HAMILTON AUGUSTO ROSCHEL DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
EFE, EEFE - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
49 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 49
- Juvenile fibromyalgia syndrome: Blunted heart rate response and cardiac autonomic dysfunction at diagnosis(2016) MAIA, Magda M.; GUALANO, Bruno; SA-PINTO, Ana L.; SALLUM, Adriana M. E.; PEREIRA, Rosa M. R.; LEN, Claudio A.; TERRERI, Maria T. A.; BARBOSA, Cassia M.; ROSCHEL, Hamilton; SILVA, Clovis A.Objective: To assess aerobic capacity and cardiac autonomic modulation in juvenile fibromyalgia syndrome (JFM) patients at diagnosis in response to graded exercise text. Methods: A multicenter cross-sectional study included 25 JFM patients and 25 healthy controls. Both groups participated only in physical education classes at school. A treadmill graded cardiorespiratory test was performed and the heart-rate (HR) response during exercise was evaluated by the chronotropic reserve (CR). Pain, functional ability, and health-related quality of life (HRQL) were assessed. Results: The median current age was similar in JFM and controls (15 vs. 15 years, p = 0.890), as well as body mass index (p = 0.332), female gender (p = 1.000), and Tanner stages (p = 0.822). The medians of HRQL parameters (total score/physical health/psychosocial health) were significantly lower in JFM vs. controls according to patient and parent self-reports (p < 0.001). The median of peak HR [181 (150-198) vs. 197 (181-202) bpm, p < 0.001], chronotropic reserve [84 (53-98) vs. 99 (84-103)%, p < 0.001], and resting to peal< [96 (65-181) vs. 127 (61-185) bpm, p = 0.010] were significantly lower in JFM compared to controls. The median of Delta EIRR1 [15 (3-39) vs. 35 (9-52) bpm, p < 0.0011, Delta FIRR2 [37 (20-57) vs. 51 (32-94) bpm, p < 0.001], peak VO2 [32.34 (24.24-39.65) vs. 36A (28.56-52.71) ml/kg/min, p = 0.005], peak speed [5 (4-6.3) vs. 5.9 (4.0-6.3) mph, p = 0.001], time to exhaustion [11.5 (8.5-14.5) vs. 14 (11-18) min, p < 0.0011, and working capacity on power [3.37 (2.04-5.6) vs. 3.89 (2.91-6.55) W/kg, p = 0.006] were significantly lower in JFM compared to controls. The frequency of chronotropic incompetence (<= 80%) was significantly higher in JFM vs. controls (p = 0.0006). Conclusions: This study identified chronotropic incompetence and delayed HR recovery in JFM patients, indicating autonomic dysfunction. Aerobic exercise training should be considered in all JFM patients and may improve cardiac autonomic impairment, thus reducing cardiovascular risk.
- Exercise-Induced Increases in Insulin Sensitivity After Bariatric Surgery Are Mediated By Muscle Extracellular Matrix Remodeling (vol 69, pg 1675, 2020)(2021) DANTAS, Wagner S.; ROSCHEL, Hamilton; MURAI, Igor H.; GIL, Saulo; DAVULURI, Gangarao; AXELROD, Christopher L.; GHOSH, Sujoy; NEWMAN, Susan S.; ZHANG, Hui; SHINJO, Samuel K.; NEVES, Willian das; MEREGE-FILHO, Carlos; TEODORO, Walcy R.; CAPELOZZI, Vera L.; PEREIRA, Rosa Maria; BENATTI, Fabiana B.; SA-PINTO, Ana L. de; CLEVA, Roberto de; SANTO, Marco A.; KIRWAN, John P.; GUALANO, Bruno
- GLUT4 translocation is not impaired after acute exercise in skeletal muscle of women with obesity and polycystic ovary syndrome(2015) DANTAS, Wagner Silva; MARCONDES, Jose Antonio Miguel; SHINJO, Samuel Katsuyuki; PERANDINI, Luiz Augusto; ZAMBELLI, Vanessa Olzon; NEVES, Willian Das; BARCELLOS, Cristiano Roberto Grimaldi; ROCHA, Michele Patrocinio; YANCE, Viviane Dos Reis Vieira; PEREIRA, Renato Tavares Dos Santos; MURAI, Igor Hisashi; PINTO, Ana Lucia De Sa; ROSCHEL, Hamilton; GUALANO, BrunoObjectiveThe aim of this study was to examine the effects of acute exercise on insulin signaling in skeletal muscle of women with polycystic ovary syndrome (PCOS) and controls (CTRL). MethodsFifteen women with obesity and PCOS and 12 body mass index-matched CTRL participated in this study. Subjects performed a 40-min single bout of exercise. Muscle biopsies were performed before and 60 min after exercise. Selected proteins were assessed by Western blotting. ResultsCTRL, but not PCOS, showed a significant increase in PI3-k p85 and AS160 Thr 642 after a single bout of exercise (P=0.018 and P=0.018, respectively). Only PCOS showed an increase in Akt Thr 308 and AMPK phosphorylation after exercise (P=0.018 and P=0.018, respectively). Total GLUT4 expression was comparable between groups (P>0.05). GLUT4 translocation tended to be significantly higher in both groups after exercise (PCOS: P=0.093; CTRL: P=0.091), with no significant difference between them (P>0.05). ConclusionsA single bout of exercise elicited similar GLUT4 translocation in skeletal muscle of PCOS and CTRL, despite a slightly differential pattern of protein phosphorylation. The absence of impairment in GLUT4 translocation suggests that PCOS patients with obesity and insulin resistance may benefit from exercise training.
