RAFAEL STELMACH
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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conferenceObject Aerobic exercise training cannot be prescribed based on predictive heart rate equations in moderate or severe asthmatic patients(2012) MENDES, Felipe; TEIXEIRA, Renata; PINTO, Andrezza; STELMACH, Rafael; CUKIER, Alberto; MARTINS, Milton; CARVALHO, Celso- Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety(2012) LAURINO, Renata Andre; BARNABE, Viviane; SARAIVA-ROMANHOLO, Beatriz M.; STELMACH, Rafael; CUKIER, Alberto; NUNES, Maria do Patrocinio T.OBJECTIVES: The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. METHODS: Asthmatic individuals were assigned to a chest physiotherapy group that included a breathing retraining program held once a week for three months or a paired control group that included a Subtle Touch program. All patients were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV, the Sheehan Anxiety Scale, the Quality of Life Questionnaire, and spirometry parameter measurements. RESULTS: Both groups had high marks for panic disorder and agoraphobia, which limited their quality of life. The Breathing Retraining Group program improved the clinical control of asthma, reduced panic symptoms and agoraphobia, decreased patient scores on the Sheehan Anxiety Scale, and improved their quality of life. Spirometry parameters were unchanged. CONCLUSION: Breathing retraining improves the clinical control of asthma and anxiety symptoms and the health-related quality of life in asthmatic patients.
conferenceObject Factors Associated with Health Related Quality of Life of Patients with Chronic Obstructive Pulmonary Disease (CP)(2012) KIMURA, Miako; STELMACH, RafaelconferenceObject Heterogeneity of small airways flow and hyperinflation are markers of a persistent obstruction phenotype in severe non-controlled asthmatics(2012) CARVALHO-PINTO, Regina Maria; CUKIER, Alberto; ANGELINI, Luciene; FERNANDES, Frederico Leon Arrabal; SALGE, Joao Marcos; STELMACH, RafaelconferenceObject Physical training for asthmatics: Which patients obtain most clinical benefits?(2012) MENDES, Felipe; PINTO, Andrezza; SARAIVA-ROMANHOLO, Beatriz; STELMACH, Rafael; CUKIER, Alberto; GIAVINA-BIANCHI, Pedro; MARTINS, Milton; CARVALHO, CelsoconferenceObject Correlation between airway smooth muscle (ASM) and eosinophilic inflammation in severe non-controlled asthmatics(2012) CARVALHO-PINTO, Regina Maria; CUKIER, Alberto; MAUAD, Thais; DOLHNIKOFF, Marisa; GREGORIO, Marcelo Gervilla; PIRES NETO, Ruy Camargo; TELES, Aila Mirtes; RABE, Klaus F.; STELMACH, Rafael- Clinical characteristics and possible phenotypes of an adult severe asthma population(2012) CARVALHO-PINTO, Regina Maria de; CUKIER, Alberto; ANGELINI, Luciene; ANTONANGELO, Leila; MAUAD, Thais; DOLHNIKOFF, Marisa; RABE, Klaus F.; STELMACH, RafaelBackground: Currently, there are no studies of well-characterized severe asthmatics in Brazil. We aimed to study a population of severe treated asthmatics still uncontrolled to characterize them and define possible phenotypes. Methods: Descriptive cross-sectional outpatient study of severe asthmatics, evaluating functional and inflammatory markers, health-related quality of life, anxiety and depression symptoms, clinical control status, and characteristics related to atopy, age of asthma onset, induced sputum eosinophil levels, and airflow limitation. We also grouped the subgroups characteristics to identify phenotypes. The study is registered on ClinicalTrial.gov NCT 01089322. Results: From 128 eligible patients with severe/uncontrolled asthma, 74 fulfilled the inclusion criteria. The cohort was comprised of 85% women, frequently with a body mass index higher than 31 kg m(-2), atopy (60%), early-onset disease (50%), sputum eosinophilia (80%), comorbidities, and reduced quality of life. Nonatopics had significant higher asthma onset (19 y.a.) and twice level of induced sputum eosinophil. Late-onset patients had significantly less atopy (57%) and higher levels of induced sputum eosinophils. Non-eosinophilics had lower levels of inflammatory markers. Patients with airflow limitation had more intensive care unit admissions (56%) and 1.5 times more airway resistance. Subgroups characteristics identified a priori four well-characterized phenotypes, with 55% presenting sputum eosinophilia. Conclusion: Our data emphasize the high burden of disease, the persistence of inflammation and the existence of clinical possible phenotypes population sharing common features with published cohorts. Despite the necessity of further investigation into pathogenic mechanisms, this study with clinically difficult patient group may help to improve future asthma care.
conferenceObject Effect of aerobic exercise training on bronchial hyperresponsiveness, airway inflammation and health related quality of life in asthmatic patients: A pilot study(2012) PINTO, Andrezza; MENDES, Felipe; AGONDI, Rosana; SARAIVA-ROMANHOLO, Beatriz; STELMACH, Rafael; CUKIER, Alberto; MARTINS, Milton; KALIL, Jorge; CARVALHO, Celso; GIAVINA-BIANCHI, Pedro