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Seasonal variation in admission rates to intensive care units.

Intensive care physicians perceive that there is seasonal variation in the number of admissions to critical care services. There is, however, little published evidence to support this belief. Data were therefore collected from five adjacent critical care units in the eastern region over a period of 8 years, in order to quantify any seasonal variation that may exist. Data on 16 355 critically ill patients were obtained between 1992 and 2000. Analysis showed clear winter peaks; December had a 30% higher admission rate than the quietest month, February. There was a small, but increasing, summer peak. The admission rate also exhibits an increasing linear trend, equivalent to a 6.6% annual increase in admissions per critical care bed. We conclude that there is significant seasonal variation in critical care activity, and that this is important to consider when planning services.

Adult↗

Seasonal variation in bone lead contribution to blood lead during pregnancy.

Population blood lead level (PbB) often shows seasonal variation, frequently being higher in summer and lower in winter. As vitamin D metabolites also show seasonal variability, and the metabolites are associated with bone metabolism, some authors have posited a role for bone lead release in seasonal PbB changes. We made third trimester and postdelivery PbB measurements on 414 immigrant women (98% Latina) in Los Angeles. We measured in vivo tibia and calcaneus (heel) lead concentration postdelivery via K-shell X-ray fluorescence. We saw evidence of seasonal variation in prenatal PbB, but not postnatal PbB. PbB was highest in spring and lowest in autumn. Tibia lead concentration was associated with prenatal PbB, as reported before. The contribution of tibia lead to prenatal PbB varied seasonally, with the greatest contribution occurring in the winter quarter and the least in the summer quarter. The temporal pattern of bone lead contribution to PbB follows the seasonal alteration of insolation. There was no seasonal component in prenatal PbB associated with calcaneus lead, nor were there seasonal variations in either calcaneus or tibia lead contributions to postnatal PbB. Bone turnover in the third trimester of pregnancy may be higher in winter months than in summer months, resulting in greater fetal lead exposure in spring than at other times of the year.

Bone and Bones↗

Seasonal variation in consumption and plasma concentrations of fatty acids in Japanese female dietitians.

OBJECTIVE: To study seasonal variation in intake and plasma concentrations of fatty acids (FAs) in Japanese female dietitians. SUBJECTS AND METHODS: We assessed consumption of FAs based on four season 7 consecutive day weighed diet records from 71 Japanese female dietitians in 1996-1997. Using overnight fasting venous blood, plasma concentrations of FAs were analyzed by gas chromatography. Seasonal variation in consumption and plasma concentrations was examined by ANOVA for repeated values, followed by Tukey's multiple t-test. We calculated Spearman's partial rank correlation coefficients (CCs) between intake and plasma concentrations of FAs. Furthermore, we computed inter-seasonal Spearman's partial rank CCs for consumption and plasma concentrations of FAs. RESULTS: Statistically significant seasonal differences were observed in consumption for most FAs, except for myristic acid, monounsaturated FAs, oleic acid, n-6 polyunsaturated FAs (PUFAs), linoleic acid, gamma-linolenic acid, alpha-linolenic acid, PUFAs/saturated FAs, and n-6 PUFAs/n-3 PUFAs, and for most plasma concentrations, except for stearic acid, gamma-linolenic acid, n-3 PUFAs, alpha-linolenic acid, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and n-3 highly unsaturated FAs (HUFAs). However, statistically significant Spearman's partial rank CCs between intake and plasma concentrations were observed for EPA, DHA, n-3 HUFAs, n-6 PUFAs/n-3 PUFAs and n-6 PUFAs/n-3 HUFAs for almost all seasons. CONCLUSIONS: Seasonal variation exists in consumption and plasma concentrations of FAs, so that this should be taken into account in epidemiological analyses, including case-control and cohort studies.

Adult↗

Seasonal variations of fatty acid compositions in various Korean shellfish.

Seasonal variations of fatty acids in various Korean shellfish were investigated in relation to the changes in total fatty acids contents, the ratio of polyunsaturated fatty acids to saturated fatty acids (P/S), and that of n-3 fatty acids to n-6 fatty acids (n-3/n-6). A distinct seasonal pattern was found in total fatty acids contents with maximal values in early summer and minimal values in late summer. The percentage of monounsaturated fatty acids was lowest in most species throughout the year. In summer months, the proportion of polyunsaturated fatty acids decreased while that of saturated fatty acids increased. The major contributing factor to the seasonal variation of polyunsaturated fatty acids was n-3 fatty acids. These results led to the lowest levels of P/S and n-3/n-6 in summer. Nevertheless, the data suggest that bivalve shellfish would be excellent sources of n-3 fatty acids, especially eicosapentaenoic acid and docosahexaenoic acid.

