The self-reported density of truck traffic on residential streets and the impact on asthma, hay fever and eczema in young adolescents.

BACKGROUND: Conflicting results have been reported, mostly in developed countries, on the relationship between exposure to traffic and allergic diseases. This study aims to examine the impact of truck traffic on asthma, rhinitis and eczema in early adolescence in Skopje, the capital of the Republic of Macedonia, as a developing country with a lower middle rate of high truck traffic exposure and low prevalence rates of allergic diseases. METHODS: Self-reported data was used, obtained through the International Study of Asthma and Allergies in Childhood Phase 3 written questionnaires, from 3026 adolescents aged 13-14 years from Skopje. Truck traffic density on the street of residence on weekdays was correlated to current and ever-diagnosed asthma, rhinitis and eczema by odds ratios (OR, 95% CI) in binary logistic regression, with and without adjustments for potential confounding factors separately and for their joint effect. RESULTS: A positive association of truck traffic density appeared to be limited to current dry night cough (aOR: 1.63; 1.07-2.47; aOR: 2.17; 1.40-3.35; and aOR: 2.33; 1.43-3.79 for truck traffic seldom, frequently through the day, and almost the whole day, respectively) with an exposure-response relationship and to current wheeze only for truck traffic almost the whole day (aOR: 1.87; 1.02-3.42). CONCLUSION: The findings suggest an aggravating effect of truck traffic on current asthma symptoms, but not on asthma, allergic rhinitis and eczema diagnoses. It seems that it probably has an impact as a direct respiratory irritant in early adolescence.

Improvement of cerebral oxygenation during laparoscopy using intermittent sequential compression of legs.

The creation of CO2 pneumoperitoneum during laparoscopy causes a series of adverse effects. Impairment of brain oxygen saturation during laparoscopy is a result of increased intra-abdominal pressure, absorbed CO2 and increased intracranial pressure. The aim of this study is to investigate the possible effects of pneumatic inter-mittent sequential compression (ISC) of legs on oxygenation of the brain during laparoscopy. 100 patients, ASA groups 1 and 2, subjected to elective laparoscopic cholecystectomy, were included in this study. The patients were divided into two groups consisting of 50 patients each, group I, control group, and group II, where ISC was applied. Oxygen saturation of the mixed venous blood from the internal jugular vein (SjvO2) is an indirect assessment of cerebral oxygen use (oxygenation of the brain). Blood samples were obtained from the bulb of the right jugular vein, as the dominant side for venous drainage from the brain. Informed consent was obtained from each patient. Blood samples of 2 ml were obtained several times during the operation; the first sample immediately after anesthesia induction in order to establish the baseline values of SjvO2, the second sample immediately after the creation of the pneumoperitoneum, and then every 15 minutes respectively until the end of the pneumoperitoneum. The last sample was obtained before the extubation of the patients. The ISC in group II was terminated after obtaining the last blood sample. Results showed that the average values of oxygen saturation of the mixed venous blood from the internal jugular vein--SjvO2 levels were higher in group II where ISC was applied (82.3%→86.4%→85.3%→80.2%→82.8%→80.4%), compared to group I, without ISC (85.5%→77.8%→80.6%→83.8%→84.8%), statistically significant in the second and third measurement for p<0.05 for the second and the third measurement, i.e. after the creation of pneumoperitoneum, when the decreease in the brain oxygenation is most dramatic in the group without ISC. In conclusion, application of intermittent sequential compression of the legs is a simple and safe technique for preserving the brain oxygenation during laparoscopy by restoring the blood return from the legs.

Measuring nasal volumes with acoustic rhinometry.

