Thesis--University of Oklahoma. / Bibliography: leaf 44.

Thesis (M.A.)--University of South Florida, 2006. / Title from PDF of title page. Document formatted into pages; contains 68 pages. Includes bibliographical references.

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No. of bitstreams: 1 tacao_gy_me_prud.pdf: 2135735 bytes, checksum: 93545f4e3b7def501ab6778934b0c728 (MD5) Previous issue date: 2017-08-28 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: A poluição atmosférica se tornou um importante problema de saúde pública a nível mundial e tem sido apontada como causa de impactos negativos na saúde humana. Esse impacto inclui aumento de mortalidade, de admissões hospitalares, de visitas à emergência e de utilização de medicamentos, devidas a doenças respiratórias e cardiovasculares. Objetivo: Essa dissertação teve como objetivos: analisar o impacto da exposição a poluentes atmosféricos nas doenças respiratórias e cardiovasculares na população adulta, além de investigar as doenças respiratórias nas crianças e adolescentes de uma cidade do sudoeste do estado de São Paulo moradores próximos a uma usina de cana-de-açúcar. Métodos: O estudo foi do tipo transversal, retrospectivo, de base populacional, utilizando-se de dados por meio de um Inquérito de Saúde para adultos e International Study of Asthma and Allergies in Childhood (ISAAC) em crianças e adolescentes, foram entrevistados no total 335 indivíduos. Os questionários foram aplicados diretamente à pessoa ou ao responsável para os menores de 12 anos. Foram utilizados os blocos temáticos de doenças respiratórias e cardiovasculares. Para assegurar a qualidade na coleta dos dados, foram realizadas entrevistas diretamente no domicílio por pesquisadores devidamente treinados. Para análise sanguínea foi analisado hemograma completo e glicemia de maneira que, fossem analisados níveis anormais para possível detecção de fatores de risco cardiovasculares. Conclusões: A exposição a queima de biomassa em moradores próximos a uma usina de cana de açúcar gerou impacto negativo no sistema respiratório nos moradores, tanto adultos quanto crianças moradoras do distrito, principalmente em mulheres e crianças. / Introduction: Air pollution is an important public health problem worldwide and has been cited as the cause of negative impacts on human health. This impact includes increased mortality, hospital admissions, emergency visits and medication use, due to respiratory and cardiovascular diseases. Objective: The objective of this dissertation was to analyze the impact of exposure to air pollutants on respiratory and cardiovascular diseases in the adult population, as well as to investigate respiratory diseases in children and adolescents living nearby a sugarcane factory in a city in the southwest of São Paulo. Methods: The study was a cross-sectional, retrospective, population-based study using data from an Adult Health Survey and International Study of Asthma and Allergies in Childhood (ISAAC) in children and adolescents, a total of 335 individuals were interviewed. The questionnaires were applied directly to the person or guardian for those under 12 years of age. Thematic blocks of respiratory and cardiovascular diseases were used. To ensure the quality of the data collection, interviews were conducted directly at the home by properly trained researchers. For blood analysis, complete blood count and glycemia were analyzed so that abnormal levels were analyzed for the possible detection of cardiovascular risk factors. Conclusions: Exposure to biomass burning in residents nearby a sugarcane plantation generated a negative impact on the respiratory system in residents, both adults and children living in the district, especially in women and children. / FAPESP: 15/14648-8

A estreita relação entre saúde da criança e fatores sociais e econômicos é reconhecida há muito tempo, mas ainda a grande maioria das crianças pobres que adoece morre mais. Portanto, é necessário ampliar o conhecimento a respeito da rede de determinantes (distais, intermediários e proximais) dos problemas de saúde mais prevalentes nas crianças. As doenças respiratórias constituem uma das principais causas de morbidade e mortalidade infantil no Brasil e no mundo Justifica-se, pois, reconhecer os processos determinantes dos problemas respiratórios, considerando a determinação social do processo saúde-doença. Assim, os objetivos deste trabalho foram estimar a prevalência dos problemas respiratórios nos diferentes grupos sociais homogêneos; caracterizar como esses problemas se relacionam às formas de reprodução social das famílias e