CELSO RICARDO FERNANDES DE CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
44 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 44
- Musculoskeletal Dysfunction and Pain in Adults with Asthma(2011) LUNARDI, Adriana Claudia; MARQUES, Cibele Cristine Berto; MENDES, Felipe Augusto Rodrigues; MARQUES, Amelia Pasqual; STELMACH, Rafael; CARVALHO, Celso Ricardo FernandesBackground. The mechanical alterations related to the overload of respiratory muscles observed in adults with persistent asthma might lead to the development of chronic alterations in posture, musculoskeletal dysfunction and pain; however, these changes remain poorly understood. Objective. This study aimed to assess postural alignment, muscle shortening and chronic pain in adults with persistent asthma. Methods. This cross-sectional and controlled study enrolled 30 patients with mild (n = 17) and severe ( n = 13) persistent asthma. Fifteen non-asthmatic volunteers were also assessed. Asthma was classified by the Global Initiative for Asthma (GINA) guidelines. Postural alignment and muscle shortening were evaluated by head and shoulder positions, chest wall mobility, and posterior ( trunk and lower limb) muscle flexibility. In addition, the measures used were previously tested for their reproducibility. Pain complaints were also assessed. Results. In comparison with non-asthmatic subjects, patients with mild or severe persistent asthma held their head and shoulders more forward and had lower chest wall expansion, decreased shoulder internal rotation, and decreased thoracic spine flexibility. Chronic lower thoracic, cervical, and shoulder pain was significantly increased in patients with mild or severe asthma compared with non-asthmatic subjects (p < 0.05). Conclusion. Adults with persistent asthma have musculoskeletal dysfunction and chronic pain that is independent of the severity of their disease but that might be related to their age at the onset of disease symptoms.
- Effect of an Exercise Program on Lymphocyte Proliferative Responses of COPD Patients(2018) FERNANDES, Juliana Ruiz; SILVA, Cibele Cristine Berto Marques da; SILVA, Aline Grandi da; PINTO, Regina Maria de Carvalho; DUARTE, Alberto Jose da Silva; CARVALHO, Celso Ricardo; BENARD, GilExercise training has been shown to reduce symptoms and exacerbations in COPD patients; however, the exercise effect on patients' immune response is poorly known. We thus verified if an exercise program (EP) impacted on proliferative T cell response of COPD patients. Fourteen non-O-2 dependent COPD patients on standard treatment were studied. EP consisted in 24 sessions of aerobic and muscular training. Peripheral blood mononuclear cells were stimulated with the mitogen phytohemagglutinin and antigens from Haemophilus influenzae and cytomegalovirus, and the lymphocyte proliferative response (LPR) was assessed through the expression of Ki67 before and after the EP. The Quality of life [COPD assessment test (CAT)], dyspnea [(modified Medical Research Council scale (mMRC)], and 6-min walk distance were also assessed. The EP program increased significantly the LPR of TCD4+ lymphocytes to phytohemagglutinin and cytomegalovirus and H. influenzae antigens, but with TCD8+ lymphocytes the increase was less marked. Consistent with this, a higher proportion of TCD8+ than TCD4+ cells did not express the costimulatory molecule CD28. The EP also resulted in improvement of the quality of life, dyspnea, and physical capacity. The improvement in TCD4+ cell function may represent an additional mechanism through which the EP results in less exacerbations and hospitalizations.
conferenceObject Comparison of CPAP and others lung expansion techniques on thoracoabdominal mechanics after abdominal surgery: A randomized trial(2013) PAISANI, Denise; LUNARDI, Adriana; SILVA, Cibele Marques da; PORRAS, Desiderio Cano; CARVALHO, CelsoconferenceObject Comparison of incentive spirometers on thoracoabdominal mechanics and inspiratory muscular activity in elderly(2012) LUNARDI, Adriana; BARBOSA, Renata; PAISANI, Denise; SILVA, Cibele Marques da; CANO, Desideiro; CELSO, Carvalho- Lung expansion techniques on thoracoabdominal mechanics in patients underwent to open abdominal and laparoscopic surgeries(2015) LUNARDI, Adriana; SILVA, Cibele Marques da; CANO, Desiderio; PAISANI, Denise; CARVALHO, Celso R. F.
