PERCIVAL DEGRAVA SAMPAIO BARROS
Índice h a partir de 2011
26
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
20 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 20
- Baixa prevalência das manifestações extra-articulares renais, cardíacas, pulmonares e neurológicas nas espondiloartrites: análise do Registro Brasileiro de Espondiloartrites(2012) RODRIGUES, Carlos Ewerton Maia; VIEIRA, Walber Pinto; BORTOLUZZO, Adriana B.; GONÇALVES, Célio Roberto; SILVA, José Antonio Braga da; XIMENES, Antonio Carlos; BÉRTOLO, Manoel B.; RIBEIRO, Sandra L. E.; KEISERMAN, Mauro; MENIN, Rita; SKARE, Thelma L.; CARNEIRO, Sueli; AZEVEDO, Valderílio F.; ALBUQUERQUE, Elisa N.; BIANCHI, Washington A.; BONFIGLIOLI, Rubens; CAMPANHOLO, Cristiano; CARVALHO, Hellen M. S.; COSTA, Izaias P.; DUARTE, Angela P.; KOHEM, Charles L.; LEITE, Nocy H.; LIMA, Sonia A. L.; MEIRELLES, Eduardo S.; PEREIRA, Ivânio A.; PINHEIRO, Marcelo M.; POLITO, Elizandra; RESENDE, Gustavo G.; ROCHA, Francisco Airton C.; SANTIAGO, Mittermayer B.; SAUMA, Maria de Fátima L. C.; VALIM, Valeria; SAMPAIO-BARROS, Percival D.OBJECTIVE: To describe the extra-articular manifestations (cardiac, renal, pulmonary, and neurological), usually not related to spondyloarthritis (SpA), in a large cohort of Brazilian patients. MATERIALS AND METHODS: This retrospective study analyzed 1,472 patients diagnosed with SpA and cared for at 29 health care centers distributed in the five major geographic regions in the country, participating in the Brazilian Registry of Spondyloarthritis (BRS). All patients were assessed for the prevalence of major extra-articular manifestations (cardiac, renal, pulmonary, and neurological), classified according to the diagnosis [ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), arthritis associated with inflammatory bowel disease (IBD), undifferentiated spondyloarthritis (uSpA), and juvenile SpA], and according to the clinical presentation (axial, peripheral, mixed, and enthesitis). RESULTS: Of the patients with SpA assessed, 963 had AS, 271 PsA, 49 ReA, 48 arthritis associated with IBD, 98 uSpA, and 43 juvenile SpA. Cardiac involvement was reported in 44 patients (3.0%), pulmonary involvement in 19 (1.3%), renal involvement in 17 (1.2%), and neurological involvement in 13 patients (0.9%). Most patients with visceral involvement had AS or PsA, and the mixed (axial + peripheral) and/or predominantly axial clinical form. CONCLUSION: Cardiac, renal, pulmonary, and neurological extra-articular manifestations are quite infrequent in SpA, ranging from 0.9% to 3% in this large Brazilian cohort, and affected predominantly patients with AS and PsA.
article 33 Citação(ões) na Scopus Effect of age at disease onset in the clinical profile of spondyloarthritis: a study of 1424 Brazilian patients(2012) SKARE, T. L.; LEITE, N.; BORTOLUZZO, A. B.; GONCALVES, C. R.; SILVA, J. A. B. da; XIMENES, A. C.; BERTOLO, M. B.; RIBEIRO, S. L. E.; KEISERMAN, M.; MENIN, R.; CARNEIRO, S.; AZEVEDO, V. F.; VIEIRA, W. P.; ALBUQUERQUE, E. N.; BIANCHI, W. A.; BONFIGLIOLI, R.; CAMPANHOLO, C.; CARVALHO, H. M. S.; COSTA, I. P.; DUARTE, A. P.; GAVI, M. B. O.; KOHEM, C. L.; LIMA, S. A. L.; MEIRELLES, E. S.; PEREIRA, I. A.; PINHEIRO, M. M.; POLITO, E.; RESENDE, G. G.; ROCHA, F. A. C.; SANTIAGO, M. B.; SAUMA, M. F. L. C.; SAMPAIO-BARROS, P. D.Objectives To analyse demographic and clinical variables in patients with disease onset before and after 40, 45 and 50 years in a large series of Brazilian SpA patients. Methods A common protocol of investigation was prospectively applied to 1424 SpA patients in 29 centres distributed through the main geographical regions in Brazil. The mean age at disease onset was 28.56 +/- 12.34 years, with 259 patients (18.2%) referring disease onset after 40 years, 15.1 (10.6%) after 45 years and 81 (5.8%) after 50 years. Clinical