LEANDRO LARA DO PRADO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Behcet's Disease Activity: An Important Factor For Immunogenicity Of Unadjuvanted Influenza A/H1N1 Vaccine(2013) PRADO, Leandro L.; SAAD, Carla G. S.; MORAES, Julio C. B.; RIBEIRO, Ana Cristina Medeiros; AIKAWA, Nadia E.; SILVA, Clovis A.; SCHAINBERG, Claudia G.; SAMPAIO-BARROS, Percival D.; PRECIOSO, Alexander R.; ISHIDA, Maria A.; BONFA, Eloisa; GONCALVES, CeliobookPart Miopatias autoimunes sistêmicas(2023) PRADO, Leandro Lara do; LUSTOSA, KristophersonbookPart Artrites Infecciosas(2018) PRADO, Leandro Lara do; LEVY-NETO, MaurícioconferenceObject Metabolic Syndrome: The Genesis of Nephrolithiasis in Gout Patients?(2012) MELLO, Filipi M.; TOMITA, Rafael B.; FULLER, Ricardo; FILHO, Marco Antonio G. P.; BARROS, Thiago B. M.; PRADO, Leandro L. do; AUGUSTO, Kristopherson L.; GOLDENSTEIN-SCHAINBERG, ClaudiaBackground/Purpose: Gout patients have a high frequency of metabolic syndrome (MS), a disorder known to be associated with hyperinsulinemia. The latter condition augments proximal tubular sodium reabsorption and leads to reduced renal urate excretion and hyperuricemia. There are no data, however, evaluating whether MS can influence gout-associated clinical characteristics. Thus, we aimed to determine the prevalence of MS in our population and to investigate if the presence of MS would characterize a particular clinical and laboratorial gout profile. Methods: This was a cross-sectional study of 158 gout patients (ACR criteria). MS was defined in accordance to the National Cholesterol Education Program ATP III (NCEP-ATP III) and the International Diabetes Federation (IDF) criteria. Demographic, anthropometric (body mass index - BMI) and clinical data were evaluated. Fasting serum levels of UA, glucose, triglycerides and cholesterol fractions were analyzed by routine laboratory tests. Nephrolithiasis was demonstrated by usual ultrasonography and urate under-excretion defined as UA clearance lower than 7.5 ml/min. Statistical comparisons were performed using Fisher’s exact, chi-square, students T and Spearman’s tests and P<0.05 was considered significant. Results: The frequency of MS in gout patients was 73% and 71% according to NCEP ATPIII and IDF criteria respectively. Further comparison of 125 patients with MS and those 33 without this condition revealed similar mean ages (63.0 ± 11.5 vs 62.5 ± 12.9; p>0,05) and male predominance (94% and 75%). As expected, those with MS had higher BMI (30.2 ± 5.5kg/m2 vs 27.0 5.8kg/m2; p=0.005) and higher prevalences of systemic arterial hypertension (93.3% vs 75% p=0.012) and diabetes (25.8% vs 0, p=0.001), though comparable frequency of coronary artery disease (22.5% vs 16.7%; p=0.469). With regard to gout clinical/laboratorial characteristic, patients with MS had more nephrolitiasis (37.1% vs 16.7%, p=0.026), but they did not differ from patients without MS concerning the presence of tophi (52.8% vs. 55.6%; p = 0.780) or uric acid underexcretion (83.1% vs 94.4%; p=0.148). Current alcohol consumption, mean estimated creatinine clearance and mean serum levels of uric acid, were alike in both groups (p>0.05). Conclusion: The novel demonstration that MS in gout is associated to nephrolithiasis suggests that this condition may underlie the genesis of uric acid stones. Whether insulin resistance may account for a renal alteration that may ultimately impair buffering and amplification of acidic urine remains to be determined. Moreover, the elevated prevalence of MS in gout patients from our country (almost 3⁄4) is higher than overall rates of 63% MS in gout worldwide, indicating possible influence of dietary, geographical and/or genetic background.bookPart Síndrome de Sjögren(2016) PASOTO, Sandra Gofinet; LOURENçO, Silvia Vanessa; PRADO, Leandro Lara do; GUEDES, Lissiane Karine NoronhabookPart Síndrome de Behçet(2018) PRADO, Leandro Lara do; GONçALVES, Célio Roberto- Ankylosing spondylitis and psoriatic arthritis: revisiting screening of latent tuberculosis infection and its follow-up