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  • article 0 Citação(ões) na Scopus
    Transcriptomic signatures of classical monocytes reveal pro-inflammatory modules and heterogeneity in polyarticular juvenile idiopathic arthritis
    (2024) HOUNKPE, Bidossessi W.; SALES, Lucas P.; RIBEIRO, Surian C. R.; PEREZ, Mariana O.; CAPARBO, Valeria F.; DOMICIANO, Diogo Souza; FIGUEIREDO, Camille P.; PEREIRA, Rosa M. R.; BORBA, Eduardo F.
    Introduction Polyarticular juvenile idiopathic arthritis (pJIA) is a childhood-onset autoimmune disease. Immune cells contribute to persistent inflammation observed in pJIA. Despite the crucial role of monocytes in arthritis, the precise involvement of classical monocytes in the pathogenesis of pJIA remains uncertain. Here, we aimed to uncover the transcriptomic patterns of classical monocytes in pJIA, focusing on their involvement in disease mechanism and heterogeneity.Methods A total of 17 healthy subjects and 18 premenopausal women with pJIA according to ILAR criteria were included. Classical monocytes were isolated, and RNA sequencing was performed. Differential expression analysis was used to compare pJIA patients and healthy control group. Differentially expressed genes (DEGs) were identified, and gene set enrichment analysis (GSEA) was performed. Using unsupervised learning approach, patients were clustered in two groups based on their similarities at transcriptomic level. Subsequently, these clusters underwent a comparative analysis to reveal differences at the transcriptomic level.Results We identified 440 DEGs in pJIA patients of which 360 were upregulated and 80 downregulated. GSEA highlighted TNF-alpha and IFN-gamma response. Importantly, this analysis not only detected genes targeted by pJIA therapy but also identified new modulators of immuno-inflammation. PLAUR, IL1B, IL6, CDKN1A, PIM1, and ICAM1 were pointed as drivers of chronic hyperinflammation. Unsupervised learning approach revealed two clusters within pJIA, each exhibiting varying inflammation levels.Conclusion These findings indicate the pivotal role of immuno-inflammation driven by classical monocytes in pJIA and reveals the existence of two subclusters within pJIA, regardless the positivity of rheumatoid factor and anti-CCP, paving the way to precision medicine.
  • article 0 Citação(ões) na Scopus
    Cardiorespiratory abnormalities in ICU survivors of COVID-19 with postacute sequelae of SARS-CoV-2 infection are unrelated to invasive mechanical ventilation
    (2024) LONGOBARDI, Igor; PRADO, Danilo Marcelo Leite do; ANDRADE, Danieli Castro Oliveira de; GOESSLER, Karla Fabiana; OLIVEIRA JUNIOR, Gersiel Nascimento de; AZEVEDO, Rafael de Almeida; LEITAO, Alice Erwig; SANTOS, Jhonnatan Vasconcelos Pereira; PINTO, Ana Lucia de Sa; GUALANO, Bruno; ROSCHEL, Hamilton
    Postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) often leads to exertional intolerance and reduced exercise capacity, particularly in individuals previously admitted to an intensive care unit (ICU). However, the impact of invasive mechanical ventilation (IMV) on PASC-associated cardiorespiratory abnormalities during exercise remains poorly understood. This single-center, cross-sectional study aimed to gather knowledge on this topic. Fifty-two patients with PASC recruited similar to 6 mo after ICU discharge were clustered based on their need for IMV (PASC + IMV, n = 27) or noninvasive support therapy (PASC + NIS, n = 25). Patients underwent pulmonary function and cardiopulmonary exercise testing (CPX) and were compared with a reference group (CONTROL, n = 19) comprising individuals of both sexes with similar age, comorbidities, and physical activity levels but without a history of COVID-19 illness. Individuals with PASC, irrespective of support therapy, presented with higher rates of cardiorespiratory abnormalities than CONTROL, especially dysfunctional breathing patterns, dynamic hyperinflation, reduced oxygen uptake and oxygen pulse, and blunted heart rate recovery (all P < 0.05). Only the rate of abnormal oxygen pulse was greater among PASC + IMV group than PASC + NIS group (P = 0.05). Mean estimates for all CPX variables were comparable between PASC + IMV and PASC + NIS groups (all P > 0.05). These findings indicate significant involvement of both central and peripheral factors, leading to exertional intolerance in individuals with PASC previously admitted to the ICU, regardless of their need for IMV.
  • article
    Global, regional, and national burden of other musculoskeletal disorders, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021
