The pulmonary deposition and retention of indium-111 labeled ultrafine carbon particles in healthy individuals

Context: Particulate air pollution, for example, from ultrafine (UF) particles, has negative health effects. However, there is still limited knowledge regarding the fate of inhaled particles in the human body.

Objectives: To describe the normal lung deposition and 1 week particle retention of indium-111 labeled UF carbon particles in healthy subjects. Additionally, the possibility to extend the follow-up period to 4 weeks was also investigated for one of the subjects.

Results: The cumulative pulmonary particle clearance 1 week post-administration, corrected for activity leaching and mucocilliary transport of activity deposited in the central airways, was 4.3?±?8.5% (average ± standard deviation at group level), with marginal translocation of particles from lungs to blood, 0.3%. There was no observable elimination of particles from the body via urine. Seven days after exposure, the cumulated activity leaching was 3% (group level), which indicates a stable bonding between the particles and Indium-111. The volunteer followed for a total of 4 weeks, showed a cumulative decrease of activity retention in the lungs of 10.5%. After correction for activity leaching and clearance from central airway deposition, the estimated particle clearance was about 2%.

Conclusions: No evidence for particle translocation from the lungs could be proven 7 days after exposure. It is possible to follow-up Indium-111 labeled UF carbon particles at least 1 month post-administration without increasing the administered activity.     

Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Ecological Study in the Basque Country,Spain (2000–2011)

Chronic obstructive pulmonary disease (COPD) is a prevalent condition in adults aged ≥40 years characterized by progressive airflow limitation associated with chronic inflammatory response to noxious particles in the airways and lungs. Smoking, genetics, air pollution, nutrition and other factors may influence COPD development. Most hospitalizations and deaths for COPD are caused by its acute exacerbations, which greatly affect the health and quality of life of COPD patients and pose a high burden on health services. The aims of this project were to identify trends, geographic patterns and risk factors for COPD exacerbations, as revealed by hospitalizations and deaths, in the Basque Country, Spain, over a period of 12 years (2000–2011). Hospitalization and mortality rates for COPD were 262 and 18 per 100,000 population, respectively, with clusters around the biggest cities. Hospital mortality was 7.4%. Most hospitalized patients were male (77.4%) and accounted for 72.1% of hospital mortality. Hospitalizations decreased during the study period, except for 50–64 year-old women, peaking significantly. Using a multivariate modeling approach it was shown that hospitalizations were positively correlated with increased atmospheric concentrations of NO₂, CO, PM₁₀, and SO₂, and increased influenza incidence, but were negatively associated with increased temperatures and atmospheric O₃ concentration. COPD exacerbations decreased in the Basque Country during 2000–2011, but not among 50–64-year-old women, reflecting the high smoking prevalence among Spanish women during the 1970–1990s. The main metropolitan areas were those with the highest risk for COPD exacerbations, calling attention to the role of heavy car traffic. Influenza virus, cold temperatures, and increased atmospheric NO₂, CO, PM₁₀, and SO₂ (but decreased O₃) concentrations were identified as potential contributors to the burden of COPD exacerbations in the community. These findings are important for both the understanding of the disease process and in providing potential targets for COPD-reducing initiatives and new avenues for research.     

Air pollution and pregnancy outcomes based on exposure evaluation using a land use regression model: A systematic review

This review systematically assessed those studies investigating the association between air pollution and birth outcomes using land use regression (LUR) models for exposure assessment. Fifty-four studies were identified which were published between 2007 and 2019. Most of these were conducted in America, Spain and Canada, while only five were conducted in China. One hundred and ninety-seven LUR models were developed for different pollutants. The main pollutants that these studies assessed were NO₂ and PM_2.5, and the main pregnancy outcomes investigated were preterm birth (PTB), small for gestational age (SGA) and birth weight. Studies consistently found that NO₂ exposure during pregnancy was associated with reduced fetal growth and development. The effect of NO₂ on other adverse pregnancy outcomes is unclear. In addition, it was found that increased PM_2.5 (aerodynamic equivalent diameter ≤ 2.5 um) exposure during pregnancy reduced birth weight. The effect of PM_2.5 on other adverse pregnancy outcomes is also unclear. The relationship between other pollutants and adverse pregnancy outcomes is uncertain based on the existing research. Exposure assessment with LUR modeling has been widely used in Europe and North America, but used less in China. Future studies are recommended to use LUR modeling for individual exposure evaluation in China to better characterize the relationship between air pollution and adverse pregnancy outcomes. In addition, further research is required given that a lot of the associations looked at in the review were inconclusive.     

