Rodrigo Bazan
@fmb.unesp.br
Associate Professor
Unesp - Universidade Estadual Paulista
RESEARCH, TEACHING, or OTHER INTERESTS
Neurology (clinical), Neuroscience, Neurology, General Neuroscience
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
João Paulo Martins, Fernanda Bono Fukushima, Leandra Navarro Benatti, Rodrigo Bazan, Katherine Di Santi Correa da Silva, and Edison Iglesias de Oliveira Vidal
SAGE Publications
Background Motoric cognitive risk syndrome (MCRS) is a pre-dementia syndrome of growing interest, yet it remains understudied in Latin America with a significant lack of information on the interaction between its risk factors and race. Objective To estimate the prevalence of MCRS among older adults in Brazil, investigate its association with various clinical and sociodemographic variables, and explore the potential of effect modification by race. Methods This cross-sectional, population-based study was conducted among community-dwelling older adults in Brazil, with data collected between 2015 and 2016. The diagnosis of MCRS was established following the standard recommended by the original study that first described it. We used Poisson regression models to analyze the association between MCRS and a list of 21 variables identified from a systematic review. Results A total of 4677 participants aged 60 years and older were included. The prevalence of MCRS in the Brazilian population of older adults was 4.34% (95% CI: 3.20%–5.48%). Higher levels of education and physical activity showed protective associations with MCRS, while depression and stroke demonstrated risk associations. A significant cross-over interaction between race and depression regarding MCRS was observed, such that the association of depression with MCRS was approximately three times higher among White individuals than Black individuals. Conclusions Our results challenge previous estimates that Latin America is the region with the highest prevalence of MCRS among older adults and signal the need for further studies to better investigate the modification of effect of the association between depression and MCRS by race.
Luana Aparecida Miranda, Fernanda Cristina Winckler, Taís Regina da Silva, Hélio Rubens de Carvalho Nunes, Gabriel Pinheiro Modolo, Natalia Cristina Ferreira, Diandra B. Favoretto, Luan Aguiar, Silméia Garcia Zanati Bazan, Taiza G.S. Edwards,et al.
Elsevier BV
Maiara Silva Tramonte, Ana Claudia Pires Carvalho, Ana Elisa Vayego Fornazari, Gustavo Di Lorenzo Villas Boas, Gabriel Pinheiro Modolo, Natalia Cristina Ferreira, Marcos Christiano Lange, Marcos Ferreira Minicucci, Rodrigo Bazan, and Laura Cardia Gomes Lopes
BMJ
ObjectivesTo evaluate the determining factors of severe functional impairment (SFI) outcome at discharge and in-hospital mortality in patients who had an acute ischaemic stroke and thus favouring early implementation of primary palliative care (PC).MethodsA retrospective descriptive study by the analysis of 515 patients who had an acute ischaemic stroke admitted at stroke unit, aged≥18 years, from January 2017 to December 2018. Previous clinical and functional status data, National Institute of Health Stroke Scale (NIHSS) on admission, and data related to the evolution during hospitalisation were evaluated, relating them to the SFI outcome at discharge and death. The significance level was set at 5%.ResultsOf 515 patients included, 15% (77) died, 23.3%(120) had an SFI outcome and 9.1% (47) were evaluated by the PC team. It was observed that NIHSS Score≥16 is responsible for a 15.5-fold increase in the occurrence of death outcome. The presence of atrial fibrillation was responsible for a 3.5-fold increase in the risk of this outcome.ConclusionNIHSS Score is an independent predictor of in-hospital death and SFI outcomes at discharge. Knowledge about the prognosis and risk of developing unfavourable outcomes is important for planning the care of patients affected by a potentially fatal and limiting acute vascular insult.
Juli T. Souza, Marcos F. Minicucci, Natália C. Ferreira, Bertha F. Polegato, Marina P. Okoshi, Gabriel P. Modolo, Filipe W. Leal-Pereira, Bethan E. Phillips, Philip J. Atherton, Kenneth Smith,et al.
