BRUNO GUALANO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina - Líder
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- 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 JessicaTo 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.
- COVID-19 quarantine in adolescents with autoimmune rheumatic diseases: mental health issues and life conditions(2022) IHARA, Bianca P.; LINDOSO, Livia M.; SETOUE, Debora N. D.; TANIGAVA, Nicolas Y.; HELITO, Alberto C.; SIMON, Juliana R.; VIANA, Vivianne S. L.; STRABELLI, Claudia A. A.; PEDROSO, Camilla A. A.; SIECZKOWSKA, Sofia M.; PEREIRA, Rosa M. R.; AIKAWA, Nadia E.; KOZU, Katia T.; ELIAS, Adriana M.; BUSCATTI, Izabel M.; GUALANO, Bruno; QUEIROZ, Ligia B.; CASELLA, Caio B.; V, Guilherme Polanczyk; SILVA, Clovis A. A.; CAMPOS, Lucia M. M. A.Objectives To assess mental health and life conditions in adolescents with autoimmune rheumatic diseases (ARDs) and healthy controls quarantined during COVID-19 pandemic. Method A cross-sectional study included 155 ARD adolescents and 105 healthy controls. Online survey included self-reported strengths and difficulties questionnaire (SDQ), and a semi-structured questionnaire with demographic data, daily home and school routine, physical activities, and COVID-19 information during the pandemic. Results Among patients, 56% had juvenile idiopathic arthritis (JIA), 29% juvenile systemic lupus erythematosus (JSLE), and 15% juvenile dermatomyositis (JDM). No differences were found regarding sex, ethnicity, and current age between ARD patients and controls (p > 0.05). Abnormal emotional SDQ (38% vs. 35%, p = 0.653) were similar in both groups. Logistic regression analyses in ARD patients demonstrated that female (OR = 2.4; 95%CI 1.0-6.0; p = 0.044) was associated with severe emotional SDQ dysfunction, whereas sleep problems were considered as a risk factor for both worse total SDQ (OR = 2.6; 95%CI 1.2-5.5; p = 0.009) and emotional SDQ scores (OR = 4.6; 95%CI 2.2-9.7; p < 0.001). Comparisons between ARD patients with and without current prednisone use showed higher median scores of peer problems in the first group [3 (0-10) vs. 2 (0-7), p = 0.049], whereas similar median and frequencies between JIA, JSLE, and JDM (p > 0.05). Conclusions Approximately one third of JIA, JSLE, and JDM patients presented abnormal total and emotional scores of SDQ during COVID-19 quarantine. Sleep problems were the main factor associated with emotional difficulties in these ARD adolescents. The knowledge of mental health issues rates in adolescents with ARD supports the development of prevention strategies, like sleep hygiene counseling, as well as the references of the affected patients to specialized mental health services, as necessary.
- Gaps on rheumatologists' knowledge of physical activity(2021) ASTLEY, Camilla; PINTO, Ana Jessica; BONFA, Eloisa; SILVA, Clovis Artur Almeida da; GUALANO, BrunoTo assess the rheumatologists' knowledge and willingness to prescribe physical activity, we conducted a nationwide survey. All adult and paediatric rheumatologist members of the Brazilian Rheumatology Society were invited to fulfil a questionnaire on their knowledge and willingness to promote physical activity. Four hundred twenty-eight rheumatologists participated in the survey, representing approximately 25% of the society's members. Forty-five percent of the rheumatologists reported having had training to prescribe physical activity, and 68% believe that physical activity is a part of patients' treatment. Most reported assessing physical activity levels (86%) and recommending physical activity (98%) always or most of the time. However, 48% do not know the minimum physical activity recommendations for health maintenance, nor do they know how much vigorous activity should be done in replacement of moderate activity. In addition, only 20% are aware of physical activity recommendation for paediatric patients, whereas 31% know that very light-intensity physical activity promotes health-related beneficial effects. Year of graduation, having been trained on physical activity prescription, and regularly recommending physical activity to patients did not associate with the overall score of correct answers (OR: 1.00 [0.99, 1.02], p = 0.391; OR: 0.99 [0.69, 1.44], p = 983; OR: 0.90 [0.61, 1.32], p = 0.576; respectively). Rheumatologists are highly willing to promote physical activity, but major gaps in their knowledge were identified. Given the widespread recognition of physical activity as a key element on the management of rheumatic patients, these data hint to the need of incorporating physical activity in the rheumatologist' training.