微创心脏手术中排气研究

目的探讨微创心脏手术中的排气技术，并评价排气效果。方法选取复旦大学附属中山医院2011年6月至2013年6月收治的56例行微创心脏手术患者为微创组，男31例、女25例，年龄33～7l（57-3±7．2）岁；同期56例行常规胸骨正中切口心脏二尖瓣成形术患者为对照组，男27例、女29例，年龄51～69（53．7±6,8）岁。比较两组患者术后心腔内残留气泡量、心电图异常发生率、术后清醒时间、术后思维能力及脑部并发症发生率等指标。结果微创组心腔内残留气泡量少量占69．6％、中量占30．4％，对照组少量占73．2％、中量占26．8％，两组差异无统计学意义（P〉0．05）。微创组心电图异常发生率与对照组差异无统计学意义（32．1％VS．26．8％，P〉0．05）。微创组术后思维能力评价好85．7％、中12．5％、差1．8％，对照组好78．6％、中19．6％、差1．8％，两组差异无统计学意义（P〉0．05）。两组脑部并发症发生率差异无统计学意义（1．8％vs．1．8％，P〉0．05）。结论采取一系列心脏排气措施可使微创心脏手术的空气栓塞发生率与胸骨正中切口手术相似，在空气栓塞并发症方面无需承担更高的风险。     

Effects of Reflex Middle-Ear Muscle Contractions on Cochlear Responses to Bone-Conducted Sound

The effects of contralaterally elicited middle-ear muscle (MEM) reflexes on cochlear microphonic responses to air- and bone-conducted tones were examined in decerebrate cats. Stapedius effects on bone conduction were almost identical in configuration and amplitude to those on air conduction at all frequencies. However, tensor tympani effects were more complex, the configuration of the bone-conduction effects varying with the location of the transducer on the skull and with frequency. The relative contributions of the two muscles to the effects of joint contractions varied markedly between animals. It is suggested that non-reflex MEM contractions associated with activity of the facial musculature might provide protection against masking of environmental sounds by the low-frequency bone-conducted sound generated by such activity     

Insights in particulate matter‐induced allergic airway inflammation: Focus on the epithelium

Outdoor air pollution is a major environmental health problem throughout the world. In particular, exposure to particulate matter (PM) has been associated with the development and exacerbation of several respiratory diseases, including asthma. Although the adverse health effects of PM have been demonstrated for many years, the underlying mechanisms have not been fully identified. In this review, we focus on the role of the lung epithelium and specifically highlight multiple cytokines in PM‐induced respiratory responses. We describe the available literature on the topic including in vitro studies, findings in humans (ie observations in human cohorts, human controlled exposure and ex vivo studies) and in vivo animal studies. In brief, it has been shown that exposure to PM modulates the airway epithelium and promotes the production of several cytokines, including IL‐1, IL‐6, IL‐8, IL‐25, IL‐33, TNF‐α, TSLP and GM‐CSF. Further, we propose that PM‐induced type 2‐promoting cytokines are important mediators in the acute and aggravating effects of PM on airway inflammation. Targeting these cytokines could therefore be a new approach in the treatment of asthma.     

Coûts de l’hypotrophie par retard de la croissance intra-utérine (RCIU) attribuable à la pollution atmosphérique en France

Exposure of pregnant women to fine particulate matter < 2.5 μm in diameter (PM_2.5) is responsible for low birthweight (LBW) and intellectual disabilities, as expressed by a lower intelligence quotient (IQ). We estimated the attributable cost due to PM_2.5 of healthcare at birth and cognitive retardation of children with LBW in metropolitan France in 2012. The cost of specific care of the 8300 (range, 3100–13,300) children born every year in France with a LBW attributable to PM_2.5 exposure is estimated at € 25 million (range, € 9.5–39 million). Among these 8300 children, 1880 will present an intelligence quotient (IQ) lower than the average of the general population. The annual cost of the care of these intellectual deficiencies attributable to PM_2.5 is estimated at € 15 million and that of the mental handicap on the lifespan of the LBW children born in 2012 attributable to PM_2.5 is estimated at € 1.2 billion (range, € 458 million to € 1.9 billion). Beyond the elevated costs borne by future generations and the intellectual impoverishment of our society, it is essential to provide continued minimal monitoring of pregnant women exposed to air pollution. For the decision-makers, it is urgent to take effective measures and actions to protect the health of exposed populations.     

