GABRIELA RIBEIRO VIOLA FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Sexual function in female juvenile idiopathic arthritis patients(2019) PITTA, Ana Claudia; FERREIRA, Gabriela Ribeiro Viola; TOMIOKA, Renato Bussadori; LOURENCO, Daniela Mencaroni Rodrigues; KOZU, Katia; AIKAWA, Nadia Emi; SALLUM, Adriana Maluf Elias; CAMPOS, Lucia Maria Arruda; ABDO, Carmita Helena Najjar; PEREIRA, Rosa Maria Rodrigues; BARACAT, Edmund Chada; BONFA, Eloisa; SILVA, Clovis ArturObjective: To evaluate sexual function female adolescents and young adults with juvenile idiopathic arthritis (JIA) and healthy controls. Methods: After exclusion, 21 female adolescent and young JIA patients and 25 healthy controls were selected for this study. Sexual function was assessed by the Sexual Quotient Questionnaire for Females (SQQ-F) score, which is a validated tool and adapted for Brazilian Portuguese language. Demographic data, JIA clinical/laboratory parameters and treatment were also assessed. Results: The median current age [26.5 (17-38.1) vs. 29.3 (19.7-35.8) years, p = 0.700)] as well as age at the first sexual activity [18 (14-30) vs. 17 (10-24) years, p = 0.158] were similar in JIA patients and healthy controls. The median of SQQF score was alike in both groups [75.9 (50-92) vs. 78.2 (58-94), p = 0.529], as well as frequencies of sexual dysfunction (14% vs. 12%, p = 1.000). The frequencies of all sexual domains (desire/sexual fantasies, desire/interest, arousal/foreplay, arousal/lubrication, arousal/in tune with partner, penetration/relaxation, pain/penetration, desire/involvement, orgasm and general satisfaction scores) were similar in JIA patients and healthy controls (p > 0.05). Conclusions: To our knowledge, this was the first study using a validated sexual score in a chronic arthritis population suggesting a low frequency of overall sexual dysfunction in young JIA patients. Future multicenter studies with a large sample will be necessary to confirm this finding.
- Disseminated histoplamosis in adolescent mimicking granulomatosis with polyangiitis(2017) WEELDEN, Marlon van; VIOLA, Gabriela R.; KOZU, Katia T.; AIKAWA, Nadia E.; IVO, Claudia M.; SILVA, Clovis A.
- Substance use and sexual function in juvenile idiopathic arthritis(2016) WEELDEN, Marlon van; LOURENCO, Benito; VIOLA, Gabriela R.; AIKAWA, Nadia E.; QUEIROZ, Ligia B.; SILVA, Clovis A.Objective: to evaluate alcohol/tobacco/illicit drug use and sexual function in adolescent juvenile idiopathic arthritis (JIA) and healthy controls. Methods: 174 adolescents with pediatric rheumatic diseases were selected. A cross-sectional study with 54 JIA patients and 35 controls included demographic/anthropometric data and puberty markers assessments, physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk and a questionnaire that evaluated sexual function, bullying and alcohol/tobacco/illicit drug use. Clinical/laboratorial data and treatment were also assessed in JIA. Results: The median current age was similar between JIA patients and controls [15(10-19) vs. 15(12-18) years, p = 0.506]. Frequencies of alcohol/tobacco/illicit drug use were high and similar in both JIA and controls (43% vs. 46%, p = 0.829). However, age at alcohol onset was significantly higher in those with JIA [15(11-18) vs. 14(7-18) years, p = 0.032], particularly in poliarticular onset (p = 0.040). High risk for substance abuse/dependence (CRAFFT score >= 2) was found in both groups (13% vs. 15%, p = 1.000), likewise bullying (p = 0.088). Further analysis of JIA patients regarding alcohol/tobacco/illicit drug use showed that the median current age [17(14-19) vs. 13(10-19) years, p < 0.001] and education years [11(6-13) vs. 7(3-12) years, p < 0.001] were significant higher in those that used substances. Sexual activity was significantly higher in the former group (48% vs. 7%, p < 0.001). A positive correlation was evidenced between CRAFFT score and current age in JIA patients (p = 0.032, r = + 0.296). Conclusion: A high risk for substance abuse/dependence was observed in both JIA and controls. JIA substance users were more likely to have sexual intercourse. Therefore, routine screening is suggested in all visits of JIA adolescents. (C) 2016 Elsevier Editora Ltda.
