WILSON JACOB FILHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina - Líder
23 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 23
- Chronic Traumatic Encephalopathy Presenting as Alzheimer's Disease in a Retired Soccer Player(2016) GRINBERG, Lea T.; ANGHINAH, Renato; NASCIMENTO, Camila Fernandes; AMARO JR., Edson; LEITE, Renata P.; MARTIN, Maria da Graca M.; NASLAVSKY, Michel S.; TAKADA, Leonel T.; JACOB FILHO, Wilson; PASQUALUCCI, Carlos A.; NITRINI, RicardoThe relationship between soccer and chronic traumatic encephalopathy (CTE) is not well established. We report clinicopathological correlations in an 83-year-old retired center-back soccer player, with no history of concussion, manifesting typical Alzheimer-type dementia. Examination revealed mixed pathology including widespread CTE, moderate Alzheimer's disease, hippocampal sclerosis, and TDP-43 proteinopathy. This case adds to a few CTE cases described in soccer players. Furthermore, it corroborates that CTE may present clinically as typical Alzheimer-type dementia. Further studies investigating the extent to which soccer is a risk for CTE are needed.
- Muscle strength, postural balance, and cognition are associated with braking time during driving in older adults(2016) ALONSO, Angelica C.; PETERSON, Mark D.; BUSSE, Alexandre L.; JACOB-FILHO, Wilson; BORGES, Mauricio T. A.; SERRA, Marcos M.; LUNA, Natalia M. S.; MARCHETTI, Paulo H.; GREVE, Julia M. D. A.Background: Despite the well-known declines in driving performance with advancing age, there is little understanding of the specific factors that predict changes in key determinants such as braking time. Objectives: The aims of this study were to determine the extent to which age, muscle strength, cognition and postural balance are associated with braking performance in middle-aged and older adults. Methods: Male and female middle-aged adults (n = 62, age = 39.3 +/- 7.1 years) and older adults (n = 102, age = 70.4 +/- 5.8 years) were evaluated for braking performance, as well as in several motor and cognitive performance tasks. The motor evaluation included isokinetic ankle plantar flexor muscle strength, handgrip strength, and postural balance with and without a cognitive task. The cognitive assessment included the Mini Mental State Examination. Braking performance was measured using a driving simulator. Results: Older adults exhibited 17% slower braking time, lower strength, and poorer performance in the postural balance (p < 0.001). For both older and middle-aged adults, significant correlates of braking time included performance in the postural balance tests, muscle strength, and cognitive function. However, after full model adjustment, only postural balance and cognitive function were significantly associated. Conclusion: Muscle strength, postural balance, and cognition are associated with braking time, and may affect the safety of and driving performance in older adults. These findings may help to inform specific targeted interventions that could preserve driving performance during aging.
conferenceObject Prognostic effect of delirium superimposed on dementia in hospitalized older adults: a prospective cohort study(2016) AVELINO-SILVA, T. J.; CURIATI, J. A.; CAMPORA, F.; JACOB-FILHO, W.- Oral Infections and Cytokine Levels in Patients with Alzheimer's Disease and Mild Cognitive Impairment Compared with Controls(2016) CESTARI, Jose Augusto Ferrari; FABRI, Gisele Maria Campos; KALIL, Jorge; NITRINI, Ricardo; JACOB-FILHO, Wilson; SIQUEIRA, Jose Tadeu Tesseroli de; SIQUEIRA, Silvia Regina D. T.Background: Oral infections are prevalent in the adult population. Their impact includes the implication as a risk factor for Alzheimer's disease (AD), altering its progression. One of the potential mechanisms involves immune mediators such as circulating cytokines. Objective: The goal of the present study was to investigate the prevalence of oral infections and blood levels of IL-1 beta, TNF-alpha, and IL-6 in patients with AD, mild cognitive impairment (MCI), and controls. Methods: Sixty-five elderly were evaluated (25 AD, 19 MCI, and 21 controls) by the following methods: Mini Mental State Exam, Questionnaire of Functional Activities, periodontal and oral evaluation, and blood concentrations of IL-1 beta, TNF-alpha and IL-6. Results: Patients with AD had high serum IL-6 levels (p = 0.029), and patients with periodontitis had high serum TNF-alpha levels (p = 0.005). There was an association between IL-6 and TNF-alpha in patients with AD/MCI and periodontitis (p = 0.023). Conclusion: The increased levels of TNF-alpha and IL-6 in this study suggests their implication in the overlapping mechanisms between oral infections and AD. Longitudinal studies are necessary for further investigation.
