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au:PALOMINOS, PENELOPE ESTHER

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Epidemiological analysis of patients with psoriatic arthritis in follow-up at the brazilian Unified Health System
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Rossetto, Chayanne Natielle

; Palominos, Penélope Esther

; Machado, Natalia Pereira

; Paiva, Eduardo dos Santos

; Azevedo, Valderílio Feijó

Advances in Rheumatology

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2023, Volume 63 elocation 47

Abstract: En | Text: En | PDF: En

Abstract Introduction/Objectives Psoriatic arthritis (PsA) is a chronic multisystem osteoarticular disease that requires specialized care. Most Brazilians depend on the public healthcare provided by the Unified Health System (Sistema Único de Saúde, SUS). This study aimed to describe the epidemiological characteristics of patients with PsA in follow-up in SUS, focusing on the incidence and prevalence of the disease, comorbidities, and hospitalizations. Methods We collected data from the Outpatient Data System of SUS (Sistema de Informações Ambulatoriais do SUS, SIA/SUS) regarding outpatient visits and hospitalizations in the Brazilian public healthcare system from January 2008 to March 2021 using the Techtrials Disease Explorer® platform and the medical code related to PsA were selected. Results We evaluated 40,009 patients and found a prevalence of 24.4 cases of visits due to PsA per 100,000 patients in follow-up in SUS. Female patients were predominant (54.38%). The incidence of visits due to PsA has been increasing in recent years and we observed an incidence of 8,982 new visits in 2020. The main comorbidities of these patients were osteoarthritis, lower back pain, shoulder injuries, oncological diseases, crystal arthropathies, and osteoporosis. Hospitalizations were mainly due to treating clinical or cardiovascular conditions and performing orthopedic procedures. Conclusion The number of visits due to PsA in SUS has increased in recent years, mainly on account of new diagnoses of the disease, although the prevalence found in this study's population was lower than that observed in the general population.

https://doi.org/10.1186/s42358-023-00327-x

Survival of immunobiological drugs in psoriasis: preliminary data from a Tertiary Hospital experience in Southern Brazil
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Lima, Elis Costa de

; Boza, Juliana Catucci

; Palominos, Penélope Esther

; Xavier, Ricardo Machado

; Cestari, Tania Ferreira

Anais Brasileiros de Dermatologia

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jun 2021, Volume 96 N. 3 Pages 376 - 379

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.abd.2020.08.011 54 downloads

Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis
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Lage, Ricardo da Cruz

; Marques, Claudia Diniz Lopes

; Oliveira, Thauana Luiza

; Resende, Gustavo Gomes

; Kohem, Charles Lubianca

; Saad, Carla Gonçalves

; Ximenes, Antônio Carlos

; Gonçalves, Célio Roberto

; Bianchi, Washington Alves

; Meirelles, Eduardo de Souza

; Keiserman, Mauro Waldemar

; Chiereghin, Adriano

; Campanholo, Cristiano Barbosa

; Lyrio, André Marun

; Schainberg, Cláudia Goldenstein

; Pieruccetti, Lenise Brandao

; Yazbek, Michel Alexandre

; Palominos, Penelope Esther

; Goncalves, Rafaela Silva Guimarães

; Assad, Rodrigo Luppino

; Bonfiglioli, Rubens

; Lima, Sônia Maria Alvarenga Anti Loduca

; Carneiro, Sueli

; Azevedo, Valderílio Feijó

; Albuquerque, Cleandro Pires

; Bernardo, Wanderley Marques

; Sampaio-Barros, Percival Degrava

; Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 4

Abstract: En | Text: En | PDF: En

Abstract Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.

https://doi.org/10.1186/s42358-020-00160-6 505 downloads

Brazilian Society of Rheumatology 2020 guidelines for psoriatic arthritis
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Carneiro, Sueli

; Palominos, Penelope Esther

; Anti, Sônia Maria Alvarenga

; Assad, Rodrigo Luppino

; Gonçalves, Rafaela Silva Guimarães

; Chiereghin, Adriano

; Lyrio, Andre Marun

; Ximenes, Antônio Carlos

; Saad, Carla Gonçalves

; Gonçalves, Célio Roberto

; Kohem, Charles Lubianca

; Marques, Cláudia Diniz Lopes

; Schainberg, Cláudia Goldenstein

; Meirelles, Eduardo de Souza

; Resende, Gustavo Gomes

; Pieruccetti, Lenise Brandao

; Keiserman, Mauro Waldemar

; Yazbek, Michel Alexandre

; Sampaio-Barros, Percival Degrava

; Lage, Ricardo da Cruz

; Bonfiglioli, Rubens

; Oliveira, Thauana Luíza

; Azevedo, Valderílio Feijó

; Bianchi, Washington Alves

; Bernardo, Wanderley Marques

; Simões, Ricardo dos Santos

; Pinheiro, Marcelo de Medeiros

; Campanholo, Cristiano Barbosa

Advances in Rheumatology

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2021, Volume 61 elocation 69

