15 results on '"Carolina de Souza Müller"'
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2. Significant weight loss in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database
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Michael Hughes, Calvin Heal, Elise Siegert, Eric Hachulla, Paolo Airó, Antonella Riccardi, Oliver Distler, Marco Matucci-Cerinic, Andrea Doria, Lorenzo Baretta, Alexandra Balbir-Gurman, Patricia E Carreira, Vanessa Smith, Carlos Alberto, Jörg Distler von Mühlen, Ulf Müller-Ladner, Lidia P Ananieva, László Czirják, Jörg Henes, Jeska de Vries-Bouwstra, Mengtao Li, Fabian Mendoza, Nemanja Damjanov, Ivan Castellví, Alessandro Giollo, Stefan Heitmann, Edoardo Rosato, Lorenzo Dagna, Christopher P Denton, Marie Vanthuyne, Fabio Cacciapaglia, Valeria Riccieri, Nicolas Hunzelmann, Ami Shah, Carlomaurizio Montecucco, Raffaele Pellerito, Ruxandra Maria Ionescu, Simona Rednic, Ulrich Walker, Maria Rosa Pozzi, Anna-Maria Hoffmann-Vold, Marie-Elise Truchetet, Susanne Ullman, Carolina de Souza Müller, Juan Jose Alegre-Sancho, Eduardo Kerzberg, Francesco Del Galdo, Gabriela Riemekasten, Branimir Anic, Marko Baresic, Miroslav Mayer, Fahrettin Oksel, Figen Yargucu, Ellen De Langhe, Ina Kötter, Mohammed Tikly, Radim Becvar, Douglas Veale, Dorota Krasowska, Andrea Lo Monaco, Lidia Rudnicka, Ana Maria Gheorghiu, Piercarlo Sarzi Puttini, Mislav Radic, Armando Gabrielli, Maria João Salvador, Carlos de la Puente, Gabriela Szücs, Sule Yavuz, Rosario Foti, Otylia Kowal Bielecka, Codrina Ancuta, Peter Villiger, Sabine Adler, Patrick Jego, Michaela Kohm, Eugene J Kucharz, Dominique Farge Bancel, Tim Schmeiser, Alberto Cauli, Alessandra Vacca, Kamal Solanki, Piotr Wiland, Paloma García de la Peña Lefebvre, Jorge Juan Gonzalez Martin, Sergio Jimenez, Lesley Ann Saketkoo, Roger Hesselstrand, Francesca Ingegnoli, Jean Sibilia, Merete Engelhart, Esthela Loyo, Carmen Tineo, Francesco Paolo Cantatore, Brigitte Krummel-Lorenz, Petros Sfikakis, Cristiane Kayser, Vera Ortiz Santamaria, Bojana Stamenkovic, Giovanna Cuomo, Francesco Puppo, Thierry Zenone, Nihal Fathi, Ira Litinsky, Carlo Chizzolini, Monika Swacha, Washington Bianchi, Breno Valdetaro Bianchi, Maria Üprus, Kati Otsa, Masataka Kuwana, Panayiotis Vlachoyiannopoulos, Sarah Kahl, Bernard Coleiro, François Spertini, Walid Ahmed Abdel Atty Mohamed, Sergey Moiseev, Pavel Novikov, Dominik Majewski, Simon Stebbings, Svetlana Agachi, Massimiliano Limonta, Carlo Francesco Selmi, Elena Rezus, Kristine Herrmann, Brigitte Granel, Goda Seskute, Matthias Seidel, Paul Hasler, Maurizio Cutolo Vera Bernardino, Carmen Pizzorni, Jadranka Morovic-Vergles, Daniel Furst, Ana-Maria Ramazan, Gianluigi Bajocchi, Lisa Stamp, Doron Rimar, Antonella Marcoccia, Srdan Novak, Luc Mouthon, Jiri Stork, Lorinda S Chung, Hadi Poormoghim, Francis Gaches, Laura Belloli, Cristina-Mihaela Tanaseanu, Fabiola Atzeni, Kilian Eyerich, Ivien M Hsu, Jacob van Laar, Mary Ellen Csuka, Omer Nuri Pamuk, Maura Couto, Arsene Mekinian, Murat Inanc, Ivan Foeldvari, Julia Martínez-Barrio, Yair Levy, Juliana Markus, Susana Oliveira, Hughes, Michael, Heal, Calvin, Siegert, Elise, Hachulla, Eric, Airó, Paolo, Riccardi, Antonella, Distler, Oliver, Matucci-Cerinic, Marco, Doria, Andrea, Baretta, Lorenzo, Balbir-Gurman, Alexandra, E Carreira, Patricia, Smith, Vanessa, Alberto, Carlo, Distler von Mühlen, Jörg, Müller-Ladner, Ulf, P Ananieva, Lidia, Czirják, László, Henes, Jörg, de Vries-Bouwstra, Jeska, Li, Mengtao, Mendoza, Fabian, Damjanov, Nemanja, Castellví, Ivan, Giollo, Alessandro, Heitmann, Stefan, Rosato, Edoardo, Dagna, Lorenzo, P Denton, Christopher, Vanthuyne, Marie, Cacciapaglia, Fabio, Riccieri, Valeria, Hunzelmann, Nicola, Shah, Ami, Montecucco, Carlomaurizio, Pellerito, Raffaele, Maria Ionescu, Ruxandra, Rednic, Simona, Walker, Ulrich, Rosa Pozzi, Maria, Hoffmann-Vold, Anna-Maria, Truchetet, Marie-Elise, Ullman, Susanne, de Souza Müller, Carolina, Jose Alegre-Sancho, Juan, Kerzberg, Eduardo, Del Galdo, Francesco, Riemekasten, Gabriela, Anic, Branimir, Baresic, Marko, Mayer, Miroslav, Oksel, Fahrettin, Yargucu, Figen, De Langhe, Ellen, Kötter, Ina, Tikly, Mohammed, Becvar, Radim, Veale, Dougla, Krasowska, Dorota, Lo Monaco, Andrea, Rudnicka, Lidia, Maria Gheorghiu, Ana, Sarzi Puttini, Piercarlo, Radic, Mislav, Gabrielli, Armando, João Salvador, Maria, de la Puente, Carlo, Szücs, Gabriela, Yavuz, Sule, Foti, Rosario, Kowal Bielecka, Otylia, Ancuta, Codrina, Villiger, Peter, Adler, Sabine, Jego, Patrick, Kohm, Michaela, J Kucharz, Eugene, Farge Bancel, Dominique, Schmeiser, Tim, Cauli, Alberto, Vacca, Alessandra, Solanki, Kamal, Wiland, Piotr, García de la Peña Lefebvre, Paloma, Juan Gonzalez Martin, Jorge, Jimenez, Sergio, Ann Saketkoo, Lesley, Hesselstrand, Roger, Ingegnoli, Francesca, Sibilia, Jean, Engelhart, Merete, Loyo, Esthela, Tineo, Carmen, Paolo Cantatore, Francesco, Krummel-Lorenz, Brigitte, Sfikakis, Petro, Kayser, Cristiane, Ortiz Santamaria, Vera, Stamenkovic, Bojana, Cuomo, Giovanna, Puppo, Francesco, Zenone, Thierry, Fathi, Nihal, Litinsky, Ira, Chizzolini, Carlo, Swacha, Monika, Bianchi, Washington, Valdetaro Bianchi, Breno, Üprus, Maria, Otsa, Kati, Kuwana, Masataka, Vlachoyiannopoulos, Panayioti, Kahl, Sarah, Coleiro, Bernard, Spertini, Françoi, Ahmed Abdel Atty Mohamed, Walid, Moiseev, Sergey, Novikov, Pavel, Majewski, Dominik, Stebbings, Simon, Agachi, Svetlana, Limonta, Massimiliano, Francesco Selmi, Carlo, Rezus, Elena, Herrmann, Kristine, Granel, Brigitte, Seskute, Goda, Seidel, Matthia, Hasler, Paul, Cutolo Vera Bernardino, Maurizio, Pizzorni, Carmen, Morovic-Vergles, Jadranka, Furst, Daniel, Ramazan, Ana-Maria, Bajocchi, Gianluigi, Stamp, Lisa, Rimar, Doron, Marcoccia, Antonella, Novak, Srdan, Mouthon, Luc, Stork, Jiri, S Chung, Lorinda, Poormoghim, Hadi, Gaches, Franci, Belloli, Laura, Tanaseanu, Cristina-Mihaela, Atzeni, Fabiola, Eyerich, Kilian, M Hsu, Ivien, van Laar, Jacob, Ellen Csuka, Mary, Nuri Pamuk, Omer, Couto, Maura, Mekinian, Arsene, Inanc, Murat, Foeldvari, Ivan, Martínez-Barrio, Julia, Levy, Yair, Markus, Juliana, and Oliveira, Susana
