ALBERTO CUKIER
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
143 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 143
- Exercise training is a determinant of weight-loss and improvement on asthma control, airway inflammation and psychosocial morbidity in obese asthmatics: A RCT(2015) FREITAS, Patricia D.; FERREIRA, Palmira G.; SILVA, Aline G.; CUKIER, Alberto; STELMACH, Rafael; CARVALHO-PINTO, Regina; SALGE, Joao M.; MANCINI, Marcio C.; MARTINS, Milton A.; CARVALHO, Celso R. F.
- Comparação entre medidas objetivas do tabagismo e tabagismo autodeclarado em pacientes com asma ou DPOC: será que nossos pacientes dizem a verdade?(2015) STELMACH, Rafael; FERNANDES, Frederico Leon Arrabal; CARVALHO-PINTO, Regina Maria; ATHANAZIO, Rodrigo Abensur; RACHED, Samia Zahi; PRADO, Gustavo Faibischew; CUKIER, AlbertoObjective: Smoking prevalence is frequently estimated on the basis of self-reported smoking status. That can lead to an underestimation of smoking rates. The aim of this study was to evaluate the difference between self-reported smoking status and that determined through the use of objective measures of smoking at a pulmonary outpatient clinic. Methods: This was a cross-sectional study involving 144 individuals: 51 asthma patients, 53 COPD patients, 20 current smokers, and 20 never-smokers. Smoking status was determined on the basis of self-reports obtained in interviews, as well as through tests of exhaled carbon monoxide (eCO) and urinary cotinine. Results: All of the asthma patients and COPD patients declared they were not current smokers. In the COPD and asthma patients, the median urinary cotinine concentration was 167 ng/mL (range, 2-5,348 ng/mL) and 47 ng/mL (range, 5-2,735 ng/mL), respectively (p < 0.0001), whereas the median eCO level was 8 ppm (range, 0-31 ppm) and 5 ppm (range, 2-45 ppm), respectively (p < 0.05). In 40 (38%) of the patients with asthma or COPD (n = 104), there was disagreement between the self-reported smoking status and that determined on the basis of the urinary cotinine concentration, a concentration > 200 ng/mL being considered indicative of current smoking. In 48 (46%) of those 104 patients, the self-reported non-smoking status was refuted by an eCO level > 6 ppm, which is also considered indicative of current smoking. In 30 (29%) of the patients with asthma or COPD, the urinary cotinine concentration and the eCO level both belied the patient claims of not being current smokers. Conclusions: Our findings suggest that high proportions of smoking pulmonary patients with lung disease falsely declare themselves to be nonsmokers. The accurate classification of smoking status is pivotal to the treatment of lung diseases. Objective measures of smoking could be helpful in improving clinical management and counseling.
- High-intensity interval training (HIIT) versus constant-load exercise (CLE) on the short-acute beta agonist (SABA) consumption and peak-expiratory flow (PEF) in subjects with moderate to severe asthma(2023) SILVA, Ronaldo Aparecido Da; FERNANDES, Thiago; STELMACH, Rafael; CUKIER, Alberto; CARVALHO-PINTO, Regina Maria; CARVALHO, Celso R. F.
- 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.
- 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
bookPart Asma(2018) ATHANAZIO, Rodrigo; ALMEIDA, Guilherme Eler de; CUKIER, Alberto- 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.
- 2020 Brazilian Thoracic Association recommendations for the management of asthma(2020) PIZZICHINI, Marcia Margaret Menezes; CARVALHO-PINTO, Regina Maria de; CANCADO, Jose Eduardo Delfini; RUBIN, Adalberto Sperb; CERCI NETO, Alcindo; CARDOSO, Alexandre Pinto; CRUZ, Alvaro Augusto; FERNANDES, Ana Luisa Godoy; BLANCO, Daniella Cavalet; VIANNA, Elcio Oliveira; CORDEIRO JUNIOR, Gediel; RIZZO, Jose Angelo; FRITSCHER, Leandro Genehr; CAETANO, Lilian Serrasqueiro Ballini; PEREIRA, Luiz Fernando Ferreira; RABAHI, Marcelo Fouad; OLIVEIRA, Maria Alenita de; LIMA, Marina Andrade; ALMEIDA, Marina Buarque de; STELMACH, Rafael; PITREZ, Paulo Marcio; CUKIER, AlbertoThe pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
- Pulmonary arterial enlargement is a predictor of higher risk of exacerbations in non-cystic fibrosis bronchiectasis patients(2021) FREITAS, Leonardo Vinicius De; NUNES, Blenda; MIRANDA, Renato; MAIA, Ana Luisa; RACHED, Samia; CUKIER, Alberto; STELMACH, Rafael; PINTO, Regina Carvalho; ATHANAZIO, Rodrigo
conferenceObject Clinical, Radiological And Functional Features In Mounier Kuhn Syndrome(2013) MAIORANO, M. C. N. T.; RACHED, S. Z.; ATHANAZIO, R. A.; CARVALHO-PINTO, R. M.; STELMACH, R.; CUKIER, A.