    (2023) GILL, Tiffany K.; MITTINTY, Manasi Murthy; MARCH, Lyn M.; STEINMETZ, Jaimie D.; CULBRETH, Garland T.; CROSS, Marita; KOPEC, Jacek A.; WOOLF, Anthony D.; HAILE, Lydia M.; HAGINS, Hailey; ONG, Kanyin Liane; KOPANSKY-GILES, Deborah R.; DREINHOEFER, Karsten E.; BETTERIDGE, Neil; ABBASIAN, Mohammadreza; ABBASIFARD, Mitra; ABEDI, Krishna; ADESINA, Miracle Ayomikun; AITHALA, Janardhana P.; AKBARZADEH-KHIAVI, Mostafa; THAHER, Yazan Al; ALALWAN, Tariq A.; ALZAHRANI, Hosam; AMIRI, Sohrab; ANTONY, Benny; ARABLOO, Jalal; ARAVKIN, Aleksandr Y.; ARUMUGAM, Ashokan; ARYAL, Krishna K.; ATHARI, Seyyed Shamsadin; ATREYA, Alok; BAGHDADI, Soroush; BARDHAN, Mainak; BARRERO, Lope H.; BEARNE, Lindsay M.; BEKELE, Alehegn Bekele; BENSENOR, Isabela M.; BHARDWAJ, Pankaj; BHATTI, Rajbir; BIJANI, Ali; BORDIANU, Theresa; BOUAOUD, Souad; BRIGGS, Andrew M.; CHEEMA, Huzaifa Ahmad; CHRISTENSEN, Steffan Wittrup McPhee; CHUKWU, Isaac Sunday; CLARSEN, Benjamin; DAI, Xiaochen; LUCA, Katie de; DESYE, Belay; DHIMAL, Meghnath; Thanh Chi Do; FAGBAMIGBE, Adeniyi Francis; FORGHANI, Siamak Farokh; FERREIRA, Nuno; GANESAN, Balasankar; GEBREHIWOT, Mesfin; GHASHGHAEE, Ahmad; GRAHAM, Simon Matthew; I, Netanja Harlianto; HARTVIGSEN, Jan; I, Ahmed Hasaballah; HASANIAN, Mohammad; HASSEN, Mohammed Bheser; I, Simon Hay; HEIDARI, Mohammad; HSIAO, Alexander Kevin; ILIC, Irena M.; JOKAR, Mohammad; KHAJURIA, Himanshu; KHAN, Md Jobair; KHANAL, Praval; KHATERI, Sorour; KIADALIRI, Ali; KIM, Min Seo; KISA, Adnan; KOLAHI, Ali-Asghar; KRISHAN, Kewal; KRISHNAMOORTHY, Vijay; LANDIRES, Ivan; LARIJANI, Bagher; Thao Thi Thu Le; LEE, Yo Han; LIM, Stephen S.; LO, Justin; MADANI, Seyedeh Panid; MALAGON-ROJAS, Jeadran N.; MALIK, Iram; MARATEB, Hamid Reza; MATHEW, Ashish J.; MERETOJA, Tuomo J.; MESREGAH, Mohamed Kamal; MESTROVIC, Tomislav; MIRAHMADI, Alireza; MISGANAW, Awoke; MOHAGHEGH, Sadra; MOKDAD, Ali H.; MOMENZADEH, Kaveh; MOMTAZMANESH, Sara; MONASTA, Lorenzo; MONI, Mohammad Ali; MORADI, Yousef; MOSTAFAVI, Ebrahim; MUHAMMAD, Jibran Sualeh; MURRAY, Christopher J. L.; MUTHU, Sathish; NARGUS, Shumaila; NASSERELDINE, Hasan; NEUPANE, Subas; NIAZI, Robina Khan; OH, In-Hwan; OKATI-ALIABAD, Hassan; OULHAJ, Abderrahim; PACHECO-BARRIOS, Kevin; PARK, Seoyeon; PATEL, Jay; PAWAR, Shrikant; PEDERSINI, Paolo; PERES, Mario F. P.; PETCU, Ionela-Roxana; PETERMANN-ROCHA, Fanny Emily; POURSADEQIYAN, Mohsen; QATTEA, Ibrahim; QURESHI, Maryam Faiz; RAFFERTY, Quinn; RAHIMI-DEHGOLAN, Shahram; RAHMAN, Mosiur; RAMASAMY, Shakthi Kumaran; RASHEDI, Vahid; REDWAN, Elrashdy Moustafa Mohamed; RIBEIRO, Daniel Cury; ROEVER, Leonardo; SAFARY, Azam; SAGOE, Dominic; SHARIF-ASKARI, Fatemeh Saheb; SAHEBKAR, Amirhossein; SALEHI, Sana; SHAFAAT, Amir; SHAHABI, Saeed; SHARMA, Saurab; SHASHAMO, Bereket Beyene; SHIRI, Rahman; SINGH, Ambrish; SLATER, Helen; SMITH, Amanda E.; SUNUWAR, Dev Ram; TABISH, Mohammad; THARWAT, Samar; ULLAH, Irfan; TAHBAZ, Sahel Valadan; VASANKARI, Tommi Juhani; VILLAFANE, Jorge Hugo; VOLLSET, Stein Emil; WIANGKHAM, Taweewat; YONEMOTO, Naohiro; YOU, Yuyi; ZARE, Iman; ZHENG, Peng; VOS, Theo; BROOKS, Peter M.
    Background Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431-564) people had other musculoskeletal disorders in 2020, an increase of 123 center dot 4% (116 center dot 9-129 center dot 3) in total cases from 221 million (192-253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107-124) from 2020 to 2050, to an estimated 1060 million (95% UI 964-1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47 center dot 4% (44 center dot 9-49 center dot 4) higher in females than in males and increased with age to a peak at 65-69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42 center dot 7 million [29 center dot 4-60 center dot 0]) and was associated with 83 100 deaths (73 600-91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data.
  • article
    Association Between Wearable Device Use and Quality of Life in Patients With Idiopathic Inflammatory Myopathies and Primary Systemic Vasculitis
    (2024) PEREIRA, Nathalia G.; SANTOS, Alexandre M. Dos; SHINJO, Samuel K.
    Background Despite the increasing use of wearable devices worldwide, concise data on these instruments in patients with systemic autoimmune rheumatic diseases, including idiopathic inflammatory myopathies (IIM) and primary systemic vasculitis (PSV), are lacking. Objectives The aim of this study is to investigate the knowledge and use of wearable devices and to assess their impact on the general quality of life of patients with IIM and PSV. Moreover, we compared these characteristics between patients with IIM and PSV users and non-users of wearable devices. Methods This single -center, cross-sectional study was conducted between January 2023 and June 2023. We included adult patients with IIM and PSV and a control group (CTR) and evaluated their use of cell phones and wearables, level of physical activity, and quality of life. Results A total of 132 patients with IIM, 82 with PSV, and 178 in the CTR were evaluated. Overall, 169 patients and 144 in the CTR were aware of wearable devices, of whom 50 (29.6%) and 47 (32.6%), respectively, had already used this technology. In addition, the IPAQ-Mets and EQ-5D scores were lower in the IIM and PSV groups than in the CTR, and the fatigue severity scale (FSS) scores were higher in the IIM and PSV groups than in the CTR. Patients who used the devices showed FSS scores of 29 (18-40) points, with higher levels of IPAQ-Mets among device users, indicating greater physical activity than among nonusers. Conclusion Based on the results, the use of wearable devices is associated with better fatigue and IPAQ scores. Possibly, the use of such devices can have an impact on better lifestyle habits among these patients.