and demographic variables and disease indices (BASDAI, BASFI, BASRI, MASES, ASQoL) were investigated. Ankylosing spondylitis was the most frequent disease (66.3%), followed by psoriatic arthritis (18%), undifferentiated SpA (6.7%), reactive arthritis (5.5%), and enteropathic arthritis (3.5%). Results Comparing the groups according to age of disease onset, those patients with later onset presented statistical association with female gender, peripheral arthritis, dactylitis, nail involvement and psoriasis, as well as negative statistical association with inflammatory low hack pain, alternating buttock pain, radiographic sacroiliitis, hip involvement, positive familial history, HLA-B27 and uveitis. BASDAI, BASFI and quality of life, as well as physicians and patient's global assessment, were similar in all the groups. Radiographic indices showed worse results in the younger age groups. Conclusion There are two different clinical patterns in SpA defined by age at disease onset: one with predominance of axial symptoms in the group with disease onset <= 40 years and another favouring the peripheral manifestations in those with later disease onset.- Sexual activity in ankylosing spondylitis(2012) GALLINARO, Andrea Lopes; AKAGAWA, Lilian Lie; OTUZI, Mariana Hissami Ichiba; SAMPAIO-BARROS, Percival Degrava; GONCALVES, Celio RobertoObjective: To assess the sexual activity of patients with ankylosing spondylitis, correlating it with disease activity and functional indices. Patients and methods: Thirty-two patients with ankylosing spondylitis and 32 healthy controls were assessed regarding pain, fatigue, sexual activity (by use of pictures of seven sexual positions), disease activity (by use of Bath Ankylosing Spondylitis Disease Activity Index - BASDAI), and functional capacity (by use of Bath Ankylosing Spondylitis Functional Index - BASFI). After the interview, the patients were divided into two groups: group A (with sexual activity) and group B (no sexual activity). Results: Group B showed statistical association with longer disease duration (P = 0.01), and higher BASFI (P = 0.0007) and BASDAI (P = 0.03) scores. No correlation was observed between age and functional capacity. Man lying on his back and woman on top was the most frequent, enjoyable and least painful position. The position with the woman on her back and a man lying on top was the least chosen. Control individuals reported a higher frequency of sexual activity, longer duration of intercourse, and less pain and fatigue; the reported frequency of orgasms, however, was similar in both groups. Conclusion: The chronic nature of ankylosing spondylitis, with poor functional capacity and higher disease activity, interferes with sexual intercourse. When sexual activity was possible, orgasm and sexual satisfaction did not differ from those of healthy controls.
conferenceObject EPIDEMIOLOGIC PROFILE OF JUVENILE SPONDYLOARTHRITIS COMPARED TO ADULT-ONSET SPONDYLOARTHRITIS IN A LARGE BRAZILIAN COHORT(2012) DUARTE, A. P.; MARQUES, C. D. L.; BORTOLUZZO, A. B.; GONCALVES, C. R.; SILVA, Braga J. A. da; XIMENES, A. C.; BERTOLO, M. B.; RIBEIRO, S. L.; KEISERMAN, M.; MENIN, R.; SKARE, T. L.; CARNEIRO, S.; AZEVEDO, V. F.; VIEIRA, W. P.; ALBUQUERQUE, E. N.; BIANCHI, W. A.; BONFIGLIOLI, R.; CAMPANHOLO, C.; CARVALHO, H. M. S.; COSTA, I. P.; KOHEM, C. L.; LEITE, N. H.; LIMA, S. A. L.; MEIRELLES, E. S.; PEREIRA, I. A.; PINHEIRO, M. M.; POLITO, E.; RESENDE, G. G.; ROCHA, F. A. C.; SANTIAGO, M. B.; SAUMA, M. F. L. C.; VALIM, V.; SAMPAIO-BARROS, P. D.