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,weight loss, systemic sclerosis, nutrition ,Immunology ,Disease ,computer.software_genre ,General Biochemistry, Genetics and Molecular Biology ,Scleroderma ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Risk Factors ,Weight loss ,Internal medicine ,Weight Loss ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,610 Medicine & health ,Aged ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,Database ,business.industry ,Middle Aged ,medicine.disease ,030104 developmental biology ,Mood ,Databases as Topic ,Female ,Outcomes research ,medicine.symptom ,business ,computer ,Rheumatism - Abstract
Gastrointestinal (GI) involvement is almost universal in patients with systemic sclerosis (SSc) and is associated with significant disease-related morbidity and mortality.1 The entire GI tract can be involved and other disease features (eg, low mood, terminal organ failure and functional hand impairment) can result in significant nutritional impairment. Severe GI involvement has been reported to occur in ~10% of patients with SSc and often occurs early in the course of the disease.2 However, identification of patients at high risk of clinically significant weight loss is extremely challenging, including from the high prevalence of GI symptoms in patients with SSc. Therefore, there is a need to understand high-risk patients including potentially modifiable risk factors, with a view to early intervention strategies. Against this background, the aim of this study was to examine potential clinical risk factors of significant weight loss in patients with SSc. We performed an analysis of patients with SSc enrolled in the multinational, longitudinal European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) database. In our study, we defined significant weight loss as 4.5 kg and/or least 5% of their body weight at 5 months onwards.3 Patients with a recorded second visit after 3 months and before 12 months were included in the analysis. We adopted a pragmatic approach (relevant to clinical practice) in …
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- 2020
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3. Geographic variation as a risk factor for digital ulcers in systemic sclerosis patients: a multicentre registry
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Carolina de Souza Müller, Ejr Souza, H A Mariz, J. Sekiyama, I. P. da Costa, Apt Del-Rio, Amc Horimoto, Andréa Tavares Dantas, C B Kahwage, R A Rezende, Cristiane Kayser, and I Guimarães
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Contracture ,Cross-sectional study ,medicine.medical_treatment ,Immunology ,Disease ,Logistic regression ,Severity of Illness Index ,Scleroderma ,Microscopic Angioscopy ,Fingers ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Risk Factors ,Internal medicine ,Skin Ulcer ,Severity of illness ,Odds Ratio ,medicine ,Humans ,Immunology and Allergy ,Registries ,Risk factor ,skin and connective tissue diseases ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,Geography ,integumentary system ,business.industry ,Smoking ,Raynaud Disease ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Logistic Models ,030104 developmental biology ,Amputation ,Physical therapy ,Female ,business ,Brazil - Abstract
To evaluate the influence of geographic variation on the risk of digital ulcer (DU) development in systemic sclerosis (SSc) patients.This cross-sectional, multicentre study evaluated patients with SSc from centres located in different geographic regions of Brazil (subtropical and tropical climate zones). Demographic and clinical data were collected.The study included 141 patients with SSc (26 from the subtropical and 115 from the tropical zone). In total, 43 DUs were observed in 23 (16%) of the patients. By a simple logistic regression model, the presence of DUs was associated with a higher modified Rodnan skin score, previous necrosis or amputation of the extremities, flexion contracture of the fingers, active smoking, higher avascular score on capillaroscopy, higher severity of Raynaud's phenomenon, a higher Health Assessment Questionnaire Disability Index (HAQ-DI) score, a higher visual analogue scale score for Raynaud's phenomenon and overall disease, and the subtropical climate zone. Using multiple logistic regression, the presence of DUs was significantly associated with patients living in the subtropical climate zone [odds ratio (OR) = 5.4, p = 0.002], necrosis or amputation (OR = 5.2, p = 0.011), and a higher HAQ-DI score (OR = 2.6, p = 0.021).In this multicentre study in a continental country with different climates, patients with SSc living in a subtropical climate region had a 5.4 times higher risk of developing DUs than patients living in a warmer region (tropical climate), suggesting a more severe course of peripheral vasculopathy among patients living in geographic regions with relatively cold weather.
