HELOISA HELENA DE SOUSA MARQUES
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
97 resultados
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- Echocardiographic Follow-up of Perinatally HIV-infected Children and Adolescents Results From a Single-center Retrospective Cohort Study in Brazil(2020) VALLILO, Nathalia Gaspar; DURIGON, Giuliana Stravinskas; LIANZA, Alessandro Cavalcanti; DINIZ, Maria de Fatima Rodrigues; SAWAMURA, Karen Saori Shiraishi; BRITO, Carolina Rocha; MARQUES, Heloisa Helena de Souza; FERRARO, Alexandre Archanjo; LEAL, Gabriela NunesBackground: The effects of HIV and antiretroviral therapy on cardiovascular system of perinatally infected children throughout their development are not fully understood. Objectives: To determine the prevalence of cardiac abnormalities in a retrospective cohort of perinatally HIV-infected patients and to investigate associations between echocardiographic and clinical data during their follow-up. Methods: Review of medical records and echocardiogram reports of 148 perinatally HIV-infected patients between January 1991 and December 2015. Results: Four hundred and eighty echocardiograms were analyzed and 46 (31%) patients showed cardiac abnormalities, frequently subclinical and transient. Nadir CD4 count was higher in patients with consistently normal echocardiogram: 263 (4-1480) versus 202 (5-1746) cells/mu L, P = 0.021. Right ventricular (RV) dilation was detected in 18.9%, left ventricular (LV) dilation in 21.6%, septal hypertrophy in 12.2%, LV posterior wall hypertrophy in 6%, LV systolic dysfunction in 8% and pulmonary hypertension in 8.7% of patients. Opportunistic infections were associated with RV dilation [odds ratio (OR = 4.34; 1.78-10.53; P < 0.01)], pulmonary hypertension (OR = 8.78; 2.80-27.51; P < 0.01) and LV systolic dysfunction (OR = 5.38; 1.55-18.71; P < 0.01). Longer duration of highly active antiretroviral therapy was associated with reduced risk of LV dilation (OR = 0.91; 0.85-0.97; P < 0.01) and systolic dysfunction (OR = 0.71; 0.59-0.85; P < 0.01). Protease inhibitors use was associated with reduced risk of RV dilation (OR = 0.54; 0.30-0.97; P < 0.05), LV dilation (OR = 0.35; 0.21-0.60; P < 0.01) and LV systolic dysfunction (OR = 0.07; 0.02-0.31; P < 0.01). Higher CD4 count was associated with lower risk of LV systolic dysfunction (OR = 0.82; 0.69-0.98; P < 0.05). Conclusions: Echocardiograms identified cardiac abnormalities among children with perinatally acquired HIV infection, and data suggest that immunologic status and therapeutic strategies throughout development can influence cardiac disease burden in this population.
- Hepatitis C in Children and Adolescents of a Brazilian Tertiary Center Identifying Patients Eligible for Direct-Acting Antivirals(2020) HIRSCH, Camila Bellettini; PEREIRA, Maria Fernanda Badue; BENEVIDES, Gabriel Nuncio; BERNARDES, Tamires Miranda; PALANDRI, Giovanna Gavros; BASTOS, Karina Lucio de Medeiros; TOMA, Ricardo Katsuya; AZEVEDO, Ramiro Anthero de; MARQUES, Heloisa Helena de SousaWe evaluated 113 pediatric patients with chronic hepatitis C from 2009 to 2019 at a Brazilian tertiary center. Seventy patients received pegylated-interferon treatment. The sustained virologic response was 61.4%, and 92.8% reported side effects. Currently, we are following 39 patients with chronic hepatitis C, 24 of whom are eligible for treatment with direct-acting antivirals according to Brazilian recommendations.
bookPart Doenças causadas por helmintos(2017) SAKANE, Pedro Takanori; MARQUES, Heloisa Helena de SousabookPart Meningites e meningoencefalites(2023) SANTOS, Ariane Guissi dos; MARQUES, Heloisa Helena de SousabookPart Arboviroses(2023) BUENO, Catarina; CRUZ, Vitória Paula Dias; MARQUES, Heloisa Helena de Sousa; SUMITA, Nairo Massakazu- Mycobacterial Disease in Immunocompromised Children in a High Endemic Area(2018) SCHUWARTZ, Constance Dell' Santo Vieira; GALASTRI, Anne Layze; DURIGON, Giuliana Stravinskas; LITVINOV, Nadia; PEREIRA, Maria Fernanda Badue; MARQUES, Heloisa Helena de Sousa
bookPart Infecções congênitas e perinatais(2017) MARQUES, Heloisa Helena de Sousa; ANDRADE, Samantha Brasil de; NAGAIASSU, Meire; CECCON, Maria Esther Jurfest Rivero; GALASTRI, Anne Layze- Lomentospora prolificans fungemia in hematopoietic stem cell transplant patients: First report in South America and literature review(2018) PENTEADO, Fernando D.; LITVINOV, Nadia; SZTAJNBOK, Jaques; THOMAZ, Danilo Y.; SANTOS, Antonio M. dos; VASCONCELOS, Dewton M.; MOTTA, Adriana L.; ROSSI, Flavia; FERNANDES, Juliana F.; MARQUES, Heloisa Helena S.; BENARD, Gil; ALMEIDA JR., Joao N. deLomentospora prolificans is a filamentous fungus and an emerging pathogen in immunocompromised patients. It is encountered most commonly in Australia, Spain, and USA. We described the first case of Lomentospora prolificans fungemia in South America. The patient was a hematopoietic stem cell transplantation (HSCT) recipient who developed the infection 37days after stem cells infusion. In addition, we performed a literature review of invasive lomentosporiosis in HSCT patients.
