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BACKGROUND AND AIM: Identifying clinical characteristics and outcomes of different ethnicities in the US may inform treatment for hospitalized COVID-19 patients. Aim of this study is to identify predictors of mortality among US races/ethnicities. DESIGN SETTING AND PARTICIPANTS: We retrospectively analyzed de-identified data from 9,873 COVID-19 patients who were hospitalized at 15 US hospital centers in 11 states (March 2020-November 2020). Main Outcomes and Measures: The primary outcome was to identify predictors of mortality in hospitalized COVID-19 patients. RESULTS: Among the 9,873 patients, there were 64.1% African Americans (AA), 19.8% Caucasians, 10.4% Hispanics, and 5.7% Asians, with 50.7% female. Males showed higher in-hospital mortality (20.9% vs. 15.3%, p=0.001). Non- survivors were significantly older (67 vs. 61 years) than survivors. Patients in New York had the highest in-hospital mortality (OR=3.54 (3.03 - 4.14)). AA patients possessed higher prevalence of comorbidities, had longer hospital stay, higher ICU admission rates, increased requirement for mechanical ventilation and higher in-hospital mortality compared to other races/ethnicities. Gastrointestinal symptoms (GI), particularly diarrhea, were more common among minority patients. Among GI symptoms and laboratory findings, abdominal pain (5.3%, p=0.03), elevated AST (n=2653, 50.2%, p=

Introduction: The World Health Organization (WHO) has proposed to monitor intrinsic capacity (IC) in the older population as a public health strategy through the Integrated Care for Older People (ICOPE) program. Although the program has been developed based on solid concepts, scientific evidence on its practical applicability is still scarce. Objectives: To evaluate IC in Brazilian older adults, its progress over time, and its association with sociodemographic and health factors and outcomes. To evaluate the psychometric properties of the WHO/ICOPE screening tool. Methods: This is a prospective multicenter cohort study with a 36-month follow-up. We will recruit 3838 people aged ≥ 60 years, registered in the health care units included in the study by the participating centers. We will collect sociodemographic and health data and will administer tools to assess IC domains, both those provided for in the ICOPE screening tool and the sequence of confirmatory assessments provided for in the program. Participants will be reassessed every 6 months for 36 months. Expected results: To establish the profile of IC in the study population and to understand its progress and the variables associated with the clinical outcomes of interest. To reveal the diagnostic and psychometric properties of the WHO/ICOPE screening tool. The project is funded by the Brazilian National Council for Scientific and Technological Development (CNPq). Relevance: Understanding the potential use of the ICOPE public health strategy proposed by the WHO within the scope of the Brazilian Unified Health System (SUS) by integrating several research centers in the field of Geriatrics and Gerontology throughout Brazil.

Background Despite improvement in devices, in‐stent restenosis remains a frequent and challenging complication of percutaneous coronary interventions. Methods and Results The RESTO (Morphological Parameters of In‐Stent Restenosis Assessed and Identified by OCT [Optical Coherence Tomography]; study NCT04268875) was a prospective multicenter registry including patients presenting with coronary syndromes related to in‐stent restenosis. All patients underwent preintervention OCT analysis, which led to analysis of in‐stent restenosis phenotype, number of strut layers, and presence of stent underexpansion. The primary end point was the in‐stent restenosis type according to the OCT morphological classification. The 1‐year incidence of target vessel failure (a composite of death from cardiac causes, target‐vessel myocardial infarction, or ischemia‐driven target‐vessel revascularization) was assessed. The study included 297 patients. The culprit stent was a drug‐eluting stent in 74.2% of cases. OCT analysis revealed the presence of neoatherosclerosis in 57% (52% calcified), neointimal hyperplasia in 43% (58% homogeneous), stent underexpansion (minimal stent area

