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Open Journal of Rheumatology and Autoimmune Diseases 2022年第4期12卷 114-118页

作者： Rafael Giovani Misse alexandre moura dos santos Abrahão Fontes Baptista Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de S&#227 o Paulo S&#227 o Paulo Brazil Center for Mathematics Computation and Cognition Federal University of ABC (UFABC) S&#227 o Bernardo do Campo Brazil

To the best of our knowledge, this is the first report in the literature showing the efficacy of transcranial direct current stimulation (tDCS) in treating refractory post-herpetic neuralgia in a patient with dermatomyositis. In addition, our results showed that tDCS sessions are safe and do not lead to disease relapse. Therefore, despite the limitations of being a case report, this study provides encouraging results that need to be widely explored in studies with a representative number of patients and with an appropriate design for patients with this systemic rheumatic autoimmune disease.

关键词： Cerebral Neuromodulation Dermatomyositis Neuralgia Pain Treatment

Pain and Fatigue Perceptions of Patients with Systemic Autoimmune Myopathies before and during the COVID-19 Pandemic Period

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第4期12卷 83-98页

作者： Rafael Giovani Missé Isabela Bruna Pires Borges Bruna Lindoso Correia Lorenza Rosa Silvério da Silva Marlise Sítima Mendes Simões alexandre moura dos santos Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Brazil

Objective: To assess general pain and fatigue and their association with the disease status of patients with systemic autoimmune myopathies (SAMs), in terms of the impact of the COVID-19 pandemic on these parameters. Methods: This is a cross-sectional and prospective cohort study that included 72 patients with SAMs who were matched by age and gender with 67 healthy individuals. The patients engaged in an interview via a validity survey to measure disease status, and assess a visual analog scale (VAS) for pain and fatigue in two periods: before (phase I) and during (phase II) of the Brazilian COVID-19 pandemic. For cross-sectional analysis, patients’ data from phase I were compared to healthy individuals’ information, whereas for prospective analysis, data of the patients who were assessed in phase II were compared to the same patients’ data from phase I. Results: The patients had significantly more pain perception, comparable fatigue perception and fatigue severity, when compared to the healthy individuals. During the COVID-19 pandemic period, the disease activity, pain and fatigue perceptions, and fatigue severity remained unchanged. Despite this, the pain and fatigue perceptions correlated significantly with patients’ VAS, the patient health outcome, and fatigue severity. In addition, the pain perception correlated to creatine phosphokinase, whereas fatigue perceptions correlated to physicians' VAS. Conclusions: The study showed that patients with SAMs have significantly increased pain perceptions compared to healthy individuals. During the COVID-19 pandemic period, the pain and fatigue perceptions remained unchanged in patients with SAMs but they correlated to several disease status parameters.

关键词： COVID-19 Pandemic Fatigue Inflammatory Myopathies Myositis Physical Activity

Transcranial direct current electrical stimulation in combination with aerobic exercise:A pilot study in post-COVID-19 systemic autoimmune rheumatic patients

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World Journal of Rheumatology 2023年第1期11卷 1-12页

作者： Rafael Giovani Missé alexandre moura dos santos Isabela Bruna Pires Borges Marlise Sítima Mendes Simões Lorenza Rosa Silvério Bruna Lindoso Correia Ana Wook Sook Kim Aline Marques Caetano Sandra Gofinet Pasoto Carla Gonçalves Schahin Saad Diogo Souza Domiciano Clarice Tanaka Julia Maria D’Andrea Greve Abrahão Fontes Baptista Samuel Katsuyuki Shinjo Division of Rheumatology Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil Departamento de Fisioterapia Fonoaudiologia e Terapia OcupacionalHospital das Clínicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloNúcleo de Assistência e Pesquisa em NeuromodulaçãoSao PauloBrazil Laboratório de Estudos do Movimento Instituto de Ortopedia e TraumatologiaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil

