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Article ; Online: Author's response: "Lower mean phosphate independently predicts mortality in critically ill patients: results from a prospective cohort study".

Lima Júnior, Washington / Calderaro, Débora Cerqueira / Passos, Rogério / Côrte, Margaret / Leal, Jose Adalberto / Mayrink, Marcelo Oliveira / Ferreira, Gilda

Journal of critical care

2023 Volume 78, Page(s) 154374

MeSH term(s)	Humans ; Prospective Studies ; Critical Illness ; Cohort Studies ; Intensive Care Units ; Phosphates
Chemical Substances	Phosphates
Language	English
Publishing date	2023-08-01
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2023.154374
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Zs.A 2152: Show issues

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Article ; Online: Lower mean phosphate independently predicts mortality in critically ill patients: Results from a prospective cohort study.

Lima, Washington / Calderaro, Débora Cerqueira / Passos, Rogério / Côrte, Margaret / Leal, Jose Adalberto / Mayrink, Marcelo Oliveira / Ferreira, Gilda

Journal of critical care

2023 Volume 75, Page(s) 154273

Abstract: Purpose: To evaluate lower mean phosphate as a prognostic tool in critically ill patients.: Methods: This is a prospective single-center cohort study including adult patients (> 18 years) with a length of intensive care unit (ICU) stay of at least 24 ...

Abstract	Purpose: To evaluate lower mean phosphate as a prognostic tool in critically ill patients. Methods: This is a prospective single-center cohort study including adult patients (> 18 years) with a length of intensive care unit (ICU) stay of at least 24 h. Phosphatemia was evaluated within 1 h of ICU admission and once daily. Mean phosphate, calculated by the simple arithmetic mean of daily phosphate measurements, was proposed and tested. Standard severity scores were applied. Multivariate and survival analyses were performed. Results: A total of 317 patients were included, of whom 111 (35%) presented hypophosphatemia. Hypophosphatemia associated with surgical conditions, nutritional therapy, hypovitaminosis D, hyperparathyroidism, mechanical ventilation (need and duration), and ICU and hospital length of stay were evaluated. Admission APACHE II and SOFA (ICU days 1, 3, and 7) scores and ICU and in-hospital mortality were greater in the hypophosphatemia group than control group. Higher APACHE II (RR: 1.1; 95%CI: 1.01-1.2; p = 0.045) and lower mean phosphate (RR: 0.02; 95%CI: 0.001-0.09; p = 0.044) independently predicted ICU and in-hospital mortality. Conclusions: Hypophosphatemia is frequent in the ICU, and was associated with unfavorable outcomes. This study introduces the importance of longitudinal monitoring of phosphate levels, since lower mean phosphate is an independent predictor of mortality in critically ill patients.
MeSH term(s)	Adult ; Humans ; Prospective Studies ; Cohort Studies ; Intensive Care Units ; Critical Illness/therapy ; Hospital Mortality ; Hypophosphatemia ; Phosphates ; Length of Stay
Chemical Substances	Phosphates
Language	English
Publishing date	2023-02-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2023.154273
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Zs.A 2152: Show issues

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Article ; Online: Author's response: Lower mean phosphate independently predicts mortality in critically ill patients: Results from a prospective cohort study.

Lima Júnior, Washington / Calderaro, Débora Cerqueira / Passos, Rogério / Côrte, Margaret / Leal, Jose Adalberto / Mayrink, Marcelo Oliveira / Ferreira, Gilda

Journal of critical care

2023 Volume 76, Page(s) 154311

MeSH term(s)	Humans ; Prospective Studies ; Critical Illness ; Cohort Studies ; Intensive Care Units ; Phosphates
Chemical Substances	Phosphates
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2023.154311
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Zs.A 2152: Show issues

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Article ; Online: Neuropsychiatric Syndromes in Childhood-Onset Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis.

Santos, Flávia Patrícia Sena Teixeira / Nascimento, Bruno Ramos / Calderaro, Débora Cerqueira / Ferreira, Gilda Aparecida / Correa, Humberto

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases

2019 Volume 27, Issue 5, Page(s) 206–214

Abstract: Objective: The aim of this study was to access the prevalence of 19 neuropsychiatric syndromes in childhood-onset systemic lupus erythematosus (cSLE), as defined by the American College of Rheumatology (ACR) in 1999, by performing a systematic review ... ...

