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[PMID]:28453399
[Au] Autor:Rossner A; Jordan CE; Wake C; Soto-Garcia L
[Ad] Endereço:a Center for Air Resources Engineering and Science , Clarkson University , Potsdam , NY , USA.
[Ti] Título:Monitoring of carbon monoxide in residences with bulk wood pellet storage in the Northeast United States.
[So] Source:J Air Waste Manag Assoc;67(10):1066-1079, 2017 Oct.
[Is] ISSN:2162-2906
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The interest in biomass fuel is continuing to expand globally and in the northeastern United States as wood pellets are becoming a primary source of fuel for residential and small commercial systems. Wood pellets for boilers are often stored in basement storage rooms or large bag-type containers. Due to the enclosed nature of these storage areas, the atmosphere may exhibit increased levels of carbon monoxide. Serious accidents in Europe have been reported over the last decade in which high concentrations of carbon monoxide (CO) have been found in or near bulk pellet storage containers. The aim of this study was to characterize the CO concentrations in areas with indoor storage of bulk wood pellets. Data was obtained over approximately 7 months (December 2013 to June 2014) at 25 sites in New Hampshire and Massachusetts: 16 homes using wood pellet boilers with indoor pellet storage containers greater than or equal to 3 ton capacity; 4 homes with wood pellet heating systems with outdoor pellet storage; 4 homes using other heating fuels; and a university laboratory site. CO monitors were set up in homes to collect concentrations of CO in the immediate vicinity of wood pellet storage containers, and data were then compared to those of homes using fossil fuel systems. The homes monitored in this study provided a diverse set of housing stock spanning two and a half centuries of construction, with homes built from 1774 to 2013, representing a range of air exchange rates. The CO concentration data from each home was averaged hourly and then compared to a threshold of 9 ppm. While concentrations of CO were generally low for the homes studied, the need to properly design storage locations for pellets is and will remain a necessary component of wood pellet heating systems to minimize the risk of CO exposure. IMPLICATIONS: This paper is an assessment of carbon monoxide (CO) exposure from bulk wood pellet storage in homes in New Hampshire and Massachusetts. Understanding the CO concentrations in homes allows for better designs for storage bins and ventilation for storage areas. Hence, uniform policies for stored wood pellets in homes, schools, and businesses can be framed to ensure occupant safety. Currently in New York State rebates for the installation of wood pellet boilers are only provided if the bulk pellet storage is outside of the home, yet states such as New Hampshire, Vermont, and Maine currently do not have these restrictions.
[Mh] Termos MeSH primário: Poluentes Atmosféricos/análise
Poluição do Ar em Ambientes Fechados/análise
Monóxido de Carbono/análise
Monitoramento Ambiental/métodos
Madeira/química
[Mh] Termos MeSH secundário: Europa (Continente)
Calefação/métodos
Habitação
Seres Humanos
Massachusetts
New Hampshire
New York
Ventilação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Air Pollutants); 7U1EE4V452 (Carbon Monoxide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1080/10962247.2017.1321054


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[PMID]:28858756
[Au] Autor:Abu Awad Y; Koutrakis P; Coull BA; Schwartz J
[Ad] Endereço:Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA. Electronic address: yara.abuawad@mail.harvard.edu.
[Ti] Título:A spatio-temporal prediction model based on support vector machine regression: Ambient Black Carbon in three New England States.
[So] Source:Environ Res;159:427-434, 2017 11.
[Is] ISSN:1096-0953
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Fine ambient particulate matter has been widely associated with multiple health effects. Mitigation hinges on understanding which sources are contributing to its toxicity. Black Carbon (BC), an indicator of particles generated from traffic sources, has been associated with a number of health effects however due to its high spatial variability, its concentration is difficult to estimate. We previously fit a model estimating BC concentrations in the greater Boston area; however this model was built using limited monitoring data and could not capture the complex spatio-temporal patterns of ambient BC. In order to improve our predictive ability, we obtained more data for a total of 24,301 measurements from 368 monitors over a 12 year period in Massachusetts, Rhode Island and New Hampshire. We also used Nu-Support Vector Regression (nu-SVR) - a machine learning technique which incorporates nonlinear terms and higher order interactions, with appropriate regularization of parameter estimates. We then used a generalized additive model to refit the residuals from the nu-SVR and added the residual predictions to our earlier estimates. Both spatial and temporal predictors were included in the model which allowed us to capture the change in spatial patterns of BC over time. The 10 fold cross validated (CV) R of the model was good in both cold (10-fold CV R = 0.87) and warm seasons (CV R = 0.79). We have successfully built a model that can be used to estimate short and long-term exposures to BC and will be useful for studies looking at various health outcomes in MA, RI and Southern NH.
