Alfésio Braga | Universidade Unisantos (original) (raw)

Papers by Alfésio Braga

PLOS ONE, 2015

(A) Dot-plot of individual PM2.5 levels (μg/m3</sup... more (A) Dot-plot of individual PM2.5 levels (μg/m3) of traffic professionals and forest institute staffers (FI). Each data point represents the average of two measurements 15 days apart. PM2.5 levels were defined in the three categories (lower: ≤22 μg/m3; middle: 23–37.5 μg/m3; upper: >37.5 μg/m3). (B) Bar graphs showing the percentage distribution of subjects in the three PM2.5 categories.* p<0.001</p

PLOS ONE, 2015

* Unpaired t-test or Mann Whitney test. Data were expressed as mean ± standard deviation... more * Unpaired t-test or Mann Whitney test. Data were expressed as mean ± standard deviation or median (interquartile range).Interleukins (IL) 2, 5, 10 and interferon gamma (IFN-γ) tear levels in traffic professionals and Forest Institute workers.</p

ISEE Conference Abstracts, 2014

*Introduction:* Effects of urban air pollutants on pulmonary function usually show an association... more *Introduction:* Effects of urban air pollutants on pulmonary function usually show an association with obstructive diseases. The aim of this study was to investigate the effects of heterogeneous ai...

Introduction: Air pollutants have been associated with gestational adverse effects. The aim of th... more Introduction: Air pollutants have been associated with gestational adverse effects. The aim of this study was to evaluate the impact of maternal exposure to indoor, outdoor and individual nitrogen ...

Brazilian Journal of Development, 2021

Introdução: Asma e obesidade são doenças frequentes em crianças e adolescentes e a sua associação... more Introdução: Asma e obesidade são doenças frequentes em crianças e adolescentes e a sua associação causa um impacto significativo em Saúde Pública. Objetivo: Avaliou o estado nutricional e a função pulmonar de crianças asmáticas e não asmáticas a serem seguidas em um estudo de painel sobre os efeitos da poluição na saúde respiratória. Método: Estudo transversal com a população formada por crianças asmáticas e não asmáticas com idade entre 6 a 12 anos de ambos os sexos, em fase escolar, de duas escolas municipais de Santos-SP. Foram realizadas espirometrias e medidas antropométricas de 80 escolares. Os pais ou responsáveis responderam também a questionários para avaliar presença de doença ou sintomas respiratórios (ISAAC) e, no caso dos asmáticos, o controle da doença. Resultados: Observou-se uma diferença entre os grupos de asmáticos e não asmáticos nos aspectos IMC/Idade Percentil (86,9 e 93,3, respectivamentep = 0,01) e IMC/Idade Z-Escore (1,78 e 2,31, respectivamentep = 0,02). Ambos os grupos se apresentam com valores indicativos de sobrepeso, entretanto o grupo não asmático apresentou um valor médio mais elevado, próximo do limite para obesidade. Não foi observada diferença entre os valores médios do Índice de Tiffenau (%) entre asmáticos (98,2; dp = 19,2) e não asmáticos (99,3; dp = 16,9). A baixa frequência de sintomas entre os asmáticos mostra o bom controle da doença entre os participantes. Conclusão: Foram formados dois grupos bem definidos no que se refere à presença ou não de asma e sintomas de doença respiratória, com características antropométricas especificas, sem diferenças nas provas de função pulmonar entre os dois grupos analisados no início do seguimento.

International Journal of Biometeorology, 2018

In Brazil, chronic diseases account for the largest percentage of all deaths among men and women.... more In Brazil, chronic diseases account for the largest percentage of all deaths among men and women. Among the cardiovascular diseases, stroke is the leading cause of death, accounting for 10% of all deaths. We evaluated associations between stroke and mean air temperature using recorded mortality data and meteorological station data from 2002 to 2011. A time series analysis was applied to 55,633 mortality cases. Ischemic and hemorrhagic strokes (IS and HS, respectively) were divided to test different impact on which subgroup. Poisson regression with distributed lag non-linear model was used and adjusted for seasonality, pollutants, humidity, and days of the week. HS mortality was associated with low mean temperatures for men relative risk (RR) = 2.43 (95% CI, 1.12-5.28) and women RR = 1.39 (95% CI, 1.03-1.86). RR of IS mortality was not significant using a 21-day lag window. Analyzing the lag response separately, we observed that the effect of temperature is acute in stroke mortality (higher risk among lags 0-5). However, for IS, higher mean temperatures were significant for this subtype with more than 15-day lag. Our findings showed that mean air temperature is associated with stroke mortality in the city of São Paulo for men and women and IS and HS may have different triggers. Further studies are needed to evaluate physiologic differences between these two subtypes of stroke.