BACKGROUND Systemic autoimmune rheumatic diseases(SARDs)are a group of diseases with multiorgan involvement and a high prevalence of chronic pain and fatigue.Patients with SARDs and post-coronavirus disease 2019(COVID-19)syndrome experience aggravation of symptoms.In this context,it is essential to establish strategies to reduce chronic pain and fatigue and improve quality of life.AIM To assess the efficacy of transcranial direct current stimulation(tDCS)for the treatment of fatigue and pain-associated post-COVID-19 syndrome in patients with SARDs.METHODS This study included nine patients with different types of SARDs.All patients had reverse transcription-polymerase chain reaction(RT-PCR)test confirmed COVID-19 as well as significant,persistent fatigue and pain that began to worsen after infection.Anodal tDCS was administered in five daily sessions(2mA,20 min).Concomitantly,patients were involved in aerobic exercise program.All participants were evaluated using specific questionnaires and strength assessment by handgrip and physical function by timed-up-and-go test and sit-to-stand test at baseline(within one week before tDCS protocol),and one week after tDCS protocol.During all procedures,the patients’treatments remained unchanged.RESULTS The sample comprised eight women and one man with a mean age of 48.7±9.6 years.After the tDCS protocol,pain and fatigue significantly improved on the visual analog scale(P<0.05).The physical function also improved 9.5±2.7 vs 6.8±0.8(P=0.001)for timed-up-go-test and 10.3±3.7 vs 15.1±4.0(P=0.037)for sit-to-stand test.None of the patients experienced any adverse events.CONCLUSION The present study showed that tDCS in combination with aerobic exercise was effective in improving physical function,and reducing fatigue/pain in SARDs patients with post-COVID-19 syndrome.

关键词： Autoimmune diseases COVID-19 Fatigue Neuromodulation Physical function Rheumatic diseases Pain

Impact of an Exercise Training Program in a Patient with Relapsing Polychondritis: A Case Report

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Open Journal of Rheumatology and Autoimmune Diseases 2018年第3期8卷 93-98页

作者： alexandre moura dos santos Diego Sales de Oliveira Rafael Giovani Misse Letícia Alves Perin Jean Marcos de Souza Fernanda Rodrigues Lima Rosa Maria Rodrigues Pereira Samuel Katsuyuki Shinjo Division of Rheumatology Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil

Background: Exercise training has demonstrating to be safe and promote benefits for several rheumatologic autoimmune diseases. However, no study has evaluated the safety and benefits of exercise in relapsing polychondritis. Aim: To evaluate the effectiveness of an exercise training program in a patient with relapsing polychondritis. Case presentation: A 67-year-old female patient with relapsing polychondritis in remission was submitted to a 12-week, twice weekly, aerobic and resistance training program. Aerobic capacity, muscle strength and function capacity, as well as body composition, were evaluated at baseline and after 12-weeks. Conclusions: Exercise training program demonstrated to be effective for increasing aerobic capacity, muscle strength and function, and for improving body composition in the patient. Further studies are necessary to confirm these findings.

关键词： Exercise Training Relapsing Polychondritis Aerobic Training Resistance Training

Effects of Exercise Training on Endothelial Function,Arterial Structure,and Physical Conditioning in Patients with Systemic Autoimmune Myopathies:A Case Series Study

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第2期9卷 57-68页

作者： Rafael Giovani Misse Isabela Bruna Pires Borges alexandre moura dos santos Diego Sales de Oliveira Jean Marcos de Souza Bruno Gualano Valéria Aparecida Costa Hong Luis Aparecido Bortolotto Samuel Katsuyuki Shinjo Faculdade de Medicina FMUSP Universidade de Sao Paulo SP Brazil Hypertension Unit Instituto do Coracao Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo SP Brazil

