ANCA-associated vasculitis following Oxford-AstraZeneca COVID-19 vaccine in Brazil: Is there a causal relationship? A case report.

This article presents a case of rapidly progressive glomerulonephritis following the Oxford-AstraZeneca COVID-19 vaccine in a female patient 58 years old. After 5 days, she presented fatigue, paleness, arthralgia on hands, knees, ankles, foamy urine, and elevated blood pressure. Exams showed serum creatinine of 2.2 mg/dL (baseline creatinine of 1.0 mg/dL). Urinalysis revealed hematuria, and her 24-h urinary protein excretion was 4.4 g. Additional exams showed hypercholesterolemia, severe anemia, and normal serum albumin. Testing of antineutrophil cytoplasmic antibodies anti-myeloperoxidase was positive at a titer of 1/80. Serum and urine protein electrophoresis and other exams showed no alterations. She was started on steroid pulse therapy after worsening kidney function, reaching serum creatinine of 3.3 mg/dL. A kidney biopsy revealed crescentic glomerulonephritis with glomerular sclerosis, fibrous crescents, interstitial fibrosis, and tubular atrophy. Induction therapy was given with intravenous cyclophosphamide 0.5 g/m2 for 6-monthly pulses, followed by maintenance therapy with oral azathioprine at 2 mg/kg and prednisone tapering. The patient did not develop any complications during the induction therapy, and is currently on maintenance therapy with a serum creatinine of 1.87 mg/dL.

Impact of Time-Zero Biopsy on the Outcome of Transplanted Kidneys.

BACKGROUND: A low supply of donated organs led to the expansion of criteria for kidney transplantation (KT), and the impact on late glomerular function rates (eGFR) is still uncertain. This study aimed to correlate the histologic findings at time-zero biopsy (TzB) with the final eGFR, to identify criteria that could help achieve a more thorough preimplantation evaluation of the organ. METHODS: Records from 395 adult deceased KTs were reviewed. TzBs were analyzed considering histologic criteria by compartment (vascular, interstitial, tubular, and inflammatory) and correlated with the eGFR after 1 year. RESULTS: Among donors, 56.9% were men (mean age 39 years), with the main causes of death being brain trauma (44.2%) and stroke (46.0%). Histologic analysis of TzB revealed 6.0% of glomerulosclerosis; 18.8% presenting vascular alterations; interstitial fibrosis in 54.6%; tubular changes in 76.9%, and nonspecific inflammatory infiltrate in 2.3%. Linear regression analysis showed that the main histologic findings that had impact in the eGFR were interstitial fibrosis (P = .000), followed by tubular alterations (P = .036) and glomerulosclerosis (P = .008). CONCLUSIONS: Histologic variables like interstitial fibrosis and tubular alterations show the most significant negative correlation with final eGFR. The effect of glomerulosclerosis may not be as important as formerly suggested in the literature.

Projeto Paciente Seguro ­ fase 1: relato de experiência / Patient Safety Project - phase 1: experience report

O Ministério da Saúde em parceria com um dos hospitais de excelência do Brasil desenvolveu o Projeto Paciente Seguro pelo Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde, com o propósito de apoiar instituições na implementação do Programa Nacional de Segurança do Paciente. Este estudo tem como objetivo relatar a experiência da fase I do Projeto Paciente Seguro. Trata-se de um relato de experiência realizado no período de maio de 2016 a dezembro de 2017. A metodologia utilizada para implementar os protocolos foi o Modelo de Melhoria, o qual aplica testes rápidos em pequena escala para melhoria nos processos assistenciais. As intervenções realizadas permitiram identificar que compartilhar experiências, envolver a equipe assistencial e lideranças nos testes, foi fundamental para trabalhar a segurança do paciente nas instituições, obtendo uma redução de 100% em quedas e de 51,6% em lesão por pressão

The Ministry of Health in partnership with one of the hospitals of excellence in Brazil developed the Safe Patient Project through the Institutional Development Support Program of the Unified Health System, with the purpose of supporting institutions in the implementation of the National Patient Safety Program. This study aims to report the experience of phase I of the Safe Patient Project. This is an experience report carried out from May 2016 to December 2017. The methodology used to implement the protocols was the Improvement Model, which applies rapid tests on a small scale to improve care processes. The interventions made it possible to identify that sharing experiences, involving the assistance team and leadership in the tests, was fundamental to work on patient safety in the institutions, obtaining a reduction of 100% in falls and 51.6% in pressure injuries

Expression patterns of CD56+ and CD16+ cells in renal transplant biopsies with acute rejection: Associations with microcirculation injuries and graft survival.