conferenceObject Prognostic effects of delirium motor subtypes in hospitalized older adults: a prospective cohort study(2016) AVELINO-SILVA, T. J.; CURIATI, J. A.; CAMPORA, F.; JACOB-FILHO, W.- 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.
- Do age and sex impact on the absolute cell numbers of human brain regions?(2016) OLIVEIRA-PINTO, Ana V.; ANDRADE-MORAES, Carlos H.; OLIVEIRA, Lays M.; PARENTE-BRUNO, Danielle R.; SANTOS, Raquel M.; COUTINHO, Renan A.; ALHO, Ana T. L.; LEITE, Renata E. P.; SUEMOTO, Claudia K.; GRINBERG, Lea T.; PASQUALUCCI, Carlos A.; JACOB-FILHO, Wilson; LENT, RobertoWhat is the influence of sex and age on the quantitative cell composition of the human brain? By using the isotropic fractionator to estimate absolute cell numbers in selected brain regions, we looked for sex- and age-related differences in 32 medial temporal lobes (comprised basically by the hippocampal formation, amygdala and parahippocampal gyrus), sixteen male (29-92 years) and sixteen female (25-82); and 31 cerebella, seventeen male (29-92 years) and fourteen female (25-82). These regions were dissected from the brain, fixed and homogenized, and then labeled with a DNA-marker (to count all nuclei) and with a neuron-specific nuclear marker (to estimate neuron number). Total number of cells in the medial temporal lobe was found to be 1.91 billion in men, and 1.47 billion in women, a difference of 23 %. This region showed 34 % more neurons in men than in women: 525.1 million against 347.4 million. In contrast, no sex differences were found in the cerebellum. Regarding the influence of age, a quadratic correlation was found between neuronal numbers and age in the female medial temporal lobe, suggesting an early increase followed by slight decline after age 50. The cerebellum showed numerical stability along aging for both neurons and non-neuronal cells. In sum, results indicate a sex-related regional difference in total and neuronal cell numbers in the medial temporal lobe, but not in the cerebellum. On the other hand, aging was found to impact on cell numbers in the medial temporal lobe, while the cerebellum proved resilient to neuronal losses in the course of life.
- Effects of Brazil nut consumption on selenium status and cognitive performance in older adults with mild cognitive impairment: a randomized controlled pilot trial(2016) CARDOSO, Barbara Rita; APOLINARIO, Daniel; BANDEIRA, Veronica da Silva; BUSSE, Alexandre Leopold; MAGALDI, Regina Miksian; JACOB-FILHO, Wilson; COZZOLINO, Silvia Maria FranciscatoOxidative stress is closely related to cognitive impairment, and the antioxidant system may be a potential therapeutic target to preserve cognitive function in older adults. Selenium plays an important antioxidant role through selenoproteins. This controlled trial aimed to investigate the antioxidant and cognitive effects of the consumption of Brazil nuts, the best selenium food source. We enrolled 31 older adults with mild cognitive impairment (MCI) who were randomly assigned to ingestion of Brazil nuts or to the control group. Participants of the treatment group consumed one Brazil nut daily (estimated 288.75 A mu g/day) for 6 months. Blood selenium concentrations, erythrocyte glutathione peroxidase (GPx) activity, oxygen radical absorbance capacity, and malondialdehyde were evaluated. Cognitive functions were assessed with the CERAD neuropsychological battery. Eleven participants of the treated group and nine of the control group completed the trial. The mean age of the participants was 77.7 (+/- 5.3) years, 70 % of whom were female. We observed increased selenium levels after the intervention, whereas the control group presented no change. Among the parameters related to the antioxidant system, only erythrocyte GPx activity change was significantly different between the groups (p = 0.006). After 6 months, improvements in verbal fluency (p = 0.007) and constructional praxis (p = 0.031) were significantly greater on the supplemented group when compared with the control group. Our results suggest that the intake of Brazil nut restores selenium deficiency and provides preliminary evidence that Brazil nut consumption can have positive effects on some cognitive functions of older adults with MCI.
