PAULO HILARIO NASCIMENTO SALDIVA

(Fonte: Lattes)
Índice h a partir de 2011
53
Lattes
ResearcherID
ORCID
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder

Filtros

Mostrar mais
Limpar filtros

Configurações

search.filters.applied.f.dateIssued: 2023 ×

Resultados de Busca

Agora exibindo 1 - 10 de 22
  • article 5 Citação(ões) na Scopus
    Wildfire-related PM2.5 and health economic loss of mortality in Brazil
    (2023) WU, Yao; LI, Shanshan; XU, Rongbin; CHEN, Gongbo; YUE, Xu; YU, Pei; YE, Tingting; WEN, Bo; COELHO, Micheline de Sousa Zanotti Stagliorio; SALDIVA, Paulo Hilario Nascimento; GUO, Yuming
    Background: Wildfire imposes a high mortality burden on Brazil. However, there is a limited assessment of the health economic losses attributable to wildfire-related fine particulate matter (PM2.5). Methods: We collected daily time-series data on all-cause, cardiovascular, and respiratory mortality from 510 immediate regions in Brazil during 2000-2016. The chemical transport model GEOS-Chem driven with Global Fire Emissions Database (GFED), in combination with ground monitored data and machine learning was used to estimate wildfire-related PM2.5 data at a resolution of 0.25 degrees x 0.25 degrees. A time-series design was applied in each immediate region to assess the association between economic losses due to mortality and wildfire-related PM2.5 and the estimates were pooled at the national level using a random-effect meta-analysis. We used a metaregression model to explore the modification effect of GDP and its sectors (agriculture, industry, and service) on economic losses.Results: During 2000-2016, a total of US$81.08 billion economic losses (US$5.07 billion per year) due to mortality were attributable to wildfire-related PM2.5 in Brazil, accounting for 0.68% of economic losses and equivalent to approximately 0.14% of Brazil's GDP. The attributable fraction (AF) of economic losses due to wildfire-related PM2.5 was positively associated with the proportion of GDP from agriculture, while negatively associated with the proportion of GDP from service.Conclusion: Substantial economic losses due to mortality were associated with wildfires, which could be influenced by the agriculture and services share of GDP per capita. Our estimates of the economic losses of mortality could be used to determine optimal levels of investment and resources to mitigate the adverse health impacts of wildfires.
  • article 2 Citação(ões) na Scopus
    Mutational signatures and increased retrotransposon insertions in xeroderma pigmentosum variant skin tumors
    (2023) CORRADI, Camila; VILAR, Juliana B.; BUZATTO, Vanessa C.; SOUZA, Tiago A. de; CASTRO, Ligia P.; MUNFORD, Veridiana; VECCHI, Rodrigo De; GALANTE, Pedro A. F.; ORPINELLI, Fernanda; MILLER, Thiago L. A.; BUZZO, Jose L.; SOTTO, Mirian N.; SALDIVA, Paulo; OLIVEIRA, Jocelanio W. de; CHAIBUB, Sulamita C. W.; SARASIN, Alain; MENCK, Carlos F. M.
    This manuscript describes the genetic alterations found in the skin tumors of XP-V patients deficient in translesion synthesis. The alterations include mutation signatures and retrotransposition insertions, which provide mechanistic information about DNA polymerase eta functions. Xeroderma pigmentosum variant (XP-V) is an autosomal recessive disease with an increased risk of developing cutaneous neoplasms in sunlight-exposed regions. These cells are deficient in the translesion synthesis (TLS) DNA polymerase eta, responsible for bypassing different types of DNA lesions. From the exome sequencing of 11 skin tumors of a genetic XP-V patients' cluster, classical mutational signatures related to sunlight exposure, such as C>T transitions targeted to pyrimidine dimers, were identified. However, basal cell carcinomas also showed distinct C>A mutation spectra reflecting a mutational signature possibly related to sunlight-induced oxidative stress. Moreover, four samples carry different mutational signatures, with C>A mutations associated with tobacco chewing or smoking usage. Thus, XP-V patients should be warned of the risk of these habits. Surprisingly, higher levels of retrotransposon somatic insertions were also detected when the tumors were compared with non-XP skin tumors, revealing other possible causes for XP-V tumors and novel functions for the TLS polymerase eta in suppressing retrotransposition. Finally, the expected high mutation burden found in most of these tumors renders these XP patients good candidates for checkpoint blockade immunotherapy.
