Virginia Ferriani - Academia.edu (original) (raw)
Papers by Virginia Ferriani
Abstracts Accepted for Publication, 2019
common in females with 7% compared to 4% in males. Urine sediment changes were more common in mal... more common in females with 7% compared to 4% in males. Urine sediment changes were more common in males (8% vs 4%). Gastrointestinal involvement was more common in females (37% vs 29%). Contractures occurred more often in males with 62% compared with 46% in females. Tendon friction rub was observed in 21% of males and 3% of females (p=0.001). Physician global scores of disease activity and damage were higher in males with 48 for both assessments compared to 36 and 30 in females. Conclusion: Male patients with jSSc have a higher severity of disease, as it has been reported in adults.
Abstracts Accepted for Publication, 2019
Background: Juvenile idiopathic arthritis (JIA) in recent decades has changed its course, thanks ... more Background: Juvenile idiopathic arthritis (JIA) in recent decades has changed its course, thanks to the use of genetically engineered biological drugs. If therapy with methotrexane is inefficient etanercept is the drug of choice for JIA treatment. Etanercept has been used in Chelyabinsk regional pediatric hospital during 10 years. Objectives: Performance and safety assessment of etanercept in patients with JIA in Chelyabinsk regional pediatric hospital. Methods: 51 children aged from 3 to 17 (mean age 10,0 years) diagnosed with JIA were under monitoring (12 boys, 39 girls). Disease duration was from 2 to 15 years (mean duration 5,4 years). JIA was diagnosed based on ILAR diagnostic criteria. Oligo arthritis was diagnosed in 9 children, sero-negative polyarthritis was diagnosed in 34 children. 3 patients had systemic JIA (without active systemic presentations), 5 children had enthesitic JIA. X-ray stage 1-2 was observed in 45 children and stage 3-4 in five. Enhancement antigens HLA В 27 were found in 11 children. In all children methotrexate was ineffective in dose of 15 mg/m 2 during 6-12 months. Etanercept was introduced in dose of 0.8 mg QW. Therapy duration was from 3 months to 8 years (mean duration 29 months). Assessment of disease activity and therapy efficiency was conducted in accordance with ACR pedi criteria. Nonparametric statistical methods were used to compare results. Results: Prior to etanercept use high disease activity was observed in all children. Mean number of joints with active arthritis was 8 [4, 10] (Ме[25;75%]). Mean number of joints with functional impairments-4 [2;10]. Mean ESR (according to Panchenkov)-23 [10;35] mm/h, CRP 12,0 [5,7;32] g/L. Assessment of functional activity according to CHAQ questionnaire-1,25 [1;2]. Activity assessment according to VAS by doctor-70 [60;70]. Assessment of parents/patients according to VAS 70 [60;80]. No active systemic presentations and eye lesions were found in children under monitoring. On the background of etanercept therapy a decrease in disease activity was observed in 50 patients. Mean number of joints with active arthritis was 0 [0;2] (Ме[25;75%]) (Р£0.0001). Mean number of joints with functional impairments-0 [0;.2] (Р£0.0001). Mean ESR was 5 [3,6] mm/h (Р£0.0001), CRP 3 [2;4] g/L (Р£0.0001). Assessment of functional activity according to CHAQ questionnaire was 0,125 [0;0,5] (Р£0.0001). Activity assessment according to VAS by doctor-10 [5;20] (Р£0.0001). Assessment of parents according to VAS 10 [5;20] (Р£0.0001). Clinical disease remission (according to ACR pedi criteria 90%) was observed in 32 patients after 6-12 months of treatment. Remission duration up to now is from 1 to 7 years. Efficiency according to ACR pedi criteria is 70% in 11 children, 50% in 5, 30% in 2. Etanercept was well-tolerated. Drug was cancelled in 9 patients. 6 patient (11,8%) developed bilateral uveitis, one patient had an allergic reaction (rash), one-systemic manifestations, one-urinary tract infection. There were no cases of tuberculosis. Conclusion: Etanercept therapy was highly effective and safe in patients with JIA. Clinical remission was achieved in 62,7% children. Decrease in disease activity was observed in 98% of children. 11,8% patient developed uveitis, on average, after a year of using etanercept.
