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Role of Cognitive Behavioral Therapy in Fibromyalgia: A Systematic Review

Open Journal of Rheumatology and Autoimmune Diseases 2021年第4期11卷 169-187页

作者： Heloisa Lima Heller Aline Rizzo Borges Luís Otávio Amarante Franco João Pedro De Oliveira Aucelio Marcos Igor Albanaz Vargas Rebeca Naoum Lorga Mirella Bastos Sales Natália Vargas Do Nascimento Gabriela Furlan Ribeiro Barbosa Netto Beatriz Carneiro Passos Beatriz Pires Paes Beatriz Toledo Mendes Bruna De paula Gonçalves Sousa Lyra Ciro Moisés Oliveira Vieira Dos Santos Gustavo Araújo Do Nascimento Santos Maria Luiza Pimentel De Oliveira Matheus Macêdo Da Silva Maurício Silva De Jesus Paulo Ricardo Guimaraes Rocha Storni Tamires Martinelli De Oliveira Ferraz Viviane Cristina Uliana Peterle ana paula monteiro gomides reis Centro Universitário de Brasília Brasília Brazil Universidade Católica de Brasília Brasília Brazil Centro Universitário Euro Americano Brasília Brazil

A literature search of articles from 2002-2019 was performed using Medline, Embase, Cochrane, LILACS, IBECS, CRD, and Epistemonikos databases, to analyze the effects of Cognitive-Behavioral Therapy (CBT) in the treatment of fibromyalgia. Twenty-seven articles were selected in which CBT was performed exclusively by specialist physicians, associated or not with conventional pharmacological treatment and/or physical exercise. In most articles, CBT worked with self-knowledge and cognitive restructuring, attempting to reduce pain perception, and it showed a general improvement in daily activities by decreasing patient’s limitations, such as morning stiffness. The literature showed significant correlations of CBT in pain processing over time. When CBT was compared to conventional pharmacological therapy, a certain superiority of CBT could be observed concerning the quality of life, catastrophizing, and acceptance of pain. However, when they were simultaneously applied, this improvement in quality of life was not observed.

关键词： Cognitive Behavioral Therapy Fibromyalgia Pain

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Differential Diagnosis and Association of Acquired Immunodeficiency Syndrome and Systemic Erythematous Lupus: A Brief Review

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Advances in Infectious Diseases 2019年第1期9卷 1-7页

作者： ana paula monteiro gomides Simone Appenzeller Gecilmara Pileggi Licia Maria Henrique da Mota University of Brasilia (UnB) Brasília Brazil University Center of Brasília-UniCeub Brasília Brazil Faculty of Medical Science State University of Campinas (UNICAMP) S&#227 o Paulo Brazil Medical School of Barretos-FACISB S&#227 o Paulo Brazil

Acquired immunodeficiency syndrome and lupus erythematosus are multisystem diseases that can affect several organs and systems at different stages of disease evolution. Both diseases share common clinical manifestations, which may lead to diagnostic difficulties, especially at the onset of the disease. Another additional challenge is when there is an association of the two pathologies. The objective of this brief review is to describe the clinical manifestations of the diseases and to make considerations regarding the moment of onset of symptoms. Knowledge of these common manifestations and their peculiarities may alert clinicians to possible diagnoses and avoid errors in the evaluation and conduction of these patients.

关键词： Acquired Immunodeficiency Syndrome Systemic Lupus Erythematosus Overlapping Systemic Diseases

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High Remission Rates in a Brazilian Cohort of Initial Rheumatoid Arthritis after 15 Years of Follow-Up

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Open Journal of Rheumatology and Autoimmune Diseases 2021年第2期11卷 53-63页

作者： Heloisa Lima Heller ana paula gomides reis Cleandro Albuquerque Isadora Jochims Luciana Muniz Talita Yokoy Licia Mota Centro Universitário de Brasília UniCEUB Brasília Brasil Universidade de Brasília UnB Brasília Brasil

