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Song J, Qiu W, Huang X, Guo Y, Chen W, Wang D, Zhang X. Association of ambient carbon monoxide exposure with hospitalization risk for respiratory diseases: A time series study in Ganzhou, China. Front Public Health 2023; 11:1106336. [PMID: 36866098 PMCID: PMC9972102 DOI: 10.3389/fpubh.2023.1106336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
Background Ambient carbon monoxide (CO) exposure is associated with increased mortality and hospitalization risk for total respiratory diseases. However, evidence on the risk of hospitalization for specific respiratory diseases from ambient CO exposure is limited. Methods Data on daily hospitalizations for respiratory diseases, air pollutants, and meteorological factors from January 2016 to December 2020 were collected in Ganzhou, China. A generalized additive model with the quasi-Poisson link and lag structures was used to estimate the associations between ambient CO concentration and hospitalizations of total respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), and influenza-pneumonia. Possible confounding co-pollutants and effect modification by gender, age, and season were considered. Results A total of 72,430 hospitalized cases of respiratory diseases were recorded. Significant positive exposure-response relationships were observed between ambient CO exposure and hospitalization risk from respiratory diseases. For each 1 mg/m3 increase in CO concentration (lag0-2), hospitalizations for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia increased by 13.56 (95% CI: 6.76%, 20.79%), 17.74 (95% CI: 1.34%, 36.8%), 12.45 (95% CI: 2.91%, 22.87%), 41.25 (95% CI: 18.19%, 68.81%), and 13.5% (95% CI: 3.41%, 24.56%), respectively. In addition, the associations of ambient CO with hospitalizations for total respiratory diseases and influenza-pneumonia were stronger during the warm season, while women were more susceptible to ambient CO exposure-associated hospitalizations for asthma and LRTI (all P < 0.05). Conclusion In brief, significant positive exposure-response relationships were found between ambient CO exposure and hospitalization risk for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia. Effect modification by season and gender was found in ambient CO exposure-associated respiratory hospitalizations.
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Affiliation(s)
- Jiahao Song
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Qiu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuezan Huang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - You Guo
- First Affiliated Hospital, Gannan Medical University, Ganzhou, China,Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China,School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,*Correspondence: Dongming Wang ✉
| | - Xiaokang Zhang
- First Affiliated Hospital, Gannan Medical University, Ganzhou, China,Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China,School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China,Xiaokang Zhang ✉
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Mehrpooya M, Ganjali MR, Mousavi SA, Hedayat N, Allahyarzadeh A. Comprehensive Review of Fuel-Cell-Type Sensors for Gas Detection. Ind Eng Chem Res 2023. [DOI: 10.1021/acs.iecr.2c03790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Mehdi Mehrpooya
- Department of Renewable Energies and Environment, Faculty of New Sciences and Technologies, University of Tehran, Tehran1439957131, Iran
- Hydrogen and Fuel Cell Laboratory, Faculty of New Sciences and Technologies, University of Tehran, Tehran1439957131, Iran
| | - Mohammad Reza Ganjali
- Center of Excellence in Electrochemistry, School of Chemistry, College of Science, University of Tehran, Tehran1417614411, Iran
- National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran1439957131, Iran
| | - Seyed Ali Mousavi
- Hydrogen and Fuel Cell Laboratory, Faculty of New Sciences and Technologies, University of Tehran, Tehran1439957131, Iran
| | - Nader Hedayat
- Department of Chemical and Biomolecular Engineering, The University of Akron, Akron, Ohio44325, United States
| | - Ali Allahyarzadeh
- Department of Renewable Energies and Environment, Faculty of New Sciences and Technologies, University of Tehran, Tehran1439957131, Iran
- Mechanical Engineering, Polytechnic School, University of São Paulo, São Paulo68503, Brazil
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Zhang Y, Wang S, Feng Z, Song Y. Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China. Front Public Health 2022; 10:1071229. [PMID: 36530677 PMCID: PMC9755172 DOI: 10.3389/fpubh.2022.1071229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
Background Influenza is a serious public health problem, and its prevalence and spread show significant spatiotemporal characteristics. Previous studies have found that air pollutants are linked to an increased risk of influenza. However, the mechanism of influence and the degree of their association have not been determined. This study aimed to determine the influence of the air environment on the spatiotemporal distribution of influenza. Methods The kernel density estimation and Getis-Ord Gi * statistic were used to analyze the spatial distribution of the influenza incidence and air pollutants in China. A simple analysis of the correlation between influenza and air pollutants was performed using Spearman's correlation coefficients. A linear regression analysis was performed to examine changes in the influenza incidence in response to air pollutants. The sensitivity of the influenza incidence to changes in air pollutants was evaluated by performing a gray correlation analysis. Lastly, the entropy weight method was used to calculate the weight coefficient of each method and thus the comprehensive sensitivity of influenza incidence to six pollution elements. Results The results of the sensitivity analysis using Spearman's correlation coefficients showed the following ranking of the contributions of the air pollutants to the influenza incidence in descending order: SO2 >NO2 >CO> PM2.5 >O3 >PM10. The sensitivity results obtained from the linear regression analysis revealed the following ranking: CO>NO2 >SO2 >O3 >PM2.5 >PM10. Lastly, the sensitivity results obtained from the gray correlation analysis showed the following ranking: NO2 >CO>PM10 >PM2.5 >SO2 >O3. According to the sensitivity score, the study area can be divided into hypersensitive, medium-sensitive, and low-sensitive areas. Conclusion The influenza incidence showed a strong spatial correlation and associated sensitivity to changes in concentrations of air pollutants. Hypersensitive areas were mainly located in the southeastern part of northeastern China, the coastal areas of the Yellow River Basin, the Beijing-Tianjin-Hebei region and surrounding areas, and the Yangtze River Delta. The influenza incidence was most sensitive to CO, NO2, and SO2, with the occurrence of influenza being most likely in areas with elevated concentrations of these three pollutants. Therefore, the formulation of targeted influenza prevention and control strategies tailored for hypersensitive, medium-sensitive, low-sensitive, and insensitive areas are urgently needed.
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Affiliation(s)
- Yu Zhang
- School of Geographical Sciences, Northeast Normal University, Changchun, China
| | - Shijun Wang
- School of Geographical Sciences, Northeast Normal University, Changchun, China
- Key Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, China
| | - Zhangxian Feng
- School of Geographical Sciences, Northeast Normal University, Changchun, China
- Key Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, China
| | - Yang Song
- School of Geographical Sciences, Northeast Normal University, Changchun, China
- Key Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, China
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Gäbel P, Koller C, Hertig E. Development of Air Quality Boxes Based on Low-Cost Sensor Technology for Ambient Air Quality Monitoring. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22103830. [PMID: 35632239 PMCID: PMC9144299 DOI: 10.3390/s22103830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 06/12/2023]
Abstract
Analyses of the relationships between climate, air substances and health usually concentrate on urban environments because of increased urban temperatures, high levels of air pollution and the exposure of a large number of people compared to rural environments. Ongoing urbanization, demographic ageing and climate change lead to an increased vulnerability with respect to climate-related extremes and air pollution. However, systematic analyses of the specific local-scale characteristics of health-relevant atmospheric conditions and compositions in urban environments are still scarce because of the lack of high-resolution monitoring networks. In recent years, low-cost sensors (LCS) became available, which potentially provide the opportunity to monitor atmospheric conditions with a high spatial resolution and which allow monitoring directly at vulnerable people. In this study, we present the atmospheric exposure low-cost monitoring (AELCM) system for several air substances like ozone, nitrogen dioxide, carbon monoxide and particulate matter, as well as meteorological variables developed by our research group. The measurement equipment is calibrated using multiple linear regression and extensively tested based on a field evaluation approach at an urban background site using the high-quality measurement unit, the atmospheric exposure monitoring station (AEMS) for meteorology and air substances, of our research group. The field evaluation took place over a time span of 4 to 8 months. The electrochemical ozone sensors (SPEC DGS-O3: R2: 0.71-0.95, RMSE: 3.31-7.79 ppb) and particulate matter sensors (SPS30 PM1/PM2.5: R2: 0.96-0.97/0.90-0.94, RMSE: 0.77-1.07 µg/m3/1.27-1.96 µg/m3) showed the best performances at the urban background site, while the other sensors underperformed tremendously (SPEC DGS-NO2, SPEC DGS-CO, MQ131, MiCS-2714 and MiCS-4514). The results of our study show that meaningful local-scale measurements are possible with the former sensors deployed in an AELCM unit.
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Affiliation(s)
- Paul Gäbel
- Regional Climate Change and Health, Faculty of Medicine, University of Augsburg, Universitätsstraße 2, 86159 Augsburg, Germany;
| | - Christian Koller
- Faculty of Design, Hochschule München, Lothstraße 34, 80335 Munich, Germany;
| | - Elke Hertig
- Regional Climate Change and Health, Faculty of Medicine, University of Augsburg, Universitätsstraße 2, 86159 Augsburg, Germany;
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Jiang H, Zhang S, Bi X, Ma W, Wei Z. Proarrhythmic effects of carbon monoxide in human ventricular tissue: insights from computational modeling. Comput Biol Med 2022; 140:105066. [PMID: 34839185 DOI: 10.1016/j.compbiomed.2021.105066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 11/03/2022]
Abstract
Epidemiological studies have demonstrated that ambient air pollution has been closely associated with cardiovascular diseases. Carbon monoxide (CO) is a common ambient air pollutant that can cause adverse effects on the heart. CO is known to cause tissue ischemia, resulting in ventricular arrhythmias. However, accumulating biological studies showed that CO could exert effects on multiple cardiac ionic channels under normoxic conditions, which might indicate new proarrhythmic mechanisms other than ischemia-mediated electrophysiology changes. In this work, we evaluated the functional impacts of CO on human ventricles using a multi-scale model of human ventricular tissue. Experimental data regarding the effects of CO on different ion channels were incorporated into the cell model to explore the alterations of ventricular electrophysiology. Simulation results suggested that CO significantly prolonged the duration of ventricular action potentials, enhanced the transmural dispersion of repolarization, and reduced the adaptability of ventricular tissue to fast heart rates. In addition, simulated pseudo-ECGs showed consistent manifestations with the clinical observation that CO caused an apparent QT interval prolongation and T-wave widening, indicating that CO affected the heart's abnormal ventricular repolarization.