  • article 4 Citação(ões) na Scopus
    International Guideline for Idiopathic Inflammatory Myopathy-Associated Cancer Screening: an International Myositis Assessment and Clinical Studies Group (IMACS) initiative
    (2023) OLDROYD, Alexander G. S.; CALLEN, Jeffrey P.; CHINOY, Hector; CHUNG, Lorinda; FIORENTINO, David; GORDON, Patrick; MACHADO, Pedro M.; MCHUGH, Neil; SELVA-O'CALLAGHAN, Albert; SCHMIDT, Jens; TANSLEY, Sarah L.; VLEUGELS, Ruth Ann; WERTH, Victoria P.; AGGARWAL, Rohit; SHINJO, Samuel Katsuyuki
    Adult-onset idiopathic inflammatory myopathy (IIM) is associated with an increased cancer risk within the 3 years preceding and following IIM onset. Evidence- and consensus-based recommendations for IIM-associated cancer screening can potentially improve outcomes. This International Guideline for IIM-Associated Cancer Screening provides recommendations addressing IIM-associated cancer risk stratification, cancer screening modalities and screening frequency. The international Expert Group formed a total of 18 recommendations via a modified Delphi approach using a series of online surveys. First, the recommendations enable an individual patient's IIM-associated cancer risk to be stratified into standard, moderate or high risk according to the IIM subtype, autoantibody status and clinical features. Second, the recommendations outline a 'basic' screening panel (including chest radiography and preliminary laboratory tests) and an 'enhanced' screening panel (including CT and tumour markers). Third, the recommendations advise on the timing and frequency of screening via basic and enhanced panels, according to risk status. The recommendations also advise consideration of upper or lower gastrointestinal endoscopy, nasoendoscopy and 18F-FDG PET-CT scanning in specific patient populations. These recommendations are aimed at facilitating earlier IIM-associated cancer detection, especially in those who are at a high risk, thus potentially improving outcomes, including survival. In this Evidence-Based Guideline article, an international, multidisciplinary group of experts presents evidence-based consensus recommendations on screening for cancer in patients with adult-onset idiopathic inflammatory myopathy, addressing cancer risk stratification, screening modalities and screening frequency.
  • article 0 Citação(ões) na Scopus
    Correction to: An Intersectoral Approach to Hypertension Care: Solutions for Improving Blood Pressure Control in São Paulo, Brazil(Jan, 10.1093/ajh/hpae005/7517527, 2024)
    (2024) AVEZUM, Alvaro; DRAGER, Luciano F.; REIKER, Theresa; BIGONI, Alessandro; LEONEL, Lays P.; ABREU, Ariane; BORTOLOTTO, Luiz; PALMEIRIM, Marta Solveig; SILVEIRA, Mariana; AQUINO, Beatriz; MAGGION, Rafael Venijio; BAXTER, Yara Carnevalli; MUNOZ, Daniel Cobos; DIB, Karina Mauro; AMARAL, Amaury Zatorre; SARIC, Jasmina; JARRETT, Caitlin; BOCH, Johannes
  • article 7 Citação(ões) na Scopus
    Prediction of Liver Steatosis Applying a New Score in Subjects from the Brazilian Longitudinal Study of Adult Health
    (2020) PERAZZO, Hugo; BENSENOR, Isabela; MILL, Jose Geraldo; PACHECO, Antonio G.; FONSECA, Maria de Jesus Mendes da; GRIEP, Rosane Haerter; LOTUFO, Paulo; CHOR, Dora
    Goals:To develop a noninvasive algorithm for diagnosis of liver steatosis and to compare its diagnostic value with available predictive models.Background:Liver steatosis represents the most frequent liver disease worldwide.Study:This cross-sectional study analyzed data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Patients were randomly divided into training (n=6571) and validation (n=3286) cohort. Abdominal ultrasound (US), used to grade steatosis, and overnight fasting blood tests were performed at the same day. Fatty Liver Index (FLI), Hepatic Steatosis Index, and Nonalcoholic Fatty Liver Disease-Liver Fat Score were calculated. A backward stepwise multivariate logistic regression analysis was used to develop the new predictive model, Steato-ELSA.Results:In total, 9857 subjects [58% female, age=51 (interquartile range, 45 to 58) years, body mass index=26.4 (23.9 to 29.6) Kg/m(2)] were included. Body mass index, waist circumference, homeostasis model of assessment of insulin resistance, transaminases, and triglycerides were independently associated with steatosis in the multivariate model (Hosmer-Lemeshow P=0.279). In the validation cohort, the area under the receiver-operator characteristics (95% confidence interval) for prediction of mild and moderate steatosis were: (i) 0.768 (0.751-0.784) and 0.829 (0.810-0.848) for Steato-ELSA; (ii) 0.762 (0.745-0.779) and 0.819 (0.799-0.838) for Fatty Liver Index; (iii) 0.743 (0.727-0.761) and 0.800 (0.779-0.822) for Hepatic Steatosis Index; and (iv) 0.719 (0.701-0.737) and 0.769 (0.747-0.791) for Nonalcoholic Fatty Liver Disease-Liver Fat Score. Steato-ELSA performed significantly better than other models and yielded sensitivity (Se)/specificity (Sp) (95% confidence interval): (i) for mild steatosis (score >= 0.386): Se=65.6% (63.0-68.3) and Sp=73.7% (71.8-75.6); (ii) for moderate steatosis (score >= 0.403): Se=83.5% (80.0-86.9) and Sp=68.7% (67.0-70.4).Conclusions:Steato-ELSA is an accurate and inexpensive tool that uses simple parameters to identify individuals at high risk of liver steatosis.
  • article 0 Citação(ões) na Scopus
    Tr iglycer ide-glucose index demonstrates reasonable performance as a screening tool but exhibits limited diagnostic utility for insulin resistance: Data from the ELSA-Brasil cohort
    (2024) OLIVEIRA, Phablo Wendell C.; MILL, Jose Geraldo; SANTOS, Itamar de Souza; LOTUFO, Paulo Andrade; MOLINA, Maria del Carmen Bisi; MENDES, Fernanda Duarte; SANTOS, Hully Cantao dos; FARIA, Carolina Perim de
    Insulin resistance (IR) is a key risk factor for chronic metabolic diseases, but its laboratory diagnosis is still costly; thus, the triglyceride-glucose (TyG) index has been proposed as a surrogate method. Our aim was to provide a detailed analysis of cutoffs and test the hypothesis that the TyG index would present reasonable performance parameters for IR screening. This is a cross-sectional study with baseline data from 12,367 eligible participants of both sexes (aged 35-74 years) from the Brazilian Longitudinal Study of Adult Health. TyG correlation and agreement with the Homeostasis Model Assessment for Insulin Resistance were analyzed. Positive and negative predictive values (PV + , PV-) and likelihood ratio (LR + , LR-) were calculated. A moderate positive correlation between TyG and Homeostasis Model Assessment for Insulin Resistance was observed (Pearson r = 0.419). The area under the receiver operating characteristic curve of TyG for IR diagnosis was 0.742 and the optimal cutoff was 4.665, reaching a kappa agreement value of 0.354. For this cutoff, a PV + of 59.3% and PV- of 76.0%, as well as an LR+ of 2.07 and LR- of 0.45 were obtained. Alternatively, because high sensitivity is desired for screening tests, selecting a lower cutoff, such as 4.505, increases the PV- to 82.1%, despite decreasing the PV + to 50.8%. We conclude that TyG has important performance limitations for detecting IR, but that it may still be reasonably useful to help screening for IR in adults because it can be calculated from low-cost routine blood tests.