Abstracts Accepted for Publication, 2019
Current microbiology, Jan 22, 2018
The aims of this study were to analyze the presence of Streptococcus mutans (SM)-DNA in cord bloo... more The aims of this study were to analyze the presence of Streptococcus mutans (SM)-DNA in cord blood (CB), maternal peripheral blood (PB), and maternal saliva (SA) and compare with data collected in health surveys. Sixty-four healthy women with pregnancies to term and without complications attending for elective cesarean section in the Clinical Hospital of Ribeirao Preto, Sao Paulo were included. Samples of PB and unstimulated SA were obtained on the day of hospitalization and samples of CB were collected after the delivery section. Samples were investigated using polymerase chain reaction for the presence of SM-DNA using specific primers. The results show over 50% of the sample of PB and CB showed SM-DNA detectable. There was a positive correlation between the SM detection in PB/CB and SA (P < 0.05). Pregnant women, who reported tooth brushing more than three times a day, often showed detectable SM-DNA in PB and CB (P < 0.05). In conclusion, the majority of children can have co...
Annals of the Rheumatic Diseases, 2013
Correlation of JADAS71 with single markers of DA ranged from 0.48-0.75 for the whole cohort (see ... more Correlation of JADAS71 with single markers of DA ranged from 0.48-0.75 for the whole cohort (see Table 1). Within the individual subtypes, the strongest correlation was with AJC (range 0.71-0.94). Correlation with PGA and PGE was moderate (range 0.29-0.75) and correlation with the ESR was strongest for undifferentiated and systemic JIA (0.76 and 0.59) but low to moderate for all other subtypes of JIA (range 0.2-0.41). Conclusions: JADAS71 correlated well with AJC, PGE and PGA but did not correlate well with the ESR in all ILAR subtypes. Correlation of JADAS71 with measures of disease severity is moderate, with some variation between subtypes. The ESR is not routinely measured in all children with JIA in the UK, as illustrated by its availability in just 62% of this cohort at baseline. Given the high frequency of unmeasured ESR assessments, we suggest further work is required to assess the validity of JADAS without inclusion of the ESR.
Brazilian oral research, Jan 15, 2017
The present study compared IgA specificity against oral streptococci in colostrum and saliva samp... more The present study compared IgA specificity against oral streptococci in colostrum and saliva samples. Sixty-two mother-and-child pairs were included; samples of colostrum (C) and saliva (MS) were collected from the mothers and saliva samples were collected from babies (BS). The specificity of IgA against Streptococcus mutans and S. mitis were analyzed by western blot. Only 30% of babies' samples presented IgA reactivity to S. mutans, while 74 and 80% of MS and C, respectively, presented this response. IgA reactivity to S. mutans virulence antigens (Ag I/II, Gtf and GbpB) in positive samples showed differences between samples for Gtf and especially for GbpB (p < 0.05), but responses to Ag I/II were similar (p > 0.05). The positive response of Gtf-reactive IgA was different between C (90%) and MS (58%) samples (p < 0.05), but did not differ from BS (p > 0.05). GbpB was the least detected, with 48 and 26% of C and MS, and only 5% of BS samples presenting reactivity (p &...
Arthritis & rheumatology (Hoboken, N.J.), Oct 12, 2017
Objectives To define the molecular basis of a multisystem phenotype with progressive musculoskele... more Objectives To define the molecular basis of a multisystem phenotype with progressive musculoskeletal disease of the hands and feet including camptodactyly, subluxation and tendon rupture reminiscent of Jaccoud's arthropathy. Methods We ascertained two families segregating an autosomal dominant phenotype encompassing musculoskeletal disease and variable additional features including psoriasis, dental abnormalities, cardiac valve involvement, glaucoma and basal ganglia calcification. We measured the expression of interferon-stimulated genes in peripheral blood and skin, and undertook targeted Sanger sequencing of the IFIH1 gene encoding the cytosolic double-stranded RNA sensor MDA5. We also assessed the functional consequences of IFIH1 gene variants using an in vitro interferon beta reporter assay in HEK293 cells. Results We recorded an upregulation of type I interferon-induced gene transcripts in all five patients tested, and identified a heterozygous gain-of-function mutation in...