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Affiliation(s)
- Huasen Jiang
- College of Computer Science and Technology, Ocean University of China, Qingdao, 266100, China
| | - Shugang Zhang
- College of Computer Science and Technology, Ocean University of China, Qingdao, 266100, China.
| | - Xiangpeng Bi
- College of Computer Science and Technology, Ocean University of China, Qingdao, 266100, China
| | - Wenjian Ma
- College of Computer Science and Technology, Ocean University of China, Qingdao, 266100, China
| | - Zhiqiang Wei
- College of Computer Science and Technology, Ocean University of China, Qingdao, 266100, China
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6
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Chu LM, Shaefi S, Byrne JD, Alves de Souza RW, Otterbein LE. Carbon monoxide and a change of heart. Redox Biol 2021; 48:102183. [PMID: 34764047 PMCID: PMC8710986 DOI: 10.1016/j.redox.2021.102183] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 12/25/2022] Open
Abstract
The relationship between carbon monoxide and the heart has been extensively studied in both clinical and preclinical settings. The Food and Drug Administration (FDA) is keenly focused on the ill effects of carbon monoxide on the heart when presented with proposals for clinical trials to evaluate efficacy of this gasotransmitter in a various disease settings. This review provides an overview of the rationale that examines the actions of the FDA when considering clinical testing of CO, and contrast that with the continued accumulation of data that clearly show not only that CO can be used safely, but is potently cardioprotective in clinically relevant small and large animal models. Data emerging from Phase I and Phase II clinical trials argues against CO being dangerous to the heart and thus it needs to be redefined and evaluated as any other substance being proposed for use in humans. More than twenty years ago, the belief that CO could be used as a salutary molecule was ridiculed by experts in physiology and medicine. Like all agents designed for use in humans, careful pharmacology and safety are paramount, but continuing to hinder progress based on long-standing dogma in the absence of data is improper. Now, CO is being tested in multiple clinical trials using innovative delivery methods and has proven to be safe. The hope, based on compelling preclinical data, is that it will continue to be evaluated and ultimately approved as an effective therapeutic.
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Affiliation(s)
- Louis M Chu
- Harvard Medical School, Departments of Surgery, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Shazhad Shaefi
- Departments of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | | | - Rodrigo W Alves de Souza
- Harvard Medical School, Departments of Surgery, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Leo E Otterbein
- Harvard Medical School, Departments of Surgery, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
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7
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Song Y, Zhang Y, Wang T, Qian S, Wang S. Spatio-temporal Differentiation in the Incidence of Influenza and Its Relationship with Air Pollution in China from 2004 to 2017. CHINESE GEOGRAPHICAL SCIENCE 2021; 31:815-828. [PMID: 34580569 PMCID: PMC8457542 DOI: 10.1007/s11769-021-1228-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/25/2021] [Indexed: 05/19/2023]
Abstract
The Healthy China Initiative is a major health strategy being pursued by the country. To prevent and control different types of diseases as well as their complex variants, research on the spatio-temporal differentiation among and mechanisms of influence of epidemic diseases is growing worldwide. This study analyzed monthly data on the incidence of influenza by using different methods, including Moran's I, the hotspot analysis model, concentration analysis, and correlation analysis, to determine the characteristics of spatio-temporal differentiation in the incidence of influenza across prefecture-level cities in China from 2004 to 2017, and to examine its relationship with air pollution. According to the results, the overall incidence of influenza in China exhibited a trend of increase from 2004 to 2017, with small peaks in 2009 and 2014. More cases of influenza were recorded in the first and fourth quarters of each year. Regions with higher incidences of influenza were concentrated in northwestern and northern China, and in the coastal areas of southeastern China. Over time, the distribution of regions with a higher incidence of influenza has shifted from the west to the east of the country. A significant relationship was observed between the incidence of influenza and factors related to air pollution. The contents of five air pollutants (PM2.5, PM10, SO2, NO2, and CO) were significantly positively correlated with the incidence of influenza, with a decreasing order of contribution to it of SO2 > CO > NO2 > PM2.5 > PM10. The content of O3 in the air was negatively correlated with the incidence of influenza. The influence of air pollution-related factors on the incidence of influenza in different regions and seasons showed minor differences. The large-scale empirical results provided here can supply a scientific basis for governmental disease control authorities to formulate strategies for regional prevention and control.
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Affiliation(s)
- Yang Song
- School of Geographical Sciences, Northeast Normal University, Changchun, 130024 China
- Key Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, 130024 China
| | - Yu Zhang
- School of Geographical Sciences, Northeast Normal University, Changchun, 130024 China
| | - Tingting Wang
- School of Geographical Sciences, Northeast Normal University, Changchun, 130024 China
| | - Sitong Qian
- School of Geographical Sciences, Northeast Normal University, Changchun, 130024 China
| | - Shijun Wang
- School of Geographical Sciences, Northeast Normal University, Changchun, 130024 China
- Key Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, 130024 China
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8
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Influence of pretreatment conditions on low-temperature CO oxidation over Pd supported UiO-66 catalysts. MOLECULAR CATALYSIS 2021. [DOI: 10.1016/j.mcat.2021.111633] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Gentile D, Adams R, Klatka M, Bradberry S, Gray L, Thanacoody R, Jackson G, Sandilands EA. Carbon monoxide exposures reported to the UK National Poisons Information Service: a 4-year study. J Public Health (Oxf) 2021; 44:565-574. [PMID: 33993287 DOI: 10.1093/pubmed/fdab132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/23/2021] [Accepted: 04/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Unintentional carbon monoxide (CO) poisoning poses a public health challenge. The UK National Poisons Information Service (NPIS) provides advice to healthcare professionals via the online database, TOXBASE®, and a 24-hour telephone line. Our aim was to analyse all CO-related enquiries to the NPIS. METHODS We analysed enquiries regarding unintentional CO exposure (1st July 2015-30th June 2019). Information on patient demographics, CO source and location, clinical features and poisoning severity was collected from telephone enquiries and TOXBASE accesses. RESULTS 2970 unintentional non-fire-related CO exposures were reported. Exposures occurred commonly in the home (60%) with faulty boilers frequently implicated (27.4%). Although five fatalities were reported, 68.7% of patients experienced no or minor symptoms only (headache most frequently reported). Despite being the gold standard measurement, blood carboxyhaemoglobin concentration was only recorded in 25.6% patients, with no statistically significant correlation with severity. CONCLUSIONS Unintentional CO exposures in the UK commonly occur in domestic settings and although are generally of low severity, fatalities continue to occur. Carboxyhaemoglobin measurement is important to confirm exposure but further work is required to assess its validity as a prognostic indicator in CO exposure. Public health policy should continue to focus on raising awareness of the dangers of CO.
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Affiliation(s)
- Daniela Gentile
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Richard Adams
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Michal Klatka
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Sally Bradberry
- National Poisons Information Service (Birmingham Unit), City Hospital, Birmingham B18 7QH, UK
| | - Laurence Gray
- National Poisons Information Service (Cardiff Unit), University Hospital Llandough, Penarth CF64 2XX, UK
| | - Ruben Thanacoody
- National Poisons Information Service (Newcastle Unit), Regional Drug and Therapeutics Centre, Newcastle upon Tyne NE2 4AB, UK
| | - Gillian Jackson
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Euan A Sandilands
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
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Al-Owais MM, Steele DS, Holden AV, Benson AP. Deterministic and Stochastic Cellular Mechanisms Contributing to Carbon Monoxide Induced Ventricular Arrhythmias. Front Pharmacol 2021; 12:651050. [PMID: 33995065 PMCID: PMC8113948 DOI: 10.3389/fphar.2021.651050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/12/2021] [Indexed: 11/26/2022] Open
Abstract
Chronic exposure to low levels of Carbon Monoxide is associated with an increased risk of cardiac arrhythmia. Microelectrode recordings from rat and guinea pig single isolated ventricular myocytes exposed to CO releasing molecule CORM-2 and excited at 0.2/s show repolarisation changes that develop over hundreds of seconds: action potential prolongation by delayed repolarisation, EADs, multiple EADs and oscillations around the plateau, leading to irreversible repolarisation failure. The measured direct effects of CO on currents in these cells, and ion channels expressed in mammalian systems showed an increase in prolonged late Na+, and a decrease in the maximal T- and L-type Ca++. peak and late Na+, ultra-rapid delayed, delayed rectifier, and the inward rectifier K+ currents. Incorporation of these CO induced changes in maximal currents in ventricular cell models; (Gattoni et al., J. Physiol., 2016, 594, 4193-4224) (rat) and (Luo and Rudy, Circ. Res., 1994, 74, 1071-1096) (guinea-pig) and human endo-, mid-myo- and epi-cardial (O'Hara et al., PLoS Comput. Biol., 2011, 7, e1002061) models, by changes in maximal ionic conductance reproduces these repolarisation abnormalities. Simulations of cell populations with Gaussian distributions of maximal conductance parameters predict a CO induced increase in APD and its variability. Incorporation of these predicted CO induced conductance changes in human ventricular cell electrophysiology into ventricular tissue and wall models give changes in indices for the probability of the initiation of re-entrant arrhythmia.
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Affiliation(s)
- Moza M. Al-Owais
- School of Biomedical Sciences, University of Leeds, Leeds, United Kingdom
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Ruan HL, Deng WS, Wang Y, Chen JB, Hong WL, Ye SS, Hu ZJ. Carbon monoxide poisoning: a prediction model using meteorological factors and air pollutant. BMC Proc 2021; 15:1. [PMID: 33648509 PMCID: PMC7923450 DOI: 10.1186/s12919-021-00206-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background While the influence of meteorology on carbon monoxide (CO) poisoning has been reported, few data are available on the association between air pollutants and the prediction of CO poisoning. Our objective is to explore meteorological and pollutant patterns associated with CO poisoning and to establish a predictive model. Results CO poisoning was found to be significantly associated with meteorological and pollutant patterns: low temperatures, low wind speeds, low air concentrations of sulfur dioxide (SO2) and ozone (O38h), and high daily temperature changes and ambient CO (r absolute value range: 0.079 to 0.232, all P values < 0.01). Based on the above factors, a predictive model was established: “logitPj = aj - 0.193 * temperature - 0.228 * wind speed + 0.221 * 24 h temperature change + 1.25 * CO - 0.0176 * SO2 + 0.0008 *O38h; j = 1, 2, 3, 4; a1 = -4.12, a2 = -2.93, a3 = -1.98, a4 = -0.92.” The proposed prediction model based on combined factors showed better predictive capacity than a model using only meteorological factors as a predictor. Conclusion Low temperatures, wind speed, and SO2 and high daily temperature changes, O38h, and CO are related to CO poisoning. Using both meteorological and pollutant factors as predictors could help facilitate the prevention of CO poisoning. Supplementary Information The online version contains supplementary material available at 10.1186/s12919-021-00206-7.
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Affiliation(s)
- Hai-Lin Ruan
- Department of Emergency, Liuzhou Worker's Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, 545005, PR China
| | - Wang-Shen Deng
- Department of Emergency, Liuzhou Worker's Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, 545005, PR China
| | - Yao Wang
- Department of Emergency, Liuzhou Worker's Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, 545005, PR China
| | - Jian-Bing Chen
- Guangxi Liuzhou Meteorological Bureau, Liuzhou, Guangxi, 545001, PR China
| | - Wei-Liang Hong
- Guangxi Liuzhou Environmental Protection Bureau, Liuzhou, Guangxi, 545006, PR China
| | - Shan-Shan Ye
- Department of Emergency, Liuzhou Worker's Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, 545005, PR China
| | - Zhuo-Jun Hu
- Department of Respiration, Liuzhou Worker's Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, 545005, PR China.
