1
|
Matthaios VN, Holland I, Kang CM, Hart JE, Hauptman M, Wolfson JM, Gaffin JM, Phipatanakul W, Gold DR, Koutrakis P. The effects of urban green space and road proximity to indoor traffic-related PM 2.5, NO 2, and BC exposure in inner-city schools. J Expo Sci Environ Epidemiol 2024:10.1038/s41370-024-00669-8. [PMID: 38615139 DOI: 10.1038/s41370-024-00669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Since there are known adverse health impacts of traffic-related air pollution, while at the same time there are potential health benefits from greenness, it is important to examine more closely the impacts of these factors on indoor air quality in urban schools. OBJECTIVE This study investigates the association of road proximity and urban greenness to indoor traffic-related fine particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in inner-city schools. METHODS PM2.5, NO2, and BC were measured indoors at 74 schools and outdoors at a central urban over a 10-year period. Seasonal urban greenness was estimated using the Normalized Difference Vegetation Index (NDVI) with 270 and 1230 m buffers. The associations between indoor traffic-related air pollution and road proximity and greenness were investigated with mixed-effects models. RESULTS The analysis showed linear decays of indoor traffic-related PM2.5, NO2, and BC by 60%, 35%, and 22%, respectively for schools located at a greater distance from major roads. The results further showed that surrounding school greenness at 270 m buffer was significantly associated (p < 0.05) with lower indoor traffic-related PM2.5: -0.068 (95% CI: -0.124, -0.013), NO2: -0.139 (95% CI: -0.185, -0.092), and BC: -0.060 (95% CI: -0.115, -0.005). These associations were stronger for surrounding greenness at a greater distance from the schools (buffer 1230 m) PM2.5: -0.101 (95% CI: -0.156, -0.046) NO2: -0.122 (95% CI: -0.169, -0.075) BC: -0.080 (95% CI: -0.136, -0.026). These inverse associations were stronger after fully adjusting for regional pollution and meteorological conditions. IMPACT STATEMENT More than 90% of children under the age of 15 worldwide are exposed to elevated air pollution levels exceeding the WHO's guidelines. The study investigates the impact that urban infrastructure and greenness, in particular green areas and road proximity, have on indoor exposures to traffic-related PM2.5, NO2, and BC in inner-city schools. By examining a 10-year period the study provides insights for air quality management, into how road proximity and greenness at different buffers from the school locations can affect indoor exposure.
Collapse
Affiliation(s)
- V N Matthaios
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Department of Public Health Policy and Systems, University of Liverpool, Liverpool, UK.
| | - I Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, USA
| | - C M Kang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - M Hauptman
- Harvard Medical School, Boston, MA, USA
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - J M Wolfson
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J M Gaffin
- Harvard Medical School, Boston, MA, USA
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | - W Phipatanakul
- Harvard Medical School, Boston, MA, USA
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
| | - D R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - P Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
2
|
Borchert W, Grady ST, Chen J, DeVille NV, Roscoe C, Chen F, Mita C, Holland I, Wilt GE, Hu CR, Mehta U, Nethery RC, Albert CM, Laden F, Hart JE. Air Pollution and Temperature: a Systematic Review of Ubiquitous Environmental Exposures and Sudden Cardiac Death. Curr Environ Health Rep 2023; 10:490-500. [PMID: 37845484 PMCID: PMC11016309 DOI: 10.1007/s40572-023-00414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE OF REVIEW Environmental exposures have been associated with increased risk of cardiovascular mortality and acute coronary events, but their relationship with out-of-hospital cardiac arrest (OHCA) and sudden cardiac death (SCD) remains unclear. SCD is an important contributor to the global burden of cardiovascular disease worldwide. RECENT FINDINGS Current literature suggests a relationship between environmental exposures and cardiovascular disease, but their relationship with OHCA/SCD remains unclear. A literature search was conducted in PubMed, Embase, Web of Science, and Global Health. Of 5138 studies identified by our literature search, this review included 30 studies on air pollution, 42 studies on temperature, 6 studies on both air pollution and temperature, and 1 study on altitude exposure and OHCA/SCD. Particulate matter air pollution, ozone, and both hot and cold temperatures are associated with increased risk of OHCA/SCD. Pollution and other exposures related to climate change play an important role in OHCA/SCD incidence.