Rev Soc Cardiol Estado De Sao Paulo, Feb 1, 2005
Revista Brasileira De Reumatologia, 2009
Journal of Pediatric Gastroenterology & Nutrition, 2016
Objective: Pancreatitis is a rare and a life-threatening systemic lupus erythematosus (SLE) manif... more Objective: Pancreatitis is a rare and a life-threatening systemic lupus erythematosus (SLE) manifestation in childhood-onset SLE (cSLE). The objective of this study was to systematically classify pancreatitis in cSLE according to the International Study Group of Pediatric Pancreatitis and determine the overall prevalence, clinical features, laboratory, and first episode outcomes. Methods: A multicenter cohort study in 10 pediatric rheumatology centers, including 852 patients with cSLE. Results: Pancreatitis was diagnosed in 22 of 852 (2.6%) patients with cSLE. It was classified as acute pancreatitis in 20 (91%), acute recurrent pancreatitis in 2 (9%), and none of them had chronic pancreatitis. None of them had gallstones, traumatic pancreatitis, or reported alcohol/tobacco use. The comparison of patients with pancreatitis (first episode) and without this complication revealed a shorter disease duration (1 [0-10] vs 4 [0-23] years, P < 0.0001) and higher median of Systemic Lupus Erythematosus Disease Activity Index 2000 (21 [0-41] vs 2 [0-45], P < 0.0001). The frequencies of fever (P < 0.0001), weight loss (P < 0.0001), serositis (P < 0.0001), nephritis (P < 0.0001), arterial hypertension (P < 0.0001), acute renal failure (P < 0.0001), macrophage activation syndrome (P < 0.0001), and death (P ¼ 0.001) were also higher in patients with pancreatitis. The frequencies of intravenous methylprednisolone use (P < 0.0001) and the median of prednisone dose (55 [15-60] vs 11 [1-90] mg/day, P < 0.0001) were significantly higher in patients with pancreatitis. Of note, the 2 patients with acute recurrent pancreatitis had 2 episodes, with painfree interval of 1 and 4 years. Conclusions: This was the first study characterizing pancreatitis using the International Study Group of Pediatric Pancreatitis standardized definitions in patients with cSLE showing that the predominant form is acute pancreatitis seen in association with glucocorticoid treatment and active severe disease.
Objectives: Analysis of the mucosal immune system represents an interesting way to understand the... more Objectives: Analysis of the mucosal immune system represents an interesting way to understand the microbial colonization in early life, particularly the response of salivary IgA. Previous study showed in children with 6 months of age, a high complexity of SIgA response to antigens (Ags) of mutans streptococcal (MS), but little is known about the ontogeny of the mucosal immune system in the first 3 months of life especially in preterm (PT, < 37 weeks). We compared the levels and specificity of SIgA to MS and others species enrolled with initial infection in fullterm (FT) and PT early in life. Methods: Stimulate saliva from 160 children, with 0 day of life and after 3 months, were enrolled in this study. Salivary IgA and IgM levels were determined by ELISA. Subsets of 24 FT and 24 PT showing similar salivary IgA levels were paired. SIgA antibody reactivity to MS, S. sanguinis (SSA), S.mitis (SMI) and S.gordonii (SGO) Ags was determined in Western blot assays. Results: Levels of SIg...