  • article 4 Citação(ões) na Scopus
    Assessing socioeconomic bias of exposure to urban air pollution: an autopsy-based study in Sao Paulo, Brazil
    (2023) SINGER, Julio da Motta; ANDRE, Carmen Diva Saldiva de; ANDRE, Paulo Afonso de; ROCHA, Francisco Marcelo Monteiro; WAKED, Dunia; VAZ, Aline Macedo; GOIS, Gustavo Ferreira; ANDRADE, Maria de Fatima; VERAS, Mariana Matera; SALDIVA, Paulo Hilario Nascimento; BARROZO, Ligia Vizeu
    Background The characterisation of individual exposure to air pollution in urban scenarios is a challenge in environmental epidemiological studies. We investigated if the city's pollution monitoring stations over or underes-timate the exposure of individuals depending on their socioeconomic conditions and daily commuting times. Methods The amount of black carbon accumulated in the lungs of 604 deceased who underwent autopsy in Sao Paulo was considered as a proxy for PM10. The concentrations of PM10 in the residence of the deceased were estimated by interpolating an ordinary kriging model. These two-exposure metrics allowed us to construct an environmental exposure misclassification index ranging from -1 to 1. The association between the index and daily commuting, socioeconomic context index (GeoSES), and street density as predictors was assessed by means of a multilevel linear regression model. Findings With a decrease of 0.1 units in GeoSES, the index increases, on average, by 0.028 units and with an increase of 1 h in daily commuting, the index increases, on average, by 0.022 units indicating that individual exposure to air pollution is underestimated in the lower GeoSES and in people with many hours spent in daily commuting. Interpretation Reduction of health consequences of air pollution demands not only alternative fuel and more efficient mobility strategies, but also should include profound rethink of cities.
  • conferenceObject
    Lung ECM composition, its influence factors and transcriptomics in the lungs of severe COVID-19.
    (2023) COSTA, Natalia de Souza Xavier; RIBEIRO JUNIOR, Gabriel; NASCIMENTO, Ellen Toledo Do; BRITO, Jose Mara De; MONTEIRO, Jhonatas Sirino; SETUBAL, Joao Carlos; PINHO, Joao Renato Rebello; PEREIRA, Roberta Verciano; MONTEIRO, Renata Aparecida De Almeida; DUARTE NETO, Amaro Nunes; SALDIVA, Paulo Hilario Nascimento; SILVA, Luiz Fernando Ferraz Da; DOLHNIKOFF, Marisa; MAUAD, Thais
  • article 1 Citação(ões) na Scopus
    Association Between Hydrological Conditions and Dengue Fever Incidence in Coastal Southeastern China From 2013 to 2019
    (2023) LI, Chuanxi; WANG, Zhendong; YAN, Yu; QU, Yinan; HOU, Liangyu; LI, Yijie; CHU, Cordia; WOODWARD, Alistair; SCHIKOWSKI, Tamara; SALDIVA, Paulo Hilario Nascimento; LIU, Qiyong; ZHAO, Qi; MA, Wei
    IMPORTANCE Dengue fever is a climate-sensitive infectious disease. However, its association with local hydrological conditions and the role of city development remain unclear. OBJECTIVE To quantify the association between hydrological conditions and dengue fever incidence in China and to explore the modification role of city development in this association. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study collected data between January 1, 2013, and December 31, 2019, from 54 cities in 4 coastal provinces in southeast China. The Standardized Precipitation Evapotranspiration Index (SPEI) was calculated from ambient temperature and precipitation, with SPEI thresholds of 2 for extreme wet conditions and -2 for extreme dry conditions. The SPEI-dengue fever incidence association was examined over a 6-month lag, and the modification roles of 5 city development dimensions were assessed. Data were analyzed in May 2022. EXPOSURES City-level monthly temperature, precipitation, SPEI, and annual city development indicators from 2013 to 2019. MAIN OUTCOMES AND MEASURES The primary outcome was city-level monthly dengue fever incidence. Spatiotemporal bayesian hierarchal models were used to examine the SPEI-dengue fever incidence association over a 6-month lag period. An interaction term between SPEI and each city development indicator was added into the model to assess the modification role of city development. RESULTS Included in the analysis were 70 006 dengue fever cases reported in 54 cities in 4 provinces in China from 2013 to 2019. Overall, a U-shaped cumulative curve was observed, with wet and dry conditions both associated with increased dengue fever risk. The relative risk [RR] peaked at a 1-month lag for extreme wet conditions (1.27; 95% credible interval [CrI], 1.05-1.53) and at a 6-month lag for extreme dry conditions (1.63; 95% CrI, 1.29-2.05). The RRs of extreme wet and dry conditions were greater in areas with limited economic development, health care resources, and income per capita. Extreme dry conditions were higher and prolonged in areas with more green space per capita (RR, 1.84; 95% CrI, 1.37-2.46). Highly urbanized areas had a higher risk of dengue fever after extreme wet conditions (RR, 1.80; 95% CrI, 1.26-2.56), while less urbanized areas had the highest risk of dengue fever in extreme dry conditions (RR, 1.70; 95% CrI, 1.11-2.60). CONCLUSIONS AND RELEVANCE Results of this study showed that extreme hydrological conditions were associated with increased dengue fever incidence within a 6-month lag period, with different dimensions of city development playing various modification roles in this association. These findings may help in developing climate change adaptation strategies and public health interventions against dengue fever.