avaliar os determinantes proximais, intermediários e distais associados à sua ocorrência. Este estudo populacional transversal foi realizado no município de Itupeva (SP), numa amostra representativa de 261 crianças menores de dois anos. A partir de um modelo teórico hierarquizado, centrado na categoria da reprodução social, foram compostos os perfis de reprodução social, utilizando-se uma base teórico-metodológica-operacional que predefiniu três grupos sociais homogêneos (GSH): formas de trabalhar e de viver adequadas (GSH1); formas de trabalhar ou de viver adequadas (GSH2) e formas de trabalhar e de viver inadequadas (GSH3). Os problemas respiratórios foram detectados segundo informações obtidas por meio de inquérito recordatório do último mês. Associações foram verificadas pelo teste Qui-quadrado (variáveis categóricas) ou teste de Fischer, e teste t de Student (variáveis contínuas). Utilizou-se o modelo de regressão logística não condicional para a análise múltipla. Para evitar exclusão de variáveis importantes, utilizou-se um nível de significância de 0,20 e para indicar associação estatisticamente significativa, nível de 0,05. Na análise múltipla, as associações foram expressas em odds ratio e seu intervalo de confiança [IC] para 95%. A prevalência de problema respiratório foi de 71,6% (IC95% 65,8 - 77,0), sendo maior nos estratos inferiores, porém sem diferença estatisticamente significativa: 64,0% no GSH1, 75,8% no GSH2 e de 71,5% GSH3 (p>0,05). Com relação ao total da amostra, a escolaridade do pai se mostrou estatisticamente diferente entre as crianças que haviam apresentado problema respiratório e aquelas que não haviam apresentado: 56,1% dos pais das crianças com problemas respiratórios tinham menos de 7 anos de estudo, enquanto 62,9% dos pais das crianças sem problemas respiratórios tinham mais de 7 anos de estudo. A escolaridade materna seguiu a mesma tendência. A ocorrência de problemas respiratórios foi discretamente maior nas crianças do sexo feminino, e naquelas de 12 a 18 meses. A primeira etapa da regressão logística testou cada variável que se associou com a ocorrência de problemas respiratórios (p<0,20). A segunda etapa foi verificar em cada nível hierárquico (determinantes distais, intermediários e proximais), as variáveis que mantinham associação com a ocorrência de problemas respiratórios, quando analisadas em conjunto com as outras variáveis do mesmo nível. A terceira etapa incluiu, no modelo, os determinantes distais (variáveis sociodemográficas e de trabalho do chefe) e intermediários (formas de viver). Nessa fase, o modelo selecionou, como significativamente associadas com a ocorrência de problemas respiratórios, a escolaridade do pai e a ventilação da casa. Variáveis essas que permaneceram na quarta etapa, em que se incluíram os determinantes proximais (características infantis e de atendimento à saúde). Permaneceram significativamente associadas à ocorrência de problemas respiratórios, até a última etapa do modelo hierarquizado, a escolaridade do pai e a idade da criança, o que demonstra a importância dos determinantes distais no desfecho do processo saúde-doença. Embora a melhoria nas formas de trabalhar e de viver das famílias aparentemente não seja atribuição de profissionais de saúde, uma vez que se atrelam a transformações estruturais, estes são responsáveis pela conscientização da população e sua mobilização em torno de objetivos comuns, em busca de uma melhor integração social / The close relation between children\'s health and socioeconomics factors is recognized for a long time; however, even so the most majority of poor children which become sick die more than others. Therefore, it\'s necessary to enlarge de knowledge about the determinants (distal, intermediate and proximal) of most prevalent children\'s health problems. Respiratory disease is one of the main causes of infant morbidity and mortality in Brazil and in the world. So it\'s justified to recognize the processes that determine the respiratory problems, considering the social determination of health-disease process. Thus, this work aimed to estimate the prevalence of respiratory problems at different homogeneous social groups; to characterize how these problems are related to social reproduction of families and to evaluate the proximal and distal determinants related to their occurrence. This transverse population study was carried out at the city of Itupeva (São Paulo, Brazil), with a representative sample of 261 children under 2 years old. Based on a hierarchical theoretical model, focused on social reproduction, the profiles of social reproduction