ADRIANA MALUF ELIAS SALLUM

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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina

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Autor e Coautores FMUSP-HC Normalizados: LUCIA MARIA MATTEI DE ARRUDA CAMPOS ×

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  • article 0 Citação(ões) na Scopus
    Safety and immunogenicity of influenza A(H3N2) component vaccine in juvenile systemic lupus erythematosus
    (2023) AIKAWA, Nadia Emi; BORBA, Eduardo Ferreira; BALBI, Verena Andrade; SALLUM, Adriana Maluf Elias; BUSCATTI, Izabel Mantovani; CAMPOS, Lucia Maria Arruda; KOZU, Katia Tomie; GARCIA, Cristiana Couto; CAPAO, Artur Silva Vidal; PROENCA, Adriana Coracini Tonacio de; LEON, Elaine Pires; DUARTE, Alberto Jose da Silva; LOPES, Marta Heloisa; SILVA, Clovis Artur; BONFA, Eloisa
    Introduction Seasonal influenza A (H3N2) virus is an important cause of morbidity and mortality in the last 50 years in population that is greater than the impact of H1N1. Data assessing immunogenicity and safety of this virus component in juvenile systemic lupus erythematosus (JSLE) is lacking in the literature.Objective To evaluate short-term immunogenicity and safety of influenza A/Singapore (H3N2) vaccine in JSLE.Methods 24 consecutive JSLE patients and 29 healthy controls (HC) were vaccinated with influenza A/Singapore/INFIMH-16-0019/2016(H3N2)-like virus. Influenza A (H3N2) seroprotection (SP), seroconversion (SC), geometric mean titers (GMT), factor increase in GMT (FI-GMT) titers were assessed before and 4 weeks post-vaccination. Disease activity, therapies and adverse events (AE) were also evaluated.Results JSLE patients and controls were comparable in current age [14.5 (10.1-18.3) vs. 14 (9-18.4) years, p = 0.448] and female sex [21 (87.5%) vs. 19 (65.5%), p = 0.108]. Before vaccination, JSLE and HC had comparable SP rates [22 (91.7%) vs. 25 (86.2%), p = 0.678] and GMT titers [102.3 (95% CI 75.0-139.4) vs. 109.6 (95% CI 68.2-176.2), p = 0.231]. At D30, JSLE and HC had similar immune response, since no differences were observed in SP [24 (100%) vs. 28 (96.6%), p = 1.000)], SC [4 (16.7%) vs. 9 (31.0%), p = 0.338), GMT [162.3 (132.9-198.3) vs. 208.1 (150.5-287.8), p = 0.143] and factor increase in GMT [1.6 (1.2-2.1) vs. 1.9 (1.4-2.5), p = 0.574]. SLEDAI-2K scores [2 (0-17) vs. 2 (0-17), p = 0.765] and therapies remained stable throughout the study. Further analysis of possible factors influencing vaccine immune response among JSLE patients demonstrated similar GMT between patients with SLEDAI < 4 compared to SLEDAI >= 4 (p = 0.713), as well as between patients with and without current use of prednisone (p = 0.420), azathioprine (p = 1.0), mycophenolate mofetil (p = 0.185), and methotrexate (p = 0.095). No serious AE were reported in both groups and most of them were asymptomatic (58.3% vs. 44.8%, p = 0.958). Local and systemic AE were alike in both groups (p > 0.05).Conclusion This is the first study that identified adequate immune protection against H3N2-influenza strain with additional vaccine-induced increment of immune response and an adequate safety profile in JSLE. (www.clinicaltrials.gov, NCT03540823).
  • conferenceObject
    Yellow Fever Vaccination in Brazil: Short-Term Safety in Pediatric Autoimmune Rheumatic Diseases
    (2018) AIKAWA, Nadia E.; BALBI, Verena A.; TONACIO, Adriana C.; SALLUM, Adriana M. E.; CAMPOS, Lucia M. A.; KOZU, Katia T.; VENDRAMINI, Margarete B.; FONTOURA, Nicole; SARTORI, Ana M. C.; ANTONANGELO, Leila; SILVA, Clovis A.; BONFA, Eloisa
  • conferenceObject
    Dyslipidemia in Juvenile Dermatomyositis: The Role of Disease Activity
    (2012) KOZU, Katia T.; SILVA, Clovis Artur; BONFA, Eloisa; SALLUM, Adriana M.; PEREIRA, Rosa M. R.; VIANA, Vilma S.; BORBA, Eduardo F.; CAMPOS, Lucia M. A.