Background The percentage of women

Stability of dispersed materials remains an important question in a wide variety of fields such as cosmetics, catalysis, food or energy and the environment. As stability is directly linked to the size of the dispersed colloids it is essential to assess the size distribution of colloidal suspensions. Nowadays, microfluidic-based approaches generate increasing interest as they represent flexible and fast measurements allowing high throughput experimentations. However, characterization of colloidal dispersions is usually performed by dynamic light scattering (DLS), that requires static measurements as well as significant volumes, that are not compatible with on-line analysis and microfluidics. Moreover, due to flow-induced decorrelation terms, DLS measurements in microfluidic channels are only accurate at very low shear rates.This work aimed at developing an on-line microfluidic device for dispersed materials characterization using DLS. The main challenges of this project were i) to adapt the microfabrication of the PDMS device in order to combine microchannels of hundreds of microns with a milli-fluidic cavity to perform the DLS measurements, and ii) to downsize the DLS set up. A PDMS microchip, consisting in a millimeter cavity for DLS measurements in parallel with a microchannel, was designed to perform the measurement on the sample without stopping the suspension flow during the microfluidic experiment. The cavity geometry was then optimized thanks to numerical simulation to ensure a good sweep efficiency and to downscale as much as possible without impairing the DLS signal.By adapting the microfabrication process, a PDMS microfluidic chip was designed allowing the size measurements of successive suspensions containing 100 and 12 ​nm diameter particles. This work is a first step towards the implementation of a new technological building block for online microfluidic characterization.© 2017 Elsevier Inc. All rights reserved.

Uma das metas do Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) / Interprofissionalidade foi inserção e a implementação dos elementos da Educação Interprofissional (EIP) nos currículos dos cursos de graduação em saúde. O objetivo deste trabalho é apresentar o levantamento e caracterização da interprofissionalidade e das práticas colaborativas presentes nos conteúdos das disciplinas curriculares dos cursos de graduação da área da saúde das Instituições de Ensino Superior (IES) do estado de São Paulo que participaram do PET – Saúde/Interprofissionalidade. O percurso metodológico adotado se deu a partir da solicitação aos coordenadores de cursos de graduação das IES para preenchimento de um questionário estruturado, com questões sobre iniciativas/conteúdos e disciplinas inseridas nos seus currículos que desenvolviam competências e habilidades relacionadas à EIP e Prática Colaborativa. O estudo produziu evidências sobre o perfil estadual paulista dos projetos aprovados no PET – Saúde/Interprofissionalidade no tocante à existência de conteúdos curriculares com enfoque na EIP. Os resultados mostraram que maior parte dos cursos apresenta disciplinas em conjunto com áreas distintas da saúde, porém sem aplicar, explicitamente, os fundamentos teóricos e metodológicos da EIP. Conclui-se que há intenção na implementação e desenvolvimento das competências e habilidades colaborativas e interprofissionais nos diferentes cursos de graduação em saúde caracterizados, porém constatam-se diversos desafios nessa direção que dificultam o processo. Apesar dos coordenadores de curso demonstrarem domínio do referencial conceitual e metodológico da EIP, existe uma diversidade de entendimento sobre qual o momento mais adequado para a adoção desta estratégia no currículo.

Abstract Background At a regional or continental scale, the characterization of environmental health inequities (EHI) expresses the idea that populations are not equal in the face of pollution. It implies an analysis be conducted in order to identify and manage the areas at risk of overexposure where an increasing risk to human health is suspected. The development of methods is a prerequisite for implementing public health activities aimed at protecting populations. Methods This paper presents the methodological framework developed by INERIS (French National Institute for Industrial Environment and Risks) to identify a common framework for a structured and operationalized assessment of human exposure. An integrated exposure assessment approach has been developed to integrate the multiplicity of exposure pathways from various sources, through a series of models enabling the final exposure of a population to be defined. Results Measured data from environmental networks reflecting the actual contamination of the environment are used to gauge the population’s exposure. Sophisticated methods of spatial analysis are applied to include additional information and take benefit of spatial and inter-variable correlation to improve data representativeness and characterize the associated uncertainty. Integrated approaches bring together all the information available for assessing the source-to-human-dose continuum using a Geographic Information System, multimedia exposure and toxicokinetic model. Discussion One of the objectives of the integrated approach was to demonstrate the feasibility of building complex realistic exposure scenarios satisfying the needs of stakeholders and the accuracy of the modelling predictions at a fine spatial-temporal resolution. A case study is presented to provide a specific application of the proposed framework and how the results could be used to identify an overexposed population. Conclusion This framework could be used for many purposes, such as mapping EHI, identifying vulnerable populations and providing determinants of exposure to manage and plan remedial actions and to assess the spatial relationships between health and the environment to identify factors that influence the variability of disease patterns.