were composed by using an operationalmethodological- theoretical basis that pre-defined three homogeneous social groups (HSG): proper ways of working and living (HSG1), proper ways of working or living (HSG2); improper ways of working and living (HSG3). The respiratory problems were detected through information got from the remainder inquiry of the last month. Associations were observed through Chi-square test (scaled variables) or Fischer Test, and Student t-test (continuous variables). The non-conditional logistic regression model was used to accomplish the multiple analyses. In order to avoid exclusion of important variables, it was used a significance level of 0.20, and a level of 0.05 was used to indicate a statistically significant association. At the multiple analysis, the association were expressed by odds ratio (OR) and their confidence interval (CI) to 95%. The prevalence of respiratory problem was 71.6% (CI95% 65.8 - 77), being greater at inferior layers, but without a statistically significant difference: 64.0% at HSG1, 75.8% at HSG2 and 71.5% at HSG3 (p>0.05). With regard to the total of sample, father\'s schooling level has showed to be statistically different among children which have presented respiratory problem and children which not presented: 56.1% of fathers (children with respiratory problems) have less than seven years of schooling, while 62.9 of fathers (children without respiratory problems) have more than seven years of schooling. Mother\'s schooling follows the same tendency. The occurrence of respiratory problems was a little bigger to female children and to those with ages among 12-18 months. The first step of logistic regression has tested each variable associated with the occurrence of respiratory problem (p<0.20). The objective of the second step was to check in each hierarchical level (distal, intermediate and proximal determinants) the variables that kept an association with the occurrence of respiratory problems when analyzed together with others of the same level. The third step has included (in the model) the distal determinants (socialdemographics variables and work of household variables) and intermediate determinants (ways of living). At this stage, the model has chosen, as significantly related to respiratory problems, the father\'s schooling level and the house ventilation. These variables have remained in the fourth step, and in these same step it has been included the proximal determinants (infant characteristics and health care). Also the father\'s schooling level and children\'s age have remained significantly associated to until the last step of the model respiratory problems; this demonstrates the importance of the distal determinants in the conclusion of the process health-disease. Although the improvement of the ways of working and living of the families appear not to be part of attributions of health professionals (once these ways are linked to structural transformations), they are responsible to aware and mobilize the population around a common objective, that is a better social integration

Orientador: Carlos Roberto Silveira Correa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T23:23:18Z (GMT). No. of bitstreams: 1 Fialho_PaulaMayaraMatos_M.pdf: 4006179 bytes, checksum: 3811feb02dfa10d8653c3dbcd13e9b40 (MD5) Previous issue date: 2012 / Resumo: A associação entre toxocaríase, asma e aumento de peso ainda não foi estudada. Considerando-se que, provavelmente, haja diferenças entre os diversos fatores de risco para asma, assim como, o aumento de peso e levando-se em consideração que a toxocaríase é uma doença que acomete principalmente crianças, torna-se importante descrever a associação entre essas três variáveis. O objetivo deste trabalho foi estudar a associação entre toxocaríase, prevalência de asma e o sobrepeso e obesidade em crianças adscritas em uma Unidade Básica de Saúde (UBS) do município de Campinas, SP. Os resultados desta dissertação são apresentados no capítulo que engloba o artigo, Associação entre toxocaríase, asma e o índice de massa corporal em crianças, trata-se de um estudo transversal, realizado a partir de uma análise documental feita nos prontuários de 116 crianças atendidas na UBS do Jardim Santa Mônica em Campinas entre os anos 1996 a 1998. As seguintes informações foram obtidas dos prontuários: peso, altura, idade, sexo, presença ou não de asma, resultado do teste sorológico para Toxocara canis, presença ou não de eosinofilia. Para avaliação da antropometria foi usado os escores z. Para o estudo das associações entre presença de sorologia positiva para Toxocara canis, asma