  • article 63 Citação(ões) na Scopus
    Associations Between Extreme Temperatures and Cardiovascular Cause-Specific Mortality: Results From 27 Countries
    (2023) ALAHMAD, Barrak; KHRAISHAH, Haitham; ROYE, Dominic; VICEDO-CABRERA, Ana Maria; GUO, Yuming; PAPATHEODOROU, Stefania I.; ACHILLEOS, Souzana; ACQUAOTTA, Fiorella; ARMSTRONG, Ben; BELL, Michelle L.; PAN, Shih-Chun; COELHO, Micheline de Sousa Zanotti Stagliorio; COLISTRO, Valentina; DANG, Tran Ngoc; DUNG, Do Van; DONATO, Francesca K. De'; ENTEZARI, Alireza; GUO, Yue-Liang Leon; HASHIZUME, Masahiro; HONDA, Yasushi; INDERMITTE, Ene; INIGUEZ, Carmen; JAAKKOLA, Jouni J. K.; KIM, Ho; LAVIGNE, Eric; LEE, Whanhee; LI, Shanshan; MADUREIRA, Joana; MAYVANEH, Fatemeh; ORRU, Hans; OVERCENCO, Ala; RAGETTLI, Martina S.; RYTI, Niilo R. I.; SALDIVA, Paulo Hilario Nascimento; SCOVRONICK, Noah; SEPOSO, Xerxes; SERA, Francesco; SILVA, Susana Pereira; STAFOGGIA, Massimo; TOBIAS, Aurelio; GARSHICK, Eric; BERNSTEIN, Aaron S.; ZANOBETTI, Antonella; SCHWARTZ, Joel; GASPARRINI, Antonio; KOUTRAKIS, Petros
    Background:Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. Methods:We used unified data collection protocols within the Multi-Country Multi-City Collaborative Network to assemble a database of daily counts of specific cardiovascular causes of death from 567 cities in 27 countries across 5 continents in overlapping periods ranging from 1979 to 2019. City-specific daily ambient temperatures were obtained from weather stations and climate reanalysis models. To investigate cardiovascular mortality associations with extreme hot and cold temperatures, we fit case-crossover models in each city and then used a mixed-effects meta-analytic framework to pool individual city estimates. Extreme temperature percentiles were compared with the minimum mortality temperature in each location. Excess deaths were calculated for a range of extreme temperature days. Results:The analyses included deaths from any cardiovascular cause (32 154 935), ischemic heart disease (11 745 880), stroke (9 351 312), heart failure (3 673 723), and arrhythmia (670 859). At extreme temperature percentiles, heat (99th percentile) and cold (1st percentile) were associated with higher risk of dying from any cardiovascular cause, ischemic heart disease, stroke, and heart failure as compared to the minimum mortality temperature, which is the temperature associated with least mortality. Across a range of extreme temperatures, hot days (above 97.5th percentile) and cold days (below 2.5th percentile) accounted for 2.2 (95% empirical CI [eCI], 2.1-2.3) and 9.1 (95% eCI, 8.9-9.2) excess deaths for every 1000 cardiovascular deaths, respectively. Heart failure was associated with the highest excess deaths proportion from extreme hot and cold days with 2.6 (95% eCI, 2.4-2.8) and 12.8 (95% eCI, 12.2-13.1) for every 1000 heart failure deaths, respectively. Conclusions:Across a large, multinational sample, exposure to extreme hot and cold temperatures was associated with a greater risk of mortality from multiple common cardiovascular conditions. The intersections between extreme temperatures and cardiovascular health need to be thoroughly characterized in the present day-and especially under a changing climate.
