Indoor secondhand tobacco smoke emission levels in six Lebanese cities

Background: To date, Lebanon has failed to enact comprehensive clean indoor air laws despite ratification of the Framework Convention on Tobacco Control (FCTC), which calls for the protection of non-smokers from exposure to secondhand tobacco smoke (SHS). Complicating the problem of SHS exposure in Lebanon is the widespread use of the tobacco water-pipe. While most research on SHS has involved cigarette smoking as a source of emissions, other sources, including tobacco water-pipes, may be an important contributor. Methods: $PM_{2.5}$ concentrations $(\mu g/m^3)$ were measured in a sample of 28 public venues located in six major Lebanese cities. Active smoker density (number of smokers$/100 m^3$) was calculated for both water-pipe and cigarette smokers. Venues were then categorised as having higher density of water-pipe smokers or higher density of cigarette smokers, and resultant emission levels were compared between the two groups. Results: Cigarette and water-pipe smoking was observed in 14 venues, while cigarette smoking only and water-pipe smoking only were found in 12 venues and one venue, respectively. Among all smoking-permitted venues, the mean $PM_{2.5}$ concentration was $342 \mu g/m^3$. Venues with a higher density of water-pipe smokers $(n =14)$ showed a similar median $PM_{2.5}$ concentration $349 \mu g/m^3$ compared with venues with a higher density of cigarette smokers $(n =13; 241 \mu g/m^3; p=0.159)$. The mean $PM_{2.5}$ concentration in the single venue with a voluntary smoke-free policy was $6 \mu g/m^3$. Conclusions: Despite ratification of the FCTC in 2005, both cigarette and water-pipe smoking are commonly practised in enclosed public places throughout Lebanon, leading to unsafe levels of indoor particulate pollution. Smoke-free policies are needed in Lebanon to protect the public's health, and should apply to all forms of tobacco smoking

Coinfections and their molecular consequences in the porcine respiratory tract

Understudied, coinfections are more frequent in pig farms than single infections. In pigs, the term “Porcine Respiratory Disease Complex” (PRDC) is often used to describe coinfections involving viruses such as swine Influenza A Virus (swIAV), Porcine Reproductive and Respiratory Syndrome Virus (PRRSV), and Porcine CircoVirus type 2 (PCV2) as well as bacteria like Actinobacillus pleuropneumoniae, Mycoplasma hyopneumoniae and Bordetella bronchiseptica. The clinical outcome of the various coinfection or superinfection situations is usually assessed in the studies while in most of cases there is no clear elucidation of the fine mechanisms shaping the complex interactions occurring between microorganisms. In this comprehensive review, we aimed at identifying the studies dealing with coinfections or superinfections in the pig respiratory tract and at presenting the interactions between pathogens and, when possible, the mechanisms controlling them. Coinfections and superinfections involving viruses and bacteria were considered while research articles including protozoan and fungi were excluded. We discuss the main limitations complicating the interpretation of coinfection/superinfection studies, and the high potential perspectives in this fascinating research field, which is expecting to gain more and more interest in the next years for the obvious benefit of animal health

Data sharing: A new editorial initiative of the international committee of medical journal editors. Implications for the editors´ network

The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiolog

Data sharing: A new editorial initiative of the international committee of medical journal editors. Implications for the editors´ network

The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiolog

Large Scale Association Analysis Identifies Three Susceptibility Loci for Coronary Artery Disease

Genome wide association studies (GWAS) and their replications that have associated DNA variants with myocardial infarction (MI) and/or coronary artery disease (CAD) are predominantly based on populations of European or Eastern Asian descent. Replication of the most significantly associated polymorphisms in multiple populations with distinctive genetic backgrounds and lifestyles is crucial to the understanding of the pathophysiology of a multifactorial disease like CAD. We have used our Lebanese cohort to perform a replication study of nine previously identified CAD/MI susceptibility loci (LTA, CDKN2A-CDKN2B, CELSR2-PSRC1-SORT1, CXCL12, MTHFD1L, WDR12, PCSK9, SH2B3, and SLC22A3), and 88 genes in related phenotypes. The study was conducted on 2,002 patients with detailed demographic, clinical characteristics, and cardiac catheterization results. One marker, rs6922269, in MTHFD1L was significantly protective against MI (OR = 0.68, p = 0.0035), while the variant rs4977574 in CDKN2A-CDKN2B was significantly associated with MI (OR = 1.33, p = 0.0086). Associations were detected after adjustment for family history of CAD, gender, hypertension, hyperlipidemia, diabetes, and smoking. The parallel study of 88 previously published genes in related phenotypes encompassed 20,225 markers, three quarters of which with imputed genotypes The study was based on our genome-wide genotype data set, with imputation across the whole genome to HapMap II release 22 using HapMap CEU population as a reference. Analysis was conducted on both the genotyped and imputed variants in the 88 regions covering selected genes. This approach replicated HNRNPA3P1-CXCL12 association with CAD and identified new significant associations of CDKAL1, ST6GAL1, and PTPRD with CAD. Our study provides evidence for the importance of the multifactorial aspect of CAD/MI and describes genes predisposing to their etiology

