PM10

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jimmylegs
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Re: PM10

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Contribution of metals in resuspended dust to indoor and personal inhalation exposures: Relationships between PM10 and settled dust (2018)
https://www.sciencedirect.com/science/a ... 2318304529
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Re: PM10

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jimmylegs wrote: Sun May 24, 2020 4:38 am Contribution of metals in resuspended dust to indoor and personal inhalation exposures: Relationships between PM10 and settled dust (2018)
https://www.sciencedirect.com/science/a ... 2318304529
Prevalence of Multiple Sclerosis in a Turkish City Bordering an Iron and Steel Factory
https://pubmed.ncbi.nlm.nih.gov/29629528/?dopt=Abstract

..Conclusions: We found that the prevalence of MS was more than two fold higher in Karabük than in Akçakoca, which supports a link between air pollution and the pathogenesis of MS. However, larger etiological and epidemiological studies are needed to confirm this hypothesis.


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Re: PM10

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right off PM10 now, but fwiw

Renal function and historical environmental cadmium pollution from zinc smelters (1994)
https://www.sciencedirect.com/science/a ... 369492936X
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Re: PM10

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2020 Jun 2
Department of Respiratory and Critical Care Medicine, General Hospital of Northern Theater Command, 83 Wen Hua Rd, Shenyang, China
Air Pollution and Temperature Are Associated With Increased COVID-19 Incidence: A Time Series Study
https://pubmed.ncbi.nlm.nih.gov/32502664/

Abstract

Objectives: Although the COVID-19 is known to cause by human-to-human transmission, it remains largely unclear whether ambient air pollutants and meteorological parameters could promote its transmission.

Methods: A retrospective study is conducted to study whether air quality index (AQI), four ambient air pollutants (PM2.5, PM10, NO2 and CO) and five meteorological variables (daily temperature, highest temperature, lowest temperature, temperature difference and sunshine duration) could increase COVID-19 incidence in Wuhan and XiaoGan between Jan 26th to Feb 29th in 2020.

Results: First, a significant correlation was found between COVID-19 incidence and AQI in both Wuhan (R2 = 0.13, p < 0.05) and XiaoGan (R2 = 0.223, p < 0.01). Specifically, among four pollutants, COVID-19 incidence was prominently correlated with PM2.5 and NO2 in both cities. In Wuhan, the tightest correlation was observed between NO2 and COVID-19 incidence (R2 = 0.329, p < 0.01). In XiaoGan, in addition to the PM2.5 (R2 = 0.117, p < 0.01) and NO2 (R2 = 0.015, p < 0.05), a notable correlation was also observed between the PM10 and COVID-19 incidence (R2 = 0.105, p < 0.05). Moreover, temperature is the only meteorological parameter that constantly correlated well with COVID-19 incidence in both Wuhan and XiaoGan, but in an inverse correlation (p < 0.05).

Conclusions: AQI, PM2.5, NO2, and temperature are four variables that could promote the sustained transmission of COVID-19.
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Re: PM10

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2020 Sep 1
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan
Acute Particulate Matter Exposure Is Associated With Disturbances in Heart Rate Complexity in Patients With Prior Myocardial Infarction
https://pubmed.ncbi.nlm.nih.gov/32446047/

..Conclusion: Our results suggest that coarse PM may acutely affect cardiac autonomic balance. MSE is a sensitive marker for detecting changes in autonomic imbalance in patients with prior MI following acute PM exposure.
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Re: PM10

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2020 Jul 1
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis
Marriage as a Social Tie in the Relation of Depressive Symptoms Attributable to Air Pollution Exposure Among the Elderly
https://pubmed.ncbi.nlm.nih.gov/32379603/

Abstract

Background: Air pollution is a risk factor for depression or depressive symptoms. However, few studies have examined an effect modifier as a protective factor against depressive symptoms associated with air pollution, including social support. Notably, less is known about a married relationship in the association between exposure to air pollution and depressive symptoms among the elderly.

