PALMIRA GABRIELE FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- Exercise training is a determinant of weight-loss and improvement on asthma control, airway inflammation and psychosocial morbidity in obese asthmatics: A RCT(2015) FREITAS, Patricia D.; FERREIRA, Palmira G.; SILVA, Aline G.; CUKIER, Alberto; STELMACH, Rafael; CARVALHO-PINTO, Regina; SALGE, Joao M.; MANCINI, Marcio C.; MARTINS, Milton A.; CARVALHO, Celso R. F.
- Effect of weight-loss on the dynamic hyperinflation in obese asthmatics(2015) SILVA, Aline G.; FREITAS, Patricia D.; FERREIRA, Palmira G.; FERNANDES, Frederico L. A.; SALGE, Joao M.; STELMACH, Rafael; CUKIER, Alberto; MARTINS, Milton A.; CARVALHO, Celso R. F.
- Airway resistance and obesity are independent factors for the occurrence of dynamic hyperinflation in asthmatics(2015) FERREIRA, Palmira G.; FREITAS, Patricia D.; SILVA, Aline G.; FERNANDES, Frederico L. A.; SALGE, Joao M.; STELMACH, Rafael; CUKIER, Alberto; CARVALHO-PINTO, Regina; MARTINS, Milton A.; CARVALHO, Celso R. F.
conferenceObject Dynamic hyperinflation and exercise limitation in obese asthmatics(2014) FERREIRA, Palmira G.; FREITAS, Patricia D.; SILVA, Aline G.; STELMACH, Rafael; CUKIER, Alberto; FERNANDES, Frederico L. A.; MARTINS, Milton A.; CARVALHO, Celso R. F.conferenceObject Effects of exercise training in a weight loss lifestyle intervention on clinical control, quality of life and psychosocial symptoms in obese asthmatics: A RCT(2014) FREITAS, Patricia D.; FERREIRA, Palmira G.; ANALUCI, S.; STELMACH, Rafael; PINTO, Regina C.; SAGE, Joao M.; MARTINS, Milton A.; MANCINI, Marcio C.; CARVALHO, Celso R. F.- The Role of Exercise in a Weight-Loss Program on Clinical Control in Obese Adults with Asthma A Randomized Controlled Trial(2017) FREITAS, Patricia D.; FERREIRA, Palmira G.; SILVA, Aline G.; STELMACH, Rafael; CARVALHO-PINTO, Regina M.; FERNANDES, Frederico L. A.; MANCINI, Marcia C.; SATO, Maria N.; MARTINS, Milton A.; CARVALHO, Celso R. F.Rationale: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. Objectives: To examine the effect of exercise training in a weight loss program on asthma control, quality of life, inflammatory biomarkers, and lung function. Methods: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program plus exercise (WL + E group, n = 28) or a weight-loss program plus sham (WL + S group, n = 27), where the weight-loss program included nutrition (caloric restriction) and psychological therapies. The WL + E group incorporated aerobic and resistance muscle training, whereas the WL + S group incorporated breathing and stretching exercises. Measurements and Main Results: The primary outcome was clinical improvement in asthma control over 3 months. Secondary outcomes included quality of life, lung function, body composition, aerobic capacity, muscle strength, and inflammatory/antiinflammatory biomarkers. After 3 months, 51 patients were analyzed. Compared with the WL + S group, the WL + E group demonstrated improved clinical control scores (median [25th to 75th percentile],-0.7 [-1.3 to -0.3] vs. -0.3 [-0.9 to 0.4]; P = 0.01) and greater weight loss (mean +/- SD, -6.8% +/- 3.5 vs. -3.1% +/- 2.6; P < 0.001) and aerobic capacity (median [25th to 75th percentile], 3.0 [2.4 to 4.0] vs. 0.9 [-0.3 to 1.3] ml O-2 X kg(-1) X min(-1); P < 0.001). These improvements in the WL + E group were also accompanied by improvements in lung function, antiinflammatory biomarkers, and vitamin D levels, as well as reductions in airway and systemic inflammation. Conclusions: Adding exercise to a short-term weight-loss program should be considered as a useful strategy for achieving clinical control of asthma in obese patients.
- Mechanisms underlying the role of exercise training as part of a weight loss program on asthma control in obese asthmatics(2016) FREITAS, Patricia; FERREIRA, Palmira G.; SILVA, Aline G.; STELMACH, Rafael; CARVALHO-PINTO, Regina; FERNANDES, Frederico L. A.; MARTINS, Milton A.; MANCINI, Marcio C.; SATO, Maria N.; CARVALHO, Celso R. F.