BACKGROUND: The study investigated whether immunohistochemical features of interstitial and glomerular CD56 and CD16 infiltrates - NK cells markers - could be associated with microcirculation injury scores - peritubular capillaritis (ptc) and glomerulitis (g) - and graft survival. METHODS: The research analyzed the immunohistochemical pattern of CD56 and CD16 in interstitial and glomerular compartments of biopsies for-cause biopsies from 59 recipients diagnosed with acute rejection (mean = 135.5 days post-transplant). RESULTS: Interstitial CD56+ cells had an increased expression for glomerulitis (g ≥ 1) (P = 0.02) and peritubular capillaritis (ptc ≥ 2) (P = 0.003) presence. It was noted that interstitial CD56 + cells with mean above 0.56 cells/mm2 had worse allograft survival. CD56+ cells in the interstitial compartment with mean less than or equal to 0.56cells/mm2 was related with absence or mild peritubular capillaritis (P = 0.012) and mean above 0.56 cells/mm2 , respectively, with glomerulitis (P = 0.002) presence. Interstitial CD16 cells showed greater positive results in relation to peritubular capillaritis (P = 0.0001) cases. Similarly, it was observed that glomerular CD16+ cells had higher positive results in glomerulitis (P = 0.009) presence. CONCLUSIONS: The study findings showed that CD56+ cell infiltrated in the interstitial compartment was significantly associated with microcirculation injury scores, especially the glomerulitis, and graft survival.

Compartment-specific expression of natural killer cell markers in renal transplantation: immune profile in acute rejection.

Natural killer (NK) cells have been implicated in graft dysfunction. Here, we formulated hypothesis that distinct patterns of expression NK cells markers correlated with acute rejection in kidney transplantation. Therefore, we studied the pattern of NK cell markers CD56, CD57, and CD16 in different compartments of biopsies obtained from recipients diagnosed with acute graft rejection, with or without donor-specific antibodies (DSA). DSA-negative biopsies-from patients with acute T-cell mediated rejection (aTCMR) had an increased expression of CD56+ and CD57+ cells (P = 0.004 and P = 0.001) in the interstitial compartment in comparison with DSA-positive biopsies from patients acute antibody-mediated rejection (aABMR) with (aABMR C4d+) and without C4d deposition (aABMR C4d-). CD16+ cells was increased (P = 0.03) in the glomerular compartment in DSA-positive biopsies. We assume that CD16+ expression and antibody-dependent cellular cytotoxicity (ADCC) in microvascular injury can be associated with aABMR. IFN-γ release from cytoplasmic granules of NK cell could be associated with aTCMR. Our findings suggest that NK cells need to be carefully evaluated because variations in NK cell marker expression might imply the involvement of different immune system pathways in graft rejection.

Estratégias de enfrentamentos e sobrecarga dos familiares cuidadores de pacientes psiquiátricos: revisão de literatura / Coping and burden from family caregivers of psychiatric patients: literature review

A desinstitucionalização psiquiátrica resultou em maior responsabilidade dos familiares no cuidado informal dos pacientes, o que pode resultar em elevada sobrecarga para estes cuidadores. Essa sobrecarga pode ser diminuída com o uso de estratégias eficazes de enfrentamento, segundo o modelo teórico da sobrecarga. Foi realizada uma busca sistemática nos indexadores SciELO, LILACS, Pubmed, Web of Science e PsycINFO, sendo encontrados 36 estudos internacionais que avaliaram a relação entre coping e sobrecarga dos familiares cuidadores. Os resultados indicaram que os familiares utilizam uma diversidade de estratégias de enfrentamento, mas, em geral, elas não estão associadas a um menor grau de sobrecarga. As estratégias de evitação e de resignação estão claramente associadas a um maior grau de sobrecarga, devendo, portanto, ser evitadas.

Psychiatric deinstitutionalization has resulted in greater responsibility for family members in the informal care of patients, which may result in high degree of burden for these caregivers. Burden may be reduced by the utilization of effective coping strategies, according to the theoretical model of burden. A systematic search was conducted in SciELO, LILACS, Pubmed, Web of Science and PsycINFO databases, where were found 36 international studies evaluating the relationship between coping and burden of family caregivers. Results indicate that family members use several types of coping strategies, but these strategies in general are not associated with a lower degree of burden. Two strategies, avoidance and resignation, were clearly associated with a higher level of burden and should, therefore, be avoided.

