ORCID Profile
0000-0002-9171-6113
Current Organisations
Florida International University
,
York University Dahdaleh Institute for Global Health Research
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Publisher: Walter de Gruyter GmbH
Date: 1996
DOI: 10.1515/REVEH.1996.11.3.119
Abstract: This review summarizes studies comparing the epidemiology of asthma, allergic rhinitis, and atopic dermatitis in eastern versus western German populations. These studies clearly revealed that the prevalence of physician-diagnosed allergic rhinitis was higher in western Germany than in eastern Germany. The rate for asthma also tended to be higher in western than in eastern populations, whereas a tendency for less atopic dermatitis was found in western German children. When sensitization rates, as measured by RAST and skin-prick tests, were compared, a clear increase was found in western versus eastern young-adult German populations. This phenomenon may be related to exposure to different allergens, such as those associated with nutritional patterns or pet ownership, as well as to different environmental factors, such as outdoor and indoor pollutants. If lifestyle or environmental factors play a role in developing allergic sensitization, then one would expect the rates of sensitization in eastern and western Germany to converge as the two societies become more similar.
Publisher: American Public Health Association
Date: 04-2013
Abstract: Objectives. We described the racial/ethnic disparities in survival among people diagnosed with AIDS in Florida from 1993 to 2004, as the availability of highly active antiretroviral therapy (HAART) became widespread. We determined whether these disparities decreased after controlling for measures of community-level socioeconomic status. Methods. We compared survival from all causes between non-Hispanic Blacks and non-Hispanic Whites vis-a-vis survival curves and Cox proportional hazards models controlling for demographic, clinical, and area-level poverty factors. Results. Racial/ethnic disparities in survival peaked for those diagnosed during the early implementation of HAART (1996–1998) with a Black-to-White hazard ratio (HR) of 1.72 (95% confidence interval [CI] = 1.62, 1.83) for males and 1.40 (95% CI = 1.24, 1.59) for females. These HRs declined significantly to 1.48 (95% CI = 1.35, 1.64) for males and nonsignificantly to 1.25 (95% CI = 1.05, 1.48) for females in the 2002 to 2004 diagnosis cohort. Disparities decreased significantly for males but not females when controlling for baseline demographic factors and CD4 count and percentage, and became nonsignificant in the 2002 to 2004 cohort after controlling for area poverty. Conclusions. Area poverty appears to play a role in racial/ethnic disparities even after controlling for demographic factors and CD4 count and percentage.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Elsevier BV
Date: 11-2017
Publisher: Mary Ann Liebert Inc
Date: 04-2018
Publisher: OMICS Publishing Group
Date: 2012
Publisher: Oxford University Press (OUP)
Date: 03-05-2011
DOI: 10.1093/AJE/KWR034
Publisher: Elsevier BV
Date: 19-01-1998
Publisher: Springer Science and Business Media LLC
Date: 19-06-2012
Publisher: Wiley
Date: 18-01-2011
DOI: 10.1002/AJIM.20923
Abstract: Increasing numbers of US workers are diabetic. We assessed the relationship between glycemic control and work hours and type of occupation among employed US adults with type 2 diabetes. Data were obtained from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). A representative s le of employed US adults ≥20 years with self-reported type 2 diabetes (n = 369) was used. Two dichotomous glycemic control indicators, based on various HbA1c level cut-points, were used as dependent variables in weighted logistic regression analyses with adjustment for confounders. Adults working over 40 hr/week were more likely to have suboptimal glycemic control (HbA1c ≥ 7%) compared to those working 20 hr or less (odds ratio = 5.09 95% confidence interval: [1.38-18.76]). Work-related factors, such as number of hours worked, may affect the ability of adults with type 2 diabetes to reach and maintain glycemic control goals. These factors should be considered in the development of workplace policies and accommodations for the increasing number of workers with type 2 diabetes.