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Kim YM, Shin HJ, Choi DW, Kim JM, Lee SW, Jeong SH, Kim H. Comparison of high-flow nasal cannula oxygen therapy and conventional reserve-bag oxygen therapy in carbon monoxide intoxication: A pilot study. Am J Emerg Med 2020; 38:1621-1626. [DOI: 10.1016/j.ajem.2019.158451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/11/2019] [Accepted: 09/14/2019] [Indexed: 01/11/2023] Open
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Bagheri F, Rashedi V. Simultaneous exposure to noise and carbon monoxide increases the risk of Alzheimer's disease: a literature review. Med Gas Res 2020; 10:85-90. [PMID: 32541134 PMCID: PMC7885712 DOI: 10.4103/2045-9912.285562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 02/18/2020] [Indexed: 02/06/2023] Open
Abstract
Dementia is a syndrome of cognitive and functional decline, commonly occurring in later life as a result of neurodegenerative and cerebrovascular processes beginning earlier in the life course. An excess of free radicals has an essential role in neurodegenerative diseases and aging. This paper aims to review the effects of noise and carbon monoxide as a risk factor in Alzheimer's disease as well as the role of free radicals in the progress of Alzheimer's disease. Articles included in this review were identified through a search of the databases PubMed, Scopus, and Google Scholar using the search terms Alzheimer's disease, dementia, noise, reactive oxygen species, and Carbon Monoxide. The literature search was restricted to the years 1982 to 2020 and articles published in the English language. The metabolism rate of the body is very high when exposed to noise and carbon monoxide; this leads to overproduction of reactive oxygen species and oxidative stress conditions. Oxidative stress has an essential role in the mechanisms concerned in Alzheimer's disease. In addition to the consequences of noise and a chemical substance on the auditory system, they also have non-auditory effects that affect the brain and induced neurodegenerative disease.
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Affiliation(s)
- Fereshteh Bagheri
- Department of Audiology, School of Rehabilitation Sciences, Babol University of Medical Sciences, Mazandaran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Van Wyck DW. Beyond the burn: Studies on the physiological effects of flamethrowers during World War II. Mil Med Res 2020; 7:8. [PMID: 32102691 PMCID: PMC7045602 DOI: 10.1186/s40779-020-00237-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/17/2020] [Indexed: 11/10/2022] Open
Abstract
Flamethrowers are widely considered one of warfare's most controversial weapons and are capable of inflicting gruesome physical injuries and intense psychological trauma. Despite being the last of the major combatants in World War II (WWII) to develop them, the United States military quickly became the most frequent and adept operator of portable flamethrowers. This gave the U.S. military ample opportunity to observe the effects of flamethrowers on enemy soldiers. However, while most people in modern times would consider immolation by flamethrower to be an unnecessarily painful and inhumane way to inflict casualties, immolation was, at one point during World War II (WWII), referred to as "mercy killing" by the U.S. Chemical Warfare Service (CWS). This mischaracterization arose from a series of first-hand accounts describing what were believed to be quick, painless, and unmarred deaths, as well as from a poor and incomplete understanding of flamethrower lethality. As a result, indirect mechanisms such as hypoxia and carbon monoxide poisoning were generally absent from accounts of the flamethrower's fatal effects. It was not until several years after flamethrowers were introduced to the frontlines that the CWS and National Defense Research Committee (NDRC) conducted a series of tests to better understand the physiological and toxicological effects of flamethrowers. This article examines how the initial absence of scientific data on the physiologic effects of flamethrowers led to an inaccurate understanding of their lethality, and bizarre claims that one of history's most horrific instruments of war was considered one of the more "humane" weapons on the battlefield.
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Affiliation(s)
- David W Van Wyck
- , 4/3 SFG (A) Bldg Z-4157 South Post Rd, Fort Bragg, NC, 28310, USA.
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15
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Casillas S, Galindo A, Camarillo-Reyes LA, Varon J, Surani SR. Effectiveness of Hyperbaric Oxygenation Versus Normobaric Oxygenation Therapy in Carbon Monoxide Poisoning: A Systematic Review. Cureus 2019; 11:e5916. [PMID: 31788375 PMCID: PMC6855999 DOI: 10.7759/cureus.5916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/15/2019] [Indexed: 12/19/2022] Open
Abstract
Carbon monoxide (CO) is a gas product of combustion, considered highly poisonous. Prolonged CO exposure is responsible for more than half of fatal poisonings and is also one of the leading causes of poisoning in Western countries. We aimed to compare the effectiveness of therapy with hyperbaric oxygen (HBO) versus normobaric oxygen (NBO) in the setting of carbon monoxide poisoning (COP). We independently searched the National Library of Medicine's Medline (PubMed™), ScienceDirect™, and Scielo™ for any relevant studies published from 1989 to 2017, using the following keywords: hyperbaric therapy, hyperbaric oxygenation, normobaric therapy, carbon monoxide poisoning, carboxyhemoglobin, Haldane effect. We analyzed the studies that suggested the effectiveness of HBO or NBO. Also, we searched for studies related to COP; including history, epidemiology (risk factors, incidence, demographics), pathophysiology, clinical manifestations, diagnosis, and treatment. Sixty-eight articles were found, sixteen of which dealt with either HBO or NBO or both. Twelve suggested HBO as the treatment of choice in COP; four studies indicated that NBO was an adequate treatment due to its cost-effectiveness and availability in the emergency department (ED). HBO has been shown in several studies to be effective in moderate to high-risk COP situations, being the therapy of choice to avoid sequelae, especially neurologically. NBO can be considered as a reasonable alternative due to its cost-effectiveness. The availability and understanding of different therapeutic interventions are critical in the management of patients with COP in ED and the Critical Care unit.
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Affiliation(s)
| | | | | | - Joseph Varon
- Critical Care, United General Hospital, Houston, USA
| | - Salim R Surani
- Internal Medicine, Texas A&M Health Science Center, Temple, USA
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16
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Cheng J, Xu Z, Zhang X, Zhao H, Hu W. Estimating cardiovascular hospitalizations and associated expenses attributable to ambient carbon monoxide in Lanzhou, China: Scientific evidence for policy making. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 682:514-522. [PMID: 31129539 DOI: 10.1016/j.scitotenv.2019.05.110] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Air pollution is an important trigger of cardiovascular disease worldwide, but few studies have determined the cardiovascular disease, health, and economic burdens attributable to ambient carbon monoxide (CO). This study aimed to examine the association between CO and CVD hospitalizations, and quantified the attributable CVD hospitalizations, associated hospital stays and hospitalization costs for CO in Lanzhou, one of the most air-polluted Chinese cities historically. METHODS Daily data on CVD hospitalizations, air pollutants, and weather records from 2013 to 2017 were obtained for Lanzhou, China. Generalized additive model with a quasi-Poisson link was used to model the association between CO and CVD hospitalizations, after controlling for other air pollutants, weather conditions, day of week, long-term trend, influenza and pneumonia incidence. The effects of CO on hospital stays and hospitalization expenses from CVD were also quantified. RESULTS CO concentrations below the current Chinese ambient air quality standard had a significant impact on CVD hospitalizations. Each 1 mg/m3 increase in CO concentration on the present day and previous 4 days (lag 0-4) was associated with an 11% (95% confidence interval: 3%-20%) increase in total CVD hospitalizations. During the study period, CO was responsible for 11.74% of total CVD hospitalizations, equating to 62,792 inpatient days and 149 million RMB. Each adult patient on average spent approximately 5% of annual salary on medicine from CO-related CVD treatment during hospitalization. Maintaining the historical CO concentration within 1 to 3 mg/m3 could avert hundreds of total CVD hospitalizations and save millions of RMB annually in Lanzhou, China. CONCLUSIONS Exposure to low-level ambient CO concentration increased the risk of CVD hospitalizations and resulted in substantial health and economic burdens in Lanzhou, China. Our findings can be used for evidence-based practice and policy making to assess the cost-effectiveness of prevention measures.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Xiaoru Zhang
- Department of Information, Lanzhou University Second Hospital, Lanzhou, China
| | - Hui Zhao
- Department of Pharmacy, Lanzhou University Second Hospital, Lanzhou, China.
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
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17
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Wardi G, Brice J, Correia M, Liu D, Self M, Tainter C. Demystifying Lactate in the Emergency Department. Ann Emerg Med 2019; 75:287-298. [PMID: 31474479 DOI: 10.1016/j.annemergmed.2019.06.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 06/26/2019] [Accepted: 06/26/2019] [Indexed: 01/13/2023]
Abstract
The role of lactic acid and its conjugate base, lactate, has evolved during the past decade in the care of patients in the emergency department (ED). A recent national sepsis quality measure has led to increased use of serum lactate in the ED, but many causes for hyperlactatemia exist outside of sepsis. We provide a review of the biology of lactate production and metabolism, the many causes of hyperlactatemia, and evidence on its use as a marker in prognosis and resuscitation. Additionally, we review the evolving role of lactate in sepsis care. We provide recommendations to aid lactate interpretation in the ED and highlight areas for future research.
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Affiliation(s)
- Gabriel Wardi
- Department of Emergency Medicine, University of California at San Diego, San Diego, CA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of California at San Diego, San Diego, CA.
| | - Jessica Brice
- Department of Emergency Medicine, University of California at San Diego, San Diego, CA
| | - Matthew Correia
- Department of Emergency Medicine, University of California at San Diego, San Diego, CA
| | - Dennis Liu
- Department of Emergency Medicine, University of California at San Diego, San Diego, CA
| | - Michael Self
- Department of Emergency Medicine, University of California at San Diego, San Diego, CA
| | - Christopher Tainter
- Department of Emergency Medicine, University of California at San Diego, San Diego, CA; Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, University of California at San Diego, San Diego, CA
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18
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Rahimi M, Aghabiklooei A, Nasouhi S, Mashayekhian M, Ghoochani A, Yousefi Y, Hassanian-Moghaddam H. A 5-year Assessment on Carbon Monoxide Poisoning in a Referral Center in Tehran-Iran. Int J Prev Med 2019; 10:116. [PMID: 31367280 PMCID: PMC6639846 DOI: 10.4103/ijpvm.ijpvm_338_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/04/2019] [Indexed: 12/28/2022] Open
Abstract
Background: Carbon monoxide (CO) poisoning results in hundreds of deaths and thousands of emergency department visits all over Iran annually. In this study, we aim to provide an epidemiologic analysis of this poisoning in different consciousness levels. Methods: This single-center retrospective study was conducted at a referral poison center from March 21, 2007 to March 19, 2012 in Tehran, Iran. All CO poisoned children and adults who hospitalized were evaluated based on their on-arrival consciousness level. Results: Two-hundred-sixty patients with pure CO poisoning were enrolled with the majority of males (55.4%). CO exposure was unintentional in 99.6% of cases. The average period between CO exposure and the patients' hospital admission was 6.4 hours (SD = 11.2). Most of the toxicities had occurred at home (73.5%). On arrival acid-base status revealed respiratory acidosis cases in 11.9% of cases. Central nervous system imaging revealed 6.2% abnormal finding. Typically, patients presented with vomiting (25.8%), nausea (22.7%), and dizziness (11.3%). Twenty-nine patients (11.2%) needed intubation and mechanical ventilation. Thirty-six patients admitted to ICU with a median [IQR] hospital stay of 6 [2, 18] days. Ultimately, 202 (78.6%) patients discharged and 47 (18.3%) left the hospital against medical advice, 5 (1.9%) died, and 10 (3.8%) experienced sequellae. Two patients (0.8%), were transferred to other hospitals for specialized care. Conclusions: The incidence and mortality rate of CO poisoning in the current study are still higher than many other parts of the world. Ongoing health prevention strategies are not efficiently working. Hence, constant public education and warning about CO toxicity should be highlighted.
