Risk Of Respiratory Disease Research Articles

Assessment of the health risk for people residing on the territory influenced by the vostochny cosmodrome under multi-factor and multi-environment exposure to chemicals

Rocket and space activities occupy an important place among modern sources of impact on the environment. Its results can manifest themselves in an area where a cosmodrome is located, adjacent territories, in areas where separated parts of a launch vehicle fall. This impact has certain specific features that create population health risks. Health risks for population of Tsiolkovsky settlement were assessed upon exposure to chemicals that pollute the environment in accordance with the methodical approaches stipulated in the valid Guide (R 2.1.10.3968-23). Initial data were represented by results of environmental surveillance accomplished within social-hygienic monitoring and in field conditions as well as by data collected for a project aimed at substantiating a sanitary protection zone for the Vostochny Cosmodrome launch sites. Average annual concentrations and their 95 % confidence intervals, which were established based on average daily concentrations, were used to calculate chronic chemical exposures. The 95 % percentile of maximum single concentrations was employed to calculate acute exposures. Ambient air was established to make the greatest contribution (88.99 %) into non-carcinogenic health risks for people residing in Tsiolkovsky settlement. Particulate matter made the greatest contribution (42.4 %) to the risk of chronic non-carcinogenic effects. Alerting chronic non-carcinogenic risks of respiratory diseases (up to 5.9 HI) and the blood system (up to 4.1 HI) were established under combined inhalation chemical exposures. Major contributions to non-carcinogenic risks are made by particulate matter (up to 42.4 %), lead (up to 25.9 %), nitrogen oxide (up to 20.2 %), nitrogen dioxide and carbon oxide (23.1 % each).

The effect of dietary antioxidant on lung function in pedicab during the COVID-19 pandemic

Rickshaw drivers have a high risk of respiratory disease, especially in the COVID-19 pandemic which is very risky to the respiratory system. The purpose was to determine the effect of antioxidant intake in food on the lung function of pedicab drivers in Surabaya. This study was a cross-sectional design, in May-July 2019. The variables of this study were lung function value and intake of foods containing antioxidants (vitamins A, C, and E). The research respondents were pedicab drivers in the Surabaya area. The method used a structured interview method, used the 24-hour recall method. The chi-square test was used to determine whether there was a difference between the value of lung function and the classification of intake of vitamins A, C, and E. The respondents of this study were 62 people with decreased lung function, and 62 people without decreased lung function. there were only 6 respondents who had vitamin A intake per day, while as many as 108 respondents had less level of vitamin A intake per day (87.10%). While the intake of vitamins C and E was still at a lower level in all respondents (100%). The average intake of vitamins A, D, and E on holidays was higher than on weekdays. Vitamin A intake has been shown to affect lung function. There was had significant relationship between dietary vitamin A intake and lung function in FEV1/FVC value. In addition, further research is needed to determine other dietary factors and other lifestyles to be able to maintain the quality of lung health for pedicab drivers.

Characteristics of infant formula consumed in the first months of life and allergy in the EDEN mother-child cohort.

The evidence regarding the association between infant formula (IF) composition and the prevention of allergy and respiratory diseases remains sparse and inconclusive. This study aimed to evaluate whether some IF characteristics were associated with the risk of allergy or respiratory diseases in childhood. Among1243 formula-fed children from the EDEN mother-child cohort, IF characteristics concerning long-chain polyunsaturated fatty acids (LCPUFAs) enrichment, prebiotic/probiotic enrichment, and hydrolysis of proteins were identified from the ingredients list. Eczema, wheezing, food allergy, asthma, and allergic rhinitis up to age 8 years were prospectively collected and summarized into four allergic and respiratory multimorbidity clusters. Associations between 4-month IF characteristics and risk of allergy or respiratory diseases were tested using logistic regressions adjusted on main confounders. The consumption of LCPUFA-enriched formula was not linked to allergic and respiratory multimorbidity clusters, but to a lower risk of any allergy, eczema, and wheezing. Probiotic-enriched formula consumption was associated with a lower risk of belonging to the 'Allergy without asthma' cluster (odds ratio [OR][95% confidence interval,CI] = 0.63 [0.40-0.99]), and consumption of a formula enriched in Bifidobacterium lactis was associated with a lower risk of any allergy (OR[95% CI] = 0.59 [0.41-0.85]). Partially hydrolysed formula (pHF) consumption was associated with a higher risk of belonging to the 'Allergy without asthma' cluster (OR[95%CI] = 2.73 [1.65-4.51]). This study confirms the positive association between pHFconsumption and the risk of allergy found in previous observational studies and suggests that consumption of LCPUFA-enriched or probiotic-enriched formula was associated with a lower risk of allergy.

