BRUNO GUALANO

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Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina - Líder

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Autor: LIMA, Fernanda Rodrigues × Categoria: original article ×

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  • article 16 Citação(ões) na Scopus
    Exercise as an Adjuvant Treatment in Persistent Active Polymyositis
    (2014) MATTAR, Melina Andrade; GUALANO, Bruno; ROSCHEL, Hamilton; PERANDINI, Luiz Augusto; DASSOUKI, Thalita; LIMA, Fernanda Rodrigues; SHINJO, Samuel Katsuyuki; PINTO, Ana Lucia de Sa
    Objectives: A growing number of studies have suggested that exercise may promote therapeutic effects in patients with idiopathic inflammatory myopathy. This prospective case series study aimed to report on the effects of exercise in patients with persistent active myositis. Methods: Three patients with persistent active polymyositis were submitted to a 12-week supervised exercise program comprising both aerobic and strength exercises. Results: After the intervention, the patients presented improvements in selected parameters of muscle function and aerobic conditioning. In addition, an overall improvement was detected in the quality of life, as measured by both the 36-item Short-Form Health Survey and the Health Assessment Questionnaire questionnaires. Importantly, exercise did not increase serum levels of creatine kinase and aldolase. Conclusions: The findings herein suggest that a combined aerobic and strength training program may be tolerable and potentially effective in improving muscle function, aerobic conditioning, and quality of life in patients with persistent active polymyositis.
  • article 72 Citação(ões) na Scopus
    Safety and possible effects of low-intensity resistance training associated with partial blood flow restriction in polymyositis and dermatomyositis
    (2014) MATTAR, Melina Andrade; GUALANO, Bruno; PERANDINI, Luiz Augusto; SHINJO, Samuel Katsuyuki; LIMA, Fernanda Rodrigues; SA-PINTO, Ana Lucia; ROSCHEL, Hamilton
    Introduction: Our aim was to evaluate the safety and efficacy of a low-intensity resistance training program combined with partial blow flow restriction (BFR training) in a cohort of patients with polymyositis (PM) and dermatomyositis (DM). Methods: In total, 13 patients with PM and DM completed a 12-week twice a week low-intensity (that is, 30% one-repetition-maximum (1RM)) resistance exercise training program combined with partial blood flow restriction (BFR). Assessments of muscle strength, physical function, quadriceps cross sectional (CSA) area, health-related quality of life, and clinical and laboratory parameters were assessed at baseline and after the intervention. Results: The BFR training program was effective in increasing the maximal dynamic strength in both the leg-press (19.6%, P < 0.001) and knee-extension exercises (25.2% P < 0.001), as well as in the timed-stands (15.1%, P < 0.001) and timed-up-and-go test (-4.5%, P = 0.002). Quadriceps CSA was also significantly increased after the intervention (4.57%, P = 0.01). Similarly, all of the components of the Short Form-36 Health Survey, the Health Assessment Questionnaire scores, and the patient-and physician reported Visual Analogue Scale were significantly improved after training (P < 0.05). Importantly, no clinical evidence or any other self-reported adverse event were found. Laboratory parameters (creatine kinase and aldolase) were also unchanged (P > 0.05) after the intervention. Conclusions: We demonstrated that a 12-week supervised low-intensity resistance training program associated with partial blood flow restriction may be safe and effective in improving muscle strength and function as well as muscle mass and health-related quality of life in patients with PM and DM.
