Melissa Alexandre Fernandes

Melissa Alexandre Fernandes
Centro Hospitalar Universitário de Lisboa Central · Internal Medicine Department | Autoimmune Disease Unit

Doctor of Medicine

About

24
Publications
2,533
Reads
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60
Citations
Additional affiliations
January 2014 - December 2020
Centro Hospitalar Universitário de Lisboa Central
Position
  • Medical Doctor
January 2014 - December 2020
Centro Hospitalar Universitário de Lisboa Central
Position
  • Medical Doctor

Publications

Publications (24)
Book
Full-text available
Systemic Lupus Erythematosus (SLE) is an autoimmune disease of unknown etiology that often affects women during childbearing age. Pregnant women with SLE are considered high-risk patients, with pregnancy outcomes being complicated by high maternal and fetal mortality and morbidity. Obstetric morbidity includes preterm birth, fetal growth restrictio...
Article
Introduction: Clinical outcomes in rheumatoid arthritis have greatly improved with therapeutic advances. Despite the availability of substantial clinical trial evidence, there is a lack of real-life data. The aim of this study was to assess disease status and quality of life in an outpatient population treated with biological disease-modifying ant...
Poster
Full-text available
Title: Neutrophil to lymphocyte ratio and microcirculation impact in patients with systemic sclerosis – a cross-sectional study Introduction: Neutrophil to lymphocyte ratio (NLR) is usually applied as a prognostic marker in cardiovascular disease, infections, inflammatory disorders or cancers. Physiopathology of systemic sclerosis (SSc) is mediate...
Poster
Full-text available
Introduction: Systemic Sclerosis (SSc) evolves due to endothelial damage, immune dysregulation and fibrosis. Microvascular damage is usually visualized by nailfold capillaroscopy (NFC), being the scleroderma pattern (SP) the most frequent among these patients. In this study, we aimed to characterize NFC abnormalities in patients with Raynaud’s phen...
Article
Antiphospholipid syndrome (APS) is a systemic autoimmune disease which manifests as thrombotic and/or obstetric adverse events, mediated by persistent circulating antiphospholipid antibodies (aPL) detected by means of three tests: lupus anticoagulant, anticardiolipin and anti β2-glycoprotein I antibodies. It can be isolated or associated with other...
Chapter
Full-text available
Nailfold capillaroscopy (NFC) is a simple, validated, and noninvasive method to assess the microcirculation, through direct visualization of the capillaries. Main patterns are classified, according to Cutolo et al., as scleroderma, further divided into early, active, or late patterns, or nonscleroderma. NFC findings include dilated loops, tortuosit...
Article
Full-text available
Antiphospholipid syndrome (APS) is a systemic autoimmune disease which manifests as thrombotic and/or obstet-ric adverse events, mediated by persistent circulating antiphospholipid antibodies (aPL) detected by means of three tests: lupus anticoagulant, anti-cardiolipin and anti β2-glycoprotein I antibodies. It can be isolated or associated with oth...
Article
Full-text available
Key Clinical Message The report highlights the importance of strict clinico‐histological correlations when skin biopsies are performed in diagnostic doubt in systemic lupus erythematosus. Furthermore, PUVA is never indicated in autoimmune conditions involving photosensitivity, due to high potential for internal and cutaneous aggravation of the dise...
Article
Pregnancy requires a special management in women with inflammatory rheumatic diseases (RDs), with the aim of controlling maternal disease activity and avoiding fetal complications. Despite the heterogeneous course of RDs during pregnancy, their impact on pregnancy largely relates to the extent of active inflammation at the time of conception. There...
Article
Full-text available
Purpose of Review This review focuses on new pathogenesis and clinical-therapeutic aspects of obstetric anti-phospholipid syndrome (ob-APS) in the last 5 years. Recent Findings The pathogenesis of ob-APS is multifactorial, including placental infarctions, infiltration of inflammatory cells that cause acute and chronic inflammation, leading to unco...
Poster
Introduction: Nailfold videocapillaroscopy (NVC) is a non-invasive technique used to investigate skin microcirculation, having a significant role in the diagnosis of scleroderma spectrum disorders (SSDs). This group includes Systemic Sclerosis (SSc), Localized Scleroderma (LC), Overlap Syndromes (OS), Mixed Connective Tissue Disease (MCTD) and Scle...
Poster
Introduction: Nailfold videocapillaroscopy (NVC) is a non-invasive technique used to investigate skin microcirculation. This technique allows the distinction between primary and secondary Raynaud Phenomenon (RP) and it has a significant role in the diagnosis of scleroderma spectrum disorders (SSDs). Capillary abnormalities as enlarged or giant capi...
Article
Full-text available
A 18-year-old woman with systemic lupus erythematosus (SLE) presented with right sided migraine and blurred vision of the right eye. Ophthalmologic evaluation revealed multiple bilateral exudative retinal detachments, with increased choroidal thickness measured with optical coherence tomography (OCT). Acute renal dysfunction contraindicated fluores...
Conference Paper
Full-text available
Background Nailfold capillaroscopy (NC) is non-invasive and used by clinicians as a diagnostic tool. It allows the distinction between primary and secondary Raynaud Phenomenon (RP), the latter usually associated to autoimmune diseases (AID). Objectives Characterize the utility of NC assessment for diagnosis of AID and to evaluate main differences...
Article
Full-text available
Introduction:Central pontine and extrapontine myelinolysis (CPEPM) is a rare demyelinating syndrome. It has been observed to be more prevalent in liver transplant recipients, with worse prognosis. Rapid corrections of hyponatremia and immunosuppressive agents, such as calcineurin inhibitors, have been pointed as possible causes for the development...
Technical Report
A Unidade de Doenças Auto-Imunes (UDAI) do Hospital Curry Cabral (HCC), integrada na Unidade Funcional de Medicina 7.2, nesta segunda metade de 2016, manteve a sua forte dinâmica nas suas diversas áreas de actividade. Deste modo, há que começar por agradecer aos elementos da unidade, pelo esforço permanente com que têm desempenhado as suas activida...
Conference Paper
Background Current recommendations for Rheumatoid Arthritis (RA) treatment focus on a treat to target approach [1, 2]. Long term individual drug persistence has been associated to factors such as type of biological agent and higher disease activity [3, 4]. Here we present data from a tertiary referral centre. Objectives To determine factors associ...
Poster
Full-text available
Obesity is correlated with multiple endocrine, hematologic, and morphological alterations, the majority being directly secondary to obesity. The authors of this study attempt to identify the main disturbances and complications in patients with obesity before undergoing bariatric surgery.

Network

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Projects

Projects (3)
Project
To share case reports presenting atypical clinical features or challenging diagnosis, in order to improve medical approaches in future similar cases.
Project
As physicians, the clinical management of autoimmune diseases presents a considerable challenge. Research on this area will allow an early diagnosis and treatment of these disorders, further improving its prognosis. Some of the presented manuscripts and case reports may help other doctors to manage difficult situations. Sharing our research also provides an opportunity to start and develop other projects with other researchers and expand our network.