BackgroundPrevious studies have reported increased risk of myocardial infarction (MI) after increases in ambient particulate matter (PM) air pollution concentrations in the hours and days before MI onset.ObjectivesWe hypothesized that acute increases in fine PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) may be associated with increased risk of MI and that chronic obstructive pulmonary disease (COPD) and diabetes may increase susceptibility to PM2.5. We also explored whether both transmural and nontransmural infarctions were acutely associated with ambient PM2.5 concentrations.MethodsWe studied all hospital admissions from 2004 through 2006 for first acute MI of adult residents of New Jersey who lived within 10 km of a PM2.5 monitoring site (n = 5,864), as well as ambient measurements of PM2.5, nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone.ResultsUsing a time-stratified case-crossover design and conditional logistic regression showed that each interquartile-range increase in PM2.5 concentration (10.8 μg/m3) in the 24 hr before arriving at the emergency department for MI was not associated with an increased risk of MI overall but was associated with an increased risk of a transmural infarction. We found no association between the same increase in PM2.5 and risk of a nontransmural infarction. Further, subjects with COPD appeared to be particularly susceptible, but those with diabetes were not.ConclusionsThis PM–transmural infarction association is consistent with earlier studies of PM and MI. The lack of association with nontransmural infarction suggests that future studies that investigate the triggering of MI by ambient PM2.5 concentrations should be stratified by infarction type.

Background Previous studies of air pollution and birth outcomes have not evaluated whether complicated pregnancies might be susceptible to the adverse effects of air pollution. We hypothesized that trimester mean pollutant concentrations would be associated with fetal growth restriction, with larger risks among complicated pregnancies. Methods We used a multiyear linked birth certificate and maternal/newborn hospital discharge dataset of singleton, term births to mothers residing in New Jersey at the time of birth, who were White (non-Hispanic), African American (non-Hispanic), or Hispanic. We defined very small for gestational age (VSGA) as a fetal growth ratio <0.75, small for gestational age (SGA) as ≥0.75 and <0.85, and ‘reference’ births as ≥0.85. Using polytomous logistic regression, we examined associations between mean pollutant concentrations during the 1st, 2nd, and 3rd trimesters and the risks of SGA/VSGA, as well as effect modification of these associations by several pregnancy complications. Results We found significantly increased risk of SGA associated with 1st and 3rd trimester PM2.5, and increased risk of VSGA associated with 1st, 2nd, and 3rd trimester NO2 concentrations. Pregnancies complicated by placental abruption and premature rupture of the membrane had ~2-5 fold greater excess risks of SGA/VSGA than pregnancies not complicated by these conditions, although these estimates were not statistically significant. Conclusions These findings suggest that ambient air pollution, perhaps specifically traffic emissions during early and late pregnancy and/or factors associated with residence near a roadway during pregnancy, may affect fetal growth. Further, pregnancy complications may increase susceptibility to these effects in late pregnancy.

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Angiosarcoma of the breast represent <1% of breast malignancies. It can arise de novo (primary) or following treatment for breast carcinoma (secondary). Primary breast angiosarcoma usually affects young women and is extremely rare in the male patient population. Imaging features can have a nonspecific appearance. Histologically, the diagnosis can be challenging, especially in small core needle biopsies. Mastectomy or wide local excision is the usual treatment for both forms of angiosarcoma. Prognosis and recurrence is worse with increasing grade of tumor. Herein, we discuss the rare occurrence of primary breast angiosarcoma in a man with history of immunodeficiency. Clinical, radiological and pathologic findings will be discussed.

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