Altered levels of IFN-γ, IL-4, and IL-5 depend on the TLR4 rs4986790 genotype in COPD smokers but not those exposed to biomass-burning smoke.

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with tobacco smoking and biomass-burning smoke exposure. Toll-like receptor 4 (TLR4) single-nucleotide polymorphisms (SNPs) may contribute to its pathogenesis. The study aimed to assess the association of rs4986790 and rs4986791 in the TLR4 gene in a Mexican mestizo population with COPD secondary to tobacco smoking (COPD-TS) and biomass-burning smoke (COPD-BBS) and to evaluate whether the genotypes of risk affect cytokine serum levels. Materials and methods: We enrolled 2,092 participants and divided them into two comparisons according to their environmental exposure. SNPs were genotyped using TaqMan probes. Serum cytokine levels (IL-4, IL-5, IL-6, IL-10, and INF-γ) were quantified by ELISA. Results: The rs4986790 AA genotype in COPD-TS was associated with a higher COPD risk (OR = 3.53). Haplotype analysis confirmed this association, identifying a block containing the rs4986790 allele (A-C, OR = 3.11). COPD-TS exhibited elevated IL-6, IL-4, and IL-5 levels compared with smokers without COPD (SWOC), whereas COPD-BBS displayed higher IFN-γ, IL-6, and IL-10 levels. The AA carriers in the COPD-TS group had elevated IL-4, IL-5, and IFN-γ compared with carriers of AG or GG. Conclusion: The rs4986790 common allele and the A-C haplotype (rs4986790-rs4986791) were associated with a higher COPD risk in smokers; COPD patients carrying the AA genotype showed increased pro-inflammatory cytokines.

Atmospheric black carbon observations and its valley-mountain dynamics: Eastern cordillera of the central Andes of Peru.

Glacial bodies in the Peruvian Andes Mountains store and supply freshwater to hundreds of thousands of people in central Peru. Atmospheric black carbon (BC) is known to accelerate melting of snow and ice, in addition to contributing to air pollution and the health of people. Currently there is limited understanding on the sources and temporal variability of BC in valley and mountain environments in Peru. To address this problem, this study combined surface observations of BC collected during 2022-2023 with WRF model simulations and HYSPLIT trajectories to analyze the dispersion and sources of BC in valley and high elevation environments and the associated local atmospheric circulations. Results show high BC concentrations are associated with the valley-mountain wind system that occurs on both sides of the Huaytapallana mountain range. A pronounced circulation occurs on the western slopes of Huaytapallana when concentrations of BC increase during daylight hours, which transports atmospheric pollutants from cities in the Mantaro River Valley to the Huaytapallana mountain range. Low concentrations of BC are associated with circulations from the east that are channeled by the pronounced ravines of the Andes-Amazon transition. On average, during the season of highest BC concentrations (July-November), the relative contributions of fossil fuels are dominant to biomass burning at the valley observatory and are slightly lower at the Huaytapallana observatory. These results demonstrate the need to promote mitigation actions to reduce emissions of BC and air pollution associated with forest fires and local anthropogenic activity.

Ethanol, acetaldehyde, and methanol in the gas phase and rainwater in different biomes and urban regions of Brazil.

In the context of the increasing global use of ethanol biofuel, this work investigates the concentrations of ethanol, methanol, and acetaldehyde, in both the gaseous phase and rainwater, across six diverse urban regions and biomes in Brazil, a country where ethanol accounts for nearly half the light-duty vehicular fuel consumption. Atmospheric ethanol median concentrations in São Paulo (SP) (12.3 ± 12.1 ppbv) and Ribeirão Preto (RP) (12.1 ± 10.9 ppbv) were remarkably close, despite the SP vehicular fleet being ∼13 times larger. Likewise, the rainwater VWM ethanol concentration in SP (4.64 ± 0.38 µmol L-1) was only 26 % higher than in RP (3.42 ± 0.13 µmol L-1). This work demonstrated the importance of evaporative emissions, together with biomass burning, as sources of the compounds studied. The importance of biogenic emissions of methanol during forest flooding was identified in campaigns in the Amazon and Atlantic forests. Marine air masses arriving at a coastal site led to the lowest concentrations of ethanol measured in this work. Besides vehicular and biomass burning emissions, secondary formation of acetaldehyde by photochemical reactions may be relevant in urban and non-urban regions. The combined deposition flux of ethanol and methanol was 6.2 kg ha-1 year-1, avoiding oxidation to the corresponding and more toxic aldehydes. Considering the species determined here, the ozone formation potential (OFP) in RP was around two-fold higher than in SP, further evidencing the importance of emissions from regional distilleries and biomass burning, in addition to vehicles. At the forest and coastal sites, the OFP was approximately 5 times lower than at the urban sites. Our work evidenced that transition from gasoline to ethanol or ethanol blends brings the associated risk of increasing the concentrations of highly toxic aldehydes and ozone, potentially impacting the atmosphere and threatening air quality and human health in urban areas.