The Impact of Malnutrition on the Developing Lung and Long-Term Lung Health: A Narrative Review of Global Literature.

Worldwide, over 2 billion children under the age of 5 experience stunting, wasting, or are underweight. Malnutrition contributes to 45% of all deaths in this age group (approximately 3.1 million deaths) [1]. Poverty, food insecurity, suboptimal feeding practices, climate change, and conflict are all contributing factors. Malnutrition causes significant respiratory problems, including increased risk of respiratory infections, impaired lung function, and increased risk of subsequent adult respiratory disease, including asthma, COPD, and lung cancer. Childhood malnutrition not only has serious consequences for children's health but it also has numerous consequences on wellbeing and educational attainment. Childhood malnutrition is a complex and multifaceted problem. However, by understanding and addressing the underlying causes, and investing in prevention and treatment programs, it is possible to maximize children's health and wellbeing on a global scale. This narrative review will focus on the impact of childhood malnutrition on lung development, the consequent respiratory disease, and what actions can be taken to reduce the burden of malnutrition on lung health.

P30 Exposure to particulate matter induces structural and pigmentary changes to human skin

Abstract Introduction and aims The majority of the world’s population reside in places with high levels of air pollution. The impact of air pollution on human health has been extensively studied and demonstrates a significant correlation between particulate matter (PM) and risk of cardiovascular and respiratory diseases. However, little is known about the impact of air pollution on human skin health. Here, we develop an ex vivo skin model to investigate cutaneous changes induced by the topical application of PM. Methods PM (0, 0.5, 3, 6, 10, 20 and 40 μg mL−1) was topically applied to Genoskin® NativeSkin Access® (Genoskin, Salem, MA, USA) human ex vivo skin samples of White European ancestry (n = 3) for 8 days, with reapplication on day 4. Resultant samples were assessed using haematoxylin and eosin staining (for morphometric analyses), immunofluorescence for Ki67 and terminal deoxynucleotidyl transferase dUTP nick-end labelling (TUNEL) (to determine cellular turnover), while pigmentary changes were analysed by colourimetry, Warthin–Starry (WS) staining and immunohistochemistry for the melanin markers tyrosinase (TYR), gp100 and c-kit. Results Morphological assessment revealed that epidermal thickness was significantly reduced following exposure to higher doses of PM (r = −0.9163, P < 0.01). In addition, there was reduced epidermal cell proliferation (Ki67) and increased apoptosis (TUNEL) at higher doses of PM. Exposure to PM resulted in a dose-dependent decrease in individual typology angle, which is indicative of skin colour becoming darker (r = −0.7895, P < 0.05). Furthermore, WS staining demonstrated significantly increased epidermal melanin (r = 0.9583, P < 0.01) and significantly increased expression of melanin markers TYR (P < 0.01), gp100 (P < 0.001) and c-kit (P < 0.01) in response to PM exposure. Conclusions This study confirms that PM induces pigmentary changes to ex vivo human skin by increasing epidermal melanin. Increased expression of c-kit in response to PM exposure suggests that increased pigmentation occurs owing to the upregulation of the microphthalmia-associated transcription factor signalling pathway. Further investigation of the mechanistic drivers of increased pigmentation is warranted.

Transcriptome assessment of healthy highrisk stocker cattle defines mechanisms of inflammatory regulation induced by tulathromycin metaphylaxis

Tulathromycin is commonly used as metaphylaxis to reduce bovine respiratory disease (BRD) risk. Current secondary phar­macodynamics characteristics of tulathromycin on the host are poorly understood. RNA Sequencing (RNA-Seq) techniques were used to measure gene expression in healthy cattle admin­istered tulathromycin to elucidate the genomic mechanisms over time.

