12 results on '"Cunha Santos, Filipe"'
Search Results
2. Risk Factors for Infection, Predictors of Severe Disease, and Antibody Response to COVID-19 in Patients With Inflammatory Rheumatic Diseases in Portugal-A Multicenter, Nationwide Study
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Machado, Ana Rita, Barreira, Sofia, Bandeira, Matilde, Veldhoen, Marc, Gomes, Andreia, Serrano, Marta, Duarte, Catarina, Rato, Maria, Miguel Fernandes, Bruno, Garcia, Salomé, Pinheiro, Filipe, Bernardes, Miguel, Madeira, Nathalie, Miguel, Cláudia, Torres, Rita, Bento Silva, Ana, Pestana, Jorge, Almeida, Diogo, Mazeda, Carolina, Cunha Santos, Filipe, Pinto, Patrícia, Sousa, Marlene, Parente, Hugo, Sequeira, Graça, Santos, Maria José, Fonseca, João Eurico, Romão, Vasco C., and Repositório da Universidade de Lisboa
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Inflammatory rheumatic diseases ,SARS-CoV-2 ,Seroconversion ,Antibody response ,COVID-19 ,General Medicine - Abstract
Copyright © 2022 Cruz-Machado, Barreira, Bandeira, Veldhoen, Gomes, Serrano, Duarte, Rato, Miguel Fernandes, Garcia, Pinheiro, Bernardes, Madeira, Miguel, Torres, Bento Silva, Pestana, Almeida, Mazeda, Cunha Santos, Pinto, Sousa, Parente, Sequeira, Santos, Fonseca and Romão. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms., Objective: To identify risk factors for SARS-CoV-2 infection and for severe/critical COVID-19, and to assess the humoral response after COVID-19 in these patients. Methods: Nationwide study of adult patients with inflammatory RMDs prospectively followed in the Rheumatic Diseases Portuguese Register-Reuma.pt-during the first 6 months of the pandemic. We compared patients with COVID-19 with those who did not develop the disease and patients with mild/moderate disease with those exhibiting severe/critical COVID-19. IgG antibodies against SARS-CoV-2 were measured ≥3 months after infection and results were compared with matched controls. Results: 162 cases of COVID-19 were registered in a total of 6,363 appointments. Patients treated with TNF inhibitors (TNFi; OR = 0.160, 95% CI 0.099-0.260, P < 0.001) and tocilizumab (OR 0.147, 95% CI 0.053-0.408, P < 0.001) had reduced odds of infection. Further, TNFi tended to be protective of severe and critical disease. Older age, major comorbidities, and rituximab were associated with an increased risk of infection and worse prognosis. Most patients with inflammatory RMDs (86.2%) developed a robust antibody response. Seroconversion was associated with symptomatic disease (OR 13.46, 95% CI 2.21-81.85, P = 0.005) and tended to be blunted by TNFi (OR 0.17, 95% CI 0.03-1.05; P = 0.057). Conclusions: TNFi and tocilizumab reduced the risk of infection by SARS-CoV-2. Treatment with TNFi also tended to reduce rates of severe disease and seroconversion. Older age, general comorbidities and rituximab were associated with increased risk for infection and worse prognosis, in line with previous reports. Most patients with RMDs developed a proper antibody response after COVID-19, particularly if they had symptomatic disease., We acknowledge the generous sharing of the expression constructs by Dr. Florian Krammer, Icahn School of Medicine at Mount Sinai, New York, USA [Development of SARS-CoV-2 reagents was partially supported by the NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C] and the protein production by Drs. Paula Alves and Rute Castro at Instituto de Biologia Experimental e Tecnológica (iBET) Oeiras, Portugal as part of the Serology COVID consortium.
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- 2022
3. Systemic sclerosis and rheumatoid arthritis overlap syndrome – management of severe cardiac, pulmonary and articular involvement.