Evolución de los riesgos ambientales en el contexto de la crisis económica. Informe SESPAS 2014

This article aims to analyze the impact of the economic and financial crisis on environmental determinants of health. The World Health Organization estimates that between 13% and 27% of the disease burden in countries could be prevented by improving the environment. These effects are larger in vulnerable populations, especially among the poorest. In the last decade, outdoor air pollution (the most significant environmental health risk in most European countries) has declined, mostly due to the European policy of reducing emissions and to the decrease in activity following the economic crisis. During the last few years, this improvement in air quality has occurred simultaneously with a reduction in investment in environmental protection and could therefore be offset in the medium-term. The economic crisis has not reduced the trend for higher temperatures in Spain and Europe because climate change is a global phenomenon that is not directly related to local emissions. To reduce the risk of an increase in the health impact of environmental factors, certain key aspects should be considered, such as the need to maintain or develop adequate monitoring and control systems and the opportunity to implement policies that help improve the quality of the environment and reduce the vulnerability of different population groups in a cross-disciplinary framework of transparency and citizen participation.     

玻璃体切割联合消毒空气填充术治疗特发性黄斑裂孔疗效的Meta分析

目的系统评价玻璃体切割手术联合空气填充治疗特发性黄斑裂孔的疗效。方法利用计算机检索Pubmed、Web of Science、Cochrane Library、Embase、中国知网及万方数据库,搜集玻璃体切割手术联合空气填充与全氟丙烷(C3F8)填充治疗特发性黄斑裂孔的相关文献。采用Cochrane系统评价的方法,由两位评价者独立进行文献检索、筛选、质量评价及数据提取。从选取的文献中提取手术时间、术后俯卧时间、裂孔闭合率及术后最佳矫正视力。采用Review Manager 5.3软件进行Meta分析,以评价玻璃体切割手术联合空气填充治疗特发性黄斑裂孔的治疗效果。采用均数差(MD)及其95%置信区间(CI)表示计量资料的效应量。各文献研究间的异质性采用Q和I²检验。如P<0.05或I²>50%则认为异质性较大,采用随机效应模型进行分析;反之,采用固定效应模型。结果在各数据库初步检索到文献84篇。去除重复、内容不相符或者主要结局指标不完善及数据不能提取的文献,最终本研究纳入文献6篇。其中,1篇为英文文献,5篇为中文文献。6篇文献共纳入505只眼。其中,消毒空气组255只眼,C3F8组250只眼。3篇文献在随机分配序列生成中被评为高风险,其余纳入文献均为低风险,高风险文献进行Minors评分均为合格。纳入文献在随访偏倚、报告偏倚及其他偏倚中均被评为低风险。消毒空气组手术时间低于C3F8组。各研究间患者的手术时间组间异质性较小(I²=0)。经固定效应模型分析,两组患者手术时间的比较,差异有统计学意义(MD=-6.34,95%CI:-8.98~-3.71,P<0.05)。各研究间患者的裂孔闭合率组间异质性较小(I²=0)。经固定效应模型分析,两组患者裂孔闭合率的比较,差异无统计学意义(MD=0.91,95%CI:0.45~1.83,P>0.05)。消毒空气组患者的俯卧时间低于C3F8组。各研究间患者的俯卧时间组间异质性较大(I²=99%)。经随机效应模型分析,两组患者术后俯卧时间的比较,差异有统计学意义(MD=-18.90,95%CI:-24.78~-13.01,P<0.05)。各研究间患者的术后最佳矫正视力组间异质性较大(I²=66%)。经随机效应模型分析,两组患者术后最佳矫正视力的比较,差异无统计学意义(MD=0.00,95%CI:-0.16~0.16,P>0.05)。结论玻璃体切割手术联合空气填充治疗特发性黄斑裂孔在减少手术时间及术后俯卧位时间方面的效果较好。