Fatty Acids↗

Seasonal variation of lipid-lowering effects of complex spa therapy.

BACKGROUND AND OBJECTIVE: It has been shown that spa therapy has a lipid-lowering effect. Also, seasonal variations in spa therapy effects have been found for some outcome measures. The aim of the present study is to investigate whether the lipid-lowering effects of spa therapy as a complex health intervention also are subject to seasonal variation. METHOD: The effect of 3-week resident spa therapy at the Austrian spa Bad Tatzmannsdorf was studied in 395 patients with moderate musculoskeletal chronic pain over a time of 2 years. Spa therapy included balneotherapy, exercise therapy, and dietary measures. Total cholesterol (CHOL), HDL, LDL, triglycerides (TG), and the CHOL/HDL ratio were assessed at the beginning and end of therapy. RESULTS: Spa therapy was associated with a decrease of CHOL, HDL, and LDL (p < 0.001). TG and CHOL/HDL did not change. The decrease of lipids was smaller for older patients, females, and normal weight individuals. CHOL decrease showed a seasonal variation independent of weight loss (p = 0.04), being largest in fall (-6.1%) and smallest in spring (-2.4%). CHOL and CHOL/HDL for obese individuals showed the greatest decrease in winter (-10% for CHOL, -9% for CHOL/HDL ratio), whereas corresponding measures increased for normal-weight subjects. CONCLUSIONS: The lipid-lowering effect of spa therapy could be confirmed; it is partly moderated by season. The results suggest that the effect of some components of spa therapy such as exercise therapy, diet, and relaxation may be subject to seasonal variation.

Adult↗

Seasonal variations in the onset of childhood leukaemia and lymphoma.

Infection has long been suspected as a possible factor in the aetiology of leukaemia and lymphoma. If seasonal variation in the onset of disease could be shown in any of the diagnostic subgroups of leukaemia or lymphoma, this would provide supportive evidence of an aetiology linked to exposure to infection. All cases in the Manchester Children's Tumour Registry (aged 0-14 years at diagnosis) with acute lymphoblastic leukaemia (ALL), acute non-lymphocytic leukaemia (ANLL), Hodgkin's disease (HD) or non-Hodgkin lymphoma (NHL) between 1 January 1954 and 31 December 1996 were included in an analysis of seasonal variation in the month of first symptom and the month of diagnosis. Cases of common acute lymphoblastic leukaemia (c-ALL) diagnosed from 1979 onwards were also analysed separately. The groups considered for analysis were: all cases of ALL (n = 1070), ALL diagnosed between 18 and 95 months of age (n = 730), ALL diagnosed over 95 months of age (n = 266), c-ALL (n = 309), ANLL (n = 244), all infant acute leukaemias (ALL and ANLL under 18 months; n = 107), HD (n = 166) and NHL (n = 189). Using the Edwards method, both c-ALL and HD demonstrated significant seasonal variation (P = 0.037 and 0.001 respectively) in date of first symptom, with peaks occurring in November and December respectively. Using this method, no indication of seasonal variation was found in the other diagnostic groups for date of first symptom or in any of the diagnostic groups for date of diagnosis. For comparison with a previous study, a further analysis based on date of diagnosis for all ALL cases, using summer-winter ratios, showed a significant summer excess. These results provide supportive evidence for an infectious aetiology for c-ALL and HD, and possibly for all ALL, which warrants further investigation.

Adolescent↗

Seasonal variations in hydraulic performance of rock-plant filters.