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Sofia Pinto, Ana, Cunha Santos, Filipe, Paiva Dinis, Sara, Madeira, Nathalie, Fonseca Ferreira, Joana, and Vaz, Claúdia
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SYSTEMIC scleroderma , *RHEUMATOID arthritis , *MEDICAL screening , *SYNDROMES - Abstract
Introduction: The presence of another rheumatological condition in patients with systemic sclerosis (SSc) is not uncommon. To report a case of a patient with SSc-RA overlap and perform a review of the cases reported in the literature. Material and methods: A chart review of the present case report was performed. After, we performed a literature search in MEDLINE, EMBASE and Cochrane databases. Results: We included 26 articles. Sixty-three patients were reviewed, 51 were female with a mean age of 45.03 years at the time of the first diagnosis. Sixty-three patients were diagnosed with limited cutaneous SSc. Regarding organ involvement, the most frequently reported were cutaneous, vascular, pulmonary and gastrointestinal involvement. Erosions were presenting 65.08% of patients. A panoply of treatments was used. Conclusions: The authors concluded that screening for an associated disease should be encouraged since the overlap with SSc may affect prognosis and treatment. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Risk factors for infection, predictors of severe disease and antibody response to COVID-19 in patients with rheumatic diseases in Portugal – a multicentre, nationwide study
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Cruz-Machado, Ana Rita, primary, Barreira, Sofia C, additional, Bandeira, Matilde, additional, Veldhoen, Marc, additional, Gomes, Andreia, additional, Serrano, Marta, additional, Duarte, Catarina, additional, Rato, Maria, additional, Fernandes, Bruno Miguel, additional, Garcia, Salomé, additional, Pinheiro, Filipe, additional, Bernardes, Miguel, additional, Madeira, Nathalie, additional, Miguel, Cláudia, additional, Torres, Rita, additional, Bento Silva, Ana, additional, Pestana, Jorge, additional, Almeida, Diogo, additional, Mazeda, Carolina, additional, Cunha Santos, Filipe, additional, Pinto, Patrícia, additional, Sousa, Marlene, additional, Parente, Hugo, additional, Sequeira, Graça, additional, Santos, Maria José, additional, Fonseca, João Eurico, additional, and Romão, Vasco C, additional
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- 2021
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5. SÍNDRÓME DE SÓBREPÓSIÇÃÓ DE ESCLERÓSE SISTÉMICA E ARTRITE REUMATÓIDE.
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Sofia Pinto, Ana, Cunha Santos, Filipe, Fonseca Ferreira, Joana, and Vaz, Cláudia
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Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
6. FRACTURA DE STRESS NA ARTRITE REUMATÓIDE.
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Sofia Pinto, Ana, Cunha Santos, Filipe, Fonseca Ferreira, Joana, and Vaz, Cláudia
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Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
7. CONSULTA MULTIDISCIPLINAR DE PATOLOGIA DO INTERSTÍCIO PULMONAR - CASUÍSTICA.
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Sofia Pinto, Ana, Cunha Santos, Filipe, Natal, Rebeca, Vaz Rodrigues, Luis, Rodrigues, Lara, Fonseca Ferreira, Joana, and Vaz, Cláudia
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Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
8. DOENÇA LINFOPROLIFERATIVA EM DOENTE COM ARTRITE REUMATÓIDE SOB METOTREXATO.
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Cunha Santos, Filipe, Sofia Pinto, Ana, Fonseca Ferreira, Joana, and Vaz, Cláudia
- Abstract
Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
9. A FLAUTISTA.
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Sofia Pinto, Ana, Cunha Santos, Filipe, Fonseca Ferreira, Joana, and Vaz, Cláudia
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Copyright of Acta Reumatológica Portuguesa is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
10. Systematic literature review to inform the Portuguese recommendations for the management of Raynaud's phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases.