World Allergy Organization Journal, 2015
Clinical and experimental rheumatology
To describe onset features, classification and treatment of juvenile dermatomyositis (JDM) and ju... more To describe onset features, classification and treatment of juvenile dermatomyositis (JDM) and juvenile polymyositis (JPM) from a multicentre registry. Inclusion criteria were onset age lower than 18 years and a diagnosis of any idiopathic inflammatory myopathy (IIM) by attending physician. Bohan & Peter (1975) criteria categorisation was established by a scoring algorithm to define JDM and JPM based on clinical protocol data. Of the 189 cases included, 178 were classified as JDM, 9 as JPM (19.8: 1) and 2 did not fit the criteria; 6.9% had features of chronic arthritis and connective tissue disease overlap. Diagnosis classification agreement occurred in 66.1%. Median onset age was 7 years, median follow-up duration was 3.6 years. Malignancy was described in 2 (1.1%) cases. Muscle weakness occurred in 95.8%; heliotrope rash 83.5%; Gottron plaques 83.1%; 92% had at least one abnormal muscle enzyme result. Muscle biopsy performed in 74.6% was abnormal in 91.5% and electromyogram perfor...
Clinical and experimental rheumatology
We report the cross-cultural adaptation and validation into Brazilian-Portuguese of the parent... more We report the cross-cultural adaptation and validation into Brazilian-Portuguese of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children regardless the underlying disease. The Brazilian CHAQ was revalidated, while the CHQ has been derived from the Portuguese version. A total of 471 subjects were enrolled: 157 patients with JIA (27% systemic onset, 38% polyarticular onset, 9% extended oligoarticular subtype, and 26% persistent oligoarticular subtype) and 314 healthy children. The CHAQ discriminated clinically healthy subjects from JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having...
Jornal de Pediatria, 2003
Objetivo: estudar o impacto da artrite crônica na qualidade de vida relacionada à saúde, por meio... more Objetivo: estudar o impacto da artrite crônica na qualidade de vida relacionada à saúde, por meio de dois instrumentos autoaplicáveis: a versão destinada aos pais do Childhood Health Assessment Questionnaire (CHAQ) e do Child Health Questionnaire (CHQ) PF50 ®. Método: os dois questionários foram respondidos por 36 pais, após instruções durante 1 a 2 visitas clínicas, sendo os índices da Capacidade Funcional (CHAQ), Físico e Psicossocial (CHQ) comparados com as medidas essenciais de atividade da doença: (1) a avaliação global pelo médico, (2) a avaliação global pelos pais, ambas em escala analógica visual de 10 cm, (3) o número de articulações ativas, (4) o numero de articulações com limitação dos movimentos, (5) a velocidade de hemossedimentação. Resultados: houve diferença significante entre os grupos oligoarticular e poliarticular, sendo os índices de atividade maiores no poliarticular, com exceção da velocidade de hemossedimentação, avaliação global pelos pais e índice psicossocial, confirmando diferentes níveis de percepção pelos pais sobre a atividade e prognóstico. A melhor responsividade estatística frente à intervenção terapêutica, em duas visitas consecutivas, foi a medida da avaliação global pelo médico entre as subjetivas, tendo as medidas avaliadas por instrumentos de responsividade intermediária, quando comparadas com o numero de articulações ativas, número de articulações com limitação dos movimentos e a velocidade de hemossedimentação. Conclusão: a medida da responsividade de dois instrumentos de avaliação funcional e da qualidade de vida indicou a sua sensibilidade relativa para estimar a melhora clínica em pacientes com artrites idiopáticas juvenis, recebendo tratamento específico.
Current Allergy and Asthma Reports, 2001
Cockroach allergy has been recognized as an important cause of asthma. Exposure to high levels of... more Cockroach allergy has been recognized as an important cause of asthma. Exposure to high levels of cockroach allergens in the home is a major risk factor for symptoms in sensitized individuals. Previously identified allergens from Blatella germanica and Periplaneta americana include Bla g 2 (inactive aspartic proteinase), Bla g 4 (calycin), Bla g 5 (glutathione-S-transferase), Bla g 6 (troponin), the Group 1 cross-reactive allergens Bla g 1 and Per a 1, Per a 3 (arylphorin), and Per a 7 (tropomyosin). The primary site of cockroach allergen accumulation is the kitchen. However, lower levels of allergen can be found in bedding, on the bedroom floor, and in sofa dust. Strategies for decreasing exposure to cockroach have been investigated. The results suggest that a sustained decrease in cockroach allergen levels is difficult to accomplish, even after successful extermination of cockroach populations. The use of recombinant cockroach allergens may lead to the development of new approaches to asthma treatment in the future.