  • article 0 Citação(ões) na Scopus
    Quality of life, fatigue, sleep quality, and mental health in systemic lupus erythematosus patients with a high cardiovascular risk profile
    (2023) MAZZOLANI, Bruna Caruso; SMAIRA, Fabiana Infante; SIECZKOWSKA, Sofia; ROMERO, Marina; RIBEIRO, Thaina Toledo; AMARANTE, Milla Cordeiro; PASOTO, Sandra; PINTO, Ana Lucia de Sa; LIMA, Fernanda Rodrigues; BENATTI, Fabiana Braga; BONFA, Eloisa; ROSCHEL, Hamilton; GUALANO, Bruno
    Systemic lupus erythematosus (SLE) patients report worse health-related quality of life (HRQL), fatigue, anxiety, depression, and sleep quality, when compared to the general population and other chronic diseases. Furthermore, cardiometabolic diseases are highly prevalent in SLE and are also associated with these parameters. Thus, it is plausible to suggest that SLE patients with a high cardiovascular risk may report worse results for these parameters. The aim of the study is to describe HRQL, fatigue, anxiety and depression symptoms, and sleep quality in a sample of SLE patients with a high cardiovascular risk profile (i.e., BMI between 25 and 40 kg/m2 and/or dyslipidemia, hypertension, or diabetes). This was a cross-sectional study where patients were assessed for (i) demographic, anthropometric, and disease-related parameters, (ii) HRQL, (iii) fatigue, (iv) anxiety and depression symptoms, and (v) sleep quality. One-hundred patients completed the study; however, only 87 patients were assessed for sleep quality data. Patients averaged 41.7 & PLUSMN; 9 years, and most patients were classified as overweight/obese (87%). SF-36 scores for physical and mental components summary were 51.3 & PLUSMN; 9.6 and 54.2 & PLUSMN; 15.6, respectively, with ""bodily pain"" and ""role emotional"" presenting the lower scores. The total SLEQOL score was 105.1 & PLUSMN; 42.0, with lower scores reported for ""self-image"" and ""mood."" Fatigue score was 30.8 & PLUSMN; 8.9, and 78% and 93% reported severe symptoms of anxiety and depression, respectively. The average sleep effectiveness was 82.9 & PLUSMN; 6.6%. Sleep latency, total time in bed (TTiB), and total sleep time (TST) were 8.4 & PLUSMN; 8.9, 495.8 & PLUSMN; 79.7, and 409.7 & PLUSMN; 69.9 min, respectively. Patients reported an average of 17.8 & PLUSMN; 6.2 WE, with 4.5 & PLUSMN; 1.5 min duration and a WASO of 77.7 & PLUSMN; 36.6 min. Despite similar HRQL, fatigue, and sleep quality parameters to those reported by other SLE populations, SLE patients with a high cardiovascular risk had a higher prevalence of depression and anxiety. Understanding SLE patients' quality of life and psychological symptoms is of utmost importance to improve disease management. The findings of this study highlight the need for more intensive and global care regarding mental health when considering a high cardiovascular risk in SLE.
  • article 22 Citação(ões) na Scopus
    The effects of exercise on lipid profile in systemic lupus erythematosus and healthy individuals: a randomized trial
    (2015) BENATTI, Fabiana Braga; MIOSSI, Renata; PASSARELI, Marisa; NAKANDAKARE, Edna R.; PERANDINI, Luiz; LIMA, Fernanda Rodrigues; ROSCHEL, Hamilton; BORBA, Eduardo; BONFA, Eloisa; GUALANO, Bruno; PINTO, Ana Lucia de Sa
    The aim of the present study was to evaluate the effects of an exercise training program on lipid profile and composition of high-density lipoprotein (HDL) subfractions in systemic lupus erythematosus (SLE) patients and healthy controls. A 12-week, randomized trial was conducted. Thirty-three physically inactive SLE patients were randomly assigned into two groups: trained (SLE-TR, n = 17) and non-trained (SLE-NT, n = 16). A gender-, BMI-, and age-matched healthy control groups (C-TR, n = 11) also underwent the exercise program. Subjects were assessed at baseline (Pre) and 12 weeks after the 3-month exercise training program (Post) for lipid profile (HDL, low-density lipoprotein, very low-density lipoprotein, and total cholesterol and triglycerides levels) and composition of the HDL subfractions HDL2 and HDL3. SLE patients showed significantly lower contents of Apo A-I, phospholipid, and triglyceride in the HDL3 subfraction (p < 0.05, between-group comparisons) than healthy controls at baseline. The exercise training program did not affect any of the parameters in the SLE-TR group (p > 0.05, within-group comparisons), although there was a trend toward decreased circulating Apo B levels (p = 0.06, ES = -0.3, within-group comparison). In contrast, the same exercise training program was effective in increasing contents of cholesterol, triglyceride, and phospholipid in the HDL2 subfraction in the C-TR group (p = 0.036, ES = 2.06; p = 0.038, ES = 1.77; and p = 0.0021, ES = 2.37, respectively, within-group comparisons), whereas no changes were observed in the composition of the HDL3 subfraction. This study showed that SLE patients have a less effective response to a 12-week exercise training program than healthy individuals, with regard to lipid profile and chemical composition of HDL subfractions. These results reinforce the need for further studies to define the optimal training protocol to improve lipid profile and particularly the HDL composition in these patients (registered at clinicaltrials.gov as NCT01515163).
