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Article: Younger age is associated with cardiovascular pathological phenotype of severe COVID-19 at autopsy.

Giugni, Fernando R / Duarte-Neto, Amaro N / da Silva, Luiz Fernando F / Monteiro, Renata A A / Mauad, Thais / Saldiva, Paulo H N / Dolhnikoff, Marisa

Frontiers in medicine

2024 Volume 10, Page(s) 1327415

Abstract: Introduction: COVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19.: Methods: This study ...

Abstract	Introduction: COVID-19 affects patients of all ages. There are few autopsy studies focusing on the younger population. We assessed an autopsy cohort aiming to understand how age influences pathological outcomes in fatal COVID-19. Methods: This study included autopsied patients, aged 6 months to 83 years, with confirmed COVID-19 in 2020-2021. We collected tissue samples from deceased patients using a minimally invasive autopsy protocol and assessed pathological data following a systematic approach. Results: Eighty-six patients were included, with a median age of 55 years (IQR 32.3-66.0). We showed that age was significantly lower in patients with acute heart ischemia ( Conclusion: We showed that age modulates pathological outcomes in fatal COVID-19. Younger age is associated with cardiovascular abnormalities and older age with pulmonary findings.
Language	English
Publishing date	2024-01-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1327415
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Article ; Online: Effects of land cover and air pollution on the risk of preterm births.

Moreira, Tiana C L / Polizel, Jefferson L / Réquia, Weeberb J / Saldiva, Paulo Hilario Nascimento / Silva Filho, Demostenes F da / Saldiva, Silvia Regina Dias Medici / Mauad, Thais

Revista de saude publica

2024 Volume 58, Page(s) 8

Abstract: Objective: To evaluate the association between gestational age and green areas, urban built areas, and the concentration of particulate matter 2.5 (PM2.5) in the city of São Paulo, analyzing the irregular distribution of these areas and pollution levels ...

Abstract	Objective: To evaluate the association between gestational age and green areas, urban built areas, and the concentration of particulate matter 2.5 (PM2.5) in the city of São Paulo, analyzing the irregular distribution of these areas and pollution levels above the recommended level. Methods: The study population consisted of a cohort of live births from 2012, and data from the Live Birth Information System (Sinasc) of the city of São Paulo were used. Using satellite images and supervised classification, the distribution and quantity of green areas and built areas in the city of São Paulo was obtained, as well as the concentrations of PM2.5. Logistic regressions were used to obtain possible associations. Results: The results of the study show that a lower percentage of green areas is significantly associated with a higher chance of preterm births. A higher building density was positively associated with the odds ratio for preterm birth. We did not find any significant associations between air pollution (PM2.5) and preterm births. Conclusions: The results of this study show that greener areas are less associated with preterm births when compared with less green areas.
MeSH term(s)	Infant, Newborn ; Humans ; Female ; Premature Birth ; Brazil ; Air Pollution ; Gestational Age ; Particulate Matter
Chemical Substances	Particulate Matter
Language	Portuguese
Publishing date	2024-03-11
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	732179-x
ISSN	1518-8787 ; 0034-8910
ISSN (online)	1518-8787
ISSN	0034-8910
DOI	10.11606/s1518-8787.2024058005504
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Article ; Online: Airway smooth muscle and long-term clinical efficacy following bronchial thermoplasty in severe asthma.

Wijsman, Pieta C / Goorsenberg, Annika W M / d'Hooghe, Julia N S / Ten Hacken, Nick H T / J T H Roelofs, Joris / Mauad, Thais / Weersink, Els J M / Shah, Pallav / Annema, Jouke T / Bonta, Peter I

Thorax

2024 Volume 79, Issue 4, Page(s) 359–362

Abstract: The mechanism of action of bronchial thermoplasty (BT) treatment for patients with severe asthma is incompletely understood. This study investigated the 2.5-year impact of BT on airway smooth muscle (ASM) mass and clinical parameters by paired data ... ...