Abstract: En | Text: En | PDF: En

Abstract Psoriatic arthritis (PsA) is a chronic and systemic immune disease characterized by inflammation of peripheral and/ or axial joints and entheses in patients with psoriasis (PsO). Extra-articular and extracutaneous manifestations and numerous comorbidities can also be present. These recommendations replace the previous version published in May 2013. A systematic review of the literature retrieved 191 articles that were used to formulate 12 recommendations in response to 12 clinical questions, divided into 4 sections: diagnosis, non-pharmacological treatment, conventional drug therapy and biologic therapy. These guidelines provide evidence-based information on the clinical management for PsA patients. For each recommendation, the level of evidence (highest available), degree of strength (Oxford) and degree of expert agreement (interrater reliability) are reported.

https://doi.org/10.1186/s42358-021-00219-y

The Brazilian Society of Rheumatology guidelines for axial spondyloarthritis – 2019
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Resende, Gustavo Gomes

; Meirelles, Eduardo de Souza

; Marques, Cláudia Diniz Lopes

; Chiereghin, Adriano

; Lyrio, Andre Marun

; Ximenes, Antônio Carlos

; Saad, Carla Gonçalves

; Gonçalves, Célio Roberto

; Kohem, Charles Lubianca

; Schainberg, Cláudia Goldenstein

; Campanholo, Cristiano Barbosa

; Bueno Filho, Júlio Silvio de Sousa

; Pieruccetti, Lenise Brandao

; Keiserman, Mauro Waldemar

; Yazbek, Michel Alexandre

; Palominos, Penelope Esther

; Goncalves, Rafaela Silva Guimarães

; Lage, Ricardo da Cruz

; Assad, Rodrigo Luppino

; Bonfiglioli, Rubens

; Anti, Sônia Maria Alvarenga

; Carneiro, Sueli

; Oliveira, Thauana Luíza

; Azevedo, Valderílio Feijó

; Bianchi, Washington Alves

; Bernardo, Wanderley Marques

; Pinheiro, Marcelo de Medeiros

; Sampaio-Barros, Percival Degrava

Advances in Rheumatology

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2020, Volume 60 elocation 19

Abstract: En | Text: En | PDF: En

Abstract Spondyloarthritis is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. The classification axial spondyloarthritis is adopted when the spine and/or the sacroiliac joints are predominantly involved. This version of recommendations replaces the previous guidelines published in May 2013. A systematic literature review was performed, and two hundred thirty-seven studies were selected and used to formulate 29 recommendations answering 15 clinical questions, which were divided into four sections: diagnosis, non-pharmacological therapy, conventional drug therapy and biological therapy. For each recommendation the level of evidence supporting (highest available), the strength grade according to Oxford, and the degree of expert agreement (inter-rater reliability) is informed. These guidelines bring evidence-based information on clinical management of axial SpA patients, including, diagnosis, treatment, and prognosis.

https://doi.org/10.1186/s42358-020-0116-2 1116 downloads

Latent tuberculosis infection in patients with rheumatic diseases
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Anton, Camila

; Machado, Felipe Dominguez

; Ramirez, Jorge Mario Ahumada

; Bernardi, Rafaela Manzoni

; Palominos, Penélope Esther

; Brenol, Claiton Viegas

; Mello, Fernanda Carvalho de Queiroz

; Silva, Denise Rossato

Jornal Brasileiro de Pneumologia

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2019, Volume 45 N. 2 elocation e20190023

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A maioria das pessoas infectadas por Mycobacterium tuberculosis (Mtb) não possui sinais ou sintomas da doença, quadro conhecido como infecção latente por tuberculose (ILTB). A introdução de agentes biológicos, sobretudo inibidores do fator de necrose tumoral (iTNF), para o tratamento de doenças imunomediadas, como artrite reumatoide (AR) e outras doenças reumatológicas, aumentou o risco de reativação de ILTB, levando ao desenvolvimento de tuberculose (TB) ativa. Assim, esta revisão abordará os aspectos relacionados à ILTB em pacientes com doenças reumatológicas, especialmente naqueles em uso de medicamentos iTNF. Para tanto, serão considerados a definição e a prevalência de ILTB, os mecanismos associados às doenças e às medicações em uso, bem como os critérios para rastreamento, diagnóstico e tratamento da ILTB. Como a reativação da ILTB é responsável pela grande proporção de casos de TB ativa, o diagnóstico e o tratamento adequados são cruciais, principalmente em grupos de alto risco, como os pacientes com doenças reumatológicas.