Methods: This study included 2122 marrieds and 607 non-marrieds, recruited in 2014-2017 from different regions of South Korea. Depressive symptoms were measured by the Korean version of the Geriatric Depression Scale Short Form (SGDS-K). After adjustment for potential confounders using propensity score of being assigned to the marrieds, we examined the extent of whether the effects of exposure to air pollutants (PM10, PM2.5, and NO2) on depressive symptoms were different between marrieds and non-marrieds. Subgroup analyses by gender and residence area were also performed.

Results: Marrieds than non-marrieds were less likely to have depressive symptoms and had smaller SGDS-K associated with increased exposure to PM10 and PM2.5 concentrations, respectively. After stratification of subjects by gender and residence area, the interaction term appeared to be significant among men and the non-metropolitan group, indicating the protective effect of married relationships on depressive symptoms attributable to air pollution exposure in them.

Limitations: Although we adjusted the propensity score, our findings might be confounded by the contextual effect associated with married relationships.

Conclusions: A married relationship, as a social tie, may attenuate the effect of exposure to air pollution on depressive symptoms among the elderly. Nonetheless, additional research is worthwhile to explore the extent of other social relationships in the association between air pollution exposure and depressive symptoms.
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2020 Aug 1
Association Between Ambient Air Pollution and Daily Hospital Admissions for Depression in 75 Chinese Cities
https://pubmed.ncbi.nlm.nih.gov/32312109/
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2020 Jul 1
Association between short-term exposure to ambient air pollution and hospital visits for depression in China
https://pubmed.ncbi.nlm.nih.gov/32268289/
Last edited by Petr75 on Sun Jan 03, 2021 4:03 am, edited 2 times in total.
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Re: PM10

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Petr75 wrote: Wed Jun 10, 2020 8:19 am 2020 Jun 2
Department of Respiratory and Critical Care Medicine, General Hospital of Northern Theater Command, 83 Wen Hua Rd, Shenyang, China
Air Pollution and Temperature Are Associated With Increased COVID-19 Incidence: A Time Series Study
https://pubmed.ncbi.nlm.nih.gov/32502664/
2020 Aug
School of Business, Central South University, Changsha, Hunan, China
Correlation Between Environmental Pollution Indicators and COVID-19 Pandemic: A Brief Study in Californian Context
https://pubmed.ncbi.nlm.nih.gov/32405084/

Abstract

In December 2019, the novel coronavirus COVID-19 outbreak was first detected in Wuhan Hubei province, China. The April 24, 2020, the Centers for Disease Control and Preventions (CDC) has confirmed more than 39,000 cases, including >1800 deaths. California's Governor Gavin Newsom ordered mandatory stay at home after World Health Organization (WHO) declared COVID-19 as a global pandemic in early March. We have evaluated the correlation between environmental pollution determinants and the COVID-19 outbreak in California by using the secondary published data from the Centers for Disease Control and the Environmental Pollution Agency (EPA). We employed Spearman and Kendall correlation tests to analyze the association of PM 2.5, PM 10, SO2, NO2, Pb, VOC, and CO with COVID-19 cases in California. Our findings indicate that environmental pollutants such as PM10, PM2.5, SO2, NO2, and CO have a significant correlation with the COVID-19 epidemic in California. Overall, our study is a useful supplement to encourage regulatory bodies to promote changes in environmental policies as pollution source control can reduce the harmful effects of environmental pollutants.
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Re: PM10

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2020 Oct
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
Ambient Air Pollutants Aggravate Association of Snoring With Prevalent Hypertension: Results From the Henan Rural Cohort
https://pubmed.ncbi.nlm.nih.gov/32464360/

Abstract

Aim: We aimed to assess if snoring and ambient air pollutants were jointly associated with prevalent hypertension in a cross-sectional study.

Methods: A total of 28440 participants aged 18-79 years were obtained from the Henan Rural Cohort. Snoring evaluated using Pittsburgh sleep quality index (PSQI) scale was classified into 'Never', '<3 times/week' and '≥3 times/week' groups. Concentrations of air pollutants (PM1, PM2.5, PM10, and NO2) were evaluated by a satellite-based spatiotemporal model. The independent and joint associations between snoring and air pollutants on prevalence of hypertension were analyzed by logistic regression models.