MDPI AG
Background/Objectives: The acute phase of stroke is marked by inflammation and mobility changes that can compromise nutritional status. This study was a randomized, double-blind, placebo-controlled trial evaluating the effectiveness of creatine supplementation for older people during seven days of hospitalization for stroke compared to usual care. Method: The primary outcome measures were changes in functional capacity, strength, muscle mass, and muscle degradation. The secondary outcomes were changes in serum biomarkers related to inflammation, fibrosis, anabolism, and muscle synthesis. In addition, a follow-up 90 days after the stroke verified functional capacity, strength, quality of life, and mortality. Following admission for an acute stroke, participants received either creatine (10 g) or a visually identical placebo (10 g) orally twice daily. Both groups received supplementation with protein to achieve the goal of 1.5 g of protein/kg of body weight/day and underwent daily mobility training during seven days of hospitalization. Results: Thirty older people were included in two similar groups concerning baseline attributes (15—treatment/15—placebo). Conclusions: Creatine supplementation did not influence functional capacity, strength, or muscle mass during the first 7 days or outcomes 90 days after stroke. There were no serious adverse events associated with creatine supplementation. However, it decreased progranulin levels, raising a new possibility of creatine action. This finding needs further exploration to understand the biological significance of creatine–progranulin interaction.
Monalisa Resende Nascimento, Tiago Soares Bernardes, Kelly Cristina Sousa Santos, Gabrielly Fernanda Silva, Rodrigo Bazan, Luciane Aparecida Pascucci Sande de Souza, and Gustavo José Luvizutto
Elsevier BV
Luis Henrique Vallesquino Murayama, Pedro Tadao Hamamoto Filho, Fernanda Cristina Winckler, Havy Alexssander Abrami Meirelles, Natalie Carlos Ferreira Mello Sampaio, Bruno Zanluqui Moreira, Raul Pansardis Sampaio, Renan Macionil Cotrim, Silméia Garcia Zanati Bazan, Cristiane Lara Mendes Chiloff,et al.
Elsevier BV
Juliana Tereza Coneglian de Almeida, Rodrigo Bazan, Sarah Nascimento Silva, Lukas Fernando Silva, Juliana Machado Rugolo, Mônica Aparecida de Paula de Sordi, Carlos Clayton Macedo de Freitas, and Vania dos Santos Nunes-Nogueira
Elsevier BV
Fabrício Moreira Reis, Eduarda Baccarin Ferrari, Nayrana Soares do Carmo Reis, Fabiana Lourenço Costa, Paula Naomi Morimoto, Alejandra Del Carmen Villanueva Maurício, João Carlos Hueb, Rodrigo Bazan, Vanessa Burgugi Banin, Pasqual Barretti,et al.
MDPI AG
Background: The coronary artery calcium score and left atrial volume have been shown to predict the incidence of acute myocardial infarction and death from cardiovascular disease in patients undergoing peritoneal dialysis. However, the association between these factors has not been well-established. Methods: This cross-sectional, prospective, single-center study was conducted on patients undergoing outpatient peritoneal dialysis, who were followed up at a university hospital between March 2018 and August 2019. The coronary artery calcium score was calculated based on cardiovascular computed tomography findings. The score was “positive” when it was ≥100 Agatston and “negative” when it was <100 Agatston. The left atrial volume was obtained using the biplane disc method at the end of the left ventricular systole, and then it was indexed to the body surface. Results: Forty-four patients were evaluated. They had an age [mean (range)] of 56 (43–65) years and had been on dialysis therapy for 11.7 (6.8–25.4) months. Univariate analysis revealed a relationship between the coronary artery calcium score and left atrial volume index and the following variables: age, diabetes, overhydration, pulse wave velocity, E/A ratio, and left ventricular mass index. In multivariate logistic regression analysis, only the left atrial volume index was independently associated with a positive coronary artery calcium score. Conclusions: The left atrial volume index was associated with a positive coronary artery calcium score in patients on peritoneal dialysis, regardless of other factors. It may be a useful risk marker for coronary artery disease in this population.