[Mh] Termos MeSH primário: Poluentes Atmosféricos/análise
Monitoramento Ambiental/métodos
Modelos Teóricos
Material Particulado/análise
Fuligem/análise
Máquina de Vetores de Suporte
[Mh] Termos MeSH secundário: Massachusetts
New Hampshire
Rhode Island
Estações do Ano
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Air Pollutants); 0 (Particulate Matter); 0 (Soot)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171120
[Lr] Data última revisão:
171120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE


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[PMID]:28722620
[Au] Autor:Nitzan O; Blum A; Marva E; Katz A; Tzadok BS; Nachum-Biala Y; Baneth G; Peretz A
[Ad] Endereço:Faculty of Medicine in the Galilee, Bar Ilan University, Ramat Gan, Israel.
[Ti] Título:Case Report: Infectious Diseases in Pilgrims Visiting the Holy Land.
[So] Source:Am J Trop Med Hyg;97(2):611-614, 2017 Aug.
[Is] ISSN:1476-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Every year Christian pilgrims from around the world visit the holy sites located around the Sea of Galilee. Some become ill during their stay with infectious diseases that were acquired in their country of origin, and are hospitalized at Poriya Medical Center. They pose a diagnostic challenge due to language barriers, the rarity of these infections in Israel, and the fact that diagnostic tests are not readily available. All patient records from 2015 of Holy Land tourists hospitalized at Poriya Medical Center were screened for the diagnosis of imported zoonotic diseases that are not commonly diagnosed in Israel. Three patients who were on a Holy Land tour were hospitalized during 2015 with laboratory-confirmed diagnostically challenging zoonotic infectious diseases: a 91-year-old priest from Ethiopia diagnosed with relapsing fever due to , an 85-year-old retired mountaineer from New Hampshire diagnosed with human granulocytic anaplasmosis, and a 57-year-old farmer from central Brazil diagnosed with leptospirosis. These case reports emphasize the importance of considering imported zoonotic infectious diseases and obtaining appropriate diagnostic tests when treating Holy Land travelers to Israel.
[Mh] Termos MeSH primário: Anaplasmose
Doenças Transmissíveis
Leptospirose
Febre Recorrente
Viagem/estatística & dados numéricos
Zoonoses
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Animais
Etiópia
Seres Humanos
Israel
Masculino
Meia-Idade
New Hampshire
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE
[do] DOI:10.4269/ajtmh.17-0097


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[PMID]:28719869
[Au] Autor:Barnaby R; Liefeld A; Jackson BP; Hampton TH; Stanton BA
[Ad] Endereço:Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States. Electronic address: Roxanna.L.Barnaby@dartmouth.edu.
[Ti] Título:Effectiveness of table top water pitcher filters to remove arsenic from drinking water.
[So] Source:Environ Res;158:610-615, 2017 10.
[Is] ISSN:1096-0953
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Arsenic contamination of drinking water is a serious threat to the health of hundreds of millions of people worldwide. In the United States ~3 million individuals drink well water that contains arsenic levels above the Environmental Protection Agency (EPA) maximum contaminant level (MCL) of 10µg/L. Several technologies are available to remove arsenic from well water including anion exchange, adsorptive media and reverse osmosis. In addition, bottled water is an alternative to drinking well water contaminated with arsenic. However, there are several drawbacks associated with these approaches including relatively high cost and, in the case of bottled water, the generation of plastic waste. In this study, we tested the ability of five tabletop water pitcher filters to remove arsenic from drinking water. We report that only one tabletop water pitcher filter tested, ZeroWater®, reduced the arsenic concentration, both As and As , from 1000µg/L to < 3µg/L, well below the MCL. Moreover, the amount of total dissolved solids or competing ions did not affect the ability of the ZeroWater® filter to remove arsenic below the MCL. Thus, the ZeroWater® pitcher filter is a cost effective and short-term solution to remove arsenic from drinking water and its use reduces plastic waste associated with bottled water.
