[Depression and anxiety in mothers of children who grow up in an area with industrial pollution].

This study aimed to investigate the effects of chemical pollution with hexavalent chromium on the mental health of mothers with school/pre-school age children, residents of the area of the Asopos basin in Eastern Central Greece. The people of this area have been experiencing great threat regarding their health each and every day, as a result of the well-documented pollution by hexavalent chromium in drinking and ground-water, which is related to the widespread industrial activity, the usage of hexavalent chromium in various processes and the discharges of Cr-bearing wastes. The environmental impact of hexavalent chromium is a controversial issue critical to the protection of groundwater resources, as it affects the soil and the products from local cultivations used in daily food. This condition has been documented scientifically and was published in the mass media as a serious threat to human and animal life in the specific area. Although in Greece serious environmental-technological disasters have occurred during the last decades, there is a lack of studies on the possible consequences, including the psychological impact on the local population. The sample of this study included eighty-eight mothers of young children, residents of the area of Asopos, who were compared with eighty-eight mothers living in a non-polluted area - the area of Kiato in Northern Peloponnese, as a control group. They were assessed by the CES-D scale and the Spielberger State-Trait Anxiety Scale (STAI I-II), which have been standardized for the Greek population. Results indicated that depression and anxiety were significantly correlated with the place of residence [CES-D: t(169,496)=3.45, p=0.001; STAI I-II: A-state: t(174)=10,131, p=0.000; A-trait: t(174)=8,728, p=0.000]. Mothers from the Asopos basin reported more symptoms of depression (Mean=24,14, SD=11,345) than the control group (Mean=18,68, SD=9,625). Similarly, they have scored higher in both subscales of STAI I-II, measuring state and trait anxiety (A-state: Mean=49,66, SD=12,345; A-trait: Mean=46,76, SD=11,458) than the control group (A-state: Mean=32,24, SD=10,383; A-trait: Mean=32,32, SD=10,474). Regarding the anxiety as a personality trait (STAI-II), mothers in Asopos Area reported higher levels of stress that is likely to be associated with the long-term stressful situation of pollution. It could be assumed that mothers from Asopos Area scored higher in both anxiety scales, as a result of the environmental disaster that has been occurred in the area and the high risk that this poses to life. These results confirm relevant literature findings on depression and feelings of anger in regions that have suffered industrial or physical disasters, and suggest that fighting against chemical pollution in Asopos area also needs additional implementation with psychological support to mothers of children growing in the area. Up to date, no psychosocial support has been provided to the residents at the community level. Further research should be carried out in order to measure the impact of chemical pollution on the psychological well-being and health of all members of the local community.

[Polycystic ovary syndrome].

The Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of reproductive age with complex but interesting reproductive and metabolic ramifications. The effects of various endocrine-hormonal dysfunctions in psychiatry are well known and have been targeted by scientific study for quite some time. During the past few years, psychiatric research has shifted its interest to the cellular level. Steroids that originate in the periphery (e.g. ovaries), as well as those synthesized by the central nervous system (neurosteroids), have neuroplastic effects and interfere with almost all known neurotransmitter systems. Therefore steroid de-regulation that is caused by the PCOS is related to psychiatric symptomatology on both a pathophysiological and a clinical level. In medical psychiatric practice, PCOS is related to many disorders: bipolar disorder and its treatment, epilepsy, depression, cognitive disorders, sleep disorders, eating disorders, and somatoform disorders. On a psychological level, women suffering from PCOS may display depressive symptoms, anxiety, body image dissatisfaction, diminished sexual interest, and compromised quality of life. Therefore, we believe that it is useful for the clinical psychiatrist to keep in mind the psychiatric and the psychological aspects of PCOS, and their impact on patient diagnosis, course and treatment.

Dysfunctional endothelial nitric oxide biosynthesis in healthy smokers with impaired endothelium-dependent vasodilatation.

