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Abstract

Background: Air pollution is a severe problem in Poland, with Kraków area being among the regions with the worse air quality. Viral croup or pseudocroup is a common childhood disease that may manifest with severe upper respiratory tract obstruction. Our aim was to evaluate the associations between incidence and severity of viral croup symptoms among children living in Kraków area, Poland, and air pollution. Methods: Th e retrospective cross-sectional study included Kraków area residents <18 years of age admitted to the Emergency Department of St. Louis Children Hospital in Kraków, Poland over 2-year period. Daily mean concentrations of air pollutants: particulate matter (PM10 and PM2.5), nitric oxides (NOx), carbon oxide (CO), sulfur dioxide, ozone, and benzene were retrieved from public database of measurements performed at three local stations. Numbers of cases of viral croup per week were correlated with weekly mean concentrations of air pollutants. Mean air temperature was treated as a cofactor. Results: During the studied period, mean concentrations of PM10, PM2.5, and NOx exceeded the allowable levels (yearly means) specifi ed by Polish law regulations. Signifi cant positive correlations of moderate strength were observed between weekly mean concentrations of most air pollutants, especially PM10, PM2.5, CO and benzene, and numbers of cases of viral croup recorded per week, confi rmed in the analysis restricted to non-holiday period and to winter months only. Th e correlations between NOx, CO, benzene and croup prevalence were independent of temperature in non-holiday period. Conclusions: Our results support adverse impact of air pollution on children’s respiratory health.
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Abstract

Background: In early phase of acute pancreatitis (AP), systemic inflammatory response syndrome may lead to organ failure. The severe form of AP is associated with high mortality that may be prevented by timely diagnosis and treatment of the predicted severe cases. Serum interleukin 6 (IL-6) and urokinase-type plasminogen activator receptor (uPAR) have been proposed as accurate early markers of severe AP. The aim of the study was to assess whether widely available blood count indexes: neutrophil to lymphocyte (NLR), lymphocyte to monocyte (LMR) and platelet to lymphocyte ratios correlate with IL-6 and uPAR and may be utilized to predict organ complications at the early phase of AP. Methods: The study included 95 adult patients with AP treated at the Surgical Ward Complex of Health Care Centers in Wadowice, Poland. Organ failure was diagnosed according to modified Marshall scoring system, as recommended by 2012 Atlanta classification. Blood samples for laboratory tests were collected on days 1, 2 and 3 following the onset of AP symptoms. Results: Patients with organ failure presented significantly lower LMR on day 1 and signifi cantly higher NLR on days 2 and 3. Strong positive correlations between NLR and IL-6 and moderate correlations between NLR and uPAR were observed throughout the study. Day 2 and 3 NLR values significantly predicted organ failure at the early phase of AP. Conclusions: Taking into account the wide availability of NLR, it may be considered as a surrogate of more expensive tests to help the early assessment of organ failure complicating AP.
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