e IMC, foi utilizado o teste Wilcoxon para duas amostras. A amplitude da idade foi de 2 a 14 anos. Quanto ao sexo, 57,8% foram do sexo masculino. A prevalência de asma foi de 37,9% e a de crianças com sorologia positiva para infecção por T. canis foi de 54,3%. Comparando-se a distribuição z do IMC das crianças com sorologia positiva para infecção por T. canis com os das não infectadas, observou-se que os escores z mais elevados eram os das crianças com asma e com toxocaríase. Este trabalho aponta para a existência de uma associação entre a infecção por T. canis, asma e aumento do índice de massa corporal em crianças. A infecção por Toxocara tem associação com duas doenças de maior relevância na pediatria, a asma e a obesidade, as quais necessitam da atenção de todos os profissionais da saúde / Abstract: The association between toxocariasis, asthma and weight gain has not been studied. Considering that probably there are differences between the various risk factors for asthma, as well as weight gain and taking into account that toxocariasis is a disease that mainly affects children, it is important to describe the association between these three variables. The objective of this study was to investigate the association between toxocariasis and prevalence of overweight and obesity and asthma in children ascribed in a Health Basic Unit (UBS) in Campinas in São Paulo States. The results of this work are presented in the chapter that includes the article, "Association between toxocariasis, asthma and body mass index in children", it is a cross-sectional study from a documentary analysis made in the clinical reports of 116 children seen at UBS Jardim Santa Mônica in Campinas between the years 1996 to 1998. The following information was obtained from clinical reports: weight, height, age, sex, presence or absence of asthma, the serologic test for Toxocara canis, presence or not of eosinophilia. To evaluate the anthropometric z scores. To study the associations between positive serology for Toxocara canis, asthma and BMI, we used the Wilcoxon test for two samples. The age range was from 2 to 14 years. Regarding gender, 57.8% were male. The prevalence of asthma was 37.9% and children with positive serology for T. canis was 54.3%. Comparing the distribution of BMI z of children with positive serology for T. canis with those not infected, it was observed that the z-scores were higher for children with asthma and toxocariasis. This work points to the existence of an association between infection with T. canis, asthma and increased body mass index in children. Toxocara infection is associated with two diseases of major relevance in pediatrics, asthma and obesity, which require the attention of all health professionals / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis, is a growing problem worldwide due to the emergence of multi-drug resistant and extensively-drug resistant strains of the bacteria. A key to combatting the spread of these strains lies in the understanding of gene expression occurring in Mtb. This study focuses on the development and optimization of a luciferase-based bioluminescent transcriptional reporter that can be used to monitor gene expression in Mtb. The luminescent signal emitted from the reporter can be measured and correlated with the level of transcription of certain genes. This study focuses specifically on a gene called whiB7 which encodes a transcription factor known to contribute to the drug resistance of Mtb. The drug-inducible whiB7 promoter was cloned into various locations in the luciferase plasmid in order to determine the ideal configuration of the reporter for maximum luminescence. The optimized luciferase reporter was then compared with a fluorescent transcriptional reporter, mCherry, also under control of the whiB7 promoter. Fluorescent reporters present some disadvantages including delayed kinetics and inability to accurately reflect gene downregulation due to long half-life of reporter proteins. It was hypothesized that the luciferase reporter would solve these problems by offering a more sensitive and dynamic tool to monitor gene expression. Quantitative real-time PCR was used to measure whiB7 mRNA present in cultures containing either the luciferase or mCherry reporters. The luminescent and fluorescent signal given from these reporters was then compared to actual mRNA expression. It was observed that the signal from the luciferase reporter more closely matched mRNA expression at each timepoint, indicating that the luciferase reporter is a better gauge of actual gene expression levels than the mCherry reporter.

