LUCIANA PARENTE COSTA SEGURO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 59 Citação(ões) na Scopus
    Long-term complications of past glucocorticoid use
    (2013) SEGURO, Luciana P. C.; ROSARIO, Cristina; SHOENFELD, Yehuda
    Glucocorticoids (GC) are essential in the management of several medical conditions but its long-term use is associated with complications in diverse organs and systems. The aim of the present study is to review the long-term complications of past GC use. Permanent damage related to GC can affect patient's life even years after its withdrawal. Classical examples are cataracts and esthetic problems like skin atrophy, striae, acne and obesity. Interestingly, for some complications, the risk of an incident event can persist for past GC use. Higher risks of osteoporosis, osteonecrosis, cardiovascular disease, infections and cancer have been associated with prior GC therapy. These evidences reinforce the importance of limiting our GC prescriptions at its lower possible dose.
  • article 88 Citação(ões) na Scopus
    First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR)
    (2018) PONS-ESTEL, Bernardo A.; BONFA, Eloisa; SORIANO, Enrique R.; CARDIEL, Mario H.; IZCOVICH, Ariel; POPOFF, Federico; CRINITI, Juan M.; VASQUEZ, Gloria; MASSARDO, Loreto; DUARTE, Margarita; BARILE-FABRIS, Leonor A.; GARCIA, Mercedes A.; AMIGO, Mary-Carmen; ESPADA, Graciela; CATOGGIO, Luis J.; SATO, Emilia Inoue; LEVY, Roger A.; VASQUEZ, Eduardo M. Acevedo; CHACON-DIAZ, Rosa; GALARZA-MALDONADO, Claudio M.; GAMARRA, Antonio J. Iglesias; MOLINA, Jose Fernando; NEIRA, Oscar; SILVA, Clovis A.; PENA, Andrea Vargas; GOMEZ-PUERTA, Jose A.; SCOLNIK, Marina; PONS-ESTEL, Guillermo J.; UGOLINI-LOPES, Michelle R.; SAVIO, Veronica; DRENKARD, Cristina; ALVARELLOS, Alejandro J.; UGARTE-GIL, Manuel F.; BABINI, Alejandra; CAVALCANTI, Andre; LINHARES, Fernanda Athayde Cardoso; SALINAS, Maria Jezabel Haye; FUENTES-SILVA, Yurilis J.; SILVA, Ana Carolina Montandon de Oliveira e; GARNICA, Ruth M. Eraso; URIBE, Sebastian Herrera; GOMEZ-MARTIN, Diana; SEVRINI, Ricardo Robaina; QUINTANA, Rosana M.; GORDON, Sergio; FRAGOSO-LOYO, Hilda; ROSARIO, Violeta; SAURIT, Veronica; APPENZELLER, Simone; REIS NETO, Edgard Torres dos; CIEZA, Jorge; NARANJO, Luis A. Gonzalez; BELLO, Yelitza C. Gonzalez; COLLADO, Maria Victoria; SARANO, Judith; RETAMOZO, Soledad; SATTLER, Maria E.; GAMBOA-CARDENAS, Rocio V.; CAIROLI, Ernesto; CONTI, Silvana M.; AMEZCUA-GUERRA, Luis M.; SILVEIRA, Luis H.; BORBA, Eduardo F.; PERA, Mariana A.; MOREYRA, Paula B. Alba; ARTURI, Valeria; BERBOTTO, Guillermo A.; GERLING, Cristian; GOBBI, Carla A.; GERVASONI, Viviana L.; SCHERBARTH, Hugo R.; BRENOL, Joao C. Tavares; CAVALCANTI, Fernando; COSTALLAT, Lilian T. Lavras; SILVA, Nilzio A. Da; MONTICIELO, Odirlei A.; SEGURO, Luciana Parente Costa; XAVIER, Ricardo M.; LLANOS, Carolina; GUARDADO, Ruben A. Montufar; TORRE, Ignacio Garcia de la; PINEDA, Carlos; HERNANDEZ, Margarita Portela; DANZA, Alvaro; GUIBERT-TOLEDANO, Marlene; REYES, Gil Llerena; COLMAN, Maria Isabel Acosta; AQUINO, Alicia M.; MORA-TRUJILLO, Claudia S.; MUNOZ-LOUIS, Roberto; VALLADARES, Ignacio Garcia; OROZCO, Maria Celeste; BURGOS, Paula I.; BETANCUR, Graciela V.; ALARCON, Graciela S.
    Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an 'overarching' treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.