[Mh] Termos MeSH primário: Arsênico/análise
Água Potável/química
Filtração/normas
Poluentes Químicos da Água/análise
Purificação da Água/métodos
[Mh] Termos MeSH secundário: Filtração/economia
New Hampshire
Purificação da Água/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Drinking Water); 0 (Water Pollutants, Chemical); N712M78A8G (Arsenic)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171120
[Lr] Data última revisão:
171120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE


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[PMID]:28692390
[Au] Autor:Daly ER; Dufault K; Swenson DJ; Lakevicius P; Metcalf E; Chan BP
[Ad] Endereço:1 New Hampshire Department of Health and Human Services, Concord, NH, USA.
[Ti] Título:Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015.
[So] Source:Public Health Rep;132(1_suppl):73S-79S, 2017 Jul/Aug.
[Is] ISSN:1468-2877
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Opioid-related overdoses and deaths in New Hampshire have increased substantially in recent years, similar to increases observed across the United States. We queried emergency department (ED) data in New Hampshire to monitor opioid-related ED encounters as part of the public health response to this health problem. METHODS: We obtained data on opioid-related ED encounters for the period January 1, 2011, through December 31, 2015, from New Hampshire's syndromic surveillance ED data system by querying for (1) chief complaint text related to the words "fentanyl," "heroin," "opiate," and "opioid" and (2) opioid-related International Classification of Diseases ( ICD) codes. We then analyzed the data to calculate frequencies of opioid-related ED encounters by age, sex, residence, chief complaint text values, and ICD codes. RESULTS: Opioid-related ED encounters increased by 70% during the study period, from 3300 in 2011 to 5603 in 2015; the largest increases occurred in adults aged 18-29 and in males. Of 20 994 total opioid-related ED visits, we identified 18 554 (88%) using ICD code alone, 690 (3%) using chief complaint text alone, and 1750 (8%) using both chief complaint text and ICD code. For those encounters identified by ICD code only, the corresponding chief complaint text included varied and nonspecific words, with the most common being "pain" (n = 3335, 18%), "overdose" (n = 1555, 8%), "suicidal" (n = 816, 4%), "drug" (n = 803, 4%), and "detox" (n = 750, 4%). Heroin-specific encounters increased by 827%, from 4% of opioid-related encounters in 2011 to 24% of encounters in 2015. CONCLUSIONS: Opioid-related ED encounters in New Hampshire increased substantially from 2011 to 2015. Data from New Hampshire's ED syndromic surveillance system provided timely situational awareness to public health partners to support the overall response to the opioid epidemic.
[Mh] Termos MeSH primário: Analgésicos Opioides/envenenamento
Overdose de Drogas/epidemiologia
Serviço Hospitalar de Emergência/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Overdose de Drogas/diagnóstico
Serviço Hospitalar de Emergência/tendências
Feminino
Seres Humanos
Classificação Internacional de Doenças/classificação
Classificação Internacional de Doenças/estatística & dados numéricos
Masculino
Meia-Idade
New Hampshire/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.1177/0033354917707934


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[PMID]:28615018
[Au] Autor:Winterbottom EF; Koestler DC; Fei DL; Wika E; Capobianco AJ; Marsit CJ; Karagas MR; Robbins DJ
[Ad] Endereço:Molecular Oncology Program, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
[Ti] Título:The aquaglyceroporin AQP9 contributes to the sex-specific effects of in utero arsenic exposure on placental gene expression.
[So] Source:Environ Health;16(1):59, 2017 Jun 14.
[Is] ISSN:1476-069X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sex-specific factors play a major role in human health and disease, including responses to environmental stresses such as toxicant exposure. Increasing evidence suggests that such sex differences also exist during fetal development. In a previous report using the resources of the New Hampshire Birth Cohort Study (NHBCS), we found that low-to-moderate in utero exposure to arsenic, a highly toxic and widespread pollutant, was associated with altered expression of several key developmental genes in the fetal portion of the placenta. These associations were sex-dependent, suggesting that in utero arsenic exposure differentially impacts male and female fetuses. In the present study, we investigated the molecular basis for these sex-specific responses to arsenic. METHODS: Using NanoString technology, we further analyzed the fetal placenta samples from the NHBCS for the expression of genes encoding arsenic transporters and metabolic enzymes. Multivariable linear regression analysis was used to examine their relationship with arsenic exposure and with key developmental genes, after stratification by fetal sex. RESULTS: We found that maternal arsenic exposure was strongly associated with expression of the AQP9 gene, encoding an aquaglyceroporin transporter, in female but not male fetal placenta. Moreover, AQP9 expression associated with that of a subset of female-specific arsenic-responsive genes. CONCLUSIONS: Our results suggest that AQP9 is upregulated in response to arsenic exposure in female, but not male, fetal placenta. Based on these results and prior studies, increased AQP9 expression may lead to increased arsenic transport in the female fetal placenta, which in turn may alter the expression patterns of key developmental genes that we have previously shown to be associated with arsenic exposure. Thus, this study suggests that AQP9 may play a role in the sex-specific effects of in utero arsenic exposure.