Introduction. Exercise training has been effective in improving endothelial function and decreasing arterial stiffness in several systemic autoimmune diseases. However, to date, no studies have assessed patients with systemic autoimmune myopathies (SAM). Methods. Five female patients with definite SAM (3 dermatomyositis and 2 polymyositis) who underwent a 12-week, twice-a-week, exercise training program were assessed prospectively. The following parameters were assessed: endothelial function measured by flow-mediated dilatation (FMD), carotid femoral by pulse wave velocity (PWV), disease status by International Myositis Assessment & Clinical Studies Group (IMACS) set score, the ventilatory anaerobic threefold (VAT), respiratory compensation point (RCP), maximum effort (ME), maximal oxygen uptake (VO2max) measured by ergospyrometer, and strength and muscle function. Results. Mean age of the patients and duration of disease were 43.9 and 10.5 years, respectively. The median FMD and PWV were 10.2% and 7.1 m/s. After exercise training, important FMD reduction was observed in 4 out of 5 patients, whereas the PWV parameters decreased in only 2 out of 5 patients. The exercise training was safe, without clinical intercurrences or disease relapses. Moreover, an increase in strength and functionality was observed. Concerning aerobic capacity, there was a decrease in the VAT and an increase in ME, without al-terations in the maximum oxygen consumption. Conclusions. In general, exercise training does not alter endothelial function and PWV values, but improves muscle strength and function and also, does not lead to disease reactivation (Clinical Trials (NCT03092167)).

关键词： Dermatomyositis Endothelial Function Exercise Polymyositis Pulse Wave Velocity

Dealing with Multisource Information for Estuarine Flood Risk Appraisal in Two Western European Coastal Areas

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International Journal of Disaster Risk Science 2022年第2期13卷 199-213页

作者： Ana Rodrigues Rilo alexandre Manuel de Oliveira Soares Tavares Paula Maria dos santos Freire José Luis Zêzere Estuarine and Coastal Zones Unit LNEC-National Civil Engineering Laboratory.1700-075 LisbonPortugal Centre of Geographical Studies Institute of Geography and Spatial PlanningUniversidade de Lisboa1700-066 LisbonPortugal Centre for Social Studies and Earth Sciences Department Coimbra University3030-790 CoimbraPortugal

Estuaries are usually affected by compound flooding triggers that cause diverse territorial damages.While fluvial flood risk assessment frameworks are well established in the literature,integrated management instruments that deal with estuarine flood risk remain incomplete and often lacking.This research presents a methodology to extract relevant information from multiple sources post-event and a database building process that is applied to two contrasting estuaries(the Tagus River estuary in Portugal,and the Shannon River estuary in Ireland)in the Western European coastal area.Overall,a total of 274 documents were analyzed and the information was stored in two databases.Multiple correspondence analysis was applied to extract the most informative and relevant estuarine flood indicators.An integrated estuarine flood risk assessment framework is presented and discussed based on the extracted indicators.The framework is driven by two distinct dimensions(oceanic and hydrographic)and revealed the transversal position of triggers of estuarine floods,reflecting the compounding effects usually present in these areas.The results also highlight two levels of flood risk mostly based on damage typology.

关键词： Estuarine floods Estuarine flood indicators Multiple correspondence analysis Post-hazard multisource information Western Europe

Rescuing agroforestry as strategy for agriculture in Southern Brazil

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Journal of Forestry Research 2016年第4期27卷 739-746页

作者： alexandre Siminski Karine Louise dos santos Juliano Gil Nunes Wendt Universidade Federal de Santa Catarina Centro de Curitibanos

Knowledge about agricultural ecosystems, as well as about ecological and social interactions that occur in an agricultural context, is essential to promote a balanced environment for production. Incorporating the forest landscape into farming systems has promoted the development of integrated production systems such as agroforestry. However, many aspects of the relationship between farming and the forest landscape have changed since the modernization of agriculture introduced by the Green Revolution. The objectives of this review are：（1） to contribute to the understanding of the changes in cultivation strategies and in the dynamics of agricultural systems,particularly in the context of farming in Santa Catarina State, Brazil;（2） to contribute to the understanding of agroforestry systems as a strategy to reintroduce the element of forestry into agricultural production systems; and（3） to compile a list of forest plant species that could be used in agroforestry. The approach adopted in this manuscript seeks to highlight the potential of agroforestry systems to conserve natural resources and thereby to support agricultural development by connecting environmental conservation with income for farmers.

