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
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
- 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
- Development of a prototype step to evaluate the physical capacity of healthy individuals and patients with respiratory and heart diseases(2017) SILVA, Gabriela de Andrade; FIGUEIREDO, Thamyres; PERILLO, Marcelo Porto; VENEZUELA, Joao Henrique Marques; MORIYA, Henrique Takachi; CARVALHO, Celso Ricardo Fernandes de; BARBOSA, Renata Cleia ClaudinoStep tests are tests representing the daily physical activities that can classify different degrees of physical capacity of healthy and non-healthy individuals evaluating the causes that limit stress and exercise tolerance. Despite being widely employed in clinical practice, currently there are several variations in the implementation, testing standards, and step sizes which contribute to greater difficulty in assessment and interpretation of the examiner. Thus, the objective of this study was to produce a step with an integrated software system to facilitate the evaluation and interpretation of the data obtained during the test from the incremental step clocked externally. This exploratory study has developed a prototype step to assist physiotherapists in monitoring real-time test, sending the results to a computer program. The results may be stored and processed by the program in order that the events are reconhecid error. The step was built with an MDF wooden board; Rubber tube; Aluminum plate; Copper wiring with insulation coating; Screws; Angles; Wing nuts and rubber flooring. In addition, for communication with the computer, the integrated circuit needs to be manufactured and connected to a microcontroller, as well as a USB serial cable. The development of a single, standardized instrument, with the ability to identify errors and track the progress of the test, can be a first step towards a consensus and standardization of the test.
- Fenótipos de asma em crianças e adolescentes de baixa renda: análise de agrupamentos(2017) CABRAL, Anna Lucia Barros; SOUSA, Andrey Wirgues; MENDES, Felipe Augusto Rodrigues; CARVALHO, Celso Ricardo Fernandes deObjetivo: Estudos que caracterizam fenótipos de asma predominantemente incluem adultos ou foram realizados em crianças e adolescentes de países desenvolvidos; portanto, sua aplicabilidade em outras populações, tais como as de países em desenvolvimento, permanece indeterminada. Nosso objetivo foi determinar como crianças e adolescentes asmáticas de baixa renda no Brasil são distribuídos através de uma análise de clusters. Métodos: Foram incluídos 306 crianças e adolescentes (6-18 anos de idade) com diagnóstico clínico de asma e sob tratamento médico por pelo menos um ano de acompanhamento. No momento da inclusão, todos os pacientes estavam clinicamente estáveis. Vinte variáveis comumente determinadas na prática clínica e consideradas importantes na definição dos fenótipos de asma foram selecionadas para a análise de clusters. As variáveis com alta multicolinearidade foram excluídas. Uma análise de clusters foi realizada utilizando-se um teste aglomerativo em duas etapas e log-likelihood distance measure.Resultados: Três clusters foram definidos para nossa população. O cluster 1 (n = 94) incluiu indivíduos com função pulmonar normal, inflamação eosinofílica leve, poucas exacerbações, início mais tardio da asma e atopia leve. O cluster 2 (n = 87) incluiu pacientes com função pulmonar normal, número moderado de exacerbações, início precoce da asma, inflamação eosinofílica mais grave e atopia moderada. O cluster 3 (n = 108) incluiu pacientes com função pulmonar ruim, exacerbações frequentes, inflamação eosinofílica e atopia graves. Conclusões: A asma foi caracterizada por presença de atopia, número de exacerbações e função pulmonar em crianças e adolescentes de baixa renda no Brasil. As muitas semelhanças entre esta e outras análises de clusters de fenótipos indicam que essa abordagem apresenta boa generalização.
- Identifying COPD patients at risk for worse symptoms, quality of life and self-efficacy: A cluster analysis(2017) LOPES, Aline Costa; CARVALHO, Celso; XAVIER, Rafaella Fagundes; CAPORALI, Ana Carolina Alves; STELMACH, Rafael; FERNANDES, Frederico Leon Arrabal; HARRISON, Samantha L.
- The Role of Exercise in a Weight-Loss Program on Clinical Control in Obese Adults with Asthma A Randomized Controlled Trial(2017) FREITAS, Patricia D.; FERREIRA, Palmira G.; SILVA, Aline G.; STELMACH, Rafael; CARVALHO-PINTO, Regina M.; FERNANDES, Frederico L. A.; MANCINI, Marcia C.; SATO, Maria N.; MARTINS, Milton A.; CARVALHO, Celso R. F.Rationale: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. Objectives: To examine the effect of exercise training in a weight loss program on asthma control, quality of life, inflammatory biomarkers, and lung function. Methods: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program plus exercise (WL + E group, n = 28) or a weight-loss program plus sham (WL + S group, n = 27), where the weight-loss program included nutrition (caloric restriction) and psychological therapies. The WL + E group incorporated aerobic and resistance muscle training, whereas the WL + S group incorporated breathing and stretching exercises. Measurements and Main Results: The primary outcome was clinical improvement in asthma control over 3 months. Secondary outcomes included quality of life, lung function, body composition, aerobic capacity, muscle strength, and inflammatory/antiinflammatory biomarkers. After 3 months, 51 patients were analyzed. Compared with the WL + S group, the WL + E group demonstrated improved clinical control scores (median [25th to 75th percentile],-0.7 [-1.3 to -0.3] vs. -0.3 [-0.9 to 0.4]; P = 0.01) and greater weight loss (mean +/- SD, -6.8% +/- 3.5 vs. -3.1% +/- 2.6; P < 0.001) and aerobic capacity (median [25th to 75th percentile], 3.0 [2.4 to 4.0] vs. 0.9 [-0.3 to 1.3] ml O-2 X kg(-1) X min(-1); P < 0.001). These improvements in the WL + E group were also accompanied by improvements in lung function, antiinflammatory biomarkers, and vitamin D levels, as well as reductions in airway and systemic inflammation. Conclusions: Adding exercise to a short-term weight-loss program should be considered as a useful strategy for achieving clinical control of asthma in obese patients.