  • article 5 Citação(ões) na Scopus
    Maternal exposure to air pollution alters energy balance transiently according to gender and changes gut microbiota
    (2023) ZORDAO, Olivia Pizetta; CAMPOLIM, Clara Machado; YARIWAKE, Victor Yuji; CASTRO, Gisele; FERREIRA, Clilton Krauess de Oliveira; SANTOS, Andrey; NORBERTO, Sonia; VERAS, Mariana Matera; SAAD, Mario Jose Abdalla; SALDIVA, Paulo Hilario Nascimento; KIM, Young-Bum; PRADA, Patricia Oliveira
    IntroductionThe timing of maternal exposure to air pollution is crucial to define metabolic changes in the offspring. Here we aimed to determine the most critical period of maternal exposure to particulate matter (PM2.5) that impairs offspring's energy metabolism and gut microbiota composition. MethodsUnexposed female and male C57BL/6J mice were mated. PM2.5 or filtered air (FA) exposure occurred only in gestation (PM2.5/FA) or lactation (FA/PM2.5). We studied the offspring of both genders. ResultsPM(2.5) exposure during gestation increased body weight (BW) at birth and from weaning to young in male adulthood. Leptin levels, food intake, Agrp, and Npy levels in the hypothalamus were also increased in young male offspring. Ikbke, Tnf increased in male PM2.5/FA. Males from FA/PM2.5 group were protected from these phenotypes showing higher O-2 consumption and Ucp1 in the brown adipose tissue. In female offspring, we did not see changes in BW at weaning. However, adult females from PM2.5/FA displayed higher BW and leptin levels, despite increased energy expenditure and thermogenesis. This group showed a slight increase in food intake. In female offspring from FA/PM2.5, BW, and leptin levels were elevated. This group displayed higher energy expenditure and a mild increase in food intake. To determine if maternal exposure to PM2.5 could affect the offspring's gut microbiota, we analyzed alpha diversity by Shannon and Simpson indexes and beta diversity by the Linear Discriminant Analysis (LDA) in offspring at 30 weeks. Unlike males, exposure during gestation led to higher adiposity and leptin maintenance in female offspring at this age. Gestation exposure was associated with decreased alpha diversity in the gut microbiota in both genders. DiscussionOur data support that exposure to air pollution during gestation is more harmful to metabolism than exposure during lactation. Male offspring had an unfavorable metabolic phenotype at a young age. However, at an older age, only females kept more adiposity. Ultimately, our data highlight the importance of controlling air pollution, especially during gestation.
  • article 1 Citação(ões) na Scopus
    Main autopsyfindings of visceral involvement by fatal mpox in patients with AIDS: necrotising nodular pneumonia, nodular ulcerative colitis, and diffuse vasculopathy
    (2023) DUARTE-NETO, Amaro Nunes; GONCALVES, Ana Maria; ELIODORO, Raissa Heloisa de Araujo; MARTINS, Wilker Dias; CLARO, Ingra Morales; VALENCA, Ian Nunes; PAES, Vitor Ribeiro; TEIXEIRA, Ralcyon; SZTAJNBOK, Jaques; SILVA, Ivan Leonardo Avelino Franca e; LEITE, Luiz Antonio Ferreira; MALAQUE, Ceila Maria Sant'Ana; BORGES, Luciana Marques Sansao; GONZALEZ, Mario Peribanez; BARRA, Luiz Alberto Costa; PEREIRA JUNIOR, Luiz Carlos; MELLO, Claudia Figueiredo; QUEIROZ, Wladimir; ATOMYA, Angela Naomi; FERNEZLIAN, Sandra de Morais; ALVES, Venancio Avancini Ferreira; LEITE, Katia Ramos Moreira; FERREIRA, Cristiane Rubia; SALDIVA, Paulo Hilario Nascimento; MAUAD, Thais; SILVA, Luiz Fernando Ferraz da; FARIA, Nuno R.; CORREA, Maria Cassia Jacinto Mendes; SABINO, Ester Cerdeira; SOTTO, Mirian Nacagami; DOLHNIKOFF, Marisa
  • article 2 Citação(ões) na Scopus
    Productivity-adjusted life years lost due to non-optimum temperatures in Brazil: A nationwide time-series study
    (2023) WEN, Bo; ADEMI, Zanfina; WU, Yao; XU, Rongbin; YU, Pei; YE, Tingting; COELHO, Micheline de Sousa Zanotti Stagliorio; SALDIVA, Paulo Hilario Nascimento; GUO, Yuming; LI, Shanshan