Collapse
Affiliation(s)
- William Borchert
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA.
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Stephanie T Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Jie Chen
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicole V DeVille
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Charlotte Roscoe
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Futu Chen
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
| | - Carol Mita
- Countway Library, Harvard Medical School, Boston, MA, USA
| | - Isabel Holland
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Grete E Wilt
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Cindy R Hu
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Unnati Mehta
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel C Nethery
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
- Division of Preventative Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
DeVille NV, Iyer HS, Holland I, Bhupathiraju SN, Chai B, James P, Kawachi I, Laden F, Hart JE. Neighborhood socioeconomic status and mortality in the nurses' health study (NHS) and the nurses' health study II (NHSII). Environ Epidemiol 2023; 7:e235. [PMID: 36777531 PMCID: PMC9916023 DOI: 10.1097/ee9.0000000000000235] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022] Open
Abstract
Few studies have prospectively examined long-term associations between neighborhood socioeconomic status (nSES) and mortality risk, independent of demographic and lifestyle risk factors. Methods We assessed associations between nSES and all-cause, nonaccidental mortality among women in the Nurses' Health Study (NHS) 1986-2014 (N = 101,701) and Nurses' Health Study II (NHSII) 1989-2015 (N = 101,230). Mortality was ascertained from the National Death Index (NHS: 19,228 deaths; NHSII: 1556 deaths). Time-varying nSES was determined for the Census tract of each residential address. We used principal component analysis (PCA) to identify nSES variable groups. Multivariable Cox proportional hazards models were conditioned on age and calendar period and included time-varying demographic, lifestyle, and individual SES factors. Results For NHS, hazard ratios (HRs) comparing the fifth to first nSES quintiles ranged from 0.89 (95% confidence interval [CI] = 0.84, 0.94) for percent of households receiving interest/dividends, to 1.11 (95% CI = 1.06, 1.17) for percent of households receiving public assistance income. In NHSII, HRs ranged from 0.72 (95% CI: 0.58, 0.88) for the percent of households receiving interest/dividends, to 1.27 (95% CI: 1.07, 1.49) for the proportion of households headed by a single female. PCA revealed three constructs: education/income, poverty/wealth, and racial composition. The racial composition construct was associated with mortality (HRNHS: 1.03; 95% CI = 1.01, 1.04). Conclusion In two cohorts with extensive follow-up, individual nSES variables and PCA component scores were associated with mortality. nSES is an important population-level predictor of mortality, even among a cohort of women with little individual-level variability in SES.