- Exercise training attenuates insulin resistance and improves beta-cell function in patients with systemic autoimmune myopathies: a pilot study(2019) OLIVEIRA, Diego Sales de; BORGES, Isabela Bruna Pires; SOUZA, Jean Marcos de; GUALANO, Bruno; PEREIRA, Rosa Maria Rodrigues; SHINJO, Samuel KatsuyukiIntroduction/objectives To assess the effects of exercise training on insulin resistance and beta-cell function in patients with systemic autoimmune myopathies (SAMs). Method This quasi-experimental, prospective study includes 9 patients with SAMs (six with dermatomyositis, two with antisynthetase syndrome, and one with polymyositis). Patients were submitted to a 12-week, twice a week, exercise training program comprising aerobic and resistance exercises. Baseline and after the intervention, we evaluated disease status, aerobic capacity, muscle strength, body composition, insulin resistance, and beta-cell function parameters. Results The patients have a mean age of 46.7 years and stable disease. No clinical or laboratory parameter impairment was observed after the intervention. Compared with baseline, aerobic capacity, muscle strength, and function increased after 12 weeks (P < 0.05), while no changes were observed for body composition. Data from the oral glucose tolerance test showed that exercise did not change glucose area under the curve (AUC), whereas insulin and C-peptide AUC decreased significantly (P < 0.05). Furthermore, Matsuda index and HOMA2 percentage (both surrogates of insulin resistance) also improved (P < 0.05). Conclusion Exercise training improved aerobic capacity, muscle strength, and muscle function in patients with SAMs. In addition, exercise training led to an attenuation of insulin resistance and improvements in beta-cell function parameters. These data indicate that exercise training can mitigate metabolic impairments, attenuating the cardiovascular risk in SAMs.
- Effects of a lifestyle intervention on cardiovascular risk factors in systemic lupus erythematosus patients: The study ""Living well with lupus""(2024) SIECZKOWSKA, Sofia Mendes; MAZZOLANI, Bruna Caruso; SMAIRA, Fabiana Infante; ROMERO, Marina; PASOTO, Sandra Gofinet; PINTO, Ana Lucia de Sa; LIMA, Fernanda Rodrigues; OLIVEIRA, Victor Rodrigues De; UEDA, Serli; BENATTI, Fabiana Braga; ROSCHEL, Hamilton; GUALANO, BrunoObjectiveThe aim of the present study was to investigate the effects of a lifestyle intervention on cardiometabolic risk factors in patients with systemic lupus erythematosus with a high cardiovascular risk profile.MethodsThis trial was conducted in Sao Paulo, Brazil between August 2020 and March 2023. The patients were randomly assigned to lifestyle intervention or control. The intervention was a 6-month multifaced program focused on behavioral changes through personalized recommendations for increasing physical activity (structured and non-structured) and improving eating aspects. Cardiometabolic risk score (primary outcome), anthropometry and visceral fat, aerobic capacity, blood pressure, inflammatory and oxidative stress markers, and blood flow and endothelial function were assessed before and after the intervention.ResultsA total of 80 patients were randomized. Twelve and 6 patients dropped out due to personal reasons in the intervention and control groups, respectively. Average adherence rate for the intervention was 56.9%. Intention-to-treat analysis showed no significant difference between groups in the cardiometabolic risk score (intervention group - Pre: 1.7 +/- 3.6; Post: -1.6 +/- 4.0; control group - Pre: -1.9 +/- 3.6; Post: -2.0 +/- 3.8; estimated mean difference between groups at post: -0.4; 95% confidence intervals: -2.7; 1.9; p = 0.96). This finding was confirmed by exploratory, per-protocol analysis. No significant differences were observed between adherents vs. non-adherent participants. Secondary outcomes did not change between groups.ConclusionThis 6-month, individualized, lifestyle intervention did not improve cardiovascular risk factors in SLE patients with a high cardiovascular risk profile.Trial Registration:clinicaltrials.gov (NCT04431167).ConclusionThis 6-month, individualized, lifestyle intervention did not improve cardiovascular risk factors in SLE patients with a high cardiovascular risk profile.Trial Registration:clinicaltrials.gov (NCT04431167).