Association between ambient temperature and risk of notifiable infectious diseases in China from 2011 to 2019

ABSTRACT Previous studies on temperature and infectious diseases primarily focused on individual disease types, yielding inconsistent conclusions. This study collected monthly data on notifiable infectious disease cases and meteorological variables across 7 provinces in China from 2011 to 2019. A distributed lag nonlinear model was used to evaluate the association between ambient temperature and infectious diseases within each province, and random meta-analysis was applied to evaluate the pooled effect. Extreme hot temperature (the 97.5th percentile) was positively associated with the risk of respiratory infectious diseases with the relative risk (RR) of 1.45 (95%CI: 1.01–2.08). Conversely, extreme cold temperature (the 2.5th percentile) was negatively associated with intestinal infectious diseases and zoonotic diseases and vector-borne diseases, reporting RRs of 0.43 (95%CI: 0.30–0.60) and 0.46 (95%CI: 0.38–0.57), respectively. This study described the nonlinear association between ambient temperature and infectious diseases with different transmission routes, informing comprehensive prevention and control strategies for temperature-related infectious diseases.

Opening windows as a supplementary ventilation strategy for large classrooms in a pandemic situation: Field measurements and simulation

The coronavirus disease 2019 (COVID-19) has led to significant global health emergencies in recent years, prompting widespread recommendations across various regions for opening windows in building codes. However, official guidelines have not adequately addressed the details of window opening arrangements related to the supporting evidence from existing literature. This study investigated the risk of disease outbreaks via respiratory transmission in large university studio classrooms. It examined the effectiveness of window-door opening strategies combined with mechanical ventilation in mitigating the infection risk of respiratory diseases in such spaces. A full-scale school ventilation performance test bed was used to measure indoor airflow and CO2 distribution patterns. Comparisons were made with the numerical simulation of exhaled viral emissions. A modified Wells-Riley equation was employed to calculate inhalation exposure and disease infection risks at the room level. Measurements showed that fresh air ventilation from the mechanical system was relatively low compared to existing standards, especially in pandemic situations. The results show that opening windows can lead to a decrease to low probabilities (below 5 %) of infection risk in 85.02 % area of a classroom over an 8-h period, which demonstrates that window-opening behavior is an effective supplementary strategy for large educational spaces with mechanically ventilated systems during emergencies when active measures are insufficient for diluting diseases. Furthermore, the study reveals that maximizing outdoor air rates by opening all windows may occasionally result in adverse indoor airflow redistribution, increasing virus load from 0.0382 to 0.8926 quanta/m3 near the virus source locations.

Epidemiological characteristics of chronic non-communicable diseases in Dongfang, China, 2021: a cross-sectional survey

ObjectivesThe study aimed to understand the composition, epidemiological characteristics and disease burden of chronic non-communicable diseases and to evaluate the association between sociodemographic factors and chronic non-communicable diseases.DesignA cross-sectional study.Setting...

Respiratory symptoms and outcomes among cigar smokers: findings from the Population Assessment of Tobacco and Health (PATH) study waves 2–5 (2014–2019)

BackgroundThe mechanisms by which cigarette smoking increases the risk of respiratory disease have been studied. However, less is known about risks of respiratory symptoms and outcomes associated with smoking cigars, and risks by cigar types have not been previously explored. The aim of this study was to examine associations between cigar use, including traditional cigars, cigarillos, filtered cigars, and dual cigar and cigarette use, and functionally important respiratory symptoms (FIRS), lifetime asthma diagnosis, uncontrolled asthma, and new cases of FIRS.MethodsData from Waves 2–5 (2014–19) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal study, were analyzed in two ways. For cross-sectional analysis, the analytic sample included adults 18 and older at each wave, resulting in 44,040 observations. Separately, longitudinal analyses were assessed among adults 18 and older at Wave 2, resulting in 7,930 individuals. Both analyses excluded adults with chronic obstructive pulmonary disease (COPD) or non-asthma respiratory disease.ResultsCurrent established cigarillo smokers had higher odds of having FIRS (Adjusted odds ratio (AOR): 1.72; 95% CI: 1.08, 2.74) compared to never smokers of cigarillos and cigarettes, after adjusting for covariates. Current established filtered cigar smokers had higher odds of asthma diagnosis (AOR: 1.35; 95% CI: 1.10, 1.66) while current established dual smokers of filtered cigars and cigarettes had higher odds of uncontrolled asthma (AOR: 5.13; 95% CI: 1.75, 15.02) compared to never smokers of filtered cigars or cigarettes. Both current established cigar smokers and current established dual smokers of cigarettes and cigars had higher odds of new FIRS compared to never cigar or cigarette smokers (AORs: 1.62; 95% CI: 1.02, 2.60 for exclusive cigars and 2.55; 95% CI 1.57, 4.14 for dual smokers).ConclusionsThis study provides evidence that cigar smokers or dual smokers of cigars and cigarettes have greater odds of FIRS, asthma, and uncontrolled asthma and that new incidence of FIRS is higher among any cigar smokers compared to never cigar or cigarette smokers. Understanding health impacts associated with cigar use provides information for supporting policy development, as well as for designing clinical interventions focused on smoking cessation for cigars.

