lucas Enock V. Roberto, Valeria Valim, Priscilla Gomes Tosta, Weverton Machado Luchi, Rafael Burgomeister Lourenço, Júlia Guasti P. Vianna, Fernanda Morello Nicole, Matheus Campello Vieira, Paulo de Coelho Castro, and Érica Vieira Serrano
Subjects: medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Anemia, Inflammatory arthritis, 030232 urology & nephrology, Hepatosplenomegaly, Case Report, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Arthropathy, Biopsy, medicine, 030212 general & internal medicine, Creatinine, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, Dermatology, chemistry, Etiology, Sarcoidosis, medicine.symptom, lcsh:RC925-935, business
Abstract: Sarcoidosis is a multisystem disease with unknown etiology, marked by T lymphocytes and macrophages agglomeration, which leads to the formation of noncaseating granulomas in the affected tissues. We describe a case of a 40-year-old black patient referred to our service for evaluation of nephrolithiasis and persistent elevation of plasma creatinine. He reported important weight loss, fever episodes, and abdominal and low back intermittent pain in the past 6 months. The investigation revealed elevated serum calcium level, hepatosplenomegaly, retroperitoneal lymphadenopathy, anemia, thrombocytopenia, and nephrolithiasis. The initial diagnostic hypothesis was lymphoproliferative disease, but the laparoscopic propaedeutic showed multiple white lesions on the liver surface, which biopsy identified as noncaseating granulomas with asteroid corpuscles, suggestive of sarcoidosis. He was treated with corticosteroids with significant improvement in symptoms and in calcium and creatinine levels. Besides, the patient presented a long-term large joints arthropathy, especially on the knees (with bilateral prosthesis), wrists, and ankles, of unknown etiology. We discuss the systemic manifestations of sarcoidosis related to the reported case, as well as the possible overlapping of idiopathic juvenile arthritis with sarcoidosis.
Published: 2019

45. Yellow Fever Virus Genotyping Tool and Investigation of Suspected Adverse Events Following Yellow Fever Vaccination

Author: Carlos Eduardo Calzavara, Betânia Paiva Drumond, Rodrigo Fabiano do Carmo Said, Gabriela Fernanda Garcia Oliveira, Olindo Assis Martins-Filho, Andréa Teixeira-Carvalho, Ana Carolina Campi-Azevedo, Renata Santos Tourinho, Erna Geessien Kroon, Izabela Maurício de Rezende, Valeria Valim, Andreza Parreiras Gonçalves, Leonardo Soares Pereira, Pedro Augusto Alves, Maria Rita Teixeira Dutra, Matheus Soares Arruda, and Jaquelline Germano de Oliveira
Subjects: 0301 basic medicine, 030106 microbiology, Immunology, adverse event, Arbovirus, Virus, Article, yellow fever, 03 medical and health sciences, vaccine, Drug Discovery, Medicine, wild-type virus, Pharmacology (medical), Adverse effect, Genotyping, yellow fever virus, Pharmacology, Attenuated vaccine, business.industry, Yellow fever, immunisation, Outbreak, medicine.disease, YFV-17DD, vaccination, Virology, Vaccination, 030104 developmental biology, Infectious Diseases, arbovirus, genotyping, business
Abstract: The yellow fever (YF) vaccine consists of an attenuated virus, and despite its relative safety, some adverse events following YF vaccination have been described. At the end of 2016, Brazil experienced the most massive sylvatic yellow fever outbreak over the last 70 years and an intense campaign of YF vaccination occurred in Minas Gerais state in Southeast Brazil from 2016 to 2018. The present study aimed to develop a genotyping tool and investigate 21 cases of suspected adverse events following YF vaccination. Initial in silico analyses were performed using partial NS5 nucleotide sequences to verify the discriminatory potential between wild-type and vaccine viruses. Samples from patients were screened for the presence of the YFV RNA, using 5&prime, UTR as the target, and then used for amplification of partial NS5 gene amplification, sequencing, and phylogenetic analysis. Genotyping indicated that 17 suspected cases were infected by the wild-type yellow fever virus, but four cases remained inconclusive. The genotyping tool was efficient in distinguishing the vaccine from wild-type virus, and it has the potential to be used for the differentiation of all yellow fever virus genotypes.
Published: 2019

46. DRY SYMPTOMS, HISTOLOGICAL ABNORMALITIES IN LABIAL SALIVARY GLANDS AND SJOGREN’S SYNDROME ARE COMMON IN SYSTEMIC LUPUS ERYTHEMATOSOUS

