BIANCA PIRES IHARA

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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina

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  • article 1 Citação(ões) na Scopus
    Intermittent abdominal pain in IgA vasculitis
    (2022) BUSCATTI, Izabel Mantovani; SIMON, Juliana Russo; VIANA, Vivianne Saraiva Leitao; ARABI, Tamima Mohamad Abou; TRINDADE, Vitor Cavalcanti; MAIA, Ana Carolina Cortez; MELO, Lara Regina Cavalcante; IHARA, Bianca Pires; AIKAWA, Nadia Emi; SILVA, Clovis Artur
    Objective: To assess intermittent abdominal pain in IgA vasculitis patients and its relation to demographic data, clinical manifestations and treatments. Methods: A retrospective cohort study included 322 patients with IgA vasculitis (EULAR/PRINTO/PRES criteria) seen at the Pediatric Rheumatology Unit in the last 32 years. Sixteen patients were excluded due to incomplete data in medical charts. Intermittent abdominal pain was characterized by new abdominal pain after complete resolution in the first month of disease. Results: Intermittent abdominal pain was observed in 35/306 (11%) IgA vasculitis patients. The median time between first and second abdominal pain was 10 days (3-30 days). The main treatment of intermittent abdominal pain included glucocorticoid [n=26/35 (74%)] and/or ranitidine [n=22/35 (63%)]. Additional analysis showed that the frequency of intermittent purpura/petechiae (37 vs. 21%; p=0.027) and the median of purpura/petechiae duration [20 (3-90) vs. 14 (1-270) days; p=0.014] were significantly higher in IgA vasculitis patients with intermittent abdominal pain compared to those without. Gastrointestinal bleeding (49 vs. 13%; p<0.001), nephritis (71 vs. 45%; p=0.006), glucocorticoid (74 vs. 44%; p=0.001) and intravenous immunoglobulin use (6 vs. 0%; p=0.036) were also significantly higher in the former group. The frequency of ranitidine use was significantly higher in IgA vasculitis patients with intermittent abdominal pain versus without (63 vs. 28%; p<0.001), whereas the median of ranitidine duration was reduced in the former group [35 (2-90) vs. 60 (5-425) days; p=0.004]. Conclusions:Intermittent abdominal pain occurred in nearly a tenth of IgA vasculitis patients, in the first 30 days of disease, and was associated with other severe clinical features. Therefore, this study suggests that these patients should be followed strictly with clinical and laboratorial assessment, particularly during the first month of disease course.
  • article 0 Citação(ões) na Scopus
    Impact of COVID-19 on physical and mental functioning in adolescents with disabilities in a sports nongovernmental organization
    (2023) LAURENTINO, Moises de Freitas; LINDOSO, Livia; ASTLEY, Camilla; LAVORATO, Sofia Simao Martins; IHARA, Bianca Pires; LIMA, Dandara Carvalho Casado de; GUALANO, Bruno; QUEIROZ, Ligia Bruni; PEREIRA, Rosa Maria Rodrigues; POLANCZYK, Guilherme Vanoni; CAMARGO, Olavo Pires de; SILVA, Clovis Artur; GRANGEIRO, Patricia Moreno
    Objective:This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0-10) vs. 5 (0-10), p=0.018] and prosocial [7 (0-10) vs. 9 (3-10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21-99) vs. 94 (67-100), p<0.001] and higher happiness scores in the PODCI scale [90 (65-100) vs. 80 (0-100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01-1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04-0.43, p=0.001) and screen time >= 3 h/day (OR=0.09; 95%CI 0.02-0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.
  • article 7 Citação(ões) na Scopus
    Laboratory-confirmed pediatric COVID-19 in patients with rheumatic diseases: A case series in a tertiary hospital
    (2021) IHARA, Bianca P.; STRABELLI, Claudia A. A.; SIMON, Juliana R.; VIANA, Vivianne S. L.; SALLUM, Adriana M. E.; KOZU, Katia T.; AIKAWA, Nadia E.; LEAL, Gabriela N.; PEREIRA, Maria F. B.; MARQUES, Heloisa H.; SILVA, Clovis A.; CAMPOS, Lucia M.