Reducing the risk of droplet inhalation for taxi drivers by regulating the air supply position according to the exhalation source

The environment inside taxis is relatively closed, making it easy for the drivers to contact with droplets exhaled by the passengers and creating a high risk of respiratory diseases. To study the diffusion of droplets in taxis, the numerical simulation was performed based on gas–solid two–phase flow. The renormalization-group k–epsilon (RNG k–ε) turbulence model and the discrete phase model were used to study the transmission characteristics of droplets with different exhalation sources, and the air-supply positions were chosen to reduce the risk of driver infection from droplet inhalation. Based on the likelihood–exposure–consequence (LEC) method, the cumulative inhalation ratio of droplets was used to assess drivers' infection risk during working. The results show that, the driver's infection risk is least when the passenger sits in the front seat, reducing the risk by 32%–87%. Furthermore, the risk is reduced by 38%–85% when the air supply is changed from two-sided to central. Therefore, the combination that minimizes the risk of inhalation infection for taxi drivers is the passenger sitting in the front seat and the air being supplied centrally in the taxi, which can provide a reference for improving the car layout and ventilation system of the taxi.

Risk of respiratory diseases among hospitalized patients with hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a systemic disorder associated with various metabolic and inflammatory comorbidities. Although HS shares risk factors and pathogenic pathways with various respiratory conditions, few studies have explored the relationship between HS and respiratory disease. This is a cross-sectional, case-control, population-based study that examined the United States National Inpatient Sample database from January 1, 2002, to December 31, 2012. HS was identified using ICD-9-CM codes during hospital admissions. Multivariable logistic regression was used to evaluate for adjusted associations between HS and respiratory diagnoses as compared to matched controls. Twenty-three thousand seven hundred and sixty-seven hospital admissions for HS were compared with 95,068 age- and sex-matched controls. HS patients had significantly higher adjusted odds of asthma (OR: 1.233; 95% CI: [1.170-1.299]; P < 0.001), chronic airway obstruction (OR: 1.532; 95% CI: [1.419-1.651]; P < 0.001), sarcoidosis (OR: 1.601; 95% CI: [1.157-2.214]; P < 0.001), and sleep apnea (OR: 1.274; 95% CI: [1.182-1.374]; P < 0.001). HS is associated with several common forms of respiratory disease. Knowledge of these associations may allow for better recognition of respiratory disease in HS patients.

Exposure to volatile organic compounds and mortality in US adults: A population-based prospective cohort study