The increase in life expectancy can be a consequence of the world’s socioeconomic, sanitary and nutritional conditions. Some studies have demonstrated that individuals with a satisfactory diet variety score present a lower risk of malnutrition and better health status. Zinc and selenium are important micronutrients that play a role in many biochemical and physiological processes of the immune system. Deficient individuals can present both innate and adaptive immunity abnormalities and increased susceptibility to infections. Primary immunodeficiency diseases, also known as inborn errors of immunity, are genetic disorders classically characterized by an increased susceptibility to infection and/or dysregulation of a specific immunologic pathway. IgA deficiency (IgAD) is the most common primary antibody deficiency. This disease is defined as serum IgA levels lower than 7 mg/dL and normal IgG and IgM levels in individuals older than four years. Although many patients are asymptomatic, selected patients suffer from different clinical complications, such as pulmonary infections, allergies, autoimmune diseases, gastrointestinal disorders and malignancy. Knowing the nutritional status as well as the risk of zinc and selenium deficiency could be helpful for the management of IgAD patients. Objectives: to investigate the anthropometric, biochemical, and nutritional profiles and the status of zinc and selenium in patients with IgAD. Methods: in this descriptive study, we screened 16 IgAD patients for anthropometric and dietary data, biochemical evaluation and determination of plasma and erythrocyte levels of zinc and selenium. Results: dietary intake of zinc and selenium was adequate in 75% and 86% of the patients, respectively. These results were consistent with the plasma levels (adequate levels of zinc in all patients and selenium in 50% of children, 25% of adolescents and 100% of adults). However, erythrocyte levels were low for both micronutrients (deficiency for both in 100% of children, 75% of adolescents and 25% of adults). Conclusion: our results highlight the elevated prevalence of erythrocyte zinc and selenium deficiency in patients with IgAD, and the need for investigation of these micronutrients in their follow-up.

Objective. The aim of this study was to compare the concentration of iodine in drinking water in the same or different seasons of the year in Brazilian macroregions. Method. Water samples were collected from the Basic Health Units of eight municipalities that make up the different Brazilian macroregions and the Federal District. Sample collection took place in the summer, autumn, winter, and spring seasons. The spectrophotometric method with “leuco crystal violet” was used to determine the concentration of iodine in the water. Descriptive statistics on the data were performed. To verify if there was a difference in the concentration of iodine in the water between the climatic seasons of the year in the same place and between the same seasons in different locations, the Mann–Whitney or Kruskal–Wallis test was used and a p

The diaphragm is the primary respiratory muscle, and its dysfunction predisposes patients to respiratory failure. Diaphragm function can be assessed by ultrasound measurement - Diaphragmatic Thickening Fraction (DTF). Respiratory viral infections (including SARS-CoV-2) can cause diaphragm dysfunction. Our case series follows three patients infected with COVID-19 pneumonia. Bedside diaphragmatic ultrasound assessments measuring DTF were trended over patient's hospital course until clinical improvement (i.e., off oxygen) or worsening (i.e., intubation). Our preliminary results suggest a correlation between DTF trends and respiratory status in patients requiring 100% oxygen. Further studies are required to assess DTF and its possible correlation to respiratory failure.

