Association between short-term exposure of fine particulate matters and blood pressure in children and adolescents / 中国学校卫生

Objective@#To evaluate the association of short-term fine particulate matters (PM2.5) exposure and blood pressure in children and adolescents.@*Methods@#A total of 144 813 junior and senior middle school students who participated in the physical examination in the 2017-2018 academic year in a northern city of China, with complete record of demographic characteristics, blood pressure and no history of heart and other important organ diseases were selected as the study subjects. Data on PM2.5 and other pollutants and meteorological data were obtained from the nearest air quality and meteorological monitoring stations of each schools. A generalized linear mixed effect model was used to analyze the association between short-term exposure of PM2.5 and blood pressure.@*Results@#The 6 day average concentration of PM2.5 (lag05) increased by 10 μg/m 3 was associated with an increase of 0.177(95%CI=0.148-0.207)mm Hg (1 mm Hg=0.133 kPa) in systolic blood pressure and 4.4%(OR=1.044, 95%CI=1.030-1.058) increase of the prevalence of high systolic blood pressure. And it was also associated with -0.021(95%CI=-0.040--0.002)mm Hg decrease in diastolic blood pressure, but had no significant correlation with the prevalence of high diastolic blood pressure. In general, a 10 μg/m 3 increase of PM2.5 was associated with 3.3% increase in the prevalence of high blood pressure (OR=1.03, 95%CI=1.02-1.05), and difference of boys and girls were found in different lagged days (P<0.05).@*Conclusion@#Short-term exposure of PM2.5 is associated with increased systolic blood pressure and prevalence of high blood pressure among children and adolescents. Attention should be paid to the prevention of short-term exposure of PM2.5 to protect the health of children and adolescents.

Dipyrone & 2,5-dimethylcelecoxib suppress Th2-related chemokine production in monocyte.

Background & objectives: Selective cyclooxygenase-2 (COX-2) inhibitor is a form of non steroidal anti-inflammatory drug (NSAID) and is commonly used in autoimmune and rheumatic diseases to control inflammation and alleviate pain. Tumour necrosis factor-alpha (TNF-α) production and an imbalance of T helper 1 (Th1)/Th2 contribute to the pathogenesis of autoimmune and also anti-tumour activity. Dipyrone is a NSAID used to treat pain worldwide. The celecoxib analogue, 2,5-dimethylcelecoxib (DMC), lacks COX-2 inhibitory activity but exhibits anti-tumour properties. However, the effects and the mechanisms of dipyrone and 2,5-dimethylcelecoxib on tumour necrosis factor (TNF)-α and Th1- and Th2-related chemokines in monocytes remain poorly defined. This study was carried out to investigate the effects of dipyrone and 2,5-dimethylcelecoxib on the expression of Th1 (IP-10) and Th2 (I-309 and MDC) and TNF-α in human monocytes and the associated intracellular mechanism. methods: THP-1 cells and peripheral blood mononuclear cells (PBMCs) were pre-treated with dipyrone (10-9 – 10-4 M) and 2,5-dimethylcelecoxib (10-9 – 10-5 M) 2 h before lipopolysaccharide (LPS) stimulation. Cell supernatant was collected 24 h after LPS stimulation. TNF-α, I-309, MDC and IP-10 concentrations of cell supernatants were determined using ELISA. Intracellular signaling was evaluated by western blot. results: Dipyrone and 2,5-dimethylcelecoxib downregulated LPS-induced Th2-related chemokine I-309 and macrophage derived chemokine (MDC) production. Only high dose of 2,5-dimethylcelecoxib (10-5 M), but not dipyrone downregulated LPS-induced IP-10. Only very high dose of 2,5-dimethylcelecoxib had effect on LPS-induced TNF-α expression in PBMCs. Dipyrone and 2,5-dimethylcelecoxib suppressed LPS-induced p65 and JNK MAPK (C-Jun N-terminal kinase mitogen activated protein kinase). expression. Interpretation & conclusions: Dipyrone and 2,5-dimethylcelecoxib downregulated LPS-induced Th2-related chemokine I-309 and MDC in THP-1 cells. The suppressive effect on Th2-related

Prevalence and risk factors for early presentation of asthma among preschool children in Taiwan.

