CARLA ROMAGNOLLI QUINTINO
Projetos de Pesquisa
Unidades Organizacionais
SCPACEX-62, Hospital Universitário
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Impact of metabolically healthy obesity on carotid intima-media thickness - The Brazilian Longitudinal Study of Adult Health(2020) ROMAGNOLLI, Carla; BENSENOR, Isabela M.; SANTOS, Itamar S.; LOTUFO, Paulo A.; BITTENCOURT, Marcio S.Background and aims: Obesity increases the risk of metabolic abnormalities, which contributes to elevated cardiovascular risk. However, the independent role of obesity in the development of cardiovascular disease is still debatable. There are individuals with an obesity phenotype without metabolic abnormalities: ""metabolically healthy obesity"" (MHO). This study evaluates the association between MHO and carotid intima-media thickness (CIMT), an early marker of subclinical atherosclerosis. Methods and results: This is a cross-sectional analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used a strict definition to classify MHO: body mass index >30 kg/m2 and meeting none of the four metabolic syndrome criteria. Data from 10,335 participants were analyzed. The obesity prevalence in our population was 21.2% (n = 2191). The prevalence of MHO was 5.6% (n = 124). When individuals were stratified according to metabolic health, we found the metabolically healthy individuals were younger, more likely to be women and never smokers. The mean CIMT of the sample was 0.81 mm (+0.20). The mean CIMT of the metabolically healthy subsample was 0.70 mm (+0.13) in individuals without obesity and 0.76 mm (+0.13) in individuals with obesity (p < 0.001). The mean CIMT of the metabolically unhealthy subsample was 0.81 mm (+0.20) in individuals without obesity and 0.88 mm (+0.20) in individuals with obesity (p <0.001). These findings remained essentially unchanged after multivariate adjustment for confounding factors. Conclusion: The concept of MHO, even with the strict definition, seems inadequate, as even in this population, obesity is associated with higher CIMT levels.
- Cutaneous vasculitis in lupus treated with IV immunoglobulin(2021) STUMPF, Matheo Augusto Morandi; QUINTINO, Carla Romagnolli; RODRIGUES, Marcelo Arlindo Vasconcelos Miranda; CAMPOS, Fernando Peixoto Ferraz de; MARUTA, Celina Wakisaka
- Obesity, metabolic syndrome and cardiovascular prognosis: from the Partners coronary computed tomography angiography registry(2017) HULTEN, Edward A.; BITTENCOURT, Marcio Sommer; PRESTON, Ryan; SINGH, Avinainder; ROMAGNOLLI, Carla; GHOSHHAJRA, Brian; SHAH, Ravi; ABBASI, Siddique; ABBARA, Suhny; NASIR, Khurram; BLAHA, Michael; HOFFMANN, Udo; CARLI, Marcelo F. Di; BLANKSTEIN, RonObjective: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (< 50%), or obstructive CAD (>= 50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results: Mean age of the cohort was 57 +/- 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m(2), p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m(2), after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions: Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m(2). Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.
- Cerebrovascular risk factors and their time-dependent effects on stroke survival in the EMMA cohort study(2023) GOULART, A. C.; VARELLA, A. C.; TUNES, G.; ALENCAR, A. P.; SANTOS, I. S.; ROMAGNOLLI, C.; GOODEN, T. E.; THOMAS, G. N.; LIP, G. Y. H.; OLMOS, R. D.; LOTUFO, P. A.; BENSENOR, I. M.To investigate the time-dependent effects of traditional risk factors on functional disability in all-cause mortality post-stroke, we evaluated data from a long-term stroke cohort. Baseline cerebrovascular risk factors (CVRF) and functionality at 1 and 6 months were evaluated in survivors from a prospective stroke cohort using the modified Rankin scale (m-RS), which classifies participants as improvement of disability, unchanged disability (at least moderate), and worsening disability. Cox regression models considering baseline risk factors, medication use, and functionality 6 months after stroke were fitted to identify their time-dependent effects up to 12 years of follow-up. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) are presented. Among 632 survivors (median age 68, 54% male, 71% first-ever episode), age and functional disability (unchanged and worsening) 6 months after ischemic stroke had time-dependent effects on all-cause mortality risk up to 12 years of follow-up. The most impacting risk factors were unchanged (at least moderate) (HR, 2.99; 95%CI: 1.98-4.52) and worsening disability (HR, 2.85; 95%CI: 1.26-6.44), particularly in the first two years after a stroke event (Time 1: >= 6 mo to <2.5 y). Worsening disability also impacted mortality in the period from >= 2.5 to <7.5 years (Time 2) of follow-up (HR, 2.43 (95%CI: 1.03-5.73). Other baseline factors had a fixed high-risk effect on mortality during follow-up. Post-stroke and continuous medication use had a fixed protective effect on mortality. Functional disability was the main contributor with differential risks of mortality up to 12 years of follow-up.
- Igg4-related disease: A diagnostic challenge(2021) OLMOS, R. D.; RODRIGUES, M. A. V. M.; FERREIRA, C. R.; ETRUSCO, R. C. F.; ROMAGNOLLI, C.Immunoglobulin IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition with a characteristic histopathological appearance that can affect almost any organ. The clinical features result from a focal or diffuse appearance of a tumor-like swelling of the affected organs, identified by physical and/or imaging examination. Herein, we report the case of a 38-year-old male complaining of a worsening chronic right lumbar pain associated with legs and scrotum edema. He also had itchy and erythematous cutaneous lesions on the abdominal wall over the last 8 months, and complained of a diffuse and mild to moderate abdominal discomfort. On examination, the liver was firmly enlarged and tender. His legs had 2+ symmetrical pitting edema extending from his feet to just above the knees. An abdominal computed tomography scan showed a large mass (10 x 8 x 4cm) involving the abdominal infrarenal aorta and the iliac arteries, and compressing the inferior vena cava, with dilated iliac veins, raising the possibility of lymphoproliferative disease. During the initial investigation, the laboratory workup revealed anemia, without other marked changes. A laparoscopic-guided biopsy of the peri-aortic mass was undertaken. The histological report associated with IgG4 immunoglobulin measurement rendered the diagnosis of IgG4-RD. The patient had a favorable outcome after the use of glucocorticoids with the abdominal mass remission. © 2021 The Authors.