Publisher: Informa UK Limited
Date: 14-08-2015
Publisher: Elsevier BV
Date: 09-02-1996
DOI: 10.1016/0048-9697(95)04945-2
Abstract: The internal burden of arsenic among 5- to 14-year-old eastern German children in the heavily polluted areas of Hettstedt, a region of smelting and copper mining, and Bitterfeld, a center of chemical production and coal mining, was compared with that in a control area (Zerbst) by means of urinary arsenic concentrations in 1992-94. The unadjusted geometric mean among the 950 children was significantly higher in Hettstedt (5.1 micrograms/l 95% C.I. 4.8-5.5) but not in Bitterfeld (4.3 micrograms/l 95% C.I. 3.7-4.9) compared with the control area (4.0 micrograms/l 95% C.I. 3.5-4.5). This difference persisted after adjustment for relevant confounders. Despite these regional differences, recent fish consumption was as strongly associated with urinary arsenic levels (42% increase, 95% C.I. 18-71%). Additionally, although the geometric mean among the children in Hettstedt (4.8 micrograms As/g creatinine 95% C.I. 4.5-5.1) was higher than that found in an environmental survey of eastern German children (3.60 micrograms As/g creatinine 95% C.I. 3.06-4.24), it was similar to that found among western German children (4.59 micrograms As/g creatinine 95% C.I. 4.20-5.02). This suggests that the arsenic contamination in Hettstedt is not substantially increasing the internal burden of arsenic among children above that found in other German children.
Publisher: Elsevier BV
Date: 02-1997
Abstract: Hettstedt, a city in former East Germany with a history of mining and smelting of nonferrous ores, has multiple lead waste deposits and the remains of a former lead and copper-silver smelter. A small-area analysis of lead concentrations in blood and in household dust was undertaken in a cross-sectional study to determine if children living near the sources had particularly high burdens of lead. The overall geometric mean of the region was 38.0 micrograms Pb/liter blood with a 95% confidence interval (CI) of 36.5-39.5. The burden of lead among children living in the region containing the lead tailings piles and adjacent smelters was almost twice as high (77.4 micrograms Pb/liter blood 95% CI 65.0-92.0). It decreased in the areas farther northeast from the smelter. Lead levels in the children residing in areas southwest of the smelters were not appreciably elevated. The same pattern was found in house dust lead concentrations. This analysis helped target areas where follow-up is needed and found that not only distance from lead sources, but also meteorological factors played an important role in lead exposure.
Publisher: Project MUSE
Date: 2018
Publisher: Informa UK Limited
Date: 03-1997
DOI: 10.1080/00039899709602877
Abstract: Internal burdens of mercury were evaluated among 5- to 14-y-old eastern German children in the heavily polluted areas of Bitterfeld, a center of chemical production and coal mining, and Hettstedt, a region of nonferrous metal smelting and mining. We compared blood and urine mercury concentrations in these children with mercury burdens in children who lived in a control area. The unadjusted geometric means of mercury levels in the total group were 0.25 microg/l (95% confidence interval = 0.24, 0.27) in blood and 0.36 microg mercury/g creatinine (95% confidence interval = 0.33, 0.39) in urine. Mercury levels in blood and urine were not significantly higher in children who occupied the two polluted areas, compared with children in the control area. The most significant factor that affected urinary mercury levels was the number of dental amalgam fillings 27% of the variance in the regression model was explained by the presence of these fillings.