Introduction: Rheumatoid arthritis (RA) is a chronic systemic rheumatic disease which is usually treated with corticosteroids and immunobiologicals. The goal of this article is to carry out an assessment of disease a... 详细信息

ana;">Introduction: Rheumatoid arthritis (RA) is a chronic systemic rheumatic disease which is usually treated with corticosteroids and immunobiologicals. The goal of this article is to carry out an assessment of disease activity indices in a cohort of patients with rheumatoid arthritis. Patients and Methods: This is a prospective cohort study. Individuals from the Initial Rheumatoid Arthritis Brasília Cohort, which is an incident cohort of early RA diagnosed patients, were monitored at the Rheumatology Service of the Hospital Universitário de Brasília (HUB), University of Brasília (UnB), Brazil. A cross-sectional analysis was carried out from 2017 to 2018 to evaluate patients with 15 or more years of follow-up, through a direct interview and review of medical records. The main focus of the study is on the assessment of disease activity, based on the indices: 28-joint Disease Activity Score based on Creactive protein (DAS 28 CPR) and based on erythrocyte sedimentation rate (DAS 28 ESR), Clinical Disease Activity Index (CDAI), and Simple Disease Activity Index (SDAI). The reference remission criteria used were the Composite Disease Activity Indices. Results: 107 patients were evaluated, mostly women, mean age of 55.1 years. Concerning the disease characteristics, 75.5% of the patients were positive for rheumatoid factor and 12 (11.3%) had documented erosive disease. The mean Health Assessment Questionnaire (HAQ) at the time of assessment was 0.6 (median 0.35). The indices analyzed showed: DAS28-ESR 48.6% of patients were in remission and 12.1% had low activity levels, DAS28-CRP 55.1% and 11.2%, SDAI 42% and 26.1%, CDAI 41.1% and 27.1%. These remission and low disease activity levels are higher than those generally found in the literature. Conclusion: This study presents a cohort of patients with RA who started treatment at an early stage

关键词： Rheumatoid Arthritis Remission Induction Therapeutics

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Hospital Admissions and Mortality in Patients with Rheumatic Heart Disease in Brazil: An analysis from 2008 to 2018

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Advances in Infectious Diseases 2020年第3期10卷 176-180页

作者： Mariana Silva Nunes Gustavo Tedde-Filho João Carlos Geber-Júnior Willian Darwin Júnior Viviane Uliane Peterle ana paula monteiro gomides Academic of Centro Universitário de Brasília Brasília Brazil Medical Clinic Department of Universidade de Sã o Paulo S&#227 o Paulo Brazil Universidade de Sã o Paulo S&#227 o Paulo Brazil Centro Universitário de Brasília Brasília Brazil

Introduction: The Rheumatic Fever (RF) is a systemic inflammatory disease, caused by Group A beta-hemolytic Streptococcus, predominating in children and adolescents. The clinical manifestations are varied and included in Jones Criteria for diagnosis. The cardiac manifestations are the most relevant, causing severe sequelae such as valvulitis. The RF is still a major public health problem in developing countries despite its primary prophylaxis being simple and effective if well applied. The overall objective of this study was to evaluate the number of hospital admissions and deaths in Brazil from 2008 to 2018. Methodology: Cross-sectional, descriptive, quantitative, documentary study with database provided by the Health Informatics Department of the Brazilian Ministry of Health (DATASUS). Results: In the studied period, a higher prevalence was observed among females (48,232 hospitalizations) and in the adult age group (59,270 hospitalizations and 3972 deaths). The total number of hospitalizations was 83,209 and the total number of deaths was 6572. The total mortality rate was 7.84. The region with the highest number of hospitalizations was the Southeast (22,863 hospitalizations). The total amount spent in hospitalizations was R$879,676,458.63, with an average value per hospitalization of R$ 10,496.21. The average length of stay was 12.7 days. Conclusion: Rheumatic heart disease is an important cause of hospitalizations in Brazil. Measures of early diagnosis and adequate treatment should be strongly stimulated.

