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
111 resultados
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- Airway remodeling is reversed by aerobic training in a murine model of chronic asthma(2015) SILVA, R. A.; ALMEIDA, F. M.; OLIVO, C. R.; SARAIVA-ROMANHOLO, B. M.; MARTINS, M. A.; CARVALHO, C. R. F.The aim of this study was to investigate if the aerobic training (AT) reverses airway remodeling (AR) in an asthma model. BALB/c were divided into four groups: control (unsensitized and untrained); ovalbumin (OVA: sensitized and untrained); AT (unsensitized and trained) and OVA+AT. Allergic inflammation was induced with intraperitoneal and OVA inhalation. AT (low intensity; 5x/week; 60min/session) was performed at 7, 15, and 30 days. Leukocyte counting in the bronchoalveolar lavage fluid; the expression of IL-5, eotaxin, RANTES, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1); AR features (airway smooth muscle, epithelium thickness, collagen and elastic fibers, mucus production); and AR inducers (transforming growing factor-beta, osteopontin, vascular endothelial growth factor). OVA induced an increase in leukocyte airway migration and increased AR features (P<0.05). After 7 days, AT reversed the OVA-induced eosinophil and macrophage airway migration, the expression of IL-5, eotaxin, RANTES, ICAM-1, VCAM-1, and all AR inducers. However, total reversion of the AR features and inducers and airway inflammation occurred only after 15 days of AT compared with the OVA groups (P<0.05) and the effects were maintained until the 30th day. AT reverses AR after 15 days and this effect is preceded by the inhibition of leukocyte migration and occurs simultaneously with the reduction in the expression of inflammatory mediators and AR inducers.
- 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.
- Comparison of the Effects of Aerobic Conditioning Before and After Pulmonary Allergic Inflammation(2015) SILVA, Ronaldo Aparecido da; ALMEIDA, Francine Maria; OLIVO, Clarice Rosa; SARAIVA-ROMANHOLO, Beatriz Mangueira; PERINI, Adenir; MARTINS, Milton Arruda; CARVALHO, Celso Ricardo FernandesThe aim of this study is to compare the effects of aerobic conditioning (AC) before (ACBS) and after (ACAS) allergic sensitization. BALB/c mice were divided into two main groups: ACBS and ACAS. Each groups was divided into subgroups: control (nonsensitized/nontrained), AC (nonsensitized/trained), ovalbumin (OVA) (sensitized/nontrained), AC + OVA (trained/sensitized), and OVA + AC (sensitized/trained). Sensitization was induced using OVA and AC performed in treadmill (moderate intensity). We examined IgE and IgG(1) levels, eosinophil counting, expression of Th1 (interleukin (IL)-2, IFN-alpha) and Th2 cytokines (IL-4, IL-5, IL-13), IL-10, vascular endothelial growth factor (VEGF), and airway remodeling. IgE and IgG(1) were decreased only when exercise was performed before sensitization (ACBS); however, there was a decrease of eosinophils, Th2 cytokines, VEGF, and airway remodeling and increase in IL-10 in either ACBS or ACAS groups. Our results demonstrate that aerobic conditioning reduces Th2 response before and after sensitization by increasing IL-10 while the production of anaphylactic antibodies is reduced only when exercise is performed before sensitization.
article Reference values: necessary in order to understand patient limitations(2011) CARVALHO, Celso Ricardo Fernandes- 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.
- Are blue-collar workers more physically active than white-collar at work?(2021) AZEVEDO, Leonardo Malta; CHIAVEGATO, Luciana Dias; CARVALHO, Celso R. F.; BRAZ, Juliano Ribeiro; CABRAL, Cristina Maria Nunes; PADULA, Rosimeire SimpriniThis study evaluates the physical activity level at work and leisure time of white-collar and two groups of blue-collar workers from the latex glove industry and the association of physical activity level and musculoskeletal complains and work ability. The workers' sociodemographic and behavioral health characteristics, work ability index, musculoskeletal complains, total step count and caloric expenditure for three consecutive days, were assessed. The blue-collar workers that move most from the workstation (longD) were more physically active at work compared to white-collar and blue-collar that moved close the workstation (shortD). But in leisure-time the result is reversed, white-collar and blue-collar groups were significantly more active. There was no association between physical activity level and musculoskeletal pain intensity and work ability. All the groups of workers exhibited satisfactory physical activity levels, but only blue-collar (longD) were more physically active (10,000 steps per day).