  • article 2 Citação(ões) na Scopus
    COVID-19 quarantine in adolescents with autoimmune rheumatic diseases: mental health issues and life conditions
    (2022) IHARA, Bianca P.; LINDOSO, Livia M.; SETOUE, Debora N. D.; TANIGAVA, Nicolas Y.; HELITO, Alberto C.; SIMON, Juliana R.; VIANA, Vivianne S. L.; STRABELLI, Claudia A. A.; PEDROSO, Camilla A. A.; SIECZKOWSKA, Sofia M.; PEREIRA, Rosa M. R.; AIKAWA, Nadia E.; KOZU, Katia T.; ELIAS, Adriana M.; BUSCATTI, Izabel M.; GUALANO, Bruno; QUEIROZ, Ligia B.; CASELLA, Caio B.; V, Guilherme Polanczyk; SILVA, Clovis A. A.; CAMPOS, Lucia M. M. A.
    Objectives To assess mental health and life conditions in adolescents with autoimmune rheumatic diseases (ARDs) and healthy controls quarantined during COVID-19 pandemic. Method A cross-sectional study included 155 ARD adolescents and 105 healthy controls. Online survey included self-reported strengths and difficulties questionnaire (SDQ), and a semi-structured questionnaire with demographic data, daily home and school routine, physical activities, and COVID-19 information during the pandemic. Results Among patients, 56% had juvenile idiopathic arthritis (JIA), 29% juvenile systemic lupus erythematosus (JSLE), and 15% juvenile dermatomyositis (JDM). No differences were found regarding sex, ethnicity, and current age between ARD patients and controls (p > 0.05). Abnormal emotional SDQ (38% vs. 35%, p = 0.653) were similar in both groups. Logistic regression analyses in ARD patients demonstrated that female (OR = 2.4; 95%CI 1.0-6.0; p = 0.044) was associated with severe emotional SDQ dysfunction, whereas sleep problems were considered as a risk factor for both worse total SDQ (OR = 2.6; 95%CI 1.2-5.5; p = 0.009) and emotional SDQ scores (OR = 4.6; 95%CI 2.2-9.7; p < 0.001). Comparisons between ARD patients with and without current prednisone use showed higher median scores of peer problems in the first group [3 (0-10) vs. 2 (0-7), p = 0.049], whereas similar median and frequencies between JIA, JSLE, and JDM (p > 0.05). Conclusions Approximately one third of JIA, JSLE, and JDM patients presented abnormal total and emotional scores of SDQ during COVID-19 quarantine. Sleep problems were the main factor associated with emotional difficulties in these ARD adolescents. The knowledge of mental health issues rates in adolescents with ARD supports the development of prevention strategies, like sleep hygiene counseling, as well as the references of the affected patients to specialized mental health services, as necessary.
