LUCIANA PARENTE COSTA SEGURO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, 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 BASELINE CHARACTERISTICS OFA LONGITUDINAL, MULTINATIONAL, MULTIETHNIC STUDYOF LUPUS PATIENTS, WITH ORWITHOUT LUPUS NEPHRITIS(2023) NIETO, Romina; QUINTANA, Rosana; BORBA, Eduardo; HERNANDEZ, Lucia; FERNANDEZ, Diana; MAURELLI, Laura; ALBA, Paula; BORDON, Florencia; ARIZPE, Fernando; BERBOTTO, Guillermo; SERRANO, Rosa; BERTOLACCINI, Maria; KERSBERG, Eduardo; GARGIULO, Maria; RODRIGUEZ, Anabella; BARBOSA, Vitalina; GASPARIN, Andrese; CAVALCANTI, Fernando; ALVES, Laissa; PARENTE, Luciana; OLIVEIRA, Lucas de; NEIRA, Oscar; MASSARDO, Loreto; AROCA, Gustavo; NIETO, Ivana; MENDEZ, Paul; IGLESIAS, Antonio; ZUNIGA, Andres; VERA, Olga; PEREZ, Mario; NARES, Eduardo; AMEZCUA, Luis; GONZALEZ, Yelitza; GONZALEZ, Octavio; GALARZA, Dionicio; VAZQUEZ, Carolina; BARRIOS, Marcelo; LINARES, Magaly; REATEGUI, Cristina; QUIROS, Ana; POLANCO, Teresandris; PIZZAROSSA, Carina; REBELLA, Martin; CRESPO, Maria; DANZA, Alvaro; BONFA, Eloisa; ALARCON, Graciela; ZAZZETTI, Federico; ORILLION, Ashley; SBARIGIA, Urbano; ESTEL, Guillermo PonsconferenceObject EARLY AND LATE ONSET BIOPSY-PROVEN LUPUS NEPHRITIS WITHOUT OTHER ASSOCIATED AUTOIMMUNE DISEASES: SEVERITY AND LONG-TERM OUTCOME(2018) LOPES, M.; SANTOS, L.; SEGURO, L.; BONFA, E.conferenceObject PERIPHERAL NERVOUS SYSTEM DISEASE IN SYSTEMIC LUPUS ERYTHEMATOSUS: THE ROLE OF PREDISPOSING CONDITIONS(2018) FARGETTI, S.; BONFA, E.; SHINJO, S. K.; PASOTO, S. G.; SEGURO, L. P. C.; LOPES, M. R. U.; GONCALVES, C. R.; BORBA, E. F.conferenceObject SHORT AND LONG-TERM FOLLOW-UP OF PERIPHERAL NEUROPATHY DUE TO SYSTEMIC LUPUS ERYTHEMATOSUS: EVIDENCE OF A FAVORABLE OUTCOME(2018) FARGETTI, S.; BONFA, E.; SHINJO, S. K.; PASOTO, S. G.; SEGURO, L. P. C.; LOPES, M. R. U.; GONCALVES, C. R.; BORBA, E. F.- Short-term Accrual 2019 European League Against Rheumatism/American College of Rheumatology Domains and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage in Lupus Patients With and Without Nephritis at Disease Onset(2023) MUNHOZ, Gabriela A.; AIKAWA, Nadia E.; SILVA, Clovis A.; PASOTO, Sandra G.; PEDROSA, Tatiana N.; SEGURO, Luciana P. C.; BONFA, Eloisa; BORBA, Eduardo F.ObjectiveTo determine in a historical inception cohort the impact of lupus nephritis at disease onset in short-term accrual 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) domains. The possible association with treatment and damage was also investigated.MethodsOne hundred thirty-three consecutive adult systemic lupus erythematosus patients according to the 2019 EULAR/ACR criteria were divided according to the presence (RENAL-lupus) or absence of renal involvement (NONRENAL-lupus) at disease onset. The 2019 EULAR/ACR score and Systemic Lupus International Collaborating Clinics/ACR (SDI) were longitudinally evaluated over 3 years.ResultsRENAL-lupus (n = 49 [36.8%]) and NONRENAL-lupus (n = 84 [63.2%]) were similar regarding age (p = 0.704), female sex (p = 0.313), and black race (p = 0.506). At study entry, RENAL-lupus had higher 2019 EULAR/ACR total domains (30 [12-42] vs. 22 [10-36], p < 0.001) and used more often glucocorticoid (p < 0.001), mycophenolate mofetil (p = 0.007), and cyclophosphamide (p = 0.001). After 3 years, a stable number of domain scores was observed for the RENAL-lupus (30 [12-42] vs. 30 [12-42], p = 0.125), whereas an increase was observed for the NONRENAL-lupus (22 [10-36] vs. 23 [10-40], p < 0.001) compared with baseline. Accordingly, RENAL-lupus patients had a lower frequency of additional domains (3/49 [6.1%] vs. 37/84 [44.0%], p < 0.0001). New kidney involvement occurred in 15 (44.1%) of 34 patients of the NONRENAL-lupus. Both groups evolved with a comparable increase in frequency of patients with damage (SDI >= 1) at the end of the study (23/49 [46.9%] vs. 34/89 [40.54%], p = 0.585) with a similar median of SDI (1 [0-4] vs. 0 [0-2], p = 0.132).ConclusionsThe distinct pattern of accrual 2019 EULAR/ACR domains in patients with and without nephritis at disease onset suggests that close surveillance for additional organ involvement, including kidney, is mandatory in NONRENAL lupus in the first 3 years of disease. The unexpected comparable early damage in both groups despite milder disease and less intense immunosuppression in NONRENAL lupus reinforces the need for new and tailored therapies for these patients.