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Affiliation(s)
- Mitra Rahimi
- Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Aghabiklooei
- Department of Forensic Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheil Nasouhi
- Emergency Department, AJA University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Ghoochani
- Department of Medical Sciences, Amin Police University, Tehran, Iran
| | - Yavar Yousefi
- Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhao Y, Hu J, Tan Z, Liu T, Zeng W, Li X, Huang C, Wang S, Huang Z, Ma W. Ambient carbon monoxide and increased risk of daily hospital outpatient visits for respiratory diseases in Dongguan, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 668:254-260. [PMID: 30852202 DOI: 10.1016/j.scitotenv.2019.02.333] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 04/13/2023]
Abstract
BACKGROUND The toxicity of high-concentration carbon monoxide (CO) on human health has previously been documented. However, the epidemiological evidence on the association between acute exposure to ambient CO and respiratory diseases is relatively lacking and controversial. OBJECTIVES To examine the short-term association between ambient CO and hospital outpatient visits for respiratory diseases in Dongguan, China. METHODS The number of daily hospital outpatient visits for respiratory diseases, and air pollution and meteorological data were collected from January 2013 to August 2017. A generalized additive model with a quasi-Poisson link was used to estimate the association between ambient CO concentration and the total number of hospital outpatient visits for all respiratory diseases and those for asthma, bronchiectasis, chronic obstructive pulmonary disease (COPD) and pneumonia. We further analyzed the effect of ambient CO by gender and age. RESULTS Over the study period, a 24-h mean concentration of ambient CO of 0.88 mg/m3 (below the limit for CO in China) and a total of 89,484 hospital outpatient visits for respiratory diseases were recorded. Ambient CO was found to increase the risk for asthma, bronchiectasis, pneumonia and the total number of respiratory diseases. The per interquartile range (IQR) increase in ambient CO at lag03 day corresponded to a 5.62% (95% confidence interval (CI): 3.24%, 8.05%), 8.86% (95% CI: 4.89%, 12.98%), 6.67% (95% CI: 0.87%, 12.81%) and 7.20% (95% CI: 2.35%, 12.29%) increased risk in outpatient visits for all respiratory diseases, asthma, bronchiectasis and pneumonia, respectively. Each association was partially weakened after adjusting for co-pollutants. The effect of ambient CO on respiratory diseases appeared to be greater for females and the elderly. CONCLUSIONS Short-term exposure to ambient CO was associated with increased risk of outpatient visits for respiratory diseases. Our analysis may help to understand the health effects of low-levels of CO and provide evidence for the creation of air quality standards.
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Affiliation(s)
- Yiju Zhao
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan 523905, China
| | - Jianxiong Hu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Zhenwei Tan
- Record Room, The Fifth People's Hospital of Dongguan, Dongguan 523905, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Caiyan Huang
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan 523905, China
| | - Shengyong Wang
- Medical College, Jinan University, Guangzhou 510632, China
| | - Zhao Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Wenjun Ma
- School of Public Health, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
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20
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Wang Y, Yao C, Xu C, Zeng X, Zhou M, Lin Y, Zhang P, Yin P. Carbon monoxide and risk of outpatient visits due to cause-specific diseases: a time-series study in Yichang, China. Environ Health 2019; 18:36. [PMID: 31014335 PMCID: PMC6477706 DOI: 10.1186/s12940-019-0477-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/05/2019] [Indexed: 05/08/2023]
Abstract
BACKGROUND Previous studies showed inconsistent results on risk of increased outpatient visits for cause-specific diseases associated with ambient carbon monoxide (CO). METHODS Daily data for CO exposure and outpatient visits for all-causes and five specific diseases in Yichang, China from 1st January 2016 to 31st December 2017 were collected. Generalised additive models with different lag structures were used to examine the short-term effects of ambient CO on outpatient visits. Potential effect modifications by age, sex and season were examined. RESULTS A total of 5,408,021 outpatient visits were recorded. We found positive and statistically significant associations between CO and outpatient visits for multiple outcomes and all the estimated risks increased with longer moving average lags. An increase of 1 mg/m3 of CO at lag06 (a moving average of lag0 to lag6), was associated with 24.67% (95%CI: 14.48, 34.85%), 21.79% (95%CI: 12.24, 31.35%), 39.30% (95%CI: 25.67, 52.92%), 25.83% (95%CI: 13.91, 37.74%) and 19.04% (95%CI: 8.39, 29.68%) increase in daily outpatient visits for all-cause, respiratory, cardiovascular, genitourinary and gastrointestinal diseases respectively. The associations for all disease categories except for genitourinary diseases were statistically significant and stronger in warm seasons than cool seasons. CONCLUSION Our analyses provide evidences that the CO increased the total and cause-specific outpatient visits and strengthen the rationale for further reduction of CO pollution levels in Yichang. Ambient CO exerted adverse effect on respiratory, cardiovascular, genitourinary, gastrointestinal and neuropsychiatric diseases especially in the warm seasons.
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Affiliation(s)
- Yu Wang
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Chengye Yao
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Chengzhong Xu
- Yichang Center for Disease Control and Prevention, 3 Dalian Road, Yichang, 443005 China
| | - Xinying Zeng
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 China
| | - Yun Lin
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Pei Zhang
- Yichang Center for Disease Control and Prevention, 3 Dalian Road, Yichang, 443005 China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 China
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21
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Spatial distribution and toxicity potential of gaseous criteria air pollutants in the ambient air around a typical haulage truck stop. SN APPLIED SCIENCES 2019. [DOI: 10.1007/s42452-019-0373-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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22
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Wang IJ, Yeom SR, Park SW, Lee SH, Han SK, Park SC, Ryu JH, Hwang SY. Poison severity score and sequential organ failure assessment score: Carbon monoxide poisoning prognosis. PLoS One 2019; 14:e0212025. [PMID: 30822313 PMCID: PMC6396897 DOI: 10.1371/journal.pone.0212025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 01/26/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose We aimed to examine the utility of the Poison Severity Score (PSS) and Sequential Organ Failure Assessment (SOFA) score as early prognostic predictors of short-term outcomes in patients with carbon monoxide (CO) poisoning. We hypothesized that both the PSS and the SOFA score would be useful prognostic tools. Methods This was retrospective observational study of patients with CO poisoning who presented to the emergency department and were admitted for more than 24 hours. We calculated PSS, the initial SOFA score, a second (2nd) SOFA score, and a 24-hour delta SOFA score. The primary outcome was reported as the cerebral performance category (CPC) scale score at discharge. We classified those with CPC 1–2 as the good outcome group and those with CPC 3–5 as the poor outcome group. Results This study included 192 patients: 174 (90.6%) belonged to the good outcome group, whereas 18 (9.4%) belonged to the poor outcome group. The PSS (1.00 [0.00, 1.00] vs 3.00 [3.00, 3.00], p < 0.001), initial SOFA (1.00 [0.00, 2.00] vs 4.00 [3.25, 6.00], p < 0.001), 2nd SOFA score (0.00 [0.00, 1.00] vs 4.00 [3.00, 7.00], p < 0.001), and 24-hour delta SOFA score (-1.00 [-1.00, 0.00] vs 0.00 [-1.00, 1.00], p = 0.047) of the good outcome group were significantly higher than those of the poor outcome group. The areas under the receiver operating characteristic curve for PSS and the initial SOFA and 2nd SOFA scores were 0.977 (95% confidence interval [CI] 0.944–0.993), 0.945 (95% CI 0.903–0.973), and 0.978 (95% CI 0.947–0.994), respectively. Conclusion The PSS, initial SOFA score, and 2nd SOFA score predict acute poor outcome accurately in patients with CO poisoning.
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Affiliation(s)
- Il Jae Wang
- Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Seok-Ran Yeom
- Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
- * E-mail:
| | - Sung-Wook Park
- Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Sung-Hwa Lee
- Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Sang-Kyoon Han
- Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Soon-Chang Park
- Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ji-Ho Ryu
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Yangsan, South Korea
| | - Seong-Youn Hwang
- Department of Emergency Medicine, Samsung Changwon Hospital, Gyeongsangnam-do, Changwon, South Korea
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Ates Alkan F, Karis D, Cakmak G, Ercan AM. Analysis of the Relationship Between Hemorheologic Parameters, Aluminum, Manganese, and Selenium in Smokers. Biol Trace Elem Res 2019; 187:22-31. [PMID: 29704205 DOI: 10.1007/s12011-018-1352-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/16/2018] [Indexed: 01/25/2023]
Abstract
Smoking is a significant risk factor in fatal pathologies including cardio-cerebrovascular and respiratory diseases. Aluminum (Al) is a toxic element without known biological function, but with recognized toxic effects. Manganese (Mn) and selenium (Se) are essential trace elements involved in cellular antioxidant defense mechanisms. Al, Mn, and Se carry out their metabolic activities via blood flow and tissue oxygenation. The structure and number of red blood cells (RBC) play important role in tissue oxygenation throughout blood flow. Increased hematocrit (Hct) as a result of probable hypoxia induces disturbed blood flow, RBC aggregation (RBC Agg), RBC deformability index (Tk), and oxygen delivery index (ODI). Therefore, we aimed to investigate the effects of altered Al, Mn, and Se levels on number, structure, and function of RBCs (Hct, blood and plasma viscosity (BV and PV, respectively), RBC Agg, Tk, ODI) in smokers without diagnosis of chronic obstructive pulmonary disease (COPD) in a study group (n = 128) categorized as ex-smokers (ES), smokers (S), and healthy controls (HC). Elements were analyzed in serum using ICP-OES. BV and PV were measured via Brookfield and Harkness viscometers at 37 °C, respectively. Smokers had statistically higher serum Al and Mn levels, BV, RBC, Hgb, Hct, PV, fibrinogen, RBC Agg, Tk45, and pulmonary blood flow rate, but lower serum Se levels and ODI45 values versus HC. In conclusion, increased Al, Mn, and hemorheological parameters and decreased Se and ODI45 might result from inflammatory response in defense mechanism in smokers without diagnosis of COPD. Our results point out that serum Al, Mn, and Se with hemorheological parameters may be beneficial markers of tissue oxygenation and defense mechanism before the clinic onset of COPD in smokers.