Abstract	The mechanism of action of bronchial thermoplasty (BT) treatment for patients with severe asthma is incompletely understood. This study investigated the 2.5-year impact of BT on airway smooth muscle (ASM) mass and clinical parameters by paired data analysis in 22 patients. Our findings demonstrate the persistence of ASM mass reduction of >50% after 2.5 years. Furthermore, sustained improvement in asthma control, quality of life and exacerbation rates was found, which is in line with previous reports. An association was found between the remaining ASM and both the exacerbation rate (r=0.61, p=0.04 for desmin, r=0.85, p<0.01 for alpha smooth muscle actin (SMA)) and post-bronchodilator forced expiratory volume in 1 s predicted percentage (r=-0.69, p=0.03 for desmin, r=-0.58, p=0.08 for alpha SMA). This study provides new insight into the long-term impact of BT.
MeSH term(s)	Humans ; Bronchial Thermoplasty ; Bronchi/surgery ; Quality of Life ; Desmin/therapeutic use ; Asthma/drug therapy ; Treatment Outcome ; Muscle, Smooth
Chemical Substances	Desmin
Language	English
Publishing date	2024-03-15
Publishing country	England
Document type	Journal Article
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thorax-2023-220967
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Article: Balanced spatial distribution of green areas creates healthier urban landscapes

Cirino, Douglas William / Tambosi, Leandro Reverberi / Mauad, Thais / de Freitas, Simone Rodrigues / Metzger, Jean Paul

Journal of applied ecology. 2022 July, v. 59, no. 7

2022

Abstract: The benefits of green infrastructure on human well‐being in urban areas are already well‐established, with strong evidence of the positive effects of the amount and proximity to green areas. However, the understanding of how the spatial distribution and ... ...

Abstract	The benefits of green infrastructure on human well‐being in urban areas are already well‐established, with strong evidence of the positive effects of the amount and proximity to green areas. However, the understanding of how the spatial distribution and type of green areas affect health is still an open question. Here, through a land sharing and sparing framework, we explore how different spatial configurations of green and built‐up areas and how different types of green areas can affect cardiovascular and respiratory hospitalizations in São Paulo city, Brazil. Sharing/sparing indicators were selected as the main explanatory factors in the control of all groups of diseases. Land sharing appeared as a favourable spatial condition to prevent cardiovascular hospitalization, while land sparing and arboreal vegetation were relevant to reduce hospitalization by lower respiratory diseases. For upper respiratory diseases, forests seem to provide a disservice, once they were associated with increased rates of hospitalization by respiratory allergies causes. Considering that hospitalization rates and severity of cardiovascular diseases are substantially higher than those of upper respiratory ones, dense vegetation tends to provide more services than disservices. The land sharing configuration, which is characterized by green areas spread throughout the urban network (in streets, gardens, small squares or parks), should lead to higher exposure and use of the benefits of green areas, which may then explain the greater prevention of cardiovascular diseases. These novel results indicate that a more balanced distribution of green areas across built‐up areas creates healthier urban spaces, and thus can be used as an urban planning strategy to leverage the health benefits provided by green infrastructure. Policy implications. Aiming to reduce hospitalizations by cardiovascular and pulmonary causes, urban planning should promote the spreading of green areas across the cities, in order to increase daily contact with natural attributes, giving preference to distribution over total quantity of green in urban landscape.
Keywords	applied ecology ; green infrastructure ; issues and policy ; landscapes ; social welfare ; Brazil
Language	English
Dates of publication	2022-07
Size	p. 1884-1896.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	410405-5
ISSN	1365-2664 ; 0021-8901
ISSN (online)	1365-2664
ISSN	0021-8901
DOI	10.1111/1365-2664.14195
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Article: Atmospheric microplastic fallout in outdoor and indoor environments in São Paulo megacity

Amato-Lourenço, Luís Fernando / dos Santos Galvão, Luciana / Wiebeck, Hélio / Carvalho-Oliveira, Regiani / Mauad, Thais

Science of the total environment. 2022 May 15, v. 821

2022

Abstract: Plastics are widely used by society, and their degradation into millimetre fragments, called microplastics (MPs), has become a global environmental threat to ecosystems and human health. However, airborne MPs' presence and fallout fluxes from the ... ...

