FERNANDO HENRIQUE CARLOS DE SOUZA
Projetos de Pesquisa
Unidades Organizacionais
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Gathering Patients' and Physicians' Perceptions to Improve Outcomes in Systemic Autoimmune Myopathies(2019) BERTOGLIO, Isabela; ABRAHAO, Glaucia; UGOLINI-LOPES, Michelle Remiao; SOUZA, Fernando Henrique; MIOSSI, Renata; SHINJO, Samuel; BONFA, Eloisa- The Brazilian Society of Rheumatology recommendations on investigation and diagnosis of systemic autoimmune myopathies(2019) SOUZA, Fernando Henrique Carlos de; ARAUJO, Daniel Brito de; VILELA, Veronica Silva; SIMOES, Ricardo Santos; BERNARDO, Wanderley Marques; FRANK, Thais Amanda; CUNHA, Bernardo Matos da; SHINJO, Samuel KatsuyukiBackground This research is recommended by the Myopathy Committee of the Brazilian Society of Rheumatology for the investigation and diagnosis of systemic autoimmune myopathies. Body A systematic literature review was performed in the Embase, Medline (PubMed) and Cochrane databases, including studies published until October 2018. PRISMA was used for the review, and the articles were evaluated, based on the Oxford levels of evidence. Ten recommendations were developed addressing different aspects of systemic autoimmune myopathy investigation and diagnosis. Conclusions The European League Against Rheumatism/ American College of Rheumatology (EULAR/ACR) classification stands out for the diagnosis of systemic autoimmune myopathies. Muscular biopsy is essential, aided by muscular magnetic resonance images and electroneuromyography in complementary research. Analysis of the factors related to prognosis with the evaluation of extramuscular manifestations, and comorbidities and intense investigation regarding differential diagnoses are mandatory.
conferenceObject Distinctive Pattern of LTBI Screening Parameters in Ankylosing Spondylitis (AS) and Psoriatic Arthritis (PsA) in Endemic Areas(2019) SHIMABUCO, Andrea; RIBEIRO, Ana Cristina de Medeiros; MIOSSI, Renata; BONFIGLIOLI, Karina; MORAES, Julio Cesar Bertacini; GONCALVES, Celio; SAMPAIO-BARROS, Percival; GOLDENSTEIN-SCHAINBERG, Claudia; SOUZA, Fernando Henrique; PRADO, Leandro; UGOLINI-LOPES, Michelle Remiao; YUKI, Emily; BONFA, Eloisa; SAAD, Carla Goncalves Schahin- Guidelines of the Brazilian Society of Rheumatology for the treatment of systemic autoimmune myopathies(2019) SOUZA, Fernando Henrique Carlos de; ARAUJO, Daniel Brito de; VILELA, Veronica Silva; BEZERRA, Mailze Campos; SIMOES, Ricardo Santos; BERNARDO, Wanderley Marques; MIOSSI, Renata; CUNHA, Bernardo Matos da; SHINJO, Samuel KatsuyukiBackground: Recommendations of the Myopathy Committee of the Brazilian Society of Rheumatology for the management and therapy of systemic autoimmune myopathies (SAM). Main body: The review of the literature was done in the search for the Medline (PubMed), Embase and Cochrane databases including studies published until June 2018. The Prisma was used for the systematic review and the articles were evaluated according to the levels of Oxford evidence. Ten recommendations were developed addressing the management and therapy of systemic autoimmune myopathies. Conclusions: Robust data to guide the therapeutic process are scarce. Although not proven effective in controlled clinical trials, glucocorticoid represents first-line drugs in the treatment of SAM. Intravenous immunoglobulin is considered in induction for refractory cases of SAM or when immunosuppressive drugs are contra-indicated. Consideration should be given to the early introduction of immunosuppressive drugs. There is no specific period determined for the suspension of glucocorticoid and immunosuppressive drugs when individually evaluating patients with SAM. A key component for treatment in an early rehabilitation program is the inclusion of strength-building and aerobic exercises, in addition to a rigorous evaluation of these activities for remission of disease and the education of the patient and his/her caregivers.
- LTBI SCREENING IN SPONDYLOARTHRITIS PATIENTSPRIOR TO ANTI-TNF TREATMENT AND FOLLOW-UP IN AN ENDEMIC AREA(2019) SHIMABUCO, Andrea; MEDEIROS, Ana; MIOSSI, Renata; BONFIGLIOLI, Karina; MORAES, Julio; GONCALVES, Celio; SAMPAIO-BARROS, Percival D.; GOLDENSTEIN-SCHAINBERG, Claudia; SOUZA, Fernando; PRADO, Leandro; LOPES, Michelle; BONFA, Eloisa; SAAD, Carla
- Nailfold capillary changes in adult new-onset dermatomyositis: a prospective cross-sectional study(2019) MIOSSI, Renata; SOUZA, Fernando Henrique Carlos de; SHINJO, Samuel KatsuyukiObjectives It is to prospectively analyze nailfold capillaroscopy (NC) findings in new-onset dermatomyositis (DM) and to correlate NC findings with serum angiogenic cytokines and DM clinical and laboratory features. Materials and methods Twenty-three patients with DM who experienced < 12 months of symptoms were included in the study. To assess serum cytokine levels, 23 age-, sex-, and ethnicity-matched healthy volunteers were used. NC characteristics and DM activity parameters were analyzed. Results Significantly higher serum angiogenin (ANG) and vascular endothelial growth factor-1 (VEGF1) levels were observed in DM patients than in controls. Capillary density and avascular areas correlated positively and negatively, respectively, with serum levels of ANG. Moreover, the capillary density correlated inversely with the number of enlarged and giant capillaries and avascular areas. The number of enlarged capillaries correlated positively with patient and physician visual analogue scales (VAS), the presence of a facial rash, giant capillaries, and microhemorrhages. Giant capillaries had a positive correlation with physician and cutaneous VAS, enlarged capillaries, avascular areas, microhemorrhages and bushy capillaries, and a negative correlation with capillary density. Microhemorrhages correlated positively with the ""V-neck"" sign and physician VAS. VEGF1 showed no relationship with the NC parameters with DM-related clinical and laboratory features. Additionally, 15 out of 23 patients were assessed prospectively after 3.21 years. All patients had a major clinical response with significant improvement in all NC parameters, except for enlarged and bushy capillaries. Conclusions The NC may be a useful tool to assess disease activity in recent-onset DM, and it can also reinforce the role of ANG in the angiogenesis of this myopathy.