- Cardiovascular medications and long-term mortality among stroke survivors in the Brazilian Study of Stroke Mortality and Morbidity (EMMA)(2022) SOUZA, Karla A. S.; VARELLA, Ana C.; OLMOS, Rodrigo D.; ROMAGNOLLI, Carla; GOODEN, Tiffany E.; THOMAS, G. Neil; LIP, Gregory Y. H.; SANTOS, Itamar S.; LOTUFO, Paulo A.; BENSENOR, Isabela M.; GOULART, Alessandra C.Aim To investigate the association between medication use and long-term all-cause mortality in a Brazilian stroke cohort. Methods Both ischemic and hemorrhagic stroke were evaluated. Medication use was assessed as: never, only pre-stroke, only post-stroke, and continuous use. We evaluated anti-hypertensives, anti-diabetics, lipid-lowering drugs, anti-platelets, and anti-coagulants. Cox regression models were adjusted for sociodemographic and cardiovascular risk factors. Results Among 1173 incident stroke cases (median age: 68; 86.8% were ischemic, 70% first-ever stroke), medication use was low (overall: 17.5% pre-stroke, 26.4% post-stroke, and 40% were under continuous use). Anti-hypertensives and anti-platelets (aspirin) were the continuous cardiovascular medications used most often, at 83.5% and 72%, respectively, while statins (39.7%) and anti-diabetics (31.3%) were the least used. Medication use (pre-stroke, post-stroke and continuous use) was associated with a reduction in all-cause mortality risk, particularly among those under continuous use (multivariable hazard ratio, 0.52; 95% confidence interval (CI), 0.46-0.66) compared with never-users. Among ischemic stroke patients, this effect was similar (multivariable hazard ratio, 0.52; 95% CI, 0.40-0.68). No significant associations were evident among hemorrhagic stroke patients. Conclusions The risk of all-cause mortality was reduced by 48% among those with ischemic stroke under continuous use of medications. Secondary prevention should be emphasized more strongly in clinical practice. Geriatr Gerontol Int 2022; center dot center dot: center dot center dot-center dot center dot.
- Patient and Public Involvement and Engagement (PPIE): first steps in the process of the engagement in research projects in Brazil(2022) BENSENOR, I. M.; GOULART, A. C.; THOMAS, G. N.; LIP, G. Y. H.; ARASALINGAM, Ajini; BEANE, Abi; BENSENOR, Isabela M.; BROCKLEHURST, Peter; CHENG, Kar Keung; EL-BOURI, Wahbi; FENG, Mei; GREENFIELD, Sheila; GUO, Yutao; GURUPARAN, Mahesan; GUSSO, Gustavo; GOODEN, Tiffany E.; HANIFFA, Rashan; HUMPHREYS, Lindsey; JOLLY, Kate; JOWETT, Sue; KODIPPILY, Chamira; KUMARENDRAN, Balachandran; LANCASHIRE, Emma; LANE, Deirdre A.; LI, Xuewen; LIP, Gregory Y. H.; LI, Yan-guang; LOBBAN, Trudie; LOTUFO, Paulo A.; MANASEKI-HOLLAND, Semira; MOORE, David; NIRANTHARAKUMAR, Krishnarajah; OLMOS, Rodrigo D.; PASCHOAL, Elisabete; PIRASANTH, Paskaran; POWSIGA, Uruthirakumar; ROMAGNOLLI, Carla; SANTOS, Itamar S.; SHANTSILA, Alena; SHERON, Vethanayagan Antony; SHRIBAVAN, Kanesamoorthy; SZMIGIN, Isabelle; SUBASCHANDREN, Kumaran; SURENTHIRAKUMARAN, Rajendra; TAI, Meihui; THAVARAJAH, Bamini; THOMAS, G. Neil; TOIPPA, Timo; VARELLA, Ana C.; WANG, Hao; WANG, Jingya; ZHANG, Hui; ZHONG, JiaoyuePatient and Public Involvement and Engagement (PPIE) - sometimes called Community Engagement and Involvement (CEI) - comes as a big challenge but one that can be very helpful for health care professionals and stakeholders in planning better health policies for attending to the main needs of the community. PPIE involves three pillars: public involvement, public engagement, and participation. Public involvement occurs when members of the general population are actively involved in developing the research question, designing, and conducting the research. Public engagement tells people about new studies, why they are important, the impact of results, the possible implication of the main findings for the community, and the possible impact of these new findings in society, as well as, in the dissemination of knowledge to the general population. Participation is being a volunteer in the study. Our experience with PPIE, to the best of our knowledge the first initiative in Brazil, is a partnership with the University of Birmingham, the University of Liverpool, and the NIHR Global Health Group on Atrial Fibrillation (AF) Management focusing on the AF care pathway exploring the important aspects of diagnosis and treatment in the primary care system from a low-middle income area in Sao Paulo. The involvement of patients/public in the research represents a new step in the process of inclusion of all segments of our society based on patient illness and the gaps in knowledge aiming to open new horizons for continuous improvement and better acceptance of research projects.