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Search Results: 1 - 10 of 463612 matches for " Clovis Artur A.; "
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Acupuntura em adolescentes com fibromialgia juvenil
Clovis Artur Almeida Silva
Revista Paulista de Pediatria , 2012,
Lupus eritematoso discóide na infancia
Sampaio, Maria Carolina de A.;Silva, Clovis Artur A.;Pereira, Rosa Maria R.;Oliveira, Zilda Najjar P. de;
Revista Paulista de Pediatria , 2007, DOI: 10.1590/S0103-05822007000200012
Abstract: objective: to review the literature about discoid lupus erythematosus (dle) in childhood. data sources: textbooks and journals indexed for medline and scielo in the last ten years. the following key-words were searched: "discoid lupus erythematosus", "chronic cutaneous lupus erythematosus", "lupus erythematosus in childhood", "lupus erythematosus in children", "discoid lupus erythematosus in childhood", "discoid lupus erythematosus in children". data synthesis: disease onset occurs predominantly between five and ten years old. family history of lupus erythematosus is present in 11-35% of cases. the female/male ratio varies from 1/1 to 2.4/1. development of systemic lupus erythematosus (sle) is present in 24-27% of patients. localized discoid lesions are observed in 56-75% of patients. the face is the most frequent site of involvement. localized and generalized dle have a similar course. the histological findings are typical, with interface dermatitis. igm and igg are the most frequent deposits in the basement membrane zone. the treatments usually used are: sunscreens, topical corticosteroids and antimalarials. immunosuppressive agents, thalidomide, dapsone and retinoids can be used in refractory cases. conclusions: childhood dle shows slight female predominance, high prevalence of familiar history of lupus erythematosus, and it evolves to systemic lupus erythematosus in a higher proportion than adult dle. disseminated dle and localized dle have similar prognosis. the histological findings did not differ from those described in adults.
Osteomielite cr?nica multifocal recorrente da mandíbula: relato de três casos
Paim, Luciana B.;Liphaus, Bernadete Lourdes;Rocha, André C.;Castellanos, Aura Ligia Z.;Silva, Clovis Artur A.;
Jornal de Pediatria , 2003, DOI: 10.1590/S0021-75572003000500016
Abstract: objective: to report three cases of chronic recurrent multifocal osteomyelitis of the mandible, an inflammatory disease affecting one or more bones with absence of isolated microorganisms in affected areas. description: the first case is a 13 year-old female presenting with pain and fever after dental treatment. the patient received antibiotic treatment for osteomyelitis, but developed progressive enlargement of the mandible and palmoplantar pustulosis. bone scintigraphy showed intense and diffuse uptake in the mandible. the swelling decreased after indomethacin and hyperbaric oxygen therapy. case 2 is a 9 year-old female patient with recurrent pain and edema of the right mandible for three years. the diagnosis of osteomyelitis was established and amoxicillin introduced. after three months, tomography showed diffuse mandible osteolysis. indomethacin and hyperbaric oxygen therapy were introduced, however the patient presented a relapse and was treated with prednisone, rofecoxib and methotrexate. patient 3, a 10 year-old male, had palmoplantar pustulosis and recurrent enlargement of the mandible. tomography showed diffuse mandible osteolysis and scintigraphy revealed intense and diffuse uptake in the mandible. the patient was treated with prednisone. rofecoxib was replaced after two relapses. comments: chronic recurrent multifocal osteomyelitis of the mandible is often associated with prolonged pain periods and periods of activity and remission of the inflammatory process. its recognition is important to prevent the patient from being submitted to prolonged antibiotic therapy and unnecessary invasive procedures.
Terapia com agentes biológicos na crian?a e no adolescente
Suehiro, Ricardo Maisse;Aikawa, Nádia Emi;Carvalho, Jozélio Freire de;Silva, Clovis Artur A. da;
Revista Paulista de Pediatria , 2010, DOI: 10.1590/S0103-05822010000200016
Abstract: objective: to review the physiopathology and new therapeutical targets, the available biologic agents, the main indications and the current scientific evidence for the use of biological therapies in the pediatric population. data sources: a bibliographical search was obtained from medline and scielo databases in english and portuguese from 2000 to 2009. the key-words included were "biologic agent", "children" and "adolescent". data synthesis: biologic agents are important therapeutic options to treat refractory autoimmune diseases to conventional therapies in childhood and adolescence. excluding juvenile idiopathic arthritis, the majority of studies in other autoimmune diseases are uncontrolled trials. conclusions: biologic agents have shown efficacy in the treatment of pediatric autoimmune diseases such as juvenile idiopathic arthritis, idiopathic inflammatory myositis, juvenile systemic lupus erythematosus, vasculitis, chronic uveitis, inflammatory bowel diseases, and chronic immune thrombocytopenic purpura, as well as in non-hodgkin lymphoma. considering the high cost and the potential adverse events, the choice to use them must be individualized and followed by a specialist.