- Exercise Enhances the Effect of Bariatric Surgery in Markers of Cardiac Autonomic Function(2021) GIL, Saulo; PECANHA, Tiago; DANTAS, Wagner S.; MURAI, Igor Hisashi; MEREGE-FILHO, Carlos Alberto Abujabra; SA-PINTO, Ana Lucia de; PEREIRA, Rosa Maria Rodrigues; CLEVA, Roberto de; SANTO, Marco Aurelio; REZENDE, Diego Augusto Nunes; KIRWAN, John P.; GUALANO, Bruno; ROSCHEL, HamiltonBackground Bariatric surgery improves cardiovascular health, which might be partly ascribed to beneficial alterations in the autonomic nervous system. However, it is currently unknown whether benefits from surgery on cardiac autonomic regulation in post-bariatric patients can be further improved by adjuvant therapies, namely exercise. We investigated the effects of a 6-month exercise training program on cardiac autonomic responses in women undergoing bariatric surgery. Methods Sixty-two women eligible for bariatric surgery were randomly allocated to either standard of care (control) or an exercise training intervention. At baseline (PRE) and 3 (POST3) and 9 (POST9) months after surgery, we assessed chronotropic response to exercise (CR%; i.e., percentage change in heart rate from rest to peak exercise) and heart rate recovery (HRR30s, HRR60s, and HRR120s; i.e., decay of heart rate at 30, 60, and 120 s post exercise) after a maximal exercise test. Results Between-group absolute changes revealed higher CR% (Delta = 8.56%, CI95% 0.22-19.90, P = 0.04), HRR30s (Delta = 12.98 beat/min, CI95% 4.29-21.67, P = 0.01), HRR60s (Delta = 22.95 beat/min, CI95% 11.72-34.18, P = 0.01), and HRR120s (Delta = 34.54 beat/min, CI95% 19.91-49.17, P < 0.01) in the exercised vs. non-exercised group. Conclusions Our findings demonstrate that exercise training enhanced the benefits of bariatric surgery on cardiac autonomic regulation. These results highlight the relevance of exercise training as a treatment for post-bariatric patients, ensuring optimal cardiovascular outcomes.
- 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, HamiltonIntroduction: 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.
- Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial(2019) MURAI, Igor H.; ROSCHEL, Hamilton; DANTAS, Wagner S.; GIL, Saulo; MEREGE-FILHO, Carlos; CLEVA, Roberto de; SA-PINTO, Ana L. De; LIMA, Fernanda; SANTO, Marco A.; BENATTI, Fabiana B.; KIRWAN, John P.; PEREIRA, Rosa M.; GUALANO, BrunoContext: Bone loss after bariatric surgery potentially could be mitigated by exercise. Objective: To investigate the role of exercise training (ET) in attenuating bariatric surgery-induced bone loss. Design: Randomized, controlled trial. Setting: Referral center for bariatric surgery. Patients: Seventy women with severe obesity, aged 25 to 55 years, who underwent Roux-en-Y gastric bypass (RYGB). Intervention: Supervised, 6-month, ET program after RYGB vs. standard of care (RYGB only). Outcomes: Areal bone mineral density (aBMD) was the primary outcome. Bone microarchitecture, bone turnover, and biochemical markers were secondary outcomes. Results: Surgery significantly decreased femoral neck, total hip, distal radius, and whole body aBMD (P < 0.001); and increased bone turnover markers, including collagen type I C-telopeptide (CTX), procollagen type I N-propeptide (P1NP), sclerostin, and osteopontin (P < 0.05). Compared with RYGB only, exercise mitigated the percent loss of aBMD at femoral neck [estimated mean difference (EMD), -2.91%; P = 0.007;], total hip (EMD, -2.26%; P = 0.009), distal radius (EMD, -1.87%; P = 0.038), and cortical volumetric bone mineral density at distal radius (EMD, -2.09%; P = 0.024). Exercise also attenuated CTX (EMD, -0.20 ng/mL; P = 0.002), P1 NP (EMD, -17.59 ng/mL; P = 0.024), and sclerostin levels (EMD, -610 pg/mL; P = 0.046) in comparison with RYGB. Exercise did not affect biochemical markers (e.g., 25(OH)D, calcium, intact PTH, phosphorus, and magnesium). Conclusion: Exercise mitigated bariatric surgery-induced bone loss, possibly through mechanisms involving suppression in bone turnover and sclerostin. Exercise should be incorporated in postsurgery care to preserve bone mass.
