WILSON JACOB FILHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina - Líder
21 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 21
- Effects of Brazil nut consumption on selenium status and cognitive performance in older adults with mild cognitive impairment: a randomized controlled pilot trial (vol 55, pg 107, 2016)(2021) CARDOSO, Barbara Rita; APOLINARIO, Daniel; BANDEIRA, Veronica da Silva; BUSSE, Alexandre Leopold; MAGALDI, Regina Miksian; JACOB-FILHO, Wilson; COZZOLINO, Silvia Maria Franciscato
conferenceObject Bullseye - targeted geriatric assessment improves prognostication in hospitalized older adults(2021) AVELINO-SILVA, T. J.; CAMPORA, F.; CURIATI, J. A.; JACOB-FILHO, W.; ALIBERTI, M.- Are the 50's, the transition decade, in choroid plexus aging?(2021) TAHIRA, Ana; MARQUES, Fernanda; LISBOA, Bianca; FELTRIN, Arthur; BARBOSA, Andre; OLIVEIRA, Katia Cristina de; PEREIRA, Carlos Alberto de Braganca; LEITE, Renata; GRINBERG, Lea; SUEMOTO, Claudia; FERRETTI-REBUSTINI, Renata Eloah de Lucena; PASQUALUCCI, Carlos Augusto; JACOB-FILHO, Wilson; BRENTANI, Helena; PALHA, Joana AlmeidaThe choroid plexus (CP) is an important structure for the brain. Besides its major role in the production of cerebrospinal fluid (CSF), it conveys signals originating from the brain, and from the circulatory system, shaping brain function in health and in pathology. Previous studies in rodents have revealed altered transcriptome both during aging and in various diseases of the central nervous system, including Alzheimer's disease. In the present study, a high-throughput sequencing of the CP transcriptome was performed in postmortem samples of clinically healthy individuals aged 50's through 80's. The data shows an age-related profile, with the main changes occurring in the transition from the 50's to the 60's, stabilizing thereafter. Specifically, neuronal and membrane functions distinguish the transcriptome between the 50's and the 60's, while neuronal and axon development and extracellular structure organization differentiate the 50's from the 70's. These findings suggest that changes in the CP transcriptome occur early in the aging process. Future studies will unravel whether these relate with processes occurring in late- onset brain diseases.
- The Impact of Frailty on the Relationship between Life-Space Mobility and Quality of Life in Older Adults During the COVID-19 Pandemic(2021) SARAIVA, M. D.; APOLINARIO, D.; AVELINO-SILVA, T. J.; TAVARES, C. De Assis Moura; GATTAS-VERNAGLIA, I. F.; FERNANDES, C. Marques; RABELO, L. M.; YAMAGUTI, S. Tavares Fernandes; KARNAKIS, T.; KALIL-FILHO, R.; JACOB-FILHO, W.; ALIBERTI, Marlon Juliano RomeroBackground The COVID-19 pandemic has led to abrupt restrictions of lile-space mobility. The impact of shelter-in-place orders on older adults' health and well-being is still unclear. Objective To investigate the relationship between life-space mobility and quality of life (QoL) in older adults with and without frailty during the COVID-19 pandemic. Design Multicenter prospective cohort study based on structured telephone interviews. Setting Four geriatric outpatient clinics in the metropolitan area of Sao Paulo, Brazil. Participants 557 community-dwelling adults aged 60 years and older. Measurements The Life-Space Assessment was used to measure community mobility before and during the COVID-19 pandemic, and a previously validated decrease of >= 5 points defined restricted life-space mobility. Frailty was assessed through the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale. The impact of shelter-in-place orders on QoL was evaluated with the question << How is the COVID-19 pandemic affecting your QoL?>>, to which participants could respond << not at all >>, << to some extent >>, or << to a great extent >>. We used ordinal logistic regressions to investigate the relationship between restricted life-space mobility and impact on QoL, adjusting our analyses for demographics, frailty, comorbidities, cognition, functionality, loneliness, depression, and anxiety. We explored whether frailty modified the association between life-space mobility and impact on QoL. Results Participants were on average 80 +/- 8 years old, 65% were women, and 33% were frail. The COVID-19 quarantine led to a restriction of community mobility in 79% of participants and affected the QoL for 77% of participants. We found that restricted life-space mobility was associated with impact on QoL in older adults during the pandemic, although frailty modified the magnitude of the association (P-value for interaction=0.03). Frail participants who experienced restricted life-space mobility had twice the odds of reporting an impact on QoL when compared with non-frail individuals, with respective adjusted odds ratios of 4.20 (95% CI=2.36-7.50) and 2.18 (95% CI=1.33-3.58). Conclusion Older adults experienced substantial decreases in life-space mobility during the COVID-19 pandemic, and this unexpected change impacted their QoL. Providers should be particularly watchful for the consequences of abrupt life-space restrictions on frail individuals.
- Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID-19: a prospective observational study(2021) GIL, Saulo; JACOB FILHO, Wilson; SHINJO, Samuel Katsuyuki; FERRIOLLI, Eduardo; BUSSE, Alexandre Leopold; AVELINO-SILVA, Thiago Junqueira; LONGOBARDI, Igor; OLIVEIRA JUNIOR, Gersiel Nascimento de; SWINTON, Paul; GUALANO, Bruno; ROSCHEL, HamiltonBackground Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID-19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID-19 patients. Methods We evaluated prospectively 196 patients at hospital admission for muscle mass and strength. Ten patients did not test positive for SARS-CoV-2 during hospitalization and were excluded from the analyses. Results The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (+/- 15) years, body mass index of 29.5 (+/- 6.9) kg/m(2). The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. The crude hazard ratio (HR) for LOS was greatest for handgrip strength comparing the strongest versus other patients (1.47 [95% CI: 1.07-2.03; P = 0.019]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex-specific mean and standard deviation (1.23 [95% CI: 1.06-1.43; P = 0.007]). Mean LOS was shorter for the strongest patients (7.5 +/- 6.1 days) versus others (9.2 +/- 8.4 days). Evidence of associations were also present for vastus lateralis cross-sectional area. The crude HR identified shorter hospital stay for patients with greater sex-specific standardized values (1.20 [95% CI: 1.03-1.39; P = 0.016]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross-sectional area (0.63 [95% CI: 0.46-0.88; P = 0.006). Mean LOS for the patients with the lowest muscle cross-sectional area was longer (10.8 +/- 8.8 days) versus others (7.7 +/- 7.2 days). The magnitude of associations for handgrip strength and vastus lateralis cross-sectional area remained consistent and statistically significant after adjusting for other covariates. Conclusions Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID-19, which stresses the value of muscle health in prognosis of this disease.
- Serotonin receptor inhibitor is associated with falls independent of frailty in older adults(2021) LIN, Sumika M.; BORGES, Marcus K.; SIQUEIRA, Alaise S. S. de; BIELLA, Marina M.; JACOB-FILHO, Wilson; CESARI, Matteo; VOSHAAR, Richard C. Oude; APRAHAMIAN, IvanObjectives: To evaluate whether fall risk in older adults is associated with the use of selective serotonin receptor inhibitor (SSRI) monotherapy among geriatric outpatients, and whether this association is moderated by the presence of depressive disorder and/or frailty. Methods: Prospective cohort study with a 12-month follow-up and including 811 community-dwelling adults aged 60 or older from a university-based Geriatric Outpatient Unit. Major depressive disorder (MDD) was diagnosed according to DSM-5 criteria; subsyndromal depression as not meeting MDD criteria, but a Geriatric Depression Scale 15-item score ? 6 points. Frailty was evaluated with the FRAIL questionnaire. The association between SSRI use, depression, or both as well as the association between SSRI use, frailty, or both with falls were estimated through a generalized estimating equation (GEE) adjusted for relevant confounders. Results: At baseline, 297 patients (36.6%) used a SSRI (82 without remitted depression) and 306 (37.7%) were classified as physically frail. Frailty was more prevalent among SSRI users (44.8% versus 33.7%, p =.004). After 12 months, 179 participants had at least one fall (22.1%). SSRI use, depression as well as frailty were all independently associated with falls during follow-up. Nonetheless, patients with concurrent of SSRI usage and non-remitted depression had no higher risk compared to either remitted SSRI users or depressed patients without SSRIs. In contrast, concurrence of SSRI use and frailty increases the risk of falling substantially above those by SSRI usage or frailty alone. Conclusion: SSRI usage was independently associated with falls. Especially in frail-depressed patients, treatment strategies for depression other than SSRIs should be considered.