sRAGE levels are decreased in plasma and sputum of COPD secondary to biomass-burning smoke and tobacco smoking: Differences according to the rs3134940 AGER variant.

The receptor for advanced glycation end products (RAGE) and its gene (AGER) have been related to lung injury and inflammatory diseases, including chronic obstructive pulmonary disease (COPD). We aimed to evaluate the association of rs2071288, rs3134940, rs184003, and rs2070600 AGER single-nucleotide variants and the soluble-RAGE plasma and sputum levels with COPD secondary to biomass-burning smoke (BBS) and tobacco smoking. Four groups, including 2189 subjects, were analyzed: COPD secondary to BBS exposure (COPD-BBS, n = 342), BBS-exposed subjects without COPD (BBES, n = 774), tobacco smoking-induced COPD (COPD-TS, n = 434), and smokers without COPD (SWOC, n = 639). Allelic discrimination assays determined the AGER variants. The sRAGE was quantified in plasma (n = 240) and induced-sputum (n = 72) samples from a subgroup of patients using the ELISA technique. In addition, a meta-analysis was performed for the association of rs2070600 with COPD susceptibility. None of the studied genetic variants were found to be associated with COPD-BBS or COPD-TS. A marginal association was observed for the rs3134940 with COPD-BBS (p = 0.066). The results from the meta-analysis, including six case-control studies (n = 4149 subjects), showed a lack of association of rs2070600 with COPD susceptibility (p = 0.681), probably due to interethnic differences. The sRAGE plasma levels were lower in COPD-BBS compared to BBS and in COPD-TS compared to SWOC. The sRAGE levels were also lower in sputum samples from COPD-BBS than BBES. Subjects with rs3134940-TC genotypes exhibit lower sRAGE plasma levels than TT subjects, mainly from the COPD-BBS and SWOC groups. The AGER variants were not associated with COPD-BBS nor COPD-TS, but the sRAGE plasma and sputum levels are related to both COPD-BBS and COPD-TS and are influenced by the rs3134940 variant.

Amitriptyline effectiveness in burning mouth syndrome: An in-depth case series analysis.

OBJECTIVES: To assess the effectiveness of amitriptyline (AMT), and to identify the determinants of the treatment's effectiveness in patients diagnosed with burning mouth syndrome (BMS). BACKGROUND: Treatment of BMS is challenging and no established treatment protocol is available. AMT may be an important treatment option, cout not all patients benefit from this drug. Studies assessing factors related to treatment response are valuable in improving decision-making. MATERIALS AND METHODS: This case series study examined the medical records of all patients diagnosed with BMS at an oral medicine unit in a university hospital from 2008 to 2022. The patients were divided into responders to AMT and non-responders to AMT. Data on demographic information, comorbidities, medications, types of symptoms and oral subsites affected were collected. Descriptive and bivariate analyses were conducted to assess the association between the independent variables and the outcome, using the Chi-squared test (P < .05). RESULTS: Three hundred and fourty-nine patients reported a burning mouth sensation, 50 of them (14.3%) being diagnosed with primary BMS. Of these, 35 were treated with AMT, and 26 (74.2%) responded significantly to AMT. All males responded to AMT, whereas only 67.9% of females responded. The mean dose of AMT among responders was 29.8 ± 12.3 mg, with most patients achieving a response with 25 mg (61.5% of patients), followed by 50 mg (23%). The concomitant use of an anticonvulsant resulted in non-response. CONCLUSIONS: AMT may be effective in BMS management for most patients.

Local and NON-LOCAL source apportionment of black carbon and combustion generated PM2.5.

