UBIRATAN DE PAULA SANTOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
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- Effects of biomass burning on nasal mucociliary clearance and mucus properties after sugarcane harvesting(2011) GOTO, Danielle Miyuki; LANCA, Marina; OBUTI, Camila Akemi; BARBOSA, Cristiane Maria Galvao; SALDIVA, Paulo Hilario Nascimento; ZANETTA, Dirce Maria Trevisan; LORENZI-FILHO, Geraldo; SANTOS, Ubiratan de Paula; NAKAGAWA, Naomi KondoObjective: Biofuel from sugarcane is widely produced in developing countries and is a clean and renewable alternative source of energy. However, sugarcane harvesting is mostly performed after biomass burning. The aim of this study was to evaluate the effects of harvesting after biomass burning on nasal mucociliary clearance and the nasal mucus properties of farm workers. Methods: Twenty seven sugarcane workers (21-45 years old) were evaluated at the end of two successive time-periods: first at the end of a 6-month harvesting period (harvesting), and then at the end of a 3-month period without harvesting (non-harvesting). Nasal mucociliary clearance was evaluated by the saccharine transit test, and mucus properties were analyzed using in vitro mucus contact angle and mucus transportability by sneeze. Arterial blood pressure, heart rate, respiratory rate, pulse oximetry, body temperature, associated illness, and exhaled carbon monoxide were registered. Results: Data are presented as mean values (95% confidence interval). The multivariate model analysis adjusted for age, body-mass index, smoking status and years of working with this agricultural practice showed that harvesting yielded prolonged saccharine transit test in 7.83 min (1.88-13.78), increased mucus contact angle in 8.68 degrees (3.18-14.17) and decreased transportability by sneeze in 32.12 mm (-44.83 to -19.42) compared with the non-harvesting period. No significant differences were detected in any of the clinical parameter at either time-period. Conclusion: Sugarcane harvesting after biomass burning negatively affects the first barrier of the respiratory system in farm workers by impairing nasal mucociliary clearance and inducing abnormal mucus properties.
- Work-related asthma consequences on socioeconomic, asthma control, quality of life, and psychological status compared with non-work-related asthma: A cross-sectional study in an upper-middle-income country(2023) ROIO, Lavinia Clara; STELMACH, Rafael; MIZUTANI, Rafael F. F.; TERRA-FILHO, Mario; SANTOS, Ubiratan d. P.BackgroundWork-related asthma (WRA) is the most prevalent occupational respiratory disease, and it has negative effects on socioeconomic standing, asthma control, quality of life, and mental health status. Most of the studies on WRA consequences are from high-income countries; there is a lack of information on these effects in Latin America and in middle-income countries. MethodsThis study compared socioeconomic, asthma control, quality of life, and psychological outcomes among individuals diagnosed with WRA and non-work-related asthma (NWRA) in a middle-income country. Patients with asthma, related and not related to work, were interviewed using a structured questionnaire to assess their occupational history and socioeconomic conditions, and with questionnaires to assess asthma control (Asthma Control Test and Asthma Control Questionnaire-6), quality of life (Juniper's Asthma Quality of Life Questionnaire), and presence of anxiety and depression symptoms (Hospital Anxiety and Depression Scale). Each patient's medical record was reviewed for exams and use of medication, and comparisons were made between individuals with WRA and NWRA. ResultsThe study included 132 patients with WRA and 130 with NWRA. Individuals with WRA had worse socioeconomic outcomes, worse asthma control, more quality-of-life impairment, and a higher prevalence of anxiety and depression than individuals with NWRA. Among individuals with WRA, those who had been removed from occupational exposure had a worse socioeconomic impact. ConclusionsConsequences on socioeconomic, asthma control, quality of life, and psychological status are worse for WRA individuals when compared with NWRA.
- Biomarkers related to silicosis and pulmonary function in individuals exposed to silica(2023) LOMBARDI, Elisa M. S.; MIZUTANI, Rafael F.; TERRA-FILHO, Mario; PAULA, Santos Ubiratan deBackgroundThe identification of markers that can facilitate the early diagnosis of silicosis has remained challenging. We evaluated the association of inflammatory markers with the presence of silicosis and lung function impairment in individuals exposed to silica. Methods Individuals exposed and not exposed to silica were assessed by occupational history, clinical findings, lung function, chest imaging findings, and inflammatory markers. Results Among 297 men evaluated, 51 were unexposed controls (G1), 149 were exposed to silica without silicosis (G2), and 97 were exposed to silica with silicosis (G3). Inflammatory marker levels were higher in G3 than in G2 and G1. Platelet/lymphocyte ratio (PLR), lactate dehydrogenase (LDH), soluble tumor necrosis factor II (sTNFRII), and macrophage inflammatory protein-4 (MIP-4) were associated with silicosis, and LDH, neutrophil/lymphocyte ratio (NLR), sTNFRII, monocyte chemoattractant protein-1 (MCP-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and fibrinogen were negatively associated with lung function. Conclusion Blood inflammatory markers are associated with silicosis and impaired lung function.
