Application of conventional and microbeam synchrotron radiation x-ray fluorescence and absorption for the characterization of human nails.

The synchrotron radiation based spectroscopies X-ray fluorescence and X-ray absorption fine structure are used to detect illness-related changes in the elemental distribution and bonding environment of metals in human nails. The effective atomic number of a collection of nails is determined using two methods, the X-ray transmittance and the scattering method, and is found equal to 7.5 +/- 0.5. X-ray fluorescence maps of the elemental distributions, recorded with a lateral resolution of 5 microm, reveal that S, Ca and Zn are distributed homogeneously while Fe tends to cluster. In the Fe-rich clusters, which have a diameter in the range 15-30 microm, the Fe concentration is 10 times higher than in the matrix. The Zn K edge X-ray Absorption Fine Structure spectra reveal that Zn, in the nails from healthy donors and patients suffering from lung diseases, is four-fold coordinated with N and S and the Zn-N and Zn-S distances are equal to 2.03 A and 2.25 A, respectively. Finally the signature of various bonds in the C-, O- and N- K near edge X-ray absorption fine structure spectra is discussed.

Tidal breathing flow-volume loop analysis for the diagnosis and staging of tracheal collapse in dogs.

BACKGROUND: Tracheoscopy is generally used for the diagnosis of tracheal collapse (TC) in dogs; yet, it is costly, requires anesthesia, and can irritate the airway. The tidal breathing flow-volume loop (TBFVL) is a safe, quick, and noninvasive pulmonary function test currently used in humans. HYPOTHESIS: TBFVL will differentiate dogs with TC from healthy controls and contribute to disease grading. ANIMALS: Twenty-eight dogs with naturally occurring TC and 10 healthy controls. METHODS: Cross-sectional, prospective clinical study: The 38 dogs were assigned to one of 4 groups based on tracheoscopy results: group A (n=10, healthy controls), group B (n=10, grade I TC), group C (n=10, grade II TC), and group D (n=8, grade III TC). The TBFVL measurement was performed on all dogs and loops were assessed for their shape. Forty-four TBFVL parameters were calculated. RESULTS: Two types of TBFVL shapes were identified: Type I, representative of the 10 healthy controls, and Type II, representative of the 28 dogs with TC. Statistical analysis showed the dogs could be differentiated into healthy or affected by TC by 3 indices, TE/TI (expiratory time divided by inspiratory time), TI/TTOT (inspiratory time divided by total respiratory time), and EF75/IF75 (expiratory flow at end tidal volume plus 75% end tidal volume divided by inspiratory flow at end tidal volume plus 75% end tidal volume). The TC could also be graded as mild-moderate (grades I and II) or severe (grade III), showing a diagnostic value of 97.4%. CONCLUSION AND CLINICAL IMPORTANCE: TBFVL is accurate, quick, noninvasive, and safe and can contribute to the diagnosis of TC in dogs.

Bronchoalveolar lavage fluid eosinophils are correlated to natural killer cells in eosinophilic pneumonias.

BACKGROUND: Eosinophilic lung diseases comprise a group of heterogeneous pulmonary disorders linked by increased eosinophils in bronchoalveolar lavage fluid (BALF). There is supporting evidence that natural killer (NK) cells participate in the regulation of eosinophilic inflammation. OBJECTIVE: Our aim was to investigate the relationship between eosinophils and NK cells in BALF in patients with different interstitial lung diseases (ILDs) focusing on eosinophilic pneumonias. METHODS: Of 114 patients who presented with increased BALF eosinophils (>5%), 74 patients were classified into the following groups: 27 had eosinophilic pneumonia (EP), 17 had idiopathic pulmonary fibrosis (IPF), 16 had hypersensitivity pneumonitis (HSP) and 14 had cryptogenic organizing pneumonia (COP/BOOP). Total BALF cells, cell density and cell differential counts were assessed and lymphocyte subsets CD3+, CD4+, CD8+, CD19+, CD3-CD16/56+ (NK) and CD3+CD16/56+ (NKT) were determined by flow cytometry. RESULTS: Significant differences were observed in the percentages of lymphocytes (p < 0.001) and CD3+CD16/56+ cells (p = 0.023) among patient groups. In patients with EP, the percentage of eosinophils correlated positively with the number of CD3-CD16/56+ cells (r = 0.522, p = 0.005), the percentage of CD3-CD16/56+ cells (r = 0.690, p < 0.001), and the absolute count of CD3+CD16/56+ absolute cells (r = 0.609, p = 0.001). However, in patients with IPF, HSP or COP/BOOP, no correlation between the percentage of eosinophils and CD3-CD16/56+ or CD3+CD16/56+ cells was observed. CONCLUSIONS: Eosinophil inflammation seems to develop through a different pathway in EP compared to other ILDs.

