ALEXANDRE LEOPOLD BUSSE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/66, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
- Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms(2023) SILVA, V. C.; DIAS, A. S.; GREVE, J. M. D.; DAVIS, C. L.; SOARES, A. L. D. S.; BRECH, G. C.; AYAMA, S.; JACOB-FILHO, W.; BUSSE, A. L.; BIASE, M. E. M. de; CANONICA, A. C.; ALONSO, A. C.The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.
conferenceObject PILATES METHOD IMPROVES PHYSICAL CAPACITY AND ANTI-OXIDATIVE SYSTEM IN ELDERLY WOMEN(2022) LACCHINI, Silvia; OLIVEIRA, Patrick Rodrigues De; ALVES, Tatiana Pereira; DIAS, Danielle Da Silva; BUSSE, Alexandre Leopold; ANGELIS, Katia De; JACOB FILHO, Wilson- High Prevalence of Energy and Nutrients Inadequacy among Brazilian Older Adults(2023) MAGALHAES, Natalia Vieira; WAITZBERG, Dan Linetzky; LOPES, Natalia Correia; VICEDOMINI, Ana Carolina Costa; PRUDENCIO, Ana Paula Aguiar; JACOB-FILHO, Wilson; BUSSE, Alexandre Leopold; FERDINANDO, Douglas; ALVES, Tatiana Pereira; PEREIRA, Rosa Maria Rodrigues; TORRINHAS, Raquel Susana; BELARMINO, GilianePoor nutrition increases the risk of diseases and adverse health outcomes in older adults. We evaluated the potential inadequacy of nutrient intake among older adults in Brazil and its association with body anthropometry and composition outcomes. Dietary intake was obtained from 295 community-living older adults (>60 years old), of both genders, using a seven-day food record. Nutrient inadequacy was further identified based on the Dietary Reference Intakes and European Guidelines. Skeletal muscle mass (SM), strength and performance, and the diagnosis of sarcopenia were assessed using reference methods. Nutritional inadequacy was high, with energy, dietary fiber, and six micronutrients exhibiting the greatest inadequacy levels (>80%). Energy intake was correlated with SM strength (p = 0.000) and performance (p = 0.001). Inadequate energy, fiber, and protein intakes influenced BMI, while inadequate intake of vitamin B6 directly affected the diagnosis of sarcopenia (p & LE; 0.005). Further research is required to investigate whether these inadequacies can be associated with other clinical health outcomes.
- Use of computerized tests to assess the cognitive impact of interventions in the elderly(2014) OLIVEIRA, Rafaela Sanches de; TREZZA, Beatriz Maria; BUSSE, Alexandre Leopold; JACOB FILHO, WilsonABSTRACT With the aging of the population, the possibility of the occurrence of cognitive decline rises. A number of types of intervention seek to attenuate or reverse this impairment. The use of computerized tests helps quantify the effects of interventions on cognitive function in the elderly. The objective of the present review was to analyze studies that have utilized computerized cognitive tests to determine the effects of interventions in the elderly population, describing the batteries and tests employed, the populations studied and reports by authors on the limitations or benefits of employing these tests in older adults. The review was performed on the PubMed database using the descriptors: cognitive computerized test and elderly. We retrieved 530 studies and, following analysis of their abstracts, selected 32 relevant to the subject. The studies utilized 19 different types of computerized tests and batteries to assess the interventions, which were predominantly drug trials. There were no reports on limitations in the use of the computerized tests, suggesting this type of intervention had good applicability, sensitivity, and little or no practice effects in this population.
