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
8 resultados
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- 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.
- 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.
- Poor agreement of objectively measured and self-reported physical activity in juvenile dermatomyositis and juvenile systemic lupus erythematosus(2016) PINTO, Ana Jessica; ROSCHEL, Hamilton; BENATTI, Fabiana Braga; PINTO, Ana Lcia de Sa; SALLUM, Adriana Maluf Elias; SILVA, Clovis Arthur; GUALANO, BrunoTo examine the agreement and association between objectively measured and indirectly assessed physical activity levels in patients with juvenile dermatomyositis (JDM) and juvenile systemic lupus erythematosus (JSLE) patients. The sample consisted of 19 JDM patients (age 8 to 22 years) and 20 JSLE patients (age 9 to 18 years). Physical activity level was objectively measured using ActigraphA (R) accelerometers and indirectly assessed by the short-form International Physical Activity Questionnaire (IPAQ). Spearman's correlation coefficients were calculated to test possible associations between physical activity levels across the two instruments. The Bland-Altman technique was used to calculate bias and limits of agreement. Correlations between objectively measured and indirectly assessed physical activity levels in JDM and JSLE were weak, varying from R = 0.03 to R = 0.33 (all p > 0.05). Total physical activity was correlated between accelerometer and IPAQ in JSLE (R = 0.51, p = 0.021). Bland-Altman analyses suggested that IPAQ tended to highly underestimate sedentary time and light physical activity in JDM (mean bias 105.7 and 199.8 min, respectively) and JSLE (mean bias 36.4 and 127.8 min, respectively). Mean biases of moderate-to-vigorous physical activity were also highly variable, ranging from -42.9 to 54.9 min and -59.4 to 89.8 min for JDM and JSLE, respectively. IPAQ was shown to not be valid to assess physical activity levels in patients with JDM and JSLE when compared against accelerometry. While the validation of reliable self-reported instruments that measure physical activity in pediatric rheumatic patients remains necessary, the use of validated tools that objectively measure physical activity is recommended in both clinical and research settings.
- GLUT4 Translocation is not Impaired After Acute Exercise in Skeletal Muscle of Women with Obesity and Polycystic Ovary Syndrome (vol 23, pg 2207, 2015)(2016) 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, Bruno
article 14 Citação(ões) na Scopus Effects of acute aerobic exercise on leukocyte inflammatory gene expression in systemic lupus erythematosus(2016) PERANDINI, L. A.; SALES-DE-OLIVEIRA, D.; ALMEIDA, D. C.; AZEVEDO, H.; MOREIRA-FILHO, C. A.; CENEDEZE, M. A.; BENATTI, F. B.; LIMA, F. R.; BORBA, E.; BONFA, E.; SA-PINTO, A. L.; ROSCHEL, H.; CAMARA, N. O.; GUALANO, B.Systemic lupus erythematosus (SLE) is an autoimmune disease with a persistent systemic inflammation. Exercise-induced inflammatory response in SLE remains to be fully elucidated. The aim of this study was to assess the effects of acute exercise on leukocyte gene expression in active (SLEACTIVE) and inactive SLE (SLEINACTIVE) patients and healthy controls (HC). Methods: All subjects (n = 4 per group) performed a 30-min single bout of acute aerobic exercise (similar to 70% of VO2 peak) on a treadmill, and blood samples were collected for RNA extraction from circulating leukocyte at baseline, at the end of exercise, and after three hours of recovery. The expression of a panel of immune-related genes was evaluated by a quantitative PCR array assay. Moreover, network-based analyses were performed to interpret transcriptional changes occurring after the exercise challenge. Results: In all groups, a single bout of acute exercise led to the down-regulation of the gene expression of innate and adaptive immunity at the end of exercise (e.g., TLR3, IFNG, GATA3, FOXP3, STAT4) with a subsequent up-regulation occurring upon recovery. Exercise regulated the expression of inflammatory genes in the blood leukocytes of the SLE patients and HC, although the SLE groups exhibited fewer modulated genes and less densely connected networks (number of nodes: 29, 40 and 58; number of edges: 29, 60 and 195; network density: 0.07, 0.08 and 0.12, for SLEACTIVE, SLEINACTIVE and HC, respectively). Conclusion: The leukocytes from the SLE patients, irrespective of disease activity, showed a down-regulated inflammatory gene expression immediately after acute aerobic exercise, followed by an up-regulation at recovery. Furthermore, less organized gene networks were observed in the SLE patients, suggesting that they may be deficient in triggering a normal exercise-induced immune transcriptional response.- RESISTANCE TRAINING AND CO-SUPPLEMENTATION WITH CREATINE AND PROTEIN IN OLDER SUBJECTS WITH FRAILTY(2016) COLLINS, J.; LONGHURST, G.; ROSCHEL, H.; GUALANO, B.Background: Studies assessing the effects co-supplementation with creatine and protein, along with resistance training, in older individuals with frailty are lacking. Objectives: This is an exploratory trial from the Pro-Elderly study (""Protein Intake and Resistance Training in Aging"") aimed at gathering knowledge on the feasibility, safety, and efficacy of co-supplementation with creatine and protein supplementation, combined with resistance training, in older individuals with frailty. Design: A 14-week, double-blind, randomized, parallel-group, placebo controlled exploratory trial. Setting, participants: The subjects were randomly assigned to whey protein and creatine co-supplementation (WHEY+CR) or whey protein supplementation (WHEY) group. All subjects undertook a supervised exercise training program and were assessed at baseline and after 14 weeks. Measurements: Muscle function, body composition, blood parameters, and self-reported adverse events were assessed. Results: No interaction effects (between-group differences) were observed for any dependent variables (p > 0.05 for all). However, there were main time-effects in handgrip (WHEY+CR = 26.65 +/- 31.29; WHEY = 13.84 +/- 14.93 Kg; p = 0.0005), timed-up-and-go (WHEY+CR = -11.20 +/- 9.37; WHEY = -17.76 +/- 21.74 sec; p = 0.006), and timed-stands test (WHEY+CR = 47.50 +/- 35.54; WHEY = 46.87 +/- 24.23 reps; p = 0.0001), suggesting that WHEY+CR and WHEY were similarly effective in improving muscle function. All of the subjects showed improvements in at least two of the three functional tests, regardless of their treatments. Body composition and blood parameters were not changed (p > 0.05). No severe adverse effects were observed. Conclusions: Co-supplementation with creatine and whey protein was well-tolerable and free of adverse events in older subjects with frailty undertaking resistance training. Creatine supplementation did not augment the adaptive effects of resistance training along with whey protein on body composition or muscle function in this population.