Hypoxemia: an early indication of pigeon breeders' disease. Clinical and laboratory findings among pigeon breeders in the Salonica area.

The purpose of this study is to identify pathological findings among pigeon breeders in the Salonica area. Fifty-four volunteer breeders with varying intensity of contact with pigeons participated in the study. All the breeders, after filling in a questionnaire that included questions about the existence of conjunctivitis, rhinitis, chronic cough and sputum, were subjected to clinical examination and spirometric, hematological (arterial and venous), radiographic and immunologic tests. Twenty-five point nine percent of the breeders suffered from conjunctivitis, 31.5% from rhinitis and 33.3% from chronic cough and sputum. Fourteen point eight percent of them had class I precipitins, 7.4% had class II, 5.6% had class III and 16.7% had class IV and a positive correlation of precipitin class with the number of pigeons bred was found. Seven breeders (13%) had hypoxemia at rest and other 8 (14.8%) presented with hypoxemia after the exercise testing. Two breeders presented with a combination of findings of allergic alveolitis that satisfied the criteria of the Pigeon Breeders' Disease (PBD). A substantial number of the examined pigeon breeders were sensitized to pigeon serum antigens. Arterial hypoxemia, either at rest and/or after exercise was observed in 27.8% of breeders. Three point seven percent of breeders presented with clinical and laboratory findings consistent with PBD. Chronic cough and sputum in pigeon breeders should be considered as a possible manifestation of PBD.

The effects of environmental pollution on the respiratory system of children in western Macedonia, Greece.

The indoor and outdoor environmental pollution effects on the respiratory system of 3,559 children aged 9-12 were studied. It was a cross-sectional and interlocal (geographical differentiation) study. The research was conducted during the period between 2000-2001 in five cities of Western Macedonia and more particularly: 1046 children from Ptolemaida, 1249 children from Kozani, 466 from Florina, 419 from Kastoria and 379 from Grevena. The study was performed by means of a questionnaire for the detection of respiratory diseases during childhood, plus spirometry and rhinomanometry measurements. The diachronic quantitative analysis of environmental pollutants was conducted by The Laboratory of Physics of the Atmosphere of the Aristotle University of Thessaloniki. The environmental pollution was found to have a detrimental effect on the respiratory system of children, mainly attributable to the occurrence of rhinitis and infectious bronchitis. The highest prevalence of rhinitis (40.3%) and infectious bronchitis (12.1%) was observed in Ptolemaida, which is a highly polluted region, whereas the lowest (21.2% and 6.7%, respectively) was seen in Grevena, a non-polluted area. As for the indoor pollution, maternal smoking was found to increase the prevalence of respiratory problems in children. Finally, the father's educational level and a past history of nursery school attendance increase the prevalence of respiratory diseases during childhood.

Allergenic fungi spore records (15 years) and sensitization in patients with respiratory allergy in Thessaloniki-Greece.

BACKGROUND: The prevalence of respiratory allergy to fungi spores (FS) is not precisely known but is estimated at 20-30% of atopic patients. There are no aerobiological records, necessary for respiratory allergy diagnosis and treatment, in Thessaloniki and generally in Greece. AIM: Creation of a database on FS circulation and investigation of skin sensitivity (SS) of asthmatics by using skin prick tests (SPT). MATERIAL AND METHODS: Daily records and identification of 15 airborne FS species were conducted, using a Burkard trap during 1987-2001. SS to 5 most common FS extracts was investigated, by using SPT in a total of 1311 asthmatics with atopy, submitted to the Out-Patient Clinic of Asthma (Pulmonary Dept, Aristotle Univ, Thessaloniki) in 1990-2001. RESULTS: The FS recorded in the 15-year period were as follows: Cladosporium spp. (72.2%), Alternaria spp. (9.8%), Ustilago spp. (8.1%), Ascospores (2.7%), Agrocybe spp. (1.5%), Helminthosporium spp. (1.4%), Leptosphaeria spp (1.2%), Agrogybe spp. (1.1%), whereas the species Botrytis, Stemphylium, Pleospora, Nigrospora, Epicoccum. Fusarium, Torula and Phoma presented concentrations <1%. The highest numbers of airborne FS were recorded during summer. Positive skin reaction to FS was observed in 421 (32%) patients of the 1311 asthmatics. Positive skin reaction to Altemaria species was observed in 177 patients (13.5%), in 98 (7.4%) to Cladosporium, 65 (5%) to Aspergillus, 45 (3.4%) to Fusarium and 36 (2.7%) to Rhizopus. FS sensitivity is much more frequent in younger men. CONCLUSIONS: For the first time in Thessaloniki-Greece, 15 allergenic FS species circulation has been recorded for the last 15 years. SS was more frequently detected for the species of Alternaria, Cladosporium and Aspergillus.

