The effect of air pollution on drivers' safety performance.

Numerous studies have determined the adverse effects of air pollution on the health, welfare, and comfort of humans. More recently, the effects of air pollution on cognitive performance of humans are also focused. However, as a group in direct exposure to air pollution, drivers are rarely studied. The present study aims to evaluate the effect of air pollution on the performance of drivers. Their performance is evaluated by observing the number of recorded accidents. The effect of pollutant concentration (primarily PM2.5) on the number of accidents is investigated in a case study in Tehran. The temperature inversion phenomenon is used as an instrumental variable in a two-stage least squares method. The results indicate that temperature inversion had a significant positive correlation with the concentration of pollutants. Considering temperature inversion as an instrumental variable for these pollutants, it is observed that 1 µg/m3 increase in concentration of PM2.5, increased the number of accidents approximately by 4% in 1 day, for the range of parameters studied. No significant relationship was observed regarding the effect of NO2 and CO on accidents during the study period.

Rifampicin for Idiopathic Granulomatous Lobular Mastitis: A Promising Alternative for Treatment.

BACKGROUND: Idiopathic granulomatous lobular mastitis (IGLM) is a chronic, non-caseating, inflammatory breast disease of obscure aetiology characterized by multiple masses, abscesses and sinus formation. There is no standard treatment to date, but surgical procedures and systemic corticosteroids are effective in its treatment despite high recurrence rates. PATIENTS AND METHODS: This prospective study including 30 patients with IGLM between November 2012 and May 2016 aimed to investigate the possibility of administration of Rifampicin (300 mg twice daily for a period of 6-9 months) as an alternative therapy for both surgery and corticosteroids in patients with IGLM. All patients were diagnosed by core needle biopsy. RESULTS: All patients were of reproductive age and had a history of breast feeding, which is the most important predisposing factor for IGLM. The mean age was 31.6 ± 5.8 years (range 23-42 years). Eighteen patients (60%) were treated by Rifampicin for 6 months, whereas 12 patients (40%) were treated for 9 months. Twelve months after the beginning of therapy, all patients showed complete clinical and ultrasonographic responses. No serious side effects were reported to stop the treatment course. The median follow-up after finishing the course of treatment was 15.5 months (average 3-35 months) with no episodes of disease relapse. CONCLUSION: Rifampicin is effective in the treatment of patients with IGLM with complete clinical and ultrasonographic response after 6-9 months and could be used as a solo medical therapy alternative to both surgery and corticosteroids.

The outcome of oncoplastic techniques in defect reconstruction after resection of central breast tumors.

BACKGROUND: Traditionally, conservative breast surgery was contraindicated in centrally located breast tumors, with total mastectomy as the treatment of choice. However, restorations of the central defects by the oncoplastic volume displacement or replacement techniques have been shown to be effective. The aim of the current study was to assess the surgical outcome of oncoplastic techniques after central breast tumors resection. METHODS: Thirty patients with central breast cancer, including two patients with Paget disease, treated at the Oncology Center of Mansoura University (Egypt) between June 2011 and December 2014 were included in this study. The oncoplastic techniques performed were Grisotti advancement rotational flap in eight (26.7%) patients, classic skin-sparing mastectomy (SSM) with latissimus dorsi pedicled flap in 20 (66.7%) patients, and skin-reducing mastectomy (SRM) with latissimus dorsi pedicled flap using wise pattern inverted T incision in two (6.7%) patients. The choice of the oncoplastic techniques depends on the achievement of free safety margins, the breast volume, and its ptotic degree. RESULTS: The median age was 40.5 years (range; 23-55). There were no major complications that require repeating the oncoplastic techniques. Recorded complications included wound dehiscence (4/30, 13.3%) donor site seroma (4/30, 13.3%), and surgical site infection (1/30, 3.3%). The 6-month subjective patient satisfaction was excellent in 21 (70%) patients, good in 6 (20%) patients, and fair in 3 (10%) patients. There was no episode of local recurrence or systemic metastasis after an average follow-up duration of 24 months (range; 6-42). CONCLUSIONS: Restoring the central defect after resection of the central breast tumors can be safely achieved using oncoplastic procedures including the Grisotti technique or the design of SSM or SRM with immediate breast reconstruction. In our patients, these procedures yield a satisfactory esthetic outcome with lower morbidity.