- An outbreak of invasive fusariosis in a children's cancer hospital(2015) LITVINOV, Nadia; SILVA, Mariama Tomaz N. da; HEIJDEN, Inneke M. van der; GRACA, Mariana G.; OLIVEIRA, Larissa Marques de; FU, Liang; GIUDICE, Mauro; AQUINO, Maria Zilda de; ODONE-FILHO, Vicente; MARQUES, Heloisa Helena; COSTA, Silvia F.; LEVIN, Anna S.Fusarium is considered an emerging pathogen, and there are few reports of fusariosis in children. The objective of this study was to describe an outbreak of invasive fusariosis in a children's cancer hospital. A neutropenic 17-year-old male patient hospitalized for 10 days for a relapse of acute myeloid leukaemia, under chemotherapy, presented fever without any other symptoms; a thoracic computerized tomography showed bilateral pulmonary nodules. During voriconazole treatment, 1-cm reddened and painful subcutaneous nodules appeared on arms and legs and the culture of a skin biopsy revealed F. solani. Another case occurred 11 days later and started an outbreak investigation. Water samples for cultures were collected from taps, showers and water reservoirs. Air from all patient rooms was sampled. Faucets and the drains of sinks and showers were swabbed and cultured. Environmental and clinical isolates were typed. There were 10 confirmed cases of infection caused by Fusarium spp. F. oxysporum and F. solani were isolated from water, swabs and air in patient rooms. Many control measures were instituted, but the outbreak was only controlled 1 year after the first case, when water filters filtering 0.2 mu m were installed at the exit of all faucets and showers in all patient rooms (points-of-use). Typing demonstrated that clinical isolates of F. oxysporum were similar to those of the environment. In conclusion, to our knowledge this is the first reported outbreak of invasive fusariosis in children with oncohaematologic disease. It was controlled using 0.2-mu m filters in all tap faucets and showers. Clinical Microbiology and Infection (C) 2014 European Society of Clinical Microbiology and Infectious Diseases.
- Cytomegalovirus infection in transplant recipients(2015) AZEVEDO, Luiz Sergio; PIERROTTI, Ligia Camera; ABDALA, Edson; COSTA, Silvia Figueiredo; STRABELLI, Tania Mara Varejao; CAMPOS, Silvia Vidal; RAMOS, Jessica Fernandes; LATIF, Acram Zahredine Abdul; LITVINOV, Nadia; MALUF, Natalya Zaidan; CAIAFFA FILHO, Helio Hehl; PANNUTI, Claudio Sergio; LOPES, Marta Heloisa; SANTOS, Vera Aparecida dos; LINARDI, Camila da Cruz Gouveia; YASUDA, Maria Aparecida Shikanai; MARQUES, Heloisa Helena de SousaCytomegalovirus infection is a frequent complication after transplantation. This infection occurs due to transmission from the transplanted organ, due to reactivation of latent infection, or after a primary infection in seronegative patients and can be defined as follows: latent infection, active infection, viral syndrome or invasive disease. This condition occurs mainly between 30 and 90 days after transplantation. In hematopoietic stem cell transplantation in particular, infection usually occurs within the first 30 days after transplantation and in the presence of graft-versus-host disease. The major risk factors are when the recipient is cytomegalovirus seronegative and the donor is seropositive as well as when lymphocyte-depleting antibodies are used. There are two methods for the diagnosis of cytomegalovirus infection: the pp65 antigenemia assay and polymerase chain reaction. Serology has no value for the diagnosis of active disease, whereas histology of the affected tissue and bronchoalveolar lavage analysis are useful in the diagnosis of invasive disease. Cytomegalovirus disease can be prevented by prophylaxis (the administration of antiviral drugs to all or to a subgroup of patients who are at higher risk of viral replication) or by preemptive therapy (the early diagnosis of viral replication before development of the disease and prescription of antiviral treatment to prevent the appearance of clinical disease). The drug used is intravenous or oral ganciclovir; oral valganciclovir; or, less frequently, valacyclovir. Prophylaxis should continue for 90 to 180 days. Treatment is always indicated in cytomegalovirus disease, and the gold-standard drug is intravenous ganciclovir. Treatment should be given for 2 to 3 weeks and should be continued for an additional 7 days after the first negative result for viremia.