Results: The mean age of all participants was 56.0 ± 12.2 years. The frequencies and prevalence of participants with hypertension were 3666 (32.39%) in men and 5576(32.57%) in women, respectively. The odds ratio (OR) and 95% confidence interval (CI) of participants with snoring frequency of <3 times/week, ≥3 times/week was 1.10(1.02-1.20), and 1.15(1.08-1.23) for hypertension, compared to those without snoring. Participants with a snoring (≥3 times/week) and higher exposure concentrations of PM1, PM2.5, PM10, and NO2 had 2.58-fold(95% CI: 2.30-2.90), 3.03-fold(95% CI: 2.69-3.41), 2.89-fold(95% CI: 2.57-3.25) and 2.75-fold(95% CI: 2.44-3.10) for hypertension, compared to those without snoring and low concentrations of air pollutants. Additionally, participants with high PM1 and ≥3 times/week snoring (OR: 1.32, 95% CI: 1.18-1.48) was at a higher likelihood for prevalent hypertension, compared to those without snoring and with high PM1.

Conclusions: Snoring and high ambient air pollutants might be important predictors of hypertension, and higher concentration of PM1 might aggravate the association between snoring and hypertension.
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Re: PM10

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2020 Jun 7
School of Earth and Environmental Sciences, Seoul National University, Seoul, South Korea
Association of Air Pollution With Osteoporotic Fracture Risk Among Women Over 50 Years of Age
https://pubmed.ncbi.nlm.nih.gov/32507945/

Abstract

Introduction: Air particulate matter (PM) is an environmental exposure associated with oxidation and inflammation. Whether particulate matter is associated with risk of osteoporotic bone fracture is unclear. We investigated the association between exposure to PM and risk of bone fractures.

Materials and methods: We collected data of 44,602 participants living in three metropolitan cities in Republic of Korea from National Health Insurance Service database. We examined the association of 2 year averaged concentrations of PM and osteoporotic fracture over 4 years. Exposure to 2-year averaged air pollution [PM2.5 (< 2.5 μm in aerodynamic diameter), PM10 [< 10 μm in aerodynamic diameter], PM coarse (PM ranging from 2.5 μm to 10 μm)] concentrations were estimated from 2008 to 2009 in Air Korea data. The adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for osteoporotic fractures were calculated using the multivariate Cox proportional hazards model.

Results: After adjusting for age, household income, and Charlson Comorbidity Index, PM 2.5 in one pollutant model increased the risk of osteoporotic fractures, compared to the first quartile group (4th quartile group aHR = 1.13, 95% CI 1.02-1.24). Also, PM 2.5 increased the risk of spine and non-spine fractures compared to the first quartile group (4th quartile group aHR = 1.17, 95% CI 1.00-1.38, aHR = 1.16, 95% CI 1.01-1.33). We found no association between PM10/PM coarse and osteoporotic fractures.

Conclusion: We found that PM2.5 is a risk factor for osteoporotic bone fractures.

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MS

2012 Jun 12
Risk of fractures in patients with multiple sclerosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369507/
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Re: PM10

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2020 Jun
Institute for Anatomy I, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
Associations of Air Pollution and Noise With Local Brain Structure in a Cohort of Older Adults
https://pubmed.ncbi.nlm.nih.gov/32539589/

Abstract

Background: Despite the importance of understanding associations of air pollution and noise exposure with loss of neurocognitive performance, studies investigating these exposures and local brain structure are limited.

Objective: We estimated associations of residential air pollution and noise exposures with neurocognitive test performance and the local gyrification index (lGI), a marker for local brain atrophy, among older adults.

Methods: For n=615 participants from the population-based 1000BRAINS study, based on the German Heinz Nixdorf Recall study, we assessed residential exposures to particulate matter (PM10, PM2.5, PM2.5abs), accumulation mode particle number (PNAM), and nitrogen oxides (NOx, NO2), using land-use regression and chemistry transport models. Weighted 24-h and nighttime noise were modeled according to the European noise directive. We evaluated associations of air pollution and noise exposure at the participants' 2006-2008 residential addresses with neurocognitive test performance and region-specific lGI values (n=590) from magnetic resonance imaging, both assessed in 2011-2015, using linear regression and adjusting for demographic and personal characteristics.

