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Article: The phase angle cut-off point capable of discriminating hemodialysis patients with reduced exercise tolerance: a cross-sectional study.

de Souza Francisco, Davi / Moraes, Igor Gutierrez / Brito, Camila Porto / Righetti, Renato Fraga / Yamaguti, Wellington Pereira

BMC sports science, medicine & rehabilitation

2024 Volume 16, Issue 1, Page(s) 34

Abstract: Background: Phase angle (PhA) is a prognostic marker of all-cause mortality in chronic kidney disease. However, no study has investigated this marker as a predictor of exercise intolerance in hemodialysis (HD) patients. The aim of this study was to ... ...

Abstract	Background: Phase angle (PhA) is a prognostic marker of all-cause mortality in chronic kidney disease. However, no study has investigated this marker as a predictor of exercise intolerance in hemodialysis (HD) patients. The aim of this study was to determine a cut-off point for the PhA capable of discriminating HD patients with reduced exercise tolerance. Methods: Thirty-one patients (80.6% men, median age 69 years) were included. The evaluations were performed on three different days, before the HD session. The outcomes evaluated were: biochemical markers, inflammatory and nutritional status, body composition, peripheral muscle strength and exercise tolerance. Performance ≤50% of the predicted value in the six-minute step test (6MST) was defined as reduced exercise tolerance. Results: Patients presented an average of 67.6 steps (50.5% of predicted) in the 6MST. Fifteen patients (48.4%) were classified with reduced exercise tolerance. The receiver operating characteristic curve indicated a cut-off point of 3.73° for the PhA (sensitivity = 87%, specificity = 81%, and area under the curve = 0.88 [95% CI: 0.76-1.00]; p < 0.001). Patients with reduced exercise tolerance had worse inflammatory and nutritional status, lower PhA and greater impairment of peripheral muscle strength. Conclusion: The cut-off point of 3.73° for the PhA is sensitive and specific to discriminate HD patients with reduced exercise tolerance. Trial registration: This study was registered in the Clinical Trials database (no. NCT03779126, date of first registration 19/12/2018).
Language	English
Publishing date	2024-02-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2719537-5
ISSN	2052-1847
ISSN	2052-1847
DOI	10.1186/s13102-024-00825-5
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Article ; Online: Resilience Improves the Quality of Life and Subjective Happiness of Physiotherapists during the COVID-19 Pandemic.

Pigati, Patricia Angeli da Silva / Righetti, Renato Fraga / Dourado, Victor Zuniga / Nisiaymamoto, Bruna Tiemi Cunha / Saraiva-Romanholo, Beatriz Mangueira / Tibério, Iolanda de Fátima Lopes Calvo

International journal of environmental research and public health

2022 Volume 19, Issue 14

Abstract: Resilience is an individual characteristic that protects mental health. However, its impact on the lives of Brazilian physiotherapists during COVID-19 is not known. This study aimed to analyze whether resilience modulates the perceived quality of life ( ... ...

Abstract	Resilience is an individual characteristic that protects mental health. However, its impact on the lives of Brazilian physiotherapists during COVID-19 is not known. This study aimed to analyze whether resilience modulates the perceived quality of life (QoL) and subjective happiness (SH) of physiotherapists who work with COVID-19 patients, compared with those who do not. A cross-sectional study was conducted between 22 August and 22 October 2020. Physiotherapists working in critical and non-critical hospital sectors were invited to participate in the study. The participants completed sociodemographic questionnaires and were graded on the 14-item Resilience Scale, 36-item Short-Form Health Survey (SF-36), and the Subjective Happiness Scale. In total, 519 physiotherapists were enrolled in the study. Physiotherapists with low resilience who worked with COVID-19 patients reported lower scores on the SF-36 subscales (except for social functioning) and the Subjective Happiness Scale, compared with those with high resilience who did not work with COVID-19 patients. These responses were modulated by age, sex, absence from work, receipt of personal protective equipment, host leadership, and practice and maintenance of regular physical activity. In conclusion, physiotherapists with low resilience who worked with COVID-19 patients presented lower perceptions of QoL and SH, compared with the other study participants.
MeSH term(s)	COVID-19/epidemiology ; Cross-Sectional Studies ; Happiness ; Humans ; Pandemics ; Physical Therapists ; Quality of Life/psychology ; Surveys and Questionnaires
Language	English
Publishing date	2022-07-18
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19148720
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Article: Neuromuscular Electrical Stimulation in Patients With Severe COVID-19 Associated With Sepsis and Septic Shock.

