ABSTRACT
BACKGROUND: The aim was to analyze the temporal relationship between short-term air pollution exposure and acute symptomatic unprovoked pulmonary embolism (PE). PATIENTS/METHODS: We performed a prospective, multicenter study in consecutive patients diagnosed with acute symptomatic unprovoked PE from February 2012 to January 2013. We analyzed demographic and clinical data, patients' addresses, meteorological and air pollutants data (PM10, SO2, CO, NO2, ozone emission data). We considered the number of days the patient had symptoms, and the study period constituted the previous 30 days. Likewise, the mean annual data of the reference season were calculated as well as the data of the 30-day study period corresponding to the same dates in the previous 3 years in order to obtain the monthly mean of the different pollutants for each period. RESULTS: A total of 162 patients with acute symptomatic PE were recruited (43.2% unprovoked PE). The air pollutants could be determined in 50% of the patients with unprovoked PE, and a final analysis was performed in 35 patients. In the multiple comparison analysis to verify a possible correlation between the study period and the annual median, only NO2 showed a statistically significant association (p = 0.009). When comparing the study period with the previous 3 years, only NO2 maintained a statistically significant association for the 3 study periods. CONCLUSIONS: We found a relationship between short-term exposure to NO2 and the presence of unprovoked PE.
Subject(s)
Air Pollutants , Air Pollution , Pulmonary Embolism , Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Humans , Lung , Particulate Matter/adverse effects , Particulate Matter/analysis , Prospective Studies , Pulmonary Embolism/epidemiology , Pulmonary Embolism/etiology , PyrazinesABSTRACT
La Histiocitosis de células de Langerhans (HPCL) es una enfermedad de etiología incierta, que puede manifestarse como enfermedad sistémica o enfermedad localizada. Su forma de presentación limitada a pulmón, se denomina Histiocitosis X. Su incidencia es desconocida, siendo >90% de los casos fumadores, entre 20-40 años, y más frecuente en mujeres. El tabaco juega un papel fundamental en el desarrollo de la enfermedad, sin estar claro el mecanismo fisiopatológico. La presentación clínica de la enfermedad pulmonar es variable, desde síntomas larvados de tos, disnea dolor torácico, sudoración o pérdida de peso, a neumotórax en un 15%. El diagnóstico se basa en Pruebas de imagen (TACAR), Pruebas respiratorias, Histológicas e munohistoquímicas. Su confirmación histológica se realiza mediante biopsia transbronquial, en nuestro caso criobiopsia pulmonar, aumentando así el rendimiento diagnóstico y evitando complicaciones. El abandono del tabaco, evita la progresión de la enfermedad e incluso logra su regresión (AU)
Pulmonary Langerhans cell histiocytosis(PLCH) is a disease of uncertain etiology, which manifest itself either as a Systemic or a localized disease. When confined to the lungs, it is known as Histiocytosis X. Although the exact incidence rate in unknown, more than 90% of cases are smokers of between 20 and 40 years old, most commonly women. Smoking plays a major role in the development of the disease, though the physiopathological mechanisms remain unclear. The clinical presentation of the disease varies from a non-specific cough, dyspnea, thoracic pain, weight loss, and pneumothorax. The diagnosis is based on high-resolution CT, respiratory, histological and immunohistochemistry tests. Histological confirmation is achieved via transbronchial biopsy, in our case lung criobiopsy, which increases the diagnostic yield and avoids complications. Smoking cessationprevents progression of the disease and can even lead to its regression (AU)