- Let's Talk About Lupus. Overview of an Innovative, High-Reach, Online Program to Fill the Education Gaps of Latin Americans Living With Lupus(2022) DRENKARD, Cristina; FUENTES-SILVA, Yurilis; SEGURO, Luciana Parente Costa; REIS-NETO, Edgard Torres dos; IBANEZ, Soledad; ELERA-FITZCARRALD, Claudia; REATEGUI-SOKOLOVA, Cristina; LINHARES, Fernanda Athayde; BERMUDEZ, Witjal; FERREYRA-GARROT, Leandro; ACOSTA, Carlota; V, Carlo Caballero-Uribe; SATO, Emilia Inoue; BONFA, Eloisa; PONS-ESTEL, Bernardo A.Background/Objective The Latin American population living with lupus lacks reliable and culturally competent health education resources. We describe a Spanish and Portuguese online program to educate Latin American people about lupus. Methods An extensive network of Latin American stakeholders participated in the program design, implementation, dissemination, and evaluation. Patients and rheumatologists selected core topics. Rheumatologists prepared the content using evidence-based data. Adaptations were conducted to meet the audience's health literacy and cultural values. Social media was used to post audiovisual resources and facilitate users' interactions with peers and educators, and a Web site was created to offer in-depth knowledge. Results The most massive outreach was through Facebook, with more than 20 million people reached and 80,000 followers at 3 months, between the Spanish and Portuguese pages. Nearly 90% of followers were from Latin America. A high engagement and positive responses to a satisfaction survey indicate that Facebook users valued these resources. The Spanish and Portuguese Web sites accumulated more than 62,000 page views, and 71.7% of viewers were from Latin American. Conclusions The engagement of patients and stakeholders is critical to provide and disseminate reliable lupus education. Social media can be used to educate and facilitate interactions between people affected by lupus and qualified health care professionals. Social media-based health education has extensive and scalable outreach but is more taxing for the professional team than the Web site. However, the Web site is less likely to be used as a primary education source by Latin American people because they value social interactions when seeking lupus information.
conferenceObject INDUCTION TREATMENT IN LUPUS NEPHRITIS IN A REAL-LIFE SITUATION: CYCLOPHOSPHAMIDE OR MYCOPHENOLATE MOFETIL?(2018) MUNHOZ, G. A.; LACERDA, M. L. M.; SEGURO, L. P. C.; UGOLINI-LOPES, M. R.; BORBA, E. F. B.; BONFA, E.- Short- and Long-Term Outcome of Systemic Lupus Erythematosus Peripheral Neuropathy Bimodal Pattern of Onset and Treatment Response(2021) FARGETTI, Simone; UGOLINI-LOPES, Michelle R.; PASOTO, Sandra G.; SEGURO, Luciana P. C.; SHINJO, Samuel K.; BONFA, Eloisa; BORBA, Eduardo F.Background/Objective: Our aim was to describe the short- and long-term outcome of peripheral neuropathy (PN) attributed exclusively to systemic lupus erythematosus (SLE). Methods: Systemic lupus erythematosus patients with defined PN (clinical and electroneuromyography) were retrospectively evaluated at onset, 1-year, and 5-year follow-up using a standardized electronic chart database that started in 2000. Exclusion criteria were comorbidities, drugs, and infections. Age-, sex-, and disease duration-matched SLE patients without PN were selected as controls. Results: Lupus PN was identified in 38 (1.8%) of 2074 patients, and almost two thirds had PN onset in the first 5 years of SLE (63.2%). Peripheral neuropathy SLE had higher frequencies of cutaneous vasculitis (50% vs 21.1%, p = 0.002), lymphopenia (60.5% vs 36.8%, p = 0.027), anti-Sm (52.6% vs 27.6%, p = 0.013), and higher SLEDAI-2K scores (11.5 +/- 10.5 vs 4.9 +/- 6.7, p < 0.001) compared with controls. The most common type was polyneuropathy (71.1%) with sensory-motor pattern (68.4%). At PN diagnosis, all patients received glucocorticoid and 97.4% started immunosuppressive therapy (50% intravenous cyclophosphamide, 42.1% azathioprine). After 1-year follow-up, 92.1% had a favorable outcome with complete (36.8%) or partial remission (55.2%), in parallel with a decrease in prednisone dose (48.3 +/- 17.9 vs 15.3 +/- 13.4 mg/d, p < 0.001), symptomatic therapy (57.9% vs 29.7%, p = 0.02), and SLEDAI-2K score (11.5 +/- 10.5 vs 1.7 +/- 3.7, p < 0.001). SLEDAI-2K scores were higher in patientswho had PN onsetwith less than 1 year of SLE duration, compared with those with more than 5 years of disease (21.3 +/- 9.1 vs 3.9 +/- 5.3, p < 0.001). Early-PN-onset group had a better response to treatment (complete remission at 1-year follow-up 61.5% vs 25%, p = 0.039). At 5-year follow-up, 89.3% remained with complete/partial remission. Conclusions: Peripheral neuropathy attributed to SLE itself is a rare manifestation with a bimodal pattern, characterized by a predominant early-onset group associated with high disease activity and a higher rate of complete remission, and a late-onset group with low disease activity and a partial therapy response.
- Longitudinal Extensive Transverse Myelitis and Central Diabetes Insipidus: A Severe Flare of Systemic Lupus Erythematosus(2017) DEVEZA, Leticia Miranda Alle; NEVES, Emily Figueiredo Vieira; SEGURO, Luciana Parente Costa; PEREIRA, Samira Luisa dos Apostolos; BONFA, Eloisa; PASOTO, Sandra Gofinet