Abstract	Plastics are widely used by society, and their degradation into millimetre fragments, called microplastics (MPs), has become a global environmental threat to ecosystems and human health. However, airborne MPs' presence and fallout fluxes from the atmosphere are poorly understood and can vary significantly by different conditions, especially in megacities of low- and middle-income countries, where high levels of vehicular air pollution, a high-density population, high plastic use, and inadequate disposal are environmental threats related to airborne MPs. In this study, we investigate the amount, chemical composition, and morphological characteristics of outdoor and indoor airborne MPs fallout in the megacity of São Paulo and assess the influence of weather and seasons on airborne MPs fallout. The results were as follows: MPs were found in all samples with an average fallout rate of 309.40 ± 214.71 MPs/m²/day in the indoor environment, and 123.20 ± 47.09 MPs/m²/day in the outdoor environment; MPs concentrations were higher in the indoor environment than the outdoor environment, with more fibres than particles; polyester fibres (100%), polyethylene (59%) and polypropylene (26%) particles were the dominant polymers indoors, while in outdoors, polyester fibres (76%) and polyethylene (67%) and polyethylene terephthalate (25%) particles were dominant. Fragment was the dominant morphology of particles found in indoor and outdoor samples (64% and 74%, respectively). Outdoor MPs fallout correlated positively with rainfall, wind velocity, and relative humidity. This evidence is the first on airborne MPs in a Latin America megacity and highlights the relevant role that this source plays in different environments.
Keywords	air pollution ; chemical composition ; cities ; environment ; human health ; microplastics ; polyethylene ; polyethylene terephthalates ; polypropylenes ; rain ; relative humidity ; wind speed ; Brazil ; Latin America
Language	English
Dates of publication	2022-0515
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2022.153450
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Article ; Online: A single-centre, retrospective study of the incidence of invasive fungal infections during 85 years of autopsy service in Brazil.

Dantas, Kátia Cristina / Mauad, Thais / de André, Carmen D Saldiva / Bierrenbach, Ana Luiza / Saldiva, Paulo Hilário Nascimento

Scientific reports

2021 Volume 11, Issue 1, Page(s) 3943

Abstract: Autopsy continues to play an essential role in monitoring opportunistic fungal infections. However, few studies have analysed the historical trends of fungal infections in autopsies. Here, we analyse available data on fungal infections obtained from ... ...

Abstract	Autopsy continues to play an essential role in monitoring opportunistic fungal infections. However, few studies have analysed the historical trends of fungal infections in autopsies. Here, we analyse available data on fungal infections obtained from autopsy reports during 85 years of autopsies performed by the largest autopsy service in Brazil. All invasive fungal infections presented in autopsy reports between 1930 and 2015 were included. Of the 158,404 autopsy reports analysed, 1096 involved invasive fungal infections. In general, paracoccidioidomycosis (24%) was the most frequent infection, followed by candidiasis (18%), pneumocystosis (11.7%), cryptococcosis (11%), aspergillosis (11%) and histoplasmosis (3.8%). Paracoccidioidomycosis decreased after the 1950s, whereas opportunistic fungal infections increased steadily after the 1980s during the peak of the AIDS pandemic. The lung was the most frequently affected organ (73%). Disseminated infection was present in 64.5% of cases. In 26% of the 513 cases for which clinical charts were available for review, the diagnosis of opportunistic fungal infections was performed only at autopsy. Our unique 85-year history of autopsies showed a transition from endemic to opportunistic fungal infections in São Paulo, Brazil, reflecting increased urbanization, the appearance of novel diseases, such as AIDS in the 1980s, and advances in medical care over time.
MeSH term(s)	Autopsy/trends ; Brazil/epidemiology ; History, 20th Century ; History, 21st Century ; Humans ; Incidence ; Invasive Fungal Infections/epidemiology ; Invasive Fungal Infections/history ; Mycoses/epidemiology ; Opportunistic Infections/epidemiology ; Opportunistic Infections/microbiology ; Retrospective Studies
Language	English
Publishing date	2021-02-17
Publishing country	England
Document type	Historical Article ; Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-83587-1
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Article ; Online: Atmospheric microplastic fallout in outdoor and indoor environments in São Paulo megacity.