- A multidimensional program including standing exercises, health education, and telephone support to reduce sedentary behavior in frail older adults: Randomized clinical trial(2021) TOSI, Fabiana C.; LIN, Sumika M.; GOMES, Gisele C.; APRAHAMIAN, Ivan; NAKAGAWA, Naomi K.; VIVEIRO, Larissa; BACHA, Jessica M. R.; JACOB-FILHO, Wilson; POMPEU, Jose E.Objectives: The primary aim of this study was to evaluate the effect of a multidimensional program including home-based standing exercises, health education, and telephone support for the reduction of sedentary behavior in community-dwelling frail older adults. The secondary aim of this study was to evaluate the safety and adherence of the program. Study design: A single-blind, randomized controlled trial. Methods: A total of 43 frail older adults were randomly assigned to the intervention and control groups. The intervention consisted of combined strategies including home-based standing exercises, health education, and telephone support for 16 weeks for frail older adults. The control group received orientation regarding the harmful effects of a sedentary lifestyle. Sedentary behavior was evaluated by total sedentary time, accumulated sedentary time in bouts of at least 10 min, and by the break in sedentary time, measured by an accelerometer used for at least 600 min/day for 4 days. Safety was assessed by self-reporting of possible adverse events. Adherence was assessed based on the number of days in which standing exercises were performed by the participants. Repeated measures ANOVA and Tukeys post hoc test were used to analyze the collected data. Results: The intervention group reduced the sedentary time by 30 min/day (p= 0.048), but without significant maintenance after 30 days of the program. Of the total number of participants, 82% (n = 14) of the intervention group participants showed more than 70% adherence to the program. The main adverse effects faced by the intervention group participants were tiredness (53%; n = 9) and lower limb pain (47%; n = 8). Conclusions: The multidimensional program reduced sedentary behavior, was safe, and showed satisfactory adherence in frail older adults.
- Impact of the COVID-19 pandemic on the life-space mobility of older adults with cancer(2021) GATTAS-VERNAGLIA, Isabella Figaro; RAMOS, Paola Teruya; PERINI, Maria Laura Lazaretti; HIGA, Camila Suemi; APOLINARIO, Daniel; ALIBERTI, Marlon Juliano Romero; KANAJI, Ana Lumi; ADRIAZOLA, Izabela Ono; SARAIVA, Marcos Daniel; AVELINO-SILVA, Thiago Junqueira; TAVARES, Caio de Assis Moura; JACOB-FILHO, Wilson; KARNAKIS, Theodora
- COVID-19 is not over and age is not enough: Using frailty for prognostication in hospitalized patients(2021) ALIBERTI, Marlon Juliano Romero; SZLEJF, Claudia; AVELINO-SILVA, Vivian I.; SUEMOTO, Claudia Kimie; APOLINARIO, Daniel; DIAS, Murilo Bacchini; GARCEZ, Flavia Barreto; TRINDADE, Carolina B.; AMARAL, Jose Renato das Gracas; MELO, Leonardo Rabelo de; AGUIAR, Renata Cunha de; COELHO, Paulo Henrique Lazzaris; HOJAIJ, Naira Hossepian Salles de Lima; SARAIVA, Marcos Daniel; SILVA, Natalia Oliveira Trajano da; JACOB-FILHO, Wilson; AVELINO-SILVA, Thiago J.Background Frailty screening using the Clinical Frailty Scale (CFS) has been proposed to guide resource allocation in acute care settings during the pandemic. However, the association between frailty and coronavirus disease 2019 (COVID-19) prognosis remains unclear. Objectives To investigate the association between frailty and mortality over 6 months in middle-aged and older patients hospitalized with COVID-19 and the association between acute morbidity severity and mortality across frailty strata. Design Observational cohort study. Setting Large