Abstracts Accepted for Publication, 2019
common in females with 7% compared to 4% in males. Urine sediment changes were more common in mal... more common in females with 7% compared to 4% in males. Urine sediment changes were more common in males (8% vs 4%). Gastrointestinal involvement was more common in females (37% vs 29%). Contractures occurred more often in males with 62% compared with 46% in females. Tendon friction rub was observed in 21% of males and 3% of females (p=0.001). Physician global scores of disease activity and damage were higher in males with 48 for both assessments compared to 36 and 30 in females. Conclusion: Male patients with jSSc have a higher severity of disease, as it has been reported in adults.
Abstracts Accepted for Publication, 2019
Background: Juvenile idiopathic arthritis (JIA) in recent decades has changed its course, thanks ... more Background: Juvenile idiopathic arthritis (JIA) in recent decades has changed its course, thanks to the use of genetically engineered biological drugs. If therapy with methotrexane is inefficient etanercept is the drug of choice for JIA treatment. Etanercept has been used in Chelyabinsk regional pediatric hospital during 10 years. Objectives: Performance and safety assessment of etanercept in patients with JIA in Chelyabinsk regional pediatric hospital. Methods: 51 children aged from 3 to 17 (mean age 10,0 years) diagnosed with JIA were under monitoring (12 boys, 39 girls). Disease duration was from 2 to 15 years (mean duration 5,4 years). JIA was diagnosed based on ILAR diagnostic criteria. Oligo arthritis was diagnosed in 9 children, sero-negative polyarthritis was diagnosed in 34 children. 3 patients had systemic JIA (without active systemic presentations), 5 children had enthesitic JIA. X-ray stage 1-2 was observed in 45 children and stage 3-4 in five. Enhancement antigens HLA В 27 were found in 11 children. In all children methotrexate was ineffective in dose of 15 mg/m 2 during 6-12 months. Etanercept was introduced in dose of 0.8 mg QW. Therapy duration was from 3 months to 8 years (mean duration 29 months). Assessment of disease activity and therapy efficiency was conducted in accordance with ACR pedi criteria. Nonparametric statistical methods were used to compare results. Results: Prior to etanercept use high disease activity was observed in all children. Mean number of joints with active arthritis was 8 [4, 10] (Ме[25;75%]). Mean number of joints with functional impairments-4 [2;10]. Mean ESR (according to Panchenkov)-23 [10;35] mm/h, CRP 12,0 [5,7;32] g/L. Assessment of functional activity according to CHAQ questionnaire-1,25 [1;2]. Activity assessment according to VAS by doctor-70 [60;70]. Assessment of parents/patients according to VAS 70 [60;80]. No active systemic presentations and eye lesions were found in children under monitoring. On the background of etanercept therapy a decrease in disease activity was observed in 50 patients. Mean number of joints with active arthritis was 0 [0;2] (Ме[25;75%]) (Р£0.0001). Mean number of joints with functional impairments-0 [0;.2] (Р£0.0001). Mean ESR was 5 [3,6] mm/h (Р£0.0001), CRP 3 [2;4] g/L (Р£0.0001). Assessment of functional activity according to CHAQ questionnaire was 0,125 [0;0,5] (Р£0.0001). Activity assessment according to VAS by doctor-10 [5;20] (Р£0.0001). Assessment of parents according to VAS 10 [5;20] (Р£0.0001). Clinical disease remission (according to ACR pedi criteria 90%) was observed in 32 patients after 6-12 months of treatment. Remission duration up to now is from 1 to 7 years. Efficiency according to ACR pedi criteria is 70% in 11 children, 50% in 5, 30% in 2. Etanercept was well-tolerated. Drug was cancelled in 9 patients. 6 patient (11,8%) developed bilateral uveitis, one patient had an allergic reaction (rash), one-systemic manifestations, one-urinary tract infection. There were no cases of tuberculosis. Conclusion: Etanercept therapy was highly effective and safe in patients with JIA. Clinical remission was achieved in 62,7% children. Decrease in disease activity was observed in 98% of children. 11,8% patient developed uveitis, on average, after a year of using etanercept.
