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
38 resultados
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- It is over there, next to that fat lady: a qualitative study of fat women's own body perceptions and weight-related discriminations(2020) ULIAN, Mariana Dimitrov; SATO, Priscila de Morals; PINTO, Ana Jessica; BENATTI, Fabiana B.; CAMPOS-FERRAZ, Patricia Lopes de; COELHO, Desire; ROBLE, Odilon J.; SABATINI, Fernanda; PEREZ, Isabel; ABURAD, Luiz; VESSONI, Andre; UNSAIN, Ramiro Fernandez; GUALANO, Bruno; SCAGLIUSI, Fernanda B.We investigated fat women's perceptions of their own bodies and their experiences with weight-related discriminations, and how these situations affected their well-being. Thirty-nine obese women were interviewed, and three axes of analysis were identified: (1) repercussions of being fat, (2) living with a fat body, and (3) am I a person or just a fat body? These axes were composed of eight themes which had similar meaning or complemented each other. The results showed our participants had mechanisms to diminish the magnitude of their stigmatized bodies (e.g., attempting to lose weight and changing their current food choices). Participants also reported being fat had physical and psychological consequences for them. Most notably, their larger bodies influenced their self-evaluation, making them feel devalued, unlovable, incapable, and incomplete. They reported stigmatizing experiences in familiar situations, at the workplace and in public spaces, and reported being stigmatized by both close and unknown individuals, including healthcare professionals. These professionals were reported to treat patients disrespectfully, which urges attention to health care inequalities for obese people. Our results stress stigmatizing attitudes towards fat people and their own considerations about themselves have negative consequences in their physical and mental well-being.
- 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, BrunoSystemic 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.
- Before I Saw a Gas Canister, Now I See a Person: Post Obesity-Intervention Body Acceptance and Responses to Weight Stigma among Urban Brazilian Gorda Women(2020) SCAGLIUSI, Fernanda Baeza; ULIAN, Mariana Dimitrov; GUALANO, Bruno; ROBLE, Odilon Jose; UNSAIN, Ramiro Fernandez; CARRIERS, Maria Regina; SATO, Priscila de Morais; STURTZSREETHARAN, Cindi; BREWIS, Alexandra; WUTICH, AmberWeight stigma is reportedly globalizing, but there is limited evidence of how concerns around weight change are impacting those in many places. Additionally, few studies to date have considered how weight stigma operates in the context of interventions that purposefully eschew from a focus on weight itself. We have used qualitative analysis to examine body acceptance and responses to weight stigma among urban Brazilian gorda women participating in two forms of Health at Every Size (R) (HAES (R)) interventions: an intensive HAES (R) program (I-HAES (R), n=26), which directly addressed weight stigma and a traditional, less-intensive HAES (R) program (CTRL, n=13). Individual, semi-structured interviews regarding how participants felt about their bodies were conducted post-intervention. Exploratory content analysis followed an inductive approach. The I-HAES (R)-group was more prone to accept their bodies, to feel well-being, to do new things, and to give proactive responses to weight stigma, while the CTRL-group internalized and accepted stigma, reported a lack of body acceptance, and indicated they were less able to challenge stigma in their lives. Interdisciplinary, intensive HAES (R) interventions appear able to meaningfully tackle responses to weight stigma and promote body acceptance, important in contexts where stigma is a major component of how women experience their weight.