Estratégias de enfrentamentos e sobrecarga dos familiares cuidadores de pacientes psiquiátricos: revisão de literatura / Coping and burden from family caregivers of psychiatric patients: literature review

A desinstitucionalização psiquiátrica resultou em maior responsabilidade dos familiares no cuidado informal dos pacientes, o que pode resultar em elevada sobrecarga para estes cuidadores. Essa sobrecarga pode ser diminuída com o uso de estratégias eficazes de enfrentamento, segundo o modelo teórico da sobrecarga. Foi realizada uma busca sistemática nos indexadores SciELO, LILACS, Pubmed, Web of Science e PsycINFO, sendo encontrados 36 estudos internacionais que avaliaram a relação entre coping e sobrecarga dos familiares cuidadores. Os resultados indicaram que os familiares utilizam uma diversidade de estratégias de enfrentamento, mas, em geral, elas não estão associadas a um menor grau de sobrecarga. As estratégias de evitação e de resignação estão claramente associadas a um maior grau de sobrecarga, devendo, portanto, ser evitadas. (AU)

Psychiatric deinstitutionalization has resulted in greater responsibility for family members in the informal care of patients, which may result in high degree of burden for these caregivers. Burden may be reduced by the utilization of effective coping strategies, according to the theoretical model of burden. A systematic search was conducted in SciELO, LILACS, Pubmed, Web of Science and PsycINFO databases, where were found 36 international studies evaluating the relationship between coping and burden of family caregivers. Results indicate that family members use several types of coping strategies, but these strategies in general are not associated with a lower degree of burden. Two strategies, avoidance and resignation, were clearly associated with a higher level of burden and should, therefore, be avoided. (AU)

The role of renin-angiotensin system in the chronic allograft nephropathy: an immunohistochemical study.

BACKGROUND: Evidences suggest a role of renin-angiotensin system (RAS) in the development of chronic allograft injury. METHODS: We correlated intrarenal angiotensin-converting enzyme, angiotensin II (Angio II) and transforming growth factor ß1 (TGFß1) expression in 58 biopsies-proven chronic allograft nephropathy (CAN) with tissue injury and allograft survival. RESULTS: The biopsies with CAN were graded according to Banff classification as I (22 cases), II (17) and III (19); 27 biopsies also showed a mononuclear inflammatory infiltrate in scarred areas. There were increased expression of angiotensin converting-enzyme (ACE), Angio II and TGFß1 mainly in tubulointerstitial compartment in the group with CAN; there was no association of Angio II and TGFß1 expression with interstitial fibrosis. There were no significant differences of ACE, Angio II and TGFß1 expression between the patients treated and untreated with RAS blockade, and with the graft outcome. Interstitial inflammatory infiltrate had positive correlation with interstitial fibrosis and significant impact on graft survival at 8 years. CONCLUSIONS: Our study showed in a group of cases with CAN a high percentage of inflammatory infiltrate that correlated with interstitial fibrosis and graft outcome. The chronic inflammatory changes in these cases did not show significant association with local RAS expression.

Sobrecarga de familiares cuidadores de pacientes psiquiátricos: relação com assertividade / Burden in family caregivers of psychiatric patients: relation with assertive behavior / Sobrecarga de familiares cuidadores de pacientes psiquiátricos: relación con assertividad

Foi avaliada a sobrecarga de familiares cuidadores de pacientes psiquiátricos e sua relação com as habilidades sociais e assertividade. Participaram 53 familiares, atendidos em um CAPS tipo I. Utilizou-se a Escala de Sobrecarga BI, o Inventário de Habilidades Sociais IHS-Del-Prette, a Escala de Assertividade RAS e um Questionário Sociodemográfico e Clínico. Os resultados mostraram que os familiares com maior grau de inibição e timidez (RAS) apresentaram escores significativamente mais elevados de sobrecarga. A análise de regressão múltipla mostrou que a timidez foi o principal fator preditivo da sobrecarga. Não foi encontrada relação da sobrecarga com os escores do IHS-Del-Prette. Os dados apontam para a necessidade de implementar ações psicoeducacionais nos serviços de saúde mental, envolvendo o treinamento de assertividade dos familiares cuidadores, contribuindo, assim, para um melhor relacionamento com os pacientes e uma busca mais eficiente de suporte social, para o desempenho do papel de cuidador com menor sobrecarga...

