CLAUDIA GOLDENSTEIN SCHAINBERG

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LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina

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Autor: FULLER, Ricardo ×

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  • conferenceObject
    EFFECTIVENESS OF LONG-TERM USE OF MINIMALIST FOOTWEAR ON PAIN AND FUNCTION IN KNEE OSTEOARTHRITIS
    (2013) GOLDENSTEIN-SCHAINBERG, Claudia; FULLER, Ricardo; MATIAS, Alessandra; YOKOTA, Mariane; BUTUGAN, Marco; TROMBINI-SOUZA, Francis; SACCO, Isabel
  • conferenceObject
    Metabolic Syndrome: The Genesis of Nephrolithiasis in Gout Patients?
    (2012) MELLO, Filipi M.; TOMITA, Rafael B.; FULLER, Ricardo; FILHO, Marco Antonio G. P.; BARROS, Thiago B. M.; PRADO, Leandro L. do; AUGUSTO, Kristopherson L.; GOLDENSTEIN-SCHAINBERG, Claudia
    Background/Purpose: Gout patients have a high frequency of metabolic syndrome (MS), a disorder known to be associated with hyperinsulinemia. The latter condition augments proximal tubular sodium reabsorption and leads to reduced renal urate excretion and hyperuricemia. There are no data, however, evaluating whether MS can influence gout-associated clinical characteristics. Thus, we aimed to determine the prevalence of MS in our population and to investigate if the presence of MS would characterize a particular clinical and laboratorial gout profile. Methods: This was a cross-sectional study of 158 gout patients (ACR criteria). MS was defined in accordance to the National Cholesterol Education Program ATP III (NCEP-ATP III) and the International Diabetes Federation (IDF) criteria. Demographic, anthropometric (body mass index - BMI) and clinical data were evaluated. Fasting serum levels of UA, glucose, triglycerides and cholesterol fractions were analyzed by routine laboratory tests. Nephrolithiasis was demonstrated by usual ultrasonography and urate under-excretion defined as UA clearance lower than 7.5 ml/min. Statistical comparisons were performed using Fisher’s exact, chi-square, students T and Spearman’s tests and P<0.05 was considered significant. Results: The frequency of MS in gout patients was 73% and 71% according to NCEP ATPIII and IDF criteria respectively. Further comparison of 125 patients with MS and those 33 without this condition revealed similar mean ages (63.0 ± 11.5 vs 62.5 ± 12.9; p>0,05) and male predominance (94% and 75%). As expected, those with MS had higher BMI (30.2 ± 5.5kg/m2 vs 27.0 5.8kg/m2; p=0.005) and higher prevalences of systemic arterial hypertension (93.3% vs 75% p=0.012) and diabetes (25.8% vs 0, p=0.001), though comparable frequency of coronary artery disease (22.5% vs 16.7%; p=0.469). With regard to gout clinical/laboratorial characteristic, patients with MS had more nephrolitiasis (37.1% vs 16.7%, p=0.026), but they did not differ from patients without MS concerning the presence of tophi (52.8% vs. 55.6%; p = 0.780) or uric acid underexcretion (83.1% vs 94.4%; p=0.148). Current alcohol consumption, mean estimated creatinine clearance and mean serum levels of uric acid, were alike in both groups (p>0.05). Conclusion: The novel demonstration that MS in gout is associated to nephrolithiasis suggests that this condition may underlie the genesis of uric acid stones. Whether insulin resistance may account for a renal alteration that may ultimately impair buffering and amplification of acidic urine remains to be determined. Moreover, the elevated prevalence of MS in gout patients from our country (almost 3⁄4) is higher than overall rates of 63% MS in gout worldwide, indicating possible influence of dietary, geographical and/or genetic background.
  • article 9 Citação(ões) na Scopus
    Increased prevalence of simple renal cysts in patients with gout
    (2013) HASEGAWA, Eduardo Massato; FULLER, Ricardo; CHAMMAS, Maria Cristina; MELLO, Filipe Martins de; GOLDENSTEIN-SCHAINBERG, Claudia
    The aim of this study was to determine the prevalence of simple renal cysts in gout patients and evaluate associated risk factors for its development. Hundred and forty-six patients followed at our outpatient Gout Unit and 47 sex- and age-matched healthy kidney donors who had undergone routine renal ultrasonography, using a static gray scale and real-time B-mode units with a 3.5- or 5.0-MHz transducer, were evaluated for the presence of renal cysts. Demographic and clinical characteristics of gout patients were evaluated considering possible risk factors for the occurrence of simple renal cysts such as age, male gender, hypertension, and renal impairment. The prevalence of simple renal cyst was 26.0 % in gout patients and 10.6 % in control group (P = 0.045). Gout patients with simple renal cysts presented less renal lithiasis than those without this complication (5.2 vs 25.9 %; P = 0.003) in spite of an overall higher frequency of renal stones in gout patients compared to control group (20.5 vs. 6.3 %, P = 0.025). The presence of simple renal cyst in gout was not associated with previously reported factors such as age (P = 0.296), male predominance (P = 0.688), hypertension (P = 0.314), and renal impairment (P = 254). Moreover, no association with disease duration (P = 0.843) or tophi (P = 0.616) was observed. In conclusion, gout patients have an increased prevalence of simple renal cysts associated with a lower occurrence of nephrolithiasis. Whether renal cysts have any protective effect in the development of nephrolithiasis in gout remains to be determined.