  • article
    Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021
    (2024) WU, Ai-Min; CROSS, Marita; ELLIOTT, James M.; CULBRETH, Garland; COUSIN, Ewerton; HAILE, Lydia M.; STEINMETZ, Jaimie; HAGINS, Hailey; KOPEC, Jacek A.; BROOKS, Peter M.; WOOLF, Anthony; KOPANSKY-GILES, Deborah R.; WALTON, David M.; TRELEAVEN, Julia M.; DREINHOEFER, Karsten E.; BETTERIDGE, Neil; ABBASIFARD, Mitra; ABBASI-KANGEVARI, Zeinab; ADDO, Isaac Yeboah; ADESINA, Miracle Ayomikun; ADNANI, Qorinah Estiningtyas Sakilah; AITHALA, Janardhana P.; ALHALAIQA, Fadwa Alhalaiqa Naji; ALIMOHAMADI, Yousef; AMIRI, Sohrab; AMU, Hubert; ANTONY, Benny; ARABLOO, Jalal; ARAVKIN, Aleksandr Y.; ASGHARI-JAFARABADI, Mohammad; ATOMSA, Gamechu Hunde; AZADNAJAFABAD, Sina; AZZAM, Ahmed Y.; BAGHDADI, Soroush; BALOGUN, Saliu A.; BALTA, Asaminew Birhanu; BANACH, Maciej; BANAKAR, Morteza; BARROW, Amadou; BASHIRI, Azadeh; BEKELE, Alehegn; BENSENOR, Isabela M.; BHARDWAJ, Pankaj; BHAT, Ajay Nagesh; BILCHUT, Awraris Hailu; BRIGGS, Andrew M.; BUCHBINDER, Rachelle; CAO, Chao; CHAURASIA, Akhilanand; CHIRINOS-CACERES, Jesus Lorenzo; CHRISTENSEN, Steffan Wittrup McPhee; COBERLY, Kaleb; DADRAS, Omid; DAI, Xiaochen; LUCA, Katie de; DEHGHAN, Azizallah; DONG, Huan-Ji; EKHOLUENETALE, Michael; ELHADI, Muhammed; ESHETU, Habitu Birhan; ESKANDARIEH, Sharareh; ETAEE, Farshid; FAGBAMIGBE, Adeniyi Francis; FARES, Jawad; FATEHIZADEH, Ali; FEIZKHAH, Alireza; FERREIRA, Manuela L.; FERREIRA, Nuno; FISCHER, Florian; FRANKLIN, Richard Charles; GANESAN, Balasankar; GEBREMICHAEL, Mathewos Alemu; GEREMA, Urge; GHOLAMI, Ali; GHOZY, Sherief; GILL, Tiffany K.; GOLECHHA, Mahaveer; GOLEIJ, Pouya; GOLINELLI, Davide; GRAHAM, Simon Matthew; HAJ-MIRZAIAN, Arvin; HARLIANTO, Netanja I.; HARTVIGSEN, Jan; HASANIAN, Mohammad; HASSEN, Mohammed Bheser; I, Simon Hay; HEBERT, Jeffrey J.; HEIDARI, Golnaz; HOVEIDAEI, Amir Human; HSIAO, Alexander Kevin; IBITOYE, Segun Emmanuel; IWU, Chidozie C. D.; JACOB, Louis; JANODIA, Manthan Dilipkumar; JIN, Yingzhao; JONAS, Jost B.; JOSHUA, Charity Ehimwenma; KANDEL, Himal; KHADER, Yousef Saleh; KHAJURIA, Himanshu; KHAN, Ejaz Ahmad; KHAN, Moien A. B.; KHATATBEH, Moawiah Mohammad; KHATERI, Sorour; KASHANI, Hamid Reza Khayat; KHONJI, Mohammad Saeid; KHUBCHANDANI, Jagdish; KIM, Yun Jin; KISA, Adnan; KOLAHI, Ali-Asghar; KOOHESTANI, Hamid Reza; KRISHAN, Kewal; KUDDUS, Mohammed; KUTTIKKATTU, Ambily; LASRADO, Savita; LEE, Yo Han; LEGESSE, Samson Mideksa; LIM, Stephen S.; LIU, Xuefeng; LO, Justin; MALIH, Narges; MANANDHAR, Shisir Prasad; MATHEWS, Elezebeth; MESREGAH, Mohamed Kamal; MESTROVIC, Tomislav; MILLER, Ted R.; MIRGHADERI, Seyed Peyman; MISGANAW, Awoke; MOHAMMADI, Esmaeil; MOHAMMED, Shafiu; MOKDAD, Ali H.; MOMTAZMANESH, Sara; MONI, Mohammad Ali; MOSTAFAVI, Ebrahim; MURRAY, Christopher J. L.; NAIR, Tapas Sadasivan; NEJADGHADERI, Seyed Aria; NZOPUTAM, Ogochukwu Janet; OH, In-Hwan; OKONJI, Osaretin Christabel; OWOLABI, Mayowa; PACHECO-BARRIOS, Kevin; FALLAHY, Mohammad Taha Pahlevan; PARK, Seoyeon; PATEL, Jay; PAWAR, Shrikant; PEDERSINI, Paolo; PERES, Mario F. P.; PETCU, Ionela-Roxana; POURAHMADI, Mohammadreza; QATTEA, Ibrahim; RAM, Pradhum; RASHIDI, Mohammad-Mahdi; RAWAF, Salman; REZAEI, Nazila; REZAEI, Negar; SAEED, Umar; SHARIF-ASKARI, Fatemeh Saheb; SALAHI, Saina; SAWHNEY, Monika; SCHUMACHER, Austin E.; SHAFIE, Mahan; SHAHABI, Saeed; SHAHBANDI, Ataollah; SHAMEKH, Ali; SHARMA, Saurab; SHIRI, Rahman; SHOBEIRI, Parnian; SINAEI, Ehsan; SINGH, Ambrish; SINGH, Jasvinder A.; SINGH, Paramdeep; SKRYABINA, Anna Aleksandrovna; SMITH, Amanda E.; TABISH, Mohammad; TAN, Ker-Kan; TEGEGNE, Masresha Derese; THARWAT, Samar; VAHABI, Seyed Mohammad; TAHBAZ, Sahel Valadan; VASANKARI, Tommi Juhani; VENKETASUBRAMANIAN, Narayanaswamy; VOLLSET, Stein Emil; WANG, Yuan-Pang; WIANGKHAM, Taweewat; YONEMOTO, Naohiro; ZANGIABADIAN, Moein; ZARE, Iman; ZEMEDIKUN, Dawit T.; ZHENG, Peng; ONG, Kanyin Liane; VOS, Theo; MARCH, Lyn M.
