DAGOBERTO CALLEGARO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Reducing infection risk in multiple sclerosis and neuromyelitis optica spectrum disorders: a Brazilian reference center's approach(2022) GOMES, Ana Beatriz Ayroza Galvao Ribeiro; FEO, Lucas Bueno; SILVA, Guilherme Diogo; DISSEROL, Caio Cesar Diniz; PAOLILO, Renata Barbosa; LARA, Amanda Nazareth; TONACIO, Adriana Coracini; MENDES, Maria Fernanda; PEREIRA, Samira Luisa Apostolos; CALLEGARO, DagobertoBackground Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the most common autoimmune diseases of the central nervous system (CNS). They present chronic relapsing courses that demand treatment with disease-modifying drugs (DMDs) to prevent inflammatory activity. Disease-modifying drugs lead to immunomodulation or immunosuppression through diverse mechanisms (e.g., shifting lymphocyte and cytokine profile, suppressing specific lymphocyte subpopulations). Thus, patients are more prone to infectious complications and associated worsening of disease. Objective To present feasible strategies for mitigating the infection risk of MS and NMOSD treated patients. Methods Targeted literature review concerning the management of infection risk with an emphasis on vaccination, therapy-specific measures, and particularities of the Brazilian endemic infectious diseases' scenario. Conclusion We propose a vaccination schedule, infectious screening routine, and prophylactic measures based on the current scientific evidence. Awareness of emergent tropical diseases is necessary due to evidence of demyelinating events and possible parainfectious cases of MS and NMOSD.
- Clinical Features of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorders(2021) APOSTOLOS-PEREIRA, Samira Luisa; FERREIRA, Lis Campos; BOAVENTURA, Mateus; SOUSA, Nise Alessandra de Carvalho; MARTINS, Gabriela Joca; D'ALMEIDA, Jose Arthur; PITOMBEIRA, Milena; MENDES, Lucas Silvestre; FUKUDA, Thiago; CABECA, Hideraldo Luiz Souza; ROCHA, Luciano Chaves; OLIVEIRA, Bianca Santos de; STELLA, Carla Renata Vieira; OLIVEIRA, Enedina Maria Lobato de; AMORIM, Leizian de Souza; CASTRO, Andrea Ferrari de; GOMES NETO, Antonio Pereira; SILVA, Guilherme Diogo; BUENO, Lucas; MACHADO, Maria de Morais; DIAS-CARNEIRO, Rafael Castello; DIAS, Ronaldo Maciel; MOREIRA, Alvaro Porto; PICCOLO, Ana; GRZESIUK, Anderson Kuntz; MUNIZ, Andre; DISSEROL, Caio Diniz; VASCONCELOS, Claudia Ferreira; KAIMEN-MACIEL, Damacio; DINIZ, Denise Sisterolli; COMINI-FROTA, Elizabeth; ROCHA, Fernando Coronetti; SANTOS, Gutemberg Augusto Cruz dos; FRAGOSO, Yara Dadalti; OLIVAL, Guilherme Sciascia do; RUOCCO, Heloisa Helena; SIQUEIRA, Heloise Helena; SATO, Henry Koity; FIGUEIREDO JR., Jose Alexandre; CALIA, Leandro Cortoni; DOURADO JR., Mario Emilio Teixeira; SCOLARI, Leticia; SOARES NETO, Herval Ribeiro; MELGES, Luiz; GONCALVES, Marcus Vinicius Magno; PIMENTEL, Maria Lucia Vellutini; RIBEIRO, Marlise de Castro; ARAMBULA, Omar Gurrola; GAMA, Paulo Diniz da; MENON, Renata Leite; THOMAZ, Rodrigo Barbosa; MORALES, Rogerio de Rizo; SOBREIRA, Silvana; MACHADO, Suzana Nunes; RIBEIRO, Taysa Gonsalves Jube; PEREIRA, Valeria Coelho Santa Rita; COSTA, Vanessa Maia; NOBREGA JUNIOR, Adaucto Wanderley da; ALVES-LEON, Soniza Vieira; PERIN, Marilia Mamprim de Morais; DONADI, Eduardo; ADONI, Tarso; GOMES, Sidney; FERREIRA, Maria Brito; CALLEGARO, Dagoberto; MENDES, Maria Fernanda; BRUM, Doralina; GLEHN, Felipe vonBackground and Objectives To describe the clinical features and disease outcomes of coronavirus disease 2019 (COVID-19) in patients with neuromyelitis optica spectrum disorder (NMOSD). Methods The Neuroimmunology Brazilian Study Group has set up the report of severe acute respiratory syndrome (SARS-CoV2) cases in patients with NMOSD (pwNMOSD) using a designed web-based