  • article 8 Citação(ões) na Scopus
    Nephrolithiasis in gout: prevalence and characteristics of Brazilian patients
    (2019) HOFF, Leonardo Santos; GOLDENSTEIN-SCHAINBERG, Claudia; FULLER, Ricardo
    Background The aims of this article were to assess the prevalence of nephrolithiasis and the factors associated with nephrolithiasis in Brazilian patients with primary gout. Methods One hundred twenty-three patients with primary gout were recruited from a tertiary referral hospital in Sao Paulo, Brazil. All patients underwent ultrasonography and had their clinical and laboratory characteristics assessed. Results One hundred fifteen (93.5%) patients were male, with a mean age of 62.9 +/- 9.4 years. Twenty-three (18.7%) patients had asymptomatic nephrolithiasis (detected only by ultrasonography), 7 (6.0%) had symptomatic nephrolithiasis (detected by ultrasonography and a positive clinical history), and 13 (10.0%) had a history of kidney stones, but ultrasonography at evaluation did not show nephrolithiasis. Therefore, 35.0% of the patients had nephrolithiasis (detected either by ultrasonography and/or a positive clinical history). Nephrolithiasis was associated with male gender (43 [100%] vs 72 [90%], p = 0.049), the use of potassium citrate (13 [30.2%] vs 0, p < 0.001) and the use of medications for diabetes (10 [23.3%] vs 8 [10%], p = 0.047) and dyslipidemia (15 [34.9%] vs 10 [12.5%], p = 0.003); benzbromarone had an inverse association with nephrolithiasis (21 [48.8%] vs 55 [68.8%], p = 0.030). In patients with and without nephrolithiasis, no differences were found in the laboratory and ultrasonography characteristics, including serum uric acid levels, urinary uric acid excretion and urine pH. Conclusions The prevalence of nephrolithiasis in primary gout was 35.0%, and 18.7% of the patients were asymptomatic. Nephrolithiasis was associated with male gender, diabetes and dyslipidemia. A positive history of nephrolithiasis probably biased the prescription of potassium citrate and benzbromarone.
  • article 5 Citação(ões) na Scopus
    Long-term use of minimal footwear in older adult women with knee osteoarthritis: Mechanisms of action in the knee adduction moment
    (2020) TROMBINI-SOUZA, Francis; FULLER, Ricardo; GOLDENSTEIN-SCHAINBERG, Claudia; SACCO, Isabel C. N.
    Studies have shown the short- and long-term effects of wearing minimalist footwear in reducing knee loads in patients with knee osteoarthritis (OA). This study aimed to investigate the mechanisms underpinning the reduction in external knee adduction moment (EKAM) in older adult women who wore this type of footwear through a randomized controlled trial. Fifty-six participants with medial compartment knee OA were equally allocated to either an intervention group (IG) that wore minimalist footwear (Moleca (R)) or to a control group (CG) that continued regular clinical treatment for OA for six months. The influence of lower limb joint kinematics and joint frontal moments, center of pressure displacement, and foot progression angle in predicting the reduction of EKAM were assessed after a six-month intervention. Surprisingly, none of the seven independent variables predicted the first peak EKAM in the multiple regression model for the 1G. For the CG, the increase of one unit in the first peak of the hip adduction moment resulted in a 1.01 units increase in the first peak EKAM. Additionally, a one-unit reduction in the ankle eversion angle resulted in an increase of 0.16 units in the percent change in the first peak EKAM. Thus, wearing the Moleca (R) shoe for six months helped the participants keep a natural gait pattern without increasing the hip moment or the ankle inversion angle compared to the women who did not wear the Moleca (R) footwear.
