CLOVIS ARTUR ALMEIDA DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
33 resultados
Resultados de Busca
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conferenceObject Macrophage Activation Macrophage Activation Syndrome: A Severe and Frequent Manifestation of Acute Pancreatitis in Childhood-Onset Compared to Adult Systemic Lupus Erythematosus Patients(2014) SPELLING, Natali W.; OTSUZI, Carini I.; BARROS, Diego L.; SILVA, Mariana A. da; PEREIRA, Rosa M. R.; CAMPOS, Lucia M. A.; BORBA, Eduardo F.; BONFA, Eloisa; SILVA, Clovis A.- Health related quality of life measure in systemic pediatric rheumatic diseases and its translation to different languages: an international collaboration(2014) MOORTHY, Lakshmi Nandini; ROY, Elizabeth; KURRA, Vamsi; PETERSON, Margaret G. E.; HASSETT, Afton L.; LEHMAN, Thomas J. A.; SCOT, Christiaan; EL-GHONEIMY, Dalia; SAAD, Shereen; FEKY, Reem El; AL-MAYOUF, Sulaiman; DOLEZALOVA, Pavla; MALCOVA, Hana; HERLIN, Troels; NIELSEN, Susan; WULFFRAAT, Nico; ROYEN, Annet van; MARKS, Stephen D.; BELOT, Alexandre; BRUNNER, Jurgen; HUEMER, Christian; FOELDVARI, Ivan; HORNEFF, Gerd; SAURENMAN, Traudel; SCHROEDER, Silke; PRATSIDOU-GERTSI, Polyxeni; TRACHANA, Maria; UZIEL, Yosef; AGGARWAL, Amita; CONSTANTIN, Tamas; CIMAZ, Rolando; GIANI, Theresa; CANTARINI, Luca; FALCINI, Fernanda; MANZONI, Silvia Magni; RAVELLI, Angelo; RIGANTE, Donato; ZULIAN, Fracnceso; MIYAMAE, Takako; YOKOTA, Shumpei; SATO, Juliana; MAGALHAES, Claudia S.; LEN, Claudio A.; APPENZELLER, Simone; KNUPP, Sheila Oliveira; RODRIGUES, Marta Cristine; SZTAJNBOK, Flavio; ALMEIDA, Rozana Gasparello de; JESUS, Adriana Almeida de; CAMPOS, Lucia Maria de Arruda; SILVA, Clovis; LAZAR, Calin; SUSIC, Gordana; AVCIN, Tadej; CUTTICA, Ruben; BURGOS-VARGAS, Ruben; FAUGIER, Enrique; ANTON, Jordi; MODESTO, Consuelo; VAZQUEZ, Liza; BARILLAS, Lilliana; BARINSTEIN, Laura; STERBA, Gary; MALDONADO, Irama; OZEN, Seza; KASAPCOPUR, Ozgur; DEMIRKAYA, Erkan; BENSELER, SusaBackground: Rheumatic diseases in children are associated with significant morbidity and poor health-related quality of life (HRQOL). There is no health-related quality of life (HRQOL) scale available specifically for children with less common rheumatic diseases. These diseases share several features with systemic lupus erythematosus (SLE) such as their chronic episodic nature, multi-systemic involvement, and the need for immunosuppressive medications. HRQOL scale developed for pediatric SLE will likely be applicable to children with systemic inflammatory diseases. Findings: We adapted Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY (c)) to Simple Measure of Impact of Illness in Youngsters (SMILY (c)-Illness) and had it reviewed by pediatric rheumatologists for its appropriateness and cultural suitability. We tested SMILY (c)-Illness in patients with inflammatory rheumatic diseases and then translated it into 28 languages. Nineteen children (79% female, n= 15) and 17 parents participated. The mean age was 12 +/- 4 years, with median disease duration of 21 months (1-172 months). We translated SMILY (c)-Illness into the following 28 languages: Danish, Dutch, French (France), English (UK), German (Germany), German (Austria), German (Switzerland), Hebrew, Italian, Portuguese (Brazil), Slovene, Spanish (USA and Puerto Rico), Spanish (Spain), Spanish (Argentina), Spanish (Mexico), Spanish (Venezuela), Turkish, Afrikaans, Arabic (Saudi Arabia), Arabic (Egypt), Czech, Greek, Hindi, Hungarian, Japanese, Romanian, Serbian and Xhosa. Conclusion: SMILY (c)-Illness is a brief, easy to administer and score HRQOL scale for children with systemic rheumatic diseases. It is suitable for use across different age groups and literacy levels. SMILY (c)-Illness with its available translations may be used as useful adjuncts to clinical practice and research.
