{"title":"Eplerenone–A novel Mineralocorticoid receptor antagonist for the clinical application","authors":"Nannan Wu, Yuanyuan Zhang, D. Zhao","doi":"10.4103/ed.ed_7_21","DOIUrl":"https://doi.org/10.4103/ed.ed_7_21","url":null,"abstract":"Aldosterone is produced from the zona glomerulosa of the adrenal cortex in the adrenal gland, which is main mineralocorticoid hormone. Upon binding the mineralocorticoid receptor, it regulates sodium and potassium absorption, secretion, and retention, thereby maintaining stable blood pressure levels. However, abnormal aldosterone synthesis and metabolism could be pathogenic and contribute to multiple organ fibrosis and structural remodeling. For instance, hyperaldosteronemia is critically involved in the development of hypertension, heart failure (HF), and renal disease. Therefore, mineralocorticoid receptor antagonists (MRAs) that could fight against high concentrations of aldosterone play an important role in the treatment of diseases caused by hyperaldosteronism. Eplerenone, as a novel selective MRA, has better therapeutic efficiency and fewer side effects comparing to the classical drug spironolactone. In this review, first, we go through the biosynthesis and biologic properties of aldosterone and then introduce how hyperaldosteronemia facilitates certain diseases progression. Aldosterone is an important part of the renin-angiotensin-aldosterone system (RAAS), which plays a crucial role in essential hypertension, atrial tremor, and tissue fibrosis. Second, we summarize current evidence of clinical application of eplerenone in the control of primary aldosteronism, hypertension, HF, nephropathy, insulin resistance, and liver damage. It is exciting that many studies have shown that the use of eplerenone in these diseases yields good outcomes accompanied with fewer adverse effects such as hyperkalemia, metabolic acidosis, hypotension, and acute kidney failure, which indicates that eplerenone is a strong and safe MRA and inhibitor of RAAS system. This review focuses on therapeutic efficacy and disadvantages of eplerenone when treating a series of different diseases. Ultimately, we hope to shed light on future therapeutic strategies in diseases associated with hyperaldosteronemia.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"1 1","pages":"1 - 11"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79609010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Michael, Adewale Olufemi Ashimi, T. Amole, A. Yusuf
{"title":"Awareness of health and environmental hazards of plastic bag use and available substitutes among health workers of two hospitals in a rural area of Northwest Nigeria","authors":"G. Michael, Adewale Olufemi Ashimi, T. Amole, A. Yusuf","doi":"10.4103/ed.ed_26_21","DOIUrl":"https://doi.org/10.4103/ed.ed_26_21","url":null,"abstract":"Objective: This study assessed health-care workers' awareness of the health and environmental hazards associated with plastic bags and available substitutes. Methods: This cross-sectional questionnaire-based survey was carried out in two rural hospitals in Northwest Nigeria over a 4-week study period. It included permanently employed health workers who were residents in the study community. The data were analyzed using SPSS version-20; the association between respondents' sociodemographic characteristics and awareness of the harmful effects of plastic-bags was determined using the Chi-square test. Results: There were 200 respondents aged 20–55 years with a mean of 31.7 ± 8.6 years. Most, 45% (90/200), respondents were nurses/midwives; 21% (42/200) were doctors. Most respondents, 49% (98/200), would throw away the plastic bags after a single use; 23.5% (47/200) would keep and reuse, while 45.5% (91/200) use reusable bags for shopping. Most respondents, 91% (182/200), were aware of the harmful effect on the environment, while 74% (148/200) knew it could be harmful to health. Respondents' age (>30 years) was significantly associated with awareness of the harmful effects of used plastic bags (P = 0.03), while male gender, age >30 years, being married, and of non-Hausa/Fulani ethnicity were associated with awareness of plastic-bag substitutes. Conclusions: Most respondents were aware of the health and environmental hazards of plastic bags and the available substitutes. Promoting reuse of plastic bags and the use of available substitutes will help to control this growing hazard.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"264 1","pages":"16 - 21"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90880788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuanyuan Zhang, Alexandra Wehbe, Xu-hong Wang, Rongxin Sun, Zhao Zheng, D. Zhao
{"title":"The prevalence of thyroid nodules and risk factors of thyroid nodules with metabolic disorder in Beijing: A cross-sectional study","authors":"Yuanyuan Zhang, Alexandra Wehbe, Xu-hong Wang, Rongxin Sun, Zhao Zheng, D. Zhao","doi":"10.4103/ed.ed_14_21","DOIUrl":"https://doi.org/10.4103/ed.ed_14_21","url":null,"abstract":"Background: In recent years, the prevalence of thyroid nodules (TNs) has been increasing, but the relationship between metabolic abnormalities and the incidence of TNs is not well defined, and there is scant data evaluating this relationship stratified by gender. This study aims to analyze the prevalence of TNs and possible risk factors for TNs across gender lines and various metabolic states in Beijing, China. Patients and Methods: A total of 6001 subjects who underwent thyroid ultrasounds as part of a routine medical checkup at Luhe Hospital between 2017 and 2018 were enrolled in this study. Multivariate adjustment logic was used to analyze possible demographic and clinical risk factors of TN stratified by gender. Results: The prevalence of TNs was 44.1%, of which 45.9% were female and 40% were male. In general, the prevalence of TNs increased in parallel with advancing age. These findings were even starker among females, with TN prevalences of 37.5%, 46.5%, 52.9%, and 54.1%, among participants in <55-, 