  • article 26 Citação(ões) na Scopus
    Effect of creatine supplementation on measured glomerular filtration rate in postmenopausal women
    (2011) NEVES JR., Manoel; GUALANO, Bruno; ROSCHEL, Hamilton; LIMA, Fernanda Rodrigues; SA-PINTO, Ana Lucia de; SEGURO, Antonio Carlos; SHIMIZU, Maria Heloisa; SAPIENZA, Marcelo Tatit; FULLER, Ricardo; LANCHA JR., Antonio Herbert; BONFA, Eloisa
    We aimed to investigate whether creatine supplementation affects the measured glomerular filtration rate in postmenopausal women (age, 58 +/- 3 years). Subjects were randomly assigned to receive either creatine (20 g(.)day(-1) for 1 week and 5 g(.)day(-1) thereafter) or a placebo. Kidney function was assessed at baseline and after 12 weeks. [Cr-51] EDTA clearance remained unchanged (CR-PRE: 86.16 +/- 14.36 mL(.)min(-1) per 1.73 m(2), POST: 87.25 +/- 17.60 mL(.)min(-1) per 1.73 m(2); PL-PRE: 85.15 +/- 8.54 mL(.)min(-1) per 1.73 m(2), POST: 87.18 +/- 9.64 mL(.)min(-1) per 1.73 m(2); p = 0.81). Thus, we concluded that creatine supplementation does not affect glomerular filtration rate in postmenopausal women.
  • article 10 Citação(ões) na Scopus
    The Liposuction-Induced Effects on Adiponectin and Selected Cytokines Are Not Affected by Exercise Training in Women
    (2014) SOLIS, Marina Yazigi; ARTIOLI, Guilherme Giannini; MONTAG, Eduardo; PAINELLI, Vitor de Salles; SAITO, Fabio Lopes; LIMA, Fernanda Rodrigues; ROSCHEL, Hamilton; GUALANO, Bruno; LANCHA JUNIOR, Antonio Herbert; BENATTI, Fabiana Braga
    It has been suggested that the abrupt liposuction-induced decrease in adipose tissue could affect adipokine secretion pattern. We hypothesized that exercise training could positively impact adipokine metabolism following liposuction. The aim of this study was to investigate the effects of liposuction on inflammation-related adipokines in women who were either exercise-trained or remained sedentary after surgery. Thirty-six healthy normal-weight women underwent an abdominal liposuction and two months after surgery were randomly allocated into two groups: trained (TR, n = 18, four-month exercise program) and nontrained (NT, n = 18). Inflammation-related adipokine serum levels (TNF-alpha, IL-6, IL-10, and adiponectin) and abdominal and thigh subcutaneous adipose tissue (scAT) mRNA levels were assessed before (PRE) and six months after surgery (POST6). TNF-alpha, IL-6, and IL-10 serum levels were unchanged in both groups. In contrast, TNF-alpha, IL-6, and IL-10 mRNA levels in scAT were increased, whereas adiponectin scAT mRNA and serum levels were decreased at POST6 (P < 0.05, main effect for time). No changes were observed in mRNA levels of MCP-1, CD14, and CD68 in any of the groups. In conclusion, liposuction downregulates adiponectin scAT gene expression and serum levels and upregulates scAT gene expression of inflammation-related genes six months after surgery in normal-weight women, irrespective of exercise training.