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- 2016
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4. A gender gap in primary and secondary heart dysfunctions in systemic sclerosis: a EUSTAR prospective study
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Antonio C. Zea Mendoza, Jean Sibilia, Kamal Solanki, Cristina Mihaela Tanaseanu, Fredrick M. Wigley, Guido Valesini, M. Govoni, Lisa K. Stamp, Christopher P. Denton, Yolanda Braun-Moscovici, Ruxandra Ionescu, Øyvind Midtvedt, Ileana Nicoara, Aleksandra Stanković, Rüdiger Hein, Alina Dumitrascu, Susanne Ullman, Alan Tyndall, Sergio A. Jimenez, Irena Butrimiene, Alan Doube, Eugene J. Kucharz, Mohammed Tikly, Pier Luigi Meroni, Simon Stebbings, Renata Sokolik, Alexandra Balbir Gurman, Roger Hesselstrand, Kirsten Damgaard, Francesco Paolo Cantatore, Razvan Ionitescu, Silvana Zeni, Marco Matucci-Cerinic, Maria Rosa Pozzi, Jacques-Eric Gottenberg, Srdan Novak, Ana Maria Gherghe, David Launay, Liliana Groppa, Carlomaurizio Montecucco, Roxana Sfrent Cornateanu, Stefan Heitmann, Paloma García de la Peña Lefebvre, Daniela Opris, Peter T. Chapman, Line V. Iversen, Bernard Coleiro, Ulf Müller-Ladner, John Highton, Mara Oleszowsky, Gabriella Szücs, Magdalena Kopec-Medrek, Carlos De La Puente Buijdos, Paola Caramaschi, Magdalena Szmyrka-Kaczmarek, Rucsandra Dobrota, Gabriele Valentini, Fabiana Montoya, Blaz Rozman, Alberto Sulli, Hélène Chifflot, Raffaella Scorza, Patricia Carreira, Paulius Venalis, Lisa Maria Bambara, Torhild Garen, Isabela Tiglea, Agneta Scheja, Duska Martinovic, Jörg H W Distler, Jörg Henes, Giovanni Lapadula, Luc Mouthon, Diana Karpec, Douglas J. Veale, Valeria Riccieri, Nicolas Hunzelmann, Muriel Elhai, Serena Guiducci, Codrina Ancuta, Simonetta Pisarri, Thierry Zenone, Esthela Loyo, Branimir Anić, Claudia Günther, R. Becvar, Eugen Russu, Serena Vettori, Carlo Chizzolini, Vanessa Smith, Mengtao Li, Stanislaw Sierakowsky, Carmel Mallia, Małgorzata Widuchowska, Carolina de Souza Müller, László Czirják, Algirdas Venalis, Adrian Hij, Marta Valero Exposito, Simona Rednic, Miroslav Mayer, Laura Groseanu, Walter Alberto Sifuentes Giraldo, Murray Baron, Dominique Farge, Anna Kotulska, Marko Baresic, Svetlana Agachi, Martin Aringer, Merete Engelhart, John L. O'Donnell, Jérôme Avouac, Filip De Keyser, Ulrich A. Walker, Roberto Caporali, Harald Burkhardt, P. G. Vlachoyiannopoulos, Maurizio Cutolo, Frank A. Wollheim, Edoardo Rosato, Suzanne Kafaja, Valderílio Feijó Azevedo, Kilian Eyerich, Paolo Airò, Emmanuel Chatelus, L. Ananieva, Ira Litinsky, Andrea Lo Monaco, Vanesa Cosentino, Rita Rugiene, Eric Hachulla, P. Saar, Bojana Stamenkovic, Brigitte Krummel-Lorenz, Yannick Allanore, Elisabeth Knott, Oliver Distler, Matthias Seidel, Silvia Rodriguez Rubio, Franco Cozzi, Mihai Bojinca, Nemanja Damjanov, Maria João Salvador, Joanna Busquets, Otylia Kowal Bielecka, André Kahan, Jacek Szechiński, Daniel E. Furst, C. Mihai, Rodica Chirieac, Ewa Morgiel, Georg Schett, Armando Gabrielli, Giovanna Cuomo, Piotr Wiland, Maya N. Starovoytova, Sebastião Cezar Radominski, Gitte Strauss, Lealea Chiaburu, Florenzo Iannone, Carol M. Black, Andrea Himsel, Eduardo Kerzberg, Cecília Varjú, Vera Ortiz Santamaria, Gabriela Riemekasten, Dorota Krasowska, Marilena Gorga, Monica Popescu, Marie O'Rourke, Henrik Nielsen, Raffaele Pellerito, Ada Corrado, Elhai, M, Avouac, J, Walker, Ua, Matucci Cerinic, M, Riemekasten, G, Airò, P, Hachulla, E, Valentini, Gabriele, Carreira, Pe, Cozzi, F, Balbir Gurman, A, Braun Moscovici, Y, Damjanov, N, Ananieva, Lp, Scorza, R, Jimenez, S, Busquets, J, Li, M, Müller Ladner, U, Kahan, A, Distler, O, Allanore, Y, EUSTAR co, Author, EUSTAR co, Authors, Matucci-Cerinic, M, Airo, P, Valentini, G, Gurman, Ab, Braun-Moscovici, Y, Mt, Li, Muller-Ladner, U, Allanore, Y EUSTAR co-authors: Serena Guiducci, Alan, Tyndall, Giovanni, Lapadula, Florenzo, Iannone, Radim, Becvar, Stanislaw, Sierakowsky, Otylia Kowal Bielecka, Maurizio, Cutolo, Alberto, Sulli, Cuomo, Giovanna, Vettori, Serena, Simona, Rednic, Ileana, Nicoara, Vlachoyiannopoulos, P, Montecucco, C, Roberto, Caporali, Srdan, Novak, László, Czirják, Cecilia, Varju, Carlo, Chizzolini, Eugene, J Kucharz, Anna, Kotulska, Magdalena, Kopec-Medrek, Malgorzata, Widuchowska, Blaz, Rozman, Carmel, Mallia, Bernard, Coleiro, Armando, Gabrielli, Dominique, Farge, Adrian, Hij, Roger, Hesselstrand, Agneta, Scheja, Frank, Wollheim, Duska, Martinovic, Govoni, M, Andrea Lo Monaco, Nicolas, Hunzelmann, Raffaele, Pellerito, Lisa Maria Bambara, Paola, Caramaschi, Carol, Black, Christopher, Denton, Jörg, Hene, Vera Ortiz Santamaria, Stefan, Heitmann, Dorota, Krasowska, Matthias, Seidel, Mara, Oleszowsky, Harald, Burkhardt, Andrea, Himsel, Maria, J Salvador, Bojana, Stamenkovic, Aleksandra, Stankovic, Mohammed, Tikly, Maya, N Starovoytova, Merete, Engelhart, Gitte, Strau, Henrik, Nielsen, Kirsten, Damgaard, Gabriella, Szüc, Antonio Zea Mendoza, Carlos de la Puente Buijdos, Walter, A Sifuentes Giraldo, Øyvind, Midtvedt, Torhild, Garen, David, Launay, Guido, Valesini, Valeria, Riccieri, Ruxandra Maria Ionescu, Daniela, Opri, Laura, Groseanu, Fredrick, M