- Pulmonary cryptococcosis in childhood systemic lupus erythematosus and Sjogren syndrome overlap: a rare opportunistic infection(2013) MARQUES, V. L. S.; GOMES, R. C.; VIOLA, G. R.; MAIA, M. M.; DURIGON, G. S.; AIKAWA, N. E.; SILVA, C. ArturMeningitis is the main manifestation of cryptococcosis in adult systemic lupus erythematosus (SLE) patients, and other organs and systems, such as the lungs, are rarely affected in this fungal infection. To our knowledge, no case of pulmonary cryptococcosis has been described in the pediatric lupus population. Therefore, we report herein one patient with childhood SLE (C-SLE) and Sjogren's syndrome overlap that presented encapsulated Cryptococcus yeast cells in lung tissue. A 14-year-old girl was diagnosed with C-SLE. At the age of 16 years and 5 months, she presented with fever, cough and dyspnea, without headache, vomiting, and also without signs of meningeal irritation or other clinical manifestations. She was being treated with mycophenolate mofetil, hydroxychloroquine and prednisone. Chest radiography and chest computer tomography showed a single nodule in the left posterior apex and three nodular lesions in the left hemithorax respectively. Bronchoalveolar lavage and transbronchial biopsy were normal and without isolation of bacteria or fungi. Voriconazole was empirically introduced for 21 days. Fifteen days after the first biopsy, she underwent open thoracotomy with surgical left lung biopsy and was diagnosed with pulmonary cryptococcosis. Voriconazole was replaced with oral fluconazole and this antifungal therapy was maintained with improvement of clinical manifestations and without marked alteration of radiological images. In conclusion, we report the first case of pulmonary cryptococcosis in Sjogren's and C-SLE patient with a satisfactory clinical response to antifungal therapy. Fungal infections should be excluded in the presence of lung nodules and etiological identification is required for proper treatment.
conferenceObject Luteinized Unruptured Follicle Syndrome in Young Female with Juvenile Idiopathic Arthritis(2017) TOMIOKA, Renato B. B.; FERREIRA, Gabriela R. V.; AIKAWA, Nadia E.; MACIEL, Gustavo A. R.; SERAFINI, Paulo C.; BARACAT, Edmund; CAMPOS, Lucia M. A.; GOLDENSTEIN-SCHAINBERG, Claudia; PEREIRA, Rosa M. R.; BONFA, Eloisa; SILVA, Clovis A.conferenceObject Reduced Ovarian Reserve in Young Juvenile Idiopathic Arthritis Patients(2016) TOMIOKA, Renato B. B.; FERREIRA, Gabriela R. V.; AIKAWA, Nadia E.; MACIEL, Gustavo A. R.; SERAFINI, Paulo C.; BARACAT, Edmund C.; GOLDENSTEIN-SCHAINBERG, Claudia; PEREIRA, Rosa M. R.; BONFA, Eloisa; SILVA, Clovis A.- Ovarian reserve in young juvenile idiopathic arthritis patients(2019) FERREIRA, Gabriela R. V.; TOMIOKA, Renato B.; AIKAWA, Nadia E.; LEON, Elaine P.; MACIEL, Gustavo A. R.; SERAFINI, Paulo C.; BARACAT, Edmund C.; GOLDENSTEIN-SCHAINBERG, Claudia; PEREIRA, Rosa M. R.; BONFA, Eloisa; SILVA, Clovis A.Objectives: Juvenile idiopathic arthritis (JIA) occurs during reproductive age, however, there are no systematic data regarding ovarian function in this disease. Methods: Twenty-eight post-pubertal JIA patients and age-matched 28 healthy controls were studied. Complete ovarian function was assessed during the early follicular phase of the menstrual cycle including anti-Mullerian hormone (AMH), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and antral follicle count (AFC) by ovarian ultrasound, and anti-corpus lutheum antibodies (anti-CoL). Demographic data, menstrual abnormalities, disease parameters and treatment were also evaluated. Results: The mean current age (22.6 +/- 6.59 vs. 22.5 +/- 6.59 years, p = .952) was similar in JIA patients and healthy controls with a higher median menarche age [13(8-16) vs. 12(8-14) years, p = .029]. A lower median AMH levels [2.65(0.47-9.08) vs. 4.83(0.74-17.24) ng/mL, p = .029] with a higher LH [8.44 +/- 4.14 vs. 6.03 +/- 2.80 IU/L, p = .014] and estradiol levels [52.3(25.8-227.4) vs. 38.9(26.2-133.6) pg/mL, p = .008] were observed in JIA compared to control group. Anti-CoL and AFC were similar in both groups (p > .05). Further analysis of JIA patients revealed that current age, disease duration, number of active/limited joints, ESR, CRP, patient/physician VAS, JADAS 71, DAS 28, CHAQ, HAQ, patient/parents PedsQL, PF-SF 36, cumulative glucocorticoid and cumulative methotrexate doses were not correlated with AMH, FSH, estradiol levels or AFC (p > .05). Conclusion: The present study was the first to suggest diminished ovarian reserve, not associated to hypothalamic pituitary gonadal axis, in JIA patients during reproductive age. The impact of this dysfunction in future fertility of these patients needs to be evaluated in prospective studies.