OBJECTIVES: Acoustic rhinometry is used to objectively measure the minimal cross sectional area and volumes of nasal cavities. However, no data for healthy subjects has been reported in Macedonia. Therefore, we wanted to establish the normal range among healthy adults and to evaluate the changes after nasal decongestion. METHODS: We included 50 males and 50 females in this study (mean age: 23.2 years; age range: 19 to 40 years). An acoustic rhinometer was used to evaluate the first minimal cross-sectional area (MCA1), the distance from the tip of the probe to the first minimal cross-sectional area (D1), the second minimal cross sectional area (MCA2), the distance from the tip of the probe to the second minimal cross sectional area (D2), the volume between the tip of the nosepiece and 3 cm into the nasal cavity (V03), the volume of the nasal cavity between 2 to 5 cm from the tip of the nosepiece (V25), the volume of the nasal cavity between 4 to 7 cm from the tip of the nosepiece (V47), and the volume between the tip of the nosepiece and 7 cm into the nasal cavity (V07). These measurements were taken before and after nasal decongestion. RESULTS: Data acquired from the male group before decongestion were as follows: MCA1 L: 0.71+/-0.07 (cm2); D1 L: 0.34+/-0.05 (cm); MCA2 L: 0.46+/-0.13 (cm2); D2 L: 2.46+/-0.11 (cm); MCA1 R: 0.73+/-0.06 (cm2); D1 R: 0.35+/-0.05 (cm); MCA2 R: 0.47+/-0.11 (cm2); D2 R: 2.41+/-0.18 (cm); V03 L 2.59+/-0.82 (cm3); V25 L; 4.83+/-1.93 (cm3); V47 L; 7.82+/-2.94 (cm3); V07 L: 11.48+/-4.23 (cm3); V03 R 2.55+/-0.72 (cm3); V25 R; 4.71+/-1.76 (cm3); V47 R; 7.60+/-2.30 (cm3); V07 R: 12.03+/-3.65 (cm3); data acquired from the female group before decongestion were: MCA1 L: 0.65+/-0.12 (cm2); D1 L: 0.35+/-0.05 (cm); MCA2 L: 0.50+/-0.12 (cm2); D2 L: 2.36+/-0.15 (cm); MCA1 R: 0.65+/-0.11 (cm2); D1 R: 0.35+/-0.04 (cm); MCA2 R: 0.49+/-0.13 (cm2); D2 R: 2.41+/-0.13 (cm); V03 L 2.64+/-0.58 (cm3); V25 L; 5.11+/-1.17 (cm3); V47 L; 8.30+/-2.20 (cm3); V07 L: 12.38+/-3.19 (cm3); V03 R 2.42+/-0.56 (cm3); V25 R; 4.43+/-1.34 (cm3); V47 R; 7.35+/-2.29 (cm3); V07 R: 11.06+/-3.19 (cm3) The increase in MCA1 and MCA2 after nasal decongestion was significant (p<0.001), both in females and males. The increases in V03, V25, V47 and V07 after nasal decongestion were statistically significant both in the female and male groups as well (p<0.001). CONCLUSION: Acoustic rhinometry is a convenient method for assessing the geometry of the nasal cavity. The maximal effect of decongestion is found in the anterior and middle parts of the nasal cavity, at the level of the inferior and middle turbinates.

Influence of physical activity and television-watching time on asthma and allergic rhinitis among young adolescents: preventive or aggravating?

BACKGROUND: Related to exercise hypothesis, the aim of the present study was to explore the influence of physical activity on asthma and allergic rhinitis in a developing country where publicity campaigns about the benefits of exercise are scarce. METHODS: The analysed data were self-reported and obtained through the standardized International Study of Asthma and Allergies in Childhood Phase Three written questionnaires completed by 3026 adolescents 13/14 year old in Skopje (Republic of Macedonia). Vigorous physical activity and television-watching timeboth unadjusted and adjusted for confounding factorswere used as variables for analysis. Odds ratios (OR, 95 % CI) in binary logistic regression were employed for statistic analysis of the data. RESULTS: Vigorous physical activity both > or = 3 times and 1-2 times per week was associated with an increased risk of current wheeze (aOR: 1.66; 1.08-2.55; p = 0.020 and aOR: 1.70; 1.23-2.36; p = 0.001, respectively), speech-limiting wheeze (aOR: 3.15; 1.13-8.77; p = 0.028 and aOR: 4.62; 2.22-9.62; p = 0.000, respectively) and exercise-induced wheeze (aOR: 2.72; 1.93-3.83; p = 0.000 and aOR: 4.01; 3.12-5.14; p = 0.000, respectively). Frequent physical activity was positively associated only with current allergic rhinitis symptoms (aOR: 1.40; 1.04-1.90; p = 0.029). Television watching > or = 3 hours a day increased the risk of current wheeze (aOR: 1.34; 1.01-1.77; p = 0.042) and exercise-induced wheeze (aOR: 1.32; 1.05-1.65; p = 0.016). CONCLUSION: The findings support the aggravating role of sedentary regimen and poor physical fitness on asthma symptoms, but not on allergic rhinitis. Physical activity may trigger asthma symptoms when physical fitness is poor and asthma is not controlled.

Overweight hypothesis in asthma and eczema in young adolescents.

BACKGROUND: A positive association between body mass index (BMI) and allergic diseases has recently been suggested; however the sex-dependence of this association remains controversial. The aim of the present study was to explore the relationship between BMI and asthma and eczema, as well as its sex-dependence in young adolescents. METHODS: Self-reported data obtained through the standardized International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three written questionnaires of 2926 young adolescents aged 13-14 years old from randomly selected schools in Skopje (Republic of Macedonia) were used. The BMI for each individual was calculated and used-both unadjusted and adjusted for confounding factors-as a variable for analysis. The international cut-off points for BMI for overweight and obesity by sex and age were used. Because of the very low prevalence of obesity (1.5 %), obese respondents were included in the overweight group. The data were statistically analyzed by the chi-square test, the t-test for independent samples and odds ratios (OR, 95 % CI) in binary logistic regression. RESULTS: Being overweight was significantly associated with an increased risk of having a dry night cough without a cold or chest infection (adjusted OR: 1.54; 95 % CI: 1.09-2.16; p = 0.01) and with having had self-reported asthma at some time (adjusted OR: 2.36; 95 % CI: 1.02-5.44; p = 0.04) in boys only. A significant association between overweight and other symptoms of asthma or atopic eczema was not established. CONCLUSION: These findings suggest a male-specific positive association between overweight and a current dry night cough and having received a diagnosis of asthma at some time. No association was found with other asthma symptoms or atopic eczema in young adolescents.