Experimental Eye Research, 2019

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Pediatric Rheumatology, 2017

Introduction: In 2015 the historic Jones criteria for the diagnosis of Acute Rheumatic Fever (ARF... more Introduction: In 2015 the historic Jones criteria for the diagnosis of Acute Rheumatic Fever (ARF) were revised introducing two different sets of criteria for low-risk and for moderate/high-risk populations (according to ARF incidence). In Italy the exact ARF incidence is unknown but small regional or local reports suggest an incidence of 2-5/100.000 per year, suggesting that our population might be considered at moderate risk for ARF. Objectives: To evaluate the performance of the revised Jones criteria in a retrospective population and to compare it with the performance of the previous version of Jones criteria. Methods: We conducted a retrospective study on 288 patients with ARF (108 female; median age 8.5 years, IQR 7.1-10.3) diagnosed from 2001 to 2015 in a Pediatric Rheumatology Division by pediatric rheumatologists, discharged with an ICD 9 code consistent with ARF. We retrospectively applied the two sets (for low-risk and for moderate/high-risk) of the 2015 revised Jones criteria and the 1992 version of the Jones criteria. Results: Of 288 patients, 253 (87.8%) met the 1992 version of the Jones criteria, 237 (82.3%) met the revised criteria for low-risk populations and 259 (89.9%) for moderate/high-risk populations. None of these differences was significant. Prevalence of major and minor criteria is shown in Table. With the exception of difference in arthritis, the 1992 version and the 2015 revised version did not show major differences. Of the 288 patients with a clinical diagnosis of ARF 29 did not meet any version of the Jones criteria. Patients in this group presented with isolated chorea or silent carditis without other manifestations. Prevalence of the clinical characteristics and comparison among the 1992 version of Jones criteria and the 2015 revised Jones criteria (low risk and moderate-high risk populations): Values are expressed in Number (percentage). *p value (Fisher Exact test) Conclusion: The revised Jones criteria for low-risk populations are slightly more sensitive than the 1992 version of Jones criteria, while the revised Jones criteria for moderate/high populations are slightly less sensitive than the 1992 version. In this population, the revised criteria did not substantially modify the diagnosis of ARF. Approximately 10% of patients presented with isolated chorea or silent carditis.

PloS one, 2015

Air pollution is one of the most environmental health concerns in the world and has serious impac... more Air pollution is one of the most environmental health concerns in the world and has serious impact on human health, particularly in the mucous membranes of the respiratory tract and eyes. However, ocular hazardous effects to air pollutants are scarcely found in the literature. Panel study to evaluate the effect of different levels of ambient air pollution on lacrimal film cytokine levels of outdoor workers from a large metropolitan area. Thirty healthy male workers, among them nineteen professionals who work on streets (taxi drivers and traffic controllers, high pollutants exposure, Group 1) and eleven workers of a Forest Institute (Group 2, lower pollutants exposure compared to group 1) were evaluated twice, 15 days apart. Exposure to ambient PM2.5 (particulate matter equal or smaller than 2.5 μm) was 24 hour individually collected and the collection of tears was performed to measure interleukins (IL) 2, 4, 5 and 10 and interferon gamma (IFN-γ) levels. Data from both groups were co...

Arthritis care & research, Jan 17, 2015

To investigate the association between exposure to air pollutants in the São Paulo metropolitan a... more To investigate the association between exposure to air pollutants in the São Paulo metropolitan area and disease activity in childhood-onset systemic lupus erythematosus (C-SLE) patients. A longitudinal panel study was carried out based on 409 consecutive visits of C-SLE patients (ACR criteria) living in the São Paulo metropolitan area. Disease activity was evaluated according to Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and the patients were divided in two groups: SLEDAI≤8 and SLEDAI>8. Daily concentrations of inhaled particulate matter (PM10 ), sulfur dioxide (SO2 ), nitrogen dioxide (NO2 ), ozone (O3 ) and carbon monoxide (CO) were evaluated on the 31 days preceding the medical visits. A generalized estimation equation (GEE) model was used to assess the impact of these measurements on the SLEDAI-2K score, considering the fixed effects for repetitive measurements. The models were adjusted for erythrocyte sedimentation rate (ESR), corticosteroid use (...

Modern rheumatology, Jan 11, 2017

The objective of this study is to evaluate the influence of exposure to air pollutants and inhala... more The objective of this study is to evaluate the influence of exposure to air pollutants and inhalable environmental elements during pregnancy and after birth until childhood-onset systemic lupus erythematosus(cSLE) diagnosis. This case-control study comprised 30 cSLE patients and 86 healthy controls living in the Sao Paulo metropolitan area. A structured and reliable questionnaire (kappa index for test-retest was 0.78) assessed demographic data, gestational and perinatal-related-factors, and exposure to inhalable elements during pregnancy and after birth (occupational exposure to inhalable particles and/or volatile vapor, and/or tobacco, as well as, the presence of industrial activities or gas stations near the home/work/daycare/school). Tropospheric pollutants included: particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO). The median current age was similar between cSLE patients and healthy controls [16.0 (5-21) versus 15.0 (4-...

American Journal of …, Jan 1, 2010

Page 1. / Poster Discussion Session / Sunday, May 16/1:30 A106 BIOMASS SMOKE: ORGANIC DOES NOT ME... more Page 1. / Poster Discussion Session / Sunday, May 16/1:30 A106 BIOMASS SMOKE: ORGANIC DOES NOT MEAN LESS HARMFUL! PM-4:00 PM / Room 225-227 (Second Level), Morial Convention Center Impact Of Sugar ...