Wigley, Carmen, M Mihai, Roxana Sfrent Cornateanu, Razvan, Ionitescu, Ana Maria Gherghe, Marilena, Gorga, Rucsandra, Dobrota, Mihai, Bojinca, Georg, Schett, Jörg Hw Distler, Pierluigi, Meroni, Silvana, Zeni, Luc, Mouthon, Filip De Keyser, Vanessa, Smith, Francesco, P Cantatore, Ada, Corrado, Susanne, Ullman, Line, Iversen, Maria, R Pozzi, Kilian, Eyerich, Rüdiger, Hein, Elisabeth, Knott, Jacek, Szechinski, Piotr, Wiland, Magdalena, Szmyrka-Kaczmarek, Renata, Sokolik, Ewa, Morgiel, Brigitte, Krummel-Lorenz, Petra, Saar, Martin, Aringer, Claudia, Günther, Branimir, Anic, Marko, Baresic, Miroslav, Mayer, Sebastião, C Radominski, Carolina de Souza Müller, Valderílio, F Azevedo, Svetlana, Agachi, Liliana, Groppa, Lealea, Chiaburu, Eugen, Russu, Thierry, Zenone, Simon, Stebbing, John, Highton, Lisa, Stamp, Peter, Chapman, Murray, Baron, John, O'Donnell, Kamal, Solanki, Alan, Doube, Douglas, Veale, Marie, O'Rourke, Esthela, Loyo, Edoardo, Rosato, Simonetta, Pisarri, Cristina-Mihaela, Tanaseanu, Monica, Popescu, Alina, Dumitrascu, Isabela, Tiglea, Rodica, Chirieac, Codrina, Ancuta, Daniel, E Furst, Suzanne, Kafaja, Paloma García de la Peña Lefebvre, Silvia Rodriguez Rubio, Marta Valero Exposito, Jean, Sibilia, Emmanuel, Chatelu, Jacques Eric Gottenberg, Hélène, Chifflot, Ira, Litinsky, Algirdas, Venali, Irena, Butrimiene, Paulius, Venali, Rita, Rugiene, Diana, Karpec, Eduardo, Kerzberg, Fabiana, Montoya, Vanesa, Cosentino, and Chizzolini, Carlo
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0301 basic medicine ,Male ,heart dysfunction ,Databases, Factual ,Epidemiology ,autoimmune diseases ,epidemiology ,systemic sclerosis ,Kaplan-Meier Estimate ,0302 clinical medicine ,Cardiovascular Disease ,Immunology and Allergy ,Prospective Studies ,Age of Onset ,skin and connective tissue diseases ,Prospective cohort study ,ddc:616 ,Orvostudományok ,Middle Aged ,Prognosis ,Connective tissue disease ,3. Good health ,Europe ,Cardiovascular Diseases ,Cohort ,Disease Progression ,Female ,Autoimmune Diseases ,Systemic Sclerosis ,Human ,Adult ,medicine.medical_specialty ,Prognosi ,Immunology ,Socio-culturale ,Klinikai orvostudományok ,Autoimmune Disease ,General Biochemistry, Genetics and Molecular Biology ,Follow-Up Studie ,03 medical and health sciences ,Sex Factors ,Rheumatology ,Internal medicine ,medicine ,Humans ,Sex Distribution ,Systemic Sclerosi ,Aged ,030203 arthritis & rheumatology ,Lupus erythematosus ,Scleroderma, Systemic ,business.industry ,medicine.disease ,Pulmonary hypertension ,Prospective Studie ,030104 developmental biology ,Heart failure ,Age of onset ,business ,Follow-Up Studies - Abstract
OBJECTIVES: In agreement with other autoimmune diseases, systemic sclerosis (SSc) is associated with a strong sex bias. However, unlike lupus, the effects of sex on disease phenotype and prognosis are poorly known. Therefore, we aimed to determine sex effects on outcomes. METHOD: We performed a prospective observational study using the latest 2013 data extract from the EULAR scleroderma trials and research (EUSTAR) cohort. We looked at (i) sex influence on disease characteristics at baseline and (ii) then focused on patients with at least 2 years of follow-up to estimate the effects of sex on disease progression and survival. RESULTS: 9182 patients with SSc were available (1321 men) for the baseline analyses. In multivariate analysis, male sex was independently associated with a higher risk of diffuse cutaneous subtype (OR: 1.68, (1.45 to 1.94); p
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- 2014
5. Nailfold capillaroscopy in leprosy
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Fabiane Mulinari-Brenner, Vanessa Irusta Dal Pizzol, Scheila Fritsch, Gabriela Poglia Fonseca, Vanessa Cristhine Dalombo Ottoboni, Carolina de Souza Müller, and Adma Silva de Lima
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Dermatology ,Microscopic Angioscopy ,Nail Diseases ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Leprosy ,medicine ,Humans ,In patient ,Mycobacterium leprae ,Aged ,Nailfold Capillaroscopy ,030203 arthritis & rheumatology ,Leprosy, paucibacillary ,biology ,business.industry ,Communication ,Middle Aged ,medicine.disease ,biology.organism_classification ,Leprosy, Tuberculoid ,Leprosy, borderline ,Leprosy, Lepromatous ,Nails ,Leprosy, tuberculoid ,RL1-803 ,Leprosy, Multibacillary ,Female ,business ,Leprosy, lepromatous - Abstract
Due to mounting evidences of interaction between Hansen's bacilli with endothelial cells and the paucity of studies addressing the presence of nailfold capillaroscopic alterations in patients with Hansen's disease, a study was carried out in order to verify the presence of capillaroscopic alterations in patients with leprosy in its various forms and its correlation with clinical parameters. Ten patients were evaluated at a specialized university service. Sixty percent of those had some capillaroscopic change, such as micro-hemorrhages, ectatic, bushy and corkscrew capillaries. Such changes were unspecific, which suggests there is not a specific pattern for this disease.