Raul Pansardis Sampaio, Marcelo Ortolani Fogaroli, Fabio Pires Botta, Gabriel Pinheiro Módolo, Gustavo José Luvizutto, Luiz Eduardo Betting, Marco Antônio Zanini, Rodrigo Bazan, and Pedro Tadao Hamamoto Filho
Elsevier BV
Gislene Diniz Morais, Pablo Andrei Appelt, Eduardo de Moura Neto, Rodrigo Bazan, Ariana Moura Cabral, Adriano de Oliveira Andrade, Gustavo José Luvizutto, and Luciane Aparecida Pascucci Sande de Souza
SAGE Publications
Introduction. Nonlinear EEG provides information about dynamic properties of the brain. This study aimed to compare nonlinear EEG parameters estimated from patients with Long COVID in different cognitive and motor tasks. Materials and Methods. This 12-month prospective cohort study included 83 patients with Long COVID: 53 symptomatic and 30 asymptomatic. Brain electrical activity was evaluated by EEG in 4 situations: (1) at rest, (2) during the Trail Making Test Part A (TMT-A), (3) during the TMT Part B (TMT-B), and (4) during a coordination task: the Box and Blocks Test (BBT). Nonlinear EEG parameters were estimated in the time domain (activity and complexity). Assessments were made at 0 to 3, 3 to 6, and 6 to 12 months after inclusion. Results. There was a decrease in activity and complexity during the TMT-A and TMT-B, and an increase of these parameters during the BBT in both groups. There was an increase in activity at rest and during the TMT-A in the COVID-19 group at 0 to 3 months compared to the control, an increase in activity in the TMT-B in the COVID-19 group at 3 to 6 months compared to the control, and reduced activity and complexity at rest and during the TMT-A at 6 to 12 months compared to the control. Conclusion. The tasks followed a pattern of increased activity and complexity in cognitive tasks, which decreased during the coordination task. It was also observed that an increase in activity at rest and during cognitive tasks in the early stages, and reduced activity and complexity at rest and during cognitive tasks in the late phases of Long COVID.
Shelagh B Coutts, Sandeep Ankolekar, Ramana Appireddy, Juan F Arenillas, Zarina Assis, Peter Bailey, Philip A Barber, Rodrigo Bazan, Brian H Buck, Ken S Butcher,et al.
Elsevier BV
Ricardo Mattos Ferreira, Fabiane Valentini Francisqueti Ferron, Vera Therezinha Medeiros Borges, José Carlos Peraçoli, Artur Junio Togneri Ferron, Meliza Goi Roscani, João Carlos Hueb, Rodrigo Bazan, Luis Cuadrado Martin, and Silméia Garcia Zanati Bazan
Elsevier BV
Sanjit Aaron, Jorge M. Ferreira, Jonathan M. Coutinho, Patrícia Canhão, Adriana B. Conforto, Antonio Arauz, Marta Carvalho, Jaime Masjuan, Vijay K. Sharma, Jukka Putaala,et al.
Ovid Technologies (Wolters Kluwer Health)
BACKGROUND: Decompressive neurosurgery is recommended for patients with cerebral venous thrombosis (CVT) who have large parenchymal lesions and impending brain herniation. This recommendation is based on limited evidence. We report long-term outcomes of patients with CVT treated by decompressive neurosurgery in an international cohort. METHODS: DECOMPRESS2 (Decompressive Surgery for Patients With Cerebral Venous Thrombosis, Part 2) was a prospective, international cohort study. Consecutive patients with CVT treated by decompressive neurosurgery were evaluated at admission, discharge, 6 months, and 12 months. The primary outcome was death or severe disability (modified Rankin Scale scores, 5–6) at 12 months. The secondary outcomes included patient and caregiver opinions on the benefits of surgery. The association between baseline variables before surgery and the primary outcome was assessed by multivariable logistic regression. RESULTS: A total of 118 patients (80 women; median age, 38 years) were included from 15 centers in 10 countries from December 2011 to December 2019. Surgery (115 craniectomies and 37 hematoma evacuations) was performed within a median of 1 day after diagnosis. At last assessment before surgery, 68 (57.6%) patients were comatose, fixed dilated pupils were found unilaterally in 27 (22.9%) and bilaterally in 9 (7.6%). Twelve-month follow-up data were available for 113 (95.8%) patients. Forty-six (39%) patients were dead or severely disabled (modified Rankin Scale scores, 5–6), of whom 40 (33.9%) patients had died. Forty-two (35.6%) patients were independent (modified Rankin Scale scores, 0–2). Coma (odds ratio, 2.39 [95% CI, 1.03–5.56]) and fixed dilated pupil (odds ratio, 2.22 [95% CI, 0.90–4.92]) were predictors of death or severe disability. Of the survivors, 56 (78.9%) patients and 61 (87.1%) caregivers expressed a positive opinion on surgery. CONCLUSIONS: Two-thirds of patients with severe CVT were alive and more than one-third were independent 1 year after decompressive surgery. Among survivors, surgery was judged as worthwhile by 4 out of 5 patients and caregivers. These results support the recommendation to perform decompressive neurosurgery in patients with CVT with impending brain herniation.