ABSTRACT Most people infected by Mycobacterium tuberculosis (Mtb) do not have any signs or disease symptoms, a condition known as latent tuberculosis infection (LTBI). The introduction of biological agents, mainly tumor necrosis factor (TNF) inhibitors, for the treatment of immune-mediated diseases such as Rheumatoid Arthritis (RA) and other rheumatic diseases, increased the risk of reactivation of LTBI, leading to development of active TB. Thus, this review will approach the aspects related to LTBI in patients with rheumatologic diseases, especially those using iTNF drugs. For this purpose it will be considered the definition and prevalence of LTBI, mechanisms associated with diseases and medications in use, criteria for screening, diagnosis and treatment. Considering that reactivation of LTBI accounts for a large proportion of the incidence of active TB, adequate diagnosis and treatment are crucial, especially in high-risk groups such as patients with rheumatologic diseases.

https://doi.org/10.1590/1806-3713/e20190023 3912 downloads

Correlation of enthesitis indices with disease activity and function in axial and peripheral spondyloarthritis: a crosssectional study comparing MASES, SPARCC and LEI
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Palominos, Penélope Esther

; Campos, Ana Paula Beckhauser de

; Ribeiro, Sandra Lúcia Euzébio

; Xavier, Ricardo Machado

; Xavier, Jady Wroblewski

; Oliveira, Felipe Borges de

; Guerra, Bruno

; Saldanha, Carla

; Mancuso, Aline Castello Branco

; Kohem, Charles Lubianca

; Gasparin, Andrese Aline

; Sampaio-Barros, Percival Degrava

Advances in Rheumatology

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2019, Volume 59 elocation 23

Abstract: En | Text: En | PDF: En

Abstract Background: The presence of enthesitis is associated with higher disease activity, more disability and incapacity to work and a poorer quality of life in spondyloarthritis (SpA). There is currently no consensus on which clinical score should be used to assess enthesitis in SpA. The objective of the present work was to compare the correlation of three enthesitis indices (MASES, SPARCC and LEI) with measures of disease activity and function in a heterogeneous population of patients with axial and peripheral SpA. Methods: A cross-sectional study was conducted in three Brazilian public university hospitals; patients fulfilling ASAS classification criteria for peripheral or axial SpA were recruited and measures of disease activity and function were collected and correlated to three enthesitis indices: MASES, SPARCC and LEI using Spearman's Correlation index. ROC curves were used to determine if the the enthesitis indices were useful to discriminate patients with active disease from those with inactive disease. Results: Two hundred four patients were included, 71.1% (N = 145) fulfilled ASAS criteria for axial SpA and 28.9% (N = 59) for peripheral SpA. In axial SpA, MASES performed better than LEI (p = 0.018) and equal to SPARCC (p = 0.212) regarding correlation with disease activity (BASDAI) and function (BASFI). In peripheral SpA, only MASES had a weak but statistical significant correlation with DAS28-ESR (rs 0.310 p = 0.05) and MASES had better correlation with functional measures (HAQ) than SPARCC (p = 0.034). Conclusion: In this sample composed of SpA patients with high coexistence of axial and peripheral features, MASES showed statistical significant correlation with measures of disease activity and function in both axial and peripheral SpA.

https://doi.org/10.1186/s42358-019-0066-8 958 downloads

The effects of cultural background on patient-perceived impact of psoriatic arthritis - a qualitative study conducted in Brazil and France
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Palominos, Penélope Esther

; Gossec, Laure

; Kreis, Sarah

; Hinckel, César Luis

; Chakr, Rafael Mendonça da Silva

; Moro, Ana Laura Didonet

; Campbell, Willemina

; Wit, Maarten de

; Goel, Niti

; Kohem, Charles Lubianca

; Xavier, Ricardo Machado

Advances in Rheumatology

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2018, Volume 58 elocation 33

Abstract: En | Text: En | PDF: En

Abstract Background: In psoriatic arthritis (PsA) almost all qualitative studies have been performed in European populations. This work aimed to evaluate the impact of PsA in Brazilian and French subjects, as well as to explore cultural differences in the experience of disease and to recognize domains important for patients living with PsA outside Europe. Methods: A qualitative study was conducted in two university hospitals in Brazil and France; outpatients fulfilling Classification Criteria for PsA participated in individual interviews regarding the impact of PsA; interviews were conducted in the local language. The sample size was defined by saturation; interviews were recorded and transcribed and content analysis was performed. Results: Fifteen patients were interviewed in Brazil and 13 in France. Mean disease duration was 16.5 ± 12.5 years (range: 8 months to 47 years) and 14.4 ± 8.4 years (range 12 months to 29 years) for Brazilian and French subjects, respectively. A broad impact was perceived: 67 codes emerged from the interviews and were grouped in 41 categories. Although 2/3 of categories were common to both nationalities, some important health domains from the perspective of PsA patients from a non-European background were brought to light including sexual dysfunction, emotional impact of psoriasis and impact of prejudice on social and professional life. Conclusions: This study highlights the importance of assessing the impact of PsA on a national level, emphasizing the common cross-cultural aspects but also revealing domains of interest for patients with PsA living outside Europe which merit further study.