  • article 13 Citação(ões) na Scopus
    Ultra-processed food consumption associates with higher cardiovascular risk in rheumatoid arthritis
    (2020) SMAIRA, Fabiana Infante; MAZZOLANI, Bruna Caruso; PECANHA, Tiago; SANTOS, Kamila Meireles dos; REZENDE, Diego Augusto Nunes; ARAUJO, Maria Eugenia; BONFIGLIOLI, Karina; SCAGLIUSI, Fernanda Baeza; BENATTI, Fabiana Braga; PINTO, Ana Lucia de Sa; LIMA, Fernanda Rodrigues; PEREIRA, Rosa Maria R.; ROSCHEL, Hamilton; GUALANO, Bruno; PINTO, Ana Jessica
    To investigate the association between food consumption stratified by processing level and cardiovascular risk factors in rheumatoid arthritis. In this cross-sectional study, 56 patients (age: 62.5 +/- 7.9 years, BMI: 28.4 +/- 5.1 kg/m(2)) had food consumption evaluated according to the processing level (e.g., unprocessed or minimally processed foods, processed foods, and ultra-processed foods) and associated with cardiovascular risk factors. The most prevalent food processing level was unprocessed or minimally processed foods (42.6 +/- 12.6% of total energy intake [TEI]), followed by processed (24.2 +/- 11.9%TEI), ultra-processed (18.1 +/- 11.8%TEI), and culinary ingredients (15.1 +/- 6.4%TEI). Adjusted regression models showed that higher consumption of ultra-processed foods was positively associated with Framingham risk score (beta = 0.06, CI: 95% 0.001, 0.11, p = 0.045) and glycated hemoglobin (beta = 0.04, CI: 95% 0.01, 0.08, p = 0.021). In contrast, higher consumption of unprocessed or minimally processed foods was associated with lower 10-year risk of developing cardiovascular diseases (beta = -0.05, CI: 95% - 0.09, -0.003, p = 0.021) and LDL (beta = -1.09, CI: 95% - 1.94, -0.24, p = 0.013). Patients with rheumatoid arthritis consuming more ultra-processed foods showed worse metabolic profile, whereas those consuming more unprocessed or minimally processed foods had lower cardiovascular risks. A food pattern characterized by a high ultra-processed food consumption appears to emerge as a novel, modifiable risk factor for cardiovascular diseases in rheumatoid arthritis.
  • article 49 Citação(ões) na Scopus
    Creatine Supplementation Associated or Not with Strength Training upon Emotional and Cognitive Measures in Older Women: A Randomized Double-Blind Study
    (2013) ALVES, Christiano Robles Rodrigues; MEREGE FILHO, Carlos Alberto Abujabra; BENATTI, Fabiana Braga; BRUCKI, Sonia; PEREIRA, Rosa Maria R.; PINTO, Ana Lucia de Sa; LIMA, Fernanda Rodrigues; ROSCHEL, Hamilton; GUALANO, Bruno
    Purpose: To assess the effects of creatine supplementation, associated or not with strength training, upon emotional and cognitive measures in older woman. Methods: This is a 24-week, parallel-group, double-blind, randomized, placebo-controlled trial. The individuals were randomly allocated into one of the following groups (n=14 each): 1) placebo, 2) creatine supplementation, 3) placebo associated with strength training or 4) creatine supplementation associated with strength training. According to their allocation, the participants were given creatine (4 x 5 g/d for 5 days followed by 5 g/d) or placebo (dextrose at the same dosage) and were strength trained or not. Cognitive function, assessed by a comprehensive battery of tests involving memory, selective attention, and inhibitory control, and emotional measures, assessed by the Geriatric Depression Scale, were evaluated at baseline, after 12 and 24 weeks of the intervention. Muscle strength and food intake were evaluated at baseline and after 24 weeks. Results: After the 24-week intervention, both training groups (ingesting creatine supplementation and placebo) had significant reductions on the Geriatric Depression Scale scores when compared with the non-trained placebo group (p = 0.001 and p = 0.01, respectively) and the non-trained creatine group (p < 0.001 for both comparison). However, no significant differences were observed between the non-trained placebo and creatine (p = 0.60) groups, or between the trained placebo and creatine groups (p = 0.83). Both trained groups, irrespective of creatine supplementation, had better muscle strength performance than the non-trained groups. Neither strength training nor creatine supplementation altered any parameter of cognitive performance. Food intake remained unchanged. Conclusion: Creatine supplementation did not promote any significant change in cognitive function and emotional parameters in apparently healthy older individuals. In addition, strength training per se improved emotional state and muscle strength, but not cognition, with no additive effects of creatine supplementation.