Amato-Lourenço, Luís Fernando / Dos Santos Galvão, Luciana / Wiebeck, Hélio / Carvalho-Oliveira, Regiani / Mauad, Thais

The Science of the total environment

2022 Volume 821, Page(s) 153450

Abstract	Plastics are widely used by society, and their degradation into millimetre fragments, called microplastics (MPs), has become a global environmental threat to ecosystems and human health. However, airborne MPs' presence and fallout fluxes from the atmosphere are poorly understood and can vary significantly by different conditions, especially in megacities of low- and middle-income countries, where high levels of vehicular air pollution, a high-density population, high plastic use, and inadequate disposal are environmental threats related to airborne MPs. In this study, we investigate the amount, chemical composition, and morphological characteristics of outdoor and indoor airborne MPs fallout in the megacity of São Paulo and assess the influence of weather and seasons on airborne MPs fallout. The results were as follows: MPs were found in all samples with an average fallout rate of 309.40 ± 214.71 MPs/m
MeSH term(s)	Air Pollution, Indoor/analysis ; Brazil ; Ecosystem ; Environmental Monitoring/methods ; Humans ; Microplastics ; Plastics
Chemical Substances	Microplastics ; Plastics
Language	English
Publishing date	2022-01-29
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2022.153450
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Article ; Online: Growth of the airway smooth muscle layer from late gestation to childhood is mediated initially by hypertrophy and subsequently hyperplasia.

Wang, Kimberley C W / Donovan, Graham M / Saglani, Sejal / Mauad, Thais / James, Alan L / Elliot, John G / Noble, Peter B

Respirology (Carlton, Vic.)

2022 Volume 27, Issue 7, Page(s) 493–500

Abstract: Background and objective: The airway smooth muscle (ASM) layer thickens during development. Identifying the mechanism(s) for normal structural maturation of the ASM reveals pathways susceptible to disease processes. This study characterized thickening ... ...

Abstract	Background and objective: The airway smooth muscle (ASM) layer thickens during development. Identifying the mechanism(s) for normal structural maturation of the ASM reveals pathways susceptible to disease processes. This study characterized thickening of the ASM layer from foetal life to childhood and elucidated the underlying mechanism in terms of hypertrophy, hyperplasia and extracellular matrix (ECM) deposition. Methods: Airways from post-mortem cases were examined from seven different age groups: 22-24 weeks gestation, 25-31 weeks gestation, term (37-41 weeks gestation), <0.5 year, 0.5-1 year, 2-5 years and 6-10 years. The ASM layer area (thickness), the number and size of ASM cells and the volume fraction of ECM were assessed by planimetry and stereology. Results: From late gestation to the first year of life, normalized ASM thickness more than doubled as a result of ASM hypertrophy. Thereafter, until childhood, the ASM layer grew in proportion to airway size, which was mediated by ASM hyperplasia. Hypertrophy and hyperplasia of ASM were accompanied by a proportional change in ECM such that the broad composition of the ASM layer was constant across age groups. Conclusion: These data suggest that the mechanisms of ASM growth from late gestation to childhood are temporally decoupled, with early hypertrophy and subsequent proliferation. We speculate that the developing airway is highly susceptible to ASM thickening in the first year of life and that the timing of an adverse event will determine structural phenotype.
MeSH term(s)	Asthma/metabolism ; Child ; Female ; Humans ; Hyperplasia/metabolism ; Hyperplasia/pathology ; Hypertrophy/metabolism ; Hypertrophy/pathology ; Muscle, Smooth/metabolism ; Myocytes, Smooth Muscle/metabolism ; Pregnancy ; Respiratory System/pathology
Language	English
Publishing date	2022-03-09
Publishing country	Australia
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1435849-9
ISSN	1440-1843 ; 1323-7799
ISSN (online)	1440-1843
ISSN	1323-7799
DOI	10.1111/resp.14240
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Article ; Online: Heterogeneity of Airway Smooth Muscle Remodeling in Asthma.

