RODRIGO CERQUEIRA BORGES
Projetos de Pesquisa
Unidades Organizacionais
SVFOFITO-62, Hospital Universitário
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Two 6-minute Walk Tests Are Required During Hospitalisation for Acute Exacerbation of COPD(2016) OSADNIK, Christian R.; BORGES, Rodrigo C.; MCDONALD, Christine F.; CARVALHO, Celso R. F.; HOLLAND, Anne E.The 6-minute walk test (6MWT) is recommended to be performed twice to accurately assess exercise performance in stable chronic obstructive pulmonary disease (COPD) due to the presence of a learning effect. It is unknown whether a learning effect exists when the 6MWT is performed during hospitalisation for acute exacerbation of COPD (AECOPD). This study investigated whether repeat 6MWTs are necessary when conducted in inpatients with AECOPD. Pooled analysis was undertaken of data from two studies (Australia and Brazil) involving 46 participants (25 males, mean age 67.2 years, FEV1 43% predicted) admitted with AECOPD. Two 6MWTs, separated by >= 20 minutes, were performed on the day of discharge. Six-minute walk distance (6MWD; primary outcome), perceived dyspnoea (Borg scale), heart rate and oxyhaemoglobin saturation were recorded. 6MWD data from tests one (T1) and two (T2) were analysed via visual inspection of Bland-Altman plots. Factors associated with test improvement or decline were explored. Mean 6MWD difference between T1 and T2 was 6.2m, however limits of agreement were wide (-92.2 m to 104.5 m). 32 (70%) participants improved (by any distance) from T1 to T2 by a mean (+/- standard deviation) of 32m +/- 28 m. Of these, 14 (30%) improved by a distance > 30 m. Fourteen (30%) participants recorded poorer 6MWD at T2 by a mean of 52m +/- 36 m. No factors were able to identify participants who improved or declined upon repeat testing. When performed in patients admitted to hospital with AECOPD, the 6MWT needs to be conducted twice in order to better estimate 6MWD.
- Dendritic cells in COVID-19 immunopathogenesis: insights for a possible role in determining disease outcome(2021) BORGES, Rodrigo Cerqueira; HOHMANN, Miriam Sayuri; BORGHI, Sergio MarquesSARS-CoV-2 is the causative agent of the COVID-19 pandemic. This novel coronavirus emerged in China, quickly spreading to more than 200 countries worldwide. Although most patients are only mildly ill or even asymptomatic, some develop severe pneumonia and become critically ill. One of the biggest unanswered questions is why some develop severe disease, whilst others do not. Insight on the interaction between SARS-CoV-2 and the immune system and the contribution of dysfunctional immune responses to disease progression will be instrumental to the understanding of COVID-19 pathogenesis, risk factors for worst outcome, and rational design of effective therapies and vaccines. In this review we have gathered the knowledge available thus far on the epidemiology of SARS-COV-2 infection, focusing on the susceptibility of older individuals, SARS-CoV-2-host cell interaction during infection and the immune response directed at SARS-CoV-2. Dendritic cells act as crucial messengers linking innate and adaptative immunity against viral infections. Thus, this review also brings a focused discussion on the role of dendritic cells and their immune functions during SARS-CoV-2 infection and how immune evasion strategies of SARS-CoV-2 and advancing age mediate dendritic cell dysfunctions that contribute to COVID-19 pathogenesis and increased susceptibility to worst outcomes. This review brings to light the hypothesis that concomitant occurrence of dendritic cell dysfunction/cytopathic effects induced by SARS-CoV-2 and/or aging may influence disease outcome in the elderly. Lastly, a detailed discussion on the effects and mechanisms of action of drugs currently being tested for COVID-19 on the function of dendritic cells is also provided.