55–65-, 65–75-, and >75-year-old age groups, respectively. The prevalence of TNs was significantly higher among patients with obesity (46.8% vs. 43%, P = 0.008), central obesity (45% vs. 40.4%, P = 0.005), hypertension (47.1% vs. 42.4%, P < 0.001), metabolic syndrome (MetS) (46.1% vs. 41%, P < 0.001), and low TSH levels (46.5% vs. 37.1%, P < 0.001). MetS and obesity were independent risk factors for the prevalence of TNs (odds ratio [OR] = 1.167, [1.002–1.277] and (OR = 0.038, [1.01–1.396]), respectively). TSH had a protective effect on the prevalence of TNs (OR = 0.664, [0.585–0.75]). Conclusions: The present study supports the existing research that contends a strong correlation between older age, MetS, and other clinical risk factors and the prevalence of TNs. This relationship only persisted among women when stratified by gender. These results set the precedent for further research on how gender influences the incidence of TNs, particularly in the setting of other clinical and demographic risk factors.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"277 1","pages":"22 - 28"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80064227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raymond F. Palmer, Tatjana Walker, Roger B. Perales, R. Rincon, C. Jaén, Claudia S. Miller
{"title":"Disease comorbidities associated with chemical intolerance","authors":"Raymond F. Palmer, Tatjana Walker, Roger B. Perales, R. Rincon, C. Jaén, Claudia S. Miller","doi":"10.4103/ed.ed_18_21","DOIUrl":"https://doi.org/10.4103/ed.ed_18_21","url":null,"abstract":"Background: Chemical intolerance (CI) is characterized by multisystem symptoms initiated by a one-time high-dose or a persistent low-dose exposure to environmental toxicants. Prior studies have investigated symptom clusters rather than defined comorbid disease clusters. We use a latent class modeling approach to determine the number and type of comorbid disease clusters associated with CI. Methods: Two hundred respondents with and without CI were recruited to complete the Quick Environmental Exposure and Sensitivity Inventory (QEESI), and a 17-item comorbid disease checklist. A logistic regression model was used to predict the odds of comorbid disease conditions between groups. A latent class analysis was used to inspect the pattern of dichotomous item responses from the 17 comorbid diseases. Results: Those with the highest QEESI scores had significantly greater probability of each comorbid disease compared to the lowest scoring individuals (P < 0.0001). Three latent class disease clusters were found. Class 1 (17% of the sample) was characterized by a cluster consisting of irritable bowel syndrome (IBS), arthritis, depression, anxiety, fibromyalgia, and chronic fatigue. The second class (53% of the sample) was characterized by a low probability of any of the co-morbid diseases. The third class (30% of the sample) was characterized only by allergy. Discussion: We have demonstrated that several salient comorbid diseases form a unique statistical cluster among a subset of individuals with CI. Understanding these disease clusters may help physicians and other health care workers to gain a better understanding of individuals with CI. As such, assessing their patients for CI may help identify the salient initiators and triggers of their CI symptoms—therefore guide potential treatment efforts.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"184 1","pages":"134 - 141"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76195109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sangita Patel, Rahul Khokhariya, Jagruti Y. Rathod, Deya Chatterji, Jesal Patel
{"title":"Water safety planning in India: Assessment of water quality in urban Vadodora","authors":"Sangita Patel, Rahul Khokhariya, Jagruti Y. Rathod, Deya Chatterji, Jesal Patel","doi":"10.4103/ed.ed_21_21","DOIUrl":"https://doi.org/10.4103/ed.ed_21_21","url":null,"abstract":"","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"1 1","pages":"127 - 133"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89262935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Dwivedi, Seema Mishra, Ruchika Agnihotri, V. Kumar, Pragya Sharma, G. Sinam, Vivek Pandey
{"title":"Micro-environmental conditions and high population density affects the transmission of severe acute respiratory syndrome corona virus-2 in metropolitan cities of India","authors":"S. Dwivedi, Seema Mishra, Ruchika Agnihotri, V. Kumar, Pragya Sharma, G. Sinam, Vivek Pandey","doi":"10.4103/ed.ed_15_21","DOIUrl":"https://doi.org/10.4103/ed.ed_15_21","url":null,"abstract":"Aim: The present study explores the effects of high population density (PD), climatic and environmental factors on transmission of coronavirus disease 2019 (COVID-19) in selected metropolitan cities of India. Materials and Methods: A data extraction sheet has been prepared to summarize the data of confirmed severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) cases and number of deaths in ten metropolitan cities, which was taken from Government of India website. The data on environmental factors of each selected metropolitan city were compiled from the official website and climatic conditions from Meteorological Department Government of India. Results: In India, maximum positive COVID-19 cases (>32%) has been found in tropical wet and dry climate zone. While the incidence of COVID-19 cases has been found less in the arid zone of India. Poor correlation has been found between level of Vitamin D, total COVID-19 cases, and mortalities in the studied metropolitan cities. No significant correlation was found between the health care index and COVID-19 cases and mortality. Conclusions: Correspondence and principal component analysis statistics showed high PD, poverty, climatic and environmental factors influenced the SARS-CoV-2 transmission in metropolitan cities of India.