conferenceObject PILATES METHOD IMPROVES PHYSICAL CAPACITY AND ANTI-OXIDATIVE SYSTEM IN ELDERLY WOMEN(2022) LACCHINI, Silvia; OLIVEIRA, Patrick Rodrigues De; ALVES, Tatiana Pereira; DIAS, Danielle Da Silva; BUSSE, Alexandre Leopold; ANGELIS, Katia De; JACOB FILHO, Wilson- Functional health literacy and glycaemic control in older adults with type 2 diabetes: a cross-sectional study(2014) SOUZA, Jonas Gordilho; APOLINARIO, Daniel; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; CAMPORA, Flavia; JACOB-FILHO, WilsonObjectives To investigate the relationship between functional health literacy and glycaemic control in a sample of older patients with type 2 diabetes. Design Cross-sectional study. Setting A government-financed outpatient geriatric clinic in SAo Paulo, Brazil. Participants 129 older patients with type 2 diabetes, a mean (SD) age of 75.9 (6.2) years, a mean glycosylated haemoglobin (HbA1c) of 7.2% (1.4), of which 14.7% had no formal education and 82.9% had less than a high-school diploma. Measures HbA1c was used as a measure of glycaemic control. Functional health literacy was assessed with the 18-item Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18), a validated instrument to evaluate pronunciation and comprehension of commonly used medical terms. Regression models were controlled for demographic data, depressive symptoms, diabetes duration, treatment regimen, diabetes knowledge and assistance for taking medications. Results Functional health literacy below adequate was encountered in 56.6% of the sample. After controlling for potential confounding factors, patients with inadequate functional health literacy were more likely than patients with adequate functional health literacy to present poor glycaemic control (OR=4.76; 95% CI 1.36 to 16.63). In a fully adjusted linear regression model, lower functional health literacy (=-0.42; p<0.001), longer diabetes duration (=0.24; p=0.012) and lack of assistance for taking medications (=0.23; p=0.014) were associated with higher levels of HbA1c. Contrary to our expectations, illiterate patients did not have poorer outcomes when compared with patients with adequate functional health literacy, raising the hypothesis that illiterate individuals are more likely to have their difficulties recognised and compensated. However, the small subsample of illiterate patients provided limited power to reject differences with small magnitude. Conclusions Patients with inadequate functional health literacy presented with higher odds of poor glycaemic control. These findings reinforce the importance of addressing limited functional health literacy in clinical practice.
- Chemical Composition of Quasi-ultrafine Particles and their Sources in Elderly Residences of Sao Paulo Megacity(2020) SEGALIN, Bruna; FORNARO, Adalgiza; KUMAR, Prashant; KLEMM, Otto; ANDRADE, Maria F.; TREZZA, Beatriz Maria; BUSSE, Alexandre; FILHO, Wilson J.; GONCALVES, Fabio L. T.Atmospheric quasi-ultrafine particles (qUFP; PM<0.25) can cause harmful effects to human health, mainly to elderly people. Although not always considered, these effects can be mostly due to its chemical composition. The scope of this work is (i) to quantify the abundance of ions and trace elements in qUFP in elderly residences, (ii) to identify the sources of these qUFP and (iii) to estimate the respiratory deposition doses (RDD) of qUFP and black carbon (rBC), which is an important component of qUFP, to various parts of the respiratory tract. In order to evaluate the qUFP chemical composition in elderly residences in the Metropolitan Area of Sao Paulo (MASP), we collected qUFP by using a Personal Cascade Impactor Sampler (PCIS). We analysed ions by chromatography and trace elements by Energy Dispersive X-Ray Fluorescence. We identified the sources of qUFP by applying Positive Matrix Factorization. We calculated the RDD through an equation, which use the tidal volume of lung, the typical breath frequency, the deposition fraction and the mass concentration of different size fractions of a PM. We collected 60 samples from 59 residences between May 2014 and July 2015. The major of ions concentrations in qUFP were found to be SO42- and NH4+, and the major trace elements were Si and Fe. Some residences have a high concentration of the toxic heavy metals Cu, Ni, Pb and Cr. We found six dominant sources of the indoor qUFP: vehicular emission (57%), secondary inorganic aerosol (21%), soil and construction (7%), wall painting (7%), cooking (5%) and industry (3%). The maximum RDD of qUFP and rBC are in the tracheobronchial part. Our results show that vehicular emissions dominate the indoor qUFP concentrations and uptake in elderly residences in the MASP.