Tiago Soares Bernardes, Kelly Cristina Sousa Santos, Monalisa Resende Nascimento, César Augusto Noronha e Sousa Filho, Rodrigo Bazan, Janser Moura Pereira, Luciane Aparecida Pascucci Sande de Souza, and Gustavo José Luvizutto
Elsevier BV
Jéssica Miranda de Aquino Miranda, Pedro Henrique Sousa de Andrade, Maria Eduarda Salum Aveiro Henrique, Bruno Henrique de Souza Fonseca, Rodrigo Bazan, Luciane Aparecida Pascucci Sande de Souza, and Gustavo José Luvizutto
Informa UK Limited
INTRODUCTION
Transcranial direct current stimulation (tDCS) has a priming effect on post- stroke motor rehabilitation.
OBJECTIVE
We verified whether tDCS combined with task-specific training was superior to nonintervention, task-specific training, or simulated intervention in improving spatio-temporal gait parameters and functional mobility in stroke patients.
METHODS
We searched MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Central, Web of Science, and LILACS for articles published until May 2024, using terms related to stroke, tDCS, and task-specific training. The risk of bias was assessed using the PEDro scale. The Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to classify the certainty of the evidence for each outcome. Meta-analysis was performed using a random-effects model.
RESULTS
A total of 1,685 studies were identified, of which 18 were included in the qualitative analysis. Seven studies were included in the meta-analysis; all outcomes were classified as "very low quality." Improvements in walking speed only were associated with tDCS combined with task-specific training (mean difference [MD], 0.06; 95% confidence interval [CI]: 0.04, 0.07; p < 0.001; I = 0%). There were no differences in other spatio-temporal gait parameters or functional mobility.
CONCLUSION
This systematic review provides low-quality evidence that tDCS, in combination with task-specific training, increases speed in individuals after stroke. Both interventions, tDCS and task-specific training, are inexpensive and easy to implement; therefore, the mean estimate may be considered clinically worthwhile, although the CIs spans both clinically trivial and worthwhile effects.
REGISTRATION
International Prospective Register of Systematic Reviews (PROSPERO; number CRD42023396021).
Maiara Silva Tramonte, Ana Claudia Pires Carvalho, Gabriela Figueiredo Pucci, Mariana Soares Pinheiro, Ana Elisa Vayego Fornazari, Gustavo Di Lorenzo Villas Boas, Marcos Christiano Lange, Marcos Ferreira Minicucci, Rodrigo Bazan, and Laura Cardia Gomes Lopes
SAGE Publications
Background and Purpose Primary palliative care (PC) aims to improve the quality of life for patients with acute ischemic stroke but is often misinterpreted as withdrawal of care. The self-fulfilling prophecy withdrawal bias is feared in this context of PC’s early implementation. This study evaluates stroke patients who died in the hospital to determine the impact of PC evaluation. Methods A retrospective descriptive analysis of patients who died from acute ischemic stroke was conducted. The study included patients aged ≥18 years admitted to the Stroke Unit of a quaternary hospital in Brazil from January 2017 to December 2018. The impact of PC assessment on outcomes was analyzed, with significance set at 5%. Results Among the patients who died during hospitalization as a result of an ischemic stroke (n = 77), 39 (%) were assessed by the palliative care team. There was no difference in the total length of stay or duration of antibiotic therapy. Logistic regression corrected for significant variables from the univariate analysis revealed that PC evaluation was associated with a 31-fold increase in opioid use ( P < 0.001), a nearly 14-fold increase in discharges to the ward, and a threefold reduction in ICU length of stay ( P = 0.011). Conclusion PC team involvement was associated with higher rates of discharge to the floors, inferring more time spent with family and increased opioid use, suggesting better symptom control, without reducing the overall length of stay or duration of antibiotic therapy. This underscores that PC does not equate to withdrawal of care.
Gabriela Vieira de Paula, Gustavo José Luvizutto, Luana Aparecida Miranda, Taís Regina da Silva, Lucas Tadeu Carvalho Silva, Fernanda Cristina Winckler, Gabriel Pinheiro Modolo, Cristiane Lara Mendes Chiloff, Silméia Garcia Zanati Bazan, Rafael Dalle Molle da Costa,et al.