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- 2016
6. Autoantibody profile and clinical correlation in a group of patients with systemic sclerosis in southern Brazil
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Valderílio Feijó Azevedo, Sebastião Cezar Radominski, Carolina de Souza Müller, José Hermênio Cavalcante Lima Filho, and Eduardo dos Santos Paiva
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medicine.medical_specialty ,Pathology ,systemic sclerosis ,autoantibodies ,Cross-sectional study ,Population ,Disease ,Scleroderma ,Rheumatology ,Internal medicine ,Synovitis ,Cardiac conduction ,medicine ,Outpatient clinic ,skin and connective tissue diseases ,education ,education.field_of_study ,integumentary system ,business.industry ,autoimmunity ,Autoantibody ,Escleroderma sistêmico ,medicine.disease ,autoimunidade ,autoanticorpos ,business - Abstract
OBJETIVOS: Este estudo visou à análise das manifestações da esclerose sistêmica (ES), com ênfase na pesquisa dos autoanticorpos e de suas correlações clínicas, na população de pacientes em acompanhamento no ambulatório de ES do Hospital de Clínicas da Universidade Federal do Paraná. METODOLOGIA: Realizou-se um estudo transversal com 96 pacientes em acompanhamento no ambulatório de ES do hospital, entre setembro de 2007 e setembro de 2009. RESULTADOS: A maioria dos pacientes era do sexo feminino, com idade entre a quarta e quinta décadas e tempo de doença com mediana de 10 anos. A forma cutânea limitada de ES foi a mais prevalente. Na análise dos autoanticorpos, o anticorpo anticentromérico (ACA) associou-se a ES forma limitada, idade mais avançada ao diagnóstico, maior tempo de doença, intervalo maior entre o surgimento do fenômeno de Raynaud (FRy) e o primeiro sintoma não FRy, maior prevalência de hipertensão arterial sistêmica (HAS) e de bloqueios de condução cardíaca. O anticorpo antitopoisomerase-1 (antitopo-1, previamente denominado anti-Scl-70) foi mais comum na forma difusa da ES, na presença de doença ativa e de úlceras digitais. O anticorpo anti-RNA polimerase III (antipol III) correlacionou-se com a forma difusa de ES, presença de doença ativa e sinovite. CONCLUSÕES: Este estudo vem ressaltar e ratificar o papel relevante dos autoanticorpos na avaliação dos pacientes com ES, sendo possível correlacionar o perfil autoimune dessa população com manifestações específicas da doença OBJECTIVES: To assess the manifestations of systemic sclerosis (SSc), with an emphasis on the analysis of autoantibodies and their clinical correlations, in a population of patients followed up at the SSc Outpatient Clinics of the Hospital de Clínicas of the Universidade Federal do Paraná. METHODOLOGY: Cross-sectional study with 96 patients followed up at the SSc Outpatient Clinics of the hospital between September 2007 and September 2009. RESULTS: Most patients were of the female sex, in their forties or fifties, and the median time of disease was ten years. The limited cutaneous form of SSc was more prevalent. The analysis of the autoantibodies showed the association of anticentromere antibody (ACA) with the following: the limited form of SSc; more advanced age at the time of diagnosis; longer disease time; longer interval between the appearance of the Raynaud's phenomenon (RyP) and the first non-RyP symptom; systemic arterial hypertension (SAH); and cardiac conduction blocks. The antitopoisomerase-1 antibody (ATA-1, previously called anti-Scl-70) was more common in the presence of the diffuse form of SSc, active disease, and digital ulcers. The anti-RNA polymerase III antibody (anti-Pol III) correlated with the diffuse form of SSc, disease activity, and synovitis. CONCLUSIONS: This study emphasizes and confirms the important role of autoantibodies in assessing patients with SSc, allowing the correlation between the autoimmune profile of patients with SSc and specific manifestations of the disease
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- 2011
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7. Uso da capilaroscopia ungueal como método diagnóstico e prognóstico de rosácea
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Carolina de Souza Müller, Adma Silva de Lima Wojcik, Fabiane Mullinari Brenner, and Gabriela Poglia Fonseca
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medicine.medical_specialty ,business.industry ,Dermatology ,medicine.disease ,Control subjects ,Surgery ,Metronidazole ,Rosacea ,medicine ,Stage (cooking) ,business ,Nailfold Capillaroscopy ,medicine.drug - Abstract
FUNDAMENTOS: Não há um método adequado e fidedigno de avaliação e seguimento da severidade na rosácea. OBJETIVO: Determinar a importância da capilaroscopia periungueal como método diagnóstico e prognóstico em pacientes portadores de rosácea. MÉTODOS: Estudo transversal onde foram submetidos ao exame da capilaroscopia periungueal 8 pacientes com rosácea e 8 controles no período entre maio e julho de 2009. Foram coletados dados clínicos relacionados ao sexo, idade, fototipo, classificação da rosácea de acordo com a classificação de Plewig e Kligman e a classificação da National Rosacea Society. Adicionalmente, avaliamos o tempo de evolução da doença e tratamentos previamente utilizados. RESULTADOS: A grande maioria das pacientes avaliadas (6 das 8 pacientes) apresentavam rosácea grau I (vascular) ou eritêmato-teleangiectásica. A idade média de duração da rosácea foi de 5,96 anos, sendo que 87,5% faziam tratamento com metronidazol tópico. Nenhum paciente tanto do grupo rosácea como controle demonstrou evidência de desvascularização ao exame capilaroscópico. CONCLUSÃO: A capilaroscopia periungueal apresenta um padrão inespecífico e não parece auxiliar no diagnóstico ou prognóstico da rosácea.
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- 2011
- Full Text
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8. A comparison between nailfold capillaroscopy patterns in adulthood in juvenile and adult-onset systemic sclerosis: A EUSTAR exploratory study
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F. Lauffer, Kati Otsa, Oliver Distler, S. Zeni, Marco Matucci Cerinic, Maria Rosa Pozzi, Margarita Pileckyte, John Highton, Paola Caramaschi, Jacek Szechiński, Maria João Salvador, Diana Karpec, Maurizio Cutolo, Codrina Ancuta, Patrizia Boracchi, Simonetta Pisarri, Fabiana Montoya, Vanessa Smith, Mengtao Li, Carolina de Souza Müller, Patricia Carreira, C. Mihai, Henrik Nielsen, Luc Mouthon, L. Denisov, Marc Frerix, Pier Luigi Meroni, Øyvind Midtvedt, Francesco Paolo Cantatore, Ada Corrado, Sebastião Cezar Radominski, Serena Guiducci, Francesco Puppo, Simon Stebbings, Armando Gabrielli, Giovanna Cuomo, Irena Butrimiene, Piotr Wiland, Ira Litinsky, Maria Uprus, Merete Engelhart, Roger Hesselstrand, Ulrich A Walker, Rodica Chirieac, Ulf Müller-Ladner, David Launay, Kirsten Damgaard, Kamal Solanki, Cristina Mihaela Tanaseanu, Torhild Garen, Isabela Tiglea, Aleksandra Stanković, L. Ananieva, Francesca Ingegnoli, Magdalena Szmyrka-Kaczmarek, Jörg Henes, Alan Tyndall, Roberta Gualtierotti, Rüdiger Hein, Ewa Morgiel, Edoardo Rosato, Ivan Foeldvari, Valderílio Feijó Azevedo, Gitte Strauss, Valeria Riccieri, Anna Kotulska, Marta