ISEE Conference Abstracts

Environmental science and pollution research international, Jan 14, 2017

Heavy metal contamination is a long-standing and very well-known public health problem, and its e... more Heavy metal contamination is a long-standing and very well-known public health problem, and its exposure can cause damage to several organs of human body, especially on the central nervous system of young children and teenagers. The aim of this article is to evaluate lead, cadmium, and manganese contamination in 125 children from 6 to 13 years old living in contaminated areas during the period from 2006 to 2009 (São Vicente, Cubatão Downtown, Bertioga and Cubatão Pilões/Água Fria). This estuary area is the most important example of environmental degradation by chemicals from industrial sources. This is a cross-sectional study through clinical examinations and dental enamel tests. All mothers from these children lived in the area since before the pregnancy. Lead, cadmium, and manganese levels (μg/g) were measured on dental enamel samples through graphite furnace atomic absorption spectrometry, searching for the occurrence of heavy metals. The mean lead concentrations were 139.48 μg/g...

Brazilian Journal of Medical and Biological Research, 2006

The objective of the present study was to determine the impact of acute short-term exposure to ai... more The objective of the present study was to determine the impact of acute short-term exposure to air pollution on the cardiorespiratory performance of military fireman living and working in the city of Guarujá, São Paulo, Brazil. Twenty-five healthy non-smoking firemen aged 24 to 45 years had about 1 h of exposure to low and high levels of air pollution. The tests consisted of two phases: phase A, in Bertioga, a town with low levels of air pollution, and phase B, in Cubatão, a polluted town, with a 7-day interval between phases. The volunteers remained in the cities (Bertioga/Cubatão) only for the time required to perform the tests. Cumulative load 10 ± 2 min-long exertion tests were performed on a treadmill, consisting of a 2-min stage at a load of 7 km/ h, followed by increasing exertion of 1 km h-1 min-1 until the maximum individual limit. There were statistically significant differences (P < 0.05) in anaerobic threshold (AT) between Cubatão (35.04 ± 4.91 mL kg-1 min-1) and Bertioga (36.98 ± 5.62 mL kg-1 min-1 ; P = 0.01), in the heart rate at AT (AT HR ; Cubatão 152.08 ± 14.86 bpm, Bertioga 157.44 ± 13.64 bpm; P = 0.001), and in percent maximal oxygen consumption at AT (AT%VO 2max ; Cubatão 64.56 ± 6.55%, Bertioga 67.40 ± 5.35%; P = 0.03). However, there were no differences in VO 2max , maximal heart rate or velocity at AT (AT vel) observed in firemen between towns. The acute exposure to pollutants in Cubatão, SP, caused a significant reduction in the performance at submaximal levels of physical exertion.

Brazilian Journal of Infectious Diseases, 2007

Potent antimicrobial agents have been developed as a response to the development of antibiotic-re... more Potent antimicrobial agents have been developed as a response to the development of antibiotic-resistant bacteria, which especially affect patients with prolonged hospitalization in Intensive Care Units (ICU) and who had been previously treated with antimicrobials, especially third-generation cephalosporins.This study was to determine how changes in the empirical treatment of infections in ICU patients affect the incidence of Gram-negative bacteria species and their susceptibility to antimicrobials, and examine the impact of these changes on nosocomial infections. A prospective interventional study was performed in a university hospital during two periods: 1) First period (September 1999 to February 2000); and 2) Second period (August 2000 to December 2000); empirical treatment was changed from ceftriaxone and/or ceftazidime in the first period to piperacillin/tazobactam in the second. ICU epidemiological and infection control rates, as well as bacterial isolates from upper airways were analyzed. Ceftazidime consumption dropped from 34.83 to 0.85 DDD/1000 patients per day (p=0.004). Piperacillin/tazobactam was originally not available; its consumption reached 157.07 DDD/1000 patients per day in the second period (p=0.0002). Eighty-seven patients and 66 patients were evaluated for upper airway colonization in the first and second periods, respectively. There was a significant decrease in the incidence of K. pneumoniae (p=0.004) and P. mirabilis (p=0.036), restoration of K. pneumoniae susceptibility to cephalosporins (p<0.0001) and reduction of ventilator-associated pneumonia rates (p<0.0001). However, there was an increase in P. aeruginosa incidence (p=0.005) and increases in ceftazidime (p=0.003) and meropenem (p<0.0001) susceptibilities. Changing antimicrobial selective pressure on multi-resistant Gram-negative bacteria helps control ventilator-associated pneumonia and decreases antimicrobial resistance.

PLOS ONE, 2015

ISEE Conference Abstracts, 2014

Brazilian Journal of Development, 2021

International Journal of Biometeorology, 2018

Experimental Eye Research, 2019

Pediatric Rheumatology, 2017

PloS one, 2015

Arthritis care & research, Jan 17, 2015

Modern rheumatology, Jan 11, 2017

American Journal of …, Jan 1, 2010

ISEE Conference Abstracts

Environmental science and pollution research international, Jan 14, 2017

Brazilian Journal of Medical and Biological Research, 2006

Brazilian Journal of Infectious Diseases, 2007