Collapse
Affiliation(s)
- Nicole V. DeVille
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas School of Public Health, Las Vegas, Naveda
| | - Hari S. Iyer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shilpa N. Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Boyang Chai
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
4
|
Xu Y, Chen JT, Holland I, Yanosky JD, Liao D, Coull BA, Wang D, Rexrode K, Whitsel EA, Wellenius GA, Laden F, Hart JE. Analysis of long- and medium-term particulate matter exposures and stroke in the US-based Health Professionals Follow-up Study. Environ Epidemiol 2021; 5:e178. [PMID: 34909558 PMCID: PMC8663831 DOI: 10.1097/ee9.0000000000000178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/14/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Stroke is a leading cause of mortality worldwide, and air pollution is the third largest contributor to global stroke burden. Existing studies investigating the association between long-term exposure to particulate matter (PM) and stroke incidence have been mixed and very little is known about the associations with medium-term exposures. Therefore, we wanted to evaluate these associations in an cohort of male health professionals. METHODS We assessed the association of PM exposures in the previous 1 and 12 months with incident total, ischemic, and hemorrhagic stroke in 49,603 men in the prospective US-based Health Professionals' Follow-up Study 1988-2007. We used spatiotemporal prediction models to estimate monthly PM less than 10 (PM10) and less than 2.5 (PM2.5), and PM2.5-10 at all mailing addresses. We used time-varying Cox proportional hazards models adjusted for potential confounders based on previous literature to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each 10-μg/m3 increase in exposure in the preceding 1 and 12 months. We explored possible effect modification by age, obesity, smoking, aspirin use, diet quality, physical activity, diabetes, and Census region. RESULTS We observed 1,467 cases of incident stroke. Average levels of 12-month PM10, PM2.5-10, and PM2.5 were 20.7, 8.4, and 12.3 µg/m3, respectively. In multivariable adjusted models, we did not observe consistent associations between PM and overall or ischemic stroke. There was a suggestion of increased risk of hemorrhagic stroke (12-month PM10 multivariable HR: 1.13 [0.86, 1.48]; PM2.5-10: 1.12 [0.78, 1.62]; PM2.5:1.17 [0.76, 1.81], all per 10 µg/m3). There was little evidence of effect modification. CONCLUSIONS We observed only weak evidence of an association between long-term exposure to PM and risks of overall incident stroke. There was a suggestion of increasing hemorrhagic stroke risk.
Collapse
Affiliation(s)
- Yenan Xu
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
| | - Jarvis T. Chen
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Jeff D. Yanosky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Brent A. Coull
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA
| | - Dong Wang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Kathryn Rexrode
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Gregory A. Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
5
|
Hart JE, Hohensee C, Laden F, Holland I, Whitsel EA, Wellenius GA, Winkelmayer WC, Sarto GE, Warsinger Martin L, Manson JE, Greenland P, Kaufman J, Albert C, Perez MV. Long-Term Exposures to Air Pollution and the Risk of Atrial Fibrillation in the Women's Health Initiative Cohort. Environ Health Perspect 2021; 129:97007. [PMID: 34523977 PMCID: PMC8442602 DOI: 10.1289/ehp7683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is associated with substantial morbidity and mortality. Short-term exposures to air pollution have been associated with AF triggering; less is known regarding associations between long-term air pollution exposures and AF incidence. OBJECTIVES Our objective was to assess the association between long-term exposures to air pollution and distance to road on incidence of AF in a cohort of U.S. women. METHODS We assessed the association of high resolution spatiotemporal model predictions of long-term exposures to particulate matter (PM 10 and PM 2.5 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), and distance to major roads with incidence of AF diagnosis, identified through Medicare linkage, among 83,117 women in the prospective Women's Health Initiative cohort, followed from enrollment in Medicare through December 2012, incidence of AF, or death. Using time-varying Cox proportional hazards models adjusted for age, race/ethnicity, study component, body mass index, physical activity, menopausal hormone therapy, smoking, diet quality, alcohol consumption, educational attainment, and neighborhood socioeconomic status, we estimated the relative risk of incident AF in association with each pollutant. RESULTS A total of 16,348 incident AF cases were observed over 660,236 person-years of follow-up. Most exposure-response associations were nonlinear. NO 2 was associated with risk of AF in multivariable adjusted models [Hazard Ratio ( HR ) = 1.18 ; 95% confidence interval (CI): 1.13, 1.24, comparing the top to bottom quartile, p -for-trend = < 0.0001 ]. Women living closer to roadways were at higher risk of AF (e.g., HR = 1.07 ; 95% CI: 1.01, 1.13 for living within 50 m of A3 roads, compared with ≥ 1,000 m , p -for-trend = 0.02 ), but we did not observe adverse associations with exposures to PM 10 , PM 2.5 , or SO 2 . There were adverse associations with PM 10 (top quartile HR = 1.10 ; 95% CI: 1.05, 1.16, p -for-trend = < 0.0001 ) and PM 2.5 (top quartile HR = 1.09 ; 95% CI: 1.03, 1.14, p -for-trend = 0.002 ) in sensitivity models adjusting for census region. DISCUSSION In this study of postmenopausal women, NO 2 and distance to road were consistently associated with higher risk of AF. https://doi.org/10.1289/EHP7683.