Volatile organic compounds (VOCs) are ubiquitous in both indoor and outdoor environments. Evidence on the associations of individual and joint VOC exposure with all-cause and cause-specific mortality is limited. Measurements of 15 urinary VOC metabolites were available to estimate exposure to 12 VOCs in the National Health and Nutritional Examination Survey (NHANES) 2005–2006 and 2011–2018. The environment risk score (ERS) was calculated using LASSO regression to reflect joint exposure to VOCs. Follow-up data on death were obtained from the NHANES Public-Use Linked Mortality File through December 31, 2019. Cox proportional hazard models and restricted cubic spline models were applied to evaluate the associations of individual and joint VOC exposures with all-cause and cause-specific mortality. Population attributable fractions were calculated to assess the death burden attributable to VOC exposure. During a median follow-up of 6.17 years, 734 (8.34 %) deaths occurred among 8799 adults. Urinary metabolites of acrolein, acrylonitrile, 1,3-butadiene, and ethylbenzene/styrene were significantly associated with all-cause, cardiovascular disease (CVD), respiratory disease (RD), and cancer mortality in a linear dose-response manner. Linear and robust dose-response relationships were also observed between ERS and all-cause and cause-specific mortality. Each 1-unit increase in ERS was associated with a 33.6 %, 39.1 %, 109.8 %, and 67.8 % increase for all-cause, CVD, RD, and cancer mortality risk, respectively. Moreover, joint exposure to VOCs contributed to 17.95 % of all-cause deaths, 13.49 % of CVD deaths, 35.65 % of RD deaths, and 33.85 % of cancer deaths. Individual and joint exposure to VOCs may enhance the risk of all-cause and cause-specific mortality. Reducing exposure to VOCs may alleviate the all-cause and cause-specific death burden.

Lifestyle Behaviors of Childhood and Adolescence: Contributing Factors, Health Consequences, and Potential Interventions

In this narrative review, we summarized evidence from peer-reviewed articles, published before February 2024, that investigated lifestyle behaviors among children (≤12 years) and adolescents (13-18 years) representing different geographic descents. These behaviors included dietary patterns, screen time, physical activity, smoking, alcohol consumption, oral hygiene, unsafe sex, and sleep duration and quality. We documented the significant impacts of parental, school, and sociodemographic factors on the adoption of numerous lifestyle behaviors in this age category. Several health consequences could be attributed to unhealthy lifestyle behaviors during childhood and adolescence. For example, poor dietary habits can lead to a higher risk of obesity and cardiovascular disease. Physical inactivity contributes to the development of musculoskeletal and psychological disorders. Excessive screen time is associated with visual acuity problems, poor sleep, and psychological and behavioral problems. Tobacco use poses a significant risk for severe respiratory and cardiovascular diseases. Risky sexual behaviors are related to sexually transmitted infections and exposure to violence. Short sleep duration is associated with a lack of physical fitness and poor cognitive function. However, potential interventions, such as school-based health programs, community outreach initiatives, and national health policies and regulations, can improve lifestyle behaviors among children and adolescents.

A prospective study on the relationship between exposure to solid fuels for heating and its duration and the risk of morbidity of respiratory diseases among residents aged 30-79 years

Objective: To research the association between exposure to solid fuels for heating and its duration and the risk of respiratory diseases morbidity. Methods: Data from the China Kadoorie Biobank project sited in Pengzhou City, Sichuan Province. Cox proportional hazard regression model was used to analyze the association between exposure to solid fuels for heating and its duration and the risk of total respiratory diseases and the association between exposure to solid fuels for heating and the risk of chronic obstructive pulmonary disease (COPD) and pneumonia among respiratory diseases. Results: A total of 46 082 participants aged 30-79 years were enrolled, with 11 634 (25.25%) heating during the winter, of whom 8 885 (19.28%) used clean fuels and 2 749 (5.97%) used solid fuels, of whom 34 448 (74.75%) did not heat. After controlling for multiple confounding factors, Cox proportional hazard regression model was used, which revealed that compared with clean fuels, unheating could reduce the risk of total respiratory disease (HR=0.81,95%CI:0.77-0.86), COPD (HR=0.86,95%CI:0.78-0.95) and pneumonia (HR=0.80,95%CI:0.74-0.86), respectively. Exposure to solid fuels increased the risk of total respiratory disease (HR=1.10, 95%CI:1.01-1.20) and were not associated with COPD and pneumonia. Compared with no solid fuel exposure, the risk of total respiratory disease (1-19 years:HR=1.23, 95%CI:1.10-1.37; 20-39 years:HR=1.25, 95%CI:1.16-1.35; ≥40 years:HR=1.26, 95%CI:1.15-1.39) and COPD (1-19 years: HR=1.21, 95%CI:1.03-1.42; 20-39 years: HR=1.30, 95%CI:1.16-1.46; ≥40 years:HR=1.35, 95%CI:1.18-1.54) increased with the length of exposure of solid fuels (trend test P<0.001). Solid fuels exposure for 1-19 years and 20-39 years increased the risk of COPD by 23% (HR=1.23,95%CI:1.02-1.49) and 16% (HR=1.16, 95%CI:1.00-1.35). Conclusion: Heating solid fuels exposure increases the risk of total respiratory disease, COPD, and pneumonia.