Righetti, Renato Fraga / Grams, Samantha Torres / Costa, Wesla Neves da Silva / Saraiva, Leandro Teixeira / de Salles, Isabel Chateaubriand Diniz / Yamaguti, Wellington Pereira

Frontiers in medicine

2022 Volume 9, Page(s) 751636

Abstract: Background: Neuromuscular electrical stimulation (NMES) can be applied to critically ill patients. However, its results on muscle strength and functionality in patients with COVID-19 are unknown.: Objective: Evaluate the effects of intervention with ... ...

Abstract	Background: Neuromuscular electrical stimulation (NMES) can be applied to critically ill patients. However, its results on muscle strength and functionality in patients with COVID-19 are unknown. Objective: Evaluate the effects of intervention with NMES on muscle mass and functionality of patients with severe COVID-19 associated with sepsis and septic shock. Methods: Seven patients with COVID-19 associated with sepsis or septic shock were selected, but only 5 patients completed all days of the intervention with NMES. The intervention was performed by a single physiotherapist on 7 consecutive days in a daily session of 40 min. The outcome measures were the femoris cross-sectional area; thickness of the anterior compartment of the quadriceps muscle; rectus femoris echogenicity; International Classification of Functioning, Disability, and Health (ICF)-muscle strength; PFIT-s, DEMMI, and the SOMS; feasibility, and safety. The patients were evaluated on days 1, 5, and 8. Results: The rectus femoris cross-sectional area decreased significantly from days 1 to 8, but showed maintenance of the thickness of the anterior compartment of the quadriceps muscle from days 1 to 8. The MRC score increased significantly from days 1 to 5 and kept this improvement until day 8. All patients showed an increase in the MRC score and reduction of the ICF-muscle strength, meaning improved muscle strength from days 1 to 8. The PFIT-s increased significantly from days 1 to 5 and improved until day 8 compared to day 5. DEMMI and SOMS score increased significantly on day 8 compared to days 1 and 5. Conclusion: Rehabilitation with NMES showed improvement in muscle strength and functionality of patients in this study with a potential protective effect on muscle mass loss in patients with critical COVID-19 associated with sepsis and septic shock. This study is the first report of the potential effects of neuromuscular electrical stimulation in patients with severe COVID-19 associated with sepsis and septic shock.
Language	English
Publishing date	2022-02-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.751636
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Article ; Online: Resilience and its impact on the mental health of physiotherapists during the COVID-19 pandemic in São Paulo, Brazil.

Pigati, Patricia Angeli da Silva / Righetti, Renato Fraga / Nisiaymamoto, Bruna Tiemi Cunha / Saraiva-Romanholo, Beatriz Mangueira / Tibério, Iolanda de Fátima Lopes Calvo

Journal of affective disorders

2022 Volume 310, Page(s) 422–428

Abstract: Objective: To analyze whether resilience modulates the levels of depression, anxiety, stress and the impact of events in physiotherapists who work with COVID-19 patients with those who do not.: Methods: A cross-sectional study was conducted from ... ...

Abstract	Objective: To analyze whether resilience modulates the levels of depression, anxiety, stress and the impact of events in physiotherapists who work with COVID-19 patients with those who do not. Methods: A cross-sectional study was conducted from August 2020 up to October 2020. A total of 519 physiotherapists were enrolled and divided according to resilience and whether they worked with COVID-19 patients. Volunteers answered sociodemographic questionnaires, rating their depression, anxiety, and stress on a scale (DASS-21). The impact of event scale revised (IES-R) and 14-item resilience scale (14-RS) were also used. Results: Physiotherapists with low resilience present scores significantly high of depression, anxiety, stress and impact of event compared to the high resilience group (P < .001). Additionally, working with COVID-19 patients also resulted in increased levels of depression, anxiety, stress, and impact of event compared with the NO COVID-19 group (P < .001). These responses were modulated by age, sex, number of absences from work, whether or not personal protective equipment was received, host leadership, and the practice and maintenance of regular physical activity. Limitations: The responses to the questionnaires were anonymous and self-administered. We cannot assess whether these people had a previous diagnosis of depression, anxiety and stress. Conclusions: Low resilience and work with COVID-19 patients were associated with high levels of depression, anxiety, and stress and worse psychological impacts of events. Several aspects modulate these responses and can contribute to improving the resilience and mental health of physiotherapists who are responsible for the care of COVID-19 patients.
MeSH term(s)	Anxiety/epidemiology ; Anxiety/psychology ; Brazil/epidemiology ; COVID-19/epidemiology ; Cross-Sectional Studies ; Depression/epidemiology ; Depression/psychology ; Humans ; Mental Health ; Pandemics ; Physical Therapists ; Resilience, Psychological ; SARS-CoV-2
Language	English
Publishing date	2022-05-13
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2022.05.049
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Article: Skeletal Muscle Wasting and Function Impairment in Intensive Care Patients With Severe COVID-19.