- Efeito agudo do salbutamol no sistema cardiovascular durante o exercício físico em pacientes com asma moderada ou grave: estudo aleatorizado, duplo-cego e cruzado(2018) MELO, Jaqueline Ribas de; FEITOZA, Maiane da Silva; CUCATO, Gabriel Grizzo; MEDEIROS, Wladimir Musetti; STELMACH, Rafael; CUKIER, Alberto; CARVALHO, Celso Ricardo Fernandes de; MENDES, Felipe Augusto RodriguesABSTRACT Salbutamol is a β2-agonist of short duration commonly used in patients with asthma to prevent symptoms during or after exercise. Hemodynamic changes at rest are well described. However, there is little data on the effects on heart rate (HR) and blood pressure (BP) during exercise and recovery phase in patients with moderate or severe asthma A randomized, double-blind, cross-over study was conducted, including 15 individuals with moderate and severe asthma, mean age 46.4±9.3 years. Patients underwent a maximal 2-day exercise test with 400 mcg salbutamol or 4 placebo puffs. Throughout the protocol, HR, BP, perceived exertion and peak of expiratory flow (PEF) were monitored. After the use of salbutamol, the PEF value increased by a mean of 28.0±47.7L/m, remaining increased at 5, 10 and 15 minutes of passive recovery compared to placebo (p<0.05). The HR, BP and effort perception variables were similar across interventions at all stages of the protocol (p>0.05). These results suggest that the use of salbutamol is safe and that HR does not need to be adjusted to prescribe exercise intensity following salbutamol administration in subjects with moderate or severe asthma.
- Interventions to Increase Physical Activity in Middle-Age Women at the Workplace: A Randomized Controlled Trial(2014) RIBEIRO, Marcos Ausenka; MARTINS, Milton Arruda; CARVALHO, Celso R. F.Purpose A four-group randomized controlled trial evaluated the impact of distinct workplace interventions to increase the physical activity (PA) and to reduce anthropometric parameters in middle-age women. Methods One-hundred and ninety-five women age 40-50 yr who were employees from a university hospital and physically inactive at their leisure time were randomly assigned to one of four groups: minimal treatment comparator (MTC; n = 47), pedometer-based individual counseling (PedIC; n = 53), pedometer-based group counseling (PedGC; n = 48), and aerobic training (AT; n = 47). The outcomes were total number of steps (primary outcome), those performed at moderate intensity (>= 110 steps per minute), and weight and waist circumference (secondary outcomes). Evaluations were performed at baseline, at the end of a 3-month intervention, and 3 months after that. Data were presented as delta [(after 3 months-baseline) or (after 6 months-baseline)] and 95% confidence interval. To detect the differences among the groups, a one-way ANOVA and a Holm-Sidak post hoc test was used (P < 0.05). The Cohen effect size was calculated, and an intention-to-treat approach was performed. Results Only groups using pedometers (PedIC and PedGC) increased the total number of steps after 3 months (P < 0.05); however, the increase observed in PedGC group (1475 steps per day) was even higher than that in PedIC (512 steps per day, P < 0.05) with larger effect size (1.4). The number of steps performed at moderate intensity also increased only in the PedGC group (845 steps per day, P < 0.05). No PA benefit was observed at 6 months. Women submitted to AT did not modify PA daily life activity but reduced anthropometric parameters after 3 and 6 months (P < 0.05). Conclusions Our results show that in the workplace setting, pedometer-based PA intervention with counseling is effective increasing daily life number of steps, whereas AT is effective for weight loss.
