[Association of exhaled nitric oxide with asthma and atopy among children living in Santiago, Chile]. / Óxido nítrico exhalado, asma y atopia: análisis en un panel de niños en Santiago, Chile.

BACKGROUND: Chronic airway inflammation is a central process in asthma. Measurement of exhaled nitric oxide (eNO) is a non-invasive biomarker of eosinophilic airway inflammation. AIM: To measure eNO levels in a population of asthmatic and non-asthmatic children and to evaluate their relationship with asthma and atopy. MATERIAL AND METHODS: We studied 143 asthmatic and non-asthmatic children aged 6 to 14 years attended a hospital and primary health service. Participants were tested for allergies and followed during the winter months of 2010 and 2011. They were visited regularly at their homes and eNO levels were measured on each visit using a handheld equipment. Mean eNO distribution were compared by the presence of asthma or atopy using t-test and regression models. RESULTS: No significant differences for mean eNO levels were detected, according to presence of asthma or atopy, by any of the statistical methods used. Regression models showed significant effects for age but not for sex. CONCLUSIONS: There were no differences in eNO levels in the studied children by the presence of asthma or atopy.

[Kidney involvement in Idiopathic Light Chain disease. Report of one case]. / Enfermedad renal por depósito idiopático de cadenas livianas: Caso clínico.

Idiopathic Light Chain disease (ILCD) is a systemic disease characterized by a deposit in different organs of light chain monoclonal immunoglobulins, produced by an abnormal clone of B cells. It is usually found in the course ofa plasma cell dyscrasia and in other lymphoproliferative alterations; however it may occur in absence of any hematologic disease and is denominated as idiopathic. We report a 51-year-old mole admitted to the hospital due to anasarca. Laboratory evaluation showed a serum creatinine of 1.4 mg/dl, a serum albumin of1.6 g/dl, a serum cholesterol of 687 mg/dl and a proteinuria of 5.3 g/day Light chains with a predominance of a monoclonal component were identified in urinary proteins by electrophoresis and kappa chains were identified by immunofixation. A renal biopsy showed a diffuse nodular glomerulopathy with a 35% tubular atrophy and interstitial sclerosis. Electrón microscopy confirmed light chain deposition. The bone marrow biopsy showed a myeloid hyperplasia. The patient was initially treated with methylprednisolone and plasmapheresis with a reduction in serum creatinine and disappearance of urinary kappa component. Albuminuria persisted and a malnutrition-inflammatory complex syndrome was diagnosed. Hemodialysis with ultrafiltration was started along with cyclophosphamide. The patient received hemodialysis for six months and continued with methylprednisolone.

Óxido nítrico exhalado, asma y atopia: análisis en un panel de niños en Santiago, Chile / Association of exhaled nitric oxide with asthma and atopy among children living in Santiago, Chile

Background: Chronic airway inflammation is a central process in asthma. Measurement of exhaled nitric oxide (eNO) is a non-invasive biomarker of eosinophilic airway inflammation. Aim: To measure eNO levels in a population of asthmatic and non-asthmatic children and to evaluate their relationship with asthma and atopy. Material and Methods: We studied 143 asthmatic and non-asthmatic children aged 6 to 14 years attended a hospital and primary health service. Participants were tested for allergies and followed during the winter months of 2010 and 2011. They were visited regularly at their homes and eNO levels were measured on each visit using a handheld equipment. Mean eNO distribution were compared by the presence of asthma or atopy using t-test and regression models. Results: No significant differences for mean eNO levels were detected, according to presence of asthma or atopy, by any ofthe statistical methods used. Regression models showed significant effects for age but not for sex. Conclusions: There were no differences in eNO levels in the studied children by the presence of asthma or atopy.