  • article 6 Citação(ões) na Scopus
    Home-based exercise program for adolescents with juvenile dermatomyositis quarantined during COVID-19 pandemic: a mixed methods study
    (2021) ASTLEY, Camilla; SIECZKOWSKA, Sofia Mendes; MARQUES, Isabela Gouveia; IHARA, Bianca Pires; LINDOSO, Livia; LAVORATO, Sofia Simao Martins; CAMPOS, Lucia Maria Arruda; PEREIRA, Rosa Maria Rodrigues; ELIAS, Adriana Maluf; AIKAWA, Nadia Emi; KOZU, Katia; IRAHA, Amanda Yuri; FRANCO, Tathiane Christine; ROSCHEL, Hamilton; QUEIROZ, Ligia Bruni; POLANCZYK, Guilherme Vanoni; SILVA, Clovis Artur; GUALANO, Bruno
    Background Exercise has been suggested to prevent deterioration of health-related quality of life (HRQL) and overall health in pediatric rheumatologic diseases during the COVID-19 pandemic. Herein we describe the effects of a 12-week, home-based, exercise program on overall health and quality of life among quarantined patients with juvenile dermatomyositis (JDM). Method This prospective, quasi-experimental, mixed methods (qualitative and quantitative) study was conducted between July and December 2020, during the most restricted period of COVID-19 pandemic in Brazil. The home-based exercise program consisted of a 12-week, three-times-a-week, aerobic and strengthening (bodyweight) training program. Qualitative data were systematically evaluated. Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory (PedsQOL) and Pittsburgh Sleep Quality Index (PSQI) evaluate symptoms of mental health disorder, HRQL, and quality of sleep. Findings 11 patients (out of 27) met the inclusion criteria (91% female; mean +/- SD age: 13.5 +/- 3.2 years). Adherence to the intervention was 72.6%. Barriers to exercise involved poor internet connectivity, excessive weekly sessions, and other commitments. Even though not statistically significant, Self-report SDQ subscales Total Difficulties Score, Emotional Problems Score, and PedsQOL School Functioning Score improved after intervention (- 2.4; 95%confidence interval [CI] -5.1; 0.2, p = 0.06; - 1.0; 95%CI -2.2; 0.2, p = 0.09 and; 11.7; 95%CI -2.5; 25.8, p = 0.09, respectively). Remaining SDQ subscales were not altered. Six themes emerged from patients' and parents' comments (qualitative results). Patients engaged in exercise reported other health-related benefits including increased motivation, concentration and strength. Interpretation A home-based exercise program was associated with qualitative perceptions of improvements in overall health and HRQL by quarantined adolescents with JDM during COVID-19 pandemic. Lessons from this trial may help developing interventions focused on tackling physical inactivity in JDM.
  • article 7 Citação(ões) na Scopus
    Lessons learned from a home-based exercise program for adolescents with pre-existing chronic diseases during the COVID-19 quarantine in Brazil
    (2021) MARQUES, Isabela Gouveia; ASTLEY, Camilla; SIECZKOWSKA, Sofia Mendes; IRAHA, Amanda Yuri; FRANCO, Tathiane Christine; SMAIRA, Fabiana Infante; MAZZOLANI, Bruna Caruso; MIRANDA, Luana Cristina do Amaral; IHARA, Bianca Pires; PEREIRA, Rosa Maria R.; QUEIROZ, Ligia Bruni; SILVA, Clovis Artur; GUALANO, Bruno
  • conferenceObject
    ASYMPTOMATIC SARS-COV-2 INFECTION IN PEDIATRIC PATIENTS WITH JUVENILE DERMATOMYOSITIS AND OTHER RHEUMATIC DISEASES OF ONE TERTIARY REFERRAL HOSPITAL
    (2023) SIMON, Juliana R.; ELIAS, Adriana M.; PEREIRA, Maria F. B.; MARQUES, Heloisa H.; IHARA, Bianca P.; STRABELLI, Claudia A. A.; CAMPOS, Reinan T.; KOZU, Katia T.; AIKAWA, Nadia E.; SAKITA, Neusa K.; GRISI, Sandra J. F. E.; FERRER, Ana Paula S.; SANTOS, Vera A.; BAIN, Vera; SILVA, Clovis A.; CAMPOS, Lucia M. A.