BACKGROUND: The mechanisms involved in the dysfunction of both endothelium-dependent vasodilatation (EDV) and NO biosynthesis related to smoking are unclear. In this study, EDV was assessed in healthy smokers and nonsmokers in vivo and, using serum from the same individuals, was related to the NO biosynthetic pathway in vitro. METHODS AND RESULTS: Flow-mediated EDV of the brachial artery was measured in 23 male patients (8 nonsmokers and 15 smokers). Serum was collected, added to confluent ( approximately 85%) monolayers of human umbilical vein endothelial cells (HUVECs), and incubated for 12 hours. Basal and substance P-stimulated NO production was measured. The HUVECs used for measuring basal NO production were lysed, and both endothelial NO synthase (eNOS) protein expression and eNOS activity were determined. EDV was lower in smokers compared with nonsmokers (P<0.001). HUVECs treated with serum from smokers compared with nonsmokers showed significantly lower basal (P<0.0001) and stimulated (P<0.02) NO production, higher eNOS expression (P<0.0001), but lower eNOS activity (P<0.004). There was a significant positive correlation between in vivo EDV and in vitro substance P-stimulated NO production (rho=0.57, P<0.01) and between basal NO production and eNOS activity (r=0.54, P<0.008) and a negative correlation between basal NO production and eNOS protein expression (r=-0.60, P<0.003). CONCLUIONS: This is the first study to combine an in vivo model with a near-physiological in vitro model to demonstrate an association between decreased NO production and reduced EDV. Cigarette smoking was associated with reduced EDV, NO generation, and eNOS activity in the presence of increased eNOS protein expression.

HLA-A and -B antigens and larynx carcinoma in Greeks.

The frequency of HLA antigens in 30 Greek larynx carcinoma patients was more prominent for the A21, A28 and B17 antigens compared to 400 healthy unrelated controls from the same population. It is suggested that immunogenetic factors may contribute to the pathogenesis of this neoplasia.

HLA antigens and asthma in Greeks.

HLA-A and -B antigens were determined in a group of 76 Greek asthmatic patients: 35 children (1.5-15 years) and 41 adults (18-73 years). The results were compared to those of 400 healthy unrelated controls from the same population. The standard NIH lymphocytotoxicity test was applied. When all 76 patients were compared to the controls, a statistically significant lower frequency of HLA-B5 and -B35 antigens was noted. When adults were analysed alone, an increased frequency of HLA-B8 was found. On the other hand, in the asthmatic children sub-group, the HLA-A10 antigen was significantly higher and the HLA-B5 was significantly lower than in the controls. These data imply that different HLA antigens may be involved in the pathogenesis of several clinical forms of asthma and that, in order to study the role of immunogenetic factor(s) in the pathogenesis of this disease, more adequate grouping criteria are needed.

HLA-A and -B antigens in chronic bronchitis.

The A- and B- types of Human Leucocyte Antigens (HLA) were examined in a group of Greek patients with a diagnosis of chronic bronchitis. The results were compared to those of 400 healthy unrelated controls (smokers and non-smokers) from the same population. A statistically significant increase of HLA-A1 and HLA-B17 was noted; a similar increase was also noted when only healthy smokers were utilized as a control group. These results support the hypothesis that genetic factors are also involved in the pathogenesis of this common disease.

HLA antigens in Burger's disease.

The HLA A and B types of 20 Greek patients with thromboangiitis obliterans (TAO) were studied and compared with a panel of 400 controls. A nonstatistically significant increase in the frequencies of HLA B5, B7 and A9 antigens was found. These antigens were found to be associated with a relative risk of 3.47, 3.24 and 2.07 respectively. These findings are partially in agreement with those of a joint English-Swiss study which also found a negative association with B12 antigens; in the Greek population, also of European origin, a negative association was observed with the B8 antigen.

HLA antigens and bronchogenic carcinoma in the Greek population.

The distribution of HLA antigens was studied in 85 Greek patients with bronchogenic carcinoma. Fifty-seven specific HLA antisera were used to determine 27 HLA-A and B antigens, with the two-stage standard NIH microlymphocytotoxicity assay. The results were compared with those in a control group, consisting of 400 healthy individuals. In the whole group of patients there was a significantly higher frequency of HLA-AW19 and HLA-A29 (p less than 0.003 and p less than 0.006 respectively) and a lower frequency of HLA-A2 and HLA-A3 (p less than 0.014 and p less than 0.006 respectively) than in the control population. In patients with squamous cell carcinoma there was a significantly higher frequency of HLA-AW19 and lower frequency of HLA-A2 (p less than 0.02 and p less than 0.05 respectively). In small cell carcinoma patients there was a significantly lower frequency of HLA-A3 (p less than 0.04) than among the controls. In patients with adenocarcinoma no significant change of HLA antigen frequencies was observed when compared to the controls.