Valero Exposito, R. Becvar, José António Pereira da Silva, Blaz Rozman, Vera Ortiz-Santamaria, Paloma García de la Peña Lefebvre, Szilvia Szamosi, Małgorzata Widuchowska, Gabriella Szücs, Martin Aringer, Paulius Venalis, Roberto Caporali, Kilian Eyerich, Florenzo Iannone, Alina Dumitrascu, Eugene J. Kucharz, Laura Groseanu, Alessandra Vacca, Monica Popescu, Cristiane Kayser, Yannick Allanore, Brigitte Krummel-Lorenz, P. Saar, Mihai Bojinca, Magdalena Kopec-Medrek, Eduardo Kerzberg, Cecília Varjú, Nemanja Damjanov, Luis Eduardo Coelho Andrade, Rita Rugiene, Paolo Airò, Filip De Keyser, Nicola Ughi, Bojana Stamenkovic, Claudia Günther, Ruxandra Ionescu, László Czirják, Matthias Seidel, Silvia Rodriguez Rubio, Paola Gottschalk, Dirk M. Wuttge, Alan Doube, Vanesa Cosentino, Thierry Zenone, Dominique Farge-Bancel, Esthela Loyo, Algirdas Venalis, Renata Sokolik, Alberto Sulli, Rosario Foti, Stefan Heitmann, Eric Hachulla, Juan José Alegre-Sancho, Carlomaurizio Montecucco, Daniela Opris, Ingegnoli, F, Boracchi, P, Gualtierotti, R, Smith, V, Cutolo, M, Foeldvari, I, Airò, P, Alegre-Sancho, Jj, Allanore, Y, Ananieva, Lp, Ancuta, C, Andrade, Le, Aringer, M, Becvar, R, Bojinca, M, Butrimiene, I, Cantatore, Fp, Caporali, R, Caramaschi, P, Carreira, Pe, Chirieac, R, Corrado, A, Cosentino, V, Cuomo, G, Czirjak, L, Da Silva, Ja, la Peña Lefebvre, Pg, De Keyser, F, de Souza Müller, C, Damgaard, K, Damjanov, N, Denisov, Ln, Distler, O, Doube, A, Dumitrascu, A, Engelhart, M, Exposito, Mv, Eyerich, K, Farge-Bancel, D, Azevedo, Vf, Foti, R, Frerix, M, Gabrielli, A, Garen, T, Gottschalk, P, Groseanu, L, Guiducci, S, Günther, C, Hachulla, Hein, R, Heitmann, S, Henes, J, Hesselstrand, R, Highton, J, Iannone, F, Ionescu, Rm, Kayser, C, Karpec, D, Kerzberg, E, Kotulska, A, Kopec-Medrek, M, Kucharz, E, Krummel-Lorenz, B, Lauffer, F, Launay, D, Li, M, Litinsky, I, Loyo, E, Cerinic, Mm, Meroni, P, Midtvedt, Ø, Mihai, Cm, Montecucco, C, Montoya, F, Morgiel, E, Mouthon, L, Müller-Ladner, U, Nielsen, H, Opris, D, Ortiz-Santamaria, V, Otsa, K, Pileckyte, M, Pisarri, S, Popescu, M, Pozzi, Mr, Puppo, F, Radominski, Sc, Riccieri, V, Rosato, E, Rozman, B, Rubio, Sr, Rugiene, R, Saar, P, Salvador, Mj, Seidel, M, Sokolik, R, Solanki, K, Stamenkovic, B, Stankovic, A, Stebbings, S, Strauss, G, Sulli, A, Szamosi, S, Szechinski, J, Szmyrka-Kaczmarek, M, Szücs, G, Tanaseanu, Cm, Tiglea, I, Tyndall, A, Ughi, N, Uprus, M, Vacca, A, Varju, C, Venalis, A, Venalis, P, Walker, Ua, Widuchowska, M, Wiland, P, Wuttge, Dm, Zeni, S, and Zenone, T.
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Adolescent ,Klinikai orvostudományok ,Biochemistry ,Juvenile systemic sclerosi ,Scleroderma ,Microscopic Angioscopy ,Systemic sclerosi ,Scleroderma, Localized ,Young Adult ,Medicine ,Juvenile ,Humans ,Young adult ,Age of Onset ,skin and connective tissue diseases ,Child ,Nailfold Capillaroscopy ,Videocapillaroscopy ,Aged ,Retrospective Studies ,EUSTAR ,Scleroderma, Systemic ,integumentary system ,Capillaroscopy ,business.industry ,Similar distribution ,Microcirculation ,Autoantibody ,Retrospective cohort study ,Orvostudományok ,Cell Biology ,Middle Aged ,medicine.disease ,Dermatology ,Capillaries ,Nailfold capillaroscopy ,Female ,Age of onset ,Cardiology and Cardiovascular Medicine ,business ,Juvenile systemic sclerosis ,Systemic sclerosis - Abstract
Objective: Qualitative capillaroscopy patterns in juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database. Methods: Data collected between June 2004 and April 2013 were examined with focus on capillaroscopy. In this retrospective exploratory study, series of patients with juvenile-onset SSc were matched with series of adult-onset SSc having the same gender and autoantibody profile. Results: 30 of 123 patients with juvenile-onset and 2108 of 7133 with adult-onset SSc had data on capillaroscopy. Juvenile-onset SSc showed scleroderma pattern more frequently than adult-onset SSc (93.3% and 88%). The OR was 2.44 and 95% Cl 0.57-10.41. An active scleroderma pattern was present in 58% of juvenile- and 61% of adult-onset SSc. The OR was 0.91 and 95% Cl 0.28-2.93. The late scleroderma pattern was present in 61% of juvenile- and 55.5% of adult-onset SSc. The OR was 1.06 and 95% Cl 0.34-3.56. Conclusion: This is the first exploratory study on the comparison of capillaroscopy between juvenile- and adult-onset SSc in adulthood. Juvenile-onset SSc had an increase prevalence of sderoderma pattern, but a similar distribution of the three patterns was suggested. Further studies are needed to define this issue. (C) 2015 Elsevier Inc. All rights reserved.
- Published
- 2015
9. Pulmonary magnetic resonance imaging is similar to chest tomography in detecting inflammation in patients with systemic sclerosis
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Danny Warszawiak, Eduardo dos Santos Paiva, Dante L. Escuissato, and Carolina de Souza Müller
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Adult ,Male ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Adolescent ,Population ,Inflammation ,Disease ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Medicine ,Humans ,In patient ,Chest tomography ,education ,Computed tomography ,Lung ,General Environmental Science ,Aged ,030203 arthritis & rheumatology ,Aged, 80 and over ,education.field_of_study ,Scleroderma, Systemic ,medicine.diagnostic_test ,business.industry ,Interstitial lung disease ,Magnetic resonance imaging ,respiratory system ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,respiratory tract diseases ,medicine.anatomical_structure ,Cross-Sectional Studies ,030228 respiratory system ,Magnetic resonance ,Case-Control Studies ,General Earth and Planetary Sciences ,Systemic sclerosis ,Female ,Radiology ,medicine.symptom ,lcsh:RC925-935 ,business ,Tomography, X-Ray Computed - Abstract
Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are prevalent complications of systemic sclerosis (SSc) and are currently the leading causes of death related to the disease. The accurate recognition of these conditions is therefore of utmost importance for patient management. A study was carried out with 24 SSc patients being followed at the Rheumatology Department of the Hospital de Clínicas of Universidade Federal do Paraná (UFPR) and 14 healthy volunteers, with the objective of evaluating the usefulness of lung magnetic resonance imaging (MRI) when assessing ILD in SS patients. The results obtained with lung MRI were compared to those obtained by computed tomography (CT) of the chest, currently considered the examination of choice when investigating ILD in SS patients. The assessed population was predominantly composed of women with a mean age of 50 years, limited cutaneous SS, and a disease duration of approximately 7 years. In most cases, there was agreement between the findings on chest CT and lung MRI. Considering it is a radiation-free examination and capable of accurately identifying areas of lung tissue inflammatory involvement, lung MRI showed to be a useful examination, and further studies are needed to assess whether there is an advantage in using lung MRI instead of chest CT when assessing ILD activity in SS patients.