Introduction: Neutrophils (PMNs) and Macrophages are the first responders recruited consecutively to the site of injury/inflammation. PMNs’ response/fate as well as macrophage reprogramming ultimately determine the course of resolution of inflammation. Physiologic wound healing has a significant inflammatory component. An exaggerated inflammation however is self-defeating leading to delayed healing. Parenteral vitamin C (VitC) attenuated inflammation in murine sepsis models and in patients with sepsis. However information about the mechanisms by which VitC regulates these events is limited. Methods: Humanized mice lacking VitC synthesis capability (Gulo-/-) were used. VitC sufficient and deficient mice were challenged with sterile inflammation, or septic insults. Some VitC deficient mice received parenteral VitC (200mg/kg) following the challenge to give deficient + AscA mice up to 14 days. Using a murine model of excisional wound, two full thickness excisional wounds were created on the back of the different Gulo-/- mice groups. Wound tissues were excised at day 7 and 14 post-wounding for analysis. Cell counts, immunohistochemistry, circulating free DNA, the expression of pro- and anti-inflammatory proteins were investigated. Additional in vitro experiments were carried out using human PMN (huPMNs), THP-1 monocyte/macrophage, and neonatal human dermal fibroblasts (HnDF). Results: VitC deficiency delayed resolution of lung inflammation and led to exaggerated pro-inflammatory responses. PMNs from VitC deficient mice demonstrated increased autophagy, histone citrullination, and NFκB activation, while inhibiting apoptosis. VitC sufficiency/supplementation restored macrophage phenotype, as well as attenuated neutrophil extracellular trap (NET) formation. VitC attenuated pro-inflammatory responses in THP-1 macrophages. In wound healing model, wounds from VitC sufficient/AscA infused mice had lower gene expression of the pro-inflammatory mediators; higher expression of genes promoting wound healing and resolution. Exposure of HnDF to AscA increased their intracellular VitC levels; promoted fibroblast proliferation and induced expression of fibroblast self-renewal genes. Conclusion: Our findings identify VitC as a novel regulator of PMN and macrophage responses. In wound healing, VitC favorably impacted the spatiotemporal expression of transcripts associated with early resolution of inflammation and tissue remodeling. Collectively, these results substantiate the protective notion of parenteral VitC and support its clinical use.

Obesity is recognized as an important risk factor for the development of many chronic diseases such as hypertension, Type 2 diabetes mellitus (T2DM) cardiovascular disease, cancer, renal disease, neurologic dysfunction, metabolic syndrome and asthma (3, 4). Circulating serum adiponectin levels in obese asthmatics have been reported to be low. Therefore, we aimed to investigate the role of adiponectin in a mucus hypersecretion model and hypothesized that adiponectin would decrease IL-13 induced MUC5AC expression from differentiated NHBE cells and that increasing concentrations of IL-13 would cause a decrease in Adipo R1 and Adipo R2 expression. MUC5AC expression with exposure to adiponectin was not significant. However, mRNA expression of Adipo R1 and Adipo R2 was significantly decreased by stimulation of IL-13 for acute (24 hours) and chronic (14 days) exposure. Therefore, the obese state and specifically IL-13 concentration could play a role in Adipo R1 and Adipo R2 expression within NHBE cells.

