Previous studies have found that fine particulate matter (PM2.5) air pollution is associated with decreased lung function. However, most current research focuses on children with asthma, leading to small sample sizes and limited generalization of results. The current study aimed to measure the short-term and lag effects of PM2.5 among school-aged children using repeated measurements of lung function.This prospective panel study included 848 schoolchildren in Zhejiang Province, China. Each year from 2014–2017, two lung function tests were conducted from November 15th to December 31st. Daily air pollution data were derived from the monitoring stations nearest to the schools. A mixed-effects regression model was used to investigate the relationship between PM2.5 and lung function. The effect of PM2.5 on lung function reached its greatest at 1-day moving average PM2.5 exposure. For every 10 μg/m3 increase in the 1-day moving average PM2.5 concentration, Forced Vital Capacity (FVC) of children decreased by 33.74 mL (95% CI: 22.52, 44.96), 1-s Forced Expiratory Volume (FEV1) decreased by 32.56 mL (95% CI: 21.41, 43.70), and Peak Expiratory Flow (PEF) decreased by 67.45 mL/s (95% CI: 45.64, 89.25). Stronger associations were found in children living in homes with smokers. Short-term exposure to PM2.5 was associated with reductions in schoolchildren’s lung function. This finding indicates that short-term exposure to PM2.5 is harmful to children’s respiratory health, and appropriate protective measures should be taken to reduce the adverse effects of air pollution on children’s health.
The spatiotemporal characteristics and human health risks of 12 heavy metals (Al, As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sb, Se, and Tl) in fine particulate matter (PM2.5) in Zhejiang Province were investigated. The annual average PM2.5 concentration was 58.83 µg/m3 in 2015 in Zhejiang. Element contents in PM2.5 varied greatly with the season and locations. Al, Pb, and Mn were the most abundant elements among the studied metal(loid)s in PM2.5. The non-carcinogenic risks of the 12 elements through inhalation and dermal contact exposure were lower than the safe level for children and adults. However, there were potential non-carcinogenic risks of Tl, As, and Sb for children and Tl for adults through ingestion exposure. The carcinogenic risks from As, Be, Cd, Cr, Pb, and Ni through inhalation exposure were less than the acceptable level (1 × 10−4) for children and adults. Pb may carry a potential carcinogenic risk for both children and adults through ingestion. More attention should be paid to alleviate non-carcinogenic and carcinogenic health risks posed by particle-bound toxic elements through ingestion exposure.
BACKGROUND: Acute diverticulitis in immunocompromised patients is associated with high morbidity and mortality rates with either medical or surgical treatment. Thus, management approach is controversial, especially for patients presenting with nonperforated disease. OBJECTIVE: This study aimed to report the Mayo clinic experience of acute diverticulitis management in immunocompromised patients. DESIGN: This design is based on a retrospective cohort study. SETTING: This study was conducted with institutional data composed from 3 tertiary referral centers. PATIENTS: Immunocompromised patients presenting with acute diverticulitis at 3 Mayo clinic sites between 2016 and 2020 were included. MAIN OUTCOME MEASURES: The main outcome measures were the management algorithm and short-term outcomes. RESULTS: Immunocompromised patients presenting with acute uncomplicated diverticulitis (86) were all managed nonoperatively at presentation with a success rate of 93% (80/86). Two patients (2.3%, 2/86) required surgery during the same admission, and 4 patients (4.8%, 4/84) had 30-day readmission. Complicated diverticulitis patients with abscess (22) were all managed nonoperatively first with a success rate of 95.4% (21/22). One patient (4.6%, 1/22) required surgery during the same admission. All the patients who presented with obstruction (2), fistula (1), or free perforation (11) underwent surgery except one who chose hospice. Overall, the major complication rate was 50% (8/16) and mortality rate was 18.8% (3/16) among patients who underwent surgery during the same admission. For patients who presented with perforated diverticulitis, the mortality rate was 27.3% (3/11), compared with 0% (0/111) for patients who presented with nonperforated disease. LIMITATIONS: This cohort was limited by its retrospective nature and heterogeneity of the patient population. CONCLUSIONS: Nonoperative management was safe and feasible for immunocompromised patients with colonic diverticulitis without perforation at our center. Perforated colonic diverticulitis in immunocompromised patients was associated with high morbidity and mortality rate. See Video Abstract at http://links.lww.com/DCR/B988. MANEJO DE LA DIVERTICULITIS AGUDA EN PACIENTES INMUNOCOMPROMETIDOS: EXPERIENCIA DE LA CLINICA MAYO ANTECEDENTES: La diverticulitis aguda en pacientes inmunocomprometidos se asocia con una alta tasa de morbilidad y mortalidad con el tratamiento médico o quirúrgico. Por lo tanto, el enfoque de manejo es controvertido, especialmente para pacientes que presentan enfermedad no perforada. OBJETIVO: El propósito fue informar la experiencia de la clínica Mayo en el manejo de la diverticulitis aguda en pacientes inmunocomprometidos. DISEÑO: Este es un estudio de cohorte retrospectivo ENTORNO CLÍNICO: Este estudio se realizó con datos institucionales compuestos de tres centros de referencia terciarios. PACIENTES: Se incluyeron pacientes inmunocomprometidos que presentaron diverticulitis aguda en tres sitios de la clínica Mayo entre 2016 y 2020. RESULT...
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