    Background Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050. Methods Systematic reviews identified population -representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta -regression tool. Prevalence was forecast to 2050 using a mixed -effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2 center dot 5th and 97 center dot 5th percentiles of 100 draws of the posterior distribution. Findings Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age -standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age -standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age -standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0 center dot 2% [-1 center dot 3 to 1 center dot 7]). Globally, females had a higher agestandardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32 center dot 5% (23 center dot 9-42 center dot 3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing. Interpretation Although age -standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle -income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain. Funding Bill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.
  • article
    HLA haplotype frequencies and diversity in patients with hemoglobinopathies
    (2023) SCIGLIUOLO, Graziana M.; BOUKOUACI, Wahid; CAPPELLI, Barbara; VOLT, Fernanda; FRANCO, Monica M. Rivera; DHEDIN, Nathalie; LATOUR, Regis Peffault de; DEVALCK, Christine; DALLE, Jean-Hugues; CASTELLE, Martin; HERMINE, Olivier; CHARDIN, Marie Ouachee; POIRE, Xavier; BRICHARD, Benedicte; PAILLARD, Catherine; RAFII, Hanadi; KENZEY, Chantal; WU, Ching-Lien; BOUASSIDA, Jihene; ROBIN, Marie; RAUS, Nicole; ROCHA, Vanderson; RUGGERI, Annalisa; GLUCKMAN, Eliane; TAMOUZA, Ryad
    The genetic diversity of the human leukocyte antigen (HLA) system was shaped by evolutionary constraints exerted by environmental factors. Analyzing HLA diversity may allow understanding of the underlying pathways and offer useful tools in transplant setting. The aim of this study was to investigate the HLA haplotype diversity in patients with sickle cell disease (SCD, N = 282) or beta-thalassemia (beta-Thal, N = 60), who received hematopoietic cell transplantation (HCT) reported to Eurocord and the Soci & eacute;t & eacute; Francophone de Greffe de Moelle et de Th & eacute;rapie Cellulaire (SFGM-TC). We identified 405 different HLA-A-B-DRB1 haplotypes in SCD and 108 in beta-Thal patients. Using data from African and European populations of the ""1000 Genomes Project"" for comparison with SCD and beta-Thal, respectively, we found that the haplotypes HLA-A*30-B*14-DRB1*15 (OR 7.87, 95% CI: 1.66-37.3, p (b) = 0.035), HLA-A*23-B*08 (OR 6.59, 95% CI: 1.8-24.13, p (b) = 0.023), and HLA-B*14-DRB1*15 (OR 10.74, 95% CI: 3.66-31.57, p (b) = 0.000) were associated with SCD, and the partial haplotypes HLA-A*30-B*13 and HLA-A*68-B*53 were associated with beta-Thal (OR 4.810, 95% CI: 1.55-14.91, p (b) = 0.033, and OR 17.52, 95% CI: 2.81-184.95, p (b) = 0.011). Our results confirm the extreme HLA genetic diversity in SCD patients likely due to their African ancestry. This diversity seems less accentuated in patients with beta-Thal. Our findings emphasize the need to expand inclusion of donors of African descent in HCT donor registries and cord blood banks.
  • article 0 Citação(ões) na Scopus
    Comparative analysis of primary health care attributes between children under and over 3 years of age using the primary care assessment tool
    (2024) OMORI, Luciana Harumi Miranda; AVIGO, Deoclecio; SANTOS, Itamar de Souza; GUSSO, Gustavo Diniz Ferreira; FERNANDES, Maria Teresa Bechere
    Introduction: Child health actions in Brazil have their primary focus on early childhood. A new epidemiological pro file is emerging for children after the first one thousand days: an increase in non -communicable chronic diseases. This research aimed to analyze the attributes of Primary Health Care comparatively among different age groups, using three years of age as the cutoff point. Methods: The study design was cross-sectional and conducted in three Primary Health Care Units and three Ambulatory Medical Assistance facilities in the Western Region of Sao Paulo. The PCA Tool Brazil was used as the assessment instrument. Results: A total of 311 interviews were conducted with caregivers of children aged 0 to 12 years; 153 children were under three years old, and 158 were three years or older. The attributes that showed statistically significant differences between age groups ( < 3 years and > 3 years) were af filiation (4.9 x 3.8), longitudinality (5.7 x 5.2), information system (7.4 x 6.3), and services provided (5.4 x 4.5). Through linear regression analysis, it was observed that there was a trend for better overall and essential scores in the evaluations of the group of children under three years old who attended Primary Health Care Units. Conclusion: The comparative analysis of Primary Health Care attributes among pediatric age groups revealed a trend towards higher scores, according to caregivers ' perceptions, for children under three years old. This study suggests the need for the implementation of programs that can better address the healthcare needs of children beyond early childhood.