The prevalence of allergic asthma and rhinitis in children of Polichni, Thessaloniki.

AIM: To define the prevalence of asthma and rhinitis in primary school children in the Polichni Municipality of the city of Thessaloniki. METHODS AND RESULTS: The parents of 2005 students living in the area of Polichni completed a questionnaire for the detection of pulmonary disease in childhood. Of 493 children who gave positive answers to the questions about allergies, asthma and rhinitis, 203 were excluded after an interview with the parents, because they suffered from either atopic dermatitis or drug allergy or had normal lgE levels. Of the remaining children, 290 were further examined: methacholine test was positive in 109, exercise test was positive in 67, nasal provocation test with histamine was positive in 244, and rhinodilation test with tramazoline was positive in 206. Skin prick tests were positive in 142 children (90 to grass-cereal pollen, 66 to acarea and 59 to Parietaria officinalis). CONCLUSIONS: We found that 168 children suffered from rhinitis, 84 from both asthma and rhinitis concurrently and 38 from asthma alone. Only 37 % of the parents knew that their children suffered from asthma, while even fewer (32 %) knew that their children had rhinitis. The prevalence of asthma was 6.1 % and that of rhinitis was 12.6 % among children aged 9-12 years in the area of Polichni, Thessaloniki. Childhood rhinitis and asthma seem to be frequently underdiagnosed and undertreated.

The prevalence of allergic asthma and rhinitis in children of Polichni, Thessaloniki

Aim: To define the prevalence of asthma and rhinitis in primary school children in the Polichni Municipality of the city of Thessaloniki. Methods and results: The parents of 2005 students living in the area of Polichni completed a questionnaire for the detection of pulmonary disease in childhood. Of 493 children who gave positive answers to the questions about allergies, asthma and rhinitis, 203 were excluded after an interview with the parents, because they suffered from either atopic dermatitis or drug allergy or had normal lgE levels. Of the remaining children, 290 were further examined: methacholine test was positive in 109, exercise test was positive in 67, nasal provocation test with histamine was positive in 244, and rhinodilation test with tramazoline was positive in 206. Skin prick tests were positive in 142 children (90 to grass-cereal pollen, 66 to acarea and 59 to Parietaria officinalis). Conclusions: We found that 168 children suffered from rhinitis, 84 from both asthma and rhinitis concurrently and 38 from asthma alone. Only 37 % of the parents knew that their children suffered from asthma, while even fewer (32 %) knew that their children had rhinitis. The prevalence of asthma was 6.1 % and that of rhinitis was 12.6 % among children aged 9-12 years in the area of Polichni, Thessaloniki. Childhood rhinitis and asthma seem to be frequently underdiagnosed and undertreated (AU)

Información básica: El objetivo del estudio era definir la prevalencia de asma y rinitis en estudiantes de educación primaria en colegios del municipio de Polichni en la ciudad de Tesalónica. Métodos y resultados: Los padres de 2.005 estudiantes, que vivían en el área de Polichni, rellenaron un cuestionario para la detección de enfermedades pulmonares durante la infancia. De los 493 niños que respondieron de manera positiva a las preguntas referentes a alergias, asma y rinitis, se excluyó a 203 después de una entrevista con los padres porque padecían dermatitis atópica o alergia a fármacos, o presentaban valores normales de IgE. Por lo que respecta a los otros niños, se examinó con más detenimiento a 290; 109 respondieron positivamente a la prueba de la metacolina, 67 realizaron una prueba de esfuerzo positiva, 244 una prueba de provocación nasal positiva con histamina y 206 una prueba positiva de rinodilatación con tramazolina, mientras que las pruebas de punción cutánea fueron positivas en 142 niños (90 a polen de gramíneas-cereales, 66 a ácaros y 59 a Parietaria officinalis). Conclusiones: Se comprobó que 168 niños presentaban rinitis, 84 asma y rinitis al mismo tiempo y 38 sólo asma. Únicamente el 37 por ciento de los padres sabían que sus hijos padecían asma, mientras que un porcentaje aún menor (32 por ciento) sabía que sus hijos tenían rinitis. Se observó que la prevalencia de asma es del 6,1 por ciento, mientras que la de la rinitis es del 12,6 por ciento en los niños de 9-12 años del área de Polichni en Tesalónica. Parece que la rinitis y el asma durante la infancia suelen ser enfermedades diagnosticadas y tratadas insuficientemente (AU)

Allergenic pollen records (15 years) and sensitization in patients with respiratory allergy in Thessaloniki, Greece.