case report form. All neuroimmunology outpatient centers and individual neurologists were invited to register their patients across the country. Data collected between March 19 and July 25, 2020, were uploaded at the REDONE.br platform. Inclusion criteria were as follows: (1) NMOSD diagnosis according to the 2015 International Panel Criteria and (2) confirmed SARS-CoV2 infection (reverse transcription-polymerase chain reaction or serology) or clinical suspicion of COVID-19, diagnosed according to Center for Disease Control / Council of State and Territorial Epidemiologists (CDC/CSTE) case definition. Demographic and NMOSD-related clinical data, comorbidities, disease-modifying therapy (DMT), COVID-19 clinical features, and severity were described. Results Among the 2,061 pwNMOSD followed up by Brazilian neurologists involved on the registry of COVID-19 in pwNMOSD at the REDONE.br platform, 34 patients (29 women) aged 37 years (range 8-77), with disease onset at 31 years (range 4-69) and disease duration of 6 years (range 0.2-20.5), developed COVID-19 (18 confirmed and 16 probable cases). Most patients exhibited mild disease, being treated at home (77%); 4 patients required admission at intensive care units (severe cases); and 1 patient died. Five of 34 (15%) presented neurologic manifestations (relapse or pseudoexacerbation) during or after SARS-CoV2 infection. Discussion Most NMOSD patients with COVID-19 presented mild disease forms. However, pwNMOSD had much higher odds of hospitalization and intensive care unit admission comparing with the general Brazilian population. The frequency of death was not clearly different. NMOSD disability, DMT type, and comorbidities were not associated with COVID-19 outcome. SARS-CoV2 infection was demonstrated as a risk factor for NMOSD relapses. Collaborative studies using shared NMOSD data are needed to suitably define factors related to COVID-19 severity and neurologic manifestations.
- Management of central nervous system demyelinating diseases during the coronavirus disease 2019 pandemic: a practical approach(2020) APOSTOLOS-PEREIRA, Samira Luisa; SILVA, Guilherme Diogo; DISSEROL, Caio Cesar Diniz; FEO, Lucas Bueno; MATOS, Aline de Moura Brasil; SCHOEPS, Vinicius Andreoli; GOMES, Ana Beatriz Ayroza Galvao Ribeiro; BOAVENTURA, Mateus; MENDES, Maria Fernanda; CALLEGARO, DagobertoBackground: The novelcoronavirus disease 2019(COVID-19) pandemic poses a potential threattopatients with autoimmune disorders, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Such patients are usually treated with immunomodulatory or immunosuppressive agents, which may tamper with the organism's normal response to infections. Currently, noconsensus has been reached on how to manage MS and NMOSD patients during the pandemic. Objective: To discuss strategies to manage those patients. Methods: We focus on how to 1) reduce COVID-19 infection risk, such as social distancing, telemedicine, and wider interval between laboratory testing/imaging; 2) manage relapses, such as avoiding treatment of mild relapse and using oral steroids; 3) manage disease-modifying therapies, such as preference for drugs associated with lower infection risk (interferons, glatiramer, teriflunomide, and natalizumab) and extended-interval dosing of natalizumab, when safe; 4) individualize the chosen MS induction-therapy (anti-CD20 monoclonal antibodies, alemtuzumab, and cladribine); 5) manage NMOSD preventive therapies, including initial therapy selection and current treatment maintenance; 6) manage MS/NMOSD patients infected with COVID-19. Conclusions: In the future, real-world case series of MS/NMOSD patients infected with COVID-19 will help us define the best management strategies. For the time being, we rely on expert experience and guidance.