ANDRESSA SILVA ABREU

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 3 de 3
  • conferenceObject
    Regular Measure of Disease Activity During the Routine Care of Rheumatoid Arthritis Patients Involves Some Extra Work but Positive Results
    (2012) GUEDES, Lissiane K. N.; RIBEIRO, Ana Cristina Medeiros; BONFIGLIOLI, Karina Rossi; DOMICIANO, Diogo; VIZIOLI, Carolina Reither; CUNHA, Gilmara Franco da; ABREU, Andressa Silva; MELLO, Filipi M.; FOELKEL, Ana Luiza de Aguiar; GONCALVES, Celio R.; LAURINDO, Ieda
    Background/Purpose: According to treat to target recommendations the use of validated composite measures of disease activity, which include joint assessments, is needed in routine clinical practice to guide treatment decisions with the final objective of reaching remission or low disease activity in patients with RA.Objective: to study the outcome of adding avalidated composite measure of disease activity (DAS28) to routine clinical visits. Methods: Since 2007 all RA patients (ACR-1987 criteria) in regular follow-up at the Rheumatology Service of a tertiary center change to electronic files with a DAS28-ESR calculator and this measure became mandatory in the routine care visits. Inclusion criteria: patients in regular follow-up for at least 2 years before 2007and no use of biologic agents during the study period (January 2007-December 2011). All patients could receive, free of charge, traditional DMARDs (chloroquine, methotrexate, sulfasalazine, leflunomide and azathioprine), corticosteroids (including intra-articular injections), analgesic and antiinflamatory medications as needed and according to a pre-established protocol. The first DAS28 recorded in the electronic files was compared to the last one recorded in 2011, after 4 years of regular measure of disease activity guiding therapeutic decisions (RA-study group). ERA patients (less than one year of symptoms at the beginning of treatment) submitted to a therapeutic strategy of tight control and DAS28 based clinical decisions were also evaluated. Results: a total of 304 patients was included, 217 consisting our study group(RA-SG) (86% female, mean age 63±11yrs, mean disease duration 22±10yrs) and 87 ERA patients (83% female, mean age 53±12yrs, mean disease duration 6.7±1.6yrs). ERA patients were significantly younger and with shorter disease duration. DAS28 values and different levels of disease activity are depicted below: RA-SG n217 ERA n87 2007 2011 2007 2011 DAS28 mean (SD) 3.9* (1.4) 3.3* (1.3) 3.7** (1.7) 2.9** (1.4)% DAS28 < 2.6 17* 34* 29** 45**% low disease activity 18 16 12** 24**% moderate disease activity 47 39 30** 9**% high disease activity 18 11 24 16*,** p0.05 Conclusion: regularly applying validate composite indexes such as DAS 28 leads to better control of disease activity, mainly an increased percentage of patients in DAS28 remission.
  • conferenceObject
    Fat Mass and Resistin: Predictive Factors For Anti-TNF Therapy Response In Ankylosing Spondylitis Patients
    (2013) SAAD, Carla G. S.; ABREU, Andressa Silva; RIBEIRO, Ana Cristina Medeiros; MORAES, Julio C. B.; PERANDINI, Luiz A.; DASSOUKI, Thalita; PEREIRA, Rosa M. R.; BONFA, Eloisa; PINTO, Ana Lucia S.
  • article 2 Citação(ões) na Scopus
    Spondyloptosis in athlete
    (2014) ASSAD, Ana Paula Luppino; ABREU, Andressa Silva; SEGURO, Luciana Parente Costa; GUEDES, Lissiane Karine Noronha; LIMA, Fernanda Rodrigues; PINTO, Ana Lucia de Sa
    The adolescent athletes are at greater risk of low back pain and structural spine injuries. Spondylolysis is responsible for the majority of back pain cases in young athletes, rarely occurring in adults. We report a case of a 13-year-old judo female athlete, who came to our service with 5 months of progressive low back pain during training which was initially attributed to mechanical causes, without any further investigation by imaging methods. At admission, the patient had lumbar deformity, antalgic posture and bilaterally positive unipodalic lumbar hyperextension maneuver. After a research which showed spondyloptosis, the patient underwent surgery. In this article, we discuss, based on this case report, the diagnostic approach to low back pain in young athletes, since the complaint of chronic back pain can be a marker of a structural lesion that may be permanent and bring irreversible functional loss.