Adriano Dias

Bio: Adriano Dias is an academic researcher from Sao Paulo State University. The author has contributed to research in topics: Population & Pregnancy. The author has an hindex of 17, co-authored 95 publications receiving 1003 citations. Previous affiliations of Adriano Dias include State University of Campinas & University of Huelva.

The study of cardiovascular risk in adolescents – ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents

Abstract: The Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”) is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA.

Associação entre perda auditiva induzida pelo ruído e zumbidos

Abstract: The objective of this study was to verify an association between noise-induced hearing loss (NIHL) and tinnitus in workers exposed to occupational noise. Workers with a history of work noise exposure who attended two audiology outpatient clinics were interviewed and evaluated. The statistical association between NIHL and tinnitus was evaluated using an adjusted linear regression model, with tinnitus as the dependent variable and NIHL, classified into six levels, as the independent variable, with age and length of noise exposure as covariates. Data were collected from 284 workers between April and October, 2003, in Bauru, Sao Paulo State, Brazil. Tinnitus was observed to increase with the progression of auditory damage, controlled by age and length of noise exposure. These results suggest that investment in hearing conservation programs is needed, especially for source noise emission control and for intervention in hearing loss progression that is caused by noise exposure, in order to maintain auditory health and reduce the associated symptoms.

Occupational noise as a risk factor for work-related injuries

Abstract: OBJETIVO: Verificar se a exposicao ocupacional ao ruido e fator de risco relevante para acidentes do trabalho. METODOS: Estudo de caso-controle de base populacional. Os dados foram coletados entre 16/5/2002 e 15/10/2002, na cidade de Botucatu, Estado de Sao Paulo. Os casos foram definidos como trabalhadores que sofreram acidentes ocupacionais tipicos nos ultimos 90 dias, identificados por intermedio de amostragem aleatoria sistematica de domicilios residenciais. Os controles foram trabalhadores nao acidentados, aleatoriamente alocados a partir da mesma populacao que originou os casos, emparelhados na razao 3:1 segundo sexo, faixa etaria e setor censitario de moradia. Ajustou-se um modelo de regressao logistica multipla, tendo como variavel independente a exposicao ocupacional ao ruido, controlada por covariaveis de interesse. RESULTADOS: Foram analisados 94 casos e 282 controles. Ajustando-se um modelo de regressao logistica condicional multipla observou-se que trabalhar sempre e as vezes exposto a ruido intenso associou-se a um risco relativo de acidentar-se de 5,0 (IC 95%: 2,8-8,7; p<0,001) e 3,7 (IC 95%: 1,8-7,4; p=0,0003), respectivamente, tendo como referencia trabalhar nao exposto a ruido, controlado para diversas covariaveis. CONCLUSOES: Com base nos resultados encontrados, justifica-se o investimento em programas de conservacao auditiva particularmente voltados para o controle da emissao de ruidos na fonte. Essas medidas objetivam nao apenas a manutencao da saude auditiva, mas tambem a diminuicao da acidentabilidade dos trabalhadores.

Sífilis materna e congênita: ainda um desafio

Abstract: This descriptive study collected socio-demographic, obstetric, and diagnostic and treatment-related data from pregnant and postpartum women and their partners, for the 67 pregnant or postpartum women reported with syphilis to the National System of Diseases of Notification, users of public maternity hospitals in the Federal District of Brazil from 2009 to 2010 Data on clinical and laboratory follow-up of the newborn were obtained from the hospital patient charts, compulsory notification forms, and Infant Health Cards Of the pregnant women, 418% were adequately treated; the main reason for inadequate treatment was the absence (836%) or inadequate treatment of the partner (881%) More than a third required repeat treatment at the maternity hospital due to lack of documentation of treatment during the prenatal period Of the newborns diagnosed with congenital syphilis, 48% received radiographic investigation, 42% received a spinal tap, and 36% failed to receive any kind of intervention Thus, the quality of prenatal care was insufficient to guarantee the control of congenital syphilis and achieve the goal of reducing incidence of the disease

Temporal trends in incidence of Type 1 diabetes between 1986 and 2006 in Brazil.

