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Household air pollution from solid fuel combustion was estimated to cause 2.31 million deaths worldwide in 2019; cardiovascular disease is a substantial contributor to the global burden. We evaluated the cross-sectional association between household air pollution (24-h gravimetric kitchen and personal particulate matter (PM2.5) and black carbon (BC)) and C-reactive protein (CRP) measured in dried blood spots among 107 women in rural Honduras using wood-burning traditional or Justa (an engineered combustion chamber) stoves. A suite of 6 additional markers of systemic injury and inflammation were considered in secondary analyses. We adjusted for potential confounders and assessed effect modification of several cardiovascular-disease risk factors. The median (25th, 75th percentiles) 24-h-average personal PM2.5 concentration was 115 µg/m3 (65,154 µg/m3) for traditional stove users and 52 µg/m3 (39, 81 µg/m3) for Justa stove users; kitchen PM2.5 and BC had similar patterns. Higher concentrations of PM2.5 and BC were associated with higher levels of CRP (e.g., a 25% increase in personal PM2.5 was associated with a 10.5% increase in CRP [95% CI: 1.2-20.6]). In secondary analyses, results were generally consistent with a null association. Evidence for effect modification between pollutant measures and four different cardiovascular risk factors (e.g., high blood pressure) was inconsistent. These results support the growing evidence linking household air pollution and cardiovascular disease.

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Household air pollution (HAP) is estimated to be an important risk factor for cardiovascular disease, but little clinical evidence exists and collecting biomarkers of disease risk is difficult in low-resource settings. Among 54 Nicaraguan women with woodburning cookstoves, we evaluated cross-sectional associations between 48-hour measures of HAP (eg, fine particulate matter, PM2.5 ) and C-reactive protein (CRP) via dried blood spots; secondary analyses included seven additional biomarkers of systemic injury and inflammation. We conducted sub-studies to calculate the intraclass correlation coefficient (ICC) in biomarkers collected over four consecutive days in Nicaragua and to assess the validity of measuring biomarkers in dried blood by calculating the correlation with paired venous-drawn samples in Colorado. Measures of HAP were associated with CRP (eg, a 25% increase in indoor PM2.5 was associated with a 7.4% increase in CRP [95% confidence interval: 0.7, 14.5]). Most of the variability in CRP concentrations over the 4-day period was between-person (ICC: 0.88), and CRP concentrations were highly correlated between paired dried blood and venous-drawn serum (Spearman ρ = .96). Results for secondary biomarkers were primarily consistent with null associations, and the sub-study ICCs and correlations were lower. Assessing CRP via dried blood spots provides a feasible approach to elucidate the association between HAP and cardiovascular disease risk.

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Los dientes permanentes presentan desarrollo y formación radicular incompleta al momento de su erupción, el tejido pulpar es el encargado de culminar el proceso de formación radicular por intermedio de los odontoblastos que producen dentina, si la misma se ve afectada por traumatismo, lesión cariosa, resorción intracoronal pre eruptiva (PEIR por sus siglas en inglés) y/o fractura, se altera la vitalidad e incluso puede llegar a producirse necrosis pulpar, lo que ocasionará una interrupción de la formación radicular normal. Para el tratamiento de dientes permanentes jóvenes e inmaduros que han sufrido algún tipo de lesión, pero que aún mantienen la vitalidad pulpar, el procedimiento de apicogénesis con agregado de trióxido mineral (MTA) puede ser considerado como una opción viable, debido a la biocompatibilidad y capacidad de inducir la formación de tejidos duros. En el presente reporte de caso se presenta una pieza dental con antecedente de PEIR, tratada mediante apicogénesis con MTA, lográndose resultados favorables en cuanto al engrosamiento de paredes dentinales, desarrollo radicular y mantenimiento de la vitalidad pulpar.

The permanent teeth have an incomplete development and root formation at the time of its eruption, the pulp tissue is responsible for completing the process of root formation by means of odontoblasts that produce dentin, if it is affected by trauma, carious lesion, Pre-eruptive intracoronal resorption (PEIR) and / or fracture, pulp vitality is altered and pulp necrosis may even occur, which will cause an interruption of the normal radicular formation. For the treatment of immature permanent teeth that have suffered some type of injury, but still maintain pulp vitality, the procedure of apexogenesis with added mineral trioxide (MTA) can be considered as a viable option, due to the biocompatibility and capacity of induce the formation of hard tissues. In this case report we present a tooth with a history of PEIR, treated by apexogenesis with MTA, achieving favorable results in terms of thickening of dentinal walls, root development and maintenance of pulpal vitality.

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Antecedentes: La caries de infancia temprana (ECC) por sus siglas en inglés, viene siendo un problema de gran impacto en la salud pública. Todo profesional de la salud cumple un rol fundamental en el ámbito de la promoción de la salud bucal. Objetivo: El objetivo del presente estudio fue determinar el conocimiento sobre caries de infancia temprana en personal de salud del primer nivel de atención, Cajamarca, Perú-2017. Metodología: Se analizaron 180 encuestas que evaluaron el conocimiento sobre ECC en todo el personal del primer nivel de atención de los establecimientos de salud en la provincia de Cajamarca, Perú-2017. Se realizó un análisis bivariado para encontrar diferencias de los conocimientos según tipo de profesional mediante la prueba de Chicuadrado corregida por Yates y la prueba de Kruskal Wallis. El presente estudio contó con un nivel de confianza del 95% y un p<0.05%. Resultados: Al evaluar los conocimientos sobre ECC se obtuvo que los cirujanos dentistas respondieron correctamente el 86.3% (n=138) de las preguntas, los técnicos de enfermería 70.7% (n=509), los profesionales en enfermería 70.4% (n=259), los profesionales en obstetricia 62.9% (n=150), y los médicos el 61.7% (n=148). Conclusiones: De manera general se concluye que los profesionales encuestados tienen un conocimiento sobre ECC, por encima del 60%.