[Mh] Termos MeSH primário: Aquaporinas/genética
Arsênico/toxicidade
Poluentes Ambientais/toxicidade
Desenvolvimento Fetal/efeitos dos fármacos
Expressão Gênica/efeitos dos fármacos
Exposição Materna
[Mh] Termos MeSH secundário: Adolescente
Adulto
Aquaporinas/metabolismo
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
New Hampshire
Placenta/efeitos dos fármacos
Gravidez
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (AQP9 protein, human); 0 (Aquaporins); 0 (Environmental Pollutants); N712M78A8G (Arsenic)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1186/s12940-017-0267-8


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[PMID]:28558807
[Au] Autor:Kaushal A; Zhang H; Karmaus WJJ; Everson TM; Marsit CJ; Karagas MR; Tsai SF; Wen HJ; Wang SL
[Ad] Endereço:Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, 38152, USA.
[Ti] Título:Genome-wide DNA methylation at birth in relation to in utero arsenic exposure and the associated health in later life.
[So] Source:Environ Health;16(1):50, 2017 May 30.
[Is] ISSN:1476-069X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In utero arsenic exposure may alter fetal developmental programming by altering DNA methylation, which may result in a higher risk of disease in later life. We evaluated the association between in utero arsenic exposure and DNA methylation (DNAm) in cord blood and its influence in later life. METHODS: Genome-wide DNA methylation in cord blood from 64 subjects in the Taiwanese maternal infant and birth cohort was analyzed. Robust regressions were applied to assess the association of DNA methylation with in utero arsenic exposure. Multiple testing was adjusted by controlling false discovery rate (FDR) of 0.05. The DAVID bioinformatics tool was implemented for functional annotation analyses on the detected CpGs. The identified CpGs were further tested in an independent cohort. For the CpGs replicated in the independent cohort, linear mixed models were applied to assess the association of DNA methylation with low-density lipoprotein (LDL) at different ages (2, 5, 8, 11 and 14 years). RESULTS: In total, 579 out of 385,183 CpGs were identified after adjusting for multiple testing (FDR = 0.05), of which ~60% were positively associated with arsenic exposure. Functional annotation analysis on these CpGs detected 17 KEGG pathways (FDR = 0.05) including pathways for cardiovascular diseases (CVD) and diabetes mellitus. In the independent cohort, about 46% (252 out of 553 CpGs) of the identified CpGs showed associations consistent with those in the study cohort. In total, 11 CpGs replicated in the independent cohort were in the pathways related to CVD and diabetes mellitus. Via longitudinal analyses, we found at 5 out of the 11 CpGs methylation was associated with LDL over time and interactions between DNA methylation and time were observed at 4 of the 5 CpGs, cg25189764 (coeff = 0.157, p-value = 0.047), cg04986899 (coeff. For interaction [coeff.int] = 0.030, p-value = 0.024), cg04903360 (coeff.int = 0.026, p-value = 0.032), cg08198265 (coeff.int = -0.063, p-value = 0.0021), cg10473311 (coeff.int = -0.021, p-value = 0.027). CONCLUSION: In utero arsenic exposure was associated with cord blood DNA methylation at various CpGs. The identified CpGs may help determine pathological epigenetic mechanisms linked to in utero arsenic exposure. Five CpGs (cg25189764, cg04986899, cg04903360, cg08198265 and cg10473311) may serve as epigenetic markers for changes in LDL later in life.