  • article 22 Citação(ões) na Scopus
    Dyslipidaemia in juvenile dermatomyositis: the role of disease activity
    (2013) KOZU, K. T.; SILVA, C. A.; BONFA, E.; SALLUM, A. M.; PEREIRA, R. M. R.; VIANA, V. S.; BORBA, E.; CAMPOS, L. M.
    Objective To evaluate the presence of dyslipidaemia in JDM and its possible risk factors. Methods Twenty-five JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycaemia, insulin, antibodies and muscle enzymes. JDM scores were assessed: CMAS, MMT, DAS, MYOACT and MYTAX. Results Abnormal lipid profile was found in nine patients and four controls (36% vs. 16%, p=0.196). TDM patients demonstrated significant higher levels of triglycerides (TG) [80(31-340) vs. 61(19-182) mgldL, p=0.011 j and higher frequency of abnormal levels of high density lipoproteins (HDL) (28% vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidaemia demonstrated significant lower median of HDL levels 129(0-49) vs. 50(39-72) mgldL, p=0.0005, higher frequency of low HDL levels (77% vs. 0%, p=0.0001),.higher TG levels [128(31-340) vs. 69(46-138) mgldL, p=0.011), and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) when compared to those without this condition. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidaemia had higher ESR (26 vs. I 4.5mmllsthour, p=0.006), CRP (2.1 vs. 0.4mgldL, p=0.01), DAS (6 vs. 2, p=0.008), MYOACT(0.13 vs. 0.01, p=0.012), MYTAX(0.06vs.0,p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidaemia. Positive correlations were detected between TG levels and CRP (7-.19.697, p=0.001), DAS (r-0.610, p=0.001), MYOACT (r=0.661, p=0.001),114YTAX (r-0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body composition, lipodystrophy, anti-LPL antibodies, and treatment except by higher frequency of cyclosporine current use in patients with dys.lipidaemia (33% vs. 0%, p=0.03). Conclusions Dyslipidaemia in JDM patients was characterised by increased levels of TG and low levels of HDL. Disease activity and cyclosporine use were the mainly factors associated to these abnormalities.
  • article 0 Citação(ões) na Scopus
    Heart function in juvenile idiopathic arthritis patients: A biventricular two-dimensional speckle-tracking echocardiography study
    (2022) LIANZA, Alessandro C.; LEAL, Gabriela N.; AIKAWA, Nadia E.; KOZU, Katia T.; DINIZ, Maria De Fatima R.; SAWAMURA, Karen S. S.; MENEZES, Carolina R. B.; MARTINS, Camila Lino; CAMPOS, Lucia M.; ELIAS, Adriana M.; SILVA, Clovis A.
    Objectives We evaluated cardiac function in juvenile idiopathic arthritis (JIA) patients by 2D speckle-tracking echocardiography (2DSTE) and to assess possible associations with clinical, laboratorial, and treatment data. Methods A group of 42 JIA patients and 42 healthy controls were evaluated using both conventional echocardiography and 2DSTE. JIA patients underwent clinical and laboratory assessment. Results Conventional echocardiography data demonstrated normal left ventricular (LV) ejection fraction in both groups (71 vs. 71%; p = .69). 2DSTE analysis demonstrated that JIA patients presented significantly lower LV global systolic longitudinal strain (LVGLS) (-18.76 vs. -22%; p < .0001), LV systolic strain rate (LVSSR) (1.06 vs. 1.32 s(-1); p < .0001), LV diastolic strain rate (LVDSR) (1.58 vs. 1.8 s(-1); p < .0137), right ventricular global systolic strain (RVGLS) (-24.1% vs. -27.7%; p = .0002), and right ventricular systolic strain rate (RVSSR) (1.4 vs. 1.8 s(-1); p = .0035). JIA patients under biological agents presented higher LVGLS (p = .02) and RVLS (p = .01). We also detected an association between LVGLS and C-reactive protein [CRP; -20% in normal CRP (10/42) vs. -18% in elevated CRP patients (32/42), p = .03]. Conclusions JIA patients present different echocardiographic status from healthy patients. Moreover, our data suggest that JIA patients under biological agents present association with better cardiac function as shown by strain analysis.
  • conferenceObject
    NUTRITIONAL ASSESSMENT, BODY COMPOSITION AND PHASE ANGLE IN JUVENILE DERMATOMYOSITIS PATIENTS
    (2023) PUGLIESE, Camila; KOZU, Katia T.; CAMPOS, Lucia M. A.; AIKAWA, Nadia E.; SILVA, Clovis A. A.; ELIAS, Adriana M.