Collapse
Affiliation(s)
- Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Chancellor Hohensee
- Women’s Health Initiative Clinical Coordinating Center, Division of Public Health, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Gregory A. Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Wolfgang C. Winkelmayer
- Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, Texas, USA
| | - Gloria E. Sarto
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Lisa Warsinger Martin
- Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - JoAnn E. Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Philip Greenland
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Joel Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Christine Albert
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Cardiology, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Marco V. Perez
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California, USA
| |
Collapse
|
6
|
Klompmaker JO, Hart JE, Holland I, Sabath MB, Wu X, Laden F, Dominici F, James P. County-level exposures to greenness and associations with COVID-19 incidence and mortality in the United States. Environ Res 2021; 199:111331. [PMID: 34004166 PMCID: PMC8123933 DOI: 10.1016/j.envres.2021.111331] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND COVID-19 is an infectious disease that has killed more than 555,000 people in the US. During a time of social distancing measures and increasing social isolation, green spaces may be a crucial factor to maintain a physically and socially active lifestyle while not increasing risk of infection. OBJECTIVES We evaluated whether greenness was related to COVID-19 incidence and mortality in the US. METHODS We downloaded data on COVID-19 cases and deaths for each US county up through June 7, 2020, from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. We used April-May 2020 Normalized Difference Vegetation Index (NDVI) data, to represent the greenness exposure during the initial COVID-19 outbreak in the US. We fitted negative binomial mixed models to evaluate associations of NDVI with COVID-19 incidence and mortality, adjusting for potential confounders such as county-level demographics, epidemic stage, and other environmental factors. We evaluated whether the associations were modified by population density, proportion of Black residents, median home value, and issuance of stay-at-home orders. RESULTS An increase of 0.1 in NDVI was associated with a 6% (95% Confidence Interval: 3%, 10%) decrease in COVID-19 incidence rate after adjustment for potential confounders. Associations with COVID-19 incidence were stronger in counties with high population density and in counties with stay-at-home orders. Greenness was not associated with COVID-19 mortality in all counties; however, it was protective in counties with higher population density. DISCUSSION Exposures to NDVI were associated with reduced county-level incidence of COVID-19 in the US as well as reduced county-level COVID-19 mortality rates in densely populated counties.
Collapse
Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - M Benjamin Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Xiao Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Boston, MA, 02215, USA
| |
Collapse
|
7
|
Holland I, DeVille NV, Browning MHEM, Buehler RM, Hart JE, Hipp JA, Mitchell R, Rakow DA, Schiff JE, White MP, Yin J, James P. Measuring Nature Contact: A Narrative Review. Int J Environ Res Public Health 2021; 18:ijerph18084092. [PMID: 33924490 PMCID: PMC8069863 DOI: 10.3390/ijerph18084092] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
While many studies suggest evidence for the health benefits of nature, there is currently no standardized method to measure time spent in nature or nature contact, nor agreement on how best to define nature contact in research. The purpose of this review is to summarize how nature contact has been measured in recent health research and provide insight into current metrics of exposure to nature at individual and population scales. The most common methods include surrounding greenness, questionnaires, and global positioning systems (GPS) tracking. Several national-level surveys exist, though these are limited by their cross-sectional design, often measuring only a single component of time spent in nature, and poor links to measures of health. In future research, exposure assessment combining the quantifying (e.g., time spent in nature and frequency of visits to nature) and qualifying (e.g., greenness by the normalized difference of vegetation index (NDVI) and ratings on perception by individuals) aspects of current methods and leveraging innovative methods (e.g., experience sampling methods, ecological momentary assessment) will provide a more comprehensive understanding of the health effects of nature exposure and inform health policy and urban planning.
