MARIA LUCIA BUENO GARCIA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
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- GTSP1 expression in non-smoker and nondrinker patients with squamous cell carcinoma of the head and neck(2017) SOARES, Pamela de Oliveira; CURY, Patricia Maluf; LOPEZ, Rossana Veronica Mendoza; CERNEA, Claudio Roberto; FUKUYAMA, Erika Erina; FIGUEIREDO, David Livingstone Alves; NOBREGA, Francisco Gorgonio da; CURIONI, Otavio Alberto; NUNES, Fabio Daumas; MOYSES, Raquel Ajub; GARCIA, Maria Lucia BuenoIntroduction The main risk factors for head and neck squamous cell carcinoma (HNSCC) are tobacco and alcohol consumption and human papillomavirus (HPV) infection. However, in a subset of patients, no risk factors can be identified. Glutathione S-transferase p (GTSP1) is a carcinogen-detoxifying enzyme that is activated by exposure to carcinogens, and it is associated with a reduction in response to toxic therapies. We studied the expression of GTSP1 in tumor and non-tumor tissue samples from patients with and without these risks to identify whether GTSP1 expression differs according to exposure to carcinogens. Materials and methods Non-smoker/non-drinker (NSND) and smoker/drinker (SD) patients were matched according to age, gender, tumor site, TNM stage, grade and histological variants to establish 47 pairs of patients who have been previously tested for HPV. GTSP1 immunostaining was analyzed using a semi-quantitative method with scores ranging from 0 to 3 according to the area of immunostaining. Results GTSP1 expression was detected in the tumors of both groups. GTSP1 expression was higher in the non-tumor margins of SD patients (p = 0.004). There was no association between GTSP1 expression and positivity for HPV. No differences in survival were observed according to GTSP1 staining in tumors and non-tumor margins. Conclusion This study showed that GTSP1 was expressed in tumors of HNSCC patients regardless of smoking, drinking or HPV infection status. The difference in GTSP1 expression in non-tumor margins between the two groups may have been due to two possible reasons. First, elevated GTSP1 expression in SD patients might be the result of activation of GTSP1 in response to exposure to carcinogens. Second, alternatively, impairment in the detoxifying system of GTSP1, as observed by the reduced expression of GTSP1, might make patients susceptible to carcinogens other than tobacco and alcohol, which may be the underlying mechanism of carcinogenesis in the absence of risk factors.
- Kidney injury and other complications related to colonoscopy in inpatients at a tertiary teaching hospital(2018) IVANOVIC, Ligia Fidelis; SILVA, Bruno C.; LICHTENSTEIN, Arnaldo; PAIVA, Edison Ferreira de; BUENO-GARCIA, Maria LuciaOBJECTIVES: To describe clinical complications related to colonoscopy in inpatients with multiple diseases. Among the known complications, acute kidney injury was the primary focus. METHODS: This was an observational retrospective study of 97 inpatients. Data relating to age; gender; comorbidities; current medication; blood tests (renal function, blood glucose and LDL cholesterol levels); length of hospital stay; indication, results, and complications of colonoscopies; and time to the development of kidney injury were collected between June 2011 to February 2012. RESULTS: A total of 108 colonoscopies (9 screening and 88 diagnostic) were conducted in 97 patients. Renal injury occurred in 41.2% of the patients. The univariate analysis revealed that kidney injury was related to the use of diuretics, statins, calcium channel blockers, and angiotensin converting enzyme inhibitor; however, the multivariate analysis showed that only the use of diuretics was associated with kidney injury. The occurrence of kidney injury and the time to its development were independent of the previous glomerular filtration rate as calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. CONCLUSIONS: The use of diuretics was the only independent variable associated with the development of kidney injury in inpatients with multiple comorbidities who underwent colonoscopy. The occurrence of kidney injury and the time to its development were independent of previous CKD-EPI-based assessments of renal function. These results highlight the increased risk of colonoscopy in such patients, and its indication should be balanced strictly and perhaps avoided as a screening test.
