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
- Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly(2016) SOUZA, Jonas Gordilho; APOLINARIO, Daniel; FARFEL, José Marcelo; JALUUL, Omar; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; CAMPORA, Flávia; JACOB-FILHO, WilsonABSTRACT Objective To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge. Methods A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control. Results We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency. Conclusion This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills.
- Effects of resistance training and aerobic exercise in elderly people concerning physical fitness and ability: a prospective clinical trial(2013) ROMA, Maria Fernanda Bottino; BUSSE, Alexandre Leopold; BETONI, Rosana Aparecida; MELO, Antonio Cesar de; KONG, Juwando; SANTAREM, Jose Maria; JACOB FILHO, WilsonOBJECTIVE: To compare the effects of physical fitness and function on older adults in two programs of supervised exercise activity: resistance training and aerobic exercise. METHODS: This study is a randomized, prospective clinical trial composed of sedentary elderly people who did not have contraindications to exercise. Participants were divided into two groups: group one performed 6 exercises of resistance training twice a week, and group two participated in walking activity for 30 minutes twice a week. Functional assessment (time 0,6 and 12 months) was measured by the Short Physical Performance Battery (time to sit or stand, gait speed, and balance), flexibility test, and the six-minute walking test. We randomly selected 96 patients: 46 in the Resistance Training Group and 50 in the Aerobic Exercise Group. In the Resistance Training Group, 46 attended the first assessment and 20 attended until the third section. In the Aerobic Exercise Group, 50 attended the first assessment and 12 attended until the third assessment. RESULTS: Mean age was 68.8 years in the Resistance Training Group and 69.1 years in the Aerobic Exercise Group. The Resistance Training Group showed improvement in the sit/stand (p=0.022), balance with feet in a row (p=0.039) and queued (p=0.001). The second showed a statistical difference in speed and balance with the feet lined up and the feet together (p=0.008; p=0.02; and p=0.043, respectively). Concerning flexibility, the Resistance Training Group had improvement (p=0.001), whereas in the Aerobic Exercise Group, no significant difference was seen (p=0.359). Both groups had improvement in the six-minute walking test, but no significant improvement was seen in the Aerobic Exercise Group (p=0.033). CONCLUSION: Both groups showed improvement in physical fitness. No statistical difference was seen when groups was compared in the short physical performance battery, flexibility, and six-minute walking test.
- 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.
- 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.
- 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.
- Learning effect of computerized cognitive tests in older adults(2014) OLIVEIRA, Rafaela Sanches de; TREZZA, Beatriz Maria; BUSSE, Alexandre Leopold; JACOB FILHO, WilsonObjective To evaluate the learning effect of computerized cognitive testing in the elderly. Methods Cross-sectional study with 20 elderly, 10 women and 10 men, with average age of 77.5 (±4.28) years. The volunteers performed two series of computerized cognitive tests in sequence and their results were compared. The applied tests were: Trail Making A and B, Spatial Recognition, Go/No Go, Memory Span, Pattern Recognition Memory and Reverse Span. Results Based on the comparison of the results, learning effects were observed only in the Trail Making A test (p=0.019). Other tests performed presented no significant performance improvements. There was no correlation between learning effect and age (p=0.337) and education (p=0.362), as well as differences between genders (p=0.465). Conclusion The computerized cognitive tests repeated immediately afterwards, for elderly, revealed no change in their performance, with the exception of the Trail Making test, demonstrating high clinical applicability, even in short intervals.
- 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.