- Pulmonary hyperinflation and postural balance in COPD patients(2016) PEREIRA, Ana Carolina Alves Caporali; XAVIER, Rafaella Fagundes; OLIVEIRA, Cristino Carneiro; LOPES, Aline Costa; SILVA, Cibele Cristine Berto Marques da; CLARK, Ross; STELMACH, Rafael; DENEHY, Linda; CARVALHO, Celso Ricardo Fernandes de
- The Mini-Balance Evaluation System Test Can Predict Falls in Clinically Stable Outpatients With COPD A 12-MO PROSPECTIVE COHORT STUDY(2019) PEREIRA, Ana Carolina A. C.; XAVIER, Rafaella F.; LOPES, Aline C.; SILVA, Cibele C. B. M. da; OLIVEIRA, Cristino C.; FERNANDES, Frederico L. A.; STELMACH, Rafael; CARVALHO, Celso R. F.Purpose: This study evaluated the accuracy of the Mini-Balance Evaluation System Test (Mini-BESTest) for predicting falls in patients with chronic obstructive pulmonary disease (COPD) and investigated whether postural balance is a risk factor for falls. Methods: Postural balance was evaluated by the Mini-BESTest at baseline, and the incidence of falls over a 12-mo period was prospectively measured by a self-reported falls diary and confirmed by telephone calls. A discriminative power analysis was performed using receiver operating characteristic (ROC) curve and logistic regression analysis. Results: Sixty-seven outpatients with COPD (mean age SD = 67 +/- 9.3 yr) were included. Twenty-five patients (37.3%) experienced 1 fall, and 28.2% of the falls resulted in injuries. The Mini-BESTest predicted falls in patients with COPD at the 6- and 12-mo follow-ups with a cut-off score of 22.5 (area under the curve = 0.85 and 0.87) with good sensitivity and specificity (85.7% and 66.7%; 84% and 73.8%, respectively). Higher scores on the Mini-BESTest were associated with a lower risk of falls at 12 mo (OR = 0.50; 95% CI, 0.36-0.70; P < .001). Conclusions: Postural balance assessed by the Mini-BESTest is a good predictor of falls in patients with COPD. Our results imply that impaired balance contributes to the risk of falling and that balance training and fall prevention programs may be required for this population.
- Age-associated phenotypic imbalance in TCD4 and TCD8 cell subsets: comparison between healthy aged, smokers, COPD patients and young adults(2022) FERNANDES, Juliana Ruiz; PINTO, Thalyta Nery Carvalho; ARRUDA, Lia Barbara; SILVA, Cibele Cristine Berto Marques da; CARVALHO, Celso Ricardo Fernandes de; PINTO, Regina Maria Carvalho; DUARTE, Alberto Jose da Silva; BENARD, GilBackground COPD is associated with an abnormal lung immune response that leads to tissue damage and remodeling of the lung, but also to systemic effects that compromise immune responses. Cigarette smoking also impacts on innate and adaptative immune responses, exerting dual, pro- and anti-inflammatory effects. Previously, we showed that COPD patients presented accelerated telomere shortening and decreased telomerase activity, while, paradoxically, cigarette-smokers exhibited preserved telomerase activity and slower rate of telomere shortening. Results Here, we evaluated the naive, CM, EM and T-EMRA subsets of TCD4 and TCD8 cells according to the expression of CCR7/CD45RA. We compared age-matched COPD patients, cigarette-smokers without clinical-laboratory evidence of pulmonary compromise, and healthy individuals. They were additionally compared with a group of young adults. For each subset we analysed the expression of markers associated with late differentiation, senescence and exhaustion (CD27/CD28/CD57/KLRG1/PD1). We show that COPD patients presented a drastically reduced naive cells pool, and, paradoxically, increased fractions of naive cells expressing late differentiation, senescence or exhaustion markers, likely impacting on their immunocompetence. Pronounced phenotypic alterations were also evidenced in their three memory T-cell subsets compared with the other aged and young groups, suggesting an also dysfunctional memory pool. Surprisingly, our smokers showed a profile closer to the Healthy aged than COPD patients. They exhibited the usual age-associated shift of naive to EM TCD4 and TCD8 cells, but not to CM or T-EMRA T-cells. Nonetheless, their naive T-cells phenotypes were in general similar to those of the Youngs and Healthy aged, suggesting a rather phenotypically preserved subset, while the memory T-cells exhibited increased proportions of cells with the late-differentiation or senescence/exhaustion markers as in the Healthy aged. Conclusion Our study extends previous findings by showing that COPD patients have cells expressing a full range of late differentiated, senescent or exhausted phenotypes encompassing all TCD4 and TCD8 subsets, consistent with a premature immunosenescence phenotype. Surprisingly, the smokers group's results suggest that moderate to heavy chronic cigarette smoking did not accelerate the pace of immunosenescence as compared with the Healthy aged.
- Thoracoabdominal asynchrony decreases chest wall volume and affects respiratory kinematics in COPD(2015) PORRAS, Desiderio C.; SILVA, Cibele C. B. Marques da; LUNARDI, Adriana C.; PAISANI, Denise M.; STELMACH, Rafael; CUKIER, Alberto; MORIYA, Henrique T.; CARVALHO, Celso R. F.
- Postural balance and predictors of falls in COPD patients(2017) XAVIER, Rafaella; PEREIRA, Ana Carolina; LOPES, Aline; MARQUES, Cibele; LUNARDI, Adriana; STELMACH, Rafael; FERNANDES, Frederico; CARVALHO, Celso