Abstract	Objective: The aim of this study was to access the prevalence of 19 neuropsychiatric syndromes in childhood-onset systemic lupus erythematosus (cSLE), as defined by the American College of Rheumatology (ACR) in 1999, by performing a systematic review and meta-analysis of relevant publications. Methods: A literature search from April 1999 to March 2018 identified studies investigating neuropsychiatric syndromes in cSLE patients, applying 1999 ACR Case Definitions, with a sample of at least 20 patients. Case reports, small case series, reviews, articles that did not use 1999 ACR case definitions, and those with adult SLE patients were excluded. The methodological quality of the studies was determined through the Loney quality assessment. Prevalence estimates with a 95% confidence interval were combined using random-effect (DerSimonian-Laird) models. Results: A total of 143 articles were identified and 9 were included. In a population of 1463 cSLE patients, 351 (29.9%) presented 869 neuropsychiatric cSLE events (2.48 events/patient). The results for each syndrome were headache (52.2%), seizure disorders (48.6%), cognitive dysfunction (32.9%), mood disorder (28.3%), psychosis (22.7%), cerebrovascular disease (19.5%), acute confusional state (15.7%), movement disorder (9.4%), anxiety disorder (7.2%), aseptic meningitis (5.1%), mononeuropathy single/multiplex (4.9%), myelopathy (4.2%), demyelinating syndrome (3.2%), cranial neuropathy (2.7%), polyneuropathy (2.6%), Guillain-Barré syndrome (2.5%), autonomic disorder (1.9%), plexopathy (1.3%), and myasthenia gravis (1.3%). Conclusions: Neuropsychiatric syndromes are prevalent among cSLE patients. The most prevalent were headaches, seizures, cognitive dysfunction, mood disorders, and psychosis. Determining the prevalence of each neuropsychiatric syndrome in cSLE may improve clinical awareness of these potentially fatal and disabling conditions.
MeSH term(s)	Adult ; Headache ; Humans ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/epidemiology ; Lupus Vasculitis, Central Nervous System/diagnosis ; Lupus Vasculitis, Central Nervous System/epidemiology ; Seizures ; Syndrome
Language	English
Publishing date	2019-04-25
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1283266-2
ISSN	1536-7355 ; 1076-1608
ISSN (online)	1536-7355
ISSN	1076-1608
DOI	10.1097/RHU.0000000000001029
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Zs.A 4815: Show issues

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Article ; Online: Presentation and prognosis of shrinking lung syndrome in systemic lupus erythematosus: report of four cases.

Calderaro, Débora Cerqueira / Ferreira, Gilda Aparecida

Rheumatology international

2011 Volume 32, Issue 5, Page(s) 1391–1396

Abstract: Systemic lupus erythematosus is an autoimmune systemic disease that commonly affects the respiratory system. Shrinking lung syndrome is a rare respiratory complication associated with systemic lupus erythematosus. Patients present with dyspnea alone or ... ...

Abstract	Systemic lupus erythematosus is an autoimmune systemic disease that commonly affects the respiratory system. Shrinking lung syndrome is a rare respiratory complication associated with systemic lupus erythematosus. Patients present with dyspnea alone or associated with chest pain and orthopnea, lung volume reduction with no parenchymal abnormalities and a restrictive ventilatory defect on pulmonary function tests. The pathogenesis, treatment, and prognosis of shrinking lung syndrome remain controversial. This study describes the clinical features, investigations, and outcome of a series of four patients with systemic lupus erythematosus and shrinking lung syndrome regularly followed on Rheumatology Service of the Clinics Hospital of the Federal University of Minas Gerais, Brazil, with a brief review of literature. It emphasizes that, despite prognosis of shrinking lung syndrome has been reported as good, it may cause severe functional pulmonary abnormalities and must be treated promptly and aggressively in order to, at least, stabilize pulmonary function tests.
MeSH term(s)	Adolescent ; Chest Pain/etiology ; Chest Pain/physiopathology ; Drug Therapy, Combination ; Dyspnea/etiology ; Dyspnea/physiopathology ; Fatal Outcome ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Lung/drug effects ; Lung/physiopathology ; Lung Diseases/diagnosis ; Lung Diseases/drug therapy ; Lung Diseases/etiology ; Lung Diseases/physiopathology ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/drug therapy ; Middle Aged ; Predictive Value of Tests ; Respiratory Function Tests ; Treatment Outcome ; Young Adult
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2011-03-23
Publishing country	Germany
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	8286-7
ISSN	1437-160X ; 0172-8172
ISSN (online)	1437-160X
ISSN	0172-8172
DOI	10.1007/s00296-011-1863-5
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Zs.A 1639: Show issues

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Article: Atorvastatin reduced soluble receptors of TNF-alpha in systemic lupus erythematosus.