Abstracts Accepted for Publication, 2019
Current microbiology, Jan 22, 2018
The aims of this study were to analyze the presence of Streptococcus mutans (SM)-DNA in cord bloo... more The aims of this study were to analyze the presence of Streptococcus mutans (SM)-DNA in cord blood (CB), maternal peripheral blood (PB), and maternal saliva (SA) and compare with data collected in health surveys. Sixty-four healthy women with pregnancies to term and without complications attending for elective cesarean section in the Clinical Hospital of Ribeirao Preto, Sao Paulo were included. Samples of PB and unstimulated SA were obtained on the day of hospitalization and samples of CB were collected after the delivery section. Samples were investigated using polymerase chain reaction for the presence of SM-DNA using specific primers. The results show over 50% of the sample of PB and CB showed SM-DNA detectable. There was a positive correlation between the SM detection in PB/CB and SA (P < 0.05). Pregnant women, who reported tooth brushing more than three times a day, often showed detectable SM-DNA in PB and CB (P < 0.05). In conclusion, the majority of children can have co...
Annals of the Rheumatic Diseases, 2013
Correlation of JADAS71 with single markers of DA ranged from 0.48-0.75 for the whole cohort (see ... more Correlation of JADAS71 with single markers of DA ranged from 0.48-0.75 for the whole cohort (see Table 1). Within the individual subtypes, the strongest correlation was with AJC (range 0.71-0.94). Correlation with PGA and PGE was moderate (range 0.29-0.75) and correlation with the ESR was strongest for undifferentiated and systemic JIA (0.76 and 0.59) but low to moderate for all other subtypes of JIA (range 0.2-0.41). Conclusions: JADAS71 correlated well with AJC, PGE and PGA but did not correlate well with the ESR in all ILAR subtypes. Correlation of JADAS71 with measures of disease severity is moderate, with some variation between subtypes. The ESR is not routinely measured in all children with JIA in the UK, as illustrated by its availability in just 62% of this cohort at baseline. Given the high frequency of unmeasured ESR assessments, we suggest further work is required to assess the validity of JADAS without inclusion of the ESR.
Brazilian oral research, Jan 15, 2017
The present study compared IgA specificity against oral streptococci in colostrum and saliva samp... more The present study compared IgA specificity against oral streptococci in colostrum and saliva samples. Sixty-two mother-and-child pairs were included; samples of colostrum (C) and saliva (MS) were collected from the mothers and saliva samples were collected from babies (BS). The specificity of IgA against Streptococcus mutans and S. mitis were analyzed by western blot. Only 30% of babies' samples presented IgA reactivity to S. mutans, while 74 and 80% of MS and C, respectively, presented this response. IgA reactivity to S. mutans virulence antigens (Ag I/II, Gtf and GbpB) in positive samples showed differences between samples for Gtf and especially for GbpB (p < 0.05), but responses to Ag I/II were similar (p > 0.05). The positive response of Gtf-reactive IgA was different between C (90%) and MS (58%) samples (p < 0.05), but did not differ from BS (p > 0.05). GbpB was the least detected, with 48 and 26% of C and MS, and only 5% of BS samples presenting reactivity (p &...
Arthritis & rheumatology (Hoboken, N.J.), Oct 12, 2017
Objectives To define the molecular basis of a multisystem phenotype with progressive musculoskele... more Objectives To define the molecular basis of a multisystem phenotype with progressive musculoskeletal disease of the hands and feet including camptodactyly, subluxation and tendon rupture reminiscent of Jaccoud's arthropathy. Methods We ascertained two families segregating an autosomal dominant phenotype encompassing musculoskeletal disease and variable additional features including psoriasis, dental abnormalities, cardiac valve involvement, glaucoma and basal ganglia calcification. We measured the expression of interferon-stimulated genes in peripheral blood and skin, and undertook targeted Sanger sequencing of the IFIH1 gene encoding the cytosolic double-stranded RNA sensor MDA5. We also assessed the functional consequences of IFIH1 gene variants using an in vitro interferon beta reporter assay in HEK293 cells. Results We recorded an upregulation of type I interferon-induced gene transcripts in all five patients tested, and identified a heterozygous gain-of-function mutation in...