[Mh] Termos MeSH primário: Arsênico
Metilação de DNA/efeitos dos fármacos
Poluentes Ambientais
Exposição Materna
Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente
Efeitos Tardios da Exposição Pré-Natal/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Arsênico/toxicidade
Arsênico/urina
Criança
Pré-Escolar
Ilhas de CpG/genética
Poluentes Ambientais/toxicidade
Poluentes Ambientais/urina
Epigênese Genética
Feminino
Sangue Fetal/química
Desenvolvimento Fetal
Seres Humanos
Recém-Nascido
Masculino
New Hampshire
Gravidez
Estudos Prospectivos
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Environmental Pollutants); N712M78A8G (Arsenic)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE
[do] DOI:10.1186/s12940-017-0262-0


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[PMID]:28429891
[Au] Autor:Wright WL; Morrell E; Lee J; Cuellar NG; White P
[Ad] Endereço:Wright & Associates Family Healthcare, PLLC, Amherst, New Hampshire.
[Ti] Título:Comparison of immunization rates of adults ages 65 years and older managed within two nurse practitioner-owned clinics with national immunization rates.
[So] Source:J Am Assoc Nurse Pract;29(7):384-391, 2017 Jul.
[Is] ISSN:2327-6924
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Adults ages ≥65 years are at increased risk for infectious diseases. Ensuring these individuals are fully vaccinated is imperative. The purpose of this study was to assess the immunization rates of adults ages ≥65 years managed by nurse practitioners (NPs) and compare the results with national immunization rates and Healthy People 2020 goals. METHODS: A convenience sample of adults ages ≥65 years was obtained from two NP-managed clinics. The vaccine records of each subject were reviewed for documentation of having received five vaccines (tetanus, diphtheria, and pertussis; influenza; pneumococcal polysaccharide vaccine 23; pneumococcal conjugate vaccine 13; and herpes zoster vaccine). CONCLUSIONS: One hundred and fifty females (70.8%) and 62 males (29.2%) met inclusion criteria. NP-managed patients had higher immunization rates than the national averages across all five major vaccines. The herpes zoster vaccination rates exceeded the recommendations from Healthy People 2020 whereas pneumococcal and influenza rates were below. IMPLICATIONS FOR PRACTICE: The stocking of vaccines within the NP-managed clinics, direct billing to Medicare for Part D vaccines, and previsit care planning likely contributed to the high vaccination rates. These high immunization rates in patients managed by NPs provide support for the important role that NPs play in the care of older adults.
[Mh] Termos MeSH primário: Imunização/utilização
Profissionais de Enfermagem/normas
Padrões de Prática em Enfermagem/normas
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Vacina contra Herpes Zoster/uso terapêutico
Seres Humanos
Imunização/estatística & dados numéricos
Vacinas contra Influenza/uso terapêutico
Masculino
New Hampshire
Profissionais de Enfermagem/organização & administração
Vacinas Pneumocócicas/uso terapêutico
Padrões de Prática em Enfermagem/organização & administração
Padrões de Prática em Enfermagem/estatística & dados numéricos
Medicina Preventiva/estatística & dados numéricos
Vacinas/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Herpes Zoster Vaccine); 0 (Influenza Vaccines); 0 (Pneumococcal Vaccines); 0 (Vaccines)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1002/2327-6924.12459


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[PMID]:28410520
[Au] Autor:Farzan SF; Brickley EB; Li Z; Gilbert-Diamond D; Gossai A; Chen Y; Howe CG; Palys T; Karagas MR
[Ad] Endereço:Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. Electronic address: sffarzan@usc.edu.
[Ti] Título:Maternal and infant inflammatory markers in relation to prenatal arsenic exposure in a U.S. pregnancy cohort.
[So] Source:Environ Res;156:426-433, 2017 07.
[Is] ISSN:1096-0953
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Accumulating evidence indicates that arsenic (As), a potent environmental toxicant, may increase cardiovascular disease risk and adversely affect endothelial function at high levels of exposure. Pregnancy is a vulnerable time for both mother and child; however, studies examining the association between prenatal As exposure and plasma biomarkers of inflammation and endothelial function in mothers and newborns are lacking. METHODS: We examined maternal urinary As levels at gestational weeks 24-28 and levels of inflammatory biomarkers in plasma from 563 pregnant women and 500 infants' cord blood. We assessed a multiplexed panel of circulating inflammatory and endothelial function markers, including tumor necrosis factor alpha (TNFα), monocyte chemoattractant protein 1 (MCP1), intercellular adhesion molecule (ICAM1) and vascular cell adhesion molecule (VCAM1). RESULTS: Compared with the bottom tertile, the highest tertile of maternal urinary As during pregnancy was associated with a 145.2ng/ml (95% CI 4.1, 286.3; p=0.04) increase in cord blood ICAM1 and 557.3ng/ml (95% CI -56.4, 1171.1; p=0.09) increase in cord blood VCAM1. Among mothers, the highest tertile of maternal urinary As during pregnancy was related to a 141.8ng/ml (95% CI 26.1, 257.5; p=0.02) increase maternal plasma VCAM1 levels. Urinary As was unrelated to MCP1 or TNFα in maternal plasma and cord blood. In structural equation models, the association between maternal urinary As and infant VCAM was mediated by maternal levels of VCAM (ß : 0.024, 95% CI: 0.002, 0.050). CONCLUSION: Our observations indicate that As exposure during pregnancy may affect markers of vascular health and endothelial function in both pregnant women and children, and suggest further investigation of the potential impacts on cardiovascular health in these susceptible populations.