- Mesothelioma in situ with regressive malignant pleural effusion and an unexpected evolution: A case report(2022) ALMEIDA, Gustavo C. de; SANTOS, Ubiratan de P.; PARENTE, Yuri de D. M.; COLARES, Philippe de F. B.; MIZUTANI, Rafael F.; BERNARDI, Fabiola del C.; TERRA, Ricardo M.; TERRA-FILHO, MarioMalignant pleural mesothelioma (MPM) is an aggressive neoplasm that originates from hyperplasia and metaplasia of the mesothelial cells that cover the pleural cavity. Previous exposure to asbestos is the main risk factor. Since MPM is often diagnosed at an advanced stage with rapid evolution and resistance to treatment, it is associated with an unfavorable outcome. Mesothelioma in situ (MIS) has been postulated as a preinvasive phase of MPM; however, its diagnostic criteria have been defined only recently. Diagnosis of MIS may represent an opportunity for early therapies with better results, but the optimal approach has not been defined thus far. Here, we report on a case of a 74-year-old man with right-sided pleural effusion and a previous history of occupational exposure to asbestos for 9 years who was diagnosed with MIS after a latency of 36 years. During follow-up, spontaneous disease regression was observed 5 months after the initial diagnosis; however, it recurred in the form of invasive epithelioid MPM. There is a paucity of literature on MIS and its evolution; however, our case provides relevant knowledge of this unusual behavior, which is important to define follow-up and therapeutic strategies for future cases.
- Tunnel excavation triggering pulmonary sarcoidosis(2012) KAWANO-DOURADO, L. B.; CARVALHO, C. R. R.; SANTOS, U. P.; CANZIAN, M.; COLETTA, E. N. A.; PEREIRA, C. A. C.; KAIRALLA, R. A.Context A definite cause of sarcoidosis has not been identified, however past research suggests that environmental factors may be triggers of the granulomatous response in genetically susceptible individuals. Case Presentation A 22-year-old male non-smoker, presented with progressive exertional dyspnea and cough of 3 months duration. One year before, when he started working in tunnel excavation, he had a normal chest radiograph. Chest imaging revealed bilateral nodules and masses of peribronchovascular distribution plus mediastinal lymphadenomegaly. Histologic lymph node analysis revealed non-caseating confluent granulomas. Sarcoidosis was diagnosed. The patient was treated with corticosteroids and advised to change jobs. Complete remission of the disease was achieved and persisted for at least one year without steroid treatment. Discussion Sarcoidosis is believed to have environmental triggers. The timing of the onset of sarcoidosis in this patient following intensive exposure to tunnel dust suggests an environmental contribution. The recognition that sarcoidosis may have occupational triggers have medical, employment, and legal implications. Am. J. Ind. Med. 55: 390-394, 2012. (C) 2011 Wiley Periodicals, Inc.
- Evaluation of peak expiratory flow in adolescents and its association with inhalable particulate in a Brazilian medium-sized city(2018) MISSAGIA, Suelem; AMARAL, Camila Alves Silva do; JESUS, Alessandra Santos de; ARBEX, Marcos Abdo; SANTOS, Ubiratan de Paula; ANDRÉ, Carmem Diva Saldiva de; ANDRÉ, Paulo Afonso de; SALDIVA, Paulo Hilário do Nascimento; MARTINS, Lourdes Conceição; BRAGA, Alfésio Luís Ferreira; PEREIRA, Luiz Alberto AmadorABSTRACT: Introduction: High particulate matter (PM10) concentrations are associated with increased incidence of respiratory symptoms and decreased lung function. This study evaluates the air pollution effects in children’s and adolescents’ lung function using peak expiratory flow (PEF) measurements over a given period, in an area exposed to industrial emissions. Methodology: This was a panel study. The effects of air pollution on respiratory symptoms and PEF were investigated in 117 children and adolescents from three public schools in areas of exposure to air pollution from a mining company in a Brazilian medium-sized city, from 2008 to 2009. The average daily PM10, temperature and humidity were recorded by the monitoring network in the region. Association between daily records of PEF and PM10 was assessed in mixed-effect regression models, controlling for temperature, humidity, and body mass index. Results: About 60,000 PEF measurements were performed. Increases of 14µg/m3 in PM10 were associated with decreased PEF in the morning (-1.04%, 95%CI -1.32; -0.77) and evening (-1.2%, 95%CI -1.49, -0.92). Discussion: We found a significant negative association between particulate matter and peak expiratory flow rate in this population, and these remained significant even after adjusted for temperature, humidity, body mass index, coughing, wheezing and coryza. Conclusion: Adverse effects were found and it suggests an association between increase in PM10 and reduced lung function.