conferenceObject Identification of ""autoinflammatory interferonopathies""? a New Class of Autoinflammatory Conditions?(2014) JESUS, Adriana Almeida de; DENG, Zuoming; BROOKS, Stephen; LIU, Yin; KIM, Hanna; SANCHEZ, Gina A. Montealegre; CHAPELLE, Dawn C.; HUANG, Yan; HASHKES, Philip; NASRULLAYEVA, Gulnara; TERRERI, Maria Teresa; ARABSHAHI, Bita; PUNARO, Marilynn G.; MOORTHY, Lakshmi N.; REINHARDT, Adam; SILVA, Clovis A.; SATO, Emilia I.; LILLEBY, Vibke; FLEISHER, Thomas; GOLDBACH-MANSKY, RaphaelaconferenceObject Human Papilloma Virus and Chlamydia Trachomatis Infections in Rheumatoid Arthitis Under Anti-TNF Therapy.(2014) WAISBERG, Mariana G.; RIBEIRO, Ana C. M.; CANDIDO, Wellington M.; MEDEIROS, Poliana B.; MATSUZAKI, Cezar N.; BELDI, Mariana C.; TACLA, Maricy; CAIAFFA-FILHO, Helio H.; BONFA, Eloisa; SILVA, Clovis A.bookPart Problemas de saúde pela atividade física(2014) SILVA, Clovis Artur Almeida da- Ovarian reserve in adult patients with childhood-onset lupus: a possible deleterious effect of methotrexate?(2014) ARAUJO, D. B. de; YAMAKAMI, L. Y. S.; AIKAWA, N. E.; BONFA, E.; VIANA, V. S. T.; PASOTO, S. G.; PEREIRA, R. M. R.; SERAFIN, P. C.; BORBA, E. F.; SILVA, C. A.Objectives: To assess ovarian reserve markers and anti-corpus luteum antibodies (anti-CoL) in adult patients with childhood-onset systemic lupus erythematosus (c-SLE). Method: Fifty-seven adult c-SLE female patients and 21 healthy controls were evaluated for anti-CoL. Ovarian reserve was assessed by: follicle stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, anti-Mullerian hormone (AMH), and antral follicle count (AFC). Demographic data, menstrual abnormalities, disease activity, damage, and treatment were also analysed. Results: The median current age was similar in adult c-SLE patients and controls (27.7 vs. 27.7 years, p = 0.414). The medians of AMH (1.1 vs. 1.5 ng/mL, p = 0.037) and AFC (6 vs. 16, p < 0.001) were significantly reduced in SLE patients compared to controls without significant menstrual abnormalities. Anti-CoL were solely observed in c-SLE patients (16% vs. 0%, p = 0.103) and were not associated with demographic data, ovarian reserve parameters, disease activity/damage, and treatment. Further evaluation of c-SLE patients treated with cyclophosphamide revealed a higher median of FSH levels compared to c-SLE patients not treated with cyclophosphamide and controls (8.8 vs. 5.7 vs. 5.6 IU/L, p = 0.032) and lower median AMH (0.4 vs. 1.5 vs. 1.5 ng/mL, p = 0.004) and AFC (4.0 vs. 6.5 vs. 16 IU/L, p = 0.001) levels. Nineteen patients treated exclusively with methotrexate demonstrated a negative correlation between the cumulative dose and AMH levels (p = 0.027, r = -0.507). Conclusions: The present study demonstrated for the first time that a high cumulative methotrexate dose is a possible cause of subclinical ovarian dysfunction in adult c-SLE patients. Further studies are required to confirm this deleterious effect in other rheumatic diseases, particularly juvenile idiopathic arthritis and idiopathic inflammatory myopathy.