- Gender differences in the perception of asthma respiratory symptoms in five Latin American countries(2022) BORGES, Rodrigo C.; ALITH, Marcela B.; NASCIMENTO, Oliver A.; JARDIM, Jose R.Objectives To determine the differences between sexes in perceptions of asthma symptoms, asthma control, daily activities, and symptom exacerbation in Latin American countries. Methods This cross-sectional study was performed using data from the Latin America Asthma Insight and Management (LA-AIM) study (n = 2167) carried out in Argentina, Brazil, Mexico, Venezuela, and Puerto Rico. Face-to-face interviews were conducted, and patients orally completed a 53-question survey assessing five main domains of asthma: symptoms, impact on daily activities, disease control, exacerbation, and treatment/medication. Results Of the 2167 participants, 762 (35.2%) were males and 1405 (64.8%) were females. Male participants smoked more than females, but history of rhinitis and allergies was more common in females (p < 0.05). Women aged 18-40 years had a higher proportion of uncontrolled asthma compared to men of the same age (37.8% and 30.0%, respectively). A higher proportion of symptomatic females reported more frequent symptoms (daytime cough, shortness of breath, breathlessness/wheezing, sputum, tightness in the chest, etc.) than males (p < 0.05). Females also experienced more limitations in sports/recreational activities, normal physical exertion, social activities, sleep, and daily activities. Females consulted with health professionals more often than males (67.8% and 59.6%, respectively; p < 0.05). Asthma caused a feeling of lack of control over life in 42.6% of females and 31.4% of males. Conclusion In Latin America, females report more asthma symptoms, poorer asthma control, more impact on their daily activities, and more visits with health professionals than males.
- Impact of Resistance Training in Chronic Obstructive Pulmonary Disease Patients During Periods of Acute Exacerbation(2014) BORGES, Rodrigo C.; CARVALHO, Celso R.Objective: To evaluate the effects of whole-body resistance training on exercise capacity, health-related quality of life (DROOL), and muscle strength in patients hospitalized for exacerbation of chronic obstructive pulmonary disease. Design: Randomized controlled trial. Setting: University hospital. Participants: Patients (N=46) were randomized to either a control group (CG) or training group (TG), and 29 patients completed the study. Intervention: Training consisted of weight-lifting exercises for 6 muscle groups in the upper and lower limbs (2 sets of 8 repetitions each), and the initial load was set at 80% of the 1-repetition maximum load. Main Outcome Measures: Patients were evaluated on the second day of hospitalization, at hospital discharge, and 30 days postdischarge. Patients were evaluated on the basis of the 6-minute walking distance (6MWD), DROOL, muscle strength, systemic inflammatory markers, and level of physical activity in daily life (PADL). Results: The CG showed a reduction in the strength of lower-limb muscles (P<.05) but not in the 6MWD (P>.05). In contrast, patients from the TG improved strength in the lower-limb muscles and 6MWD during and 30 days after hospitalization (P<.05). The TG also improved the impact domain in HRQOL after hospitalization. No improvement in PADL was observed in the TG. Finally, a reduction in the blood levels of inflammatory markers was observed only in the TO after hospitalization. Conclusions: Our results suggest that resistance training during hospitalization improves the 6MWD, DROOL, and lower-limb muscle strength, without altering the levels of systemic inflammation. However, future research should explore this intervention in larger randomized trials. (c) 2014 by the American Congress of Rehabilitation Medicine
- Physical Activity In Daily Life In Brazilian COPD Patients During and After Exacerbation(2012) BORGES, Rodrigo Cerqueira; CARVALHO, Celso Ricardo FernandesBackground: Although hospitalization is recognized as an important cause of reduction in physical activity in daily life (PADL) in COPD, there is only one study evaluating this effect, and it was performed in European COPD patients who have a lower PADL than that of South American COPD patients. Objectives: To investigate the effect of hospitalization due to acute exacerbation of PADL in Brazilian COPD patients and to evaluate the factors that determines the physical activity levels during hospitalization and after discharge. Methods: PADL was quantified using a 3-axis accelerometer on the 3rd day of hospitalization and 1 month after discharge in Brazilian COPD patients who were hospitalized due to disease exacerbation. Six-minute walking distance (6MWD), lower limb strength and pulmonary function were also evaluated. Results: A total of 20 patients completed the study. During hospitalization, patients spent most of the time (87%) lying down or sitting; however, 1 month after they were walking >40 min/day. In addition, patients with prior hospitalization had a lower level of physical activity compared to those without a previous history of hospitalization. The time spent walking during hospitalization was significantly explained by the quadriceps strength (r(2) = 0.29; p < 0.05), while 1 month after, the time spent walking was only significantly explained by the 6MWD (r(2) = 0.51; p = 0.02). Conclusions: Brazilian COPD patients are inactive during hospitalization but become active 1 month after discharge. Previously hospitalized are more inactive both during and after exacerbation. The quadriceps strength and 6MWD explain the physical activity levels during hospitalization and at home, respectively.