This research evaluated the family caregivers' burden regarding the care of psychiatric patients and its relation to social skills and assertiveness. The sample was composed of 53 family caregivers of patients who were treated in a community mental health service (CAPS type I). They were interviewed with the application of the Burden Scale BI, the Social Skills Inventory IHS-Del-Prette, the Assertiveness Scale RAS, and a Sociodemographic and Clinical Questionnaire. Results showed that family caregivers presenting higher degree of inhibition and shyness (RAS) had significantly higher burden scores. Multiple regression analysis showed that shyness was the main predictive factor for burden. No relation was found between burden and IHS-Del-Prette scores. Data indicated the need to implement psychoeducational programs in mental health services in order to increase caregivers' assertive behavior, so that they could develop a better relationship with patients and a more efficient search for social support, contributing to decrease burden...

Fue evaluada la sobrecarga de familiares cuidadores de pacientes psiquiátricos y suya relación con las habilidades sociales y asertividad. Participaran 53 familiares, atendidos en un CAPS tipo I. Fueron utilizados Escala de Sobrecarga BI y asertividad RAS, el Inventario de Habilidades Sociales IHS-Del-Prette y un Cuestionario Sociodemográfico y Clínico. Resultados mostraran que los familiares con el más alto grado de inhibición y timidez (RAS) presentaran escores significativamente más elevados de sobrecarga. El análisis de regresión múltiple mostró que la timidez fue el principal factor predictivo de sobrecarga. No fue encontrado relación de la sobrecarga con los escores del IHS-Del-Prette. Los dados apuntan para la necesidad de implantar acciones psicoeducativos en los servicios de salud mental, envolviendo capacitación de asertividad de los familiares cuidadores, contribuyendo para un mejor relacionamiento con los pacientes y una busca más eficaz de suporte social, para el desempeño del papel de cuidador con menor sobrecarga...

Sobrecarga de familiares cuidadores de pacientes psiquiátricos: relação com assertividade / Burden in family caregivers of psychiatric patients: relation with assertive behavior / Sobrecarga de familiares cuidadores de pacientes psiquiátricos: relación con assertividad

Foi avaliada a sobrecarga de familiares cuidadores de pacientes psiquiátricos e sua relação com as habilidades sociais e assertividade. Participaram 53 familiares, atendidos em um CAPS tipo I. Utilizou-se a Escala de Sobrecarga BI, o Inventário de Habilidades Sociais IHS-Del-Prette, a Escala de Assertividade RAS e um Questionário Sociodemográfico e Clínico. Os resultados mostraram que os familiares com maior grau de inibição e timidez (RAS) apresentaram escores significativamente mais elevados de sobrecarga. A análise de regressão múltipla mostrou que a timidez foi o principal fator preditivo da sobrecarga. Não foi encontrada relação da sobrecarga com os escores do IHS-Del-Prette. Os dados apontam para a necessidade de implementar ações psicoeducacionais nos serviços de saúde mental, envolvendo o treinamento de assertividade dos familiares cuidadores, contribuindo, assim, para um melhor relacionamento com os pacientes e uma busca mais eficiente de suporte social, para o desempenho do papel de cuidador com menor sobrecarga.(AU)

This research evaluated the family caregivers' burden regarding the care of psychiatric patients and its relation to social skills and assertiveness. The sample was composed of 53 family caregivers of patients who were treated in a community mental health service (CAPS type I). They were interviewed with the application of the Burden Scale BI, the Social Skills Inventory IHS-Del-Prette, the Assertiveness Scale RAS, and a Sociodemographic and Clinical Questionnaire. Results showed that family caregivers presenting higher degree of inhibition and shyness (RAS) had significantly higher burden scores. Multiple regression analysis showed that shyness was the main predictive factor for burden. No relation was found between burden and IHS-Del-Prette scores. Data indicated the need to implement psychoeducational programs in mental health services in order to increase caregivers' assertive behavior, so that they could develop a better relationship with patients and a more efficient search for social support, contributing to decrease burden.(AU)