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OBJECTIVE: To determine the association of exposure to polycyclic aromatic hydrocarbons (PAHs) with lung function and pH of exhaled breath condensate (EBC) in Mexican schoolchildren. METHODS: A pilot study was performed in a subsample of 64 schoolchildren from Mexico City. Lung function and pH of EBC were measured and metabolites of PAHs in urine samples were determined. The association was analyzed using robust regression models. RESULTS: A 10% increase in the concentrations of 2-hydroxyfluorene was significantly negatively associated with forced expiratory volume in 1 second (-11.2 mL, 95% CI: -22.2 to -0.02), forced vital capacity (-11.6 mL, 95% CI: -22.9 to -0.2), and pH of EBC (-0.035, 95% CI: -0.066 to -0.005). CONCLUSION: Biomarkers of PAHs exposure were inversely associated with lung function and decrease of ph of EBC as a marker of airway inflammation in Mexican schoolchildren.

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INTRODUCTION: Air pollutant exposure has been associated with an increase in inflammatory markers and a decline in lung function in asthmatic children. Several studies suggest that dietary intake of fruits and vegetables might modify the adverse effect of air pollutants. METHODS: A total of 158 asthmatic children recruited at the Children's Hospital of Mexico and 50 non-asthmatic children were followed for 22 weeks. Pulmonary function was measured and nasal lavage collected and analyzed every 2 weeks. Dietary intake was evaluated using a 108-item food frequency questionnaire and a fruit and vegetable index (FVI) and a Mediterranean diet index (MDI) were constructed. The impact of these indices on lung function and interleukin-8 (IL-8) and their interaction with air pollutants were determined using mixed regression models with random intercept and random slope. RESULTS: FVI was inversely related to IL-8 levels in nasal lavage (p < 0.02) with a significant inverse trend (test for trend p < 0.001), MDI was positively related to lung function (p < 0.05), and children in the highest category of MDI had a higher FEV1 (test for trend p < 0.12) and FVC (test for trend p < 0.06) than children in the lowest category. A significant interaction was observed between FVI and ozone for FEV1 and FVC as was with MDI and ozone for FVC. No effect of diet was observed among healthy children. CONCLUSION: Our results suggest that fruit and vegetable intake and close adherence to the Mediterranean diet have a beneficial effect on inflammatory response and lung function in asthmatic children living in Mexico City.

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BACKGROUND: The biological mechanisms involved in inflammatory response to air pollution are not clearly understood. OBJECTIVE: In this study we assessed the association of short-term air pollutant exposure with inflammatory markers and lung function. METHODS: We studied a cohort of 158 asthmatic and 50 nonasthmatic school-age children, followed an average of 22 weeks. We conducted spirometric tests, measurements of fractional exhaled nitric oxide (Fe(NO)), interleukin-8 (IL-8) in nasal lavage, and pH of exhaled breath condensate every 15 days during follow-up. Data were analyzed using linear mixed-effects models. RESULTS: An increase of 17.5 microg/m(3) in the 8-hr moving average of PM(2.5) levels (interquartile range) was associated with a 1.08-ppb increase in Fe(NO) [95% confidence interval (CI), 1.01-1.16] and a 1.07-pg/mL increase in IL-8 (95% CI 0.98-1.19) in asthmatic children and a 1.16 pg/ml increase in IL-8 (95% CI, 1.00-1.36) in nonasthmatic children. The 5-day accumulated average of exposure to particulate matter <2.5 microm in aerodynamic diamter (PM(2.5)) was significantly inversely associated with forced expiratory volume in 1 sec (FEV(1)) (p=0.048) and forced vital capacity (FVC) (p=0.012) in asthmatic children and with FVC (p=0.021) in nonasthmatic children. Fe(NO) and FEV(1) were inversely associated (p=0.005) in asthmatic children. CONCLUSIONS: Exposure to PM(2.5) resulted in acute airway inflammation and decrease in lung function in both asthmatic and nonasthmatic children.

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BACKGROUND: Assessment of the adverse effects of oxidative stress related to air pollution is limited by the lack of biological markers of dose to the lungs. OBJECTIVE: We evaluated the use of exhaled breath condensate (EBC) malondialdehyde as a biomarker of exposure to traffic-related pollution in children with asthma as part of a panel study in Mexico City. METHODS: Standard spirometry and collection of EBC and nasal lavage were performed. Environmental monitoring sites were located within 5 km of the children's homes and schools. Data were analyzed by using generalized estimating equations. RESULTS: A total of 480 samples of malondialdehyde were obtained from 107 patients with asthma, with a median level of 18.7 (interquartile range [IQR], 12.4-28.7) nmol. Ambient particulates less than 2.5 microg/m(3) and ozone levels on the day of sampling were significantly associated with higher malondialdehyde levels. A 14.2-microg/m(3) (IQR) increase in 8-hour moving average particulates less than 2.5 microg/m(3) in size was associated with a 1.12-nmol increase in malondialdehyde and a 15.9-ppb (IQR) increase in 8-hour moving average ozone with a 1.16-nmol increase in malondialdehyde. Malondialdehyde levels were inversely associated with forced vital capacity and FEV(1) and positively associated with IL-8 levels in nasal lavage. CONCLUSION: Exhaled breath condensate malondialdehyde was related to both air pollution exposure and changes in lung function and inflammatory markers.

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