  • conferenceObject
    MENTAL HEALTH ISSUES AND LIFE CONDITIONS OF ADOLESCENTS WITH JUVENILE DERMATOMYOSITIS AND OTHER AUTOIMMUNE RHEUMATIC DISEASES DURING COVID-19 QUARANTINE
    (2023) IHARA, Bianca; ELIAS, Adriana; SIMON, Juliana; VIANA, Vivianne; STRABELLI, Claudia; PEREIRA, Rosa; AIKAWA, Nadia; KOZU, Katia; BUSCATTI, Izabel; FERREIRA, Juliana; QUEIROZ, Ligia; GUALANO, Bruno; SILVA, Clovis; CAMPOS, Lucia
  • article 0 Citação(ões) na Scopus
    Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic
    (2023) CAMPOS, Reinan T.; LINDOSO, Livia; SOUSA, Renan A. de; HELITO, Alberto C.; IHARA, Bianca P.; STRABELLI, Claudia A. A.; PARADELAS, Levi M. V.; CARNEIRO, Beatriz O. L.; CARDOSO, Maria Paula R.; SOUZA, Jean Paulo V. de; FREIRE, Marianna R. de M.; ASTLEY, Camilla; LAURENTINO, Moises F.; BUSCATTI, Izabel M.; KOZU, Katia; AIKAWA, Nadia E.; SALLUM, Adriana M. E.; FERREIRA, Juliana C. O.; SIMON, Juliana R.; VIANA, Vivianne S. L.; QUEIROZ, Ligia B.; GUALANO, Bruno; ROSCHEL, Hamilton; PEREIRA, Rosa Maria R.; TOMA, Ricardo K.; WATANABE, Andreia; GRANGEIRO, Patricia M.; CASELLA, Caio B.; FARHAT, Sylvia C.; V, Guilherme Polanczyk; CAMPOS, Lucia Maria A.; SILVA, Clovis A.
    Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases.Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pitts-burgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0).Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inat-tention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent var-iables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00-7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08-3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12-4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93-0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95-0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19-0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16-0.77; p = 0.026) remained inversely associated with abnormal HI scores.Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppres-sive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal pro-gram to protect the mental health of adolescents with and without chronic illnesses during future pandemics.
  • article 14 Citação(ões) na Scopus
    A home-based exercise program during COVID-19 pandemic: Perceptions and acceptability of juvenile systemic lupus erythematosus and juvenile idiopathic arthritis adolescents.
    (2022) SIECZKOWSKA, Sofia Mendes; ASTLEY, Camilla; MARQUES, Isabela Gouveia; IRAHA, Amanda Yuri; FRANCO, Tathiane Christine; IHARA, Bianca Pires; LAVORATO, Sofia Simao Martins; LINDOSO, Livia; SETOUE, Debora Narumi Demitrol; TANIGAVA, Nicolas Yamada; CAMPOS, Lucia Maria Arruda; PEREIRA, Rosa Maria Rodrigues; AIKAWA, Nadia Emi; ROSCHEL, Hamilton; QUEIROZ, Ligia Bruni; V, Guilherme Polanczyk; SILVA, Clovis Artur; GUALANO, Bruno
    Objectives To investigate the perceptions and acceptability of a home-based exercise intervention in systemic lupus erythematosus (JSLE) and juvenile idiopathic arthritis (JIA) adolescent patients during the COVID-19 pandemic, and to explore the effects of the intervention on health-related quality of life (HRQoL), sleep quality, and mental health conditions parameters. Methods This was a randomized controlled trial of a 12-week, home-based exercise training program conducted between October and December 2020. During this period, social distancing measures were in place in Brazil to contain the spread of COVID-19. Adolescent patients diagnosed with JSLE and JIA participated in the study. Health-related qualitative and quantitative data were collected before and after the follow-up. Results 21 JSLE patients and 30 JIA patients were analyzed. Six themes emerged from patients' feedback: 1) Suitability of the home-based format; 2) Appropriate trainer supervision, 3) Motivators and facilitators for the program; 4) Barriers to the program; 5) Health benefits; 6) Patients' suggestions to improve the program. Overall, data indicated that the intervention showed good acceptability and elicited improvements in the perceived HRQoL and fatigue in JIA and JSLE patients during the pandemic. However, further quantitative analyses with validated HRQoL, sleep quality, and mental health conditions instruments did not capture these benefits (p>0.05). Conclusion Our main findings based on in-depth qualitative assessments suggest that a home-based exercise training program was suitable and well-accepted by adolescents with JSLE and JIA during the COVID-19 pandemic. Nonetheless, adherence was not high, particularly among JIA patients, suggesting that facilitators and barriers identified in the current study should be explored to improve the quality of new home-based exercise programs implementation, particularly in a future emerging crisis.