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
3 resultados
Resultados de Busca
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- Pulmonary arterial enlargement is a predictor of higher risk of exacerbations in non-cystic fibrosis bronchiectasis patients(2021) FREITAS, Leonardo Vinicius De; NUNES, Blenda; MIRANDA, Renato; MAIA, Ana Luisa; RACHED, Samia; CUKIER, Alberto; STELMACH, Rafael; PINTO, Regina Carvalho; ATHANAZIO, Rodrigo
- Home-based pulmonary rehabilitation in people with bronchiectasis: a randomised controlled trial(2021) JOSE, Anderson; HOLLAND, Anne E.; SELMAN, Jessyca P. R.; CAMARGO, Cristiane Oliveira de; FONSECA, Diogo Simoes; ATHANAZIO, Rodrigo A.; RACHED, Samia Z.; CUKIER, Alberto; STELMACH, Rafael; CORSO, Simone DalAim: To investigate the short- and long-term effects of home-based pulmonary rehabilitation (HBPR) on functional capacity, quality of life, peripheral muscle strength, dyspnoea and daily physical activity in people with bronchiectasis. Methods: Randomised controlled trial with 63 participants with bronchiectasis. The HBPR group performed three sessions per week for 8 weeks (aerobic exercise: step training for 20 min; resistance training: exercises for quadriceps, hamstrings, deltoids and biceps brachii using elastic bands). The control group received a recommendation to walk at moderate intensity, three times per week. A weekly phone call was conducted for all participants, and the HBPR group received a home visit every 15 days. The primary outcome was distance in the incremental shuttle walk test (ISWT). Secondary outcomes were time in the endurance shuttle walk test (ESWT), number of steps in the incremental step test, quality of life, quadriceps muscle strength and daily physical activity. Measures were taken before and after intervention and 6 months later. Results: After the intervention, the HBPR group had increased ISWT distance compared with the control group with between-group difference 87.9 m (95% CI 32.4-143.5 m). In addition, between-group differences were found in the ESWT, incremental step test, quality of life and quadriceps muscle strength, favouring the HBPR group. After 6 months, no differences were observed between the groups. Conclusion: HBPR is an effective alternative offering of pulmonary rehabilitation for people with bronchiectasis. However, the programme was not effective in maintaining the benefits after 6 months of follow-up.
- Identification of asthma phenotypes based on extrapulmonary treatable traits(2021) FREITAS, Patricia Duarte; XAVIER, Rafaella Franca; MCDONALD, Vanessa Marie; GIBSON, Peter Gerard; CORDOVA-RIVERA, Laura; FURLANETTO, Karina Couto; OLIVEIRA, Joice Mara de; CARVALHO-PINTO, Regina Maria; CUKIER, Alberto; STELMACH, Rafael; CARVALHO, Celso Ricardo FernandesAsthma is a heterogeneous and complex disease, and a description of asthma phenotypes based on extrapulmonary treatable traits has not been previously reported. The objective of this study was to identify and characterise clusters based on clinical, functional, anthropometrical and psychological characteristics in participants with moderate-to-severe asthma. This was a cross-sectional multicentre study involving centres from Brazil and Australia. Participants (n=296) with moderate-to-severe asthma were consecutively recruited. Physical activity and sedentary time, clinical asthma control, anthropometric data, pulmonary function and psychological and health status were evaluated. Participants were classified by hierarchical cluster analysis and the clusters compared using ANOVA, Kruskal Wallis and Chi-squared tests. Multiple logistic and linear regression models were performed to evaluate the association between variables. We identified four clusters: 1) participants with controlled asthma who were physically active, 2) participants with uncontrolled asthma who were physically inactive and more sedentary; 3) participants with uncontrolled asthma and low physical activity, who were also obese and experienced anxiety and/or depression symptoms; and 4) participants with very uncontrolled asthma who were physically inactive, more sedentary, obese and experienced anxiety and/or depression symptoms. Higher levels of sedentary time, female sex and anxiety symptoms were associated with increased odds of exacerbation risk, while being more active showed a protective factor for hospitalisation. Asthma control was associated with sex, the occurrence of exacerbation, physical activity and health status. Physical inactivity, obesity and symptoms of anxiety and/or depression were associated with worse asthma outcomes, and closely and inextricably associated with asthma control. This cluster analysis highlights the importance of assessing extrapulmonary traits to improve personalised management and outcomes for people with moderate and severe asthma.