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Costa E, Cunha-Santos F, Dourado E, Oliveira D, Falzon L, Romão V, Duarte AC, Cordeiro A, Santiago T, and Sepriano A
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- Humans, Portugal epidemiology, Calcium Channel Blockers therapeutic use, Fingers blood supply, Practice Guidelines as Topic, Iloprost therapeutic use, Phosphodiesterase 5 Inhibitors therapeutic use, Vasodilator Agents therapeutic use, Raynaud Disease therapy, Raynaud Disease etiology, Raynaud Disease drug therapy, Scleroderma, Systemic complications, Scleroderma, Systemic therapy, Connective Tissue Diseases complications, Connective Tissue Diseases therapy, Skin Ulcer therapy, Skin Ulcer etiology, Skin Ulcer drug therapy
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Objective: To perform a systematic literature review (SLR) aimed at evaluating the efficacy and safety of pharmacological and non-pharmacological treatments for Raynaud's phenomenon (RP) and digital ulcers (DU) in patients with systemic sclerosis (SSc) and other connective tissue diseases (CTD), in order to inform the Portuguese recommendations for managing RP and DU in these patients., Methods: A SLR was conducted until May 2022 to identify studies assessing the efficacy and safety of pharmacological and non-pharmacological interventions for RP and DU in SSc and other CTD. Eligible study designs included randomized controlled trials (RCTs), controlled clinical trials, and their extensions for assessing efficacy and safety of interventions. Observational studies with a comparator were included for evaluating the efficacy and safety of non-pharmacological interventions and safety of pharmacological interventions. The risk of bias of each study was assessed using standard tools., Results: Out of 71 publications meeting the inclusion criteria, 59 evaluated pharmacological and 12 non-pharmacological interventions. We found moderate quality evidence supporting the efficacy of calcium channel blockers, phosphodiesterase-5 inhibitors, and intravenous prostacyclin analogues in reducing RP frequency, severity, and duration. Intravenous iloprost had a small to moderate effect size in improving DU healing. Phosphodiesterase-5 inhibitors were effective in reducing total DU count, new DU occurrence, and enhancing DU healing. Bosentan effectively prevented new DU in SSc patients. No new safety concerns were associated with these treatments. The studies on non-pharmacological interventions were, in general, of low quality, and had a small sample size. Warming measures decreased frequency and duration of RP attacks; laser therapy improved RP-related outcomes; local oxygen-ozone therapy improved RP outcomes as an add-on therapy; bone marrow mononuclear cell implantation improved DU-associated pain; periarterial sympathectomy and vascular bypass reduced DU number and finger amputation risk., Conclusion: The available evidence supports the efficacy and safety of pharmacological interventions, namely nifedipine, sildenafil, iloprost, and bosentan in treating RP and DU in patients with SSc and other CTD. Scarce and low-quality evidence does support the use of some non-pharmacological interventions but with only a modest effect size. This SLR underscores the limited availability of high-quality evidence for determining the optimal treatment.
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- 2024
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11. Portuguese Recommendations for the management of Raynaud's phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases.
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Santiago T, Duarte AC, Sepriano A, Castro A, Rosa B, Resende C, Oliveira D, Dourado E, Costa E, Cunha-Santos F, Terroso G, Boleto G, Silva I, Barbosa L, Silva J, Sousa Neves J, Salvador MJ, Gonçalves MJ, Gomes Guerra M, Miriam Ferreira R, Duarte-Fernandes R, Barreira S, Silvestre Teixeira V, Tomás AL, Romão V, and Cordeiro A
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- Humans, Portugal, Connective Tissue Diseases complications, Connective Tissue Diseases therapy, Fingers blood supply, Fingers pathology, Raynaud Disease therapy, Raynaud Disease etiology, Scleroderma, Systemic complications, Scleroderma, Systemic therapy, Skin Ulcer therapy, Skin Ulcer etiology
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Objective: To develop evidence-based recommendations for the non-pharmacological and pharmacological management of Raynaud's phenomenon (RP) and digital ulcers (DUs) in patients with systemic sclerosis and other immune-mediated connective tissue diseases (CTDs)., Methods: A task force comprising 21 rheumatologists, two surgeons (vascular and plastic), two nurses, and one patient representative was established. Following a systematic literature review performed to inform the recommendations, statements were formulated and discussed during two meetings (one online and one in-person). Levels of evidence, grades of recommendation (GoR), and level of agreement (LoA) were determined., Results: Five overarching principles and 13 recommendations were developed. GoR ranged from A to D. The mean ± standard difference (SD) LoA with the overarching principles and recommendations ranged from 7.8±2.1 to 9.8±0.4. Briefly, the management of RP and DUs in patients with CTDs should be coordinated by a multidisciplinary team and based on shared decisions with patients. Nifedipine should be used as first-line therapy for RP and/or DUs. Sildenafil, tadalafil, and/or iloprost IV are second-line options for severe and/or refractory patients with RP and/or DUs. Sildenafil, tadalafil and/or Iloprost IV, should be prescribed for healing and prevention (also including bosentan) of DUs. In patients with RP and/or DUs, non-pharmacological interventions might be considered as add-ons, but there is limited quality and quantity of scientific evidence supporting their use., Conclusions: These recommendations will inform rheumatologists, specialist nurses, other healthcare professionals, and patients about a comprehensive and personalized management of RP and DUs. A research agenda was developed to address unmet needs, particularly for non-pharmacologic interventions.