- Survival, Causes of Death, and Prognostic Factors in Systemic Sclerosis: Analysis of 947 Brazilian Patients(2012) SAMPAIO-BARROS, Percival D.; BORTOLUZZO, Adriana B.; MARANGONI, Roberta G.; ROCHA, Luiza F.; RIO, Ana Paula T. Del; SAMARA, Adil M.; YOSHINARI, Natalino H.; MARQUES-NETO, Joao FranciscoObjective. To analyze survival, prognostic factors, and causes of death in a large cohort of patients with systemic sclerosis (SSc). Methods. From 1991 to 2010, 947 patients with SSc were treated at 2 referral university centers in Brazil. Causes of death were considered SSc-related and non-SSc-related. Multiple logistic regression analysis was used to identify prognostic factors. Survival at 5 and 10 years was estimated using the Kaplan-Meier method. Results. One hundred sixty-eight patients died during the followup. Among the 110 deaths considered related to SSc, there was predominance of lung (48.1%) and heart (24.5%) involvement. Most of the 58 deaths not related to SSc were caused by infection, cardiovascular or cerebrovascular disease, and cancer. Male sex, modified Rodnan skin score (mRSS) > 20, osteoarticular involvement, lung involvement, and renal crisis were the main prognostic factors associated to death. Overall survival rate was 90% for 5 years and 84% for 10 years. Patients presented worse prognosis if they had diffuse SSc (85% vs 92% at 5 yrs, respectively, and 77% vs 87% at 10 yrs, compared to limited SSc), male sex (77% vs 90% at 5 yrs and 64% vs 86% at 10 yrs, compared to female sex), and mRSS > 20 (83% vs 90% at 5 yrs and 66% vs 86% at 10 yrs, compared to mRSS <20). Conclusion. Survival was worse in male patients with diffuse SSc, and lung and heart involvement represented the main causes of death in this South American series of patients with SSc. (First Release Aug 15 2012; J Rheumatol 2012;39:1971-8; doi:10.3899/jrheum.111582)
- Comparison of the Clinical Expression of Patients with Ankylosing Spondylitis from Europe and Latin America(2012) BENEGAS, Mariana; MUNOZ-GOMARIZ, Elisa; FONT, Pilar; BURGOS-VARGAS, Ruben; CHAVES, Jose; PALLEIRO, Daniel; COCCO, Jose Maldonado; GUTIERREZ, Miguel; SAENZ, Ricardo; STECKMEN, Ivan; RILLO, Oscar; MULERO, Juan; SAMPAIO-BARROS, Percival; BARCELOS, Anabela; CRUYSSEN, Bert Vander; VAZQUEZ-MELLADO, Janitzia; ESTEVEZ, Eduardo CollantesObjective. To compare the clinical, demographic, and serologic characteristics and the treatment of patients diagnosed with ankylosing spondylitis (AS) from Europe (EU) and Latin America (LA). Methods. We included 3439 patients from national registries: the Spanish Registry of Spondyloarthritis (REGISPONSER), the Belgian registry (ASPECT), and the Latin American Registry of Spondyloarthropathies (RESPONDIA). We selected patients with diagnosis of AS who met the modified New York classification criteria. Demographic, clinical, disease activity, functional, and metrological measurement data were recorded. Current treatment was recorded. The population was classified into 2 groups: patients with disease duration < 10 years and those with disease duration >= 10 years. A descriptive and comparative analysis of variables of both groups was carried out. Results. There were 2356 patients in EU group and 1083 in LA group. Prevalence of HLA-B27 was 71% in LA group and 83% in EU group (p < 0.001). We found a greater frequency of peripheral arthritis and enthesitis (p < 0.001) in the LA population; prevalence of arthritis was 57% in LA and 42% in EU, and for enthesitis, 54% and 38%. Except for treatment with anti-tumor necrosis factor (anti-TNF), the use of nonsteroidal antiinflammatory drugs (NSAID), corticosteroids, and disease-modifying antirheumatic drugs (DMARD), and the association of anti-TNF and methotrexate use showed a significant difference (p < 0.001) in the 2 populations. Conclusion. The principal differences in the clinical manifestations of patients with AS from EU and LA were the greater frequency of peripheral arthritis and enthesitis in LA group, the higher percentage of HLA-B27 in EU group, and the form of treatment, with a greater use of NSAID, steroids, and DMARD in the LA group.