Rev Soc Cardiol Estado De Sao Paulo, Feb 1, 2005
Revista Brasileira De Reumatologia, 2009
Journal of Pediatric Gastroenterology & Nutrition, 2016
Objective: Pancreatitis is a rare and a life-threatening systemic lupus erythematosus (SLE) manif... more Objective: Pancreatitis is a rare and a life-threatening systemic lupus erythematosus (SLE) manifestation in childhood-onset SLE (cSLE). The objective of this study was to systematically classify pancreatitis in cSLE according to the International Study Group of Pediatric Pancreatitis and determine the overall prevalence, clinical features, laboratory, and first episode outcomes. Methods: A multicenter cohort study in 10 pediatric rheumatology centers, including 852 patients with cSLE. Results: Pancreatitis was diagnosed in 22 of 852 (2.6%) patients with cSLE. It was classified as acute pancreatitis in 20 (91%), acute recurrent pancreatitis in 2 (9%), and none of them had chronic pancreatitis. None of them had gallstones, traumatic pancreatitis, or reported alcohol/tobacco use. The comparison of patients with pancreatitis (first episode) and without this complication revealed a shorter disease duration (1 [0-10] vs 4 [0-23] years, P < 0.0001) and higher median of Systemic Lupus Erythematosus Disease Activity Index 2000 (21 [0-41] vs 2 [0-45], P < 0.0001). The frequencies of fever (P < 0.0001), weight loss (P < 0.0001), serositis (P < 0.0001), nephritis (P < 0.0001), arterial hypertension (P < 0.0001), acute renal failure (P < 0.0001), macrophage activation syndrome (P < 0.0001), and death (P ¼ 0.001) were also higher in patients with pancreatitis. The frequencies of intravenous methylprednisolone use (P < 0.0001) and the median of prednisone dose (55 [15-60] vs 11 [1-90] mg/day, P < 0.0001) were significantly higher in patients with pancreatitis. Of note, the 2 patients with acute recurrent pancreatitis had 2 episodes, with painfree interval of 1 and 4 years. Conclusions: This was the first study characterizing pancreatitis using the International Study Group of Pediatric Pancreatitis standardized definitions in patients with cSLE showing that the predominant form is acute pancreatitis seen in association with glucocorticoid treatment and active severe disease.
Objectives: Analysis of the mucosal immune system represents an interesting way to understand the... more Objectives: Analysis of the mucosal immune system represents an interesting way to understand the microbial colonization in early life, particularly the response of salivary IgA. Previous study showed in children with 6 months of age, a high complexity of SIgA response to antigens (Ags) of mutans streptococcal (MS), but little is known about the ontogeny of the mucosal immune system in the first 3 months of life especially in preterm (PT, < 37 weeks). We compared the levels and specificity of SIgA to MS and others species enrolled with initial infection in fullterm (FT) and PT early in life. Methods: Stimulate saliva from 160 children, with 0 day of life and after 3 months, were enrolled in this study. Salivary IgA and IgM levels were determined by ELISA. Subsets of 24 FT and 24 PT showing similar salivary IgA levels were paired. SIgA antibody reactivity to MS, S. sanguinis (SSA), S.mitis (SMI) and S.gordonii (SGO) Ags was determined in Western blot assays. Results: Levels of SIg...
World Allergy Organization Journal, 2015
Clinical and experimental rheumatology
To describe onset features, classification and treatment of juvenile dermatomyositis (JDM) and ju... more To describe onset features, classification and treatment of juvenile dermatomyositis (JDM) and juvenile polymyositis (JPM) from a multicentre registry. Inclusion criteria were onset age lower than 18 years and a diagnosis of any idiopathic inflammatory myopathy (IIM) by attending physician. Bohan & Peter (1975) criteria categorisation was established by a scoring algorithm to define JDM and JPM based on clinical protocol data. Of the 189 cases included, 178 were classified as JDM, 9 as JPM (19.8: 1) and 2 did not fit the criteria; 6.9% had features of chronic arthritis and connective tissue disease overlap. Diagnosis classification agreement occurred in 66.1%. Median onset age was 7 years, median follow-up duration was 3.6 years. Malignancy was described in 2 (1.1%) cases. Muscle weakness occurred in 95.8%; heliotrope rash 83.5%; Gottron plaques 83.1%; 92% had at least one abnormal muscle enzyme result. Muscle biopsy performed in 74.6% was abnormal in 91.5% and electromyogram perfor...