- Serum cytokines in childhood-Takayasu arteritis: Are they biomarkers for indolent disease activity?(2023) CLEMENTE, Gleice; TERRERI, Maria Teresa; PEREIRA, Rosa M. R.; GUALANO, Bruno; SILVA, Clovis Artur; SOUZA, Alexandre Wagner de
- Disordered Eating Attitudes and Food Choice Motives Among Individuals Who Follow a Vegan Diet in Brazil(2023) MAZZOLANI, Bruna Caruso; SMAIRA, Fabiana Infante; ESTEVES, Gabriel P.; SANTINI, Martin Hindermann; LEITAO, Alice Erwig; ANDRE, Heloisa C. Santo; GUALANO, Bruno; ROSCHEL, HamiltonIMPORTANCE It remains controversial whether adhering to a vegan diet may be associated with a higher prevalence of disordered eating. Also, main food choice motives and their association with disordered eating in this population are still unknown. OBJECTIVE To determine the association between disordered eating attitudes and food choice motives of individuals who follow a vegan diet. DESIGN, SETTING, AND PARTICIPANTS This is a cross-sectional online survey conducted between September 2021 and January 2023. Individuals of both sexes, aged 18 years or older, following a vegan diet for at least 6 months, currently living in Brazil were recruited through advertisements on social media. EXPOSURE Adherence to a vegan diet and food choice motives. MAIN OUTCOMES AND MEASURES Disordered eating attitudes and food choice motives. RESULTS Nine hundred seventy-one participants completed the online survey. Median (IQR) age and BMI of participants was 29 (24-36) years and 22.6 (20.3-24.9), respectively, and 800 participants (82.4%) were female. Most participants (908 respondents [94%]) were categorized with the lowest level of disturbed eating attitudes. ""Need and hunger,"" ""liking,"" ""health,"" ""habits,"" and ""natural concerns"" were the most important food choice motives in this population, while ""affect regulation,"" ""social norms,"" and ""social image"" were the less important ones. Adjusted models showed that ""liking,"" ""need and hunger,"" and ""health"" were associated with lower levels of disordered eating attitudes, while ""price,"" ""pleasure,"" ""sociability,"" ""traditional eating,"" ""visual appeal,"" ""social norms,"" ""social image,"" ""weight control,"" and ""affect regulation"" were associated with higher levels of disordered eating attitudes. CONCLUSIONS AND RELEVANCE In this cross-sectional study, as opposed to previous suggestions, levels of disordered eating were very low among vegans, although certain food choice motives were associated with disordered eating attitudes. Understanding the motivations of adhering to diets that may impose restrictions, which include vegan diets, may help tailor interventions focused on promoting healthy eating and preventing or treating disordered eating.
- Exercise modifies hypothalamic connectivity and brain functional networks in women after bariatric surgery: a randomized clinical trial(2023) MEREGE-FILHO, Carlos A. A.; GIL, Saulo S.; KIRWAN, John P.; MURAI, Igor H.; DANTAS, Wagner S.; NUCCI, Mariana P.; PASTORELLO, Bruno; LIMA, Alisson Padilha de; BAZAN, Paulo R.; PEREIRA, Rosa M. R.; SA-PINTO, Ana L. de; LIMA, Fernanda R.; BRUCKI, Sonia M. D.; CLEVA, Roberto de; SANTO, Marco A.; LEITE, Claudia da Costa; OTADUY, Maria Concepcion Garcia; ROSCHEL, Hamilton; GUALANO, BrunoBackgroundObesity is a disease that may involve disrupted connectivity of brain networks. Bariatric surgery is an effective treatment for obesity, and the positive effects on obesity-related conditions may be enhanced by exercise. Herein, we aimed to investigate the possible synergistic effects of Roux-en-Y Gastric Bypass (RYGB) and exercise training on brain functional networks. MethodsThirty women eligible for bariatric surgery were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 15, age = 41.0 & PLUSMN; 7.3 years) or RYGB plus Exercise Training (RYGB + ET: n = 15, age = 41.9 & PLUSMN; 7.2 years). Clinical, laboratory, and brain functional connectivity parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6-month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). ResultsExercise superimposed on bariatric surgery (RYGB + ET) increased connectivity between hypothalamus and sensorial regions (seed-to-voxel analyses of hypothalamic connectivity), and decreased default mode network (DMN) and posterior salience (pSAL) network connectivity (ROI-to-ROI analyses of brain networks connectivity) when compared to RYGB alone (all p-FDR < 0.05). Increases in basal ganglia (BG) network connectivity were only observed in the exercised training group (within-group analyses). ConclusionExercise training is an important component in the management of post-bariatric patients and may improve the hypothalamic connectivity and brain functional networks that are involved in controlling food intake.