Hydraulic retention time (HRT) may be one of the major factors causing seasonal variations in treatment efficiency of rock-plant filters. Six meso-scale rock-plant filters, three with narrowleaf cattails (Typha augustifolia) and three unplanted, were investigated to evaluate the influence of plant factors on HRT. Tracer studies were conducted during summer, fall, and spring to evaluate seasonal variations in hydraulic performance. Significant evapotranspiration was observed during summer, up to 38.7 mm d(-1), which was five times the corresponding Class A pan evaporation and more than 58% of the applied water. This caused effective HRT to increase by about 50%. Significant gravel expansion also was observed after 2 years of operation. Total bed volume increased up to 21.8%. This increase in bed volume may help maintain porosity and prevent dogging in wetlands. It also caused the subsurface flow pattern to vary from plug flow. High evapotranspiration significantly increased effective HRT in rock-plant filters, which consequently contributed to seasonal variations in treatment performance. Changes in effective HRT should be considered both in process modeling to account for seasonal hydraulic variations and in wetland operations to prevent potential dry-out during warm seasons.

Filtration↗

Circadian and seasonal variations of electrolytes in aging humans.

The circadian and seasonal variations of a set of routinely determined variables (chloride, sodium, potassium, calcium, inorganic phosphorus, magnesium, creatinine, urea and urate) were documented in young men (mean age +/- SD: 24.0 +/- 3.9 yr) and in healthy elderly men (75.3 +/- 6.6) and women (78.2 +/- 9.1). The same urinary variables, except magnesium, were studied in young men. The circadian variability of serum variables was between 2 and 11% except for serum inorganic phosphorus (12-22% according to the group). By contrast, urinary chloride, sodium and potassium revealed large peak-trough differences (55-75%) and the variability of urinary creatinine, urate and urea was also not negligible (20-30%). ANOVA validated seasonal variations for most of the plasma variables and for urinary calcium, phosphorus and uric acid. No age or sex difference in either 24 h means or amplitudes could be observed. These data are of interest for the concept of reference values, for the diagnosis of certain bone and renal disease as well as for chronooptimization in treatment of potential electrolytes deficiency states.

Aged↗

Seasonal variation of the abdominal aortic aneurysm rupture in southwestern Greece.

OBJECTIVE: To examine the hypothesis of seasonal variation in the rupture of abdominal aortic aneurysm in our region. DESIGN: Retrospective open study. SETTING: University Hospital, Greece. PATIENTS: Forty-six patients with abdominal aortic aneurysm admitted between 1991-1995. INTERVENTION: The month of admission was registered. MAIN OUTCOME MEASURES: The seasonal variation in the abdominal aortic aneurysm rupture. RESULTS: The majority of ruptures (78%) occurred during the months October and April, a phenomenon proven to be periodical (p<0.05). CONCLUSIONS: The abdominal aortic aneurysm rupture clearly showed seasonal variation.

Aged↗

Seasonal variation in blood pressure in normotensive women studied by home measurements.

1. The factors influencing the seasonal variation in blood pressure measured at home in normotensive women were examined. 2. Sixteen female subjects (56.3 +/- 7.9 years old, mean +/- SD) measured their blood pressure and pulse rate at home each morning for more than 20 times per month for at least 1.5 years. Blood pressure and body weight were also determined in the office once or twice a month in that period. Monthly means of outdoor and indoor temperatures and daytime length were obtained from the Meteorological Observatory. The single cosinor method was used to evaluate circannual rhythm. 3. We observed a biphasic seasonal variation in self-recorded blood pressure measured at home, environmental temperature and daytime length but found no apparent seasonal variation in body weight and blood pressure measured in the office. The lowest levels of systolic and diastolic blood pressure measured at home were observed in July. The longest daytime length was recorded in June, while the highest outdoor temperature and indoor temperature were recorded in August, indicating that the longest daytime length preceded and the highest environmental temperature lagged behind the lowest level of blood pressure. The shortest daytime length is in December. The lowest outdoor and indoor temperature were observed in January, while the highest levels of self-recorded systolic blood pressure and diastolic blood pressure were in January and December, respectively. Half-amplitudes of self-recorded systolic and diastolic blood pressure were 2.6 +/- 1.0 mmHg and 2.0 +/- 0.8 mmHg, respectively. 4. These findings indicate the importance of a seasonal effect, i.e. daytime length and the environmental temperature, on the blood pressure of individuals.

Adult↗

Seasonal variations of serum lipids and apoproteins.