- Prevalence and Factors Associated with Sarcopenia in Hospitalized Elderly Patients(2022) BORGES, Rodrigo Cerqueira; CORREA, Daniel Imay; CORREA, Lourdes Jaqueline Sampaio; COLOMBO, Alexandra Siqueira; CARVALHO, Celso Ricardo FernandesBackground/Purpose: Sarcopenia is a public health problem; however, it remains poorly evaluated during hospitalization. The aim of this study was to evaluate the prevalence of sarcopenia and the factors associated with this condition in hospitalized elderly patients Methods: A total of 122 elderly individuals were evaluated in this case-control study (61=hospitalized and 61=non-hospitalized). Sarcopenia was defined and evaluated according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). The Charlson comorbidity index, geriatric depression scale, body mass index (BMI), Barthel Index, Mini-Mental State Examination (MMSE), Lawton-Brody index, and Mini Nutritional Assessment Instrument-Short Form (MNA-SF) were also used for the evaluations. Results: The prevalence of sarcopenia was 38% in hospitalized patients compared to 11% in controls. Hospitalized elderly patients showed a significant reduction in functionality, muscle strength, and mental and nutritional status compared to the controls. Sarcopenic patients were older, had a lower BMI, and obtained worse MMSE results than non-sarcopenic individuals. There was an association between the MMSE results and the BMI in patients with sarcopenia that was independent of the group. Conclusion: Sarcopenia is highly prevalent in hospitalized elderly individuals, and it is associated with cognitive state and BMI.
- Muscle degradation, vitamin D and systemic inflammation in hospitalized septic patients(2020) BORGES, Rodrigo Cerqueira; BARBEIRO, Hermes Vieira; BARBEIRO, Denise Frediani; SORIANO, Francisco GarciaPurpose: To date, the relationship between systemic inflammation and muscle changes observed by ultrasonog-raphy in septic patients in clinical studies is not known. Furthermore, the role of vitamin Don muscle changes in these patients needs to be investigated. Materials and methods: Forty-five patients admitted to the ICU due to severe sepsis or septic shock. Blood samples were collected to evaluate systemic inflammation (interleukin (IL)-10, IL-1 beta, IL-1 alpha, IL-6, IL-8 and tumor necrosis factor-alpha(TNF-alpha)) and vitamin D. Muscle mass was evaluated by ultrasound during hospitalization. Clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip) were performed after the awakening of patients. Results: There was a reduction in day 2 values to hospital discharge on TNF-alpha, IL-8. IL-6 and IL-10 (p < .05). The muscle mass showed a significant decline from day 6 of the ICU. After awakening, the patients had a significant increase in muscle strength (p < .05). There was a positive association between muscle mass variation (day 2 - ICU) with absolute values of IL-8 (r = 0.38 p = .05). For muscle strength, there was a negative association between handgrip strength with IL-8 (r = -0.36 p < .05) on ICU discharge. The vitamin D showed a positive association with the handgrip strength of the day 1 of the awakening (r = 0.51 p < .05). Conclusions: In septic patients, there is an association between inflammation and changes in muscle mass and strength during ICU stay, which is similar to those observed in experimental studies. In addition, there was an association of vitamin D with recovery of muscle strength during hospitalization.