Current methods for measuring black carbon aerosol (BC) by optical methods apportion BC to fossil fuel and wood combustion. However, these results are aggregated: local and non-local combustion sources are lumped together. The spatial apportioning of carbonaceous aerosol sources is challenging in remote or suburban areas because non-local sources may be significant. Air quality modeling would require highly accurate emission inventories and unbiased dispersion models to quantify such apportionment. We propose FUSTA (FUzzy SpatioTemporal Apportionment) methodology for analyzing aethalometer results for equivalent black carbon coming from fossil fuel (eBCff) and wood combustion (eBCwb). We applied this methodology to ambient measurements at three suburban sites around Santiago, Chile, in the winter season 2021. FUSTA results showed that local sources contributed ∼80% to eBCff and eBCwb in all sites. By using PM2.5 - eBCff and PM2.5 - eBCwb scatterplots for each fuzzy cluster (or source) found by FUSTA, the estimated lower edge lines showed distinctive slopes in each measurement site. These slopes were larger for non-local sources (aged aerosols) than for local ones (fresh emissions) and were used to apportion combustion PM2.5 in each site. In sites Colina, Melipilla and San Jose de Maipo, fossil fuel combustion contributions to PM2.5 were 26 % (15.9 µg m-3), 22 % (9.9 µg m-3), and 22 % (7.8 µg m-3), respectively. Wood burning contributions to PM2.5 were 22 % (13.4 µg m-3), 19 % (8.9 µg m-3) and 22% (7.3 µg m-3), respectively. This methodology generates a joint source apportionment of eBC and PM2.5, which is consistent with available chemical speciation data for PM2.5 in Santiago.

Burning mouth in oncology care: a systematic review.

Burning mouth, also referred to as oral dysesthesia, is an underreported condition among cancer patients that may represent an early symptom of cancer or an adverse effect of treatment. This review sought to characterize this symptom in oncology care where burning symptoms may occur. A systematic review of the literature was performed based on the PRISMA statement, and the protocol was registered at PROSPERO database. A structured search was done using eight databases. The process of study selection was conducted in two distinct phases. The JBI Critical Appraisal Tools were utilized to evaluate the risk of bias in the studies included. Of the total number of studies assessed, sixteen met the eligibility criteria. Of these studies included, 7 were case reports, 7 cross-sectional studies, and 2 non-randomized clinical trials. Most studies presented low risk of bias (n = 9), while the remaining studies were evaluated and scored as moderate (n = 5) or high (n = 2) risk of bias. Burning mouth was reported as a first symptom of cancer in three studies, and as an adverse event of radiotherapy (n = 2), chemoradiotherapy (n = 2), and chemotherapy (n = 9). Burning mouth was a first symptom in 0.62% of oral squamous cell carcinoma (OSCC), and 3.3% of patients with pain as chief complaint. Oral dysesthesia prevalence was 13.6% in patients experiencing chemotherapy-induced oral adverse events. The symptom of burning mouth should be examined in oncology care, as it may be underreported and therefore undertreated. New therapies may be related to a higher risk of oral burning and studies assessing approach to management are needed. Current management borrows from the current management of burning mouth in the non-cancer setting.

Efficacy of 660 nm Photobiomodulation in Burning Mouth Syndrome Management: A Single-Blind Quasi-Experimental Controlled Clinical Trial.

Background: Burning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa without any evidence of clinical signs or underlining condition. Several treatment modalities have been utilized with various results and levels of evidence. Lately, photobiomodulation (PBM) has emerged as a noninvasive effective therapy due to its anti-inflammatory and biostimulatory effects, especially the low-power laser setting of red wavelength. Objective: This single-blind quasi-experimental controlled clinical trial aimed to evaluate the PBM effectiveness at a low level of red laser light in patients with BMS compared with sham control. Materials and methods: Thirty patients diagnosed with BMS were consecutively assigned to intervention (PBM therapy) and control (sham) groups. The protocol for PBM dosimetry was as follows: laser 660 nm; spot size: 0.04 cm2; power output: 100 mW; emission mode: continuous wave; power density: 6 J/cm2; irradiation time: 10 sec per point within 1 cm2 surface area of the symptomatic area. The treatment protocol was based on once a week for a total of 10 sessions. Results: Our results showed no statistically significant difference in reduction of pain intensity between the two groups at all the evaluated timepoints during the course of treatment. However, in both groups, we observed a statistically significant reduction of maximum pain intensity of 50% compared with patient-self reporting before the treatment. Conclusions: Further randomized clinical trials to validate our positive results with a large sample size with a long-term follow-up and understanding further the sham placebo effect are warranted.

