ALBERTO CUKIER
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
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- Identification of functional phenotypes in people with COPD: influence of postural balance, physical activity, sedentary behaviour and quadriceps muscle strength(2019) XAVIER, Rafaella; CAPORALI, Ana Carolina; LOPES, Aline; OLIVEIRA, Cristino; FERNANDES, Frederico; STELMACH, Rafael; PINTO, Regina Carvalho; CUKIER, Alberto; CARVALHO, Celso
- Effects of a behaviour change intervention aimed at increasing physical activity on clinical control of adults with asthma: study protocol for a randomised controlled trial(2019) FREITAS, Patricia D.; XAVIER, Rafaella F.; PASSOS, Natalia F. P.; CARVALHO-PINTO, Regina M.; CUKIER, Alberto; MARTINS, Milton A.; CAVALHERI, Vinicius; HILL, Kylie; STELMACH, Rafael; CARVALHO, Celso R. F.Background: In adults with asthma, physical activity has been associated with several asthma outcomes. However, it is unclear whether changes in physical activity, measured via an accelerometer, have an effect on asthma control. The objective of the present study is, in adults with moderate-to-severe asthma, to investigate the effects of a behaviour change intervention, which aims to increase participation in physical activity, on asthma clinical control. Methods: This is a single-blind (outcome assessor), two-arm, randomised controlled trial (RCT). Fifty-five participants with moderate-to-severe asthma, receiving optimized pharmacological treatment, will be randomly assigned (computer-generated) into either a Control Group (CG) or an Intervention Group (IG). Both groups will receive usual care (pharmacological treatment) and similar educational programmes. In addition to these, participants in the IG will undergo the behaviour change intervention based on feedback, which aims to increase participation in physical activity. This intervention will be delivered over eight sessions as weekly one-on-one, face-to-face 40-min consultations. Both before and following the completion of the intervention period, data will be collected on asthma clinical control, levels of physical activity, health-related quality of life, asthma exacerbation and levels of anxiety and depression symptoms. Anthropometric measurements will also be collected. Information on comorbidities, lung function and the use of asthma medications will be extracted from the participant's medical records. Discussion: If successful, this study will demonstrate that, in adults with asthma, a behavioural change intervention which aims to increase participation in physical activity also affects asthma control.
conferenceObject Dynamic Hyperinflation and Exercise Performance in Non-Cystic Fibrosis Bronchiectasis: Clinical, Radiological and Functional Correlations(2019) MAIORANO, M. C.; FERNANDES, F. L. A.; SALGE, J. M.; STELMACH, R.; CUKIER, A.; ATHANAZIO, R. A.- Identification of Phenotypes in People with COPD: Influence of Physical Activity, Sedentary Behaviour, Body Composition and Skeletal Muscle Strength(2019) XAVIER, Rafaella F.; PEREIRA, Ana Carolina A. C.; LOPES, Aline C.; CAVALHERI, Vinicius; PINTO, Regina M. C.; CUKIER, Alberto; RAMOS, Ercy M. C.; CARVALHO, Celso R. F.Introduction People with chronic obstructive pulmonary disease (COPD) present high prevalence of physical inactivity that leads to a negative effect on health-related quality of life (HRQoL). The present study investigated COPD phenotypes according to their levels of physical activity and sedentary behaviour, as well as body composition and skeletal muscle strength. Methods This is an observational and cross-sectional study. Anthropometric data and COPD clinical control were collected and all participants underwent assessments of lung function, HRQoL, dyspnoea, levels of physical activity and sedentary behaviour, body composition and skeletal muscle strength. Participants were classified using hierarchical cluster analysis. Age, dyspnoea and obstruction (ADO) index was used to determine prognosis and calculated for each cluster. Results One hundred and fifty-two participants were included. Three distinct phenotypes were identified. Participants in phenotype 1 were more physically active, less sedentary and had better body composition and lower ADO index (p < 0.0001 for all variables). Overall, participants in phenotypes 2 and 3 were less physically active, more sedentary having a higher ADO index. However, participants in phenotype 2 were older, whereas participants in phenotype 3 had worse HRQoL, clinical control and body composition. Lung function did not differ across the three phenotypes. Conclusions Our results show that physical activity, sedentary behaviour and body composition should be considered to determine phenotypes in people with COPD and are involved in the prognosis of the disease. Less sedentary patients have better prognosis while age, body composition and clinical control seems to differentiate physically inactive patients.