- IMPACT OF TWO TYPES OF PHYSICAL ACTIVITY UNDER RISK ENVIRONMENTAL CONDITIONS ON KIDNEY FUNCTION(2019) SANTOS, U. P.; ZANETTA, D. M. T.; LEITE, M. R.; CARDOSO, A.; BURDMANN, E. A.
- Exposure to fine particles increases blood pressure of hypertensive outdoor workers: A panel study(2019) SANTOS, Ubiratan Paula; BRAGA, Alfesio Luis Ferreira; GARCIA, Maria Lucia Bueno; PEREIRA, Luiz Alberto Amador; LIN, Chin An; CHIARELLI, Paulo S.; ANDRE, Carmen Diva Saldiva de; ANDRE, Paulo Afonso de; SINGER, Julio M.; SALDIVA, Paulo Hilario NascimentoBackground: Hypertension and air pollution are two important risk factors for cardiovascular morbidity and mortality. Although several studies suggest that air pollution has a significant impact on blood pressure, studies on long-term effects are sparse and still controversial. Objective: To evaluate the effects of exposure of outdoor workers to different levels of traffic-generated PM2.5 on blood pressure. Design: This is an observational panel study. Participants: 88 non-smoking workers exposed to different concentrations of air pollution were evaluated weekly along four successive weeks. Measurements: In each week, personal monitoring of 24-h PM2.5 concentration and 24-h ambulatory blood pressure were measured. The association between blood pressure variables and PM2.5, adjusted for age, body mass index, time in job, daily work hours, diabetes, hypertension and cholesterol was assessed by means of multiple linear regression models fitted by least squares. Results: Exposure to PM2.5 (ranging from 8.5 to 89.7 mu g/m(3)) is significantly and consistently associated with an increase in average blood pressure. An elevation of 10 mu g/m(3) in the concentration of PM2.5 is associated with increments of 3.9 mm Hg (CI 95% = [1.5; 6.3]) in average systolic 24-h blood pressure for hypertensive and/or diabetic workers. Conclusion: Exposure to fine particles, predominantly from vehicular traffic, is associated with elevated blood pressure in hypertensive and/or diabetic workers.
- O trabalho no corte de cana-de-açúcar, riscos e efeitos na saúde: revisão da literatura(2018) LEITE, Marceli Rocha; ZANETTA, Dirce Maria Trevisan; TREVISAN, Iara Buriola; BURDMANN, Emmanuel de Almeida; SANTOS, Ubiratan de PaulaOBJECTIVE: Describe the main work risks for sugarcane cutters and their effects on workers' health. METHODS: Critical review of articles, with bibliographic research carried out in the PubMed, SciELO Medline, and Lilacs databases. The following keywords were used: sugarcane workers, sugarcane cutters, sugarcane harvesting, cortadores de cana-de-acucar, and colheita de cana-de-acucar. The inclusion criteria were articles published between January 1997 and June 2017, which evaluated working conditions and health effects on sugarcane cutters. Those that did not deal with the work impact of cutting burned and unburnt sugarcane in the cutter's health were excluded. The final group of manuscripts was selected by the lead author of this study and reviewed by a co-author. Disagreements were resolved by consensus using the predefined inclusion and exclusion criteria and, where necessary, the final decision was made by consulting a third co-author. RESULTS: From the 89 articles found, 52 met the selection criteria and were evaluated. Studies have shown that cutters work under conditions of physical and mental overload, thermal overload, exposure to pollutants, and are subject to accidents. The main effects observed were respiratory, cardiovascular, renal, musculoskeletal, heat stress, dehydration, genotoxic, and those due to accidents. CONCLUSIONS: Work on the manual cutting of sugarcane, especially of burned sugarcane, exposes workers to various risks, with different health impacts. Risk reduction for exposure to pollution and thermal and physical overload is required as a measure to preserve the health of the worker.