Collapse
Affiliation(s)
- Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
- Correspondence: (I.H.); (N.V.D.)
| | - Nicole V. DeVille
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Correspondence: (I.H.); (N.V.D.)
| | | | - Ryan M. Buehler
- Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA 02215, USA;
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
| | - J. Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, NC 27695, USA;
- Center for Geospatial Analytics, North Carolina State University, Raleigh, NC 27695, USA
| | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR, UK;
| | - Donald A. Rakow
- Section of Horticulture, School of Integrative Plant Science, Cornell University, Ithaca, NY 14853, USA;
| | - Jessica E. Schiff
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
| | - Mathew P. White
- European Centre for Environment and Human Health, University of Exeter, Cornwall TR1 3HD, UK;
- Urban and Environmental Psychology Group, University of Vienna, Vienna 1010, Austria
| | - Jie Yin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
- College of Architecture and Urban Planning, Tongji University, Shanghai 200092, China
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (J.Y.); (P.J.)
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02115, USA
| |
Collapse
|
8
|
Klompmaker JO, Hart JE, Holland I, Sabath MB, Wu X, Laden F, Dominici F, James P. County-level exposures to greenness and associations with COVID-19 incidence and mortality in the United States. medRxiv 2020:2020.08.26.20181644. [PMID: 32908990 PMCID: PMC7480038 DOI: 10.1101/2020.08.26.20181644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND COVID-19 is an infectious disease that has killed more than 246,000 people in the US. During a time of social distancing measures and increasing social isolation, green spaces may be a crucial factor to maintain a physically and socially active lifestyle while not increasing risk of infection. OBJECTIVES We evaluated whether greenness is related to COVID-19 incidence and mortality in the United States. METHODS We downloaded data on COVID-19 cases and deaths for each US county up through June 7, 2020, from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. We used April-May 2020 Normalized Difference Vegetation Index (NDVI) data, to represent the greenness exposure during the initial COVID-19 outbreak in the US. We fitted negative binomial mixed models to evaluate associations of NDVI with COVID-19 incidence and mortality, adjusting for potential confounders such as county-level demographics, epidemic stage, and other environmental factors. We evaluated whether the associations were modified by population density, proportion of Black residents, median home value, and issuance of stay-at-home order. RESULTS An increase of 0.1 in NDVI was associated with a 6% (95% Confidence Interval: 3%, 10%) decrease in COVID-19 incidence rate after adjustment for potential confounders. Associations with COVID-19 incidence were stronger in counties with high population density and in counties with stay-at-home orders. Greenness was not associated with COVID-19 mortality in all counties; however, it was protective in counties with higher population density. Discussion: Exposures to NDVI had beneficial impacts on county-level incidence of COVID-19 in the US and may have reduced county-level COVID-19 mortality rates, especially in densely populated counties.
Collapse
Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, Massachusetts 02115
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, Massachusetts 02115
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, 181 Longwood Avenue, Boston, Massachusetts 02115
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, 181 Longwood Avenue, Boston, Massachusetts 02115
| | - M Benjamin Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, Massachusetts 02115
| | - Xiao Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, Massachusetts 02115
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, Massachusetts 02115
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, 181 Longwood Avenue, Boston, Massachusetts 02115
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, Massachusetts 02115
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, Massachusetts 02115
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, Massachusetts 02115
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Boston, Massachusetts 02215
| |
Collapse
|
9
|
McMahon J, Puglia F, Martin I, Mitchell D, Dover S, Bentley R, Parmar S, Smith A, Kerawala C, Holland I. Measuring health-related benefit and quality of care in oral and maxillofacial surgery: British Association of Oral and Maxillofacial Surgeons Outcomes Project. Br J Oral Maxillofac Surg 2018; 56:439-443. [DOI: 10.1016/j.bjoms.2018.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 05/23/2018] [Indexed: 10/14/2022]
|
10
|
Bujtár P, Steele P, Holland I, Halsnad M. Buttress guide: direct positioning splint to align a complex fracture of the zygoma. Br J Oral Maxillofac Surg 2016; 55:97-99. [PMID: 27443807 DOI: 10.1016/j.bjoms.2016.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 04/16/2016] [Indexed: 10/21/2022]
Affiliation(s)
- P Bujtár
- Great Ormond Street Hospital for Children, Department of Plastic Surgery, WC1N 3JH London, UK.