- Gender characterization in a large series of Brazilian patients with spondyloarthritis(2012) CARVALHO, Hellen M. S. de; BORTOLUZZO, Adriana B.; GONCALVES, Celio R.; SILVA, Jose Antonio Braga da; XIMENES, Antonio Carlos; BERTOLO, Manoel B.; RIBEIRO, Sandra L. E.; KEISERMAN, Mauro; MENIN, Rita; SKARE, Thelma L.; CARNEIRO, Sueli; AZEVEDO, Valderilio F.; VIEIRA, Walber P.; ALBUQUERQUE, Elisa N.; BIANCHI, Washington A.; BONFIGLIOLI, Rubens; CAMPANHOLO, Cristiano; COSTA, Izaias P.; DUARTE, Angela P.; GAVI, Maria Bernadete O.; KOHEM, Charles L.; LEITE, Nocy H.; LIMA, Sonia A. L.; MEIRELLES, Eduardo S.; PEREIRA, Ivanio A.; PINHEIRO, Marcelo M.; POLITO, Elizandra; RESENDE, Gustavo G.; ROCHA, Francisco Airton C.; SANTIAGO, Mittermayer B.; SAUMA, Maria de Fatima L. C.; SAMPAIO-BARROS, Percival D.An increasing number of women have been diagnosed with spondyloarthritis (SpA) in recent decades. While a few studies have analyzed gender as a prognostic factor of the disease, no studies have addressed this matter with a large number of patients in South America, which is a peculiar region due to its genetic heterogeneity. The aim of the present study was to analyze the influence of gender on disease patterns in a large cohort of Brazilian patients with SpA. A prospective study was carried out involving 1,505 patients [1,090 males (72.4%) and 415 females (27.6%)] classified as SpA according to the European Spondyloarthropaties Study Group criteria who attended at 29 reference centers for rheumatology in Brazil. Clinical and demographic variables were recorded and the following disease indices were administered: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Radiologic Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and Ankylosing Spondylitis Quality of Life (ASQoL). Ankylosing spondylitis (AS) was the most frequent disease in the group (65.4%), followed by psoriatic arthritis (18.4%), undifferentiated SpA (6.7%), reactive arthritis (3.3%), arthritis associated to inflammatory bowel disease (3.2%), and juvenile SpA (2.9%). The male-to-female ratio was 2.6:1 for the whole group and 3.6:1 for AS. The females were older (p<0.001) and reported shorter disease duration (p=0.002) than the male patients. The female gender was positively associated to peripheral SpA (p<0.001), upper limb arthritis (p<0.001), dactylitis (p=0.011), psoriasis (p<0.001), nail involvement (p<0.001), and family history of SpA (p=0.045) and negatively associated to pure axial involvement (p< 0.001), lumbar inflammatory pain (p=0.042), radiographic sacroiliitis (p<0.001), and positive HLA-B27 (p=0.001). The number of painful (p<0.001) and swollen (p=0.006) joints was significantly higher in the female gender, who also achieved higher BASDAI (p<0.001), BASFI (p=0.073, trend), MASES (p=0.019), ASQoL (p=0.014), and patient's global assessment (p=0.003) scores, whereas the use of nonsteroidal anti-inflammatory drugs (p<0.001) and biological agents (p=0.003) was less frequent in the female gender. Moreover, BASRI values were significantly lower in females (p<0.001). The female gender comprised one third of SpA patients in this large cohort and exhibited more significant peripheral involvement and less functional disability, despite higher values in disease indices.
conferenceObject TESTICULAR SERTOLI CELL FUNCTION IN ANKYLOSING SPONDYLITIS: THE POSSIBLE EFFECT OF TNF BLOCKAGE(2012) SAAD, C. G. S.; ALMEIDA, B. P. de; SOUZA, F. H. C.; MORAES, J. C. B.; NUKUMIZU, L. A.; SAMPAIO-FARROS, P. D.; VIANA, V. S. T.; BONFA, E.; SILVA, C. A.Introduction: Inhibin B is an important testicular Sertoli cell function marker allowing a global evaluation of testicular tissue. However there are no data regarding this cell function in ankylosing spondylitis (AS) patients.in this hormone production. Materials and Methods: 20 consecutive male AS patients and 24 healthy controls were evaluated. At study entry, AS patients were not receiving sulfasalazine/methotrexate and they never used biological/cytotoxic agents. Serum dimeric inhibin B levels were measured by a double-antibody ELISA. Demographic, disease parameters and urologic evaluation were systematically performed. The latter included testicular Döppler ultrasound, hormone profile and semen analysis. Ten of these patients received anti-TNF treatment and they were re-evaluated for inhibin B and disease parameters at 6 months(6M). Four of them also repeated sperm analysis. Results: At study entry, the median of current and spermarche age were similar in AS patients and controls [33(17-53) vs. 28.5(15-54) years, p=0.175; 13(9-18) vs. 12(11-15)years, p=0.358; respectively]. The median of inhibin B [68(23-265) vs. 112.9(47.8-231.9)pg/mL, p=0.111], FSH