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Affiliation(s)
- Fatma Ates Alkan
- Department of Biophysics, Cerrahpasa Medical Faculty, Istanbul University, 34098, Fatih/Istanbul, Turkey.
| | - Denizhan Karis
- Department of Biophysics, Cerrahpasa Medical Faculty, Istanbul University, 34098, Fatih/Istanbul, Turkey
| | - Gulfidan Cakmak
- Department of Respiratory Medicine, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Alev Meltem Ercan
- Department of Biophysics, Cerrahpasa Medical Faculty, Istanbul University, 34098, Fatih/Istanbul, Turkey
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24
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Nandy T, Coutu RA, Ababei C. Carbon Monoxide Sensing Technologies for Next-Generation Cyber-Physical Systems. SENSORS 2018; 18:s18103443. [PMID: 30322155 PMCID: PMC6211057 DOI: 10.3390/s18103443] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Abstract
Carbon monoxide (CO) is a toxic gas, and environmental pollutant. Its detection and control in residential and industrial environments are necessary in order to avoid potentially severe health problems in humans. In this review paper, we discuss the importance of furthering research in CO sensing technologies for finding the proper material with low-range detection ability in very optimum condition. We build our discussion through the perspective of a cyber-physical system (CPS) modeling framework, because it provides a comprehensive framework to model and develop automated solutions for detection and control of poisonous chemical compounds, such as the CO. The most effective CO sensors, then, can be used in CPS network to provide a pathway for real-time monitoring and control in both industrial and household environment. In this paper, first, we discuss the necessity of CO detection, the proposal of a basic CPS framework for modeling and system development, how the CPS-CO model can be beneficiary to the environment, and a general classification of the various CO detection mechanisms. Next, a broad overview emphasizes the sensitivity, selectivity, response and recovery time, low concentration detection ability, effects of external parameters and other specifications that characterize the performance of the sensing methods proposed so far. We will discuss recent studies reported on the use of metal oxide semiconductor (MOS) sensing technologies for the detection of CO. MOS based micro-sensors play an important role in the measurement and monitoring of various trace amounts of CO gas. These sensors are used to sense CO through changes in their electrical properties. In addition to MOS based sensors, optical sensing methods have recently become popular, due to their increased performance. Hence, a brief overview of newly proposed optical based CO detection methods is provided as well.
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Affiliation(s)
- Turja Nandy
- Department of Electrical and Computer Engineering, Marquette University, Milwaukee, WI 53233, USA.
| | - Ronald A Coutu
- Department of Electrical and Computer Engineering, Marquette University, Milwaukee, WI 53233, USA.
| | - Cristinel Ababei
- Department of Electrical and Computer Engineering, Marquette University, Milwaukee, WI 53233, USA.
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Stearns D, Sircar K. National unintentional carbon monoxide poisoning estimates using hospitalization and emergency department data. Am J Emerg Med 2018; 37:421-426. [PMID: 29929888 DOI: 10.1016/j.ajem.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 10/14/2022] Open
Abstract
Unintentional non-fire-related (UNFR) carbon monoxide (CO) poisoning is a leading cause of poisoning in the US and a preventable cause of death. We generated national estimates of accidental CO poisoning and characterized the populations most at risk. UNFR CO poisoning cases were assessed using hospitalization and emergency department (ED) data from the Healthcare Costs and Utilization Project National Inpatient Sample and Nationwide Emergency Department Sample databases. We used hospitalization data from 2003 to 2013 and ED data from 2007 to 2013. We calculated trends using a linear regression of UNFR CO poisonings over the study period and age-adjusted rates using direct standardization and U.S. Census Bureau estimates. During 2003-2013, approximately 14,365 persons (4.1 cases/million annually) with confirmed or probable UNFR CO poisoning were admitted to hospitals and the annual rate of poisonings showed a weak downward trend (p = 0.12). During 2007-2013, approximately 101,847 persons (48.3 visits/million annually) visited the ED and the annual rate of poisonings showed a significant downward trend (p ≤ 0.01). Most UNFR CO hospital cases involved patients who were older (aged 45-64 years), white, male, or living in the South or Midwest. Overall, the rate of hospitalizations did not change over the study period. Unintentional CO poisoning is preventable and these cases represent the most recent national estimates. ED visits declined over the study period, but the hospitalization rates did not change. This emphasizes the need for prevention efforts, such as education in the ED setting, increased use of CO alarms, and proper use and maintenance of fuel-powered household appliances.
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Affiliation(s)
- Dorothy Stearns
- Asthma and Community Health Branch, Division of Environmental Health Sciences and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Chamblee, GA 30341, United States
| | - Kanta Sircar
- Asthma and Community Health Branch, Division of Environmental Health Sciences and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Chamblee, GA 30341, United States.
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26
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Herlihy CR, Barry C. Anesthesia and Burns. Anesthesiology 2018. [DOI: 10.1007/978-3-319-74766-8_78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Liu C, Yin P, Chen R, Meng X, Wang L, Niu Y, Lin Z, Liu Y, Liu J, Qi J, You J, Kan H, Zhou M. Ambient carbon monoxide and cardiovascular mortality: a nationwide time-series analysis in 272 cities in China. Lancet Planet Health 2018; 2:e12-e18. [PMID: 29615203 DOI: 10.1016/s2542-5196(17)30181-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 10/14/2017] [Accepted: 11/28/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Evidence of the acute health effects of ambient carbon monoxide air pollution in developing countries is scarce and mixed. We aimed to evaluate short-term associations between carbon monoxide and daily cardiovascular disease mortality in China. METHODS We did a nationwide time-series analysis in 272 major cities in China from January, 2013, to December, 2015. We extracted daily cardiovascular disease mortality data from China's Disease Surveillance Points system. Data on daily carbon monoxide concentrations for each city were obtained from the National Urban Air Quality Real-time Publishing Platform. City-specific associations between carbon monoxide concentrations and daily mortality from cardiovascular disease, coronary heart disease, and stroke were estimated with over-dispersed generalised linear models. Bayesian hierarchical models were used to obtain national and regional average associations. Exposure-response association curves and potential effect modifiers were evaluated. Two-pollutant models were fit to evaluate the robustness of the effects of carbon monoxide on cardiovascular mortality. FINDINGS The average annual mean carbon monoxide concentration in these cities from 2013 to 2015 was 1·20 mg/m3, ranging from 0·43 mg/m3 to 2·45 mg/m3. For a 1 mg/m3 increase in average carbon monoxide concentrations on the present day and previous day (lag 0-1), we observed significant increments in mortality of 1·12% (95% posterior interval [PI] 0·42-1·83) from cardiovascular disease, 1·75% (0·85-2·66) from coronary heart disease, and 0·88% (0·07-1·69) from stroke. These associations did not vary substantially by city, region, and demographic characteristics (age, sex, and level of education), and the associations for cardiovascular disease and coronary heart disease were robust to the adjustment of criteria co-pollutants. We did not find a threshold below which carbon monoxide exposure had no effect on cardiovascular disease mortality. INTERPRETATION This analysis is, to our knowledge, the largest study done in a developing country, and provides robust evidence of the association between short-term exposure to ambient carbon monoxide and increased cardiovascular disease mortality, especially coronary heart disease mortality. FUNDING Public Welfare Research Program.
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Affiliation(s)
- Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
| | - Xia Meng
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lijun Wang
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Zhijing Lin
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Yunning Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiangmei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinlei Qi
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinling You
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China.
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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Al-Owais MM, Hettiarachchi NT, Kirton HM, Hardy ME, Boyle JP, Scragg JL, Steele DS, Peers C. A key role for peroxynitrite-mediated inhibition of cardiac ERG (Kv11.1) K + channels in carbon monoxide-induced proarrhythmic early afterdepolarizations. FASEB J 2017; 31:4845-4854. [PMID: 28743763 PMCID: PMC5636698 DOI: 10.1096/fj.201700259r] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/05/2017] [Indexed: 12/20/2022]
Abstract
Exposure to CO causes early afterdepolarization arrhythmias. Previous studies in rats have indicated that arrhythmias arose as a result of augmentation of the late Na+ current. The purpose of the present study was to examine the basis for CO-induced arrhythmias in guinea pig myocytes in which action potentials (APs) more closely resemble those of human myocytes. Whole-cell current- and voltage-clamp recordings were made from isolated guinea pig myocytes as well as from human embryonic kidney 293 (HEK293) cells that express wild-type or a C723S mutant form of ether-a-go-go-related gene (ERG; Kv11.1). We also monitored the formation of peroxynitrite (ONOO-) in HEK293 cells fluorimetrically. CO-applied as the CO-releasing molecule, CORM-2-prolonged the APs and induced early afterdepolarizations in guinea pig myocytes. In HEK293 cells, CO inhibited wild-type, but not C723S mutant, Kv11.1 K+ currents. Inhibition was prevented by an antioxidant, mitochondrial inhibitors, or inhibition of NO formation. CO also raised ONOO- levels, an effect that was reversed by the ONOO- scavenger, FeTPPS [5,10,15,20-tetrakis-(4-sulfonatophenyl)-porphyrinato-iron(III)], which also prevented the CO inhibition of Kv11.1 currents and abolished the effects of CO on Kv11.1 tail currents and APs in guinea pig myocytes. Our data suggest that CO induces arrhythmias in guinea pig cardiac myocytes via the ONOO--mediated inhibition of Kv11.1 K+ channels.-Al-Owais, M. M., Hettiarachchi, N. T., Kirton, H. M., Hardy, M. E., Boyle, J. P., Scragg, J. L., Steele, D. S., Peers, C. A key role for peroxynitrite-mediated inhibition of cardiac ERG (Kv11.1) K+ channels in carbon monoxide-induced proarrhythmic early afterdepolarizations.
