Normal variation of bronchial reactivity in nonasthmatics is associated with the level of mite-specific IgE.

OBJECTIVE: To investigate association between non-specific bronchial reactivity (NBR) and level of mite specific IgE amongst mite-sensitized non-asthmatic subjects. METHODS: Subjects attending occupational check-up were assessed for: respiratory symptoms, atopic status (skin prick testing [SPT], total and specific IgE), spirometry and NBR. Individuals without history of respiratory disease (N = 234) were included into analysis. RESULTS: All subjects had normal spirometry and 99% had normal NBR while 41.8% had detectable specific IgE to mites. Lung function parameters and NBR were significantly lower in mite sensitized subjects. Multiple regression analysis controlling for age, gender, smoking, family history, SPT, IgE, and lung function showed that NBR was significantly associated only with mite specific IgE level (beta = 0.26; 95% CI, 0.05-0.47; p = 0.018). CONCLUSION: Even in subjects without allergic symptoms, IgE-mediated sensitization does not appear to be all or nothing phenomenon influencing the normal variability of underlying airway reactivity.

Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients.

AIM: To test the predictive value of stairs climbing test for the development of postoperative complications in lung cancer patients with forced expiratory volume in one second (FEV1)<2 L, selected for an elective lung surgery. METHODS: The prospective study was conducted in 101 consecutive patients with an FEV1<2 L selected for elective lung surgery for lung cancer. Preoperative examination included medical history and physical examination, lung function testing, electrocardiography, laboratory testing, and chest radiography. All patients underwent stairs climbing with pulse oximetry before the operation with the number of steps climbed and the time to complete the test recorded. Oxygen saturation and pulse rate were measured every 20 steps. Data on postoperative complications including oxygen use, prolonged mechanical ventilation, and early postoperative mortality were collected. RESULTS: Eighty-seven of 101 patients (86%) had at least one postoperative complication. The type of surgery was significantly associated with postoperative complications (25.5% patients with lobectomy had no early postoperative complications), while age, gender, smoking status, postoperative oxygenation, and artificial ventilation were not. There were more postoperative complications in more extensive and serious types of surgery (P<0.001). The stairs climbing test produced a significant decrease in oxygen saturation (-1%) and increase in pulse rate (by 10/min) for every 20 steps climbed. The stairs climbing test was predictive for postoperative complications only in lobectomy group, with the best predictive parameter being the quotient of oxygen saturation after 40 steps and test duration (positive likelihood ratio [LR], 2.4; 95% confidence interval [CI], 1.71-3.38; negative LR, 0.53; 95% CI, 0.38-0.76). In patients with other types of surgery the only significant predictive parameter for incident severe postoperative complications was the number of days on artificial ventilation (P=0.006). CONCLUSION: Stairs climbing test should be done in routine clinical practice as a standard test for risk assessment and prediction of the development of postoperative complications in lung cancer patients selected for elective surgery (lobectomy). Comparative to spirometry, it detects serious disorders in oxygen transport that are a baseline for a later development of cardiopulmonary postoperative complications and mortality in this subgroup of patients.

[The importance of exhaled breath condensate analysis in diagnosing a lung disease]. / Vaznost analize kondenzata izdahnutog zraka u plucnim bolestima.

Exhaled breath condensate (EBC) contains aerosolised airway lining fluid and volatile compounds that provide non-invasive insight in biochemical and inflammatory activities in the lung. The interest in EBC has grown rapidly since this easily sampled fluid showed measurable properties that clearly indicate a disease. EBC assays provide evidence of redox deviation, acid-base status, and of the degree and type of inflammation in acute and chronic asthma, chronic obstructive pulmonary disease, cystic fibrosis, adult respiratory distress syndrome, and other lung diseases. Because of uncertain and variable degrees of dilution, EBC does not provide precise assessment of individual solute concentrations within native airway lining fluid. However, it can provide information when concentrations differ substantially between health and disease. Because, EBC assays are approachable and easy to perform, they will become integral components of future clinical studies, and after standardisation is accomplished, they might be used to diagnose and monitor therapy in clinical practice.

[Household gas poisonings]. / Otrovanja plinovima u kucanstvu.

Exposure to toxic gases which can induce serious health effects, can occur in the working as well as in general environment, including home. The severity of gas poisoning is determined by its physical and chemical characteristics, intensity and duration of exposure, and concomitant diseases and injuries in the poisoned person. Manifestations of gas toxic action involve simple asphyxia, local irritation of respiratory mucosa, systemic toxicity, and a combination of these mechanisms. This article describes the characteristics, modes of exposure and health effects of most common gases causing poisoning at home. These include gas fuels, carbon monoxide, ammonia, chlorine, and fire gases such as nitrogen and sulphur oxides, hydrogen cyanide and phosgene. First aid as well as preventive measures to avoid exposure to toxic gases and prevent fire at home are also given. The Croatian Poison Control Centre gathered data on toxic gas exposures in households between November 2005 and July 2006. During this period 30 persons (3 % of the total number of cases) were exposed to toxic gases at home, including carbon monoxide, irritating vapours from cleaning agents and disinfectants, gas fuels, septic tank gases, tear-gas, and chlorofluorocarbons from refrigerators.

Sexual life after cervical carcinoma.

The aim of this study is to determine the differences in sexual life of women with cervical cancer after surgery and radiation therapy. A total of 210 patients treated for cervical cancer at the Department of Obstetrics and Gynecology, School of Medicine, University of Zagreb, Croatia between March 2001 and March 2003 were asked to fill in the questionnaire. Sexual life had worsened in 42.86% of the surgical patients, as had in 25.00% of irradiated patients (p < 0.01). The main reason of sex life impairment was fear of pain (55.55% and 42.86%, respectively (p > 0.05)). More than 80% of patients didn't notice any changes in their partner's behavior. Almost every third woman felt certain change in her "body image", similar in both groups (p > 0.05). Need for consultations regarding sex life after diagnosis were recognized by 71.43% of patients. In conclusion we can say that considerable amount of attention should be given to psychological and sexual aspects of recovery of patients, because those aspects can significantly influence patients rehabilitation and prognosis.