Publications by authors named "Sheila Marcia de Araujo Fontenele"

Article Synopsis
  • Systemic sclerosis (SSc) is a complex autoimmune disease, and recent clinical trials have prompted an update to the treatment guidelines from the Brazilian Society of Rheumatology.
  • A systematic review was conducted using randomized clinical trials, following the PICO framework, with evidence graded by GRADE methodology to create new treatment recommendations.
  • Six specific pharmacological recommendations were formulated, including new drugs like rituximab and nintedanib for managing various SSc-related complications, including skin issues and interstitial lung disease.
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Nailfold capillaroscopy (NFC) is a reproducible, simple, low-cost, and safe imaging technique used for morphological analysis of nail bed capillaries. It is considered to be extremely useful for the investigation of Raynaud's phenomenon and for the early diagnosis of systemic sclerosis (SSc). The capillaroscopic pattern typically associated with SSc, scleroderma ("SD") pattern, is characterized by dilated capillaries, microhemorrhages, avascular areas and/or capillary loss, and distortion of the capillary architecture.

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Bisphosphonates are considered first-line agents in the treatment of postmenopausal osteoporosis based on extensive experience of use, safety, and proven efficacy in reducing vertebral, non-vertebral and femur fractures. However, post-marketing reports based on the treatment of millions of patients/year over lengthy periods of time have revealed the occurrence of initially unexpected adverse effects, such as osteonecrosis of the jaw and atypical femoral fracture, leading to the restriction of treatment duration with bisphosphonates by global regulatory agencies. However, despite the association between these effects and bisphosphonates, this risk should be analyzed in the context of osteoporosis treatment, alongside the benefit of preventing osteoporotic fractures and their clinical consequences.

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