Critérios de remiss o e melhora clínica nas doen as reumáticas pediátricas
Clovis Artur Almeida da Silva
Revista Brasileira de Reumatologia , 2005, DOI: 10.1590/s0482-50042005000100001
Envolvimento renal na púrpura de Henoch-Sch?nlein: uma análise multivariada de fatores prognósticos iniciais
Almeida, José Luiz J. de;Campos, Lúcia Maria A.;Paim, Luciana B.;Leone, Claudio;Koch, Vera Hermínia K.;Silva, Clovis Artur A.;
Jornal de Pediatria , 2007, DOI: 10.1590/S0021-75572007000400012
Abstract: objectives: to identify initial predictive factors of renal involvement in children and adolescents with henoch-sch?nlein purpura. methods: we reviewed the medical records of 142 patients admitted to our university hospital over a 21-year period with a diagnosis of henoch-sch?nlein purpura. the initial predictive factors assessed, observed during the first 3 months, included: demographic data, clinical manifestations (persistent palpable purpura, arthritis, abdominal pain, severe abdominal pain, gastrointestinal bleeding, orchitis, central nervous system involvement and pulmonary hemorrhage), laboratory tests (serum iga levels) and treatment given (corticosteroids, intravenous immunoglobulin and immunosuppressive drugs). patients were divided into two groups (presence or absence of nephritis) and assessed by univariate and multivariate analysis. results: evidence of nephritis was detected in 70 patients (49.3%). the univariate analysis revealed that severe abdominal pain (p = 0.0049; or = 1.6; 95%ci 1.18-2.21), gastrointestinal bleeding (p = 0.004; or = 1.6; 95%ci 1.10-2.26) and corticosteroid use (p = 0.0012; or = 1.7; 95%ci 1.28-2.40) were all associated with increased incidence of renal involvement. in the multivariate analysis, logistic regression demonstrated that the only independent variable that predicted nephritis was intense abdominal pain (p < 0.012; or = 2.593; 95%ci 1.234-5.452). conclusions: severe abdominal pain was a significant predictor of nephritis in henoch-sch?nlein purpura. consequently, pediatric patients exhibiting this clinical manifestation should be rigorously monitored, due to the increased risk of renal involvement.
Síndrome de ativa??o macrofágica associada com artrite idiopática juvenil sistêmica
Silva, Clovis Artur A.;Silva, Carlos Henrique M.;Robazzi, Tereza Cristina M. V.;Lotito, Ana Paola N.;Mendroni Junior, Alfredo;Jacob, Cristina M. A.;Kiss, Maria Helena B.;
Jornal de Pediatria , 2004, DOI: 10.2223/JPED.1267
Abstract: objective: to describe the characteristics of macrophage activation syndrome associated with juvenile idiopathic arthritis. description: this is a retrospective study involving 462 patients with juvenile idiopathic arthritis. seven (1.5%) of those patients suffered from systemic onset juvenile idiopathic arthritis and developed macrophage activation syndrome. the median age of the juvenile idiopathic arthritis onset was 3 years and 10 months and the median duration of juvenile idiopathic arthritis before macrophage activation syndrome was 8 years and 4 months. all of them presented with fever, jaundice, hepatosplenomegaly, bleeding, pancytopenia, abnormal liver function tests and abnormal coagulation profile. three cases presented associated infections and one patient developed macrophage activation syndrome two weeks after the administration of sulfasalazine. three patients died and the macrophage hemophagocytosis was present in five. the treatment of macrophage activation syndrome included pulse therapy with methylprednisolone in all of them, cyclosporine a in three, plasma exchange in two and intravenous immunoglobulin in two. comments: macrophage activation syndrome is a complication of the systemic onset juvenile idiopathic arthritis with a high morbidity and mortality rate.