| | - P Steele
- Southern General Hospital, Department of Oral and Maxillofacial Surgery, Glasgow, UK
| | - I Holland
- Southern General Hospital, Department of Oral and Maxillofacial Surgery, Glasgow, UK
| | - M Halsnad
- Southern General Hospital, Department of Oral and Maxillofacial Surgery, Glasgow, UK
| |
Collapse
|
11
|
Smith A, Changez H, Wright P, Wales C, Holland I, MacIvor C, McMahon J. Oral surgery: The role of microbiology. Br Dent J 2014; 217:161. [PMID: 25146784 DOI: 10.1038/sj.bdj.2014.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
12
|
Dunphy L, MacIver C, Holland I. Removal of plates post open reduction and internal fixation (O.R.I.F.) of fractures of the mandible: a retrospective review. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
13
|
|
14
|
Dunphy L, McIver C, Holland I. P118 Facial lacerations. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
15
|
MacIver C, Dunphy L, Holland I. P119 Management of odontogenic sepsis in a Regional Maxillofacial Unit. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60208-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
16
|
Bessell EM, Graus F, López-Guillermo A, Villá S, Verger E, Petit J, Holland I, Byrne P. CHOD/BVAM regimen plus radiotherapy in patients with primary CNS non-Hodgkin's lymphoma. Int J Radiat Oncol Biol Phys 2001; 50:457-64. [PMID: 11380234 DOI: 10.1016/s0360-3016(01)01451-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the efficacy and toxicity, including long-term neurotoxicity, of combined therapy with the CHOD/BVAM regimen given before cranial radiotherapy in the treatment of primary CNS lymphoma (PCNSL). METHODS AND MATERIALS Thirty-one consecutive patients with PCNSL were treated with one cycle of cyclophosphamide, doxorubicin, vincristine, and dexamethasone (CHOD) and two of carmustine (BCNU), vincristine, cytosine arabinoside, and methotrexate (BVAM), followed by cranial radiotherapy (45 Gy whole brain plus a 10-Gy boost for single lesions). The median age was 59 years (range 21-70) and 39% had poor performance status. The median follow-up of patients was 4.1 years (range 2.7-9.0). RESULTS Twenty-one patients had no PCNSL at the end of treatment. The 5-year actuarial probability of survival was 31% (95% confidence interval [CI]: 11%-57%), with a median survival of 38 months. Patients < 60 years had a survival significantly longer than those > or = 60 years (4-year survival: 58% (95% CI: 34-82%) vs. 29% (95% CI: 5-53%), respectively; p = 0.04). Two patients died during chemotherapy from pulmonary embolism and bronchopneumonia, respectively, with no evidence of PCNSL at the autopsy. Dementia probably related to treatment occurred in 5 (62%) of the 8 patients 60 years and older, and 4 of them died without evidence of relapse of PCNSL. Dementia correlated with developing brain atrophy and leuco-encephalopathy on serial CT or MR scans. CONCLUSION This regimen can be given with the planned dose intensity to patients aged less than 70 years, and produces better survival than that reported with radiotherapy alone; however, dementia occurs in the majority of patients aged 60 years of age or more.