Fue evaluada la sobrecarga de familiares cuidadores de pacientes psiquiátricos y suya relación con las habilidades sociales y asertividad. Participaran 53 familiares, atendidos en un CAPS tipo I. Fueron utilizados Escala de Sobrecarga BI y asertividad RAS, el Inventario de Habilidades Sociales IHS-Del-Prette y un Cuestionario Sociodemográfico y Clínico. Resultados mostraran que los familiares con el más alto grado de inhibición y timidez (RAS) presentaran escores significativamente más elevados de sobrecarga. El análisis de regresión múltiple mostró que la timidez fue el principal factor predictivo de sobrecarga. No fue encontrado relación de la sobrecarga con los escores del IHS-Del-Prette. Los dados apuntan para la necesidad de implantar acciones psicoeducativos en los servicios de salud mental, envolviendo capacitación de asertividad de los familiares cuidadores, contribuyendo para un mejor relacionamiento con los pacientes y una busca más eficaz de suporte social, para el desempeño del papel de cuidador con menor sobrecarga.(AU)

Mononuclear inflammatory infiltrate and microcirculation injury in acute rejection: role in renal allograft survival.

This study aimed at investigating associations between monocytes/macrophages (Mo) infiltration and three important criteria associated with acute antibody-mediated rejection: C4d staining, microcirculation injury, and graft survival time. By quantitative analysis, Mo were counted in peritubular capillaries and in the interstitial compartment (peritubular/interstitial Mo), and they were also identified in glomeruli (glomerular Mo). The study included 47 patients who received renal allograft between 1991 and 2009. Capillaritis and glomerulitis were classified by the Banff scoring system, and C4d and Mo were analyzed by immunohistochemistry. In the quantitative analysis, the mean values of 50 Mo per 10 high-power fields (HPF) and 4 Mo per glomerulus were used as cut-off points for the peritubular/interstitial and glomerular compartments, respectively. Positive C4d cases were associated with the groups of biopsies with a mean value ≥50 Mo per 10 HPF (p = 0.01) and ≥4 Mo per glomerulus (p = 0.02). The group with a mean value ≥4 Mo per glomerulus also showed association with the presence of glomerulitis (p = 0.02). Peritubular/interstitial Mo did not associate with glomerulitis. Capillaritis did not show association with peritubular/interstitial or glomerular Mo. As regards graft survival, the infiltration of Mo in glomeruli interfered with allograft survival (p = 0.01). The group with a mean value of ≥4 glomerular Mo presented worse survival at the time of the 1-year follow-up. According to the literature, our data showed that infiltration of mononuclear cells was associated with C4d staining, microcirculation injury, and glomerulitis, in particular, and that glomerular macrophages could influence renal allograft survival.

O prontuário da família na perspectiva da coordenação da atenção à saúde / Family's medical records in the perspective of the health care coordination

No Brasil, a saúde da família é uma estratégia de reorganização da atenção básica. Neste cenário, a coordenação da atenção, cuja essência é a disponibilidade de informações, apresenta-se como uma ferramenta para a qualificação das ações de saúde. Na Saúde da Família, o prontuário da família representa uma rica fonte de informações para a equipe de saúde desenvolver a coordenação da atenção. Os objetivos do estudo, descritivo com abordagem qualitativa, foram analisar o prontuário da família e seu conjunto informacional e identificar a "percepção" da equipe de saúde frente a sua sistematização, uso e importância para a coordenação e qualificação da atenção. Observou-se pequena padronização do registro da informação, da classificação e do arquivamento dos prontuários, além de pouco uso de seu conteúdo informacional. Notou-se que o emprego do prontuário da família para o exercício da coordenação não ocorreu a contento. Faz-se necessária uma melhor gestão deste documento, bem como sua efetiva utilização para favorecer a coordenação e a qualificação da atenção.

In Brazil, Family Health is a strategy for reorganization of primary care. In this scenario, the coordination of care, essence of which is the availability of information, is a tool for classification of health. In family health, the medical records of the family are a rich source of information for the health care team to develop the coordination of care. This descriptive study of qualitative approach, aims to analyze the records of the family and its information set, and to identify the "perception" of the health care team facing its systematization, use and importance to the coordination and qualified care. There is little standardization of registry information, classification and archiving of records, and little use of their information content. It was noted that the use of family's medical records for the coordination did not occur satisfactorily. There must be better management of this document as well as its effective use to support coordination and care qualification.

Is systemic lupus erithematosus a new risk factor for atherosclerosis?