- Compare the safety of constant-load or intensity interval training for clinically stables patients with moderate and severe asthma(2017) SILVA, Ronaldo Aparecido Da; ROCCO, Patricia Goncalves Leite; MAZZUCATTO, Flavio; QUEIROS, Douglas Silva; STELMACH, Rafael; CARVALHO-PINTO, Regina Maria de; MARTINS, Milton Arruda; CARVALHO, Celso Ricardo Fernandes
- Factors associated with balance impairment in COPD patients(2017) XAVIER, Rafaella; PEREIRA, Ana Carolina; LOPES, Aline; SILVA, Cibele Marques da; CUKIER, Alberto; PINTO, Regina Carvalho; CARVALHO, Celso
- Comparison physical activity barriers in asthmatic and non-asthmatic children(2017) SOUSA, Andrey; CABRAL, Anna Lucia; CARVALHO, Celso; MARTINS, Milton
- Dynamic hyperinflation and exercise limitations in obese asthmatic women(2017) FERREIRA, Palmira Gabriele; FREITAS, Patricia Duarte; SILVA, Aline Grandi; PORRAS, Desiderio Cano; STELMACH, Rafael; CUKIER, Alberto; FERNANDES, Frederico Leon Arrabal; MARTINS, Milton Arruda; CARVALHO, Celso R. F.Obese individuals and patients with asthma can develop dynamic hyperinflation (DH) during exercise; however, no previous study has investigated DH as a factor associated with reduced exercise capacity in obese asthmatic women. The aim of the present study was to examine the occurrence of DH and exercise limitations in obese asthmatics. Obese grade II [obese group (Ob-G); BMI 35-39.9 kg/m(2); n = 36] and nonobese [nonobese group (NOb-G); BMI 18.5-29.9 kg/m(2); n = 18] asthmatic patients performed a cardiopulmonary test to quantify peak (V) over dot(O2) and a sub-maximal exercise test to assess DH. Anthropometric measurements, quadriceps endurance, and lung function were also evaluated. A forward stepwise regression was used to evaluate the association between exercise tolerance (wattage) and limiting exercise factors. Fifty-four patients completed the protocol. The Ob-G (n = 36) presented higher peak (V) over dot(O2) values but lower power-to-weight ratio values than the NOb-G (P < 0.05). DH was more common in the Ob-G (72.2%) than in the NOb-G (38.9%, P < 0.05). The Ob-G had a greater reduction in the inspiratory capacity (-18 vs. -4.6%, P < 0.05). Exercise tolerance was associated with quadriceps endurance (r = 0.65; p < 0.001), oxygen pulse (r = 0.52; p = 0.001), and DH (r = -0.46, P = 0.005). The multiple regression analysis showed that the exercise tolerance could be predicted from a linear association only for muscular endurance (r = 0.82 and r(2) = 0.67). This study shows that dynamic hyperinflation is a common condition in obese asthmatics; they have reduced fitness for activities of daily living compared to nonobese asthmatics. However, peripheral limitation was the main factor associated with reduced capacity of exercise in these patients. NEW & NOTEWORTHY This is the first study to investigate the occurrence of dynamic hyperinflation (DH) in obese asthmatics. Our results demonstrate that obese asthmatics present a higher frequency and intensity of DH than nonobese asthmatics. We also show that physical deconditioning in this population is linearly associated with cardiac (O-2 pulse), respiratory (DH), and peripheral muscle (resistance) limitation. However, multiple linear regression demonstrated that peripheral muscle limitation may explain the exercise limitation in this population.
- Comparison between the phase angle and phase shift parameters to assess thoracoabdominal asynchrony in COPD patients(2017) PORRAS, Desiderio Cano; LUNARDI, Adriana C.; SILVA, Cibele C. B. Marques da; PAISANI, Denise M.; STELMACH, Rafael; MORIYA, Henrique T.; CARVALHO, Celso R. F.Determining the presence of thoracoabdominal asynchrony in chronic obstructive pulmonary disease (COPD) patients is clinically relevant, but there is no consensus on the optimal parameters for performing this analysis. We assessed 22 COPD patients (FEV1 40 +/- 10% predicted) and 13 healthy controls during rest and exercise with optoelectronic plethysmography (70% maximum workload) on a cycle ergometer. Thoracoabdominal asynchrony was calculated by using phase angle and phase shift parameters following a three-compartment model involving the upper and lower rib cages and abdomen. Patients were classified as having thoracoabdominal asynchrony (TAA +) or not (TAA -) based on control values (mean +/- 2 SDs). The chest wall volume and compartmental contribution were also measured. Thoracoabdominal asynchrony was observed in the lower rib cage. The phase angle detected more TAA+ patients at rest (15 vs. 7 patients) and during exercise (14 vs. 8 patients) compared with the phase shift. TAA+ patients also presented a lower chest wall volume, lower rib cage contribution, and higher abdominal contribution to chest wall volume compared with the control and TAA - patients. Thoracoabdominal asynchrony was more detectable during rest and exercise using the phase angle parameter, and it was observed in the lower rib cage compartment, reducing the chest wall volume during exercise in patients with COPD. NEW & NOTEWORTHY This study contributes to advance the knowledge over the previous lack of consensus on the assessment of thoracoabdominal asynchrony. We rigorously evaluated the related features that interfere in the measurement of the asynchrony (measurement tool, chest wall model and calculation parameter). Our results suggest that phase angle detects more suitably thoracoabdominal asynchrony that occurs on the lower ribcage and leads to a reduction in the chest wall volume during exercise in COPD patients.