  • article 35 Citação(ões) na Scopus
    Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial
    (2015) TROMBINI-SOUZA, Francis; MATIAS, Alessandra B.; YOKOTA, Mariane; BUTUGAN, Marco K.; GOLDENSTEIN-SCHAINBERG, Claudia; FULLER, Ricardo; SACCO, Isabel C. N.
    Background: Efforts have been made to retard the progressive debilitating pain and joint dysfunction in patients with knee osteoarthritis. We aimed to evaluate the therapeutic effect of a low-cost minimalist footwear on pain, function, clinical and gait-biomechanical aspects of elderly women with knee osteoarthritis. Methods: Throughout a randomized, parallel and controlled clinical trial, fifty-six patients with medial knee osteoarthritis were randomly allocated to an intervention (n = 28) or control group (n = 28), and assessed at baseline and after three and six months. The intervention involved wearing Moleca footwear for at least 6 h/day, 7 days/week, over 6 months. The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index was the primary outcome. The secondary outcomes were the other subscales, Lequesne score, distance walked in 6 min, knee oedema and effusion, knee adduction moment and paracetamol intake. Intention-to-treat analysis was performed using two-way casewise ANOVA (< .05) and Cohen's d coefficient. Findings: Intervention group showed improvement in pain (effect size: 1.41, p < .001), function (effect size: 1.22, p = .001), stiffness (effect size: 0.76, p = .001), Lequesne score (effect size: 1.07, p < .001), and reduction by 21.8% in the knee adduction moment impulse (p = .017) during gait wearing Moleca (R). The analgesic intake was lower in the intervention group. Interpretation: The long-term use of Moleca (R) footwear relieves pain, improves self-reported function, reduces the knee loading while wearing Moleca (R), refrains the increase of analgesic intalce in elderly women with knee ostearthritis and can be considered as a conservative mechanical treatment option.
  • conferenceObject
    ABILITY OF COLLAGEN TYPE V IN IN VITRO DIFFERENTIATION OF RABBIT ADIPOSE TISSUE-DERIVED STEM CELLS INTO CHONDROCYTE-LIKE PHENOTYPE
    (2013) GOLDENSTEIN-SCHAINBERG, Claudia; FULLER, Ricardo; VELOSA, Paula; CARRASCO, Solange; CAPELOZZI, Vera; YOSHINARI, Natalino; TEODORO, Walcy; CRUZ, Isabele
  • article 10 Citação(ões) na Scopus
    Post-Adipose-Derived Stem Cells (ADSC) Stimulated by Collagen Type V (Col V) Mitigate the Progression of Osteoarthritic Rabbit Articular Cartilage
    (2021) CRUZ, Isabele Camargo Brindo da; VELOSA, Ana Paula Pereira; CARRASCO, Solange; SANTOS FILHO, Antonio dos; MIRANDA, Jurandir Tomaz de; POMPEU, Eduardo; FERNANDES, Tiago Lazzaretti; BUENO, Daniela Franco; FANELLI, Camila; GOLDENSTEIN-SCHAINBERG, Claudia; FABRO, Alexandre Todorovic; FULLER, Ricardo; SILVA, Pedro Leme; CAPELOZZI, Vera Luiza; TEODORO, Walcy Rosolia
    Collagen is essential for cartilage adhesion and formation. In the present study, histology, immunofluorescence, morphometry, and qRT-PCR suggested that adipose-derived stem cells (ADSCs) stimulated by type V collagen (Col V) induce a significant increase of type II collagen (Col II) in the degenerative area of surgical-induced osteoarthritic rabbit articular cartilage (OA). In vitro, the effects of Col V on the proliferation and differentiation of ADSC were investigated. The expression of the cartilage-related genes Col2a1 and Acan was significantly upregulated and Pou5fl was downregulated post-ADSC/Col V treatment. Post-ADSC/Col V treatment, in vivo analyses revealed that rabbits showed typical signs of osteoarthritic articular cartilage regeneration by hematoxylin and eosin (H&E) and Safranin O/Fast Green staining. Immunohistochemical staining demonstrated that the volume of Col II fibers and the expression of Col II protein were significantly increased, and apoptosis Fas ligand positive significantly decreased post-ADSC/Col V treatment. In conclusion, the expression of Col II was higher in rabbits with surgical-induced osteoarthritic articular cartilage; hence, ADSC/Col V may be a promising therapeutic target for OA treatment.
  • bookPart
    Osteoartrite
    (2018) FULLER, Ricardo; SILVA, Henrique Carriço; GOLDENSTEIN-SCHAINBERG, Cláudia
  • bookPart
    Osteoartrite
    (2016) FULLER, Ricardo; SCHAINBERG, Cláudia Goldenstein