CAMILA DE GODOI CARNEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Does F-18-FDG-PET/MRI Add Metabolic Information to Anatomic Image in Childhood-onset Takayasu's Arteritis Patients? A Multicenter Case Series(2021) CLEMENTE, Gleice; SOUZA, Alexandre; FILHO, Hilton Leao; COELHO, Fernando; BUCHPIGUEL, Carlos; LIMA, Marcos; PIOTO, Daniela Petry; FRAGA, Melissa; SAKAMOTO, Ana Paula; CARNEIRO, Camila; PEREIRA, Rosa; AIKAWA, Nadia; SILVA, Clovis Artur; CAMPOS, Lucia; ASTLEY, Camilla; GUALANO, Bruno; TERRERI, MariaconferenceObject Exercise Improves Arterial Inflammation in Childhood-onset Takayasu Arteritis: A Randomized Controlled Trial(2019) ASTLEY, Camilla; CLEMENTE, Gleice; TERRERI, Maria Teresa; CARNEIRO, Camila; LIMA, Marcos; BUCHPIGUEL, Carlos; LEAO FILHO, Hilton; LIMA, Fernanda; SA-PINTO, Ana Lucia; SILVA, Clovis; AIKAWA, Nadia; GIL, Saulo; ROSCHEL, Hamilton; PEREIRA, Rosa; GUALANO, Bruno- In-depth cardiovascular and pulmonary assessments in children with multisystem inflammatory syndrome after SARS-CoV-2 infection: A case series study(2022) ASTLEY, Camilla; PEREIRA, Maria Fernanda Badue; LIMA, Marcos Santos; BUCHPIGUEL, Carlos Alberto; CARNEIRO, Camila G.; SAPIENZA, Marcelo Tatit; LEAL, Gabriela Nunes; PRADO, Danilo Marcelo Leite do; PECANHA, Tiago; SIECZKOWSKA, Sofia Mendes; MATSUO, Olivia Mari; LINDOSO, Livia; MARQUES, Heloisa Helena; SILVA, Clovis Artur; GUALANO, BrunoWe assessed PET-CT myocardial blood flow (MBF) using N-13 ammonia, brachial flow-mediated dilation, and cardiopulmonary exercise test in five post-discarged MIS-C survivors. None of the patients (median age: 9, range: 7-18 years; 3 females; 2 males) had preexisting pediatric chronic conditions. At the follow-up visit, two patients exhibited severe perfusion defect developed in the left ventricular cavity, suggesting extensive myocardial ischemia (MBF <2.0) and one patient showed persistent mild pericardial effusion. Others two patients demonstrated endothelial dysfunction. Nevertheless, all patients had lower predicted values in the VO2peak, VO2VAT, OUES, and O-2 Pulse (range: 35.2%-64.5%; 15.6%-38.2%; 1.0-1.3 L/min; 4-7 ml/beat), respectively. Our d suggested that previously health MIS-C patients had impaired MBF, endothelial dysfunction and lower cardiopulmonary capacity at follow-up analysis. Multidisciplinary further investigations should be conducted to reinforce these findings.
