Perfil de especialistas e de serviços em reumatologia pediátrica no estado de São Paulo

• Autor(a) principal: Terreri, Maria Teresa Ramos Ascensão [UNIFESP]
• Data de Publicação: 2013
• Outros Autores: Campos, Lúcia Maria Mattei de Arruda, Okuda, Eunice Mitiko, Silva, Clovis Artur Almeida da, Sacchetti, Silvana Brasilia, Marini, Roberto, Ferriani, Virginia Paes Leme [UNIFESP], Ventura, Maria Heloiza, Fernandes, Taciana, Sato, Juliana de Oliveira, Fernandes, Elizabeth C., Len, Claudio Arnaldo [UNIFESP], Barbosa, Cassia Maria Passarelli Lupoli [UNIFESP], Lotito, Ana Paola, Santos, Maria Carolina dos, Aikawa, Nádia Emi, Facó, Mércia, Piotto, Daniela Gerent Petry [UNIFESP], Bugni, Vanessa [UNIFESP], Kozu, Kátia Tomie [UNIFESP], Romanelli, Paulo Roberto Stocco, Sallum, Adriana Maluf Elias, Febronio, Marília, Fraga, Melissa [UNIFESP], Magalhães, Cláudia Saad
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0482-50042013000400006; http://repositorio.unifesp.br/handle/11600/7906
• topic: Paediatric rheumatology; Epidemiology; Registry; Reumatologia pediátrica; Epidemiologia; Registro

INTRODUCTION: Paediatric rheumatology (PR) is an emerging specialty, practised by a limited number of specialists. Currently, there is neither a record of the profile of rheumatology patients being treated in Brazil nor data on the training of qualified rheumatology professionals in the country. OBJECTIVE: To investigate the profile of PR specialists and services, as well as the characteristics of paediatric patients with rheumatic diseases, for estimating the current state of rheumatology in the state of São Paulo. PATIENTS AND METHODS: In 2010, the scientific department of PR of the Paediatric Society of São Paulo administered a questionnaire that was answered by 24/31 accredited specialists in PR practising in state of São Paulo and by 8/21 institutions that provide PR care. RESULTS: Most (91%) of the surveyed professionals practise in public institutions. Private clinics (28.6%) and public institutions (37.5%) reported not having access to nailfold capillaroscopy, and 50% of the private clinics reported not having access to acupuncture. The average duration of professional practise in PR was 9.4 years, and 67% of the physicians had attended postgraduate programmes. Seven (87.5%) public institutions perform teaching activities, in which new paediatric rheumatologists are trained, and five (62.5%) offer postgraduate programmes. Two-thirds of the surveyed specialists use immunosuppressants and biological agents classified as restricted use by the Health Secretariat. The disease most frequently reported was juvenile idiopathic arthritis (29.1-34.5%), followed by juvenile systemic lupus erythematosus (JSLE) (11.6-12.3%) and rheumatic fever (9.1-15.9%). The incidence of vasculitis (including Henoch-Schönlein purpura, Wegener's granulomatosis, and Takayasu's arteritis) and autoinflammatory syndromes was higher in public institutions compared to other institutions (P = 0.03, P = 0.04, P = 0.002, and P < 0.0001, respectively). Patients with JSLE had the highest mortality rate (68% of deaths), mainly due to infection. CONCLUSION: The field of PR in the state of São Paulo has a significant number of specialists with postgraduate degrees who mostly practise at teaching institutions with infrastructures appropriate for the care of high-complexity patients.