  • article 1 Citação(ões) na Scopus
    Classes and predictors of reversal in male patients with congenital hypogonadotropic hypogonadism: a crosssectional study of six international referral centres
    (2024) DWYER, Andrew A.; MCDONALD, Isabella R.; CANGIANO, Biagio; GIOVANELLI, Luca; MAIONE, Luigi; SILVEIRA, Leticia F. G.; RAIVIO, Taneli; LATRONICO, Ana Claudia; YOUNG, Jacques; QUINTON, Richard; BONOMI, Marco; PERSANI, Luca; SEMINARA, Stephanie B.; LEE, Christopher
    Background Although some male patients with congenital hypogonadotropic hypogonadism (CHH) undergo spontaneous reversal following treatment, predictors of reversal remain elusive. We aimed to assemble the largest cohort of male patients with CHH reversal to date and identify distinct classes of reversal. Methods This multicentre cross-sectional study was conducted in six international CHH referral centres in Brazil, Finland, France, Italy, the UK, and the USA. Adult men with CHH (ie, absent or incomplete spontaneous puberty by age 18 years, low serum testosterone concentrations, and no identifiable cause of hypothalamic-pituitary-gonadal [HPG] axis dysfunction) were eligible for inclusion. CHH reversal was defined as spontaneous recovery of HPG axis function off treatment. Centres provided common data elements on patient phenotype, clinical assessment, and genetics using a structured, harmonised data collection form developed by COST Action BM1105. Latent class mixture modelling (LCMM) was applied to establish whether at least two distinct classes of reversal could be identified and differentially predicted, and results were compared with a cohort of patients without CHH reversal to identify potential predictors of reversal. The primary outcome was the presence of at least two distinct classes of reversal. Findings A total of 87 male patients with CHH reversal and 108 without CHH reversal were included in the analyses. LCMM identified two distinct reversal classes (75 [86%] in class 1 and 12 [14%] in class 2) on the basis of mean testicular volume, micropenis, and serum follicle-stimulating hormone (FSH) concentration. Classification probabilities were robust (0998 for class 1 and 0838 for class 2) and modelling uncertainty was low (entropy 090). Compared with class 1, patients in class 2 had significantly larger testicular volume (p<00001), no micropenis, and higher serum FSH concentrations (p=0041), consistent with the Pasqualini syndrome (fertile eunuch) subtype of CHH. Patients without CHH reversal were more likely to have anosmia (p=0016), cryptorchidism (p=00012), complete absence of puberty (testicular volume <4 cm 3 ; p=00016), and two or more rare genetic variants (ie, oligogenicity; p=00001). Among patients who underwent genetic testing, no patients (of 75) with CHH reversal had a rare pathogenic ANOS1 variant compared with ten (11%) of 95 patients without CHH reversal. Individuals with CHH reversal had a significantly higher rate of rare variants in GNRHR than did those without reversal (nine [12%] of 75 vs three [3%] of 95; p=0025). Interpretation Applying LCMM to a large cohort of male patients with CHH reversal uncovered two distinct classes of reversal. Genetic investigation combined with careful clinical phenotyping could help surveillance of reversal after withdrawing treatment, representing the first tailored management approach for male patients with this rare endocrine disorder.
  • article 1 Citação(ões) na Scopus
    Splenic irradiation for myelofibrosis prior to hematopoietic cell transplantation: A global collaborative analysis
    (2024) GAGELMANN, Nico; HOBBS, Gabriela S.; CAMPODONICO, Edoardo; HELBIG, Grzegorz; NOVAK, Polona; SCHROEDER, Thomas; SCHNEIDER, Artur; RAUTENBERG, Christina; REINHARDT, Hans Christian; BOSQUES, Linette; HEUSER, Michael; PANAGIOTA, Victoria; THOL, Felicitas; GURNARI, Carmelo; MACIEJEWSKI, Jaroslaw P.; CICERI, Fabio; RATHJE, Kristin; ROBIN, Marie; PAGLIUCA, Simona; RUBIO, Marie-Therese; ROCHA, Vanderson; FUNKE, Vaneuza; HAMERSCHLAK, Nelson; SALIT, Rachel; SCOTT, Bart L.; DUARTE, Fernando; MITRUS, Iwona; CZERW, Tomasz; GRECO, Raffaella; KROEGER, Nicolaus
    Splenomegaly is the clinical hallmark of myelofibrosis. Splenomegaly at the time of allogeneic hematopoietic cell transplantation (HCT) is associated with graft failure and poor graft function. Strategies to reduce spleen size before HCT especially after failure to Janus kinase (JAK) inhibition represent unmet clinical needs in the field. Here, we leveraged a global collaboration to investigate the safety and efficacy of splenic irradiation as part of the HCT platform for patients with myelofibrosis. We included 59 patients, receiving irradiation within a median of 2 weeks (range, 0.9-12 weeks) before HCT. Overall, the median spleen size prior to irradiation was 23 cm (range, 14-35). Splenic irradiation resulted in a significant and rapid spleen size reduction in 97% of patients (57/59), with a median decrease of 5.0 cm (95% confidence interval, 4.1-6.3 cm). The most frequent adverse event was thrombocytopenia, with no correlation between irradiation dose and hematological toxicities. The 3-year overall survival was 62% (95% CI, 48%-76%) and 1-year non-relapse mortality was 26% (95% CI, 14%-38%). Independent predictors for survival were severe thrombocytopenia and anemia before irradiation, transplant-specific risk score, higher-intensity conditioning, and present portal vein thrombosis. When using a propensity score matching adjusted for common confounders, splenic irradiation was associated with significantly reduced relapse (p = .01), showing a 3-year incidence of 12% for splenic irradiation versus 29% for patients with immediate HCT and 38% for patients receiving splenectomy. In conclusion, splenic irradiation immediately before HCT is a reasonable approach in patients experiencing JAK inhibition failure and is associated with a low incidence of relapse. Outcomes of splenic irradiation before transplant in myelofibrosis. image
  • article 0 Citação(ões) na Scopus
    Persistent hypofibrinolysis in severe COVID-19 associated with elevated fibrinolysis inhibitors activity
    (2024) OKAZAKI, Erica; BARION, Barbara Gomes; ROCHA, Tania Rubia Flores da; GIACOMO, Giovanna Di; HO, Yeh-Li; ROTHSCHILD, Cynthia; FATOBENE, Giancarlo; MORAES, Bruna del Guerra de Carvalho; STEFANELLO, Bianca; VILLACA, Paula Ribeiro; ROCHA, Vanderson Geraldo; ORSI, Fernanda Andrade
    Hypercoagulability and reduced fibrinolysis are well-established complications associated with COVID-19. However, the timelines for the onset and resolution of these complications remain unclear. The aim of this study was to evaluate, in a cohort of COVID-19 patients, changes in coagulation and fibrinolytic activity through ROTEM assay at different time points during the initial 30 days following the onset of symptoms in both mild and severe cases. Blood samples were collected at five intervals after symptoms onset: 6-10 days, 11-15 days, 16-20 days, 21-25 days, and 26-30 days. In addition, fibrinogen, plasminogen, PAI-1, and alpha 2-antiplasmin activities were determined. Out of 85 participants, 71% had mild COVID-19. Twenty uninfected individuals were evaluated as controls. ROTEM parameters showed a hypercoagulable state among mild COVID-19 patients beginning in the second week of symptoms onset, with a trend towards reversal after the third week of symptoms. In severe COVID-19 cases, hypercoagulability was observed since the first few days of symptoms, with a tendency towards reversal after the fourth week of symptoms onset. A hypofibrinolytic state was identified in severe COVID-19 patients from early stages and persisted even after 30 days of symptoms. Elevated activity of PAI-1 and alpha 2-antiplasmin was also detected in severe COVID-19 patients. In conclusion, both mild and severe cases of COVID-19 exhibited transient hypercoagulability, reverted by the end of the first month. However, severe COVID-19 cases sustain hypofibrinolysis throughout the course of the disease, which is associated with elevated activity of fibrinolysis inhibitors. Persistent hypofibrinolysis could contribute to long COVID-19 manifestations.