- Incremental Shuttle Walking Test: A Reproducible and Valid Test to Evaluate Exercise Tolerance in Adults With Noncystic Fibrosis Bronchiectasis(2014) CANNARGO, Anderson Alves de; AMARAL, Tatiane S.; RACHED, Samia Z.; ATHANAZIO, Rodrigo A.; LANZA, Fernanda C.; SAMPAIO, Luciana M.; CARVALHO, Celso R. de; CUKIER, Alberto; STELMACH, Rafael; CORSO, Simone DalObjective: To analyze the reliability, validity, and determinants of the incremental shuttle walk test (ISWT) in adults with noncystic fibrosis bronchiectasis. Design: Cross-sectional study. Setting: Outpatient clinic. Participants: Subjects (N=75; 26 men) underwent, on different days, cardiopulmonary exercise testing (CPET) and 2 ISWTs, 30 minutes apart. The number of steps in daily life was recorded. Concurrent validity was tested by the relation between distance walked with peak load and oxygen consumption (V) over doto(2). Interventions: None. Main Outcome Measures: Distance walked (m) was compared between the first and second ISWTs; greatest distance walked was correlated with peak load and Vo(2)peak obtained from CPET, steps per day, and dyspnea evaluated by the Medical Research Council (MRC) scale; and desaturation was compared between CPET and the ISWT. Results: Distance walked was equivalent between the first ISWT (441 +/- 152m) and the second ISWT (445 +/- 153m) with an excellent intraclass correlation coefficient (.995; 95% confidence interval, .99-.997). There were significant correlations between distance walked and peak load (r=.82), (V) over doto(2) (r=.72), steps per day (r=.61), and the MRC scale (r=-.69). Age, body mass index, sex, forced vital capacity (% predicted), dyspnea, and steps per day explained 70% of the variation in distance walked (m) and 60% of the variance when expressed as percent predicted. Higher desaturation was observed during the ISWT (-4%+/- 4%) than cycling (-2 +/- 3%) (P<.001). Conclusions: The ISWT is reliable, represents functional capacity, and induces greater desaturation than cycling. Age, body composition, pulmonary function, dyspnea, and physical activity in daily life are determinants of the distance walked on the ISWT. (C) 2014 by the American Congress of Rehabilitation Medicine
- Increased physical activity reduces sleep disturbances in asthma: A randomized controlled trial(2023) PASSOS, Natalia Febrini; FREITAS, Patricia D.; CARVALHO-PINTO, Regina Maria; CUKIER, Alberto; CARVALHO, Celso R. F.Background and objective Individuals with asthma are more likely to develop sleep-disordered breathing. Exercise training improves sleep; however, the effect of physical activity (PA) on improving sleep quality remains unknown. This study had two objectives: (i) to evaluate the effect of a behavioural intervention to increase physical activity in daily living (PADL) on sleep quality in adults with asthma; (ii) to verify the association between a change in sleep quality, quality of life, anxiety, depression and asthma symptoms. Methods This randomized controlled clinical trial included adults physically inactive with asthma. Participants were randomized into the control (CG; n = 25) and intervention groups (IG; n = 24). IG was submitted to a behavioural intervention to increase PADL, and CG received the usual care. Pre- and post-intervention assessments of sleep quality (by actigraphy and questionnaire), PADL level (by accelerometry), asthma control, health-related quality of life and anxiety and depression levels were conducted. Results Both groups were similar at baseline. After the intervention, IG increased daily steps and moderate to vigorous PA levels. IG also improved sleep efficiency and latency as well as increased asthma-symptom-free days compared to CG. In addition, a greater proportion of participants in the IG had improved sleep quality after the intervention. Lastly, IG presented clinical improvement in the asthma-related quality of life questionnaire and a reduction in anxiety symptoms. Conclusion Our results demonstrate that a behavioural intervention can increase PA, enhance behavioural sleep quality, efficiency and quality of life and reduce asthma and anxiety symptoms.