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- 2024
12. Severe infections in Portuguese patients with rheumatoid arthritis under biologic treatment - a multicenter, nationwide study (SIPPRA-B Study).
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Oliveira Pinheiro F, Seabra Rato M, Madureira P, Araújo F, Salvador MJ, Fraga V, Brites L, Cunha Santos F, Silva A, Lopes AR, Cruz M, Vilas Boas JP, Pontes Ferreira M, Samões B, Beirão T, Santos I, Carvalho D, Costa L, and Bernardes M
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- Humans, Female, Adult, Middle Aged, Male, Cohort Studies, Portugal epidemiology, Adrenal Cortex Hormones therapeutic use, Arthritis, Rheumatoid drug therapy, Antirheumatic Agents adverse effects, Biological Products adverse effects, Asthma chemically induced
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Introduction: Despite years of experience with biological disease modifying anti-rheumatic drugs (bDMARD) in rheumatoid arthritis (RA), little is known about differences in infectious risk among bDMARDs. The aim of this study was to assess the incidence and type of infections in RA patients on bDMARDs and to determine possible predictors., Methods: A retrospective multicenter cohort study that included patients registered in the Rheumatic Diseases Portuguese Registry (Reuma.pt) with RA, and exposed to at least one bDMARD until April 2021. RA patients under bDMARD and with at least one episode of severe infection (SI), defined as infection that requires hospitalization, use of parenteral antibiotics or that resulted in death, were compared to patients with no report of SI. Demographic and clinical data at baseline and at the time of each SI were collected to establish comparisons between different groups of bDMARDs. Comparisons between different bDMARDs were assessed and logistic regression was performed to identify predictors of SI., Results: We included 3394 patients, 2833 (83.5%) female, with a mean age at RA diagnosis of 45.5±13.7 years. SI was diagnosed in 142 of the 3394 patients evaluated (4.2%), totaling 151 episodes of SI. At baseline, patients with SI had a significantly higher proportion of prior orthopedic surgery, asthma, interstitial lung disease, chronic kidney disease and corticosteroid use, higher mean age and longer median disease duration at first bDMARD. Nine patients died (6.0%). Ninety-two SI (60.9%) occurred with the first bDMARD, the majority leading to discontinuation of the bDMARD within 6 months (n=75, 49.7%), while 65 (43.0%) restarted the same bDMARD and 11 (7.3%) switched to another bDMARD (6 of them to a different mechanism of action). In the multivariate analysis, we found that chronic kidney disease, asthma, infliximab, corticosteroid use, interstitial lung disease, previous orthopedic surgery, higher Health Assessment Questionnaire and DAS284V-ESR are independent predictors of SI., Conclusion: This study described the incidence and types of SI among Portuguese RA patients on biologics, identifying several predictors of SI, both globally and with different bDMARDs. Physicians should be aware of the real-word infectious risk in RA patients on bDMARDs when making treatment decisions.
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- 2023
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