- Association between Traffic Air Pollution and Reduced Forced Vital Capacity: A Study Using Personal Monitors for Outdoor Workers(2016) SANTOS, Ubiratan Paula; GARCIA, Maria Lucia Siqueira Bueno; BRAGA, Alfesio Luis Ferreira; PEREIRA, Luiz Alberto Amador; LIN, Chin An; ANDRE, Paulo Afonso de; ANDRE, Carmen Diva Saldiva de; SINGER, Julio da Motta; SALDIVA, Paulo Hilario NascimentoBackground The effects of outdoor air pollution on lung function in adults are still controversial. Objective Evaluate the effects of exposure to different levels of traffic-generated PM2.5 on workers' lung functions in Sao Paulo, Brazil. Methods To cover a wide range of exposures, 101 non-smoking workers from three occupations (taxi drivers, traffic controllers, and forest rangers) were selected for the study. After clinical evaluation, the participants were scheduled to attend four consecutive weekly visits in which they received a 24-hour personal PM2.5 sampler and had lung function tests measured on the following day. The association between the spirometric variables and the averaged PM2.5 levels was assessed using robust regression models adjusted for age, waist circumference, time at the job, daily work hours, diabetes or hypertension and former smoking habits. Results Relative to workers in the lowest exposed group (all measures <25 mu g/m(3)), those with the highest level of exposure (all measures >39.6 mu g/m(3)) showed a reduction of predicted FVC (-12.2%; CI 95%: [-20.0% to -4.4%]), a marginal reduction of predicted FEV1 (-9.1%; CI 95%: [-19.1% to 0.9%]) and an increase of predicted FEF25-75%/FVC (14.9%; CI 95%: [2.9% to 26.8%]) without changes of FEV1/FVC. Conclusions Exposure to vehicular traffic air pollution is associated with a small but significant reduction of FVC without a reduction of FEV1/FVC.
- Lacrimal Cytokines Assessment in Subjects Exposed to Different Levels of Ambient Air Pollution in a Large Metropolitan Area(2015) MATSUDA, Monique; BONATTI, Rodolfo; MARQUEZINI, Monica V.; GARCIA, Maria L. B.; SANTOS, Ubiratan P.; BRAGA, Alfesio L. F.; ALVES, Milton R.; SALDIVA, Paulo H. N.; MONTEIRO, Mario L. R.Background 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. Design 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. Methods 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 mu m) 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-gamma) levels. Data from both groups were compared using Student's t test or Mann-Whitney test for cytokines. Individual PM2.5 levels were categorized in tertiles (lower, middle and upper) and compared using one-way ANOVA. Relationship between PM2.5 and cytokine levels was evaluated using generalized estimating equations (GEE). Results PM2.5 levels in the three categories differed significantly (lower: <= 22 mu g/m(3); middle: 23-37.5 mu g/m(3); upper: >37.5 mu g/m(3); p<0.001). The subjects from the two groups were distributed unevenly in the lower category (Group 1 = 8%; Group 2 = 92%), the middle category (Group 1 = 89%; Group 2 = 11%) and the upper category (Group 1 = 100%). A significant relationship was found between IL-5 and IL-10 and PM2.5 levels of the group 1, with an average decrease of 1.65 pg/mL of IL-5 level and of 0.78 pg/mL of IL-10 level in tear samples for each increment of 50 mu g/m(3) of PM2.5 (p = 0.01 and p = 0.003, respectively). Conclusion High levels of PM2.5 exposure is associated with decrease of IL-5 and IL-10 levels suggesting a possible modulatory action of ambient air pollution on ocular surface immune response.
- Chemical composition modulates the adverse effects of particles on the mucociliary epithelium(2015) CARVALHO-OLIVEIRA, Regiani; PIRES-NETO, Ruy Camargo; BUSTILLOS, Jose Oscar Viega; MACCHIONE, Mariangela; DOLHNIKOFF, Marisa; SALDIVA, Paulo H. Nascimento; GARCIA, Maria Lucia BuenoOBJECTIVE: We compared the adverse effects of two types of real ambient particles; i.e., total suspended particles from an electrostatic precipitator of a steel mill and fine air particles from an urban ambient particulate matter of 2.5 mu m, on mucociliary clearance. METHOD: Mucociliary function was quantified by mucociliary transport, ciliary beating frequency and the amount of acid and neutral mucous in epithelial cells through morphometry of frog palate preparations. The palates were immersed in one of the following solutions: total suspended particles (0.1 mg/mL), particulate matter 2.5 mm 0.1 mg/mL (PM0.1) or 3.0 mg/mL (PM3.0) and amphibian Ringer's solution (control). Particle chemical compositions were determined by X-ray fluorescence and gas chromatography/mass spectrometry. RESULTS: Exposure to total suspended particles and PM3.0 decreased mucociliary transport. Ciliary beating frequency was diminished by total suspended particles at all times during exposure, while particulate matter of 2.5 mm did not elicit changes. Particulate matter of 2.5 mm reduced epithelial mucous and epithelium thickness, while total suspended particles behaved similarly to the control group. Total suspended particles exhibited a predominance of Fe and no organic compounds, while the particulate matter 2.5 mm contained predominant amounts of S, Fe, Si and, to a lesser extent, Cu, Ni, V, Zn and organic compounds. CONCLUSION: Our results showed that different compositions of particles induced different airway epithelial responses, emphasizing that knowledge of their individual characteristics may help to establish policies aimed at controlling air pollution.