Informa UK Limited
INTRODUCTION
We compared fixed and articulated ankle-foot orthoses (AFOs) in home-based mobility tasks to assess short-term mobility, dynamic balance, quality of life, anxiety/depression, disability level, stroke severity, autonomy, human functioning, and patient satisfaction.
METHODS
This was a two-arm, parallel-group, randomized controlled trial with concealed allocation, assessor blinding, and a complete case analysis involving patients with chronic stroke. The participants were randomized into two groups: fixed (n = 24) and articulated (n = 23) AFOs. The AFOs were custom-fabricated, and both groups performed four-week home-based mobility tasks five days weekly. Primary outcome measures included changes in balance and mobility assessed using the Tinetti Performance-Oriented Mobility Assessment (POMA), Timed Up and Go (TUG) test, and Functional Ambulation Category (FAC). Secondary outcomes included quality of life, anxiety/depression, disability, stroke severity, autonomy, human functioning, and patient satisfaction.
RESULTS
In a between-group comparison, after adjusting for age, sex, stroke severity, and thrombolysis, the articulated AFO group showed better performance in the TUG test (p = 0.020; d = 0.93), POMA-Gait (p = 0.001; d = 0.53), POMA-Total (p = 0.048; d = 0.98), and FAC (p = 0.003; d = 1.03) than the fixed AFO group. Moreover, significant difference was noted in human functioning (moving around using equipment)between the groups (p = 0.047; d = 92).
CONCLUSION
A program involving home-based mobility tasks and articulated AFOs improved functional mobility after stroke.
Gabrielly Fernanda Silva, Lorrane Freitas Campos, Jéssica Mariana de Aquino Miranda, Flávia Guirro Zuliani, Bruno Henrique de Souza Fonseca, Amaro Eduardo Tavares de Araújo, Priscilla Flávia de Melo, Luiz Gustavo Suzuki, Luiz Paulo Aniceto, Rodrigo Bazan,et al.
Informa UK Limited
BACKGROUND AND PURPOSE
Enhancing afferent information from the paretic limb can improve post-stroke motor recovery. However, uncertainties exist regarding varied sensory peripheral neuromodulation protocols and their specific impacts. This study outlines the use of repetitive peripheral sensory stimulation (RPSS) and repetitive magnetic stimulation (rPMS) in individuals with stroke.
METHODS
This scoping review was conducted according to the JBI Evidence Synthesis guidelines. We searched studies published until June 2023 on several databases using a three-step analysis and categorization of the studies: pre-analysis, exploration of the material, and data processing.
RESULTS
We identified 916 studies, 52 of which were included (N = 1,125 participants). Approximately 53.84% of the participants were in the chronic phase, displaying moderate-to-severe functional impairment. Thirty-two studies used RPSS often combining it with task-oriented training, while 20 used rPMS as a standalone intervention. The RPSS primarily targeted the median and ulnar nerves, stimulating for an average of 92.78 min at an intensity that induced paresthesia. RPMS targeted the upper and lower limb paretic muscles, employing a 20 Hz frequency in most studies. The mean stimulation time was 12.74 min, with an intensity of 70% of the maximal stimulator output. Among the 114 variables analyzed in the 52 studies, 88 (77.20%) were in the "s,b" domain, with 26 (22.8%) falling under the "d" domain of the ICF.
DISCUSSION AND CONCLUSION
Sensory peripheral neuromodulation protocols hold the potential for enhancing post-stroke motor recovery, yet optimal outcomes were obtained when integrated with intensive or task-oriented motor training.
Natalia Cristina Ferreira, Gustavo José Luvizutto, Silméia Garcia Zanati Bazan, Luana Aparecida Miranda Bonome, Fernanda Cristina Winckler, Daniel Fabiano Barbosa dos Santos, Cristiane Lara Mendes Chiloff, Gabriel Pinheiro Modolo, Carlos Clayton Macedo de Freitas, Pasqual Barretti,et al.