Co-infections of porcine respiratory cells and tissues with the influenza A virus and the Porcine reproductive and respiratory syndrome virus

Les co-infections respiratoires chez le porc sont plus fréquentes que les infections causées par un seul micro-organismes. Dans un premier temps, un recensement des études sur les co-infections respiratoires porcines a permis de mettre à jour les connaissances sur ces co-infections virales et/ou bactériennes et de détailler les probables conséquences moléculaires sur l’hôte porcin. Le virus du syndrome dysgénésique et respiratoire porcin (ou Porcine Reproductive and Respiratory Syndrome Virus, PRRSV) et les virus responsables de l’influenza porcin A (swine Influenza A Virus, swIAV), sont des acteurs majeurs du complexe respiratoire porcin. Le swIAV infecte principalement les cellules épithéliales alors que le PRRSV infecte des cellules exprimant CD163 comme les macrophages alvéolaires (MA). Dans le but d’évaluer la réponse antivirale de l'hôte porcin et d'étudier l'effet d’une pré-infection par le PRRSV sur la réplication du swIAV, une série de co-infections et de surinfections a été effectuée sur des cellules épithéliales trachéales et sur des tranches pulmonaires fines. Les résultats montrent que le PRRSV est capable d'interférer avec l'infection par swIAV et d’altérer la réponse antivirale cellulaire sans infecter les cellules épithéliales. Cet effet du PRRSV parait moins important en augmentant le délai entre les inoculations virales. Finalement, une série d’expérimentations nous a permis d’identifier les agents pathogènes circulant chez des porcs provenant d’un abattoir local et d’évaluer l’effet des différentes infections bactériennes et virales résolues ou pas sur l’immunité entraînée des macrophages alvéolaires et leur capacité à répliquer les virus suite à une surinfection. Ces travaux contribuent à la compréhension de la réponse immune porcine suite aux co-infections respiratoires, pour une meilleure gestion des maladies respiratoire chez le porc.Respiratory co-infections in pigs are more common than infections caused by a single pathogen. First of all, we identified the viral and bacterial porcine co-infections studies and we detailed the possible molecular consequences on the porcine host. The porcine reproductive and respiratory syndrome virus (PRRSV) and the swine Influenza A Virus (swIAV), are major contributors to the porcine respiratory disease complex. SwIAV primarily infects epithelial cells while PRRSV infects cells expressing CD163 such as alveolar macrophages (AM). In order to evaluate the antiviral response of the porcine host and to study the effect of a pre-infection with PRRSV on the replication of swIAV, a series of co-infections and superinfections were carried out on tracheal epithelial cells and precision-cut lung slices. The results showed that PRRSV can interfere with swIAV infection and alter the cellular antiviral response without infecting epithelial cells. This effect of PRRSV appears to be less important following an increase in the delay between viral inoculations. Finally, a series of experiments enabled us to identify the pathogens circulating in pigs from a local slaughterhouse and to assess the effect of the various bacterial and viral infections, on the alveolar macrophages trained immunity and their ability to replicate viruses in case of superinfection. This study contributes to the understanding of porcine immune response to respiratory coinfections for a better management of respiratory diseases in swine

Is sustainable transportation limited by urban form? An international GIS-based approach