Disease mapping is used to identify high risk areas, inform resource allocation and generate hypotheses. The stroke and diabetes belts in the U.S. have encouraged public dialogue and spurred research. Lung cancer is the leading cause of U.S. cancer mortality, accounting for 158135 deaths in 2010 compared to 129180 from cerebrovascular disease and 68905 from diabetes mellitus. If one exists, defining a distinct pattern of high lung cancer mortality could increase public awareness of the disease and facilitate investigation of its determinants. To begin our inquiry, we generated a map and observed an area of high lung cancer mortality, primarily in the Southeast. However, variability in county rates, likely due to small populations, made determining patterns difficult. Spatial smoothing can clarify obscured patterns. We downloaded county lung cancer mortality rates, population sizes and death counts. Concurrent incidence and mortality rates for lung cancer were nearly equivalent, so mortality was used as a proxy for risk. After downloading county population centroids with latitudes and longitudes, we implemented a median-based, weighted, two-dimensional smoothing algorithm to enhance spatial patterns by borrowing strength from neighbor counties. The algorithm selected three proximate centroids, forming a “triple,” anchored by the centroid of the county to be smoothed. The parameter for nearest neighbor (NN) counties was set to NN=10, with the number of triples (NTR) for each county NTR=(2/3)*NN, producing seven collinear triples for each county with a center angle ≥135°. Median rates for the top and bottom 50% of neighbor counties were calculated and weighted by 1/SE, creating a “window,” whereby if the original rate was between the two medians, or if the county population was sufficiently large, it was not smoothed. If the original rate was outside the window, it was adjusted according to the corresponding neighbor median. Ten iterations of this process were conducted for each county. Smoothed rates were imported to ArcGIS and joined to a U.S. counties layer. Congruent counties in or near the Southeast with rates above 64 per 100,000 were defined as one class. We observed clustering of high lung cancer mortality, comprising 724 counties and forming an arc not evident in the unsmoothed data. This area, which we define as the lung cancer belt, included nearly all of Arkansas, Kentucky and Tennessee, and portions of 16 other states. Heavily affected regions include much of the Ohio Valley, Central Appalachia, the Tennessee Valley, the Ozarks, the Mississippi Delta and the northern Gulf Coast. Smoking, a modifiable behavior, causes the majority of lung cancer deaths, and is the single leading cause of mortality in the United States. Lung cancer mortality rates presented at the state level obscure differences within states. The lung cancer belt may provide a tool to identify areas in greatest need of resources. National survey data could be utilized to determine demographic, socioeconomic and behavioral differences between the lung cancer belt and the rest of the nation.

Background: Vitamin D is known to be associated with inflammatory diseases, but its relationship with allergic diseases is unclear. The study objective is to determine the association of serum vitamin D levels and markers of wheeze, asthma and atopy. Methods: Data (n = 9,463) on serum vitamin D levels and atopy were obtained from 2005-2006 National Health and Nutrition Examination Survey. Serum vitamin D level was categorized into four groups: Normal (≥30ng/ml), Insufficient (21-29ng/ml), Deficient (11-20ng/ml) and Severely Deficient (≤10ng/ml). Atopy was defined as at least 1 positive allergen-specific IgE level measured for a panel of 5 common aeroallergens- cat, dog, house dust mite, cock roach and Alternaria species. Doctor-diagnosed asthma and wheeze in the previous 12 months were assessed by means of questionnaire. Multivariable logistic regression analyses were conducted to investigate the association of serum vitamin D with wheeze, asthma and atopy adjusting for age, sex, race, smoking, outdoor physical activity, body mass index and poverty income ratio. Results: Overall, 15%, 14% and 28% of subjects had wheeze, asthma and atopy, respectively. Approximately 21% had normal serum vitamin D levels, while 35%, 28% and 5% had insufficient, deficient and severely deficient levels. Compared to subjects with normal vitamin D levels, those with insufficient, deficient and severely deficient levels had increased relative odds of wheeze and atopy with highest adjusted estimates in subjects with severe vitamin D deficiency (adjusted odds ratio [OR] 2.31, 95% Confidence Interval [CI] 1.73-3.10 for wheeze; OR 1.49, 95% CI 1.17-1.89 for atopy). Conclusion: Low serum vitamin D levels were found to be associated with wheeze and atopy. Findings contribute to ongoing efforts to understanding the role of vitamin D in atopic diseases.