Enfermedad renal por depósito idiopático de cadenas livianas: Caso clínico / Kidney involvement in idiopathic light chain disease: Report of one case

Idiopathic Light Chain disease (ILCD) is a systemic disease characterized by a deposit in different organs of light chain monoclonal immunoglobulins, produced by an abnormal clone ofB cells. It is usually found in the course ofa plasma cell dyscrasia and in other lymphoproliferative alterations; however it may occur in absence of any hematologic disease and is denominated as idiopathic. We report a 51-year-old mole admitted to the hospital due to anasarca. Laboratory evaluation showed a serum creatinine of 1.4 mg/dl, a serum albumin of1.6 g/dl, a serum cholesterol of 687 mg/dl and a proteinuria of 5.3 g/day Light chains with a predominance of a monoclonal component were identified in urinary proteins by electrophoresis and kappa chains were identified by immunofixation. A renal biopsy showed a diffuse nodular glomerulopathy with a 35% tubular atrophy and interstitial sclerosis. Electrón microscopy confirmed light chain deposition. The bone marrow biopsy showed a myeloid hyperplasia. Thepatient was initially treated with methylprednisolone and plasmapheresis with a reduction in serum creatinine and disappearance of urinary kappa component. Albuminuriapersisted and a malnutrition-inflammatory complex syndrome was diagnosed. Hemodialysis with ultrafiltration was started along with cyclophosphamide. Thepatient receivedhemodialysisforsixmonths and continued with methylprednisolone.

Toxicological evaluation of realistic emission source aerosols (TERESA): introduction and overview.

Determining the health impacts of sources and components of fine particulate matter (PM(2.5)) is an important scientific goal. PM(2.5) is a complex mixture of inorganic and organic constituents that are likely to differ in their potential to cause adverse health outcomes. The Toxicological Evaluation of Realistic Emissions of Source Aerosols (TERESA) study focused on two PM sources--coal-fired power plants and mobile sources--and sought to investigate the toxicological effects of exposure to emissions from these sources. The set of papers published here document the power plant experiments. TERESA attempted to delineate health effects of primary particles, secondary (aged) particles, and mixtures of these with common atmospheric constituents. TERESA involved withdrawal of emissions from the stacks of three coal-fired power plants in the United States. The emissions were aged and atmospherically transformed in a mobile laboratory simulating downwind power plant plume processing. Toxicological evaluations were carried out in laboratory rats exposed to different emission scenarios with extensive exposure characterization. The approach employed in TERESA was ambitious and innovative. Technical challenges included the development of stack sampling technology that prevented condensation of water vapor from the power plant exhaust during sampling and transfer, while minimizing losses of primary particles; development and optimization of a photochemical chamber to provide an aged aerosol for animal exposures; development and evaluation of a denuder system to remove excess gaseous components; and development of a mobile toxicology laboratory. This paper provides an overview of the conceptual framework, design, and methods employed in the study.

Electrocardiographic and respiratory responses to coal-fired power plant emissions in a rat model of acute myocardial infarction: results from the Toxicological Evaluation of Realistic Emissions of Source Aerosols Study.

BACKGROUND: Ambient particulate matter (PM) derived from coal-fired power plants may have important cardiovascular effects, but existing toxicological studies are inadequate for understanding these effects. The Toxicological Evaluation of Realistic Emissions of Source Aerosols (TERESA) study aims to evaluate the toxicity of primary and secondary PM derived from coal-fired power plants. As a part of this effort, we evaluated in susceptible animals the effect of stack emissions on cardiac electrophysiology and respiratory function under exposure conditions intended to simulate an aged plume with unneutralized acidity and secondary organic aerosols (POS exposure scenario). METHODS: Rats with acute myocardial infarction were exposed to either stack emissions (n = 15) or filtered air (n = 14) for 5 h at a single power plant. Respiration and electrocardiograms were continuously monitored via telemetry and heart rate, heart rate variability (HRV), premature ventricular beat (PVB) frequency, electrocardiographic intervals, and respiratory intervals and volumes were evaluated. Similar experiments at another power plant were attempted but were unsuccessful. RESULTS: POS exposure (fine particle mass = 219.1 µg/m(3); total sulfate = 172.5 µg/m(3); acidic sulfate = 132.5 µg/m(3); organic carbon = 50.9 µg/m(3)) was associated with increased PVB frequency and decreased respiratory expiratory time and end-inspiratory pause, but not with changes in heart rate, HRV, or electrocardiographic intervals. RESULTS from a second power plant were uninterpretable. CONCLUSIONS: Short-term exposure to primary and unneutralized secondary PM formed from aged emissions from a coal-fired power plant, as simulated by the POS scenario, may be associated with increased risk of ventricular arrhythmias in susceptible animals.