Author: Ronaldo Vieira, Lidia Balarini, Érica Vieira Serrano, Sarah Firme, Rafaella Vila Real Barbosa, Ana Paula Espíndula Gianordoli, Valeria Valim, Fabiano Cade, Lucas Sueti, and Maria Carmen Lopes Ferreira Silva Santos
Subjects: Pathology, medicine.medical_specialty, business.industry, Systemic lupus, Medicine, Sjogren s, business
Published: 2019
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47. MAJOR SALIVARY GLAND ULTRASONOGRAPHY IS ASSOCIATED WITH HISTOLOGICAL ANALYSIS, AUTOANTIBODIES AND GLANDULAR DYSFUNCTION IN PRIMARY SJOGREN’S SYNDROME

Author: Lucas Dos Santos Bragança, Érica Vieira Serrano, Ketty Lysie Libardi Lira Machado, Thallys Henrique Alves Pereira, Valeria Valim, and Sávio Carvalho Deotti
Subjects: Pathology, medicine.medical_specialty, business.industry, Major Salivary Gland, Autoantibody, Medicine, Sjogren s, Ultrasonography, business
Published: 2019
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48. JACCOUD'S ARTHROPATHY ASSOCIATED WITH PSORIATIC ARTHRITIS

Author: Letícia Fonseca Favarato, Lucas Marques De Aguiar Ferreira, Miriam Kuster Huber, Érica Vieira Serrano, Maria Bernadete Renoldi de Oliveira Gavi, Elisabeth Lima Barboza, Thaís Chaves Belisário, and Valeria Valim
Subjects: Psoriatic arthritis, medicine.medical_specialty, business.industry, Arthropathy, medicine, medicine.disease, business, Dermatology
Published: 2019
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49. THERAPEUTIC ITINERARIES OF USERS WITH RHEUMATOID ARTHRITIS USING BIOLOGICAL THERAPY IN BRAZILIAN PUBLIC HEALTH SYSTEM – SISTEMA UNICO DE SAUDE (SUS): LIMITS AND POTENTIALITIES

Author: Mirhelen Mendes de Abreu, Bruna Costa Da Mata, Eliana Zandonade, Poliane Sampaio Buffon, Fernanda Lopes, Gabrieli Freitas, and Valeria Valim
Subjects: medicine.medical_specialty, business.industry, Rheumatoid arthritis, Public health, Family medicine, Medicine, business, medicine.disease
Published: 2019
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50. YELLOW FEVER PRIMARY VACCINATION IS SAFE AND EFFECTIVE IN RHEUMATIC AUTOIMMUNE DISEASE

Author: Érica Vieira Serrano, Arthur Dalmaso Pinto, Andre Teixeira Carvalho, Ruben Horst Duque, Valquiria Garcia Dinis, Luiz Felippe Favoretto Genelhu, Daniela Bergamim Pereira, Larissa Carvalho Caser, Priscila Costa Martins Rocha, Elizandra Polito, Luiza Correa Rodrigues, Emily Hime Miranda, João Gabriel Fragoso Dias, Karine Gadioli Oliveira, Sonia Alves Gouvea, Flavia Zon Pretti, Orlindo Assis Martins Filho, Brunela P. Borjaille, Laiza Hombre Dias, Valeria Valim, Sheila Maria Barbosa de Lima, Ingrid de Oliveira Koehlert, Samira Tatiyama Miyamoto, Thays Zanon Casagrande, Maria De Lourdes De Sousa Mais, Enan Sales Magalhães, Lídia Balarini da Silva, Lauro Pereira Da Silva Pinto-Neto, Maryella Dos Santos Giacomim, Maria da Penha Gomes Gouvea, Ana Paula Espíndula Gianordoli, Fernanda Morello Nicole Bastista, Maria Bernadete Renoldi de Oliveira Gavi, Ana Paula Neves Burian, Raquel Altoé Giovelli, Ana Carolina Campi Azevedo, Ana Lidia Silva De Souza, Vanessa Peruhype Magalhães, Ketty Lysie Libardi Lira Machado, Gelaci Sobreiro Pontin, Gisela Freitas Trindade, Leticia Resende Brandao, Bruna Costa da Mata Moura, Maria de Fatima Bissoli, Daniela Linhares Merlo, Carolina Zorzaneli Costa, and Thalles Brandão Clemente
Subjects: Autoimmune disease, business.industry, Primary vaccination, Yellow fever, Immunology, medicine, medicine.disease, business
Published: 2019
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