Aspectos da sexualidade e gravidez em adolescentes com artrite idiopática juvenil (AIJ)
Silva, Clovis Artur Almeida;Suehiro, Ricardo Maisse;Leal, Marta Miranda;Liphaus, Bernadete Lourdes;Campos, Lucia Maria M. A.;Barros, Venina Viana de;Zugaib, Marcelo;
Revista Brasileira de Reumatologia , 2005, DOI: 10.1590/S0482-50042005000300015
Abstract: the objective of the present study is to describe the sexuality aspects, pregnancy and postpartum in three adolescents with juvenile idiopathic arthritis (jia). from 1983 to 2004, 4,638 patients were followed at the pediatric rheumatology unit of the pediatric department of fmusp, of which 537 (11.5%) were diagnosed with jia (ilar criteria) and three of these patients became pregnant during the follow-up period. the age at their first sexual intercourse ranged from 16 to 18 years old. patient 1 presented a twin pregnancy, with active disease throughout pregnancy, and was on 15 mg of prednisone per day. patients 2 and 3 were at disease remission, with no drug treatment, and had full-term pregnancies free of complications; patient 2, however, had a disease flare-up one year after the delivery. all newborns were adequate for gestational age and developed no complications during the neonatal period. only patient 1 required prednisone, naproxen e chloroquine during breast-feeding. the increased frequency of pregnancy in adolescents is a reality in pediatric rheumatology centers, and it shows the importance of more debate concerning sexuality aspects and contraception in this population.
Síndromes autoinflamatórias hereditárias na faixa etária pediátrica
Jesus, Adriana Almeida;Oliveira, Jo?o Bosco;Hilário, Maria Odete Esteves;Terreri, Maria Teresa R. A.;Fujihira, Erika;Watase, Mariana;Carneiro-Sampaio, Magda;Silva, Clovis Artur Almeida;
Jornal de Pediatria , 2010, DOI: 10.1590/S0021-75572010000500003
Abstract: objective: to describe the most prevalent pediatric hereditary autoinflammatory syndromes. sources: a review of the literature including relevant references from the pubmed and scielo was carried out using the keywords autoinflammatory syndromes and child. summary of the findings: the hereditary autoinflammatory syndromes are caused by monogenic defects of innate immunity and are classified as primary immunodeficiencies. these syndromes are characterized by recurrent or persistent systemic inflammatory symptoms and must be distinguished from infectious diseases, autoimmune diseases, and other primary immunodeficiencies. this review describes the epidemiological, clinical and laboratory features, prognosis, and treatment of the main autoinflammatory syndromes, namely: familial mediterranean fever; tnf receptor associated periodic syndrome; the cryopyrinopathies; mevalonate kinase deficiency; pediatric granulomatous arthritis; pyogenic arthritis, pyoderma gangrenosum and acne syndrome; majeed syndrome; and deficiency of interleukin 1 receptor antagonist. the cryopyrinopathies discussed include neonatal-onset multisystem inflammatory disease (also known as chronic infantile neurologic, cutaneous and articular syndrome) muckle-wells syndrome, and familial cold autoinflammatory syndrome. conclusions: pediatricians must recognize the clinical features of the most prevalent autoinflammatory syndromes. early referral to a pediatric rheumatologist may allow early diagnosis and institution of treatment, with improvement in the quality of life of these patients.
Care delivery for the child to grow up despite the pain: the family's experience
Rossato, Lisabelle Mariano;Angelo, Margareth;Silva, Clovis Artur Almeida;
Revista Latino-Americana de Enfermagem , 2007, DOI: 10.1590/S0104-11692007000400006
Abstract: this study aimed to understand the meaning of the experience of families having a child experiencing pain due to juvenile rheumatoid arthritis and to construct a theoretical model representing this experience. grounded theory and symbolic interactionism were used as methodological framework and theoretical framework, respectively. data were collected by semistructured interviews with 12 families. data analysis allowed for the construction of the theoretical model caring for the child to grow despite the pain, which describes an experience based on motivational elements: wanting to see the child without pain and wanting to see the child live a normal life, reviewing how the family lives the transition in its development cycles, retaking and integrating them in the family dynamic with the appearance of the disease and pain in the child. this theoretical model provides a framework for teaching, research and care, permitting advances in terms of theoretical nursing knowledge.
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