- d Argyrophilic Grain Disease: Demographics, Clinical, and Neuropathological Features From a Large Autopsy Study(2016) RODRIGUEZ, Roberta Diehl; SUEMOTO, Claudia Kimie; MOLINA, Mariana; NASCIMENTO, Camila Fernandes; LEITE, Renata Elaine Paraizo; FERRETTI-REBUSTINI, Renata Eloah de Lucena; FARFEL, Jose Marcelo; HEINSEN, Helmut; NITRINI, Ricardo; UEDA, Kenji; PASQUALUCCI, Carlos Augusto; JACOB-FILHO, Wilson; YAFFE, Kristine; GRINBERG, Lea TenenholzArgyrophilic grain disease (AGD) is a frequent late-onset, 4 repeat tauopathy reported in Caucasians with high educational attainment. Little is known about AGD in non-Caucasians or in those with low educational attainment. We describe AGD demographics, clinical, and neuropathological features in a multiethnic cohort of 983 subjects >50 years of age from Sao Paulo, Brazil. Clinical data were collected through semistructured interviews with an informant and included in the Informant Questionnaire on Cognitive Decline in the Elderly, the Clinical Dementia Rating, and the Neuropsychiatric Inventory. Neuropathologic assessment relied on internationally accepted criteria. AGD was frequent (15.2%) and was the only neuropathological diagnosis in 8.9% of all cases (mean, 78.9 +/- 9.4 years); it rarely occurred as an isolated neuropathological finding. AGD was associated with older age, lower socioeconomic status (SES), and appetite disorders. This is the first study of demographic, clinical, and neuropathological aspects of AGD in different ethnicities and subjects from all socioeconomic strata. The results suggest that prospective studies of AGD patients include levels of hormones related to appetite control as possible antemortem markers. Moreover, understanding the mechanisms behind higher susceptibility to AGD of low SES subjects may disclose novel environmental risk factors for AGD and other neurodegenerative diseases.
- Using temporal orientation, category fluency, and word recall for detecting cognitive impairment: the 10-point cognitive screener (10-CS)(2016) APOLINARIO, Daniel; LICHTENTHALER, Daniel Gomes; MAGALDI, Regina Miksian; SOARES, Aline Thomaz; BUSSE, Alexandre Leopold; AMARAL, Jose Renato das Gracas; JACOB-FILHO, Wilson; BRUCKI, Sonia Maria DozziObjectives: A screening strategy composed of three-item temporal orientation and three-word recall has been increasingly used for detecting cognitive impairment. However, the intervening task administered between presentation and recall has varied. We evaluated six brief tasks that could be useful as intervening distractors and possibly provide incremental accuracy: serial subtraction, clock drawing, category fluency, letter fluency, timed visual detection, and digits backwards. Methods: Older adults (n = 230) consecutively referred for suspected cognitive impairment underwent a comprehensive assessment for gold-standard diagnosis, of whom 56 (24%) presented cognitive impairment not dementia and 68 (30%) presented dementia. Among those with dementia, 87% presented very mild or mild stages (Clinical Dementia Rating 0.5 or 1). The incremental value of each candidate intervening task in a model already containing orientation and word recall was assessed. Results: Category fluency (animal naming) presented the highest incremental value among the six candidate intervening tasks. Reclassification analyses revealed a net gain of 12% among cognitively impaired and 17% among normal participants. A four-point scaled score of the animal naming task was added to three-item temporal orientation and three-word recall to compose the 10-point Cognitive Screener. The education-adjusted 10-point Cognitive Screener outperformed the longer Mini-Mental State Examination for detecting both cognitive impairment (area under the curve 0.85 vs 0.77; p = 0.027) and dementia (area under the curve 0.90 vs 0.83; p= 0.015). Conclusions: Based on empirical data, we have developed a brief and easy-to-use screening strategy with higher accuracy and some practical advantages compared with commonly used tools.
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