- Oxygen uptake kinetics and chronotropic responses to exercise are impaired in survivors of severe COVID-19(2022) LONGOBARDI, Igor; PRADO, Danilo Marcelo Leite do; GOESSLER, Karla Fabiana; MELETTI, Matheus Molina; OLIVEIRA JUNIOR, Gersiel Nascimento de; ANDRADE, Danieli Castro Oliveira de; GUALANO, Bruno; ROSCHEL, HamiltonThe post-acute phase of coronavirus disease 2019 (COVID-19) is often marked by several persistent symptoms and exertional intolerance, which compromise survivors' exercise capacity. This was a cross-sectional study aiming to investigate the impact of COVID-19 on oxygen uptake (V_O2) kinetics and cardiopulmonary function in survivors of severe COVID-19 about 3-6 mo after in-tensive care unit (ICU) hospitalization. Thirty-five COVID-19 survivors previously admitted to ICU (5 +/- 1 mo after hospital discharge) and 18 controls matched for sex, age, comorbidities, and physical activity level with no prior history of SARS-CoV-2 infection were recruited. Subjects were submitted to a maximum-graded cardiopulmonary exercise test (CPX) with an initial 3-min period of a constant, moderate-intensity walk (i.e., below ventilatory threshold, VT). V_O2 kinetics was remarkably impaired in COVID-19 survivors as evidenced at the on-transient by an 85% (P = 0.008) and 28% (P = 0.001) greater oxygen deficit and mean response time (MRT), respectively. Furthermore, COVID-19 survivors showed an 11% longer (P = 0.046) half-time of recovery of V_O2 (T1/2V_O2) at the off-transient. CPX also revealed cardiopulmonary impairments following COVID-19. Peak oxygen uptake (V_O2peak), percent -predicted V_O2peak, and V_O2 at the ventilatory threshold (V_O2VT) were reduced by 17%, 17%, and 12% in COVID-19 survivors, respec-tively (all P < 0.05). None of the ventilatory parameters differed between groups (all P > 0.05). In addition, COVID-19 survivors also presented with blunted chronotropic responses (i.e., chronotropic index, maximum heart rate, and heart rate recovery; all P < 0.05). These findings suggest that COVID-19 negatively affects central (chronotropic) and peripheral (metabolic) factors that impair the rate at which V_O2 is adjusted to changes in energy demands.
- Home-Based Exercise Training in the Recovery of Multisystem Inflammatory Syndrome in Children: A Case Series Study(2023) ASTLEY, Camilla; LEAL, Gabriela Nunes; GIL, Saulo; SUGUITA, Priscila; FINK, Thais; BAIN, Vera; PEREIRA, Maria Fernanda Badue; MARQUES, Heloisa Helena; SIECZKOWSKA, Sofia; PRADO, Danilo; LIMA, Marcos Santos; CARNEIRO, Camila G.; BUCHPIGUEL, Carlos Alberto; SILVA, Clovis Artur; GUALANO, BrunoObjective: To assess the potential therapeutic role of exercise on health-related quality of life, assessed by the Pediatric Outcomes Data Collection Instrument (PODCI), coronary flow reserve (CFR), cardiac function, cardiorespiratory fitness, and inflammatory and cardiac blood markers in multisystemic inflammatory syndrome in children (MIS-C) patients. Methods: This is a case series study of a 12-wk, home-based exercise intervention in children and adolescents after MIS-C diagnosis. From 16 MIS-C patients followed at our clinic, 6 were included (age: 7-16 years; 3 females). Three of them withdrew before the intervention and served as controls. The primary outcome was health-related quality of life, assessed PODCI. Secondary outcomes were CFR assessed by 13N-ammonia PET-CT imaging, cardiac function by echocardiography, cardiorespiratory fitness, and inflammatory and cardiac blood markers. Results: In general, patients showed poor health-related quality of life, which seemed to be improved with exercise. Additionally, exercised patients showed improvements in coronary flow reserve, cardiac function, and aerobic conditioning. Non-exercised patients exhibited a slower pattern of recovery, particularly in relation to health-related quality of life and aerobic conditioning. Conclusions: Our results suggest that exercise may play a therapeutic role in the treatment of post-discharge MIS-C patients. As our design does not allow inferring causality, randomized controlled trials are necessary to confirm these preliminary findings.
- Impact of COVID-19 on physical and mental functioning in adolescents with disabilities in a sports nongovernmental organization(2023) LAURENTINO, Moises de Freitas; LINDOSO, Livia; ASTLEY, Camilla; LAVORATO, Sofia Simao Martins; IHARA, Bianca Pires; LIMA, Dandara Carvalho Casado de; GUALANO, Bruno; QUEIROZ, Ligia Bruni; PEREIRA, Rosa Maria Rodrigues; POLANCZYK, Guilherme Vanoni; CAMARGO, Olavo Pires de; SILVA, Clovis Artur; GRANGEIRO, Patricia MorenoObjective:This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0-10) vs. 5 (0-10), p=0.018] and prosocial [7 (0-10) vs. 9 (3-10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21-99) vs. 94 (67-100), p<0.001] and higher happiness scores in the PODCI scale [90 (65-100) vs. 80 (0-100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01-1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04-0.43, p=0.001) and screen time >= 3 h/day (OR=0.09; 95%CI 0.02-0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.
- 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, HamiltonBackground 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.