Ferreira, Gilda Aparecida / Teixeira, Antonio Lúcio / Calderaro, Debora Cerqueira / Sato, Emília Inoue

Clinical and experimental rheumatology

2016 Volume 34, Issue 1, Page(s) 42–48

Abstract: Objectives: The aim of this study was to evaluate the efficacy of atorvastatin to reduce the plasma levels of TNF system molecules (TNF-α, sTNFR1 and sTNFR2) and to assess their association with risk factors for accelerate atherosclerosis and clinical ... ...

Abstract	Objectives: The aim of this study was to evaluate the efficacy of atorvastatin to reduce the plasma levels of TNF system molecules (TNF-α, sTNFR1 and sTNFR2) and to assess their association with risk factors for accelerate atherosclerosis and clinical disease activity scores in SLE patients. Methods: In a previous study, 64 female SLE patients received 20 mg/day of atorvastatin and 24 SLE patients (non-treated group) were followed for 8 weeks. Plasma levels of TNF-α, sTNFR 1 and sTNFR 2 were measured by ELISA, at baseline and at the end of the study. Results: The plasma levels of sTNFR1 and sTNFR 2 showed a positive correlation with SLEDAI score. We also found a positive correlation between TNF-α and sTNFR 1 levels and SLICC score. Patients with current nephritis and patients with anti-ds-DNA antibodies presented higher sTNFR1 and sTNFR2 levels. Patients with abdominal obesity and arterial hypertension also had higher plasma levels of soluble receptors. At the end of 8 weeks, we observed a significant decrease in sTNFR1 plasma levels in patients receiving atorvastatin [median (percentile), 876.5 (717-1284 pg/ml) vs. 748 (629.6-917.3 pg/ml), p=0.03], without difference regarding TNF-α and sTNFR2 plasma levels. The SLEDAI and SLICC scores were independent determinants of the plasma levels of sRTNF1. Conclusions: Atorvastatin reduced soluble receptors of TNF-α. The plasma levels of TNF-α, sTNFR1 and sTNFR2 may play a role in SLE activity and atherosclerosis, and might be evaluated as targets for new therapies.
MeSH term(s)	Adult ; Anti-Inflammatory Agents/therapeutic use ; Atherosclerosis/blood ; Atherosclerosis/diagnosis ; Atherosclerosis/immunology ; Atherosclerosis/prevention & control ; Atorvastatin Calcium/therapeutic use ; Biomarkers/blood ; Brazil ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Lupus Erythematosus, Systemic/blood ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/immunology ; Receptors, Tumor Necrosis Factor, Type I/blood ; Receptors, Tumor Necrosis Factor, Type II/blood ; Risk Factors ; Severity of Illness Index ; Time Factors ; Treatment Outcome ; Tumor Necrosis Factor-alpha/blood ; Young Adult
Chemical Substances	Anti-Inflammatory Agents ; Biomarkers ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Receptors, Tumor Necrosis Factor, Type I ; Receptors, Tumor Necrosis Factor, Type II ; TNFRSF1A protein, human ; TNFRSF1B protein, human ; Tumor Necrosis Factor-alpha ; Atorvastatin Calcium (48A5M73Z4Q)
Language	English
Publishing date	2016-01
Publishing country	Italy
Document type	Controlled Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605886-3
ISSN	1593-098X ; 0392-856X
ISSN (online)	1593-098X
ISSN	0392-856X
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Zs.A 2002: Show issues

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Article ; Online: Oral and maxillofacial manifestations of IgG4-related disease: A clinicopathological study.

Pereira, Glauce Guimarães / Pontes, Flávia Sirotheau Corrêa / Soares, Ciro Dantas / de Carvalho, Maria Goretti Freire / da Silva, Tarcília Aparecida / Calderaro, Débora Cerqueira / Ferreira, Gilda Aparecida / Tanure, Leandro Augusto / de Souza, Lucas Lacerda / Rodrigues-Fernandes, Carla Isabelly / de Almeida, Oslei Paes / Fonseca, Felipe Paiva / Pontes, Hélder Antônio Rebelo

Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology

2022 Volume 51, Issue 5, Page(s) 493–500

Abstract: Background: IgG4-related disease is a fibroinflammatory and immune-mediated condition, which has extremely variable clinical manifestations. In this study, we aim to investigate the clinicopathological features of IgG4-related disease involving the oral ...