James, Alan L / Donovan, Graham M / Green, Francis H Y / Mauad, Thais / Abramson, Michael J / Cairncross, Alvenia / Noble, Peter B / Elliot, John G

American journal of respiratory and critical care medicine

2022 Volume 207, Issue 4, Page(s) 452–460

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Humans ; Asthma ; Bronchi/metabolism ; Muscle, Smooth ; Thorax/metabolism ; Airway Remodeling
Language	English
Publishing date	2022-11-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202111-2634OC
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Article: Postmortem chest computed tomography in COVID-19: A minimally invasive autopsy method.

Savoia, Paulo / Valente Yamada Sawamura, Marcio / de Almeida Monteiro, Renata Aparecida / Nunes Duarte-Neto, Amaro / Morais Martin, Maria da Graça / Dolhnikoff, Marisa / Mauad, Thais / Nascimento Saldiva, Paulo Hilário / da Costa Leite, Claudia / Ferraz da Silva, Luiz Fernando / Cardoso, Ellison Fernando

European journal of radiology open

2024 Volume 12, Page(s) 100546

Abstract: Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology ... ...

Abstract	Objectives: Performing autopsies in a pandemic scenario is challenging, as the need to understand pathophysiology must be balanced with the contamination risk. A minimally invasive autopsy might be a solution. We present a model that combines radiology and pathology to evaluate postmortem CT lung findings and their correlation with histopathology. Methods: Twenty-nine patients with fatal COVID-19 underwent postmortem chest CT, and multiple lung tissue samples were collected. The chest CT scans were analyzed and quantified according to lung involvement in five categories: normal, ground-glass opacities, crazy-paving, small consolidations, and large or lobar consolidations. The lung tissue samples were examined and quantified in three categories: normal lung, exudative diffuse alveolar damage (DAD), and fibroproliferative DAD. A linear index was used to estimate the global severity of involvement by CT and histopathological analysis. Results: There was a positive correlation between patient mean CT and histopathological severity score indexes - Pearson correlation coefficient (R) = 0.66 (p = 0.0078). When analyzing the mean lung involvement percentage of each finding, positive correlations were found between the normal lung percentage between postmortem CT and histopathology (R=0.65, p = 0.0082), as well as between ground-glass opacities in postmortem CT and normal lungs in histopathology (R=0.65, p = 0.0086), but negative correlations were observed between ground-glass opacities extension and exudative diffuse alveolar damage in histological slides (R=-0.68, p = 0.005). Additionally, it was found is a trend toward a decrease in the percentage of normal lung tissue on the histological slides as the percentage of consolidations in postmortem CT scans increased (R =-0.51, p = 0.055). The analysis of the other correlations between the percentage of each finding did not show any significant correlation or correlation trends (p ≥ 0.10). Conclusions: A minimally invasive autopsy is valid. As the severity of involvement is increased in CT, more advanced disease is seen on histopathology. However, we cannot state that one specific radiological category represents a specific pathological correspondent. Ground-glass opacities, in the postmortem stage, must be interpreted with caution, as expiratory lungs may overestimate disease.
Language	English
Publishing date	2024-01-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2810314-2
ISSN	2352-0477
ISSN	2352-0477
DOI	10.1016/j.ejro.2024.100546
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