Coronary microvascular dysfunction (CMVD) is common and associated with poorer outcomes in patients with ST Segment Elevation Myocardial Infarction (STEMI). The index of microcirculatory resistance (IMR) and the index of hyperemic microvascular resistance (HMR) are both invasive indexes of microvascular resistance proposed for the diagnosis of severe CMVD after primary percutaneous coronary intervention (pPCI). However, these indexes are not routinely assessed in STEMI patients. Our main objective was to clarify the association between IMR or HMR and long-term major adverse cardiovascular events (MACE), through a systematic review and meta-analysis of observational studies. We searched Medline, PubMed, and Google Scholar for studies published in English until December 2020. The primary outcome was a composite of cardiovascular death, non-cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and rehospitalization for heart failure occurring after at least 6 months following CMVD assessment. We identified 6 studies, reporting outcomes in 1094 patients (mean age 59.7 ± 11.4 years; 18.2% of patients were women) followed-up from 6 months to 7 years. Severe CMVD, defined as IMR > 40 mmHg or HMR > 3mmHg/cm/sec was associated with MACE with a pooled HR of 3.42 [2.45; 4.79]. Severe CMVD is associated with an increased risk of long-term adverse cardiovascular events in patients with STEMI. Our results suggest that IMR and HMR are useful for the early identification of severe CMVD in patients with STEMI after PCI, and represent powerful prognostic assessments as well as new therapeutic targets for clinical intervention.

No início de 2020 o mundo foi surpreendido pelo surgimento e rápido avanço da Covid-19. O impacto sobre os programas educacionais foi enorme. Sendo o distanciamento social uma das poucas formas de mitigar o avanço da pandemia, o ensino remoto emergencial (ERE) passou a ser uma imposição. Neste contexto ganha grande relevância avaliar estas iniciativas a fim de promover rapidamente as mudanças necessárias para que se consiga, minimamente, cumprir os objetivos dos programas educacionais. Neste artigo discutiremos os fundamentos para a avaliação de programas educacionais no contexto da ERE e da Covid-19. Apresentaremos os princípios básicos de uma avaliação de programas educacionais que são aplicáveis desde a uma aula isoladamente, até ao curso como um todo. Discutiremos a aplicação dos modelos experimentais, Kirkpatrick, modelo lógico e CIPP (Contexto, Insumo, Processo e Produto). A avaliação das atividades educacionais que utilizaram o ERE, implementado durante a pandemia em 2020, é uma oportunidade para rever práticas e induzir mudanças substanciais no processo de formação das próximas gerações de profissionais da saúde e dos docentes.

Aims: To identify the frequency in changes of bone metabolism, including below the average value for age, osteopenia, and osteoporosis, in people living with HIV/AIDS (PLWHA) and to compare the frequency of factors associated with bone mineral density (BMD) and body composition between sex. Methods: This observational study assessed 106 PLWHA (65 male) recruited from the University Hospital of Ribeirão Preto Medical School from 2013 to 2014. BMD was measured using Dual Energy X-ray Absorptiometry (DXA). Standard deviation values for Z- and T-score proposed by the International Society for Clinical Densitometry were adopted to classify participants below the average value for age, osteopenia, and osteoporosis. Qui-square and Fischer’s exact tests were employed to compare males and females based on their factors associated with BMD reduction. Results: Fifty-two (49%) PLWHA presented at least one diagnosis for below the average value for age, osteopenia, and osteoporosis, being 37 (57%) and 15 (37%) male and female, respectively. Frequency of alcohol consumption was higher in males (n=20; 30.8%) than females (n=05; 12.2%) (p=0.028). Conclusions: A high rate of PLWHA showed changes in bone metabolism, with a higher frequency in males. The frequency of alcohol consumption was higher in males, and it may partially explain the possible causes of the increased rates of bone metabolism changes observed in this group. This information may help develop strategies for reducing the frequency of diagnosis for below the average value for age, osteopenia, osteoporosis improving quality of life in PLWHA.