Acute bone marrow aplasia associated with intravenous administration of deferoxamine (desferrioxamine).

The authors report the clinical course and fatal outcome of a case of acute bone marrow aplasia, after intravenous administration of deferoxamine (desferrioxamine) to a 16-year-old girl with homozygous beta-thalassaemia. The type of aplasia was mainly that of a megakaryocytic thrombocytopenia, but the 2 other haemopoetic series were also involved. The absence of any other toxic factors and the quite rapid onset of the bone marrow failure after this type of treatment strongly suggest that intravenous administration of high doses of deferoxamine was the potential toxic factor.

HLA antigens and Adamantiades-Behçet's disease (A-BD) in Greeks.

The distribution frequency of HLA-A and B antigens was determined in 24 Greek individuals with Adamantiades-Behçet's disease (A-BD) as well as in 280 controls. The standard NIH technique was used for tissue typing. There was an increased incidence of HLA-B5 in the patients group (75% compared to controls 32%). The calculated P corrected value was Pc less than 0.02, the relative risk (RR) was 6.23 and the aetiological fraction (EF) 0.68. This study agrees with the reported association between A-BD and HLA-B5 in other populations from the Mediterranean basin, the Middle East and Far East.

Neuro-ophthalmic presentation of cone dysfunction syndromes in the adult.

Cone dysfunction syndromes are probably part of the spectrum of cone-rod degenerations and can present with widely varying clinical pictures. Thus, although the age of onset is usually before the third decade, patients can present at any age, and, although family history is usually positive, in typical cases it may be quite negative. Patients can have initially very subtle, bizarre, or poorly described visual complaints so that numerous examiners may label them "functional" or "malingering." They can present with the classic symptoms of hemeralopia, poor acuity, and reduced color vision, but these complaints may be absent. Visual acuity and color vision can be normal or severely reduced and the fundi may show classic changes such as bulls-eye maculopathy, macular choroidal atrophy, pigment clumping in the maculae, mild peripheral pigmentary changes, or a fundus flavimaculata-like change. The patients here reported were considered as having normal fundi by several competent ophthalmologists as a rule, however. Visual fields can vary from normal to ring scotomas, central scotomas, and other interesting types of defects, even simulating a hemianopia. Although involvement is usually symmetrical between the two eyes, this is not always the case, and one of our patients had a strictly uniocular cone dystrophy. Cone dysfunction can be considered in a patient of any age even with normal acuity, good color vision, and a normal ophthalmoscopic examination. A high index of suspicion should prompt specific questioning about hemeralopia, or reduced visual function in brightly illuminated situations, and better vision in twilight or under dim illumination. Patients may falsely describe hemeralopia as "glare" or "photophobia." Careful testing of color vision, a meticulous tangent screen examination, and specifically looking for diffuse narrowing of retinal arterioles in a patient with an otherwise normal fundus appearance will usually suffice to prompt the clinician to order electroretinography, which is the definitive diagnostic criterion for the cone dystrophies. It is important to consider this diagnosis before embarking on an otherwise fruitless and expensive neuroimaging investigation.

HLA-A and B antigens and pulmonary tuberculosis in Greeks.

A significantly increased frequency of the HLA-B27 antigen was found in Greek adult patients suffering from pulmonary tuberculosis. This finding is discussed in connection with the literature, and it is suggested that the HLA system is involved in the pathogenesis of the disease.

HLA antigens in diabetics with calcified shoulder periarthritis (CSP).

The distribution frequencies of HLA-A and B antigens was determined in 94 maturity onset diabetics (40 with CSP and 54 without CSP), as well as in 400 unrelated age- and sex-matched Greek controls. The standard NIH technique was used for tissue typing. There was an increased prevalence of the antigen B27 only in diabetics with CSP (35%) when compared either to the controls (6.8%) or to diabetics without CSP (9.2%). The calculated p-corrected values were Pc = 0.00027 and Pc greater than 0.005 respectively. These findings indicate that the MHC in man may control the genetic susceptibility of a subgroup of insulin-independent diabetics to develop CSP.

Human leukocyte antigens and vesicoureteral reflux in Greek children.

Human leukocyte antigens (HLAs) were determined in 43 Greek children suffering from vesicoureteral reflux. Children carrying HLA AW19 + 29 were found to have a higher risk of developing the disease. It is suggested that the HLA system may play a role in the pathogenesis of vesicoureteral reflux.