Results: Air pollution and noise were associated with language and short-term/working memory and with local atrophy of the fronto-parietal network (FPN), a functional resting-state network associated with these cognitive processes. For example, per 2-μg/m3
PM10, local brain atrophy was more pronounced in the posterior brain regions of the FPN, with a −0.02 [95% confidence interval (CI): −0.04, 0.00] lower lGI. In contrast, in the anterior regions of the FPN, weighted 24-h and nighttime noise were associated with less local brain atrophy [e.g., 0.02 (95% CI: 0.00, 0.04) for 10dB (A) 24-h noise].

Conclusions: Air pollution and noise exposures were associated in opposite directions with markers of local atrophy of the FPN in the right brain hemisphere in older adults, suggesting that both chronic air pollution and noise exposure may influence the physiological aging process of the brain.
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Re: PM10

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2020 Jun 6
Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
The Association Between Short-Term Exposure to Ambient Air Pollution and Fractional Exhaled Nitric Oxide Level: A Systematic Review and Meta-Analysis of Panel Studies
https://pubmed.ncbi.nlm.nih.gov/32544661/

Abstract

Several epidemiological studies have evaluated the fractional exhaled nitric oxide (FeNO) of ambient air pollution but the results were controversial. We therefore conducted a systematic review and meta-analysis to investigate the associations between short-term exposure to air pollutants and FeNO level. We searched PubMed and Web of Science and included a total of 27 articles which focused on associations between ambient air pollutants (PM10, PM2.5, black carbon (BC), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3)) exposure and the change of FeNO. Random effect model was used to calculate the percent change of FeNO in association with a 10 or 1 μg/m3 increase in air pollutants exposure concentrations. A 10 μg/m3 increase in short-term PM10, PM2.5, NO2, and SO2 exposure was associated with a 3.20% (95% confidence interval (95%CI): 1.11%, 5.29%), 2.25% (95%CI: 1.51%, 2.99%),4.90% (95%CI: 1.98%, 7.81%), and 8.28% (95%CI: 3.61%, 12.59%) change in FeNO, respectively. A 1 μg/m3 increase in short-term exposure to BC was associated with 3.42% (95%CI: 1.34%, 5.50%) change in FeNO. The association between short-term exposure to O3 and FeNO level was insignificant (P>0.05). Future studies are warranted to investigate the effect of multiple pollutants, different sources and composition of air pollutants on airway inflammation.


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MS

2003 May
Department of Neurology, Dokuz Eylül University, School of Medicine, Izmir, Turkey
Nitric Oxide as an Activity Marker in Multiple Sclerosis
https://pubmed.ncbi.nlm.nih.gov/12736739/


Abstract

Nitric oxide (NO) molecules have one of the most important roles in the pathogenesis of multiple sclerosis (MS). It has been stated that a continuous and high concentration of NO metabolites in CSF and in the serum of MS patients in relapse may cause toxic damage to myelin and oligodendroglia. The aim of this study was to investigate whether NO is a marker of disease activity and is correlated with other disease activity markers such as active lesions on brain magnetic resonance imaging (MRI) and increased immunoglobulin G (IgG) index. Cerebrospinal fluid (CSF) and peripheral serum (PS) samples were taken from patients with definite MS (n = 24) during relapse and remission and from control subjects (n = 18). The Griess reaction was used to measure the NO metabolites, nitrite and nitrate in CSF and PS. Cranial MRI was carried out with triple dose (0,3 mmol/kg) gadolinium and the IgG index was determined. Nitrite and nitrate concentrations (NNCs) of CSF were 11.16 +/- 8.60 micromol/ml in relapse and 6.72 +/- 3.50 micromol/ml in remission, whereas in PS they were 12.89 +/- 7.62 micromol/ml during relapse and 12.35 +/- 6.62 micromol/ml during remission. In control subjects NNCs in CSF and PS were 7.42 +/- 2.81 micromol/ml and 4.37 +/- 1.63 micromol/ml respectively. NNCs in CSF during relapse period were significantly higher than those of both remission phase and control subjects (p = 0.000). Although serum NNCs did not differ in relapse and remission, they were still higher than normal controls. Validity analysis revealed that NNC measurement in CSF was 71 % specific and 66 % sensitive to disease activity. The most important result was the significant correlation of increased NNCs with the existence of active lesion in cranial MRI and an increase in IgG index (p < 0.05).In conclusion, these results add background data to assist in further outlining the possible role of NO in the pathogenesis of MS. Together with the other markers it may be used as an activity marker in relapses of MS.
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Re: PM10

