Olas de calor,temperatura ambiente y riesgo de infarto de miocardio: un estudio ecológico en la Comunidad de Madrid

Introduction and objectivesEpisodes of extreme heat are associated with increased morbidity and mortality in chronically-ill patients but there is a need to clearly establish the relationship between extreme heat and myocardial infarction. The aim of this study was to analyze the relationship between the incidence of ST-segment elevation myocardial infarction (STEMI) and maximum temperature, in particular during heat wave alert periods (HWAP).MethodsThe population studied consisted of confirmed STEMI cases registered in the Infarction Code of the Community of Madrid between June 2013 and June 2017. Incidence rate ratios (IRR) adjusted for trend and seasonality and 95%CI were estimated using time series regression models.ResultsA total of 6465 cases of STEMI were included; 212 cases occurred during the 66-day period of HWAP and 1816 cases during the nonalert summer period (IRR, 1.14; 95%CI, 0.96-1.35). The minimum incidence rate was observed at the maximum temperature of 18 °C. Warmer temperatures were not associated with a higher incidence (IRR,1.03; 95%CI, 0.76-1.41), whereas colder temperatures were significantly associated with an increased risk (IRR, 1.25; 95%CI, 1.02-1.54). No effect modification was observed by age or sex.ConclusionsWe did not find an increased risk of STEMI during the 66 days of HWAP in the Community of Madrid between June 2013 and June 2017. However, an increased risk was found during colder temperatures. No extra health resources for STEMI management are required during periods of extreme heat, but should be considered during periods of cold weather.     

Discharge Planning in the Era of Climate Change

We are living in an era of climate change, which has a tremendous impact on the health of our patients. Therefore, radiological nurses should be aware of and address climate change–related problems that impact patient health, such as heat, air quality, drought, wildfires, increased precipitation, and extreme weather. This article highlights the concerns and consequences of climate change on patients discharged from interventional radiological and other outpatient settings. Recommendations for discharge planning are provided to support, protect, and promote the health of patients in radiological services.     

Probabilistic classification learning with corrective feedback is associated with in vivo striatal dopamine release in the ventral striatum,while learning without feedback is not

The basal ganglia (BG) mediate certain types of procedural learning, such as probabilistic classification learning on the ‘weather prediction task’ (WPT). Patients with Parkinson's disease (PD), who have BG dysfunction, are impaired at WPT‐learning, but it remains unclear what component of the WPT is important for learning to occur. We tested the hypothesis that learning through processing of corrective feedback is the essential component and is associated with release of striatal dopamine. We employed two WPT paradigms, either involving learning via processing of corrective feedback (FB) or in a paired associate manner (PA). To test the prediction that learning on the FB but not PA paradigm would be associated with dopamine release in the striatum, we used serial ¹¹C‐raclopride (RAC) positron emission tomography (PET), to investigate striatal dopamine release during FB and PA WPT‐learning in healthy individuals. Two groups, FB, (n = 7) and PA (n = 8), underwent RAC PET twice, once while performing the WPT and once during a control task. Based on a region‐of‐interest approach, striatal RAC‐binding potentials reduced by 13–17% in the right ventral striatum when performing the FB compared to control task, indicating release of synaptic dopamine. In contrast, right ventral striatal RAC binding non‐significantly increased by 9% during the PA task. While differences between the FB and PA versions of the WPT in effort and decision‐making is also relevant, we conclude striatal dopamine is released during FB‐based WPT‐learning, implicating the striatum and its dopamine connections in mediating learning with FB. Hum Brain Mapp 35:5106–5115, 2014. © 2014 The Authors. Human Brain Mapping Published by Wiley Periodicals, Inc.     

Japanese Cedar (Cryptomeria japonica) Pollinosis in Jeju,Korea: Is It Increasing?

Jeju is an island in South Korea located in a temperate climate zone. The Japanese cedar tree (JC) has become the dominant tree species while used widely to provide a windbreak for the tangerine orchard industry. An increase in pollen counts precedes atopic sensitization to pollen and pollinosis, but JC pollinosis in Jeju has never been studied. We investigated JC pollen counts, sensitization to JC pollen, and JC pollinosis. Participants were recruited among schoolchildren residing in Jeju City, the northern region (NR) and Seogwipo City, the southern region (SR) of the island. The JC pollen counts were monitored. Sensitization rates to common aeroallergens were evaluated by skin prick tests. Symptoms of pollinosis were surveyed. Among 1,225 schoolchildren (49.6% boys, median age 13 years), 566 (46.2%) were atopic. The rate of sensitization to Dermatophagoides pteronyssinus (35.8%) was highest, followed by D. farinae (26.2%), and JC pollen (17.6%). In the SR, 156 children (23.8%) were sensitized to JC pollen; this rate was significantly higher than that in the NR (59 children, 10.4%, P<0.001). A significant increment in the sensitization rate for JC pollen with increasing school level was observed only in the SR. JC pollen season in the SR started earlier and lasted longer than that in the NR. JC pollen season in Jeju was defined as extending from late January to mid-April. The prevalence of JC pollinosis was estimated to be 8.5%. The prevalence differed significantly between the NR and SR (5.3% vs 11.3%, P<0.001), mainly due to the difference in sensitization rates. JC pollen is the major outdoor allergen for early spring pollinosis in Jeju. JC pollen season is from late January to mid-April. Warmer weather during the flowering season scatters more JC pollen in the atmosphere, resulting in a higher sensitization rate in atopic individuals and, consequently, making JC pollinosis more prevalent.     