  • article 48 Citação(ões) na Scopus
    Exposure to Air Pollutants and Disease Activity in Juvenile-Onset Systemic Lupus Erythematosus Patients
    (2015) FERNANDES, Elisabeth C.; SILVA, Clovis A.; BRAGA, Alfesio L. F.; SALLUM, Adriana M. E.; CAMPOS, Lucia M. A.; FARHAT, Sylvia C. L.
    ObjectiveTo investigate the association between exposure to air pollutants in the Sao Paulo metropolitan area and disease activity in juvenile-onset systemic lupus erythematosus (SLE) patients. MethodsA longitudinal panel study based on 409 consecutive visits of juvenile-onset SLE patients living in the Sao Paulo metropolitan area was carried out. Disease activity was evaluated in accordance with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and the patients were divided into 2 groups: those with SLEDAI scores 8 and those with SLEDAI scores >8. Daily concentrations of inhaled particulate matter (PM10), sulfur dioxide, nitrogen dioxide (NO2), ozone, and carbon monoxide (CO) were evaluated on the 21 days preceding the medical visits. A generalized estimation equation model was used to assess the impact of these measurements on SLEDAI-2K scores, considering the fixed effects for repetitive measurements. The models were adjusted for erythrocyte sedimentation rate, corticosteroid use (daily and cumulative doses), antimalarial use, the use of immunosuppressive agents, the presence of infection 20 days preceding the medical appointment, and the minimum temperature and relative humidity outdoors. ResultsPM(10), NO2, and CO were risk factors for juvenile-onset SLE disease activity (SLEDAI-2K score >8) approximately 2 weeks after exposure. A 13.4 g/m(3) increase in the PM10 moving average (from lag 12 to lag 15) was associated with a 34% increase (95% confidence interval 7.0-68.0) in the risk of a SLEDAI-2K score >8. ConclusionThis is the first study to show that exposure to inhaled pollutants may increase the risk of disease activity in children with juvenile-onset SLE in a large urban center.
  • conferenceObject
    A Brazilian Multicenter Study of 71 Children and Adolescents with Takayasu's Arteritis
    (2012) TERRERI, Maria Teresa; CLEMENTE, Gleice; SILVA, Clovis; SACCHETTI, Silvana; SALLUM, Adriana M.; CAMPOS, Lucia M. A.; SANTOS, Maria Carolina; SZTAJNBOK, Flavio; ALMEIDA, Rozana Gasparello de; FERRIANI, Virginia P.; BICA, Blanca E.; ROBAZZI, Teresa; BANDEIRA, Marcia; CAVALCANTI, Andre; LESSA, Marise; OLIVEIRA, Sheila K. Feitosa de; HILARIO, Maria Odete
    Background/Purpose: Takayasu’s arteritis is a chronic granulomatous disease that affects the vascular wall of the large arteries and can result in end organ damage. It is more prevalent in young women, but can also occur in the childhood. The disease is rare and there are few reports about the clinical features at this age. Our aim was to describe the clinical features of Takayasu’s arteritis in children and adolescents in our population. Methods: In this Brazilian multicenter retrospective study including 10 pediatric rheumatology centers we identified 71 children and adolescents with Takayasu’s arteritis. Patients’ demographic, clinical, laboratory, angiographic, therapeutic data and disease outcome were recorded. Results: Of the 71 patients, 51 (72%) were girls, with a mean age at onset of 9.2 years (range 4 months to 17.2 years); the average time to diagnosis was 1.2 years; and the mean follow-up time was 5.4 years. The most frequent angiographic type was type IV (41%) followed by type V (27%) and the abdominal aorta was the most affected vessel (63.4%). The main lesion was arterial stenosis (84.5% of patients). At initial presentation 80.6% of patients had increased acute phase reactants and 41% of patients had a positive Mantoux test. The predominant clinical symptoms at onset were constitutional (77.5%), followed by neurological (70.4%) and musculoskeletal symptoms (64.8%). The main cardiovascular manifestation was arterial hypertension (84.5%). At the final evaluation, neurological symptoms were predominant (22.7%) and decrease of peripheral pulses (66.7%) was the main cardiovascular manifestation. Sixty four (90.1%) patients were treated with corticosteroids, 30 patients (42.3%) with methotrexate as the first immunosuppressive treatment and 18 (25.4%) were treated with cyclophosphamide as initial therapy. Infliximab was used in only 4 patients throughout the follow-up. At the final evaluation, 55% of patients were in disease remission, 28% had active disease, 7% died and in 10% the outcome was unknown. Conclusion: Takayasu’s arteritis is a rare childhood disease. In this multicenter study we observed a high rate of disease remission, however prospective studies are needed in order to better define overall disease outcome.
