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Background: Some studies have proposed that subclinical hypothyroidism (SCH) has adverse effects on the cardiovascular system, but little is known about the effect on patients undergoing cardiovascular operations. We examined the influence of preoperative SCH on postoperative outcome in patients undergoing coronary artery bypass grafting (CABG). Methods: Among patients who underwent CABG between July 2005 and June 2007 at Seoul National University Bundang Hospital, 224 with normal thyroid function and 36 with SCH were enrolled. Preoperative risks and postoperative outcomes were evaluated prospectively without thyroid hormone replacement. Results: There were no significant differences in primary outcomes (major adverse cardiovascular events) and secondary outcomes such as wound problems, mediastinitis, leg infection, respiratory complications, delirium, or reoperation during the same hospitalization. However, patients with SCH had a higher incidence of postoperative atrial fibrillation than those with normal thyroid function after adjustment for age, gender, body mass index, and other independent variables such as emergency operation, the use of cardiopulmonary bypass, combined valvular operation, preoperative creatinine levels, left ventricular systolic dysfunction, and nonuse of β-blockers (45.5% vs 29%; odds ratio, 2.552; 95% confidence interval, 1.117 to 5.830; p = 0.026). Conclusions: SCH appears to influence the postoperative outcome for patients by increasing the development of postoperative atrial fibrillation. However, it is still unproven whether preoperative thyroxine replacement therapy for patients with SCH might prevent postoperative atrial fibrillation after CABG. [Copyright &y& Elsevier]

Background: The prevalence of allergic rhinitis (AR) is increasing worldwide. Allergic diseases develop in susceptible subjects when they are exposed to specific environmental factors. Objective: We analyzed changes in the prevalence of AR and identified genetic and environmental factors in early childhood that affect risk. Methods: We used the International Study of Asthma and Allergies in Childhood questionnaire to collect data on AR, allergies, and environmental exposures from 4554 elementary school students from 5 areas of Seoul, Korea, in 2008. We also obtained DNA from 1050 subjects from 1 area of Seoul for genotype analysis of IL13. Results: We identified genetic and environmental factors during infancy and early childhood that increased the risk for current AR (resulting in a diagnosis of AR and AR symptoms in the past 12 months) in elementary school–aged children. These included allergic disease in parents and antibiotic use in infants, allergic disease in parents and exposure of infants to mold, and allergic disease in parents and moving an infant to a newly built house. The risk of current AR also increased in subjects with GA or AA at nucleotide 2044 in IL13 who had been exposed to mold in the home during infancy (adjusted odds ratio, 3.27; 95% CI, 1.75-6.11) compared with subjects who had GG at this position and had not been exposed to mold (adjusted odds ratio, 3.27; 95% CI, 1.75-6.11). Conclusion: The prevalence of AR is increasing in Korean children. Children with a family history of allergic disease and exposure to specific environmental risk factors during infancy are more likely to have AR. Children with GA or AA at IL13(+2044) are at increased risk for AR when exposed to mold in the home during the first year of life. [ABSTRACT FROM AUTHOR]

Background: Air pollution is associated with depressive and anxiety symptoms in the general population. However, this relationship among pregnant women remains largely unknown.Objective: To evaluate the association between pregnancy air pollution exposure and maternal depressive and anxiety symptoms during the third trimester assessed using the Center for Epidemiologic Studies-Depression and State-Trait Anxiety Inventory scales, respectively.Methods: We analyzed 1481 pregnant women from a cohort study in Seoul. Maternal exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and <10 μm (PM10), as well as to nitrogen dioxide (NO2) and ozone (O3) for each trimester and the entire pregnancy was assessed at participant's residential address by land use regression models. We estimated the relative risk (RR) and corresponding confidence interval (CI) of the depressive and anxiety symptoms associated with an interquartile range (IQR) increase in PM2.5, PM10, NO2, and O3 using modified Poisson regression.Results: In single-pollutant models, an IQR increase in PM2.5, PM10, and NO2 during the second trimester was associated with an increased risk of depressive symptoms (PM2.5 RR = 1.15, 95% CI: 1.04, 1.27; PM10 RR = 1.13, 95% CI: 1.04, 1.23; NO2 RR = 1.15, 95% CI: 1.03, 1.29) after adjusting for relevant covariates. Similarly, an IQR increase in O3 during the third trimester was associated with an increased risk of depressive symptoms (RR = 1.09, 95% CI: 1.01, 1.18), while the IQR increase in O3 during the first trimester was associated with a decreased risk (RR = 0.89, 95% CI: 0.82, 0.96). Exposure to PM2.5, PM10, and NO2 during the second trimester was significantly associated with anxiety symptoms. The associations with PM2.5 and O3 in single-and multi-pollutant models were consistent.Conclusions: Our findings indicate that increased levels of particulate matter, NO2, and O3 during pregnancy may elevate the risk of depression or anxiety in pregnant women. [ABSTRACT FROM AUTHOR]

• The associations of air pollution with birth weight distribution were examined. • Associations between air pollution and reduced birth weight were of greater magnitude at the lower quantiles of birth weight. • A pattern of greater negative association was found in the lower socioeconomic group. An association between maternal exposure to air pollution and the birth weight distribution has been reported, but the extent to which this relationship varies according to socioeconomic status (SES) is unknown. This study examined the relationship using the data from a Korean birth cohort. Data for singleton births in Seoul from 2007 to 2017 (n = 1739) were analyzed. Maternal exposures to particulate matter with an aerodynamic diameter <10 µm (PM 10) and <2.5 µm (PM 2.5), as well as to nitrogen dioxide (NO 2) and ozone (O 3) for each trimester and the entire pregnancy were estimated using residential address, gestational age, and the birth date. The associations between the interquartile range (IQR) increases in pollutant concentrations and the changes in birth weight were examined using linear regression and quantile regression models. The socioeconomic disparities in the associations were investigated using a derived SES variable based on the composite of parental education and occupation. This SES variable was then interacted with the air pollutant. In the gestational age-adjusted models, particulate air pollutants (PM 10 and PM 2.5) and O 3 were associated with birth weight decreases for the lower birth weight percentiles. For example, the decrease in mean birthweight per IQR increase in PM 2.5 during second trimester was −21.1 g (95% confidence interval (CI) = −41.8, −0.4), whereas the quantile-specific associations were: 10th percentile −27.0 g (95% CI = −46.6, −7.3); 50th percentile −22.2 g (95% CI = −39.6, −4.8); and 90th percentile −22.9 g (95% CI = −45.5, −0.2). Particulate air pollutants and O 3 showed a pattern of socioeconomic inequalities; the reduced birth weight was of greater magnitude for children from a low SES group. Negative associations between particulate air pollutants and O 3 and birth weight were consistently greater at the lower quantiles of the birth weight distribution, especially in lower SES group. [ABSTRACT FROM AUTHOR]