Collapse
Affiliation(s)
- E M Bessell
- Department of Clinical Oncology, Nottingham City Hospital, UK
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Turner M, Griffin MJ, Holland I. Airsickness and aircraft motion during short-haul flights. Aviat Space Environ Med 2000; 71:1181-9. [PMID: 11439716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND There is little quantitative information that can be used to predict the incidence of airsickness from the motions experienced in military or civil aviation. This study examines the relationship between low-frequency aircraft motion and passenger sickness in short-haul turboprop flights within the United Kingdom. METHODS A questionnaire survey of 923 fare-paying passengers was conducted on 38 commercial airline flights. Concurrent measurements of aircraft motion were made on all journeys, yielding approximately 30 h of aircraft motion data. RESULTS Overall, 0.5% of passengers reported vomiting, 8.4% reported nausea (range 0% to 34.8%) and 16.2% reported illness (range 0% to 47.8%) during flight. Positive correlations were found between the percentage of passengers who experienced nausea or felt ill and the magnitude of low-frequency lateral and vertical motion, although neither motion uniquely predicted airsickness. The incidence of motion sickness also varied with passenger age, gender, food consumption and activity during air travel. No differences in sickness were found between passengers located in different seating sections of the aircraft, or as a function of moderate levels of alcohol consumption. CONCLUSIONS The passenger responses suggest that a useful prediction of airsickness can be obtained from magnitudes of low frequency aircraft motion. However, some variations in airsickness may also be explained by individual differences between passengers and their psychological perception of flying.
Collapse
Affiliation(s)
- M Turner
- Human Factors Research Unit, Institute of Sound and Vibration Research, University of Southampton, Southampton, England.
| | | | | |
Collapse
|
18
|
Duncan L, Holland I, Postlethwaite K, Hawkesford J, Smith D. Implants in the maxillary sinus — how far can you go? Br J Oral Maxillofac Surg 1998. [DOI: 10.1016/s0266-4356(98)90511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Abstract
One hundred computerized tomography (CT) scans from patients with rhinosinusitis were compared with 100 CT scans from patients with intraorbital disease. There were no significant bony anatomical differences between the rhinosinusitis group and the control group and there remained no difference when 17% of the control group, who were incidentally found to have mucosal changes, were excluded from the control data. None of the anatomical bony variations compared between the two groups showed any significant difference, including any associated with narrowing of the ostiomeatal complex (P = 0.41). Eight per cent of all subjects (n = 200) had Onodi cells and 7% had an asymmetrical anterior skull base. In conclusion, bony anatomical variations appear not to influence the prevalence of rhinosinusitis. Intrinsic mucosal disease is probably of much more importance than the bony anatomy.
Collapse
Affiliation(s)
- N S Jones
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Nottingham, UK
| | | | | |
Collapse
|
20
|
Wilcock D, Jaspan T, Holland I, Cherryman G, Worthington B. Comparison of magnetic resonance angiography with conventional angiography in the detection of intracranial aneurysms in patients presenting with subarachnoid haemorrhage. Clin Radiol 1996; 51:330-4. [PMID: 8641094 DOI: 10.1016/s0009-9260(96)80109-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Thirty-nine patients admitted with proven subarachnoid haemorrhage were imaged both with 3-D time of flight (TOF) magnetic resonance angiography (MRA) and conventional angiography. As the definitive examination, catheter angiography demonstrated 37 aneurysms; ten patients had no aneurysm, the remaining 29 patients had 37 aneurysms. We found the sensitivity of 3-D TOF MRA for the detection of aneurysms to be 81% and specificity to be 100% when the reporting radiologist inspects not only the MIP reconstructions but also the MRA source data and the axial spin-echo images. The investigation is less accurate if all the available imaging data is not considered.