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2020 Jun 17
Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Impacts of Ambient Air Pollution on Glucose Metabolism in Korean Adults: A Korea National Health and Nutrition Examination Survey Study
https://pubmed.ncbi.nlm.nih.gov/32552747/

Abstract

Background: Exposure to air pollution was reported to affect glucose metabolism, increasing the risk of diabetes mellitus. We conducted an epidemiological study on glucose metabolism and air pollution by exploring the levels of fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) with changes in ambient air quality, depending on the characteristics of the susceptible population. ..
Conclusions: Our study provides scientific evidence supporting that short- and mid-term exposure to air pollution is associated with changes in biological markers related to diabetes. This finding suggests that the impact of air pollution should be reflected in chronic disease management when establishing local health care policies.

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MS

2014 Dec
Department of Functional Biology, University of Valencia , Valencia , Spain
Perturbed Glucose Metabolism: Insights Into Multiple Sclerosis Pathogenesis
https://pubmed.ncbi.nlm.nih.gov/25520698/

Abstract

Multiple sclerosis (MS) is a complex debilitating disease of the central nervous system (CNS) perceived to result from the autoimmune effect of T cells in damaging myelin sheath. However, the exact pathogenesis of the disease remains elusive. Initial studies describing the possibility of defective pyruvate metabolism in MS were performed in 1950s. The group observed elevated blood pyruvate level in both fasting and postprandial times in MS patients with relapse. Similarly, other investigators also reported increased fasting pyruvate level in this disease. These reports hint to a possible abnormality of pyruvate metabolism in MS patients. In addition, increase in levels of Krebs cycle acids like alpha-ketoglutarate in fasting and citrate after glucose intake in MS patients further strengthened the connection of disturbed pyruvate metabolism with MS progression. These studies led the investigators to explore the role of disturbed glucose metabolism in pathophysiological brain function. Under normal circumstances, complex molecules are metabolized into simpler molecules through their respective pathways. Differential expression of genes encoding enzymes of the glucose metabolic pathway in CNS may result in neurological deficits. In this review article, we discuss the studies related to disturbed carbohydrate metabolism in MS and other neurodegenerative diseases. These observations open new perspectives for the understanding of metabolic dynamics in MS yet many puzzling aspects and critical questions need to be addressed. Much more research is required to fully unravel the disease mechanism, and a proper understanding of the disease could eventually lead to new treatments.
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Re: PM10

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2020 Sep
Centro de Investigaciones y Transferencia San Nicolás, Universidad Tecnológica Nacional (CONICET), San Nicolás, Argentina
Short-term exposure to particulate matter (PM 10 and PM 2.5), nitrogen dioxide (NO 2), and ozone (O 3) and all-cause and cause-specific mortality: Systematic review and meta-analysis
https://pubmed.ncbi.nlm.nih.gov/32590284/

Abstract

Background: Air pollution is a leading cause of mortality and morbidity worldwide. Short-term exposure (from one hour to days) to selected air pollutants has been associated with human mortality. This systematic review was conducted to analyse the evidence on the effects of short-term exposure to particulate matter with aerodynamic diameters less or equal than 10 and 2.5 µm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on all-cause mortality, and PM10 and PM2.5 on cardiovascular, respiratory, and cerebrovascular mortality.

Methods: We included studies on human populations exposed to outdoor air pollution from any source, excluding occupational exposures..