Physico-chemical characteristics,water absorption,soaking and cooking properties of some Sicilian populations of chickpea (Cicer arietinum L.)

The physical and physico-chemical properties of several Kabuli chickpeas originating from Sicily (South Italy) were determined. Twelve genotypes in all, including two controls (ILC484, of the ICARDA genebank, and ‘Calia’, a traditional Italian cultivar), were analysed. A large variability among genotypes was ascertained for swelling capacity (coefficient of variation [CV]=27.9%), swelling index (CV=30.5%) and calcium content (CV=39.3%). The lowest variability was observed for seed coat (CV=8.6%) and seed weight (CV=9.6%). Genotype statistically affected all traits, whose mean values were: seed weight, 0.340±0.03 g; seed coat, 4.47±0.38%; seed volume, 0.292±0.04 ml; seed density, 1.18±0.15 g/ml; hydration capacity, 0.361±0.09 g/seed; hydration index, 1.05±0.21; swelling capacity, 0.346±0.10 ml/seed; swelling index, 1.21±0.37; cooking texture, 2.61±0.38 kg/cm²; and calcium, 109.6±43.11 mg/100 g dry weight. Correlation coefficients among characteristics were also estimated. The genotype ‘44M33’ was found to be interesting having good seed weight and low seed coat incidence and calcium content, all important attributes affecting cooking quality.     

Effect of prescribed burning on wildfire severity: a landscape-scale case study from the 2003 fires in Victoria

This study examined the effect of previous fuel reduction burning (FRB) on the severity of the >1 million ha 2003 Alpine Fire in eastern Victoria. Sixty-five paired observations (130 total) of fire severity were completed across the broad fire area using GIS (Geographic Information System) analysis. Despite the broad scatter in this large data set, a number of strong trends were evident. A Fire Severity Index (FSI) was calculated from the correlated fire, weather and topographic variables, with a three-factor model using the forest fire danger index (FFDI), fire or FRB age and percentage of north-western aspect, best explaining the variation in measured fire-severity data. The most important finding was that the reduction in fire severity and suppression assistance effects of previous fuel-reduction burning started to decline substantially when the FFDI exceeded 50. Above FFDI 50, landscape-scale fires became ‘weather-dominated’ and variation in fuel and topography became less important to continued fire spread. The greatest effects of previous FRB in reducing wildfire severity and in assisting fire suppression occurred when (1) the FFDI fell to 25 or less (late in the evening and overnight); (2) the age of the FRB was less than 3 years (i.e. when all three components of fuel—surface, bark and elevated material—were still substantially reduced). Some fire-severity reduction effects were still evident for FRBs up to 10 years old, but there was almost no evidence of FRBs older than 10 years having any effect on fire severity. FRBs up to 10 years old also had measurable effects on increasing burnt area patchiness and decreasing canopy loss, both of which have ecological implications. This study provides fire managers planning rotational landscape FRB with important information on likely effects of the burning on fire severity.     

Weather changes and pain in rheumatology patients

Objective: Many rheumatology patients report exacerbation of joint symptoms with weather changes. We report the first of a two‐part study on the influence of weather on rheumatological conditions. This survey aims to describe perceived weather sensitivity in our patient population. Methods: Two hundred rheumatology patients seen consecutively in a tertiary hospital were given a 10‐item questionnaire (Jamieson). This questionnaire has been well validated with good test‐retest reliability (r = 0.91) and ability to distinguish patients with weather sensitivity. New patients and soft tissue clinic patients were not included. Results: Seventy‐four percent of patients reported weather sensitivity, with humidity and low temperature reported most frequently as being associated with worsening of symptoms (66% and 72%, respectively). Seventy percent of weather sensitive subjects described pain exacerbation prior and/or during weather changes. Various rheumatological conditions had similar rates of weather sensitivity, except fibromyalgia which reported 100% weather sensitivity. Conclusion: A significant proportion of rheumatology patients report weather sensitivities. Further studies would be useful to further explore actual versus perceived effects of weather as this may have behavioural, housing and medical implications. Our discussion includes a brief summary of current literature and various postulates why patients may have increased weather sensitivity.     

Nanoparticle delivery in infant lungs

The lung surface is an ideal pathway to the bloodstream for nanoparticle-based drug delivery. Thus far, research has focused on the lungs of adults, and little is known about nanoparticle behavior in the immature lungs of infants. Here, using nonlinear dynamical systems analysis and in vivo experimentation in developing animals, we show that nanoparticle deposition in postnatally developing lungs peaks at the end of bulk alveolation. This finding suggests a unique paradigm, consistent with the emerging theory that as alveoli form through secondary septation, alveolar flow becomes chaotic and chaotic mixing kicks in, significantly enhancing particle deposition. This finding has significant implications for the application of nanoparticle-based inhalation therapeutics in young children with immature lungs from birth to 2 y of age.