- Association between muscle wasting and muscle strength in patients who developed severe sepsis and septic shock(2018) BORGES, Rodrigo; SORIANO, Francisco; CARVALHO, Celso
- ASSOCIATION BETWEEN MUSCLE WASTING AND MUSCLE STRENGTH IN PATIENTS WHO DEVELOPED SEVERE SEPSIS AND SEPTIC SHOCK(2019) BORGES, Rodrigo Cerqueira; SORIANO, Francisco GarciaPurpose: To evaluate the association between the rectus femoris cross-sectional area (RFCSA) and the muscular strength obtained at the bedside in patients forwarded to the intensive care unit (ICU) for severe sepsis and septic shock. Methods: An observational study of prospective cohort. RFCSA was assessed by ultrasound on the following day of the ICU admission and monitored during hospitalization. The patients performed clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip dynamometry), when they could understand the verbal commands of the examiners. Results: In 37 patients hospitalized for sepsis there was a significant decline in RFCSA of 5.18 (4.49-5.96) cm(2) on the 2nd day of ICU for 4.37 (3.71-5.02) cm(2) at hospital discharge. Differently, the handgrip strength showed an increase from the awakening of 12.00 (7.00-20.00) Kgf to 19.00 (14.00-26.00) Kgf until hospital discharge. Patients in mechanical ventilation had a greater tendency to decline in the RFCSA compared with patients who did not receive mechanical ventilation, however without being significant (P = 0.08). There was a negative association between RFCSA delta (2nd day of ICU-ICU discharge) and handgrip strength (r = 0.51, P < 0.05), and a male and Sepsis-related Organ Failure Assessment score positive association with the RFCSA delta. Conclusion: There was an association of RFCSA with clinical muscle strength tests. In addition, it has been shown that sepsis can lead to short-term muscle degradation, regardless of whether they are submitted to mechanical ventilation or not.
- Physical activity, muscle strength, and exercise capacity 3 months after severe sepsis and septic shock(2015) BORGES, Rodrigo Cerqueira; CARVALHO, Celso R. F.; COLOMBO, Alexandra Siqueira; BORGES, Mariucha Pereira da Silva; SORIANO, Francisco GarciaTo quantify the physical activity in daily life (PADL), muscle strength, and exercise capacity in the short and medium term in survivors of severe sepsis and septic shock. Prospective cohort study with a follow-up from hospital admission to 3 months after hospital discharge. Seventy-two patients admitted to the ICU for severe sepsis or septic shock and a control group of healthy sedentary subjects (n = 50) were enrolled. All patients had their PADL quantified by an accelerometer during their hospital stay and 3 months after. Exercise capacity and handgrip and quadriceps muscle strength were also evaluated. During hospitalization, patients spent the majority of their time inactive in a lying or sitting position (90 +/- A 34 % of daily time). Physical inactivity was partially reduced 3 months after (58 +/- A 20 % of daily time). However, the time patients spent walking was only 63 % of the time reported for healthy subjects. Patients also showed lower movement intensity when compared with controls (2.1 +/- A 0.3 vs 2.5 +/- A 0.4 m/s(2)). At hospital discharge, muscle strength and exercise capacity were approximately 54 % of the predicted value, and these parameters showed significant increase in patients 3 months after (70 % of predicted value). Multivariable analysis demonstrated that the use of systemic corticosteroids and hospitalization time negatively influenced quadriceps strength and exercise capacity at the time of hospital discharge. Our results suggest that survivors of sepsis admitted to the ICU have a substantial reduction in physical activity, exercise capacity, and muscle strength compared to healthy subjects that persist even 3 months after hospital discharge.