  • article 0 Citação(ões) na Scopus
    Vasoconstriction in septic shock
    (2024) BACKER, Daniel De; HAJJAR, Ludhmila; MONNET, Xavier
  • article 0 Citação(ões) na Scopus
    Pathophysiology of chikungunya virus infection associated with fatal outcomes
    (2024) SOUZA, William M. de; FUMAGALLI, Marcilio J.; LIMA, Shirlene T. S. de; PARISE, Pierina L.; CARVALHO, Deyse C. M.; HERNANDEZ, Cristian; JESUS, Ronaldo de; DELAFIORI, Jeany; CANDIDO, Darlan S.; CARREGARI, Victor C.; MURARO, Stefanie P.; SOUZA, Gabriela F.; MELLO, Leda M. Simoes; CLARO, Ingra M.; DIAZ, Yamilka; KATO, Rodrigo B.; TRENTIN, Lucas N.; COSTA, Clauber H. S.; MAXIMO, Ana Carolina B. M.; CAVALCANTE, Karene F.; FIUZA, Tayna S.; VIANA, Vania A. F.; MELO, Maria Elisabeth L.; FERRAZ, Clarissa P. M.; SILVA, Debora B.; DUARTE, Larissa M. F.; BARBOSA, Priscilla P.; AMORIM, Mariene R.; JUDICE, Carla C.; TOLEDO-TEIXEIRA, Daniel A.; RAMUNDO, Mariana S.; V, Patricia Aguilar; ARAUJO, Emerson L. L.; COSTA, Fabio T. M.; CERQUEIRA-SILVA, Thiago; KHOURI, Ricardo; BOAVENTURA, Viviane S.; FIGUEIREDO, Luiz Tadeu M.; FANG, Rong; MORENO, Brechla; LOPEZ-VERGES, Sandra; MELLO, Liana Perdigao; SKAF, Munir S.; CATHARINO, Rodrigo R.; GRANJA, Fabiana; MARTINS-DE-SOUZA, Daniel; PLANTE, Jessica A.; PLANTE, Kenneth S.; SABINO, Ester C.; DIAMOND, Michael S.; EUGENIN, Eliseo; PROENCA-MODENA, Jose Luiz; FARIA, Nuno R.; WEAVER, Scott C.
    Chikungunya virus (CHIKV) is a mosquito -borne alphavirus that causes acute, subacute, and chronic human arthritogenic diseases and, in rare instances, can lead to neurological complications and death. Here, we combined epidemiological, virological, histopathological, cytokine, molecular dynamics, metabolomic, proteomic, and genomic analyses to investigate viral and host factors that contribute to chikungunya-associated (CHIK) death. Our results indicate that CHIK deaths are associated with multi -organ infection, central nervous system damage, and elevated serum levels of pro -inflammatory cytokines and chemokines compared with survivors. The histopathologic, metabolite, and proteomic signatures of CHIK deaths reveal hemodynamic disorders and dysregulated immune responses. The CHIKV East -Central -South -African lineage infecting our study population causes both fatal and survival cases. Additionally, CHIKV infection impairs the integrity of the blood -brain barrier, as evidenced by an increase in permeability and altered tight junction protein expression. Overall, our findings improve the understanding of CHIK pathophysiology and the causes of fatal infections.
  • article 0 Citação(ões) na Scopus
    Impaired health-related quality of life in idiopathic inflammatory myopathies: a cross-sectional analysis from the COVAD-2 e-survey
    (2024) YOSHIDA, Akira; LI, Yuan; MAROUFY, Vahed; KUWANA, Masataka; SHAHARIR, Syahrul Sazliyana; MAKOL, Ashima; SEN, Parikshit; LILLEKER, James B.; AGARWAL, Vishwesh; KADAM, Esha; GOO, Phonpen Akawatcharangura; DAY, Jessica; MILCHERT, Marcin; CHEN, Yi-Ming; DEY, Dzifa; VELIKOVA, Tsvetelina; SAHA, Sreoshy; GRACIA-RAMOS, Abraham Edgar; PARODIS, Ioannis; NIKIPHOROU, Elena; TAN, Ai Lyn; NUNE, Arvind; CAVAGNA, Lorenzo; GUTIERREZ, Carlos Enrique Toro; CABALLERO-URIBE, Carlo Vinicio; SAAVEDRA, Miguel A.; SHINJO, Samuel Katsuyuki; ZIADE, Nelly; KIBBI, Lina El; KNITZA, Johannes; DISTLER, Oliver; CHINOY, Hector; AGARWAL, Vikas; AGGARWAL, Rohit; GUPTA, Latika
    Objectives To investigate health-related quality of life in patients with idiopathic inflammatory myopathies (IIMs) compared with those with non-IIM autoimmune rheumatic diseases (AIRDs), non-rheumatic autoimmune diseases (nrAIDs) and without autoimmune diseases (controls) using Patient-Reported Outcome Measurement Information System (PROMIS) instrument data obtained from the second COVID-19 vaccination in autoimmune disease (COVAD-2) e-survey database. Methods Demographics, diagnosis, comorbidities, disease activity, treatments and PROMIS instrument data were analysed. Primary outcomes were PROMIS Global Physical Health (GPH) and Global Mental Health (GMH) scores. Factors affecting GPH and GMH scores in IIMs were identified using multivariable regression analysis. Results We analysed responses from 1582 IIM, 4700 non-IIM AIRD and 545 nrAID patients and 3675 controls gathered through 23 May 2022. The median GPH scores were the lowest in IIM and non-IIM AIRD patients {13 [interquartile range (IQR) 10-15] IIMs vs 13 [11-15] non-IIM AIRDs vs 15 [13-17] nrAIDs vs 17 [15-18] controls, P < 0.001}. The median GMH scores in IIM patients were also significantly lower compared with those without autoimmune diseases [13 (IQR 10-15) IIMs vs 15 (13-17) controls, P < 0.001]. Inclusion body myositis, comorbidities, active disease and glucocorticoid use were the determinants of lower GPH scores, whereas overlap myositis, interstitial lung disease, depression, active disease, lower PROMIS Physical Function 10a and higher PROMIS Fatigue 4a scores were associated with lower GMH scores in IIM patients. Conclusion Both physical and mental health are significantly impaired in IIM patients, particularly in those with comorbidities and increased fatigue, emphasizing the importance of patient-reported experiences and optimized multidisciplinary care to enhance well-being in people with IIMs.
