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
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- 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.
- 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.
- 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.
- Effectiveness of Multimodal Training Compared to a Uni-Modal Walking Intervention on Postural Control, Strength, Gait Speed and Flexibility in Community-Dwelling Older Adults(2024) CAMPOS, Camila Machado de; VIVEIRO, Larissa Alamino Pereira de; BUSSE, Alexandre Leopold; FERDINANDO, Douglas Cerqueira; JACOB FILHO, Wilson; LANGE, Belinda; POMPEU, Jose EduardoBackground: Multimodal training may induce positive effects in different physical domains. Compared to unimodal training, multimodal training allows similar effect sizes at lower overall training volumes. Studies are needed to investigate the potential value of multimodal training with systematic training, especially compared to other exercise-based interventions. This study aimed to compare the effects of a multimodal training with an outdoor walking program, on postural control, muscle strength, and flexibility in community-dwelling older adults. Methods: This study is a pragmatic controlled clinical trial. We compared two real community exercise groups: a multimodal group (n = 53) and an outdoor, overground walking group (n = 45). Both groups participated in 32 sessions of training, twice a week, over 16 weeks. Participants were evaluated using the Mini-Balance Evaluation Systems Test (Mini-BESTest), Handgrip, 5-Times Sit-to-Stand Test, 3-meter Gait Speed Test, and Sit and Reach Test. Results: There was an interaction effect between evaluation and group in the Mini- BESTest with difference between pre and post-intervention only in multimodal group. Regarding gait speed, there was an interaction effect between evaluation and group with difference between pre and post-intervention only in the walking group. In the Sit and Reach Test: there was interaction effect between evaluation and group with difference between pre and post-intervention only in the walking group. Conclusion: The multimodal training improved postural control, while an outdoor walking program improved gait speed and flexibility. Both interventions improved muscle strength without between-group differences.
- Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults(2023) CANONICA, Alexandra Carolina; ALONSO, Angelica Castilho; BRECH, Guilherme Carlos; PETERSON, Mark; LUNA, Natalia Mariana Silva; BUSSE, Alexandre Leopold; JACOB-FILHO, Wilson; ROSA, Juliana Leme; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; GREVE, Julia Maria D'AandreaContext: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. Objectives: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults' drives.Design: Male and female middle-aged adults (n = 62, age = 30.3 +/- 7.1 years) and older adults (n = 102, age = 70.4 +/- 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task.Results: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength.Conclusions: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor.
- Smoking Intensity Increases Diaphragm Muscle Injury: A Clinicopathologic Study(2023) NUCCI, Ricardo Aparecido Baptista; BUSSE, Alexandre Leopold; SOUZA, Romeu Rodrigues de; MAIFRINO, Laura Beatriz Mesiano; PASQUALUCCI, Carlos Augusto; ANARUMA, Carlos Alberto; LEITE, Renata Elaine Paraizo; RODRIGUEZ, Roberta Diehl; SUEMOTO, Claudia Kimie; JACOB-FILHO, WilsonBackground: Studying the effects of smoking intensity is important to evaluate the risk of tobacco use on a range of illnesses, such as as sarcopenia among the elderly. Thus, this study aimed to analyze the effects of pack-years of cigarette smoking on the diaphragm muscle (DIAm) histopathology of postmortem samples. Methods: Subjects were divided into three groups: never-smoker (n = 46); less than 30 pack-years of smoking (n = 12); and more than 30 pack-years of smoking (n = 30). Diaphragm samples were stained with Picrosirius red and hematoxylin and eosin stain for general structure. Results: Participants with more than 30 pack-years of cigarette smoking had a significant increase in adipocytes, blood vessels and collagen deposit, as well as an increase in histopathological alterations. Conclusions: Pack-years of smoking was associated with DIAm injury. However, further clinicopathological studies are needed to confirm our findings.
- Advancing cognitive assessment in telemedicine: Validity and reliability of the telephone 10-point cognitive screener(2023) RICO, Bruno Marcondes Hottum; ALIBERTI, Marlon Juliano Romero; SILVA, Natalia Oliveira Trajano da; BUSSE, Alexandre Leopold; SUEMOTO, Claudia Kimie; AVELINO-SILVA, Thiago Junqueira; MAGALDI, Regina Miksian; APOLINARIO, Daniel