  • article 3 Citação(ões) na Scopus
    Sexual function in female juvenile idiopathic arthritis patients
    (2019) PITTA, Ana Claudia; FERREIRA, Gabriela Ribeiro Viola; TOMIOKA, Renato Bussadori; LOURENCO, Daniela Mencaroni Rodrigues; KOZU, Katia; AIKAWA, Nadia Emi; SALLUM, Adriana Maluf Elias; CAMPOS, Lucia Maria Arruda; ABDO, Carmita Helena Najjar; PEREIRA, Rosa Maria Rodrigues; BARACAT, Edmund Chada; BONFA, Eloisa; SILVA, Clovis Artur
    Objective: To evaluate sexual function female adolescents and young adults with juvenile idiopathic arthritis (JIA) and healthy controls. Methods: After exclusion, 21 female adolescent and young JIA patients and 25 healthy controls were selected for this study. Sexual function was assessed by the Sexual Quotient Questionnaire for Females (SQQ-F) score, which is a validated tool and adapted for Brazilian Portuguese language. Demographic data, JIA clinical/laboratory parameters and treatment were also assessed. Results: The median current age [26.5 (17-38.1) vs. 29.3 (19.7-35.8) years, p = 0.700)] as well as age at the first sexual activity [18 (14-30) vs. 17 (10-24) years, p = 0.158] were similar in JIA patients and healthy controls. The median of SQQF score was alike in both groups [75.9 (50-92) vs. 78.2 (58-94), p = 0.529], as well as frequencies of sexual dysfunction (14% vs. 12%, p = 1.000). The frequencies of all sexual domains (desire/sexual fantasies, desire/interest, arousal/foreplay, arousal/lubrication, arousal/in tune with partner, penetration/relaxation, pain/penetration, desire/involvement, orgasm and general satisfaction scores) were similar in JIA patients and healthy controls (p > 0.05). Conclusions: To our knowledge, this was the first study using a validated sexual score in a chronic arthritis population suggesting a low frequency of overall sexual dysfunction in young JIA patients. Future multicenter studies with a large sample will be necessary to confirm this finding.
  • article 38 Citação(ões) na Scopus
    Outcomes of 847 childhood-onset systemic lupus erythematosus patients in three age groups
    (2017) LOPES, S. R. M.; GORMEZANO, N. W. S.; GOMES, R. C.; AIKAWA, N. E.; PEREIRA, R. M. R.; TERRERI, M. T.; MAGALHAES, C. S.; FERREIRA, J. C.; OKUDA, E. M.; SAKAMOTO, A. P.; SALLUM, A. M. E.; APPENZELLER, S.; FERRIANI, V. P. L.; BARBOSA, C. M.; LOTUFO, S.; JESUS, A. A.; ANDRADE, L. E. C.; CAMPOS, L. M. A.; BONFA, E.; SILVA, C. A.
    Objective The objective of this study was to assess outcomes of childhood systemic lupus erythematosus (cSLE) in three different age groups evaluated at last visit: group A early-onset disease (<6 years), group B school age (6 and <12 years) and group C adolescent (12 and <18 years). Methods An observational cohort study was performed in ten pediatric rheumatology centers, including 847 cSLE patients. Results Group A had 39 (4%), B 395 (47%) and C 413 (49%). Median disease duration was significantly higher in group A compared to groups B and C (8.3 (0.1-23.4) vs 6.2 (0-17) vs 3.3 (0-14.6) years, p<0.0001). The median Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) (0 (0-9) vs 0 (0-6) vs 0 (0-7), p=0.065) was comparable in the three groups. Further analysis of organ/system damage revealed that frequencies of neuropsychiatric (21% vs 10% vs 7%, p=0.007), skin (10% vs 1% vs 3%, p=0.002) and peripheral vascular involvements (5% vs 3% vs 0.3%, p=0.008) were more often observed in group A compared to groups B and C. Frequencies of severe cumulative lupus manifestations such as nephritis, thrombocytopenia, and autoimmune hemolytic anemia were similar in all groups (p>0.05). Mortality rate was significantly higher in group A compared to groups B and C (15% vs 10% vs 6%, p=0.028). Out of 69 deaths, 33/69 (48%) occurred within the first two years after diagnosis. Infections accounted for 54/69 (78%) of the deaths and 38/54 (70%) had concomitant disease activity. Conclusions This large multicenter study provided evidence that early-onset cSLE group had distinct outcomes. This group was characterized by higher mortality rate and neuropsychiatric/vascular/skin organ damage in spite of comparable frequencies of severe cumulative lupus manifestations. We also identified that overall death in cSLE patients was an early event mainly attributed to infection associated with disease activity.