Perinatal Risk Factors for Asthma and Allergic Rhinitis in Children and Adolescents.

In this study, we evaluated the associations between birth-related exposures, postnatal factors, and the risk of allergic rhinitis and asthma in children and adolescents. We performed a comprehensive search of five literature databases up to May 2023. To quantify the associations of birth-related exposures (birth weight, delivery mode, prematurity, sex, maternal age, and parental allergy history) and postnatal factors (birth order, number of siblings, breastfeeding exclusivity, and breastfeeding duration) with allergic disease, we calculated pooled odds ratios and 95% confidence intervals. We conducted subgroup analyses for allergic disease type, birth order, number of siblings, and parental allergy history. The methodological quality of the identified studies was evaluated using the Newcastle-Ottawa Scale. This meta-analysis included 31 studies, encompassing 218,899 patients in total. The birth-related exposures of low birth weight, maternal age, and prematurity (less than 37 weeks gestation) were not significantly associated with the risk of asthma or allergic rhinitis during childhood or adolescence. Male sex, family history of allergy, and cesarean delivery were linked to an elevated risk of asthma or allergic rhinitis. Among postnatal factors, exclusive breastfeeding, breastfeeding for longer than 6 months, second or later birth order, and having siblings exhibited protective effects against allergic diseases in offspring. The risks of allergic rhinitis and asthma were elevated in male patients, those delivered by cesarean section, and those with a family history of allergy. Conversely, exclusive breastfeeding, breastfeeding for longer than 6 months, and having siblings corresponded to a reduced risk of respiratory allergic diseases.

The effect of dust storms on air quality and public health in the city of Hillah

Dust storms, which have become frequent events, pose great risks to health and the environment. There are three factors responsible for generating them: strong winds, lack of rain, and lack of vegetation cover. AirQ+ software developed by the World Health Organization, was used to assess the health risks resulting from short-term exposure to PM2.5 measured using Continuous Particulate Monitor BAM-1020 for a period of two years from Jan 2021 to Jan 2023. The frequency and intensity of dust storms were recorded during the summer and spring of 2022, with high concentrations. The concentrations of the pollutant PM2.5 range during storm days (213.89 - 674.48 μg/m3), where short-term exposure causes an increase in the risk of respiratory illnesses and cardiovascular diseases. The most severe dust storms (674.48 μg/m3) caused a rise in the risk relative to 3.395 for respiratory diseases and 1.801 for cardiovascular disease. The great danger of dust storms is evident by comparing them with corresponding days for the year 2021, where the relative risk did not exceed 1.03for respiratory diseases and 1.01) for cardiovascular diseases. In general, air quality was classified using the concentrations obtained, where the concentrations of PM2.5 increased strongly, especially during the dry months, and the sand and dust storms that happened in 2022 caused the air quality to become dangerous by 2%, very unhealthy by 6%, and unhealthy by 8%. As for the other pollutants (SO2, NO2, and CO), they did not rise much beyond the allowable limit, and it has no direct relationship with dust storms, i.e. they did not increase with their increase. Several health and safety precautions and environmental control techniques can be used to lessen the effects of sand and dust storms. Although it is unreasonable to take action to stop or prevent widespread sand and dust storms from occurring, management measures can be taken to lessen their effects.

Assessment of Lung Function in Scavenger Workers at Some Waste Dumpsites in Baghdad City

Waste scavengers face occupational hazards from exposure to toxic landfill emissions, putting them at risk for respiratory illnesses. This study aimed to assess the impacts of landfill gases on lung function in scavengers. Spirometry was used to evaluate lung function in scavengers at 5 dumpsites in Baghdad compared to non-exposed controls. The results showed that winter measurements in the internal measuring point for carbon dioxide indicated that the highest concentration was 454.89 ppm in the Adhamiya landfill and the lowest concentration was 397.65 ppm in the Baghdad Aljadeeda landfill. Lung disease cases were recorded and correlated to landfill sites, work duration, and seasons. The results of the lung efficiency examination showed a clear decrease in spirometry parameters at high-pollution landfill sites with varying concentrations of particulates and gases compared to the control group—more airway restriction cases correlated with increased years of scavenger exposure and higher pollutant levels. As noted, severe respiratory symptoms increased in the summer season likely due to the influence of climatic factors.

