GUILHERME DE AMORIM AVILLA GIMENEZ JUNIOR
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
LIM/22 - Laboratório de Patolologia Cardiovascular, Hospital das Clínicas, Faculdade de Medicina
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- Anticholinergic burden and cognitive performance: cross-sectional results from the ELSA-Brasil study(2022) SANTOS, Adriana Nancy Medeiros dos; GIMENEZ JUNIOR, Guilherme Amorim Avilla; BENSENOR, Isabela M.; GOULART, Alessandra C.; BRUNONI, Andre R.; VIANA, Maria Carmen; LOTUFO, Paulo A.; SUEMOTO, Claudia KimieObjectives Using multiple drugs with anticholinergic properties is common and might lead to cumulative anticholinergic toxicity and increased risk of cognitive impairment. Therefore, we sought to investigate the association between the Anticholinergic Cognitive Burden (ACB) Scale and cognitive performance among middle-aged and older adults. Methods In this cross-sectional study with 13,065 participants from the baseline visit of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), mean age was 51.7 +/- 9.0 years old, 55% women, and 53% white. The ACB was calculated based on the medications in use. We investigated the association of ACB with global cognition and memory, verbal fluency (VF), and trail-making test version B (TMT-B) z-scores, using multiple linear regression models adjusted for sociodemographic and clinical variables. Results Overall, 16% of participants had an ACB score greater than 0. ACB was associated with poor cognitive performance in all tests in crude analysis. After adjustment for sociodemographic characteristics, the association remained significant for the global cognitive score, as well as the memory and the TMT-B z-scores. However, after further adjustments for clinical variables, only trend associations of ACB with poor memory (beta = - 0.02, 95% Cl = - 0.05, 0.00, p = 0.056) and the TMT-B z-scores (beta = - 0.02, 95% Cl = - 0.04, 0.00, p = 0.054) were found. In stratified analyses by age groups, ACB was associated with poor cognitive performance on the TMT-B (beta = - 0.03, 95% Cl = - 0.05, - 0.01, p = 0.005) in individuals aged less than 65 years old. Conclusion Although the ACB was associated with poor executive function only among middle-aged adults in adjusted analysis, residual confounding may partly explain our results.
- Death trends based on autopsy data compared to the beginning of the coronavirus pandemic in Brazil(2021) GIMENEZ JUNIOR, G. A. A.; ZILLI, P. K.; SILVA, L. F. F.; PASQUALUCCI, C. A.; CAMPO, A. B.; SUEMOTO, C. K.The novel Coronavirus disease (COVID-19) is responsible for thousands of deaths worldwide, especially in Brazil, currently one of the leading countries in number of infections and deaths. The beginning of the COVID-19 epidemic in Brazil is uncertain due to the low number of tests done in the country. The excess number of deaths can suggest the beginning of the pandemic in this context. In this article, we used an autoregressive integrated moving average (ARIMA) model to investigate possible excesses in the number of deaths processed by the Sao Paulo Autopsy Service according to different causes of deaths: all-cause, cardiovascular, and pulmonary causes. We calculated the expected number of deaths using data from 2019 to 2020 (n=17,011), and investigated different seasonal patterns using harmonic dynamic regression with Fourier terms with residuals modeled by an ARIMA method. We did not find any abnormalities in the predicted number of deaths and the real values in the first months of 2020. We found an increase in the number of deaths only by March 20, 2020, right after the first COVID-19 confirmed case in the city of Sao Paulo, which occurred on March 16, 2020.