Frontiers Media SA
BackgroundSince the implementation of the stroke care line in Brazil, the relationship (adequacy) of costs spent during hospitalization with the Brazilian Ministry of Health indicators for a stroke unit have not yet been analyzed.AimsThis study aimed to assess the adequacy of a comprehensive stroke center for key performance indicators and analyze the costs involved in hospitalization. We verified the association between stroke severity at admission and care costs during hospitalization.MethodsA retrospective medical chart review of 451 patients was performed using semiautomatic electronic data from a single comprehensive stroke center in Brazil between July 2018 and January 2020. Clinical and resource utilization data were collected, and the mean acute treatment cost per person was calculated. The Kruskal–Wallis test with Dunn’s post-test was used to compare the total costs between stroke types and reperfusion therapies. A robust linear regression test was used to verify the association between stroke severity at hospital admission and the total hospitalization costs. Good adequacy rates were observed for several indicators.ResultsData from 451 patients were analyzed. The stroke unit had good adaptation to key performance indicators, but some critical points needed revision and improvement to adapt to the requirements of the Ministry of Health. The average total cost of the patient’s stay was the USD 2,637.3, with the daily hospitalization, procedure, operating room, and materials/medication costs equating to USD 2,011.1, USD 220.7, USD 234.1, and USD 98.8, respectively. There was a positive association between the total cost and length of hospital stay (p &lt; 0.001).ConclusionThe stroke unit complied with most of the main performance indicators proposed by the Brazilian Ministry of Health. Underfunding of the costs involved in the hospitalization of patients was verified, and high costs were associated with the length of stay, stroke severity, and mechanical thrombectomy.
Luana Aparecida Miranda, Gustavo José Luvizutto, Pedro Augusto Cândido Bessornia, Natalia Eduarda Furlan, Fernanda Cristina Winckler, Natalia Cristina Ferreira, Pedro Tadao Hamamoto Filho, Juli Thomaz de Souza, Luis Cuadrado Martin, Silméia Garcia Zanati Bazan,et al.
Frontiers Media SA
ObjectiveWe evaluated the extent to which frailty mediated the association between age, poor functional outcomes, and mortality after acute ischemic stroke when patients were treated with brain reperfusion (thrombolytic therapy and/or thrombectomy).Materials and methodsThis retrospective cohort study included patients diagnosed with ischemic stroke who had undergone intravenous cerebral reperfusion therapy and/or mechanical thrombectomy. We created a mediation model by analyzing the direct natural effect of an mRS score &gt; 2 and death on age-mediated frailty according to the Frailty Index.ResultsWe enrolled 292 patients with acute ischemic stroke who underwent brain reperfusion. Their mean age was 67.7 ± 13.1 years. Ninety days after the stroke ictus, 54 (18.5%) participants died, and 83 (28.4%) lived with moderate to severe disability (2 &lt; mRS &lt; 6). In the mediation analysis of the composite outcome of disability (mRS score &gt; 2) or death, frailty accounted for 28% of the total effect of age. The models used to test for the interaction between age and frailty did not show statistically significant interactions for either outcome, and the addition of the interaction did not significantly change the direct or indirect effects, nor did it improve model fit.ConclusionFrailty mediated almost one-third of the effect of age on the composite outcome of disability or death after acute ischemic stroke.
Juli Thomaz de Souza, Marcos F. Minicucci, Natália C. Ferreira, Bertha F. Polegato, Marina Politi Okoshi, Gabriel P. Modolo, Bethan E. Phillips, Philip J. Atherton, Kenneth Smith, Daniel Wilkinson,et al.
Springer Science and Business Media LLC
Abstract Background Stroke is a leading cause of mortality and disability, and its sequelae are associated with inadequate food intake which can lead to sarcopenia. The aim of this study is to verify the effectiveness of creatine supplementation on functional capacity, strength, and changes in muscle mass during hospitalization for stroke compared to usual care. An exploratory subanalysis will be performed to assess the inflammatory profiles of all participants, in addition to a follow-up 90 days after stroke, to verify functional capacity, muscle strength, mortality, and quality of life. Methods Randomized, double-blind, unicenter, parallel-group trial including individuals with ischemic stroke in the acute phase. The duration of the trial for the individual subject will be approximately 90 days, and each subject will attend a maximum of three visits. Clinical, biochemical, anthropometric, body composition, muscle strength, functional capacity, degree of dependence, and quality of life assessments will be performed. Thirty participants will be divided into two groups: intervention (patients will intake one sachet containing 10g of creatine twice a day) and control (patients will intake one sachet containing 10g of placebo [maltodextrin] twice a day). Both groups will receive supplementation with powdered milk protein serum isolate to achieve the goal of 1.5g of protein/kg of body weight/day and daily physiotherapy according to the current rehabilitation guidelines for patients with stroke. Supplementation will be offered during the 7-day hospitalization. The primary outcomes will be functional capacity, strength, and changes in muscle mass after the intervention as assessed by the Modified Rankin Scale, Timed Up and Go test, handgrip strength, 30-s chair stand test, muscle ultrasonography, electrical bioimpedance, and identification of muscle degradation markers by D3-methylhistidine. Follow-up will be performed 90 days after stroke to verify functional capacity, muscle strength, mortality, and quality of life. Discussion The older population has specific nutrient needs, especially for muscle mass and function maintenance. Considering that stroke is a potentially disabling event that can lead the affected individual to present with numerous sequelae, it is crucial to study the mechanisms of muscle mass loss and understand how adequate supplementation can help these patients to better recover. Trial registration The Brazilian Clinical Trials Registry (ReBEC) RBR-9q7gg4. Registered on 21 January 2019.