Clinical and experimental rheumatology
We report the cross-cultural adaptation and validation into Brazilian-Portuguese of the parent... more We report the cross-cultural adaptation and validation into Brazilian-Portuguese of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children regardless the underlying disease. The Brazilian CHAQ was revalidated, while the CHQ has been derived from the Portuguese version. A total of 471 subjects were enrolled: 157 patients with JIA (27% systemic onset, 38% polyarticular onset, 9% extended oligoarticular subtype, and 26% persistent oligoarticular subtype) and 314 healthy children. The CHAQ discriminated clinically healthy subjects from JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having...
Jornal de Pediatria, 2003
Objetivo: estudar o impacto da artrite crônica na qualidade de vida relacionada à saúde, por meio... more Objetivo: estudar o impacto da artrite crônica na qualidade de vida relacionada à saúde, por meio de dois instrumentos autoaplicáveis: a versão destinada aos pais do Childhood Health Assessment Questionnaire (CHAQ) e do Child Health Questionnaire (CHQ) PF50 ®. Método: os dois questionários foram respondidos por 36 pais, após instruções durante 1 a 2 visitas clínicas, sendo os índices da Capacidade Funcional (CHAQ), Físico e Psicossocial (CHQ) comparados com as medidas essenciais de atividade da doença: (1) a avaliação global pelo médico, (2) a avaliação global pelos pais, ambas em escala analógica visual de 10 cm, (3) o número de articulações ativas, (4) o numero de articulações com limitação dos movimentos, (5) a velocidade de hemossedimentação. Resultados: houve diferença significante entre os grupos oligoarticular e poliarticular, sendo os índices de atividade maiores no poliarticular, com exceção da velocidade de hemossedimentação, avaliação global pelos pais e índice psicossocial, confirmando diferentes níveis de percepção pelos pais sobre a atividade e prognóstico. A melhor responsividade estatística frente à intervenção terapêutica, em duas visitas consecutivas, foi a medida da avaliação global pelo médico entre as subjetivas, tendo as medidas avaliadas por instrumentos de responsividade intermediária, quando comparadas com o numero de articulações ativas, número de articulações com limitação dos movimentos e a velocidade de hemossedimentação. Conclusão: a medida da responsividade de dois instrumentos de avaliação funcional e da qualidade de vida indicou a sua sensibilidade relativa para estimar a melhora clínica em pacientes com artrites idiopáticas juvenis, recebendo tratamento específico.
Current Allergy and Asthma Reports, 2001
Cockroach allergy has been recognized as an important cause of asthma. Exposure to high levels of... more Cockroach allergy has been recognized as an important cause of asthma. Exposure to high levels of cockroach allergens in the home is a major risk factor for symptoms in sensitized individuals. Previously identified allergens from Blatella germanica and Periplaneta americana include Bla g 2 (inactive aspartic proteinase), Bla g 4 (calycin), Bla g 5 (glutathione-S-transferase), Bla g 6 (troponin), the Group 1 cross-reactive allergens Bla g 1 and Per a 1, Per a 3 (arylphorin), and Per a 7 (tropomyosin). The primary site of cockroach allergen accumulation is the kitchen. However, lower levels of allergen can be found in bedding, on the bedroom floor, and in sofa dust. Strategies for decreasing exposure to cockroach have been investigated. The results suggest that a sustained decrease in cockroach allergen levels is difficult to accomplish, even after successful extermination of cockroach populations. The use of recombinant cockroach allergens may lead to the development of new approaches to asthma treatment in the future.