Abstract	Background: IgG4-related disease is a fibroinflammatory and immune-mediated condition, which has extremely variable clinical manifestations. In this study, we aim to investigate the clinicopathological features of IgG4-related disease involving the oral and maxillofacial region. Methods: Cases of IgG4-related disease manifesting in the oral and maxillofacial region were retrieved from three Brazilian institutions. Clinical and serological data were obtained from the patients' medical charts, while microscopic and immunohistochemical findings were revised by oral pathologists. Diagnosis followed the American College of Rheumatology/European League against Rheumatism criteria. Results: Seven patients diagnosed with IgG4-related disease were included in this study. Women were affected in all analysed cases, with a mean age of 55.4 years. Two patients presented with the clinical involvement of more than one oral and maxillofacial anatomic site. Therefore, our sample comprised nine oral and maxillofacial anatomic sites affected by IgG4-related disease. The submandibular gland was affected in four cases, the tongue and the parotid gland in two cases each, and the palate in one case. In a few cases, exploratory lower lip biopsy was used as a diagnostic approach. A moderate-to-severe lymphoid infiltrate containing plasma cells and lymphocytes, with an increased IgG4/IgG ratio, was common. Treatment varied and steroids were the most frequently used (57.4%). Six patients remained alive, while one died from unknown causes. Conclusion: Although major salivary glands are commonly affected by IgG4-related disease, the oral cavity can also be involved, and lower lip biopsy may be an auxiliary diagnostic tool.
MeSH term(s)	Female ; Humans ; Immunoglobulin G/analysis ; Immunoglobulin G4-Related Disease/diagnosis ; Immunoglobulin G4-Related Disease/pathology ; Lip/pathology ; Middle Aged ; Salivary Glands/pathology ; Submandibular Gland
Chemical Substances	Immunoglobulin G
Language	English
Publishing date	2022-04-11
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1021270-x
ISSN	1600-0714 ; 0904-2512
ISSN (online)	1600-0714
ISSN	0904-2512
DOI	10.1111/jop.13296
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Zs.A 825: Show issues

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Article: Methotrexate and Non-Surgical Periodontal Treatment Change the Oral-Gut Microbiota in Rheumatoid Arthritis: A Prospective Cohort Study.

Oliveira, Sicília Rezende / de Arruda, José Alcides Almeida / Corrêa, Jôice Dias / Carvalho, Valessa Florindo / Medeiros, Julliane Dutra / Schneider, Ayda Henriques / Machado, Caio Cavalcante / Duffles, Letícia Fernanda / Fernandes, Gabriel da Rocha / Calderaro, Débora Cerqueira / Júnior, Mario Taba / Abreu, Lucas Guimarães / Fukada, Sandra Yasuyo / Oliveira, Renê Donizeti Ribeiro / Louzada-Júnior, Paulo / Cunha, Fernando Queiroz / Silva, Tarcília Aparecida

Microorganisms

2023 Volume 12, Issue 1

Abstract: This study evaluated the changes in the composition of oral-gut microbiota in patients with rheumatoid arthritis (RA) caused by methotrexate (MTX) and non-surgical periodontal treatment (NSPT). Assessments were performed at baseline (T0), 6 months after ... ...

Abstract	This study evaluated the changes in the composition of oral-gut microbiota in patients with rheumatoid arthritis (RA) caused by methotrexate (MTX) and non-surgical periodontal treatment (NSPT). Assessments were performed at baseline (T0), 6 months after MTX treatment (T1), and 45 days after NSPT (T2). The composition of the oral and gut microbiota was assessed by amplifying the V4 region of the 16S gene from subgingival plaques and stools. The results of the analysis of continuous variables were presented descriptively and non-parametric tests and Spearman's correlation were adopted. A total of 37 patients (27 with periodontitis) were evaluated at T0; 32 patients (24 with periodontitis) at T1; and 28 patients (17 with periodontitis) at T2. MTX tended to reduce the alpha diversity of the oral-gut microbiota, while NSPT appeared to increase the number of different species of oral microbiota. MTX and NSPT influenced beta diversity in the oral microbiota. The relative abundance of oral microbiota was directly influenced by periodontal status. MTX did not affect the periodontal condition but modified the correlations that varied from weak to moderate (
Language	English
Publishing date	2023-12-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms12010068
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Article ; Online: Neutrophil extracellular traps in rheumatoid arthritis and periodontitis: Contribution of PADI4 gene polymorphisms.