关键词： Rheumatic Heart Disease Hospitalizations Number of Deaths

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Six-Minute Walk Test in Patients with Rheumatoid Arthritis

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第1期9卷 14-24页

作者： Sandor Balsamo ana paula monteiro gomides Licia Maria Henrique da Mota Frederico Santos de Santana Raphaela Franco Miranda Talita Yokoy Luciana Muniz Leopoldo Luiz Santos-Neto Universidade de Brasília (UnB) Brasília Brazil Laboratório de Aptidã o Física e Reumatologia do Hospital Universitário de Brasília (LAR/HUB) Brasília Brazil Grupo de Estudo e Pesquisa em Exercício de Forç a e Saúde (GEPEEFS) Brasília Brazil Curso Superior de Educaç o Física Centro Universitário UNIEURO Brasília Brazil Ambulatório de Reumatologia Hospital Universitário de Brasília (HUB) Brasília Brazil

Background: The 6-minute walk test (6TC) was initially used as an instrument for assessing physical and cardiorespiratory capacity, but is currently being used to monitor treatments, and compare physical interventions and prognostic evaluation. Although already recognized as a research method in several specialties, 6TC has not been used in rheumatology. Patients with rheumatoid arthritis (RA) may have impaired functional capacity as well as increased cardiovascular mortality. An adequate functional evaluation of these patients is necessary and the 6TC may be useful in this sense. Objective: The aim of this study was to perform the 6-minute walk test in RA patients and to compare the performance with a control group. Method: A cross-sectional study was carried out in which the sample consisted of 85 women, 46 patients with rheumatoid arthritis and 39 healthy controls. A descriptive analysis of the data was performed. One-Way ANOVA methodology was used to compare the patient and control groups followed by the graphic analysis. Results: The distance walked on the 6TC by RA patients was on average 522.2 meters. In the distance control group found in the 6TC was on average 628.8 meters, the difference being statistically significant. Conclusion: In this study the distance covered in 6TC by women with RA was lower than that of healthy women of the same age.

关键词： 6-Minute Walk Test Rheumatoid Arthritis Functional Capacity Physical Capacity Cardiorespiratory Capacity Person Performed

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Enteroparasitoses in Patients with Rheumatoid Arthritis

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Advances in Infectious Diseases 2017年第4期7卷 143-152页

作者： ana paula monteiro gomides Alex Luiz de Oliveira Pires Cleandro Pires Albuquerque Talita Yokoy de Souza Luciana Muniz Caliandra Maria Bezerra Luna Lima Leopoldo Luiz Santos-Neto Licia Maria Henrique da Mota Universidade de Brasília (UnB) Brasília Brazil Universidade Federal da Paraíba Jo&#227 o Pessoa Brazil

Background: Patients with rheumatic diseases have profound alterations in the immune system as a result of underlying diseases and the treatments used, which increases the risk of occurrence and severity of infections, including enteroparasitosis. The current treatment for rheumatoid arthritis involves immunosuppressive therapies powerfully needed for screening infectious processes. The prevalence of parasitic infections in rheumatoid arthritis patients is not currently documented in literature. The objective of the current study was to determine the prevalence of parasitic diseases in a population with RA. Methods: We collected demographic and socioeconomic data from 67 patients at the Hospital Universitário de Brasília from July 2015 to April 2016. All patients underwent a parasitological examination of their stool and multiple variables were analyzed using Poisson regression method. Results: The mean age of patients was 53.9 years. They were predominantly in women (94%) and caucasian (47.8%). The mean disease duration was 9.2 years and most patients had the disease in remission or light activity. The prevalence of parasitic infections in these patients was 11.9%, all cases being that of protozoa of the following species: Endolimax nana, Entamoeba histolytica and Entamoeba coli. The final multivariate analysis indicated that the presence of disease had a significant statistical relationship between the presence of enteroparasitosis and rheumatoid arthritis with no fatigue by VAS (p = 0.0488) and best current health index by VAS (p = 0.0012). Conclusion: This study indicates that the prevalence of enteroparasitoses in a population with Rheumatoid Arthritis was 11.9% and all cases were found of protozoa.

关键词： Parasitic Infections Rheumatoid Arthritis Protozoosis Enteroparasitoses Intestinal Infection

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