Collapse
Affiliation(s)
- D Wilcock
- Department of Radiology, University Hospital, Nottingham, UK
| | | | | | | | | |
Collapse
|
21
|
Holland I. Cutaneous surgical anatomy of the head and neck. Br J Oral Maxillofac Surg 1992. [DOI: 10.1016/0266-4356(92)90194-n] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
22
|
Bessell EM, Punt J, Firth J, Hope T, Holland I, Lowe J. Primary non-Hodgkin's lymphoma of the central nervous system: phase II study of chemotherapy (BVAM) prior to radiotherapy. Clin Oncol (R Coll Radiol) 1991; 3:193-8. [PMID: 1718398 DOI: 10.1016/s0936-6555(05)80738-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Ten patients were diagnosed as having primary non-Hodgkin's lymphoma of the central nervous system at University Hospital, Nottingham, between September 1986 and April 1989. None had clinical evidence of HIV-1 infection. All the patients started treatment with chemotherapy (BVAM), designed to cross the blood-brain barrier, followed by radiotherapy. Seven patients completed both chemotherapy and radiotherapy. Dose reduction during chemotherapy was necessary in three patients because of neutropenia. In two of the six patients with solitary tumours, complete resection was achieved surgically prior to treatment. Five of the remaining eight patients (63%) had radiological evidence of a complete response with chemotherapy. The other three patients had no response to chemotherapy but one had a complete response after radiotherapy. The two-year cause-specific survival of the 10 patients was 37%. Two of the three patients who had a postoperative performance status of 0 or 1 (ECOG/WHO) are alive and disease-free at 26 and 46 months from diagnosis. The median survival of the seven patients with a performance status of 2-4 was 10 months with two patients alive and disease-free at 19 and 26 months. The two-year cause-specific survival of these seven patients was 22%.
Collapse
Affiliation(s)
- E M Bessell
- Department of Clinical Oncology, Nottingham General Hospital, UK
| | | | | | | | | | | |
Collapse
|
23
|
Quayle AA, Marouf H, Holland I. Alveolar ridge augmentation using a new design of inflatable tissue expander: surgical technique and preliminary results. Br J Oral Maxillofac Surg 1990; 28:375-82. [PMID: 2177655 DOI: 10.1016/0266-4356(90)90034-i] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ridge augmentation with particulate hydroxyapatite (HA) is compromised by the propensity for the HA particles to disseminate throughout any surgically created space within the tissues. Several techniques designed to overcome this problem have been described, including the use of inflatable tissue expanders. Some of the residual problems related to this technique are attributable to aspects of expander design and surgical technique. This paper which describes a new design of tissue expander which is completely submerged in use, also describes in detail the surgical technique associated with it. Preliminary results are discussed.
Collapse
Affiliation(s)
- A A Quayle
- Department of Oral and Maxillofacial Surgery, Turner Dental School, University of Manchester
| | | | | |
Collapse
|
24
|
Abstract
Haemangiopericytoma is an uncommon vascular tumour which has rarely been recorded in the larynx. The diagnostic and histopathological difficulties are discussed. A total laryngectomy was performed because of the size and site of the tumour, the associated risk of local recurrence and the high metastatic rate.
Collapse
Affiliation(s)
- P J Bradley
- Combined Head and Neck Oncology Clinic, University Hospital, Queens Medical Centre, Nottingham, England
| | | | | | | | | | | |
Collapse
|
25
|
|
26
|
Abstract
A review was performed of the computed tomograms (CTs) of 500 children which had been reported as showing widening of the supratentorial subarachnoid spaces with normal cerebral substance. On the basis of this a radiological diagnosis of cerebral atrophy had been made in all but five, who were said to have megalencephaly. From these, the children with large or abnormally enlarging heads, but normal or only slightly enlarged ventricles, were selected; there were 40 such cases (8%). The clinical condition either improved or remained stable over a period of 2 years; in the majority the scan abnormality regressed (22.5%) or remained static (67.5%). In three cases there was slight progression of the CT changes before stabilisation, but only one case developed classical communicating hydrocephalus necessitating a shunt procedure. This condition is a generally benign and mild form of communicating hydrocephalus, for which an aetiological factor was apparent in about two-thirds of the cases studied.
Collapse
|
27
|
Abstract
Three cases of pneumatosis coli (PC) in adult patients with acute myeloid leukaemia seen over the last five years in Hammersmith Hospital are reported. Although definite conclusions are impossible, we suggest that that pneumatosis could be due to damage to the bowel mucosa as a result of the disease or the treatment. The literature is reviewed and discussed in an inconclusive attempt to discover the source of the gas.
Collapse
|