  • article 0 Citação(ões) na Scopus
    Epidemiological, immunological, and treatment response profile of patients with lupus nephritis in Brazil
    (2024) NUNES, Mariana Sousa Teixeira; JORGE, Lecticia Barbosa; YU, Luis; WORONIK, Viktoria; DIAS, Cristiane Bitencourt
    Background and hypothesis Brazil has the largest number of individuals of African descent outside Africa and a very admixed population. Among cases of lupus nephritis (LN) in the country, there are differences in incidence, and even in severity, depending on the location and characteristics of the population studied. The aim of this study was to describe the clinical and epidemiological characteristics of LN in Brazil, as well as to determine which of those characteristics would be risk factors for a poor renal prognosis. Methods This was a retrospective, descriptive observational study of patients diagnosed with LN who underwent kidney biopsy between 1999 and 2015 in the Nephrology Department of the Hospital das Clinicas, in Sao Paulo, Brazil. Data were collected from electronic medical records. Results We evaluated 398 patients, among who 94.1% and 77.7% tested positive for antinuclear antibodies and anti-DNA antibodies, respectively, whereas 33.7% showed the full-house pattern. The time from LN symptom onset to biopsy was <6 months in 47.5% (early biopsy group) and >= 6 months in 52.5% (late biopsy group). In the early biopsy group, the chronicity index was lower and the activity index was higher. Multivariate analysis showed that a higher chronicity index was the only independent risk factor for progression to requiring kidney replacement therapy. Conclusion Late biopsy seems to be associated with negative renal outcomes in LN. However, it seems that a higher chronicity index is the main predictor of a poor renal outcome among patients with LN in Brazil.
  • article 0 Citação(ões) na Scopus
    Characteristics of emerging new autoimmune diseases after COVID-19 vaccination: A sub-study by the COVAD group
    (2024) SHUMNALIEVA, Russka; RAVICHANDRAN, Naveen; HANNAH, Jennifer; JAVAID, Mahnoor; DAROOKA, Naitica; ROY, Debaditya; GONZALEZ, Daniel E.; VELIKOVA, Tsvetelina; MILCHERT, Marcin; KUWANA, Masataka; JOSHI, Mrudula; GRACIA-RAMOS, Abraham Edgar; BOYD, Peter; YAADAV, Praggya; CHENG, Karen; KOBERT, Linda; CAVAGNA, Lorenzo; SEN, Parikshit; DAY, Jessica; MAKOL, Ashima; GUTIERREZ, Carlos Enrique Toro; CABALLERO-URIBE, Carlo V.; SAHA, Sreoshy; PARODIS, Ioannis; DEY, Dzifa; NIKIPHOROU, Elena; DISTLER, Oliver; KADAM, Esha; TAN, Ai Lyn; SHINJO, Samuel Katsuyuki; ZIADE, Nelly; KNITZA, Johannes; CHINOY, Hector; AGGARWAL, Rohit; AGARWAL, Vikas; GUPTA, Latika
    Background: Despite the overall safety and efficacy of COVID-19 vaccinations, rare cases of systemic autoimmune diseases (SAIDs) have been reported post-vaccination. This study used a global survey to analyze SAIDs in susceptible individuals' post-vaccination. Methods: A cross-sectional study was conducted among participants with self-reported new-onset SAIDs using the COVID-19 Vaccination in Autoimmune Diseases (COVAD) 2 study dataset-a validated, patient-reported e-survey-to analyze the long-term safety of COVID-19 vaccines. Baseline characteristics of patients with new-onset SAIDs and vaccinated healthy controls (HCs) were compared after propensity score matching based on age and sex in a 1:4 ratio. Results: Of 16 750 individuals, 74 (median age 52 years, 79.9% females, and 76.7% Caucasians) had new-onset SAID post-vaccination, mainly idiopathic inflammatory myopathies (IIMs) (n = 23, 31.51%), arthritis (n = 15; 20.53%), and polymyalgia rheumatica (PMR) (n = 12, 16.40%). Higher odds of new-onset SAIDs were noted among Caucasians (OR = 5.3; 95% CI = 2.9-9.7; p < .001) and Moderna vaccine recipients (OR = 2.7; 95% CI = 1.3-5.3; p = .004). New-onset SAIDs were associated with AID multimorbidity (OR = 1.4; 95% CI = 1.1-1.7; p < .001), mental health disorders (OR = 1.6; 95% CI = 1.3-1.9; p < .001), and mixed race (OR = 2.2; 95% CI = 1.2-4.2; p = .010), where those aged >60 years (OR = 0.6; 95% CI = 0.4-0.8; p = .007) and from high/medium human development index (HDI) countries (compared to very high HDI) reported fewer events than HCs. Conclusion: This study reports a low occurrence of new-onset SAIDs following COVID-19 vaccination, primarily IIMs, PMR, and inflammatory arthritis. Identified risk factors included pre-existing AID multimorbidity, mental health diseases, and mixed race. Revaccination was well tolerated by most patients; therefore, we recommend continuing COVID-19 vaccination in the general population. However, long-term studies are needed to understand the autoimmune phenomena arising post-vaccination.
  • article 0 Citação(ões) na Scopus
    New approaches to second-degree burn healing: Polyvinyl alcohol membrane loaded to arnica combined to laser therapy
    (2024) CARDOSO, Carolina Silva; CARVALHO, Filipe Feitosa de; GOMES, Rodrigo Cesar; GIANINI, Reinaldo Jose; FANELLI, Camilla; NORONHA, Irene de Lourdes; SANTOS, Nelson Brancaccio dos; KOMATSU, Daniel; RANDAZZO-MOURA, Priscila
    Second-degree burns require greater care, as the damage is more extensive and worrisome and the use of a biomaterial can help in the cell repair process, with better planning, low cost, and better accessibility. Arnica has anti-inflammatory and analgesic properties in skin lesions treatments and laser therapy is another therapeutic alternative for burns. Evaluate the effects of arnica incorporated into PVA associated or not with low intensity laser on burns in rats. PVA and PVA with arnica (PVA+A) were obtained and characterized physicochemically. Through in vivo studies, the effects of PVA and PVA+A with or without the application of laser on the lesions allowed histological and immunohistochemical analyzes. PVA+A was biocompatible and with sustained release of the active, being a promising pharmacological tool and confirmed that laser therapy was effective in accelerating the healing process, due to its potential biomodulator, improving inflammatory aspects, promoting rapid healing in skin lesions. Graphical Abstract