Abstract: Background: Scarce information is available about the variation in the incidence of Type 1 diabetes in the Brazilian population in the last decades. Aim: The objective of this study was to assess the long-term trends (1986–2006) in the incidence of Type 1 diabetes in Bauru, Sao Paulo State, Brazil. Subjects and methods: The annual incidence of Type 1 diabetes (per 100,000 per yr) from 1986 to 2006 was determined in children ≤14 yr of age, using the capture and recapture method. Results: A total of 176 cases were diagnosed in the study population. The overall incidence was 10.4/100,000 with a range of 2.82/100,000 in 1987 to 18.49/100,000 in 2002 representing a 6.56-fold increase within the same population. The estimated incidence, using the capture and recapture method varied from 2.82/100,000 per yr in 1987 to 27.20/100,000 per yr in 2002, representing a 9.6-fold variation. The global pattern of incidence variation was categorized as high (10-19.99/100,000 per yr), and very high (≥20/100,000 per yr) in 71.43% of the study-years. Incidence was slightly higher among females, Caucasians, children in the 5–9 yr of age range and belonging to lower socio-economic classes. Most diagnoses were established during the colder months and/or with higher pluviometric indexes. Conclusions: The incidence of Type 1 diabetes in children is increasing in Bauru, Sao Paulo State, Brazil, and the global pattern of incidence was classified as high or very high, mainly in the last 10 yr. All Brazilian regions should be involved in the study.

Role of WHO.

Abstract: OVERVIEW The GRA Marketing Internship Program is offered to students who are interested in gaining valuable work experience through efforts in marketing, membership, sales, and events. Interns work directly to assist the Director of Marketing and Communications on various tasks relating to upcoming GRA events. During this internship, students will work a minimum of 10 hours a week and a maximum of 20 hours a week. Students are encouraged to earn credit for their internship, however this is a paid internship. Students interested in obtaining credit for their internship must consult their academic advisor or the intern coordinator at their academic unit.

Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies

Abstract: Objective To develop a practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤16 weeks’ gestation to estimate a woman’s risk of pre-eclampsia. Design Systematic review and meta-analysis of cohort studies. Data sources PubMed and Embase databases, 2000-15. Eligibility criteria for selecting studies Cohort studies with ≥1000 participants that evaluated the risk of pre-eclampsia in relation to a common and generally accepted clinical risk factor assessed at ≤16 weeks’ gestation. Data extraction Two independent reviewers extracted data from included studies. A pooled event rate and pooled relative risk for pre-eclampsia were calculated for each of 14 risk factors. Results There were 25 356 688 pregnancies among 92 studies. The pooled relative risk for each risk factor significantly exceeded 1.0, except for prior intrauterine growth restriction. Women with antiphospholipid antibody syndrome had the highest pooled rate of pre-eclampsia (17.3%, 95% confidence interval 6.8% to 31.4%). Those with prior pre-eclampsia had the greatest pooled relative risk (8.4, 7.1 to 9.9). Chronic hypertension ranked second, both in terms of its pooled rate (16.0%, 12.6% to 19.7%) and pooled relative risk (5.1, 4.0 to 6.5) of pre-eclampsia. Pregestational diabetes (pooled rate 11.0%, 8.4% to 13.8%; pooled relative risk 3.7, 3.1 to 4.3), prepregnancy body mass index (BMI) >30 (7.1%, 6.1% to 8.2%; 2.8, 2.6 to 3.1), and use of assisted reproductive technology (6.2%, 4.7% to 7.9%; 1.8, 1.6 to 2.1) were other prominent risk factors. Conclusions There are several practical clinical risk factors that, either alone or in combination, might identify women in early pregnancy who are at “high risk” of pre-eclampsia. These data can inform the generation of a clinical prediction model for pre-eclampsia and the use of aspirin prophylaxis in pregnancy.

Regulation of Glucose Homeostasis by Glucocorticoids.