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Affiliation(s)
- Moza M Al-Owais
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom; and
| | - Nishani T Hettiarachchi
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom; and
| | - Hannah M Kirton
- Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Matthew E Hardy
- Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - John P Boyle
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom; and
| | - Jason L Scragg
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom; and
| | - Derek S Steele
- Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Chris Peers
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom; and
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Eggert E, Huss F. Medical and biological factors affecting mortality in elderly residential fire victims: a narrative review of the literature. Scars Burn Heal 2017; 3:2059513117707686. [PMID: 29799550 PMCID: PMC5965309 DOI: 10.1177/2059513117707686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
For older people (aged over 65 years), the risk of dying in a residential fire is
doubled compared to the general population. Obvious causes of death mainly
include smoke inhalation and burn injuries. That older people are more fragile
and have more concurrent diseases is inherent, but what is it that makes them
more vulnerable? It is known that the number of elderly people is increasing
globally and that the increased risk of death in fires can be explained, at
least in part, by physical and/or cognitive disabilities as well as
socioeconomic and behavioural factors. The possibility that medical illnesses
and an aging organism/tissues might explain this increased risk has not been
shown to the same extent. Therefore, this narrative literature review focuses on
medical and biological explanations. An initial search using the terms
‘elderly’, ‘fatal’, ‘residential’ and ‘fire’ yielded some interesting articles.
Using a broader snowball search also accepting grey literature, several
additional risk factors could be identified. Cardiovascular diseases, in
particular atherosclerotic heart disease, greatly increases the vulnerability
to, for example, carbon monoxide and probably also other asphyxiating gases.
Cardiovascular diseases and lack of physical fitness may also increase
vulnerability to heat. Burned elderly patients are also at a higher risk of
death than younger patients, but it is controversial whether it is age itself or
the pre-existing illnesses that come with age that increase the risk.
Immunosenescence, malnutrition and female gender are other risk factors for
poorer outcome after burns, all of which are common among older people. Elderly people have an increased risk of dying in house fires for several known
reasons. This review explores possible medical/biological explanations and finds
heart disease to be an important explanation.
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Affiliation(s)
- Erik Eggert
- The Burn Center, Department of Plastic- and Maxillofacial Surgery, Uppsala University Hospital, Sweden
| | - Fredrik Huss
- The Burn Center, Department of Plastic- and Maxillofacial Surgery, Uppsala University Hospital, Sweden.,Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden
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Kolecka M, von Pückler K, De Decker S, Cortellini S, Wurtinger G, Schmidt MJ. Magnetic resonance imaging and clinical findings in carbon monoxide intoxication in dogs. A case series. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2017; 45:40-45. [PMID: 27580184 DOI: 10.15654/tpk-160018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/09/2016] [Indexed: 11/13/2022]
Abstract
This paper presents magnetic resonance imaging (MRI) findings of three dogs after carbon monoxide intoxication. In the first and second cases, MRI changes were confined to both caudate nuclei and in the first case also to the putamen as bilaterally symmetric diffuse homogenous T2 and FLAIR hyperintense, T1 hypointense lesions. No contrast enhancement was seen. In the third case MRI revealed multiple areas of hyperintensity bilaterally on T2 and FLAIR as well as ill-defined areas within the frontal, parietal and occipital grey matter. The caudal colliculi, globus pallidus, substantia nigra and central area of the thalamus showed bilaterally hyperintense lesions on T2w and FLAIR with moderate enhancement after intravenous contrast administration.
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Affiliation(s)
- Malgorzata Kolecka
- Malgorzata Kolecka, Klinik für Kleintiere, Department für klinische Veterinärmedizin, Justus-Liebig-Universität Gießen, Frankfurter Straße 108, 35392 Gießen, E-Mail:
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Olujimi OO, Ana GREE, Ogunseye OO, Fabunmi VT. Air quality index from charcoal production sites, carboxyheamoglobin and lung function among occupationally exposed charcoal workers in South Western Nigeria. SPRINGERPLUS 2016; 5:1546. [PMID: 27652119 PMCID: PMC5020008 DOI: 10.1186/s40064-016-3227-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/06/2016] [Indexed: 11/10/2022]
Abstract
Charcoal production is often accompanied with gaseous and particulate emission into the atmosphere and occupationally exposed workers could be affected. This cross sectional comparative study was carried out to assess the levels of carbon monoxide (CO), carbon dioxide (CO2), sulphur dioxide (SO2), nitrogen dioxide (NO2) and particulate matter (PM2.5) generated during the phases of charcoal production and their relationship with certain biomarkers among charcoal workers (subjects) and non-charcoal workers (controls) such as carboxyhaemoglobin (COHb), forced expiratory volume in the first second of expiration (FEV1), peak expiratory flow rate (PEFR) and body mass index (BMI) in Igbo-Ora, Oyo State and Alabata, Ogun State, which are two of the major hubs of charcoal production in South Western Nigeria. Four communities in Igbo-Ora and six communities in Alabata were purposively selected and levels of pollutant gases were assessed using appropriate gas meters, PM2.5 was assessed with Thermo Scientific MIE pDR-1500, FEV1 and PEFR were measured with Piko-1 spirometer while COHb was assessed using non-invasive pulse CO-oximeter (Rad 57). Data were statistically analyzed and results were compared with recommended guidelines. The mean FEV1, PEFR, COHb and BMI for subjects and controls were 2.35 ± 0.73 and 2.69 ± 0.56, 253.72 ± 103.45 and 330.02 ± 94.61 (p < 0.01), 13.28 ± 3.91 and 8.50 ± 3.68 (p < 0.01) and 21.97 ± 2.19 and 23.36 ± 3.74 (p < 0.05) respectively. There was a statistically significant difference between actual and expected values of FEV1 (p < 0.01) and PEFR (p < 0.01) among charcoal workers. There existed a positive correlation between CO and COHb while FEV1 and PEFR correlated negatively with PM2.5. The study showed that charcoal workers are exposed to high levels of CO and PM2.5, contributing to lowered respiratory functions for FEV1 and PEFR and high levels of COHb compared to the control group. Routine respiratory and carboxyheamoglobin assessment of persons involved in charcoal production is also recommended.
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Affiliation(s)
- O O Olujimi
- Department of Environmental Management and Toxicology, Federal University of Agriculture, Abeokuta, Ogun State Nigeria ; Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - G R E E Ana
- Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - O O Ogunseye
- Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - V T Fabunmi
- Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Khadem-Rezaiyan M, Afshari R. Carbon monoxide poisoning in Northeast of Iran. J Forensic Leg Med 2016; 41:1-4. [DOI: 10.1016/j.jflm.2016.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/23/2016] [Accepted: 04/01/2016] [Indexed: 10/22/2022]
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Hampson NB. Myth busting in carbon monoxide poisoning. Am J Emerg Med 2016; 34:295-7. [DOI: 10.1016/j.ajem.2015.10.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 10/26/2015] [Accepted: 10/30/2015] [Indexed: 11/30/2022] Open
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Markandeya , Shukla SP, Kisku GC. A Clean Technology for Future Prospective: Emission Modeling of Gas Based Power Plant. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojap.2016.54011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Albuquerque IMD, Trevisan ME, Pasqualoto AS, Prado ALC, Pereira MB, Badaró AFV. Physical therapy performance in the rehabilitation of survivors of the Kiss nightclub tragedy: an experience report. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.004.ao01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction : As a result of a fire in the Kiss nightclub that occurred in the city of Santa Maria - RS, 242 people were killed, of whom 235 died on the day of the episode, asphyxiated by the inhalation of toxic smoke. Approximately 1,000 more were injured. Objective : To report the experience of a group of physical therapists, professors at the Federal University of Santa Maria (UFSM), in the rehabilitation of survivors of the fire, victims of burns and inhalation injury. Materials and methods : Quantitative and qualitative study, in which an evaluation protocol of physical functional ability was designed to identify rehabilitation needs. Results : Two hundred seventy patients (147 men, mean age 26.72 ± 9.5 years) were examined, of which approximately 70% had some type of clinical modification or functional impairment that indicated the need for rehabilitation. The most prevalent respiratory signs and symptoms were: dry or productive cough (59.2%); abnormal respiratory pace (11.4%); fatigue (35.92%); dyspnea (17.7%); and chest pain (16.6%). Neurological symptoms such as persistent headache (88.51%), memory loss (11.4%), and paresthesia (8.1%) were also reported. Musculoskeletal injuries (14.7%) and extensive burns (8.8%) were also observed. One hundred and eighty-nine patients were referred to outpatient physical therapy and, of these, 22 still remain at the Outpatient Physical Therapy Unit of the University Hospital of (HUSM). Conclusions : Despite the vast professional experience of this group of physical therapists, the situations experienced were unique and unprecedented, both professionally and personally, and reinforced the importance of joining forces within an emergency care unit, as well as the importance of comprehensive and multi-professional outpatient monitoring.
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Boztepe H, Yalaki Z, Bilge YD. Evaluation of neurological and cardiological findings in carbonmonoxide poisoning in children. Turk Arch Pediatr 2015; 49:314-22. [PMID: 26078683 DOI: 10.5152/tpa.2014.201010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 08/11/2014] [Indexed: 11/22/2022]
Abstract
AIM The aim of our study was to investigate the relation of blood carboxyhemoglobin level with presentation finding and clinical properties and to demonstrate neurological and cardiological findings which are indicators of tissue hypoxia in patients followed up because of carbonmonoxide (CO) poisoning. MATERIAL AND METHODS Three hundred and twenty-five patients who were followed up because of carbonmonoxide poisoning between 2011 and 2013 in our pediatric emergency department were evaluated prospectively. Ethics committee approval was obtained for the study on 10.19.2011 (number: 0437). The carbonmonoxide levels, source of intoxication, neurological and cardiological findings and treatment methods were recorded. Blood gases and cardiac enzymes were studied and electrocardiography (ECG) was performed. The data were analysed using SPSS for windows 16.0 package program. RESULTS One hundred and sixty-eight (51.7%) of the patients were female and the median age was 9 years (11 days-17 years). Two hundred and twenty-eight (70.2%) of the patients were poisoned while using heater and 78.1% presented during winter months. The median carbonmonoxide level of the patients was found to be 24.8%. Cardiac enzymes were found to be increased in 10.5% of the patients, first degree A-V block was found in 0.6% and negative T wave was found in 0.3%. Glasgow coma score was found to be below 14 in 4.6% of the patients. A significant correlation was found between the carboxyhemoglobin levels and neurological findings, cardiological findings and lactate (p<0.05). Normobaric oxygen treatment was given to 76.3% of the patients and hyperbaric oxygen treatment was given to 23.7%. CONCLUSIONS We think that neurological disorders and cardiac findings may be closely related, since systemic involvement may be easier in carbonmonoxide poisoning in children, Glasgow coma score should be assessed in the follow-up of the patients and cardiac enzymes and serum lactate levels should be monitored closely from the time of presentation.