[Mh] Termos MeSH primário: Arsênico/toxicidade
Endotélio/efeitos dos fármacos
Sangue Fetal/química
Exposição Materna
Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente
[Mh] Termos MeSH secundário: Adolescente
Adulto
Arsênico/sangue
Arsênico/urina
Biomarcadores/sangue
Biomarcadores/urina
Estudos de Coortes
Feminino
Seres Humanos
Recém-Nascido
Inflamação/sangue
Inflamação/induzido quimicamente
Inflamação/epidemiologia
Inflamação/urina
Masculino
Meia-Idade
New Hampshire/epidemiologia
Gravidez
Efeitos Tardios da Exposição Pré-Natal/sangue
Efeitos Tardios da Exposição Pré-Natal/epidemiologia
Efeitos Tardios da Exposição Pré-Natal/urina
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Biomarkers); N712M78A8G (Arsenic)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171119
[Lr] Data última revisão:
171119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE


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[PMID]:28304182
[Au] Autor:Whedon J; Tosteson TD; Kizhakkeveettil A; Kimura MN
[Ad] Endereço:1 Health Services Research, University Health System, Southern California University of Health Sciences , Whittier, CA.
[Ti] Título:Insurance Reimbursement for Complementary Healthcare Services.
[So] Source:J Altern Complement Med;23(4):264-267, 2017 Apr.
[Is] ISSN:1557-7708
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Insurance reimbursement for clinical services provided by complementary healthcare professionals in the United States likely differs by provider specialty. It is hypothesized that a lower likelihood of insurance reimbursement demonstrates that complementary healthcare services are not utilized to an optimal level and are not financially accessible to all who may need or want these services. The purpose of this project was to evaluate the likelihood of insurance reimbursement for complementary healthcare services compared with other complementary services and with conventional primary care medical services in New Hampshire. METHODS: The authors studied health claims for services provided in a nonemergent outpatient setting in New Hampshire in 2014. The study population consisted of New Hampshire residents aged 18-99 years with claims for selected clinical services commonly provided by complementary healthcare providers. The authors modeled the proportion of reimbursed claims by specialty of complementary healthcare service provider, compared with the reimbursement rate for primary care physicians' claims. The authors modeled first for the proportion of reimbursement for any selected clinical service, next for any evaluation and management (E&M) service, and finally for the most commonly used E&M procedure code, current procedural terminology (CPT) 99213 (reevaluation of established patient). RESULTS: Compared with primary care physicians, the likelihood of reimbursement for any service was 69% lower for acupuncturists, 71% lower for doctors of chiropractic medicine, and 62% lower for doctors of naturopathic medicine. For any E&M service, likelihood of reimbursement was 69% lower for acupuncturists, 78% lower for doctors of chiropractic medicine, and 60% lower for doctors of naturopathic medicine. With further restriction to CPT 99213 only, likelihood of reimbursement was 34% lower for acupuncturists, 77% lower for doctors of chiropractic medicine, and 60% lower for doctors of naturopathic medicine. CONCLUSIONS: In New Hampshire, the likelihood of health insurance reimbursement for certain clinical services differs significantly by provider specialty. More research is needed to evaluate the extent and cause of such differences and the effect of such differences on the utilization of complementary healthcare services in the United States.
[Mh] Termos MeSH primário: Terapias Complementares
Reembolso de Seguro de Saúde
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Terapias Complementares/economia
Terapias Complementares/estatística & dados numéricos
Terapias Complementares/utilização
Política de Saúde
Disparidades em Assistência à Saúde
Seres Humanos
Medicina Integrativa
Meia-Idade
New Hampshire
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.1089/acm.2016.0369



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