Biomonitoring of arsenic, lead, manganese and mercury in hair from a presumably exposed Uruguayan child population.

Aim: To perform an exposure assessment of arsenic, manganese, mercury and lead levels in hair samples from children from poor neighborhoods. Materials & methods: A total of 38 Caucasian children were recruited with the consent of their parents or tutors. Determinations were performed by atomic absorption spectrometry. Results & conclusion: Results were 0.045-0.12 µg/g-1 (arsenic), 0.56-2.05 µg/g-1 (manganese) and 0.34-27.8 µg/g-1 (lead). Lead results did not correlate with those previously reported in blood from the same individuals, suggesting that hair is not useful for exposure assessment of this contaminant. Mercury was determined for the first time in Uruguayan children showing levels <0.083 µg/g-1. Results revealed low-to-moderate metal exposure, except for some high lead findings.

Smoke emissions from biomass burning in Central Mexico and their impact on air quality in Mexico City: May 2019 case study.

Smoke emissions from biomass burning considerably influence regional and local air quality. Many natural wildfires and agricultural burns occur annually in Central Mexico during the hot, dry season (March to May), potentially leading to air quality problems. Nevertheless, the impact of these biomass burning emissions on Mexico City's air quality has not been investigated in depth. This study examines a severely deteriorated air quality case from 11 to 16 May 2019, during which fine particle concentrations (PM2.5) exceeded the 99th percentile of the available official dataset (2005-2019). Specifically, this work aims to highlight the role of fires and regional pollution in the severe episode observed in Mexico City, identifying the fires that were the sources of regional pollution, the type of fuel burned in those fires, and the dominant atmospheric transport pattern. Biomass burning emissions were calculated for different land cover types using satellite data from the Visible Infrared Imaging Radiometer Suite (VIIRS) and the Moderate-Resolution Imaging Spectroradiometer (MODIS). PM2.5 increased by a factor of 2 at some monitoring sites, and ozone concentration increased to 40 % in Mexico City during the poor air quality episode. Our results indicate that over 50 % of the fire activity observed during the 2019 fire season was concentrated in May in Central Mexico. The burning activity was mainly seen over shrubland and forest between 10 and 15 May. Moreover, the fire radiative power analysis indicates that most energy was associated with burning shrubland and forests. Organic carbon emissions were estimated highest on 14 and 15 May, coinciding with the largest number of fires. Back trajectory analysis indicates that enhanced concentration of air pollutants in Mexico City originated from biomass burning detected in neighboring states: Guerrero, Michoacán, and the State of Mexico. Smoke from fires on the specific vegetation cover was advected into Mexico City and contributed to the bad air quality episode. Further meteorological analysis evidenced that the fire intensity and emissions were worsened by low humidity and the late onset of the rainy season in Central Mexico.

The potential of Acmella oleracea as a nutraceutical source for the symptomatic treatment of Burning Mouth Syndrome.

This study analysed the phytochemical profile of Acmella oleracea extract and the molecular interactions of its main compounds with TRPV1 and CB2, target receptors in the Burning Mouth Syndrome (BMS) pathogenesis. The phytochemical profile of A. oleracea's floral buds extract treated with activated charcoal (TCEE) was analysed by High-Performance Liquid Chromatography (HPLC) coupled to Mass Spectrometry (LC-MS). The quantification of spilanthol was analysed by HPLC coupled to a Diode-Array Detector (HPLC-DAD). The phytochemical analysis revealed the presence of nine alkylamides and phenolic compounds. The TCEE showed a significant increase in spilanthol content compared to the crude extract (CEE), going from 28.33 mg/g to 117.96 mg/g. The molecular docking indicated a behaviour of the alkylamides as partial TRPV1 agonists and CB2 agonists and, for the first time, indicates the action of these compounds in the symptomatic management of BMS.

Comparative analysis of photobiomodulation therapy and transcutaneous electrical nerve stimulation for burning mouth: a randomized clinical trial.