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"53 1","pages":"116 - 126"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79249316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PM2.5 pollution and endoplasmic reticulum stress response","authors":"Eric Heng, Areeba Maysun, Kezhong Zhang","doi":"10.4103/ed.ed_22_21","DOIUrl":"https://doi.org/10.4103/ed.ed_22_21","url":null,"abstract":"Air pollution is a sustained problem of public health for the general population in urban areas, especially for those living in areas of intensive traffic or industrial activity. Accumulating evidence has confirmed a significant association between exposure to fine ambient particulate matter with aerodynamic diameters <2.5 μm (PM2.5) and the increase of morbidity and mortality associated with cardiovascular and metabolic diseases. It has been identified that inflammation and intracellular stress responses play important roles in PM2.5-caused pathogenesis. Unfolded protein response (UPR) is an intracellular stress signaling from the endoplasmic reticulum (ER) to help cell recovery from the stress caused by the accumulation of unfolded or misfolded proteins. Exposure to high levels of environmentally relevant PM2.5 may directly or indirectly interrupt the protein folding process in the ER, causing ER stress. A number of studies suggested that ER stress response, or UPR, interacts with mitochondrial stress and inflammatory responses, under PM2.5 exposure, to modulate functions and survival of specialized cell types that are involved in the development of cardiovascular, metabolic, and neurodegenerative diseases. In this review, we summarize the recent advance in understanding the mechanistic links between PM2.5 and ER stress response.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"20 1","pages":"111 - 115"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73949494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wind turbines and adverse health effects: Applying Bradford Hill's criteria for causation by Anne Dumbrille, Robert McMurtry, and Carmen Krogh – 'Big noises: Tobacco and Wind'","authors":"A. Evans","doi":"10.4103/ed.ed_24_21","DOIUrl":"https://doi.org/10.4103/ed.ed_24_21","url":null,"abstract":"","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"68 1","pages":"109 - 110"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85286737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High burden to high impact: Strengthening services for malaria elimination","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/ed.ed_10_21","DOIUrl":"https://doi.org/10.4103/ed.ed_10_21","url":null,"abstract":"Malaria is a major public health concern, and for many decades, consistent efforts have been taken to reduce the incidence of the disease as well as the associated deaths. In-fact, in the year 2019, a total of 229 million cases of the disease were reported globally. Malaria elimination has to be given utmost public health importance as the sufferings, complications of the infection, impairment in the quality of life, and the burden on the health-care delivery system are very much preventable. In the vision to accomplish malaria elimination, it is quite essential to understand the geographic conditions and the local predisposing factors before drafting the final strategy. In order to deal with this emerging situation, the World Health Organization in collaboration with the Roll Back Malaria partnership has come up with a high burden to high impact plan. It is a nation-owned and led approach developed in accordance with the set Sustainable Development Goals. In conclusion, the need of the hour is to strengthen services for elimination of malaria, and it will essentially require a multi-pronged approach involving different stakeholders, multiple sectors, and a well-co-ordinated team approach to bridge the existing lacunae and move considerable progress in the global aim to minimize sufferings and mortality attributed to a totally preventable and curable disease.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"32 1","pages":"98 - 100"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73531949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The overestimation of medical consequences of low-dose exposures: Cui bono?","authors":"Sergei V. Jargin","doi":"10.4103/ed.ed_13_21","DOIUrl":"https://doi.org/10.4103/ed.ed_13_21","url":null,"abstract":"After the Chernobyl disaster appeared papers overestimating medical consequences of low-dose radiation exposures. Examples have been discussed previously; an updated overview of selected studies is provided here. Various kinds of bias can be found in the epidemiological research reporting elevated health risks from low doses of ionizing radiation: Interpretation of spontaneous conditions as radiation-induced, dose comparisons disregarding the natural background, publication bias, etc. Admittedly, all relevant parameters cannot always be taken into account in epidemiological research. Several examples of potentially biased reports on Mayak Production Association workers and Techa river valley residents are analyzed here. Doubtful correlations between exposures to low radiation doses and nonmalignant conditions, discussed in this commentary, call into question the cause-effect character of such correlations for malignancies revealed by the same scientists. Correlations can be caused or influenced by dose-dependent selection and self-selection. Individuals with higher doses were probably more motivated to undergo medical checkups and given more attention. The medical surveillance of exposed populations is important; but more consideration should be given to potential bias. A promising approach to the study of dose-response relationships are lifelong experiments in different animal species that can reveal the net harm or potential benefit (within a certain range according to the concept of hormesis) from low-dose exposures to ionizing radiation.","PeriodicalId":11702,"journal":{"name":"Environmental Disease","volume":"71 1","pages":"101 - 107"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83889381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}