Oliveira, Sicília Rezende / de Arruda, José Alcides Almeida / Schneider, Ayda Henriques / Bemquerer, Larissa Marques / de Souza, Rayssa Maria Soalheiro / Barbim, Paula / de Mattos-Pereira, Gustavo Henrique / Calderaro, Débora Cerqueira / Machado, Caio Cavalcante / Alves, Sandra Fukada / Moreira, Paula Rocha / de Oliveira, Renê Donizeti Ribeiro / Louzada-Júnior, Paulo / Abreu, Lucas Guimarães / Cunha, Fernando Queiroz / Silva, Tarcília Aparecida

Journal of clinical periodontology

2023 Volume 51, Issue 4, Page(s) 452–463

Abstract: Aim: We sought to investigate the release of neutrophil extracellular traps (NETs) in neutrophils from individuals with rheumatoid arthritis (RA) and controls and compare the presence of NETs in gingival tissues according to periodontal status. Also, ... ...

Abstract	Aim: We sought to investigate the release of neutrophil extracellular traps (NETs) in neutrophils from individuals with rheumatoid arthritis (RA) and controls and compare the presence of NETs in gingival tissues according to periodontal status. Also, the association between single nucleotide polymorphisms (SNPs) of the peptidyl arginine deaminase type 4 (PADI4) gene and the GTG haplotype with RA, periodontitis and NETs was evaluated in vitro. Materials and methods: Peripheral neutrophils were isolated by density gradient, and NET concentration was determined by the PicoGreen method. Immunofluorescence was studied to identify NETs by co-localization of myeloperoxidase (MPO)-citrullinated histone H3 (H3Cit). Genotyping for SNPs (PADI4_89; PADI4_90; PADI4_92; and PADI4_104) was performed in 87 individuals with RA and 111 controls. Results: The release of NETs in vitro was significantly higher in individuals with RA and periodontitis and when stimulated with Porphyromonas gingivalis. Gingival tissues from subjects with RA and periodontitis revealed increased numbers of MPO-H3Cit-positive cells. Individuals with the GTG haplotype showed a higher release of NETs in vitro and worse periodontal parameters. Conclusions: The release of NETs by circulating neutrophils is associated with RA and periodontitis and is influenced by the presence of the GTG haplotype.
MeSH term(s)	Humans ; Extracellular Traps ; Protein-Arginine Deiminases/genetics ; Arthritis, Rheumatoid/genetics ; Periodontitis/genetics ; Neutrophils ; Polymorphism, Single Nucleotide
Chemical Substances	Protein-Arginine Deiminases (EC 3.5.3.15)
Language	English
Publishing date	2023-12-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	188647-2
ISSN	1600-051X ; 0303-6979
ISSN (online)	1600-051X
ISSN	0303-6979
DOI	10.1111/jcpe.13921
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Zs.A 1003: Show issues

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Article ; Online: Is chronic periodontitis premature in systemic lupus erythematosus patients?

Calderaro, Débora Cerqueira / Ferreira, Gilda Aparecida / Corrêa, Jôice Dias / Mendonça, Santuza Maria Souza / Silva, Tarcília Aparecida / Costa, Fernando Oliveira / Lúcio Teixeira, Antônio

Clinical rheumatology

2017 Volume 36, Issue 3, Page(s) 713–718

Abstract: The aim of this study was to compare the frequency and severity of chronic periodontitis (CP) in systemic lupus erythematosus (SLE) patients with individuals without rheumatic diseases. Seventy-five patients with SLE were compared to 75 individuals ... ...

Abstract	The aim of this study was to compare the frequency and severity of chronic periodontitis (CP) in systemic lupus erythematosus (SLE) patients with individuals without rheumatic diseases. Seventy-five patients with SLE were compared to 75 individuals without rheumatic diseases (control group) matched for age, educational level, and income. The activity of SLE was assessed with the Systemic Lupus Erythematosus Disease Activity Index 2000. Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for Systemic Lupus Erythematosus evaluated SLE-related damage. Dental evaluation included measuring plaque index and parameters of periodontal disease (probing depth, clinical attachment level, and bleeding on probing). Fifty-one (68 %) SLE patients and 42 (56 %) control individuals had CP (p = 0.13). Periodontal status was similar in both groups. Considering only individuals with CP, SLE patients were younger than controls (40.7 ± 9.8 versus 46.14 ± 12.5 years of age, p = 0.02). CP was not associated with activity or therapeutics in SLE patients. Severity of periodontal parameters was similar in SLE patients and control subjects; however, CP occurred earlier in SLE patients.
MeSH term(s)	Adult ; Chronic Periodontitis/diagnosis ; Chronic Periodontitis/epidemiology ; Comorbidity ; Female ; Humans ; Lupus Erythematosus, Systemic/epidemiology ; Male ; Middle Aged ; Prevalence ; Severity of Illness Index
Language	English
Publishing date	2017-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-016-3385-8
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