关键词： agriculture agricultural farming Brazil landscape cultivation modernization highlight income compile

Physical habitat condition as a key tool to maintain freshwater biodiversity in neotropical artificial ponds

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Water Biology and Security 2023年第3期2卷 30-35页

作者： Marden S.Linares Livia B.dos santos Marcos Callisto Jean C.santos Universidade Federal de Minas Gerais Instituto de Ciencias BiologicasDepartamento de GeneticaEcologia e EvoluçaoLaboratorio de Ecologia de BentosAv.Antonio Carlos 6627CEP 31270-901PampulhaBelo HorizonteMGBrazil Laboratorio de Macroecologia e Conservaçao da Biodiversidade Departamento de Botanica e EcologiaUniversidade Federal do Mato GrossoAv.Fernando Correa da Costa2367Boa EsperançaCuiabaMato GrossoCEP 78060-900Brazil Programa de Pos-Graduaçao em Ciencias Ambientais Instituto de Ciencias NaturaisHumanas e SociaisUniversidade Federal do Mato GrossoAvenida Alexandre Ferronato1200SinopMTCEP 78550-728Brazil Universidade Federal de Sergipe Departamento de EcologiaCampus Sao Cristovao-Cidade Universitaria Prof.Jose Aloísio de CamposCEP 49100-000Sao CristovaoSergipeBrazil

In areas highly affected by anthropogenic disturbances,artificial(human-made)freshwater ecosystems can provide habitat for maintaining and conserving regional freshwater biodiversity.We assessed how the physical habitat of artificial ponds affected the structure of benthic macroinvertebrate assemblages.To do so,we tested two hypotheses.(1)Physical habitat disturbances are not detrimental to the diversity of nearby artificial ponds,and(2)Physical habitat disturbances do not cause significant shifts in taxonomic composition.Our results rejected both null hypotheses,i.e.,macroinvertebrate diversity metrics correlated significantly and positively with Physical Habitat Integrity index scores,and only sites with high habitat condition scores were significantly associated with sensitive indicator taxa.Our results highlight the importance of maintaining physical habitat conditions for sustaining the ecological health of artificial ponds.

关键词： Bioindicators Ecosystem management Lentic ecosystems

Incidence of hepatocellular carcinoma in patients with chronic liver disease due to hepatitis B or C and coinfected with the human immunodeficiency virus:a retrospective cohort study

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World Journal of Gastroenterology 2018年第5期24卷 613-622页

作者： Patrícia dos santos Marcon Cristiane Valle Tovo Dimas alexandre Kliemann Patrícia Fisch Angelo Alves de Mattos Hepatology Post-Graduate Program Universidade Federal de Ciências da Saúde de Porto Alegre(UFCSPA)Porto Alegre 90020-090RSBrazil Infectology Department at Hospital Nossa Senhora da Conceicao Porto Alegre 91350-200RSBrazil Epidemiology Department at Hospital Nossa Senhora da Conceicao Porto Alegre 91350-200RSBrazil