OBJECTIVE: To compare the effect of photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) in the treatment of burning mouth. MATERIALS AND METHODS: Randomized clinical trial of 25 patients with burning mouth treated by TENS (n=12) and PBM (n=13). The patients were treated weekly for 8 weeks. Two-factor ANOVA was used to determine whether the two interventions promoted significant differences in symptoms (measured with a visual analogue scale), unstimulated salivary flow, xerostomia, and dysgeusia between T0 (baseline), T1 (after the 4th treatment session), T2 (after the 8th treatment session), and T3 (30 days after the end of treatment). RESULTS: Intragroup comparison of VAS scores for pain showed a significant difference between T0xT1, T0xT2, and T0xT3 in the TENS group and between T0xT2 and T0xT3 in the PBM group (p˂0.001). Intergroup comparison of VAS scores for pain between T2xT3 showed a better response to PBM than to TENS (p=0.003). Patients of the TENS group showed an increase in salivary flow between T1 and T2 (p=0.052). There were no expressive variations in xerostomia or dysgeusia in the two groups analyzed. CONCLUSION: TENS and PBM were effective in reducing the symptoms of burning mouth during and after treatment. The PBM group showed a better response during follow-up. TRIAL REGISTRATION: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200). CLINICAL RELEVANCE: TENS was found to be a safe and effective therapy for burning mouth. Trial registration number (TRN) and date of registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200; date: May 08, 2023).

Sphenopalatine ganglion block - a new treatment for burning mouth syndrome?: a case report

Abstract Burning mouth syndrome is a poorly understood entity for which current treatment modalities fail to provide effective relieve. Branches of the maxillary and mandibular nerves are responsible for the innervation of the affected area. These are also the nerves involved in trigeminal neuralgia, an entity where sphenopalatine block has proved to be effective. We present a case of a patient with burning mouth syndrome in whom a bilateral sphenopalatine ganglion block was successfully performed for pain treatment. It is an easy and safe technique that can be a valuable treatment option for these patients, although more studies are needed.

Sphenopalatine ganglion block ... a new treatment for burning mouth syndrome?: a case report.

Burning mouth syndrome is a poorly understood entity for which current treatment modalities fail to provide effective relieve. Branches of the maxillary and mandibular nerves are responsible for the innervation of the affected area. These are also the nerves involved in trigeminal neuralgia, an entity where sphenopalatine block has proved to be effective. We present a case of a patient with burning mouth syndrome in whom a bilateral sphenopalatine ganglion block was successfully performed for pain treatment. It is an easy and safe technique that can be a valuable treatment option for these patients, although more studies are needed.

Voltage-gated sodium channels gene expression in Burning Mouth Syndrome: a case-control study

Abstract Burning mouth syndrome (BMS) is a condition characterized by painful symptoms of the oral mucosa, despite the absence of any clinical signs. Its etiology is unknown, and there is still no effective treatment to date. Current evidence has shown neuropathic impairment in BMS patients. Neuropathic pain can be related to the dysfunction of voltage-gated sodium channels, considering that these receptors regulate the induction of action potentials in nociceptive neurons. This study evaluated the gene expression of voltage-gated sodium channels Na v 1.7, Na v 1.8 and Na v 1.9 in these patients. The gene expressions of these channels were assessed by real time RT-PCR analysis of fresh-frozen tongue biopsies in a case-control study composed of 12 patients with BMS, and 5 healthy control patients, proportionally matched by sex and age, and analyzed using the 2^(-Delta Delta CT) method. There was no statistically significant difference between the analyzed groups, despite the increase in Na v 1.7 (fold-change = 3.13, p = 0.52) and decrease in Na v 1.9 (fold-change = 0.45, p = 0.36) gene expression in the BMS group. The Na v 1.8 gene was not expressed in any of the samples analyzed. Although the gene expression in the voltage-gated sodium channels in BMS under study seems to be comparable with that of the normal oral mucosa, the functionality of these channels in BMS has not yet been identified, thus suggesting that further research is needed to better understand these voltage-gated sodium channels.

Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome

Abstract Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.

Burning mouth syndrome is an oral disease connected to emotions

Burning mouth syndrome presents several challenges, which involve the ignorance of the disease and the psychological and economic barriers for the patients who suffer from it. This letter has a reflection on how the syndrome is related to emotions.