Background: Traditional asthma prevalence surveys were based on the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, which focuses on children aged 6-7 and 13-14. However, asthma-like symptoms usually commence in preschool aged children, in whom it is difficult to make a definite diagnosis of asthma. It is worth determining the prevalence rate of asthma or asthma-like symptoms and analyzing the risk factors for this phenomenon among preschool aged children. Materials and Methods: Children aged 3-6 years were recruited from kindergartens in Keelung City, northern Taiwan. The questionnaire used was based on the ISAAC phase III core and environmental questionnaires and included questions on asthma, rhino-conjunctivitis, and eczema, along with questions to elicit common and early presentations of asthma, as well as other demographic and environmental data. The questionnaires were delivered and completed by parents. Results: 2,395 questionnaires were delivered to parents with children at 50 kindergartens, of which 2,170 questionnaires were returned (return rate 90.6%). 9.9% of these preschool children had physician-diagnosed asthma. However, 20.4% of them experienced asthma-like symptoms while attending kindergarten. Both the physician-diagnosed asthma and asthma-like symptoms groups had more clinical symptoms in all seasons except summer, compared to children without asthma. It was significant that the asthma-like symptoms commenced after joining a kindergarten (P< 0.001), and 66.5% of the children started to experience the symptoms within one month of beginning kindergarten. Using antibiotics or antipyretics in young infancy and mothers having asthma were the risk factors for developing asthma and asthma-like symptoms (P< 0.001), but parental smoking was not contributory to asthma development in preschool children. More frequent use of antipyretics in a year had a higher risk for the development of asthma and asthma-like symptoms. Conclusions: Asthma and asthma-like symptoms were common in preschool children. Early infection of the respiratory tract and use of antibiotics were associated with presentation of symptoms. Attending a kindergarten is also a risk factor for early presentation of asthma among preschool children.

Risk factors and bacterial profiles of urinary tract infections in patients with systemic lupus erythematosus.

Bacteremic urinary tract infection (UTI) is known to carry a high mortality rate, especially in immunocompromised patients. Patients with systemic lupus erythematosus (SLE) have an immunocompromised status, and thus an increased risk of infection. To evaluate the risk factors for UTI in SLE patients and to identify factors associated with bacteremic UTI, we reviewed SLE patients hospitalized for UTI over a 20-year study period. Based on our results we conclude that lupus nephritis is a risk factor for UTI in SLE patients. Clinical symptoms do not significantly distinguish bacteremic from non-bacteremic UTI in hospitalized SLE patients. Although Escherichia coli remain the most common bacteria in UTI, Salmonella spp. might need particular attention because of their high likelihood for causing bacteremia.

Increasing asthma care knowledge and competence of public health nurses after a national asthma education program in Taiwan.

One of the responsibilities of a public health nurse is to provide asthma education to local residents. However, there have been no comprehensive education programs for public health nurses on asthma care in the past. This study aimed to determine level of competence of public health nurses on asthma care in order to improve their capability through a one-day national asthma education course. In addition to lectures on updated asthma management information, data was obtained through demonstrations and practice on inhalation techniques of various kinds of inhaled devices, including the ability to use and interpret the data of a peak flow meter. Two written examinations with the same questions were given to participants before and right after the lectures. All of the 560 public health nurses in the 392 public health bureaus were invited to join the program and 522 (93.2%) participated. Five hundred and six completed both the pre- and post-tests. Before the national education program, only 10.9% of the participants knew the purpose of the peak flow meter, while 62.6% had never heard of it. Initially, they showed less confidence on teaching patients on the use of inhaled devices (2.36 and 2.59 in 5 scales). Comparing the two tests, there was a significant increase in the public nurses' knowledge as regards: 1) the general concept of asthma, 2) prevention of trigger factors and environmental control, 3) proper medication knowledge, 4) peak flow meter (PEF) monitoring, and 5) intervention after acute exacerbation of asthma (p < 0.001). A well-designed course on asthma management is an efficient scheme to improve public health nurses' knowledge and confidence on asthma care.