Carlos Alexandre Aguiar Moreira, Luis Henrique Vallesquino Murayama, Tatiane de Camargo Martins, Vinicius Tadeu Oliveira, Diego Generoso, Vania Maria de Vasconcelos Machado, Sabrina Setembre Batah, Alexandre Todorovic Fabro, Rodrigo Bazan, Marco Antônio Zanini,et al.
Springer Science and Business Media LLC
Milena Miranda Vasconcelos, Camilla Sousa Ganan, Caroline Ferreira da Silva Mazeto Pupo da Silveira, Karina Nogueira Dias Secco Malagutte, Juliane Rosa Poiati, Hélio Rubens de Carvalho Nunes, Luis Cuadrado Martin, Rodrigo Bazan, Vera Therezinha Medeiros Borges, and Silméia Garcia Zanati Bazan
Elsevier BV
Lu Ma, Xin Hu, Lili Song, Xiaoying Chen, Menglu Ouyang, Laurent Billot, Qiang Li, Alejandra Malavera, Xi Li, Paula Muñoz-Venturelli,et al.
Elsevier BV
Daniele Andreza Antonelli Rossi, Jonas Alves De Araujo Junior, Gustavo José Luvizutto, Rodrigo Bazan, Péricles Sidnei Salmazo, Gabriel Pinheiro Modolo, João Carlos Hueb, Hélio Rubens de Carvalho Nunes, Newton Key Hokama, Marcos Ferreira Minicucci,et al.
MDPI AG
Introduction: The beneficial effects of physical exercise on functional capacity and inflammatory response are well-known in cardiovascular diseases; however, studies on sickle cell disease (SCD) are limited. It was hypothesized that physical exercise may exert a favorable effect on the inflammatory response of SCD patients, contributing to an improved quality of life. This study aimed to evaluate the effect of a regular physical exercise program on the anti-inflammatory responses in SCD patients. Methods: A non-randomized clinical trial was conducted in adult SCD patients. The patients were divided into two groups: 1—Exercise Group, which received a physical exercise program three times a week for 8 weeks, and; 2—Control Group, with routine physical activities. All patients underwent the following procedures initially and after eight weeks of protocol: clinical evaluation, physical evaluation, laboratory evaluation, quality of life evaluation, and echocardiographic evaluation. Statistical analysis: Comparisons between groups were made using Student’s t-test, Mann–Whitney test, chi-square test, or Fisher’s exact test. Spearman’s correlation coefficient was calculated. The significance level was set at p < 0.05. Results: There was no significant difference in inflammatory response between the Control and Exercise Groups. The Exercise Group showed an improvement in peak VO2 values (p < 0.001), an increase in the distance walked (p < 0.001), an improvement in the limitation domain due to the physical aspects of the 36-Item Short Form Health Survey (SF-36) quality of life questionnaire (p = 0.022), and an increase in physical activity related to leisure (p < 0.001) and walking (p = 0.024) in the International Physical Activity Questionnaire (IPAQ). There was a negative correlation between IL-6 values and distance walked on the treadmill (correlation coefficient −0.444, p = 0.020) and the estimated peak VO2 values (correlation coefficient −0.480; p = 0.013) in SCD patients in both groups. Conclusions: The aerobic exercise program did not change the inflammatory response profile of SCD patients, nor did it show unfavorable effects on the parameters evaluated, and patients with lower functional capacity were those with the highest levels of IL-6.