Aged particles derived from emissions of coal-fired power plants: the TERESA field results.

The Toxicological Evaluation of Realistic Emissions Source Aerosols (TERESA) study was carried out at three US coal-fired power plants to investigate the potential toxicological effects of primary and photochemically aged (secondary) particles using in situ stack emissions. The exposure system designed successfully simulated chemical reactions that power plant emissions undergo in a plume during transport from the stack to receptor areas (e.g., urban areas). Test atmospheres developed for toxicological experiments included scenarios to simulate a sequence of atmospheric reactions that can occur in a plume: (1) primary emissions only; (2) H(2)SO(4) aerosol from oxidation of SO(2); (3) H(2)SO(4) aerosol neutralized by gas-phase NH(3); (4) neutralized H(2)SO(4) with secondary organic aerosol (SOA) formed by the reaction of α-pinene with O(3); and (5) three control scenarios excluding primary particles. The aged particle mass concentrations varied significantly from 43.8 to 257.1 µg/m(3) with respect to scenario and power plant. The highest was found when oxidized aerosols were neutralized by gas-phase NH(3) with added SOA. The mass concentration depended primarily on the ratio of SO(2) to NO(x) (particularly NO) emissions, which was determined mainly by coal composition and emissions controls. Particulate sulfate (H(2)SO(4) + neutralized sulfate) and organic carbon (OC) were major components of the aged particles with added SOA, whereas trace elements were present at very low concentrations. Physical and chemical properties of aged particles appear to be influenced by coal type, emissions controls and the particular atmospheric scenarios employed.

Effect of gas and kerosene space heaters on indoor air quality: a study in homes of Santiago, Chile.

The impact of outdoor and indoor pollution sources on indoor air quality in Santiago, Chile was investigated. Toward this end, 16 homes were sampled in four sessions. Each session included an outdoor site and four homes using different unvented space heaters (electric or central heating, compressed natural gas, liquefied petroleum gas, and kerosene). Average outdoor fine particulate matter (PM2.5) concentrations were very high (55.9 microg x m(-3)), and a large fraction of these particles penetrated indoors. PM2.5 and several PM2.5 components (including sulfate, elemental carbon, organic carbon, metals, and polycyclic aromatic hydrocarbons) were elevated in homes using kerosene heaters. Nitrogen dioxide (NO2) and ultrafine particles (UFPs) were higher in homes with combustion heaters as compared with those with electric heaters or central heating. A regression model was used to assess the effect of heater use on continuous indoor PM2.5 concentrations when windows were closed. The model found an impact only for kerosene heaters (45.8 microg m(-3)).

Development and evaluation of a photochemical chamber to examine the toxicity of coal-fired power plant emissions.

When investigating the toxicity of individual particle sources, it is important to consider the contribution of both primary and secondary particles. In this article, we present the design of a new photochemical chamber that can be used to form secondary sulfuric acid particles from diluted coal-fired power plant emissions. The chamber is a relatively small, well-mixed flow reactor that can fit in a mobile reaction laboratory. It produces high concentrations of hydroxyl radical (OH) from the photolysis of ozone (O3) in the presence of water vapor. Two chambers were built and tested. A pilot chamber was tested in the laboratory, using mixtures of NO and SO2 in air, at concentrations that are approximately 100 times lower than those in power plant stack emissions. This chamber was able to oxidize about 20% of the SO2, thereby producing 1350 microg m(-3) of H2SO4 particles. Further tests showed that increasing O3 concentrations and residence time increased the H2SO4 production. A field chamber was built subsequently and used in a toxicological study. Diluted coal-fired power plant emissions were introduced in the chamber. Over 19 days of exposure, the chamber, on average, converted 17% of the supplied SO2 emissions and produced an average of 350 microg m(-3) of H2SO4 particles. Particle losses were determined for the pilot chamber, using artificial particles whose size ranged from 50 to 1000 nm. The determined losses ranged from 21 to 42%, with no trend between the amount of particle loss and particle size. Losses for the field chamber, estimated using model calculations, were found to be similar to those of the pilot chamber.

Development of an exposure system for the toxicological evaluation of particles derived from coal-fired power plants.