de Andrade-Junior, Mario Chueire / de Salles, Isabel Chateaubriand Diniz / de Brito, Christina May Moran / Pastore-Junior, Laerte / Righetti, Renato Fraga / Yamaguti, Wellington Pereira

Frontiers in physiology

2021 Volume 12, Page(s) 640973

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-03-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2021.640973
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Article ; Online: A single dose of angiotensin-(1-7) resolves eosinophilic inflammation and protects the lungs from a secondary inflammatory challenge.

Magalhaes, Giselle Santos / Gregorio, Juliana Fabiana / Beltrami, Vinicius Amorim / Felix, Franciel Batista / Oliveira-Campos, Livia / Bonilha, Caio Santos / Righetti, Renato Fraga / Tibério, Iolanda de Fátima Lopes Calvo / De Sousa, Frederico B / Rezende, Barbara Maximino / Teixeira-Carvalho, Andréa / Santos, Robson As / Campagnole-Santos, Maria José / Rodrigues-Machado, Maria da Gloria / Teixeira, Mauro Martins / Pinho, Vanessa

Inflammation research : official journal of the European Histamine Research Society ... [et al.

2024

Abstract: Objective: Angiotensin-(1-7) [Ang-(1-7)] is a pro-resolving mediator. It is not known whether the pro-resolving effects of Ang-(1-7) are sustained and protect the lung from a subsequent inflammatory challenge. This study sought to investigate the impact ...

Abstract	Objective: Angiotensin-(1-7) [Ang-(1-7)] is a pro-resolving mediator. It is not known whether the pro-resolving effects of Ang-(1-7) are sustained and protect the lung from a subsequent inflammatory challenge. This study sought to investigate the impact of treatment in face of a second allergic or lipopolysaccharide (LPS) challenge. Methods: Mice, sensitized and challenged with ovalbumin (OVA), received a single Ang-(1-7) dose at the peak of eosinophilic inflammation, 24 h after the final OVA challenge. Subsequently, mice were euthanized at 48, 72, 96, and 120 h following the OVA challenge, and cellular infiltrate, inflammatory mediators, lung histopathology, and macrophage-mediated efferocytic activity were evaluated. The secondary inflammatory stimulus (OVA or LPS) was administered 120 h after the last OVA challenge, and subsequent inflammatory analyses were performed. Results: Treatment with Ang-(1-7) resulted in elevated levels of IL-10, CD4 Conclusion: A single dose of Ang-(1-7) resolves lung inflammation and protect the lung from a subsequent inflammatory challenge highlighting its potential therapeutic for individuals with asthma.
Language	English
Publishing date	2024-04-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1221794-3
ISSN	1420-908X ; 1023-3830
ISSN (online)	1420-908X
ISSN	1023-3830
DOI	10.1007/s00011-024-01880-x
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Article ; Online: Bleeding frequency during physiotherapy in thrombocytopenic patients undergoing hematopoietic stem cell transplantation.

Grencheski, Erick Alvaro / Kochi, Margarete Noriko / Politi, Flávia Vanessa Aurea / Santos, Tabata Maruyama Dos / Brito, Christina May Moran de / Yamaguti, Wellington Pereira / Righetti, Renato Fraga

PloS one

2021 Volume 16, Issue 7, Page(s) e0255413

Abstract: Background: During hematopoietic stem cell transplantation (HSCT) the patients perform activities of low and moderate intensity because have reduced hematological lineages, leaving them susceptible to hemorrhagic events. The objective of this study was ... ...