Seasonal variations of blood lipids, which must be considered when performing long-term studies, could be partially due to dietary changes. In the present study, serum lipid parameters were measured each month for 1 year in nuns living in a monastery, whose diet was perfectly regular and controlled. The serum lipid variations observed consisted mainly of an increase in total cholesterol, low-density lipoproteins and apolipoprotein B in autumn and spring and an increase in high-density lipoprotein cholesterol in winter, whereas apolipoproteins A-I and A-II showed a marked increase in summer and at the beginning of autumn. These variations were probably induced by factors directly related to seasonal rhythm and not to dietary factors or physical exercise. Lastly, the influence of sex hormones seems to be very minor, as postmenopausal women (one-third of the persons) had an identical variation in their lipid parameters, to that observed in the whole group.

Adult↗

Seasonal variations in children's calls to a help-line: implications for preventive services.

BACKGROUND: To investigate seasonal variations in telephone calls to a help-line for children, and their correlation to changes in length of day, latitude and age. METHOD: 691,787 calls to the Red Cross Help-Line in Norway for children in the three-year period 1996-1998 were included. RESULTS: Monthly frequencies of calls deviated significantly from an expected even distribution (chi2=9446.34, df=11, P<0.0001). The frequency curve for calls peaked in April and October and had its lowest level in July and December. Variation was pronounced: the mean number of daily calls varied between 436 in July and 886 in April. There was a strong and positive correlation between the number of calls and the change in length of day across the year (r(s)=0.76, N=12, P<0.01). Increasing latitude correlated positively with the range of the monthly observed/expected ratios of calls (r(s)=0.79, N=7, P<0.05). The frequency of calls was largest among children 12 to 14 years of age. Age correlated negatively with the range of monthly observed/expected ratios of calls (r=-0.94, N=12, P<0.001). LIMITATIONS: Social and cultural factors could not be explored in the design used in the present study. CONCLUSIONS: The frequency of calls from children correlates positively with change in length of day (i.e., maximal in spring and fall), and the magnitude of the seasonal variation correlates positively with latitude and negatively with age. Knowledge of seasonal variation in requests for help may have value in planning services for children.

Adolescent↗

Seasonal variation in immune measurements and MRI markers of disease activity in MS.

BACKGROUND: The exact mechanisms by which T cells contribute to MS progression are not known. Recently, the results of cross-sectional studies suggested seasonal variation of both interferon (IFN)-gamma production and the number of active MRI lesions in MS. OBJECTIVE: To investigate whether seasonal fluctuations of IFN-gamma and active MRI lesions could be confirmed and whether any correlations could be detected. METHODS: Data were analyzed from a group of 28 MS patients in whom detailed longitudinal monitoring of both immune function and MRI measurements had taken place. RESULTS: Significant seasonal variation was observed in T-cell activation as measured by the ability of T cells to secrete the pro-inflammatory cytokines tumor necrosis factor-alpha and IFN-gamma. Maximum values were found in samples obtained during autumn. Even though clear fluctuations were observed, no significant seasonal variation could be detected in the number of active MRI lesions. Fluctuations of in vitro IFN-gamma secretion correlated weakly with changes in active MRI lesions. CONCLUSIONS: The finding of seasonal variation of immune function in serially MRI-monitored MS patients suggests an environmental role in T-cell activation.

Adult↗

A seasonal variation in the incidence of ruptured abdominal aortic aneurysms.

OBJECTIVE: To discover whether there is a seasonal variation in the incidence of rupture of abdominal aortic aneurysms. DESIGN: Deaths per month due to rupture of abdominal aortic aneurysm were analysed retrospectively using a cosinor regression model. SETTING: England and Wales. SUBJECTS: 19,599 patients who died from rupture of abdominal aortic aneurysm between January 1991 and December 1995 according to death certification data. INTERVENTIONS: None. RESULTS: A seasonal variation in the incidence of rupture of abdominal aortic aneurysm occurs, with a peak in winter (p = 0.003). The ratio of rupture of abdominal aortic aneurysm in males and females decreased from more than 12 to 1 below age 60 years to less than 5 to 1 over age 80 years. CONCLUSIONS: There is a seasonal variation in the incidence of recorded deaths from abdominal aortic aneurysm in England and Wales, with a peak of deaths in the cold winter months. The underlying cause is unknown, but hypertension and tobacco smoking are predisposing factors to aortic aneurysm rupture. Exposure to tobacco smoke is known to be greater indoors in cold weather and there is a winter peak of blood pressure in hypertensive patients.

Age Factors↗

Seasonal variation in postdexamethasone cortisol values in depressed inpatients. Results of least squares cosine spectral analysis.