- Published
- 2015
10. Rituximab-induced regression of CREST-related calcinosis
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Valderílio Feijó Azevedo, Carolina de Souza Müller, Pedro Gabriel Lorencetti, Dayane Raquel de Paula, and Fabiane Barbero Klem
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medicine.medical_specialty ,Pulmonary Fibrosis ,Arthritis ,Scleroderma ,Antibodies, Monoclonal, Murine-Derived ,Rheumatology ,Scleroderma, Limited ,Calcinosis ,Internal medicine ,Synovitis ,Humans ,Medicine ,business.industry ,Remission Induction ,Lung fibrosis ,General Medicine ,Middle Aged ,medicine.disease ,Dermatology ,Antirheumatic Agents ,Female ,Crest ,Rituximab ,business ,medicine.drug - Abstract
About a quarter of sclerodermic patients present calcinosis. However, patients with limited form of the disease are more likely to have calcinosis than patients with diffuse form. We report a case of a 54-year-old female patient with limited cutaneous scleroderma using rituximab (RTX) to treat lung fibrosis and arthritis. Into RTX treatment, she also had a complete resolution of calcinosis in her hands. The patient reported improvement in dyspnea and synovitis after two courses of RTX (four weekly infusions 375 mg/m(2) each). After 7 months of the first infusion, the calcinosis in her fingers had a complete remission, especially the right thumb. Based on current evidences, we discuss the use of rituximab as a promising therapy to treat not only lung disease but also calcinosis in patients with scleroderma.
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- 2012
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11. Envolvimento das musculaturas esquelética e cardíaca na esclerose sistêmica
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Eduardo dos Santos Paiva, Carolina de Souza Müller, and Lilian Schade
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left ventricular dysfunction ,medicine.medical_specialty ,disfunção ventricular esquerda ,Ejection fraction ,business.industry ,systemic sclerosis ,Skeletal muscle ,miosite ,medicine.disease ,Positive correlation ,Gastroenterology ,Surgery ,Atrophy ,medicine.anatomical_structure ,Rheumatology ,escleroderma sistêmico ,Internal medicine ,medicine ,In patient ,medicine.symptom ,Myopathy ,Serum creatine phosphokinase ,business ,myositis ,Myositis - Abstract
Pacientes com Esclerose Sistêmica (ES) podem apresentar envolvimento muscular na forma de miosite ou miopatianão inflamatória. É verificada também associação entre acometimento muscular e disfunção ventricular esquerda (DVE) em pacientes com ES, o que lhes confere pior prognóstico. Avaliamos 87 pacientes do Hospital de Clínicas da Universidade Federal do Paraná, com diagnóstico de ES, quanto à presença de manifestações da musculatura esquelética e a relação destas com DVE. Verificamos uma prevalência de 42,5% de acometimento muscular nos pacientes avaliados, observando uma correlação positiva com a forma difusa da doença. Afastadas outras causas de DVE, três dos quatro pacientes com fração de ejeção abaixo do valor de normalidade apresentaram alteração de força muscular, atrofia e/ou elevação de enzima creatinofosfoquinase sérica (CPK) Patients with systemic sclerosis (SSc) can have muscle involvement in the form of myositis or non-infl ammatory myopathy. The muscle involvement can be associated with left ventricular dysfunction (LVD) in patients with SSc, resulting in worse prognosis. Eighty-seven patients of the Hospital de Clínicas of the Universidade Federal do Paraná, diagnosed with SSc, were assessed regarding the presence of skeletal muscle manifestations and their relation with LVD. A 42.5% prevalence of muscle involvement was observed in the patients studied, as well as a positive correlation with the diffuse form of the disease. Excluding other causes of LVD, three of the four patients with ejection fraction below the normal reference value had alteration of the muscle strength, atrophy and/or serum creatine phosphokinase (CPK) elevation
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- 2011
12. Preliminary criteria for the very early diagnosis of systemic sclerosis: results of a Delphi Consensus Study from EULAR Scleroderma Trials and Research Group
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Chris T. Derk, Wanda Maglione, Ileana Nicoara, Ulrich A. Walker, Alexandra Balbir-Gurman, Evelien Ton, R. E. de Souza, Branimir Anić, Roberto Caporali, L. Lonzetti, Jiri Stork, Daniela Opris, Ina Kötter, Stefan Heitmann, Stefano Bombardieri, J.M. van Laar, Evgeny Nasonov, Paul Hasler, Srdan Novak, S. Alhasani, Yannick Allanore, James R. Seibold, Murat Inanc, C. A. Von Mühlen, Raffaella Scorza, P. Eilbacher, G. Udrea, Oliver Distler, Brigitte Krummel-Lorenz, Britta Maurer, Otylia Kowal-Bielecka, Valeria Riccieri, Gianluca Moroncini, Alberto Sulli, Daniel E. Furst, Susanne Ullman, Y. Braun, Alessandro Mathieu, F. Stoeckl, I. Miniati, Percival D. Sampaio-Barros, Nemanja Damjanov, Henrik Nielsen, Patricia Carreira, Raffaele Pellerito, M. Buslau, Marco Matucci-Cerinic, E. De Langhe, Thierry Zenone, Peter Nash, D. Comina, Armando Gabrielli, Luc Mouthon, Jae Bum Jun, G. Riemekasten, Blaž Rozman, N. Del Papa, L. Alhajjar, Jutta G Richter, Jaap Fransen, Eric Hachulla, Stanislaw Sierakowsky, Miroslav Mayer, Małgorzata Widuchowska, Nicolas Hunzelmann, Ingo H. Tarner, M. Saracco, Coziana Ciurtin, Carlo Chizzolini, Maurizio Cutolo, P. Rehberger, Matthias Seidel, R. Ionitescu, Simona Rednic, Ulf Müller-Ladner, Paola Caramaschi, F.H.J. van den Hoogen, J.A. Pereira da Silva, Camillo Ribi, Christopher P. Denton, S. Bellando Randone, Magdalena Szmyrka-Kaczmarek, A Tyndall, Carmen Pizzorni, D. Launay, Jérôme Avouac, Rene Westhovens, Margitta Worm, Frank A. Wollheim, M. Lemos Lopes, C. Mihai, A. Sipek-Dolnicar, Alessandra Vacca, M. Meurer, Laura Bazzichi, Cord Sunderkötter, Cecília Varjú, Eugeniusz J. Kucharz, Søren Jacobsen, Vanessa Smith, Richard M. Silver, Gabriele Valentini, AT Kotulska, F De Keyser, M. Baresic, E. Rath, Marie Vanthuyne, Carolina de Souza Müller, S. Popa, Guido Valesini, Madelon C. Vonk, Dominique Farge, Ruxandra Ionescu, P. Coelho, B. Granel, A. Della Rossa, Maria João Salvador, T. Tourinho, Annegret Kuhn, Ewa Morgiel, C. Durant, L. Czirják, Maria Uprus, Tatiana Nevskaya, Paolo Amerio, Paolo Airò, Hans P. Kiener, D. Vealex, Avouac, J, Fransen, J, Walker, Ua, Riccieri, V, Smith, V, Muller, C, Miniati, I, Tarner, Ih, Randone, Sb, Cutolo, M, Allanore, Y, Distler, O, Valentini, Gabriele, Czirjak, L, MÜLLER LADNER, U, Furst, De, Tyndall, A, MATUCCI CERINIC, M, Eustar, Group, and University of Zurich