- Acute Muscle Mass Loss Predicts Long-Term Fatigue, Myalgia, and Health Care Costs in COVID-19 Survivors(2023) GIL, Saulo; OLIVEIRA JUNIOR, Gersiel Nascimento de; SARTI, Flavia Mori; FILHO, Wilson Jacob; LONGOBARDI, Igor; TURRI, Jose Antonio Orellana; SHINJO, Samuel Katsuyuki; FERRIOLLI, Eduardo; -SILVA, Thiago Junqueira Avelino; BUSSE, Alexandre Leopold; GUALANO, Bruno; ROSCHEL, HamiltonObjective: We examined the impact of loss of skeletal muscle mass in post-acute sequelae of SARS-CoV-2 infection, hospital readmission rate, self-perception of health, and health care costs in a cohort of COVID-19 survivors.Design: Prospective observational study.Setting and Participants: Tertiary Clinical Hospital. Eighty COVID-19 survivors age 59 +/- 14 years were prospectively assessed.Methods: Handgrip strength and vastus lateralis muscle cross-sectional area were evaluated at hospital admission, discharge, and 6 months after discharge. Post-acute sequelae of SARS-CoV-2 were evaluated 6 months after discharge (main outcome). Also, health care costs, hospital readmission rate, and self -perception of health were evaluated 2 and 6 months after hospital discharge. To examine whether the magnitude of muscle mass loss impacts the outcomes, we ranked patients according to relative vastus lateralis muscle cross-sectional area reduction during hospital stay into either ""high muscle loss"" (-18 +/- 11%) or ""low muscle loss"" (-4 +/- 2%) group, based on median values. Results: High muscle loss group showed greater prevalence of fatigue (76% vs 46%, P =.0337) and myalgia (66% vs 36%, P = .0388), and lower muscle mass (-8% vs 3%, P < .0001) than low muscle loss group 6 months after discharge. No between-group difference was observed for hospital readmission and self -perceived health (P > .05). High muscle loss group demonstrated greater total COVID-19-related health care costs 2 ($77,283.87 vs. $3057.14, P = .0223, respectively) and 6 months ($90,001.35 vs $12, 913.27, P = .0210, respectively) after discharge vs low muscle loss group. Muscle mass loss was shown to be a predictor of total COVID-19-related health care costs at 2 (adjusted f3 = $10, 070.81, P < .0001) and 6 months after discharge (adjusted f3 = $9885.63, P < .0001). Conclusions and Implications: COVID-19 survivors experiencing high muscle mass loss during hospital stay fail to fully recover muscle health. In addition, greater muscle loss was associated with a higher frequency of post-acute sequelae of SARS-CoV-2 and greater total COVID-19-related health care costs 2 and 6 months after discharge. Altogether, these data suggest that the loss of muscle mass resulting from COVID-19 hospitalization may incur in an economical burden to health care systems.(c) 2022 AMDA -The Society for Post-Acute and Long-Term Care Medicine.
- Sleep quality is a predictor of muscle mass, strength, quality of life, anxiety and depression in older adults with obesity(2023) GENARIO, Rafael; GIL, Saulo; OLIVEIRA-JUNIOR, Gersiel; LEITAO, Alice Erwig; FRANCO, Tathiane; SALES, Ruan Celio dos Santos; FERRIOLLI, Eduardo; BUSSE, Alexandre Leopold; JACOB FILHO, Wilson; GUALANO, Bruno; ROSCHEL, HamiltonWe aimed to investigate associations between sleep quality with selected quantitative and qualitative parameters of health in older individuals with obesity. Cross-sectional assessment (n = 95 men/women; & GE; 65 years; BMI & GE; 30 kg/m(2)) of sleep quality, body composition, handgrip strength, quality-of-life, anxiety/depression. Mean PSQI score was 6.3. Poor sleepers (n = 49) presented lower appendicular lean mass (ALM) (16.2 vs 17.8 kg; p = 0.0273), ALM/BMI (0.47 vs 0.53 kg/BMI; p = 0.0085), fat mass (48.6 vs 46.6%; p = 0.0464), handgrip strength (19.7 vs 22.0 kgf; p = 0.0542) and handgrip/BMI (0.57 vs 0.66 kgf/BMI; p = 0.0242) than good sleepers. They also had higher anxiety (8.6 vs 5.6; p = 0.0100) and depression (4.8 vs 3.2; p = 0.0197) scores, worse health-related quality-of-life and lower scores in mental (62.8 vs 73.0; p = 0.0223) and physical (52.9 vs 67.3; p = 0.0015) domains. Adjusted models showed that PSQI was negatively associated with ALM (& beta; = - 0.13, 95% CI - 0.25; - 0.01) and health-related quality of life on physical (& beta; = - 2.76, 95% CI - 3.82; - 1.70) and mental (& beta; = - 2.25, 95% CI - 3.38; - 1.12) domains, and positively associated with anxiety (& beta; = 0.57; 95% CI 0.26; 0.87) and depression (& beta; = 0.31; 95% CI 0.13; 0.49). Poor sleep quality associates with impaired selected quantitative and qualitative parameters of health. Additionally, sleep quality was shown as an independent predictor of ALM, health-related quality-of-life, anxiety and depression in older individuals with obesity.
conferenceObject PILATES METHOD IMPROVES PHYSICAL CAPACITY AND ANTI-OXIDATIVE SYSTEM IN ELDERLY WOMEN(2022) LACCHINI, Silvia; OLIVEIRA, Patrick Rodrigues De; ALVES, Tatiana Pereira; DIAS, Danielle Da Silva; BUSSE, Alexandre Leopold; ANGELIS, Katia De; JACOB FILHO, Wilson