- Does [18F]F-FDG-PET/MRI add metabolic information to magnetic resonance image in childhood-onset Takayasu's arteritis patients? A multicenter case series(2022) CLEMENTE, Gleice; SOUZA, Alexandre W. de; LEAO FILHO, Hilton; COELHO, Fernando M. A.; BUCHPIGUEL, Carlos; LIMA, Marcos; CARNEIRO, Camila; PEREIRA, Rosa M. R.; AIKAWA, Nadia; SILVA, Clovis A.; CAMPOS, Lucia M. A.; ALVES, Gabriel; ASTLEY, Camilla; GUALANO, Bruno; TERRERI, Maria TeresaBackground The observation that 2-deoxy-2[18F]fluoro-D-glucose-positron emission tomography/magnetic resonance imaging ([18F]F-FDG-PET/MRI) revealed high-grade arterial wall FDG uptake, without arterial wall thickening with contrast-enhancement, in a considerable number of c-TA patients in our previous study, encouraged us to compare patients with both PET and MR angiography (MRA) positives, with those with PET positive but MRA negative. Our aim was to evaluate the relevance of these two imaging modalities together. Methods A three-center cross-sectional study with 17 patients who fulfilled the EULAR/PRINTO/PReS criteria for c-TA and who underwent [18F]F-FDG-PET/MRI was previously performed. Herein we compared patients/vessels with positive PET (arterial wall F-18-FDG uptake higher than liver) and positive MRA (arterial wall thickening with contrast-enhancement)-group 1, with those with positive PET but negative MRA-group 2. Results Median disease duration of 17 c-TA patients was 10.4 years. Nine patients were classified as group 1 and six as group 2. Median of metabolic inflammatory volume (MIV) of all arterial segments was significantly higher in group 1 (2346 vs. 1177 cm(3); p = 0.036). Fifty-four (19%) from 284 available arterial segments presented positive findings in vessel wall in one or both images. Positive findings were concordant between PET and MRA in only 13% arterial segments (group 1); most changes (28-59.6%) that were discordant between both images, were positive in PET and negative in MRA (group 2). Conclusion Our study demonstrated that [18F]F-FDG-PET/MRI added information about inflammation in vessel wall of c-TA patients. Prospective multicenter studies are needed in order to get solid data to guide immunosuppressive tapering and withdrawal.
- Is positron emission tomography/magnetic resonance imaging a reliable tool for detecting vascular activity in treated childhood-onset Takayasu's arteritis? A multicentre study(2022) CLEMENTE, Gleice; PEREIRA, Rosa M. R.; AIKAWA, Nadia; SILVA, Clovis A.; CAMPOS, Lucia M. A.; ALVES, Gabriel; BUCHPIGUEL, Carlos; LIMA, Marcos; CARNEIRO, Camila; FILHO, Hilton L.; MORBECK, Fernando; NETO, Guilherme; FILHO, Vicente O.; SOUZA, Alexandre W. D.; TERRERI, Maria TeresaObjectives Toassess whether F-18-fluordeoxiglucose (F-18-FDG) PET/MRI) with angiographic sequences can contribute to detecting vessel wall inflammation in patients with childhood-onset Takayasu's arteritis (c-TA) under immunosuppressive therapy. Methods A three-centre cross-sectional study was conducted. F-18-FDG PET/MRI scans were performed in c-TA patients and in oncologic patients, who served as the control group. Clinical and laboratory characteristics were also analysed. Results Seventeen c-TA patients (65% females) between the ages of 6 and 21 years with a mean disease duration of 9.4 years were recruited. Only one patient presented clinical disease activity and six (35.6%) had increased ESR and/or CRP levels. The most frequent magnetic resonance angiography (MRA) findings were stenosis and thickening, observed in 82.4 and 70.6% of c-TA patients, respectively. F-18-FDG PET revealed F-18-FDG uptake greater than the liver in at least one arterial segment in 15 (88.2%) patients in a qualitative analysis and a median maximum standardized uptake value (SUVmax) of 3.22 (interquartile range 2.76-3.69) in a semi-quantitative analysis. c-TA patients presented significantly higher SUVmax values than oncologic patients (P < 0.001). A positive correlation between SUVmax and CRP levels (rho = 0.528, P = 0.029) was seen. Conclusion A state-of-the-art imaging modality was used in c-TA patients and revealed a strong arterial FDG uptake even in patients in apparent remission. We suppose that this finding may represent silent activity in the vessel wall; however, we cannot exclude the possibility of arterial remodelling. Importantly, a negative imaging scan may help in immunosuppression withdrawal in daily clinical practice.