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medicine.medical_specialty ,Delphi Technique ,2745 Rheumatology ,Immunology ,MEDLINE ,Delphi method ,610 Medicine & health ,Skin Diseases ,General Biochemistry, Genetics and Molecular Biology ,Scleroderma ,Microscopic Angioscopy ,Diagnosis, Differential ,Fingers ,Rheumatology ,1300 General Biochemistry, Genetics and Molecular Biology ,medicine ,Immunology and Allergy ,Edema ,Humans ,skin and connective tissue diseases ,computer.programming_language ,Core set ,2403 Immunology ,Scleroderma, Systemic ,business.industry ,10051 Rheumatology Clinic and Institute of Physical Medicine ,Raynaud Disease ,medicine.disease ,Surgery ,Early Diagnosis ,Family medicine ,Antibodies, Antinuclear ,Cohort ,2723 Immunology and Allergy ,diagnostic criteria ,early diagnosis ,systemic sclerosis ,Evaluation of complex medical interventions Auto-immunity, transplantation and immunotherapy [NCEBP 2] ,Observational study ,business ,computer ,Delphi ,Rheumatism - Abstract
ObjectiveTo identify a core set of preliminary items considered as important for the very early diagnosis of systemic sclerosis (SSc).MethodsA list of items provided by European League Against Rheumatism (EULAR) Scleroderma Trial and Research(EUSTAR) centres were subjected to a Delphi exercise among 110 experts in the field of SSc. In round 1, experts were asked to choose the items they considered as the most important for the very early diagnosis of SSc. In round 2, experts were asked to reconsider the items accepted after the first stage. In round 3, the clinical relevance of selected items and their importance as measures that would lead to an early referral process were rated using appropriateness scores.ResultsPhysicians from 85 EUSTAR centres participated in the study and provided an initial list of 121 items. After three Delphi rounds, the steering committee, with input from external experts, collapsed the 121 items into three domains containing seven items, developed as follows: skin domain (puffy fingers/puffy swollen digits turning into sclerodactily); vascular domain (Raynaud's phenomenon, abnormal capillaroscopy with scleroderma pattern) and laboratory domain (antinuclear, anticentromere and antitopoisomerase-I antibodies). Finally, the whole assembly of EUSTAR centres ratified with a majority vote the results in a final face-to-face meeting.ConclusionThe three Delphi rounds allowed us to identify the items considered by experts as necessary for the very early diagnosis of SSc. The validation of these items to establish diagnostic criteria is currently ongoing in a prospective observational cohort.
- Published
- 2010
13. Manifestações clínicas e laboratoriais de polimiosite em um caso de leptospirose
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Acir Rachid Filho, Eduardo dos Santos Paiva, David C. Titton, and Carolina de Souza Müller
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Pathology ,medicine.medical_specialty ,Rheumatology ,business.industry ,medicine ,Disease ,medicine.disease ,business ,Leptospirosis ,Polymyositis ,Dermatology ,Myositis ,Infectious agent - Abstract
Sometimes, it is not possible to establish an obvious distinction between the muscular manifestations due to infectious diseases and the idiopathic myositis. In fact, in some situations it is believed there is a causal relationship between those diseases. We describe the case of a patient with clinical and laboratorial features of polymyositis who had developed leptospirosis previously. The hypothesis of the infectious agent acting as a "trigger" to the muscular disease is discussed.
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- 2006
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14. Hipertensão arterial pulmonar e acidente vascular encefálico em paciente com Arterite de Takayasu
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Sebastião Cezar Radominski, Salun Coelho Aragão, Carolina de Souza Müller, Eduardo dos Santos Paiva, and Carlos Frederico Rodrigues Parchen
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Aorta ,medicine.medical_specialty ,business.industry ,Vascular inflammation ,Takayasu arteritis ,medicine.disease ,Stenosis ,Rheumatology ,Great vessels ,medicine.artery ,Internal medicine ,Pulmonary artery ,cardiovascular system ,Cardiology ,Medicine ,Radiology ,business ,Vasculitis - Abstract
Takayasu arteritis (TA) is a rare illness characterized by vasculitis of great vessels, mainly of aorta and its branches. The vascular inflammation leads to irregularities of the vessel wall causing stenosis and aneurysms. The pulmonary artery (PA) involvement is frequent in TA. Despite this, the development of pulmonary arterial hypertension is less common, modifying the treatment and the prognosis of the patients. We describe a case of a patient with TA with multiple stenosis in pulmonary arteries, pulmonary arterial hypertension and cerebrovascular disease, as well as review of the literature on the subject.
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- 2006
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15. Paralisia periódica hipocalêmica na síndrome de Sjögren
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José Gastão Rocha de Carvalho, Sinara da Silva Freitas, Carolina de Souza Müller, Carlos Frederico Rodrigues Parchen, and Acir Rachid Filho
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Mechanical ventilation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Periodic paralysis ,medicine.disease ,Intensive care unit ,Surgery ,law.invention ,Rheumatology ,Renal tubular dysfunction ,Distal renal tubular acidosis ,law ,Anesthesia ,medicine ,Paralysis ,Breathing ,medicine.symptom ,business ,Subclinical infection - Abstract
Subclinical renal tubular dysfunction in Sjogren's syndrome can affect a significant number of patients, the majority presenting with distal renal tubular acidosis (type 1). Such findings may be the first symptom of the auto-immune disease, and can contribute for a prolonged disease duration and severity. Potassium depletion resulting from distal renal tubular acidosis can be extremely severe, and can jeopardise patient's life, if its diagnosis and treatment are delayed. Hypocalemic periodic paralysis was observed in almost 40% of patients who suffer from Sjogren's syndrome and distal renal tubular acidosis. The case that follows describes a patient who was diagnosed with Sjogren's syndrome four years ago. Three days before being admitted to hospital, the patient complained that her lower limbs were numb and weak, and that breathing was difficult. Symptoms intensified, the patient was broght to the Intensive Care Unit, where the serum potassium was 2 mEq/L at admittance. Hypocalemic paralysis was diagnosed, and the patient was immediately treated with IV KCl 19.1% and supplementary oxygen by mask. Mechanical ventilation was not required. The patient was discharged with serum potassium corrected to 3.4 mEq/L.
- Published
- 2006
- Full Text
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