BACKGROUND: Very limited allergenic pollen records exist in Greece so far; moreover, there is a lack of investigation on patient sensitization. The above data are necessary for respiratory allergy diagnosis and treatment worldwide. METHODOLOGY: Daily records and identification of 16 airborne pollen species were made using a Burkard trap (1987-2001). Skin sensitivity to 13 most common pollen extracts was investigated, in a sample of 1311 asthmatics with atopy, admitted to the Out-Patient Clinic for Asthma (1990-2001). Skin sensitivity to 55 allergens, including 13 pollen extracts, was detected by skin prick test. RESULTS: The following pollen concentrations were recorded: cypress (24.9% of the total), oak (20.8%), wall pellitory (13.6%), olive (9.1%), pine (8.9%), grasses (6.3%), plane (5.4%), hazel (3%), goosefoot (2.5%) and poplar (1.4%). The respective percentages of birch, ragweed, mugwort, willow, alder and elm were lower than 1%. The highest counts of airborne pollen grains were detected from March to June. Regarding patient sensitization, sensitivity was detected to: grasses in 530 patients (40.4%), olive 417 (31.8%), goosefoot 240 (18.3%), wall pellitory 201 (15.3%), mugwort 198 (15.1%), plantain 194 (14.6%), cypress 166 (12.7%), hazel 126 (9.6%), pine 122 (9.3%), poplar 111 (8.4%), plane 107 (8,2%), oak 99 (7.6%) and to birch 89 patients (6.8%). The sensitivity to pollen grains displays preponderance (57.9%) to males. CONCLUSIONS: For the first time in Thessaloniki, Greece, 15-year allergenic pollen records were conducted. Clinical observations confirm that the pollen mainly implicated in respiratory allergy symptoms are grasses, olive and wall pellitory.

15-year aeroallergen records. Their usefulness in Athens Olympics, 2004.

INTRODUCTION: About 5-25% of 16 000 athletes involved in preparation for the Athens 2004 Olympics may encounter respiratory allergy (asthma and rhinoconjunctivitis) triggered by exposure to aeroallergens (pollen and fungi spores). AIM: Provide information about circulating aeroallergens in three Olympic cities and ensure safety for the allergic athletes who will visit Greece from January to September 2004. METHODS: Aeroallergens were recorded using a Burkard volumetric trap. The most frequently implicated pollen (cypress, hazel, wall pellitory, plane, olive, grasses, goosefoot and mugwort) and fungi spores (Alternaria spp., Cladosporium spp.) are presented. These data derive from a 15-year database created by the Pulmonary Department, Thessaloniki, a 2-year database (University of Heraklion-Crete) and a 6-year database by the Pediatric Department, Athens. The above data and the current aeroallergen counts will be continuously announced by the mass media and Internet during the Athens 2004 Olympics. RESULTS: Are expressed as: (A) Presentation (Graphs, Tables) of the fluctuation of mean daily values of pollen grains or fungi spores/m3. (B) Presentation (Tables) of the start, peak and end time of aeroallergen circulation. Peak pollen concentrations were observed between March and May (athletes preparation time). During the 2004 Olympics (August-September) relatively high concentrations of goosefoot, mugwort, Alternaria and Cladosporium will be observed. Aeroallergens circulate in Athens 10-15 days earlier than in Thessaloniki and 10 days later than in Heraklion. CONCLUSIONS: The data presented in the study are expected to help allergic Olympic athletes achieve peak performance under prophylactic measures.

Canine atopic dermatitis in Greece: clinical observations and the prevalence of positive intradermal test reactions in 91 spontaneous cases.