Increased postoperative complications after laparoscopic gastrectomy in patients with preserved ratio impaired spirometry

BackgroundPreserved ratio impaired spirometry (PRISm), defined as decreased forced expiratory volume in the first second in the setting of normal ratio, is associated with an increased risk of respiratory disease and systemic comorbidities. Unlike severe obstructive pulmonary disease, little is known about the impact of PRISm on short-term outcomes in patients undergoing laparoscopic gastrectomy (LG) and its association with small airway dysfunction (SAD). MethodsThis study enrolled 830 patients who underwent preoperative spirometry and LG between January 2021 and August 2023. Of these, 228 patients were excluded. Participants were categorized into 3 groups based on their baseline lung function, and postoperative outcomes were subsequently analyzed. Potential associations between postoperative outcomes and various clinical variables were examined using univariate and multivariate analyses. ResultsPRISm was identified in 16.6% of the patients, whereas SAD was present in 20.4%. The incidence of postoperative pulmonary complications (PPCs) was notably higher in the SAD group (20.3% vs 9.8%, P = .002) and the PRISm group (28.0% vs 9.8%, P < .001) than the normal group. Among the 3 groups, pneumonia was the most frequently observed PPC. Multivariate analysis revealed that both SAD (odds ratio [OR], 2.34; 95% CI, 1.30–4.22; P = .005) and PRISm (OR, 3.26; 95% CI, 1.80–5.90; P < .001) independently constituted significant risk factors associated with the occurrence of PPCs. Univariate analysis showed that female was a possible risk factor for PPCs in PRISm group. ConclusionOur study showed that PRISm and SAD were associated with the increased PPCs in patients undergoing LG for gastric cancer.

Impact of physical and sexual abuse on risk of hospitalisations for physical and mental illnesses: insights from two large prospective cohort studies

Physical abuse can lead to severe health consequences that extend beyond immediate harm. We explored the associations of physical abuse experienced during childhood and adulthood with a wide range of adult health conditions requiring hospital treatment. We utilised data from a sub-cohort of 157,366 UK Biobank participants (46.4% of the baseline population; age range 45-81; 89,101 women) and repeated analyses in an independent population of 85,929 adults from the Finnish Public Sector (FPS) study (age range 17-78; 68,544 women). Participants in both cohorts reported instances of physical and sexual abuse at study baseline. Follow-up included 77 common health conditions ascertained from linkage data to national hospital and mortality registries. Mean follow-up duration was 4.6 years (SD 0.14) in UK Biobank and 10.6 years (4.3) in FPS. Physical and sexual abuse was associated with 22 mental and physical health conditions. After multivariable adjustments, participants who experienced abuse during both early and later stages of life had a 2.12- (95% confidence interval 1.39-3.23) to 3.37-fold (1.52-7.45) increased risk of mental and behavioural disorders, a 1.46 (1.20-1.79) to 1.83 (1.05-3.20) times increased risk of metabolic, haematologic, and respiratory diseases, and a 1.24 (1.07-1.45) times higher risk of inflammatory diseases compared with non-exposed participants. The absolute risk difference between these groups was greatest for metabolic and haematologic conditions (rate 381 and risk difference 160 per 100,000 person-years). Frailty, comorbidities, and competing risk of death did not modify these associations, but the possibility of bias or residual confounding cannot be excluded. Repeated exposure to physical and sexual abuse amplifies the risk of hospitalisations from mental disorders and physical diseases spanning diverse organ systems. Addressing this issue may necessitate multifaceted strategies, including shifts in societal norms, legal measures, and increased healthcare provision for affected individuals and their families. Wellcome Trust, UK Medical Research Council, U.S. National Institute on Aging, Academy of Finland.