- Poor muscle strength and function in physically inactive childhood-onset systemic lupus erythematosus despite very mild disease(2016) PINTO, Ana Jessica; BENATTI, Fabiana Braga; ROSCHEL, Hamilton; PINTO, Ana Lucia de Sa; SILVA, Clovis Artur; SALLUM, Adriana Maluf Elias; GUALANO, BrunoObjective: To compare muscle strength (i.e. lower- and upper-body strength) and function between physically inactive childhood-onset systemic lupus erythematosus patients (C-SLE) and healthy controls (CTRL). Methods: This was a cross-sectional study and the sample consisted of 19 C-SLE (age between 9 and 18 years) and 15 CTRL matched by age, sex, body mass index (BMI), and physical activity levels (assessed by accelerometry). Lower- and upper-body strength was assessed by the one-repetition-maximum (1-RM) test. Isometric strength was assessed through a handgrip dynamometer. Muscle function was evaluated by the timed-stands test (TST) and the timed-up-and-go test (TUG). Results: When compared with CTRL, C-SLE showed lower leg-press and bench-press 1-RM (p = 0.026 and p = 0.008, respectively), and a tendency toward lower handgrip strength (p = 0.052). C-SLE showed lower TST scores (p = 0.036) and a tendency toward higher TUG scores (p = 0.070) when compared with CTRL. Conclusion: Physically inactive C-SLE patients with very mild disease showed reduced muscle strength and functionality when compared with healthy controls matched by physical activity levels. These findings suggest C-SLE patients may greatly suffer from a physically inactive lifestyle than healthy controls do. Moreover, some sub-clinical ""residual"" effect of the disease or its pharmacological treatment seems to affect C-SLE patients even with a well-controlled disease. (C) 2016 Elsevier Editora Ltda.
- Physical (in)activity and its influence on disease-related features, physical capacity, and health-related quality of life in a cohort of chronic juvenile dermatomyositis patients(2016) PINTO, Ana Jessica; SOLIS, Marina Yazigi; PINTO, Ana Lucia de Sa; SILVA, Clovis Artur; SALLUM, Adriana Maluf Elias; ROSCHEL, Hamilton; GUALANO, BrunoObjectives: To objectively measure physical activity levels in a cohort of juvenile dermatomyositis (JDM) patients; to compare physical capacity and health-related quality of life in JDM patients and their healthy controls (CTRL) matched by physical activity levels; and to associate physical activity variables with disease-related parameters, physical capacity, and health-related quality of life. Methods: This was a cross-sectional study in which 19 JDM patients and 19 CTRL matched by physical activity levels, age, sex, and body mass index were compared. Physical activity was objectively measured using accelerometers. Results: In our cohort, only one of the 19 JDM patients (5%) achieved the minimum recommended moderate-to-vigorous physical activity levels (MVPA) (i.e., minimum of 60 min/day). JDM showed lower aerobic condition (e.g., VO2peak), muscle function (e.g., timed-stands test), and health-related quality of life in comparison to CTRL (p < 0.05). Sedentary time was positively correlated with disease duration (r = 0.649; p = 0.003), and negatively with VO2peak (r = -0.459; p = 0.048). Moreover, MVPA was negatively associated with disease duration (r = -0.509; p = 0.026), and positively associated with VO2peak (r = 0.797; p < 0.001), and current use of corticoid (r = 0.748; p < 0.001). Conclusion: Physical capacity and health-related quality of life were reduced in JDM patients when compared with CTRL matched by physical activity levels, suggesting that the disease itself and/or glucocorticoid use may adversely affect overall health in JDM, despite an apparently well-controlled disease. Physical (in)activity correlated with important disease-related and physical capacity parameters, suggesting that sedentary lifestyle may be an important, but preventable, factor associated with poor overall health in JDM.