- Effects of the elastic tape on thoracoabdominal mechanic, dyspnea, exercise capacity and physical activity level in patients with COPD(2019) PINTO, Thiago Fernandes; XAVIER, Rafaella Fagundes; LUNARDI, Adriana; BERTO, Cibele; CUKIER, Alberto; STELMACH, Rafael; PINTO, Regina Carvalho; MORIYA, Henrique Takashi; VITORASSO, Renato De Lima; SILVA, Ronaldo; AMATO, Marcelo Brito Passos; CARVALHO, Celso Ricardo Fernandes
- Exploratory analysis of requests for authorization to dispense high-cost medication to COPD patients: the Sao Paulo ""protocol""(2019) CARVALHO-PINTO, Regina Maria; SILVA, Ingredy Tavares da; NAVACCHIA, Lucas Yoshio Kido; GRANJA, Flavia Munhos; MARQUES, Gustavo Garcia; NERY, Telma de Cassia dos Santos; FERNANDES, Frederico Leon Arrabal; CUKIER, Alberto; STELMACH, RafaelObjective: A resolution passed by the government of the Brazilian state of Sao Paulo established a protocol for requesting free COPD medications, including tiotropium bromide, creating regional authorization centers to evaluate and approve such requests, given the high cost of those medications. Our objective was to analyze the requests received by an authorization center that serves cities in the greater metropolitan area of (the city of) Sao Paulo between 2011 and 2016. Methods: Data regarding the authorization, return, or rejection of the requests were compiled and analyzed in order to explain those outcomes. Subsequently, the clinical and functional data related to the patients were evaluated. Results: A total of 7,762 requests for dispensing COPD medication were analyzed. Requests related to male patients predominated. Among the corresponding patients, the mean age was 66 years, 12% were smokers, 88% had frequent exacerbations, and 84% had severe/very severe dyspnea. The mean FEV1 was 37.2% of the predicted value. The total number of requests decreased by 24.5% from 2012 to 2013 and was lowest in 2015. Most (65%) of the requests were accepted. The main reasons for the rejection/return of a request were a post-bronchodilator FEV1/FVC ratio > 0.7, a post-bronchodilator FEV1 > 50% of the predicted value, and failure to provide information regarding previous use of a long-acting beta(2) agonist. During the study period, the total number of requests returned/rejected decreased slightly, and there was improvement in the quality of the data included on the forms. Conclusions: Here, we have identified the characteristics of the requests for COPD medications and of the corresponding patients per region served by the authorization center analyzed, thus contributing to the improvement of local public health care measures.
- Effects of a behaviour change intervention aimed at increasing physical activity on clinical control of adults with asthma: an RCT(2019) FREITAS, Patricia Duarte; PASSOS, Natalia F. P.; CARVALHO-PINTO, Regina M.; CUKIER, Alberto; CAVALHERI, Vinicius; HILL, Kylie; STELMACH, Rafael; CARVALHO, Celso R. F.
- Impact of polymorphisms in genes involved in nicotine dependence pathways on the smoking burden of COPD patients(2019) SILVA, Isadora Costa Da; FERNANDES, Frederico Leon Arrabal; DINARDO, Carla Luana; CARVALHO-PINTO, Regina Maria; FARIAS, Camila; CUKIER, Alberto
- Daily symptom variability in patients with stable COPD in Brazil(2019) PENHA, Marcio; MENEZES, Ana Maria Baptista; GODOY, Irma; COSTA, Claudia Henrique; RUBIN, Adalberto; GREGORIO, Marcelo; LIMA, Marina; ALBUQUERQUE NETO, Aldo; PEREIRA, Monica Corso; TANNI, Suzana; ATHANAZIO, Rodrigo; BESSA, Elizabeth; WEHRMEISTER, Fernando; LOURENCO, Cristina; CUKIER, Alberto
- Seasonal changes influence the improvement in asthma symptoms by exercise training in subjects with asthma**(2019) MENDES, Felipe A. R.; FRANCA-PINTO, Andrezza; MARTINS, Milton A.; CUKIER, Alberto; STELMACH, Rafael; GIAVINA-BIANCHI, Pedro; CARVALHO, Celso R. F.Objective: To investigate whether patients with moderate-to-severe asthma who commence an exercise training program in winter or summer show differences in exercise capacity, health-related quality of life (HRQoL) and asthma symptoms. Methods: Forty-two consecutive subjects visiting the outpatient clinic were enrolled in the 17-week rehabilitation program. One group of patients received the intervention from summer to winter (SWG, n = 21), and the other group participated from winter to summer (WSG, n = 21). Before and after the exercise training program, all patients were evaluated by cardiopulmonary exercise test, pulmonary function test, quality of life questionnaire and a daily diary that evaluated clinical asthma symptoms. Results: After the training period, both groups improved similarly in health-related quality of life (HRQoL) and aerobic capacity. The WSG patients had a greater increase that those in the SWG in asthma symptom-free days (p < 0.05). Conclusions: Our results indicate that seasonal variations affect the improvement in asthma symptoms after an exercise training program but have no effect on health-related quality of life, exercise capacity or pulmonary function.