To investigate the toxicity of particles originating from coal-fired power plants it is necessary to consider the effects of both primary particles and secondary components formed in the air through atmospheric reactions. This report describes a new exposure system that can be used to expose animals to both directly emitted particles and to secondary particles. The system consists of three main components. The first is a sampling system to continuously collect and dilute power plant stack emissions. The second is a reaction laboratory that contains reaction chambers to simulate atmospheric reactions. The following atmospheric reactions were simulated: (1) the oxidation of sulfur dioxide to form sulfuric acid, (2) the neutralization of sulfuric acid by ammonia, and (3) the reaction of alpha-pinene with ozone to form secondary organic aerosol. Using these chambers with the diluted emissions, different typical atmospheric scenarios can be simulated. The final component is a mobile toxicology laboratory where animals are exposed to the resulting test aerosols. We report here the characteristics of the test aerosol exposures obtained at a coal-fired electric power plant. Particle exposures were characterized for concentrations of mass, elements, elemental carbon, organic species, inorganic ions, strong acidity, particle number, and size distributions. Mass concentrations ranged from a few micrograms per cubic meter for a scenario of primary emissions only, to about 250 microg m(-3) for the most complex scenario. We show that the different scenarios produced a large variation in the composition of the test aerosol, thus potentially changing the toxicity of the emissions.

A counter-current parallel-plate membrane denuder for the non-specific removal of trace gases.

In this paper we present a counter-current parallel-plate membrane diffusion denuder for the non-specific removal of trace gases from an air flow. In this design, gaseous pollutants are removed by diffusing from a sample channel to two purge channels by crossing microporous membranes. In the laboratory, at a sample flow rate of 5 L/min and purge flow rates of 5 L/min each, gas removal efficiencies ranged from 84% for CO to 72% for SF6. Removal efficiencies increased with lower sample flow rate, a higher sample to purge flow rate ratio, a longer channel length, and using molecules with higher diffusion coefficient. Removal efficiencies were, however, not affected by the sample channel height. In addition, gas penetration was exponentially associated with the product of channel length, diffusion coefficient, and the inverse of sample flow rate. Particle losses were significant (10-25% losses) only for particles smaller than 50 nm. In a field evaluation, the denuder's performance was tested with an aerosol produced in a photochemical chamber. The denuder's performance was similar to that observed in the laboratory and was stable over time. Finally, the denuder was tested with a semivolatile organic aerosol. Particle mass losses due to volatilization were about 30%.

The influences of ambient particle composition and size on particle infiltration in Los Angeles, CA, residences.

Particle infiltration is a key determinant of the indoor concentrations of ambient particles. Few studies have examined the influence of particle composition on infiltration, particularly in areas with high concentrations of volatile particles, such as ammonium nitrate (NH4NO3). A comprehensive indoor monitoring study was conducted in 17 Los Angeles-area homes. As part of this study, indoor/outdoor concentration ratios during overnight (nonindoor source) periods were used to estimate the fraction of ambient particles remaining airborne indoors, or the particle infiltration factor (FINF), for fine particles (PM2.5), its nonvolatile (i.e., black carbon [BC]) and volatile (i.e., nitrate [NO3-]) components, and particle sizes ranging between 0.02 and 10 microm. FINF was highest for BC (median = 0.84) and lowest for NO3- (median = 0.18). The low FINF for NO3- was likely because of volatilization of NO3- particles once indoors, in addition to depositional losses upon building entry. The FINF for PM2.5 (median = 0.48) fell between those for BC and NO3-, reflecting the contributions of both particle components to PM25. FINF varied with particle size, air-exchange rate, and outdoor NO3- concentrations. The FINF for particles between 0.7 and 2 microm in size was considerably lower during periods of high as compared with low outdoor NO3- concentrations, suggesting that outdoor NO3- particles were of this size. This study demonstrates that infiltration of PM2.5 varies by particle component and is lowest for volatile species, such as NH4NO3. Our results suggest that volatile particle components may influence the ability for outdoor PM concentrations to represent indoor and, thus, personal exposures to particles of ambient origin, because volatilization of these particles causes the composition of PM2.5 to differ indoors and outdoors. Consequently, particle composition likely influences observed epidemiologic relationships based on outdoor PM concentrations, especially in areas with high concentrations of NH4NO3 and other volatile particles.