International audienc

Salvage abdominal irradiation for refractory non-Hodgkin's lymphoma

Background: Abdominal irradiation, as a part of treatment, is often ignored in the management of refractory non-Hodgkin′s lymphoma (NHL). Objective: To evaluate the efficacy and the toxicity of this approach after failure of chemotherapy. Materials and Methods: 27 patients with intraabdominal lymphoma underwent salvage irradiation between 1982 and 2001. All patients were treated with a Cobalt-60 machine. The total dose administered to the abdomen was 18-20 Gy at the rate of 1.5-1.8 Gy per daily fraction, followed by a boost to gross disease up to 20 Gy. All patients had previously been heavily pretreated with chemotherapy. Fourteen patients, nine with follicular and five with diffuse lymphomas, had primary refractory tumors that had never achieved remission. Thirteen patients, six with follicular and seven with aggressive tumors, had refractory relapsed tumors after achieving one or more complete remissions. Results: The response rate was 77%. The median follow-up was 53 months. The 5-year and 10-year survival rates were 25 and 17%, respectively. The in-field and out-of-field recurrence rates were 22 and 33%, respectively. Survival rates were significantly better for patients with refractory relapse compared to those with primary refractory lymphoma (P < 0.01). There was no significant difference in terms of response, recurrence, or survival rates between follicular and aggressive types. Out-of-field recurrence occurred more frequently in initial stage III and IV disease. Toxic deaths occurred in three patients (11%). Conclusion: Salvage radiotherapy for refractory abdominal NHL is a feasible alternative for both follicular and diffuse subtypes and may provide significant palliation and prolongation of survival. It is less effective in patients with primary refractory NHL than in those with refractory relapsed NHL

Salvage abdominal irradiation for refractory non-Hodgkin's lymphoma

Background: Abdominal irradiation, as a part of treatment, is often ignored in the management of refractory non-Hodgkin\u2032s lymphoma (NHL). Objective: To evaluate the efficacy and the toxicity of this approach after failure of chemotherapy. Materials and Methods: 27 patients with intraabdominal lymphoma underwent salvage irradiation between 1982 and 2001. All patients were treated with a Cobalt-60 machine. The total dose administered to the abdomen was 18-20 Gy at the rate of 1.5-1.8 Gy per daily fraction, followed by a boost to gross disease up to 20 Gy. All patients had previously been heavily pretreated with chemotherapy. Fourteen patients, nine with follicular and five with diffuse lymphomas, had primary refractory tumors that had never achieved remission. Thirteen patients, six with follicular and seven with aggressive tumors, had refractory relapsed tumors after achieving one or more complete remissions. Results: The response rate was 77%. The median follow-up was 53 months. The 5-year and 10-year survival rates were 25 and 17%, respectively. The in-field and out-of-field recurrence rates were 22 and 33%, respectively. Survival rates were significantly better for patients with refractory relapse compared to those with primary refractory lymphoma (P &lt; 0.01). There was no significant difference in terms of response, recurrence, or survival rates between follicular and aggressive types. Out-of-field recurrence occurred more frequently in initial stage III and IV disease. Toxic deaths occurred in three patients (11%). Conclusion: Salvage radiotherapy for refractory abdominal NHL is a feasible alternative for both follicular and diffuse subtypes and may provide significant palliation and prolongation of survival. It is less effective in patients with primary refractory NHL than in those with refractory relapsed NHL

Prospecting potential links between PRRSV infection susceptibility of alveolar macrophages and other respiratory infectious agents present in conventionally reared pigs

International audiencePorcine Reproductive and Respiratory Syndrome virus (PRRSV) is one of the main component of the porcine respiratory disease complex (PRDC), which strongly impact the pig production. Although PRRSV is often considered as a primary infection that eases subsequent respiratory coinfections, the possibility that other PRDC components may facilitate PRRSV infection has been largely overlooked. The main cellular targets of PRRSV are respiratory macrophages among them alveolar macrophages (AM) and pulmonary intravascular macrophages (PIM). AM, contrarily to PIM, are directly exposed to the external respiratory environment, among them co-infectious agents. In order to explore the possibility of a co-infections impact on the capacity of respiratory macrophages to replicate PRRSV, we proceed to in vitro infection of AM and PIM sampled from animals presenting different sanitary status, and tested the presence in the respiratory tract of these animals of the most common porcine respiratory pathogens (PCV2, Actinobacillus pleuropneumoniae, Mycoplasma hyopneumoniae, Mycoplasma hyorhinis, Mycoplasma floculare, Pasteurella multocida, Bordetella bronchiseptica, Streptoccocus suis). In this exploratory study with a limited number of animals, no statistic differences were observed between AM and PIM susceptibility to in vitro PRRSV infection, nor between AM coming from animals presenting very contrasting respiratory coinfection loads