Coronary physiological assessment is now widely used to assess epicardial coronary lesions in cath lab. Based on clinical evidence, fractional flow reserve (FFR) is the gold standard method to select whether epicardial coronary lesions need revascularization. While additional epicardial indexes, such as instantaneous wave-free ratio (iFR), are also used for revascularization decision-making, several indexes are now also available to explore the coronary microcirculation. Therefore, coronary physiological assessment now allows to explore the entire coronary tree and offer the potential of precision medicine for patients affected by coronary artery disease (CAD). This paper will provide review of the epicardial and microvascular indexes available for the assessment of coronary physiology. More specifically, the already demonstrated contributions of these indexes in the management of CAD and the role they could play in precision medicine will be reviewed with special emphasis on chronic coronary syndrome.

Introdução: O sobrepeso e a obesidade tem sido um problema mundial, causado por fatores genéticos, hábitos alimentares e ausência de atividade física, que influencia nas mudanças físicas, psicológicas e sociais, elevando cada vez mais o nível de prevalência de obesidade em crianças e adolescentes. Objetivo: Verificar a prevalência de sobrepeso e obesidade e os fatores de risco associados em adolescentes. Materiais e Métodos: Foi realizado um estudo descritivo com um delineamento transversal, com 70 adolescentes de ambos os sexos, do ensino médio de uma escola pública da cidade de Tocantins-MG, no segundo semestre de 2016. Aplicou-se o Questionário Internacional de Atividade Física e para o cálculo de sobrepeso e obesidade, foi utilizado o índice de massa corporal (IMC). A pressão arterial foi obtida por meio do método auscultatório. Resultados: Do total de avaliados, 22,9% foram considerados com sobrepeso e 1,4% obesos. Com relação ao nível de atividade física, 15,7% dos avaliados foram considerados muito ativos e 27,1% ativos; entretanto 41,4% eram insuficientemente ativos A, 12,9% insuficientemente ativo B e 2,9% sedentários. Não houve diferença estatística entre sobrepeso/obesidade segundo o nível de atividade física (p>0,05), assim como também não houve associação do sobrepeso/obesidade com a pressão arterial. No entanto, verificou-se uma associação do sexo com o sobrepeso/obesidade, com os homens estando com um fator de proteção. Conclusão: A prevalência de sobrepeso/obesidade encontrada no estudo foi considerada elevada, apresentando associação apenas com o sexo. ABSTRACT Prevalence of overweight and obesity and the risk factors associated in adolescents Introduction: Overweight and obesity have been a worldwide problem, caused by genetic factors, eating habits and absence of physical activity, which influences physical, psychological and social changes, increasing the prevalence of obesity in children and adolescents. Aim: To verify the prevalence of overweight and obesity and the associated risk factors in adolescents. Materials and Methods: A descriptive study with a cross-sectional design was carried out, with 70 adolescents of both sexes, of the high school of a public school in the city of Tocantins-MG, in the second half of 2016. Was used The International Physical Activity Questionnaire and the body mass index (BMI). Blood pressure was obtained through the auscultatory method. Results: Of the total, 22.9% were considered overweight and 1.4% obese. Regarding the level of physical activity, 15.7% of the evaluated ones were considered very active and 27.1% active; However 41.4% were insufficiently active A, 12.9% were insufficiently active B and 2.9% were sedentary. There was no statistical difference between overweight/obesity according to the level of physical activity (p> 0.05), nor was there any association between overweight/obesity and blood pressure. However, there was an association between gender and overweight/obesity, with men having a protective factor. Conclusion: The prevalence of overweight/obesity found in the study was considered high, presenting only association with gender.