Conclusions: This study found evidence of a positive association between short-term exposure to PM10, PM2.5, NO2, and O3 and all-cause mortality, and between PM10 and PM2.5 and cardiovascular, respiratory and cerebrovascular mortality. These results were robust through several sensitivity analyses. In general, the level of evidence was high, meaning that we can be confident in the associations found in this study.
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Re: PM10

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MS

2019 Feb
Pro-Thrombotic Activity of Blood Platelets in Multiple Sclerosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406904/

Abstract

The available data, including experimental studies, clearly indicate an excessive intravascular activation of circulating platelets in multiple sclerosis (MS) and their hyper-responsiveness to a variety of physiological activators. Platelet activation is manifested as an increased adhesion and aggregation and is accompanied by the formation of pro-thrombotic microparticles. Activated blood platelets also show an expression of specific membrane receptors, synthesis many of biomediators, and generation of reactive oxygen species. Epidemiological studies confirm the high risk of stroke or myocardial infarction in MS that are ischemic incidents, strictly associated with incorrect platelet functions and their over pro-thrombotic activity. Chronic inflammation and high activity of pro-oxidative processes in the course of MS are the main factors identified as the cause of excessive platelet activation. The primary biological function of platelets is to support vascular integrity, but the importance of platelets in inflammatory diseases is also well documented. The pro-thrombotic activity of platelets and their inflammatory properties play a part in the pathophysiology of MS. The analysis of platelet function capability in MS could provide useful information for studying the pathogenesis of this disease. Due to the complexity of pathological processes in MS, medication must be multifaceted and blood platelets can probably be identified as new targets for therapy in the future.

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PM


2020 Jun 12
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
Associations of long-term exposure to air pollutants, physical activity and platelet traits of cardiovascular risk in a rural Chinese population
https://pubmed.ncbi.nlm.nih.gov/32594998/

Abstract

Background: Long-term exposure to air pollutants relate to increase risk of cardiovascular diseases that may be partially attributable to platelet dysfunction. Physical activity (PA) may attenuate inflammation to modulate platelet function. Thus, this study aimed to evaluate associations of air pollutants and PA with platelet traits of cardiovascular risk...

Conclusions: Long-term exposure to air pollutants were related to increase platelet size and these associations were attenuated by increased PA, implying that PA is a costless and affordable method to decrease adverse effects on platelet traits in relation to air pollutants.
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Re: PM10

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2020 Jul 6
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University
Air pollution-associated blood pressure may be modified by diet among children in Guangzhou, China
https://pubmed.ncbi.nlm.nih.gov/32649627/


Abstract

Objectives: To assess the associations between long-term air pollution exposure and blood pressure in children, and to explore the modifying effects of diet on prehypertension and hypertension.

Methods: We evaluated 7225 primary school children aged 6-12 years from Guangzhou, China, in 2017. The blood pressure was measured objectively. The individual 1-year average concentration of particles with an aerodynamic diameter of 2.5 μm or less or 10 μm or less (PM2.5, PM10), sulfur dioxide (SO2), and ozone (O3) before each blood pressure measurement were calculated by inverse distance weighting interpolation according to each home address. Generalized linear mixed-effects models were used to examine the health effects and potential effect modifications by diet factors after adjusting for covariates.

Results: The results showed that the estimated increase in mean SBP was 0.92 mmHg (95% CI 0.05-1.79) per interquartile range increase in O3. An interquartile range increase in the 1-year mean of SO2 and O3 was associated with odds ratios of 1.26 (95% CI 1.04-1.52) and 1.20 (95% CI 1.06-1.35) for prehypertension, respectively. In addition, an interquartile range increase in PM2.5, SO2, and O3 exposure was positively associated with hypertension, with odds ratios of 1.33 (95% CI 1.11-1.61), 1.70 (95% CI 1.33-2.16), and 1.48 (95% CI 1.20-1.83), respectively. Stronger effect estimates between PM2.5, SO2, and O3 concentration on prehypertension were exhibited among subgroups of children with a higher intake of sugar-sweetened beverages.

Conclusion: Long-term exposure to PM2.5, SO2, and O3 were associated with higher blood pressure levels in children, and dietary intake might modify these associations.
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