Air pollution from biomass burning and asthma hospital admissions in a sugar cane plantation area in Brazil

Objective: To evaluate the association between the total suspended particles (TSPs) generated from preharvest sugar cane burning and hospital admission due to asthma ( asthma hospital admissions) in the city of Araraquara.Design: An ecological time-series study. Total daily records of asthma hospital admissions (ICD 10th J15) were obtained from one of the main hospitals in Araraquara, São Paulo State, Brazil, from 23 March 2003 to 27 July 2004. the daily concentration of TSP (mu g/m(3)) was obtained using Handi-vol equipment (Energetica, Brazil) placed in downtown Araraquara. the local airport provided the daily mean figures of temperature and humidity. the daily number of asthma hospital admissions was considered as the dependent variable in Poisson's regression models and the daily concentration of TSP was considered the independent variable. the generalised linear model with natural cubic spline was adopted to control for long-time trend. Linear terms were used for weather variables.Results: TSP had an acute effect on asthma admissions, starting 1 day after TSP concentrations increased and remaining almost unchanged for the next four days. A 10 mu g/m(3) increase in the 5-day moving average (lag1-5) of TSP concentrations was associated with an increase of 11.6% (95% CI 5.4 to 17.7) in asthma hospital admissions.Conclusion: Increases in TSP concentrations were definitely associated with asthma hospital admissions in Araraquara and, despite using sugar cane alcohol to reduce air pollution from automotive sources in large Brazilian urban centres, the cities where sugar cane is harvested pay a high toll in terms of public health.Univ São Paulo, Fac Med, Lab Poluicao Atmosfer Expt, Nucleo Estudos Epidemiol Ambiental, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Grp Fisiopatol Resp & Poluicao Ambiental, São Paulo, BrazilUniv Catolica Santos, Programa Posgrad Saude Coletiva, Santos, SP, BrazilUniv Santo Amaro, Fac Med, Programa Pediat Ambiental, São Paulo, BrazilABC, Fac Med, Dept Saude Coletividade, Santo Andre, SP, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Grp Fisiopatol Resp & Poluicao Ambiental, São Paulo, BrazilWeb of Scienc

Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs

ABSTRACT Tuberculosis continues to be a major public health problem. Although efforts to control the epidemic have reduced mortality and incidence, there are several predisposing factors that should be modified in order to reduce the burden of the disease. This review article will address some of the risk factors associated with tuberculosis infection and active tuberculosis, including diabetes, smoking, alcohol use, and the use of other drugs, all of which can also contribute to poor tuberculosis treatment results. Tuberculosis can also lead to complications in the course and management of other diseases, such as diabetes. It is therefore important to identify these comorbidities in tuberculosis patients in order to ensure adequate management of both conditions

Influence of heart failure on resting lung volumes in patients with COPD

ABSTRACT Objective: To evaluate the influence of chronic heart failure (CHF) on resting lung volumes in patients with COPD, i.e., inspiratory fraction-inspiratory capacity (IC)/TLC-and relative inspiratory reserve-[1 − (end-inspiratory lung volume/TLC)]. Methods: This was a prospective study involving 56 patients with COPD-24 (23 males/1 female) with COPD+CHF and 32 (28 males/4 females) with COPD only-who, after careful clinical stabilization, underwent spirometry (with forced and slow maneuvers) and whole-body plethysmography. Results: Although FEV1, as well as the FEV1/FVC and FEV1/slow vital capacity ratios, were higher in the COPD+CHF group than in the COPD group, all major "static" volumes-RV, functional residual capacity (FRC), and TLC-were lower in the former group (p < 0.05). There was a greater reduction in FRC than in RV, resulting in the expiratory reserve volume being lower in the COPD+CHF group than in the COPD group. There were relatively proportional reductions in FRC and TLC in the two groups; therefore, IC was also comparable. Consequently, the inspiratory fraction was higher in the COPD+CHF group than in the COPD group (0.42 ± 0.10 vs. 0.36 ± 0.10; p < 0.05). Although the tidal volume/IC ratio was higher in the COPD+CHF group, the relative inspiratory reserve was remarkably similar between the two groups (0.35 ± 0.09 vs. 0.44 ± 0.14; p < 0.05). Conclusions: Despite the restrictive effects of CHF, patients with COPD+CHF have relatively higher inspiratory limits (a greater inspiratory fraction). However, those patients use only a part of those limits, probably in order to avoid critical reductions in inspiratory reserve and increases in elastic recoil