- Childhood-onset bullous systemic lupus erythematosus(2014) LOURENCO, D. M. R.; GOMES, R. Cunha; AIKAWA, N. E.; CAMPOS, L. M. A.; ROMITI, R.; SILVA, C. A.Bullous systemic lupus erythematosus has rarely been described in pediatric lupus population and the real prevalence of childhood-onset bullous systemic lupus erythematosus has not been reported. From January 1983 to November 2013, 303 childhood-onset SLE (c-SLE) patients were followed at the Pediatric Rheumatology Unit of the Childres Institute of Hospital das Clinicas da Faculdade de Medicina Universidade da Universidade de SAo Paulo, three of them (1%) diagnosed as childhood-onset bullous systemic lupus erythematosus. All three cases presented tense vesiculobullous lesions unassociated with lupus erythematosus lesions, with the median duration of 60 days (30-60). All patients fulfilled bullous systemic lupus erythematosus criteria. Two had nephritis and serositis and presented specific autoantibodies. The histological pattern demonstrated subepidermal blisters with neutrophils-predominant infiltrates within the upper dermis. Direct immunofluorescence (DIF) showed deposits of IgG and complement along the epidermal basement membrane, in the presence or absence of IgA and/or IgM. A positive indirect immunofluorescence on salt-split skin demonstrating dermal binding was observed in two cases. All of them had moderate/severe disease activity at diagnosis with median Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) of 18 (14-24). Two patients received dapsone and one with severe nephritis received immunosuppressive drugs. In conclusion, in the last 30 years the prevalence of bullous lupus in childhood-onset lupus population was low (1%) in our tertiary University Hospital. A diagnosis of SLE should always be considered in children with recurrent tense vesiculobullous lesions with or without systemic manifestations.
conferenceObject Reduction of Ovarian Reserve in Adult Patients with Dermatomyositis.(2014) SOUZA, Fernando Henrique Carlos de; SHINJO, Samuel Katsuyuki; YAMAKAMI, Lucas Yugo Shiguehara; VIANA, Vilma dos Santos Trindade; BARACAT, Edmund Chada; BONFA, Eloisa; SILVA, Clovis Artur Almeida- Fatal cryptococcal meningitis in a juvenile lupus erythematosus patient(2014) CAVALCANTE, Erica G.; MONTONI, Joao D.; OLIVEIRA, Guilherme T.; CAMPOS, Lucia M. A.; PAZ, Jose A.; SILVA, Clovis A.Cryptococcosis is a fungal infection caused by Cryptococcus neoformans, generally associated with immunodeficiency and immunosuppressive agents, and it is rarely reported in systemic lupus erythematosus (SLE), particularly in juvenile SLE (JSLE). From January 1983 to June 2011, 5,604 patients were followed at our University Hospital and 283 (5%) of them met the American College of Rheumatology (ACR) classification criteria for SLE. Only one (0.35%) of our JSLE patients had cryptococcal meningitis and is described in this report. A 10-year old girl was diagnosed with JSLE. By the age of 15 years, she presented persistent headaches, nausea and vomiting for a 5 day period without fever, after a cave-exploring trip. At that moment, she was under 10 mg/day of prednisone, azathioprine and hydroxychloroquine. A lumbar puncture was performed and India ink preparation was positive for cryptococcosis, cerebrospinal fluid culture yielded Cryptococcus neoformans and serum cryptococcal antigen titer was 1:128. Azathioprine was suspended, and liposomal amphotericin B was introduced. Despite of treatment, after four days she developed amaurosis and fell into a coma. A computer tomography of the brain showed diffuse ischemic areas and nodules suggesting fungal infection. Four days later, she developed severe sepsis and vancomycin and meropenem were prescribed, nevertheless she died due to septic shock. In conclusion, cryptococcal meningitis is a rare and severe opportunistic infection in juvenile lupus population. This study reinforces the importance of an early diagnosis and prompt introduction of antifungal agents, especially in patients with history of contact with bird droppings.
conferenceObject Abatacept Related Infections: No Association with Gammaglobulin Reduction.(2014) DINIS, Valquiria; VIANA, Vilma S. T.; LEON, Elaine P.; SILVA, Clovis A.; SAAD, Carla G. S.; MORAES, Julio C. B.; BONFA, Eloisa; RIBEIRO, Ana C. M.