Recently, a significant seasonal variation in postdexamethasone (post-DST) cortisol values in depressed patients has been reported. This study aimed to investigate seasonal variation in post-DST cortisol values in 269 depressed patients admitted to a psychiatric ward during 70 consecutive months. By means of analysis of variance no significant differences could be detected in post-DST values in depressed men or women, alone or together, between the 12 months, the period November-February versus March-October, or between the tour quartiles. By means of spectral analysis no significant seasonal rhythms, i.e. annual or harmonic rhythms, could be found in the time series of post-DST cortisol values either in the total group of depressed patients or in depressed women separately (n = 190). Spectral analysis showed a significantly biannual rhythm in the post-DST cortisol values in depressed men, with peaks in June and December and troughs in March and September. This biannual rhythm explained 12.4% of the variance in the post-DST cortisol values of depressed men. The results show that there is a significant seasonal variation in post-DST cortisol values in depressed men, but not in depressed women.

Dexamethasone↗

Seasonal variation in proliferative response and subpopulations of lymphocytes from mice housed in a constant environment.

A seasonal variation in the proliferative response to mitogens and in the proportion of splenic lymphocyte subpopulations was found in mice housed in a constant environment. The lymphoproliferative responses to T-cell and B-cell mitogens reached maximum values in autumn and summer. Identification of lymphocyte subpopulations by flow cytometry demonstrated that the proportion of T cytotoxic-suppressor (Tcs) lymphocytes was significantly higher in autumn and summer than in spring and winter. However, the proportion of B lymphocytes was significantly lower in spring than in the other three seasons, whereas the proportions of T and T helper (Th) cells did not show any seasonal variation. On the other hand, we observed a significant correlation between the level of mitogenic responsiveness and the proportion of Tcs cells, but not between the former and the proportions of B, T or Th cells. These data suggest that the seasonal variation in murine lymphoproliferative responses may depend on the cyclic changes in the proportion of Tcs lymphocytes; these changes, in turn, may be predetermined by the inherent internal biological rhythms of the animal.

Animals↗

Seasonal variations in coronary heart disease.

Coronary heart disease exhibits a winter peak and summer trough in incidence and mortality, in countries both north and south of the equator. In England and Wales, the winter peak accounts for an additional 20,000 deaths per annum. It is likely that this reflects seasonal variations in risk factors. Seasonal variations have been demonstrated in a number of lifestyle risk factors such a physical activity and diet. However, a number of studies have also suggested a direct effect of environmental temperature on physiological and rheological factors. We review the available evidence on seasonal variations in coronary heart disease and possible explanations for them.

Cold Climate↗

Seasonal variations in onset of symptoms in Crohn's disease.

BACKGROUND: Seasonal variations in onset of symptoms have been reported in ulcerative colitis but not in Crohn's disease. AIM.: To investigate whether our inflammatory bowel diseases patients presented seasonal variations in onset of symptoms. PATIENTS AND METHODS: Patients with a diagnosis of inflammatory bowel diseases established between 1995 and May 2004, and consecutively observed from June 2003 to May 2004, were included in the study. Onset of symptoms (year, season and month) was recorded. Expected onsets with a uniform distribution during the year were calculated and compared to observed onsets. STATISTICAL ANALYSIS: chi-square test, odds ratio (95% confidence interval). RESULTS: Overall 425 inflammatory bowel diseases patients were enrolled. Onset of symptoms (year and season) was established in 353/425 patients (83%; 150 Crohn's disease; 203 ulcerative colitis). Onset of symptoms in inflammatory bowel diseases patients as a whole occurred more frequently in spring-summer compared to autumn-winter (odds ratio 1.39; 95% confidence interval 1.03-1.87; p<0.03). This variation was observed in Crohn's disease (odds ratio 1.59; 95% confidence interval 1.00-2.51; p<0.05) and a similar trend, although not significant, was observed in ulcerative colitis (odds ratio 1.27; 95% confidence interval 0.86-1.88; p=0.27). CONCLUSIONS: These data indicate that onset of Crohn's disease symptoms occurred more frequently during spring-summer. A similar trend was observed in ulcerative colitis. Environmental factors, such as associated infections, smoking, use of drugs and seasonal changes in immune function may be responsible for triggering the clinical onset of inflammatory bowel diseases.

Adolescent↗