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Affiliation(s)
- Hatice Boztepe
- Clinic of Pediatrics, Ankara Education and Research Hospital, Ankara, Turkey
| | - Zahide Yalaki
- Clinic of Pediatrics, Ankara Education and Research Hospital, Ankara, Turkey
| | - Yıldız Dallar Bilge
- Clinic of Pediatrics, Ankara Education and Research Hospital, Ankara, Turkey
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Zhao H, Liu B, Zhang Q, Wu X, Yu Y, Jesse FF, Li L. Carbon monoxide augments electrical signaling in cultured neural networks of hippocampal neurons partly through activation of BKCa channels. Acta Biochim Biophys Sin (Shanghai) 2015; 47:383-9. [PMID: 25841440 DOI: 10.1093/abbs/gmv017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/30/2015] [Indexed: 02/04/2023] Open
Abstract
Carbon monoxide (CO) is often viewed as a lethal gas in light of its capacity to prevent oxygen uptake in hemoglobin; however, it also functions to regulate a variety of proteins and physiological processes. Here we show that CO is an important chemical cue, to which neurons respond strongly, and this response is then integrated into neural network activity. In cultured mouse hippocampal neurons, CO enhanced synchronized spontaneous cytosolic Ca(2+) oscillations which arose from periodic action potentials through synaptic transmission. We used single-cell patch-clamp recording to investigate the neural network. Our results showed that the frequency of spontaneous and miniature post synaptic current was increased in neurons cultured for 14-18 days after addition of CO, with no change in current amplitude. BK channels have recently been demonstrated to be important in the action of CO. Our results showed that the effect of CO on neural network electrical activity was partly abolished after blocking the BK channels. Altogether, our results suggest that CO can influence neural network electrical activity and that BK channels participate in this regulation process.
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Affiliation(s)
- Hucheng Zhao
- Institute of Man-Machine and Environmental Engineering, School of Aerospace, Tsinghua University, Beijing 100084, China
| | - Bailin Liu
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Quanyou Zhang
- Institute of Man-Machine and Environmental Engineering, School of Aerospace, Tsinghua University, Beijing 100084, China
| | - Xiao'an Wu
- Institute of Man-Machine and Environmental Engineering, School of Aerospace, Tsinghua University, Beijing 100084, China
| | - Yang Yu
- Institute of Man-Machine and Environmental Engineering, School of Aerospace, Tsinghua University, Beijing 100084, China
| | - Forrest Fabian Jesse
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, China
| | - Luming Li
- Institute of Man-Machine and Environmental Engineering, School of Aerospace, Tsinghua University, Beijing 100084, China
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38
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Peers C, Boyle JP, Scragg JL, Dallas ML, Al-Owais MM, Hettiarachichi NT, Elies J, Johnson E, Gamper N, Steele DS. Diverse mechanisms underlying the regulation of ion channels by carbon monoxide. Br J Pharmacol 2015; 172:1546-56. [PMID: 24818840 PMCID: PMC4369263 DOI: 10.1111/bph.12760] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/14/2014] [Accepted: 04/21/2014] [Indexed: 12/19/2022] Open
Abstract
Carbon monoxide (CO) is firmly established as an important, physiological signalling molecule as well as a potent toxin. Through its ability to bind metal-containing proteins, it is known to interfere with a number of intracellular signalling pathways, and such actions can account for its physiological and pathological effects. In particular, CO can modulate the intracellular production of reactive oxygen species, NO and cGMP levels, as well as regulate MAPK signalling. In this review, we consider ion channels as more recently discovered effectors of CO signalling. CO is now known to regulate a growing number of different ion channel types, and detailed studies of the underlying mechanisms of action are revealing unexpected findings. For example, there are clear areas of contention surrounding its ability to increase the activity of high conductance, Ca(2+) -sensitive K(+) channels. More recent studies have revealed the ability of CO to inhibit T-type Ca(2+) channels and have unveiled a novel signalling pathway underlying tonic regulation of this channel. It is clear that the investigation of ion channels as effectors of CO signalling is in its infancy, and much more work is required to fully understand both the physiological and the toxic actions of this gas. Only then can its emerging use as a therapeutic tool be fully and safely exploited.
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Affiliation(s)
- C Peers
- Division of Cardiovascular and Diabetes Research, LIGHT, Faculty of Medicine and Health, University of LeedsLeeds, UK
| | - J P Boyle
- Division of Cardiovascular and Diabetes Research, LIGHT, Faculty of Medicine and Health, University of LeedsLeeds, UK
| | - J L Scragg
- Division of Cardiovascular and Diabetes Research, LIGHT, Faculty of Medicine and Health, University of LeedsLeeds, UK
| | - M L Dallas
- School of Pharmacy, University of ReadingReading, UK
| | - M M Al-Owais
- Division of Cardiovascular and Diabetes Research, LIGHT, Faculty of Medicine and Health, University of LeedsLeeds, UK
| | - N T Hettiarachichi
- Division of Cardiovascular and Diabetes Research, LIGHT, Faculty of Medicine and Health, University of LeedsLeeds, UK
| | - J Elies
- Division of Cardiovascular and Diabetes Research, LIGHT, Faculty of Medicine and Health, University of LeedsLeeds, UK
| | - E Johnson
- Division of Cardiovascular and Diabetes Research, LIGHT, Faculty of Medicine and Health, University of LeedsLeeds, UK
| | - N Gamper
- Faculty of Biological Sciences, University of LeedsLeeds, UK
| | - D S Steele
- Faculty of Biological Sciences, University of LeedsLeeds, UK
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Elies J, Dallas ML, Boyle JP, Scragg JL, Duke A, Steele DS, Peers C. Inhibition of the cardiac Na⁺ channel Nav1.5 by carbon monoxide. J Biol Chem 2014; 289:16421-9. [PMID: 24719320 PMCID: PMC4047409 DOI: 10.1074/jbc.m114.569996] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Indexed: 11/17/2022] Open
Abstract
Sublethal carbon monoxide (CO) exposure is frequently associated with myocardial arrhythmias, and our recent studies have demonstrated that these may be attributable to modulation of cardiac Na(+) channels, causing an increase in the late current and an inhibition of the peak current. Using a recombinant expression system, we demonstrate that CO inhibits peak human Nav1.5 current amplitude without activation of the late Na(+) current observed in native tissue. Inhibition was associated with a hyperpolarizing shift in the steady-state inactivation properties of the channels and was unaffected by modification of channel gating induced by anemone toxin (rATX-II). Systematic pharmacological assessment indicated that no recognized CO-sensitive intracellular signaling pathways appeared to mediate CO inhibition of Nav1.5. Inhibition was, however, markedly suppressed by inhibition of NO formation, but NO donors did not mimic or occlude channel inhibition by CO, indicating that NO alone did not account for the actions of CO. Exposure of cells to DTT immediately before CO exposure also dramatically reduced the magnitude of current inhibition. Similarly, l-cysteine and N-ethylmaleimide significantly attenuated the inhibition caused by CO. In the presence of DTT and the NO inhibitor N(ω)-nitro-L-arginine methyl ester hydrochloride, the ability of CO to inhibit Nav1.5 was almost fully prevented. Our data indicate that inhibition of peak Na(+) current (which can lead to Brugada syndrome-like arrhythmias) occurs via a mechanism distinct from induction of the late current, requires NO formation, and is dependent on channel redox state.
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Affiliation(s)
- Jacobo Elies
- From the Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, Faculty of Medicine and Health and
| | - Mark L Dallas
- From the Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, Faculty of Medicine and Health and
| | - John P Boyle
- From the Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, Faculty of Medicine and Health and
| | - Jason L Scragg
- From the Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, Faculty of Medicine and Health and
| | - Adrian Duke
- Institute of Membrane and Systems Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Derek S Steele
- Institute of Membrane and Systems Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Chris Peers
- From the Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, Faculty of Medicine and Health and
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Antonio ACP, Castro PS, Freire LO. Smoke inhalation injury during enclosed-space fires: an update. J Bras Pneumol 2014; 39:373-81. [PMID: 23857686 PMCID: PMC4075838 DOI: 10.1590/s1806-37132013000300016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 04/25/2013] [Indexed: 11/22/2022] Open
Abstract
In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection.
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Tsai CF, Yip PK, Chen SY, Lin JC, Yeh ZT, Kung LY, Wang CY, Fan YM. The impacts of acute carbon monoxide poisoning on the brain: Longitudinal clinical and 99mTc ethyl cysteinate brain SPECT characterization of patients with persistent and delayed neurological sequelae. Clin Neurol Neurosurg 2014; 119:21-7. [PMID: 24635920 DOI: 10.1016/j.clineuro.2014.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 12/21/2013] [Accepted: 01/04/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Acute carbon monoxide (CO) poisoning poses a significant threat to the central nervous system. It can cause brain injury and diverse neurological deficits including persistent neurological sequelae (PNS) and delayed neurological sequelae (DNS). The study aimed to investigate the long-term impacts of acute CO poisoning on brain perfusion and neurological function, and to explore potential differences between PNS and DNS patients. METHODS We evaluated brain perfusion using (99m)Tc ethyl cysteinate (ECD) brain single photon emission computed tomography (SPECT) and assessed clinical neurological symptoms and signs one month following acute poisoning. For DNS patients, ECD SPECT and clinical evaluation were performed when their delayed symptoms appeared. All patients had follow-up SPECT imaging, along with clinical assessments six months following poisoning. RESULTS 12 PNS and 12 DNS patients were recruited between 2007 and 2010. Clinically, the main characteristic presentations were cognitive decline, emotional instability, and gait disturbance. SPECT imaging demonstrated consistent frontal hypoperfusion of varying severities in all patients, which decreased in severity at follow-up imaging. DNS patients usually had more severe symptoms and perfusion defects, along with worse clinical outcomes than the PNS group. CONCLUSION These results suggest that acute CO poisoning might lead to long term brain injuries and neurological sequelae, particularly in DNS patients.
