DANIEL KREMPEL AMADO
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
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conferenceObject Dabigatran versus Warfarin on Cognitive Outcomes in Nonvalvular Atrial Fibrillation: Results of the GIRAF Trial(2021) CARAMELLI, Bruno; YU, Pai C.; CARDOZO, Francisco A.; MAGALHAES, Iuri R.; FEITOSA, Raul R.; SPERA, Raphael; AMADO, Daniel; ROJAS, Maria Carmen Escalante; GUALANDRO, Danielle M.; CALDERARO, Daniela; TAVARES, Caio de Assis Moura A.; BORG-ES-JUNIOR, Flavio A.; PASTANA, Adriana F.; MATHEUS, Mariana G. Gomes; BRUCKI, Sonia M.; RODRIGUES, Ana C.; NITRINI, Ricardo M.; CARAMELLI, Paulo- Effects of dabigatran versus warfarin on 2-year cognitive outcomes in old patients with atrial fibrillation: results from the GIRAF randomized clinical trial(2022) CARAMELLI, Bruno; YU, Pai Ching; CARDOZO, Francisco A. M.; MAGALHAES, Iuri R.; SPERA, Raphael R.; AMADO, Daniel K.; ESCALANTE-ROJAS, Maria C.; GUALANDRO, Danielle M.; CALDERARO, Daniela; TAVARES, Caio A. M.; BORGES-JUNIOR, Flavio A.; PASTANA, Adriana F.; MATHEUS, Mariana G.; BRUCKI, Sonia M. D.; RODRIGUES, Ana Carolina O.; NITRINI, Ricardo; CARAMELLI, PauloBackground: Observational studies support a role for oral anticoagulation to reduce the risk of dementia in atrial fibrillation patients, but conclusive data are lacking. Since dabigatran offers a more stable anticoagulation, we hypothesized it would reduce cognitive decline when compared to warfarin in old patients with atrial fibrillation. Methods: The GIRAF trial was a 24-month, randomized, parallel-group, controlled, open-label, hypothesis generating trial. The trial was done in six centers including a geriatric care unit, secondary and tertiary care cardiology hospitals in Sao Paulo, Brazil. We included patients aged >= 70 years and CHA2DS2-VASc score > 1. The primary endpoint was the absolute difference in cognitive performance at 2 years. Patients were assigned 1:1 to take dabigatran (110 or 150 mg twice daily) or warfarin, controlled by INR and followed for 24 months. Patients were evaluated at baseline and at 2 years with a comprehensive and thorough cognitive evaluation protocol of tests for different cognitive domains including the Montreal Cognitive Assessment (MoCA), Mini-Mental State Exam (MMSE), a composite neuropsychological test battery (NTB), and computer-generated tests (CGNT). Results: Between 2014 and 2019, 5523 participants were screened and 200 were assigned to dabigatran (N = 99) or warfarin (N = 101) treatment. After adjustment for age, log of years of education, and raw baseline score, the difference between the mean change from baseline in the dabigatran group minus warfarin group was - 0.12 for MMSE (95% confidence interval [CI] - 0.88 to 0.63; P = 0.75), 0.05 (95% CI - 0.07 to 0.18; P = 0.40) for NTB, - 0.15 (95% CI - 0.30 to 0.01; P = 0.06) for CGNT, and - 0.96 (95% CI - 1.80 to 0.13; P = 0.02) for MoCA, with higher values suggesting less cognitive decline in the warfarin group. Conclusions: For elderly patients with atrial fibrillation, and without cognitive compromise at baseline that did not have stroke and were adequately treated with warfarin (TTR of 70%) or dabigatran for 2 years, there was no statistical difference at 5% significance level in any of the cognitive outcomes after adjusting for multiple comparisons.
conferenceObject Dabigatran versus Warfarin on Cognitive Outcomes in Nonvalvular Atrial Fibrillation: Results of the GIRAF Trial(2021) CARAMELLI, Bruno; YU, Pai C.; CARDOZO, Francisco A.; MAGALHAES, Iuri R.; FEITOSA, Raul R.; SPERA, Raphael; AMADO, Daniel; ROJAS, Maria Carmen Escalante; GUALANDRO, Danielle M.; CALDERARO, Daniela; TAVARES, Caio de Assis Moura A.; BORGES-JUNIOR, Flavio A.; PASTANA, Adriana F.; MATHEUS, Mariana G. Gomes; BRUCKI, Sonia M.; RODRIGUES, Ana C.; NITRINI, Ricardo M.; CARAMELLI, Paulo- Oxford Cognitive Screen – Brazilian Portuguese version (OCS-Br) A pilot study(2018) RAMOS, Claudia Cristina Ferreira; AMADO, Daniel Krempel; BORGES, Conrado Regis; BERGAMASCHI, Eduardo; NITRINI, Ricardo; BRUCKI, Sonia Maria DozziABSTRACT Cognitive impairment is very common in stroke patients and underdiagnosed. Symptoms such as language, praxis, visuospatial, visuoconstructive and memory impairment are prominent. The screening cognitive tests available do not address some specific characteristics of stroke patients and have major limitations in relation to the most impaired cognitive domains. Objective: To test the applicability of a Brazilian version of the Oxford Cognitive Screen in a convenience sample of individuals with normal cognition. Methods: Thirty neurologically healthy participants underwent the OCS-Br in this pilot study. Results: The mean score on each task was: naming: 3.4 (SD=0.72) (maximum value of 4); semantics: 3 (SD=0) (maximum 3); orientation: 4 (SD=0) (maximum 4); visual field: 4 (SD=0) (maximum 4); sentence reading: 14.53 (SD: 1) (maximum 15); number writing: 2.86 (0.6) (maximum 3); calculation: 3.8 (SD=0.48) (maximum 4); and accuracy on the broken hearts test: 47.3 (3.3) (maximum 50). The scores obtained were similar to those of the English original sample. Conclusion: We observed similar values on each separate OCS task in comparison to the original test, confirming that the Brazilian Portuguese version is comparable to other studies.
- Knowledge about Alzheimer's disease in the Brazilian population(2018) AMADO, Daniel Krempel; BRUCKI, Sonia Maria DozziDementia is a very common disease, but the general population's knowledge about its main etiology, Alzheimer's disease (AD), is still poor, leading to delayed seeking of healthcare services, less prevention of disease by lifestyle changes and more difficulty in managing the care of the demented. Objective: To measure knowledge about AD in a Brazilian sample, taking into account some demographic variables. Methods: A link to a self-administered online questionnaire was sent by email and via other social media to anyone older than 18 years old. Our questionnaire contained sociodemographic questions and the Alzheimer's Disease Knowledge Scale (ADKS), a well-established scale comprising 30 ""true or false"" questions about AD. Results: 1,414 people (1,076 females), with a mean age of 42.3 years (SD +/- 14.1), and 87.4% having more than 11 years of schooling, answered the online questionnaire. The mean total score for the ADKS was 21.6 out of 30 points (SD +/- 3.73); however when we excluded health professionals (36.4% of the sample), it dropped to 20.5/30 (SD +/- 3.51). The scores were positively influenced by educational level, professional skills (better for health professionals, mainly physicians) and by age (younger than 65 years). Being a caregiver or family member did not influence the knowledge about disease. Discussion: Despite the high prevalence of AD, few studies have been conducted in Brazil regarding the population's knowledge about the disease. Our study revealed a lack of information about AD in our country, even in relatives and caregivers of demented patients.