People living with HIV (PWH) experience an accelerated aging process. There is no anthropometric predictive model for appendicular skeletal muscle mass (ASM) in PWH. This study develops anthropometric models to predict and validate ASM measured by dual energy x-ray absorptiometry (DXA) in PWH; DXA scans were obtained for 125 PWH (male = 74; age >18 years) on antiretroviral therapy. Fat mass ratio was used for lipodystrophy diagnosis. A multiple stepwise linear regression considered ASMDXA as the dependent variable and validated by PRESS method. A high power of determination and low standard estimate error were found for ASMDXA-predicted (adjusted r 2 = 0.84 to 0.87, standard estimate error = 1.7–1.6 kg) and high PRESS validation coefficients (Q2PRESS = 0.84–0.86, SPRESS = 1.7–1.6 kg). The variables included were lipodystrophy diagnosis, medial calf circumference, sex, and total body weight. We present novel, reliable, and validated anthropometric models to predict ASMDXA in PWH. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis is one of the most important public health problems involving a high percentage of costs in the medical care system. Reliable diagnostic techniques for an early detection of bone deterioration and studies of factors that influence its development in menopausal women are crucial. The aim of the study was to determine the relationship between bone microarchitecture and anthropometry in climacteric women. Methods: Women were recruited at the Menopause Clinic, University Hospital of FMRP/USP, and submitted to anthropometry and to the evaluation of bone quality (Ultrasound Bone Profile Index, UBPI) and quantity (Amplitudedependent Speed of Sound, AD-SoS-) by phalangeal quantitative osteosonography (DBM Sonic BP). Descriptive analysis of the data was reported and a multiple linear regression was performed using the software SAS® 9.0. Results: 71 patients aged 58 ± 7 y were studied: 28% had BMI 18.5-24.9 kg/m², 35% BMI 24.9-29.9 and 37% BMI > 30. Mean AD-SoS was 2059 ± 79 m/s and mean UBPI was 0.67 ± 0.13. Considering AD-SoS the dependent variable, there was no statistically significant relationship between age (p = 0.20), BMI (p = 0.76), fat mass by bioelectrical impedance (p = 0.42) and by anthropometry (p = 0.95). The variables had very low effect on the UBPI when it was considered the dependent variable. Conclusions: The relation between bone microarchitecture and the anthropometry of the women studied shows that, the greater the bone quantity, the better the anthropometric parameters, without statistically significance. This work was a cross-sectional study on a small sample that needs to be validated in a prospective design.Introducción y objetivo: La osteoporosis es uno de los problemas más importantes de la Salud Pública e involucra un elevado porcentaje de los costos del Sistema de Salud. Es decisiva la aplicación de técnicas confiables de diagnóstico para la detección precoz del deterioro óseo y estudios de los factores que influencian su desarrollo en mujeres postmenopáusicas. El objetivo del estudio fue determinar la relación entre la micro arquitectura ósea y la antropometría de mujeres postmenopáusicas. Métodos: Se reclutaron mujeres, en el dispensario de Climaterio del Hospital Universitario (FMRP/USP), que fueron sometidas a antropometría y evaluación de la calidad ósea (Índice Ultrasonográfico del Perfil Óseo-UBPI) y de la cantidad ósea (Velocidad del Sonido dependiente de la Amplitud-Ad-SoS) por medio de la osteosonografía cuantitativa de falange (DBM Sonic BP). Se realizaron análisis descriptivos de los datos y regresión lineal múltiple utilizando el software SAS® 9.0. Resultados: Se estudiaron 71 pacientes con edad media de 58 ± 7 años: 28% tuvieron el IMC entre 18,5-24,9 kg/m², 35% entre 24,9-29,9 y 37% IMC arriba de 30. La media del Ad-SoS fue 2.059 ± 79 m/s y del UBPI fue 0,67 ± 0,13. Considerando el Ad-SoS como la variable dependiente, no hubo relación estadísticamente significativa entre la edad (p = 0,20), IMC (p = 0,76), masa grasa por la impedancia bioeléctrica (p = 0,42) y por la antropometría (p = 0,95). Las variables tuvieron un efecto muy bajo en el UBPI cuando este fue considerado la variable dependiente. Conclusión: La relación entre la micro arquitectura ósea y la antropometría de las mujeres estudiadas mostró que cuanto mayor es la cantidad ósea, mejores son los parámetros antropométricos sin importancia estadística. Este trabajo fue un estudio transversal de una muestra pequeña, por lo cual necesita ser validado en un diseño prospectivo.