levels and the other hormones were comparable in both groups (p>0.05). All patients and controls had normal sperm motility and concentration with two AS patients presenting borderline low inhibin B levels. Further analysis at 6M of the 10 patients referred for anti-TNF therapy, including one with borderline inhibin B, revealed that median inhibin B levels remained largely stable [126.5(24-316) vs. 116.5(28-265)pg/mL, p=0.431]. Sperm motility/concentration were preserved in the four patients that performed this analysis after anti-TNF. Conclusions: This is the first study to demonstrate, through a specific marker, a normal testicular Sertoli cell function associated with preserved sperm quality in AS patients. We further identified that anti-TNF drugs do not seem to have a deleterious effect in inhibin B production reinforcing its safety for testicular function in this disease.conferenceObject EARLY OESOPHAGEAL TREATMENT MAY BE ASSOCIATED WITH A DECREASED FREQUENCY OF GASTROESOPHAGEAL SURGERY IN A LARGE BRAZILIAN COHORT OF PATIENTS WITH SSc(2012) SAMPAIO-BARROS, P.; NASCIMENTO, I.; SEGURO, L.; FOELKEL, A. L.; DEL-RIO, A. P.; LOPES, L. R.; BRANDALISE, N. A.; ANDREOLLO, N.; MARQUES-NETO, J. F.- Gender Differences Among Spondylitis Associated with Psoriasis, Inflammatory Bowel Disease and Primary Ankylosing Spondylitis(2012) LANDI, Margarita; MALDONADO-FICCO, Hernan; MALDONADO-COCCO, Jose A.; CITERA, Gustavo; ARTURI, Pablo; SAMPAIO-BARROS, Percival; FLORES, Diana; BURGOS-VARGAS, Ruben; SANTOS, Helena; CHAVEZ-CORRALES, Jose; PALLEIRO, Daniel; GUTIERREZ, Miguel A.; VIEIRA-SOUSA, Elsa; PIMENTEL-SANTOS, Fernando; PAIRA, Sergio O.; SR., Alberto Berman; VAZQUEZ-MELLADO, Janitzia; COLLANTES-ESTEVEZ, Edu-ArdoBackground/Purpose: Differences regarding gender in primary Anky-losing Spondylitis are well known. However, there is less evidence regarding Spondylitis Associated with Psoriasis and that associated with Inflammatory Bowel Disease. To compare clinical manifestations, disease activity, functional capacity, spinal mobility and radiological findings among women and men from a multicenter, multiethnic cohort, of Ibero-American patients with Spondyloarthritis. Methods: This observational cross-section study included 2044 consecutive spondyloarthritis (SpA) patients (ESSG criteria). Demographic, clinical, disease activity, functional ability, quality of life, work status and radiologic data were evaluated and collected by RESPONDIA members from different Ibero-American countries between June and December 2006. For this analysis patients were selected only if they met modified New York criteria for AS. Data was transmitted on-line and stored in the Spanish SpA Registry (REGISPONSER) website. Categorial data were compared by X2 or Fisher’s exact tests and continuous variables by ANOVA with post-hoc tests. Results: Out of 2044 patients, 1264 met New York criteria; 73% were male, (mean age 43 years, SD 15.8), and 27% were female (mean age 45,8 years, SD = 12.6). 1072 had primary Ankylosing Spondylitis (AS), 147 Spondylitis Associated to Psoriasis (PsSp) and 45 Spondilytis associated to Inflammatory Bowel Disease (IBDSp). Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity (BASDAI), less swollen joints, worse spinal mobility (BASMI), better quality of life although worse total BASRI. Frequency of dactylitis and enthesitis was significantly more common among women. Analysing only AS, there was marked male predominance (76.2%). Male patients were also significantly younger, had lower disease activity, worse BASMI, better quality of life and less frequency of dactylitis, yet worse total BASRI. When reading only BASRI in the spine, still it was significantly higher in male patients (mean 7.3 vs 5.8 p = 0.000). However, among patients with PsSp male predominance was lower (57.8%), had significantly worse total BASRI and spinal BASRI and worse spinal mobility (BASMI). Among the 45 patients with IBDSp there was a slight female predominance (51.1%) and only differed in less lateral lumbar flexion in males (p = 0.015). Regarding work disability in the total population, men had higher permanent work disability (13.2 vs. 6.9 p < 0.05). These differences were maintained when subdividing patients according to primary AS but were no differences in PsSp. There were no patient with IBDSp and permanent work disability. Conclusion: In this gender comparative analysis among Psoriatic, IBD and primary AS, male patients were significantly younger, had longer diagnostic delay, worse total BASRI, higher BASMI, strikingly lower disease activity (BASDAI) and better quality of life. In both primary AS and PsSp groups, women had better spinal mobility and less radiographic damage.