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Affiliation(s)
- Chung-Fen Tsai
- Department of Neurology, Cardinal Tien Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
| | - Ping-Keung Yip
- Department of Neurology, Cardinal Tien Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Shao-Yuan Chen
- Department of Hyperbaric Medicine, Cardinal Tien Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Jen-Cheng Lin
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Zai-Ting Yeh
- Department of Clinical Psychology, Fu-Jen Catholic University, Taipei, Taiwan
| | - Lan-Yu Kung
- Department of Hyperbaric Medicine, Cardinal Tien Hospital, Taipei, Taiwan
| | - Cheng-Yi Wang
- Department of Chest Medicine, Cardinal Tien Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Yu-Ming Fan
- Department of Nuclear Medicine, Cardinal Tien Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
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Role of physiotherapy in the rehabilitation of survivors of the Kiss nightclub tragedy in Santa Maria, Brazil. Physiotherapy 2013; 99:269-70. [DOI: 10.1016/j.physio.2013.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/19/2013] [Indexed: 11/21/2022]
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Erenler AK, Yardan T, Baydin A, Gunay M, Amanvermez R. Heart-type fatty acid-binding protein as a potential biomarker of acute carbon monoxide poisoning. Am J Emerg Med 2013; 31:1165-9. [PMID: 23809096 DOI: 10.1016/j.ajem.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/28/2013] [Accepted: 04/02/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the role of serum heart-type fatty acid-binding protein (H-FABP) in the evaluation of patients with carbon monoxide (CO) poisoning. METHODS Forty patients with acute CO poisoning admitted to the emergency department and 15 healthy adults as the control group were included in the study. Serum H-FABP levels of patients were studied on admission and at the 6th, 12th, and 18th hours. Patients were divided into 3 groups according to clinical severity as mild, moderate, and severe. Patients were also divided into 2 groups according to treatment with hyperbaric oxygen (HBO) or normobaric oxygen. RESULTS Serum H-FABP levels of the patients were higher than those of the control group. There was a negative correlation between H-FABP levels and Glasgow Coma Scale score on admission. Heart-type fatty acid-binding protein levels were significantly higher in patients in the severe compared with mild group. Heart-type fatty acid-binding protein levels in patients treated with HBO were significantly higher than in those treated with normobaric oxygen. The cutoff value of serum H-FABP as an indicator for HBO treatment was determined as 1.5 ng/mL or higher, with a sensitivity of 85.7% and specificity of 69.7%. Serial measurement revealed that H-FABP level peaked at the sixth hour and reduced over time but remained higher than in the control group at the 18th hour. CONCLUSION Heart-type fatty acid-binding protein may be a promising novel biomarker in the evaluation of clinical severity and in the selection of patients for HBO therapy in acute CO poisoning.
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Affiliation(s)
- Ali Kemal Erenler
- Hitit University, Çorum Education and Research Hospital, Department of Emergency Medicine, Çorum, Turkey
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Abstract
Carbon monoxide (CO) poisoning is the leading cause of death as a result of unintentional poisoning in the United States. CO toxicity is the result of a combination of tissue hypoxia-ischemia secondary to carboxyhemoglobin formation and direct CO-mediated damage at a cellular level. Presenting symptoms are mostly nonspecific and depend on the duration of exposure and levels of CO. Diagnosis is made by prompt measurement of carboxyhemoglobin levels. Treatment consists of the patient's removal from the source of exposure and the immediate administration of 100% supplemental oxygen in addition to aggressive supportive measures. The use of hyperbaric oxygen is controversial.
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Dalko E, Gaudreault V, Sanchez Dardon J, Moreau R, Scorza T. Preconditioning with hemin decreases Plasmodium chabaudi adami parasitemia and inhibits erythropoiesis in BALB/c mice. PLoS One 2013; 8:e54744. [PMID: 23358441 PMCID: PMC3554635 DOI: 10.1371/journal.pone.0054744] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 12/14/2012] [Indexed: 01/03/2023] Open
Abstract
Increased susceptibility to bacterial and viral infections and dysfunctional erythropoiesis are characteristic of malaria and other hemolytic hemoglobinopathies. High concentrations of free heme are common in these conditions but little is known about the effect of heme on adaptive immunity and erythropoiesis. Herein, we investigated the impact of heme (hemin) administration on immune parameters and steady state erythropoiesis in BALB/c mice, and on parasitemia and anemia during Plasmodium chabaudi adami infection. Intra-peritoneal injection of hemin (5 mg/Kg body weight) over three consecutive days decreased the numbers of splenic and bone marrow macrophages, IFN-γ responses to CD3 stimulation and T(h)1 differentiation. Our results show that the numbers of erythroid progenitors decreased in the bone marrow and spleen of mice treated with hemin, which correlated with reduced numbers of circulating reticulocytes, without affecting hemoglobin concentrations. Although blunted IFN-γ responses were measured in hemin-preconditioned mice, the mice developed lower parasitemia following P.c.adami infection. Importantly, anemia was exacerbated in hemin-preconditioned mice with malaria despite the reduced parasitemia. Altogether, our data indicate that free heme has dual effects on malaria pathology.
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Affiliation(s)
- Esther Dalko
- Basic and Clinical Immunology of Parasitic Diseases Group, Centre for Infection and Immunity of Lille and Institut National de la Santé et de la Recherche Médicale U547, Institut Pasteur de Lille, Lille, France
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Véronique Gaudreault
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Jaime Sanchez Dardon
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Robert Moreau
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Tatiana Scorza
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
- * E-mail:
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Peers C. Modulation of ion channels and transporters by carbon monoxide: causes for concern? Front Physiol 2012; 3:477. [PMID: 23267333 PMCID: PMC3526770 DOI: 10.3389/fphys.2012.00477] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 12/05/2012] [Indexed: 01/12/2023] Open
Affiliation(s)
- Chris Peers
- Faculty of Medicine and Health, University of LeedsClarendon Way, Leeds, UK
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Reboul C, Thireau J, Meyer G, André L, Obert P, Cazorla O, Richard S. Carbon monoxide exposure in the urban environment: An insidious foe for the heart? Respir Physiol Neurobiol 2012; 184:204-12. [DOI: 10.1016/j.resp.2012.06.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 06/05/2012] [Accepted: 06/06/2012] [Indexed: 12/20/2022]
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Dallas ML, Yang Z, Boyle JP, Boycott HE, Scragg JL, Milligan CJ, Elies J, Duke A, Thireau J, Reboul C, Richard S, Bernus O, Steele DS, Peers C. Carbon monoxide induces cardiac arrhythmia via induction of the late Na+ current. Am J Respir Crit Care Med 2012; 186:648-56. [PMID: 22822026 PMCID: PMC3622900 DOI: 10.1164/rccm.201204-0688oc] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 07/10/2012] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Clinical reports describe life-threatening cardiac arrhythmias after environmental exposure to carbon monoxide (CO) or accidental CO poisoning. Numerous case studies describe disruption of repolarization and prolongation of the QT interval, yet the mechanisms underlying CO-induced arrhythmias are unknown. OBJECTIVES To understand the cellular basis of CO-induced arrhythmias and to identify an effective therapeutic approach. METHODS Patch-clamp electrophysiology and confocal Ca(2+) and nitric oxide (NO) imaging in isolated ventricular myocytes was performed together with protein S-nitrosylation to investigate the effects of CO at the cellular and molecular levels, whereas telemetry was used to investigate effects of CO on electrocardiogram recordings in vivo. MEASUREMENTS AND MAIN RESULTS CO increased the sustained (late) component of the inward Na(+) current, resulting in prolongation of the action potential and the associated intracellular Ca(2+) transient. In more than 50% of myocytes these changes progressed to early after-depolarization-like arrhythmias. CO elevated NO levels in myocytes and caused S-nitrosylation of the Na(+) channel, Na(v)1.5. All proarrhythmic effects of CO were abolished by the NO synthase inhibitor l-NAME, and reversed by ranolazine, an inhibitor of the late Na(+) current. Ranolazine also corrected QT variability and arrhythmias induced by CO in vivo, as monitored by telemetry. CONCLUSIONS Our data indicate that the proarrhythmic effects of CO arise from activation of NO synthase, leading to NO-mediated nitrosylation of Na(V)1.5 and to induction of the late Na(+) current. We also show that the antianginal drug ranolazine can abolish CO-induced early after-depolarizations, highlighting a novel approach to the treatment of CO-induced arrhythmias.
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Affiliation(s)
- Mark L. Dallas
- Division of Cardiovascular Medicine, Faculty of Medicine and Health, and
| | - Zhaokang Yang
- Institute of Membrane and Systems Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - John P. Boyle
- Division of Cardiovascular Medicine, Faculty of Medicine and Health, and
| | - Hannah E. Boycott
- Division of Cardiovascular Medicine, Faculty of Medicine and Health, and
| | - Jason L. Scragg
- Division of Cardiovascular Medicine, Faculty of Medicine and Health, and
| | - Carol J. Milligan
- Institute of Membrane and Systems Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Jacobo Elies
- Division of Cardiovascular Medicine, Faculty of Medicine and Health, and
| | - Adrian Duke
- Institute of Membrane and Systems Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Jérôme Thireau
- Inserm U1046, Physiologie et Médecine Expérimentale du Coeur et des Muscles, CHU Arnaud de Villeneuve, Montpellier, France; and
| | - Cyril Reboul
- Laboratoire de Pharm-écologie Cardiovasculaire, Faculté des Sciences, Avignon, France
| | - Sylvain Richard
- Inserm U1046, Physiologie et Médecine Expérimentale du Coeur et des Muscles, CHU Arnaud de Villeneuve, Montpellier, France; and
| | - Olivier Bernus
- Institute of Membrane and Systems Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Derek S. Steele
- Institute of Membrane and Systems Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Chris Peers
- Division of Cardiovascular Medicine, Faculty of Medicine and Health, and
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Chen Z, Yang S, Xing D. In vivo detection of hemoglobin oxygen saturation and carboxyhemoglobin saturation with multiwavelength photoacoustic microscopy. OPTICS LETTERS 2012; 37:3414-6. [PMID: 23381275 DOI: 10.1364/ol.37.003414] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A method for noninvasively detecting hemoglobin oxygen saturation (SO2) and carboxyhemoglobin saturation (SCO) in subcutaneous microvasculature with multiwavelength photoacoustic microscopy is presented. Blood samples mixed with different concentrations of carboxyhemoglobin were used to test the feasibility and accuracy of photoacoustic microscopy compared with the blood-gas analyzer. Moreover, fixed-point detection of SO2 and SCO in mouse ear was obtained, and the changes from normoxia to carbon monoxide hypoxia were dynamically monitored in vivo. Experimental results demonstrate that multiwavelength photoacoustic microscopy can detect SO2 and SCO, which has future potential clinical applications.
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Affiliation(s)
- Zhongjiang Chen
- MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China
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Mohankumar TS, Kanchan T, Pinakini KS, Menezes RG, Singh M, Sirohi P, Anwar N. Gas geyser--a cause of fatal domestic carbon monoxide poisoning. J Forensic Leg Med 2012; 19:490-3. [PMID: 23084315 DOI: 10.1016/j.jflm.2012.02.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 12/31/2011] [Accepted: 02/14/2012] [Indexed: 11/29/2022]
Abstract
Carbon monoxide is responsible for a large number of accidental domestic poisoning and deaths throughout the world. Domestic carbon monoxide poisoning is rarely reported in India and remains an under recognized problem. The diagnosis of carbon monoxide poisoning is usually based on autopsy findings, circumstantial evidence and estimation of carboxy-haemoglobin in blood. We report a case of fatal accidental carbon monoxide poisoning in a bathroom where an LPG gas water heater was installed recently. Cherry pink discolouration of the body and organs on autopsy suggested carbon monoxide poisoning. Laboratory analysis of blood by UV visible spectrophotometry revealed presence of dangerous levels of carboxy-haemoglobin. Effective preventive measures can help in bringing down the mortality and morbidity associated with carbon monoxide poisoning.
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Affiliation(s)
- T S Mohankumar
- Department of Forensic Medicine and Toxicology, JJM Medical College, Davangere, India
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