AIM To assess the incidence of hepatocellular carcinoma(HCC) in chronic liver disease due to hepatitis B virus(HBV) or hepatitis C virus(HCV) coinfected with human immunodeficiency virus(HIV).METHODS A retrospective cohort study was performed, including patients with chronic liver disease due to HBV or HCV, with and without HIV coinfection. Patients were selected in the largest tertiary public hospital complex in southern Brazil between January 2007 and June 2014. We assessed demographic and clinical data, including lifestyle habits such as illicit drug use or alcohol abuse, in addition to frequency and reasons for hospital admissions via medical records review.RESULTS Of 804 patients were included(399 with HIV coinfection and 405 monoinfected with HBV or HCV). Coinfected patients were younger(36.7 ± 10 vs 46.3 ± 12.5, P < 0.001). Liver cirrhosis was observed in 31.3% of HIV-negative patients and in 16.5% of coinfected(P < 0.001). HCC was diagnosed in 36 patients(10 HIV coinfected and 26 monoinfected). The incidence density of HCC in coinfected and monoinfected patients was 0.25 and 0.72 cases per 100 patient-years(95%CI: 0.12-0.46 vs 0.47-1.05)(long-rank P = 0.002), respectively. The ratio for the HCC incidence rate was 2.98 for HIV-negative. However, when adjusting for age or when only cirrhotic are analyzed, the absence of HIV lost statistical significance for the development of HCC. CONCLUSION In this study, the presence of HIV coinfection in chronic liver disease due to HBV or HCV showed no relation to the increase of HCC incidence.

关键词： Hepatocellular carcinoma Chronic hepatitis human immunodeficiency virus Coinfection Cirrhosis

Association of TNFA(-308G/A),IFNG(+874 A/T)and IL-10(-819 C/T)polymorphisms with protection and susceptibility to dengue in Brazilian population

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Asian Pacific Journal of Tropical Medicine 2017年第11期10卷 1065-1071页

作者： Ana Caroline Melo dos santos Edilson Leite de moura Jean Moises Ferreira alexandre Wendell Araujo de moura Ailson Darlan Sales Ferreira Rubens Pereira Bezerra Diego de Siqueira Figueiredo Karol Fireman de Farias Tiago Gomes de Andrade Elaine Virginia Martins de Souza Figueiredo Molecular Biology and Gene Expression Laboratory Federal University of AlagoasCampus ArapiracaAv Manoel Severino BarbosaBom SucessoArapiracaAL57309-005Brazil Faculty of Medicine Federal University of AlagoasCampus AC SimoesTabuleiro dos MartinsMaceioAlagoasBrazil

Objective: To evaluate gene polymorphisms and their association with susceptibility to dengue.Methods: A retrospective case-control study was performed with 262 subjects,comprising 78 dengue fever(DF) patients, 49 dengue hemorrhagic fever(DHF) patients and 135 healthy controls. Genotypic and allelic profiles were identified using polymerase chain reaction based in real time and amplification-refractory mutation system.Results: We observed a protective association of IL-10(-819 C/T) C allele(P = 0.028,OR = 0.56, CI = 0.34–0.91) against DHF, while the C/T(P = 0.047, OR = 2.10,CI = 1.01–4.38) and T/T(P = 0.008, OR = 3.82, CI = 1.38–10.59) genotypes were associated with DHF and DF, respectively. The dominant model TNFA-308 GA + AA(P = 0.043, OR = 0.45, CI = 0.20–1.00) genotypes were found to have protective effect against dengue infection. A protective association among the IFNG(+874 A/T) A/T genotype against DF(P = 0.02, OR = 0.46, CI = 0.24–0.89) and DHF(P = 0.034,OR = 0.43, CI = 0.19–0.95) was observed. When the studied single-nucleotide polymorphism was analyzed in combination, the combination GTA(P = 0.022, OR = 2.95,CI = 1.18–7.41) was statistically significantly associated with susceptibility to DF and the combination GCT(P = 0.035, OR = 0.28, CI = 0.08–0.90) with protection against the development of DHF.Conclusions: This research identifies the association of the IFNG(+874 A/T), TNFA(-308 G/A), IL-10(-819 C/T) genotypes as a factor for protection, susceptibility and severity to dengue.

关键词： Immune system IFNG TNFA IL-10 Dengue Polymorphism