- Lower genital tract infections in young female juvenile idiopathic arthritis patients(2019) V, Gabriela R. Ferreira; TOMIOKA, Renato B.; QUEIROZ, Ligia B.; KOZU, Katia; AIKAWA, Nadia E.; SALLUM, Adriana M. E.; SERAFINI, Paulo; TACLA, Maricy; BARACAT, Edmund C.; PEREIRA, Rosa M. R.; BONFA, Eloisa; SILVA, Clovis A.Background To evaluate human papillomavirus (HPV), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in juvenile idiopathic arthritis (JIA) patients. Methods After exclusion, 33 female adolescent and young JIA patients (ILAR criteria) and 28 healthy controls were selected for this study. Demographic data, gynecological, sexual function, cervical cytology and histological abnormalities were evaluated. JIA clinical/laboratorial parameters and treatment were also assessed. HPV-DNA, CT-DNA and NG-DNA testing in cervical specimens were performed by Hybrid Capture 2 assays. Results The mean current age was similar in JIA patients and controls (23.3 +/- 6.24 vs. 26.1 +/- 6.03 years, p = 0.09). The frequencies of sexual intercourse (76% vs. 89%, p = 0.201) and abnormal cervical cytology (24% vs. 11%, p = 0.201) were similar in JIA compared to controls. The higher frequency of HPV infection in JIA patients than controls (30% vs. 11%, p = 0.155) did not reach statistical significance. CT (0% vs. 7%, p = 0.207) and NG infections (0% vs. 4%, p = 0.459) were also alike in both groups. Further evaluation of JIA patients with abnormal and normal cervical cytology showed that the former group had a higher frequency of HPV infection (87% vs. 12%, p = 0.0002) with a low frequency of HPV vaccination (0% vs. 8%, p = 1.0). No differences were evidenced between these two JIA groups regarding demographic data, sexual function and clinical/laboratorial parameters. The frequencies of methotrexate (p = 0.206) and biological agent use (p = 0.238) were similar in both JIA groups. Conclusions To our knowledge, this was the first study to assess lower genital infections in JIA patients allowing the identification of HPV as main cause of cervical dysplasia. Methotrexate and biological agents do not seem to increase risk of lower genital tract infections in JIA patients.
- Chronic polyarthritis as isolated manifestation of toxocariasis(2016) VIOLA, Gabriela R.; GIACOMIN, Maria Fernanda A.; FRANCA, Camila M. P.; SALLUM, Adriana M. E.; JACOB, Cristina M. A.; SILVA, Clovis A.Human toxocariasis is a parasitic zoonosis mainly caused by Toxocara canis or Toxocara cati and is acquired by ingestion of the parasite's embryonated eggs. Arthralgia and/or arthritis were reported in up to 17% of the cases, generally with acute duration (less than 6 weeks). However, to our knowledge, chronic polyarthritis, as the isolated presentation of Toxocara infection, was not reported. One of the 5809 patients that was followed up at our service (0.017%) had chronic polyarthritis as the single manifestation of toxocariasis and was described herein. A 3-year-old girl was referred to our service with severe painful chronic polyarthritis for a period longer than 10 weeks and morning stiffness of 30 min. Dog contact exposure history in the recreational areas of neighborhood was reported. Her exams showed high levels of eosinophils in peripheral blood (29%), bone marrow aspirate revealed marked eosinophilia (32%) and Toxocara enzyme-linked immunosorbent assay (Elisa) was positive (1:1280). She was treated with paracetamol (40 mg/kg/day) and thiabendazole (25 mg/kg/day) for 10 days, and all manifestations reduced. After eight months of follow-up, she was on clinical and laboratorial remission. In conclusion, we described a case of chronic polyarthritis, as isolated manifestation of toxocariasis, mimicking juvenile idiopathic arthritis and leukemia. Importantly, this zoonosis should be considered in patients with arthritis and eosinophilia.
bookPart Artrite(2022) PUGLIESE, Camila; LOURENçO, Daniela Mencaroni Rodrigues; FERREIRA, Gabriela Ribeiro Viola; KOZU, Katia Tomie; SILVA, Clovis Artur Almeida da