Publisher: SAGE Publications
Date: 07-1997
Abstract: Exposure and risk assessment can be based on direct epidemiological investigations that study exposed in iduals or on models. Ex les from situations in Germany for both approaches are presented and discussed here. Epidemiological studies for the health risk assessment of contaminated soil typically have one or more of the following problems: the number of exposed persons is too small: critical confounders cannot be measured and controlled for appropriately or the expected effects are not large enough to be detected. Therefore, at least for most situations in Germany, epidemiological investigations designed to measure health risks infrequently provide clear answers. In contrast, direct epidemiological investigations are more likely to be able to quantify exposure. If the soil concentrations are high, one is able to identify the location of relevant “hot spots” using biological and environmental monitoring. Further, epidemiology can be used to get information about the distribution of exposure in specific populations, such as young children or amateur gardeners. Exposure assessment by modeling provides answers in situations in which no reasonable answers can be expected using epidemiological means. The model gives quantitative estimates for average and reasonable worst-case situations. The latter can be determined by modeling probability distributions.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: Wiley
Date: 14-01-2013
Publisher: SAGE Publications
Date: 09-2015
DOI: 10.1177/003335491513000513
Abstract: This study aimed to characterize premature mortality among people diagnosed with HIV infection from 2000 to 2009 in Florida, by sex and race/ethnicity, to estimate differences in premature mortality that could be prevented by linkage to HIV care and treatment. Florida surveillance data for HIV diagnoses (excluding concurrent AIDS diagnoses) were linked with vital records data to ascertain deaths through 2011. Years of potential life lost (YPLL) were obtained from the expected number of remaining years of life at a given age from the U.S. sex-specific period life tables. Among 41,565 people diagnosed with HIV infection during the study period, 5,249 died, and 2,563 (48.8%) deaths were due to HIV/AIDS. Age-standardized YPLL (aYPLL) due to HIV/AIDS per 1,000 person-years was significantly higher for females than males (372.6, 95% confidence interval [CI] 349.8, 396.2 vs. 295.2, 95% CI 278.4, 312.5) for non-Hispanic black (NHB) females than non-Hispanic white (NHW) and Hispanic females (388.2, 95% CI 360.7, 416.9 294.3, 95% CI 239.8, 354.9 and 295.0, 95% CI 242.9, 352.5, respectively) and for NHB males compared with NHW and Hispanic males (378.7, 95% CI 353.7, 404.7 210.6, 95% CI 174.3, 250.8 and 240.9, 95% CI 204.8, 280.2, respectively). In multilevel modeling controlling for in idual factors, NHB race was associated with YPLL due to HIV/AIDS for women ( p=0.04) and men ( p .001). Among people diagnosed with HIV infection, females and NHB people had a disproportionately high premature mortality from HIV/AIDS, suggesting the need for enhanced efforts to improve linkage to and retention in care and medication adherence for these groups.
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.JDIACOMP.2011.03.004
Abstract: To assess the relationships between strict HbA1c levels and mortality risk among adults with type 2 diabetes by age, insulin therapy, and hypertension comorbidity. Data of adult participants with type 2 diabetes from the third National Health and Nutrition Examination Survey (1988-1994) and its linked mortality file (with follow-up death up to 2000) were used. Having strict glycemic control (i.e., HbA1c ≤6.5%) was associated with a lower risk of mortality (hazards ratio=0.69 95% confidence interval=0.48-0.98). However, among those with strict glycemic control levels, statistically significant results were not found. Reaching strict glycemic control levels in the general US population with type 2 diabetes appears to be associated with lower mortality. Further research is needed as to how strict glycemic control affects certain diabetic groups.
Publisher: Elsevier BV
Date: 03-2016
Publisher: Wiley
Date: 05-1998
DOI: 10.1111/J.1399-3038.1998.TB00308.X
Abstract: The objective of this analysis was to examine the effect of low birth weight and prematurity on bronchial air-flow, bronchial reactivity, airway symptoms and asthma diagnosis at school age. A cross-sectional epidemiological study was performed in three small towns in the eastern part of Germany on 2470 school children aged 5-14 (89.1% of eligible children). A 78 item questionnaire to determine risk factors at birth and in early childhood was employed. 7.8% of the children were born before completing 38 gestational weeks 6.6% had a birth weight less than 2500 g. Pulmonary function analysis were done by a mobile plethysmography at the school. There were only weak restrictions in lung volume in term low birth weight (LBW) children (100 ml lower TLC, p = 0.107), and flow (257 ml lower PEFR, p = 0.108), were low. However, bronchial hyper-responsiveness indicated by 292 ml lower FEV1.0 after cold air bronchial provocation, was significantly increased compared to term normal birth weight children (p < 0.001). The effect of LBW was less in older children, only slightly stronger in girls and increased in children mechanically ventilated during the postnatal period. Correspondingly, there was a higher prevalence of diagnosed asthma in term LBW children (OR 1.6, 95%-confidence interval 1.0-2.6), however these were without an increased risk for any allergic sensitization. LBW, therefore, seems to be a risk factor for smaller lungs and hyperreactive airways primarily in term born children, whereas in preterm children the immature bronchial system seems to be recover by school age.
Location: Canada
No related grants have been discovered for Raphael Aguiar.