    Non-optimal temperatures are associated with premature deaths globally. However, the evidence is limited in low-and middle-income countries, and the productivity losses due to non-optimal temperatures have not been quantified. We aimed to estimate the work-related impacts and economic losses attributable to non-optimal temperatures in Brazil. We col-lected daily mortality data from 510 immediate regions in Brazil during 2000 and 2019. A two-stage time-series analysis was applied to evaluate the association between non-optimum temperatures and the Productivity-Adjusted Life-Years (PALYs) lost. The temperature-PALYs association was fitted for each location in the first stage and then we applied meta -analyses to obtain the national estimations. The attributable fraction (AF) of PALY lost due to ambient temperatures and the corresponding economic costs were calculated for different subgroups of the working-age population. A total of 3,629,661 of PALYs lost were attributed to non-optimal temperatures during 2000-2019 in Brazil, corresponding to 2.90 % (95 % CI: 1.82 %, 3.95 %) of the total PALYs lost. Non-optimal temperatures have led to US$104.86 billion (95 % CI: 65.95, 142.70) of economic costs related to PALYs lost and the economic burden was more substantial in males and the population aged 15-44 years. Higher risks of extreme cold temperatures were observed in the South region in Brazil while extreme hot temperatures were observed in the Central West and Northeast regions. In conclusion, non -optimal temperatures are associated with considerable labour losses as well as economic costs in Brazil. Tailored policies and adaptation strategies should be proposed to mitigate the impacts of non-optimal temperatures on the labour supply in a changing climate.
  • article 0 Citação(ões) na Scopus
    Understanding yellow fever-associated myocardial injury: an autopsy study
    (2023) GIUGNI, Fernando Rabioglio; DEMARCHIAIELLO, Vera; FARIA, Caroline Silverio; POUR, Shahab Zaki; CUNHA, Marielton dos Passos; GIUGNI, Melina Valdo; PINESI, Henrique Trombini; LEDESMA, Felipe Lourenco; MORAIS, Carolina Esteves; HO, Yeh-Li; SZTAJNBOK, Jaques; FERNEZLIAN, Sandra de Morais; SILVA, Luiz Fernando Ferraz da; MAUAD, Thais; ALVES, Venancio Avancini Ferreira; SALDIVA, Paulo Hilario do Nascimento; ANTONANGELO, Leila; DOLHNIKOFF, Marisa; DUARTE-NETO, Amaro Nunes
    Background Yellow fever (YF) is a viral hemorrhagic fever, endemic in parts of South America and Africa. There is scarce evidence about the pathogenesis of the myocardial injury. The objective of this study is to evaluate the cardiac pathology in fatal cases of YF.Methods This retrospective autopsy study included cases from the Sao Paulo (Brazil) epidemic of 2017-2019. We reviewed medical records and performed cardiac tissue histopathological evaluation, electron microscopy, immunohistochemical assays, RT-qPCR for YF virus (YFV)-RNA, and proteomics analysis on inflammatory and endothelial biomarkers.Findings Seventy-three confirmed YF cases with a median age of 48 (34-60) years were included. We observed myocardial fibrosis in 68 (93.2%) patients; cardiomyocyte hypertrophy in 68 (93.2%); endothelial alterations in 67 (91.8%); fiber necrosis in 50 (68.5%); viral myocarditis in 9 (12.3%); and secondary myocarditis in 5 (6.8%). Four out of five patients with 17DD vaccine-associated viscerotropic disease presented with myocarditis. The cardiac conduction system showed edema, hemorrhages and endothelial fibrinoid necrosis. Immunohistochemistry detected CD68-positive inflammatory interstitial cells and YFV antigens in endothelial and inflammatory cells. YFV-RNA was detected positive in 95.7% of the cardiac samples. The proteomics analysis demonstrated that YF patients had higher levels of multiple inflammatory and endothelial biomarkers in comparison to cardiovascular controls, and higher levels of interferon gamma-induced protein 10 (IP-10) in comparison to sepsis (p = 0.01) and cardiovascular controls (p < 0.001) in Dunn test.Interpretation Myocardial injury is frequent in severe YF, due to multifactorial mechanisms, including direct YFV-mediated damage, endothelial cell injury, and inflammatory response, with a possible prominent role for IP-10.