https://doi.org/10.1186/s42358-018-0036-6 286 downloads

Fears and beliefs of people living with rheumatoid arthritis: a systematic literature review
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Palominos, Penélope Esther

; Gasparin, Andrese Aline

; Andrade, Nicole Pamplona Bueno de

; Xavier, Ricardo Machado

; Chakr, Rafael Mendonça da Silva

; Igansi, Fernanda

; Gossec, Laure

Advances in Rheumatology

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2018, Volume 58 elocation 1

Abstract: En | Text: En | PDF: En

Abstract Objective: To assess the main fears and beliefs of people with rheumatoid arthritis (RA) and their effect on treatment outcomes; Methods: A systematic literature review was conducted in Pubmed/Medline; original articles published up to May 2017, reporting fears and/or beliefs of adult patients with RA were analyzed. Fears and beliefs were collected by two independent researchers and grouped into categories. Results: Among 474 references identified, 84 were analyzed, corresponding to 24,336 RA patients. Fears were reported in 38.4% of the articles (N = 32/84): most studies described fears related to pharmacological therapy (50.0%, N = 16/32) and fear of disability (28.1%, N = 9/32). Beliefs were reported in 88.0% of articles (N = 74/84) and were found to moderate the patient-perceived impact of RA in 44.6% (N = 33/74), mainly the emotional impact (18.9%, N = 14/74); measures of function, quality of life, fatigue and pain were also found to be affected by patients' beliefs in 8.1% (N = 6/74), 6.8% (N = 5/74), 2.7% (N = 2/74) and 2.7% (N = 2/74) of the articles, respectively. Beliefs about therapy were linked to adherence in 17.6% of articles (N = 13/74) and beliefs about cause of RA predicted coping patterns in 12.2% of publications (N = 9/74). Only 9.5% (N = 8/84) of articles reported fears and/or beliefs of patients living outside Europe and North America: there was only one work which recruited patients in Latin America and no article included patients from Africa. Conclusion: In RA, patients' beliefs are linked to impact of disease and non-adherence. Further research is needed on fears/beliefs of patients living outside Europe and North America.

https://doi.org/10.1186/s42358-018-0001-4 504 downloads

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Esclerose sistêmica e níveis séricos elevados de organoclorado: uma associação possível?
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Monticielo, Odirlei André

; Palominos, Penélope Esther

; Chakr, Rafael Mendonça da Silva

; Bortoli, Rodrigo

; Xavier, Ricardo Machado

; Brenol, João Carlos Tavares

Revista Brasileira de Reumatologia

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feb 2008, Volume 48 N. 1 Pages 51 - 54

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A patogênese da esclerose sistêmica (ES) é complexa e pouco conhecida. Há a participação de ativação imune, dano vascular e excessiva produção de matriz extracelular com deposição de colágeno estruturalmente normal. Fatores genéticos e ambientais contribuem para a expressão da doença nos pacientes. Dentre os fatores ambientais, diversos agentes químicos já foram associados à doença. Descrevemos o caso de uma adolescente de 16 anos, com história prévia de hepatite criptogênica e câncer de lábio, que desenvolveu quadro atípico e rapidamente progressivo de esclerose sistêmica. Inicialmente o quadro era compatível com esclerodermia em placas, porém rapidamente evoluiu para uma forma sistêmica com grave acometimento cardiopulmonar e óbito. Durante a investigação de possíveis fatores etiológicos que pudessem estar relacionados, foram encontrados níveis séricos extremamente elevados de oxiclordano, um agrotóxico organoclorado. Uma possível correlação entre a intoxicação por esse agente químico e o surgimento de ES foi aventada.

The pathogenesis of systemic sclerosis (SS) is complex and not completely understood. Autoimmune mechanisms, vascular damage, and excessive extracelular matrix with collagen deposition play a significant role. Genetic and environmental factors also are decisive to the disease expression. Among environmental factors many chemical agents have been associated with the development of SS. A 16-year-old white woman, with previous history of cryptogenic hepatitis and cancer of the lips, developed an atypical and rapidly progressive form of SS. Initial sclerodermatous plaques progressed to a systemic form with severe cardiopulmonary involvement and death. Diagnostic workup revealed extremely high blood levels of oxychlordane. A possible association of organochlorine intoxication and SS is proposed.

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