Avaliação clínica dos fatores de risco sistêmicos relacionado ao ardor bucal secundário / Clinical assessment of systemic risk factors related to secondary burning mouth

O Ardor Bucal Secundário (ABS) pode estar relacionado a diferentes doenças e condições que afetam a mucosa oral, ou representar uma manifestação oral de um quadro sistêmico. O propósito deste estudo foi investigar se existe associação entre o ABS queixa de Ardor Bucal e condições sistêmicas presentes na história médica do paciente. Foi realizado um estudo retrospectivo, constituído por 102 pacientes com ABS apresentando HAS ou DM tipo II, e o grupo controle constituído por 102 pacientes pareados por idade e sexo, com HAS ou DM tipo II e sem ABS. Na comparação entre os grupos, foram empregados os testes Qui-Quadrado de Pearson (χ2) e Exato de Fisher, além da obtenção da razão de chances (Odds ratio, OR) e seu respectivo intervalo de confiança (IC) de 95%. Foi aplicado, ainda, o modelo de regressão logística multivariada, para obtenção dos Odds ratio ajustados (ORa). Após análise multivariada, a gastrite foi identificada como fator de risco para ABS (ORa=2,50; IC 95% = 1,32­4,74; p=0,005). O uso de subclasses de anti-hipertensivos, tais como betabloqueadores (ORa = 0,36; IC 95% = 0,16-0,80; p=0,012), inibidores da enzima conversora de angiotensina (ECA) (ORa = 0,19; IC 95% = 0,06-0,56; p=0,003) e bloqueadores dos receptores da angiotensina (BRA) (ORa = 0,26; IC 95% = 0,14-0,49; p<0,001), revelou-se menos associado para o ABS. O presente estudo demonstrou que os pacientes com HAS e DM tipo II não obtiveram associação com o ABS. Todavia, nos pacientes portadores de gastrite foi observado 2,5 vezes mais chances de desenvolver a ABS. Além disso, os medicamentos antihipertensivos, inibidores da ECA, BRA e betabloqueadores, foram menos associados ao ABS (AU).

Secondary Burning Mouth (SBM) can be related to different diseases that affect the oral mucosa or represent an oral manifestation of a systemic condition presented by the patient. This study aimed to investigate whether there is an association between the complaint of SBM Complaint of Burning Mouth and Systemic Conditions presents in the patient's medical history. It was a retrospective case-control study of 102 patients with BMS and SAH or type II DM and a control group of 102 patients matched by age and sex, with SAH or type II DM and without ABS. Pearson's Chi-Square (χ2) and Fisher's Exact tests were applied to compare the groups, in addition to obtaining the odds ratio (OR) and its respective confidence interval (CI) of 95%. The multivariate logistic regression model was also applied to obtain the adjusted odds ratio (ORa). After multivariate analysis, gastritis was identified as a risk factor for SBM (ORa=2.50; 95% CI = 1.32­4.74; p=0.005). The use of antihypertensive subclasses, such as beta-blockers (ORa = 0.36; 95% CI = 0.16-0.80; p=0.012), angiotensin-converting enzyme (ACE) inhibitors (ORa = 0.19; 95% CI = 0.06- 0.56; p=0.003) and angiotensin receptor blockers (ARB) (ORa = 0.26; 95% CI = 0.14-0.49; p<0.001), proved to be less associated for ABS. The present study demonstrated that SAH and type II DM were not associated with SBM. A 2.5-fold greater chance of developing SBM was observed in patients with gastritis. In addition, antihypertensive drugs from the groups of ACE inhibitors, ARBs, and beta-blockers were shown to be less associated for SBM (AU).

Effects of household and participant characteristics on personal exposure and kitchen concentration of fine particulate matter and black carbon in rural Honduras.

Traditional cooking with solid fuels (biomass, animal dung, charcoals, coal) creates household air pollution that leads to millions of premature deaths and disability worldwide each year. Exposure to household air pollution is highest in low- and middle-income countries. Using data from a stepped-wedge randomized controlled trial of a cookstove intervention among 230 households in Honduras, we analyzed the impact of household and personal variables on repeated 24-h measurements of fine particulate matter (PM2.5) and black carbon (BC) exposure. Six measurements were collected approximately six-months apart over the course of the three-year study. Multivariable mixed models explained 37% of variation in personal PM2.5 exposure and 49% of variation in kitchen PM2.5 concentrations. Additionally, multivariable models explained 37% and 47% of variation in personal and kitchen BC concentrations, respectively. Stove type, season, presence of electricity, primary stove location, kitchen enclosure type, stove use time, and presence of kerosene for lighting were all associated with differences in geometric mean exposures. Stove type explained the most variability of the included variables. In future studies of household air pollution, tracking the cooking behaviors and daily activities of participants, including outdoor exposures, may explain exposure variation beyond the household and personal variables considered here.