article 1 Citação(ões) na Scopus Maternal mortality profile in Great ABC Region from 1997 to 2005(2011) TOGNINI, Silvana; GARCIA, Maria Lucia Bueno; BRAGA, Alfesio Luis Ferreira; MARTINS, Lourdes ConceicaoMaternal mortality profile in Great ABC Region from 1997 to 2005 Objective: To analyze the maternal mortality in the ABC Region, comparing indicators from the Committee for the Study of Maternal Mortality in the Great ABC Region (CEMM) of the II Regional Health Center of Santo Andre (DIR II), and the State Data Analysis System Foundation (SEADE). Methods: This is a cross sectional study. The information was obtained from the database of CEMM DIR II Santo Andre, which includes data from seven counties of the ABC Region. We analyzed all deaths of childbearing-age women that occurred from 1997 to 2005 in that region. The paired t test, Wilcoxon and Kruskal-Wallis tests were used for statistical analysis. Results: There were differences regarding the maternal mortality rates in the towns of Diadema, Sao Bernardo do Campo, Santo Andre and DIR 11, with the coefficients calculated by CEMM being higher than those provided by the SEADE (p < 0.001). Concerning the towns of Maua, Rio Grande da Serra, Ribeirao Pires and Sao Caetano do Sul, no significant differences were observed between these two coefficients (p > 0.05), although the coefficients provided by CEMM were higher than the coefficients obtained from SEADE. Conclusion: Our results demonstrate that the official data of maternal mortality in Brazil are still underestimated and point to the lack of healthcare quality during pregnancy, childbirth and postpartum.- pH in exhaled breath condensate and nasal lavage as a biomarker of air pollution-related inflammation in street traffic-controllers and office-workers(2013) LIMA, Thamires Marques de; KAZAMA, Cristiane Mayumi; KOCZULLA, Andreas Rembert; HIEMSTRA, Pieter S.; MACCHIONE, Mariangela; FERNANDES, Ana Luisa Godoy; SANTOS, Ubiratan de Paula; BUENO-GARCIA, Maria Lucia; ZANETTA, Dirce Maria; ANDRE, Carmen Diva Saldiva de; SALDIVA, Paulo Hilario Nascimento; NAKAGAWA, Naomi KondoOBJECTIVE: To utilize low-cost and simple methods to assess airway and lung inflammation biomarkers related to air pollution. METHODS: A total of 87 male, non-smoking, healthy subjects working as street traffic-controllers or office-workers were examined to determine carbon monoxide in exhaled breath and to measure the pH in nasal lavage fluid and exhaled breath condensate. Air pollution exposure was measured by particulate matter concentration, and data were obtained from fixed monitoring stations (8-h work intervals per day, during the 5 consecutive days prior to the study). RESULTS: Exhaled carbon monoxide was two-fold greater in traffic-controllers than in office-workers. The mean pH values were 8.12 in exhaled breath condensate and 7.99 in nasal lavage fluid in office-workers; these values were lower in traffic-controllers (7.80 and 7.30, respectively). Both groups presented similar cytokines concentrations in both substrates, however, IL-1 beta and IL-8 were elevated in nasal lavage fluid compared with exhaled breath condensate. The particulate matter concentration was greater at the workplace of traffic-controllers compared with that of office-workers. CONCLUSION: The pH values of nasal lavage fluid and exhaled breath condensate are important, robust, easy to measure and reproducible biomarkers that can be used to monitor occupational exposure to air pollution. Additionally, traffic-controllers are at an increased risk of airway and lung inflammation during their occupational activities compared with office-workers.