academic medical center in Brazil. Participants A total of 1830 patients aged >= 50 years hospitalized with COVID-19 (March-July 2020). Measurements We screened baseline frailty using the CFS (1-9) and classified patients as fit to managing well (1-3), vulnerable (4), mildly (5), moderately (6), or severely frail to terminally ill (7-9). We also computed a frailty index (0-1; frail >0.25), a well-known frailty measure. We used Cox proportional hazards models to estimate the association between frailty and time to death within 30 days and 6 months of admission. We also examined whether frailty identified different mortality risk levels within strata of similar age and acute morbidity as measured by the Sequential Organ Failure Assessment (SOFA) score. Results Median age was 66 years, 58% were male, and 27% were frail to some degree. Compared with fit-to-managing-well patients, the adjusted hazard ratios (95% confidence interval [CI]) for 30-day and 6-month mortality were, respectively, 1.4 (1.1-1.7) and 1.4 (1.1-1.7) for vulnerable patients; 1.5 (1.1-1.9) and 1.5 (1.1-1.8) for mild frailty; 1.8 (1.4-2.3) and 1.9 (1.5-2.4) for moderate frailty; and 2.1 (1.6-2.7) and 2.3 (1.8-2.9) for severe frailty to terminally ill. The CFS achieved outstanding accuracy to identify frailty compared with the Frailty Index (area under the curve = 0.94; 95% CI = 0.93-0.95) and predicted different mortality risks within age and acute morbidity groups. Conclusions Our results encourage the use of frailty, alongside measures of acute morbidity, to guide clinicians in prognostication and resource allocation in hospitalized patients with COVID-19.
- Usefulness of ECG criteria to rule out left ventricular hypertrophy in older individuals with true left bundle branch block: an observational study(2021) TAVARES, Caio Assis Moura; SAMESIMA, Nelson; NETO, Felippe Lazar; HAJJAR, Ludhmila Abrahao; GODOY, Lucas C.; PADRAO, Eduardo Messias Hirano; FACIN, Mirella; FILHO, Wilson Jacob; FARKOUH, Michael E.; PASTORE, Carlos AlbertoBackground Advanced age is associated with both left bundle branch block (LBBB) and hypertension and the usefulness of ECG criteria to detect left ventricular hypertrophy (LVH) in patients with LBBB is still unclear. The diagnostic performance and clinical applicability of ECG-based LVH criteria in patients with LBBB defined by stricter ECG criteria is unknown. The aim of this study was to compare diagnostic accuracy and clinical utility of ECG criteria in patients with advanced age and strict LBBB criteria. Methods Retrospective single-center study conducted from Jan/2017 to Mar/2018. Patients undergoing both ECG and echocardiogram examinations were included. Ten criteria for ECG-based LVH were compared using LVH defined by the echocardiogram as the gold standard. Sensitivity, specificity, predictive values, likelihood ratios, AUC, and the Brier score were used to compare diagnostic performance and a decision curve analysis was performed. Results From 4621 screened patients, 68 were included, median age was 78.4 years, (IQR 73.3-83.4), 73.5% with hypertension. All ECG criteria failed to provide accurate discrimination of LVH with AUC range between 0.54 and 0.67, and no ECG criteria had a balanced tradeoff between sensitivity and specificity. No ECG criteria consistently improved the net benefit compared to the strategy of performing routine echocardiogram in all patients in the decision curve analysis within the 10-60% probability threshold range. Conclusion ECG-based criteria for LVH in patients with advanced age and true LBBB lack diagnostic accuracy or clinical usefulness and should not be routinely assessed.
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