OBJECTIVE: To evaluate the prevalence of cardiovascular events (CVE) secondary to atherosclerosis in lupus patients and correlate them to the traditional risk factors, disease duration and drug therapy used. METHODS: A retrospective study was carried out based on data obtained from patients charts. Patients included were those who had a lupus diagnosis confirmed at least two years before inclusion in the study and had been followed since 1992. CVE were characterized as MI, angina pectoris and stroke non-related to lupus activity. Risk factors and drugs used for treatment were recorded. RESULTS: Seventy-one charts were analyzed. Patients mean age was 34.2+/-12.7 years; 68 were women and three were men; 58 were Caucasian (81.6%). Ten (14.08%) presented CVE. Patients in whom CVE were observed were older (42.7 vs. 32.8 years p=0.0021) and presented longer disease duration (10.8 vs. 7.2 years p=0.011). The traditional risk factors, daily and cumulative doses of steroids, immunosuppressive drugs and antimalarial drugs were not significant when patients with and without CVE were compared. CONCLUSION: The prevalence of CVE secondary to atherosclerosis in systemic lupus erythematosus (SLE) was 14.08%. The traditional risk factors were not associated with the development of CVE in lupus patients. Patients that presented cardiovascular events were older and presented longer disease duration. It is a premature conclusion to establish SLE as an independent risk factor for atherosclerosis development.

Lupus eritematoso sistêmico: novo fator de risco para aterosclerose? / Is systemic lupus erithematosus a new risk factor for atherosclerosis? / Is systemic lupus erithematosus a new risk factor for atherosclerosis?

OBJETIVO: Avaliar a prevalência de eventos cardiovasculares (ECV) secundários à aterosclerose em pacientes com lupus eritematoso sistêmico (LES) e correlacioná-los aos tradicionais fatores de risco, tempo de doença e drogas utilizadas na terapia. MÉTODOS: Estudo retrospectivo através da coleta e análise dos dados contidos nos prontuários de pacientes com diagnóstico confirmado há no mínimo dois anos e seguidos desde 1992. Foram considerados ECV: angina do peito (AP), IAM e acidente vascular cerebral (AVC) de causa não relacionada à atividade do LES. Foram computados os fatores de risco para aterosclerose e dados sobre tratamento. RESULTADOS: Foram analisados 71 prontuários. A média de idade dos pacientes foi de 34,2±12,7 anos; 68 mulheres e três homens; 58 caucasóides (81,6 por cento). Dez (14,08 por cento) apresentaram ECV. Os pacientes nos quais os eventos cardiovasculares foram observados apresentavam idade mais elevada (42,7 vs 32,8 anos p=0,0021) e maior tempo de doença (10,8 vs 7,2 anos p=0,011). Os tradicionais fatores de risco, as doses diárias e cumulativas de esteróides, imunossupressores e antimaláricos não apresentaram diferença estatística significante entre pacientes que apresentaram ou não ECV. CONCLUSÃO: A prevalência de secundários à aterosclerose no LES foi semelhante ao da literatura, 14,08 por cento. Os tradicionais fatores de risco não mostraram associação com a ocorrência ou não de ECV no LES. Os pacientes nos quais os eventos cardiovasculares foram observados apresentavam idade mais elevada e maior tempo de doença. É precoce estabelecer-se que o LES possa ser um fator independente no desenvolvimento da aterosclerose.

OBJECTIVE: To evaluate the prevalence of cardiovascular events (CVE) secondary to atherosclerosis in lupus patients and correlate them to the traditional risk factors, disease duration and drug therapy used. METHODS: A retrospective study was carried out based on data obtained from patientsÆ charts. Patients included were those who had a lupus diagnosis confirmed at least two years before inclusion in the study and had been followed since 1992. CVE were characterized as MI, angina pectoris and stroke non-related to lupus activity. Risk factors and drugs used for treatment were recorded. RESULTS: Seventy-one charts were analyzed. PatientsÆ mean age was 34.2±12.7 years; 68 were women and three were men; 58 were Caucasian (81.6 percent). Ten (14.08 percent) presented CVE. Patients in whom CVE were observed were older (42.7 vs. 32.8 years p=0.0021) and presented longer disease duration (10.8 vs. 7.2 years p=0.011). The traditional risk factors, daily and cumulative doses of steroids, immunosuppressive drugs and antimalarial drugs were not significant when patients with and without CVE were compared. CONCLUSION: The prevalence of CVE secondary to atherosclerosis in systemic lupus erythematosus (SLE) was 14.08 percent. The traditional risk factors were not associated with the development of CVE in lupus patients. Patients that presented cardiovascular events were older and presented longer disease duration. It is a premature conclusion to establish SLE as an independent risk factor for atherosclerosis development.