during anti-tumor necrosis factor therapy in an endemic area(2020) SHIMABUCO, Andrea Yukie; MEDEIROS-RIBEIRO, Ana Cristina de; MIOSSI, Renata; BONFIGLIOLI, Karina Rossi; MORAES, Julio Cesar Bertacini de; GONCALVES, Celio Roberto; SAMPAIO-BARROS, Percival Degrava; GOLDENSTEIN-SCHAINBERG, Claudia; SOUZA, Fernando Henrique Carlos de; PRADO, Leandro Lara do; UGOLINI-LOPES, Michele Remiao; YUKI, Emily Figueiredo Vieira Neves; BONFA, Eloisa; SAAD, Carla Goncalves SchahinOBJECTIVES: To retrospectively evaluate the performance and distinctive pattern of latent tuberculosis (TB) infection (LTBI) screening and treatment in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) under anti-tumor necrosis factor (TNF) therapy and determine the relevance of re-exposure and other risk factors for TB development. METHODS: A total of 135 and 83 patients with AS and PsA, respectively, were evaluated for LTBI treatment before receiving anti-TNF drugs via the tuberculin skin test (TST), chest radiography, and TB exposure history assessment. All subjects were evaluated for TB infection at 3-month intervals. RESULTS: The patients with AS were more often treated for LTBI than were those with PsA (42% versus 30%, p=0.043). The former also presented a higher frequency of TST positivity (93% versus 64%, p=0.002), although they had a lower frequency of exposure history (18% versus 52%, p=0.027) and previous TB (0.7% versus 6%, p=0.03). During follow-up [median, 5.8 years; interquartile range (1QR), 2.2-9.0 years], 11/218 (5%) patients developed active TB (AS, n=7; PsA, n=4). TB re-exposure was the main cause in seven patients (64%) after 12 months of therapy (median, 21.9 months; IQR, 14.2-42.8 months) and five LTBI-negative patients. TB was identified within the first year in four patients (36.3%) (median, 5.3 months; IQR, 1.2-8.8 months), two of whom were LTBI-positive. There was no difference in the TB-free survival according to the anti-TNF drug type/class; neither synthetic drug nor prednisone use was related to TB occurrence (p > 0.05). CONCLUSION: Known re-exposure is the most critical factor for incident TB cases in spondyloarthritis. There are also some distinct features in AS and PsA LTBI screening, considering the higher frequency of LTBI and TST positivities in patients with AS. Annual risk reassessment taking into consideration these peculiar features and including the TST should be recommended for patients in endemic countries.
conferenceObject INCREASED PREVALENCE OF METABOLIC SYNDROME IS ASSOCIATED TO NEPHROLITHIASIS BUT NOT TO THE PRESENCE OF TOPHUS IN GOUT PATIENTS(2012) MELLO, F. M.; TOMITA, F. R. B.; FULLER, R.; PONTES FILHO, M. A. G.; BARROS, T. B. M.; PRADO, L. L.; AUGUSTO, K. L.; GOLDENSTEIN-SCHAINBERG, C.bookPart Síndrome de Behçet(2016) PRADO, Leandro Lara do; GONçALVES, Célio Roberto- Recommendations for the treatment of Sjogren's syndrome(2015) VALIM, Valeria; TREVISANI, Virginia Fernandes Moca; PASOTO, Sandra Gofinet; SERRANO, Erica Vieira; RIBEIRO, Sandra Lucia Euzebio; FIDELIX, Tania Sales de Alencar; VILELA, Veronica Silva; PRADO, Leandro Lara do; TANURE, Leandro Augusto; LIBORIO-KIMURA, Tatiana Nayara; BRITO FILHO, Odvaldo Honor de; BARROS, Liliana Aparecida Pimenta de; MIYAMOTO, Samira Tatiyama; LOURENCO, Silvia Vanessa; SANTOS, Maria Carmen Lopes Ferreira Silva; VIEIRA, Luis Antonio; ADAN, Consuelo Bueno Diniz; BERNARDO, Wanderley MarquesThe recommendations proposed by the Sjogren's Syndrome Committee of the Brazilian Society of Rheumatology for the treatment of Sjogren's syndrome were based on a systematic review of literature in Medline (PubMed) and the Cochrane databases until October 2014 and on expert opinion in the absence of studies on the subject. 131 items classified according to Oxford & Grade were included. These recommendations were developed in order to guide the appropriate management and facilitate the access to treatment for those patients with an appropriate indication, considering the Brazilian socioeconomic context and pharmacological agents available in this country.