Abstract	Background: During hematopoietic stem cell transplantation (HSCT) the patients perform activities of low and moderate intensity because have reduced hematological lineages, leaving them susceptible to hemorrhagic events. The objective of this study was to describe the frequency of bleeding events, severity, and possible association with physical exercise in thrombocytopenic patients. Methods: A retrospective study with seventy-seven HSCT patients hospitalised, that had a platelet count ≤ 50,000 /μL and received physical exercise during physiotherapy intervention. Results: Regarding bleeding events, only six were related to physical exercise, and bleeding events occurred more frequently at platelet levels ≤ 10,000 /μL. The most frequent bleeding event was epistaxis, considered of low severity, and with the moderate possibility of being related to physical exercise; followed by extremity hematoma, considered of medium severity and highly related to physical exercise. In this study, there was no occurrence of bleeding events considered of high severity. Conclusion: Bleeding frequency in supervised physical exercise during physiotherapy in adults with thrombocytopenia undergoing HSCT is minor and relatively rare but occurs more frequently in patients with platelet count ≤10,000 /μL. These results encourage the maintenance of physical activity in this population who is at high risk of developing immobility-related complications.
MeSH term(s)	Adult ; Aged ; Allografts ; Exercise Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Hemorrhage/blood ; Hemorrhage/etiology ; Hemorrhage/therapy ; Humans ; Male ; Middle Aged ; Platelet Count ; Retrospective Studies ; Thrombocytopenia/blood ; Thrombocytopenia/therapy
Language	English
Publishing date	2021-07-30
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0255413
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Article: Lung Mechanics Over the Century: From Bench to Bedside and Back to Bench.

Biselli, Paolo Jose Cesare / Degobbi Tenorio Quirino Dos Santos Lopes, Fernanda / Righetti, Renato Fraga / Moriya, Henrique Takachi / Tibério, Iolanda Fátima Lopes Calvo / Martins, Milton Arruda

Frontiers in physiology

2022 Volume 13, Page(s) 817263

Abstract: Lung physiology research advanced significantly over the last 100 years. Respiratory mechanics applied to animal models of lung disease extended the knowledge of the workings of respiratory system. In human research, a better understanding of respiratory ...

Abstract	Lung physiology research advanced significantly over the last 100 years. Respiratory mechanics applied to animal models of lung disease extended the knowledge of the workings of respiratory system. In human research, a better understanding of respiratory mechanics has contributed to development of mechanical ventilators. In this review, we explore the use of respiratory mechanics in basic science to investigate asthma and chronic obstructive pulmonary disease (COPD). We also discuss the use of lung mechanics in clinical care and its role on the development of modern mechanical ventilators. Additionally, we analyse some bench-developed technologies that are not in widespread use in the present but can become part of the clinical arsenal in the future. Finally, we explore some of the difficult questions that intensive care doctors still face when managing respiratory failure. Bringing back these questions to bench can help to solve them. Interaction between basic and translational science and human subject investigation can be very rewarding, as in the conceptualization of "Lung Protective Ventilation" principles. We expect this interaction to expand further generating new treatments and managing strategies for patients with respiratory disease.
Language	English
Publishing date	2022-07-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2022.817263
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Article ; Online: Noninvasive ventilation and high-flow nasal cannula in patients with acute hypoxemic respiratory failure by covid-19: A retrospective study of the feasibility, safety and outcomes.

Costa, Wesla Neves da Silva / Miguel, Juliana Padovezi / Prado, Fabiana Dos Santos / Lula, Liz Helena Santos de Mello / Amarante, Gustavo Adolpho Junqueira / Righetti, Renato Fraga / Yamaguti, Wellington Pereira

Respiratory physiology & neurobiology

2022 Volume 298, Page(s) 103842

Abstract: Background: Noninvasive ventilation (NIV) and High-flow nasal cannula (HFNC) are the main forms of treatment for acute respiratory failure. This study aimed to evaluate the effect, safety, and applicability of the NIV and HFNC in patients with acute ... ...