  • article 5 Citação(ões) na Scopus
    Effects of a 16-week home-based exercise training programme on health-related quality of life, functional capacity, and persistent symptoms in survivors of severe/critical COVID-19: a randomised controlled trial
    (2023) LONGOBARDI, Igor; GOESSLER, Karla; JR, Gersiel Nascimento de Oliveira; PRADO, Danilo Marcelo Leite do; SANTOS, Jhonnatan Vasconcelos Pereira; MELETTI, Matheus Molina; ANDRADE, Danieli Castro Oliveira de; GIL, Saulo; BOZA, Joao Antonio Spott de Oliveira; LIMA, Fernanda Rodrigues; GUALANO, Bruno; ROSCHEL, Hamilton
    Background Long-lasting effects of COVID-19 may include cardiovascular, respiratory, skeletal muscle, metabolic, psychological disorders and persistent symptoms that can impair health-related quality of life (HRQoL). We investigated the effects of a home-based exercise training (HBET) programme on HRQoL and health-related outcomes in survivors of severe/critical COVID-19. Methods This was a single-centre, single-blinded, parallel-group, randomised controlled trial. Fifty survivors of severe/ critical COVID-19 (5 +/- 1 months after intensive care unit discharge) were randomly allocated (1:1) to either a 3 times a week (similar to 60-80min/session), semi-supervised, individualised, HBET programme or standard of care (CONTROL). Changes in HRQoL were evaluated through the 36-Item Short-Form Health Survey, and physical component summary was predetermined as the primary outcome. Secondary outcomes included cardiorespiratory fitness, pulmonary function, functional capacity, body composition and persistent symptoms. Assessments were performed at baseline and after 16 weeks of intervention. Statistical analysis followed intention-to-treat principles. Results After the intervention, HBET showed greater HRQoL score than CONTROL in the physical component summary (estimated mean difference, EMD: 16.8 points; 95% CI 5.8 to 27.9; effect size, ES: 0.74), physical functioning (EMD: 22.5 points, 95% CI 6.1 to 42.9, ES: 0.83), general health (EMD: 17.4 points, 95%CI 1.8 to 33.1, ES: 0.73) and vitality (EMD: 15.1 points, 95%CI 0.2 to 30.1, ES: 0.49) domains. 30-second sit-to-stand (EMD: 2.38 reps, 95%CI 0.01 to 4.76, ES: 0.86), and muscle weakness and myalgia were also improved in HBET compared with CONTROL (p<0.05). No significant differences were seen in the remaining variables. There were no adverse events. Conclusion HBET is an effective and safe intervention to improve physical domains of HRQoL, functional capacity and persistent symptoms in survivors of severe/critical COVID-19. Trial registration number NCT04615052.
  • article 127 Citação(ões) na Scopus
    Benefits of Resistance Training with Blood Flow Restriction in Knee Osteoarthritis
    (2018) FERRAZ, Rodrigo Branco; GUALANO, Bruno; RODRIGUES, Reynaldo; KURIMORI, Ceci Obara; FULLER, Ricardo; LIMA, Fernanda Rodrigues; SA-PINTO, Ana Lucia De; ROSCHEL, Hamilton
    Purpose Evaluate the effects of a low-intensity resistance training (LI-RT) program associated with partial blood flow restriction on selected clinical outcomes in patients with knee osteoarthritis (OA). Methods Forty-eight women with knee OA were randomized into one of the three groups: LI-RT (30% one repetition maximum [1-RM]) associated (blood flow restriction training [BFRT]) or not (LI-RT) with partial blood flow restriction, and high-intensity resistance training (HI-RT, 80% 1-RM). Patients underwent a 12-wk supervised training program and were assessed for lower-limb 1-RM, quadriceps cross-sectional area, functionality (timed-stands test and timed-up-and-go test), and disease-specific inventory (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) before (PRE) and after (POST) the protocol. Results Similar within-group increases were observed in leg press (26% and 33%, all P < 0.0001), knee extension 1-RM (23% and 22%; all P < 0.0001) and cross-sectional area (7% and 8%; all P < 0.0001) in BFRT and HI-RT, respectively, and these were significantly greater (all P < 0.05) than those of LI-RT. The BFRT and HI-RT showed comparable improvements in timed-stands test (7% and 14%, respectively), with the latter showing greater increases than LI-RT. Timed-up-and-go test scores were not significantly changed within or between groups. WOMAC physical function was improved in BFRT and HI-RT (-49% and -42%, respectively; all P < 0.05), and WOMAC pain was improved in BFRT and LI-RT (-45% and -39%, respectively; all P < 0.05). Four patients (of 16) were excluded due to exercise-induced knee pain in HI-RT. Conclusions Blood flow restriction training and HI-RT were similarly effective in increasing muscle strength, quadriceps muscle mass, and functionality in knee OA patients. Importantly, BFRT was also able to improve pain while inducing less joint stress, emerging as a feasible and effective therapeutic adjuvant in OA management.