The impact of domestic exposure to cat allergen (Fel d1) and house dust mite (Der p1) on wheezing from birth to the age of 4 years was investigated in a multicenter prospective birth cohort; 1,611 mothers were recruited before delivery in Ashford, England, and Barcelona and Menorca, Spain. Exposures were gathered via dust sample collection at children's home in their first year of life. Families provided complete outcome data (wheezing status in all 4 years) for 1,289 children. Domestic allergen levels varied substantially between centers. Six hundred three (47%) children never wheezed during their first 4 years of life. Der p1 did not correlate with any type of wheezing outcome. Fel d1 significantly increased the risk of wheezing in 3- and 4-year-olds in comparison to 1-year-olds. Distinct risk profiles were found for wheezing at different ages. Multivariate analysis revealed an interaction between Fel d1 and maternal asthma among children who wheeze in Year 4 (relative risk = 2.77; 95% confidence interval = 1.19-6.46). Our data support the idea that several patterns of wheezing with different risk profiles exist among young children. The effect of Fel d1 exposure varied according to age and maternal asthma.

La tuberculosis (TB) es la primera causa de muerte por un agente infeccioso en el mundo, la incidencia en la población viene disminuyendo muy lentamente y la resistencia a los medicamentos es actualmente considerada como una crisis internacional. En el Perú, la reciente Ley de Prevención y Control de la TB en el Perú (Ley 30287), declara de interés nacional la lucha contra la TB. En los últimos años, la Estrategia Sanitaria Nacional de Prevención y Control de la Tuberculosis (ESNPCT) del Ministerio de Salud (MINSA), ha obtenido avances significativos en el control de esta enfermedad; sin embargo, aún persisten desafíos que deben ser abordados. El presente artículo revisa la situación epidemiológica de la TB en el Perú, sistematiza los avances logrados durante la gestión del equipo de la ESNPCT entre los años 2011 y 2015 desde el abordaje biomédico, de gestión pública y en las determinantes sociales de la salud, además, plantea desafíos para lograr el control de la TB, en el marco de la Ley 30287 y la estrategia "Fin de la TB" de la Organización Mundial de la Salud (OMS). Palabras clave: Tuberculosis; Epidemiología; Administración de los Servicios de Salud; Salud Pública; Perú (Fuente: DeCS BIREME). TUBERCULOSIS IN PERU: EPIDEMIOLOGICAL SITUATION, PROGRESS AND CHALLENGES FOR ITS CONTROL ABSTRACTTuberculosis (TB) is the first cause of death by an infectious agent in the world, the incidence in the population is declining very slowly and drug resistance is currently considered an international crisis. In Peru, the recent TB Prevention and Control Act in Peru (Law 30287) declares the fight against TB of national interest. In recent years, the Ministry of Health's (MINSA) National Health Strategy for the Prevention and Control of Tuberculosis (ESNPCT) has achieved significant progress in the control of this disease; however, challenges still remain to be addressed. This article reviews the epidemiological situation of TB in Peru, systematizes the progress achieved during the management of the ESNPCT team between the years 2011 and 2015 from the biomedical approach, public management and social determinants of health, also posing challenges to achieving TB control under law 30287 and the "End of TB" strategy of the World Health Organization (WHO).

This study aimed to investigate the association between biomarkers of fetal exposure to smoking during the whole pregnancy, nicotine in maternal and newborns hair samples, and quantitative measurement of smoking intake and exposure evaluated by maternal self-reported questionnaire. Study subjects were 150 mothers and their newborns from a hospital in Barcelona. A questionnaire including smoking habits was completed in the third trimester of pregnancy and on the day of delivery. Nicotine content was measured in two subsequent segments of maternal hair accounting for the first and last months of pregnancy, and in fetal hair. The geometric mean of nicotine concentration in maternal hair discriminated between nonexposition (3.84 and 2.80 ng/mg in distal and proximal hair segment, respectively) and exposition to cigarette smoke during pregnancy (6.06 and 4.30 ng/mg in distal and proximal hair segment, respectively) (Po0.05), and between these two classes and active smoking (14.40 and 11.08 ng/mg in distal and proximal hair segment, respectively). Maternal hair nicotine was able to differentiate levels of exposure to tobacco smoke and levels of intake. Nicotine concentration in hair from newborns did not differentiate between exposure and nonexposure to environmental tobacco smoke (ETS) in nonsmoking mothers. Finally, chronic exposure to cigarette smoke during pregnancy, assessed by maternal hair nicotine, correlated negatively with anthropometric parameters of newborns.

Background: Awareness of the negative effects of smoking on children's health prompted a decrease in the self-reporting of parental tobacco use in periodic surveys from most industrialized countries. Our aim is to assess changes between ETS exposure at the end of pregnancy and at 4 years of age determined by the parents' self-report and measurement of cotinine in age related biological matrices.