Abstract: Glucocorticoids are steroid hormones that regulate multiple aspects of glucose homeostasis. Glucocorticoids promote gluconeogenesis in liver, whereas in skeletal muscle and white adipose tissue they decrease glucose uptake and utilization by antagonizing insulin response. Therefore, excess glucocorticoid exposure causes hyperglycemia and insulin resistance. Glucocorticoids also regulate glycogen metabolism. In liver, glucocorticoids increase glycogen storage, whereas in skeletal muscle they play a permissive role for catecholamine-induced glycogenolysis and/or inhibit insulin-stimulated glycogen synthesis. Moreover, glucocorticoids modulate the function of pancreatic α and β cells to regulate the secretion of glucagon and insulin, two hormones that play a pivotal role in the regulation of blood glucose levels. Overall, the major glucocorticoid effect on glucose homeostasis is to preserve plasma glucose for brain during stress, as transiently raising blood glucose is important to promote maximal brain function. In this chapter we will discuss the current understanding of the mechanisms underlying different aspects of glucocorticoid-regulated mammalian glucose homeostasis.

Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women

Abstract: Background About a third of women have urinary incontinence and up to a 10th have faecal incontinence after childbirth. Pelvic floor muscle training is commonly recommended during pregnancy and after birth both for prevention and the treatment of incontinence. Objectives To determine the effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence. Search methods We searched the Cochrane Incontinence Group Specialised Register, which includes searches of CENTRAL, MEDLINE, MEDLINE in Process and handsearching (searched 7 February 2012) and the references of relevant articles. Selection criteria Randomised or quasi-randomised trials in pregnant or postnatal women. One arm of the trial needed to include pelvic floor muscle training (PFMT). Another arm was either no PFMT or usual antenatal or postnatal care. Data collection and analysis Trials were independently assessed for eligibility and methodological quality. Data were extracted then cross checked. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook for Systematic Reviews of Interventions. Three different populations of women were considered separately, women dry at randomisation (prevention); women wet at randomisation (treatment); and a mixed population of women who might be one or the other (prevention or treatment). Trials were further divided into those which started during pregnancy (antenatal); and those started after delivery (postnatal). Main results Twenty-two trials involving 8485 women (4231 PFMT, 4254 controls) met the inclusion criteria and contributed to the analysis. Pregnant women without prior urinary incontinence (prevention) who were randomised to intensive antenatal PFMT were less likely than women randomised to no PFMT or usual antenatal care to report urinary incontinence up to six months after delivery (about 30% less; risk ratio (RR) 0.71, 95% CI 0.54 to 0.95, combined result of 5 trials). Postnatal women with persistent urinary incontinence (treatment) three months after delivery and who received PFMT were less likely than women who did not receive treatment or received usual postnatal care to report urinary incontinence 12 months after delivery (about 40% less; RR 0.60, 95% CI 0.35 to 1.03, combined result of 3 trials). It seemed that the more intensive the programme the greater the treatment effect. The results of seven studies showed a statistically significant result favouring PFMT in a mixed population (women with and without incontinence symptoms) in late pregnancy (RR 0.74, 95% CI 0.58 to 0.94, random-effects model). Based on the trial data to date, the extent to which mixed prevention and treatment approaches to PFMT in the postnatal period are effective is less clear (that is, offering advice on PFMT to all pregnant or postpartum women whether they have incontinence symptoms or not). It is possible that mixed prevention and treatment approaches might be effective when the intervention is intensive enough. There was little evidence about long-term effects for either urinary or faecal incontinence. Authors' conclusions There is some evidence that for women having their first baby, PFMT can prevent urinary incontinence up to six months after delivery. There is support for the widespread recommendation that PFMT is an appropriate treatment for women with persistent postpartum urinary incontinence. It is possible that the effects of PFMT might be greater with targeted rather than mixed prevention and treatment approaches and in certain groups of women (for example primiparous women; women who had bladder neck hypermobility in early pregnancy, a large baby, or a forceps delivery). These and other uncertainties, particularly long-term effectiveness, require further testing.