- Home-Based Exercise Training in Childhood-Onset Takayasu Arteritis: A Multicenter, Randomized, Controlled Trial(2021) ASTLEY, Camilla; CLEMENTE, Gleice; TERRERI, Maria Teresa; CARNEIRO, Camila G.; LIMA, Marcos S.; BUCHPIGUEL, Carlos Alberto; LEAO FILHO, Hilton; PINTO, Ana Lucia de Sa; SILVA, Clovis Artur; CAMPOS, Lucia Maria Arruda; AIKAWA, Nadia Emi; GIL, Saulo; PEREIRA, Rosa Maria Rodrigues; ROSCHEL, Hamilton; GUALANO, BrunoIntroduction: Childhood-onset Takayasu Arteritis (c-TA) is a rare, large-vessel vasculitis seen in children that could predisposing patients to a high risk of mortality. Exercise has the potential to improve overall health in several diseases, but evidence remains scant in c-TA. The main objective of this study was to investigate the safety and potential therapeutic effects of exercise in c-TA. Methods: This was a 12-week, multicenter, randomized, controlled trial, to test the effects of a home-based, exercise intervention vs. standard of care in c-TA patients in remission. The primary outcomes were arterial inflammation, assessed by [F-18] FDG-PET/MRI and systemic inflammatory markers. Secondary outcomes included, physical activity levels, functionality, body composition, disease-related parameters, and quality of life. Results: Thirty-seven patients were assessed for eligibility, which represents the total number of c-TA patients being followed by the three specialized medical ambulatory services in Sao Paulo. After exclusions, fourteen c-TA patients (71.4% females) aged 12-25 years were randomly allocated into exercised (n=5) and non-exercised groups (n=9). Exercise did not exacerbate arterial inflammation. In fact, exercised patients had a reduction in the frequency of vessel segments with severe inflammation, whereas the non-exercised patients had an opposite response (P=0.007). Greater improvements in visceral fat, steps per day, functionality and physical component SF-36 were observed in the exercised patients (P <= 0.05). Conclusions: Exercise is safe and may improve visceral fat, physical activity levels, functionality, and physical component SF-36 in c-TA patients. Thus, exercise arises as a novel, evidence-based intervention to improve general health in c-TA.
- Melatonin Increases Brown Adipose Tissue Volume and Activity in Patients With Melatonin Deficiency: A Proof-of-Concept Study(2019) HALPERN, Bruno; MANCINI, Marcio C.; BUENO, Clarissa; BARCELOS, Isabella P.; MELO, Maria Edna de; LIMA, Marcos S.; CARNEIRO, Camila G.; SAPIENZA, Marcelo T.; BUCHPIGUEL, Carlos Alberto; AMARAL, Fernanda Gaspar do; CIPOLLA-NETO, JoseMelatonin, a pineal hormone synthesized at night, is critical for the synchronization of circadian and seasonal rhythms, being a key regulator of energy metabolism in many animal species. Although studies in humans are lacking, several reports, mainly on hibernating animals, demonstrated that melatonin supplementation and a short photoperiod increase brown adipose tissue (BAT) mass. The present proof-of-concept study is the first, to our knowledge, to evaluate BAT in patients with melatonin deficiency (radiotherapy or surgical removal of pineal gland) before and after daily melatonin (3 mg) replacement for 3 months. All four studied patients presented increased BAT volume and activity measured by positron emission tomography-MRI. We also found an improvement in total cholesterol and triglyceride blood levels without significant effects on body weight, liver fat, and HDL and LDL levels. Albeit not statistically significant, fasting insulin levels and HOMA of insulin resistance decreased in all four patients. The present results show that oral melatonin replacement increases BAT volume and activity and improves blood lipid levels in patients with melatonin deficiency, suggesting that melatonin is a possible BAT activator. Future studies are warranted because hypomelatoninemia is usually present in aging and appears as a result of light-at-night exposure and/or the use of beta-blocker drugs.