Growth and other factors affecting peak expiratory flow in Greek children.

AIM: The estimation of peak expiratory flow (PEF) in children is a very easy and practical way to check lung function and helps in the diagnosis, treatment follow-up and evaluation of the development of chronic obstructive pulmonary disease. METHODS: Using a Mini-Wright flowmeter (Clement Clarke International Ltd, England), we studied the Peak Expiratory Flow (PEF) of 7,067 healthy Greek children of age range 6-17 years. All the children have a height ranging between mean value+/-2 Standard Deviations for age and sex. RESULTS: The results were correlated with age, weight, height and triceps skinfold thickness. The mean value of PEF was higher in boys than in girls at all ages, except from the age of 12-13 years. Our results have shown a very strong relationship between PEF and age up to the age of 11 years (P<0.005) but we didn't find such a relationship in older children as regards PEF and height (P<0.001). No positive correlation between PEF and weight or between PEF and triceps skinfold, was found (P > or =0.05). Moreover, a considerable difference in PEF values was found in the various groups of every age and sex according to height. CONCLUSIONS: These results indicate that height should always be considered in order to estimate PEF value. The values of this study (mean and percentiles) were compared to those of other studies. Finally, we recommend that the results of this study should be used as standards for Greek children.

The effect of environmental pollution on the respiratory system of lignite miners: a diachronic study.

BACKGROUND: It is not known whether working in surface lignite mines can cause x-ray lesions or disorders of respiratory function. OBJECTIVES: The aim of the study was to investigate the diachronic impact of environmental pollution on the respiratory system of lignite miners at mines in Eordea, Greece. METHODS: Cases of 199 workers (Group A) residing permanently in the Eordea valley and 151 (Group B) living outside the Eordea valley were studied during Phase I and then re-examined after three years (Phase II). These cases were compared to those of 71 office workers living in Eordea valley (Group C) and to 96 living in Grevena, a region without pollution (Group D). The study included the completion of the MRC questionnaire for the detection of respiratory diseases, pulmonary function tests, measurement of diffusion capacity, otorhinolaryngologic examination, rhinomanonetry as well as chest and paranasal cavity X-rays. RESULTS: Chronic bronchitis was reported by 26.8%, 24.8%, 17.9% and 10.6% respectively of the subjects of groups A, B, C and D according to the answers of the questionnaire (p<0.001). The spirometry and diffusion capacity findings presented no considerable differences either in the 4 groups or between phases I and II of the study. The main problems were detected in the upper airways. A very high prevalence of severe nasal obstruction (73%, 71.2%, 55.7% and 19.3% in Groups A, B, C and D respectively) was detected. Furthermore, a high percentage of atrophic rhinitis (14%) was detected both among workers (Groups A and B) and subjects living in the Eordea valley who participated as controls (Group C). From the X-rays, hypertrophy of nasal turbinates-cartilage and polyposis was observed as follows: Group A: 53.9%, Group B: 48.1%, Group C: 46.5% and Group D: 20.3% (p<0.001). The findings related to the upper respiratory system may be due to excessive pollution by airborne particles (fly ash) pollution in the region and particularly to chromium, nickel, cobalt and lead found at high concentration levels in airborne dust. A marked association between the total air-flow in the nose and the mid-expiratory flow (p<0.01) was detected. CONCLUSIONS: We conclude that subjects working in lignite mines under conditions of excessive pollution by airborne contaminants have a high prevalence of atrophic rhinitis and, in addition to other standard examinations, should undergo rhinomanometry testing and X-ray imaging of the paranasal cavities.

Age-related changes in bone density among healthy Greek males.

Osteoporosis in men is increasingly recognized as a problem in clinical medicine, but it has received much less attention than its counterpart in women. It is termed idiopathic if no known cause of bone disease can be identified clinically or in the laboratory. The true incidence of idiopathic osteoporosis (IO) in males is difficult to estimate because population characteristics and referral patterns differ so widely. The aim of this study was to investigate the incidence of IO in healthy Greek male volunteers by measuring bone mineral density (BMD) at four skeletal sites and examining the relations among age, BMI, and bone status. This type of information has not yet been published. We considered osteoporosis to be present when the BMD was less than or equal to -2.5 SD from the average value for healthy young men. Three hundred and sixty-three normal male volunteers were investigated. The mean age was 51.3+/-8.7 yr, and BMI was 27.5+/-3.7 kg/m2. In all subjects BMD at four skeletal sites - lumbar spine (LS), femoral neck (FN), Ward's triangle (WT), and finally trochanter (T) - was measured using dual-energy X-ray absorptiometry (DEXA). T-score, Z-score and g/cm2 values were estimated. Forty-four subjects (11%) had BMD< or =-2.5 SD (T-score). The mean age and BMI for the men with decreased BMD was 54.8+/-6.4 yr and 26.3+/-3.3 kg/m2, whereas mean age and BMI for those with normal BMD was 51.0+/-8.9 yr and 27.6+/-3.6 kg/m2, respectively. These differences were statistically significant (p<0.001 and p<0.05, respectively). A positive correlation was found between BMI and bone density (g/cm2) at three skeletal sites: LS (r=0.235, p<0.001), WT (r=0.126, p<0.001) and FN (r=0.260, p<0.001). A positive correlation was also found between BMI and T-score at all skeletal sites studied: LS (r=0.276, p<0.001), WT (r=0.133, p<0.05), FN (r=0.233, p<0.001), and T (r=0.305, p<0.001). Finally, a positive correlation was also found between BMI and Z-score: LS (r=0.256, p<0.001), WT (r=0.117, p<0.005), FN (r=0.240, p<0.001), and T (r=0.187, p<0.001). A negative correlation was found between age and bone density (g/cm2) at FN (r=-0.157, p<0.01) and WT (r=-0.183, p<0.001). The same was true between age and T-score at FN only (r=0.137, p<0.05). Furthermore, a similar correlation was found between age and Z-score at LS (r=0.174, p<0.001). When ANOVA one-way analysis was used, a significant difference was found between the different age groups and BMD (g/cm2) at FN, T, and WT (p<0.001 for all sites). For T-score, a significant difference between age groups was found only at FN (p<0.005). Finally, a significant difference in Z-score was found at FN (p<0.001) and LS (p<0.005). When multiple regression analysis was applied, it was found that BMD (g/cm2) at two sites, FN and WT, independently correlated with age and BMI (FN: p<0.001 for both, WT: p<0.01 and p<0.05, respectively). Finally, we found an accelerated trend toward decreased BMD (g/cm2), when the odds ratio was applied. In conclusion, this study demonstrated that 11% of otherwise healthy Greek men had BMD less than or equal to -2.5 SD. A strong association was found between BMD (g/cm2) and age at three skeletal sites when ANOVA one-way analysis was applied. Moreover, BMD was positively correlated with BMI and negatively correlated with age. Currently available data are sparse and much more research is needed to increase our understanding concerning the etiology of this condition as well as illuminating the relationship between bone density and fracture.