EDUARDO DE SOUZA MEIRELLES

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Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina

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  • article 27 Citação(ões) na Scopus
    Chronic Spinal and Oral Morphine-Induced Neuroendocrine and Metabolic Changes in Noncancer Pain Patients
    (2015) VALVERDE-FILHO, Joao; CUNHA NETO, Malebranche Berardo Carneiro da; FONOFF, Erich Talamoni; MEIRELLES, Eduardo de Souza; TEIXEIRA, Manoel Jacobsen
    ObjectiveInteractions between opioid use and hormonal function are documented in the literature. However, it is unclear if therapeutic intrathecal opioid therapy can induce hormonal changes, compared to oral opioid therapy. MethodsThe authors studied hormone and metabolic changes in 22 women (18-60 years) and 38 men (18-45 years) who were referred to a pain center. The patients were allocated to different treatment groups (based on assistant physicians' decision), as follows: 20 patients received oral morphine (60-120 mg/day); 20 patients, spinal morphine (0.2-10 mg/day); and 20 patients, nonopioid analgesic treatment. ResultsAll three groups experienced substantial improvement in pain scores during the whole follow-up period. Significantly impaired libido, reduced potency, hot flashes, and menstrual cycle dysfunction occurred more often in both morphine groups than in the nonopioid group. Significantly low serum total testosterone levels were more prevalent in the spinal morphine group and the oral morphine group (58.3% and 70.0%, respectively) than in the control group (16.7%). Total cholesterol values above 200 mg/dL and higher ultrasensitive C-reactive protein levels were significantly more frequent in the morphine groups than in the controls. Total body bone mineral density was below normal in men receiving spinal morphine (P = 0.014). ConclusionsHypogonadotrophic hypogonadism was more prevalent in the morphine groups and was correlated with clinical findings. Significant bone mass loss occurred in morphine users, even without hormone dysfunction when compared to nonopioid treatment. Growth hormone, thyroid stimulating hormone, adrenocorticotrophic hormones, and cardiovascular risk parameters were less compromised in morphine users.
  • article 0 Citação(ões) na Scopus
    Perfil epidemiológico da espondiloartrite de início juvenil comparada com a espondiloartrite de início na vida adulta em uma grande coorte brasileira
    (2015) DUARTE, Angela P.; MARQUES, Claudia D. L.; BORTOLUZZO, Adriana B.; GONCALVES, Celio R.; SILVA, Jose Antonio Braga da; XIMENES, Antonio Carlos; BERTOLO, Manoel B.; RIBEIRO, Sandra Lucia E.; KEISERMAN, Mauro; SKARE, Thelma L.; CARNEIRO, Sueli; MENIN, Rita; AZEVEDO, Valderilio F.; VIEIRA, Walber P.; ALBUQUERQUE, Elisa N.; BIANCHI, Washington A.; BONFIGLIOLI, Rubens; CAMPANHOLO, Cristiano; CARVALHO, Hellen M. S.; COSTA, Izaias P.; KOHEM, Charles L.; LEITE, Nocy; 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.; VALIM, Valeria; SAMPAIO-BARROS, Percival D.
  • article 10 Citação(ões) na Scopus
    Avaliação do desempenho do BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) numa coorte brasileira de 1.492 pacientes com espondiloartrites: dados do Registro Brasileiro de Espondiloartrites (RBE)
    (2015) COSTA, Izaias Pereira da; 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; CARVALHO, Hellen M. S.; DUARTE, Angela L. B. Pinto; KOHEM, Charles L.; LEITE, Nocy H.; LIMA, Sonia A. L.; MEIRELLES, Eduardo S.; PEREIRA, Ivelnio A.; PINHEIRO, Marcelo M.; POLITO, Elizandra; RESENDE, Gustavo G.; ROCHA, Francisco Airton C.; SANTIAGO, Mittermayer B.; SAUMA, Maria de Fatima L. C.; VALIM, Valeria; SAMPAIO-BARROS, Percival D.
    Objective: To analyze the results of the application of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in a large series of Brazilian patients with the diagnosis of SpA and establish its correlations with specific variables into the group. Methods: A common protocol of investigation was prospectively applied to 1492 Brazilian patients classified as SpA according to the European Spondyoarthropathies Study Group (ESSG), attended at 29 referral centers of Rheumatology in Brazil. Clinical and demographic variables, and disease indices (BASDAI, Basfi, Basri, Mases, ASQol) were applicated. The total values of BASDAI were compared to the presence of the different variables. Results: The mean score of BASDAI was 4.20 +/- 2.38. The mean scores of BASDAI were higher in patients with the combined (axial + peripheral + entheseal) (4.54 +/- 2.38) clinical presentation, compared to the pure axial (3.78 +/- 2.27) or pure peripheral (4.00 +/- 2.38) clinical presentations (p<0.001). BASDAI also presented higher scores associated with the female gender (p<0.001) and patients who did not practice exercises (p<0.001). Regarding the axial component, higher values of BASDAI were significantly associated with inflammatory low back pain (p<0.049), alternating buttock pain (p<0.001), cervical pain (p<0.001) and hip involvement (p< 0.001). There was also statistical association between BASDAI scores and the peripheral involvement, related to the lower (p=0.004) and upper limbs (p=0.025). The presence of enthesitis was also associated to higher scores of BASDAI (p=0.040). Positive HLA-B27 and the presence of cutaneous psoriasis, inflammatory bowel disease, uveitis and urethritis were not correlated with the mean scores of BASDAI. Lower scores of BASDAI were associated with the use of biologic agents (p<0.001). Conclusion: In this heterogeneous Brazilian series of SpA patients, BASDAI was able to demonstrate ""disease activity"" in patients with axial as well as peripheral disease.