- Dynamic hyperinflation and exercise limitations in obese asthmatic women(2017) FERREIRA, Palmira Gabriele; FREITAS, Patricia Duarte; SILVA, Aline Grandi; PORRAS, Desiderio Cano; STELMACH, Rafael; CUKIER, Alberto; FERNANDES, Frederico Leon Arrabal; MARTINS, Milton Arruda; CARVALHO, Celso R. F.Obese individuals and patients with asthma can develop dynamic hyperinflation (DH) during exercise; however, no previous study has investigated DH as a factor associated with reduced exercise capacity in obese asthmatic women. The aim of the present study was to examine the occurrence of DH and exercise limitations in obese asthmatics. Obese grade II [obese group (Ob-G); BMI 35-39.9 kg/m(2); n = 36] and nonobese [nonobese group (NOb-G); BMI 18.5-29.9 kg/m(2); n = 18] asthmatic patients performed a cardiopulmonary test to quantify peak (V) over dot(O2) and a sub-maximal exercise test to assess DH. Anthropometric measurements, quadriceps endurance, and lung function were also evaluated. A forward stepwise regression was used to evaluate the association between exercise tolerance (wattage) and limiting exercise factors. Fifty-four patients completed the protocol. The Ob-G (n = 36) presented higher peak (V) over dot(O2) values but lower power-to-weight ratio values than the NOb-G (P < 0.05). DH was more common in the Ob-G (72.2%) than in the NOb-G (38.9%, P < 0.05). The Ob-G had a greater reduction in the inspiratory capacity (-18 vs. -4.6%, P < 0.05). Exercise tolerance was associated with quadriceps endurance (r = 0.65; p < 0.001), oxygen pulse (r = 0.52; p = 0.001), and DH (r = -0.46, P = 0.005). The multiple regression analysis showed that the exercise tolerance could be predicted from a linear association only for muscular endurance (r = 0.82 and r(2) = 0.67). This study shows that dynamic hyperinflation is a common condition in obese asthmatics; they have reduced fitness for activities of daily living compared to nonobese asthmatics. However, peripheral limitation was the main factor associated with reduced capacity of exercise in these patients. NEW & NOTEWORTHY This is the first study to investigate the occurrence of dynamic hyperinflation (DH) in obese asthmatics. Our results demonstrate that obese asthmatics present a higher frequency and intensity of DH than nonobese asthmatics. We also show that physical deconditioning in this population is linearly associated with cardiac (O-2 pulse), respiratory (DH), and peripheral muscle (resistance) limitation. However, multiple linear regression demonstrated that peripheral muscle limitation may explain the exercise limitation in this population.
- Dynamic hyperinflation is not the main limiting factor during exercise in obese asthmatics(2016) CARVALHO, Celso Fernandes de; FERREIRA, Palmira Gabriele; FREITAS, Patricia Duarte; SILVA, Aline Grandi; STELMACH, Rafael; CUKIER, Alberto; FERNANDES, Frederico Leon Arrabal; MARTINS, Milton Arruda
- Effects of weight loss on dynamic hyperinflation in obese women asthmatics(2019) SILVA, Aline Grandi; FREITAS, Patricia Duarte; FERREIRA, Palmira Gabriele; STELMACH, Rafael; CARVALHO-PINTO, Regina Maria; SALGE, Joao Marcos; MARTINS, Milton Arruda; CARVALHO, Celso R. F.Obese adults with asthma are more likely to develop dynamic hyperinflation (DH) and expiratory flow limitation (EFL) than nonobese asthmatics, and weight-loss seems to improve the breathing mechanics during exercise. However, studies evaluating the effect of weight loss on DH in obese adults with asthma have not been performed. We sought to evaluate the effect of a weight loss program on DH in obese adults with asthma. Forty-two asthma patients were enrolled in a weight loss program (diet, psychological support, and exercise) and were subsequently divided into two groups according to the percentage of weight loss: a >= 5% group (n = 19) and a <5% group (n = 23). Before and after the intervention. DH and EFL (constant load exercise), health-related quality of life (HRQoL). asthma control, quadriceps muscle strength and endurance, body composition, and lung function were assessed. Both groups exhibited a decrease of >= 10% in inspiratory capacity (DH) before intervention, and only the >= 5% group showed clinical improvement in DH compared with the <5% group postintervention (-9.1 +/- 14.5% vs. -125 +/- 13.5%, respectively). In addition, the >= 5% group displayed a significant delay in the onset of both DH and EH, and a clinically significant improvement in HRQoL and asthma control. Furthermore, a correlation was observed between reduced waist circumference and increased inspiratory capacity (r = -0.45, P = 0.05) in the >= 5% group. In conclusion, a weight-loss of >= 5% of the body weight improves DH, which is associated with waist circumference in obese adults with asthma. In addition, the group with greater weight-loss showed a delayed onset of DH and EFL during exercise and improved asthma clinical control and HRQoL. NEW & NOTEWORTHY This is the first study to evaluate dynamic hyperinflation (DH) after a weight loss program in obese patients with asthma. Our results demonstrate that moderate weight loss can improve DH in obese patients with asthma that is associated with a decrease in abdominal fat. Moreover, a minimum of 5% in weight loss delays the onset of DH and expiratory flow limitation besides inducing a clinical improvement in asthma quality of life and clinical control.