Abstract	Background: Noninvasive ventilation (NIV) and High-flow nasal cannula (HFNC) are the main forms of treatment for acute respiratory failure. This study aimed to evaluate the effect, safety, and applicability of the NIV and HFNC in patients with acute hypoxemic respiratory failure (AHRF) caused by COVID-19. Methods: In this retrospective study, we monitored the effect of NIV and HFNC on the SpO Results: 62.2 % of patients were treated with HFNC. ROX index increased during and after NIV and HFNC treatment (P < 0.05). SpO Conclusion: The application of NIV and HFNC in the critical care unit is feasible and associated with favorable outcomes. In addition, there was no increase in the infection of physiotherapists with SARS-CoV-2.
MeSH term(s)	Acute Disease ; Administration, Inhalation ; Adult ; Aged ; Aged, 80 and over ; Brazil ; COVID-19/complications ; COVID-19/mortality ; COVID-19/therapy ; Cannula/adverse effects ; Cannula/standards ; Cannula/statistics & numerical data ; Feasibility Studies ; Female ; Humans ; Intensive Care Units ; Intubation, Intratracheal/statistics & numerical data ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Noninvasive Ventilation/adverse effects ; Noninvasive Ventilation/methods ; Noninvasive Ventilation/standards ; Noninvasive Ventilation/statistics & numerical data ; Outcome and Process Assessment, Health Care/statistics & numerical data ; Oxygen/administration & dosage ; Physical Therapists ; Positive-Pressure Respiration/adverse effects ; Positive-Pressure Respiration/standards ; Positive-Pressure Respiration/statistics & numerical data ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/mortality ; Respiratory Insufficiency/therapy ; Respiratory Rate/drug effects ; Retrospective Studies
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-01-10
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2077867-3
ISSN	1878-1519 ; 1569-9048
ISSN (online)	1878-1519
ISSN	1569-9048
DOI	10.1016/j.resp.2022.103842
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Zs.A 519: Show issues

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Article ; Online: Modulating asthma-COPD overlap responses with IL-17 inhibition.

Camargo, Leandro do Nascimento / Righetti, Renato Fraga / de Almeida, Francine Maria / Dos Santos, Tabata Maruyama / Fukuzaki, Silvia / Martins, Nilo Arthur Bezerra / Barbeiro, Miguel Cantadori / Saraiva-Romanholo, Beatriz Mangueira / Lopes, Fernanda Degobbi Tenorio Quirino Dos Santos / Leick, Edna Aparecida / Prado, Carla Máximo / Tibério, Iolanda de Fátima Lopes Calvo

Frontiers in immunology

2023 Volume 14, Page(s) 1271342

Abstract: Background: IL-17 is a modulator of the inflammatory response and is implicated in lung remodeling in both asthma and chronic obstructive pulmonary disease (COPD). Well as and probably in patients with asthma-COPD overlap (ACO).: Methods: In this ... ...

Abstract	Background: IL-17 is a modulator of the inflammatory response and is implicated in lung remodeling in both asthma and chronic obstructive pulmonary disease (COPD). Well as and probably in patients with asthma-COPD overlap (ACO). Methods: In this study, we evaluated the response of the airways and alveolar septa to anti-IL-17 treatment in an ACO model. Fifty-six male BALB/c mice were sensitized with ovalbumin (OVA group), received porcine pancreatic elastase (PPE group), or both (ACO group). Mice were then treated with either anti-IL-17 monoclonal antibody or saline. We evaluated hyperresponsiveness, bronchoalveolar lavage fluid (BALF) cell counts, and mean alveolar diameter. We quantified inflammatory, response, extracellular matrix remodeling, oxidative stress markers, and signaling pathway markers. Results: Anti-IL-17 treatment in the ACO anti-IL-17 group reduced the maximum response of respiratory system Rrs, Ers, Raw, Gtis, this when compared to the ACO group (p<0.05). There was a reduction in the total number of inflammatory cells, neutrophils, and macrophages in the BALF in the ACO anti-IL-17 group compared to the ACO group (p<0.05). There was attenuated dendritic cells, CD4+, CD8+, FOXP3, IL-1β, IL-2, IL-6, IL-13, IL-17, IL-33 in ACO anti-IL-17 group in airway and alveolar septum compared to the ACO group (p<0.05). We observed a reduction of MMP-9, MMP-12, TIMP-1, TGF-β, collagen type I in ACO anti-IL-17 group in airway and alveolar septum compared to the ACO group (p < 0.05). We also observed a reduction of iNOS and 8-iso-PGF2α in the airways and in the alveolar septum was reduced in the ACO anti-IL-17group compared to the ACO group (p < 0.05). Regarding the signaling pathways, NF-kB, ROCK-1, and ROCK-2 in the airway and alveolar septum were attenuated in the ACO anti-IL-17 group when compared to the ACO group (p<0.05). Conclusions: Our results suggest that inhibiting IL-17 modulates cell-associated cytokine production in lung tissue, extracellular matrix remodeling, and oxidative stress in ACO through the modulation of NF-kB and FOXP3.
MeSH term(s)	Animals ; Male ; Mice ; Asthma ; Forkhead Transcription Factors ; Interleukin-17 ; NF-kappa B ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Swine
Chemical Substances	Forkhead Transcription Factors ; Interleukin-17 ; NF-kappa B
Language	English
Publishing date	2023-10-27
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1271342
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