Atopic dermatitis was diagnosed in a total of 91 dogs by combining the compatible historical evidence and clinical signs with the presence of one or more positive intradermal test reactions well correlated with the exposure to the aeroallergens and the seasonality of the clinical signs. Compared to the general hospital population Yorkshire terriers, Chinese Shar-Peis and cocker spaniels showed a strong predilection. No such predilection was found regarding the sex of the animals. The age of the dogs at the onset of the clinical signs ranged from 2 months to 8 years (median: 2.5 years). Moderate to severe pruritus, noticed in all the 91 dogs, was either localized (29/91) or generalized (64/91) and non-seasonal (43/91), seasonal (19/91) or of unknown seasonality (29/91). The most common cutaneous lesions included erythema, hyperpigmentation, hypotrichosis and crusts; their body distribution was generalized (64%) or localized (36%) with the feet as the most common site of involvement. Five dogs that had unlesional skin were significantly younger and had been pruritic for a shorter period of time compared to the majority of our study population. Otitis externa (43/91) and bacterial pyoderma (30/91) were the most common conditions associated with atopic dermatitis, while the prevalence of Malassezia dermatitis was very low (2/91). Of the other allergic skin diseases flea allergic dermatitis was the most common (29/91) followed by food hypersensitivity (2 out of the 15 dogs tested). The majority of the dogs demonstrated multiple sensitivities to the 50 aeroallergens tested, while domestic mites (77/91), and particularly Dermatophagoides farinae (64/91), were the most commonly implicated. The total number of the positive intradermal test reactions was increasing parallel to the age of the dogs but it was negatively associated with the presence of skin lesions on the carpal and tarsal joints.

Management of chemotherapy-related anaemia with low-dose recombinant human erythropoietin in patients with small cell lung cancer.

We examined the efficacy of low-dose erythropoietin in the management of chemotherapy-related anaemia in patients with small cell lung cancer (SCLC). We gave recombinant human erythropoietin A (rHuEPO) to 63 SCLC patients, 30 with limited disease (LD) and 33 with extensive disease (ED) who underwent chemotherapy with carboplatin, etoposide and ifosfamide and had previously received blood transfusions for chemotherapy-related anaemia. rHuEPO was given at a dose of 2000 IU subcutaneously three times per week for 2 weeks after every chemotherapy cycle, starting 48 h after the end of chemotherapy. Before the use of rHuEPO, all patients in both groups had to be transfused after a mean of 5.5 CT cycles. In 64 CT cycles following administration of rHuEPO, only 5/30 LD patients (17%) had to be transfused in six cycles (9%). In 88 cycles following the use of rHuEPO, 7/33 ED patients (21%) had to be transfused in 11 cycles (12.5%). Haemoglobin values in patients with ED (but not those with LD) were significantly improved after rHuEPO administration on both day 14 and day 28 after chemotherapy. No adverse effects were recorded. rHuEPO considerably decreased the degree of anaemia and the need for blood transfusion at doses markedly lower (25-30 IU/kg body weight) than those reported in the literature so far (150 IU/kg body weight), without toxicity.

A comparison of the clinical efficacy and patient acceptability of terbutaline Turbuhaler and salbutamol Rotahaler, in adult patients with asthma.

This open randomized, cross-over study compared the clinical efficacy and patient acceptability of the two bronchodilator delivery systems, terbutaline Turbuhaler (0.5 mg t.i.d.) and salbutamol Rotahaler (0.4 mg t.i.d.), each given for 3 weeks. Thirty-two adult asthmatics (21 males and 11 females with a mean age of 34 years) who demonstrated at least 15% reversibility in PEF or FEV1 in response to terbutaline, were enrolled for study. The median reversibility in FEV1 was 27.5% for the terbutaline-salbutamol group and 21% for the salbutamol-turbutaline group. Two patients discontinued during terbutaline treatment (one due to respiratory infection and one due to tachycardia, exhaustion and tremor) and five patients were lost to follow-up during salbutamol treatment, leaving data from 25 patients for an 'all patients treated' analysis. Mean morning PEF was 426 l min-1 during terbutaline and 410 l min-1 during salbutamol (difference 16 l min-1, 95% CI of difference 3-28 l min-1, P = 0.016), and mean evening PEF was 446 l min-1 during terbutaline and 428 l min-1 during salbutamol (difference 18 l min-1, 95% CI 5-30 l min-1, P = 0.0076). No significant differences were detected in diary symptom scores or in use of additional study drug during the day or night, and no serious adverse events were reported. When asked to state their treatment preferences on the basis of effects, side-effects and overall, more patients preferred Turbuhaler in each case, although no statistically significant differences were detected. In conclusion, terbutaline via Turbuhaler was significantly more effective than salbutamol via Rotahaler in controlling lung function (mean daily PEF) in adults with mild to moderate asthma, and it was the preferred treatment overall in 44% of patients, compared with 16% for Rotahaler (n.s.).