- Randomized clinical trial: benefits of aerobic physical activity for 24 weeks in postmenopausal women with nonalcoholic fatty liver disease(2016) REZENDE, Rosamar E. F.; DUARTE, Sebastiao M. B.; STEFANO, Jose T.; ROSCHEL, Hamilton; GUALANO, Bruno; PINTO, Ana L. de Sa; VEZOZZO, Denise C. P.; CARRILHO, Flair J.; OLIVEIRA, Claudia P.Objective: The aim of the study was to evaluate the effectiveness of aerobic physical activity in reducing the frequency of hepatic steatosis and metabolic and cardiovascular risk in postmenopausal women with nonalcoholic fatty liver disease (NAFLD). Methods: Forty sedentary postmenopausal women (mean age 55.3 +/- 8.0 y) with biopsy-proven NAFLD were randomly divided into two groups: an exercising group (19 participants) and a control group (nonexercising, 21 participants). The exercise group underwent a supervised aerobic physical activity program of 120 min/wk for 24 weeks. The anthropometric parameters; body composition; hepatic, lipid, and glycemic profiles; homeostasis model assessment of insulin resistance index; cytokines; transient elastography (FibroScan; liver stiffness/controlled attenuation parameter); and cardiopulmonary exercise test were evaluated at baseline and after 24 weeks of protocol. Results: At baseline there were no significant differences in anthropometric, metabolic, and inflammatory parameters-stiffness and liver fat content by FibroScan between the groups. After 24 weeks, we observed a decrease of waist circumference, an increase of high-density lipoprotein cholesterol levels (P < 0.05), and improved cardiopulmonary functional capacity in the exercise group. In addition, the controlled attenuation parameter analysis showed no significant decrease of hepatic steatosis in the exercise group. With regard to the systemic inflammation, there were, however, no significant differences in the cytokines between the groups. Conclusions: An aerobic physical activity program of 24 weeks in NAFLD postmenopausal women showed improvement in some variables such as waist circumference, high-density lipoprotein cholesterol, and cardiopulmonary performance that may be beneficial in improving cardiovascular risk factors in this population.
- 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.
- Acute cardiometabolic effects of brief active breaks in sitting for patients with rheumatoid arthritis(2021) PINTO, Ana J.; MEIRELES, Kamila; PECANHA, Tiago; MAZZOLANI, Bruna C.; I, Fabiana Smaira; REZENDE, Diego; BENATTI, Fabiana B.; RIBEIRO, Ana C. M.; PINTO, Ana L. S.; LIMA, Fernanda R.; SHINJO, Samuel K.; DANTAS, Wagner S.; MELLETT, Natalie A.; MEIKLE, Peter J.; OWEN, Neville; DUNSTAN, David W.; ROSCHEL, Hamilton; GUALANO, BrunoExercise is a treatment in rheumatoid arthritis, but participation in moderate-to-vigorous exercise is challenging for some patients. Light-intensity breaks in sitting could be a promising alternative. We compared the acute effects of active breaks in sitting with those of moderate-to-vigorous exercise on cardiometabolic risk markers in patients with rheumatoid arthritis. In a crossover fashion, 15 women with rheumatoid arthritis underwent three 8-h experimental conditions: prolonged sitting (SIT), 30-min bout of moderate-to-vigorous exercise followed by prolonged sitting (EX), and 3-min bouts of light-intensity walking every 30 min of sitting (BR). Postprandial glucose, insulin, c-peptide, triglycerides, cytokines, lipid classes/subclasses (lipidomics), and blood pressure responses were assessed. Muscle biopsies were collected following each session to assess targeted proteins/genes. Glucose [-28% in area under the curve (AUC), P = 0.036], insulin (-28% in AUC, P = 0.016), and c-peptide (-27% in AUC, P = 0.006) postprandial responses were attenuated in BR versus SIT, whereas only c-peptide was lower in EX versus SIT (-20% in AUC, P = 0.002). IL-1 beta decreased during BR, but increased during EX and SIT (P = 0.027 and P = 0.085, respectively). IL-1ra was increased during EX versus BR (P = 0.002). TNF-alpha concentrations decreased during BR versus EX (P = 0.022). EX, but not BR, reduced systolic blood pressure (P = 0.013). Lipidomic analysis showed that 7 of 36 lipid classes/subclasses were significantly different between conditions, with greater changes being observed in EX. No differences were observed for protein/gene expression. Brief active breaks in sitting can offset markers of cardiometabolic disturbance, which may be particularly useful for patients who may find it difficult to adhere to exercise. NEW & NOTEWORTHY Exercise is a treatment in rheumatoid arthritis but is challenging for some patients. Light-intensity breaks in sitting could be a promising alternative. Our findings show beneficial, but differential, cardiometabolic effects of active breaks in sitting and exercise in patients with rheumatoid arthritis. Breaks in sitting mainly improved glycemic and inflammatory markers, whereas exercise improved lipidomic and hypotensive responses. Breaks in sitting show promise in offsetting aspects of cardiometabolic disturbance associated with prolonged sitting in rheumatoid arthritis.
- 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 SaThe 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).