O presente trabalho tem como objetivo avaliar a excreção urinária de iodo e relacionar com a sua quantidade presente no sal de consumo humano. Participaram do estudo 145 crianças de duas escolas: uma de zona rural e outra de urbana. Foram realizadas avaliação antropométrica e coleta de amostra de urina e do sal de cozinha cada uma das crianças voluntárias. Na escola rural, 3,8% das crianças apresentaram deficiência de iodo. Entretanto, a maioria dos valores de iodúria ficou acima de 300μg/L (62,03%) com 59,49% das amostras do sal de cozinha entre 20 e 60mg de iodo por quilo de sal. Para a escola urbana, 3,03% das crianças apresentaram iodúria inferior à 100μg/L, sendo que, 90,91% das crianças apresentaram valores de iodúria superior a 300μg/L. Desse total, 84,85% das amostras do sal de cozinha encontrava-se entre 20 e 60mg de iodo por quilo de sal. A deficiência de iodo na população estudada está controlada, destacando-se agora uma nova realidade de alta prevalência de excesso de iodo urinário.The objective of the present study was to evaluate the urinary excretion of iodine and relate it to the amount present in salt for human consumption. The study involved 145 children from two schools: a rural one and an urban one. We performed anthropometric measurements and collected a urine sample and a kitchen salt sample from each child. In the rural school, 3.38% of children had iodine deficiency. However, most of the values of urinary iodine were above 300 μg/L (62.03%) and 59.49% of the kitchen salt samples contained 20 to 60 mg iodine per kilo of salt. In the urban school, 3.03% of the children had urinary iodine excretion of less than 100 μg/L and 90.91% of the children had urinary iodine values exceeding 300 μg/L. Of this total, 84.85% of the kitchen salt samples contained 20 to 60 mg iodine per kilo of salt. Iodine deficiency is controlled in this population, with the current reality showing a high prevalence of excess urinary iodine.

Nitrogen dioxide (NO2) is a common indoor and outdoor air pollutant whose role in the induction of asthma is unclear. We investigated the effects of NO2 on the development of asthma-like responses to allergenic challenge in BALB/c mice. Ovalbumin (OVA)-immunized mice were intranasally challenged with OVA or saline solution just before starting a 3 h exposure to 5 or 20 ppm NO2 or air. Twenty parts per million of NO2 induced a significant increase of bronchopulmonary hyperreactivity in OVA-challenged mice and of permeability according to the fibronectin content of the bronchoalveolar lavage fluid (BALF) 24 h after exposure, as compared with air or 5 ppm NO2. Eosinophilia (cell counts in the BALF and eosinophil peroxidase of lung tissue) was detected at 24 and 72 h with similar levels for air and 20 ppm NO2, whereas a marked reduction was unexpectedly observed for 5 ppm NO2. At 24 h, interleukin-5 in the BALF was markedly reduced at 5 ppm compared with 20 ppm NO2 and was also more intense for 20 ppm NO2 than for the air group. In contrast to specific IgG1 titers, anti-OVA IgE titers and interleukin-4 in the BALF were not affected by NO2 exposure. Irrespective of the concentration of NO2, OVA-challenged mice did not develop late mucosal metaplasia compared with those exposed to OVA-air. These results indicate that a short exposure to NO2 can exacerbate or inhibit some features of the development of allergic disease in mice and may depend on the concentration of pollutant.